pbp_a_hnumber	pbp_a_plan_identifier	segment_id	pbp_a_ben_cov	pbp_a_plan_type	orgtype	bid_id	version	pbpver	pbp_a_org_name	pbp_a_org_marketing_name	pbp_a_org_website	pbp_a_org_type	pbp_a_plan_type	pbp_a_network_flag	pbp_a_ben_cov	pbp_a_service_area	pbp_a_contract_number	pbp_a_plan_identifier	pbp_a_segment_id	pbp_a_contract_period	pbp_a_plan_name	pbp_a_plan_geog_name	pbp_a_segment_name	pbp_a_eghp_yn	pbp_a_special_need_flag	pbp_a_special_need_plan_type	pbp_a_snp_institutional_type	pbp_a_est_memb	pbp_a_continue_yn	pbp_a_continue_costshare_yn	pbp_a_hospice_care_yn	pbp_a_snp_pct	pbp_a_snp_pop	pbp_a_snp_cond	pbp_a_curmbr_loc_phone	pbp_a_curmbr_phone	pbp_a_ttytdd_cur_loc_phone	pbp_a_ttytdd_curmbr_phone	pbp_a_prombr_loc_phone	pbp_a_prombr_phone	pbp_a_ttytdd_pro_loc_phone	pbp_a_ttytdd_prombr_phone	pbp_a_pd_curmbr_loc_phone	pbp_a_pd_curmbr_phone	pbp_a_pd_ttytdd_cur_loc_phone	pbp_a_pd_ttytdd_curmbr_phone	pbp_a_pd_prombr_loc_phone	pbp_a_pd_prombr_phone	pbp_a_pd_ttytdd_pro_loc_phone	pbp_a_pd_ttytdd_prombr_phone	pbp_a_formulary_web_addr	pbp_a_opd_web_addr
E0654	801	0		30	13	E0654_801_0	1	2009.01	IBT VOLUNTARY EMPLOYEE BENEFITS TRUST	TEAMStar Medicare Part D Prescription Drug Program	www.teamstarpartd.com	13	30				E0654	801	0	2009	IBT VEBA	National		1	2																		(866)-524-4173	(866)-524-4173		(866)-524-4174	(866)-524-4173	(866)-524-4173		(866)-524-4174	http://www.rxsolutions.com/pdpclientformulary/formulary.asp?var=IBTPDPGOLDinfoid=IBT	
E2332	801	0		30	13	E2332_801_0	1	2009.01	NATIONAL RURAL ELECTRIC COOPERATIVE ASSOCIATION	National Rural Electric Cooperative Association	www.nreca.coop	13	30				E2332	801	0	2009	NRECA Medicare Part D Plan	NRECA Medicare Part D Plan-Nationwide		1	2																		(866)-586-7322	(866)-586-7322			(866)-673-2299	(866)-673-2299			http://nreca.medicareplanrx.com	
E2630	801	0		30	13	E2630_801_0	1	2009.01	C AND O EMPLOYEES HOSPITAL ASSOCIATION	C and O Employees Hospital Association	www.coeha.com	13	30				E2630	801	0	2009	C and O Employees Hospital Association	Virginia, West VA, Kentucky, Ohio, Indiana		1	2																		(540)-862-5728	(800)-679-9135			(540)-862-5728	(800)-679-9135			http://www.coeha.com	
E2868	801	0		30	13	E2868_801_0	3	2009.01	CARPENTER'S HEALTH  AND WELFARE TRUST FUND OF STL	Carpenters' District Council of Greater St. Louis	http://www.carpdc.org/	13	30				E2868	801	0	2009	Carpenters' 2009 Plan	National		1	2																		(314)-644-4802	(800)-301-3002			(314)-644-4802	(800)-301-3002			http://www.medcohealth.com	
E3014	801	0		30	13	E3014_801_0	1	2009.01	PSERS HOP PROGRAM	Pennsylvania Public School Employees Retirement Sy	http://www.psers.state.pa.us/hop/hop.htm	13	30				E3014	801	0	2009	PSERS HOP	National		1	2																		(888)-239-1301	(888)-239-1301	(866)-394-7218	(866)-394-7218	(888)-239-1301	(888)-239-1301	(866)-394-7218	(866)-394-7218	http://www.hopbenefits.com/medicareRx/drugData/	
E4744	801	0		30	13	E4744_801_0	1	2009.01	MO DOT AND MSHP MEDICAL AND LIFE INS PLAN	MISSOURI DEPARTMENT OF TRANSPORTATION	http://www.modot.state.mo.us/	13	30				E4744	801	0	2009	MODOT's 2009 Plan	National		1	2																		(573)-751-2551	(800)-601-3002			(573)-751-2551	(800)-601-3002			http://www.wellpointrx.com/	
E5088	801	0	1	40	14	E5088_801_0	5	2009.01	DESERET HEALTHCARE EMPLOYEE BENEFITS TRUST	Deseret Mutual	www.dmba.com	14	40	2	1		E5088	801	0	2009	Deseret Secure	National Area		1	2			11100	2						(801)-578-5600	(800)-777-3622	(801)-578-5655	(800)-333-9715	(801)-578-5600	(800)-777-3622	(801)-578-5655	(800)-333-9715										
E6036	801	0	1	40	14	E6036_801_0	1	2009.01	ASOCIACION DE MAESTROS DE PUERTO RICO	PROSSAM Plus	http://www.prossamplus.com	14	40	2	1		E6036	801	0	2009	Asociacion de Maestros de Puerto Rico	PROSSAM Plus		1	2			3600	2						(787)-767-2020		(787)-767-2020		(787)-767-2020	(787)-767-2020	(787)-767-2020		(787)-767-2020	(787)-767-2020	(787)-767-2020		(787)-767-2020	(787)-767-2020	(787)-767-2020		www.amprnet.org	
E7316	801	0		30	13	E7316_801_0	4	2009.01	UNION PACIFIC RAILROAD EMPLOYES HEALTH SYSTEMS	Union Pacific RR Employes Health Systems	uphealth.com	13	30				E7316	801	0	2009	The UPREHS Prime Medicare Plan	National		1	2																		(801)-595-4300	(800)-547-0421			(801)-595-4300	(800)-547-0421			https://www.uphealth.com/medicare/formularies.shtml	
E7848	801	0		30	13	E7848_801_0	1	2009.01	OKLAHOMA STATE AND EDUCATION EMP GRP INS BOARD	HealthChoice	www.sib.ok.gov	13	30				E7848	801	0	2009	OK State and Education Emp Group Ins Board	State of Oklahoma		1	2																		(405)-717-8699	(800)-865-5142	(405)-949-2281	(866)-447-0436	(405)-717-8699	(800)-865-5142	(405)-949-2281	(866)-447-0436	www.sib.ok.gov	
H0046	001	0	1	04	01	H0046_001_0	6	2009.01	PROSALUD HMO CORPORATION	ProSalud	www.prosaludpr.com	01	04		1		H0046	001	0	2009	ProSalud PPO	Commonwealth of Puerto Rico		2	2				2						(877)-711-8111	(877)-711-8111	(877)-993-9903	(877)-993-9903	(877)-711-8111	(877)-711-8111	(877)-993-9903	(877)-993-9903	(877)-711-8111	(877)-711-8111	(877)-993-9903	(877)-993-9903	(877)-711-8111	(877)-711-8111	(877)-993-9903	(877)-993-9903	www.prosaludpr,com	
H0084	001	0	1	04	01	H0084_001_0	9	2009.01	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE	Care Improvement Plus	www.careimprovementplus.com	01	04		1		H0084	001	0	2009	Care Improvement Plus of Texas	Texas		2	2				2						(866)-648-9847	(866)-648-9847	(866)-679-3052	(866)-679-3052	(877)-625-2207	(877)-625-2207	(866)-679-3052	(866)-679-3052	(800)-690-6016	(800)-690-6016	(866)-236-1069	(866)-236-1069	(877)-625-2207	(877)-625-2207	(866)-679-3052	(866)-679-3052	http://www.careimprovementplus.com/members/texas/medicarePartD/formulary.aspx	http://www.careimprovementplus.com
H0087	801	0	1	09	04	H0087_801_0	8	2009.01	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthallianceMedicare.org	04	09	2	1		H0087	801	0	2009	Health Alliance PFFS for Employer Groups	United States		1	2			0	2						(217)-337-8478	(800)-965-4022	(866)-883-8551		(217)-337-8478	(800)-965-4022	(866)-883-8551										http://www.healthalliancemedicare.org/medicare/images/med-abridgedformulary-0807web.pdf	
H0087	802	0	1	09	04	H0087_802_0	8	2009.01	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthallianceMedicare.org	04	09	2	1		H0087	802	0	2009	Health Alliance PFFSRx for Employer Groups	United States		1	2			0	2						(217)-337-8478	(800)-965-4022	(866)-883-8551		(217)-337-8478	(800)-965-4022	(866)-883-8551		(217)-337-8478	(800)-965-4022	(866)-883-8551		(217)-337-8478	(800)-965-4022	(866)-883-8551		http://www.healthalliancemedicare.org/medicare/images/med-abridgedformulary-0807web.pdf	
H0087	803	0	1	09	04	H0087_803_0	7	2009.01	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthallianceMedicare.org	04	09	2	1		H0087	803	0	2009	Health Alliance PFFSRx for Employer Groups	United States		1	2			2	2						(217)-337-8478	(800)-965-4022	(866)-883-8551		(217)-337-8478	(800)-965-4022	(866)-883-8551		(217)-337-8478	(800)-965-4022	(866)-883-8551		(217)-337-8478	(800)-965-4022	(866)-883-8551		http://www.healthalliancemedicare.org/medicare/images/med-abridgedformulary-0807web.pdf	
H0097	001	0	1	09	04	H0097_001_0	6	2009.01	QCC INSURANCE COMPANY	Select Advantage	www.site65.com	04	09	2	1		H0097	001	0	2009	Select Advantage Silver Medical Only	Bucks,Chester,Delaware,Montgomery,Phila  Counties		2	2				2						(800)-331-0017	(800)-331-0017	(888)-857-4816		(877)-393-6733	(877)-393-6733	(877)-219-5457										http://www.site65.com/drug_formulary/formulary/all_plans.html	
H0097	002	0	1	09	04	H0097_002_0	8	2009.01	QCC INSURANCE COMPANY	Select Advantage	www.site65.com	04	09	2	1		H0097	002	0	2009	Select Advantage Silver Rx	Bucks,Chester,Delaware,Montgomery,Phila  Counties		2	2				2						(800)-331-0017	(800)-331-0017	(888)-857-4816		(877)-393-6733	(877)-393-6733	(877)-219-5457		(800)-331-0017	(800)-331-0017	(888)-857-4816		(877)-393-6733	(877)-393-6733	(877)-219-5457		http://www.site65.com/drug_formulary/formulary/all_plans.html	
H0097	801	0	1	09	04	H0097_801_0	6	2009.01	QCC INSURANCE COMPANY	Select Advantage	www.site65.com	04	09	2	1		H0097	801	0	2009	Select Advantage Group Medical Only	Bucks,Chester,Delaware,Montgomery,Phila  Counties		1	2				2						(800)-331-0017	(800)-331-0017	(800)-275-9240		(877)-393-6733	(877)-393-6733	(877)-219-5457										http://www.site65.com/drug_formulary/formulary/all_plans.html	
H0097	802	0	1	09	04	H0097_802_0	6	2009.01	QCC INSURANCE COMPANY	Select Advantage	www.site65.com	04	09	2	1		H0097	802	0	2009	Select Advantage Group Rx	Bucks,Chester,Delaware,Montgomery,Phila  Counties		1	2				2						(800)-331-0017	(800)-331-0017	(800)-275-9240		(877)-393-6733	(877)-393-6733	(877)-219-5457		(800)-331-0017	(800)-331-0017	(800)-275-9240		(877)-393-6733	(877)-393-6733	(877)-219-5457		http://www.site65.com/drug_formulary/formulary/all_plans.html	
H0104	002	0	1	04	01	H0104_002_0	8	2009.01	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Cross Blue Shield of Alabama	www.bcbsalmedicare.com	01	04		1		H0104	002	0	2009	Blue Advantage Value	State of Alabama		2	2			5416	2						(888)-234-8266	(888)-234-8266	(800)-257-3384		(888)-873-4707	(888)-873-4707	(800)-257-3384		(888)-234-8266	(888)-234-8266	(800)-257-3384		(888)-873-4707	(888)-873-4707	(800)-257-3384		www.bcbsalmedicare.com/2008/tools	www.bcbsalmedicare.com
H0104	004	0	1	04	01	H0104_004_0	7	2009.01	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Cross Blue Shield of Alabama	www.bcbsalmedicare.com	01	04		1		H0104	004	0	2009	Blue Advantage Plus	State of Alabama		2	2			7564	2						(888)-234-8266	(888)-234-8266	(800)-257-3384		(888)-873-4707	(888)-873-4707	(800)-257-3384		(888)-234-8266	(888)-234-8266	(800)-257-3384		(888)-873-4707	(888)-873-4707	(800)-257-3384		www.bcbsalmedicare.com/2008/tools	www.bcbsalmedicare.com
H0104	006	0	1	04	01	H0104_006_0	5	2009.01	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Cross Blue Shield of Alabama	www.bcbsalmedicare.com	01	04		1		H0104	006	0	2009	Blue Advantage Special Needs Plan	State of Alabama		2	1	3		8965	2			1	2		(888)-234-8266	(888)-234-8266	(800)-257-3384		(888)-873-4707	(888)-873-4707	(800)-257-3384		(888)-234-8266	(888)-234-8266	(800)-257-3384		(888)-873-4707	(888)-873-4707	(800)-257-3384		www.bcbsalmedicare.com/2008/tools	www.bcbsalmedicare.com
H0104	008	0	1	04	01	H0104_008_0	6	2009.01	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Cross Blue Shield of Alabama	www.bcbsalmedicare.com	01	04		1		H0104	008	0	2009	Blue Advantage Preferred	State of Alabama		2	2			39455	2						(888)-234-8266	(888)-234-8266	(800)-257-3384		(888)-873-4707	(888)-873-4707	(800)-257-3384		(888)-234-8266	(888)-234-8266	(800)-257-3384		(888)-873-4707	(888)-873-4707	(800)-257-3384		www.bcbsalmedicare.com/2008/tools	www.bcbsalmedicare.com
H0104	801	0	1	04	01	H0104_801_0	4	2009.01	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Cross Blue Shield of Alabama	www.bcbsalmedicare.com	01	04		1		H0104	801	0	2009	Blue Advantage Employer Group Plan 801	State of Alabama		1	2			100	2						(888)-234-8266	(888)-234-8266	(800)-257-3384		(888)-873-4707	(888)-873-4707	(800)-257-3384										www.bcbsalmedicare.com/2008/tools	www.bcbsalmedicare.com
H0104	802	0	1	04	01	H0104_802_0	5	2009.01	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Cross Blue Shield of Alabama	www.bcbsalmedicare.com	01	04		1		H0104	802	0	2009	Blue Advantage Employer Group Plan 802	State of Alabama		1	2			15000	2						(888)-234-8266	(888)-234-8266	(800)-257-3384		(888)-873-4707	(888)-873-4707	(800)-257-3384		(888)-234-8266	(888)-234-8266	(800)-257-3384		(888)-873-4707	(888)-873-4707	(800)-257-3384		www.bcbsalmedicare.com/2008/tools	www.bcbsalmedicare.com
H0104	804	0	1	04	01	H0104_804_0	5	2009.01	BLUE CROSS AND BLUE SHIELD OF ALABAMA	Blue Cross Blue Shield of Alabama	www.bcbsalmedicare.com	01	04		1		H0104	804	0	2009	Blue Advantage Employer Group Plan 804	State of Alabama		1	2			2900	2						(888)-234-8266	(888)-234-8266	(800)-257-3384		(888)-873-4707	(888)-873-4707	(800)-257-3384		(888)-234-8266	(888)-234-8266	(800)-257-3384		(888)-873-4707	(888)-873-4707	(800)-257-3384		www.bcbsalmedicare.com/2008/tools	www.bcbsalmedicare.com
H0105	001	0	1	20	08	H0105_001_0	2	2009.01	THE METHODIST OAKS	The Methodist Oaks d.b.a. The Oaks PACE	loretta@theoakssc.com	08	20		1		H0105	001	0	2009	The Methodist Oaks d.b.a. The Oaks PACE	Rural South Carolina		2	2				2														(803)-268-5300	(877)-505-3131			(803)-268-5300	(877)-505-3131			www.groveparkpharmacy.com	
H0105	002	0	1	20	08	H0105_002_0	1	2009.01	THE METHODIST OAKS	The Methodist Oaks d.b.a. The Oaks PACE	loretta@theoakssc.com	08	20		1		H0105	002	0	2009	The Methodist Oaks d.b.a. The Oaks PACE	Rural South Carolina		2	2				2														(803)-268-5300	(877)-505-3131			(803)-268-5300	(877)-505-3131			www.groveparkpharmacy.com	
H0117	004	0	1	01	01	H0117_004_0	10	2009.01	WELLCARE OF OHIO, INC.	WellCare	www.wellcare.com	01	01		1		H0117	004	0	2009	WellCare Value	Cuyahoga, Geauga, Lake, Lorain, Mahoning, Trumbull		2	2				2						(866)-687-8815	(866)-687-8815	(877)-247-6272		(866)-360-8153	(866)-360-8153	(877)-247-6272		(866)-687-8815	(866)-687-8815	(877)-247-6272		(866)-360-8153	(866)-360-8153	(877)-247-6272		www.wellcare.com	www.wellcare.com
H0117	005	0	1	01	01	H0117_005_0	7	2009.01	WELLCARE OF OHIO, INC.	WellCare	www.wellcare.com	01	01		1		H0117	005	0	2009	WellCare Value	Franklin, Hamilton, Medina, Stark, Summit Counties		2	2				2						(866)-687-8815	(866)-687-8815	(877)-247-6272		(866)-360-8153	(866)-360-8153	(877)-247-6272		(866)-687-8815	(866)-687-8815	(877)-247-6272		(866)-360-8153	(866)-360-8153	(877)-247-6272		www.wellcare.com	www.wellcare.com
H0117	007	0	1	01	01	H0117_007_0	7	2009.01	WELLCARE OF OHIO, INC.	WellCare	www.wellcare.com	01	01		1		H0117	007	0	2009	WellCare Access	Greater Cleveland and Columbus Areas		2	1	3			2			1	1		(866)-687-8815	(866)-687-8815	(877)-247-6272		(866)-360-8153	(866)-360-8153	(877)-247-6272		(866)-687-8815	(866)-687-8815	(877)-247-6272		(866)-360-8153	(866)-360-8153	(877)-247-6272		www.wellcare.com	www.wellcare.com
H0117	008	0	1	01	01	H0117_008_0	7	2009.01	WELLCARE OF OHIO, INC.	WellCare	www.wellcare.com	01	01		1		H0117	008	0	2009	WellCare Select	Cuyahoga, Lake, Lorain Counties		2	1	3			2			1	2		(866)-687-8815	(866)-687-8815	(877)-247-6272		(866)-360-8153	(866)-360-8153	(877)-247-6272		(866)-687-8815	(866)-687-8815	(877)-247-6272		(866)-360-8153	(866)-360-8153	(877)-247-6272		www.wellcare.com	www.wellcare.com
H0117	009	0	1	01	01	H0117_009_0	7	2009.01	WELLCARE OF OHIO, INC.	WellCare	www.wellcare.com	01	01		1		H0117	009	0	2009	WellCare Select	Franklin, Hamilton, Medina, Stark, Summit Counties		2	1	3			2			1	2		(866)-687-8815	(866)-687-8815	(877)-247-6272		(866)-360-8153	(866)-360-8153	(877)-247-6272		(866)-687-8815	(866)-687-8815	(877)-247-6272		(866)-360-8153	(866)-360-8153	(877)-247-6272		www.wellcare.com	www.wellcare.com
H0141	001	0	1	01	01	H0141_001_0	6	2009.01	COMMUNITY CHOICE MICHIGAN	Community Choice Michigan	www.communitychoiceadvantage.com	01	01		1		H0141	001	0	2009	Community Choice Advantage	SW, NE and Middle Michigan		2	1	3		184	2			1	3		(877)-725-4581	(877)-725-4581	(800)-649-3777	(800)-649-3777	(877)-725-4581	(877)-725-4581	(800)-649-3777	(800)-649-3777	(877)-725-4581	(877)-725-4581	(800)-649-3777	(800)-649-3777	(877)-725-4581	(877)-725-4581	(800)-649-3777	(800)-649-3777	www.ccmhmo.org	www.communitychoiceadvantage.com
H0150	001	0	1	01	01	H0150_001_0	5	2009.01	HEALTHSPRING OF ALABAMA, INC.	Healthspring of Alabama, Inc.	www.healthspring.com	01	01		1		H0150	001	0	2009	HealthSpring HealthyAdvantage Plus	Alabama		2	2			11440	2						(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(888)-767-1879	(888)-767-1879	(877)-262-9090	(877)-262-9090	(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H0150	007	0	1	01	01	H0150_007_0	3	2009.01	HEALTHSPRING OF ALABAMA, INC.	Healthspring of Alabama, Inc.	www.healthspring.com	01	01		1		H0150	007	0	2009	HealthSpringTotalCare	Alabama		2	1	3		15814	2			1	2		(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(888)-767-1879	(888)-767-1879	(877)-262-9090	(877)-262-9090	(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H0150	010	0	1	01	01	H0150_010_0	2	2009.01	HEALTHSPRING OF ALABAMA, INC.	Healthspring of Alabama, Inc.	www.healthspring.com	01	01		1		H0150	010	0	2009	HealthSpring HealthyAdvantage Select	Alabama		2	2			172	2						(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(888)-767-1879	(888)-767-1879	(877)-262-9090	(877)-262-9090	(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H0150	012	0	1	01	01	H0150_012_0	5	2009.01	HEALTHSPRING OF ALABAMA, INC.	Healthspring of Alabama, Inc.	www.healthspring.com	01	01		1		H0150	012	0	2009	HealthSpring HealthyAdvantage	Alabama		2	2			330	2						(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(888)-767-1879	(888)-767-1879	(877)-262-9090	(877)-262-9090									www.healthspring.com	www.healthspring.com
H0150	015	0	1	01	01	H0150_015_0	3	2009.01	HEALTHSPRING OF ALABAMA, INC.	Healthspring of Alabama, Inc.	www.healthspring.com	01	01		1		H0150	015	0	2009	HealthSpring SpecialCare	Alabama		2	1	1	1		2			1			(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(888)-767-1879	(888)-767-1879	(877)-262-9090	(877)-262-9090	(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H0150	017	0	1	01	01	H0150_017_0	5	2009.01	HEALTHSPRING OF ALABAMA, INC.	Healthspring of Alabama, Inc.	www.healthspring.com	01	01		1		H0150	017	0	2009	HealthSpring HealthyLiving Plus	Alabama		2	2			330	2						(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(888)-767-1879	(888)-767-1879	(877)-262-9090	(877)-262-9090	(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H0150	019	0	1	01	01	H0150_019_0	2	2009.01	HEALTHSPRING OF ALABAMA, INC.	Healthspring of Alabama, Inc.	www.healthspring.com	01	01		1		H0150	019	0	2009	HealthSpring OptimaCare	Alabama		2	1	4		746	2			1		0000001010000000000000000001	(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(888)-767-1879	(888)-767-1879	(877)-262-9090	(877)-262-9090	(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H0150	021	0	1	01	01	H0150_021_0	4	2009.01	HEALTHSPRING OF ALABAMA, INC.	Healthspring of Alabama, Inc.	www.healthspring.com	01	01		1		H0150	021	0	2009	HealthSpring HealthyLiving Premier	Alabama		2	2			134	2						(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(888)-767-1879	(888)-767-1879	(877)-262-9090	(877)-262-9090	(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H0150	802	0	1	01	01	H0150_802_0	1	2009.01	HEALTHSPRING OF ALABAMA, INC.	Healthspring of Alabama, Inc.	www.healthspring.com	01	01		1		H0150	802	0	2009	HealthSpring Retiree Adv. Care-Cal. Yr	Alabama		1	2			42	2						(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(888)-767-1879	(888)-767-1879	(877)-262-9090	(877)-262-9090									www.healthspring.com	www.healthspring.com
H0150	804	0	1	01	01	H0150_804_0	1	2009.01	HEALTHSPRING OF ALABAMA, INC.	Healthspring of Alabama, Inc.	www.healthspring.com	01	01		1		H0150	804	0	2009	HealthSpring Retiree Adv. Plus-Cal. Yr	Alabama		1	2			42	2						(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(888)-767-1879	(888)-767-1879	(877)-262-9090	(877)-262-9090	(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H0150	805	0	1	01	01	H0150_805_0	1	2009.01	HEALTHSPRING OF ALABAMA, INC.	Healthspring of Alabama, Inc.	www.healthspring.com	01	01		1		H0150	805	0	2009	HealthSpring Retiree Adv. Care-Cont. Yr	Alabama		1	2			42	2						(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(888)-767-1879	(888)-767-1879	(877)-262-9090	(877)-262-9090									www.healthspring.com	www.healthspring.com
H0150	806	0	1	01	01	H0150_806_0	1	2009.01	HEALTHSPRING OF ALABAMA, INC.	Healthspring of Alabama, Inc.	www.healthspring.com	01	01		1		H0150	806	0	2009	HealthSpring Retiree Adv. Plus-Cont. Yr	Alabama		1	2			42	2						(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(888)-767-1879	(888)-767-1879	(877)-262-9090	(877)-262-9090	(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H0151	001	0	1	01	01	H0151_001_0	9	2009.01	UNITED HEALTHCARE OF ALABAMA, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0151	001	0	2009	AARP MedicareComplete Plan 1	Central Alabama and Mobile and Baldwin Counties		2	2				2						(800)-643-4845		(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0151	015	0	1	01	01	H0151_015_0	5	2009.01	UNITED HEALTHCARE OF ALABAMA, INC.	SecureHorizons by UnitedHealthcare	www.securehorizons.com	01	01		1		H0151	015	0	2009	SecureHorizons MedicareComplete	Central Alabama and Mobile and Baldwin Counties		2	1	3			2			1	2		(800)-711-6088		(888)-685-8480		(800)-555-5757		(800)-387-1074		(800)-711-6088	(800)-711-6088	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0151	017	0	1	01	01	H0151_017_0	7	2009.01	UNITED HEALTHCARE OF ALABAMA, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicareComplete.com	01	01		1		H0151	017	0	2009	Evercare Plan IH	Jefferson and Mobile Counties		2	1	1	1		2			1			(800)-393-0993		(888)-685-8480		(888)-834-3721		(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0151	019	0	1	01	01	H0151_019_0	4	2009.01	UNITED HEALTHCARE OF ALABAMA, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0151	019	0	2009	AARP MedicareComplete Essential	Central Alabama and Mobile and Baldwin Counties		2	2				2						(800)-643-4845		(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0151	023	0	1	01	01	H0151_023_0	6	2009.01	UNITED HEALTHCARE OF ALABAMA, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0151	023	0	2009	AARP MedicareComplete Plan 2	Central Alabama and Mobile and Baldwin Counties		2	2				2						(800)-643-4845		(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0151	801	0	1	01	01	H0151_801_0	2	2009.01	UNITED HEALTHCARE OF ALABAMA, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicareComplete.com	01	01		1		H0151	801	0	2009	MedicareComplete Retiree Plan	Select Counties in Alabama		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(800)-387-1074		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0151	804	0	1	01	01	H0151_804_0	2	2009.01	UNITED HEALTHCARE OF ALABAMA, INC.	SecureHorizons by UnitedHealthcare	www.AARPMedicareComplete.com	01	01		1		H0151	804	0	2009	MedicareComplete Retiree Plan	Select Counties in AL		1	2				2						(800)-854-4317		(888)-685-8480		(888)-702-8400		(800)-387-1074		(800)-854-4317	(800)-854-4317	(888)-685-8480		(888)-702-8400	(888)-702-8400	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0154	001	0	1	01	01	H0154_001_0	5	2009.01	VIVA HEALTH, INC.	VIVA Medicare Plus	www.vivamedicaremember.com	01	01		1		H0154	001	0	2009	VIVA Medicare Plus Rx	Central Alabama		2	2			22302	2						(205)-918-2067	(800)-633-1542	(800)-548-2546	(800)-548-2546	(205)-933-8482	(888)-830-8482	(800)-548-2546	(800)-548-2546	(205)-918-2067	(800)-633-1542	(800)-548-2546	(800)-548-2546	(205)-933-8482	(888)-830-8482	(800)-548-2546	(800)-548-2546	http://www.vivamedicaremember.com/Download.aspx?ID=253Type=doc	www.vivahealth.com
H0154	008	0	1	01	01	H0154_008_0	5	2009.01	VIVA HEALTH, INC.	VIVA Medicare Plus	www.vivamedicaremember.com	01	01		1		H0154	008	0	2009	VIVA Medicare Plus Select	Central Alabama		2	2			1268	2						(205)-918-2067	(800)-633-1542	(800)-548-2546	(800)-548-2546	(205)-933-8482	(888)-830-8482	(800)-548-2546	(800)-548-2546									http://www.vivamedicaremember.com/Download.aspx?ID=253Type=doc	www.vivahealth.com
H0154	009	0	1	01	01	H0154_009_0	6	2009.01	VIVA HEALTH, INC.	VIVA Medicare Plus	www.vivamedicaremember.com	01	01		1		H0154	009	0	2009	VIVA Medicare Plus Rx Healthy Lifestyles	Central Alabama		2	1	4		2387	2			1		0000000000100000000000000000	(205)-918-2067	(800)-633-1542	(800)-548-2546	(800)-548-2546	(205)-933-8482	(888)-830-8482	(800)-548-2546	(800)-548-2546	(205)-918-2067	(800)-633-1542	(800)-548-2546	(800)-548-2546	(205)-933-8482	(888)-830-8482	(800)-548-2546	(800)-548-2546	http://www.vivamedicaremember.com/Download.aspx?ID=253Type=doc	www.vivahealth.com
H0154	010	0	1	01	01	H0154_010_0	4	2009.01	VIVA HEALTH, INC.	VIVA Medicare Plus	www.vivamedicaremember.com	01	01		1		H0154	010	0	2009	VIVA Medicare Plus Rx Extra Care	Central Alabama		2	1	3		2387	2			1	2		(205)-918-2067	(800)-633-1542	(800)-548-2546	(800)-548-2546	(205)-933-8482	(888)-830-8482	(800)-548-2546	(800)-548-2546	(205)-918-2067	(800)-633-1542	(800)-548-2546	(800)-548-2546	(205)-933-8482	(888)-830-8482	(800)-548-2546	(800)-548-2546	http://www.vivamedicaremember.com/Download.aspx?ID=253Type=doc	www.vivahealth.com
H0154	011	0	1	01	01	H0154_011_0	4	2009.01	VIVA HEALTH, INC.	VIVA Medicare Plus	www.vivamedicaremember.com	01	01		1		H0154	011	0	2009	VIVA Medicare Plus Rx Premier	Central Alabama		2	2			1193	2						(205)-918-2067	(800)-633-1542	(800)-548-2546	(800)-548-2546	(205)-933-8482	(888)-830-8482	(800)-548-2546	(800)-548-2546	(205)-918-2067	(800)-633-1542	(800)-548-2546	(800)-548-2546	(205)-933-8482	(888)-830-8482	(800)-548-2546	(800)-548-2546	http://www.vivamedicaremember.com/Download.aspx?ID=253Type=doc	www.vivahealth.com
H0154	801	0	1	01	01	H0154_801_0	2	2009.01	VIVA HEALTH, INC.	VIVA Medicare Plus	www.vivahealth.com	01	01		1		H0154	801	0	2009	VIVA Medicare Plus Rx Group Plan	State of Alabama		1	2			99	2						(205)-918-2067	(800)-633-1542	(800)-548-2546	(800)-548-2546	(205)-933-8482	(888)-830-8482	(800)-548-2546	(800)-548-2546	(205)-918-2067	(800)-633-1542	(800)-548-2546	(800)-548-2546	(205)-933-8482	(888)-830-8482	(800)-548-2546	(800)-548-2546	http://www.vivamedicaremember.com/Download.aspx?ID=253Type=doc	www.vivahealth.com
H0154	802	0	1	01	01	H0154_802_0	2	2009.01	VIVA HEALTH, INC.	VIVA Medicare Plus	www.vivahealth.com	01	01		1		H0154	802	0	2009	VIVA Medicare Plus Select Group Plan	State of Alabama		1	2			99	2						(205)-918-2067	(800)-633-1542	(800)-548-2546	(800)-548-2546	(205)-933-8482	(888)-830-8482	(800)-548-2546	(800)-548-2546									http://www.vivamedicaremember.com/Download.aspx?ID=253Type=doc	www.vivahealth.com
H0154	803	0	1	01	01	H0154_803_0	2	2009.01	VIVA HEALTH, INC.	VIVA Medicare Plus	www.vivahealth.com	01	01		1		H0154	803	0	2009	VIVA Medicare Plus Rx Group Plan (not CY)	State of Alabama		1	2			99	2						(205)-918-2067	(800)-633-1542	(800)-548-2546	(800)-548-2546	(205)-933-8482	(888)-830-8482	(800)-548-2546	(800)-548-2546	(205)-918-2067	(800)-633-1542	(800)-548-2546	(800)-548-2546	(205)-933-8482	(888)-830-8482	(800)-548-2546	(800)-548-2546	http://www.vivamedicaremember.com/Download.aspx?ID=253Type=doc	www.vivahealth.com
H0245	001	0	1	01	01	H0245_001_0	7	2009.01	UNISON HEALTH PLAN OF TENNESSEE, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H0245	001	0	2009	Unison Advantage Choice	DeSoto, Tunica and Union Counties		2	2				2						(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	http://www.unisonhealthplan.com	www.unisonhealthplan.com
H0245	002	0	1	01	01	H0245_002_0	7	2009.01	UNISON HEALTH PLAN OF TENNESSEE, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H0245	002	0	2009	Unison Advantage Preferred	DeSoto, Tunica and Union Counties		2	2				2						(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	http://www.unisonhealthplan.com	www.unisonhealthplan.com
H0245	003	0	1	01	01	H0245_003_0	7	2009.01	UNISON HEALTH PLAN OF TENNESSEE, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H0245	003	0	2009	Unison Advantage Plus	DeSoto County		2	1	3			2			1	3		(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	http://www.unisonhealthplan.com	www.unisonhealthplan.com
H0245	004	0	1	01	01	H0245_004_0	6	2009.01	UNISON HEALTH PLAN OF TENNESSEE, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H0245	004	0	2009	Unison Advantage Basic	DeSoto, Tunica and Union Counties		2	2				2						(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021									http://www.unisonhealthplan.com	www.unisonhealthplan.com
H0245	801	0	1	01	01	H0245_801_0	4	2009.01	UNISON HEALTH PLAN OF TENNESSEE, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H0245	801	0	2009	Unison Advantage Basic Group	DeSoto, Tunica and Union Counties		1	2				2						(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021									http://www.unisonhealthplan.com	www.unisonhealthplan.com
H0245	802	0	1	01	01	H0245_802_0	4	2009.01	UNISON HEALTH PLAN OF TENNESSEE, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H0245	802	0	2009	Unison Advantage Choice Group	DeSoto, Tunica and Union Counties		1	2				2						(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	http://www.unisonhealthplan.com	www.unisonhealthplan.com
H0248	001	0	1	04	01	H0248_001_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H0248	001	0	2009	HumanaChoicePPO PPO H0248-001	Honolulu County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0248	801	0	1	04	01	H0248_801_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H0248	801	0	2009	Humana Employer Sponsored	Select county in Hawaii		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0248	802	0	1	04	01	H0248_802_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H0248	802	0	2009	Humana Employer Sponsored	Select county in Hawaii		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0248	803	0	1	04	01	H0248_803_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H0248	803	0	2009	Humana Employer Sponsored Non-CY	Select county in Hawaii		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0248	804	0	1	04	01	H0248_804_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H0248	804	0	2009	Humana Employer Sponsored Non-CY	Select county in Hawaii		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0251	001	0	1	01	01	H0251_001_0	6	2009.01	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	AmeriChoice Secure Plus Complete	https://www.uhcrivervalley.com/	01	01		1		H0251	001	0	2009	AmeriChoice Secure Plus Complete	Tennessee		2	1	3			2			1	3		(800)-690-1606		(800)-884-4327		(888)-267-6061		(800)-387-1074		(800)-690-1606	(800)-690-1606	(800)-884-4327		(888)-267-6061	(888)-267-6061	(800)-387-1074		https://www.uhcrivervalley.com/SecurePlusComplete	https://www.uhcrivervalley.com/
H0302	001	0	1	01	01	H0302_001_0	4	2009.01	SUN HEALTH MEDISUN, INC.	Sun Health MediSunONE	www.medisun.com	01	01		1		H0302	001	0	2009	Sun Health MediSunONE	MediSunONE, NW Maricopa  County		2	2			18000	2						(623)-974-7430	(800)-446-8331	(623)-974-7440		(623)-974-7430	(800)-446-8331	(623)-974-7440		(623)-974-7430	(800)-446-8331	(623)-974-7440		(623)-974-7430	(800)-446-8331	(623)-974-7440		http://www.medisun.com/drug_plan/index.cfm?content=formulary_form	www.medisun.com
H0302	004	0	1	01	01	H0302_004_0	4	2009.01	SUN HEALTH MEDISUN, INC.	Sun Health MediSunONE	www.medisun.com	01	01		1		H0302	004	0	2009	Sun Health MediSunONE HeartSmart	MediSunONE HeartSmart, NW Maricopa County		2	1	4		400	2			1		0000010000000000000000000000	(623)-974-7430	(800)-446-8331	(623)-974-7440		(623)-974-7430	(800)-446-8331	(623)-974-7440		(623)-974-7430	(800)-446-8331	(623)-974-7440		(623)-974-7430	(800)-446-8331	(623)-974-7440		http://www.medisun.com/drug_plan/index.cfm?content=formulary_form	www.medisun.com
H0303	013	0	1	01	01	H0303_013_0	6	2009.01	PACIFICARE OF ARIZONA, INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0303	013	0	2009	AARP MedicareComplete Plan 1	Pima		2	2				2						(800)-950-9355		(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0303	015	0	1	01	01	H0303_015_0	5	2009.01	PACIFICARE OF ARIZONA, INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0303	015	0	2009	AARP MedicareComplete Plan 1	Maricopa - Apache Junction		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0303	034	0	1	01	01	H0303_034_0	7	2009.01	PACIFICARE OF ARIZONA, INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0303	034	0	2009	Evercare Plan DH	Maricopa, Pima, and part of Pinal counties		2	1	3			2			2	2		(866)-846-2762		(888)-685-8480		(888)-834-3721		(800)-387-1074		(866)-846-2762	(866)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0303	039	0	1	01	01	H0303_039_0	5	2009.01	PACIFICARE OF ARIZONA, INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0303	039	0	2009	AARP MedicareComplete Plan 3	Maricopa - Apache Junction		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0303	040	0	1	01	01	H0303_040_0	4	2009.01	PACIFICARE OF ARIZONA, INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0303	040	0	2009	AARP MedicareComplete Essential	Maricopa and  Pinal counties		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0303	801	0	1	01	01	H0303_801_0	2	2009.01	PACIFICARE OF ARIZONA, INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0303	801	0	2009	MedicareComplete Retiree Plan	AZ Employer Sponsored Plan Service Area		1	2				2						(800)-347-8600	(800)-347-8600	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074									www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0303	803	0	1	01	01	H0303_803_0	2	2009.01	PACIFICARE OF ARIZONA, INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0303	803	0	2009	MedicareComplete Retiree Plan	AZ Employer Sponsored Plan Service Area		1	2				2						(800)-347-8600	(800)-347-8600	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074									www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0303	804	0	1	01	01	H0303_804_0	2	2009.01	PACIFICARE OF ARIZONA, INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0303	804	0	2009	MedicareComplete Retiree Plan	AZ Employer Sponsored Plan Service Area		1	2				2						(800)-347-8600	(800)-347-8600	(888)-685-8480	(888)-685-8480	(800)-698-0822	(800)-698-0822	(800)-387-1074	(800)-387-1074	(800)-347-8600	(800)-347-8600	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0303	805	0	1	01	01	H0303_805_0	2	2009.01	PACIFICARE OF ARIZONA, INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0303	805	0	2009	MedicareComplete Retiree Plan	AZ Employer Sponsored Plan Service Area		1	2				2						(800)-347-8600	(800)-347-8600	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	(800)-347-8600	(800)-347-8600	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0307	008	0	1	01	01	H0307_008_0	7	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H0307	008	0	2009	Humana Gold Plus HMO H0307-008	Maricopa and Pinal Counties		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0307	009	0	1	02	01	H0307_009_0	7	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	02		1		H0307	009	0	2009	Humana Gold Plus HMO H0307-009	Pima and Pinal (Partial) Counties		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0307	010	0	1	02	01	H0307_010_0	7	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	02		1		H0307	010	0	2009	Humana Gold Plus HMO H0307-010	Maricopa and Pinal (Partial) Counties		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0307	801	0	1	01	01	H0307_801_0	3	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H0307	801	0	2009	Humana Employer Sponsored	Maricopa and parts of Pinal		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0307	802	0	1	01	01	H0307_802_0	3	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H0307	802	0	2009	Humana Employer Sponsored	Maricopa and parts of Pinal		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0307	803	0	1	01	01	H0307_803_0	3	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H0307	803	0	2009	Humana Employer Sponsored Non-CY	Maricopa and Pinal Counties		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0307	804	0	1	01	01	H0307_804_0	3	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H0307	804	0	2009	Humana Employer Sponsored Non-CY	Maricopa and Pinal Counties		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0316	002	0	1	01	01	H0316_002_0	5	2009.01	UNITEDHEALTHCARE OF ARIZONA INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0316	002	0	2009	AARP MedicareComplete Plan 3	Pima, Cochise, Graham and Santa Cruz counties		2	2				2						(800)-643-4845		(888)-685-8480		(800)-547-5514		(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(800)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0316	012	0	1	01	01	H0316_012_0	7	2009.01	UNITEDHEALTHCARE OF ARIZONA INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0316	012	0	2009	Evercare Plan DH	Cochise, Graham and Santa Cruz Counties		2	1	3			2			2	2		(877)-702-5110		(888)-685-8480		(888)-834-3721		(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0316	013	0	1	01	01	H0316_013_0	4	2009.01	UNITEDHEALTHCARE OF ARIZONA INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0316	013	0	2009	Evercare Plan MH	Cochise, Graham, Santa Cruz Counties		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0316	014	0	1	01	01	H0316_014_0	7	2009.01	UNITEDHEALTHCARE OF ARIZONA INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0316	014	0	2009	AARP MedicareComplete	Yavapai		2	2				2						(800)-643-4845		(888)-685-8480		(800)-547-5514		(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(800)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0316	801	0	1	01	01	H0316_801_0	3	2009.01	UNITEDHEALTHCARE OF ARIZONA INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0316	801	0	2009	MedicareComplete Retiree Plan	AZ Employer Sponsored Plan Service Area		1	2				2						(800)-854-4317		(888)-685-8480		(888)-702-8400		(800)-387-1074		(800)-854-4317	(800)-854-4317	(888)-685-8480		(888)-702-8400	(888)-702-8400	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0316	804	0	1	01	01	H0316_804_0	3	2009.01	UNITEDHEALTHCARE OF ARIZONA INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0316	804	0	2009	MedicareComplete Retiree Plan	AZ Employer Sponsored Plan Service Area		1	2				2						(800)-854-4317		(888)-685-8480		(888)-702-8400		(800)-387-1074		(800)-854-4317	(800)-854-4317	(888)-685-8480		(888)-702-8400	(888)-702-8400	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0317	001	0	1	04	01	H0317_001_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H0317	001	0	2009	HumanaChoicePPO PPO H0317-001	Maricopa and Yavapai Counties		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0317	002	0	1	04	01	H0317_002_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H0317	002	0	2009	HumanaChoicePPO PPO H0317-002	Maricopa and Yavapai Counties		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0317	004	0	1	04	01	H0317_004_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H0317	004	0	2009	HumanaChoicePPO PPO H0317-004	Pima and Pinal (Partial) Counties		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0317	801	0	1	04	01	H0317_801_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H0317	801	0	2009	Humana Employer Sponsored	Maricopa county		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0317	802	0	1	04	01	H0317_802_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H0317	802	0	2009	Humana Employer Sponsored	Maricopa County		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0317	803	0	1	04	01	H0317_803_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H0317	803	0	2009	Humana Employer Sponsored Non-CY	Maricopa, AZ		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0317	804	0	1	04	01	H0317_804_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H0317	804	0	2009	Humana Employer Sponsored Non-CY	Maricopa, AZ		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0318	001	0	1	01	01	H0318_001_0	5	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H0318	001	0	2009	Aetna Golden Medicare Select Plan	Pinal County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0318	002	0	1	01	01	H0318_002_0	4	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H0318	002	0	2009	Aetna Golden Medicare Premier Plan	Maricopa County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0318	801	0	1	01	01	H0318_801_0	4	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H0318	801	0	2009	Aetna Golden Medicare Plan	Maricopa and Pinal Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0318	802	0	1	01	01	H0318_802_0	3	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H0318	802	0	2009	Aetna Golden Medicare Plan w/Rx CY	Maricopa and Pinal Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0319	001	0	1	04	01	H0319_001_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H0319	001	0	2009	Evercare Plan IP	Maricopa, Pima, Pinal and Yuma Counties		2	1	1	1		2			1			(877)-702-5110		(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H0319	002	0	1	04	01	H0319_002_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H0319	002	0	2009	Evercare Plan DP	Maricopa County		2	1	3			2			2	2		(877)-702-5110		(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H0319	004	0	1	04	01	H0319_004_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H0319	004	0	2009	Evercare Plan MP	Maricopa and Pima Counties		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110		(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H0319	005	0	1	04	01	H0319_005_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H0319	005	0	2009	Evercare Plan AD	Maricopa County		2	1	4			2			1		0000000000000000000000000001	(877)-702-5110		(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H0319	006	0	1	04	01	H0319_006_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H0319	006	0	2009	Evercare Plan DP	Pima County		2	1	3			2			2	2		(877)-702-5110		(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H0320	001	0	1	01	01	H0320_001_0	9	2009.01	ARCADIAN HEALTH PLAN, INC.	Desert Canyon Community Care	www.desertcanyoncommunitycare.com	01	01		1		H0320	001	0	2009	Desert Canyon Comm. Care - Plus	Coconino		2	2			2878	2						(928)-777-9226	(800)-573-8597	(866)-573-8591	(866)-573-8591	(928)-777-9226	(800)-887-6177	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(928)-777-9226	(800)-887-6177	(866)-573-8613	(866)-573-8613	http://www.desertcanyoncommunitycare.com/formulary.html	
H0320	005	0	1	01	01	H0320_005_0	10	2009.01	ARCADIAN HEALTH PLAN, INC.	Desert Canyon Community Care	www.desertcanyoncommunitycare.com	01	01		1		H0320	005	0	2009	Desert Canyon Community Care-Plus	Mohave		2	2			27182	2						(928)-777-9226	(800)-573-8597	(866)-573-8591	(866)-573-8591	(928)-777-9226	(800)-887-6177	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(928)-777-9226	(800)-887-6177	(866)-573-8613	(866)-573-8613	http://www.desertcanyoncommunitycare.com/formulary.html	
H0320	006	0	1	01	01	H0320_006_0	9	2009.01	ARCADIAN HEALTH PLAN, INC.	Desert Canyon Community Care	www.desertcanyoncommunitycare.com	01	01		1		H0320	006	0	2009	Desert Canyon Comm. Care-Plus	Yavapai		2	2			8350	2						(928)-777-9226	(800)-573-8597	(866)-573-8591	(866)-573-8591	(928)-777-9226	(800)-887-6177	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(928)-777-9226	(800)-887-6177	(866)-573-8613	(866)-573-8613	http://www.desertcanyoncommunitycare.com/formulary.html	
H0321	002	0	1	01	01	H0321_002_0	7	2009.01	ARIZONA PHYSICIANS IPA, INC.	APIPA Personal Care Plus	www.myapipa.com	01	01		1		H0321	002	0	2009	APIPA Personal Care Plus	Cochise, Maricopa, Mohave and Related Counties		2	1	3			2			1	3		(877)-614-0623	(877)-614-0623	(800)-842-4681	(800)-842-4681	(877)-614-0621	(877)-614-0621	(800)-842-4681	(800)-842-4681	(877)-614-0623	(877)-614-0623	(800)-842-4681	(800)-842-4681	(877)-614-0621	(877)-614-0621	(800)-842-4681	(800)-842-4681	www.myapipa.com	www.myapipa.com
H0322	002	0	1	04	01	H0322_002_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H0322	002	0	2009	Aetna Golden Choice Select Plan	Pinal County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0322	006	0	1	04	01	H0322_006_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H0322	006	0	2009	Aetna Golden Choice Premier Plan	Maricopa County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0322	801	0	1	04	01	H0322_801_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H0322	801	0	2009	Aetna Golden Choice Plan	Maricopa and Pinal Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0322	802	0	1	04	01	H0322_802_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H0322	802	0	2009	Aetna Golden Choice Plan w/Rx CY	Maricopa and Pinal Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0322	804	0	1	04	01	H0322_804_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H0322	804	0	2009	Aetna Golden Choice Plan w/RX NCY	Maricopa and Pinal Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0332	001	0	1	01	01	H0332_001_0	6	2009.01	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	01	01		1		H0332	001	0	2009	KelseyCare Advantage Essential	Harris, Ft Bend, Galveston and Montgomery counties		2	2			3081	2						(713)-442-5177	(866)-535-8343	(713)-442-9537	(866)-302-9336	(713)-442-2273	(800)-663-7146	(713)-442-9537	(866)-302-9336									www.kelseycareadvantage.com	www.Kelseycareadvantage.com
H0332	002	0	1	01	01	H0332_002_0	9	2009.01	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	01	01		1		H0332	002	0	2009	KelseyCare Advantage Rx	Harris, Ft Bend, Galveston and Montgomery counties		2	2			3960	2						(713)-442-5177	(866)-535-8343	(713)-442-9537	(866)-302-9336	(713)-442-2273	(800)-663-7146	(713)-442-9537	(866)-302-9336	(713)-442-5177	(800)-794-1086	(713)-442-9537	(866)-302-9336	(713)-442-2273	(800)-663-7146	(713)-442-9537	(866)-302-9336	www.kelseycareadvantage.com	www.Kelseycareadvantage.com
H0332	003	0	1	02	01	H0332_003_0	6	2009.01	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	01	02		1		H0332	003	0	2009	KelseyCare Advantage Essential + Choice	Harris, Ft Bend, Galveston and Montgomery counties		2	2			458	2						(713)-442-5177	(866)-535-8343	(713)-442-9537	(866)-302-9336	(713)-442-2273	(800)-663-7146	(713)-442-9537	(866)-302-9336									www.kelseycareadvantage.com	www.Kelseycareadvantage.com
H0332	004	0	1	02	01	H0332_004_0	9	2009.01	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	01	02		1		H0332	004	0	2009	KelseyCare Advantage Rx + Choice	Harris, Ft Bend, Galveston and Montgomery counties		2	2			589	2						(713)-442-5177	(866)-535-8343	(713)-442-9537	(866)-302-9336	(713)-442-2273	(800)-663-7146	(713)-442-9537	(866)-302-9336	(713)-442-5177	(800)-794-1086	(713)-442-9537	(866)-302-9336	(713)-442-2273	(800)-663-7146	(713)-442-9537	(866)-302-9336	www.kelseycareadvantage.com	www.Kelseycareadvantage.com
H0332	801	0	1	01	01	H0332_801_0	7	2009.01	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	01	01		1		H0332	801	0	2009	KelseyCare Advantage Essential Retiree	Texas		1	2			32	2						(713)-442-5177	(866)-535-8343	(713)-442-9537	(866)-302-9336	(713)-442-2273	(800)-663-7146	(713)-442-9537	(866)-302-9336									www.kelseycareadvantage.com	www.Kelseycareadvantage.com
H0332	803	0	1	01	01	H0332_803_0	5	2009.01	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	01	01		1		H0332	803	0	2009	KelseyCare Advantage Rx Retiree	Texas		1	2			94	2						(713)-442-5177	(866)-535-8343	(713)-442-9537	(866)-302-9336	(713)-442-2273	(800)-663-7146	(713)-442-9537	(866)-302-9336	(713)-442-2273	(800)-794-1086	(713)-442-9537	(866)-302-9336	(713)-442-2273	(800)-663-7146	(713)-442-9537	(866)-302-9336	www.kelseycareadvantage.com	www.Kelseycareadvantage.com
H0332	804	0	1	02	01	H0332_804_0	7	2009.01	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	01	02		1		H0332	804	0	2009	KelseyCare Advantage Essential + Choice Retiree	Texas		1	2			8	2						(713)-442-5177	(866)-535-8343	(713)-442-9537	(866)-302-9336	(713)-442-2273	(800)-663-7146	(713)-442-9537	(866)-302-9336									www.kelseycareadvantage.com	www.Kelseycareadvantage.com
H0332	805	0	1	02	01	H0332_805_0	6	2009.01	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	01	02		1		H0332	805	0	2009	KelseyCare Advantage Rx + Choice Retiree	Texas		1	2			24	2						(713)-442-5177	(866)-535-8343	(713)-442-9537	(866)-302-9336	(713)-442-2273	(800)-663-7146	(713)-442-9537	(866)-302-9336	(713)-442-2273	(800)-794-1086	(713)-442-9537	(866)-302-9336	(713)-442-2273	(800)-663-7146	(713)-442-9537	(866)-302-9336	www.kelseycareadvantage.com	www.Kelseycareadvantage.com
H0332	806	0	1	01	01	H0332_806_0	7	2009.01	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	01	01		1		H0332	806	0	2009	KelseyCare Advantage Essential Retiree	Harris, Ft Bend, Galveston and Montgomery counties		1	2			32	2						(713)-442-5177	(866)-535-8343	(713)-442-9537	(866)-302-9336	(713)-442-2273	(800)-663-7146	(713)-442-9537	(866)-302-9336									www.kelseycareadvantage.com	www.Kelseycareadvantage.com
H0332	807	0	1	01	01	H0332_807_0	5	2009.01	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	01	01		1		H0332	807	0	2009	KelseyCare Advantage Rx Retiree	Harris, Ft Bend, Galveston and Montgomery counties		1	2			283	2						(713)-442-5177	(866)-535-8343	(713)-442-9537	(866)-302-9336	(713)-442-2273	(800)-663-7146	(713)-442-9537	(866)-302-9336	(713)-442-2273	(800)-794-1086	(713)-442-9537	(866)-302-9336	(713)-442-2273	(800)-663-7146	(713)-442-9537	(866)-302-9336	www.kelseycareadvantage.com	www.Kelseycareadvantage.com
H0332	808	0	1	02	01	H0332_808_0	7	2009.01	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	01	02		1		H0332	808	0	2009	KelseyCare Advantage Essential + Choice Retiree	Harris, Ft Bend, Galveston and Montgomery counties		1	2			8	2						(713)-442-5177	(866)-535-8343	(713)-442-9537	(866)-302-9336	(713)-442-2273	(800)-663-7146	(713)-442-9537	(866)-302-9336									www.kelseycareadvantage.com	www.Kelseycareadvantage.com
H0332	809	0	1	02	01	H0332_809_0	6	2009.01	KS PLAN ADMINISTRATORS, LLC	KelseyCare Advantage	www.kelseycareadvantage.com	01	02		1		H0332	809	0	2009	KelseyCare Advantage Rx + Choice Retiree	Harris, Ft Bend, Galveston and Montgomery counties		1	2			71	2						(713)-442-5177	(866)-535-8343	(713)-442-9537	(866)-302-9336	(713)-442-2273	(800)-663-7146	(713)-442-9537	(866)-302-9336	(713)-442-2273	(800)-794-1086	(713)-442-9537	(866)-302-9336	(713)-442-2273	(800)-663-7146	(713)-442-9537	(866)-302-9336	www.kelseycareadvantage.com	www.Kelseycareadvantage.com
H0346	001	0	1	20	08	H0346_001_0	1	2009.01	PACE VERMONT, INC.	PACE Vermont, Inc	www.pacevt.org	08	20		1		H0346	001	0	2009	PACE Vermont - Duals	Chittenden and Rutland County		2	2				2														(802)-655-6700	(888)-655-6708			(802)-655-6700	(888)-655-6708			www.pacevt.org	
H0346	002	0	1	20	08	H0346_002_0	2	2009.01	PACE VERMONT, INC.	PACE Vermont, Inc	www.pacevt.org	08	20		1		H0346	002	0	2009	PACE Vermont	Chittenden aqnd Rutland Counties		2	2				2														(802)-655-6700	(888)-655-6708			(802)-655-6700	(888)-655-6708			www.pacevt.org	
H0351	014	0	1	01	01	H0351_014_0	4	2009.01	HEALTH NET OF ARIZONA, INC.	Health Net of Arizona, Inc.	www.healthnet.com	01	01		1		H0351	014	0	2009	Health Net Ruby Option 1	Maricopa, Pinal, Pima, Sta Cruz, Cochise, Yavapai		2	2				2						(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757	(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0351	029	0	1	01	01	H0351_029_0	6	2009.01	HEALTH NET OF ARIZONA, INC.	Health Net of Arizona, Inc.	www.healthnet.com	01	01		1		H0351	029	0	2009	Health Net Amber	Maricopa, Pinal, Pima, Sta Cruz, Cochise, Yavapai		2	1	3			2			1	2		(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757	(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0351	030	0	1	01	01	H0351_030_0	2	2009.01	HEALTH NET OF ARIZONA, INC.	Health Net of Arizona, Inc.	www.healthnet.com	01	01		1		H0351	030	0	2009	Health Net Green	Maricopa, Pinal, Pima, Sta Cruz, Cochise, Yavapai		2	2				2						(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0351	032	0	1	01	01	H0351_032_0	6	2009.01	HEALTH NET OF ARIZONA, INC.	Health Net of Arizona, Inc.	www.healthnet.com	01	01		1		H0351	032	0	2009	Health Net Sage	Maricopa, Pinal, Pima, Sta Cruz, Cochise, Yavapai		2	1	4		500	2			1		0000000001000000000000000000	(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757	(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0351	033	0	1	01	01	H0351_033_0	6	2009.01	HEALTH NET OF ARIZONA, INC.	Health Net of Arizona, Inc.	www.healthnet.com	01	01		1		H0351	033	0	2009	Health Net Ruby Option 2	Maricopa, Pinal, Pima, Sta Cruz, Cochise, Yavapai		2	2				2						(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757	(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757	https://www.healthnet.com/formulary.htm	www.healthnet.com
H0351	034	0	1	01	01	H0351_034_0	6	2009.01	HEALTH NET OF ARIZONA, INC.	Health Net of Arizona, Inc.	www.healthnet.com	01	01		1		H0351	034	0	2009	Health Net Ruby Option 3	Maricopa, Pinal, Pima, Sta Cruz, Cochise, Yavapai		2	2				2						(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757	(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757	https://www.healthnet.com/formulary.htm	www.healthnet.com
H0351	801	0	1	01	01	H0351_801_0	2	2009.01	HEALTH NET OF ARIZONA, INC.	Health Net of Arizona, Inc.	www.healthnet.com	01	01		1		H0351	801	0	2009	Health Net EG	All AZ Counties		1	2				2						(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757	(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0351	803	0	1	01	01	H0351_803_0	2	2009.01	HEALTH NET OF ARIZONA, INC.	Health Net of Arizona, Inc.	www.healthnet.com	01	01		1		H0351	803	0	2009	Health Net EG	All AZ Counties		1	2				2						(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0351	804	0	1	01	01	H0351_804_0	2	2009.01	HEALTH NET OF ARIZONA, INC.	Health Net of Arizona, Inc.	www.healthnet.com	01	01		1		H0351	804	0	2009	Health Net EG	All AZ Counties		1	2				2						(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757	(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0351	806	0	1	01	01	H0351_806_0	2	2009.01	HEALTH NET OF ARIZONA, INC.	Health Net of Arizona, Inc.	www.healthnet.com	01	01		1		H0351	806	0	2009	Health Net EG	All AZ Counties		1	2				2						(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0354	001	0	1	01	01	H0354_001_0	11	2009.01	CIGNA HEALTHCARE OF ARIZONA, INC.	CIGNA Medicare Select	www.cignamedicare.com	01	01		1		H0354	001	0	2009	CIGNA Medicare Select Plus Rx	Maricopa County and City of Apache Junction		2	2				2						(800)-627-7534	(800)-627-7534	(800)-987-8816	(800)-987-8816	(800)-592-9231	(800)-592-9231	(800)-987-8816	(800)-987-8816	(800)-627-7534	(800)-627-7534	(800)-987-8816	(800)-987-8816	(800)-592-9231	(800)-592-9231	(800)-987-8816	(800)-987-8816	www.cignamedicare.com	www.cignamedicare.com
H0354	012	0	1	01	01	H0354_012_0	11	2009.01	CIGNA HEALTHCARE OF ARIZONA, INC.	CIGNA Medicare Select	www.cignamedicare.com	01	01		1		H0354	012	0	2009	CIGNA Medicare Select Plus Rx-Dual	Maricopa County and City of Apache Junction		2	1	3			2			1	2		(800)-627-7534	(800)-627-7534	(800)-987-8816	(800)-987-8816	(800)-592-9231	(800)-592-9231	(800)-987-8816	(800)-987-8816	(800)-627-7534	(800)-627-7534	(800)-987-8816	(800)-987-8816	(800)-592-9231	(800)-592-9231	(800)-987-8816	(800)-987-8816	www.cignamedicare.com	www.cignamedicare.com
H0354	014	0	1	01	01	H0354_014_0	11	2009.01	CIGNA HEALTHCARE OF ARIZONA, INC.	CIGNA Medicare Select	www.cignamedicare.com	01	01		1		H0354	014	0	2009	CIGNA Medicare Select Plus Rx-Chronic Care	Maricopa County and City of Apache Junction		2	1	4			2			1		0000001011000000000000000001	(800)-627-7534	(800)-627-7534	(800)-987-8816	(800)-987-8816	(800)-592-9231	(800)-592-9231	(800)-987-8816	(800)-987-8816	(800)-627-7534	(800)-627-7534	(800)-987-8816	(800)-987-8816	(800)-592-9231	(800)-592-9231	(800)-987-8816	(800)-987-8816	www.cignamedicare.com	www.cignamedicare.com
H0354	801	0	1	01	01	H0354_801_0	4	2009.01	CIGNA HEALTHCARE OF ARIZONA, INC.	CIGNA Medicare Select	www.cignamedicare.com	01	01		1		H0354	801	0	2009	CIGNA Medicare Select-Employer	All Counties in Arizona		1	2				2						(800)-627-7534	(800)-627-7534	(800)-987-8816	(800)-987-8816	(800)-592-9231	(800)-592-9231	(800)-987-8816	(800)-987-8816									http://www.cigna.com/sites/cignamedicare/formulary/selectPlus.html	http://www.cigna.com/sites/mapd/pdf/cigna_provider_directory.pdf
H0354	804	0	1	01	01	H0354_804_0	4	2009.01	CIGNA HEALTHCARE OF ARIZONA, INC.	CIGNA Medicare Select	www.cignamedicare.com	01	01		1		H0354	804	0	2009	CIGNA Medicare Select Plus Rx-Employer Calendar Yr	All Counties in Arizona		1	2				2						(800)-627-7534	(800)-627-7534	(800)-987-8816	(800)-987-8816	(800)-592-9231	(800)-592-9231	(800)-987-8816	(800)-987-8816	(800)-627-7534	(800)-627-7534	(800)-987-8816	(800)-987-8816	(800)-592-9231	(800)-592-9231	(800)-987-8816	(800)-987-8816	http://www.cigna.com/sites/cignamedicare/formulary/selectPlus.html	http://www.cigna.com/sites/mapd/pdf/cigna_provider_directory.pdf
H0354	805	0	1	01	01	H0354_805_0	4	2009.01	CIGNA HEALTHCARE OF ARIZONA, INC.	CIGNA Medicare Select	www.cignamedicare.com	01	01		1		H0354	805	0	2009	CIGNA Medicare Select Plus Rx-Employer NonCal Yr	All Counties in Arizona		1	2				2						(800)-627-7534	(800)-627-7534	(800)-987-8816	(800)-987-8816	(800)-592-9231	(800)-592-9231	(800)-987-8816	(800)-987-8816	(800)-627-7534	(800)-627-7534	(800)-987-8816	(800)-987-8816	(800)-592-9231	(800)-592-9231	(800)-987-8816	(800)-987-8816	http://www.cigna.com/sites/cignamedicare/formulary/selectPlus.html	http://www.cigna.com/sites/mapd/pdf/cigna_provider_directory.pdf
H0370	001	0	1	04	01	H0370_001_0	11	2009.01	COVENTRY HEALTH AND LIFE INSURANCE CO. (SOUTH DAKO	Coventry Health and Life Insurance Company	www.advantraplans.com	01	04		1		H0370	001	0	2009	Advantra Platinum PPO SD	Partial South Dakota		2	2			41	2						(866)-901-4692	(866)-901-4692	(877)-231-0573		(866)-363-4692	(866)-363-4692	(877)-231-0573		(866)-823-5178	(826)-823-5178	(877)-231-0573		(866)-363-4692	(866)-363-4692	(877)-231-0573		www.advantraplans.com	http://www.ia.chcadvantra.com/framesetdef.asp?Community=Member
H0370	002	0	1	04	01	H0370_002_0	12	2009.01	COVENTRY HEALTH AND LIFE INSURANCE CO. (SOUTH DAKO	Coventry Health and Life Insurance Company	www.advantraplans.com	01	04		1		H0370	002	0	2009	Advantra Platinum Plus PPO SD	South Dakota		2	2			196	2						(866)-901-4692	(866)-901-4692	(877)-231-0573		(866)-363-4692	(866)-363-4692	(877)-231-0573		(866)-823-5178	(866)-823-5178	(877)-231-0573		(866)-363-4692	(866)-363-4692	(877)-231-0573		www.advantraplans.com	http://www.ia.chcadvantra.com/framesetdef.asp?Community=Member
H0370	801	0	1	04	01	H0370_801_0	10	2009.01	COVENTRY HEALTH AND LIFE INSURANCE CO. (SOUTH DAKO	Coventry Health and Life Insurance Company	www.advantraplans.com	01	04		1		H0370	801	0	2009	SD/PPO-EmGp/NoRx/Cyear	South Dakota		1	2			404	2						(866)-901-4692	(866)-901-4692	(877)-231-0573		(866)-363-4692	(866)-363-4692	(877)-231-0573										www.advantraplans.com	http://www.ia.chcadvantra.com/framesetdef.asp?Community=Member
H0370	802	0	1	04	01	H0370_802_0	10	2009.01	COVENTRY HEALTH AND LIFE INSURANCE CO. (SOUTH DAKO	Coventry Health and Life Insurance Company	www.advantraplans.com	01	04		1		H0370	802	0	2009	SD/PPO-EmGp/Comm4/Cyear	South Dakota		1	2			404	2						(866)-901-4692	(866)-901-4692	(877)-231-0573		(866)-363-4692	(866)-363-4692	(877)-231-0573		(866)-823-5178	(866)-823-5178	(877)-231-0573		(866)-363-4692	(866)-363-4692	(877)-231-0573		www.advantraplans.com	http://www.ia.chcadvantra.com/framesetdef.asp?Community=Member
H0370	803	0	1	04	01	H0370_803_0	10	2009.01	COVENTRY HEALTH AND LIFE INSURANCE CO. (SOUTH DAKO	Coventry Health and Life Insurance Company	www.advantraplans.com	01	04		1		H0370	803	0	2009	SD/PPO-EmGp/Comm4/NonCyear	South Dakota		1	2			404	2						(866)-901-4692		(877)-231-0573		(866)-363-4692	(866)-363-4692	(877)-231-0573		(866)-823-5178	(866)-823-5178	(877)-231-0573		(866)-363-4692	(866)-363-4692	(877)-231-0573		www.advantraplans.com	http://www.ia.chcadvantra.com/framesetdef.asp?Community=Member
H0401	002	0	1	02	01	H0401_002_0	4	2009.01	UNITEDHEALTHCARE OF ARKANSAS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H0401	002	0	2009	AARP MedicareComplete Plus	Benton, Washington, Carroll, and Crawford Counties		2	2				2						(800)-643-4845		(888)-685-8480		(800)-547-5514		(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0401	004	0	1	02	01	H0401_004_0	4	2009.01	UNITEDHEALTHCARE OF ARKANSAS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H0401	004	0	2009	Evercare Plan DH-POS	Benton and Washington Counties		2	1	3			2			2	2		(877)-702-5110		(888)-685-8480		(888)-834-3721		(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0401	005	0	1	02	01	H0401_005_0	3	2009.01	UNITEDHEALTHCARE OF ARKANSAS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H0401	005	0	2009	Evercare Plan MH-POS	Benton and Washington counties		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110		(888)-685-8480		(888)-834-3721		(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0401	801	0	1	01	01	H0401_801_0	3	2009.01	UNITEDHEALTHCARE OF ARKANSAS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0401	801	0	2009	MedicareComplete Retiree Plan	Benton and Washington Counties		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(800)-387-1074		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0401	804	0	1	01	01	H0401_804_0	3	2009.01	UNITEDHEALTHCARE OF ARKANSAS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0401	804	0	2009	MedicareComplete Retiree Plan	Benton and Washington Counties		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0401	805	0	1	01	01	H0401_805_0	3	2009.01	UNITEDHEALTHCARE OF ARKANSAS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0401	805	0	2009	MedicareComplete Retiree Plan	Select Counites in AR		1	2				2						(800)-854-4317		(888)-685-8480		(888)-702-8400		(800)-387-1074		(800)-854-4317	(800)-854-4317	(888)-685-8480		(888)-702-8400	(888)-702-8400	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0401	806	0	1	01	01	H0401_806_0	3	2009.01	UNITEDHEALTHCARE OF ARKANSAS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0401	806	0	2009	MedicareComplete Retiree Plan	Select Counites in AR		1	2				2						(800)-854-4317		(888)-685-8480		(888)-702-8400		(800)-387-1074										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0408	001	0	1	02	01	H0408_001_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	02		1		H0408	001	0	2009	Evercare Plan IH-POS	Davidson, DeKalb, Hickman and Rutherford Counties		2	1	1	1		2			1			(800)-393-0993		(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H0408	002	0	1	02	01	H0408_002_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	02		1		H0408	002	0	2009	Evercare Plan IH-POS	Anderson, Blount, Knox and Loudon Counties		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H0410	001	0	1	37	05	H0410_001_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.EricksonAdvantage.com	05	37		1		H0410	001	0	2009	Erickson Advantage Signature with Drugs	Oakland and Wayne Counties		2	2				2						(866)-314-8188		(888)-685-8480		(800)-704-7839		(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.EricksonAdvantage.com
H0410	002	0	1	37	05	H0410_002_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.EricksonAdvantage.com	05	37		1		H0410	002	0	2009	Erickson Advantage Signature without Drugs	Oakland and Wayne Counties		2	2				2						(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839		(888)-685-8480										http://www.ericksonadvantage.com/formulary.asp	www.EricksonAdvantage.com
H0410	003	0	1	37	05	H0410_003_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.EricksonAdvantage.com	05	37		1		H0410	003	0	2009	Erickson Advantage Champion	Oakland and Wayne Counties		2	1	4			2			2		1111111110000000100000000001	(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839		(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.EricksonAdvantage.com
H0410	004	0	1	37	05	H0410_004_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.EricksonAdvantage.com	05	37		1		H0410	004	0	2009	Erickson Advantage Guardian	Wayne and Oakland Counties		2	1	1	1		2			1			(866)-314-8188		(888)-685-8480		(800)-704-7839		(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.EricksonAdvantage.com
H0423	001	0	1	01	01	H0423_001_0	6	2009.01	METROPLUS HEALTH PLAN, INC.	MetroPlus Health Plan	www.metroplus.org	01	01		1		H0423	001	0	2009	MetroPlus Medicare Advantage	MetroPlus Medicare Advantage		2	1	3			2			1	2		(800)-303-9626	(800)-303-9626	(800)-881-2812	(800)-881-2812	(800)-303-9626	(800)-303-9626	(800)-881-2812	(800)-881-2812	(800)-303-9626	(800)-303-9626	(800)-881-2812	(800)-881-2812	(800)-303-9626	(800)-303-9626	(800)-881-2812	(800)-881-2812	www.metroplus.org	www.metroplus.org
H0423	002	0	1	01	01	H0423_002_0	8	2009.01	METROPLUS HEALTH PLAN, INC.	MetroPlus Health Plan	www.metroplus.org	01	01		1		H0423	002	0	2009	MetroPlus Partnership in Care Advantage	MetroPlus Partnership in Care Advantage		2	1	4			2			1		0000000000010000000000000000	(800)-303-9626	(800)-303-9626	(800)-881-2812	(800)-881-2812	(800)-303-9626	(800)-303-9626	(800)-881-2812	(800)-881-2812	(800)-303-9626	(800)-303-9626	(800)-881-2812	(800)-881-2812	(800)-303-9626	(800)-303-9626	(800)-881-2812	(800)-881-2812	www.metroplus.org	www.metroplus.org
H0423	003	0	1	01	01	H0423_003_0	6	2009.01	METROPLUS HEALTH PLAN, INC.	MetroPlus Health Plan	www.metroplus.org	01	01		1		H0423	003	0	2009	MetroPlus Advantage Select	MetroPlus Advantage Select		2	1	3			2			1	1		(800)-303-9626	(800)-303-9626	(800)-881-2812	(800)-881-2812	(800)-303-9626	(800)-303-9626	(800)-881-2812	(800)-881-2812	(800)-303-9626	(800)-303-9626	(800)-881-2812	(800)-881-2812	(800)-303-9626	(800)-303-9626	(800)-881-2812	(800)-881-2812	www.metroplus.org	www.metroplus.org
H0427	001	0	1	02	01	H0427_001_0	7	2009.01	CLEAR CHOICE HEALTH PLANS, INC.	Clear Choice Health Plans	www.clearchoicehp.com	01	02		1		H0427	001	0	2009	Big Sky Premier	Western Montana		2	2			24	2						(541)-385-5315	(888)-863-3637	(800)-735-2900		(541)-385-5315	(888)-863-3637	(800)-735-2900		(800)-570-1673	(800)-570-1673	(800)-735-2900		(800)-570-1673	(800)-570-1673	(800)-735-2900		www.clearchoicehp.com/MedicareRxList	www.clearchoicehp.com
H0427	002	0	1	02	01	H0427_002_0	7	2009.01	CLEAR CHOICE HEALTH PLANS, INC.	Clear Choice Health Plans	www.clearchoicehp.com	01	02		1		H0427	002	0	2009	Big Sky Classic	Western Montana		2	2			70	2						(541)-385-5315	(888)-863-3637	(800)-735-2900		(541)-385-5315	(888)-863-3637	(800)-735-2900		(800)-570-1673	(800)-570-1673	(800)-735-2900		(800)-570-1673	(800)-570-1673	(800)-735-2900		www.clearchoicehp.com/MedicareRxList	www.clearchoicehp.com
H0490	001	0	1	01	01	H0490_001_0	6	2009.01	MOLINA HEALTHCARE OF OHIO	Molina Medicare	www.molinamedicare.com	01	01		1		H0490	001	0	2009	Molina Medicare Options	Western and Central Ohio		2	2				2						(800)-642-4168	(888)-665-1328	(800)-346-4128	(800)-346-4128	(800)-642-4168	(866)-403-8293	(800)-346-4128	(800)-346-4128	(800)-642-4168	(888)-665-1328	(800)-346-4128	(800)-346-4128	(800)-642-4168	(866)-403-8293	(800)-346-4128	(800)-346-4128	www.molinahealthcare.com	https://eportal.molinahealthcare.com/eportal/providers/ProviderSearchAdv.aspx
H0490	002	0	1	01	01	H0490_002_0	6	2009.01	MOLINA HEALTHCARE OF OHIO	Molina Medicare	www.molinamedicare.com	01	01		1		H0490	002	0	2009	Molina Medicare Options Select	Western and Central Ohio		2	2				2						(800)-642-4168	(888)-665-1328	(800)-346-4128	(800)-346-4128	(800)-642-4168	(866)-403-8293	(800)-346-4128	(800)-346-4128	(800)-642-4168	(888)-665-1328	(800)-346-4128	(800)-346-4128	(800)-642-4168	(866)-403-8293	(800)-346-4128	(800)-346-4128	www.molinahealthcare.com	https://eportal.molinahealthcare.com/eportal/providers/ProviderSearchAdv.aspx
H0490	003	0	1	01	01	H0490_003_0	6	2009.01	MOLINA HEALTHCARE OF OHIO	Molina Medicare	www.molinamedicare.com	01	01		1		H0490	003	0	2009	Molina Medicare Options One	Western and Central Ohio		2	2				2						(800)-642-4168	(888)-665-1328	(800)-346-4128	(800)-346-4128	(800)-642-4168	(866)-403-8293	(800)-346-4128	(800)-346-4128	(800)-642-4168	(888)-665-1328	(800)-346-4128	(800)-346-4128	(800)-642-4168	(866)-403-8293	(800)-346-4128	(800)-346-4128	www.molinahealthcare.com	https://eportal.molinahealthcare.com/eportal/providers/ProviderSearchAdv.aspx
H0496	801	0	1	09	04	H0496_801_0	4	2009.01	SUMMA INSURANCE COMPANY	SummaCare	www.summacare.com	04	09	2	1		H0496	801	0	2009	SummaCare Secure Private Fee for Service- EGWP	National		1	2			200	2						(330)-996-8885	(800)-996-6250	(800)-750-0750		(330)-996-8440	(888)-464-8440	(800)-750-0750		(300)-996-8885	(800)-996-6250	(800)-750-0750	(800)-750-0750	(800)-996-8440	(888)-464-8440	(800)-750-0750		http://www.summacare.com/media/7919/2185.pdf	
H0496	805	0	1	09	04	H0496_805_0	3	2009.01	SUMMA INSURANCE COMPANY	SummaCare	www.summacare.com	04	09	2	1		H0496	805	0	2009	PFFS- EGWP- Without Part D	National Plan		1	2			54	2						(330)-996-8885	(800)-996-6250	(800)-750-0750		(330)-996-8440	(888)-464-8440	(800)-750-0750										http://www.summacare.com/media/7919/2185.pdf	
H0504	015	0	1	01	01	H0504_015_0	9	2009.01	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com	01	01		1		H0504	015	0	2009	Blue Shield 65 Plus	Los Angeles (Partial)/Orange Counties		2	2				2						(800)-776-4466	(800)-776-4466	(800)-794-1099	(800)-794-1099	(800)-488-8000	(800)-488-8000	(888)-595-0000	(888)-595-0000	(800)-776-4466	(800)-776-4466	(800)-794-1099	(800)-794-1099	(800)-488-8000	(800)-488-8000	(888)-595-0000	(888)-595-0000	https://www.blueshieldca.com/medicarepartdplans/formulary/	www.blueshieldca.com
H0504	017	0	1	01	01	H0504_017_0	8	2009.01	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com	01	01		1		H0504	017	0	2009	Blue Shield 65 Plus	Riverside/San Bernardino Counties (Partial)		2	2				2						(800)-776-4466	(800)-776-4466	(800)-794-1099	(800)-794-1099	(800)-488-8000	(800)-488-8000	(888)-595-0000	(888)-595-0000	(800)-776-4466	(800)-776-4466	(800)-794-1099	(800)-794-1099	(800)-488-8000	(800)-488-8000	(888)-595-0000	(888)-595-0000	https://www.blueshieldca.com/medicarepartdplans/formulary/	www.blueshieldca.com
H0504	021	0	1	01	01	H0504_021_0	8	2009.01	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com	01	01		1		H0504	021	0	2009	Blue Shield 65 Plus Choice Plan	Los Angeles/Orange Counties (Partial) Choice Plan		2	2				2						(800)-776-4466	(800)-776-4466	(800)-794-1099	(800)-794-1099	(800)-488-8000	(800)-488-8000	(888)-595-0000	(888)-595-0000	(800)-776-4466	(800)-776-4466	(800)-794-1099	(800)-794-1099	(800)-488-8000	(800)-488-8000	(888)-595-0000	(888)-595-0000	https://www.blueshieldca.com/medicarepartdplans/formulary/	www.blueshieldca.com
H0504	801	0	1	01	01	H0504_801_0	6	2009.01	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com	01	01		1		H0504	801	0	2009	Blue Shield 65 Plus	MA-Only Employer Group Plan		1	2				2						(800)-776-4466	(800)-776-4466	(800)-794-1099	(800)-794-1099	(800)-488-8000	(800)-488-8000	(888)-595-0000	(888)-595-0000									https://www.blueshieldca.com/medicarepartdplans/formulary/	www.blueshieldca.com
H0504	803	0	1	01	01	H0504_803_0	7	2009.01	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com	01	01		1		H0504	803	0	2009	Blue Shield 65 Plus	MA-PD Employer Group Plan		1	2				2						(800)-776-4466	(800)-776-4466	(800)-794-1099	(800)-794-1099	(800)-488-8000	(800)-488-8000	(888)-595-0000	(888)-595-0000	(800)-776-4466	(800)-776-4466	(800)-794-1099	(800)-794-1099	(800)-488-8000	(800)-488-8000	(888)-595-0000	(888)-595-0000	https://www.blueshieldca.com/medicarepartdplans/formulary/	www.blueshieldca.com
H0504	804	0	1	01	01	H0504_804_0	7	2009.01	CALIFORNIA PHYSICIANS' SERVICE	Blue Shield of California	www.blueshieldca.com	01	01		1		H0504	804	0	2009	Blue Shield 65 Plus	MA-PD Employer Group Plan		1	2				2						(800)-776-4466	(800)-776-4466	(800)-794-1099	(800)-794-1099	(800)-488-8000	(800)-488-8000	(888)-595-0000	(888)-595-0000	(800)-776-4466	(800)-776-4466	(800)-794-1099	(800)-794-1099	(800)-488-8000	(800)-488-8000	(888)-595-0000	(888)-595-0000	https://www.blueshieldca.com/medicarepartdplans/formulary/	www.blueshieldca.com
H0523	002	0	1	01	01	H0523_002_0	6	2009.01	AETNA HEALTH OF CALIFORNIA,INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H0523	002	0	2009	Aetna Golden Medicare Select Plan	Los Angeles, Orange and Ventura Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0523	022	0	1	01	01	H0523_022_0	7	2009.01	AETNA HEALTH OF CALIFORNIA,INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H0523	022	0	2009	Aetna Golden Medicare Select Plan	Riverside and San Bernardino Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0523	031	0	1	01	01	H0523_031_0	5	2009.01	AETNA HEALTH OF CALIFORNIA,INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H0523	031	0	2009	Aetna Golden Medicare Select Plan	Kern County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0523	032	0	1	01	01	H0523_032_0	5	2009.01	AETNA HEALTH OF CALIFORNIA,INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H0523	032	0	2009	Aetna Golden Medicare Select Plan	Fresno County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0523	034	0	1	01	01	H0523_034_0	4	2009.01	AETNA HEALTH OF CALIFORNIA,INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H0523	034	0	2009	Aetna Golden Medicare Premier Plan	Fresno County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0523	047	0	1	01	01	H0523_047_0	7	2009.01	AETNA HEALTH OF CALIFORNIA,INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H0523	047	0	2009	Aetna Golden Medicare Premier Plan	Riverside and San Bernardino Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0523	048	0	1	01	01	H0523_048_0	6	2009.01	AETNA HEALTH OF CALIFORNIA,INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H0523	048	0	2009	Aetna Golden Medicare Premier Plan	Los Angeles, Orange, Ventura Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0523	051	0	1	01	01	H0523_051_0	5	2009.01	AETNA HEALTH OF CALIFORNIA,INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H0523	051	0	2009	Aetna Golden Medicare Premier Plan	Kern County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0523	801	0	1	01	01	H0523_801_0	3	2009.01	AETNA HEALTH OF CALIFORNIA,INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H0523	801	0	2009	Aetna Golden Medicare Plan	Fresno/Kern/LA/Orange/Riverside/San Bern,/Ventura		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0523	805	0	1	01	01	H0523_805_0	3	2009.01	AETNA HEALTH OF CALIFORNIA,INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H0523	805	0	2009	Aetna Golden Medicare Plan w/Rx CY	Fresno/Kern/LA/Orange/Riverside/San Bern,/Ventura		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0524	002	0	2	01	01	H0524_002_0	6	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		2		H0524	002	0	2009	Kaiser Permanente Senior Advantage	Part B Only Southern California Area		2	2				2		1				(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370		(800)-443-0815	(800)-443-0815	(800)-777-1370		(877)-473-9147	(877)-473-9147	(800)-777-1370		www.kp.org/seniorrx	www.kp.org
H0524	003	0	1	01	01	H0524_003_0	7	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		1		H0524	003	0	2009	Kaiser Permanente Senior Advantage	Los Angeles and Orange Counties Plan		2	2				2						(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370		(800)-443-0815	(800)-443-0815	(800)-777-1370		(877)-473-9147	(877)-473-9147	(800)-777-1370		www.kp.org/seniorrx	www.kp.org
H0524	008	0	1	01	01	H0524_008_0	9	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		1		H0524	008	0	2009	Kaiser Permanente Senior Advantage	Central Valley and SClara and Solano Counties Plan		2	2				2						(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370		(800)-443-0815	(800)-443-0815	(800)-777-1370		(877)-473-9147	(877)-473-9147	(800)-777-1370		www.kp.org/seniorrx	www.kp.org
H0524	010	0	2	01	01	H0524_010_0	5	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		2		H0524	010	0	2009	Kaiser Permanente Senior Advantage	Part B Only Northern California Area		2	2				2		1				(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370		(800)-443-0815	(800)-443-0815	(800)-777-1370		(877)-473-9147	(877)-473-9147	(800)-777-1370		www.kp.org/seniorrx	www.kp.org
H0524	013	0	1	01	01	H0524_013_0	5	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		1		H0524	013	0	2009	Kaiser Permanente Senior Advantage	Greater Sacramento and Sonoma County Plan		2	2				2						(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370		(800)-443-0815	(800)-443-0815	(800)-777-1370		(877)-473-9147	(877)-473-9147	(800)-777-1370		www.kp.org/seniorrx	www.kp.org
H0524	015	0	1	01	01	H0524_015_0	5	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		1		H0524	015	0	2009	Kaiser Permanente Senior Advantage	Inland Empire and San Diego County Plan		2	2				2						(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370		(800)-443-0815	(800)-443-0815	(800)-777-1370		(877)-473-9147	(877)-473-9147	(800)-777-1370		www.kp.org/seniorrx	www.kp.org
H0524	029	0	1	01	01	H0524_029_0	5	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		1		H0524	029	0	2009	Senior Advantage Medicare Medi-Cal Plan	Southern California Plan		2	1	3			2			2	3		(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370		(800)-443-0815	(800)-443-0815	(800)-777-1370		(877)-473-9147	(877)-473-9147	(800)-777-1370		www.kp.org/seniorrx	www.kp.org
H0524	030	0	1	01	01	H0524_030_0	5	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		1		H0524	030	0	2009	Senior Advantage Medicare Medi-Cal Plan	Northern California Plan		2	1	3			2			2	3		(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370		(800)-443-0815	(800)-443-0815	(800)-777-1370		(877)-473-9147	(877)-473-9147	(800)-777-1370		www.kp.org/seniorrx	www.kp.org
H0524	031	0	1	01	01	H0524_031_0	5	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		1		H0524	031	0	2009	Kaiser Permanente Senior Advantage	Marin and San Mateo Counties Plan		2	2				2						(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370		(800)-443-0815	(800)-443-0815	(800)-777-1370		(877)-473-9147	(877)-473-9147	(800)-777-1370		www.kp.org/seniorrx	www.kp.org
H0524	032	0	1	01	01	H0524_032_0	5	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		1		H0524	032	0	2009	Kaiser Permanente Senior Advantage	Alameda, Napa, SF Counties and Greater Fresno Plan		2	2				2						(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370		(800)-443-0815	(800)-443-0815	(800)-777-1370		(877)-473-9147	(877)-473-9147	(800)-777-1370		www.kp.org/seniorrx	www.kp.org
H0524	033	0	1	01	01	H0524_033_0	5	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		1		H0524	033	0	2009	Kaiser Permanente Senior Advantage	Contra Costa County Plan		2	2				2						(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370		(800)-443-0815	(800)-443-0815	(800)-777-1370		(877)-473-9147	(877)-473-9147	(800)-777-1370		www.kp.org/seniorrx	www.kp.org
H0524	034	0	1	01	01	H0524_034_0	6	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		1		H0524	034	0	2009	Kaiser Permanente Senior Advantage	Ventura County Plan		2	2				2						(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370		(800)-443-0815	(800)-443-0815	(800)-777-1370		(877)-473-9147	(877)-473-9147	(800)-777-1370		www.kp.org/seniorrx	www.kp.org
H0524	035	0	1	01	01	H0524_035_0	5	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		1		H0524	035	0	2009	Kaiser Permanente Senior Advantage	Kern County Plan		2	2				2						(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370		(800)-443-0815	(800)-443-0815	(800)-777-1370		(877)-473-9147	(877)-473-9147	(800)-777-1370		www.kp.org/seniorrx	www.kp.org
H0524	801	0	1	01	01	H0524_801_0	6	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		1		H0524	801	0	2009	Kaiser Permanente Senior Advantage	Southern California Group Part A B		1	2				2						(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370										www.kp.org/seniorrx	www.kp.org
H0524	802	0	1	01	01	H0524_802_0	6	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		1		H0524	802	0	2009	Kaiser Permanente Senior Advantage	Northern California Group Part A B		1	2				2						(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370										www.kp.org/seniorrx	www.kp.org
H0524	803	0	2	01	01	H0524_803_0	6	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		2		H0524	803	0	2009	Kaiser Permanente Senior Advantage	Southern California Group B Only		1	2				2		1				(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370										www.kp.org/seniorrx	www.kp.org
H0524	804	0	2	01	01	H0524_804_0	6	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		2		H0524	804	0	2009	Kaiser Permanente Senior Advantage	Northern California Group B Only		1	2				2		1				(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370										www.kp.org/seniorrx	www.kp.org
H0524	805	0	1	01	01	H0524_805_0	6	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		1		H0524	805	0	2009	Kaiser Permanente Senior Advantage	Southern California Group Part A B Part D		1	2				2						(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370		(800)-443-0815	(800)-443-0815	(800)-777-1370		(877)-473-9147	(877)-473-9147	(800)-777-1370		www.kp.org/seniorrx	www.kp.org
H0524	806	0	1	01	01	H0524_806_0	6	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		1		H0524	806	0	2009	Kaiser Permanente Senior Advantage	Northern California Group Part A B Part D		1	2				2						(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370		(800)-443-0815	(800)-443-0815	(800)-777-1370		(877)-473-9147	(877)-473-9147	(800)-777-1370		www.kp.org/seniorrx	www.kp.org
H0524	807	0	2	01	01	H0524_807_0	6	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		2		H0524	807	0	2009	Kaiser Permanente Senior Advantage	Southern California Group Part B only  Part D		1	2				2		1				(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370		(800)-443-0815	(800)-443-0815	(800)-777-1370		(877)-473-9147	(877)-473-9147	(800)-777-1370		www.kp.org/seniorrx	www.kp.org
H0524	808	0	2	01	01	H0524_808_0	6	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		2		H0524	808	0	2009	Kaiser Permanente Senior Advantage	Northern California Group Part B only  Part D		1	2				2		1				(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370		(800)-443-0815	(800)-443-0815	(800)-777-1370		(877)-473-9147	(877)-473-9147	(800)-777-1370		www.kp.org/seniorrx	www.kp.org
H0524	809	0	1	01	01	H0524_809_0	6	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		1		H0524	809	0	2009	FEHB Part AB with D	Southern California Plan		1	2				2						(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370		(800)-443-0815	(800)-443-0815	(800)-777-1370		(877)-473-9147	(877)-473-9147	(800)-777-1370		www.kp.org/seniorrx	www.kp.org
H0524	810	0	1	01	01	H0524_810_0	6	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		1		H0524	810	0	2009	FEHB Part AB with D	Northern California Plan		1	2				2						(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370		(800)-443-0815	(800)-443-0815	(800)-777-1370		(877)-473-9147	(877)-473-9147	(800)-777-1370		www.kp.org/seniorrx	www.kp.org
H0524	811	0	2	01	01	H0524_811_0	6	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		2		H0524	811	0	2009	FEHB Part B Only with D	Southern California Plan		1	2				2		1				(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370		(800)-443-0815	(800)-443-0815	(800)-777-1370		(877)-473-9147	(877)-473-9147	(800)-777-1370		www.kp.org/seniorrx	www.kp.org
H0524	812	0	2	01	01	H0524_812_0	6	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Permanente	www.kp.org	01	01		2		H0524	812	0	2009	FEHB Part B Only with D	Northern California Plan		1	2				2		1				(800)-443-0815		(800)-777-1370		(800)-777-1238		(800)-777-1370		(800)-443-0815	(800)-443-0815	(800)-777-1370		(877)-473-9147	(877)-473-9147	(800)-777-1370		www.kp.org/seniorrx	www.kp.org
H0532	001	0	1	01	01	H0532_001_0	8	2009.01	WESTERN HEALTH ADVANTAGE	Western Health Advantage	www.westernhealth.com	01	01		1		H0532	001	0	2009	WHA Care+ Plan	Placer, Sacramento and Yolo Counties		2	2			1000	2						(916)-563-2250	(888)-563-2250	(888)-877-5378		(916)-563-2250	(888)-563-2250	(888)-877-5378		(916)-563-2250	(888)-563-2250	(888)-877-5378		(916)-563-2250	(888)-563-2250	(888)-877-5378		www.westernhealth.com/careplus/	http://www.westernhealth.com/careplus
H0532	801	0	1	01	01	H0532_801_0	5	2009.01	WESTERN HEALTH ADVANTAGE	Western Health Advantage	www.westernhealth.com	01	01		1		H0532	801	0	2009	Employer Group MA-PD Plan	Placer, Sacramento and Yolo Counties		1	2			250	2						(916)-563-2250	(888)-563-2250	(888)-877-5378		(916)-563-2250	(888)-563-2250	(888)-877-5378		(916)-563-2250	(888)-563-2250	(888)-877-5378		(916)-563-2250	(888)-563-2250	(888)-877-5378		www.westernhealth.com/careplus/	http://www.westernhealth.com/careplus
H0532	802	0	1	01	01	H0532_802_0	5	2009.01	WESTERN HEALTH ADVANTAGE	Western Health Advantage	www.westernhealth.com	01	01		1		H0532	802	0	2009	Employer Group MA Only Plan	Placer, Sacramento and Yolo Counties		1	2			0	2						(916)-563-2250	(888)-563-2250	(888)-877-5378		(916)-563-2250	(888)-563-2250	(888)-877-5378										www.westernhealth.com/careplus/	http://www.westernhealth.com/careplus
H0540	001	0	1	09	04	H0540_001_0	7	2009.01	UNICARE LIFE AND HEALTH INS. COMPANY	Unicare Life  Health Ins. Company	www.unicare.com	04	09	2	1		H0540	001	0	2009	SecurityChoice Classic	SecurityChoice - Selected States		2	2			66573	2						(888)-445-8916	(888)-445-8916	(800)-425-5705		(888)-949-5384	(888)-949-5384	(800)-297-1538	(800)-297-1538									http://www.medicarerxrewards.com	
H0540	020	0	1	09	04	H0540_020_0	7	2009.01	UNICARE LIFE AND HEALTH INS. COMPANY	Unicare Life  Health Ins. Company	www.unicare.com	04	09	2	1		H0540	020	0	2009	SecurityChoice Plus	SecurityChoice Selected States and Counties		2	2			20020	2						(888)-445-8916	(888)-445-8916	(800)-425-5705		(888)-949-5384	(888)-949-5384	(800)-297-1538	(800)-297-1538	(888)-445-8916	(888)-445-8916	(800)-425-5705		(888)-949-5384	(888)-949-5384	(800)-297-1538	(800)-297-1538	http://www.medicarerxrewards.com	
H0540	088	0	1	09	04	H0540_088_0	7	2009.01	UNICARE LIFE AND HEALTH INS. COMPANY	Unicare Life  Health Ins. Company	www.unicare.com	04	09	2	1		H0540	088	0	2009	SecurityChoice Essential	Nationwide, Select Counties		2	2			1632	2						(888)-445-8916	(888)-445-8916	(800)-425-5705		(888)-949-5384	(888)-949-5384	(800)-297-1538	(800)-297-1538									http://www.medicarerxrewards.com	
H0540	089	0	1	09	04	H0540_089_0	9	2009.01	UNICARE LIFE AND HEALTH INS. COMPANY	Unicare Life  Health Ins. Company	www.unicare.com	04	09	2	1		H0540	089	0	2009	SecurityChoice Essential Plus	Nationwide, Select Counties		2	2			773	2						(888)-445-8916	(888)-445-8916	(800)-425-5705		(888)-949-5384	(888)-949-5384	(800)-297-1538	(800)-297-1538	(888)-445-8916	(888)-445-8916	(800)-425-5705		(888)-949-5384	(888)-949-5384	(800)-297-1538	(800)-297-1538	http://www.medicarerxrewards.com	
H0540	090	0	1	09	04	H0540_090_0	6	2009.01	UNICARE LIFE AND HEALTH INS. COMPANY	Unicare Life  Health Ins. Company	www.unicare.com	04	09	2	1		H0540	090	0	2009	SmartValue Classic	Select Counties- WI, GA, ME, CO		2	2			32111	2						(888)-445-8916	(888)-445-8916	(800)-425-5705		(888)-949-5384	(888)-949-5384	(800)-297-1538	(800)-297-1538									http://www.medicarerxrewards.com	
H0540	091	0	1	09	04	H0540_091_0	7	2009.01	UNICARE LIFE AND HEALTH INS. COMPANY	Unicare Life  Health Ins. Company	www.unicare.com	04	09	2	1		H0540	091	0	2009	SmartValue Plus	Select Counties in WI, GA, ME, CO		2	2			10787	2						(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(888)-949-5384	(888)-949-5384	(800)-297-1538	(800)-297-1538	(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538	http://www.medicarerxrewards.com	
H0540	807	0	1	09	04	H0540_807_0	4	2009.01	UNICARE LIFE AND HEALTH INS. COMPANY	Unicare Life  Health Ins. Company	www.unicare.com	04	09	2	1		H0540	807	0	2009	SecurityChoice Group Plan I	Nationwide Group Coverage		1	2			4071	2						(888)-445-8916	(888)-445-8916	(800)-425-5705		(888)-949-5384	(888)-949-5384	(800)-297-1538	(800)-297-1538	(888)-445-8916	(888)-445-8916	(800)-425-5705		(888)-949-5384	(888)-949-5384	(800)-297-1538	(800)-297-1538	http://www.medicarerxrewards.com	
H0540	808	0	1	09	04	H0540_808_0	4	2009.01	UNICARE LIFE AND HEALTH INS. COMPANY	Unicare Life  Health Ins. Company	www.unicare.com	04	09	2	1		H0540	808	0	2009	SecurityChoice Group Plan II	Nationwide Group Coverage		1	2			4071	2						(888)-445-8916	(888)-445-8916	(800)-425-5705		(888)-949-5384	(888)-949-5384	(800)-297-1538	(800)-297-1538									http://www.medicarerxrewards.com	
H0540	814	0	1	09	04	H0540_814_0	4	2009.01	UNICARE LIFE AND HEALTH INS. COMPANY	Unicare Life  Health Ins. Company	www.unicare.com	04	09	2	1		H0540	814	0	2009	SecurityChoice Group Plan III	Nationwide Group Coverage		1	2			4071	2						(888)-445-8916	(888)-445-8916	(800)-425-5705		(888)-949-5384	(888)-949-5384	(800)-297-1538	(800)-297-1538	(888)-445-8916	(888)-445-8916	(800)-425-5705		(888)-949-5384	(888)-949-5384	(800)-297-1538	(800)-297-1538	http://www.medicarerxrewards.com	
H0542	001	0	1	20	08	H0542_001_0	1	2009.01	ALTAMED HEALTH SERVICES CORPORATION	AltaMed Senior BuenaCare	www.altamed.org	08	20		1		H0542	001	0	2009	AltaMed Senior BuenaCare	Los Angeles County		2	2				2														(323)-728-0411	(877)-462-2582		(800)-735-2922	(323)-728-0411	(877)-462-2582		(800)-735-2922	http://www.altamed.org/	
H0542	002	0	1	20	08	H0542_002_0	1	2009.01	ALTAMED HEALTH SERVICES CORPORATION	AltaMed Senior BuenaCare	www.altamed.org	08	20		1		H0542	002	0	2009	AltaMed Senior BuenaCare	Los Angeles County		2	2				2														(323)-728-0411	(877)-462-2582		(800)-735-2922	(323)-728-0411	(877)-462-2582		(800)-735-2922	http://www.altamed.org/	
H0543	001	0	1	01	01	H0543_001_0	8	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	001	0	2009	AARP MedicareComplete Plan 1	Los Angeles County		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	004	0	1	01	01	H0543_004_0	7	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	004	0	2009	AARP MedicareComplete Plan 1	Orange County		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	007	0	1	01	01	H0543_007_0	4	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	007	0	2009	AARP MedicareComplete Plan 1	Riverside, San Bernadino		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	013	0	1	01	01	H0543_013_0	5	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	013	0	2009	AARP MedicareComplete Plan 1	San Diego		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	019	0	1	01	01	H0543_019_0	5	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	019	0	2009	AARP MedicareComplete	Kern		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	022	0	1	01	01	H0543_022_0	4	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	022	0	2009	AARP MedicareComplete	Ventura		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	028	0	1	01	01	H0543_028_0	5	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	028	0	2009	AARP MedicareComplete	San Mateo		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	029	0	1	01	01	H0543_029_0	3	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	029	0	2009	AARP MedicareComplete	Santa Clara		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	032	0	1	01	01	H0543_032_0	5	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	032	0	2009	AARP MedicareComplete	Santa Barbara		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	035	0	1	01	01	H0543_035_0	4	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	035	0	2009	AARP MedicareComplete Plan 1	Fresno and Madera		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	036	0	1	01	01	H0543_036_0	5	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	036	0	2009	AARP MedicareComplete	Stanislaus County		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	046	0	1	01	01	H0543_046_0	4	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	046	0	2009	AARP MedicareComplete	Santa Cruz County		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	049	0	1	01	01	H0543_049_0	4	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	049	0	2009	AARP MedicareComplete	San Luis Obispo		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	060	0	1	01	01	H0543_060_0	3	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	060	0	2009	AARP MedicareComplete Plan 3	San Diego		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	065	0	1	01	01	H0543_065_0	4	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	065	0	2009	AARP MedicareComplete Plan 2	Los Angeles		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	070	0	1	01	01	H0543_070_0	3	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	070	0	2009	AARP MedicareComplete	Alameda		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	072	0	1	01	01	H0543_072_0	3	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	072	0	2009	AARP MedicareComplete	Contra Costa		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	077	0	1	01	01	H0543_077_0	6	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	077	0	2009	AARP MedicareComplete Value	Los Angeles		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	078	0	1	01	01	H0543_078_0	7	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	078	0	2009	Evercare Plan DH	Los Angeles County		2	1	3			2			2	2		(866)-846-2762	(866)-846-2762	(888)-685-8480	(888)-685-8480	(888)-834-3721	(888)-834-3721	(800)-387-1074	(800)-387-1074	(866)-846-2762	(866)-846-2762	(888)-685-8480	(888)-685-8480	(888)-834-3721	(888)-834-3721	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	079	0	1	01	01	H0543_079_0	7	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	079	0	2009	Evercare Plan DH	Orange County		2	1	3			2			2	2		(866)-846-2762	(866)-846-2762	(888)-685-8480	(888)-685-8480	(888)-834-3721	(888)-834-3721	(800)-387-1074	(800)-387-1074	(866)-846-2762	(866)-846-2762	(888)-685-8480	(888)-685-8480	(888)-834-3721	(888)-834-3721	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	081	0	1	01	01	H0543_081_0	7	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	081	0	2009	Evercare Plan DH	Riverside and San Bernardino Counties		2	1	3			2			2	2		(866)-846-2762	(866)-846-2762	(888)-685-8480	(888)-685-8480	(888)-834-3721	(888)-834-3721	(800)-387-1074	(800)-387-1074	(866)-846-2762	(866)-846-2762	(888)-685-8480	(888)-685-8480	(888)-834-3721	(888)-834-3721	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	082	0	1	01	01	H0543_082_0	6	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	082	0	2009	AARP MedicareComplete	Nevada		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	083	0	1	01	01	H0543_083_0	5	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	083	0	2009	AARP MedicareComplete Premier	San Diego		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	084	0	1	01	01	H0543_084_0	5	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	084	0	2009	AARP MedicareComplete Premier	Orange		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	085	0	1	01	01	H0543_085_0	5	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	085	0	2009	AARP MedicareComplete	San Francisco		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	086	0	1	01	01	H0543_086_0	4	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	086	0	2009	AARP MedicareComplete	Sonoma		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	089	0	1	01	01	H0543_089_0	3	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	089	0	2009	AARP MedicareComplete	Sacramento		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	091	0	1	01	01	H0543_091_0	5	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	091	0	2009	AARP MedicareComplete	Placer		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	093	0	1	01	01	H0543_093_0	4	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	093	0	2009	AARP MedicareComplete	Yolo		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	095	0	1	01	01	H0543_095_0	5	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	095	0	2009	AARP MedicareComplete Value	Orange, Amador and El Dorado Counties		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	114	0	1	01	01	H0543_114_0	3	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	114	0	2009	AARP MedicareComplete Essential	California Counties		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671									www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	121	0	1	01	01	H0543_121_0	4	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	121	0	2009	AARP MedicareComplete Essential	Kern,L.A.,L.An.,Orange,RiversideSan Bern,San Diego		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671									www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	122	0	1	01	01	H0543_122_0	5	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	122	0	2009	AARP MedicareComplete Value	San Diego		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	125	0	1	01	01	H0543_125_0	7	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	125	0	2009	AARP MedicareComplete Plan 3	Fresno and Madera		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	126	0	1	01	01	H0543_126_0	6	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	126	0	2009	AARP MedicareComplete	San Jorcquin		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	127	0	1	01	01	H0543_127_0	4	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	127	0	2009	AARP MedicareComplete Plan 3	Riverside		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	128	0	1	01	01	H0543_128_0	6	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	128	0	2009	AARP MedicareComplete Plan 3	San Bernadino		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	129	0	1	01	01	H0543_129_0	5	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	129	0	2009	AARP MedicareComplete Plan 3	Los Angeles, Los Angeles		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	130	0	1	01	01	H0543_130_0	6	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	130	0	2009	Evercare Plan DH	San Francisco, Alameda, and Contra Costa Counties		2	1	3			2			2	2		(866)-846-2762	(866)-846-2762	(888)-685-8480	(888)-685-8480	(888)-834-3721	(888)-834-3721	(800)-387-1074	(800)-387-1074	(866)-846-2762	(866)-846-2762	(888)-685-8480	(888)-685-8480	(888)-834-3721	(888)-834-3721	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	131	0	1	01	01	H0543_131_0	6	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	131	0	2009	Evercare Plan IH	San Francisco, Alameda, and Contra Costa Counties		2	1	1	1		2			1			(866)-846-2762	(866)-846-2762	(888)-685-8480	(888)-685-8480	(888)-834-3721	(888)-834-3721	(800)-387-1074	(800)-387-1074	(866)-846-2762	(866)-846-2762	(888)-685-8480	(888)-685-8480	(888)-834-3721	(888)-834-3721	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	133	0	1	01	01	H0543_133_0	7	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	133	0	2009	Evercare Plan MH	Los Angeles		2	1	4			2			2		1111111110000000100000000001	(866)-846-2762	(866)-846-2762	(888)-685-8480	(888)-685-8480	(888)-834-3721	(888)-834-3721	(800)-387-1074	(800)-387-1074	(866)-846-2762	(866)-846-2762	(888)-685-8480	(888)-685-8480	(888)-834-3721	(888)-834-3721	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	134	0	1	01	01	H0543_134_0	6	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	134	0	2009	Evercare Plan MH	Orange County		2	1	4			2			2		1111111110000000100000000001	(866)-846-2762	(866)-846-2762	(888)-685-8480	(888)-685-8480	(888)-834-3721	(888)-834-3721	(800)-387-1074	(800)-387-1074	(866)-846-2762	(866)-846-2762	(888)-685-8480	(888)-685-8480	(888)-834-3721	(888)-834-3721	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	135	0	1	01	01	H0543_135_0	6	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	135	0	2009	Evercare Plan MH	Riverside and San Bernardino Counties		2	1	4			2			2		1111111110000000100000000001	(866)-846-2762	(866)-846-2762	(888)-685-8480	(888)-685-8480	(888)-834-3721	(888)-834-3721	(800)-387-1074	(800)-387-1074	(866)-846-2762	(866)-846-2762	(888)-685-8480	(888)-685-8480	(888)-834-3721	(888)-834-3721	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	136	0	1	01	01	H0543_136_0	6	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	136	0	2009	Evercare Plan MH	Alameda, Contra Costa, San Francisco counties		2	1	4			2			2		1111111110000000100000000001	(866)-846-2762	(866)-846-2762	(888)-685-8480	(888)-685-8480	(888)-834-3721	(888)-834-3721	(800)-387-1074	(800)-387-1074	(866)-846-2762	(866)-846-2762	(888)-685-8480	(888)-685-8480	(888)-834-3721	(888)-834-3721	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	137	0	1	01	01	H0543_137_0	7	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	137	0	2009	Evercare Plan MH-S	San Diego		2	1	4			2			2		1111111110000000100000000001	(866)-846-2762	(866)-846-2762	(888)-685-8480	(888)-685-8480	(888)-834-3721	(888)-834-3721	(800)-387-1074	(800)-387-1074	(866)-846-2762	(866)-846-2762	(888)-685-8480	(888)-685-8480	(888)-834-3721	(888)-834-3721	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	138	0	1	01	01	H0543_138_0	6	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	138	0	2009	AARP MedicareComplete Plan 2	Orange		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	139	0	1	01	01	H0543_139_0	7	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	139	0	2009	Evercare Plan MH	San Diego		2	1	4			2			2		1111111110000000100000000001	(866)-846-2762	(866)-846-2762	(888)-685-8480	(888)-685-8480	(888)-834-3721	(888)-834-3721	(800)-387-1074		(866)-846-2762	(866)-846-2762	(888)-685-8480	(888)-685-8480	(888)-834-3721	(888)-834-3721	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	140	0	1	01	01	H0543_140_0	6	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	140	0	2009	AARP MedicareComplete	Amador, El Dorado, Mendocino,Merced,Shasta,Tulare		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	802	0	1	01	01	H0543_802_0	3	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	802	0	2009	MedicareComplete Retiree Plan	CA Employer Sponsored Plan Service Area		1	2				2						(800)-228-2144	(800)-228-2144	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074									www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	804	0	1	01	01	H0543_804_0	3	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	804	0	2009	MedicareComplete Retiree Plan	CA Employer Sponsored Plan Service Area		1	2				2						(800)-228-2144	(800)-228-2144	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074									www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	805	0	1	01	01	H0543_805_0	2	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	805	0	2009	MedicareComplete Retiree Plan	CA Employer Sponsored Plan Service Area		1	2				2						(800)-228-2144	(800)-228-2144	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	(800)-228-2144	(800)-228-2144	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0543	806	0	1	01	01	H0543_806_0	2	2009.01	PACIFICARE OF CALIFORNIA/SECURE HORIZONS	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H0543	806	0	2009	MedicareComplete Retiree Plan	CA Employer Sponsored Plan Service Area		1	2				2						(800)-228-2144	(800)-228-2144	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	(800)-228-2144	(800)-228-2144	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0544	002	0	1	01	01	H0544_002_0	9	2009.01	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremorehealthplan.com	01	01		1		H0544	002	0	2009	CareMore Value Plus	Los Angeles and Orange Counties (partial)		2	2				2						(800)-822-6991	(800)-822-6991	(800)-577-5586	(800)-577-5586	(866)-622-2820	(866)-622-2820	(800)-577-5586		(800)-822-6991	(800)-822-6991	(800)-577-5586		(866)-622-2820	(866)-622-2820	(800)-577-5586		www.caremorehealthplan.com/formulary.aspx	www.caremorehealthplan.com
H0544	003	0	1	01	01	H0544_003_0	8	2009.01	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremorehealthplan.com	01	01		1		H0544	003	0	2009	CareMore Connect	Los Angeles and Orange Counties (partial)		2	1	3			2			1	2		(800)-589-3146	(800)-589-3146	(800)-577-5586		(866)-622-2820	(866)-622-2820	(800)-577-5586		(800)-589-3146	(800)-589-3146	(800)-577-5586		(866)-622-2820	(866)-622-2820	(800)-577-5586		www.caremorehealthplan.com/formulary.aspx	www.caremorehealthplan.com
H0544	004	0	1	01	01	H0544_004_0	9	2009.01	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremorehealthplan.com	01	01		1		H0544	004	0	2009	CareMore Reliance	Los Angeles and Orange Counties (partial)		2	1	4			2			1		1110001010000000000000001101	(800)-589-3145	(800)-589-3145	(800)-577-5586		(866)-622-2820	(866)-622-2820	(800)-577-5586		(800)-589-3145	(800)-589-3145	(800)-577-5586		(866)-622-2820	(866)-622-2820	(800)-577-5586		www.caremorehealthplan.com/formulary.aspx	www.caremorehealthplan.com
H0544	005	0	1	01	01	H0544_005_0	9	2009.01	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremorehealthplan.com	01	01		1		H0544	005	0	2009	CareMore Touch	Los Angeles and Orange Counties (partial)		2	1	1	1		2			1			(800)-589-3147	(800)-589-3147	(800)-577-5586		(866)-622-2820	(866)-622-2820	(800)-577-5586		(800)-589-3147	(800)-589-3147	(800)-577-5586		(866)-622-2820	(866)-622-2820	(800)-577-5586		www.caremorehealthplan.com/formulary.aspx	www.caremorehealthplan.com
H0544	007	0	1	01	01	H0544_007_0	8	2009.01	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremorehealthplan.com	01	01		1		H0544	007	0	2009	StartSmart offered by CareMore	Los Angeles and Orange Counties (partial)		2	2				2						(800)-822-8720	(800)-822-8720	(800)-577-5586		(866)-622-2820	(866)-622-2820	(800)-577-5586		(800)-822-8720	(800)-822-8720	(800)-577-5586		(866)-622-2820	(866)-622-2820	(800)-577-5586		www.caremorehealthplan.com/formulary.aspx	www.caremorehealthplan.com
H0544	008	0	1	01	01	H0544_008_0	6	2009.01	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremorehealthplan.com	01	01		1		H0544	008	0	2009	CareMore Value Plus	San Bernardino County (partial)		2	2				2						(800)-822-6991	(800)-822-6991	(800)-577-5586		(866)-622-2820	(866)-622-2820	(800)-577-5586		(800)-822-6991	(800)-822-6991	(800)-577-5586		(866)-622-2820	(866)-622-2820	(800)-577-5586		www.caremorehealthplan.com/formulary.aspx	www.caremorehealthplan.com
H0544	009	0	1	01	01	H0544_009_0	7	2009.01	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremorehealthplan.com	01	01		1		H0544	009	0	2009	CareMore Connect	San Bernardino County (partial)		2	1	3			2			1	2		(800)-589-3146	(800)-589-3146	(800)-577-5586		(866)-622-2820	(866)-622-2820	(800)-577-5586		(800)-589-3146	(800)-589-3146	(800)-577-5586		(866)-622-2820	(866)-622-2820	(800)-577-5586		www.caremorehealthplan.com/formulary.aspx	www.caremorehealthplan.com
H0544	010	0	1	01	01	H0544_010_0	8	2009.01	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremorehealthplan.com	01	01		1		H0544	010	0	2009	CareMore Reliance	San Bernardino County (partial)		2	1	4			2			1		1110001010000000000000001101	(800)-589-3145	(800)-589-3145	(800)-577-5586		(866)-622-2820	(866)-622-2820	(800)-577-5586		(800)-589-3145	(800)-589-3145	(800)-577-5586		(866)-622-2820	(866)-622-2820	(800)-577-5586		www.caremorehealthplan.com/formulary.aspx	www.caremorehealthplan.com
H0544	012	0	1	01	01	H0544_012_0	8	2009.01	CAREMORE HEALTH PLAN	CareMore Health Plan	http://www.caremorehealthplan.com	01	01		1		H0544	012	0	2009	CareMore Value Plus	Santa Clara County (partial)		2	2				2						(800)-822-6991	(800)-822-6991	(800)-577-5586	(800)-577-5586	(866)-622-2820	(866)-622-2820	(800)-577-5586		(800)-822-6991	(800)-822-6991	(800)-577-5586		(866)-622-2820	(866)-622-2820	(800)-577-5586		www.caremorehealthplan.com/formulary.aspx	www.caremorehealthplan.com
H0545	001	0	1	01	01	H0545_001_0	9	2009.01	INTER VALLEY HEALTH PLAN, INC.	Inter Valley Health Plan	www.ivhp.com	01	01		1		H0545	001	0	2009	Inter Valley Health Plan Service To Senior	Los Angeles, San Bernardino and Riverside Counties		2	2			13000	2						(800)-251-8191	(800)-251-8191	(800)-505-7150		(800)-251-8191	(800)-251-8191	(800)-505-7150		(800)-523-3142	(800)-523-3142	(800)-505-7150		(800)-523-3142	(800)-523-3142	(800)-505-7150		www.ivhp.com/ivhp/pdfs/formulary.pdf	http://www.ivhp.com
H0545	008	0	1	01	01	H0545_008_0	7	2009.01	INTER VALLEY HEALTH PLAN, INC.	Inter Valley Health Plan	www.ivhp.com	01	01		1		H0545	008	0	2009	Inter Valley Health Plan Value SNP	Los Angeles, San Bernardino and Riverside Counties		2	1	3		200	2			1	2		(800)-251-8191	(800)-251-8191	(800)-505-7150		(800)-251-8191	(800)-251-8191	(800)-505-7150		(800)-523-3142	(800)-523-3142	(800)-505-7150		(800)-523-3142	(800)-523-3142	(800)-505-7150		www.ivhp.com/ivhp/pdfs/formulary.pdf	http://www.ivhp.com
H0545	009	0	1	01	01	H0545_009_0	8	2009.01	INTER VALLEY HEALTH PLAN, INC.	Inter Valley Health Plan	www.ivhp.com	01	01		1		H0545	009	0	2009	Inter Valley Health Plan Focus SNP	Los Angeles and San Bernardino Counites		2	1	4		13000	2			1		0000000010000000000000000000	(800)-251-8191	(800)-251-8191	(800)-505-7150		(800)-251-8191	(800)-251-8191	(800)-505-7150		(800)-523-3142	(800)-523-3142	(800)-505-7150		(800)-523-3142	(800)-523-3142	(800)-505-7150		www.ivhp.com/ivhp/pdfs/formulary.pdf	http://www.ivhp.com
H0545	011	0	1	01	01	H0545_011_0	8	2009.01	INTER VALLEY HEALTH PLAN, INC.	Inter Valley Health Plan	www.ivhp.com	01	01		1		H0545	011	0	2009	Inter Valley Health Plan Total Fit	Los Angeles, Riverside and San Bernardino Counties		2	2			1000	2						(800)-251-8191	(800)-251-8191	(800)-505-7150		(800)-251-8191	(800)-251-8191	(800)-505-7150		(800)-523-3142	(800)-523-3142	(800)-505-7150		(800)-523-3142	(800)-523-3142	(800)-505-7150		www.ivhp.com/ivhp/pdfs/formulary.pdf	http://www.ivhp.com
H0545	012	0	1	01	01	H0545_012_0	4	2009.01	INTER VALLEY HEALTH PLAN, INC.	Inter Valley Health Plan	www.ivhp.com	01	01		1		H0545	012	0	2009	Inter Valley Health Plan Desert Preferred Choice	Riverside County		2	2			2500	2						(800)-251-8191	(800)-251-8191	(800)-505-7150		(800)-251-8191	(800)-251-8191	(800)-505-7150		(800)-523-3142	(800)-523-3142	(800)-505-7150		(800)-523-3142	(800)-523-3142	(800)-505-7150		www.ivhp.com/ivhp/pdfs/formulary.pdf	http://www.ivhp.com
H0545	801	0	1	01	01	H0545_801_0	3	2009.01	INTER VALLEY HEALTH PLAN, INC.	Inter Valley Health Plan	www.ivhp.com	01	01		1		H0545	801	0	2009	Inter Valley Health Plan Active Plus I	Los Angeles, Riverside and San Bernardino Counties		1	2			200	2						(800)-251-8191	(800)-251-8191	(800)-505-7150		(800)-251-8191	(800)-251-8191	(800)-505-7150		(800)-523-3142	(800)-523-3142	(800)-505-7150		(800)-523-3142	(800)-523-3142	(800)-505-7150		www.ivhp.com/ivhp/pdfs/formulary.pdf	http://www.ivhp.com
H0545	802	0	1	01	01	H0545_802_0	3	2009.01	INTER VALLEY HEALTH PLAN, INC.	Inter Valley Health Plan	www.ivhp.com	01	01		1		H0545	802	0	2009	Inter Valley Health Plan Active Plus II	Los Angeles, Riverside and San Bernardino Counties		1	2			200	2						(800)-251-8191	(800)-251-8191	(800)-505-7150		(800)-251-8191	(800)-251-8191	(800)-505-7150		(800)-523-3142	(800)-523-3142	(800)-505-7150		(800)-523-3142	(800)-523-3142	(800)-505-7150		www.ivhp.com/ivhp/pdfs/formulary.pdf	http://www.ivhp.com
H0562	002	0	1	01	01	H0562_002_0	5	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	002	0	2009	Health Net Medicare Advantage HMO with Rx	LA, Orange, Riverside and San Bernardino		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	009	0	1	01	01	H0562_009_0	5	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	009	0	2009	Health Net Healthy Heart I	San Francisco County		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	010	0	1	01	01	H0562_010_0	5	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	010	0	2009	Health Net Healthy Heart I	Sacramento County		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	011	0	1	01	01	H0562_011_0	5	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	011	0	2009	Health Net Healthy Heart I	Contra Costa County		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	012	0	1	01	01	H0562_012_0	5	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	012	0	2009	Health Net Healthy Heart I	San Diego county		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	017	0	1	01	01	H0562_017_0	6	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	017	0	2009	Health Net Medicare Advantage HMO with Rx	Santa Barbara County		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	036	0	1	01	01	H0562_036_0	5	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	036	0	2009	Health Net Healthy Heart I	San Mateo county		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	037	0	1	01	01	H0562_037_0	5	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	037	0	2009	Health Net Healthy Heart I	Santa Clara county		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	039	0	1	01	01	H0562_039_0	5	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	039	0	2009	Health Net Healthy Heart I	Yolo county		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	040	0	1	01	01	H0562_040_0	5	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	040	0	2009	Health Net Medicare Advantage HMO with Rx	San Diego County		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	044	0	1	01	01	H0562_044_0	2	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	044	0	2009	Health Net Medicare Advantage HMO without Rx	L.A., Orange, Riverside and San Bernardino		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	045	0	1	01	01	H0562_045_0	3	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	045	0	2009	Health Net Medicare Advantage HMO without Rx	No. CA Counties		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	046	0	1	01	01	H0562_046_0	2	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	046	0	2009	Health Net Medicare Advantage HMO without Rx	Contra Costa County		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	047	0	1	01	01	H0562_047_0	2	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	047	0	2009	Health Net Medicare Advantage HMO without Rx	San Diego County		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	048	0	1	01	01	H0562_048_0	2	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	048	0	2009	Health Net Medicare Advantage HMO without Rx	San Diego County		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	049	0	1	01	01	H0562_049_0	2	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	049	0	2009	Health Net Medicare Advantage HMO without Rx	San Francisco County		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	053	0	1	01	01	H0562_053_0	5	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	053	0	2009	Health Net Healthy Heart I	Sonoma County		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	055	0	1	01	01	H0562_055_0	6	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	055	0	2009	Health Net HMO Partial Dual Eligible with Rx	L.A., Kern, Orange, Riverside and San Bernardino		2	1	3		250	2			1	2		(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	056	0	1	01	01	H0562_056_0	3	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	056	0	2009	Health Net HMO CHF/COPD with Rx	Riverside and San Bernardino Counties		2	1	4			2			1		1110000000000000000000000000	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	057	0	1	01	01	H0562_057_0	2	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	057	0	2009	Health Net Medicare Advantage HMO without Rx	Santa Barbara County		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	058	0	1	01	01	H0562_058_0	5	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	058	0	2009	Health Net Healthy Heart I	Placer County, CA		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	059	0	1	01	01	H0562_059_0	5	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	059	0	2009	Health Net Healthy Heart I	Solano County, CA		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	060	0	1	01	01	H0562_060_0	5	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	060	0	2009	Health Net Healthy Heart I	Stanislaus County, CA		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	061	0	1	01	01	H0562_061_0	5	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	061	0	2009	Health Net Healthy Heart I	Santa Cruz County, CA		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	062	0	1	01	01	H0562_062_0	5	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	062	0	2009	Health Net Healthy Heart I	San Joaquin County, CA		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	068	0	1	01	01	H0562_068_0	5	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	068	0	2009	Health Net Healthy Heart I	Alameda County		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	069	0	1	01	01	H0562_069_0	2	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	069	0	2009	Health Net Medicare Advantage HMO without Rx	Alameda County		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	070	0	1	01	01	H0562_070_0	5	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	070	0	2009	Health Net HMO Dual Eligible with Rx	Portions of So. Cal., Alameda, Contra Costa, S.F.		2	1	3		6000	2			1	2		(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	071	0	1	01	01	H0562_071_0	4	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	071	0	2009	Health Net Healthy Heart I	LA, Orange, Riverside and San Bernardino Counties		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	072	0	1	01	01	H0562_072_0	8	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	072	0	2009	Health Net Healthy Heart II	LA, Orange, Riverside, San Bernardino Counties		2	1	4			2			1		0000000001000000000000000000	(800)-431-9007	(800)-431-9007	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	www.healthnet.com
H0562	076	0	1	01	01	H0562_076_0	6	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	076	0	2009	Health Net Healthy Heart I	Fresno, CA		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	077	0	1	01	01	H0562_077_0	5	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	077	0	2009	Health Net Medicare Advantage HMO with Rx	San Diego, CA		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	078	0	1	01	01	H0562_078_0	2	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	078	0	2009	Health Net Medicare Advantage HMO without Rx	San Diego, CA		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	079	0	1	01	01	H0562_079_0	5	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	079	0	2009	Health Net Medicare Advantage HMO with Rx	Kern County, CA		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	080	0	1	01	01	H0562_080_0	2	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	080	0	2009	Health Net Medicare Advantage HMO without Rx	Kern County, CA		2	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	801	0	1	01	01	H0562_801_0	2	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	801	0	2009	Health Net ER Group	California		1	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	803	0	1	01	01	H0562_803_0	2	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	803	0	2009	Health Net ER Group	California		1	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	804	0	1	01	01	H0562_804_0	2	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	804	0	2009	Health Net ER Group	California		1	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0562	806	0	1	01	01	H0562_806_0	2	2009.01	HEALTH NET_OF CA	Health Net of CA	www.healthnet.com	01	01		1		H0562	806	0	2009	Health Net ER Group	California		1	2				2						(800)-275-4737	(800)-275-4737	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0564	006	0	1	01	01	H0564_006_0	12	2009.01	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca	01	01		1		H0564	006	0	2009	Blue Cross Senior Secure Plan I	Riverside, San Bernardino, Orange, Kern, L.A.		2	2			17666	2						(888)-230-7338	(888)-230-7338	(888)-877-5378	(888)-877-5378	(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538	(888)-230-7338	(888)-230-7338	(888)-877-5378	(888)-877-5378	(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538	http://www.bluecrosscamedicarerx.com	
H0564	801	0	1	01	01	H0564_801_0	3	2009.01	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca	01	01		1		H0564	801	0	2009	Senior Secure Group Plan I	California, Select Counties		1	2			1285	2						(888)-230-7338	(888)-230-7338	(888)-877-5378	(888)-877-5378	(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538	(888)-230-7338	(888)-230-7338	(888)-877-5378	(888)-877-5378	(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538	http://www.bluecrosscamedicarerx.com	
H0564	810	0	1	01	01	H0564_810_0	3	2009.01	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca	01	01		1		H0564	810	0	2009	Senior Secure Group Plan II	California, Select Counties		1	2			10	2						(888)-230-7338	(888)-230-7338	(888)-877-5378	(888)-877-5378	(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538									http://www.bluecrosscamedicarerx.com	
H0564	811	0	1	01	01	H0564_811_0	3	2009.01	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca	01	01		1		H0564	811	0	2009	Senior Secure Group Plan III	CA, Select Counties		1	2			10	2						(888)-230-7338	(888)-230-7338	(888)-877-5378	(888)-877-5378	(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538	(888)-230-7338	(888)-230-7338	(888)-877-5378	(888)-877-5378	(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538	http://www.bluecrosscamedicarerx.com	
H0571	001	0	1	01	01	H0571_001_0	5	2009.01	CHINESE COMMUNITY HEALTH PLAN	Chinese Community Health Plan	www.cchphmo.com	01	01		1		H0571	001	0	2009	CCHP Senior Program	San Francisco County		2	2			4244	2						(415)-834-2118		(877)-681-8888		(415)-834-2118		(877)-681-8888	(877)-681-8888	(415)-834-2118	(888)-775-7888		(877)-681-8888	(415)-834-2118	(888)-775-7888		(877)-681-8888	www.cchphmo.com/seniorprogram.html	
H0571	002	0	2	01	01	H0571_002_0	5	2009.01	CHINESE COMMUNITY HEALTH PLAN	Chinese Community Health Plan	www.cchphmo.com	01	01		2		H0571	002	0	2009	CCHP Senior Plan B-only Plan	San Francisco County		2	2			6	2		2				(415)-834-2118		(877)-681-8888		(415)-834-2118		(877)-681-8888		(415)-834-2118	(888)-775-7888		(877)-681-8888	(415)-834-2118	(888)-775-7888		(877)-681-8888	www.cchphmo.com/seniorprogram.html	
H0571	005	0	1	01	01	H0571_005_0	4	2009.01	CHINESE COMMUNITY HEALTH PLAN	Chinese Community Health Plan	www.cchphmo.com	01	01		1		H0571	005	0	2009	CCHP Senior Select Program	San Francisco County		2	1	3		3027	2			1	3		(415)-834-2118		(877)-681-8888		(415)-834-2118		(877)-681-8888		(415)-834-2118	(888)-775-7888		(877)-681-8888	(415)-834-2118	(888)-775-7888		(877)-681-8888	www.cchphmo.com/seniorprogram.html	
H0571	006	0	1	01	01	H0571_006_0	4	2009.01	CHINESE COMMUNITY HEALTH PLAN	Chinese Community Health Plan	www.cchphmo.com	01	01		1		H0571	006	0	2009	CCHP Senior Program	Northern San Mateo County		2	2			138	2						(415)-834-2118		(877)-681-8888		(415)-834-2118		(877)-681-8888	(877)-681-8888	(415)-834-2118	(888)-775-7888		(877)-681-8888	(415)-834-2118	(888)-775-7888		(877)-681-8888	www.cchphmo.com/seniorprogram.html	
H0571	801	0	1	01	01	H0571_801_0	1	2009.01	CHINESE COMMUNITY HEALTH PLAN	Chinese Community Health Plan	www.cchphmo.com	01	01		1		H0571	801	0	2009	CCHP Senior Plan  Employer-Only	San Francisco County		1	2			30	2						(415)-834-2118		(877)-681-8888		(415)-834-2118		(877)-681-8888		(415)-834-2118	(888)-775-7888		(877)-681-8888	(415)-834-2118	(888)-775-7888		(877)-681-8888	www.cchphmo.com/seniorprogram.html	
H0602	001	0	1	18	06	H0602_001_0	4	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	001	0	2009	RMHP Standard Plan - WS	Western Slope Colorado		2	2			5273	2						(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370									http://www.rmhp.org	
H0602	002	0	1	18	06	H0602_002_0	3	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	002	0	2009	RMHP Gold Plan - FR	Front Range Colorado		2	2			10	2						(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370									http://www.rmhp.org	
H0602	003	0	1	18	06	H0602_003_0	3	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	003	0	2009	RMHP Plus Plan - WS	Western Slope Colorado		2	2			32	2						(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370									http://www.rmhp.org	
H0602	007	0	1	18	06	H0602_007_0	3	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	007	0	2009	RMHP Standard Plan - FR	Front Range Colorado		2	2			297	2						(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370									http://www.rmhp.org	
H0602	008	0	1	18	06	H0602_008_0	3	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	008	0	2009	RMHP Gold Plan - M	Denver Metro area		2	2			10	2						(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370									http://www.rmhp.org	
H0602	009	0	1	18	06	H0602_009_0	3	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	009	0	2009	RMHP Standard Plan - M	Denver Metro area		2	2			417	2						(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370									http://www.rmhp.org	
H0602	013	0	1	18	06	H0602_013_0	4	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	013	0	2009	WINhealth Standard Medicare Plan	Select Wyoming Counties		2	2			6	2						(800)-840-2211		(800)-704-6370		(800)-840-2211		(800)-704-6370										http://www.rmhp.org	
H0602	014	0	1	18	06	H0602_014_0	5	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	014	0	2009	WINhealth Plus Medicare Plan	Select Wyoming Counties		2	2			6	2						(800)-840-2211		(800)-704-6370		(800)-840-2211		(800)-704-6370										http://www.rmhp.org	
H0602	017	0	1	18	06	H0602_017_0	9	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	017	0	2009	RMHP Standard with Standard Drug Plan - WS	Western Slope Colorado		2	2			5885	2						(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	http://www.rmhp.org	
H0602	018	0	1	18	06	H0602_018_0	10	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	018	0	2009	RMHP Gold with Enhanced Drug Plan - FR	Front Range Colorado		2	2			10	2						(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	http://www.rmhp.org	
H0602	019	0	1	18	06	H0602_019_0	9	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	019	0	2009	RMHP Plus with Enhanced Drug Plan - WS	Western Slope Colorado		2	2			32	2						(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	http://www.rmhp.org	
H0602	020	0	1	18	06	H0602_020_0	10	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	020	0	2009	RMHP Standard with Standard Drug Plan - FR	Front Range Colorado		2	2			1386	2						(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	http://www.rmhp.org	
H0602	021	0	1	18	06	H0602_021_0	9	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	021	0	2009	RMHP Gold with Enhanced Drug Plan - M	Denver Metro area		2	2			10	2						(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	http://www.rmhp.org	
H0602	022	0	1	18	06	H0602_022_0	13	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	022	0	2009	RMHP Standard with Standard Drug Plan - M	Denver Metro area		2	2			297	2						(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	http://www.rmhp.org	
H0602	023	0	1	18	06	H0602_023_0	10	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	023	0	2009	WINhealth Standard with Standard Drug Plan	Select Wyoming Counties		2	2			6	2						(800)-840-2211		(800)-704-6370		(800)-840-2211		(800)-704-6370		(800)-840-2211	(800)-840-2211		(800)-704-6370	(800)-840-2211	(800)-840-2211		(800)-704-6370	http://www.rmhp.org	
H0602	024	0	1	18	06	H0602_024_0	10	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	024	0	2009	WINhealth Plus with Enhanced Drug Plan	Select Wyoming Counties		2	2			6	2						(800)-840-2211		(800)-704-6370		(800)-840-2211		(800)-704-6370		(800)-840-2211	(800)-840-2211		(800)-704-6370	(800)-840-2211	(800)-840-2211		(800)-704-6370	http://www.rmhp.org	
H0602	026	0	1	18	06	H0602_026_0	4	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	026	0	2009	AB Basic Plan	Colorado and Select Wyoming Counties		2	2			2000	2						(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370									http://www.rmhp.org	
H0602	027	0	1	18	06	H0602_027_0	4	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	027	0	2009	RMHP Thrifty Plan - WS	Western Slope Colorado		2	2			849	2						(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370									http://www.rmhp.org	
H0602	028	0	1	18	06	H0602_028_0	4	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	028	0	2009	RMHP Thrifty Plan - FR	Front Range Colorado		2	2			23	2						(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370									http://www.rmhp.org	
H0602	029	0	1	18	06	H0602_029_0	4	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	029	0	2009	RMHP Thrifty Plan - M	Denver Metro area		2	2			23	2						(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370									http://www.rmhp.org	
H0602	035	0	1	18	06	H0602_035_0	5	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	035	0	2009	WINhealth Thrifty Plan	Select Wyoming Counties		2	2			23	2						(800)-840-2211		(800)-704-6370		(800)-840-2211		(800)-704-6370										http://www.rmhp.org	
H0602	036	0	1	18	06	H0602_036_0	11	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	036	0	2009	RMHP Thrifty with Thrifty Drug Plan - M	Denver Metro Area		2	2			23	2						(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	http://www.rmhp.org	
H0602	037	0	1	18	06	H0602_037_0	11	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	037	0	2009	WINhealh Thrifty with Thrifty Drug Plan	Select Wyoming Counties		2	2			23	2						(800)-840-2211		(800)-704-6370		(800)-840-2211		(800)-704-6370		(800)-840-2211	(800)-840-2211		(800)-704-6370	(800)-840-2211	(800)-840-2211		(800)-704-6370	http://www.rmhp.org	
H0602	038	0	1	18	06	H0602_038_0	12	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	038	0	2009	RMHP Thrifty with Thrifty Drug Plan - FR	Front Range Colorado		2	2			23	2						(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	http://www.rmhp.org	
H0602	039	0	1	18	06	H0602_039_0	11	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		1		H0602	039	0	2009	RMHP Thrifty with Thrifty Drug Plan - WS	Western Slope Colorado		2	2			849	2						(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	http://www.rmhp.org	
H0602	040	0	2	18	06	H0602_040_0	4	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		2		H0602	040	0	2009	B Basic Plan	Colorado and Select Wyoming Counties		2	2			5	2		2				(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370									http://www.rmhp.org	
H0602	041	0	2	18	06	H0602_041_0	4	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18		2		H0602	041	0	2009	B Standard Plan	Colorado and Select Wyoming Counties		2	2			5273	2		2				(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370									http://www.rmhp.org	
H0602	801	0		18	06	H0602_801_0	2	2009.01	ROCKY MOUNTAIN HEALTH PLANS	Rocky Mountain Health Plans	www.rmhp.org	06	18				H0602	801	0	2009	RMHP Employer Plan	Colorado		1	2										(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370		(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6370	http://www.rmhp.org	
H0609	002	0	1	01	01	H0609_002_0	6	2009.01	PACIFICARE OF COLORADO, INC	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H0609	002	0	2009	AARP MedicareComplete Plan 1	El Paso, Teller and Larimer counties		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0609	006	0	1	01	01	H0609_006_0	5	2009.01	PACIFICARE OF COLORADO, INC	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H0609	006	0	2009	AARP MedicareComplete Plan 2	Denver Metro		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0609	007	0	1	01	01	H0609_007_0	5	2009.01	PACIFICARE OF COLORADO, INC	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H0609	007	0	2009	AARP MedicareComplete Plan 1	Denver Metro		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0609	011	0	1	01	01	H0609_011_0	7	2009.01	PACIFICARE OF COLORADO, INC	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H0609	011	0	2009	AARP MedicareComplete	Pueblo county		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0609	012	0	1	01	01	H0609_012_0	5	2009.01	PACIFICARE OF COLORADO, INC	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H0609	012	0	2009	AARP MedicareComplete Plan 3	Denver Metro		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0609	013	0	1	01	01	H0609_013_0	5	2009.01	PACIFICARE OF COLORADO, INC	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H0609	013	0	2009	AARP MedicareComplete	Fremont county		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0609	015	0	1	01	01	H0609_015_0	3	2009.01	PACIFICARE OF COLORADO, INC	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H0609	015	0	2009	AARP MedicareComplete Essential	El Paso, Teller and Larimer counties		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671									www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0609	018	0	1	01	01	H0609_018_0	4	2009.01	PACIFICARE OF COLORADO, INC	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H0609	018	0	2009	AARP MedicareComplete Essential	Denver Metro		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671									www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0609	020	0	1	01	01	H0609_020_0	6	2009.01	PACIFICARE OF COLORADO, INC	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H0609	020	0	2009	AARP MedicareComplete Plan 3	Colorado Springs		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-547-5514	(800)-547-5514	(866)-832-8671	(866)-832-8671	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0609	801	0	1	01	01	H0609_801_0	2	2009.01	PACIFICARE OF COLORADO, INC	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H0609	801	0	2009	MedicareComplete Retiree Plan	CO Employer Sponsored Plan Service Area		1	2				2						(800)-771-4347	(800)-771-4347	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074									www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0609	803	0	1	01	01	H0609_803_0	3	2009.01	PACIFICARE OF COLORADO, INC	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H0609	803	0	2009	MedicareComplete Retiree Plan	CO Employer Sponsored Plan Service Area		1	2				2						(800)-771-4347	(800)-771-4347	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074									www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0609	804	0	1	01	01	H0609_804_0	4	2009.01	PACIFICARE OF COLORADO, INC	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H0609	804	0	2009	MedicareComplete Retiree Plan	CO Employer Sponsored Plan Service Area		1	2				2						(800)-771-4347	(800)-771-4347	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	(800)-771-4347	(800)-771-4347	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0609	805	0	1	01	01	H0609_805_0	2	2009.01	PACIFICARE OF COLORADO, INC	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H0609	805	0	2009	MedicareComplete Retiree Plan	CO Employer Sponsored Plan Service Area		1	2				2						(800)-771-4347	(800)-771-4347	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	(800)-771-4347	(800)-771-4347	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0609	806	0	2	01	01	H0609_806_0	2	2009.01	PACIFICARE OF COLORADO, INC	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		2		H0609	806	0	2009	MedicareComplete Retiree Plan	CO Employer Sponsored Plan Service Area		1	2				2		2				(800)-771-4347	(800)-771-4347	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	(800)-771-4347	(800)-771-4347	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H0613	001	0	1	20	08	H0613_001_0	1	2009.01	TOTAL LONGTERM CARE, INC.	Total Longterm Care, Inc.	totallongtermcare.org	08	20		1		H0613	001	0	2009	Total Longterm Care - Dual eligibles	Metropolitan Denver		2	2				2														(303)-869-4664	(303)-869-4664			(303)-869-4664	(877)-277-6163			http://www.totallongtermcare.org/services.html	
H0613	003	0	1	20	08	H0613_003_0	1	2009.01	TOTAL LONGTERM CARE, INC.	Total Longterm Care, Inc.	totallongtermcare.org	08	20		1		H0613	003	0	2009	Total Longterm Care - Medicare only	Metropolitian Denver		2	2				2														(303)-869-4664	(303)-869-4664			(303)-869-4664	(877)-277-6163			http://www.totallongtermcare.org/services.html	
H0620	002	0	1	04	01	H0620_002_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H0620	002	0	2009	Evercare Plan IP	Denver, Colorado Springs Area		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H0621	001	0	1	01	01	H0621_001_0	5	2009.01	COLORADO ACCESS	Colorado Access	www.coaccess.com	01	01		1		H0621	001	0	2009	Colorado Access Advantage - Plan D	Denver Metro, El Paso County and San Luis Valley		2	1	3			2			1	3		(303)-751-2657	(877)-441-6032	(888)-803-4494	(888)-803-4494	(303)-751-2436	(877)-287-6767	(888)-803-4494	(888)-803-4494	(303)-751-2657	(877)-441-6032	(888)-803-4494	(888)-803-4494	(303)-751-2436	(877)-287-6767	(888)-803-4494	(888)-803-4494	http://accessadvantage.medicareplanrx.com/jccf/medicare/H0621/001/COACCFORMULARY.pdf	http://www.coloradoaccessadvantage.com
H0621	004	0	1	01	01	H0621_004_0	8	2009.01	COLORADO ACCESS	Colorado Access	www.coaccess.com	01	01		1		H0621	004	0	2009	Colorado Access Advantage - Plan B	Denver Metro, El Paso County and San Luis Valley		2	1	4			2			1		0000000000000000000000000001	(303)-751-2657	(877)-441-6032	(888)-803-4494	(888)-803-4494	(303)-751-2436	(877)-287-6767	(888)-803-4494	(888)-803-4494	(303)-751-2657	(877)-441-6032	(888)-803-4494	(888)-803-4494	(303)-751-2436	(877)-287-6767	(888)-803-4494	(888)-803-4494	http://accessadvantage.medicareplanrx.com/jccf/medicare/H0621/001/COACCFORMULARY.pdf	http://www.coloradoaccessadvantage.com
H0621	005	0	1	01	01	H0621_005_0	8	2009.01	COLORADO ACCESS	Colorado Access	www.coaccess.com	01	01		1		H0621	005	0	2009	Colorado Access Advantage - Plan C	Denver Metro, El Paso County and San Luis Valley		2	1	4			2			1		0000000000000000000000000001	(303)-751-2657	(877)-441-6032	(888)-803-4494	(888)-803-4494	(303)-751-2436	(877)-287-6767	(888)-803-4494	(888)-803-4494	(303)-751-2657	(877)-441-6032	(888)-803-4494	(888)-803-4494	(303)-751-2436	(877)-287-6767	(888)-803-4494	(888)-803-4494	http://accessadvantage.medicareplanrx.com/jccf/medicare/H0621/001/COACCFORMULARY.pdf	http://www.coloradoaccessadvantage.com
H0621	006	0	1	01	01	H0621_006_0	7	2009.01	COLORADO ACCESS	Colorado Access	www.coaccess.com	01	01		1		H0621	006	0	2009	Colorado Access Advantage - Plan E	Denver Metro, El Paso County and San Luis Valley		2	2				2						(303)-751-2657	(877)-441-6032	(888)-803-4494	(888)-803-4494	(303)-751-2436	(877)-287-6767	(888)-803-4494	(888)-803-4494	(303)-751-2657	(877)-441-6032	(888)-803-4494	(888)-803-4494	(303)-751-2436	(877)-287-6767	(888)-803-4494	(888)-803-4494	http://accessadvantage.medicareplanrx.com/jccf/medicare/H0621/001/COACCFORMULARY.pdf	http://www.coloradoaccessadvantage.com
H0621	007	0	1	01	01	H0621_007_0	6	2009.01	COLORADO ACCESS	Colorado Access	www.coaccess.com	01	01		1		H0621	007	0	2009	Colorado Access Advantage - Plan F	Denver Metro, El Paso County and San Luis Valley		2	2				2						(303)-751-2657	(877)-441-6032	(888)-803-4494	(888)-803-4494	(303)-751-2436	(877)-287-6767	(888)-803-4494	(888)-803-4494	(303)-751-2657	(877)-441-6032	(888)-803-4494	(888)-803-4494	(303)-751-2436	(877)-287-6767	(888)-803-4494	(888)-803-4494	http://accessadvantage.medicareplanrx.com/jccf/medicare/H0621/001/COACCFORMULARY.pdf	http://www.coloradoaccessadvantage.com
H0623	001	0	1	04	01	H0623_001_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H0623	001	0	2009	HumanaChoicePPO PPO H0623-001	Denver Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0623	005	0	1	04	01	H0623_005_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H0623	005	0	2009	Humana Choice PPO (H0623-005)	Ft. Collins-Greeley		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0623	006	0	1	04	01	H0623_006_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H0623	006	0	2009	Humana Choice PPO (H0623-006)	Ft. Collins-Greeley		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0623	007	0	1	04	01	H0623_007_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H0623	007	0	2009	Humana Choice PPO (H0623-007)	Pueblo		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0623	008	0	1	04	01	H0623_008_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H0623	008	0	2009	Humana Choice PPO (H0623-008)	Pueblo		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0623	009	0	1	04	01	H0623_009_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H0623	009	0	2009	Humana Choice PPO (H0623-009)	Denver		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0623	801	0	1	04	01	H0623_801_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H0623	801	0	2009	Humana Employer Sponsored	Denver, Boulder and Colorado Springs Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0623	802	0	1	04	01	H0623_802_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H0623	802	0	2009	Humana Employer Sponsored	Denver, Boulder and Colorado Springs Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0623	803	0	1	04	01	H0623_803_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H0623	803	0	2009	Humana Employer Sponsored Non-CY	Denver, Boulder and Colorado Springs Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0623	804	0	1	04	01	H0623_804_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H0623	804	0	2009	Humana Employer Sponsored Non-CY	Denver, Boulder and Colorado Springs Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H0624	001	0	1	01	01	H0624_001_0	7	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	01		1		H0624	001	0	2009	Evercare Plan DH	Denver, Colorado Springs area		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H0624	004	0	1	01	01	H0624_004_0	7	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	01		1		H0624	004	0	2009	Evercare Plan IH	Fremont County		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H0624	005	0	1	01	01	H0624_005_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	01		1		H0624	005	0	2009	Evercare Plan MH	Denver, Colorado Springs area		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H0630	013	0	1	01	01	H0630_013_0	8	2009.01	KAISER FOUNDATION HP OF CO	Kaiser Permanente	www.kp.org	01	01		1		H0630	013	0	2009	Senior Advantage CORE MA-PD	Denver Metropolitan Area		2	2			2781	2						(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	www.kp.org/seniorrx	www.kp.org
H0630	014	0	1	01	01	H0630_014_0	5	2009.01	KAISER FOUNDATION HP OF CO	Kaiser Permanente	www.kp.org	01	01		1		H0630	014	0	2009	Senior Advantage Medicare Medicaid Plan	Denver Metropolitan Area		2	1	3		2000	2			1	2		(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	www.kp.org/seniorrx	www.kp.org
H0630	015	0	1	01	01	H0630_015_0	6	2009.01	KAISER FOUNDATION HP OF CO	Kaiser Permanente	www.kp.org	01	01		1		H0630	015	0	2009	Senior Advantage Silver MA-PD	Denver Metropolitan Area		2	2			26423	2						(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	www.kp.org/seniorrx	www.kp.org
H0630	016	0	1	01	01	H0630_016_0	7	2009.01	KAISER FOUNDATION HP OF CO	Kaiser Permanente	www.kp.org	01	01		1		H0630	016	0	2009	Senior Advantage Gold MA-PD	Denver Metropolitan Area		2	2			6213	2						(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	www.kp.org/seniorrx	www.kp.org
H0630	017	0	1	01	01	H0630_017_0	8	2009.01	KAISER FOUNDATION HP OF CO	Kaiser Permanente	www.kp.org	01	01		1		H0630	017	0	2009	Senior Advantage CORE MA-PD	Southern Colorado		2	2			182	2						(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	www.kp.org/seniorrx	www.kp.org
H0630	018	0	1	01	01	H0630_018_0	5	2009.01	KAISER FOUNDATION HP OF CO	Kaiser Permanente	www.kp.org	01	01		1		H0630	018	0	2009	Senior Advantage Silver MA-PD	Southern Colorado		2	2			274	2						(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	www.kp.org/seniorrx	www.kp.org
H0630	805	0	2	01	01	H0630_805_0	5	2009.01	KAISER FOUNDATION HP OF CO	Kaiser Permanente	www.kp.org	01	01		2		H0630	805	0	2009	Senior Advantage Group MA-PD_Part B only	Denver Metropolitan Area		1	2			453	2		1				(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	www.kp.org/seniorrx	www.kp.org
H0630	806	0	2	01	01	H0630_806_0	5	2009.01	KAISER FOUNDATION HP OF CO	Kaiser Permanente	www.kp.org	01	01		2		H0630	806	0	2009	Senior Advantage Group MA only_Part B only	Denver Metropolitan Area		1	2			17	2		1				(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656									www.kp.org/seniorrx	www.kp.org
H0630	807	0	1	01	01	H0630_807_0	5	2009.01	KAISER FOUNDATION HP OF CO	Kaiser Permanente	www.kp.org	01	01		1		H0630	807	0	2009	Senior Advantage Group MA-PD	Denver Metropolitan Area		1	2			19644	2						(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	www.kp.org/seniorrx	www.kp.org
H0630	808	0	1	01	01	H0630_808_0	5	2009.01	KAISER FOUNDATION HP OF CO	Kaiser Permanente	www.kp.org	01	01		1		H0630	808	0	2009	Senior Adv_Group_MA only	Denver Metropolitan Area		1	2			957	2						(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656									www.kp.org/seniorrx	www.kp.org
H0630	809	0	2	01	01	H0630_809_0	5	2009.01	KAISER FOUNDATION HP OF CO	Kaiser Permanente	www.kp.org	01	01		2		H0630	809	0	2009	FEHB B only with D	Denver Metropolitan Area		1	2			16	2		1				(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	www.kp.org/seniorrx	www.kp.org
H0630	810	0	1	01	01	H0630_810_0	5	2009.01	KAISER FOUNDATION HP OF CO	Kaiser Permanente	www.kp.org	01	01		1		H0630	810	0	2009	FEHB AB with D	Denver Metropolitan Area		1	2			2552	2						(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	www.kp.org/seniorrx	www.kp.org
H0630	811	0	2	01	01	H0630_811_0	5	2009.01	KAISER FOUNDATION HP OF CO	Kaiser Permanente	www.kp.org	01	01		2		H0630	811	0	2009	Senior Advantage Group MA-PD_Part B only	Southern Colorado		1	2			7	2		1				(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	www.kp.org/seniorrx	www.kp.org
H0630	812	0	2	01	01	H0630_812_0	5	2009.01	KAISER FOUNDATION HP OF CO	Kaiser Permanente	www.kp.org	01	01		2		H0630	812	0	2009	Senior Advantage Group MA only_Part B only	Southern Colorado		1	2			0	2		1				(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656									www.kp.org/seniorrx	www.kp.org
H0630	813	0	1	01	01	H0630_813_0	5	2009.01	KAISER FOUNDATION HP OF CO	Kaiser Permanente	www.kp.org	01	01		1		H0630	813	0	2009	Senior Advantage Group MA-PD	Southern Colorado		1	2			320	2						(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	www.kp.org/seniorrx	www.kp.org
H0630	814	0	1	01	01	H0630_814_0	5	2009.01	KAISER FOUNDATION HP OF CO	Kaiser Permanente	www.kp.org	01	01		1		H0630	814	0	2009	Senior Adv Group_MA only	Southern Colorado		1	2			16	2						(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656									www.kp.org/seniorrx	www.kp.org
H0630	815	0	2	01	01	H0630_815_0	5	2009.01	KAISER FOUNDATION HP OF CO	Kaiser Permanente	www.kp.org	01	01		2		H0630	815	0	2009	FEHB B only with D	Southern Colorado		1	2			0	2		1				(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	www.kp.org/seniorrx	www.kp.org
H0630	816	0	1	01	01	H0630_816_0	5	2009.01	KAISER FOUNDATION HP OF CO	Kaiser Permanente	www.kp.org	01	01		1		H0630	816	0	2009	FEHB AB with D	Southern Colorado		1	2			42	2						(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	(303)-338-3800	(800)-476-2167	(303)-338-3820	(866)-513-9964	(303)-338-3814	(800)-509-7570	(800)-509-8779	(800)-659-2656	www.kp.org/seniorrx	www.kp.org
H0710	001	0	1	04	01	H0710_001_0	6	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H0710	001	0	2009	Evercare Plan IP	Fairfld, Hrtfrd, Lthfld, New Hvn, Tollnd, Wndham		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H0710	002	0	1	04	01	H0710_002_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H0710	002	0	2009	Evercare Plan DP	Fairfld, Hrtfrd, Lthfld, New Hvn, Tollnd, Wndham		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H0710	003	0	1	04	01	H0710_003_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H0710	003	0	2009	Evercare Plan MP	Fairfld, Hrtfrd, Lthfld, New Hvn, Tollnd, Wndham		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H0712	001	0	1	02	01	H0712_001_0	8	2009.01	WELLCARE OF CONNECTICUT, INC.	WellCare	www.wellcare.com	01	02		1		H0712	001	0	2009	WellCare Choice	Fairfield, Hartford, New Haven, Tolland Counties		2	2				2						(866)-579-8006	(866)-579-8006	(877)-247-6272		(866)-238-4344	(866)-238-4344	(877)-247-6272		(866)-579-8006	(866)-579-8006	(877)-247-6272		(866)-238-4344	(866)-238-4344	(877)-247-6272		www.wellcare.com	
H0712	005	0	1	01	01	H0712_005_0	9	2009.01	WELLCARE OF CONNECTICUT, INC.	WellCare	www.wellcare.com	01	01		1		H0712	005	0	2009	WellCare Access	Fairfield, Hartford, New Haven, Tolland Counties		2	1	3			2			1	1		(866)-579-8006	(866)-579-8006	(877)-247-6272		(866)-238-4344	(866)-238-4344	(877)-247-6272		(866)-579-8006	(866)-579-8006	(877)-247-6272		(866)-238-4344	(866)-238-4344	(877)-247-6272		www.wellcare.com	
H0712	008	0	1	01	01	H0712_008_0	6	2009.01	WELLCARE OF CONNECTICUT, INC.	WellCare	www.wellcare.com	01	01		1		H0712	008	0	2009	WellCare Advance	Fairfield, Hartford, New Haven, Tolland Counties		2	2				2						(866)-579-8006	(866)-579-8006	(877)-247-6272		(866)-238-4344	(866)-238-4344	(877)-247-6272										www.wellcare.com	
H0712	011	0	1	02	01	H0712_011_0	8	2009.01	WELLCARE OF CONNECTICUT, INC.	WellCare	www.wellcare.com	01	02		1		H0712	011	0	2009	WellCare Select	Fairfield, Hartford, New Haven, Tolland Counties		2	1	3			2			1	2		(866)-579-8006	(866)-579-8006	(877)-247-6272		(866)-238-4344	(866)-238-4344	(877)-247-6272		(866)-579-8006	(866)-579-8006	(877)-247-6272		(866)-238-4344	(866)-238-4344	(877)-247-6272		www.wellcare.com	
H0712	018	0	1	02	01	H0712_018_0	8	2009.01	WELLCARE OF CONNECTICUT, INC.	WellCare	www.wellcare.com	01	02		1		H0712	018	0	2009	WellCare Premium	Fairfield, Hartford, New Haven, Tolland Counties		2	2				2						(866)-579-8006	(866)-579-8006	(877)-247-6272		(866)-238-4344	(866)-238-4344	(877)-247-6272		(866)-579-8006	(866)-579-8006	(877)-247-6272		(866)-238-4344	(866)-238-4344	(877)-247-6272		www.wellcare.com	
H0712	801	0	1	02	01	H0712_801_0	4	2009.01	WELLCARE OF CONNECTICUT, INC.	WellCare	www.wellcare.com	01	02		1		H0712	801	0	2009	WellCare Employer CT1	Nationwide		1	2				2						(866)-579-8006	(866)-579-8006	(877)-247-6272		(866)-238-4344	(866)-238-4344	(877)-247-6272		(866)-579-8006	(866)-579-8006	(877)-247-6272		(866)-238-4344	(866)-238-4344	(877)-247-6272		www.wellcare.com	
H0712	802	0	1	02	01	H0712_802_0	4	2009.01	WELLCARE OF CONNECTICUT, INC.	WellCare	www.wellcare.com	01	02		1		H0712	802	0	2009	WellCare Employer CT2	Nationwide		1	2				2						(866)-579-8006	(866)-579-8006	(877)-247-6272		(866)-238-4344	(866)-238-4344	(877)-247-6272										www.wellcare.com	
H0712	803	0	1	02	01	H0712_803_0	4	2009.01	WELLCARE OF CONNECTICUT, INC.	WellCare	www.wellcare.com	01	02		1		H0712	803	0	2009	WellCare Employer CT3	Nationwide		1	2				2						(866)-579-8006	(866)-579-8006	(877)-247-6272		(866)-238-4344	(866)-238-4344	(877)-247-6272		(866)-579-8006	(866)-579-8006	(877)-247-6272		(866)-238-4344	(866)-238-4344	(877)-247-6272		www.wellcare.com	
H0712	804	0	1	02	01	H0712_804_0	4	2009.01	WELLCARE OF CONNECTICUT, INC.	WellCare	www.wellcare.com	01	02		1		H0712	804	0	2009	WellCare Employer CT4	Nationwide		1	2				2						(866)-579-8006	(866)-579-8006	(877)-247-6272		(866)-238-4344	(866)-238-4344	(877)-247-6272										www.wellcare.com	
H0747	005	0	1	09	04	H0747_005_0	5	2009.01	EDUCATORS MUTUAL INSURANCE ASSOCIATION	Educators Mutual Insurance Association	http://www.educatorsmutual.com	04	09	2	1		H0747	005	0	2009	Educators Complete MA	State of Utah		2	2			1477	1	1					(888)-445-8957	(888)-445-8957	(888)-844-5530	(888)-844-5530	(801)-262-7475	(888)-236-4823	(888)-236-4823	(888)-236-4823									http://www.educatorsmutual.com/medicare/emia_plans.aspx	
H0747	006	0	1	09	04	H0747_006_0	6	2009.01	EDUCATORS MUTUAL INSURANCE ASSOCIATION	Educators Mutual Insurance Association	http://www.educatorsmutual.com	04	09	2	1		H0747	006	0	2009	Educators Complete Plus MA	State of Utah		2	2			1477	1	1					(888)-445-8957	(888)-445-8957	(888)-844-5530	(888)-844-5530	(801)-262-7475	(888)-236-4823	(888)-236-4823	(888)-236-4823									http://www.educatorsmutual.com/medicare/emia_plans.aspx	
H0747	007	0	1	09	04	H0747_007_0	5	2009.01	EDUCATORS MUTUAL INSURANCE ASSOCIATION	Educators Mutual Insurance Association	http://www.educatorsmutual.com	04	09	2	1		H0747	007	0	2009	Educators Complete MAPD	State of Utah		2	2			3447	1	1					(888)-445-8957	(888)-445-8957	(888)-844-5530	(888)-844-5530	(801)-262-7475	(888)-236-4823	(888)-236-4823	(888)-236-4823	(801)-262-7475	(800)-820-9731			(801)-262-7475	(888)-236-4823			http://www.educatorsmutual.com/medicare/emia_plans.aspx	
H0747	008	0	1	09	04	H0747_008_0	6	2009.01	EDUCATORS MUTUAL INSURANCE ASSOCIATION	Educators Mutual Insurance Association	http://www.educatorsmutual.com	04	09	2	1		H0747	008	0	2009	Educators Complete Plus MAPD	State of Utah		2	2			3447	1	1					(888)-445-8957	(888)-445-8957	(888)-844-5530	(888)-844-5530	(801)-262-7475	(888)-236-4823	(888)-236-4823	(888)-236-4823	(801)-262-7475	(800)-820-9731			(801)-262-7475	(888)-236-4823			http://www.educatorsmutual.com/medicare/emia_plans.aspx	
H0747	009	0	1	09	04	H0747_009_0	3	2009.01	EDUCATORS MUTUAL INSURANCE ASSOCIATION	Educators Mutual Insurance Association	http://www.educatorsmutual.com	04	09	2	1		H0747	009	0	2009	Educators Classic MA	State of Utah		2	2			739	1	1					(888)-445-8957	(888)-445-8957	(888)-844-5530	(888)-844-5530	(801)-262-7475	(888)-236-4823	(888)-236-4823	(888)-236-4823									http://www.educatorsmutual.com/medicare/emia_plans.aspx	
H0747	010	0	1	09	04	H0747_010_0	4	2009.01	EDUCATORS MUTUAL INSURANCE ASSOCIATION	Educators Mutual Insurance Association	http://www.educatorsmutual.com	04	09	2	1		H0747	010	0	2009	Educators Classic MAPD	State of Utah		2	2			1724	1	1					(888)-445-8957	(888)-445-8957	(888)-844-5530	(888)-844-5530	(801)-262-7475	(888)-236-4823	(888)-236-4823	(888)-236-4823	(801)-262-7475	(800)-820-9731			(801)-262-7475	(888)-236-4823			http://www.educatorsmutual.com/medicare/emia_plans.aspx	
H0747	801	0	1	09	04	H0747_801_0	4	2009.01	EDUCATORS MUTUAL INSURANCE ASSOCIATION	Educators Mutual Insurance Association	http://www.educatorsmutual.com	04	09	2	1		H0747	801	0	2009	Educators Group MA	Counties in the United States		1	2			4464	1	1					(888)-445-8957	(888)-445-8957	(888)-844-5530	(888)-844-5530	(801)-262-7475	(888)-236-4823	(888)-236-4823	(888)-236-4823									http://www.educatorsmutual.com/medicare/emia_plans.aspx	
H0747	802	0	1	09	04	H0747_802_0	4	2009.01	EDUCATORS MUTUAL INSURANCE ASSOCIATION	Educators Mutual Insurance Association	http://www.educatorsmutual.com	04	09	2	1		H0747	802	0	2009	Educators Group MAPD Plan 1	Counties in the United States		1	2			13392	1	1					(888)-445-8957	(888)-445-8957	(888)-844-5530	(888)-844-5530	(801)-262-7475	(888)-236-4823	(888)-236-4823	(888)-236-4823	(801)-262-7475	(800)-820-9731			(801)-262-7475	(888)-236-4823			http://www.educatorsmutual.com/medicare/emia_plans.aspx	
H0747	804	0	1	09	04	H0747_804_0	4	2009.01	EDUCATORS MUTUAL INSURANCE ASSOCIATION	Educators Mutual Insurance Association	http://www.educatorsmutual.com	04	09	2	1		H0747	804	0	2009	Educators Group MAPD Plan 2	Counties in the United States		1	2			4464	1	1					(888)-445-8957	(888)-445-8957	(888)-844-5530	(888)-844-5530	(801)-262-7475	(888)-236-4823	(888)-236-4823	(888)-236-4823	(801)-262-7475	(800)-820-9731			(801)-262-7475	(888)-236-4823			http://www.educatorsmutual.com/medicare/emia_plans.aspx	
H0752	002	0	1	01	01	H0752_002_0	11	2009.01	OXFORD HEALTH PLANS (CT), INC.	SecureHorizons by UnitedHealthCare	www.SecureHorizons.com	01	01		1		H0752	002	0	2009	AARP MedicareComplete	New Haven CT		2	2				2						(800)-234-1228	(800)-234-1228	(800)-201-4874		(800)-555-5757		(888)-685-8480		(800)-234-1228	(800)-234-1228	(800)-201-4874		(800)-555-5757	(800)-555-5757	(888)-685-8480		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H0752	801	0	1	01	01	H0752_801_0	6	2009.01	OXFORD HEALTH PLANS (CT), INC.	SecureHorizons by UnitedHealthCare	www.SecureHorizons.com	01	01		1		H0752	801	0	2009	MedicareComplete Retiree Plan	CT Employer Sponsored Plan Service Area		1	2				2						(800)-234-1228	(800)-234-1228	(800)-201-4874		(800)-303-6720		(888)-685-8480		(800)-234-1228	(800)-234-1228	(800)-201-4874		(800)-303-6720	(800)-303-6720	(888)-685-8480		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H0752	802	0	1	01	01	H0752_802_0	6	2009.01	OXFORD HEALTH PLANS (CT), INC.	SecureHorizons by UnitedHealthCare	www.SecureHorizons.com	01	01		1		H0752	802	0	2009	MedicareComplete Essential Retiree Plan	CT Employer Sponsored Plan Service Area		1	2				2						(800)-234-1228	(800)-234-1228	(800)-201-4874		(800)-303-6720		(888)-685-8480										https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H0752	803	0	1	01	01	H0752_803_0	6	2009.01	OXFORD HEALTH PLANS (CT), INC.	SecureHorizons by UnitedHealthCare	www.SecureHorizons.com	01	01		1		H0752	803	0	2009	MedicareComplete Retiree Plan	CT Employer Sponsored Plan Service Area		1	2				2						(800)-234-1228	(800)-234-1228	(800)-201-4874		(800)-303-6720		(888)-685-8480		(800)-234-1228	(800)-234-1228	(800)-201-4874		(800)-303-6720	(800)-303-6720	(888)-685-8480		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H0752	804	0	1	01	01	H0752_804_0	6	2009.01	OXFORD HEALTH PLANS (CT), INC.	SecureHorizons by UnitedHealthCare	www.SecureHorizons.com	01	01		1		H0752	804	0	2009	MedicareComplete Retiree Plan	CT Employer Sponsored Plan Service Area		1	2				2						(800)-234-1228	(800)-234-1228	(800)-201-4874		(800)-303-6720		(888)-685-8480										https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H0755	001	0	1	01	01	H0755_001_0	5	2009.01	HEALTH NET OF CONNECTICUT	Health Net of Connecticut	www.healthnet.com	01	01		1		H0755	001	0	2009	Health Net Ruby Option 1	Connecticut		2	2			38423	2						(800)-547-8734	(800)-547-8734	(888)-747-2424	(888)-747-2424	(800)-709-4192	(800)-709-4192	(888)-747-2424	(888)-747-2424	(800)-547-8734	(800)-547-8734	(888)-747-2424	(888)-747-2424	(800)-709-4192	(800)-709-4192	(888)-747-2424	(888)-747-2424	https://www.healthnet.com/formulary.htm	www.healthnet.com
H0755	020	0	1	02	01	H0755_020_0	5	2009.01	HEALTH NET OF CONNECTICUT	Health Net of Connecticut	www.healthnet.com	01	02		1		H0755	020	0	2009	Health Net Navy	Connecticut		2	2			1252	2						(800)-547-8734	(800)-547-8734	(888)-747-2424	(888)-747-2424	(800)-709-4192	(800)-709-4192	(888)-747-2424	(888)-747-2424	(800)-547-8734	(800)-547-8734	(888)-747-2424	(888)-747-2424	(800)-709-4192	(800)-709-4192	(888)-747-2424	(888)-747-2424	https://www.healthnet.com/formulary.htm	www.healthnet.com
H0755	022	0	1	01	01	H0755_022_0	4	2009.01	HEALTH NET OF CONNECTICUT	Health Net of Connecticut	www.healthnet.com	01	01		1		H0755	022	0	2009	Health Net Ruby Option 2	Connecticut		2	2			5697	2						(800)-547-8734	(800)-547-8734	(888)-747-2424	(888)-747-2424	(800)-709-4192	(800)-709-4192	(888)-747-2424	(888)-747-2424	(800)-547-8734	(800)-547-8734	(888)-747-2424	(888)-747-2424	(800)-709-4192	(800)-709-4192	(888)-747-2424	(888)-747-2424	https://www.healthnet.com/formulary.htm	www.healthnet.com
H0755	023	0	1	01	01	H0755_023_0	2	2009.01	HEALTH NET OF CONNECTICUT	Health Net of Connecticut	www.healthnet.com	01	01		1		H0755	023	0	2009	Health Net Green	Connecticut		2	2			1712	2						(800)-547-8734	(800)-547-8734	(888)-747-2424	(888)-747-2424	(800)-709-4192	(800)-709-4192	(888)-747-2424	(888)-747-2424									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0755	027	0	1	01	01	H0755_027_0	6	2009.01	HEALTH NET OF CONNECTICUT	Health Net of Connecticut	www.healthnet.com	01	01		1		H0755	027	0	2009	Health Net Sage	All CT Counties		2	1	4		722	2			1		0000000001000000000000000000	(800)-547-8734	(800)-547-8734	(888)-747-2424	(888)-747-2424	(800)-709-4192	(800)-709-4192	(888)-747-2424	(888)-747-2424	(800)-547-8734	(800)-547-8734	(888)-747-2424	(888)-747-2424	(800)-709-4192	(800)-709-4192	(888)-747-2424	(888)-747-2424	https://www.healthnet.com/formulary.htm	www.healthnet.com
H0755	028	0	1	01	01	H0755_028_0	4	2009.01	HEALTH NET OF CONNECTICUT	Health Net of Connecticut	www.healthnet.com	01	01		1		H0755	028	0	2009	Health Net Ruby Option 3	Connecticut		2	2			2759	2						(800)-547-8734	(800)-547-8734	(888)-747-2424	(888)-747-2424	(800)-709-4192	(800)-709-4192	(888)-747-2424	(888)-747-2424	(800)-547-8734	(800)-547-8734	(888)-747-2424	(888)-747-2424	(800)-709-4192	(800)-709-4192	(888)-747-2424	(888)-747-2424	https://www.healthnet.com/formulary.htm	www.healthnet.com
H0755	801	0	1	01	01	H0755_801_0	3	2009.01	HEALTH NET OF CONNECTICUT	Health Net of Connecticut	www.healthnet.com	01	01		1		H0755	801	0	2009	Health Net EG	Connecticut		1	2			7599	2						(800)-547-8734	(800)-547-8734	(888)-747-2424	(888)-747-2424	(800)-949-2516	(800)-949-2516	(888)-747-2424	(888)-747-2424	(800)-547-8734	(800)-547-8734	(888)-747-2424	(888)-747-2424	(800)-949-2516	(800)-949-2516	(888)-747-2424	(888)-747-2424	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0755	803	0	1	01	01	H0755_803_0	3	2009.01	HEALTH NET OF CONNECTICUT	Health Net of Connecticut	www.healthnet.com	01	01		1		H0755	803	0	2009	Health Net EG	Connecticut		1	2			864	2						(800)-547-8734	(800)-547-8734	(888)-747-2424	(888)-747-2424	(800)-949-2516	(800)-949-2516	(888)-747-2424	(888)-747-2424									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0755	804	0	1	01	01	H0755_804_0	3	2009.01	HEALTH NET OF CONNECTICUT	Health Net of Connecticut	www.healthnet.com	01	01		1		H0755	804	0	2009	Health Net EG	Connecticut		1	2			86	2						(800)-547-8734	(800)-547-8734	(888)-747-2424	(888)-747-2424	(800)-949-2516	(800)-949-2516	(888)-747-2424	(888)-747-2424	(800)-547-8734	(800)-547-8734	(888)-747-2424	(888)-747-2424	(800)-949-2516	(800)-949-2516	(888)-747-2424	(888)-747-2424	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0755	806	0	1	01	01	H0755_806_0	3	2009.01	HEALTH NET OF CONNECTICUT	Health Net of Connecticut	www.healthnet.com	01	01		1		H0755	806	0	2009	Health Net EG	Connecticut		1	2			86	2						(800)-547-8734	(800)-547-8734	(888)-747-2424	(888)-747-2424	(800)-949-2516	(800)-949-2516	(888)-747-2424	(888)-747-2424									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H0768	001	0	1	04	01	H0768_001_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H0768	001	0	2009	Aetna Golden Choice Standard Plan	Connecticut		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0768	002	0	1	04	01	H0768_002_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H0768	002	0	2009	Aetna Golden Choice Premier Plan	Connecticut		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0768	801	0	1	04	01	H0768_801_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H0768	801	0	2009	Aetna Golden Choice Plan	Fairfield,Hartford, Litchfield, New Haven Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0768	802	0	1	04	01	H0768_802_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H0768	802	0	2009	Aetna Golden Choice Plan w/Rx CY	Fairfield, Hartford, Litchfield,New Haven Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0806	001	0	1	02	01	H0806_001_0	5	2009.01	ALTIUS HEALTH PLANS, INC. (WYOMING)	Altius Advantra	www.altiusadvantra.com	01	02		1		H0806	001	0	2009	Altius Advantra Gold	Uinta County		2	2			1300	2						(866)-784-4918	(866)-784-4918	(866)-784-4931	(866)-784-4931	(888)-271-7641	(888)-271-7641	(888)-788-4010		(800)-708-9637	(800)-708-9637	(866)-236-1069		(888)-271-7641	(888)-271-7641	(888)-788-4010		www.altiusadvantra.com	www.altiusadvantra.com
H0806	002	0	1	02	01	H0806_002_0	5	2009.01	ALTIUS HEALTH PLANS, INC. (WYOMING)	Altius Advantra	www.altiusadvantra.com	01	02		1		H0806	002	0	2009	Altius Advantra Silver	Uinta County		2	2			280	2						(866)-784-4918	(866)-784-4918	(866)-784-4931	(866)-784-4931	(888)-271-7641	(888)-271-7641	(888)-788-4010		(800)-708-9637	(800)-708-9637	(866)-236-1069		(888)-271-7641	(888)-271-7641	(888)-788-4010		www.altiusadvantra.com	www.altiusadvantra.com
H0806	003	0	1	02	01	H0806_003_0	5	2009.01	ALTIUS HEALTH PLANS, INC. (WYOMING)	Altius Advantra	www.altiusadvantra.com	01	02		1		H0806	003	0	2009	Altius Advantra Bronze	Uinta County		2	2			700	2						(866)-784-4918	(866)-784-4918	(866)-784-4931	(866)-784-4931	(888)-271-7641	(888)-271-7641	(888)-788-4010		(800)-708-9637	(800)-708-9637	(866)-236-1069		(888)-271-7641	(888)-271-7641	(888)-788-4010		www.altiusadvantra.com	www.altiusadvantra.com
H0806	801	0	1	02	01	H0806_801_0	2	2009.01	ALTIUS HEALTH PLANS, INC. (WYOMING)	Altius Advantra	www.altiusadvantra.com	01	02		1		H0806	801	0	2009	Altius Advantra Emp Calendar Year	State of Wyoming		1	2			50	2						(866)-784-4918	(866)-784-4918	(866)-784-4931	(866)-784-4931	(888)-271-7641	(888)-271-7641	(888)-788-4010		(800)-708-9637	(800)-708-9637	(866)-236-1069		(888)-271-7641	(888)-271-7641	(888)-788-4010		www.altiusadvantra.com	www.altiusadvantra.com
H0806	802	0	1	02	01	H0806_802_0	2	2009.01	ALTIUS HEALTH PLANS, INC. (WYOMING)	Altius Advantra	www.altiusadvantra.com	01	02		1		H0806	802	0	2009	Altius Advantra Emp Non-Calendar Year	State of Wyoming		1	2			50	2						(866)-784-4918	(866)-784-4918	(866)-784-4931	(866)-784-4931	(888)-271-7641	(888)-271-7641	(888)-788-4010		(800)-708-9637	(800)-708-9637	(866)-236-1069		(888)-271-7641	(888)-271-7641	(888)-788-4010		www.altiusadvantra.com	www.altiusadvantra.com
H0806	803	0	1	02	01	H0806_803_0	2	2009.01	ALTIUS HEALTH PLANS, INC. (WYOMING)	Altius Advantra	www.altiusadvantra.com	01	02		1		H0806	803	0	2009	Altius Advantra Emp MA Only	State of Wyoming		1	2			50	2						(866)-784-4918	(866)-784-4918	(866)-784-4931	(866)-784-4931	(888)-271-7641	(888)-271-7641	(888)-788-4010										www.altiusadvantra.com	www.altiusadvantra.com
H0838	020	0	1	01	01	H0838_020_0	6	2009.01	HMO CALIFORNIA	Brand New Day	www.hmocalif.com	01	01		1		H0838	020	0	2009	Brand New Day	Counties: LA, OC, SB, Riv, Kern		2	1	4			2			1		0000000000000000000111110000	(866)-255-4795	(866)-255-4795	(866)-321-5955	(866)-321-5955	(866)-235-1805	(866)-235-1805	(866)-321-5955		(866)-255-4795	(866)-255-4795	(866)-321-5955		(866)-235-1805	(866)-235-1805	(866)-321-5955		http://www.hmocalif.com/pdf/Comprehensive_Formulary.pdf?	http://www.hmocalif.com/Directory/ps3.asp?PhysType=PCP#selection
H0846	004	0	1	09	04	H0846_004_0	4	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H0846	004	0	2009	Advantra Freedom-Freedom 1	Select counties in multiple states		2	2			27233	2						(866)-386-2330	(866)-386-2330	(866)-386-2335	(866)-386-2335	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010									http://advantrafreedom.com/templates/editorial.asp?itemID=14958	
H0846	005	0	1	09	04	H0846_005_0	5	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H0846	005	0	2009	Advantra Freedom-Freedom 2	Select counties in multiple states		2	2			64604	2						(866)-386-2330	(866)-386-2330	(866)-386-2335	(866)-386-2335	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010									http://advantrafreedom.com/templates/editorial.asp?itemID=14958	
H0846	006	0	1	09	04	H0846_006_0	4	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H0846	006	0	2009	Advantra Freedom-Freedom 3	Select counties in multiple states		2	2			42068	2						(866)-386-2330	(866)-386-2330	(866)-386-2335	(866)-386-2335	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010									http://advantrafreedom.com/templates/editorial.asp?itemID=14958	
H0846	009	0	1	09	04	H0846_009_0	4	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H0846	009	0	2009	Advantra Freedom-Freedom 2	Select counties in multiple states		2	2			2404	2						(866)-386-2330	(866)-386-2330	(866)-386-2335	(866)-386-2335	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010									http://advantrafreedom.com/templates/editorial.asp?itemID=14958	
H0846	010	0	1	09	04	H0846_010_0	4	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H0846	010	0	2009	Advantra Freedom-Freedom 2	Select counties in multiple states		2	2			2604	2						(866)-386-2330	(866)-386-2330	(866)-386-2335	(866)-386-2335	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010									http://advantrafreedom.com/templates/editorial.asp?itemID=14958	
H0846	012	0	1	09	04	H0846_012_0	5	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H0846	012	0	2009	Advantra Freedom-Freedom 6	Hawaii		2	2			200	2						(866)-386-2330	(866)-386-2330	(866)-386-2335	(866)-386-2335	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010									http://advantrafreedom.com/templates/editorial.asp?itemID=14958	
H0846	013	0	1	09	04	H0846_013_0	4	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H0846	013	0	2009	Advantra Freedom-Freedom 3	Select counties in multiple states		2	2			4808	2						(866)-386-2330	(866)-386-2330	(866)-386-2335	(866)-386-2335	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010									http://advantrafreedom.com/templates/editorial.asp?itemID=14958	
H0846	014	0	1	09	04	H0846_014_0	5	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H0846	014	0	2009	Advantra Freedom-Freedom 7	Select counties in multiple states		2	2			6180	2						(866)-386-2330	(866)-386-2330	(866)-386-2335	(866)-386-2335	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010	(999)-999-9999	(999)-999-9999	(999)-999-9999	(999)-999-9999	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010	http://advantrafreedom.com/templates/editorial.asp?itemID=14958	
H0846	015	0	1	09	04	H0846_015_0	5	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H0846	015	0	2009	Advantra Freedom-Freedom 5	Select counties in multiple states		2	2			931	2						(866)-386-2330	(866)-386-2330	(866)-386-2335	(866)-386-2335	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010	(999)-999-9999	(999)-999-9999	(999)-999-9999	(999)-999-9999	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010	http://advantrafreedom.com/templates/editorial.asp?itemID=14958	
H0846	016	0	1	09	04	H0846_016_0	4	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H0846	016	0	2009	Advantra Freedom-Freedom 3	Select counties in multiple states		2	2			5008	2						(866)-386-2330	(866)-386-2330	(866)-386-2335	(866)-386-2335	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010									http://advantrafreedom.com/templates/editorial.asp?itemID=14958	
H0846	017	0	1	09	04	H0846_017_0	4	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H0846	017	0	2009	Advantra Freedom-Freedom 1B	Select counties in multiple states		2	2			3506	2						(866)-386-2330	(866)-386-2330	(866)-386-2335	(866)-386-2335	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010									http://advantrafreedom.com/templates/editorial.asp?itemID=14958	
H0846	018	0	1	09	04	H0846_018_0	8	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H0846	018	0	2009	Advantra Freedom-Freedom 8	Select counties in North Carolina and Virginia		2	2			1053	2						(866)-386-2330	(866)-386-2330	(866)-386-2335	(866)-386-2335	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010									http://advantrafreedom.com/templates/editorial.asp?itemID=14958	
H0846	801	0	1	09	04	H0846_801_0	4	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H0846	801	0	2009	Advantra Freedom-EGO MA Only-CY and non-CY	United States and Territories		1	2			47663	2						(866)-714-9291	(866)-714-9291	(866)-386-2335	(866)-386-2335	(866)-714-9291	(866)-714-9291	(866)-386-2335	(866)-386-2335									http://advantrafreedom.com/templates/editorial.asp?itemID=14958	
H0846	803	0	1	09	04	H0846_803_0	6	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H0846	803	0	2009	Advantra Freedom-EGO MAPD-CY	United States and Territories		1	2			88	2						(866)-386-2330	(866)-386-2330	(866)-386-2335	(866)-386-2335	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010	(999)-999-9999	(999)-999-9999	(999)-999-9999	(999)-999-9999	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010	http://advantrafreedom.com/templates/editorial.asp?itemID=14958	
H0846	804	0	1	09	04	H0846_804_0	6	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H0846	804	0	2009	Advantra Freedom-EGO MAPD-Non-CY	United States and Territories		1	2			88	2						(866)-386-2330	(866)-386-2330	(866)-386-2335	(866)-386-2335	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010	(999)-999-9999	(999)-999-9999	(999)-999-9999	(999)-999-9999	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010	http://advantrafreedom.com/templates/editorial.asp?itemID=14958	
H0901	002	0	1	01	01	H0901_002_0	6	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H0901	002	0	2009	Aetna Golden Medicare Premier Plus Plan	District of Columbia		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0901	004	0	1	01	01	H0901_004_0	6	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H0901	004	0	2009	Aetna Golden Medicare Standard Plan	District of Columbia		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0901	005	0	1	01	01	H0901_005_0	6	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H0901	005	0	2009	Aetna Golden Medicare Dual Advantage Plan	District of Columbia		2	1	3			2			1	2		(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0901	007	0	1	01	01	H0901_007_0	6	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H0901	007	0	2009	Aetna Golden Medicare Premier Plan	District of Columbia		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0901	801	0	1	01	01	H0901_801_0	3	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H0901	801	0	2009	Aetna Golden Medicare Plan	District of Columbia		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0901	802	0	1	01	01	H0901_802_0	3	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H0901	802	0	2009	Aetna Golden Medicare Plan w/Rx CY	District of Columbia		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0902	002	0	1	04	01	H0902_002_0	9	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H0902	002	0	2009	Aetna Golden Choice Premier Plan	District of Columbia		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0902	801	0	1	04	01	H0902_801_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H0902	801	0	2009	Aetna Golden Choice Plan	District of Columbia		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0902	802	0	1	04	01	H0902_802_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H0902	802	0	2009	Aetna Golden Choice Plan w/Rx CY	District of Columbia		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0902	804	0	1	04	01	H0902_804_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H0902	804	0	2009	Aetna Golden Choice Plan w/RX NCY	District of Columbia		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H0908	001	0	1	01	01	H0908_001_0	6	2009.01	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Advantage by Buckeye Community Health Plan	http://www.bchpohio.com/	01	01		1		H0908	001	0	2009	Buckeye Community Health Plan	Buckeye Community Health Plan		2	1	3		100	2			1	3		(866)-246-4356	(866)-246-4356	(800)-750-0750		(866)-246-4356	(866)-246-4356	(800)-750-0750		(866)-246-4356	(866)-246-4356	(800)-750-0750		(866)-246-4356	(866)-246-4356	(800)-750-0750		to be determined	http://www.bchpohio.com/
H0913	001	0	1	01	01	H0913_001_0	9	2009.01	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	WellCare	www.wellcare.com	01	01		1		H0913	001	0	2009	WellCare Choice	Essex, Hudson, Passaic, Union Counties		2	2				2						(866)-687-8570	(866)-687-8570	(877)-247-6272		(866)-360-8137	(866)-360-8137	(877)-247-6272		(866)-687-8570	(866)-687-8570	(877)-247-6272		(866)-360-8137	(866)-360-8137	(877)-247-6272		www.wellcare.com	
H0913	002	0	1	01	01	H0913_002_0	7	2009.01	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	WellCare	www.wellcare.com	01	01		1		H0913	002	0	2009	WellCare Value	Middlesex County		2	2				2						(866)-687-8570	(866)-687-8570	(877)-247-6272		(866)-360-8137	(866)-360-8137	(877)-247-6272		(866)-687-8570	(866)-687-8570	(877)-247-6272		(866)-360-8137	(866)-360-8137	(877)-247-6272		www.wellcare.com	
H0913	003	0	1	01	01	H0913_003_0	7	2009.01	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	WellCare	www.wellcare.com	01	01		1		H0913	003	0	2009	WellCare Access	Essex, Hudson, Passaic, Union, Middlesex Counties		2	1	3			2			1	1		(866)-687-8570	(866)-687-8570	(877)-247-6272		(866)-360-8137	(866)-360-8137	(877)-247-6272		(866)-687-8570	(866)-687-8570	(877)-247-6272		(866)-360-8137	(866)-360-8137	(877)-247-6272		www.wellcare.com	
H0913	004	0	1	01	01	H0913_004_0	8	2009.01	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	WellCare	www.wellcare.com	01	01		1		H0913	004	0	2009	WellCare Select	Essex, Hudson, Passaic, Union Counties		2	1	3			2			1	2		(866)-687-8570	(866)-687-8570	(877)-247-6272		(866)-360-8137	(866)-360-8137	(877)-247-6272		(866)-687-8570	(866)-687-8570	(877)-247-6272		(866)-360-8137	(866)-360-8137	(877)-247-6272		www.wellcare.com	
H0913	005	0	1	01	01	H0913_005_0	7	2009.01	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	WellCare	www.wellcare.com	01	01		1		H0913	005	0	2009	WellCare Select	Middlesex County		2	1	3			2			1	2		(866)-687-8570	(866)-687-8570	(877)-247-6272		(866)-360-8137	(866)-360-8137	(877)-247-6272		(866)-687-8570	(866)-687-8570	(877)-247-6272		(866)-360-8137	(866)-360-8137	(877)-247-6272		www.wellcare.com	
H0913	006	0	1	01	01	H0913_006_0	5	2009.01	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	WellCare	www.wellcare.com	01	01		1		H0913	006	0	2009	WellCare Dividend	Essex, Hudson, Middlesex, Passaic, Union Counties		2	2				2						(866)-687-8570	(866)-687-8570	(877)-247-6272		(866)-360-8137	(866)-360-8137	(877)-247-6272										www.wellcare.com	
H0967	001	0	1	04	01	H0967_001_0	8	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	04		1		H0967	001	0	2009	WellCare PPO	Cuyahoga, Franklin and Hamilton Counties		2	2				2						(866)-530-9490	(866)-530-9490	(877)-247-6272		(866)-360-8153	(866)-360-8153	(877)-247-6272		(866)-530-9490	(866)-530-9490	(877)-247-6272		(866)-360-8153	(866)-360-8153	(877)-247-6272		www.wellcare.com	www.wellcare.com
H0974	001	0	1	01	01	H0974_001_0	5	2009.01	HMO MINNESOTA D/B/A BLUE PLUS	Blue Plus	www.bluecrossmn.com	01	01		1		H0974	001	0	2009	CareBlue	78 Counties within the State of Minnesota		2	1	3		220	2			1	1		(651)-662-6013	(888)-740-6013	(651)-662-8700	(888)-878-0137	(651)-662-3584	(866)-477-1584	(651)-662-8700	(888)-878-0137	(651)-662-6013	(888)-740-6013	(651)-662-8700	(888)-878-0137	(651)-662-3584	(866)-477-1584	(651)-662-8700	(888)-878-0137	www.bluecrossmn.com	www.bluecrossmn.com
H0979	004	0	1	09	04	H0979_004_0	11	2009.01	AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.	AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.	Americas1stChoice.com	04	09	2	1		H0979	004	0	2009	Patriot	Select Counties in North Carolina		2	2			1000	2						(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961									www.Americas1stChoice.com	
H0979	005	0	1	09	04	H0979_005_0	11	2009.01	AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.	AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.	Americas1stChoice.com	04	09	2	1		H0979	005	0	2009	Patriot Plus	Select Counties in North Carolina		2	2			1000	2						(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	www.Americas1stChoice.com	
H0979	006	0	1	09	04	H0979_006_0	8	2009.01	AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.	AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.	Americas1stChoice.com	04	09	2	1		H0979	006	0	2009	Presidential	Select Counties in North Carolina		2	2			1000	2						(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961									www.Americas1stChoice.com	
H0979	007	0	1	09	04	H0979_007_0	9	2009.01	AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.	AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.	Americas1stChoice.com	04	09	2	1		H0979	007	0	2009	Presidential Plus	Select Counties in North Carolina		2	2			1000	2						(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	www.Americas1stChoice.com	
H0979	020	0	1	09	04	H0979_020_0	6	2009.01	AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.	AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.	Americas1stChoice.com	04	09	2	1		H0979	020	0	2009	Ambassador	Select Counties in North Carolina		2	2			1000	2						(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961									www.Americas1stChoice.com	
H0979	021	0	1	09	04	H0979_021_0	8	2009.01	AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.	AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.	Americas1stChoice.com	04	09	2	1		H0979	021	0	2009	Presidential Plan	Select Counties in North Carolina		2	2			1000	2						(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961									www.Americas1stChoice.com	
H0979	022	0	1	09	04	H0979_022_0	11	2009.01	AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.	AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.	Americas1stChoice.com	04	09	2	1		H0979	022	0	2009	Presidential Plus Plan	Select Counties in North Carolina		2	2			1000	2						(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	www.Americas1stChoice.com	
H0979	023	0	1	09	04	H0979_023_0	6	2009.01	AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.	AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.	Americas1stChoice.com	04	09	2	1		H0979	023	0	2009	Ambassador	Select Counties in North Carolina		2	2			1000	2						(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961									www.Americas1stChoice.com	
H1013	011	0	1	01	01	H1013_011_0	7	2009.01	VISTA HEALTHPLAN OF SOUTH FLORIDA, INC.	Vista Healthplan of South Florida, Inc.	www.vistahealthplan.com	01	01		1		H1013	011	0	2009	VISTA Platinum Plan	Miami-Dade County		2	2			5500	2						(800)-441-5501	(800)-441-5501	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352	(800)-842-7442	(800)-842-7442	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352	www.vistahealthplan.com/static/MedicareD/plans_benefits.aspx	www.vistahealthplan.com
H1013	021	0	1	01	01	H1013_021_0	8	2009.01	VISTA HEALTHPLAN OF SOUTH FLORIDA, INC.	Vista Healthplan of South Florida, Inc.	www.vistahealthplan.com	01	01		1		H1013	021	0	2009	VISTA Platinum Select Plan	Broward County		2	2			1900	2						(800)-441-5501	(800)-441-5501	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352	(800)-842-7442	(800)-842-7442	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352	www.vistahealthplan.com/static/MedicareD/plans_benefits.aspx	www.vistahealthplan.com
H1013	024	0	1	01	01	H1013_024_0	6	2009.01	VISTA HEALTHPLAN OF SOUTH FLORIDA, INC.	Vista Healthplan of South Florida, Inc.	www.vistahealthplan.com	01	01		1		H1013	024	0	2009	VISTA Platinum Choice Plan	Dade, Broward, Martin and St. Lucie Counties		2	1	3		400	2			1	2		(800)-441-5501	(800)-441-5501	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352	(800)-842-7442	(800)-842-7442	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352	www.vistahealthplan.com/static/MedicareD/plans_benefits.aspx	www.vistahealthplan.com
H1013	028	0	1	01	01	H1013_028_0	6	2009.01	VISTA HEALTHPLAN OF SOUTH FLORIDA, INC.	Vista Healthplan of South Florida, Inc.	www.vistahealthplan.com	01	01		1		H1013	028	0	2009	VISTA Platinum One Plan	Miami-Dade		2	2			650	2						(800)-441-5501	(800)-441-5501	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352	(800)-842-7442	(800)-842-7442	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352	www.vistahealthplan.com/static/MedicareD/plans_benefits.aspx	www.vistahealthplan.com
H1013	802	0	1	01	01	H1013_802_0	4	2009.01	VISTA HEALTHPLAN OF SOUTH FLORIDA, INC.	Vista Healthplan of South Florida, Inc.	www.vistahealthplan.com	01	01		1		H1013	802	0	2009	VISTA Employer Group - (CY)	All Counties		1	2			100	2						(800)-441-5501	(800)-441-5501	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352	(800)-842-7442	(800)-842-7442	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352	www.vistahealthplan.com/static/MedicareD/plans_benefits.aspx	www.vistahealthplan.com
H1013	803	0	1	01	01	H1013_803_0	4	2009.01	VISTA HEALTHPLAN OF SOUTH FLORIDA, INC.	Vista Healthplan of South Florida, Inc.	www.vistahealthplan.com	01	01		1		H1013	803	0	2009	VISTA Employer Group - MA Only (CY)	National		1	2			250	2						(800)-441-5501	(800)-441-5501	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352									www.vistahealthplan.com/static/MedicareD/plans_benefits.aspx	www.vistahealthplan.com
H1013	804	0	1	01	01	H1013_804_0	4	2009.01	VISTA HEALTHPLAN OF SOUTH FLORIDA, INC.	Vista Healthplan of South Florida, Inc.	www.vistahealthplan.com	01	01		1		H1013	804	0	2009	VISTA Employer Group - MA Only (Non-Cal Yr)	National		1	2			250	2						(800)-441-5501	(800)-441-5501	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352									www.vistahealthplan.com/static/MedicareD/plans_benefits.aspx	www.vistahealthplan.com
H1013	805	0	1	01	01	H1013_805_0	4	2009.01	VISTA HEALTHPLAN OF SOUTH FLORIDA, INC.	Vista Healthplan of South Florida, Inc.	www.vistahealthplan.com	01	01		1		H1013	805	0	2009	VISTA Employer Group - (Non-Cal Yr)	National		1	2			250	2						(800)-441-5501	(800)-441-5501	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352	(800)-842-7442	(800)-842-7442	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352	www.vistahealthplan.com/static/MedicareD/plans_benefits.aspx	www.vistahealthplan.com
H1016	001	0	1	01	01	H1016_001_0	9	2009.01	AVMED, INC	AvMed Medicare Preferred	www.avmed.org	01	01		1		H1016	001	0	2009	AvMed Premier Care	Dade County		2	2			10663	2						(800)-782-8633		(877)-442-8633		(800)-250-9243		(877)-442-8633		(800)-782-8633	(800)-782-8633	(877)-442-8633		(800)-250-9243	(800)-250-9243	(877)-442-8633		http://www.avmed.org/medicare/drug-list.asp	www.avmed.org
H1016	002	0	1	01	01	H1016_002_0	11	2009.01	AVMED, INC	AvMed Medicare Preferred	www.avmed.org	01	01		1		H1016	002	0	2009	AvMed Premier Care	Broward County		2	2			9691	2						(800)-782-8633		(877)-442-8633		(800)-250-9243		(877)-442-8633		(800)-782-8633	(800)-782-8633	(877)-442-8633		(800)-250-9243	(800)-250-9243	(877)-442-8633		http://www.avmed.org/medicare/drug-list.asp	www.avmed.org
H1016	017	0	2	01	01	H1016_017_0	10	2009.01	AVMED, INC	AvMed Medicare Preferred	www.avmed.org	01	01		2		H1016	017	0	2009	AvMed Part B Only Plan	Broward Part B Only		2	2			2	2		2				(800)-782-8633		(877)-442-8633		(800)-250-9243		(877)-442-8633		(800)-782-8633	(800)-782-8633	(877)-442-8633		(800)-250-9243	(800)-250-9243	(877)-442-8633		http://www.avmed.org/medicare/drug-list.asp	www.avmed.org
H1019	001	0	1	01	01	H1019_001_0	4	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	001	0	2009	CareOne Plan	Broward		2	2				2						(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-794-4105	(800)-794-4105	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907		(877)-245-7930	(800)-794-4105	(800)-794-4105		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	002	0	1	01	01	H1019_002_0	4	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	002	0	2009	CareOne Plan	Miami-Dade		2	2				2						(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-794-4105	(800)-794-4105	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907		(877)-245-7930	(800)-794-4105	(800)-794-4105		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	004	0	1	01	01	H1019_004_0	4	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	004	0	2009	CareFree Plan	Broward		2	2				2						(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-794-4105	(800)-794-4105	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907		(877)-245-7930	(800)-794-4105	(800)-794-4105		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	005	0	1	01	01	H1019_005_0	3	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	005	0	2009	CareFree Plan	Miami-Dade		2	2				2						(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-794-4105	(800)-794-4105	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907		(877)-245-7930	(800)-794-4105	(800)-794-4105		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	006	0	1	01	01	H1019_006_0	2	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	006	0	2009	CareCenters Plan	Miami-Dade		2	2				2						(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-794-4105	(800)-794-4105	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907		(877)-245-7930	(800)-794-4105	(800)-794-4105		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	010	0	1	01	01	H1019_010_0	4	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	010	0	2009	CareOne Plan	Palm Beach		2	2				2						(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-794-4105	(800)-794-4105	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907		(877)-245-7930	(800)-794-4105	(800)-794-4105		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	011	0	1	01	01	H1019_011_0	5	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	011	0	2009	CareFree Plan	Palm Beach		2	2				2						(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-794-4105	(800)-794-4105	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907		(877)-245-7930	(800)-794-4105	(800)-794-4105		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	014	0	1	01	01	H1019_014_0	6	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	014	0	2009	CareOne Plan	Hillsborough, Pasco, Pinellas, Polk		2	2				2						(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-531-9030	(800)-531-9030	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907		(877)-245-7930	(800)-531-9030	(800)-531-9030		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	021	0	1	01	01	H1019_021_0	3	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	021	0	2009	CareComplete Plan	Palm Beach		2	2				2						(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-794-4105	(800)-794-4105	(877)-245-7930	(877)-245-7930									http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	023	0	1	01	01	H1019_023_0	5	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	023	0	2009	CareNeeds Plan	Broward		2	1	3			2			1	2		(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-794-4105	(800)-794-4105	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907		(877)-245-7930	(800)-794-4105	(800)-794-4105		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	024	0	1	01	01	H1019_024_0	4	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	024	0	2009	CareNeeds Plan	Miami-Dade		2	1	3			2			1	2		(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-794-4105	(800)-794-4105	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907		(877)-245-7930	(800)-794-4105	(800)-794-4105		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	025	0	1	01	01	H1019_025_0	3	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	025	0	2009	CareNeeds Plan	Palm Beach		2	1	3			2			1	2		(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-794-4105	(800)-794-4105	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907		(877)-245-7930	(800)-794-4105	(800)-794-4105		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	026	0	1	01	01	H1019_026_0	4	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	026	0	2009	CareNeeds Plan	Hillsborough, Pasco, Pinellas		2	1	3			2			1	2		(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-531-9030	(800)-531-9030	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907		(877)-245-7930	(800)-531-9030	(800)-531-9030		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	027	0	1	01	01	H1019_027_0	4	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	027	0	2009	CareOne Plan	Orange, Osceola, Seminole		2	2				2						(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-531-9030	(800)-531-9030	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907		(877)-245-7930	(800)-531-9030	(800)-531-9030		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	028	0	1	01	01	H1019_028_0	4	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	028	0	2009	CareNeeds Plan	Orange, Osceola, Seminole		2	1	3			2			1	2		(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-531-9030	(800)-531-9030	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907		(877)-245-7930	(800)-531-9030	(800)-531-9030		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	029	0	1	01	01	H1019_029_0	4	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	029	0	2009	CareDirect Plan	Orange, Osceola, Seminole		2	1	4			2			1		0000000010000000000000000000	(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-531-9030	(800)-531-9030	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907		(877)-245-7930	(800)-531-9030	(800)-531-9030		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	030	0	1	01	01	H1019_030_0	6	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	030	0	2009	CareSelect Plan	Orange, Osceola, Seminole		2	1	4			2			1		0000000000000000000000000001	(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-531-9030	(800)-531-9030	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-531-9030	(800)-531-9030		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	031	0	1	01	01	H1019_031_0	9	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	031	0	2009	CareComplete Plan	Broward		2	2				2						(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-794-4105	(800)-794-4105	(877)-245-7930	(877)-245-7930									http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	032	0	1	01	01	H1019_032_0	5	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	032	0	2009	CareDirect Plan	Broward		2	1	4			2			1		0000000010000000000000000000	(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-794-4105	(800)-794-4105	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907		(877)-245-7930	(800)-794-4105	(800)-794-4105		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	033	0	1	01	01	H1019_033_0	5	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	033	0	2009	CareSelect Plan	Broward		2	1	4			2			1		0000000000000000000000000001	(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-794-4105	(800)-794-4105	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907		(877)-245-7930	(800)-794-4105	(800)-794-4105		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	034	0	1	01	01	H1019_034_0	3	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	034	0	2009	CareComplete Plan	Miami-Dade		2	2				2						(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-794-4105	(800)-794-4105	(877)-245-7930	(877)-245-7930									http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	035	0	1	01	01	H1019_035_0	5	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	035	0	2009	CareDirect Plan	Miami-Dade		2	1	4			2			1		0000000010000000000000000000	(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-794-4105	(800)-794-4105	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907		(877)-245-7930	(800)-794-4105	(800)-794-4105		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	036	0	1	01	01	H1019_036_0	5	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	036	0	2009	CareSelect Plan	Miami-Dade		2	1	4			2			1		0000000000000000000000000001	(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-794-4105	(800)-794-4105	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907		(877)-245-7930	(800)-794-4105	(800)-794-4105		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	037	0	1	01	01	H1019_037_0	4	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	037	0	2009	CareDirect Plan	Palm Beach		2	1	4			2			1		0000000010000000000000000000	(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-794-4105	(800)-794-4105	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907		(877)-245-7930	(800)-794-4105	(800)-794-4105		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	038	0	1	01	01	H1019_038_0	4	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	038	0	2009	CareSelect Plan	Palm Beach		2	1	4			2			1		0000000000000000000000000001	(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-794-4105	(800)-794-4105	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907		(877)-245-7930	(800)-794-4105	(800)-794-4105		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	039	0	1	01	01	H1019_039_0	2	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	039	0	2009	CareComplete Plan	Hillsborough, Pasco, Pinellas, Polk		2	2				2						(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-531-9030	(800)-531-9030	(877)-245-7930	(877)-245-7930									http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	040	0	1	01	01	H1019_040_0	6	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	040	0	2009	CareDirect Plan	Hillsborough, Pasco, Pinellas		2	1	4			2			1		0000000010000000000000000000	(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-531-9030	(800)-531-9030	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907		(877)-245-7930	(800)-531-9030	(800)-531-9030		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	041	0	1	01	01	H1019_041_0	5	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	041	0	2009	CareSelect Plan	Hillsborough, Pasco, Pinellas		2	1	4			2			1		0000000000000000000000000001	(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-531-9030	(800)-531-9030	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907		(877)-245-7930	(800)-531-9030	(800)-531-9030		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1019	043	0	1	01	01	H1019_043_0	6	2009.01	CARE PLUS HEALTH PLAN	CarePlus Health Plans, Inc.	www.careplus-hp.com	01	01		1		H1019	043	0	2009	CareOne Plan	Brevard, Okeechobee, St. Lucie		2	2				2						(800)-794-5907	(800)-794-5907	(877)-245-7930	(877)-245-7930	(800)-794-4105	(800)-794-4105	(877)-245-7930	(877)-245-7930	(800)-794-5907	(800)-794-5907		(877)-245-7930	(800)-794-4105	(800)-794-4105		(877)-245-7930	http://www.careplus-hp.com/plans_Rx.asp	www.careplus-hp.com
H1026	001	0	1	01	01	H1026_001_0	7	2009.01	HEALTH OPTIONS, INC	Health Options, Inc / Blue Cross Blue Shield of FL	www.bcbsfl.com	01	01		1		H1026	001	0	2009	BlueMedicare HMO	Broward and Miami-Dade Counties		2	2				2						(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	www.myrxassistant.com	www.bcbsfl.com
H1026	033	0	1	01	01	H1026_033_0	7	2009.01	HEALTH OPTIONS, INC	Health Options, Inc / Blue Cross Blue Shield of FL	www.bcbsfl.com	01	01		1		H1026	033	0	2009	BlueMedicare HMO	Hillsborough, Pinellas and Pasco Counties		2	2				2						(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	www.myrxassistant.com	www.bcbsfl.com
H1026	035	0	1	01	01	H1026_035_0	6	2009.01	HEALTH OPTIONS, INC	Health Options, Inc / Blue Cross Blue Shield of FL	www.bcbsfl.com	01	01		1		H1026	035	0	2009	BlueMedicare HMO	Polk County		2	2				2						(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	www.myrxassistant.com	www.bcbsfl.com
H1026	038	0	1	01	01	H1026_038_0	7	2009.01	HEALTH OPTIONS, INC	Health Options, Inc / Blue Cross Blue Shield of FL	www.bcbsfl.com	01	01		1		H1026	038	0	2009	BlueMedicare HMO	Palm Beach County		2	2				2						(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	www.myrxassistant.com	www.bcbsfl.com
H1026	801	0	1	01	01	H1026_801_0	3	2009.01	HEALTH OPTIONS, INC	Health Options, Inc / Blue Cross Blue Shield of FL	www.bcbsfl.com	01	01		1		H1026	801	0	2009	BlueMedicare Group HMO	State of Florida		1	2				2						(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	www.myrxassistant.com	www.bcbsfl.com
H1026	802	0	1	01	01	H1026_802_0	3	2009.01	HEALTH OPTIONS, INC	Health Options, Inc / Blue Cross Blue Shield of FL	www.bcbsfl.com	01	01		1		H1026	802	0	2009	BlueMedicare Group HMO	State of Florida		1	2				2						(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	www.myrxassistant.com	www.bcbsfl.com
H1026	803	0	1	01	01	H1026_803_0	3	2009.01	HEALTH OPTIONS, INC	Health Options, Inc / Blue Cross Blue Shield of FL	www.bcbsfl.com	01	01		1		H1026	803	0	2009	BlueMedicare Group HMO	State of Florida		1	2				2						(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339									www.myrxassistant.com	www.bcbsfl.com
H1032	002	0	1	02	01	H1032_002_0	11	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	002	0	2009	WellCare Choice	Orange, Seminole, and Osceola Counties		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	008	0	1	02	01	H1032_008_0	7	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	008	0	2009	WellCare Choice	Dade County		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	010	0	1	02	01	H1032_010_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	010	0	2009	WellCare Choice	Palm Beach, St. Lucie, and Okeechobee Counties		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	012	0	1	02	01	H1032_012_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	012	0	2009	WellCare Choice	Hillsborough and Pasco Counties		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	014	0	1	02	01	H1032_014_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	014	0	2009	WellCare Choice	Pinellas County		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	019	0	1	02	01	H1032_019_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	019	0	2009	WellCare Value	Hernando County		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	025	0	1	02	01	H1032_025_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	025	0	2009	WellCare Choice	Escambia, Santa Rosa, and Okaloosa Counties		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	028	0	1	02	01	H1032_028_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	028	0	2009	WellCare Value	Orange, Seminole, and Osceola Counties		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	031	0	1	02	01	H1032_031_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	031	0	2009	WellCare Dividend	Palm Beach, St. Lucie, and Okeechobee Counties		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	032	0	1	02	01	H1032_032_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	032	0	2009	WellCare Dividend	Hernando County		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	033	0	1	02	01	H1032_033_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	033	0	2009	WellCare Dividend	Pinellas County		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	035	0	1	02	01	H1032_035_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	035	0	2009	WellCare Value	Hillsborough, Pasco and Pinellas Counties		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	037	0	1	01	01	H1032_037_0	5	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	01		1		H1032	037	0	2009	WellCare Advance	Orange, Seminole, and Osceola Counties		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272										www.wellcare.com	
H1032	040	0	1	02	01	H1032_040_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	040	0	2009	WellCare Dividend	Dade County		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	043	0	1	02	01	H1032_043_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	043	0	2009	WellCare Dividend	Broward County		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	044	0	1	02	01	H1032_044_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	044	0	2009	WellCare Value	Broward County		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	060	0	1	02	01	H1032_060_0	7	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	060	0	2009	WellCare Select	Palm Beach, St. Lucie, and Okeechobee Counties		2	1	3			2			1	2		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	061	0	1	02	01	H1032_061_0	8	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	061	0	2009	WellCare Select	Orange, Seminole, and Osceola Counties		2	1	3			2			1	2		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	064	0	1	02	01	H1032_064_0	7	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	064	0	2009	WellCare Select	Pinellas County		2	1	3			2			1	2		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	065	0	1	02	01	H1032_065_0	7	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	065	0	2009	WellCare Select	Hillsborough County		2	1	3			2			1	2		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	066	0	1	02	01	H1032_066_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	066	0	2009	WellCare Select	Broward County		2	1	3			2			1	2		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	069	0	1	02	01	H1032_069_0	7	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	069	0	2009	WellCare Choice	Manatee County		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	073	0	1	02	01	H1032_073_0	11	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	073	0	2009	WellCare Choice	Duval County		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	077	0	1	01	01	H1032_077_0	5	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	01		1		H1032	077	0	2009	WellCare Advance	Brevard and Indian River Counties		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272										www.wellcare.com	
H1032	079	0	1	02	01	H1032_079_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	079	0	2009	WellCare Value	Escambia, Santa Rosa, and Okaloosa Counties		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	085	0	1	01	01	H1032_085_0	7	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	01		1		H1032	085	0	2009	WellCare Access	Hillsborough County		2	1	3			2			1	1		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	086	0	1	01	01	H1032_086_0	7	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	01		1		H1032	086	0	2009	WellCare Access	Pinellas County		2	1	3			2			1	1		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	088	0	1	01	01	H1032_088_0	8	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	01		1		H1032	088	0	2009	WellCare Access	Broward County		2	1	3			2			1	1		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	089	0	1	01	01	H1032_089_0	7	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	01		1		H1032	089	0	2009	WellCare Access	Palm Beach, St Lucie, and Okeechobee Counties		2	1	3			2			1	1		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	091	0	1	02	01	H1032_091_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	091	0	2009	WellCare Essential	Orange, Seminole and Osceola Counties		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	097	0	1	02	01	H1032_097_0	9	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	097	0	2009	WellCare Dividend	Manatee County		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	098	0	1	02	01	H1032_098_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	098	0	2009	WellCare Dividend	Polk County		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	101	0	1	02	01	H1032_101_0	7	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	101	0	2009	WellCare Select	Clay and Duval Counties		2	1	3			2			1	2		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	102	0	1	02	01	H1032_102_0	7	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	102	0	2009	WellCare Select	Brevard County		2	1	3			2			1	2		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	104	0	1	02	01	H1032_104_0	8	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	104	0	2009	WellCare Select	Manatee County		2	1	3			2			1	2		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	106	0	1	02	01	H1032_106_0	7	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	106	0	2009	WellCare Select	Polk County		2	1	3			2			1	2		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	107	0	1	02	01	H1032_107_0	7	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	107	0	2009	WellCare Select	Miami - Dade County		2	1	3			2			1	2		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	113	0	1	02	01	H1032_113_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	113	0	2009	WellCare Value	St. Lucie, Palm Beach, and Okeechobee Counties		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	122	0	1	01	01	H1032_122_0	7	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	01		1		H1032	122	0	2009	Wellcare Access	Brevard and Indian River Counties		2	1	3			2			1	1		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	123	0	1	01	01	H1032_123_0	7	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	01		1		H1032	123	0	2009	WellCare Access	Clay and Duval Counties		2	1	3			2			1	1		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	124	0	1	01	01	H1032_124_0	7	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	01		1		H1032	124	0	2009	WellCare Access	Orange, Seminole, and Osceola Counties		2	1	3			2			1	1		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	125	0	1	01	01	H1032_125_0	7	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	01		1		H1032	125	0	2009	WellCare Access	Escambia, Santa Rosa, Okaloosa, et al		2	1	3			2			1	1		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	126	0	1	02	01	H1032_126_0	7	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	126	0	2009	WellCare Select	Escambia, Santa Rosa, and Okaloosa Counties		2	1	3			2			1	2		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	127	0	1	01	01	H1032_127_0	7	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	01		1		H1032	127	0	2009	WellCare Access	Hernando County		2	1	3			2			1	1		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	128	0	1	01	01	H1032_128_0	8	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	01		1		H1032	128	0	2009	WellCare Access	Manatee County		2	1	3			2			1	1		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	130	0	1	01	01	H1032_130_0	7	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	01		1		H1032	130	0	2009	WellCare Access	Polk County		2	1	3			2			1	1		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	131	0	1	02	01	H1032_131_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	131	0	2009	WellCare Dividend	Hillsborough and Pasco Counties		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	132	0	1	02	01	H1032_132_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	132	0	2009	WellCare Value	Polk County		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	133	0	1	02	01	H1032_133_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	133	0	2009	WellCare Value	Brevard, Indian River and Marion Counties		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	136	0	1	02	01	H1032_136_0	7	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	136	0	2009	WellCare Select	Pasco County		2	1	3			2			1	2		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	138	0	1	01	01	H1032_138_0	7	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	01		1		H1032	138	0	2009	WellCare Access	Pasco County		2	1	3			2			1	1		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	144	0	1	02	01	H1032_144_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	144	0	2009	WellCare Value	Lake County		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	145	0	1	02	01	H1032_145_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	145	0	2009	WellCare Value	Calhoun, Gadsden, Jefferson, Liberty, et. al		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	146	0	1	02	01	H1032_146_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	146	0	2009	WellCare Value	Citrus County		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	148	0	1	01	01	H1032_148_0	7	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	01		1		H1032	148	0	2009	WellCare Access	Lake and Marion Counties		2	1	3			2			1	1		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	152	0	1	02	01	H1032_152_0	8	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	152	0	2009	WellCare Select	Lake and Marion Counties		2	1	3			2			1	2		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	153	0	1	02	01	H1032_153_0	7	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	153	0	2009	WellCare Select	Calhoun, Gadsden, Jefferson, Liberty, et. al.		2	1	3			2			1	2		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	162	0	1	02	01	H1032_162_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	162	0	2009	WellCare Select	Hernando County		2	1	3			2			1	2		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	163	0	1	01	01	H1032_163_0	8	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	01		1		H1032	163	0	2009	WellCare Access	Dade County		2	1	3			2			1	1		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	164	0	1	02	01	H1032_164_0	6	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	164	0	2009	WellCare Prescription Plus	Hillsborough and Pasco Counties		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	166	0	1	02	01	H1032_166_0	8	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	166	0	2009	WellCare Value Plus	Pinellas County		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	168	0	1	02	01	H1032_168_0	8	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	168	0	2009	WellCare Premium	Clay County		2	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	801	0	1	02	01	H1032_801_0	4	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	801	0	2009	Employer Florida 1	Nationwide		1	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	802	0	1	02	01	H1032_802_0	4	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	802	0	2009	Employer Florida 2	Nationwide		1	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272		www.wellcare.com	
H1032	803	0	1	02	01	H1032_803_0	4	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	803	0	2009	Employer Florida 3	Nationwide		1	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272										www.wellcare.com	
H1032	804	0	1	02	01	H1032_804_0	4	2009.01	WELL CARE OF FLORIDA, INC.	WellCare	www.wellcare.com	01	02		1		H1032	804	0	2009	Employer Florida 4	Nationwide		1	2				2						(888)-888-9355	(888)-888-9355	(877)-247-6272		(866)-238-3885	(866)-238-3885	(877)-247-6272										www.wellcare.com	
H1035	002	0	1	02	01	H1035_002_0	6	2009.01	FLORIDA HEALTH CARE PLAN, INC.	Florida Health Care Plan, Inc.	http://fhcp.com/medicare/overview/overview.htm	01	02		1		H1035	002	0	2009	FHCP Medvantage Rx Plus	Volusia and Flagler Counties, FL		2	2			14000	2						(386)-615-4022	(877)-615-4022	(386)-615-4045	(877)-260-8312	(386)-676-7110	(800)-232-0578	(386)-615-4045	(877)-260-8312	(386)-615-4022	(877)-615-4022	(386)-615-4045	(877)-260-8312	(386)-676-7110	(800)-232-0578	(386)-615-4045	(877)-260-8312	http://fhcp.com/medicare/formulary/formulary.htm	http://fhcp.com/members/findAProvider/providers.htm
H1035	006	0	1	02	01	H1035_006_0	7	2009.01	FLORIDA HEALTH CARE PLAN, INC.	Florida Health Care Plan, Inc.	http://fhcp.com/medicare/overview/overview.htm	01	02		1		H1035	006	0	2009	FHCP Medvantage Rx	Volusia and Flagler Counties, FL		2	2			1000	2						(386)-615-4022	(877)-615-4022	(386)-615-4045	(877)-260-8312	(386)-676-7110	(800)-232-0578	(386)-615-4045	(877)-260-8312	(386)-615-4022	(877)-615-4022	(386)-615-4045	(877)-260-8312	(386)-676-7110	(800)-232-0578	(386)-615-4045	(877)-260-8312	http://fhcp.com/medicare/formulary/formulary.htm	http://fhcp.com/members/findAProvider/providers.htm
H1035	007	0	1	02	01	H1035_007_0	4	2009.01	FLORIDA HEALTH CARE PLAN, INC.	Florida Health Care Plan, Inc.	http://fhcp.com/medicare/overview/overview.htm	01	02		1		H1035	007	0	2009	FHCP Medvantage	Volusia and Flagler Counties, FL		2	2			800	2						(386)-615-4022	(877)-615-4022	(386)-615-4045	(877)-260-8312	(386)-676-7110	(800)-232-0578	(386)-615-4045	(877)-260-8312									http://fhcp.com/medicare/formulary/formulary.htm	http://fhcp.com/members/findAProvider/providers.htm
H1036	011	0	1	01	01	H1036_011_0	3	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	011	0	2009	Humana Gold Plus HMO H1036-011A	Broward County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	025	0	1	01	01	H1036_025_0	6	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	025	0	2009	Humana Gold Plus HMO H1036-025	Hillsborough County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	034	0	1	01	01	H1036_034_0	3	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	034	0	2009	Humana Gold Plus HMO H1036-034A	Dade County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	035	0	1	01	01	H1036_035_0	3	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	035	0	2009	Humana Gold Plus HMO H1036-035A	Palm Beach County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	037	0	1	01	01	H1036_037_0	4	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	037	0	2009	Humana Gold Plus HMO H1036-037C	Baker, Duval and Nassau Counties		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	040	0	1	01	01	H1036_040_0	7	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	040	0	2009	Humana Gold Plus HMO H1036-040	Pasco County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	044	0	1	01	01	H1036_044_0	3	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	044	0	2009	Humana Gold Plus HMO H1036-044	Flagler, Volusia Counties		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	047	0	1	01	01	H1036_047_0	6	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	047	0	2009	Humana Gold Plus HMO H1036-047	Orlando Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	052	0	1	01	01	H1036_052_0	4	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	052	0	2009	Humana Gold Plus HMO H1036-052	Pinellas County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	053	0	1	01	01	H1036_053_0	2	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	053	0	2009	Humana Gold Plus HMO H1036-053A	Broward County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	054	0	1	01	01	H1036_054_0	2	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	054	0	2009	Humana Gold Plus HMO H1036-054C	Dade County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	056	0	1	01	01	H1036_056_0	2	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	056	0	2009	Humana Gold Plus HMO H1036-056	Flagler, Volusia Counties		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	062	0	1	01	01	H1036_062_0	3	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	062	0	2009	Humana Gold Plus HMO H1036-062C	Palm Beach County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	063	0	1	01	01	H1036_063_0	3	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	063	0	2009	Humana Gold Plus HMO H1036-063A	Palm Beach County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	065	0	1	01	01	H1036_065_0	2	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	065	0	2009	Humana Gold Plus HMO H1036-065C	Broward County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	067	0	1	01	01	H1036_067_0	4	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	067	0	2009	Humana Gold Plus HMO H1036-067	Hernando County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	068	0	1	01	01	H1036_068_0	4	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	068	0	2009	Humana Gold Plus HMO H1036-068	St Johns, Putnam, Clay Counties		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	074	0	1	01	01	H1036_074_0	4	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	074	0	2009	Humana Gold Plus HMO H1036-074	Manatee County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	077	0	1	01	01	H1036_077_0	3	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	077	0	2009	Humana Gold Plus HMO SNP-DE H1036-077A	Dade County		2	1	3			2			1	2		(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	081	0	1	01	01	H1036_081_0	4	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	081	0	2009	Humana Gold Plus HMO H1036-081D	Baker, Duval, Nassau Counties		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	100	0	1	01	01	H1036_100_0	6	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	100	0	2009	Humana Gold Plus HMO H1036-100	Orlando Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	102	0	1	01	01	H1036_102_0	6	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	102	0	2009	Humana Gold Plus HMO SNP-DE H1036-102	Tampa Metro Area		2	1	3			2			1	2		(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	103	0	1	01	01	H1036_103_0	3	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	103	0	2009	Humana Gold Plus HMO SNP-DE H1036-103A	Broward County		2	1	3			2			1	2		(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	104	0	1	01	01	H1036_104_0	4	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	104	0	2009	Humana Gold Plus HMO SNP-DE H1036-104A	Palm Beach County		2	1	3			2			1	2		(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	105	0	1	01	01	H1036_105_0	6	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	105	0	2009	Humana Gold Plus HMO SNP-DE H1036-105	Flagler, Volusia Counties		2	1	3			2			1	2		(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	106	0	1	01	01	H1036_106_0	3	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	106	0	2009	Humana Gold Plus HMO SNP-DB H1036-106	Flagler, Volusia Counties		2	1	4			2			1		0000000000000000000000000001	(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	108	0	1	01	01	H1036_108_0	4	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	108	0	2009	Humana Gold Plus HMO SNP-DB H1036-108D	Baker, Duval, Nassau Counties		2	1	4			2			1		0000000010000000000000000000	(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	109	0	1	01	01	H1036_109_0	6	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	109	0	2009	Humana Gold Plus HMO SNP-DE H1036-109C	Baker, Duval, Nassau Counties		2	1	3			2			1	2		(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	110	0	1	01	01	H1036_110_0	4	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	110	0	2009	Humana Gold Plus HMO SNP-DB H1036-110	St. Johns, Putnam Counties		2	1	4			2			1		0000000010000000000000000000	(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	114	0	1	01	01	H1036_114_0	6	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	114	0	2009	Humana Gold Plus HMO SNP-DE H1036-114	Orlando Metro Area		2	1	3			2			1	2		(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	115	0	1	01	01	H1036_115_0	6	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	115	0	2009	Humana Gold Plus HMO SNP-DB H1036-115	Orlando Metro Area		2	1	4			2			1		0000000000000000000000000001	(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	116	0	1	01	01	H1036_116_0	6	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	116	0	2009	Humana Gold Plus HMO SNP-OA H1036-116	Orlando Metro Area		2	1	4			2			1		0000000000000000000000000001	(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	117	0	1	01	01	H1036_117_0	7	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	117	0	2009	Humana Gold Plus HMO SNP-DB H1036-117	Tampa Metro Area		2	1	4			2			1		0000000000000000000000000001	(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	118	0	1	01	01	H1036_118_0	8	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	118	0	2009	Humana Gold Plus HMO SNP-OA H1036-118	Tampa Metro Area		2	1	4			2			1		0000000000000000000000000001	(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	119	0	1	01	01	H1036_119_0	4	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	119	0	2009	Humana Gold Plus HMO H1036-119	Tampa Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	121	0	1	01	01	H1036_121_0	3	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	121	0	2009	Humana Gold Plus HMO SNP-DB H1036-121C	Broward County		2	1	4			2			1		0000000010000000000000000000	(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	122	0	1	01	01	H1036_122_0	3	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	122	0	2009	Humana Gold Plus HMO SNP-OA H1036-122C	Broward County		2	1	4			2			1		0000000000000000000000000001	(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	123	0	1	01	01	H1036_123_0	3	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	123	0	2009	Humana Gold Plus HMO H1036-123C	Broward County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	125	0	1	01	01	H1036_125_0	3	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	125	0	2009	Humana Gold Plus HMO SNP-DB H1036-125C	Dade County		2	1	4			2			1		0000000010000000000000000000	(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	126	0	1	01	01	H1036_126_0	3	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	126	0	2009	Humana Gold Plus HMO SNP-OA H1036-126C	Dade County		2	1	4			2			1		0000000000000000000000000001	(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	127	0	1	01	01	H1036_127_0	3	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	127	0	2009	Humana Gold Plus HMO H1036-127C	Dade County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	128	0	1	01	01	H1036_128_0	3	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	128	0	2009	Humana Gold Plus HMO H1036-128C	Dade County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	129	0	1	01	01	H1036_129_0	3	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	129	0	2009	Humana Gold Plus HMO H1036-129C	Palm Beach County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	130	0	1	01	01	H1036_130_0	3	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	130	0	2009	Humana Gold Plus HMO SNP-DB H1036-130C	Palm Beach County		2	1	4			2			1		0000000010000000000000000000	(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	131	0	1	01	01	H1036_131_0	3	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	131	0	2009	Humana Gold Plus HMO SNP-OA H1036-131C	Palm Beach County		2	1	4			2			1		0000000000000000000000000001	(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	801	0	1	01	01	H1036_801_0	1	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	801	0	2009	Humana Employer Sponsored	State of Florida (selected counties)		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	806	0	1	01	01	H1036_806_0	5	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	806	0	2009	Humana Employer Sponsored	State of Florida (selected counties)		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	807	0	1	01	01	H1036_807_0	1	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	807	0	2009	Humana Employer Sponsored Non-CY	State of Florida (select counties)		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1036	808	0	1	01	01	H1036_808_0	1	2009.01	HUMANA MEDICAL PLAN, INC	Humana Medical Plan, Inc.	www.humana-medicare.com	01	01		1		H1036	808	0	2009	Humana Employer Sponsored Non-CY	State of Florida (select counties)		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1043	001	0	1	20	08	H1043_001_0	1	2009.01	FLORIDA PACE CENTERS, INC.	Florida Pace Centers, Inc.	www.floridapace.org	08	20		1		H1043	001	0	2009	Florida PACE Centers, Inc.	Florida PACE Centers, Inc.		2	2				2														(305)-751-7223	(305)-262-7842			(305)-751-7223	(305)-262-7842			www.noformulary.com	
H1043	002	0	1	20	08	H1043_002_0	1	2009.01	FLORIDA PACE CENTERS, INC.	Florida Pace Centers, Inc.	www.floridapace.org	08	20		1		H1043	002	0	2009	Florida PACE Centers, Inc	Florida PACE Centers, Inc.		2	2				2														(305)-751-7223	(305)-262-7842			(305)-751-7223	(305)-262-7842			www.noformulary.com	
H1045	001	0	1	01	01	H1045_001_0	4	2009.01	PREFERRED CARE PARTNERS INC.	Preferred Care Partners, Inc.	www.mypreferredcare.com	01	01		1		H1045	001	0	2009	Preferred Care Partners PSO Health Plan	Miami-Dade County		2	2			15748	2						(866)-231-7201		(800)-406-8076		(866)-473-0218		(800)-406-8076		(866)-231-7201	(866)-231-7201	(800)-406-8076		(866)-473-0218	(866)-473-0218	(800)-406-8076		http://www.mypreferredcare.com/formulary.cfm	www.mypreferredcare.com
H1045	005	0	1	01	01	H1045_005_0	3	2009.01	PREFERRED CARE PARTNERS INC.	Preferred Care Partners, Inc.	www.mypreferredcare.com	01	01		1		H1045	005	0	2009	Preferred Care Partners PSO Health Plan	Broward County		2	2			1403	2						(866)-231-7201		(800)-406-8076		(866)-473-0218		(800)-406-8076		(866)-231-7201	(866)-231-7201	(800)-406-8076		(866)-473-0218	(866)-473-0218	(800)-406-8076		http://www.mypreferredcare.com/formulary.cfm	www.mypreferredcare.com
H1045	008	0	1	01	01	H1045_008_0	4	2009.01	PREFERRED CARE PARTNERS INC.	Preferred Care Partners, Inc.	www.mypreferredcare.com	01	01		1		H1045	008	0	2009	Preferred Care Partners SeniorHealthChoice	Miami-Dade County		2	2			5963	2						(866)-231-7201		(800)-406-8076		(866)-473-0218		(800)-406-8076		(866)-231-7201	(866)-231-7201	(800)-406-8076		(866)-473-0218	(866)-473-0218	(800)-406-8076		http://www.mypreferredcare.com/formulary.cfm	www.mypreferredcare.com
H1045	009	0	2	01	01	H1045_009_0	4	2009.01	PREFERRED CARE PARTNERS INC.	Preferred Care Partners, Inc.	www.mypreferredcare.com	01	01		2		H1045	009	0	2009	Preferred Care Partners Medicare Part B	Miami-Dade and Broward Counties		2	2			2	2		2				(866)-231-7201		(800)-406-8076		(866)-473-0218		(800)-406-8076		(866)-231-7201	(866)-231-7201	(800)-406-8076		(866)-473-0218	(866)-473-0218	(800)-406-8076		http://www.mypreferredcare.com/formulary.cfm	www.mypreferredcare.com
H1045	010	0	1	01	01	H1045_010_0	4	2009.01	PREFERRED CARE PARTNERS INC.	Preferred Care Partners, Inc.	www.mypreferredcare.com	01	01		1		H1045	010	0	2009	Preferred Care Partners Premuim Advantage	Miami-Dade County		2	2			133	2						(866)-231-7201		(800)-406-8076		(866)-473-0218		(800)-406-8076		(866)-231-7201	(866)-231-7201	(800)-406-8076		(866)-473-0218	(866)-473-0218	(800)-406-8076		http://www.mypreferredcare.com/formulary.cfm	www.mypreferredcare.com
H1045	011	0	1	01	01	H1045_011_0	5	2009.01	PREFERRED CARE PARTNERS INC.	Preferred Care Partners, Inc.	www.mypreferredcare.com	01	01		1		H1045	011	0	2009	Preferred Care Partners Premuim Advantage	Broward County		2	2			106	2						(866)-231-7201		(800)-406-8076		(866)-473-0218		(800)-406-8076		(866)-231-7201	(866)-231-7201	(800)-406-8076		(866)-473-0218	(866)-473-0218	(800)-406-8076		http://www.mypreferredcare.com/formulary.cfm	www.mypreferredcare.com
H1045	012	0	1	01	01	H1045_012_0	6	2009.01	PREFERRED CARE PARTNERS INC.	Preferred Care Partners, Inc.	www.mypreferredcare.com	01	01		1		H1045	012	0	2009	Preferred Care Partners Medicare Assist	Miami-Dade and Broward Counties		2	1	3		530	2			1	2		(866)-231-7201		(800)-406-8076		(866)-473-0218		(800)-406-8076		(866)-231-7201	(866)-231-7201	(800)-406-8076		(866)-473-0218	(866)-473-0218	(800)-406-8076		http://www.mypreferredcare.com/formulary.cfm	www.mypreferredcare.com
H1045	014	0	1	02	01	H1045_014_0	9	2009.01	PREFERRED CARE PARTNERS INC.	Preferred Care Partners, Inc.	www.mypreferredcare.com	01	02		1		H1045	014	0	2009	Preferred Care Partners Healthy America	Lake, Marion, and Sumter Counties		2	2			330	2						(866)-231-7201		(800)-406-8076		(866)-473-0218		(800)-406-8076		(866)-231-7201	(866)-231-7201	(800)-406-8076		(866)-473-0218	(866)-473-0218	(800)-406-8076		http://www.mypreferredcare.com/formulary.cfm	www.mypreferredcare.com
H1045	015	0	1	02	01	H1045_015_0	7	2009.01	PREFERRED CARE PARTNERS INC.	Preferred Care Partners, Inc.	www.mypreferredcare.com	01	02		1		H1045	015	0	2009	Preferred Care Partners Healthy America Plus	Lake, Marion, and Sumter Counties		2	2			770	2						(866)-231-7201		(800)-406-8076		(866)-473-0218		(800)-406-8076		(866)-231-7201	(866)-231-7201	(800)-406-8076		(866)-473-0218	(866)-473-0218	(800)-406-8076		http://www.mypreferredcare.com/formulary.cfm	www.mypreferredcare.com
H1076	003	0	1	01	01	H1076_003_0	6	2009.01	VISTA HEALTHPLAN, INC.	Vista Healthplan, Inc.	www.vistahealthplan.com	01	01		1		H1076	003	0	2009	VISTA Platinum Select Plan	Broward County		2	2			1000	2						(866)-847-8235	(866)-847-8235	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352	(800)-977-7339	(800)-977-7339	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352	www.vistahealthplan.com/static/MedicareD/plans_benefits.aspx	www.vistahealthplan.com
H1076	010	0	1	01	01	H1076_010_0	6	2009.01	VISTA HEALTHPLAN, INC.	Vista Healthplan, Inc.	www.vistahealthplan.com	01	01		1		H1076	010	0	2009	VISTA Platinum Value Plan	Dade, Broward and Palm Beach Counties		2	2			800	2						(866)-847-8235	(866)-847-8235	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352									www.vistahealthplan.com/static/MedicareD/plans_benefits.aspx	www.vistahealthplan.com
H1076	011	0	1	01	01	H1076_011_0	6	2009.01	VISTA HEALTHPLAN, INC.	Vista Healthplan, Inc.	www.vistahealthplan.com	01	01		1		H1076	011	0	2009	VISTA Platinum Choice Plan	Dade, Broward and Palm Beach Counties		2	1	3		1000	2			1	2		(866)-847-8235	(866)-847-8235	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352	(800)-977-7339	(800)-977-7339	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352	www.vistahealthplan.com/static/MedicareD/plans_benefits.aspx	www.vistahealthplan.com
H1076	016	0	1	01	01	H1076_016_0	8	2009.01	VISTA HEALTHPLAN, INC.	Vista Healthplan, Inc.	www.vistahealthplan.com	01	01		1		H1076	016	0	2009	VISTA Platinum Prime Plan	Palm Beach County		2	2			900	2						(866)-847-8235	(866)-847-8235	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352	(800)-977-7339	(800)-977-7339	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352	www.vistahealthplan.com/static/MedicareD/plans_benefits.aspx	www.vistahealthplan.com
H1076	802	0	1	01	01	H1076_802_0	4	2009.01	VISTA HEALTHPLAN, INC.	Vista Healthplan, Inc.	www.vistahealthplan.com	01	01		1		H1076	802	0	2009	VISTA Employer Group - (CY)	All Counties		1	2			1000	2						(866)-847-8235	(866)-847-8235	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352	(800)-977-7339	(800)-977-7339	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352	www.vistahealthplan.com/static/MedicareD/plans_benefits.aspx	www.vistahealthplan.com
H1076	803	0	1	01	01	H1076_803_0	4	2009.01	VISTA HEALTHPLAN, INC.	Vista Healthplan, Inc.	www.vistahealthplan.com	01	01		1		H1076	803	0	2009	VISTA Employer Group - MA Only (CY)	National		1	2			250	2						(866)-847-8235	(866)-847-8235	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352									www.vistahealthplan.com/static/MedicareD/plans_benefits.aspx	www.vistahealthplan.com
H1076	804	0	1	01	01	H1076_804_0	4	2009.01	VISTA HEALTHPLAN, INC.	Vista Healthplan, Inc.	www.vistahealthplan.com	01	01		1		H1076	804	0	2009	VISTA Employer Group - MA-Only (Non-Cal Yr)	National		1	2			250	2						(866)-847-8235	(866)-847-8235	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352									www.vistahealthplan.com/static/MedicareD/plans_benefits.aspx	www.vistahealthplan.com
H1076	805	0	1	01	01	H1076_805_0	4	2009.01	VISTA HEALTHPLAN, INC.	Vista Healthplan, Inc.	www.vistahealthplan.com	01	01		1		H1076	805	0	2009	VISTA Employer Group - (Non-Cal Yr)	National		1	2			250	2						(866)-847-8235	(866)-847-8235	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352	(800)-977-7339	(800)-977-7339	(888)-444-7352	(888)-444-7352	(800)-826-1013	(800)-826-1013	(888)-444-7352	(888)-444-7352	www.vistahealthplan.com/static/MedicareD/plans_benefits.aspx	www.vistahealthplan.com
H1080	004	0	1	01	01	H1080_004_0	7	2009.01	UNITED HEALTHCARE OF FL, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H1080	004	0	2009	AARP MedicareComplete	Hillsborough,Pinellas,Hernando and Pasco Counties		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1080	011	0	1	02	01	H1080_011_0	5	2009.01	UNITED HEALTHCARE OF FL, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H1080	011	0	2009	AARP MedicareComplete Plus Plan1	Charlotte, Lee, Polk, Sarasota, Manatee Counties		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1080	036	0	1	01	01	H1080_036_0	5	2009.01	UNITED HEALTHCARE OF FL, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H1080	036	0	2009	Evercare Plan DH	Tampa area Counties		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1080	042	0	1	01	01	H1080_042_0	4	2009.01	UNITED HEALTHCARE OF FL, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H1080	042	0	2009	AARP MedicareComplete	St. Lucie FL		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1080	801	0	1	01	01	H1080_801_0	4	2009.01	UNITED HEALTHCARE OF FL, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H1080	801	0	2009	MedicareComplete Retiree Plan	Select Counties in Florida		1	2				2						(800)-711-6088		(888)-685-8480		(800)-973-6467		(800)-387-1074		(800)-711-6088	(800)-711-6088	(888)-685-8480		(800)-973-6467	(800)-973-6467	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1080	804	0	1	01	01	H1080_804_0	4	2009.01	UNITED HEALTHCARE OF FL, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H1080	804	0	2009	MedicareComplete Retiree Plan	Select Counties in Florida		1	2				2						(800)-711-6088		(888)-685-8480		(800)-973-6467		(888)-685-8480										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1099	001	0	1	02	01	H1099_001_0	4	2009.01	HEALTH FIRST HEALTH PLANS, INC.	Health First Medicare Plans	healthfirsthealthplans.org	01	02		1		H1099	001	0	2009	Health First Classic Plan	All Brevard and Indian River Zip 32927/32958/32978		2	2			5000	2						(321)-434-5665	(800)-716-7737	(800)-955-8771		(321)-434-5665	(800)-716-7737	(800)-955-8771		(321)-434-5665	(800)-716-7737	(800)-955-8771	(800)-955-8771	(321)-434-5665	(800)-716-7737	(800)-955-8771		http://www.healthfirsthealthplans.org/health_plans/medicare/index.cfm	www.healthfirsthealthplans.org
H1099	006	0	1	01	01	H1099_006_0	4	2009.01	HEALTH FIRST HEALTH PLANS, INC.	Health First Medicare Plans	healthfirsthealthplans.org	01	01		1		H1099	006	0	2009	Health First Value Plan	All Brevard and Indian River Zip 32927/32958/32978		2	2			5000	2						(321)-434-5665	(800)-716-7737	(800)-955-8771		(321)-434-5665	(800)-716-7737	(800)-955-8771		(321)-434-5665	(800)-716-7737	(800)-955-8771	(800)-955-8771	(321)-434-5665	(800)-716-7737	(800)-955-8771		http://www.healthfirsthealthplans.org/health_plans/medicare/index.cfm	www.healthfirsthealthplans.org
H1099	008	0	1	01	01	H1099_008_0	4	2009.01	HEALTH FIRST HEALTH PLANS, INC.	Health First Medicare Plans	healthfirsthealthplans.org	01	01		1		H1099	008	0	2009	Health First Sunshine Plan	All Brevard and Indian River Zip 32927/32958/32978		2	1	3		5000	2			1	2		(321)-434-5665	(800)-716-7737	(800)-955-8771		(321)-434-5665	(800)-716-7737	(800)-955-8771		(321)-434-5665	(800)-716-7737	(800)-955-8771	(800)-955-8771	(321)-434-5665	(800)-716-7737	(800)-955-8771		http://www.healthfirsthealthplans.org/health_plans/medicare/index.cfm	www.healthfirsthealthplans.org
H1099	009	0	1	01	01	H1099_009_0	3	2009.01	HEALTH FIRST HEALTH PLANS, INC.	Health First Medicare Plans	healthfirsthealthplans.org	01	01		1		H1099	009	0	2009	Health First Secure Plan	All Brevard and Indian River Zip 32927/32958/32978		2	2			5000	2						(321)-434-5665	(800)-716-7737	(800)-955-8771		(321)-434-5665	(800)-716-7737	(800)-955-8771										http://www.healthfirsthealthplans.org/health_plans/medicare/index.cfm	www.healthfirsthealthplans.org
H1099	010	0	1	01	01	H1099_010_0	4	2009.01	HEALTH FIRST HEALTH PLANS, INC.	Health First Medicare Plans	healthfirsthealthplans.org	01	01		1		H1099	010	0	2009	Health First Premier Plan	All Brevard and Indian River Zip 32927/32958/32978		2	2			2000	2						(321)-434-5665	(800)-716-7737	(800)-955-8771		(321)-434-5665	(800)-716-7737	(800)-955-8771		(321)-434-5665	(800)-716-7737	(800)-955-8771	(800)-955-8771	(321)-434-5665	(800)-716-7737	(800)-955-8771		http://www.healthfirsthealthplans.org/health_plans/medicare/index.cfm	www.healthfirsthealthplans.org
H1099	011	0	1	02	01	H1099_011_0	4	2009.01	HEALTH FIRST HEALTH PLANS, INC.	Health First Medicare Plans	healthfirsthealthplans.org	01	02		1		H1099	011	0	2009	Health First Explorer Plan	All Brevard and Indian River Zip 32927/32958/32978		2	2			1000	2						(321)-434-5665	(800)-716-7737	(800)-955-8771		(321)-434-5665	(800)-716-7737	(800)-955-8771		(321)-434-5665	(800)-716-7737	(800)-955-8771	(800)-955-8771	(321)-434-5665	(800)-716-7737	(800)-955-8771		http://www.healthfirsthealthplans.org/health_plans/medicare/index.cfm	www.healthfirsthealthplans.org
H1099	802	0	1	01	01	H1099_802_0	2	2009.01	HEALTH FIRST HEALTH PLANS, INC.	Health First Medicare Plans	healthfirsthealthplans.org	01	01		1		H1099	802	0	2009	Health First Employer Group Plus	All Brevard and Indian River Zip 32927/32958/32978		1	2			1000	2						(321)-434-5665	(800)-716-7737	(800)-955-8771		(321)-434-5665	(800)-716-7737	(800)-955-8771		(321)-434-5665	(800)-716-7737	(800)-955-8771	(800)-955-8771	(321)-434-5665	(800)-716-7737	(800)-955-8771		http://www.healthfirsthealthplans.org/health_plans/medicare/index.cfm	www.healthfirsthealthplans.org
H1099	803	0	1	01	01	H1099_803_0	2	2009.01	HEALTH FIRST HEALTH PLANS, INC.	Health First Medicare Plans	healthfirsthealthplans.org	01	01		1		H1099	803	0	2009	Health First Employer Group Basic	All Brevard and Indian River Zip 32927/32958/32978		1	2			1000	2						(321)-434-5665	(800)-716-7737	(800)-955-8771		(321)-434-5665	(800)-716-7737	(800)-955-8771										http://www.healthfirsthealthplans.org/health_plans/medicare/index.cfm	www.healthfirsthealthplans.org
H1099	804	0	1	02	01	H1099_804_0	2	2009.01	HEALTH FIRST HEALTH PLANS, INC.	Health First Medicare Plans	healthfirsthealthplans.org	01	02		1		H1099	804	0	2009	Health First Employer Group POS Only	All Brevard and Indian River Zip 32927/32958/32978		1	2			1000	2						(321)-434-5665	(800)-716-7737	(800)-955-8771		(321)-434-5665	(800)-716-7737	(800)-955-8771		(321)-434-5665	(800)-716-7737	(800)-955-8771	(800)-955-8771	(321)-434-5665	(800)-716-7737	(800)-955-8771		http://www.healthfirsthealthplans.org/health_plans/medicare/index.cfm	www.healthfirsthealthplans.org
H1108	001	0	1	04	01	H1108_001_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H1108	001	0	2009	Evercare Plan IP	Atlanta and Macon Metro Areas		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H1108	002	0	1	04	01	H1108_002_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H1108	002	0	2009	Evercare Plan DP	Atlanta and Macon Metro Areas		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H1108	006	0	1	04	01	H1108_006_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H1108	006	0	2009	Evercare Plan MP	Atlanta and Macon Metro Areas		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H1108	007	0	1	04	01	H1108_007_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H1108	007	0	2009	AARP MedicareComplete Choice	Fulton County		2	2				2						(800)-711-6088	(800)-711-6088	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		(800)-711-6088	(800)-711-6088	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H1108	801	0	1	04	01	H1108_801_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H1108	801	0	2009	MedicareComplete Retiree Plan	GA Employer Sponsored Plan Service Area		1	2				2						(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(888)-685-8480		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(888)-685-8480		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H1108	802	0	1	04	01	H1108_802_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H1108	802	0	2009	MedicareComplete Retiree Plan	GA Employer Sponsored Plan Service Area		1	2				2						(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(888)-685-8480										http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H1108	803	0	1	04	01	H1108_803_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H1108	803	0	2009	MedicareComplete Retiree Plan	GA Employer Sponsored Plan Service Area		1	2				2						(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(888)-685-8480		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(888)-685-8480		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H1108	804	0	1	04	01	H1108_804_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H1108	804	0	2009	MedicareComplete Retiree Plan	GA Employer Sponsored Plan Service Area		1	2				2						(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(888)-685-8480										http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H1109	001	0	1	01	01	H1109_001_0	5	2009.01	AETNA HEALTH INC.(GEORGIA)	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H1109	001	0	2009	Aetna Golden Medicare Value Plan	Atlanta and Surrounding Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H1109	002	0	1	01	01	H1109_002_0	4	2009.01	AETNA HEALTH INC.(GEORGIA)	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H1109	002	0	2009	Aetna Golden Medicare Standard Plan	Atlanta and Surrounding Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H1109	003	0	1	01	01	H1109_003_0	4	2009.01	AETNA HEALTH INC.(GEORGIA)	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H1109	003	0	2009	Aetna Golden Medicare Premier Plan	Atlanta and Surrounding Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H1109	004	0	1	01	01	H1109_004_0	5	2009.01	AETNA HEALTH INC.(GEORGIA)	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H1109	004	0	2009	Aetna Golden Medicare Basic Plan	Atlanta and Surrounding Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H1109	801	0	1	01	01	H1109_801_0	4	2009.01	AETNA HEALTH INC.(GEORGIA)	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H1109	801	0	2009	Aetna Golden Medicare Plan	Atlanta and Surrounding Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H1109	802	0	1	01	01	H1109_802_0	4	2009.01	AETNA HEALTH INC.(GEORGIA)	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H1109	802	0	2009	Aetna Golden Medicare Plan w/Rx CY	Atlanta and Surrounding Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H1110	001	0	1	04	01	H1110_001_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H1110	001	0	2009	Aetna Golden Choice Standard Plan	Atlanta and Surrounding Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H1110	003	0	1	04	01	H1110_003_0	5	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H1110	003	0	2009	Aetna Golden Choice Premier Plan	Atlanta and Surrounding Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H1110	801	0	1	04	01	H1110_801_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H1110	801	0	2009	Aetna Golden Choice Plan	Atlanta and Surrounding Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H1110	802	0	1	04	01	H1110_802_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H1110	802	0	2009	Aetna Golden Choice Plan w/Rx CY	Atlanta and Surrounding Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H1111	002	0	1	02	01	H1111_002_0	5	2009.01	UNITED HEALTHCARE OF GEORGIA, INC.	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	02		1		H1111	002	0	2009	AARP MedicareComplete Plus	Columbia, Harris, Muscogee and Richmond Counties		2	2				2						(800)-711-6088		(888)-685-8480		(800)-555-5757		(800)-387-1074		(800)-711-6088	(800)-711-6088	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	https://www.SecureHorizons.com
H1111	004	0	1	02	01	H1111_004_0	4	2009.01	UNITED HEALTHCARE OF GEORGIA, INC.	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	02		1		H1111	004	0	2009	Evercare Plan DH-POS	Columbia, Harris, Muscogee and Richmond Counties		2	1	3			2			2	2		(877)-702-5110		(888)-685-8480		(888)-834-3721		(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	https://www.SecureHorizons.com
H1111	005	0	1	02	01	H1111_005_0	3	2009.01	UNITED HEALTHCARE OF GEORGIA, INC.	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	02		1		H1111	005	0	2009	Evercare Plan MH-POS	Columbia, Harris, Muscogee, Richmond Counties		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110		(888)-685-8480		(888)-834-3721		(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	https://www.SecureHorizons.com
H1111	801	0	1	01	01	H1111_801_0	2	2009.01	UNITED HEALTHCARE OF GEORGIA, INC.	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	01		1		H1111	801	0	2009	MedicareComplete Retiree Plan	GA Employer Sponsored Plan Service Area		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(800)-387-1074		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	https://www.SecureHorizons.com
H1111	804	0	1	01	01	H1111_804_0	2	2009.01	UNITED HEALTHCARE OF GEORGIA, INC.	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	01		1		H1111	804	0	2009	MedicareComplete Retiree Plan	GA Employer Sponsored Plan Service Area		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480										https://www.securehorizons.com/ourplans/searchformulary.html	https://www.SecureHorizons.com
H1111	805	0	1	01	01	H1111_805_0	2	2009.01	UNITED HEALTHCARE OF GEORGIA, INC.	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	01		1		H1111	805	0	2009	MedicareComplete Retiree Plan	GA Employer Sponsored Plan Service Area		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(800)-387-1074		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	https://www.SecureHorizons.com
H1111	806	0	1	01	01	H1111_806_0	2	2009.01	UNITED HEALTHCARE OF GEORGIA, INC.	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	01		1		H1111	806	0	2009	MedicareComplete Retiree Plan	GA Employer Sponsored Plan Service Area		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(800)-387-1074										https://www.securehorizons.com/ourplans/searchformulary.html	https://www.SecureHorizons.com
H1112	001	0	1	01	01	H1112_001_0	8	2009.01	WELLCARE OF GEORGIA, INC.	WellCare	www.wellcare.com	01	01		1		H1112	001	0	2009	WellCare Choice	DeKalb, Fulton, Gwinnett, et al		2	2				2						(866)-579-8006	(866)-579-8006	(877)-247-6272		(866)-238-4344	(866)-238-4344	(877)-247-6272		(866)-579-8006	(866)-579-8006	(877)-247-6272		(866)-238-4344	(866)-238-4344	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1112	003	0	1	01	01	H1112_003_0	7	2009.01	WELLCARE OF GEORGIA, INC.	WellCare	www.wellcare.com	01	01		1		H1112	003	0	2009	WellCare Advance	DeKalb, Fulton, Gwinnett, et al		2	2				2						(866)-334-7730	(866)-334-7730	(877)-247-6272	(877)-247-6272	(866)-211-1425	(866)-211-1425	(877)-247-6272										www.wellcare.com	www.wellcare.com
H1112	005	0	1	01	01	H1112_005_0	9	2009.01	WELLCARE OF GEORGIA, INC.	WellCare	www.wellcare.com	01	01		1		H1112	005	0	2009	WellCare Select	DeKalb, Fulton, Gwinnett, et al		2	1	3			2			1	2		(866)-334-7730	(866)-334-7730	(877)-247-6272	(877)-247-6272	(866)-211-1425	(866)-211-1425	(877)-247-6272		(866)-334-7730	(866)-334-7730	(877)-247-6272	(877)-247-6272	(866)-211-1425	(866)-211-1425	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1112	006	0	1	01	01	H1112_006_0	9	2009.01	WELLCARE OF GEORGIA, INC.	WellCare	www.wellcare.com	01	01		1		H1112	006	0	2009	WellCare Access	DeKalb, Fulton, Gwinnett, et al		2	1	3			2			1	1		(866)-334-7730	(866)-334-7730	(877)-247-6272	(877)-247-6272	(866)-211-1425	(866)-211-1425	(877)-247-6272		(866)-334-7730	(866)-334-7730	(877)-247-6272	(877)-247-6272	(866)-211-1425	(866)-211-1425	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1112	027	0	1	01	01	H1112_027_0	8	2009.01	WELLCARE OF GEORGIA, INC.	WellCare	www.wellcare.com	01	01		1		H1112	027	0	2009	WellCare Value	Muscogee, Harris, Chatham, et al		2	2				2						(866)-334-7730	(866)-334-7730	(877)-247-6272	(877)-247-6272	(866)-211-1425	(866)-211-1425	(877)-247-6272		(866)-334-7730	(866)-334-7730	(877)-247-6272	(877)-247-6272	(866)-211-1425	(866)-211-1425	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1112	030	0	1	01	01	H1112_030_0	8	2009.01	WELLCARE OF GEORGIA, INC.	WellCare	www.wellcare.com	01	01		1		H1112	030	0	2009	WellCare Reserve	Clayton and Harris Counties		2	2				2						(866)-334-7730	(866)-334-7730	(877)-247-6272	(877)-247-6272	(866)-211-1425	(866)-211-1425	(877)-247-6272		(866)-334-7730	(866)-334-7730	(877)-247-6272	(877)-247-6272	(866)-211-1425	(866)-211-1425	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1112	801	0	1	02	01	H1112_801_0	4	2009.01	WELLCARE OF GEORGIA, INC.	WellCare	www.wellcare.com	01	02		1		H1112	801	0	2009	Employer Georgia 1	Nationwide		1	2				2						(866)-334-7730	(866)-334-7730	(877)-247-6272	(877)-247-6272	(866)-211-1425	(866)-211-1425	(877)-247-6272		(866)-334-7730	(866)-334-7730	(877)-247-6272	(877)-247-6272	(866)-211-1425	(866)-211-1425	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1112	802	0	1	02	01	H1112_802_0	4	2009.01	WELLCARE OF GEORGIA, INC.	WellCare	www.wellcare.com	01	02		1		H1112	802	0	2009	Employer Georgia 2	Nationwide		1	2				2						(866)-334-7730	(866)-334-7730	(877)-247-6272	(877)-247-6272	(866)-211-1425	(866)-211-1425	(877)-247-6272		(866)-334-7730	(866)-334-7730	(877)-247-6272	(877)-247-6272	(866)-211-1425	(866)-211-1425	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1112	803	0	1	02	01	H1112_803_0	4	2009.01	WELLCARE OF GEORGIA, INC.	WellCare	www.wellcare.com	01	02		1		H1112	803	0	2009	Employer Georgia 3	Nationwide		1	2				2						(866)-334-7730	(866)-334-7730	(877)-247-6272	(877)-247-6272	(866)-211-1425	(866)-211-1425	(877)-247-6272										www.wellcare.com	www.wellcare.com
H1112	804	0	1	02	01	H1112_804_0	4	2009.01	WELLCARE OF GEORGIA, INC.	WellCare	www.wellcare.com	01	02		1		H1112	804	0	2009	Employer Georgia 4	Nationwide		1	2				2						(866)-334-7730	(866)-334-7730	(877)-247-6272	(877)-247-6272	(866)-211-1425	(866)-211-1425	(877)-247-6272										www.wellcare.com	www.wellcare.com
H1170	002	0	1	01	01	H1170_002_0	11	2009.01	KAISER FOUNDATION HP OF GA, INC.	Kaiser Permanente Senior Advantage	www.kp.org	01	01		1		H1170	002	0	2009	Kaiser Permanente Sr Advantage Enhanced	Atlanta Metro Area		2	2				2						(800)-232-4404		(800)-255-0056		(800)-232-4404		(800)-255-0056		(800)-232-4404	(800)-232-4404	(800)-255-0056		(800)-232-4404	(800)-232-4404	(800)-255-0056		www.kp.org/seniorrx	www.kp.org
H1170	008	0	1	01	01	H1170_008_0	12	2009.01	KAISER FOUNDATION HP OF GA, INC.	Kaiser Permanente Senior Advantage	www.kp.org	01	01		1		H1170	008	0	2009	Senior Advantage Medicare Medicaid Plan	Atlanta Metro Area		2	1	3			2			1	2		(800)-232-4404		(800)-255-0056		(800)-232-4404		(800)-255-0056		(800)-232-4404	(800)-232-4404	(800)-255-0056		(800)-232-4404	(800)-232-4404	(800)-255-0056		www.kp.org/seniorrx	www.kp.org
H1170	009	0	1	01	01	H1170_009_0	9	2009.01	KAISER FOUNDATION HP OF GA, INC.	Kaiser Permanente Senior Advantage	www.kp.org	01	01		1		H1170	009	0	2009	Kaiser Permanente Sr Advantage Basic	Atlanta Metro Area		2	2				2						(800)-232-4404		(800)-255-0056		(800)-232-4404		(800)-255-0056		(800)-232-4404	(800)-232-4404	(800)-255-0056		(800)-232-4404	(800)-232-4404	(800)-255-0056		www.kp.org/seniorrx	www.kp.org
H1170	801	0	1	01	01	H1170_801_0	6	2009.01	KAISER FOUNDATION HP OF GA, INC.	Kaiser Permanente Senior Advantage	www.kp.org	01	01		1		H1170	801	0	2009	Kaiser Permanente Employer Group Plan	Atlanta Metro Area		1	2				2						(800)-232-4404		(800)-255-0056		(800)-232-4404		(800)-255-0056										www.kp.org/seniorrx	www.kp.org
H1170	802	0	1	01	01	H1170_802_0	8	2009.01	KAISER FOUNDATION HP OF GA, INC.	Kaiser Permanente Senior Advantage	www.kp.org	01	01		1		H1170	802	0	2009	Kaiser Employer Group With Part D	Atlanta Metro Area		1	2				2						(800)-232-4404		(800)-255-0056		(800)-232-4404		(800)-255-0056		(800)-232-4404	(800)-232-4404	(800)-255-0056		(800)-232-4404	(800)-232-4404	(800)-255-0056		www.kp.org/seniorrx	www.kp.org
H1170	805	0	1	01	01	H1170_805_0	8	2009.01	KAISER FOUNDATION HP OF GA, INC.	Kaiser Permanente Senior Advantage	www.kp.org	01	01		1		H1170	805	0	2009	FEHB Part AB  with D	Atlanta Metro Area		1	2				2						(800)-232-4404		(800)-255-0056		(800)-232-4404		(800)-255-0056		(800)-232-4404	(800)-232-4404	(800)-255-0056		(800)-232-4404	(800)-232-4404	(800)-255-0056		www.kp.org/seniorrx	www.kp.org
H1216	001	0	1	02	01	H1216_001_0	9	2009.01	HARMONY HEALTH PLAN OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	02		1		H1216	001	0	2009	WellCare Value	St. Charles, St. Louis, St. Louis City Counties		2	2				2						(866)-687-8994	(866)-687-8994	(877)-247-6272		(866)-360-8138	(866)-360-8138	(877)-247-6272		(866)-687-8994	(866)-687-8994	(877)-247-6272		(866)-360-8138	(866)-360-8138	(877)-247-6272		www.wellcare.com	
H1216	003	0	1	01	01	H1216_003_0	8	2009.01	HARMONY HEALTH PLAN OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	01		1		H1216	003	0	2009	WellCare Access	St. Charles, St. Louis, St. Louis City Counties		2	1	3			2			1	1		(866)-687-8994	(866)-687-8994	(877)-247-6272		(866)-360-8138	(866)-360-8138	(877)-247-6272		(866)-687-8994	(866)-687-8994	(877)-247-6272		(866)-360-8138	(866)-360-8138	(877)-247-6272		www.wellcare.com	
H1216	004	0	1	02	01	H1216_004_0	8	2009.01	HARMONY HEALTH PLAN OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	02		1		H1216	004	0	2009	WellCare Select	St. Charles, St. Louis, St. Louis City Counties		2	1	3			2			1	2		(866)-687-8994	(866)-687-8994	(877)-247-6272		(866)-360-8138	(866)-360-8138	(877)-247-6272		(866)-687-8994	(866)-687-8994	(877)-247-6272		(866)-360-8138	(866)-360-8138	(877)-247-6272		www.wellcare.com	
H1230	001	0	1	01	01	H1230_001_0	11	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Foundation Health Plan, Inc. (Hawaii)	www.kp.org	01	01		1		H1230	001	0	2009	Kaiser Permanente Sr Advantage Enhanced	Islands of Oahu, Maui and Hawaii except for 3 ZIPs		2	2			8296	2						(800)-805-2739	(800)-805-2739	(866)-513-9961		(800)-805-2739	(800)-805-2739	(866)-513-9961		(800)-805-2739	(800)-805-2739	(866)-513-9961		(800)-805-2739	(800)-805-2739	(866)-513-9961		www.kp.org/seniormedrx	www.kp.org
H1230	003	0	1	01	01	H1230_003_0	11	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Foundation Health Plan, Inc. (Hawaii)	www.kp.org	01	01		1		H1230	003	0	2009	Kaiser Permanente Senior Advantage Basic	Islands of Oahu, Maui and Hawaii except for 3 ZIPs		2	2			32	2						(800)-805-2739	(800)-805-2739	(866)-513-9961		(800)-805-2739	(800)-805-2739	(866)-513-9961		(800)-805-2739	(800)-805-2739	(866)-513-9961		(800)-805-2739	(800)-805-2739	(866)-513-9961		www.kp.org/seniormedrx	www.kp.org
H1230	801	0	1	01	01	H1230_801_0	5	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Foundation Health Plan, Inc. (Hawaii)	www.kp.org	01	01		1		H1230	801	0	2009	Kaiser Permanente Emp Group MA only	Islands of Oahu, Maui and Hawaii (except 3 zip)		1	2			147	2						(800)-805-2739	(800)-805-2739	(866)-513-9961		(800)-805-2739	(800)-805-2739	(866)-513-9961										www.kp.org/seniormedrx	www.kp.org
H1230	802	0	2	01	01	H1230_802_0	6	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Foundation Health Plan, Inc. (Hawaii)	www.kp.org	01	01		2		H1230	802	0	2009	Kaiser Permanente Emp Group MA only Part B	Islands of Oahu, Maui and Hawaii (except 3 zip)		1	2			2	2		1				(800)-805-2739	(800)-805-2739	(866)-513-9961		(800)-805-2739	(800)-805-2739	(866)-513-9961										www.kp.org/seniormedrx	www.kp.org
H1230	803	0	1	01	01	H1230_803_0	5	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Foundation Health Plan, Inc. (Hawaii)	www.kp.org	01	01		1		H1230	803	0	2009	Kaiser Permanente Employer Grp MA-PD	Islands of Oahu, Maui and Hawaii (except 3 zips)		1	2			11824	2						(800)-805-2739	(800)-805-2739	(866)-513-9961		(800)-805-2739	(800)-805-2739	(866)-513-9961		(800)-805-2739	(800)-805-2739	(866)-513-9961		(800)-805-2739	(800)-805-2739	(866)-513-9961		www.kp.org/seniormedrx	www.kp.org
H1230	804	0	2	01	01	H1230_804_0	5	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Foundation Health Plan, Inc. (Hawaii)	www.kp.org	01	01		2		H1230	804	0	2009	Kaiser Permanente Emp Group MA-PD Part B	Islands of Oahu, Maui and Hawaii (except 3 zips)		1	2			13	2		1				(800)-805-2739	(800)-805-2739	(866)-513-9961		(800)-805-2739	(800)-805-2739	(866)-513-9961		(800)-805-2739	(800)-805-2739	(866)-513-9961		(800)-805-2739	(800)-805-2739	(866)-513-9961		www.kp.org/seniormedrx	www.kp.org
H1230	805	0	1	01	01	H1230_805_0	5	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Foundation Health Plan, Inc. (Hawaii)	www.kp.org	01	01		1		H1230	805	0	2009	FEHB AB with D	Islands of Oahu, Maui and Hawaii (except 3 zips)		1	2			2008	2						(800)-805-2739	(800)-805-2739	(866)-513-9961		(800)-805-2739	(800)-805-2739	(866)-513-9961		(800)-805-2739	(800)-805-2739	(866)-513-9961		(800)-805-2739	(800)-805-2739	(866)-513-9961		www.kp.org/seniormedrx	www.kp.org
H1230	806	0	2	01	01	H1230_806_0	5	2009.01	KAISER FOUNDATION HP, INC.	Kaiser Foundation Health Plan, Inc. (Hawaii)	www.kp.org	01	01		2		H1230	806	0	2009	FEHB B only with D	Islands of Oahu, Maui and Hawaii (except 3 zips)		1	2			23	2		1				(800)-805-2739	(800)-805-2739	(866)-513-9961		(800)-805-2739	(800)-805-2739	(866)-513-9961		(800)-805-2739	(800)-805-2739	(866)-513-9961		(800)-805-2739	(800)-805-2739	(866)-513-9961		www.kp.org/seniormedrx	www.kp.org
H1234	001	0	1	20	08	H1234_001_0	4	2009.01	LIFE ST. FRANCIS	LIFE St. Francis	www.stfrancismedical.org	08	20		1		H1234	001	0	2009	SFMC-Dual	Mercer County and portions of Burlington County		2	2				2														(609)-599-5128	(000)-000-0000			(609)-599-5128	(000)-000-0000			www.stfrancismedical.org	
H1234	002	0	1	20	08	H1234_002_0	3	2009.01	LIFE ST. FRANCIS	LIFE St. Francis	www.stfrancismedical.org	08	20		1		H1234	002	0	2009	SFMC-Medicare only	Mercer County and portions of Burlington County		2	2				2														(609)-599-5128	(000)-000-0000			(609)-599-5128	(000)-000-0000			www.stfrancismedical.org	
H1251	001	0	1	18	06	H1251_001_0	4	2009.01	HAWAII MED. SRVC. ASSN.	HMSA's 65C Plus	http://www.hmsa.com/healthplans/medicare	06	18		1		H1251	001	0	2009	65C Plus Basic Option	State of Hawaii		2	2			300	2						(808)-948-6000	(800)-776-4672	(808)-948-6222		(808)-948-5555	(800)-620-4672	(808)-948-6222										http://www.hmsa.com	http://www.hmsa.com
H1251	002	0	1	18	06	H1251_002_0	4	2009.01	HAWAII MED. SRVC. ASSN.	HMSA's 65C Plus	http://www.hmsa.com/healthplans/medicare	06	18		1		H1251	002	0	2009	65C Plus High Option	State of Hawaii		2	2			6980	2						(808)-948-6000	(800)-776-4672	(808)-948-6222		(808)-948-5555	(800)-620-4672	(808)-948-6222										http://www.hmsa.com	http://www.hmsa.com
H1251	003	0	1	18	06	H1251_003_0	5	2009.01	HAWAII MED. SRVC. ASSN.	HMSA's 65C Plus	http://www.hmsa.com/healthplans/medicare	06	18		1		H1251	003	0	2009	65C Plus Basic Option SRx	State of Hawaii		2	2			700	2						(808)-948-6000	(800)-776-4672	(808)-948-6222		(808)-948-5555	(800)-620-4672	(808)-948-6222		(808)-948-6000	(800)-776-4672	(808)-948-6222		(808)-948-5555	(800)-620-4672	(808)-948-6222		http://www.hmsa.com	http://www.hmsa.com
H1251	004	0	1	18	06	H1251_004_0	5	2009.01	HAWAII MED. SRVC. ASSN.	HMSA's 65C Plus	http://www.hmsa.com/healthplans/medicare	06	18		1		H1251	004	0	2009	65C Plus High Option SRx	State of Hawaii		2	2			32000	2						(808)-948-6000	(800)-776-4672	(808)-948-6222		(808)-948-5555	(800)-620-4672	(808)-948-6222		(808)-948-6000	(800)-776-4672	(808)-948-6222		(808)-948-5555	(800)-620-4672	(808)-948-6222		http://www.hmsa.com	http://www.hmsa.com
H1251	010	0	1	18	06	H1251_010_0	4	2009.01	HAWAII MED. SRVC. ASSN.	HMSA's 65C Plus	http://www.hmsa.com/healthplans/medicare	06	18		1		H1251	010	0	2009	65C Plus Saver Option	State of Hawaii		2	2			50	2						(808)-948-6000	(800)-776-4672	(808)-948-6222		(808)-948-5555	(800)-620-4672	(808)-948-6222										http://www.hmsa.com	http://www.hmsa.com
H1251	011	0	1	18	06	H1251_011_0	5	2009.01	HAWAII MED. SRVC. ASSN.	HMSA's 65C Plus	http://www.hmsa.com/healthplans/medicare	06	18		1		H1251	011	0	2009	65C Plus Saver Option SRx	State of Hawaii		2	2			150	2						(808)-948-6000	(800)-776-4672	(808)-948-6222		(808)-948-5555	(800)-620-4672	(808)-948-6222		(808)-948-6000	(800)-776-4672	(808)-948-6222		(808)-948-5555	(800)-620-4672	(808)-948-6222		http://www.hmsa.com	http://www.hmsa.com
H1251	801	0		18	06	H1251_801_0	1	2009.01	HAWAII MED. SRVC. ASSN.	HMSA's 65C Plus	http://www.hmsa.com/healthplans/medicare	06	18				H1251	801	0	2009	65C Plus Basic Option CY GRx	State of Hawaii		1	2										(808)-948-6000	(800)-776-4672	(808)-948-6222			(800)-620-4672	(808)-948-6222		(808)-948-6000	(800)-776-4672	(808)-948-6222		(808)-948-5555	(800)-620-4672	(808)-948-6222		http://www.hmsa.com	http://www.hmsa.com
H1251	802	0		18	06	H1251_802_0	1	2009.01	HAWAII MED. SRVC. ASSN.	HMSA's 65C Plus	http://www.hmsa.com/healthplans/medicare	06	18				H1251	802	0	2009	65C Plus High Option CY GRx	State of Hawaii		1	2										(808)-948-6000	(800)-776-4672	(808)-948-6222			(800)-620-4672	(808)-948-6222		(808)-948-6000	(800)-776-4672	(808)-948-6222		(808)-948-5555	(800)-620-4672	(808)-948-6222		http://www.hmsa.com	http://www.hmsa.com
H1251	803	0		18	06	H1251_803_0	1	2009.01	HAWAII MED. SRVC. ASSN.	HMSA's 65C Plus	http://www.hmsa.com/healthplans/medicare	06	18				H1251	803	0	2009	65C Plus Basic Option NCY GRx	State of Hawaii		1	2										(808)-948-6000	(800)-776-4672	(808)-948-6222			(800)-620-4672	(808)-948-6222		(808)-948-6000	(800)-776-4672	(808)-948-6222		(808)-948-5555	(800)-620-4672	(808)-948-6222		http://www.hmsa.com	http://www.hmsa.com
H1251	804	0		18	06	H1251_804_0	1	2009.01	HAWAII MED. SRVC. ASSN.	HMSA's 65C Plus	http://www.hmsa.com/healthplans/medicare	06	18				H1251	804	0	2009	65C Plus High Option NCY GRx	State of Hawaii		1	2										(808)-948-6000	(800)-776-4672	(808)-948-6222			(800)-620-4672	(808)-948-6222		(808)-948-6000	(800)-776-4672	(808)-948-6222		(808)-948-5555	(800)-620-4672	(808)-948-6222		http://www.hmsa.com	http://www.hmsa.com
H1251	805	0		18	06	H1251_805_0	1	2009.01	HAWAII MED. SRVC. ASSN.	HMSA's 65C Plus	http://www.hmsa.com/healthplans/medicare	06	18				H1251	805	0	2009	65C Plus Saver Option CY GRx	State of Hawaii		1	2										(808)-948-6000	(800)-776-4672	(808)-948-6222			(800)-620-4672	(808)-948-6222		(808)-948-6000	(800)-776-4672	(808)-948-6222		(808)-948-5555	(800)-620-4672	(808)-948-6222		http://www.hmsa.com	http://www.hmsa.com
H1251	806	0		18	06	H1251_806_0	1	2009.01	HAWAII MED. SRVC. ASSN.	HMSA's 65C Plus	http://www.hmsa.com/healthplans/medicare	06	18				H1251	806	0	2009	65C Plus Saver Option NCY GRx	State of Hawaii		1	2										(808)-948-6000	(800)-776-4672	(808)-948-6222			(800)-620-4672	(808)-948-6222		(808)-948-6000	(800)-776-4672	(808)-948-6222		(808)-948-5555	(800)-620-4672	(808)-948-6222		http://www.hmsa.com	http://www.hmsa.com
H1254	801	0	1	09	04	H1254_801_0	3	2009.01	UPMC HEALTH BENEFITS, INC.	UPMC Health Plan	www.upmchealthplan.com	04	09	2	1		H1254	801	0	2009	UPMC Employer Group	National		1	2			9000	2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629									N/A	
H1264	004	0	1	02	01	H1264_004_0	8	2009.01	WELLCARE OF TEXAS, INC.	WellCare	www.wellcare.com	01	02		1		H1264	004	0	2009	WellCare Value	Fort Bend, Harris, Montgomery, and San Jacinto Cty		2	2				2						(866)-687-8878	(866)-687-8878	(877)-247-6272		(866)-360-8141	(866)-360-8141	(877)-247-6272		(866)-687-8878	(866)-687-8878	(877)-247-6272		(866)-360-8141	(866)-360-8141	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1264	005	0	1	02	01	H1264_005_0	8	2009.01	WELLCARE OF TEXAS, INC.	WellCare	www.wellcare.com	01	02		1		H1264	005	0	2009	WellCare Value	Dallas, Tarrant Counties		2	2				2						(866)-687-8878	(866)-687-8878	(877)-247-6272		(866)-360-8141	(866)-360-8141	(877)-247-6272		(866)-687-8878	(866)-687-8878	(877)-247-6272		(866)-360-8141	(866)-360-8141	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1264	006	0	1	01	01	H1264_006_0	8	2009.01	WELLCARE OF TEXAS, INC.	WellCare	www.wellcare.com	01	01		1		H1264	006	0	2009	WellCare Access	Harris County		2	1	3			2			1	1		(866)-687-8878	(866)-687-8878	(877)-247-6272		(866)-360-8141	(866)-360-8141	(877)-247-6272		(866)-687-8878	(866)-687-8878	(877)-247-6272		(866)-360-8141	(866)-360-8141	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1264	007	0	1	01	01	H1264_007_0	8	2009.01	WELLCARE OF TEXAS, INC.	WellCare	www.wellcare.com	01	01		1		H1264	007	0	2009	WellCare Access	Bexar, Dallas, Tarrant Counties		2	1	3			2			1	1		(866)-687-8878	(866)-687-8878	(877)-247-6272		(866)-360-8141	(866)-360-8141	(877)-247-6272		(866)-687-8878	(866)-687-8878	(877)-247-6272		(866)-360-8141	(866)-360-8141	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1264	008	0	1	02	01	H1264_008_0	8	2009.01	WELLCARE OF TEXAS, INC.	WellCare	www.wellcare.com	01	02		1		H1264	008	0	2009	WellCare Dividend	Harris County		2	2				2						(866)-687-8878	(866)-687-8878	(877)-247-6272		(866)-360-8141	(866)-360-8141	(877)-247-6272		(866)-687-8878	(866)-687-8878	(877)-247-6272		(866)-360-8141	(866)-360-8141	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1264	009	0	1	02	01	H1264_009_0	8	2009.01	WELLCARE OF TEXAS, INC.	WellCare	www.wellcare.com	01	02		1		H1264	009	0	2009	WellCare Select	Harris County		2	1	3			2			1	2		(866)-687-8878	(866)-687-8878	(877)-247-6272		(866)-360-8141	(866)-360-8141	(877)-247-6272		(866)-687-8878	(866)-687-8878	(877)-247-6272		(866)-360-8141	(866)-360-8141	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1264	010	0	1	02	01	H1264_010_0	8	2009.01	WELLCARE OF TEXAS, INC.	WellCare	www.wellcare.com	01	02		1		H1264	010	0	2009	WellCare Select	Dallas, Tarrant Counties		2	1	3			2			1	2		(866)-687-8878	(866)-687-8878	(877)-247-6272		(866)-360-8141	(866)-360-8141	(877)-247-6272		(866)-687-8878	(866)-687-8878	(877)-247-6272		(866)-360-8141	(866)-360-8141	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1264	011	0	1	02	01	H1264_011_0	8	2009.01	WELLCARE OF TEXAS, INC.	WellCare	www.wellcare.com	01	02		1		H1264	011	0	2009	WellCare Select	Bexar County		2	1	3			2			1	2		(866)-687-8878	(866)-687-8878	(877)-247-6272		(866)-360-8141	(866)-360-8141	(877)-247-6272		(866)-687-8878	(866)-687-8878	(877)-247-6272		(866)-360-8141	(866)-360-8141	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1264	013	0	1	02	01	H1264_013_0	8	2009.01	WELLCARE OF TEXAS, INC.	WellCare	www.wellcare.com	01	02		1		H1264	013	0	2009	WellCare Value	Bexar County		2	2				2						(866)-687-8878	(866)-687-8878	(877)-247-6272		(866)-360-8141	(866)-360-8141	(877)-247-6272		(866)-687-8878	(866)-687-8878	(877)-247-6272		(866)-360-8141	(866)-360-8141	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1264	014	0	1	02	01	H1264_014_0	8	2009.01	WELLCARE OF TEXAS, INC.	WellCare	www.wellcare.com	01	02		1		H1264	014	0	2009	WellCare Dividend	Bexar County		2	2				2						(866)-687-8878	(866)-687-8878	(877)-247-6272		(866)-360-8141	(866)-360-8141	(877)-247-6272		(866)-687-8878	(866)-687-8878	(877)-247-6272		(866)-360-8141	(866)-360-8141	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1264	016	0	1	01	01	H1264_016_0	9	2009.01	WELLCARE OF TEXAS, INC.	WellCare	www.wellcare.com	01	01		1		H1264	016	0	2009	Wellcare Reserve	Fort Bend, Montgomery, San Jacinto Counties		2	2				2						(866)-687-8878	(866)-687-8878	(877)-247-6272		(866)-360-8141	(866)-360-8141	(877)-247-6272		(866)-687-8878	(866)-687-8878	(877)-247-6272		(866)-360-8141	(866)-360-8141	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1286	001	0	1	02	01	H1286_001_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H1286	001	0	2009	Evercare Plan IH-POS	Marion County		2	1	1	1		2			1			(800)-393-0993		(888)-685-8480		(888)-834-3721		(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1286	002	0	1	02	01	H1286_002_0	6	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H1286	002	0	2009	AARP MedicareComplete Plus Plan1	Spokane County		2	2				2						(800)-643-4845		(888)-685-8480		(800)-547-5514		(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1286	003	0	1	02	01	H1286_003_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H1286	003	0	2009	AARP MedicareComplete Plus Plan2	Spokane County		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514		(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1286	004	0	1	02	01	H1286_004_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H1286	004	0	2009	AARP MedicareComplete Plus	Clackamas,Marion,Multnomah,  Washington Counties		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514		(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1286	007	0	1	02	01	H1286_007_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H1286	007	0	2009	Evercare Plan MH-POS	Marion County		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110			(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1286	008	0	1	02	01	H1286_008_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H1286	008	0	2009	AARP MedicareComplete Plus	Northern WA Skagit, Whatcom Counties		2	2				2						(800)-643-4845		(888)-685-8480		(800)-547-5514		(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1286	801	0	1	02	01	H1286_801_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H1286	801	0	2009	MedicareComplete Plus Retiree Plan	Spokane WA,Multnomah,Washing,Clackamas, Marion,OR		1	2				2						(888)-867-5548		(888)-685-8480		(866)-289-3831		(800)-387-1074		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-685-8480	(866)-289-3831	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1286	803	0	1	02	01	H1286_803_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H1286	803	0	2009	MedicareComplete Retiree Plan	Select Counties in OR/WA		1	2				2						(888)-867-5548		(888)-685-8480		(866)-289-3831		(800)-387-1074		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-685-8480	(866)-289-3831	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1302	001	0	1	04	01	H1302_001_0	13	2009.01	BLUE CROSS OF IDAHO HLTH SERVICES INC	Blue Cross Of Idaho Hlth Services Inc	www.bcidaho.com	01	04		1		H1302	001	0	2009	Secure Blue	Select Counties in Idaho		2	2			90	2						(208)-395-8200	(888)-494-2583	(800)-377-1363	(800)-377-1363	(208)-387-6673	(888)-492-2583	(800)-377-1363	(800)-377-1363	(208)-395-8200	(888)-494-2583	(800)-377-1363	(800)-377-1363	(208)-387-6673	(888)-492-2583	(800)-377-1363	(800)-377-1363	http://www.bcidaho.com/pharmacy_info/medAdv_formulary_index.asp	www.bcidaho.com
H1302	004	0	1	04	01	H1302_004_0	13	2009.01	BLUE CROSS OF IDAHO HLTH SERVICES INC	Blue Cross Of Idaho Hlth Services Inc	www.bcidaho.com	01	04		1		H1302	004	0	2009	Secure Blue	Select Counties in Idaho		2	2			15	2						(208)-395-8200	(888)-494-2583	(800)-377-1363	(800)-377-1363	(208)-387-6673	(888)-492-2583	(800)-377-1363	(800)-377-1363									http://www.bcidaho.com/pharmacy_info/medAdv_formulary_index.asp	www.bcidaho.com
H1303	001	0	1	04	01	H1303_001_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1303	001	0	2009	AARP MedicareCompleteChoicePlan1	Ada and Canyon Counties		2	2				2						(800)-643-4845		(888)-685-8480		(800)-547-5514		(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1303	003	0	1	04	01	H1303_003_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1303	003	0	2009	AARP MedicareCompleteChoicePlan2	Ada and Canyon Counties		2	2				2						(800)-643-4845		(888)-685-8480		(800)-547-5514		(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1303	004	0	1	04	01	H1303_004_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1303	004	0	2009	Evercare Plan DP	Ada and Canyon Counties		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721		(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1303	006	0	1	04	01	H1303_006_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1303	006	0	2009	Evercare Plan MP	Ada and Canyon Counties		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721		(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1303	801	0	1	04	01	H1303_801_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1303	801	0	2009	MedicareComplete Choice Retiree Plan	Ada and Canyon Counties		1	2				2						(866)-289-7879		(888)-685-8480		(866)-732-2871		(800)-387-1074		(866)-289-7879	(866)-289-7879	(888)-685-8480		(866)-732-2871	(866)-732-2871	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1303	803	0	1	04	01	H1303_803_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1303	803	0	2009	MedicareComplete Retiree Plan	Ada, Canyon		1	2				2						(866)-289-7879		(888)-685-8480		(866)-732-2871		(800)-387-1074		(866)-289-7879	(866)-289-7879	(888)-685-8480		(866)-732-2871	(866)-732-2871	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1304	001	0	1	04	01	H1304_001_0	6	2009.01	REGENCE BLUE SHIELD OF IDAHO	Regence BlueShield Of Idaho	www.id.regence.com	01	04		1		H1304	001	0	2009	Regence MedAdvantage	Select Counties in Idaho/Asotin Co, WA		2	2				2						(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(208)-798-2074										www.id.regence.com	http://www.id.regence.com/member/doctor/
H1304	002	0	1	04	01	H1304_002_0	7	2009.01	REGENCE BLUE SHIELD OF IDAHO	Regence BlueShield Of Idaho	www.id.regence.com	01	04		1		H1304	002	0	2009	Regence MedAdvantage + Rx Classic	Select Counties in Idaho/Asotin Co, WA		2	2				2						(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(208)-798-2074		(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(208)-798-2074		www.id.regence.com	http://www.id.regence.com/member/doctor/
H1304	004	0	1	04	01	H1304_004_0	7	2009.01	REGENCE BLUE SHIELD OF IDAHO	Regence BlueShield Of Idaho	www.id.regence.com	01	04		1		H1304	004	0	2009	Regence MedAdvantage + Rx Enhanced	Select Counties in Idaho/Asotin Co, WA		2	2				2						(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(208)-798-2074		(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(208)-798-2074		www.id.regence.com	http://www.id.regence.com/member/doctor/
H1304	006	0	1	04	01	H1304_006_0	6	2009.01	REGENCE BLUE SHIELD OF IDAHO	Regence BlueShield Of Idaho	www.id.regence.com	01	04		1		H1304	006	0	2009	Regence MedAdvantage + Rx Core	Select Counties of ID/Asotin Co, WA		2	2				2						(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(208)-798-2074		(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(208)-798-2074		www.id.regence.com	http://www.id.regence.com/member/doctor/
H1310	001	0	1	20	08	H1310_001_0	1	2009.01	COMPREHENSIVE SENIOR CARE CORPORATION	CentraCare	mycentracare.com	08	20		1		H1310	001	0	2009	CentraCare Dual	Calhoun County		2	2				2														(269)-441-2681	(269)-441-2681			(269)-441-2681	(269)-441-2681			mycentracare.com	
H1310	003	0	1	20	08	H1310_003_0	1	2009.01	COMPREHENSIVE SENIOR CARE CORPORATION	CentraCare	mycentracare.com	08	20		1		H1310	003	0	2009	CentraCare Medicare-only	Calhoun County		2	2				2														(269)-441-2681	(269)-441-2681			(269)-441-2681	(269)-441-2681			mycentracare.com	
H1317	001	0	1	04	01	H1317_001_0	2	2009.01	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.todaysoptions.com	01	04		1		H1317	001	0	2009	Today's Options PPO Select	Clay, Kanawha Counties		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	www.todaysoptions.com
H1317	002	0	1	04	01	H1317_002_0	3	2009.01	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.todaysoptions.com	01	04		1		H1317	002	0	2009	Today's Options PPO Select powered by CCRx	Clay, Kanawha Counties		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H1317	003	0	1	04	01	H1317_003_0	7	2009.01	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.todaysoptions.com	01	04		1		H1317	003	0	2009	Today's Options PPO Complete powered by CCRx	Clay, Kanawha Counties		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H1317	801	0	1	04	01	H1317_801_0	4	2009.01	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.todaysoptions.com	01	04		1		H1317	801	0	2009	Today's Options PPO - MA Group Plan	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	www.todaysoptions.com
H1317	802	0	1	04	01	H1317_802_0	4	2009.01	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.todaysoptions.com	01	04		1		H1317	802	0	2009	Today's Options PPO - MAPD Group Plan	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H1317	803	0	1	04	01	H1317_803_0	4	2009.01	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.todaysoptions.com	01	04		1		H1317	803	0	2009	Today's Options PPO - MAPD Group Plan - NCY	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H1326	801	0	1	09	04	H1326_801_0	2	2009.01	PRIORITY HEALTH	PriorityMedicarePFFS	www.priorityhealth.com/medicare	04	09	2	1		H1326	801	0	2009	PriorityMedicare PFFS - Non-Calendar Year With PDP	Unites States		1	2			2	2						(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	http://www.priorityhealth.com/medicare08/druglist	
H1326	802	0	1	09	04	H1326_802_0	2	2009.01	PRIORITY HEALTH	PriorityMedicarePFFS	www.priorityhealth.com/medicare	04	09	2	1		H1326	802	0	2009	PriorityMedicare PFFS - Calendar Year With PDP	Unites States		1	2			4	2						(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	http://www.priorityhealth.com/medicare08/druglist	
H1326	803	0	1	09	04	H1326_803_0	2	2009.01	PRIORITY HEALTH	PriorityMedicarePFFS	www.priorityhealth.com/medicare	04	09	2	1		H1326	803	0	2009	PriorityMedicare PFFS - Non-Calendar Year No PDP	United States		1	2			2	2						(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761									http://www.priorityhealth.com/medicare08/druglist	
H1326	804	0	1	09	04	H1326_804_0	2	2009.01	PRIORITY HEALTH	PriorityMedicarePFFS	www.priorityhealth.com/medicare	04	09	2	1		H1326	804	0	2009	PriorityMedicare PFFS - Calendar Year No PDP	United States		1	2			1	2						(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761									http://www.priorityhealth.com/medicare08/druglist	
H1340	002	0	1	09	04	H1340_002_0	6	2009.01	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H1340	002	0	2009	Melody	Multi-State Area 1, 2, and 3		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H1340	014	0	1	09	04	H1340_014_0	7	2009.01	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H1340	014	0	2009	Concert	Multi-State Area 1		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	www.wellcarepffs.com/member	
H1340	020	0	1	09	04	H1340_020_0	6	2009.01	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H1340	020	0	2009	Prelude	Multi-State Area 1		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H1340	024	0	1	09	04	H1340_024_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H1340	024	0	2009	Sonata	Multi-State Area 1		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H1340	025	0	1	09	04	H1340_025_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H1340	025	0	2009	Sonata	Multi-State Area 2		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H1340	026	0	1	09	04	H1340_026_0	6	2009.01	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H1340	026	0	2009	Sonata	Multi-State Area 3		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H1340	027	0	1	09	04	H1340_027_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H1340	027	0	2009	Sonata	Multi-State Area 4		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H1340	030	0	1	09	04	H1340_030_0	6	2009.01	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H1340	030	0	2009	Melody	Multi-State Area 4		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H1340	031	0	1	09	04	H1340_031_0	7	2009.01	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H1340	031	0	2009	Melody	Multi-State Area 5		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H1340	033	0	1	09	04	H1340_033_0	8	2009.01	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H1340	033	0	2009	Concert	Multi-State Area 2		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	www.wellcarepffs.com/member	
H1340	034	0	1	09	04	H1340_034_0	8	2009.01	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H1340	034	0	2009	Concert	Multi-State Area 3		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	www.wellcarepffs.com/member	
H1340	035	0	1	09	04	H1340_035_0	8	2009.01	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H1340	035	0	2009	Concert	Multi-State Area 4		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	www.wellcarepffs.com/member	
H1340	036	0	1	09	04	H1340_036_0	8	2009.01	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H1340	036	0	2009	Concert	Multi-State Area 5		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	www.wellcarepffs.com/member	
H1340	037	0	1	09	04	H1340_037_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H1340	037	0	2009	Serenade	Multi-State Area 1		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H1340	038	0	1	09	04	H1340_038_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H1340	038	0	2009	Serenade	Multi-State Area 2		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H1340	039	0	1	09	04	H1340_039_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H1340	039	0	2009	Serenade	Multi-State Area 3		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H1340	040	0	1	09	04	H1340_040_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H1340	040	0	2009	Serenade	Multi-State Area 4		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H1340	041	0	1	09	04	H1340_041_0	6	2009.01	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H1340	041	0	2009	Quartet	Multi-State Area 1		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H1340	801	0	1	09	04	H1340_801_0	3	2009.01	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H1340	801	0	2009	Employer Plan 1	Nationwide		1	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	www.wellcarepffs.com/member	
H1340	802	0	1	09	04	H1340_802_0	3	2009.01	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H1340	802	0	2009	Employer Plan 2	Nationwide		1	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	www.wellcarepffs.com/member	
H1340	803	0	1	09	04	H1340_803_0	3	2009.01	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H1340	803	0	2009	Employer Plan 7	Nationwide		1	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H1340	804	0	1	09	04	H1340_804_0	3	2009.01	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H1340	804	0	2009	Employer Plan 8	Nationwide		1	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H1350	001	0	1	01	01	H1350_001_0	15	2009.01	BLUE CROSS OF IDAHO HEALTH SERVICES, INC	Blue Cross Of Idaho Hlth Services Inc	www.bcidaho.com	01	01		1		H1350	001	0	2009	True Blue	Select Counties in Idaho		2	2			12200	2						(208)-395-8200	(888)-494-2583	(800)-377-1363	(800)-377-1363	(208)-387-6673	(888)-492-2583	(800)-377-1363	(800)-377-1363	(208)-395-8200	(888)-494-2583	(800)-377-1363	(800)-377-1363	(208)-387-6673	(888)-492-2583	(800)-377-1363	(800)-377-1363	http://www.bcidaho.com/pharmacy_info/medAdv_formulary_index.asp	bcidaho.com
H1350	006	0	1	01	01	H1350_006_0	13	2009.01	BLUE CROSS OF IDAHO HEALTH SERVICES, INC	Blue Cross Of Idaho Hlth Services Inc	www.bcidaho.com	01	01		1		H1350	006	0	2009	True Blue	Select Counties in Idaho		2	2			3025	2						(208)-395-8200	(888)-494-2583	(800)-377-1363	(800)-377-1363	(208)-387-6673	(888)-492-2583	(800)-377-1363	(800)-377-1363									http://www.bcidaho.com/pharmacy_info/medAdv_formulary_index.asp	bcidaho.com
H1350	009	0	1	01	01	H1350_009_0	15	2009.01	BLUE CROSS OF IDAHO HEALTH SERVICES, INC	Blue Cross Of Idaho Hlth Services Inc	www.bcidaho.com	01	01		1		H1350	009	0	2009	True Blue Special Needs Plan	Select Counties in Idaho		2	1	3		720	2			1	1		(208)-395-8200	(888)-494-2583	(800)-377-1363	(800)-377-1363	(208)-387-6673	(888)-492-2583	(800)-377-1363	(800)-377-1363	(208)-395-8200	(888)-494-2583	(800)-377-1363	(800)-377-1363	(208)-387-6673	(888)-492-2583	(800)-377-1363	(800)-377-1363	http://www.bcidaho.com/pharmacy_info/medAdv_formulary_index.asp	bcidaho.com
H1355	001	0	1	04	01	H1355_001_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health Insurance Company, Inc.	www.mybravohealth.com	01	04		1		H1355	001	0	2009	Bravo Freedom	Dallas and Tarrant Counties		2	2				2						(888)-353-3789	(888)-353-3789	(800)-964-2561	(800)-964-2561	(888)-318-2827	(888)-318-2827	(800)-964-2561	(800)-964-2561	(888)-353-3789	(888)-353-3789	(800)-964-2561	(800)-964-2561	(888)-318-2827	(888)-318-2827	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.bravohealth.com
H1356	001	0	1	04	01	H1356_001_0	2	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H1356	001	0	2009	Today's Options PPO Select	Carbon, Yellowstone Counties		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	www.todaysoptions.com
H1356	002	0	1	04	01	H1356_002_0	3	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H1356	002	0	2009	Today's Options PPO Select powered by CCRx	Carbon, Yellowstone Counties		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H1356	003	0	1	04	01	H1356_003_0	6	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H1356	003	0	2009	Today's Options PPO Complete powered by CCRx	Carbon, Yellowstone Counties		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H1356	801	0	1	04	01	H1356_801_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H1356	801	0	2009	Today's Options PPO - MA Group Plan	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	www.todaysoptions.com
H1356	802	0	1	04	01	H1356_802_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H1356	802	0	2009	Today's Options PPO - MAPD Group Plan	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H1356	803	0	1	04	01	H1356_803_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H1356	803	0	2009	Today's Options PPO - MAPD Group Plan - NCY	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H1364	003	0	1	01	01	H1364_003_0	5	2009.01	UNISON HEALTH PLAN OF OHIO, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H1364	003	0	2009	Unison Advantage Plus	Holmes and Wayne counties		2	1	3			2			1	3		(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	http://www.unisonhealthplan.com	www.unisonhealthplan.com
H1364	006	0	1	01	01	H1364_006_0	10	2009.01	UNISON HEALTH PLAN OF OHIO, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H1364	006	0	2009	Unison Advantage Choice	Select Counties in Ohio		2	2				2						(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	http://www.unisonhealthplan.com	www.unisonhealthplan.com
H1364	007	0	1	01	01	H1364_007_0	7	2009.01	UNISON HEALTH PLAN OF OHIO, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H1364	007	0	2009	Unison Advantage Preferred	Select Counties in Ohio		2	2				2						(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	http://www.unisonhealthplan.com	www.unisonhealthplan.com
H1364	008	0	1	01	01	H1364_008_0	6	2009.01	UNISON HEALTH PLAN OF OHIO, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H1364	008	0	2009	Unison Advantage Basic	Select Counties in Ohio		2	2				2						(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021									http://www.unisonhealthplan.com	www.unisonhealthplan.com
H1364	801	0	1	01	01	H1364_801_0	5	2009.01	UNISON HEALTH PLAN OF OHIO, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H1364	801	0	2009	Unison Advantage Basic Group	Select Counties in Ohio		1	2				2						(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021									http://www.unisonhealthplan.com	www.unisonhealthplan.com
H1364	802	0	1	01	01	H1364_802_0	5	2009.01	UNISON HEALTH PLAN OF OHIO, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H1364	802	0	2009	Unison Advantage Choice Group	Select Counties in Ohio		1	2				2						(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	http://www.unisonhealthplan.com	www.unisonhealthplan.com
H1406	013	0	1	01	01	H1406_013_0	4	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H1406	013	0	2009	Humana Gold Plus HMO H1406-013	Cook County and partial Will County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1406	022	0	1	01	01	H1406_022_0	4	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H1406	022	0	2009	Humana Gold Plus HMO H1406-022	Partial Kane and Kendall Counties		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1406	024	0	1	01	01	H1406_024_0	3	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H1406	024	0	2009	Humana Gold Plus HMO SNP-DE H1406-024F	Cook County		2	1	3			2			1	2		(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1406	801	0	1	01	01	H1406_801_0	1	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H1406	801	0	2009	Humana Employer Sponsored	Chicago Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1406	802	0	1	01	01	H1406_802_0	1	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H1406	802	0	2009	Humana Employer Sponsored	Chicago Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1406	803	0	1	01	01	H1406_803_0	1	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H1406	803	0	2009	Humana Employer Sponsored Non-CY	Cook, Kendall and Parts of Kane Counties		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1406	804	0	1	01	01	H1406_804_0	1	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H1406	804	0	2009	Humana Employer Sponsored Non-CY	Cook, Kendall and Parts of Kane Counties		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1415	005	0	1	01	01	H1415_005_0	3	2009.01	HEALTHSPRING, INC.	HealthSpring, Inc.	www.healthspring.com	01	01		1		H1415	005	0	2009	HealthSpring TotalCare	Cook, DuPage, Kane, Lake and Will		2	1	3			2			1	2		(888)-588-4827	(888)-588-4827	(866)-206-5565	(866)-206-5565	(888)-886-1993	(888)-886-1993	(800)-391-9806	(800)-391-9806	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
H1415	010	0	1	01	01	H1415_010_0	7	2009.01	HEALTHSPRING, INC.	HealthSpring, Inc.	www.healthspring.com	01	01		1		H1415	010	0	2009	HealthSpring SpecialCare	Cook, DuPage, Kane, Lake and Will		2	1	1	1		2			1			(888)-588-4827	(888)-588-4827	(866)-206-5565	(866)-206-5565	(888)-886-1993	(888)-886-1993	(800)-391-9806	(800)-391-9806	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
H1415	013	0	1	01	01	H1415_013_0	5	2009.01	HEALTHSPRING, INC.	HealthSpring, Inc.	www.healthspring.com	01	01		1		H1415	013	0	2009	HealthSpring HealthyAdvantage	Cook, DuPage, Kane, Lake and Will		2	2				2						(888)-588-4827	(888)-588-4827	(866)-206-5565	(866)-206-5565	(888)-886-1993	(888)-886-1993	(800)-391-9806	(800)-391-9806									www.healthspring.com	
H1415	015	0	1	01	01	H1415_015_0	5	2009.01	HEALTHSPRING, INC.	HealthSpring, Inc.	www.healthspring.com	01	01		1		H1415	015	0	2009	HealthSpring OptimaCare	Cook, DuPage, Kane, Lake and Will		2	1	4			2			1		0000001010000000000000000001	(888)-588-4827	(888)-588-4827	(866)-206-5565	(866)-206-5565	(888)-886-1993	(888)-886-1993	(800)-391-9806	(800)-391-9806	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
H1415	017	0	1	02	01	H1415_017_0	7	2009.01	HEALTHSPRING, INC.	HealthSpring, Inc.	www.healthspring.com	01	02		1		H1415	017	0	2009	HealthSpring HealthyLiving PremierRx POS	Cook, DuPage, Kane, Lake, Will		2	2				2						(888)-588-4827	(888)-588-4827	(866)-206-5565	(866)-206-5565	(888)-886-1993	(888)-886-1993	(800)-391-9806	(800)-391-9806	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
H1415	021	0	1	02	01	H1415_021_0	6	2009.01	HEALTHSPRING, INC.	HealthSpring, Inc.	www.healthspring.com	01	02		1		H1415	021	0	2009	HealthSpring HealthyAdv. PremieRx POS	Cook, DuPage, Kane, Lake and Will		2	2				2						(888)-588-4827	(888)-588-4827	(866)-206-5565	(866)-206-5565	(888)-886-1993	(888)-886-1993	(800)-391-9806	(800)-391-9806	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
H1415	022	0	1	02	01	H1415_022_0	6	2009.01	HEALTHSPRING, INC.	HealthSpring, Inc.	www.healthspring.com	01	02		1		H1415	022	0	2009	HealthSpring HealthyAdv. Basic Rx POS	Cook , DuPage, Kane, Lake and Will		2	2				2						(888)-588-4827	(888)-588-4827	(866)-206-5565	(866)-206-5565	(888)-886-1993	(888)-886-1993	(800)-391-9806	(800)-391-9806	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
H1415	802	0	1	01	01	H1415_802_0	2	2009.01	HEALTHSPRING, INC.	HealthSpring, Inc.	www.healthspring.com	01	01		1		H1415	802	0	2009	HealthSpring Retiree Adv. Care-Cal. Yr	Illinois		1	2			42	2						(888)-588-4827	(888)-588-4827	(866)-206-5565	(866)-206-5565	(888)-886-1993	(888)-886-1993	(800)-391-9806	(800)-391-9806									www.healthspring.com	
H1415	804	0	1	01	01	H1415_804_0	2	2009.01	HEALTHSPRING, INC.	HealthSpring, Inc.	www.healthspring.com	01	01		1		H1415	804	0	2009	HealthSpring Retiree Adv. Plus-Cal. Yr	Illinois		1	2			42	2						(888)-588-4827	(888)-588-4827	(866)-206-5565	(866)-206-5565	(888)-886-1993	(888)-886-1993	(800)-391-9806	(800)-391-9806	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
H1415	805	0	1	01	01	H1415_805_0	2	2009.01	HEALTHSPRING, INC.	HealthSpring, Inc.	www.healthspring.com	01	01		1		H1415	805	0	2009	HealthSpring Retiree Adv. Care-Cont. Yr	Illinois		1	2			42	2						(888)-588-4827	(888)-588-4827	(866)-206-5565	(866)-206-5565	(888)-886-1993	(888)-886-1993	(800)-391-9806	(800)-391-9806									www.healthspring.com	
H1415	806	0	1	01	01	H1415_806_0	2	2009.01	HEALTHSPRING, INC.	HealthSpring, Inc.	www.healthspring.com	01	01		1		H1415	806	0	2009	HealthSpring Retiree Adv. Plus-Cont. Yr	Illinois		1	2			42	2						(888)-588-4827	(888)-588-4827	(866)-206-5565	(866)-206-5565	(888)-886-1993	(888)-886-1993	(800)-391-9806	(800)-391-9806	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
H1416	002	0	1	02	01	H1416_002_0	6	2009.01	HARMONY HEALTH PLAN OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	02		1		H1416	002	0	2009	WellCare Choice	Cook and Will Counties		2	2				2						(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		www.wellcare.com	
H1416	003	0	1	02	01	H1416_003_0	6	2009.01	HARMONY HEALTH PLAN OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	02		1		H1416	003	0	2009	WellCare Select	Cook and Will Counties		2	1	3			2			1	2		(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		www.wellcare.com	
H1416	007	0	1	01	01	H1416_007_0	6	2009.01	HARMONY HEALTH PLAN OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	01		1		H1416	007	0	2009	WellCare Access	Cook, Will, Champaign, Douglas, et al		2	1	3			2			1	1		(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		www.wellcare.com	
H1416	009	0	1	02	01	H1416_009_0	6	2009.01	HARMONY HEALTH PLAN OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	02		1		H1416	009	0	2009	WellCare Value	Cook County		2	2				2						(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		www.wellcare.com	
H1416	013	0	1	02	01	H1416_013_0	6	2009.01	HARMONY HEALTH PLAN OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	02		1		H1416	013	0	2009	WellCare Select	Champaign, Douglas, and Vermilion Counties		2	1	3			2			1	2		(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		www.wellcare.com	
H1416	014	0	1	02	01	H1416_014_0	6	2009.01	HARMONY HEALTH PLAN OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	02		1		H1416	014	0	2009	WellCare Value	Champaign, Douglas, Vermilion, et al		2	2				2						(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		www.wellcare.com	
H1416	017	0	1	02	01	H1416_017_0	7	2009.01	HARMONY HEALTH PLAN OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	02		1		H1416	017	0	2009	WellCare Select	Madison and St. Clair Counties		2	1	3			2			1	2		(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		www.wellcare.com	
H1416	018	0	1	02	01	H1416_018_0	6	2009.01	HARMONY HEALTH PLAN OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	02		1		H1416	018	0	2009	WellCare Value	Madison and St. Clair Counties		2	2				2						(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		www.wellcare.com	
H1416	019	0	1	02	01	H1416_019_0	7	2009.01	HARMONY HEALTH PLAN OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	02		1		H1416	019	0	2009	WellCare Rx	Cook, Will Counties		2	2				2						(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		www.wellcare.com	
H1416	020	0	1	02	01	H1416_020_0	7	2009.01	HARMONY HEALTH PLAN OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	02		1		H1416	020	0	2009	WellCare Rx	Champaign, Douglas, Vermilion, et al		2	2				2						(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		www.wellcare.com	
H1416	021	0	1	02	01	H1416_021_0	6	2009.01	HARMONY HEALTH PLAN OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	02		1		H1416	021	0	2009	WellCare Rx	Madison and St. Clair Counties		2	2				2						(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		www.wellcare.com	
H1416	801	0	1	02	01	H1416_801_0	4	2009.01	HARMONY HEALTH PLAN OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	02		1		H1416	801	0	2009	Employer Illinois 1	Nationwide		1	2				2						(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		www.wellcare.com	
H1416	802	0	1	02	01	H1416_802_0	4	2009.01	HARMONY HEALTH PLAN OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	02		1		H1416	802	0	2009	Employer Illinois 2	Nationwide		1	2				2						(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272		www.wellcare.com	
H1416	803	0	1	02	01	H1416_803_0	4	2009.01	HARMONY HEALTH PLAN OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	02		1		H1416	803	0	2009	Employer Illinois 3	Nationwide		1	2				2						(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272										www.wellcare.com	
H1416	804	0	1	02	01	H1416_804_0	4	2009.01	HARMONY HEALTH PLAN OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	02		1		H1416	804	0	2009	Employer Illinois 4	Nationwide		1	2				2						(866)-334-6876	(866)-334-6876	(877)-247-6272		(866)-238-7339	(866)-238-7339	(877)-247-6272										www.wellcare.com	
H1417	001	0	1	04	01	H1417_001_0	5	2009.01	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	01	04		1		H1417	001	0	2009	Health Alliance Medicare PPO10	Central Illinois		2	2			172	2						(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551									http://www.healthalliancemedicare.org/medicare/images/med-abridgedformulary-0807web.pdf	www.healthalliancemedicare.org
H1417	002	0	1	04	01	H1417_002_0	7	2009.01	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	01	04		1		H1417	002	0	2009	Health Alliance Medicare PPO10 Rx	Central Illinois		2	2			1650	2						(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	http://www.healthalliancemedicare.org/medicare/images/med-abridgedformulary-0807web.pdf	www.healthalliancemedicare.org
H1417	003	0	1	04	01	H1417_003_0	9	2009.01	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	01	04		1		H1417	003	0	2009	Health Alliance Medicare PPO30	Central Illinois		2	2			8	2						(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551									http://www.healthalliancemedicare.org/medicare/images/med-abridgedformulary-0807web.pdf	www.healthalliancemedicare.org
H1417	004	0	1	04	01	H1417_004_0	9	2009.01	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	01	04		1		H1417	004	0	2009	Health Alliance Medicare PPO30 Rx	Central Illinois		2	2			56	2						(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	http://www.healthalliancemedicare.org/medicare/images/med-abridgedformulary-0807web.pdf	www.healthalliancemedicare.org
H1417	005	0	1	04	01	H1417_005_0	8	2009.01	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	01	04		1		H1417	005	0	2009	Health Alliance Medicare PPO10 Rx Plus	Central Illinois		2	2			200	2						(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	http://www.healthalliancemedicare.org/medicare/images/med-abridgedformulary-0807web.pdf	www.healthalliancemedicare.org
H1417	006	0	1	04	01	H1417_006_0	9	2009.01	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	01	04		1		H1417	006	0	2009	Health Alliance Medicare PPO30 Rx Plus	Central Illinois		2	2			7	2						(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	http://www.healthalliancemedicare.org/medicare/images/med-abridgedformulary-0807web.pdf	www.healthalliancemedicare.org
H1417	007	0	1	04	01	H1417_007_0	8	2009.01	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	01	04		1		H1417	007	0	2009	Health Alliance Medicare PPO Basic	Central Illinois		2	2			4	2						(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551									http://www.healthalliancemedicare.org/medicare/images/med-abridgedformulary-0807web.pdf	www.healthalliancemedicare.org
H1417	008	0	1	04	01	H1417_008_0	10	2009.01	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	01	04		1		H1417	008	0	2009	Health Alliance Medicare PPO Basic Rx	Central Illinois		2	2			8	2						(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	http://www.healthalliancemedicare.org/medicare/images/med-abridgedformulary-0807web.pdf	www.healthalliancemedicare.org
H1417	009	0	1	04	01	H1417_009_0	10	2009.01	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	01	04		1		H1417	009	0	2009	Health Alliance Medicare PPO Basic Rx Plus	Central Illinois		2	2			4	2						(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	http://www.healthalliancemedicare.org/medicare/images/med-abridgedformulary-0807web.pdf	www.healthalliancemedicare.org
H1417	801	0	1	04	01	H1417_801_0	9	2009.01	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	01	04		1		H1417	801	0	2009	Medicare Employer PPO	Illinois		1	2			13	2						(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551									http://www.healthalliancemedicare.org/medicare/images/med-abridgedformulary-0807web.pdf	www.healthalliancemedicare.org
H1417	802	0	1	04	01	H1417_802_0	9	2009.01	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	01	04		1		H1417	802	0	2009	Medicare Employer PPO Rx	Illinois		1	2			100	2						(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	http://www.healthalliancemedicare.org/medicare/images/med-abridgedformulary-0807web.pdf	www.healthalliancemedicare.org
H1417	809	0	1	04	01	H1417_809_0	9	2009.01	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	01	04		1		H1417	809	0	2009	Medicare Employer PPO Rx	Illinois		1	2			30	2						(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	http://www.healthalliancemedicare.org/medicare/images/med-abridgedformulary-0807web.pdf	www.healthalliancemedicare.org
H1418	002	0	1	04	01	H1418_002_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1418	002	0	2009	HumanaChoicePPO PPO H1418-002	Chicago Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1418	007	0	1	04	01	H1418_007_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1418	007	0	2009	HumanaChoicePPO PPO H1418-007	Henry, Mercer, Rock Island, IL, and Scott, IA		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1418	801	0	1	04	01	H1418_801_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1418	801	0	2009	Humana Employer Sponsored	Chicago, St Louis		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1418	802	0	1	04	01	H1418_802_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1418	802	0	2009	Humana Employer Sponsored	Chicago, St Louis		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1418	803	0	1	04	01	H1418_803_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1418	803	0	2009	Humana Employer Sponsored Non-CY	Chicago, St Louis		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1418	804	0	1	04	01	H1418_804_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1418	804	0	2009	Humana Employer Sponsored Non-CY	Chicago, St Louis		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1419	001	0	1	01	01	H1419_001_0	5	2009.01	AETNA HEALTH OF ILLINOIS, INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H1419	001	0	2009	Aetna Golden Medicare Value Plan	Cook County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H1419	002	0	1	01	01	H1419_002_0	5	2009.01	AETNA HEALTH OF ILLINOIS, INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H1419	002	0	2009	Aetna Golden Medicare Standard Plan	Cook County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H1419	003	0	1	01	01	H1419_003_0	5	2009.01	AETNA HEALTH OF ILLINOIS, INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H1419	003	0	2009	Aetna Golden Medicare Premier Plan	Cook County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H1419	005	0	1	01	01	H1419_005_0	5	2009.01	AETNA HEALTH OF ILLINOIS, INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H1419	005	0	2009	Aetna Golden Medicare Dual Advantage Plan	Cook County		2	1	3			2			1	2		(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H1419	006	0	1	01	01	H1419_006_0	2	2009.01	AETNA HEALTH OF ILLINOIS, INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H1419	006	0	2009	Aetna Golden Medicare Basic Plan	Cook		2	2				2						(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H1419	801	0	1	01	01	H1419_801_0	4	2009.01	AETNA HEALTH OF ILLINOIS, INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H1419	801	0	2009	Aetna Golden Medicare Plan	Cook and Will Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H1419	802	0	1	01	01	H1419_802_0	4	2009.01	AETNA HEALTH OF ILLINOIS, INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H1419	802	0	2009	Aetna Golden Medicare Plan w/Rx CY	Cook and Will Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H1420	001	0	1	04	01	H1420_001_0	5	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H1420	001	0	2009	Aetna Golden Choice Standard Plan	Cook County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H1420	003	0	1	04	01	H1420_003_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H1420	003	0	2009	Aetna Golden Choice Premier Plan	Cook		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H1420	801	0	1	04	01	H1420_801_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H1420	801	0	2009	Aetna Golden Choice Plan	Cook County		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H1420	802	0	1	04	01	H1420_802_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H1420	802	0	2009	Aetna Golden Choice Plan w/Rx CY	Cook County		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H1463	001	0	1	01	01	H1463_001_0	4	2009.01	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	01	01		1		H1463	001	0	2009	Health Alliance Medicare HMO20	East Central Illinois		2	2			1866	2						(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551									http://www.healthalliancemedicare.org/medicare/images/med-abridgedformulary-0807web.pdf	www.healthalliancemedicare.org
H1463	003	0	1	01	01	H1463_003_0	7	2009.01	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	01	01		1		H1463	003	0	2009	Health Alliance Medicare HMO20 Rx	East Central Illinois		2	2			4921	2						(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	http://www.healthalliancemedicare.org/medicare/images/med-abridgedformulary-0807web.pdf	www.healthalliancemedicare.org
H1463	005	0	1	01	01	H1463_005_0	7	2009.01	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	01	01		1		H1463	005	0	2009	Health Alliance Medicare HMO20 Rx Plus	East Central Illinois		2	2			305	2						(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	http://www.healthalliancemedicare.org/medicare/images/med-abridgedformulary-0807web.pdf	www.healthalliancemedicare.org
H1463	801	0	1	01	01	H1463_801_0	4	2009.01	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	01	01		1		H1463	801	0	2009	Medicare Employer HMO	Illinois		1	2			50	2						(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551									http://www.healthalliancemedicare.org/medicare/images/med-abridgedformulary-0807web.pdf	www.healthalliancemedicare.org
H1463	802	0	1	01	01	H1463_802_0	4	2009.01	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	01	01		1		H1463	802	0	2009	Medicare Employer HMO Rx	Illinois		1	2			200	2						(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	http://www.healthalliancemedicare.org/medicare/images/med-abridgedformulary-0807web.pdf	www.healthalliancemedicare.org
H1463	809	0	1	01	01	H1463_809_0	4	2009.01	HEALTH ALLIANCE MEDICAL PLANS	Health Alliance Medical Plans	www.healthalliancemedicare.org	01	01		1		H1463	809	0	2009	Medicare Employer HMO RX	Illinois		1	2			20	2						(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	(800)-965-4022	(800)-965-4022	(866)-883-8551	(866)-883-8551	http://www.healthalliancemedicare.org/medicare/images/med-abridgedformulary-0807web.pdf	www.healthalliancemedicare.org
H1468	004	0	1	01	01	H1468_004_0	3	2009.01	OSF HEALTHPLANS, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H1468	004	0	2009	Humana Gold Plus HMO H1468-004	Central Illinois Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1468	005	0	1	01	01	H1468_005_0	4	2009.01	OSF HEALTHPLANS, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H1468	005	0	2009	Humana Gold Plus HMO H1468-005	Central Illinois Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1468	007	0	1	01	01	H1468_007_0	5	2009.01	OSF HEALTHPLANS, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H1468	007	0	2009	Humana Gold Plus HMO H1468-007	Central Illinois Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1509	001	0	1	04	01	H1509_001_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1509	001	0	2009	AARP MedicareComplete Choice	Adams, Allen, Fulton, Kosciusko, St.Joseph, Wells		2	2				2						(800)-643-4845		(888)-685-8480		(800)-547-5514		(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1509	004	0	1	04	01	H1509_004_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1509	004	0	2009	Evercare Plan DP	Indianapolis, Fort Wayne, South Bend areas		2	1	3			2			2	2		(877)-702-5110		(888)-685-8480		(888)-834-3721		(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1509	005	0	1	04	01	H1509_005_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1509	005	0	2009	Evercare Plan MP	Adams,Allen,Fulton,Kosciusko,St. Joseph,Wells		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110		(888)-685-8480		(888)-834-3721		(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1509	006	0	1	04	01	H1509_006_0	7	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1509	006	0	2009	Evercare Plan IP	Indianapolis area		2	1	1	1		2			1			(800)-393-0993		(888)-685-8480		(888)-834-3721		(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1509	007	0	1	04	01	H1509_007_0	7	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1509	007	0	2009	AARP Medicare Complete Choice	Indianapolis area		2	2				2						(800)-643-4845		(888)-685-8480		(800)-547-5514		(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1509	008	0	1	04	01	H1509_008_0	6	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1509	008	0	2009	AARP MedicareComplete Choice	Seclect Counties in IN		2	2				2						(800)-643-4845		(888)-685-8480		(800)-547-5514		(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1509	801	0	1	04	01	H1509_801_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1509	801	0	2009	MedicareComplete Choice Retiree Plan	Adams,Allen,Fulton,Kosciusko,St Joseph,Wells Cos		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1509	803	0	1	04	01	H1509_803_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1509	803	0	2009	MedicareComplete Choice Retiree Plan	Adams,Allen,Fulton,Kosciusko,St Joseph,Wells Cos		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1509	804	0	1	04	01	H1509_804_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1509	804	0	2009	MedicareComplete Retiree Plan	Select Counties in IN		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1509	805	0	1	04	01	H1509_805_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1509	805	0	2009	MedicareComplete Retiree Plan	Select Counties in IN		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1510	001	0	1	04	01	H1510_001_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1510	001	0	2009	HumanaChoicePPO PPO H1510-001	Indianapolis Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1510	004	0	1	04	01	H1510_004_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1510	004	0	2009	HumanaChoicePPO PPO H1510-004	Evansville Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1510	005	0	1	04	01	H1510_005_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1510	005	0	2009	HumanaChoicePPO PPO H1510-005	Northern Indiana Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1510	805	0	1	04	01	H1510_805_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1510	805	0	2009	Humana Employer Sponsored	Indianapolis Metro Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1510	806	0	1	04	01	H1510_806_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1510	806	0	2009	Humana Employer Sponsored	Indianapolis Metro Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1510	807	0	1	04	01	H1510_807_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1510	807	0	2009	Humana Employer Sponsored Non-CY	Indianapolis Metro Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1510	808	0	1	04	01	H1510_808_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1510	808	0	2009	Humana Employer Sponsored Non-CY	Indianapolis Metro Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1511	001	0	1	01	01	H1511_001_0	7	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H1511	001	0	2009	Anthem Senior Advantage Basic	Indiana - Select Counties		2	2			88	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
H1511	005	0	1	01	01	H1511_005_0	8	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H1511	005	0	2009	Anthem Senior Advantage Enhanced	Indiana - Select Counties		2	2			73	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
H1511	801	0	1	01	01	H1511_801_0	3	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H1511	801	0	2009	Anthem Senior Advantage Group	Indiana		1	2			15	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
H1511	803	0	1	01	01	H1511_803_0	3	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H1511	803	0	2009	Anthem Senior Advantage Group	Indiana		1	2			10	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754									www.anthem.com	www.anthem.com
H1511	804	0	1	01	01	H1511_804_0	3	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H1511	804	0	2009	Anthem Senior Advantage Group	Indiana		1	2			10	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
H1517	001	0	1	04	01	H1517_001_0	9	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	04		1		H1517	001	0	2009	Anthem Medicare Preferred Standard	Missouri - Select Counties		2	2			1005	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-652-6387	(800)-652-6387	(800)-297-1538	(800)-297-1538	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
H1517	801	0	1	04	01	H1517_801_0	4	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	04		1		H1517	801	0	2009	Anthem Medicare Preferred Group	Missouri		1	2			125	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
H1517	802	0	1	04	01	H1517_802_0	4	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	04		1		H1517	802	0	2009	Anthem Medicare Preferred Group	Missouri		1	2			50	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754									www.anthem.com	www.anthem.com
H1517	803	0	1	04	01	H1517_803_0	4	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	04		1		H1517	803	0	2009	Anthem Medicare Preferred Group	Missouri		1	2			25	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
H1518	001	0	1	20	08	H1518_001_0	1	2009.01	CATHOLIC HEALTH SYSTEM BUFFALO PACE	CHS - LIFE	www.chsbuffalo.org	08	20		1		H1518	001	0	2009	CHS Buffalo - Dual	CHS Lackawanna  Erie County		2	2				2														(716)-604-1840	(716)-604-1840			(716)-604-1840	(716)-604-1640			www.chsbuffalo.org	
H1518	002	0	1	20	08	H1518_002_0	1	2009.01	CATHOLIC HEALTH SYSTEM BUFFALO PACE	CHS - LIFE	www.chsbuffalo.org	08	20		1		H1518	002	0	2009	CHS Buffalo - Medicare only	CHS Lackawanna Erie County		2	2				2														(716)-604-1840	(716)-604-1840			(716)-604-1840	(716)-604-1640			www.chsbuffalo.org	
H1553	001	0	1	18	06	H1553_001_0	3	2009.01	THE M PLAN, INC.	The M Plan, Senior Smart Choice	www.seniorsmartchoice.com	06	18		1		H1553	001	0	2009	Senior Smart Choice Low Option	Indianapolis Metropolitan Area		2	2			1000	2						(317)-580-4520		(317)-580-4680		(317)-580-4520		(317)-580-4680											
H1553	002	0	1	18	06	H1553_002_0	3	2009.01	THE M PLAN, INC.	The M Plan, Senior Smart Choice	www.seniorsmartchoice.com	06	18		1		H1553	002	0	2009	Senior Smart Choice High Option	Indianapolis Metropolitan Area		2	2			6000	2						(317)-580-4520		(317)-580-4680		(317)-580-4520		(317)-580-4680											
H1553	005	0	1	18	06	H1553_005_0	2	2009.01	THE M PLAN, INC.	The M Plan, Senior Smart Choice	www.seniorsmartchoice.com	06	18		1		H1553	005	0	2009	Senior Smart Choice Basic Option	Indianapolis Metropolitan Area		2	2			25	2						(317)-580-4520		(317)-580-4680		(317)-580-4520		(317)-580-4680											
H1558	003	0	1	18	06	H1558_003_0	2	2009.01	WELBORN HEALTH PLAN	Welborn Health Plans	www.welbornhealthplans.com	06	18		1		H1558	003	0	2009	Medicare  Basic Plan	Gibson,Posey,Spencer,Warrick,Vanderburgh counties		2	2			15	2						(812)-426-6600	(800)-521-0265	(800)-743-3333	(800)-743-3333	(812)-426-6600	(800)-521-0265	(800)-743-3333	(800)-743-3333										www.welbornhealthplans.com
H1558	004	0	1	18	06	H1558_004_0	2	2009.01	WELBORN HEALTH PLAN	Welborn Health Plans	www.welbornhealthplans.com	06	18		1		H1558	004	0	2009	Medicare Plus Plan	Gibson,Posey,Spencer,Warrick, Vanderburgh counties		2	2			15	2						(812)-426-6600	(800)-521-0265	(800)-743-3333	(800)-743-3333	(812)-426-6600	(800)-521-0265	(800)-743-3333	(800)-743-3333										www.welbornhealthplans.com
H1607	001	0	1	04	01	H1607_001_0	10	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	04		1		H1607	001	0	2009	Anthem Medicare Preferred Standard	Indiana - Select Counties		2	2			3627	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
H1608	001	0	1	04	01	H1608_001_0	12	2009.01	COVENTRY HEALTH AND LIFE INS COMPANY	Coventry Health and Life Insurance Company	www.advantraplans.com	01	04		1		H1608	001	0	2009	Advantra Platinum PPO	Partial State of Iowa		2	2			5136	2						(866)-901-4692	(866)-901-4692	(877)-231-0573		(866)-363-4692	(866)-363-4692	(877)-231-0573	(877)-231-0573	(866)-293-4748	(866)-293-4748	(877)-231-0573		(866)-363-4692	(866)-363-4692	(877)-231-0573		http://coventry.advantrarxpremierplus2007.formularies.com/	www.ia.chcadvantra.com
H1608	002	0	1	04	01	H1608_002_0	10	2009.01	COVENTRY HEALTH AND LIFE INS COMPANY	Coventry Health and Life Insurance Company	www.advantraplans.com	01	04		1		H1608	002	0	2009	Advantra Platinum Plus PPO	Partial State of Iowa		2	2			6022	2						(866)-901-4692	(866)-901-4692	(877)-231-0573		(866)-363-4692	(866)-363-4692	(877)-231-0573	(877)-231-0573	(866)-293-4748	(866)-293-4748	(877)-231-0573		(866)-363-4692	(866)-363-4692	(877)-231-0573		http://coventry.advantrarxpremierplus2007.formularies.com/	www.ia.chcadvantra.com
H1608	003	0	1	04	01	H1608_003_0	10	2009.01	COVENTRY HEALTH AND LIFE INS COMPANY	Coventry Health and Life Insurance Company	www.advantraplans.com	01	04		1		H1608	003	0	2009	Advantra Platinum PPO SW	Western Iowa		2	2			223	2						(866)-901-4692	(866)-901-4692	(877)-231-0573		(866)-363-4692	(866)-363-4692	(877)-231-0573		(866)-293-4748	(866)-293-4748	(877)-231-0573		(866)-393-4692	(866)-393-4692	(877)-231-0573		http://coventry.advantrarxpremierplus2007.formularies.com/	www.ia.chcadvantra.com
H1608	801	0	1	04	01	H1608_801_0	9	2009.01	COVENTRY HEALTH AND LIFE INS COMPANY	Coventry Health and Life Insurance Company	www.advantraplans.com	01	04		1		H1608	801	0	2009	PPO-EmGp/No Rx/Cyear	State of Iowa		1	2			404	2						(866)-901-4692	(866)-901-4692	(877)-231-0573		(866)-363-4692	(866)-363-4692	(877)-231-0573	(877)-231-0573									http://coventry.advantrarxpremierplus2007.formularies.com/	www.ia.chcadvantra.com
H1608	802	0	1	04	01	H1608_802_0	9	2009.01	COVENTRY HEALTH AND LIFE INS COMPANY	Coventry Health and Life Insurance Company	www.advantraplans.com	01	04		1		H1608	802	0	2009	PPO-EmGp/Comm4/Cyear	State of Iowa		1	2			404	2						(866)-901-4692	(866)-901-4692	(877)-231-0573		(866)-363-4692	(866)-363-4692	(877)-231-0573	(877)-231-0573	(866)-293-4748	(866)-293-4748	(877)-231-0573		(866)-363-4692	(866)-363-4692			http://coventry.advantrarxpremierplus2007.formularies.com/	www.ia.chcadvantra.com
H1608	803	0	1	04	01	H1608_803_0	10	2009.01	COVENTRY HEALTH AND LIFE INS COMPANY	Coventry Health and Life Insurance Company	www.advantraplans.com	01	04		1		H1608	803	0	2009	PPO-EmGp/Comm4/NonCyear	State of Iowa		1	2			404	2						(866)-901-4692	(866)-901-4692	(877)-231-0573		(866)-363-4692	(866)-363-4692	(877)-231-0573	(877)-231-0573	(866)-293-4748	(866)-293-4748			(866)-363-4692	(866)-363-4692	(277)-231-0573		http://coventry.advantrarxpremierplus2007.formularies.com/	www.ia.chcadvantra.com
H1609	001	0	1	01	01	H1609_001_0	11	2009.01	COVENTRY HEALTH CARE OF IOWA, INC.	Coventry Health Care of Iowa, Inc.	www.advantraplans.com	01	01		1		H1609	001	0	2009	Advantra Silver	Partial State of Iowa		2	2			50878	2						(866)-901-4692	(866)-901-4692	(877)-231-0573	(877)-231-0573	(866)-363-4692	(866)-363-4692	(877)-231-0573	(877)-231-0573	(866)-293-4748	(866)-293-4748	(877)-231-0573	(877)-231-0573	(866)-363-4692	(866)-363-4692	(877)-231-0573	(877)-231-0573	http://coventry.advantrarxpremierplus2007.formularies.com/	www.ia.chcadvantra.com
H1609	003	0	1	01	01	H1609_003_0	13	2009.01	COVENTRY HEALTH CARE OF IOWA, INC.	Coventry Health Care of Iowa, Inc.	www.advantraplans.com	01	01		1		H1609	003	0	2009	Advantra Gold	Partial State of Iowa		2	2			14285	2						(866)-901-4692	(866)-901-4692	(877)-231-0573	(877)-231-0573	(866)-363-4692	(866)-363-4692	(877)-231-0573	(877)-231-0573	(866)-293-4748	(866)-293-4748	(877)-231-0573	(877)-231-0573	(866)-363-4692	(866)-363-4692	(877)-231-0573	(877)-231-0573	http://coventry.advantrarxpremierplus2007.formularies.com/	www.ia.chcadvantra.com
H1609	004	0	1	01	01	H1609_004_0	11	2009.01	COVENTRY HEALTH CARE OF IOWA, INC.	Coventry Health Care of Iowa, Inc.	www.advantraplans.com	01	01		1		H1609	004	0	2009	AdvantraExtra - Diabetes	Partial State of Iowa		2	1	4		3453	2			1		0000000010000000000000000000	(866)-901-4692	(866)-901-4692	(877)-231-0573	(877)-231-0573	(866)-363-4692	(866)-363-4692	(877)-231-0573	(877)-231-0573	(866)-293-4748	(866)-293-4748	(877)-231-0573	(877)-231-0573	(866)-363-4692	(866)-363-4692	(877)-231-0573	(877)-231-0573	http://coventry.advantrarxpremierplus2007.formularies.com/	www.ia.chcadvantra.com
H1609	005	0	1	01	01	H1609_005_0	12	2009.01	COVENTRY HEALTH CARE OF IOWA, INC.	Coventry Health Care of Iowa, Inc.	www.advantraplans.com	01	01		1		H1609	005	0	2009	AdvantraExtra - Cholesterol	Partial State of Iowa		2	1	4		989	2			1		0000000001000000000000000000	(866)-901-4692	(866)-901-4692	(877)-231-0573	(877)-231-0573	(866)-363-4692	(866)-363-4692	(877)-231-0573	(877)-231-0573	(866)-293-4748	(866)-293-4748	(877)-231-0573	(877)-231-0573	(866)-363-4692	(866)-363-4692	(877)-231-0573	(877)-231-0573	http://coventry.advantrarxpremierplus2007.formularies.com/	www.ia.chcadvantra.com
H1609	006	0	1	01	01	H1609_006_0	12	2009.01	COVENTRY HEALTH CARE OF IOWA, INC.	Coventry Health Care of Iowa, Inc.	www.advantraplans.com	01	01		1		H1609	006	0	2009	AdvantraOne	Partial State of Iowa		2	1	3		1673	2			1	2		(866)-901-4692	(866)-901-4692	(877)-231-0573	(877)-231-0573	(866)-363-4692	(866)-363-4692	(877)-231-0573	(877)-231-0573	(866)-293-4748	(866)-293-4748	(877)-231-0573	(877)-231-0573	(866)-363-4692	(866)-363-4692	(877)-231-0573	(877)-231-0573	http://coventry.advantrarxpremierplus2007.formularies.com/	www.ia.chcadvantra.com
H1609	007	0	1	01	01	H1609_007_0	10	2009.01	COVENTRY HEALTH CARE OF IOWA, INC.	Coventry Health Care of Iowa, Inc.	www.advantraplans.com	01	01		1		H1609	007	0	2009	Advantra Silver SW	Western Iowa		2	2			1755	2						(866)-901-4692	(866)-901-4692	(877)-231-0573	(877)-231-0573	(866)-393-4692	(866)-393-4692	(877)-231-0573	(877)-231-0573	(866)-293-4748	(866)-293-4748	(877)-231-0573	(877)-231-0573	(866)-363-4692	(866)-363-4692	(877)-231-0573	(877)-231-0573	http://coventry.advantrarxpremierplus2007.formularies.com/	www.ia.chcadvantra.com
H1609	008	0	1	01	01	H1609_008_0	10	2009.01	COVENTRY HEALTH CARE OF IOWA, INC.	Coventry Health Care of Iowa, Inc.	www.advantraplans.com	01	01		1		H1609	008	0	2009	Advantra Gold SW	Western Iowa		2	2			655	2						(866)-901-4692	(866)-901-4692	(877)-231-0573	(877)-231-0573	(866)-393-4692	(866)-393-4692	(877)-231-0573	(877)-231-0573	(866)-293-4748	(866)-293-4748	(877)-231-0573	(877)-231-0573	(866)-363-4692	(866)-363-4692	(877)-231-0573	(877)-231-0573	http://coventry.advantrarxpremierplus2007.formularies.com/	www.ia.chcadvantra.com
H1609	801	0	1	01	01	H1609_801_0	8	2009.01	COVENTRY HEALTH CARE OF IOWA, INC.	Coventry Health Care of Iowa, Inc.	www.advantraplans.com	01	01		1		H1609	801	0	2009	HMO-EmGp/No Rx/Cyear	State of Iowa		1	2			404	2						(866)-901-4692	(866)-901-4692	(877)-231-0573	(877)-231-0573	(866)-363-4692	(866)-363-4692	(877)-231-0573	(877)-231-0573									http://coventry.advantrarxpremierplus2007.formularies.com/	www.ia.chcadvantra.com
H1609	802	0	1	01	01	H1609_802_0	8	2009.01	COVENTRY HEALTH CARE OF IOWA, INC.	Coventry Health Care of Iowa, Inc.	www.advantraplans.com	01	01		1		H1609	802	0	2009	HMO-EmGp/Comm4/Cyear	State of Iowa		1	2			404	2						(866)-901-4692	(866)-901-4692	(877)-231-0573	(877)-231-0573	(866)-363-4692	(866)-363-4692	(877)-231-0573	(877)-231-0573	(866)-293-4748	(866)-293-4748	(877)-231-0573	(877)-231-0573	(866)-363-4692	(866)-363-4692	(877)-231-0573	(877)-231-0573	http://coventry.advantrarxpremierplus2007.formularies.com/	www.ia.chcadvantra.com
H1609	803	0	1	01	01	H1609_803_0	8	2009.01	COVENTRY HEALTH CARE OF IOWA, INC.	Coventry Health Care of Iowa, Inc.	www.advantraplans.com	01	01		1		H1609	803	0	2009	HMO-EmGp/Comm4/NonCyear	State of Iowa		1	2			404	2						(866)-901-4692	(866)-901-4692	(877)-231-0573	(877)-231-0573	(866)-363-4692	(866)-363-4692	(877)-231-0573	(877)-231-0573	(866)-293-4748	(866)-293-4748	(877)-231-0573	(877)-231-0573	(866)-363-4692	(866)-363-4692	(877)-231-0573	(877)-231-0573	http://coventry.advantrarxpremierplus2007.formularies.com/	www.ia.chcadvantra.com
H1643	001	0	1	09	04	H1643_001_0	8	2009.01	HM HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	04	09	2	1		H1643	001	0	2009	FreedomBlue PFFS Choice Plus	Region 1		2	2				2						(866)-675-8631	(866)-675-8631	(800)-855-1155	(800)-855-1155	(866)-730-4145	(866)-730-4145	(800)-227-8210	(800)-227-8210	(866)-675-8631	(866)-675-8631	(800)-855-1155	(800)-855-1155	(866)-730-4145	(866)-730-4145	(800)-227-8210	(800)-227-8210	http://highmark.medicare-approvedformularies.com/search.asp	
H1643	002	0	1	09	04	H1643_002_0	4	2009.01	HM HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	04	09	2	1		H1643	002	0	2009	FreedomBlue PFFS Choice	Region 1		2	2				2						(866)-675-8631	(866)-675-8631	(800)-855-1155	(800)-855-1155	(866)-730-4145	(866)-730-4145	(800)-227-8210	(800)-227-8210									http://highmark.medicare-approvedformularies.com/search.asp	
H1643	003	0	1	09	04	H1643_003_0	8	2009.01	HM HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	04	09	2	1		H1643	003	0	2009	FreedomBlue PFFS Enhanced	Region 1		2	2				2						(866)-675-8631	(866)-675-8631	(800)-855-1155	(800)-855-1155	(866)-730-4145	(866)-730-4145	(800)-227-8210	(800)-227-8210	(866)-675-8631	(866)-675-8631	(800)-855-1155	(800)-855-1155	(866)-730-4145	(866)-730-4145	(800)-227-8210	(800)-227-8210	http://highmark.medicare-approvedformularies.com/search.asp	
H1643	004	0	1	09	04	H1643_004_0	8	2009.01	HM HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	04	09	2	1		H1643	004	0	2009	FreedomBlue PFFS Choice Plus	Region 2		2	2				2						(866)-675-8631	(866)-675-8631	(800)-855-1155	(800)-855-1155	(866)-730-4145	(866)-730-4145	(800)-227-8210	(800)-227-8210	(866)-675-8631	(866)-675-8631	(800)-855-1155	(800)-855-1155	(866)-730-4145	(866)-730-4145	(800)-227-8210	(800)-227-8210	http://highmark.medicare-approvedformularies.com/search.asp	
H1643	005	0	1	09	04	H1643_005_0	4	2009.01	HM HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	04	09	2	1		H1643	005	0	2009	FreedomBlue PFFS Choice	Region 2		2	2				2						(866)-675-8631	(866)-675-8631	(800)-855-1155	(800)-855-1155	(866)-730-4145	(866)-730-4145	(800)-227-8210	(800)-227-8210									http://highmark.medicare-approvedformularies.com/search.asp	
H1643	006	0	1	09	04	H1643_006_0	8	2009.01	HM HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	04	09	2	1		H1643	006	0	2009	FreedomBlue PFFS Enhanced	Region 2		2	2				2						(866)-675-8631	(866)-675-8631	(800)-855-1155	(800)-855-1155	(866)-730-4145	(866)-730-4145	(800)-227-8210	(800)-227-8210	(866)-675-8631	(866)-675-8631	(800)-855-1155	(800)-855-1155	(866)-730-4145	(866)-730-4145	(800)-227-8210	(800)-227-8210	http://highmark.medicare-approvedformularies.com/search.asp	
H1643	801	0	1	09	04	H1643_801_0	2	2009.01	HM HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	04	09	2	1		H1643	801	0	2009	FreedomBlue PFFS MA-PDP	All West Virginia		1	2				2						(866)-675-8631	(866)-675-8631	(800)-855-1155	(800)-855-1155	(866)-730-4145	(866)-730-4145	(800)-227-8210	(800)-227-8210	(866)-675-8631	(866)-675-8631	(800)-855-1155	(800)-855-1155	(866)-730-4145	(866)-730-4145	(800)-227-8210	(800)-227-8210	http://highmark.medicare-approvedformularies.com/search.asp	
H1643	802	0	1	09	04	H1643_802_0	2	2009.01	HM HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	04	09	2	1		H1643	802	0	2009	FreedomBlue PPFS MA	All West Virginia		1	2				2						(866)-675-8631	(866)-675-8631	(800)-855-1155	(800)-855-1155	(866)-730-4145	(866)-730-4145	(800)-227-8210	(800)-227-8210									http://highmark.medicare-approvedformularies.com/search.asp	
H1643	803	0	1	09	04	H1643_803_0	2	2009.01	HM HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	04	09	2	1		H1643	803	0	2009	FreedomBlue PFFS MA-PDP Non-Calendar	All West Virginia counties		1	2				2						(866)-675-8631	(866)-675-8631	(800)-855-1155	(800)-855-1155	(866)-730-4145	(866)-730-4145	(800)-227-8210	(800)-227-8210	(866)-675-8631	(866)-675-8631	(800)-855-1155	(800)-855-1155	(866)-730-4145	(866)-730-4145	(800)-227-8210	(800)-227-8210	http://highmark.medicare-approvedformularies.com/search.asp	
H1651	001	0	1	18	06	H1651_001_0	1	2009.01	MEDICAL ASSOCIATES HEALTH PLAN, INC.	Medical Associates Health Plan, Inc.	mahealthcare.com	06	18		1		H1651	001	0	2009	Medical Associates Advantage Plus Plan	Eastern Iowa		2	2			5118	2						(866)-821-1365		(800)-735-2943		(800)-747-8900		(800)-735-2943											
H1651	002	0	1	18	06	H1651_002_0	1	2009.01	MEDICAL ASSOCIATES HEALTH PLAN, INC.	Medical Associates Health Plan, Inc.	mahealthcare.com	06	18		1		H1651	002	0	2009	Medical Associates Advantage Plan	Eastern Iowa		2	2			0	2						(866)-821-1365		(800)-735-2943		(800)-747-8900		(800)-735-2943											
H1651	003	0	1	18	06	H1651_003_0	1	2009.01	MEDICAL ASSOCIATES HEALTH PLAN, INC.	Medical Associates Health Plan, Inc.	mahealthcare.com	06	18		1		H1651	003	0	2009	Medical Associates Advantage Plan	Northwest Illinois		2	2			5118	2						(866)-821-1365		(800)-735-2943		(800)-747-8900		(800)-735-2943											
H1651	004	0	1	18	06	H1651_004_0	1	2009.01	MEDICAL ASSOCIATES HEALTH PLAN, INC.	Medical Associates Health Plan, Inc.	mahealthcare.com	06	18		1		H1651	004	0	2009	MAHP Medicare Community Plan	Northeast Iowa		2	2			1497	2						(866)-821-1365		(800)-735-2943		(800)-747-8900		(800)-735-2943											
H1651	005	0	1	18	06	H1651_005_0	1	2009.01	MEDICAL ASSOCIATES HEALTH PLAN, INC.	Medical Associates Health Plan, Inc.	mahealthcare.com	06	18		1		H1651	005	0	2009	MAHP Medicare Community Plan	Northwest IL		2	2			167	2						(866)-821-1365		(800)-735-2943		(800)-747-8900		(800)-735-2943											
H1651	008	0	1	18	06	H1651_008_0	2	2009.01	MEDICAL ASSOCIATES HEALTH PLAN, INC.	Medical Associates Health Plan, Inc.	mahealthcare.com	06	18		1		H1651	008	0	2009	Medical Associates Health Plan (MAHP) Freedom Plan	Eastern Iowa		2	2			74	2						(866)-821-1365		(800)-735-2943		(800)-747-8900		(800)-735-2943											
H1651	009	0	1	18	06	H1651_009_0	2	2009.01	MEDICAL ASSOCIATES HEALTH PLAN, INC.	Medical Associates Health Plan, Inc.	mahealthcare.com	06	18		1		H1651	009	0	2009	Medical Associates Health Plan (MAHP) Freedom Plan	Northwest Illinois		2	2			20	2						(866)-821-1365		(800)-735-2943		(800)-747-8900		(800)-735-2943											
H1657	002	0	1	02	01	H1657_002_0	7	2009.01	HARMONY HEALTH PLANS OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	02		1		H1657	002	0	2009	WellCare Value	Lake County		2	2				2						(866)-424-4963	(866)-424-4963	(877)-247-6272		(866)-360-8139	(866)-360-8139	(877)-247-6272		(866)-424-4963	(866)-424-4963	(877)-247-6272		(866)-360-8139	(866)-360-8139	(877)-247-6272		www.wellcare.com	
H1657	003	0	1	02	01	H1657_003_0	7	2009.01	HARMONY HEALTH PLANS OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	02		1		H1657	003	0	2009	WellCare Value	St. Joseph, Kosciusko, Allen, et al		2	2				2						(866)-424-4963	(866)-424-4963	(877)-247-6272		(866)-360-8139	(866)-360-8139	(877)-247-6272		(866)-424-4963	(866)-424-4963	(877)-247-6272		(866)-360-8139	(866)-360-8139	(877)-247-6272		www.wellcare.com	
H1657	004	0	1	01	01	H1657_004_0	7	2009.01	HARMONY HEALTH PLANS OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	01		1		H1657	004	0	2009	WellCare Access	St. Joseph, Kosciusko, Allen, et al		2	1	3			2			1	1		(866)-424-4963	(866)-424-4963	(877)-247-6272		(866)-360-8139	(866)-360-8139	(877)-247-6272		(866)-424-4963	(866)-424-4963	(877)-247-6272		(866)-360-8139	(866)-360-8139	(877)-247-6272		www.wellcare.com	
H1657	005	0	1	02	01	H1657_005_0	7	2009.01	HARMONY HEALTH PLANS OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	02		1		H1657	005	0	2009	WellCare Select	St. Joseph, Kosciusko, Allen Counties		2	1	3			2			1	2		(866)-424-4963	(866)-424-4963	(877)-247-6272		(866)-360-8139	(866)-360-8139	(877)-247-6272		(866)-424-4963	(866)-424-4963	(877)-247-6272		(866)-360-8139	(866)-360-8139	(877)-247-6272		www.wellcare.com	
H1657	006	0	1	02	01	H1657_006_0	8	2009.01	HARMONY HEALTH PLANS OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	02		1		H1657	006	0	2009	WellCare Select	Johnson, Marion Counties		2	1	3			2			1	2		(866)-424-4963	(866)-424-4963	(877)-247-6272		(866)-360-8139	(866)-360-8139	(877)-247-6272		(866)-424-4963	(866)-424-4963	(877)-247-6272		(866)-360-8139	(866)-360-8139	(877)-247-6272		www.wellcare.com	
H1657	007	0	1	02	01	H1657_007_0	7	2009.01	HARMONY HEALTH PLANS OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	02		1		H1657	007	0	2009	WellCare Select	Lake County		2	1	3			2			1	2		(866)-424-4963	(866)-424-4963	(877)-247-6272		(866)-360-8139	(866)-360-8139	(877)-247-6272		(866)-424-4963	(866)-424-4963	(877)-247-6272		(866)-360-8139	(866)-360-8139	(877)-247-6272		www.wellcare.com	
H1657	008	0	1	02	01	H1657_008_0	7	2009.01	HARMONY HEALTH PLANS OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	02		1		H1657	008	0	2009	WellCare Rx	Lake County		2	2				2						(866)-424-4963	(866)-424-4963	(877)-247-6272		(866)-360-8139	(866)-360-8139	(877)-247-6272		(866)-424-4963	(866)-424-4963	(877)-247-6272		(866)-360-8139	(866)-360-8139	(877)-247-6272		www.wellcare.com	
H1657	009	0	1	02	01	H1657_009_0	7	2009.01	HARMONY HEALTH PLANS OF ILLINOIS, INC.	WellCare	www.wellcare.com	01	02		1		H1657	009	0	2009	WellCare Rx	Allen, Johnson, Kosciusko, Marion, et al		2	2				2						(866)-424-4963	(866)-424-4963	(877)-247-6272		(866)-360-8139	(866)-360-8139	(877)-247-6272		(866)-424-4963	(866)-424-4963	(877)-247-6272		(866)-360-8139	(866)-360-8139	(877)-247-6272		www.wellcare.com	
H1681	001	0	1	04	01	H1681_001_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1681	001	0	2009	HumanaChoicePPO PPO H1681-001	Madison County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1681	002	0	1	04	01	H1681_002_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1681	002	0	2009	HumanaChoicePPO PPO H1681-002	Birmingham Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1681	003	0	1	04	01	H1681_003_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1681	003	0	2009	HumanaChoicePPO PPO H1681-003	Baldwin and Mobile Counties		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1681	801	0	1	04	01	H1681_801_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1681	801	0	2009	Humana Employer Sponsored	Select counties in Alabama		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1681	802	0	1	04	01	H1681_802_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1681	802	0	2009	Humana Employer Sponsored	Select counties in Alabama		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1681	803	0	1	04	01	H1681_803_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1681	803	0	2009	Humana Employer Sponsored Non-CY	Select counties in Alabama		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1681	804	0	1	04	01	H1681_804_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1681	804	0	2009	Humana Employer Sponsored Non-CY	Select counties in Alabama		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1689	012	0	1	09	04	H1689_012_0	6	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Insurance Companies, Inc.	www.anthem.com	04	09	2	1		H1689	012	0	2009	SmartValue Classic	Nationwide, Select Counties		2	2			4056	2						(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(800)-765-2585	(800)-765-2585	(877)-247-1657										www.anthem.com	
H1689	013	0	1	09	04	H1689_013_0	9	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Insurance Companies, Inc.	www.anthem.com	04	09	2	1		H1689	013	0	2009	SmartValue Plus	Nationwide, Select Counties		2	2			6190	2						(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(800)-765-2585	(800)-765-2585	(877)-247-1657		(888)-445-8916	(888)-445-8916	(888)-844-5530		(800)-765-2585	(800)-765-2585	(877)-247-1657		www.anthem.com	
H1689	801	0	1	09	04	H1689_801_0	4	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Insurance Companies, Inc.	www.anthem.com	04	09	2	1		H1689	801	0	2009	SmartValue Group Plan I	CO, CT, GA, IN, KY, ME, NH, OH, VA, WI		1	2			4071	2						(888)-445-8916	(888)-445-8916	(888)-844-5530		(800)-765-2585	(800)-765-2585	(877)-247-1657		(888)-445-8916	(888)-445-8916	(888)-844-5530		(800)-765-2585	(800)-765-2585	(877)-247-1657		www.anthem.com	
H1689	802	0	1	09	04	H1689_802_0	4	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Insurance Companies, Inc.	www.anthem.com	04	09	2	1		H1689	802	0	2009	SmartValue Group Plan II	CO, CT, GA, IN, KY, ME, NH, OH, VA, WI		1	2			4071	2						(888)-445-8916	(888)-445-8916	(888)-844-5530		(800)-765-2585	(800)-765-2585	(877)-247-1657										www.anthem.com	
H1689	807	0	1	09	04	H1689_807_0	4	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Insurance Companies, Inc.	www.anthem.com	04	09	2	1		H1689	807	0	2009	SmartValue Group Plan III	CT, GA, IN, KY, NH, OH, VA, WI, ME, CO + Nationwid		1	2			4071	2						(888)-445-8916	(888)-445-8916	(888)-844-5530		(800)-765-2585	(800)-765-2585	(877)-247-1657		(888)-445-8916	(888)-445-8916	(888)-844-5530		(800)-765-2585	(800)-765-2585	(877)-247-1657		www.anthem.com	
H1714	001	0	1	20	08	H1714_001_0	1	2009.01	VIA CHRISTI HEALTHCARE OUTREACH PROGRAM FOR ELDERS	Via Christi HOPE	www.viachristihope.com	08	20		1		H1714	001	0	2009	Via Christi HOPE	Via Christi HOPE		2	2				2														(316)-858-1111	(800)-999-9999			(316)-858-1111	(800)-999-9999			www.viachristihope.com	
H1714	002	0	1	20	08	H1714_002_0	1	2009.01	VIA CHRISTI HEALTHCARE OUTREACH PROGRAM FOR ELDERS	Via Christi HOPE	www.viachristihope.com	08	20		1		H1714	002	0	2009	Via Christi HOPE	Sedgwick Co, KS		2	2				2														(316)-858-1111	(800)-999-9999			(316)-858-1111	(800)-999-9999			www.viachristihope.com	
H1716	001	0	1	04	01	H1716_001_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1716	001	0	2009	HumanaChoicePPO PPO H1716-001	Kansas City Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1716	002	0	1	04	01	H1716_002_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1716	002	0	2009	HumanaChoicePPO PPO H1716-002	Butler, Harvey, Sedgwick, Sumner		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1716	004	0	1	04	01	H1716_004_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1716	004	0	2009	HumanaChoicePPO PPO H1716-004	Christian, Greene, Lawrence, Polk, Webster		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1716	006	0	1	04	01	H1716_006_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1716	006	0	2009	HumanaChoicePPO PPO H1716-006	St. Louis Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1716	009	0	1	04	01	H1716_009_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1716	009	0	2009	HumanaChoicePPO PPO H1716-009	Springfield		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1716	010	0	1	04	01	H1716_010_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1716	010	0	2009	Humana MyCare	Kansas City		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1716	801	0	1	04	01	H1716_801_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1716	801	0	2009	Humana Employer Sponsored	Johnson, KS, Jackson, Clay, Platte, Cass, MO		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1716	802	0	1	04	01	H1716_802_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1716	802	0	2009	Humana Employer Sponsored	Johnson, KS, Cass, Clay, Jackson, Platte, MO		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1716	803	0	1	04	01	H1716_803_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1716	803	0	2009	Humana Employer Sponsored Non-CY	Johnson, KS, Cass, Clay, Jackson, Platte, MO		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1716	804	0	1	04	01	H1716_804_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1716	804	0	2009	Humana Employer Sponsored Non-CY	Johnson, KS, Cass, Clay, Jackson, Platte, MO		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1717	001	0	1	04	01	H1717_001_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1717	001	0	2009	AARP MedicareCompleteChoicePlan1	Sedgwick County		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1717	006	0	1	04	01	H1717_006_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1717	006	0	2009	Evercare Plan DP	Sedgwick County		2	1	3			2			2	2		(877)-702-5110		(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1717	007	0	1	04	01	H1717_007_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1717	007	0	2009	Evercare Plan DP	Johnson and Wyandotte Counties		2	1	3			2			2	2		(877)-702-5110		(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1717	008	0	1	04	01	H1717_008_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1717	008	0	2009	Evercare Plan MP	Sedgwick County		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110		(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1717	009	0	1	04	01	H1717_009_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1717	009	0	2009	Evercare Plan IP	Johnson and Wyandotte Counties		2	1	1	1		2			1			(800)-393-0993		(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1717	010	0	1	04	01	H1717_010_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1717	010	0	2009	Evercare Plan MP	Johnson and Wyandotte Counties		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110		(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1717	801	0	1	04	01	H1717_801_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1717	801	0	2009	MedicareComplete Choice Retiree Plan	Sedgwick County		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1717	803	0	1	04	01	H1717_803_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1717	803	0	2009	MedicareComplete Choice Retiree Plan	Sedgwick County		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1717	804	0	1	04	01	H1717_804_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1717	804	0	2009	MedicareComplete Retiree Plan	Johnson, Sedgwick,Wyandotte		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1717	805	0	1	04	01	H1717_805_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H1717	805	0	2009	MedicareComplete Retiree Plan	Johnson, Sedgwick, Wyandotte		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1777	001	0	1	01	01	H1777_001_0	8	2009.01	CATHOLIC SPECIAL NEEDS PLAN, LLC	ArchCare Advantage	www.archcareadvantage.org	01	01		1		H1777	001	0	2009	ArchCare Advantage	Bronx, New York and Richmond Counties		2	1	1	1		2			1			(800)-373-3177		(800)-662-1220		(800)-373-3177		(800)-662-1220		(800)-373-3177	(888)-816-7977			(800)-373-3177	(800)-373-3177			www.archcareadvantage.org	
H1804	001	0	1	09	04	H1804_001_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	001	0	2009	Humana Gold Choice PFFS H1804-001	Select Counties in Wisconsin		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	005	0	1	09	04	H1804_005_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	005	0	2009	Humana Gold Choice PFFS H1804-005	Select Counties in Arizona		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	006	0	1	09	04	H1804_006_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	006	0	2009	Humana Gold Choice PFFS H1804-006	Select counties in Georgia		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	007	0	1	09	04	H1804_007_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	007	0	2009	Humana Gold Choice PFFS H1804-007	Select counties in North Carolina		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	008	0	1	09	04	H1804_008_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	008	0	2009	Humana Gold Choice PFFS H1804-008	Select counties in South Carolina		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	009	0	1	09	04	H1804_009_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	009	0	2009	Humana Gold Choice PFFS H1804-009	Select counties in Alabama		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	011	0	1	09	04	H1804_011_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	011	0	2009	Humana Gold Choice PFFS H1804-011	Select counties in Arizona		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	013	0	1	09	04	H1804_013_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	013	0	2009	Humana Gold Choice PFFS H1804-013	Select counties in Georgia		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	014	0	1	09	04	H1804_014_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	014	0	2009	Humana Gold Choice PFFS H1804-014	Select counties in Georgia		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	016	0	1	09	04	H1804_016_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	016	0	2009	Humana Gold Choice PFFS H1804-016	Select counties in North Carolina		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	018	0	1	09	04	H1804_018_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	018	0	2009	Humana Gold Choice PFFS H1804-018	Select counties in South Carolina		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	019	0	1	09	04	H1804_019_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	019	0	2009	Humana Gold Choice PFFS H1804-019	Select counties in Alabama		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	020	0	1	09	04	H1804_020_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	020	0	2009	Humana Gold Choice PFFS H1804-020	Select counties in Alabama		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	022	0	1	09	04	H1804_022_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	022	0	2009	Humana Gold Choice PFFS H1804-022	Select counties in Idaho		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	023	0	1	09	04	H1804_023_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	023	0	2009	Humana Gold Choice PFFS H1804-023	Select Counties in Wisconsin		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	025	0	1	09	04	H1804_025_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	025	0	2009	Humana Gold Choice PFFS H1804-025	Iowa		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	061	0	1	09	04	H1804_061_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	061	0	2009	Humana Gold Choice PFFS H1804-061	Select Counties in Colorado		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	063	0	1	09	04	H1804_063_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	063	0	2009	Humana Gold Choice PFFS H1804-063	Select Counties in Colorado		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	066	0	1	09	04	H1804_066_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	066	0	2009	Humana Gold Choice PFFS H1804-066	Select Counties in Idaho		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	067	0	1	09	04	H1804_067_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	067	0	2009	Humana Gold Choice PFFS H1804-067	Select Counties in Indiana		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	068	0	1	09	04	H1804_068_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	068	0	2009	Humana Gold Choice PFFS H1804-068	Select Counties in Indiana		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	075	0	1	09	04	H1804_075_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	075	0	2009	Humana Gold Choice PFFS H1804-075	Select Counties in Michigan		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	077	0	1	09	04	H1804_077_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	077	0	2009	Humana Gold Choice PFFS H1804-077	Select Counties in Michigan		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	081	0	1	09	04	H1804_081_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	081	0	2009	Humana Gold Choice PFFS H1804-081	Nebraska		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	086	0	1	09	04	H1804_086_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	086	0	2009	Humana Gold Choice PFFS H1804-086	Select Counties in Ohio		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	087	0	1	09	04	H1804_087_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	087	0	2009	Humana Gold Choice PFFS H1804-087	Select Counties in Ohio		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	089	0	1	09	04	H1804_089_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	089	0	2009	Humana Gold Choice PFFS H1804-089	Select Counties in Oklahoma		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	090	0	1	09	04	H1804_090_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	090	0	2009	Humana Gold Choice PFFS H1804-090	Select Counties in Oklahoma		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	091	0	1	09	04	H1804_091_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	091	0	2009	Humana Gold Choice PFFS H1804-091	Select Counties in Pennsylvania		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	093	0	1	09	04	H1804_093_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	093	0	2009	Humana Gold Choice PFFS H1804-093	Select Counties in Pennsylvania		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	094	0	1	09	04	H1804_094_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	094	0	2009	Humana Gold Choice PFFS H1804-094	Select Counties in West Virginia		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	095	0	1	09	04	H1804_095_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	095	0	2009	Humana Gold Choice PFFS H1804-095	Select Counties in West Virginia		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	097	0	1	09	04	H1804_097_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	097	0	2009	Humana Gold Choice PFFS H1804-097	Select Counties in Arkansas		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	098	0	1	09	04	H1804_098_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	098	0	2009	Humana Gold Choice PFFS H1804-098	Select Counties in Arkansas		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	103	0	1	09	04	H1804_103_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	103	0	2009	Humana Gold Choice PFFS H1804-103	Virginia		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	122	0	1	09	04	H1804_122_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	122	0	2009	Humana Gold Choice PFFS H1804-122	Select Counties in Florida		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	125	0	1	09	04	H1804_125_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	125	0	2009	Humana Gold Choice PFFS H1804-125	Select Counties in Illinois		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	126	0	1	09	04	H1804_126_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	126	0	2009	Humana Gold Choice PFFS H1804-126	Select Counties in Kansas		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	127	0	1	09	04	H1804_127_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	127	0	2009	Humana Gold Choice PFFS H1804-127	Select Counties in Kansas		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	128	0	1	09	04	H1804_128_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	128	0	2009	Humana Gold Choice PFFS H1804-128	Select Counties in Mississippi		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	129	0	1	09	04	H1804_129_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	129	0	2009	Humana Gold Choice PFFS H1804-129	Select counties in Mississippi		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	130	0	1	09	04	H1804_130_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	130	0	2009	Humana Gold Choice PFFS H1804-130	Select Counties in Missouri		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	131	0	1	09	04	H1804_131_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	131	0	2009	Humana Gold Choice PFFS H1804-131	Select Counties in Missouri		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	132	0	1	09	04	H1804_132_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	132	0	2009	Humana Gold Choice PFFS H1804-132	Select Counties in Texas		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	133	0	1	09	04	H1804_133_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	133	0	2009	Humana Gold Choice PFFS H1804-133	Select Counties in Texas		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	137	0	1	09	04	H1804_137_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	137	0	2009	Humana Gold Choice PFFS H1804-137	Select Counties in Illinois		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	138	0	1	09	04	H1804_138_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	138	0	2009	Humana Gold Choice PFFS H1804-138	Select Counties in Illinois		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	145	0	1	09	04	H1804_145_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	145	0	2009	Humana Gold Choice PFFS H1804-145	Select Counties in Florida		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	146	0	1	09	04	H1804_146_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	146	0	2009	Humana Gold Choice PFFS H1804-146	Select Counties in Texas		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	147	0	1	09	04	H1804_147_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	147	0	2009	Humana Gold Choice PFFS H1804-147	Select counties in Arizona		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	148	0	1	09	04	H1804_148_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	148	0	2009	Humana Gold Choice PFFS H1804-148	Select Counties in Colorado		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	149	0	1	09	04	H1804_149_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	149	0	2009	Humana Gold Choice PFFS H1804-149	Select Counties in Idaho		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	150	0	1	09	04	H1804_150_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	150	0	2009	Humana Gold Choice PFFS H1804-150	Nevada		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	153	0	1	09	04	H1804_153_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	153	0	2009	Humana Gold Choice PFFS H1804-153	Select Counties In Alabama		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	154	0	1	09	04	H1804_154_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	154	0	2009	Humana Gold Choice PFFS H1804-154	Select Counties in Alabama		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	155	0	1	09	04	H1804_155_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	155	0	2009	Humana Gold Choice PFFS H1804-155	Select Counties in Alabama		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	156	0	1	09	04	H1804_156_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	156	0	2009	Humana Gold Choice PFFS H1804-156	Select counties in Arizona		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	157	0	1	09	04	H1804_157_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	157	0	2009	Humana Gold Choice PFFS H1804-157	Select counties in Arizona		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	161	0	1	09	04	H1804_161_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	161	0	2009	Humana Gold Choice PFFS H1804-161	Select counties in Colorado		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	162	0	1	09	04	H1804_162_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	162	0	2009	Humana Gold Choice PFFS H1804-162	Select counties in Colorado		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	163	0	1	09	04	H1804_163_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	163	0	2009	Humana Gold Choice PFFS H1804-163	Select Counties in Florida		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	165	0	1	09	04	H1804_165_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	165	0	2009	Humana Gold Choice PFFS H1804-165	Select Counties in Florida		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	166	0	1	09	04	H1804_166_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	166	0	2009	Humana Gold Choice PFFS H1804-166	Select Counties in Georgia		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	167	0	1	09	04	H1804_167_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	167	0	2009	Humana Gold Choice PFFS H1804-167	Select Counties in Georgia		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	168	0	1	09	04	H1804_168_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	168	0	2009	Humana Gold Choice PFFS H1804-168	Select Counties in Georgia		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	169	0	1	09	04	H1804_169_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	169	0	2009	Humana Gold Choice PFFS H1804-169	Minnesota		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	170	0	1	09	04	H1804_170_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	170	0	2009	Humana Gold Choice PFFS H1804-170	Minnesota		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	171	0	1	09	04	H1804_171_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	171	0	2009	Humana Gold Choice PFFS H1804-171	Montana		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	172	0	1	09	04	H1804_172_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	172	0	2009	Humana Gold Choice PFFS H1804-172	Montana		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	173	0	1	09	04	H1804_173_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	173	0	2009	Humana Gold Choice PFFS H1804-173	North Dakota		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	174	0	1	09	04	H1804_174_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	174	0	2009	Humana Gold Choice PFFS H1804-174	North Dakota		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	175	0	1	09	04	H1804_175_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	175	0	2009	Humana Gold Choice PFFS H1804-175	South Dakota		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	176	0	1	09	04	H1804_176_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	176	0	2009	Humana Gold Choice PFFS H1804-176	South Dakota		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	177	0	1	09	04	H1804_177_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	177	0	2009	Humana Gold Choice PFFS H1804-177	Wyoming		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	178	0	1	09	04	H1804_178_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	178	0	2009	Humana Gold Choice PFFS H1804-178	Wyoming		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	179	0	1	09	04	H1804_179_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	179	0	2009	Humana Gold Choice PFFS H1804-179	Wyoming		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	180	0	1	09	04	H1804_180_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	180	0	2009	Humana Gold Choice PFFS H1804-180	Select Counties in Utah		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	181	0	1	09	04	H1804_181_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	181	0	2009	Humana Gold Choice PFFS H1804-181	Select Counties in Utah		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	184	0	1	09	04	H1804_184_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	184	0	2009	Humana Gold Choice PFFS H1804-184	Select Counties in Indiana		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	185	0	1	09	04	H1804_185_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	185	0	2009	Humana Gold Choice PFFS H1804-185	Select Counties in Indiana		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	187	0	1	09	04	H1804_187_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	187	0	2009	Humana Gold Choice PFFS H1804-187	Select Counties in Kansas		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	188	0	1	09	04	H1804_188_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	188	0	2009	Humana Gold Choice PFFS H1804-188	Select Counties in Kansas		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	190	0	1	09	04	H1804_190_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	190	0	2009	Humana Gold Choice PFFS H1804-190	Select Counties in Kentucky		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	192	0	1	09	04	H1804_192_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	192	0	2009	Humana Gold Choice PFFS H1804-192	Select Counties in Kentucky		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	193	0	1	09	04	H1804_193_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	193	0	2009	Humana Gold Choice PFFS H1804-193	Select Counties in Kentucky		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	195	0	1	09	04	H1804_195_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	195	0	2009	Humana Gold Choice PFFS H1804-195	Select Counties in Kentucky		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	196	0	1	09	04	H1804_196_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	196	0	2009	Humana Gold Choice PFFS H1804-196	Select counties in Idaho		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	197	0	1	09	04	H1804_197_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	197	0	2009	Humana Gold Choice PFFS H1804-197	Select counties in Idaho		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	198	0	1	09	04	H1804_198_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	198	0	2009	Humana Gold Choice PFFS H1804-198	Select counties in Illinois		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	199	0	1	09	04	H1804_199_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	199	0	2009	Humana Gold Choice PFFS H1804-199	Select counties in Illinois		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	200	0	1	09	04	H1804_200_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	200	0	2009	Humana Gold Choice PFFS H1804-200	Select counties in Illinois		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	201	0	1	09	04	H1804_201_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	201	0	2009	Humana Gold Choice PFFS H1804-201	Iowa		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	202	0	1	09	04	H1804_202_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	202	0	2009	Humana Gold Choice PFFS H1804-202	Select Counties in Mississippi		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	203	0	1	09	04	H1804_203_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	203	0	2009	Humana Gold Choice PFFS H1804-203	Select Counties in Mississippi		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	204	0	1	09	04	H1804_204_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	204	0	2009	Humana Gold Choice PFFS H1804-204	Select Counites in Missouri		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	205	0	1	09	04	H1804_205_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	205	0	2009	Humana Gold Choice PFFS H1804-205	Select Counties in Missouri		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	207	0	1	09	04	H1804_207_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	207	0	2009	Humana Gold Choice PFFS H1804-207	Select counties in Michigan		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	209	0	1	09	04	H1804_209_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	209	0	2009	Humana Gold Choice PFFS H1804-209	Select counties in Michigan		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	210	0	1	09	04	H1804_210_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	210	0	2009	Humana Gold Choice PFFS H1804-210	Nebraska		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	211	0	1	09	04	H1804_211_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	211	0	2009	Humana Gold Choice PFFS H1804-211	Select counties in New Mexico		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	212	0	1	09	04	H1804_212_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	212	0	2009	Humana Gold Choice PFFS H1804-212	Select counties in New Mexico		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	213	0	1	09	04	H1804_213_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	213	0	2009	Humana Gold Choice PFFS H1804-213	Select counties in New Mexico		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	214	0	1	09	04	H1804_214_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	214	0	2009	Humana Gold Choice PFFS H1804-214	Select counties in New Mexico		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	215	0	1	09	04	H1804_215_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	215	0	2009	Humana Gold Choice PFFS H1804-215	Select counties in New Mexico		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	216	0	1	09	04	H1804_216_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	216	0	2009	Humana Gold Choice PFFS H1804-216	Select Counties in North Carolina		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	217	0	1	09	04	H1804_217_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	217	0	2009	Humana Gold Choice PFFS H1804-217	Select Counties in North Carolina		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	218	0	1	09	04	H1804_218_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	218	0	2009	Humana Gold Choice PFFS H1804-218	Select Counties in Ohio		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	219	0	1	09	04	H1804_219_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	219	0	2009	Humana Gold Choice PFFS H1804-219	Select Counties in Ohio		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	223	0	1	09	04	H1804_223_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	223	0	2009	Humana Gold Choice PFFS H1804-223	Select Counties in Pennsylvania		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	224	0	1	09	04	H1804_224_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	224	0	2009	Humana Gold Choice PFFS H1804-224	Select Counties in Pennsylvania		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	225	0	1	09	04	H1804_225_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	225	0	2009	Humana Gold Choice PFFS H1804-225	Select Counties in South Carolina		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	226	0	1	09	04	H1804_226_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	226	0	2009	Humana Gold Choice PFFS H1804-226	Select Counties in South Carolina		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	227	0	1	09	04	H1804_227_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	227	0	2009	Humana Gold Choice PFFS H1804-227	Select Counties in Tennessee		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	228	0	1	09	04	H1804_228_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	228	0	2009	Humana Gold Choice PFFS H1804-228	Select Counties in Tennessee		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	229	0	1	09	04	H1804_229_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	229	0	2009	Humana Gold Choice PFFS H1804-229	Select Counties in Tennessee		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	230	0	1	09	04	H1804_230_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	230	0	2009	Humana Gold Choice PFFS H1804-230	Select Counties in Tennessee		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	231	0	1	09	04	H1804_231_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	231	0	2009	Humana Gold Choice PFFS H1804-231	Select Counties in Tennessee		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	232	0	1	09	04	H1804_232_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	232	0	2009	Humana Gold Choice PFFS H1804-232	Select Counties in Tennessee		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	233	0	1	09	04	H1804_233_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	233	0	2009	Humana Gold Choice PFFS H1804-233	Virginia		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	234	0	1	09	04	H1804_234_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	234	0	2009	Humana Gold Choice PFFS H1804-234	Select Counties in West Virginia		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	235	0	1	09	04	H1804_235_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	235	0	2009	Humana Gold Choice PFFS H1804-235	Select Counties in West Virginia		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	236	0	1	09	04	H1804_236_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	236	0	2009	Humana Gold Choice PFFS H1804-236	Select counties in Texas		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	237	0	1	09	04	H1804_237_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	237	0	2009	Humana Gold Choice PFFS H1804-237	Select counties in Texas		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	238	0	1	09	04	H1804_238_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	238	0	2009	Humana Gold Choice PFFS H1804-238	Select counties in Texas		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	239	0	1	09	04	H1804_239_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	239	0	2009	Humana Gold Choice PFFS H1804-239	Select counties in Wisconsin		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	240	0	1	09	04	H1804_240_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	240	0	2009	Humana Gold Choice PFFS H1804-240	Select counties in Wisconsin		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	241	0	1	09	04	H1804_241_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	241	0	2009	Humana Gold Choice PFFS H1804-241	Nevada		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	244	0	1	09	04	H1804_244_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	244	0	2009	Humana Gold Choice PFFS H1804-244	Select Counties in Alaska		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	245	0	1	09	04	H1804_245_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	245	0	2009	Humana Gold Choice PFFS H1804-245	Hawaii		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	246	0	1	09	04	H1804_246_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	246	0	2009	Humana Gold Choice PFFS H1804-246	Hawaii		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	251	0	1	09	04	H1804_251_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	251	0	2009	Humana Gold Choice PFFS H1804-251	Maine		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	252	0	1	09	04	H1804_252_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	252	0	2009	Humana Gold Choice PFFS H1804-252	Maine		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	253	0	1	09	04	H1804_253_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	253	0	2009	Humana Gold Choice PFFS H1804-253	Maine		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	254	0	1	09	04	H1804_254_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	254	0	2009	Humana Gold Choice PFFS H1804-254	Select counties in Massachusetts		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	256	0	1	09	04	H1804_256_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	256	0	2009	Humana Gold Choice PFFS H1804-256	Select counties in Massachusetts		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	257	0	1	09	04	H1804_257_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	257	0	2009	Humana Gold Choice PFFS H1804-257	New Hampshire		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	258	0	1	09	04	H1804_258_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	258	0	2009	Humana Gold Choice PFFS H1804-258	New Hampshire		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	259	0	1	09	04	H1804_259_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	259	0	2009	Humana Gold Choice PFFS H1804-259	New Hampshire		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	261	0	1	09	04	H1804_261_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	261	0	2009	Humana Gold Choice PFFS H1804-261	Select counties in Oregon		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	262	0	1	09	04	H1804_262_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	262	0	2009	Humana Gold Choice PFFS H1804-262	Select counties in Oregon		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	263	0	1	09	04	H1804_263_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	263	0	2009	Humana Gold Choice PFFS H1804-263	Rhode Island		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	265	0	1	09	04	H1804_265_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	265	0	2009	Humana Gold Choice PFFS H1804-265	Rhode Island		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	268	0	1	09	04	H1804_268_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	268	0	2009	Humana Gold Choice PFFS H1804-268	Vermont		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	269	0	1	09	04	H1804_269_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	269	0	2009	Humana Gold Choice PFFS H1804-269	Select counties in Washington		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	270	0	1	09	04	H1804_270_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	270	0	2009	Humana Gold Choice PFFS H1804-270	Select counties in Washington		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	271	0	1	09	04	H1804_271_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	271	0	2009	Humana Gold Choice PFFS H1804-271	Select counties in Washington		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	272	0	1	09	04	H1804_272_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	272	0	2009	Humana Gold Choice PFFS H1804-272	Select counties in California		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	273	0	1	09	04	H1804_273_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	273	0	2009	Humana Gold Choice PFFS H1804-273	Select counties in California		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	274	0	1	09	04	H1804_274_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	274	0	2009	Humana Gold Choice PFFS H1804-274	Select counties in California		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	275	0	1	09	04	H1804_275_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	275	0	2009	Humana Gold Choice PFFS H1804-275	Select counties in California		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	276	0	1	09	04	H1804_276_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	276	0	2009	Humana Gold Choice PFFS H1804-276	Select counties in California		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	277	0	1	09	04	H1804_277_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	277	0	2009	Humana Gold Choice PFFS H1804-277	Select counties in California		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	278	0	1	09	04	H1804_278_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	278	0	2009	Humana Gold Choice PFFS H1804-278	Select Counties in North Carolina		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	279	0	1	09	04	H1804_279_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	279	0	2009	Humana Gold Choice PFFS H1804-279	Select Counties in North Carolina		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	280	0	1	09	04	H1804_280_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	280	0	2009	Humana Gold Choice PFFS H1804-280	Select county in Utah		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	281	0	1	09	04	H1804_281_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	281	0	2009	Humana Gold Choice PFFS H1804-281	Select county in Utah		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	282	0	1	09	04	H1804_282_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	282	0	2009	Humana Gold Choice PFFS H1804-282	Hawaii		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	283	0	1	09	04	H1804_283_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	283	0	2009	Humana Gold Choice PFFS H1804-283	Select counties in Maine		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	284	0	1	09	04	H1804_284_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	284	0	2009	Humana Gold Choice PFFS H1804-284	Select counties in Maine		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	285	0	1	09	04	H1804_285_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	285	0	2009	Humana Gold Choice PFFS H1804-285	Select counties in Maine		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	286	0	1	09	04	H1804_286_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	286	0	2009	Humana Gold Choice PFFS H1804-286	Select counties in Illinois		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	287	0	1	09	04	H1804_287_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	287	0	2009	Humana Gold Choice PFFS H1804-287	Select counties in Illinois		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	288	0	1	09	04	H1804_288_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	288	0	2009	Humana Gold Choice PFFS H1804-288	Select counties in South Carolina		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	289	0	1	09	04	H1804_289_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	289	0	2009	Humana Gold Choice PFFS H1804-289	Select counties in South Carolina		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	801	0	1	09	04	H1804_801_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	801	0	2009	Humana Employer Sponsored	Nationwide		1	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	804	0	1	09	04	H1804_804_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	804	0	2009	Humana Employer Sponsored	Nationwide		1	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	805	0	1	09	04	H1804_805_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	805	0	2009	Humana Employer Sponsored Non-CY	Nationwide		1	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	806	0	1	09	04	H1804_806_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	1		H1804	806	0	2009	Humana Employer Sponsored Non-CY	Nationwide		1	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	807	0	2	09	04	H1804_807_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	2		H1804	807	0	2009	Humana Employer Sponsored	Nationwide		1	2				2		2				(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	808	0	2	09	04	H1804_808_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	2		H1804	808	0	2009	Humana Employer Sponsored	Nationwide		1	2				2		2				(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	809	0	2	09	04	H1804_809_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	2		H1804	809	0	2009	Humana Employer Sponsored Non-CY	Nationwide		1	2				2		2				(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1804	810	0	2	09	04	H1804_810_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	04	09	2	2		H1804	810	0	2009	Humana Employer Sponsored Non-CY	Nationwide		1	2				2		2				(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1806	001	0	1	04	01	H1806_001_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1806	001	0	2009	HumanaChoicePPO PPO H1806-001	Louisville Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http//www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1806	002	0	1	04	01	H1806_002_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1806	002	0	2009	HumanaChoicePPO PPO H1806-002	Lexington Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http//www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1806	801	0	1	04	01	H1806_801_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1806	801	0	2009	Humana Employer Sponsored	Louisville and Lexington Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http//www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1806	803	0	1	04	01	H1806_803_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1806	803	0	2009	Humana Employer Sponsored	Louisville and Lexington Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http//www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1806	804	0	1	04	01	H1806_804_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1806	804	0	2009	Humana Employer Sponsored Non-CY	Louisville and Lexington Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http//www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1806	805	0	1	04	01	H1806_805_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H1806	805	0	2009	Humana Employer Sponsored Non-CY	Louisville and Lexington Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http//www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1807	001	0	1	01	01	H1807_001_0	4	2009.01	UNIVERSITY HEALTH CARE, INC.	Passport Advantage	www.passportadvantage.org	01	01		1		H1807	001	0	2009	Passport Advantage	Louisville Metro Area and 15 surrounding counties		2	1	3		9237	2			1	3		(800)-578-0603	(800)-578-0603	(888)-857-4816	(888)-857-4816	(800)-578-0603	(800)-578-0603	(888)-857-4816	(888)-857-4816	(800)-578-0603	(800)-578-0603	(888)-857-4816	(888)-857-4816	(800)-578-0603	(800)-578-0603	(888)-857-4816	(888)-857-4816	www.passportadvantage.org	www.passportadvantage.org
H1837	001	0	1	01	01	H1837_001_0	10	2009.01	ESSENCE L.L.P.	Essence Healthcare	www.essencehealthcare.com	01	01		1		H1837	001	0	2009	Essence Advantage	North Puget Sound Service Area		2	2			1622	2						(425)-697-8300	(877)-392-3849	(866)-597-9561	(866)-597-9561	(425)-697-8300	(877)-392-3849	(866)-597-9561	(866)-597-9561	(425)-697-8300	(877)-392-3849	(866)-597-9561	(866)-597-9561	(425)-697-8300	(877)-392-3849	(866)-597-9561	(866)-597-9561	www.essencehealthcare.com	www.essencehealthcare.com
H1837	002	0	1	01	01	H1837_002_0	8	2009.01	ESSENCE L.L.P.	Essence Healthcare	www.essencehealthcare.com	01	01		1		H1837	002	0	2009	Essence Advantage	North Puget Sound Service Area		2	2			4373	2						(425)-697-8300	(877)-392-3849	(866)-597-9561	(866)-597-9561	(425)-697-8300	(877)-392-3849	(866)-597-9561	(866)-597-9561	(425)-697-8300	(877)-392-3849	(866)-597-9561	(866)-597-9561	(425)-697-8300	(877)-392-3849	(866)-597-9561	(866)-597-9561	www.essencehealthcare.com	www.essencehealthcare.com
H1837	003	0	1	01	01	H1837_003_0	5	2009.01	ESSENCE L.L.P.	Essence Healthcare	www.essencehealthcare.com	01	01		1		H1837	003	0	2009	Essence Advantage Plus	North Puget Sound Service Area		2	2			723	2						(425)-697-8300	(877)-392-3849	(866)-597-9561	(866)-597-9561	(425)-697-8300	(877)-392-3849	(866)-597-9561	(866)-597-9561	(425)-697-8300	(877)-392-3849	(866)-597-9561	(866)-597-9561	(425)-697-8300	(877)-392-3849	(866)-597-9561	(866)-597-9561	www.essencehealthcare.com	www.essencehealthcare.com
H1837	004	0	1	01	01	H1837_004_0	7	2009.01	ESSENCE L.L.P.	Essence Healthcare	www.essencehealthcare.com	01	01		1		H1837	004	0	2009	Essence Advantage Plus	North Puget Sound Service Area		2	2			279	2						(425)-697-8300	(877)-392-3849	(866)-597-9561	(866)-597-9561	(425)-697-8300	(877)-392-3849	(866)-597-9561	(866)-597-9561	(425)-697-8300	(877)-392-3849	(866)-597-9561	(866)-597-9561	(425)-697-8300	(877)-392-3849	(866)-597-9561	(866)-597-9561	www.essencehealthcare.com	www.essencehealthcare.com
H1837	801	0	1	01	01	H1837_801_0	1	2009.01	ESSENCE L.L.P.	Essence Healthcare	www.essencehealthcare.com	01	01		1		H1837	801	0	2009	Essence Advantage Employer Group Plan non-calendar	North Puget Sound Service Area		1	2			50	2						(425)-697-8300	(877)-392-3849	(866)-597-9561	(866)-597-9561	(425)-697-8300	(877)-392-3849	(866)-597-9561	(866)-597-9561	(425)-697-8300	(877)-392-3849	(866)-597-9561	(866)-597-9561	(425)-697-8300	(877)-392-3849	(866)-597-9561	(866)-597-9561	www.essencehealthcare.com	www.essencehealthcare.com
H1837	803	0	1	01	01	H1837_803_0	2	2009.01	ESSENCE L.L.P.	Essence Healthcare	www.essencehealthcare.com	01	01		1		H1837	803	0	2009	Essence Advantage Employer Group	North Puget Sound Service Area		1	2			50	2						(425)-697-8300	(877)-392-3849	(866)-597-9561	(866)-597-9561	(425)-697-8300	(877)-392-3849	(866)-597-9561	(866)-597-9561	(425)-697-8300	(877)-392-3849	(866)-597-9561	(866)-597-9561	(425)-697-8300	(877)-392-3849	(866)-597-9561	(866)-597-9561	www.essencehealthcare.com	www.essencehealthcare.com
H1846	001	0	1	04	01	H1846_001_0	6	2009.01	MOUNT CARMEL HEALTH INSURANCE COMPANY	MediGold	www.medigold.com	01	04		1		H1846	001	0	2009	MediGold PPO	Greater Central Ohio		2	2			800	2						(614)-546-3110	(800)-240-3851	(614)-546-3122		(800)-964-4525	(800)-964-4525	(614)-546-3122		(614)-546-3110	(800)-240-3851	(614)-546-3122		(800)-964-4525	(800)-964-4525	(614)-546-3122		www.medigold.com	www.medigold.com
H1846	801	0	1	04	01	H1846_801_0	2	2009.01	MOUNT CARMEL HEALTH INSURANCE COMPANY	MediGold	www.medigold.com	01	04		1		H1846	801	0	2009	EGWP MediGold PPO	Central Ohio, Dayton and Springfield		1	2			100	2						(614)-546-3110	(800)-240-3851	(614)-546-3122		(800)-964-4525	(800)-964-4525	(614)-546-3122		(614)-546-3110	(800)-240-3851	(614)-546-3122		(800)-964-4525	(800)-964-4525	(614)-546-3122		www.medigold.com	www.medigold.com
H1846	802	0	1	04	01	H1846_802_0	2	2009.01	MOUNT CARMEL HEALTH INSURANCE COMPANY	MediGold	www.medigold.com	01	04		1		H1846	802	0	2009	EGWP MediGold PPO Medical Only	Central Ohio, Dayton and Springfield		1	2			15	2						(614)-546-3110	(800)-240-3851	(614)-546-3122		(800)-964-4525	(800)-964-4525	(614)-546-3122										www.medigold.com	www.medigold.com
H1849	005	0	1	01	01	H1849_005_0	7	2009.01	ANTHEM HEALTH PLANS OF KENTUCKY, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H1849	005	0	2009	Anthem Senior Advantage Basic	Kentucky - Select Counties		2	2			5640	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
H1849	014	0	1	01	01	H1849_014_0	8	2009.01	ANTHEM HEALTH PLANS OF KENTUCKY, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H1849	014	0	2009	Anthem Senior Advantage Enhanced	Kentucky - Select Counties		2	2			626	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
H1849	801	0	1	01	01	H1849_801_0	3	2009.01	ANTHEM HEALTH PLANS OF KENTUCKY, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H1849	801	0	2009	Anthem Senior Advantage Group	Kentucky		1	2			1338	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
H1849	803	0	1	01	01	H1849_803_0	3	2009.01	ANTHEM HEALTH PLANS OF KENTUCKY, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H1849	803	0	2009	Anthem Senior Advantage Group	Kentucky		1	2			10	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754									www.anthem.com	www.anthem.com
H1849	804	0	1	01	01	H1849_804_0	3	2009.01	ANTHEM HEALTH PLANS OF KENTUCKY, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H1849	804	0	2009	Anthem Senior Advantage Group	Kentucky		1	2			10	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
H1903	005	0	1	01	01	H1903_005_0	6	2009.01	WELLCARE OF LOUISIANA, INC.	WellCare	www.wellcare.com	01	01		1		H1903	005	0	2009	WellCare Advance	Greater Baton Rouge Area		2	2				2						(866)-804-5926	(866)-804-5926	(877)-247-6272		(866)-238-4526	(866)-238-4526	(877)-247-6272										www.wellcare.com	www.wellcare.com
H1903	011	0	1	01	01	H1903_011_0	8	2009.01	WELLCARE OF LOUISIANA, INC.	WellCare	www.wellcare.com	01	01		1		H1903	011	0	2009	WellCare Access	Greater Baton Rouge Area		2	1	3			2			1	1		(866)-804-5926	(866)-804-5926	(877)-247-6272		(866)-238-4526	(866)-238-4526	(877)-247-6272		(866)-804-5926	(866)-804-5926	(877)-247-6272		(866)-238-4526	(866)-238-4526	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1903	014	0	1	02	01	H1903_014_0	9	2009.01	WELLCARE OF LOUISIANA, INC.	WellCare	www.wellcare.com	01	02		1		H1903	014	0	2009	WellCare Select	Greater Baton Rouge Area		2	1	3			2			1	2		(866)-804-5926	(866)-804-5926	(877)-247-6272		(866)-238-4526	(866)-238-4526	(877)-247-6272		(866)-804-5926	(866)-804-5926	(877)-247-6272		(866)-238-4526	(866)-238-4526	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1903	018	0	1	02	01	H1903_018_0	8	2009.01	WELLCARE OF LOUISIANA, INC.	WellCare	www.wellcare.com	01	02		1		H1903	018	0	2009	WellCare Value	Greater Baton Rouge Area		2	2				2						(866)-804-5926	(866)-804-5926	(877)-247-6272		(866)-238-4526	(866)-238-4526	(877)-247-6272		(866)-804-5926	(866)-804-5926	(877)-247-6272		(866)-238-4526	(866)-238-4526	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1903	022	0	1	02	01	H1903_022_0	8	2009.01	WELLCARE OF LOUISIANA, INC.	WellCare	www.wellcare.com	01	02		1		H1903	022	0	2009	WellCare Value	Acadia, Jefferson Davis, Lafayette, et al		2	2				2						(866)-804-5926	(866)-804-5926	(877)-247-6272		(866)-238-4526	(866)-238-4526	(877)-247-6272		(866)-804-5926	(866)-804-5926	(877)-247-6272		(866)-238-4526	(866)-238-4526	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1903	023	0	1	01	01	H1903_023_0	8	2009.01	WELLCARE OF LOUISIANA, INC.	WellCare	www.wellcare.com	01	01		1		H1903	023	0	2009	Wellcare Reserve	Grant, Iberville, Rapides Counties		2	2				2						(866)-804-5926	(866)-804-5926	(877)-247-6272		(866)-238-4526	(866)-238-4526	(877)-247-6272		(866)-804-5926	(866)-804-5926	(877)-247-6272		(866)-238-4526	(866)-238-4526	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1903	801	0	1	02	01	H1903_801_0	4	2009.01	WELLCARE OF LOUISIANA, INC.	WellCare	www.wellcare.com	01	02		1		H1903	801	0	2009	Employer Louisiana 1	Nationwide		1	2				2						(866)-804-5926	(866)-804-5926	(877)-247-6272		(866)-238-4526	(866)-238-4526	(877)-247-6272		(866)-804-5926	(866)-804-5926	(877)-247-6272		(866)-238-4526	(866)-238-4526	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1903	802	0	1	02	01	H1903_802_0	4	2009.01	WELLCARE OF LOUISIANA, INC.	WellCare	www.wellcare.com	01	02		1		H1903	802	0	2009	Employer Louisiana 2	Nationwide		1	2				2						(866)-804-5926	(866)-804-5926	(877)-247-6272		(866)-238-4526	(866)-238-4526	(877)-247-6272		(866)-804-5926	(866)-804-5926	(877)-247-6272		(866)-238-4526	(866)-238-4526	(877)-247-6272		www.wellcare.com	www.wellcare.com
H1903	803	0	1	02	01	H1903_803_0	4	2009.01	WELLCARE OF LOUISIANA, INC.	WellCare	www.wellcare.com	01	02		1		H1903	803	0	2009	Employer Louisiana 3	Nationwide		1	2				2						(866)-804-5926	(866)-804-5926	(877)-247-6272		(866)-238-4526	(866)-238-4526	(877)-247-6272										www.wellcare.com	www.wellcare.com
H1903	804	0	1	02	01	H1903_804_0	4	2009.01	WELLCARE OF LOUISIANA, INC.	WellCare	www.wellcare.com	01	02		1		H1903	804	0	2009	Employer Louisiana 4	Nationwide		1	2				2						(866)-804-5926	(866)-804-5926	(877)-247-6272		(866)-238-4526	(866)-238-4526	(877)-247-6272										www.wellcare.com	www.wellcare.com
H1904	001	0	1	20	08	H1904_001_0	1	2009.01	PACE GREATER NEW ORLEANS	Pace Greater New Orleans	http://www.ccano.org/pace.htm	08	20		1		H1904	001	0	2009	PACE GREATER NEW ORLEANS	PACE GREATER NEW ORLEANS		2	2				2														(504)-945-1531	(504)-945-1531			(504)-945-1531	(504)-945-1531			http://www.ccano.org/pace.htm	
H1904	002	0	1	20	08	H1904_002_0	1	2009.01	PACE GREATER NEW ORLEANS	Pace Greater New Orleans	http://www.ccano.org/pace.htm	08	20		1		H1904	002	0	2009	PACE GREATER NEW ORLEANS	PACE GREATER NEW ORLEANS		2	2				2														(504)-945-1531	(504)-945-1531			(504)-945-1531	(504)-945-1531			http://www.ccano.org/pace.htm	
H1906	001	0	1	09	04	H1906_001_0	5	2009.01	HUMANA HEALTH BENEFIT PLAN OF LA, INC.	Humana Health Benefit Plan of LA, Inc.	www.humana-medicare.com	04	09	2	1		H1906	001	0	2009	Humana Gold Choice PFFS H1906-001	Select Counties in Louisiana		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1906	002	0	1	09	04	H1906_002_0	3	2009.01	HUMANA HEALTH BENEFIT PLAN OF LA, INC.	Humana Health Benefit Plan of LA, Inc.	www.humana-medicare.com	04	09	2	1		H1906	002	0	2009	Humana Gold Choice PFFS H1906-002	Select Counties in Louisiana		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1906	003	0	1	09	04	H1906_003_0	6	2009.01	HUMANA HEALTH BENEFIT PLAN OF LA, INC.	Humana Health Benefit Plan of LA, Inc.	www.humana-medicare.com	04	09	2	1		H1906	003	0	2009	Humana Gold Choice PFFS H1906-003	Select Counties in Louisiana		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1906	006	0	1	09	04	H1906_006_0	5	2009.01	HUMANA HEALTH BENEFIT PLAN OF LA, INC.	Humana Health Benefit Plan of LA, Inc.	www.humana-medicare.com	04	09	2	1		H1906	006	0	2009	Humana Gold Choice PFFS H1906-006	Select Counties in Louisiana		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1906	007	0	1	09	04	H1906_007_0	5	2009.01	HUMANA HEALTH BENEFIT PLAN OF LA, INC.	Humana Health Benefit Plan of LA, Inc.	www.humana-medicare.com	04	09	2	1		H1906	007	0	2009	Humana Gold Choice PFFS H1906-007	Select Counties in Louisiana		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1906	801	0	1	09	04	H1906_801_0	2	2009.01	HUMANA HEALTH BENEFIT PLAN OF LA, INC.	Humana Health Benefit Plan of LA, Inc.	www.humana-medicare.com	04	09	2	1		H1906	801	0	2009	Humana Employer Sponsored	Nationwide		1	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1906	802	0	1	09	04	H1906_802_0	2	2009.01	HUMANA HEALTH BENEFIT PLAN OF LA, INC.	Humana Health Benefit Plan of LA, Inc.	www.humana-medicare.com	04	09	2	1		H1906	802	0	2009	Humana Employer Sponsored	Nationwide		1	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1906	803	0	1	09	04	H1906_803_0	2	2009.01	HUMANA HEALTH BENEFIT PLAN OF LA, INC.	Humana Health Benefit Plan of LA, Inc.	www.humana-medicare.com	04	09	2	1		H1906	803	0	2009	Humana Employer Sponsored Non-CY	Nationwide		1	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1906	804	0	1	09	04	H1906_804_0	2	2009.01	HUMANA HEALTH BENEFIT PLAN OF LA, INC.	Humana Health Benefit Plan of LA, Inc.	www.humana-medicare.com	04	09	2	1		H1906	804	0	2009	Humana Employer Sponsered Non-CY	Nationwide		1	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1906	805	0	2	09	04	H1906_805_0	4	2009.01	HUMANA HEALTH BENEFIT PLAN OF LA, INC.	Humana Health Benefit Plan of LA, Inc.	www.humana-medicare.com	04	09	2	2		H1906	805	0	2009	Humana Employer Sponsored	Nationwide		1	2				2		2				(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1906	806	0	2	09	04	H1906_806_0	4	2009.01	HUMANA HEALTH BENEFIT PLAN OF LA, INC.	Humana Health Benefit Plan of LA, Inc.	www.humana-medicare.com	04	09	2	2		H1906	806	0	2009	Humana Employer Sponsored	Nationwide		1	2				2		2				(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1906	807	0	2	09	04	H1906_807_0	4	2009.01	HUMANA HEALTH BENEFIT PLAN OF LA, INC.	Humana Health Benefit Plan of LA, Inc.	www.humana-medicare.com	04	09	2	2		H1906	807	0	2009	Humana Employer Sponsored Non-CY	Nationwide		1	2				2		2				(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1906	808	0	2	09	04	H1906_808_0	4	2009.01	HUMANA HEALTH BENEFIT PLAN OF LA, INC.	Humana Health Benefit Plan of LA, Inc.	www.humana-medicare.com	04	09	2	2		H1906	808	0	2009	Humana Employer Sponsored Non-CY	Nationwide		1	2				2		2				(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1944	001	0	1	02	01	H1944_001_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	02		1		H1944	001	0	2009	AARP MedicareComplete Plus	Middlesex, Essex, MA Suffolk, MA		2	2				2						(800)-643-4845		(888)-685-8480		(800)-547-5514		(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1944	801	0	1	02	01	H1944_801_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	02		1		H1944	801	0	2009	MedicareComplete Retiree Plan	MA Employer Sponsored Plan Service Area		1	2				2						(800)-945-0150		(888)-685-8480		(800)-945-0150		(900)-945-0150		(800)-945-0150	(800)-555-5757	(888)-685-8480		(800)-945-0150	(800)-555-5757	(900)-945-0150		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1944	802	0	1	02	01	H1944_802_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	02		1		H1944	802	0	2009	MedicareComplete Retiree Plan	MA Employer Sponsored Plan Service Area		1	2				2						(800)-945-0150		(888)-685-8480		(800)-945-0150		(900)-945-0150										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1944	803	0	1	02	01	H1944_803_0	6	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	02		1		H1944	803	0	2009	MedicareComplete Retiree Plan	MA Employer Sponsored Plan Service Area		1	2				2						(800)-945-0150		(888)-685-8480		(800)-945-0150		(900)-945-0150		(800)-945-0150	(800)-555-5757	(888)-685-8480		(800)-945-0150	(800)-555-5757	(900)-945-0150		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1944	804	0	1	02	01	H1944_804_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	02		1		H1944	804	0	2009	MedicareComplete Retiree Plan	MA Employer Sponsored Plan Service Area		1	2				2						(800)-945-0150		(888)-685-8480		(800)-945-0150		(900)-945-0150										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H1951	001	0	1	01	01	H1951_001_0	6	2009.01	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA INC	Humana Health Benefit Plan Of Louisiana Inc	www.humana-medicare.com	01	01		1		H1951	001	0	2009	Humana Gold Plus HMO H1951-001	New Orleans Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1951	005	0	1	01	01	H1951_005_0	6	2009.01	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA INC	Humana Health Benefit Plan Of Louisiana Inc	www.humana-medicare.com	01	01		1		H1951	005	0	2009	Humana Gold Plus HMO H1951-005	Baton Rouge Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1951	013	0	1	01	01	H1951_013_0	6	2009.01	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA INC	Humana Health Benefit Plan Of Louisiana Inc	www.humana-medicare.com	01	01		1		H1951	013	0	2009	Humana Gold Plus HMO H1951-013	Shreveport Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1951	017	0	1	01	01	H1951_017_0	8	2009.01	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA INC	Humana Health Benefit Plan Of Louisiana Inc	www.humana-medicare.com	01	01		1		H1951	017	0	2009	Humana Gold Plus HMO SNP-DE H1951-017	New Orleans Area		2	1	3			2			1	2		(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1951	019	0	1	01	01	H1951_019_0	9	2009.01	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA INC	Humana Health Benefit Plan Of Louisiana Inc	www.humana-medicare.com	01	01		1		H1951	019	0	2009	Humana Gold Plus HMO SNP-DE H1951-019	Baton Rouge Area		2	1	3			2			1	2		(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1951	021	0	1	01	01	H1951_021_0	8	2009.01	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA INC	Humana Health Benefit Plan Of Louisiana Inc	www.humana-medicare.com	01	01		1		H1951	021	0	2009	Humana Gold Plus HMO SNP-DE H1951-021	Shreveport Area		2	1	3			2			1	2		(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1951	023	0	1	01	01	H1951_023_0	6	2009.01	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA INC	Humana Health Benefit Plan Of Louisiana Inc	www.humana-medicare.com	01	01		1		H1951	023	0	2009	Humana Gold Plus HMO H1951-023	Alexandria Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1951	801	0	1	01	01	H1951_801_0	1	2009.01	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA INC	Humana Health Benefit Plan Of Louisiana Inc	www.humana-medicare.com	01	01		1		H1951	801	0	2009	Humana Employer Sponsored	Louisiana Group		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1951	804	0	1	01	01	H1951_804_0	1	2009.01	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA INC	Humana Health Benefit Plan Of Louisiana Inc	www.humana-medicare.com	01	01		1		H1951	804	0	2009	Humana Employer Sponsored	Louisiana Group		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1951	805	0	1	01	01	H1951_805_0	1	2009.01	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA INC	Humana Health Benefit Plan Of Louisiana Inc	www.humana-medicare.com	01	01		1		H1951	805	0	2009	Humana Employer Sponsored Non-CY	Select Louisiana Counties		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1951	806	0	1	01	01	H1951_806_0	1	2009.01	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA INC	Humana Health Benefit Plan Of Louisiana Inc	www.humana-medicare.com	01	01		1		H1951	806	0	2009	Humana Employer Sponsored Non-CY	Select Louisiana Counties		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H1961	001	0	1	01	01	H1961_001_0	9	2009.01	TENET CHOICES, INC. / PEOPLES HEALTH NETWORK	Peoples Health	www.peopleshealth.com	01	01		1		H1961	001	0	2009	Choices 65	Metro New Orleans area		2	2			32500	2						(504)-849-4500	(800)-631-8443	(888)-631-9979		(504)-849-4500	(800)-631-8443	(888)-631-9979		(504)-849-4500	(800)-631-8443		(888)-631-9979	(504)-849-4500	(800)-631-8443		(888)-631-9979	www.peopleshealth.com/formulary/index.jsp	www.peopleshealth.com
H1961	002	0	1	02	01	H1961_002_0	12	2009.01	TENET CHOICES, INC. / PEOPLES HEALTH NETWORK	Peoples Health	www.peopleshealth.com	01	02		1		H1961	002	0	2009	Choices Plus	Southeast Louisiana		2	2			10000	2						(504)-849-4500	(800)-631-8443	(888)-631-9979		(504)-849-4500	(800)-631-8443	(888)-631-9979		(504)-849-4500	(800)-631-8443		(888)-631-9979	(504)-849-4500	(800)-631-8443		(888)-631-9979	www.peopleshealth.com/formulary/index.jsp	www.peopleshealth.com
H1961	003	0	1	01	01	H1961_003_0	10	2009.01	TENET CHOICES, INC. / PEOPLES HEALTH NETWORK	Peoples Health	www.peopleshealth.com	01	01		1		H1961	003	0	2009	Secure Health	New Orleans Metro and Southeast Louisiana		2	1	3		2000	2			1	2		(504)-849-4500	(800)-631-8443	(888)-631-9979		(504)-849-4500	(800)-631-8443	(888)-631-9979		(504)-849-4500	(800)-631-8443		(888)-631-9979	(504)-849-4500	(800)-631-8443		(888)-631-9979	www.peopleshealth.com/formulary/index.jsp	www.peopleshealth.com
H1961	801	0	1	02	01	H1961_801_0	4	2009.01	TENET CHOICES, INC. / PEOPLES HEALTH NETWORK	Peoples Health	www.peopleshealth.com	01	02		1		H1961	801	0	2009	Peoples Health Group Medicare	Nationwide		1	2			1000	2						(504)-849-4500	(800)-631-8443	(888)-631-9979		(504)-849-4500	(800)-631-8443	(888)-631-9979		(504)-849-4500	(800)-631-8443		(888)-631-9979	(504)-849-4500	(800)-631-8443		(888)-631-9979	www.peopleshealth.com/formulary/index.jsp	www.peopleshealth.com
H1961	802	0	1	02	01	H1961_802_0	4	2009.01	TENET CHOICES, INC. / PEOPLES HEALTH NETWORK	Peoples Health	www.peopleshealth.com	01	02		1		H1961	802	0	2009	Peoples Health Group Medicare	Nationwide		1	2			1000	2						(504)-849-4500	(800)-631-8443	(888)-631-9979		(504)-849-4500	(800)-631-8443	(888)-631-9979		(504)-849-4500	(800)-631-8443		(888)-631-9979	(504)-849-4500	(800)-631-8443		(888)-631-9979	www.peopleshealth.com/formulary/index.jsp	www.peopleshealth.com
H1961	803	0	1	01	01	H1961_803_0	4	2009.01	TENET CHOICES, INC. / PEOPLES HEALTH NETWORK	Peoples Health	www.peopleshealth.com	01	01		1		H1961	803	0	2009	Peoples Health Group Medicare	Nationwide		1	2			1000	2						(504)-849-4500	(800)-631-8443	(888)-631-9979		(504)-849-4500	(800)-631-8443	(888)-631-9979		(504)-849-4500	(800)-631-8443		(888)-631-9979	(504)-849-4500	(800)-631-8443		(888)-631-9979	www.peopleshealth.com/formulary/index.jsp	www.peopleshealth.com
H1961	804	0	1	01	01	H1961_804_0	4	2009.01	TENET CHOICES, INC. / PEOPLES HEALTH NETWORK	Peoples Health	www.peopleshealth.com	01	01		1		H1961	804	0	2009	Peoples Health Group Medicare	Nationwide		1	2			1000	2						(504)-849-4500	(800)-631-8443	(888)-631-9979		(504)-849-4500	(800)-631-8443	(888)-631-9979		(504)-849-4500	(800)-631-8443		(888)-631-9979	(504)-849-4500	(800)-631-8443		(888)-631-9979	www.peopleshealth.com/formulary/index.jsp	www.peopleshealth.com
H1991	801	0	1	09	04	H1991_801_0	2	2009.01	HORIZON BLUE CROSS BLUE SHIELD OF NJ	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com	04	09	2	1		H1991	801	0	2009	Horizon Medicare Blue Anywhere	National		1	2				2						(800)-365-2223		(800)-855-2881		(800)-224-1234		(800)-852-7899										http://www.horizonblue.com/medicare/partd/Pharmacy_Formualry_search.aspx	
H1991	802	0	1	09	04	H1991_802_0	1	2009.01	HORIZON BLUE CROSS BLUE SHIELD OF NJ	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com	04	09	2	1		H1991	802	0	2009	Horizon Medicare Blue Anywhere w/ Rx Std	National		1	2				2						(800)-365-2223		(800)-855-2881		(800)-224-1234		(800)-852-7899		(866)-236-7376	(866)-236-7376		(866)-236-1069	(800)-224-1234	(800)-224-1234			http://www.horizonblue.com/medicare/partd/Pharmacy_Formualry_search.aspx	
H1991	803	0	1	09	04	H1991_803_0	1	2009.01	HORIZON BLUE CROSS BLUE SHIELD OF NJ	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com	04	09	2	1		H1991	803	0	2009	Horizon Medicare Blue Anywhere w/ Rx Std	National		1	2				2						(800)-365-2223		(800)-855-2881		(800)-224-1234		(800)-852-7899		(866)-236-7376	(866)-236-7376		(866)-236-1069	(800)-224-1234	(800)-224-1234			http://www.horizonblue.com/medicare/partd/Pharmacy_Formualry_search.aspx	
H2001	001	0	1	04	01	H2001_001_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H2001	001	0	2009	AARP MedicareComplete Choice	Cumberland, Kennebec, Sagadahoc and Androscoggin		2	2				2						(800)-643-4845		(888)-685-8480		(800)-547-5514		(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2001	003	0	1	04	01	H2001_003_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H2001	003	0	2009	AARP MedicareComplete Choice	York County, Androscoggin ME		2	2				2						(800)-643-4845		(888)-685-8480		(800)-547-5514		(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2001	007	0	1	04	01	H2001_007_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H2001	007	0	2009	Evercare Plan DP	Cumberland, Kennebec, Sagadahoc and York Counties		2	1	3			2			2	2		(877)-702-5110		(888)-685-8480		(888)-834-3721		(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2001	801	0	1	04	01	H2001_801_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H2001	801	0	2009	MedicareComplete Choice Retiree Plan	Cumberland, Kennebec, Sagadahoc,York ,Androscoggin		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480		(888)-867-5548	(888)-867-5548	(800)-387-1074		(888)-867-5548	(888)-867-5548	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2001	803	0	1	04	01	H2001_803_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H2001	803	0	2009	MedicareComplete Choice Retiree Plan	Cumberland, Kennebec,Sagadahoc,York ,Androscogg		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2001	804	0	1	04	01	H2001_804_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H2001	804	0	2009	MedicareComplete Retiree Plan	Select Counties in ME		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480		(888)-867-5548	(888)-867-5548	(800)-387-1074		(888)-867-5548	(888)-867-5548	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2001	805	0	1	04	01	H2001_805_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H2001	805	0	2009	MedicareComplete Retiree Plan	Select Counties in ME		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2003	001	0	1	04	01	H2003_001_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H2003	001	0	2009	Evercare Plan IP	Cumberland, Kennebec, Sagadahoc and York Counties		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H2003	002	0	1	04	01	H2003_002_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H2003	002	0	2009	Evercare Plan MP	Cumberland, Kennebec, Sagadahoc and York Counties		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H2029	001	0	1	04	01	H2029_001_0	4	2009.01	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc.	www.humana-medicare.com	01	04		1		H2029	001	0	2009	HumanaChoicePPO PPO H2029-001	Puerto Rico Island Wide		2	2				2						(866)-773-5959	(866)-773-5959	(800)-218-2560	(800)-218-2560	(800)-681-3625	(800)-681-3625	(800)-722-2850	(800)-722-2850	(866)-773-5959	(866)-773-5959		(800)-218-2560	(800)-681-3625	(800)-681-3625		(800)-722-2850	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2029	801	0	1	04	01	H2029_801_0	3	2009.01	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc.	www.humana-medicare.com	01	04		1		H2029	801	0	2009	Humana Employer Sponsored	Puerto Rico		1	2				2						(866)-773-5959	(866)-773-5959	(800)-218-2560	(800)-218-2560	(800)-681-3625	(800)-681-3625	(800)-722-2850	(800)-722-2850	(866)-773-5959	(866)-773-5959		(800)-218-2560	(800)-681-3625	(800)-681-3625		(800)-722-2850	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2029	802	0	1	04	01	H2029_802_0	3	2009.01	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc.	www.humana-medicare.com	01	04		1		H2029	802	0	2009	Humana Employer Sponsored	Puerto Rico		1	2				2						(866)-773-5959	(866)-773-5959	(800)-218-2560	(800)-218-2560	(800)-681-3625	(800)-681-3625	(800)-722-2850	(800)-722-2850									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2029	803	0	1	04	01	H2029_803_0	3	2009.01	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc.	www.humana-medicare.com	01	04		1		H2029	803	0	2009	Humana Employer Sponsored Non-CY	Puerto Rico		1	2				2						(866)-773-5959	(866)-773-5959	(800)-218-2560	(800)-218-2560	(800)-681-3625	(800)-681-3625	(800)-722-2850	(800)-722-2850	(866)-773-5959	(866)-773-5959		(800)-218-2560	(800)-681-3625	(800)-681-3625		(800)-722-2850	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2029	804	0	1	04	01	H2029_804_0	3	2009.01	HUMANA INSURANCE OF PUERTO RICO, INC.	Humana Insurance of Puerto Rico, Inc.	www.humana-medicare.com	01	04		1		H2029	804	0	2009	Humana Employer Sponsored Non-CY	Puerto Rico		1	2				2						(866)-773-5959	(866)-773-5959	(800)-218-2560	(800)-218-2560	(800)-681-3625	(800)-681-3625	(800)-722-2850	(800)-722-2850									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2034	001	0	1	01	01	H2034_001_0	6	2009.01	COMMUNITY CARE HEALTH PLAN, INC.	Community Care	www.communitycareinc.org	01	01		1		H2034	001	0	2009	Community Care's Partnership Program	Ozaukee, Washington Counties		2	1	3		343	2			1	1		(414)-385-6600	(866)-992-6600	(414)-385-6626		(414)-385-6600	(866)-992-6600	(414)-385-6626		(414)-385-6600	(866)-992-6600	(414)-385-6626		(414)-385-6600	(866)-992-6600	(414)-385-6626		www.communitycareinc.org/Assets/Formulary.pdf	www.communitycareinc.org
H2034	002	0	1	01	01	H2034_002_0	6	2009.01	COMMUNITY CARE HEALTH PLAN, INC.	Community Care	www.communitycareinc.org	01	01		1		H2034	002	0	2009	Community Care WPP Disabled	Ken, Milw, Ozaukee, Rac, Wash, Wauk Counties		2	1	3		343	2			1	1		(414)-385-6600	(866)-992-6600	(414)-385-6626		(414)-385-6600	(866)-992-6600	(414)-385-6626		(414)-385-6600	(866)-992-6600	(414)-385-6626		(414)-385-6600	(866)-992-6600	(414)-385-6626		www.communitycareinc.org/Assets/Formulary.pdf	www.communitycareinc.org
H2047	001	0	1	04	01	H2047_001_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H2047	001	0	2009	Aetna Golden Choice Standard Plan	Cumberland, Penobscot and York Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H2047	002	0	1	04	01	H2047_002_0	5	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H2047	002	0	2009	Aetna Golden Choice Premier Plan	Cumberland, Penobscot and York Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H2047	801	0	1	04	01	H2047_801_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H2047	801	0	2009	Aetna Golden Choice Plan	Cumberland, Penobscot, York Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H2047	802	0	1	04	01	H2047_802_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H2047	802	0	2009	Aetna Golden Choice Plan w/Rx CY	Cumberland, Penobscot, York Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H2063	001	0	1	20	08	H2063_001_0	1	2009.01	BILLINGS CLINIC	Billings Clinic PACE	www.billingsclinic.com	08	20		1		H2063	001	0	2009	Billings Clinic - Dual	Yellowstone, MT and *Park, MT Counties		2	2				2														(406)-247-6315	(800)-332-7156			(406)-247-6315	(800)-332-7156			www.billingsclinic.org	
H2063	002	0	1	20	08	H2063_002_0	1	2009.01	BILLINGS CLINIC	Billings Clinic PACE	www.billingsclinic.com	08	20		1		H2063	002	0	2009	Billings Clinic - Medicare Only	Yellowstone, MT and *Park, MT Counties		2	2				2														(406)-247-6315	(800)-332-7156			(406)-247-6315	(800)-332-7156			www.billingsclinic.org	
H2064	001	0	1	20	08	H2064_001_0	2	2009.01	GEISINGER COMMUNITY HEALTH SERVICES	LIFE Geisinger	www.lifegeisinger.org	08	20		1		H2064	001	0	2009	LIFE Geisinger	LIFE Geisinger		2	2				2														(570)-214-9790	(800)-395-8759			(570)-214-9790	(800)-395-8759			www.lifegeisinger.org	
H2064	002	0	1	20	08	H2064_002_0	2	2009.01	GEISINGER COMMUNITY HEALTH SERVICES	LIFE Geisinger	www.lifegeisinger.org	08	20		1		H2064	002	0	2009	LIFE Geisinger	LIFE Geisinger		2	2				2														(570)-214-9790	(800)-395-8759			(570)-214-9790	(800)-395-8759			www.lifegeisinger.org	
H2108	001	0	1	01	01	H2108_001_0	2	2009.01	BRAVO HEALTH MID- ATLANTIC INC.	Bravo Health	www.mybravohealth.com	01	01		1		H2108	001	0	2009	Bravo Select	Baltimore and District of Columbia Metro Areas		2	1	3			2			1	2		(800)-556-1570	(800)-556-1570	(800)-964-2561	(800)-964-2561	(888)-311-4483	(888)-311-4483	(800)-964-2561	(800)-964-2561	(800)-556-1570	(800)-556-1570	(800)-964-2561	(800)-964-2561	(888)-311-4483	(888)-311-4483	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H2108	020	0	1	01	01	H2108_020_0	2	2009.01	BRAVO HEALTH MID- ATLANTIC INC.	Bravo Health	www.mybravohealth.com	01	01		1		H2108	020	0	2009	Bravo Traditions	Baltimore and Suburban Maryland		2	1	1	1		2			1			(800)-556-1570	(800)-556-1570	(800)-964-2561	(800)-964-2561	(888)-311-4483	(888)-311-4483	(800)-964-2561	(800)-964-2561	(800)-556-1570	(800)-556-1570	(800)-964-2561	(800)-964-2561	(888)-311-4483	(888)-311-4483	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H2108	021	0	1	01	01	H2108_021_0	2	2009.01	BRAVO HEALTH MID- ATLANTIC INC.	Bravo Health	www.mybravohealth.com	01	01		1		H2108	021	0	2009	Bravo Gold	Baltimore and Suburban Maryland		2	2				2						(800)-556-1570	(800)-556-1570	(800)-964-2561	(800)-964-2561	(888)-311-4483	(888)-311-4483	(800)-964-2561	(800)-964-2561									www.mybravohealth.com/formulary	www.mybravohealth.com
H2108	022	0	1	01	01	H2108_022_0	2	2009.01	BRAVO HEALTH MID- ATLANTIC INC.	Bravo Health	www.mybravohealth.com	01	01		1		H2108	022	0	2009	Bravo Classic	Baltimore and Suburban Maryland		2	2				2						(800)-556-1570	(800)-556-1570	(800)-964-2561	(800)-964-2561	(888)-311-4483	(888)-311-4483	(800)-964-2561	(800)-964-2561	(800)-556-1570	(800)-556-1570	(800)-964-2561	(800)-964-2561	(888)-311-4483	(888)-311-4483	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H2108	023	0	1	02	01	H2108_023_0	2	2009.01	BRAVO HEALTH MID- ATLANTIC INC.	Bravo Health	www.mybravohealth.com	01	02		1		H2108	023	0	2009	Bravo Premier Plus	District of Columbia		2	2				2						(800)-556-1570	(800)-556-1570	(800)-964-2561	(800)-964-2561	(888)-311-4483	(888)-311-4483	(800)-964-2561	(800)-964-2561	(800)-556-1570	(800)-556-1570	(800)-964-2561	(800)-964-2561	(888)-311-4483	(888)-311-4483	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H2108	025	0	1	01	01	H2108_025_0	2	2009.01	BRAVO HEALTH MID- ATLANTIC INC.	Bravo Health	www.mybravohealth.com	01	01		1		H2108	025	0	2009	Bravo Gold	District of Columbia		2	2				2						(800)-556-1570	(800)-556-1570	(800)-964-2561	(800)-964-2561	(888)-311-4483	(888)-311-4483	(800)-964-2561	(800)-964-2561									www.mybravohealth.com/formulary	www.mybravohealth.com
H2108	026	0	1	02	01	H2108_026_0	2	2009.01	BRAVO HEALTH MID- ATLANTIC INC.	Bravo Health	www.mybravohealth.com	01	02		1		H2108	026	0	2009	Bravo Premier Plus	Baltimore and Suburban Maryland		2	2				2						(800)-556-1570	(800)-556-1570	(800)-964-2561	(800)-964-2561	(888)-311-4483	(888)-311-4483	(800)-964-2561	(800)-964-2561	(800)-556-1570	(800)-556-1570	(800)-964-2561	(800)-964-2561	(888)-311-4483	(888)-311-4483	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H2108	028	0	1	01	01	H2108_028_0	2	2009.01	BRAVO HEALTH MID- ATLANTIC INC.	Bravo Health	www.mybravohealth.com	01	01		1		H2108	028	0	2009	Bravo Classic	District of Columbia		2	2				2						(800)-556-1570	(800)-556-1570	(800)-964-2561	(800)-964-2561	(888)-311-4483	(888)-311-4483	(800)-964-2561	(800)-964-2561	(800)-556-1570	(800)-556-1570	(800)-964-2561	(800)-964-2561	(888)-311-4483	(888)-311-4483	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H2109	001	0	1	20	08	H2109_001_0	1	2009.01	JOHNS HOPKINS HEALTH SYSTEM, INC.	Hopkins Elderplus	http://www.hopkinsbayview.org/hopkinselderplus	08	20		1		H2109	001	0	2009	Johns Hopkins Health System Inc.,	Parts of Baltimore City and County, Maryland		2	2				2														(410)-550-7044	(800)-550-7044	(410)-550-0316		(410)-550-7044	(410)-550-7044	(410)-550-0316		karmaco@jhmi.edu	
H2109	002	0	1	20	08	H2109_002_0	1	2009.01	JOHNS HOPKINS HEALTH SYSTEM, INC.	Hopkins Elderplus	http://www.hopkinsbayview.org/hopkinselderplus	08	20		1		H2109	002	0	2009	Johns Hopkins Health System, Inc	Parts of Baltimore City and County, Maryland		2	2				2														(410)-550-7044	(800)-550-7044	(410)-550-0316		(410)-550-7044	(410)-550-7044	(410)-550-0316		karmaco@jhmi.edu	
H2111	001	0	1	04	01	H2111_001_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H2111	001	0	2009	Evercare Plan IP	Baltimore,East Shore MD,DC,DE, surrounding areas		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H2111	008	0	1	04	01	H2111_008_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H2111	008	0	2009	Evercare Plan DP	Washington, DC		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H2111	009	0	1	04	01	H2111_009_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H2111	009	0	2009	Evercare Plan DP	Kent, New Castle, Sussex		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H2111	010	0	1	04	01	H2111_010_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H2111	010	0	2009	Evercare Plan DP	Baltimore, Eastern Shore and Fairfax, VA area		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H2111	011	0	1	04	01	H2111_011_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H2111	011	0	2009	Evercare Plan MP	Washington, DC		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H2111	012	0	1	04	01	H2111_012_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H2111	012	0	2009	Evercare Plan MP	Kent, New Castle and Sussex, DE counties		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H2111	013	0	1	04	01	H2111_013_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H2111	013	0	2009	Evercare Plan MP	Baltimore, Eastern Shore , Fairfax, VA Areas		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H2112	001	0	1	01	01	H2112_001_0	3	2009.01	AETNA HEALTH INC. (MARYLAND)	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H2112	001	0	2009	Aetna Golden Medicare Value Plan	Baltimore and Surrounding Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H2112	002	0	1	01	01	H2112_002_0	6	2009.01	AETNA HEALTH INC. (MARYLAND)	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H2112	002	0	2009	Aetna Golden Medicare Premier Plus Plan	Baltimore and Surrounding Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H2112	007	0	1	01	01	H2112_007_0	6	2009.01	AETNA HEALTH INC. (MARYLAND)	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H2112	007	0	2009	Aetna Golden Medicare Standard Plan	Baltimore and Surrounding Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H2112	008	0	1	01	01	H2112_008_0	3	2009.01	AETNA HEALTH INC. (MARYLAND)	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H2112	008	0	2009	Aetna Golden Medicare Value Plan	Baltimore City		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H2112	009	0	1	01	01	H2112_009_0	5	2009.01	AETNA HEALTH INC. (MARYLAND)	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H2112	009	0	2009	Aetna Golden Medicare Premier Plus Plan	Baltimore City		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H2112	011	0	1	01	01	H2112_011_0	6	2009.01	AETNA HEALTH INC. (MARYLAND)	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H2112	011	0	2009	Aetna Golden Medicare Standard Plan	Baltimore City		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H2112	013	0	1	01	01	H2112_013_0	7	2009.01	AETNA HEALTH INC. (MARYLAND)	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H2112	013	0	2009	Aetna Golden Medicare Dual Advantage Plan	Baltimore and Surrounding Counties		2	1	3			2			1	2		(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H2112	014	0	1	01	01	H2112_014_0	7	2009.01	AETNA HEALTH INC. (MARYLAND)	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H2112	014	0	2009	Aetna Golden Medicare Premier Plan	Baltimore and Surrounding Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H2112	015	0	1	01	01	H2112_015_0	6	2009.01	AETNA HEALTH INC. (MARYLAND)	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H2112	015	0	2009	Aetna Golden Medicare Premier Plan	Baltimore City		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H2112	801	0	1	01	01	H2112_801_0	3	2009.01	AETNA HEALTH INC. (MARYLAND)	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H2112	801	0	2009	Aetna Golden Medicare Plan	Maryland		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H2112	802	0	1	01	01	H2112_802_0	3	2009.01	AETNA HEALTH INC. (MARYLAND)	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H2112	802	0	2009	Aetna Golden Medicare Plan w/Rx CY	Maryland		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H2150	002	0	1	18	06	H2150_002_0	7	2009.01	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org	06	18		1		H2150	002	0	2009	Kaiser Permanente Medicare Plus High w/D AB	DC, MD, VA		2	2			16300	2						(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	http://kp.org/seniorrx	
H2150	009	0	1	18	06	H2150_009_0	8	2009.01	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org	06	18		1		H2150	009	0	2009	Kaiser Permanente Medicare Plus Std w/D AB	DC, MD, VA		2	2			700	2						(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	http://kp.org/seniorrx	
H2150	017	0	1	18	06	H2150_017_0	4	2009.01	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org	06	18		1		H2150	017	0	2009	Kaiser Permanente Medicare Plus Basic no D AB	DC, MD, VA		2	2			100	2						(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008									http://kp.org/seniorrx	
H2150	021	0	1	18	06	H2150_021_0	4	2009.01	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org	06	18		1		H2150	021	0	2009	Kaiser Permanente Medicare Plus High w/o D AB	DC, MD, VA		2	2			400	2						(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008									http://kp.org/seniorrx	
H2150	022	0	1	18	06	H2150_022_0	4	2009.01	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org	06	18		1		H2150	022	0	2009	Kaiser Permanente Medicare Plus Std w/o D AB	DC, MD, VA		2	2			100	2						(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008									http://kp.org/seniorrx	
H2150	028	0	2	18	06	H2150_028_0	11	2009.01	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org	06	18		2		H2150	028	0	2009	Kaiser Permanente Medicare Plus High Option w/D B	DC, MD, VA		2	2			75	2		1				(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	http://kp.org/seniorrx	
H2150	029	0	2	18	06	H2150_029_0	11	2009.01	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org	06	18		2		H2150	029	0	2009	Kaiser Permanente Medicare Plus Std Option w/D B	DC, MD, VA		2	2			10	2		1				(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	http://kp.org/seniorrx	
H2150	030	0	2	18	06	H2150_030_0	4	2009.01	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org	06	18		2		H2150	030	0	2009	Kaiser Permanente Basic Option no D B	DC, MD, VA		2	2			5	2		1				(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008									http://kp.org/seniorrx	
H2150	031	0	2	18	06	H2150_031_0	8	2009.01	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org	06	18		2		H2150	031	0	2009	Kaiser Permanente High Option no D B	DC, MD, VA		2	2			5	2		1				(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008									http://kp.org/seniorrx	
H2150	032	0	2	18	06	H2150_032_0	5	2009.01	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org	06	18		2		H2150	032	0	2009	Kaiser Permanente Medicare Plus Std Option no D B	DC, MD, VA		2	2			5	2		1				(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008									http://kp.org/seniorrx	
H2150	801	0		18	06	H2150_801_0	4	2009.01	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org	06	18				H2150	801	0	2009	Kaiser Permanente Medicare Plus EGHP AB	DC, MD, VA		1	2										(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008		(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	http://kp.org/seniorrx	
H2150	805	0		18	06	H2150_805_0	4	2009.01	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org	06	18				H2150	805	0	2009	Kaiser Permanente Medicare Plus EGHP B Only	DC, MD, VA		1	2										(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008		(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	http://kp.org/seniorrx	
H2150	806	0		18	06	H2150_806_0	4	2009.01	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org	06	18				H2150	806	0	2009	Kaiser Permanente Medicare Plus FEHB AB with D	DC, MD, VA		1	2										(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008		(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	http://kp.org/seniorrx	
H2150	807	0		18	06	H2150_807_0	4	2009.01	KAISER FNDN HP OF THE MID-ATLANTIC STS	Kaiser Permanente Medicare Plus	kp.org	06	18				H2150	807	0	2009	Kaiser Permanente Medicare Plus FEHB B only with D	DC, MD, VA		1	2										(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008		(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	(888)-777-5536	(888)-777-5536	(866)-513-0008	(866)-513-0008	http://kp.org/seniorrx	
H2169	001	0	1	01	01	H2169_001_0	2	2009.01	UPMC HEALTH PLAN INC.	UPMC Health Plan	www.upmchealthplan.com	01	01		1		H2169	001	0	2009	UPMC for Life HMO (OH)	Ohio		2	2			300	2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629									http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H2169	002	0	1	01	01	H2169_002_0	4	2009.01	UPMC HEALTH PLAN INC.	UPMC Health Plan	www.upmchealthplan.com	01	01		1		H2169	002	0	2009	UPMC for Life HMO Rx (OH)	Ohio		2	2			400	2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H2169	003	0	1	01	01	H2169_003_0	3	2009.01	UPMC HEALTH PLAN INC.	UPMC Health Plan	www.upmchealthplan.com	01	01		1		H2169	003	0	2009	UPMC for Life HMO Rx Enhanced (OH)	Ohio		2	2			200	2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H2169	004	0	1	01	01	H2169_004_0	2	2009.01	UPMC HEALTH PLAN INC.	UPMC Health Plan	www.upmchealthplan.com	01	01		1		H2169	004	0	2009	UPMC for Life HMO (WV)	West Virginia		2	2			200	2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629									http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H2169	005	0	1	01	01	H2169_005_0	4	2009.01	UPMC HEALTH PLAN INC.	UPMC Health Plan	www.upmchealthplan.com	01	01		1		H2169	005	0	2009	UPMC for Life HMO Rx (WV)	West Virginia		2	2			200	2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H2169	006	0	1	01	01	H2169_006_0	3	2009.01	UPMC HEALTH PLAN INC.	UPMC Health Plan	www.upmchealthplan.com	01	01		1		H2169	006	0	2009	UPMC for Life HMO Rx Enhanced (WV)	West Virginia		2	2			150	2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H2169	801	0	1	01	01	H2169_801_0	4	2009.01	UPMC HEALTH PLAN INC.	UPMC Health Plan	www.upmchealthplan.com	01	01		1		H2169	801	0	2009	UPMC Employer Group	Ohio and West Virginia		1	2				2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629									http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H2169	802	0	1	01	01	H2169_802_0	4	2009.01	UPMC HEALTH PLAN INC.	UPMC Health Plan	www.upmchealthplan.com	01	01		1		H2169	802	0	2009	UPMC Employer Group - D (CY)	Ohio and West Virginia		1	2				2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H2169	803	0	1	01	01	H2169_803_0	4	2009.01	UPMC HEALTH PLAN INC.	UPMC Health Plan	www.upmchealthplan.com	01	01		1		H2169	803	0	2009	UPMC Employer Group - D (FY)	Ohio and West Virginia		1	2				2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H2174	001	0	1	01	01	H2174_001_0	5	2009.01	TRILLIUM COMMUNITY HEALTH PLAN	Trillium Advantage	www.Trilliumchp.com	01	01		1		H2174	001	0	2009	Trillium Advantage Dual SNP	Lane , Jackson counties		2	1	3		2318	2			1	3		(541)-431-1950	(800)-910-3906	(541)-431-1951	(866)-279-9750	(541)-431-1950	(800)-910-3906	(541)-431-1951	(866)-279-9750	(541)-431-1950	(800)-910-3906	(541)-431-1951	(866)-279-9750	(541)-431-1950	(800)-910-3906	(541)-431-1951	(866)-279-9750	http://www.trilliumchp.com	http://www.trilliumchp.com
H2174	002	0	1	01	01	H2174_002_0	6	2009.01	TRILLIUM COMMUNITY HEALTH PLAN	Trillium Advantage	www.Trilliumchp.com	01	01		1		H2174	002	0	2009	Trillium Advantage	Lane , Jackson counties		2	2			338	2						(541)-431-1950	(800)-910-3906	(541)-431-1951	(866)-279-9750	(541)-431-1950	(800)-910-3906	(541)-431-1951	(866)-279-9750	(541)-431-1950	(800)-910-3906	(541)-431-1951	(866)-279-9750	(541)-431-1950	(800)-910-3906	(541)-431-1951	(866)-279-9750	http://www.trilliumchp.com	http://www.trilliumchp.com
H2174	003	0	1	01	01	H2174_003_0	6	2009.01	TRILLIUM COMMUNITY HEALTH PLAN	Trillium Advantage	www.Trilliumchp.com	01	01		1		H2174	003	0	2009	Trillium Advantage ISNP	Lane , Jackson counties		2	1	1	1	2318	2			1			(541)-431-1950	(800)-910-3906	(541)-431-1951	(866)-279-9750	(541)-431-1950	(800)-910-3906	(541)-431-1951	(866)-279-9750	(541)-431-1950	(800)-910-3906	(541)-431-1951	(866)-279-9750	(541)-431-1950	(800)-910-3906	(541)-431-1951	(866)-279-9750	http://www.trilliumchp.com	http://www.trilliumchp.com
H2174	004	0	1	01	01	H2174_004_0	3	2009.01	TRILLIUM COMMUNITY HEALTH PLAN	Trillium Advantage	www.Trilliumchp.com	01	01		1		H2174	004	0	2009	Trillium Advantage Flex	Lane , Jackson counties		2	2			163	2						(541)-431-1950	(800)-910-3906	(541)-431-1951	(866)-279-9750	(541)-431-1950	(800)-910-3906	(541)-431-1951	(866)-279-9750									http://www.trilliumchp.com	http://www.trilliumchp.com
H2182	001	0	1	02	01	H2182_001_0	6	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.securehorizons.com	01	02		1		H2182	001	0	2009	AARP MedicareComplete Plus	Select Counties in GA		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.rxsolutions.com	www.securehorizons.com
H2218	001	0	1	20	08	H2218_001_0	1	2009.01	HARBOR HEALTH SERVICES	Elder Service Plan of Harbor Health Services, Inc	www.elderserviceplan.org	08	20		1		H2218	001	0	2009	Harbor Health Elder Service Plan, Dual Eligible	Norfolk and Suffolk Counties		2	2				2														(617)-296-5100	(866)-714-1277			(617)-296-5100	(866)-714-1277			www.elderserviceplan.org	
H2218	002	0	1	20	08	H2218_002_0	1	2009.01	HARBOR HEALTH SERVICES	Elder Service Plan of Harbor Health Services, Inc	www.elderserviceplan.org	08	20		1		H2218	002	0	2009	Harbor Health Elder Service Plan, Medicare only	Norfolk and Suffolk Counties		2	2				2														(617)-296-5100	(866)-714-1277			(617)-296-5100	(866)-714-1277			www.elderserviceplan.org	
H2219	001	0	1	20	08	H2219_001_0	2	2009.01	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan - Summit ElderCare	www.summiteldercare.org	08	20		1		H2219	001	0	2009	Summit ElderCare	Summit ElderCare -  Worcester, Middlesex Counties		2	2			502	2														(508)-852-2026	(800)-698-7566	(800)-439-2370	(800)-439-2370	(508)-368-9690	(800)-698-7566	(800)-889-4106	(800)-889-4106	Not Applicable	
H2219	002	0	1	20	08	H2219_002_0	2	2009.01	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan - Summit ElderCare	www.summiteldercare.org	08	20		1		H2219	002	0	2009	Summit ElderCare	Summit ElderCare - Worcester, Middlesex Counties		2	2			34	2														(508)-852-2026	(800)-698-7566	(800)-439-2370	(800)-439-2370	(508)-368-9690	(800)-698-7566	(800)-889-4106	(800)-889-4106	Not Applicable	
H2220	001	0	1	20	08	H2220_001_0	1	2009.01	UPHAMS CORNER HEALTH COMMITTEE, INC.	Uphams Corner Health Committee, Inc.	http://www.uphamscornerhealthctr.com/	08	20		1		H2220	001	0	2009	Uphams Corner Health Committee	Upham's Elder Service Plan		2	2				2														(617)-288-0970	(617)-288-0970			(617)-288-0970	(617)-288-0970			http://www.uphamscornerhealthctr.com/	
H2220	002	0	1	20	08	H2220_002_0	1	2009.01	UPHAMS CORNER HEALTH COMMITTEE, INC.	Uphams Corner Health Committee, Inc.	http://www.uphamscornerhealthctr.com/	08	20		1		H2220	002	0	2009	Uphams Corner Health Committee	Upham's Elder Service Plan		2	2				2														(617)-288-0970	(617)-288-0970			(617)-288-0970	(617)-288-0970			http://www.uphamscornerhealthctr.com/	
H2221	001	0	1	20	08	H2221_001_0	3	2009.01	ELDER SRVC PLN/CAMBRIDGE HEALTH ALLIANCE	Elder Srvc Pln/Cambridge Health Alliance	Challiance.org	08	20		1		H2221	001	0	2009	Elder Service Plan of the Cambridge Health	Counties: Middlesex and Suffolk		2	2			12	2														(617)-575-5850	(617)-575-5850			(617)-575-5850	(617)-575-5850			none	
H2221	002	0	1	20	08	H2221_002_0	3	2009.01	ELDER SRVC PLN/CAMBRIDGE HEALTH ALLIANCE	Elder Srvc Pln/Cambridge Health Alliance	Challiance.org	08	20		1		H2221	002	0	2009	Elder Service Plan of the Cambridge Health	Counties:  Middlesex and Suffolk		2	2			12	2														(617)-575-5850	(617)-575-5850			(617)-575-5850	(617)-575-5850			none	
H2222	002	0	1	20	08	H2222_002_0	1	2009.01	ELDER SERVICE PLAN OF THE NORTH SHORE	Elder Service Plan of the North Shore	www.pacenorthshore.org	08	20		1		H2222	002	0	2009	Elder Service Plan of the Northshore	Essex, Middlesex counties		2	2			50	2														(781)-715-6608	(781)-715-6608			(781)-715-6608	(781)-715-6608			None	
H2222	003	0	1	20	08	H2222_003_0	1	2009.01	ELDER SERVICE PLAN OF THE NORTH SHORE	Elder Service Plan of the North Shore	www.pacenorthshore.org	08	20		1		H2222	003	0	2009	Elder Service Plan of the Northshore	Essex, Middlesex counties		2	2			500	2														(781)-715-6608	(781)-715-6608			(781)-715-6608	(781)-715-6608			None	
H2223	001	0	1	20	08	H2223_001_0	1	2009.01	ELDER SVC PLN/E BOSTON HEALTH CENTER	Elder Svc Pln/E Boston Health Center	www.ebnhc.org	08	20		1		H2223	001	0	2009	ESP of East Boston Pharmacy Plan--Duals	Chelsea, Revere, East Boston, Everett, Winthrop MA		2	2			325	2														(617)-569-5800	(617)-569-5800			(617)-569-5800	(617)-569-5800			www.ebnhc.org	
H2223	002	0	1	20	08	H2223_002_0	1	2009.01	ELDER SVC PLN/E BOSTON HEALTH CENTER	Elder Svc Pln/E Boston Health Center	www.ebnhc.org	08	20		1		H2223	002	0	2009	ESP of East Boston Pharmacy Plan--MCR Only	Chelsea, Revere, East Boston, Everett, Winthrop MA		2	2			7	2														(617)-569-5800	(617)-569-5800			(617)-569-5800	(617)-569-5800			www.ebnhc.org	
H2224	001	0	1	01	01	H2224_001_0	8	2009.01	SENIOR WHOLE HEALTH, LLC	Senior Whole Health	www.seniorwholehealth.com	01	01		1		H2224	001	0	2009	Senior Whole Health	Brstl, Essx, Midlsex, Nrfolk, Plymth, Sufolk, Worc		2	1	3		6000	2			1	1		(617)-494-5353	(888)-794-7268	(888)-749-6455	(888)-749-6455	(617)-494-5353	(888)-794-7268	(888)-749-6455	(888)-749-6455	(617)-494-5353	(888)-794-7268	(888)-749-6455	(888)-749-6455	(617)-494-5353	(888)-566-3526	(888)-749-6455	(888)-749-6455	www.seniorwholehealth.com	www.seniorwholehealth.com
H2225	001	0	1	01	01	H2225_001_0	7	2009.01	COMMONWEALTH CARE ALLIANCE, INC.	Commonwealth Care Alliance, Inc.	www.commonwealthcare.org	01	01		1		H2225	001	0	2009	Senior Care Options Program	Greater Boston, Springfield, Merrimack Valley		2	1	3			2			1	1		(866)-610-2273	(866)-610-2273	(866)-322-7357	(866)-322-7357	(866)-610-2273	(866)-610-2273	(866)-322-7357	(866)-322-7357	(866)-610-2273	(866)-610-2273	(866)-322-7357	(866)-322-7357	(866)-610-2273	(866)-610-2273	(866)-322-7357	(866)-322-7357	http://www.commonwealthcare.org/scoformulary.pdf	www.commonwealthcare.org
H2226	001	0	1	01	01	H2226_001_0	6	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Senior Care Options	www.EvercareHealthPlans.com	01	01		1		H2226	001	0	2009	Evercare Senior Care Options	Boston, Springfield and Worcester Metro Areas		2	1	3			2			1	1		(888)-867-5511	(888)-867-5511	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(888)-867-5511	(888)-867-5511	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H2228	001	0	1	04	01	H2228_001_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H2228	001	0	2009	Evercare Plan IP	Boston, Springfield and Worcester Metro Areas		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H2228	002	0	1	04	01	H2228_002_0	6	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H2228	002	0	2009	Evercare Plan IP	Bristol, Kent, Providence and Washington Counties		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H2228	004	0	1	04	01	H2228_004_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H2228	004	0	2009	Evercare Plan DP	Boston, Springfield and Worcester Metro Areas		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H2228	009	0	1	04	01	H2228_009_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H2228	009	0	2009	Evercare Plan MP	Boston, Springfield and Worcester Metro Areas		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H2229	028	0	1	04	01	H2229_028_0	6	2009.01	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan	www.tuftshealthplan.com	01	04		1		H2229	028	0	2009	Tufts Medicare Preferred PPO Rx Plus	Barn, Bris, Ess, Hpd, Mid, Nor, Ply, Suf, Wor		2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	http://www.tuftshealthplan.com/medicare	www.tuftshealthplan.com
H2229	029	0	1	04	01	H2229_029_0	6	2009.01	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan	www.tuftshealthplan.com	01	04		1		H2229	029	0	2009	Tufts Medicare Preferred PPO Rx	Barn, Bris, Ess, Hpd, Mid, Nor, Ply, Suf, Wor		2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	http://www.tuftshealthplan.com/medicare	www.tuftshealthplan.com
H2229	030	0	1	04	01	H2229_030_0	4	2009.01	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan	www.tuftshealthplan.com	01	04		1		H2229	030	0	2009	Tufts Medicare Preferred PPO	Barn, Bris, Ess, Hpd, Mid, Nor, Ply, Suf, Wor		2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977									http://www.tuftshealthplan.com/medicare	www.tuftshealthplan.com
H2229	801	0	1	04	01	H2229_801_0	4	2009.01	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan	www.tuftshealthplan.com	01	04		1		H2229	801	0	2009	Tufts Medicare Preferred PPO Rx	Most of Massachusetts		1	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	http://www.tuftshealthplan.com/medicare	www.tuftshealthplan.com
H2229	802	0	1	04	01	H2229_802_0	4	2009.01	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan	www.tuftshealthplan.com	01	04		1		H2229	802	0	2009	Tufts Medicare Preferred PPO	Most of Massachusetts		1	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977									http://www.tuftshealthplan.com/medicare	www.tuftshealthplan.com
H2229	803	0	1	04	01	H2229_803_0	4	2009.01	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan	www.tuftshealthplan.com	01	04		1		H2229	803	0	2009	Tufts Medicare Preferred PPO Rx	Most of Massachusetts		1	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	http://www.tuftshealthplan.com/medicare	www.tuftshealthplan.com
H2230	002	0	1	04	01	H2230_002_0	8	2009.01	BLUE CROSS AND BLUE SHIELD OF MA HMO BLUE, INC.	Blue Cross and Blue Shield of Massachusetts	www.bluecrossma.com/medicare	01	04		1		H2230	002	0	2009	Medicare PPO Blue PlusRx	Massachusetts except Berkshire,Dukes and Nantucket		2	2			299	2						(800)-200-4255		(800)-522-1254		(800)-678-2265		(800)-522-1254		(800)-200-4255	(800)-200-4255	(800)-522-1254		(800)-678-2265	(800)-678-2265	(800)-522-1254		http://www.bluecrossma.com/Medicare/audience/Already_A_Member/pharmacy/index.html	www.bcbsma.com
H2230	006	0	1	04	01	H2230_006_0	7	2009.01	BLUE CROSS AND BLUE SHIELD OF MA HMO BLUE, INC.	Blue Cross and Blue Shield of Massachusetts	www.bluecrossma.com/medicare	01	04		1		H2230	006	0	2009	Medicare PPO Blue PremierRx	Massachusetts except Berkshire,Dukes and Nantucket		2	2			381	2						(800)-200-4255		(800)-522-1254		(800)-678-2265		(800)-522-1254		(800)-200-4255	(800)-200-4255	(800)-522-1254		(800)-678-2265	(800)-678-2265	(800)-522-1254		http://www.bluecrossma.com/Medicare/audience/Already_A_Member/pharmacy/index.html	www.bcbsma.com
H2230	801	0	1	04	01	H2230_801_0	5	2009.01	BLUE CROSS AND BLUE SHIELD OF MA HMO BLUE, INC.	Blue Cross and Blue Shield of Massachusetts	www.bluecrossma.com/medicare	01	04		1		H2230	801	0	2009	Medicare PPO Blue	Massachusetts except Berkshire,Dukes and Nantucket		1	2			7	2						(800)-200-4255		(800)-522-1254		(800)-678-2265		(800)-522-1254		(800)-200-4255	(800)-200-4255	(800)-522-1254		(800)-678-2265	(800)-678-2265	(800)-522-1254		http://www.bluecrossma.com/Medicare/audience/Already_A_Member/pharmacy/index.html	www.bcbsma.com
H2230	809	0	1	04	01	H2230_809_0	5	2009.01	BLUE CROSS AND BLUE SHIELD OF MA HMO BLUE, INC.	Blue Cross and Blue Shield of Massachusetts	www.bluecrossma.com/medicare	01	04		1		H2230	809	0	2009	Medicare PPO Blue	Massachusetts except Berkshire,Dukes and Nantucket		1	2			7	2						(800)-200-4255		(800)-522-1254		(800)-678-2265		(800)-522-1254										http://www.bluecrossma.com/Medicare/audience/Already_A_Member/pharmacy/index.html	www.bcbsma.com
H2237	001	0	1	01	01	H2237_001_0	5	2009.01	INDEPENDENT CARE HEALTH PLAN, INC.	iCare	www.icare-wi.org	01	01		1		H2237	001	0	2009	iCare Medicare Plan	iCare Milwaukee County Medicare Plan		2	1	3		2942	2			1	3		(414)-223-4847	(800)-777-4376	(800)-947-3529	(800)-947-3529	(414)-223-4847	(800)-777-4376	(800)-947-3529	(800)-947-3529	(414)-223-4847	(800)-777-4376	(800)-947-3529	(800)-947-3529	(414)-223-4847	(800)-777-4376	(800)-947-3529	(800)-947-3529	www.icare-wi.org	www.icare-wi.org
H2237	002	0	1	01	01	H2237_002_0	5	2009.01	INDEPENDENT CARE HEALTH PLAN, INC.	iCare	www.icare-wi.org	01	01		1		H2237	002	0	2009	iCare Medicare Plan	iCare SE Wisconsin Medicare Plan		2	1	3		2942	2			1	3		(414)-223-4847	(800)-777-4376	(800)-947-3529	(800)-947-3529	(414)-223-4847	(800)-777-4376	(800)-947-3529	(800)-947-3529	(414)-223-4847	(800)-777-4376	(800)-947-3529	(800)-947-3529	(414)-223-4847	(800)-777-4376	(800)-947-3529	(800)-947-3529	www.icare-wi.org	www.icare-wi.org
H2237	006	0	1	01	01	H2237_006_0	5	2009.01	INDEPENDENT CARE HEALTH PLAN, INC.	iCare	www.icare-wi.org	01	01		1		H2237	006	0	2009	iCare Medicare Plan-Northeast	iCare Medicare Plan-Northeast		2	2			53	2						(414)-223-4847	(800)-777-4376	(800)-947-3529	(800)-947-3529	(414)-223-4847	(800)-777-4376	(800)-947-3529	(800)-947-3529	(414)-223-4847	(800)-777-4376	(800)-947-3529	(800)-947-3529	(414)-223-4847	(800)-777-4376	(800)-947-3529	(800)-947-3529	www.icare-wi.org	www.icare-wi.org
H2256	001	1	1	01	01	H2256_001_1	8	2009.01	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan	www.tuftshealthplan.com	01	01		1		H2256	001	1	2009	Tufts Medicare Preferred HMO Prime Rx Plus	All counties except Berks, Frank, Dukes, Nantucket	Counties ESS, SUF, WOR	2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	http://www.tuftshealthplan.com/medicare	www.tuftshealthplan.com
H2256	001	2	1	01	01	H2256_001_2	9	2009.01	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan	www.tuftshealthplan.com	01	01		1		H2256	001	2	2009	Tufts Medicare Preferred HMO Prime Rx Plus	All counties except Berks, Frank, Dukes, Nantucket	Counties BAR, BRI, HPD, HPS, MID, NOR, PLY	2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	http://www.tuftshealthplan.com/medicare	www.tuftshealthplan.com
H2256	015	1	1	01	01	H2256_015_1	8	2009.01	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan	www.tuftshealthplan.com	01	01		1		H2256	015	1	2009	Tufts Medicare Preferred HMO Prime Rx	All counties except Berks, Frank, Dukes, Nantucket	Counties ESS, SUF, WOR	2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	http://www.tuftshealthplan.com/medicare	www.tuftshealthplan.com
H2256	015	2	1	01	01	H2256_015_2	8	2009.01	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan	www.tuftshealthplan.com	01	01		1		H2256	015	2	2009	Tufts Medicare Preferred HMO Prime Rx	All counties except Berks, Frank, Dukes, Nantucket	Counties BAR, BRI, HPD, HPS, MID, NOR, PLY	2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	http://www.tuftshealthplan.com/medicare	www.tuftshealthplan.com
H2256	016	1	1	01	01	H2256_016_1	5	2009.01	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan	www.tuftshealthplan.com	01	01		1		H2256	016	1	2009	Tufts Medicare Preferred HMO Prime	All counties except Berks, Frank, Dukes, Nantucket	Counties ESS, SUF, WOR	2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977									http://www.tuftshealthplan.com/medicare	www.tuftshealthplan.com
H2256	016	2	1	01	01	H2256_016_2	5	2009.01	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan	www.tuftshealthplan.com	01	01		1		H2256	016	2	2009	Tufts Medicare Preferred HMO Prime	All counties except Berks, Frank, Dukes, Nantucket	Counties BAR, BRI, HPD, HPS, MID, NOR, PLY	2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977									http://www.tuftshealthplan.com/medicare	www.tuftshealthplan.com
H2256	017	1	1	01	01	H2256_017_1	8	2009.01	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan	www.tuftshealthplan.com	01	01		1		H2256	017	1	2009	Tufts Medicare Preferred HMO Value Rx Plus	All counties except Berks, Frank, Dukes, Nantucket	Counties ESS, SUF, WOR	2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	http://www.tuftshealthplan.com/medicare	www.tuftshealthplan.com
H2256	017	7	1	01	01	H2256_017_7	8	2009.01	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan	www.tuftshealthplan.com	01	01		1		H2256	017	7	2009	Tufts Medicare Preferred HMO Value Rx Plus	All counties except Berks, Frank, Dukes, Nantucket	Counties BAR, BRI, HPD, HPS, MID, NOR, PLY	2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	http://www.tuftshealthplan.com/medicare	www.tuftshealthplan.com
H2256	018	1	1	01	01	H2256_018_1	8	2009.01	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan	www.tuftshealthplan.com	01	01		1		H2256	018	1	2009	Tufts Medicare Preferred HMO Value Rx	All counties except Berks, Frank, Dukes, Nantucket	Counties ESS, SUF, WOR	2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	http://www.tuftshealthplan.com/medicare	www.tuftshealthplan.com
H2256	018	7	1	01	01	H2256_018_7	7	2009.01	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan	www.tuftshealthplan.com	01	01		1		H2256	018	7	2009	Tufts Medicare Preferred HMO Value Rx	All counties except Berks, Frank, Dukes, Nantucket	Counties BAR, BRI, HPD, HPS, MID, NOR, PLY	2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	http://www.tuftshealthplan.com/medicare	www.tuftshealthplan.com
H2256	019	1	1	01	01	H2256_019_1	4	2009.01	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan	www.tuftshealthplan.com	01	01		1		H2256	019	1	2009	Tufts Medicare Preferred HMO Value	All counties except Berks, Frank, Dukes, Nantucket	Counties ESS, SUF, WOR	2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977									http://www.tuftshealthplan.com/medicare	www.tuftshealthplan.com
H2256	019	7	1	01	01	H2256_019_7	4	2009.01	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan	www.tuftshealthplan.com	01	01		1		H2256	019	7	2009	Tufts Medicare Preferred HMO Value	All counties except Berks, Frank, Dukes, Nantucket	Counties BAR, BRI, HPD, HPS, MID, NOR, PLY	2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977									http://www.tuftshealthplan.com/medicare	www.tuftshealthplan.com
H2256	023	0	1	01	01	H2256_023_0	5	2009.01	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan	www.tuftshealthplan.com	01	01		1		H2256	023	0	2009	Tufts Medicare Preferred HMO Basic Rx Plus	Massachusetts except Berk, Frank, Dukes, Nantucket		2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	http://www.tuftshealthplan.com/medicare	www.tuftshealthplan.com
H2256	024	0	1	01	01	H2256_024_0	5	2009.01	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan	www.tuftshealthplan.com	01	01		1		H2256	024	0	2009	Tufts Medicare Preferred HMO Basic Rx	Massachusetts except Berk, Frank, Dukes, Nantuket		2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	http://www.tuftshealthplan.com/medicare	www.tuftshealthplan.com
H2256	025	0	1	01	01	H2256_025_0	4	2009.01	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan	www.tuftshealthplan.com	01	01		1		H2256	025	0	2009	Tufts Medicare Preferred HMO Basic	Massachusetts except Berk, Frank, Dukes, Nantucket		2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977									http://www.tuftshealthplan.com/medicare	www.tuftshealthplan.com
H2256	801	0	1	01	01	H2256_801_0	4	2009.01	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan	www.tuftshealthplan.com	01	01		1		H2256	801	0	2009	Tufts Medicare Preferred HMO Rx	Most of Massachusetts		1	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	http://www.tuftshealthplan.com/medicare	www.tuftshealthplan.com
H2256	802	0	1	01	01	H2256_802_0	4	2009.01	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan	www.tuftshealthplan.com	01	01		1		H2256	802	0	2009	Tufts Medicare Preferred HMO	Most of Massachusetts		1	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977									http://www.tuftshealthplan.com/medicare	www.tuftshealthplan.com
H2256	803	0	1	01	01	H2256_803_0	4	2009.01	TUFTS ASSOCIATED HMO, INC.	Tufts Health Plan	www.tuftshealthplan.com	01	01		1		H2256	803	0	2009	Tufts Medicare Preferred HMO Rx	Most of Massachusetts		1	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	http://www.tuftshealthplan.com/medicare	www.tuftshealthplan.com
H2261	005	0	1	01	01	H2261_005_0	4	2009.01	BLUE CROSS AND BLUE SHIELD OF MA HMO BLUE, INC.	Blue Cross and Blue Shield of Massachusetts	www.bluecrossma.com/medicare	01	01		1		H2261	005	0	2009	Medicare HMO Blue PlusRx	Massachusetts except Berkshire,Dukes and Nantucket		2	2			22176	2						(800)-200-4255		(800)-522-1254		(800)-678-2265		(800)-522-1254		(800)-200-4255	(800)-200-4255	(800)-522-1254		(800)-678-2265	(800)-678-2265	(800)-522-1254		http://www.bluecrossma.com/Medicare/audience/Already_A_Member/pharmacy/index.html	www.bcbsma.com
H2261	011	0	1	01	01	H2261_011_0	4	2009.01	BLUE CROSS AND BLUE SHIELD OF MA HMO BLUE, INC.	Blue Cross and Blue Shield of Massachusetts	www.bluecrossma.com/medicare	01	01		1		H2261	011	0	2009	Medicare HMO Blue PremierRx	Massachusetts except Berkshire,Dukes and Nantucket		2	2			2084	2						(800)-200-4255		(800)-522-1254		(800)-678-2265		(800)-522-1254		(800)-200-4255	(800)-200-4255	(800)-522-1254		(800)-678-2265	(800)-678-2265	(800)-522-1254		http://www.bluecrossma.com/Medicare/audience/Already_A_Member/pharmacy/index.html	www.bcbsma.com
H2261	801	0	1	01	01	H2261_801_0	3	2009.01	BLUE CROSS AND BLUE SHIELD OF MA HMO BLUE, INC.	Blue Cross and Blue Shield of Massachusetts	www.bluecrossma.com/medicare	01	01		1		H2261	801	0	2009	Medicare HMO Blue	Massachusetts except Berkshire,Dukes and Nantucket		1	2			5107	2						(800)-200-4255		(800)-522-1254		(800)-678-2265		(800)-522-1254		(800)-200-4255	(800)-200-4255	(800)-522-1254		(800)-678-2265	(800)-678-2265	(800)-522-1254		http://www.bluecrossma.com/Medicare/audience/Already_A_Member/pharmacy/index.html	www.bcbsma.com
H2261	809	0	1	01	01	H2261_809_0	3	2009.01	BLUE CROSS AND BLUE SHIELD OF MA HMO BLUE, INC.	Blue Cross and Blue Shield of Massachusetts	www.bluecrossma.com/medicare	01	01		1		H2261	809	0	2009	Medicare HMO Blue	Massachusetts except Berkshire,Dukes and Nantucket		1	2			5107	2						(800)-200-4255		(800)-522-1254		(800)-678-2265		(800)-522-1254										http://www.bluecrossma.com/Medicare/audience/Already_A_Member/pharmacy/index.html	www.bcbsma.com
H2291	002	0	1	01	01	H2291_002_0	6	2009.01	PROSALUD HMO, CORP.	ProSalud HMO Corp	www.prosaludpr.com	01	01		1		H2291	002	0	2009	ProSalud Medicare Esencial	Commonwealth of Puerto Rico		2	2				2						(877)-711-8111	(877)-711-8111	(877)-993-9903	(877)-993-9903	(877)-711-8111	(877)-711-8111	(877)-993-9903	(877)-993-9903	(877)-711-8111	(877)-711-8111	(877)-993-9903	(877)-993-9903	(877)-711-8111	(877)-711-8111	(877)-993-9903	(877)-993-9903	www.mywhi.com	
H2312	004	0	1	01	01	H2312_004_0	10	2009.01	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org	01	01		1		H2312	004	0	2009	HAP Senior Plus - HFHS Network	Southeastern Michigan (3 Counties)		2	2				2						(313)-664-7015	(800)-801-1770	(313)-664-8000		(800)-868-3153	(800)-868-3153	(313)-664-8000		(313)-664-7015	(800)-801-1770	(313)-664-8000		(800)-868-3153	(800)-868-3153	(313)-664-8000		www.hap.org/medicare	www.hap.org
H2312	006	0	1	01	01	H2312_006_0	7	2009.01	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org	01	01		1		H2312	006	0	2009	HAP Senior Plus - HFHS Network	Southeastern Michigan (3 Counties)		2	2				2						(313)-664-7015	(800)-801-1770	(313)-664-8000		(800)-868-3153	(800)-868-3153	(313)-664-8000										www.hap.org/medicare	www.hap.org
H2312	007	0	1	01	01	H2312_007_0	8	2009.01	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org	01	01		1		H2312	007	0	2009	HAP Senior Plus - Expanded Network	Southeastern Michigan (9 Counties)		2	2				2						(313)-664-7015	(800)-801-1770	(313)-664-8000		(800)-868-3153	(800)-868-3153	(313)-664-8000		(313)-664-7015	(800)-801-1770	(313)-664-8000		(800)-868-3153	(800)-868-3153	(313)-664-8000		www.hap.org/medicare	www.hap.org
H2312	008	0	1	01	01	H2312_008_0	6	2009.01	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org	01	01		1		H2312	008	0	2009	HAP Senior Plus - Expanded Network	Southeastern Michigan (9 Counties)		2	2				2						(313)-664-7015	(800)-801-1770	(313)-664-8000		(800)-868-3153	(800)-868-3153	(313)-664-8000										www.hap.org/medicare	www.hap.org
H2312	009	0	1	01	01	H2312_009_0	8	2009.01	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org	01	01		1		H2312	009	0	2009	HAP Senior Plus - HFHS Network	Southeastern Michigan (3 Counties)		2	2				2						(313)-664-7015	(800)-801-1770	(313)-664-8000		(800)-868-3153	(800)-868-3153	(313)-664-8000		(313)-664-7015	(800)-801-1770	(313)-664-8000		(800)-868-3153	(800)-868-3153	(313)-664-8000		www.hap.org/medicare	www.hap.org
H2312	010	0	1	01	01	H2312_010_0	8	2009.01	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org	01	01		1		H2312	010	0	2009	HAP Senior Plus - Expanded Network	Southeastern Michigan (9 Counties)		2	2				2						(313)-664-7015	(800)-801-1770	(313)-664-8000		(800)-868-3153	(800)-868-3153	(313)-664-8000		(313)-664-7015	(800)-801-1770	(313)-664-8000		(800)-868-3153	(800)-868-3153	(313)-664-8000		www.hap.org/medicare	www.hap.org
H2312	801	0	1	01	01	H2312_801_0	2	2009.01	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org	01	01		1		H2312	801	0	2009	HAP Senior Plus - Group Only	Macomb, Oakland and Wayne Counties		1	2				2						(313)-664-7015	(800)-801-1770	(313)-664-8000		(800)-944-8372	(800)-944-8372	(313)-664-8000										www.hap.org/medicare	www.hap.org
H2312	803	0	1	01	01	H2312_803_0	2	2009.01	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org	01	01		1		H2312	803	0	2009	HAP Senior Plus - Group Only	Macomb, Oakland and Wayne Counties		1	2				2						(313)-664-7015	(800)-801-1770	(313)-664-8000		(800)-944-8372	(800)-944-8372	(313)-664-8000		(313)-664-7015	(800)-801-1770	(313)-664-8000		(800)-944-8372	(800)-944-8372	(313)-664-8000		www.hap.org/medicare	www.hap.org
H2312	804	0	1	01	01	H2312_804_0	2	2009.01	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org	01	01		1		H2312	804	0	2009	HAP Senior Plus - Group Only	Macomb, Oakland and Wayne Counties		1	2				2						(313)-664-7015	(800)-801-1770	(313)-664-8000		(800)-944-8372	(800)-944-8372	(313)-664-8000		(313)-664-7015	(800)-801-1770	(313)-664-8000		(800)-944-8372	(800)-944-8372	(313)-664-8000		www.hap.org/medicare	www.hap.org
H2312	805	0	1	01	01	H2312_805_0	2	2009.01	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org	01	01		1		H2312	805	0	2009	HAP Senior Plus - Group Only	Southeastern Michigan (9 Counties)		1	2				2						(313)-664-7015	(800)-801-1770	(313)-664-8000		(800)-944-8372	(800)-944-8372	(313)-664-8000										www.hap.org/medicare	www.hap.org
H2312	807	0	1	01	01	H2312_807_0	2	2009.01	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org	01	01		1		H2312	807	0	2009	HAP Senior Plus - Group Only	Southeastern Michigan (9 Counties)		1	2				2						(313)-664-7015	(800)-801-1770	(313)-664-8000		(800)-944-8372	(800)-944-8372	(313)-664-8000		(313)-664-7015	(800)-801-1770	(313)-664-8000		(800)-944-8372	(800)-944-8372	(313)-664-8000		www.hap.org/medicare	www.hap.org
H2312	808	0	1	01	01	H2312_808_0	2	2009.01	HEALTH ALLIANCE PLAN OF MICHIGAN	HAP Senior Plus	www.hap.org	01	01		1		H2312	808	0	2009	HAP Senior Plus - Group Only	Southeastern Michigan (9 Counties)		1	2				2						(313)-664-7015	(800)-801-1770	(313)-664-8000		(800)-944-8372	(800)-944-8372	(313)-664-8000		(313)-664-7015	(800)-801-1770	(313)-664-8000		(800)-944-8372	(800)-944-8372	(313)-664-8000		www.hap.org/medicare	www.hap.org
H2318	001	0	1	20	08	H2318_001_0	1	2009.01	HENRY FORD HEALTH SYSTEM	Henry Ford Health System	hfhs.org	08	20		1		H2318	001	0	2009	Henry Ford Health System-Center for Senior Indepen	Michigan, Wayne County Area		2	2				2														(313)-653-2230	(313)-653-2230			(313)-653-2230	(313)-653-2230			Milwaukee.PACE@milliman.com	
H2318	002	0	1	20	08	H2318_002_0	1	2009.01	HENRY FORD HEALTH SYSTEM	Henry Ford Health System	hfhs.org	08	20		1		H2318	002	0	2009	Henry Ford Health System-Center for Senior Indepen	Michigan, Wayne County Area		2	2				2														(313)-653-2230	(313)-653-2230			(313)-653-2230	(313)-653-2230			Milwaukee.PACE@milliman.com	
H2319	008	3	1	09	04	H2319_008_3	9	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	008	3	2009	Medicare Plus Blue Option A	State of Michigan	UP + Northern Lower Michigan	2	2			913	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	008	4	1	09	04	H2319_008_4	8	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	008	4	2009	Medicare Plus Blue Option A	State of Michigan	Ann Arbor-Jackson-Monroe Area	2	2			1142	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	008	5	1	09	04	H2319_008_5	8	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	008	5	2009	Medicare Plus Blue Option A	State of Michigan	Central lower Michigan and Thumb Area	2	2			1463	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	008	7	1	09	04	H2319_008_7	9	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	008	7	2009	Medicare Plus Blue Option A	State of Michigan	Macomb,  Oakland  Wayne Counties	2	2			4072	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	008	8	1	09	04	H2319_008_8	8	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	008	8	2009	Medicare Plus Blue Option A	State of Michigan	Grand Rapids, Lansing  Kalamazoo Area	2	2			3953	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	009	1	1	09	04	H2319_009_1	8	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	009	1	2009	Medicare Plus Blue Option B	State of Michigan	Grand Rapids  Muskegon Area	2	2			11972	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	009	2	1	09	04	H2319_009_2	8	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	009	2	2009	Medicare Plus Blue Option B	State of Michigan	Lansing and Southwest Michigan	2	2			4138	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	009	3	1	09	04	H2319_009_3	8	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	009	3	2009	Medicare Plus Blue Option B	State of Michigan	UP + Northern Lower Michigan	2	2			3002	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	009	4	1	09	04	H2319_009_4	8	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	009	4	2009	Medicare Plus Blue Option B	State of Michigan	Ann Arbor-Jackson-Monroe Area	2	2			4009	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	009	5	1	09	04	H2319_009_5	8	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	009	5	2009	Medicare Plus Blue Option B	State of Michigan	Central Lower Michigan and Thumb Area	2	2			3405	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	009	6	1	09	04	H2319_009_6	8	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	009	6	2009	Medicare Plus Blue Option B	State of Michigan	Macomb, Oakland  Wayne Counties	2	2			8403	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	010	1	1	09	04	H2319_010_1	8	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	010	1	2009	Medicare Plus Blue Option C	State of Michigan	Grand Rapids and Muskegon Area	2	2			1855	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	010	2	1	09	04	H2319_010_2	8	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	010	2	2009	Medicare Plus Blue Option C	State of Michigan	Lansing and Southwest Michigan	2	2			1058	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	010	3	1	09	04	H2319_010_3	8	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	010	3	2009	Medicare Plus Blue Option C	State of Michigan	UP + Northern Lower Michigan	2	2			881	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	010	4	1	09	04	H2319_010_4	8	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	010	4	2009	Medicare Plus Blue Option C	State of Michigan	Ann Arbor-Jackson-Monroe Area	2	2			1822	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	010	5	1	09	04	H2319_010_5	8	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	010	5	2009	Medicare Plus Blue Option C	State of Michigan	Central lower Michigan and Thumb Area	2	2			1781	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	010	6	1	09	04	H2319_010_6	8	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	010	6	2009	Medicare Plus Blue Option C	State of Michigan	Macomb, Oakland  Wayne Counties	2	2			6747	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	011	1	1	09	04	H2319_011_1	8	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	011	1	2009	Medicare Plus Blue Option D	State of Michigan	Grand Rapids  Muskegon Area	2	2			2072	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	011	2	1	09	04	H2319_011_2	8	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	011	2	2009	Medicare Plus Blue Option D	State of Michigan	Lansing and Southwest Michigan	2	2			1521	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	011	3	1	09	04	H2319_011_3	8	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	011	3	2009	Medicare Plus Blue Option D	State of Michigan	UP + Northern Lower Michigan	2	2			1006	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	011	4	1	09	04	H2319_011_4	8	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	011	4	2009	Medicare Plus Blue Option D	State of Michigan	Ann Arbor-Jackson-Monroe Area	2	2			1352	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	011	5	1	09	04	H2319_011_5	8	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	011	5	2009	Medicare Plus Blue Option D	State of Michigan	Central Lower Michigan and Thumb Area	2	2			1090	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	011	6	1	09	04	H2319_011_6	8	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	011	6	2009	Medicare Plus Blue Option D	State of Michigan	Macomb, Oakland  Wayne Counties	2	2			2344	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	801	0	1	09	04	H2319_801_0	6	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	801	0	2009	Medicare Plus Blue Employer Rx CY	State of Michigan		1	2			119000	2						(800)-422-9146	(800)-422-9146	(800)-807-4670	(800)-807-4670	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-422-9146	(800)-422-9146	(800)-807-4670	(800)-807-4670	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	802	0	1	09	04	H2319_802_0	6	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	802	0	2009	Medicare Plus Blue Employer CY	State of Michigan		1	2			52000	2						(800)-422-9146	(800)-422-9146	(800)-807-4670	(800)-807-4670	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704									www.bcbsm.com/medicare/formulary.shtml	
H2319	803	0	1	09	04	H2319_803_0	6	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	803	0	2009	Medicare Plus Blue Employer Rx non-CY	State of Michigan		1	2			2000	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
H2319	804	0	1	09	04	H2319_804_0	6	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	04	09	2	1		H2319	804	0	2009	Medicare Plus Blue Employer non-CY	State of Michigan		1	2			4000	2						(877)-241-2583	(877)-241-2583	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704									www.bcbsm.com/medicare/formulary.shtml	
H2320	007	0	1	02	01	H2320_007_0	4	2009.01	PRIORITY HEALTH	PriorityMedicare	www.priorityhealth.com/medicare	01	02		1		H2320	007	0	2009	PriorityMedicare	Michigan Counties		2	2			654	2						(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	http://www.priorityhealth.com/medicare08/druglist	www.priorityhealth.com/medicare08/doctors
H2320	008	0	1	02	01	H2320_008_0	4	2009.01	PRIORITY HEALTH	PriorityMedicare	www.priorityhealth.com/medicare	01	02		1		H2320	008	0	2009	PriorityMedicare	Michigan Counties		2	2			97	2						(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	http://www.priorityhealth.com/medicare08/druglist	www.priorityhealth.com/medicare08/doctors
H2320	009	0	1	02	01	H2320_009_0	5	2009.01	PRIORITY HEALTH	PriorityMedicare	www.priorityhealth.com/medicare	01	02		1		H2320	009	0	2009	PriorityMedicare Plus	Michigan Counties		2	2			1028	2						(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	http://www.priorityhealth.com/medicare08/druglist	www.priorityhealth.com/medicare08/doctors
H2320	010	0	1	02	01	H2320_010_0	5	2009.01	PRIORITY HEALTH	PriorityMedicare	www.priorityhealth.com/medicare	01	02		1		H2320	010	0	2009	PriorityMedicare Plus	Michigan Counties		2	2			153	2						(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	http://www.priorityhealth.com/medicare08/druglist	www.priorityhealth.com/medicare08/doctors
H2320	011	0	1	02	01	H2320_011_0	4	2009.01	PRIORITY HEALTH	PriorityMedicare	www.priorityhealth.com/medicare	01	02		1		H2320	011	0	2009	PriorityMedicare Value	Michigan Counties		2	2			37	2						(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	http://www.priorityhealth.com/medicare08/druglist	www.priorityhealth.com/medicare08/doctors
H2320	012	0	1	02	01	H2320_012_0	4	2009.01	PRIORITY HEALTH	PriorityMedicare	www.priorityhealth.com/medicare	01	02		1		H2320	012	0	2009	PriorityMedicare Value	Michigan Counties		2	2			6	2						(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	http://www.priorityhealth.com/medicare08/druglist	www.priorityhealth.com/medicare08/doctors
H2320	013	0	1	02	01	H2320_013_0	4	2009.01	PRIORITY HEALTH	PriorityMedicare	www.priorityhealth.com/medicare	01	02		1		H2320	013	0	2009	PriorityMedicare	Michigan Counties		2	2			1132	2						(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	http://www.priorityhealth.com/medicare08/druglist	www.priorityhealth.com/medicare08/doctors
H2320	014	0	1	02	01	H2320_014_0	5	2009.01	PRIORITY HEALTH	PriorityMedicare	www.priorityhealth.com/medicare	01	02		1		H2320	014	0	2009	PriorityMedicare Plus	Western and Northern Michigan Counties		2	2			1786	2						(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	http://www.priorityhealth.com/medicare08/druglist	www.priorityhealth.com/medicare08/doctors
H2320	015	0	1	02	01	H2320_015_0	4	2009.01	PRIORITY HEALTH	PriorityMedicare	www.priorityhealth.com/medicare	01	02		1		H2320	015	0	2009	PriorityMedicare Value	Western and Northern Michigan Counties		2	2			73	2						(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	http://www.priorityhealth.com/medicare08/druglist	www.priorityhealth.com/medicare08/doctors
H2320	016	0	1	02	01	H2320_016_0	4	2009.01	PRIORITY HEALTH	PriorityMedicare	www.priorityhealth.com/medicare	01	02		1		H2320	016	0	2009	PriorityMedicare	Michigan Counties		2	2			13	2						(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	http://www.priorityhealth.com/medicare08/druglist	www.priorityhealth.com/medicare08/doctors
H2320	017	0	1	02	01	H2320_017_0	5	2009.01	PRIORITY HEALTH	PriorityMedicare	www.priorityhealth.com/medicare	01	02		1		H2320	017	0	2009	PriorityMedicare Plus	Michigan Counties		2	2			12	2						(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	http://www.priorityhealth.com/medicare08/druglist	www.priorityhealth.com/medicare08/doctors
H2320	018	0	1	02	01	H2320_018_0	4	2009.01	PRIORITY HEALTH	PriorityMedicare	www.priorityhealth.com/medicare	01	02		1		H2320	018	0	2009	PriorityMedicare Value	Michigan Counties		2	2			2	2						(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	http://www.priorityhealth.com/medicare08/druglist	www.priorityhealth.com/medicare08/doctors
H2320	802	0	1	02	01	H2320_802_0	5	2009.01	PRIORITY HEALTH	PriorityMedicare	www.priorityhealth.com/medicare	01	02		1		H2320	802	0	2009	PriorityMedicare EG Non-Calendar Year	State of Michigan		1	2			1542	2						(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	http://www.priorityhealth.com/medicare08/druglist	www.priorityhealth.com/medicare08/doctors
H2320	803	0	1	02	01	H2320_803_0	5	2009.01	PRIORITY HEALTH	PriorityMedicare	www.priorityhealth.com/medicare	01	02		1		H2320	803	0	2009	PriorityMedicare EG Calendar Year	State of Michigan		1	2			3045	2						(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	http://www.priorityhealth.com/medicare08/druglist	www.priorityhealth.com/medicare08/doctors
H2320	804	0	1	01	01	H2320_804_0	5	2009.01	PRIORITY HEALTH	PriorityMedicare	www.priorityhealth.com/medicare	01	01		1		H2320	804	0	2009	PriorityMedicare EG HMO w PD Non-Cal Year	State of Michigan		1	2			123	2						(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	http://www.priorityhealth.com/medicare08/druglist	www.priorityhealth.com/medicare08/doctors
H2320	805	0	1	01	01	H2320_805_0	5	2009.01	PRIORITY HEALTH	PriorityMedicare	www.priorityhealth.com/medicare	01	01		1		H2320	805	0	2009	PriorityMedicare EG HMO w PD Cal Year	State of Michigan		1	2			4	2						(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	http://www.priorityhealth.com/medicare08/druglist	www.priorityhealth.com/medicare08/doctors
H2320	806	0	1	02	01	H2320_806_0	5	2009.01	PRIORITY HEALTH	PriorityMedicare	www.priorityhealth.com/medicare	01	02		1		H2320	806	0	2009	PriorityMedicare EG Non-Cal Year (no PD)	State of Michigan		1	2			2	2						(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761									http://www.priorityhealth.com/medicare08/druglist	www.priorityhealth.com/medicare08/doctors
H2320	807	0	1	02	01	H2320_807_0	5	2009.01	PRIORITY HEALTH	PriorityMedicare	www.priorityhealth.com/medicare	01	02		1		H2320	807	0	2009	PriorityMedicare EG Cal Year (no PD)	State of Michigan		1	2			2	2						(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761									http://www.priorityhealth.com/medicare08/druglist	www.priorityhealth.com/medicare08/doctors
H2320	808	0	1	01	01	H2320_808_0	5	2009.01	PRIORITY HEALTH	PriorityMedicare	www.priorityhealth.com/medicare	01	01		1		H2320	808	0	2009	PriorityMedicare EG HMO Non-Cal Yr (no PD)	State of Michigan		1	2			2	2						(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761									http://www.priorityhealth.com/medicare08/druglist	www.priorityhealth.com/medicare08/doctors
H2320	809	0	1	01	01	H2320_809_0	5	2009.01	PRIORITY HEALTH	PriorityMedicare	www.priorityhealth.com/medicare	01	01		1		H2320	809	0	2009	PriorityMedicare EG HMO Cal Year (no PD)	State of Michigan		1	2			2	2						(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761									http://www.priorityhealth.com/medicare08/druglist	www.priorityhealth.com/medicare08/doctors
H2322	001	0	1	04	01	H2322_001_0	8	2009.01	ALLIANCE HEALTH AND LIFE INSURANCE, CO	Alliance Medicare PPO	www.hap.org	01	04		1		H2322	001	0	2009	Alliance Medicare PPO Plan	Southeastern Michigan (9 Counties)		2	2				2						(313)-664-9050	(888)-658-2536	(313)-664-8000		(800)-868-3153	(800)-868-3153	(313)-664-8000		(313)-664-9050	(888)-658-2536	(313)-664-8000		(800)-868-3153	(800)-868-3153	(313)-664-8000		www.hap.org/medicare	www.hap.org
H2322	003	0	1	04	01	H2322_003_0	6	2009.01	ALLIANCE HEALTH AND LIFE INSURANCE, CO	Alliance Medicare PPO	www.hap.org	01	04		1		H2322	003	0	2009	Alliance Medicare PPO Plan	Southeastern Michigan (9 Counties)		2	2				2						(313)-664-9050	(888)-658-2536	(313)-664-8000		(800)-868-3153	(800)-868-3153	(313)-664-8000										www.hap.org/medicare	www.hap.org
H2322	004	0	1	04	01	H2322_004_0	8	2009.01	ALLIANCE HEALTH AND LIFE INSURANCE, CO	Alliance Medicare PPO	www.hap.org	01	04		1		H2322	004	0	2009	Alliance Medicare PPO Plan	Southeastern Michigan (9 Counties)		2	2				2						(313)-664-9050	(888)-658-2536	(313)-664-8000		(800)-868-3153	(800)-868-3153	(313)-664-8000		(313)-664-9050	(888)-658-2536	(313)-664-8000		(800)-868-3153	(800)-868-3153	(313)-664-8000		www.hap.org/medicare	www.hap.org
H2322	005	0	1	04	01	H2322_005_0	6	2009.01	ALLIANCE HEALTH AND LIFE INSURANCE, CO	Alliance Medicare PPO	www.hap.org	01	04		1		H2322	005	0	2009	Alliance Medicare PPO Value Plan	Southeastern Michigan (9 Counties)		2	2				2						(800)-868-3153	(800)-868-3153	(313)-664-8000		(800)-868-3153	(800)-868-3153	(313)-664-8000										www.hap.org/medicare	www.hap.org
H2322	006	0	1	04	01	H2322_006_0	9	2009.01	ALLIANCE HEALTH AND LIFE INSURANCE, CO	Alliance Medicare PPO	www.hap.org	01	04		1		H2322	006	0	2009	Alliance Medicare PPO Value Plan	Southeastern Michigan (9 Counties)		2	2				2						(313)-664-9050	(888)-658-2536	(313)-664-8000		(800)-868-3153	(800)-868-3153	(313)-664-8000		(313)-664-9050	(888)-658-2536	(313)-664-8000		(800)-868-3153	(800)-868-3153	(313)-664-8000		www.hap.org/medicare	www.hap.org
H2322	007	0	1	04	01	H2322_007_0	8	2009.01	ALLIANCE HEALTH AND LIFE INSURANCE, CO	Alliance Medicare PPO	www.hap.org	01	04		1		H2322	007	0	2009	Alliance Medicare PPO Value Plan	Southeastern Michigan (9 Counties)		2	2				2						(313)-664-9050	(888)-658-2536	(313)-664-8000		(800)-868-3153	(800)-868-3153	(313)-664-8000		(313)-664-9050	(888)-658-2536	(313)-664-8000		(800)-868-3153	(800)-868-3153	(313)-664-8000		www.hap.org/medicare	www.hap.org
H2322	801	0	1	04	01	H2322_801_0	3	2009.01	ALLIANCE HEALTH AND LIFE INSURANCE, CO	Alliance Medicare PPO	www.hap.org	01	04		1		H2322	801	0	2009	Alliance Medicare PPO - Group Only	Southeastern Michigan (9 Counties)		1	2				2						(313)-664-9050	(888)-658-2536	(313)-664-8000		(888)-427-7378	(888)-427-7378	(313)-664-8000										www.hap.org/medicare	www.hap.org
H2322	803	0	1	04	01	H2322_803_0	3	2009.01	ALLIANCE HEALTH AND LIFE INSURANCE, CO	Alliance Medicare PPO	www.hap.org	01	04		1		H2322	803	0	2009	Alliance Medicare PPO - Group Only	Southeastern Michigan (9 Counties)		1	2				2						(313)-664-9050	(888)-658-2536	(313)-664-8000		(888)-427-7378	(888)-427-7378	(313)-664-8000		(313)-664-9050	(888)-658-2536	(313)-664-8000		(888)-427-7378	(888)-427-7378	(313)-664-8000		www.hap.org/medicare	www.hap.org
H2322	804	0	1	04	01	H2322_804_0	3	2009.01	ALLIANCE HEALTH AND LIFE INSURANCE, CO	Alliance Medicare PPO	www.hap.org	01	04		1		H2322	804	0	2009	Alliance Medicare PPO - Group Only	Southeastern Michigan (9 Counties)		1	2				2						(313)-664-9050	(888)-658-2536	(313)-664-8000		(888)-427-7378	(888)-427-7378	(313)-664-8000		(313)-664-9050	(888)-658-2536	(313)-664-8000		(888)-427-7378	(888)-427-7378	(313)-664-8000		www.hap.org/medicare	www.hap.org
H2323	005	0	1	01	01	H2323_005_0	8	2009.01	FIDELIS SECURECARE OF MICHIGAN	Fidelis SecureCare Of Michigan	www.fidelissc.com	01	01		1		H2323	005	0	2009	Fidelis Secure Comfort	Michigan		2	1	1	1		2			1			(877)-372-8085		(888)-844-5530		(877)-372-8085		(888)-844-5530		(877)-372-7948	(877)-372-7948	(888)-844-5530		(877)-372-7948	(877)-372-7948	(888)-844-5530		http://www.fidelissc.com/ourplans/m_partD.asp	www.fidelissc.com
H2323	006	0	1	01	01	H2323_006_0	6	2009.01	FIDELIS SECURECARE OF MICHIGAN	Fidelis SecureCare Of Michigan	www.fidelissc.com	01	01		1		H2323	006	0	2009	Fidelis Secure Comfort Plus	Michigan		2	1	1	1		2			1			(734)-779-1680		(888)-844-5530		(877)-372-8085		(877)-735-8261		(734)-779-1680	(800)-931-7212	(888)-844-5530		(877)-372-8085	(877)-372-8085	(877)-735-8261		http://www.fidelissc.com/ourplans/m_partD.asp	www.fidelissc.com
H2323	007	0	1	01	01	H2323_007_0	6	2009.01	FIDELIS SECURECARE OF MICHIGAN	Fidelis SecureCare Of Michigan	www.fidelissc.com	01	01		1		H2323	007	0	2009	Fidelis Secure Independence	Michigan		2	1	1	2		2			1			(734)-779-1680		(888)-844-5530		(877)-372-8085		(877)-735-8261		(734)-779-1680	(800)-931-7212	(888)-844-5530		(877)-372-8085	(877)-372-8085	(877)-735-8261		http://www.fidelissc.com/ourplans/m_partD.asp	www.fidelissc.com
H2354	001	0	1	01	01	H2354_001_0	5	2009.01	HEALTHPLUS OF MICHIGAN	HealthPlus of Michigan	www.healthplus.org	01	01		1		H2354	001	0	2009	HealthPlus Senior - Option 1	Greater Flint Region		2	2			775	2						(800)-332-9161	(800)-332-9161	(800)-992-5070	(800)-992-5070	(800)-332-9161	(800)-332-9161	(800)-992-5070	(800)-992-5070	(800)-332-9161	(800)-332-9161	(800)-992-5070	(800)-992-5070	(800)-332-9161	(800)-332-9161	(800)-992-5070	(800)-992-5070	http://www.healthplus.org/pdfs/drug_formularies/medicareformularyweb4nov05draft1.pwww.healthplus.com	www.healthplus.org
H2354	013	0	1	01	01	H2354_013_0	5	2009.01	HEALTHPLUS OF MICHIGAN	HealthPlus of Michigan	www.healthplus.org	01	01		1		H2354	013	0	2009	HealthPlus Senior - Option 2	Greater Flint Region		2	2			705	2						(800)-332-9161	(800)-332-9161	(800)-992-5070	(800)-992-5070	(800)-332-9161	(800)-332-9161	(800)-992-5070	(800)-992-5070	(800)-332-9161	(800)-332-9161	(800)-992-5070	(800)-992-5070	(800)-332-9161	(800)-332-9161	(800)-992-5070	(800)-992-5070	http://www.healthplus.org/pdfs/drug_formularies/medicareformularyweb4nov05draft1.pwww.healthplus.com	www.healthplus.org
H2354	801	0	1	01	01	H2354_801_0	3	2009.01	HEALTHPLUS OF MICHIGAN	HealthPlus of Michigan	www.healthplus.org	01	01		1		H2354	801	0	2009	HealthPlus E.G. MA-medical only plan	Greater Flint Region		1	2			2055	2						(800)-332-9161	(800)-332-9161	(800)-992-5070	(800)-992-5070	(800)-332-9161	(800)-332-9161	(800)-992-5070	(800)-992-5070									http://www.healthplus.org/pdfs/drug_formularies/medicareformularyweb4nov05draft1.pwww.healthplus.com	www.healthplus.org
H2354	802	0	1	01	01	H2354_802_0	3	2009.01	HEALTHPLUS OF MICHIGAN	HealthPlus of Michigan	www.healthplus.org	01	01		1		H2354	802	0	2009	HealthPlus E.G. MA-PD Cal	Greater Flint Region		1	2			15	2						(800)-332-9161	(800)-332-9161	(800)-992-5070	(800)-992-5070	(800)-332-9161	(800)-332-9161	(800)-992-5070	(800)-992-5070	(800)-332-9161	(800)-332-9161	(800)-992-5070	(800)-992-5070	(800)-332-9161	(800)-332-9161	(800)-992-5070	(800)-992-5070	http://www.healthplus.org/pdfs/drug_formularies/medicareformularyweb4nov05draft1.pwww.healthplus.com	www.healthplus.org
H2354	803	0	1	01	01	H2354_803_0	3	2009.01	HEALTHPLUS OF MICHIGAN	HealthPlus of Michigan	www.healthplus.org	01	01		1		H2354	803	0	2009	HealthPlus E.G. MA-PD Non-Cal	Michigan		1	2			10	2						(800)-332-9161	(800)-332-9161	(800)-992-5070	(800)-992-5070	(800)-332-9161	(800)-332-9161	(800)-992-5070	(800)-992-5070	(800)-332-9161	(800)-332-9161	(800)-992-5070	(800)-992-5070	(800)-332-9161	(800)-332-9161	(800)-992-5070	(800)-992-5070	http://www.healthplus.org/pdfs/drug_formularies/medicareformularyweb4nov05draft1.pwww.healthplus.com	www.healthplus.org
H2386	001	0	1	20	08	H2386_001_0	3	2009.01	APPALACHIAN AENCY FOR SENIOR CITIZENS, INC.	Appalachian Agency for Senior Citizens, Inc,	www.aasc.org	08	20		1		H2386	001	0	2009	AllCARE for Seniors - Duals	Counties:  Buchanan, Dickenson, Russell, Tazewell		2	2				2														(276)-964-4915	(800)-656-2272			(276)-964-4915	(800)-656-2272			www.aasc.org	
H2386	002	0	1	20	08	H2386_002_0	2	2009.01	APPALACHIAN AENCY FOR SENIOR CITIZENS, INC.	Appalachian Agency for Senior Citizens, Inc,	www.aasc.org	08	20		1		H2386	002	0	2009	AllCARE for Seniors - Medicare only	Counties:  Buchanan, Dickenson, Russell, Tazewell		2	2				2														(276)-964-4915	(800)-656-2272			(276)-964-4915	(800)-656-2272			www.aasc.org	
H2406	001	0	1	04	01	H2406_001_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H2406	001	0	2009	Evercare Plan IP	Cleveland, Cincinnati and Columbus Areas		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H2407	001	0	1	01	01	H2407_001_0	5	2009.01	UCARE MINNESOTA	UCare	www.ucare.org	01	01		1		H2407	001	0	2009	UCare Complete	Minneapolis, St. Paul, and Surrounding Metro		2	1	3			2			1	1		(612)-676-6868	(866)-280-7202	(612)-676-6810	(800)-688-2534	(612)-676-3554	(800)-707-1711	(612)-676-6810	(800)-688-2534	(612)-676-6868	(866)-280-7202	(612)-676-6810	(800)-688-2534	(612)-676-3554	(800)-707-1711	(612)-676-6810	(800)-688-2534	www.ucare.org	www.ucare.org
H2409	003	0	1	09	04	H2409_003_0	6	2009.01	MEDICA HEALTH PLAN S OF WISCONSIN	Medica Health Plans of Wisconsin	www.medica.com	04	09	2	1		H2409	003	0	2009	Medica Advantage Solution Non-Metro Standard	WI Non-Metro Standard		2	2			34	2						(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819									http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2409	006	0	1	09	04	H2409_006_0	10	2009.01	MEDICA HEALTH PLAN S OF WISCONSIN	Medica Health Plans of Wisconsin	www.medica.com	04	09	2	1		H2409	006	0	2009	Medica Advantage Solution Non-Metro Standard w/Rx	WI Non-Metro Standard		2	2			63	2						(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2409	801	0	1	09	04	H2409_801_0	4	2009.01	MEDICA HEALTH PLAN S OF WISCONSIN	Medica Health Plans of Wisconsin	www.medica.com	04	09	2	1		H2409	801	0	2009	Medica Group Advantage Solution - Calendar Rx	National Group PFFS - Calendar Rx		1	2			21	2						(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819	(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819	(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819	(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2409	802	0	1	09	04	H2409_802_0	4	2009.01	MEDICA HEALTH PLAN S OF WISCONSIN	Medica Health Plans of Wisconsin	www.medica.com	04	09	2	1		H2409	802	0	2009	Medica Group Advantage Solution - Contract Rx	National Group PFFS - Contract Rx		1	2			385	2						(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819	(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819	(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819	(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2409	803	0	1	09	04	H2409_803_0	4	2009.01	MEDICA HEALTH PLAN S OF WISCONSIN	Medica Health Plans of Wisconsin	www.medica.com	04	09	2	1		H2409	803	0	2009	Medica Group Advantage Solution - Calendar No Rx	National Group PFFS - NO Rx		1	2			8	2						(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819	(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819									http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2410	001	0	1	09	04	H2410_001_0	5	2009.01	MEDICA HEALTH PLANS	Medica Health Plans	www.medica.com	04	09	2	1		H2410	001	0	2009	Medica Advantage Solution Standard	Select Counties In MN and ND		2	2			641	2						(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819									http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2410	009	0	1	09	04	H2410_009_0	7	2009.01	MEDICA HEALTH PLANS	Medica Health Plans	www.medica.com	04	09	2	1		H2410	009	0	2009	Medica Advantage Solution Choice	Select counties in MN and  ND		2	2			1277	2						(952)-992-2322	(800)-373-8335	(952)-992-2357	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	(952)-992-2322	(800)-373-8335	(952)-992-2357	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2410	015	0	1	09	04	H2410_015_0	9	2009.01	MEDICA HEALTH PLANS	Medica Health Plans	www.medica.com	04	09	2	1		H2410	015	0	2009	Medica Advantage Solution Standard with Rx	Select Counties in MN and ND		2	2			1190	2						(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2410	801	0	1	09	04	H2410_801_0	5	2009.01	MEDICA HEALTH PLANS	Medica Health Plans	www.medica.com	04	09	2	1		H2410	801	0	2009	Medica Group Advantage Solution - Calendar Rx	National Group PFFS - Calendar Rx		1	2			497	2						(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819	(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819	(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819	(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2410	802	0	1	09	04	H2410_802_0	5	2009.01	MEDICA HEALTH PLANS	Medica Health Plans	www.medica.com	04	09	2	1		H2410	802	0	2009	Medica Group Advantage Solution - Contract Rx	National Group PFFS - Contract Rx		1	2			738	2						(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819	(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819	(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819	(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2410	803	0	1	09	04	H2410_803_0	5	2009.01	MEDICA HEALTH PLANS	Medica Health Plans	www.medica.com	04	09	2	1		H2410	803	0	2009	Medica Group Advantage Solution - Calendar No Rx	National Group PFFS - Calendar NO Rx		1	2			8	2						(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819	(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819									http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2411	002	0	1	04	01	H2411_002_0	7	2009.01	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	01	04		1		H2411	002	0	2009	Fallon Senior Plan Preferred Enhanced Rx	WORC county,parts of FRK,HMD,HPS,MSEX,NOF counties		2	2			689	2						(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677	(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677	http://www.fchp.org/Extranet/Seniors/OnlineDrugFormulary.htm	http://www.fchp.org/FindPhysician/location.aspx
H2411	801	0	1	04	01	H2411_801_0	4	2009.01	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	01	04		1		H2411	801	0	2009	PPO MA Only	Full Service Area - Employer Groups		1	2			95	2						(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677									http://www.fchp.org/Extranet/Seniors/OnlineDrugFormulary.htm	http://www.fchp.org/FindPhysician/location.aspx
H2411	803	0	1	04	01	H2411_803_0	4	2009.01	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	01	04		1		H2411	803	0	2009	PPO MA RX Coinsurance - Calendar Year	Full Service Area - Employer Groups		1	2			326	2						(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677	(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677	http://www.fchp.org/Extranet/Seniors/OnlineDrugFormulary.htm	http://www.fchp.org/FindPhysician/location.aspx
H2416	001	0	1	01	01	H2416_001_0	4	2009.01	PRIMEWEST HEALTH SYSTEM	Primewest Health System	http://www.primewest.org	01	01		1		H2416	001	0	2009	PrimeWest Senior Health Complete	West Central and Southwest Minnesota		2	1	3		2075	2			1	1		(320)-335-5219	(800)-366-2906	(800)-627-3529	(800)-627-3529	(320)-335-5219	(800)-366-2906	(800)-627-3529	(800)-627-3529	(320)-335-5219	(800)-366-2906	(800)-627-3529	(800)-627-3529	(320)-335-5219	(800)-366-2906	(800)-627-3529	(800)-627-3529	http://www.myrxassistant.com	http://www.primewest.org/find_doctor.xml
H2417	001	0	1	01	01	H2417_001_0	4	2009.01	ITASCA MEDICAL CARE	Itasca Medical Care	http://www.co.itasca.mn.us/hhs/imcare/	01	01		1		H2417	001	0	2009	IMCare Classic	Itasca, N. Aitkin and S. Koochiching Counties		2	1	3		450	2			1	1		(218)-327-6188	(800)-843-9536	(218)-327-5549		(218)-327-6188	(800)-843-9536	(218)-327-5549		(218)-327-6188	(800)-843-9536	(218)-327-5549		(218)-327-6188	(800)-843-9536	(218)-327-5549		https://www.advancerx.com/advpcsrx_pmwroot/pmwroot/Formulary/00717/IndexForm.jsp	http://www.co.itasca.mn.us/hhs/imcare/providers.htm
H2419	001	0	1	01	01	H2419_001_0	5	2009.01	SOUTH COUNTRY HEALTH ALLIANCE	South Country Health Alliance	www.mnscha.org	01	01		1		H2419	001	0	2009	SeniorCare Complete	Select Counties in Minnesota		2	1	3		2000	2			1	1		(866)-477-1601	(866)-477-1601	(888)-878-0137	(888)-878-0137	(866)-477-1601	(866)-477-1601	(888)-878-0137	(888)-878-0137	(866)-477-1601	(866)-477-1601	(888)-878-0137	(888)-878-0137	(866)-477-1601	(866)-477-1601	(888)-878-0137	(888)-878-0137	https://www.myrxassistant.com/MyRxAssistant/app?service=external/FormularyHomesp=SSCHA	www.mnscha.org
H2422	002	0	1	01	01	H2422_002_0	5	2009.01	GROUP HEALTH	HealthPartners Classic MN Senior Health Options	www.healthpartners.com/medicare	01	01		1		H2422	002	0	2009	Classic Minnesota Senior Health Options	Twin Cities Metropolitian Area		2	1	3		2650	2			1	1		(952)-967-7029	(888)-820-4285	(952)-883-6060	(800)-443-0156	(952)-967-7029	(888)-820-4285	(952)-883-6060	(800)-443-0156	(952)-967-7029	(888)-820-4285	(952)-883-6060	(800)-443-0156	(952)-967-7029	(888)-820-4285	(952)-883-6060	(800)-443-0156	http://www.healthpartners.com/formulary/medicare.do	www.healthpartners.com/medicare
H2424	001	0	1	01	01	H2424_001_0	3	2009.01	FIRST PLAN OF MINNESOTA	FirstPlan Blue	www.firstplan.org	01	01		1		H2424	001	0	2009	First Plan Blue - MSHO	Northeastern Minnesota		2	1	3		1012	2			1	1		(877)-268-2997	(877)-268-2997	(218)-727-9870		(877)-268-2997	(877)-268-2997	(218)-727-9870		(877)-268-2997	(877)-268-2997	(218)-727-9870		(877)-268-2997	(877)-268-2997	(218)-727-9870		https://myrxassistant.com/MyRxAssistant/formulary/FirstPlan	www.firstplan.org
H2425	001	0	1	01	01	H2425_001_0	6	2009.01	BLUE PLUS	Blue Plus	www.bluecrossmn.com	01	01		1		H2425	001	0	2009	SecureBlue	56 Counties within the State of Minnesota		2	1	3		10327	2			1	1		(651)-662-6013	(888)-740-6013	(651)-662-8700	(888)-878-0137	(651)-662-3584	(866)-477-1584	(651)-662-8700	(888)-878-0137	(651)-662-6013	(888)-740-6013	(651)-662-8700	(888)-878-0137	(651)-662-3584	(866)-477-1584	(651)-662-8700	(888)-878-0137	www.bluecrossmn.com	www.bluecrossmn.com
H2450	001	0	1	18	06	H2450_001_0	12	2009.01	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	06	18		1		H2450	001	0	2009	Medica Prime Solution Basic w/Std Rx - MN	Select Counties in MN		2	2			5520	2						(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2450	002	0	1	18	06	H2450_002_0	11	2009.01	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	06	18		1		H2450	002	0	2009	Medica Prime Solution Enhanced w/Std. Rx - MN	Select Counties in MN		2	2			17175	2						(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2450	005	0	1	18	06	H2450_005_0	12	2009.01	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	06	18		1		H2450	005	0	2009	Medica Prime Solution Basic w/Enhanced Rx - MN	Select Counties in MN		2	2			419	2						(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2450	006	0	1	18	06	H2450_006_0	11	2009.01	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	06	18		1		H2450	006	0	2009	Medica Prime Solution Enhanced w/Enhanced Rx- MN	Select Counties in MN		2	2			3074	2						(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2450	007	0	1	18	06	H2450_007_0	9	2009.01	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	06	18		1		H2450	007	0	2009	Medica Prime Solution Value	Slelect counties in MN, SD, ND and WI		2	2			9	2						(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2450	008	0	1	18	06	H2450_008_0	8	2009.01	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	06	18		1		H2450	008	0	2009	Medica Prime Solution Basic w/Standard Rx - WI	Select Counties in Wisconsin		2	2			39	2						(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2450	009	0	1	18	06	H2450_009_0	7	2009.01	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	06	18		1		H2450	009	0	2009	Medica Prime Solution Enhanced w/Enhanced Rx - WI	Select counties in Wisconsin		2	2			108	2						(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2450	010	0	1	18	06	H2450_010_0	7	2009.01	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	06	18		1		H2450	010	0	2009	Medica Prime Solution Basic w/Enhanced Rx - WI	Select Counties in Wisconsin		2	2			3	2						(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2450	011	0	1	18	06	H2450_011_0	7	2009.01	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	06	18		1		H2450	011	0	2009	Medica Prime Solution Enhanced w/Standard Rx - WI	Select Counties in Wisconsin		2	2			546	2						(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2450	012	0	1	18	06	H2450_012_0	6	2009.01	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	06	18		1		H2450	012	0	2009	Medica Prime Solution Basic w/Standard Rx - ND/SD	Select Counties in North Dakota and South Dakota		2	2			21	2						(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2450	013	0	1	18	06	H2450_013_0	7	2009.01	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	06	18		1		H2450	013	0	2009	Medica Prime Solution Basic w/Enhanced Rx - ND/SD	Select Counties in North Dakota and South Dakota		2	2			3	2						(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2450	014	0	1	18	06	H2450_014_0	7	2009.01	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	06	18		1		H2450	014	0	2009	Medica Prime Solution Enhanced w/Std Rx - ND/SD	Select counties in North and South Dakota		2	2			118	2						(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2450	015	0	1	18	06	H2450_015_0	6	2009.01	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	06	18		1		H2450	015	0	2009	Medica Prime Sol. Enhanced w/Enhanced Rx - ND/SD	Select Counties in North and South Dakota		2	2			27	2						(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2345	(800)-906-5432	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2450	801	0		18	06	H2450_801_0	1	2009.01	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	06	18				H2450	801	0	2009	Medica Group Prime Solution- Calendar Rx	Select MN, ND , SD and Wisconsin counties		1	2										(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819		(800)-575-2330	(952)-992-3650	(800)-234-8819	(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819	(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2450	802	0		18	06	H2450_802_0	1	2009.01	MEDICA INSURANCE COMPANY	Medica Insurance Company	www.medica.com	06	18				H2450	802	0	2009	Medica Group Prime Solution- Contract Rx	Select MN, ND , SD and WI counties		1	2										(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819		(800)-575-2330	(952)-992-3650	(800)-234-8819	(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819	(952)-992-2330	(800)-575-2330	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	
H2456	002	0	1	01	01	H2456_002_0	6	2009.01	UCARE MINNESOTA	UCare	www.ucare.org	01	01		1		H2456	002	0	2009	UCare's Minnesota Senior Health Options	Minneapolis, St. Paul, and Greater Minnesota Area		2	1	3			2			1	1		(612)-676-6868	(866)-280-7202	(612)-676-6810	(800)-688-2534	(612)-676-3554	(800)-707-1711	(612)-676-6810	(800)-688-2534	(612)-676-6868	(866)-280-7202	(612)-676-6810	(800)-688-2534	(612)-676-3554	(800)-707-1711	(612)-676-6810	(800)-688-2534	www.ucare.org	www.ucare.org
H2457	002	0	1	01	01	H2457_002_0	3	2009.01	METROPOLITAN HEALTH PLAN	Metropolitan Health Plan MSHO	www.mhp4life.org	01	01		1		H2457	002	0	2009	MHP-MSHO	Minnesota		2	1	3		850	2			1	1		(888)-562-8000	(888)-562-8000	(800)-627-3529	(800)-627-3529	(866)-897-9958	(866)-897-9958	(800)-627-3529		(888)-562-8000	(888)-562-8000	(800)-627-3529	(800)-627-3529	(866)-897-9958	(866)-897-9958	(800)-627-3529	(800)-627-3529	http://northstaradvantageplus.medicareplanrx.com	www.mhp4life.org
H2458	002	0	1	01	01	H2458_002_0	6	2009.01	MEDICA HEALTH PLANS	Medica Health Plans	www.medica.com	01	01		1		H2458	002	0	2009	Medica Dual Solution	Specific Minnesota Counties		2	1	3		9341	2			1	1		(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2030	(800)-266-2157	(952)-992-3650	(800)-234-8819	(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2030	(800)-266-2157	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	https://www.medica.com/C11/FindADoctor/default.aspx
H2459	001	0	1	02	01	H2459_001_0	3	2009.01	UCARE MINNESOTA	UCare	www.ucare.org	01	02		1		H2459	001	0	2009	UCare for Seniors Value	Twin Cities and St. Cloud Area (16 counties)		2	2				2						(612)-676-3600	(877)-523-1515	(612)-676-6810	(800)-688-2534	(612)-676-3500	(877)-523-1518	(612)-676-6810	(800)-688-2534									www.ucare.org	www.ucare.org
H2459	002	0	1	02	01	H2459_002_0	5	2009.01	UCARE MINNESOTA	UCare	www.ucare.org	01	02		1		H2459	002	0	2009	UCare for Seniors Classic	Twin Cities and St. Cloud Area (16 counties)		2	2				2						(612)-676-3600	(877)-523-1515	(612)-676-6810	(800)-688-2534	(612)-676-3500	(877)-523-1518	(612)-676-6810	(800)-688-2534	(612)-676-3600	(877)-523-1515	(612)-676-6810	(800)-688-2534	(612)-676-3500	(877)-523-1518	(612)-676-6810	(800)-688-2534	www.ucare.org	www.ucare.org
H2459	005	0	1	02	01	H2459_005_0	3	2009.01	UCARE MINNESOTA	UCare	www.ucare.org	01	02		1		H2459	005	0	2009	UCare for Seniors Value	Greater Minnesota (71 Counties)		2	2				2						(612)-676-3600	(877)-523-1515	(612)-676-6810	(800)-688-2534	(612)-676-3500	(877)-523-1518	(612)-676-6810	(800)-688-2534									www.ucare.org	www.ucare.org
H2459	006	0	1	02	01	H2459_006_0	5	2009.01	UCARE MINNESOTA	UCare	www.ucare.org	01	02		1		H2459	006	0	2009	UCare for Seniors Classic	Greater Minnesota (71 Counties)		2	2				2						(612)-676-3600	(877)-523-1515	(612)-676-6810	(800)-688-2534	(612)-676-3500	(877)-523-1518	(612)-676-6810	(800)-688-2534	(612)-676-3600	(877)-523-1515	(612)-676-6810	(800)-688-2534	(612)-676-3500	(877)-523-1518	(612)-676-6810	(800)-688-2534	www.ucare.org	www.ucare.org
H2459	013	0	1	02	01	H2459_013_0	5	2009.01	UCARE MINNESOTA	UCare	www.ucare.org	01	02		1		H2459	013	0	2009	UCare for Seniors Value Plus	Twin Cities and St. Cloud Area (16 counties)		2	2				2						(612)-676-3600	(877)-523-1515	(612)-676-6810	(800)-688-2534	(612)-676-3500	(877)-523-1518	(612)-676-6810	(800)-688-2534	(612)-676-3600	(877)-523-1515	(612)-676-6810	(800)-688-2534	(612)-676-3500	(877)-523-1518	(612)-676-6810	(800)-688-2534	www.ucare.org	www.ucare.org
H2459	014	0	1	02	01	H2459_014_0	4	2009.01	UCARE MINNESOTA	UCare	www.ucare.org	01	02		1		H2459	014	0	2009	UCare for Seniors Value Plus	Greater Minnesota  (71 Counties)		2	2				2						(612)-676-3600	(877)-523-1515	(612)-676-6810	(800)-688-2534	(612)-676-3500	(877)-523-1518	(612)-676-6810	(800)-688-2534	(612)-676-3600	(877)-523-1515	(612)-676-6810	(800)-688-2534	(612)-676-3500	(877)-523-1518	(612)-676-6810	(800)-688-2534	www.ucare.org	www.ucare.org
H2459	016	0	1	01	01	H2459_016_0	5	2009.01	UCARE MINNESOTA	UCare	www.ucare.org	01	01		1		H2459	016	0	2009	UCare Connect	Greater Minnesota Area		2	1	3			2			1	1		(612)-676-6868	(866)-280-7202	(612)-676-6810	(800)-688-2534	(612)-676-3554	(800)-707-1711	(612)-676-6810	(800)-688-2534	(612)-676-6868	(866)-280-7202	(612)-676-6810	(800)-688-2534	(612)-676-3554	(800)-707-1711	(612)-676-6810	(800)-688-2534	www.ucare.org	www.ucare.org
H2459	017	0	1	01	01	H2459_017_0	4	2009.01	UCARE MINNESOTA	UCare	www.ucare.org	01	01		1		H2459	017	0	2009	UCare Secure	Metro and Greater Minnesota Counties - 12 Counties		2	1	4			2			1		1110011010000000100000000001	(612)-676-3600	(877)-523-1515	(612)-676-6810	(800)-688-2534	(612)-676-3500	(877)-523-1518	(612)-676-6810	(800)-688-2534	(612)-676-3600	(877)-523-1515	(612)-676-6810	(800)-688-2534	(612)-676-3500	(877)-523-1518	(612)-676-6810	(800)-688-2534	www.ucare.org	www.ucare.org
H2459	801	0	1	02	01	H2459_801_0	2	2009.01	UCARE MINNESOTA	UCare	www.ucare.org	01	02		1		H2459	801	0	2009	UCare for Seniors Employer and Union Plans	Upper Midwest		1	2				2						(612)-676-6840	(877)-447-4385	(612)-676-6810	(800)-688-2534	(612)-676-6900	(877)-598-6574	(612)-676-6810	(800)-688-2534	(612)-676-6840	(877)-447-4385	(612)-676-6810	(800)-688-2534	(612)-676-6900	(877)-598-6574	(612)-676-6810	(800)-688-2534	www.ucare.org	www.ucare.org
H2459	803	0	1	02	01	H2459_803_0	2	2009.01	UCARE MINNESOTA	UCare	www.ucare.org	01	02		1		H2459	803	0	2009	UCare for Seniors Employers Non Calendar	Upper Midwest		1	2				2						(612)-676-6840	(877)-447-4385	(612)-676-6810	(800)-688-2534	(612)-676-6900	(877)-598-6574	(612)-676-6810	(800)-688-2534	(612)-676-6840	(877)-447-4385	(612)-676-6810	(800)-688-2534	(612)-676-6900	(877)-598-6574	(612)-676-6810	(800)-688-2534	www.ucare.org	www.ucare.org
H2461	005	0	1	18	06	H2461_005_0	6	2009.01	BLUE CROSS BLUE SHIELD OF MINNESOTA	Blue Cross Blue Shield of Minnesota	www.bluecrossmn.com	06	18		1		H2461	005	0	2009	VantageBlue Value Option	State of Minnesota		2	2			1000	2						(651)-662-5020	(800)-531-6686	(888)-878-0137	(888)-878-0137	(800)-711-9874	(800)-711-9874	(888)-878-0137	(888)-878-0137									www.bluecrossmn.com	
H2461	006	0	1	18	06	H2461_006_0	6	2009.01	BLUE CROSS BLUE SHIELD OF MINNESOTA	Blue Cross Blue Shield of Minnesota	www.bluecrossmn.com	06	18		1		H2461	006	0	2009	VantageBlue Standard Option	State of Minnesota		2	2			1000	2						(651)-662-5020	(800)-531-6686	(888)-878-0137	(888)-878-0137	(800)-711-9874	(800)-711-9874	(888)-878-0137	(888)-878-0137									www.bluecrossmn.com	
H2462	004	0	1	18	06	H2462_004_0	1	2009.01	HEALTHPARTNERS	HealthPartners Freedom Plan	healthpartners.com/medicare	06	18		1		H2462	004	0	2009	HealthPartners Freedom Plan I	State of Minnesota		2	2				2						(952)-883-7979	(800)-233-9645	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156									healthpartners.com/formulary/medicare.do	
H2462	007	0	1	18	06	H2462_007_0	2	2009.01	HEALTHPARTNERS	HealthPartners Freedom Plan	healthpartners.com/medicare	06	18		1		H2462	007	0	2009	HealthPartners Freedom Plan II	State of Minnesota		2	2				2						(952)-883-7979	(800)-233-9645	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156									healthpartners.com/portal/3212.html	
H2462	008	0	1	18	06	H2462_008_0	5	2009.01	HEALTHPARTNERS	HealthPartners Freedom Plan	healthpartners.com/medicare	06	18		1		H2462	008	0	2009	HealthPartners Freedom Plan II Standard Rx	State of Minnesota		2	2				2						(952)-883-7979	(800)-233-9645	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156	(952)-883-7979	(800)-233-9645	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156	healthpartners.com/portal/3212.html	
H2462	009	0	1	18	06	H2462_009_0	4	2009.01	HEALTHPARTNERS	HealthPartners Freedom Plan	healthpartners.com/medicare	06	18		1		H2462	009	0	2009	HealthPartners Freedom Plan II Enhanced Rx	State of Minnesota		2	2				2						(952)-883-7979	(800)-233-9645	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156	(952)-883-7979	(800)-233-9645	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156	healthpartners.com/portal/3212.html	
H2462	010	0	1	18	06	H2462_010_0	1	2009.01	HEALTHPARTNERS	HealthPartners Freedom Plan	healthpartners.com/medicare	06	18		1		H2462	010	0	2009	HealthPartners Freedom Plan III	State of Minnesota		2	2				2						(952)-883-7979	(800)-233-9645	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156									healthpartners.com/formulary/medicare.do	
H2462	011	0	1	18	06	H2462_011_0	4	2009.01	HEALTHPARTNERS	HealthPartners Freedom Plan	healthpartners.com/medicare	06	18		1		H2462	011	0	2009	HealthPartners Freedom Plan III StandardRx	State of Minnesota		2	2				2						(952)-883-7979	(800)-233-9645	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156	(952)-883-7979	(800)-233-9645	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156	healthpartners.com/portal/3212.html	
H2462	012	0	1	18	06	H2462_012_0	3	2009.01	HEALTHPARTNERS	HealthPartners Freedom Plan	healthpartners.com/medicare	06	18		1		H2462	012	0	2009	HealthPartners Freedom Plan III EnhancedRx	State of Minnesota		2	2				2						(952)-883-7979	(800)-233-9645	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156	(952)-883-7979	(800)-233-9645	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156	healthpartners.com/portal/3212.html	
H2462	013	0	1	18	06	H2462_013_0	3	2009.01	HEALTHPARTNERS	HealthPartners Freedom Plan	healthpartners.com/medicare	06	18		1		H2462	013	0	2009	HealthPartners Freedom II Std Plus Rx	State of Minnesota		2	2				2						(952)-883-7979	(800)-233-9645	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156	(952)-883-7979	(800)-233-9645	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156	healthpartners.com/portal/3212.html	
H2462	014	0	1	18	06	H2462_014_0	2	2009.01	HEALTHPARTNERS	HealthPartners Freedom Plan	healthpartners.com/medicare	06	18		1		H2462	014	0	2009	HealthPartners Freedom III Std Plus Rx	State of Minnesota		2	2				2						(952)-883-7979	(800)-233-9645	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156	(952)-883-7979	(800)-233-9645	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156	healthpartners.com/portal/3212.html	
H2462	015	0	1	18	06	H2462_015_0	1	2009.01	HEALTHPARTNERS	HealthPartners Freedom Plan	healthpartners.com/medicare	06	18		1		H2462	015	0	2009	Wisconsin Freedom Plan I	Western Wisconsin		2	2				2						(952)-883-7979	(800)-233-9645	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156									healthpartners.com/formulary/medicare.do	
H2462	016	0	1	18	06	H2462_016_0	1	2009.01	HEALTHPARTNERS	HealthPartners Freedom Plan	healthpartners.com/medicare	06	18		1		H2462	016	0	2009	Wisconsin Freedom Plan II	Western Wisconsin		2	2				2						(952)-883-7979	(800)-233-9645	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156									healthpartners.com/formulary/medicare.do	
H2462	017	0	1	18	06	H2462_017_0	3	2009.01	HEALTHPARTNERS	HealthPartners Freedom Plan	healthpartners.com/medicare	06	18		1		H2462	017	0	2009	Wisconsin Plan II Standard Rx	Western Wisconsin		2	2				2						(952)-883-7979	(800)-233-9645	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156	(952)-883-7979	(800)-233-9645	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156	healthpartners.com/portal/3212.html	
H2462	801	0		18	06	H2462_801_0	2	2009.01	HEALTHPARTNERS	HealthPartners Freedom Plan	healthpartners.com/medicare	06	18				H2462	801	0	2009	HealthPartners Freedom Calendar Year	State of MN Western Wisconsin		1	2										(952)-883-7979	(800)-233-9645	(952)-883-6060	(800)-443-0156		(800)-247-7015	(952)-883-6060	(800)-443-0156	(952)-883-7979	(800)-233-9645	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156	healthpartners.com/formulary/medicare.do	
H2462	802	0		18	06	H2462_802_0	1	2009.01	HEALTHPARTNERS	HealthPartners Freedom Plan	healthpartners.com/medicare	06	18				H2462	802	0	2009	HealthPartners Freedom Non-Calendar Year	State of MN Western Wisconsin		1	2										(952)-883-7979	(800)-233-9645	(952)-883-6060	(800)-443-0156		(800)-247-7015	(952)-883-6060	(800)-443-0156	(952)-883-7979	(800)-233-9645	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156	healthpartners.com/formulary/medicare.do	
H2481	003	0	1	04	01	H2481_003_0	4	2009.01	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	http://www.caresourcehp.org	01	04		1		H2481	003	0	2009	CareSource Diamond PPO	Counties: JO, JA*, DO*, CO, CU.		2	2			12	2						(541)-471-4106	(888)-460-0185	(800)-735-2900	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-2900	(800)-735-2900									http://www.caresourcehp.com/plans/formularies/formularyindex.php	http://www.caresourcehp.com/provnet/provnet.php
H2481	004	0	1	04	01	H2481_004_0	7	2009.01	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	http://www.caresourcehp.org	01	04		1		H2481	004	0	2009	CareSource Diamond PPO Plus Rx	Counties: JO, JA*, DO*, CO, CU.		2	2			35	2						(541)-471-4106	(888)-460-0185	(800)-735-2900	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-2900	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-2900	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-2900	(800)-735-2900	http://www.caresourcehp.com/plans/formularies/formularyindex.php	http://www.caresourcehp.com/provnet/provnet.php
H2481	005	0	1	04	01	H2481_005_0	5	2009.01	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	http://www.caresourcehp.org	01	04		1		H2481	005	0	2009	CareSource Diamond PPO	Jackson County* Excl Rogue River OR, Gold Hill OR.		2	2			39	2						(541)-471-4106	(888)-460-0185	(800)-735-2900	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-2900	(800)-735-2900									http://www.caresourcehp.com/plans/formularies/formularyindex.php	http://www.caresourcehp.com/provnet/provnet.php
H2481	006	0	1	04	01	H2481_006_0	7	2009.01	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	http://www.caresourcehp.org	01	04		1		H2481	006	0	2009	CareSource Diamond PPO Plus Rx	Jackson County* Excl Rogue River OR, Gold Hill OR.		2	2			118	2						(541)-471-4106	(888)-460-0185	(800)-735-2900	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-2900	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-2900	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-2900	(800)-735-2900	http://www.caresourcehp.com/plans/formularies/formularyindex.php	http://www.caresourcehp.com/provnet/provnet.php
H2486	002	0	1	01	01	H2486_002_0	6	2009.01	HUMANA MEDICAL PLAN OF UTAH	Humana Medical Plan of Utah	www.humana-medicare.com	01	01		1		H2486	002	0	2009	Humana Gold Plus HMO H2486-002	Davis, Salt Lake, Utah, Weber		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301		(800)-833-2364	(800)-833-2364	(877)-833-4486		(800)-457-4708	(800)-457-4708	(800)-833-3301		(800)-833-2364	(800)-833-2364	(877)-833-4486		http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2486	801	0	1	01	01	H2486_801_0	1	2009.01	HUMANA MEDICAL PLAN OF UTAH	Humana Medical Plan of Utah	www.humana-medicare.com	01	01		1		H2486	801	0	2009	Humana Employer Sponsored	Utah		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301		(800)-833-2364	(800)-833-2364	(877)-833-4486		(800)-457-4708	(800)-457-4708	(800)-833-3301		(800)-833-2364	(800)-833-2364	(877)-833-4486		http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2486	802	0	1	01	01	H2486_802_0	1	2009.01	HUMANA MEDICAL PLAN OF UTAH	Humana Medical Plan of Utah	www.humana-medicare.com	01	01		1		H2486	802	0	2009	Humana Employer Sponsored	Utah		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301		(800)-833-2364	(800)-833-2364	(877)-833-4486										http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2486	803	0	1	01	01	H2486_803_0	1	2009.01	HUMANA MEDICAL PLAN OF UTAH	Humana Medical Plan of Utah	www.humana-medicare.com	01	01		1		H2486	803	0	2009	Humana Employer Sponsored Non-CY	Utah		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301		(800)-833-2364	(800)-833-2364	(877)-833-4486		(800)-457-4708	(800)-457-4708	(800)-833-3301		(800)-833-2364	(800)-833-2364	(877)-833-4486		http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2486	804	0	1	01	01	H2486_804_0	1	2009.01	HUMANA MEDICAL PLAN OF UTAH	Humana Medical Plan of Utah	www.humana-medicare.com	01	01		1		H2486	804	0	2009	Humana Employer Sponsored Non-CY	Utah		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301		(800)-833-2364	(800)-833-2364	(877)-833-4486										http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2491	001	0	1	01	01	H2491_001_0	9	2009.01	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcare.com	01	01		1		H2491	001	0	2009	'Ohana Reserve	Honolulu County		2	2				2						(866)-687-8815	(866)-687-8815	(877)-247-6272		(866)-360-8153	(866)-360-8153	(877)-247-6272		(866)-687-8815	(866)-687-8815	(877)-247-6272		(866)-360-8153	(866)-360-8153	(877)-247-6272		www.wellcare.com	www.wellcare.com
H2491	002	0	1	01	01	H2491_002_0	9	2009.01	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	WellCare	www.wellcare.com	01	01		1		H2491	002	0	2009	'Ohana Value	Honolulu County		2	2				2						(866)-687-8815	(866)-687-8815	(877)-247-6272		(866)-360-8153	(866)-360-8153	(877)-247-6272		(866)-687-8815	(866)-687-8815	(877)-247-6272		(866)-360-8153	(866)-360-8153	(877)-247-6272		www.wellcare.com	www.wellcare.com
H2537	001	0	1	20	08	H2537_001_0	1	2009.01	LIFE LUTHERAN	LIFE Lutheran Services, Inc.	www.lifelutheranservices.org	08	20		1		H2537	001	0	2009	LIFE Lutheran - Dual	Franklin County		2	2				2														(717)-264-5433	(877)-543-0000			(717)-264-5433	(877)-543-0000			www.lifelutheranservices.com	
H2537	002	0	1	20	08	H2537_002_0	1	2009.01	LIFE LUTHERAN	LIFE Lutheran Services, Inc.	www.lifelutheranservices.org	08	20		1		H2537	002	0	2009	LIFE Lutheran - Medicare Only	Franklin County		2	2				2														(717)-264-5433	(877)-543-0000			(717)-264-5433	(877)-543-0000			www.lifelutheranservices.com	
H2542	001	0	1	04	01	H2542_001_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H2542	001	0	2009	HumanaChoicePPO PPO H2542-001	Richmond Metro Areas		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2542	002	0	1	04	01	H2542_002_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H2542	002	0	2009	HumanaChoicePPO PPO H2542-002	Virginia Beach/Norfolk Metro Areas		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2542	801	0	1	04	01	H2542_801_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H2542	801	0	2009	Humana Employer Sponsored	Select Counties in Virginia		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2542	802	0	1	04	01	H2542_802_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H2542	802	0	2009	Humana Employer Sponsored	Select counties in Virginia		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2542	803	0	1	04	01	H2542_803_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H2542	803	0	2009	Humana Employer Sponsored Non-CY	Select counties in Virginia		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2542	804	0	1	04	01	H2542_804_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H2542	804	0	2009	Humana Employer Sponsored Non-CY	Select counties in Virginia		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2609	001	0	1	20	08	H2609_001_0	2	2009.01	ALEXIAN BROTHERS COMMUNITY SERVICES	Alexian Brothers Community Services	cwalters@alexianbrothers.net	08	20		1		H2609	001	0	2009	Dual Eligibles	St. Louis City and St. Louis County		2	2				2														(314)-771-5800	(314)-771-5800			(314)-771-5800	(314)-771-5800			cwalters@alexianbrothers.net	
H2609	002	0	1	20	08	H2609_002_0	2	2009.01	ALEXIAN BROTHERS COMMUNITY SERVICES	Alexian Brothers Community Services	cwalters@alexianbrothers.net	08	20		1		H2609	002	0	2009	Medicare Only	St. Louis City and St. Louis County		2	2				2														(314)-771-5800	(314)-771-5800			(314)-771-5800	(314)-771-5800			cwalters@alexianbrothers.net	
H2610	005	0	1	01	01	H2610_005_0	8	2009.01	ESSENCE L.L.P.	Essence Healthcare	www.essencehealthcare.com	01	01		1		H2610	005	0	2009	Essence Advantage	St. Louis Metropolitan Area		2	2			16315	2						(314)-851-3600	(866)-597-9560	(314)-851-3601	(866)-597-9561	(314)-851-3600	(866)-597-9560	(314)-851-3601	(866)-597-9561	(314)-851-3600	(866)-597-9560	(314)-851-3601	(866)-597-9561	(314)-851-3600	(866)-597-9560	(314)-851-3601	(866)-597-9561	www.essencehealthcare.com	www.essencehealthcare.com
H2610	006	0	1	01	01	H2610_006_0	8	2009.01	ESSENCE L.L.P.	Essence Healthcare	www.essencehealthcare.com	01	01		1		H2610	006	0	2009	Essence Advantage Plus	St. Louis Metropolitan Area		2	2			1041	2						(314)-851-3600	(866)-597-9560	(314)-851-3601	(866)-597-9561	(314)-851-3600	(866)-597-9560	(314)-851-3601	(866)-597-9561	(314)-851-3600	(866)-597-9560	(314)-851-3601	(866)-597-9561	(314)-851-3600	(866)-597-9560	(314)-851-3601	(866)-597-9561	www.essencehealthcare.com	www.essencehealthcare.com
H2610	010	0	1	01	01	H2610_010_0	8	2009.01	ESSENCE L.L.P.	Essence Healthcare	www.essencehealthcare.com	01	01		1		H2610	010	0	2009	Essence Advantage Special Needs Plan	St. Louis Metropolitan Area		2	1	4		604	2			1		0000000010000000000000000000	(314)-851-3600	(866)-597-9560	(314)-851-3601	(866)-597-9561	(314)-851-3600	(866)-597-9560	(314)-851-3601	(866)-597-9561	(314)-851-3600	(866)-597-9560	(314)-851-3601	(866)-597-9561	(314)-851-3600	(866)-597-9560	(314)-851-3601	(866)-597-9561	www.essencehealthcare.com	www.essencehealthcare.com
H2610	803	0	1	01	01	H2610_803_0	1	2009.01	ESSENCE L.L.P.	Essence Healthcare	www.essencehealthcare.com	01	01		1		H2610	803	0	2009	Essence Advantage Employer Group Plan	St. Louis Metropolitan Area		1	2			50	2						(314)-851-3600	(866)-597-9560	(314)-851-3601	(866)-597-9561	(314)-851-3600	(866)-597-9560	(314)-851-3601	(866)-597-9561	(314)-851-3600	(866)-597-9560	(314)-851-3601	(866)-597-9561	(314)-851-3600	(866)-597-9560	(314)-851-3601	(866)-597-9561	www.essencehealthcare.com	www.essencehealthcare.com
H2610	804	0	1	01	01	H2610_804_0	1	2009.01	ESSENCE L.L.P.	Essence Healthcare	www.essencehealthcare.com	01	01		1		H2610	804	0	2009	Essence Advantage Employer Group Plan non-calendar	St. Louis Metropolitan Area		1	2			50	2						(314)-851-3600	(866)-597-9560	(314)-851-3601	(866)-597-9561	(314)-851-3600	(866)-597-9560	(314)-851-3601	(866)-597-9561	(314)-851-3600	(866)-597-9560	(314)-851-3601	(866)-597-9561	(314)-851-3600	(866)-597-9560	(314)-851-3601	(866)-597-9561	www.essencehealthcare.com	www.essencehealthcare.com
H2611	001	0	1	04	01	H2611_001_0	9	2009.01	MERCY HEALTH PLANS	Mercy Health Plans	www.medicare.mercyhealthplans.com	01	04		1		H2611	001	0	2009	Mercy MedicareADVANTAGE PPO	St. Louis Metro		2	2				2						(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	http://www.medicare.mercyhealthplans.com/about/products/medicarepartd.aspx	www.medicare.mercyhealthplans.com
H2611	002	0	1	04	01	H2611_002_0	9	2009.01	MERCY HEALTH PLANS	Mercy Health Plans	www.medicare.mercyhealthplans.com	01	04		1		H2611	002	0	2009	Mercy MedicareADVANTAGE PPO	Southwest Missouri		2	2				2						(417)-836-0429	(866)-875-0189	(417)-837-0249	(800)-446-1468	(417)-837-0200	(800)-330-8449	(417)-837-0249	(800)-446-1468	(417)-836-0429	(866)-875-0189	(417)-837-0249	(800)-446-1468	(417)-837-0200	(800)-330-8449	(417)-837-0249	(800)-446-1468	http://www.medicare.mercyhealthplans.com/about/products/medicarepartd.aspx	www.medicare.mercyhealthplans.com
H2611	003	0	1	04	01	H2611_003_0	8	2009.01	MERCY HEALTH PLANS	Mercy Health Plans	www.medicare.mercyhealthplans.com	01	04		1		H2611	003	0	2009	Mercy MedicareADVANTAGE PPO	Southwest Missouri - Joplin		2	2				2						(417)-836-0429	(866)-875-0189	(417)-837-0249	(800)-446-1468	(417)-837-0266	(800)-481-4466	(417)-837-0249	(800)-446-1468	(417)-836-0429	(866)-875-0189	(417)-837-0249	(800)-446-1468	(417)-837-0266	(800)-481-4466	(417)-837-0249	(800)-446-1468	http://www.medicare.mercyhealthplans.com/about/products/medicarepartd.aspx	www.medicare.mercyhealthplans.com
H2611	005	0	1	04	01	H2611_005_0	6	2009.01	MERCY HEALTH PLANS	Mercy Health Plans	www.medicare.mercyhealthplans.com	01	04		1		H2611	005	0	2009	Mercy MedicareADVANTAGE PPO (no drug)	Southwest Missouri		2	2				2						(417)-836-0429	(866)-875-0189	(417)-837-0249	(800)-446-1468	(417)-837-0200	(800)-330-8449	(417)-837-0249	(800)-446-1468									http://www.medicare.mercyhealthplans.com/about/products/medicarepartd.aspx	www.medicare.mercyhealthplans.com
H2611	006	0	1	04	01	H2611_006_0	6	2009.01	MERCY HEALTH PLANS	Mercy Health Plans	www.medicare.mercyhealthplans.com	01	04		1		H2611	006	0	2009	Mercy MedicareADVANTAGE PPO no Rx	Southwest Missouri - Joplin (no drug)		2	2				2						(417)-836-0429	(866)-875-0189	(417)-837-0249	(800)-446-1468	(417)-837-0200	(800)-330-8449	(417)-837-0249	(800)-446-1468									http://www.medicare.mercyhealthplans.com/about/products/medicarepartd.aspx	www.medicare.mercyhealthplans.com
H2611	008	0	1	04	01	H2611_008_0	8	2009.01	MERCY HEALTH PLANS	Mercy Health Plans	www.medicare.mercyhealthplans.com	01	04		1		H2611	008	0	2009	Mercy MedicareADVANTAGE PPO AR	NW and Central Arkansas		2	2				2						(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	http://www.medicare.mercyhealthplans.com/about/products/medicarepartd.aspx	www.medicare.mercyhealthplans.com
H2611	010	0	1	04	01	H2611_010_0	4	2009.01	MERCY HEALTH PLANS	Mercy Health Plans	www.medicare.mercyhealthplans.com	01	04		1		H2611	010	0	2009	Mercy MedicareADVANTAGE PPO AR no RX	NW and Central AR		2	2				2						(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418									http://www.medicare.mercyhealthplans.com/about/products/medicarepartd.aspx	www.medicare.mercyhealthplans.com
H2611	012	0	1	04	01	H2611_012_0	6	2009.01	MERCY HEALTH PLANS	Mercy Health Plans	www.medicare.mercyhealthplans.com	01	04		1		H2611	012	0	2009	Mercy MedicareADVANTAGE PPO Plan 2	St. Louis Metro		2	2				2						(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	http://www.medicare.mercyhealthplans.com/about/products/medicarepartd.aspx	www.medicare.mercyhealthplans.com
H2611	016	0	1	04	01	H2611_016_0	7	2009.01	MERCY HEALTH PLANS	Mercy Health Plans	www.medicare.mercyhealthplans.com	01	04		1		H2611	016	0	2009	Mercy MedicareADVANTAGE PPO AR Plan 2	NW and Central AR		2	2				2						(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	http://www.medicare.mercyhealthplans.com/about/products/medicarepartd.aspx	www.medicare.mercyhealthplans.com
H2611	801	0	1	04	01	H2611_801_0	3	2009.01	MERCY HEALTH PLANS	Mercy Health Plans	www.medicare.mercyhealthplans.com	01	04		1		H2611	801	0	2009	Mercy MedicareADVANTAGE PPO for Employers	St. Louis Metro		1	2				2						(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	http://www.medicare.mercyhealthplans.com/about/products/medicarepartd.aspx	www.medicare.mercyhealthplans.com
H2611	802	0	1	04	01	H2611_802_0	5	2009.01	MERCY HEALTH PLANS	Mercy Health Plans	www.medicare.mercyhealthplans.com	01	04		1		H2611	802	0	2009	Mercy MedicareADVANTAGE PPO - Employers	Southwest Missouri		1	2				2						(417)-836-0429	(866)-875-0189	(417)-837-0249	(800)-446-1468	(417)-837-0200	(800)-330-8449	(417)-837-0249	(800)-446-1468	(417)-836-0429	(866)-875-0189	(417)-837-0249	(800)-446-1468	(417)-837-0200	(800)-330-8449	(417)-837-0249	(800)-446-1468	http://www.medicare.mercyhealthplans.com/about/products/medicarepartd.aspx	www.medicare.mercyhealthplans.com
H2611	807	0	1	04	01	H2611_807_0	3	2009.01	MERCY HEALTH PLANS	Mercy Health Plans	www.medicare.mercyhealthplans.com	01	04		1		H2611	807	0	2009	Mercy MedicareADVANTAGE PPO Emp w Rx CY	Mercy MedicareADVANTA for Empl (St. L Metro) Rx CY		1	2				2						(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	(314)-810-8300	(800)-919-6459	(314)-214-8094	(800)-468-4418	http://www.medicare.mercyhealthplans.com/about/products/medicarepartd.aspx	www.medicare.mercyhealthplans.com
H2611	809	0	1	04	01	H2611_809_0	5	2009.01	MERCY HEALTH PLANS	Mercy Health Plans	www.medicare.mercyhealthplans.com	01	04		1		H2611	809	0	2009	Mercy MedicareADVANTAGE PPO for Emp RX CY	Southwest Missouri		1	2				2						(417)-836-0429	(866)-875-0189	(417)-837-0249	(800)-446-1468	(417)-837-0200	(800)-330-8449	(417)-837-0249	(800)-446-1468	(417)-836-0429	(866)-875-0189	(417)-837-0249	(800)-446-1468	(417)-837-0200	(800)-330-8449	(417)-837-0249	(800)-446-1468	http://www.medicare.mercyhealthplans.com/about/products/medicarepartd.aspx	www.medicare.mercyhealthplans.com
H2613	001	0	1	09	04	H2613_001_0	6	2009.01	HEALTHY ALLIANCE LIFE INSURANCE COMPANY	Blue Cross Blue Shield of Missouri	http://www.bcbsmo.com	04	09	2	1		H2613	001	0	2009	SmartValue Classic	MO Selected Counties		2	2			1230	2						(888)-445-8916	(888)-445-8916	(800)-425-5705		(800)-652-6387	(800)-652-6387	(800)-297-1538	(800)-297-1538									www.anthem.com	
H2613	004	0	1	09	04	H2613_004_0	8	2009.01	HEALTHY ALLIANCE LIFE INSURANCE COMPANY	Blue Cross Blue Shield of Missouri	http://www.bcbsmo.com	04	09	2	1		H2613	004	0	2009	SmartValue Plus	MO Selected Counties		2	2			2649	2						(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(800)-652-6387	(800)-652-6387	(800)-297-1538	(800)-297-1538	(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(800)-652-6387	(800)-652-6387	(800)-822-1215	(800)-822-1215	www.anthem.com	
H2613	803	0	1	09	04	H2613_803_0	5	2009.01	HEALTHY ALLIANCE LIFE INSURANCE COMPANY	Blue Cross Blue Shield of Missouri	http://www.bcbsmo.com	04	09	2	1		H2613	803	0	2009	SmartValue Group Plan I	MO with Nationwide Group Coverage		1	2			4071	2						(866)-865-9330	(866)-865-9330	(800)-822-1215	(800)-822-1215	(800)-652-6387	(800)-652-6387	(800)-822-1215	(800)-822-1215	(866)-865-9330	(866)-865-9330	(800)-822-1215	(800)-822-1215	(800)-652-6387	(800)-652-6387	(800)-822-1215	(800)-822-1215	www.anthem.com	
H2613	804	0	1	09	04	H2613_804_0	5	2009.01	HEALTHY ALLIANCE LIFE INSURANCE COMPANY	Blue Cross Blue Shield of Missouri	http://www.bcbsmo.com	04	09	2	1		H2613	804	0	2009	SmartValue Group Plan II	MO with Nationwide Group Coverage		1	2			4071	2						(866)-865-9330	(866)-865-9330	(800)-822-1215	(800)-822-1215	(800)-652-6387	(800)-652-6387	(800)-822-1215	(800)-822-1215									www.anthem.com	
H2613	806	0	1	09	04	H2613_806_0	5	2009.01	HEALTHY ALLIANCE LIFE INSURANCE COMPANY	Blue Cross Blue Shield of Missouri	http://www.bcbsmo.com	04	09	2	1		H2613	806	0	2009	SmartValue Group Plan III	MO with Nationwide Group Coverage		1	2			4071	2						(866)-865-9330	(866)-865-9330	(800)-822-1215	(800)-822-1215	(800)-652-6387	(800)-652-6387	(800)-822-1215	(800)-822-1215	(866)-865-9330	(866)-865-9330	(800)-822-1215	(800)-822-1215	(800)-652-6387	(800)-652-6387	(800)-822-1215	(800)-822-1215	www.anthem.com	
H2643	001	0	1	01	01	H2643_001_0	7	2009.01	L. A. CARE HEALTH PLAN	L.A. Care Health Plan	www.lacare.org	01	01		1		H2643	001	0	2009	L.A. Care	Los Angeles County		2	1	3			2			1	1		(213)-694-1250	(888)-839-9909	(866)-522-2731	(866)-522-2731	(213)-694-1250	(888)-452-2273	(866)-522-2731	(866)-522-2731	(213)-694-1250	(888)-839-9909	(866)-522-2731	(866)-522-2731	(213)-694-1250	(888)-452-2273	(866)-522-2731	(866)-522-2731	www.lacare.org	www.lacare.org
H2648	001	0	1	09	04	H2648_001_0	5	2009.01	HEALTHNOW NEW YORK, INC.	Traditional Blue Medicare PFFS	www.bsneny.com	04	09	2	1		H2648	001	0	2009	Traditional Blue Medicare PFFS	BlueShield of Northeastern New York		2	2			100	2						(800)-329-2792	(800)-329-2792	(877)-834-6918		(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710									www.bcbswny.com/pharmacy, www.bsneny.com/pharmacy	
H2648	002	0	1	09	04	H2648_002_0	5	2009.01	HEALTHNOW NEW YORK, INC.	Traditional Blue Medicare PFFS	www.bcbswny.com	04	09	2	1		H2648	002	0	2009	Traditional Blue Medicare PFFS	BlueCross Blue Shield of WNY		2	2			100	2						(800)-329-2792	(800)-329-2792	(877)-834-6918		(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710									www.bcbswny.com/pharmacy, www.bsneny.com/pharmacy	
H2648	003	0	1	09	04	H2648_003_0	5	2009.01	HEALTHNOW NEW YORK, INC.	Traditional Blue Medicare PFFS	www.bsneny.com	04	09	2	1		H2648	003	0	2009	Traditional Blue Medicare PFFS w/Rx	BlueShield of Northeastern New York		2	2			100	2						(800)-329-2792	(800)-329-2792	(877)-834-6918		(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710	(800)-329-2792	(800)-329-2792	(877)-834-6918		(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710	www.bcbswny.com/pharmacy, www.bsneny.com/pharmacy	
H2648	004	0	1	09	04	H2648_004_0	5	2009.01	HEALTHNOW NEW YORK, INC.	Traditional Blue Medicare PFFS	www.bcbswny.com	04	09	2	1		H2648	004	0	2009	Traditional Blue Medicare PFFS w/Rx	BlueCross BlueShield of Western New York		2	2			100	2						(800)-329-2792	(800)-329-2792	(877)-834-6918		(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710	(800)-329-2792	(800)-329-2792	(877)-834-6918		(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710	www.bcbswny.com/pharmacy, www.bsneny.com/pharmacy	
H2648	801	0	1	09	04	H2648_801_0	6	2009.01	HEALTHNOW NEW YORK, INC.	Traditional Blue Medicare PFFS	www.bsneny.com	04	09	2	1		H2648	801	0	2009	Traditional Blue Medicare PFFS Emp MA-PD	BlueShield of Northeastern New York		1	2			22	2						(800)-329-2792	(800)-329-2792	(877)-834-6918		(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710	(800)-329-2792	(800)-329-2792	(877)-834-6918		(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710	www.bcbswny.com/pharmacy, www.bsneny.com/pharmacy	
H2648	802	0	1	09	04	H2648_802_0	6	2009.01	HEALTHNOW NEW YORK, INC.	Traditional Blue Medicare PFFS	www.bcbswny.com	04	09	2	1		H2648	802	0	2009	Traditional Blue Medicare PFFS Emp MA-PD	BlueCross BlueShield of Western New York		1	2			70	2						(800)-329-2792	(800)-329-2792	(877)-834-6918		(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710	(800)-329-2792	(800)-329-2792	(877)-834-6918		(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710	www.bcbswny.com/pharmacy, www.bsneny.com/pharmacy	
H2649	004	0	1	01	01	H2649_004_0	3	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H2649	004	0	2009	Humana Gold Plus HMO H2649-004	Kansas City Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2649	011	0	1	01	01	H2649_011_0	3	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H2649	011	0	2009	Humana Gold Plus HMO H2649-011	Wyandotte and Leavenworth Counties		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2649	012	0	1	01	01	H2649_012_0	3	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H2649	012	0	2009	Humana Gold Plus HMO H2649-012	Kansas City Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2649	015	0	1	01	01	H2649_015_0	5	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H2649	015	0	2009	Humana Gold Plus HMO SNP-DE H2649-015	Jackson		2	1	3			2			1	2		(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2649	016	0	1	01	01	H2649_016_0	4	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H2649	016	0	2009	Humana Gold Plus HMO H2649-016	Kansas City		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2649	801	0	1	01	01	H2649_801_0	1	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H2649	801	0	2009	Humana Employer Sponsored	Kansas City Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2649	802	0	1	01	01	H2649_802_0	1	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H2649	802	0	2009	Humana Employer Sponsored	Kansas City Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2649	803	0	1	01	01	H2649_803_0	1	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H2649	803	0	2009	Humana Employer Sponsored Non-CY	Kansas City Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2649	804	0	1	01	01	H2649_804_0	1	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H2649	804	0	2009	Humana Employer Sponsored Non-CY	Kansas City Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2654	004	0	1	01	01	H2654_004_0	5	2009.01	UNITED HEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H2654	004	0	2009	AARP MedicareComplete	St. Louis Area		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2654	010	0	1	02	01	H2654_010_0	6	2009.01	UNITED HEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H2654	010	0	2009	AARP MedicareComplete Plus	Springfield, Missouri area		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2654	013	0	1	02	01	H2654_013_0	5	2009.01	UNITED HEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H2654	013	0	2009	AARP MedicareComplete Plus Plan1	St. Louis area		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2654	020	0	1	01	01	H2654_020_0	4	2009.01	UNITED HEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H2654	020	0	2009	AARP MedicareComplete Essential	St. Louis Area		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2654	022	0	1	02	01	H2654_022_0	3	2009.01	UNITED HEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H2654	022	0	2009	AARP MedicareComplete Plus Plan2	St Louis Area		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2654	023	0	1	01	01	H2654_023_0	7	2009.01	UNITED HEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H2654	023	0	2009	Evercare Plan DH	Springfield Area		2	1	3			2			2	2		(877)-702-5110		(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2654	024	0	1	01	01	H2654_024_0	6	2009.01	UNITED HEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H2654	024	0	2009	Evercare Plan DH	St. Louis, MO, IL area		2	1	3			2			2	2		(877)-702-5110		(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2654	026	0	1	01	01	H2654_026_0	4	2009.01	UNITED HEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H2654	026	0	2009	Evercare Plan MH	St. Louis, MO, IL area		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110		(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2654	027	0	1	01	01	H2654_027_0	4	2009.01	UNITED HEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H2654	027	0	2009	Evercare Plan MH	Springfield Area		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110		(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2654	801	0	1	01	01	H2654_801_0	2	2009.01	UNITED HEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H2654	801	0	2009	MedicareComplete Retiree Plan	St Louis Area		1	2				2						(800)-656-0065		(888)-685-8480		(800)-480-6065	(800)-480-6065	(800)-387-1074		(800)-656-0065	(800)-656-0065	(888)-685-8480		(800)-480-6065	(800)-480-6065	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2654	802	0	1	01	01	H2654_802_0	3	2009.01	UNITED HEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H2654	802	0	2009	MedicareComplete Essential Retiree Plan	St Louis Area Counties		1	2				2						(800)-656-0065		(888)-685-8480		(800)-480-6065	(800)-480-6065	(800)-387-1074										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2654	803	0	1	01	01	H2654_803_0	2	2009.01	UNITED HEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H2654	803	0	2009	MedicareComplete Retiree Plan	Springfield Area		1	2				2						(800)-656-0065		(888)-685-8480		(800)-480-6065		(800)-387-1074		(800)-656-0065	(800)-656-0065	(888)-685-8480		(800)-480-6065	(800)-480-6065	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2654	804	0	1	01	01	H2654_804_0	2	2009.01	UNITED HEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H2654	804	0	2009	MedicareComplete Essential Retiree Plan	Springfield Area		1	2				2						(800)-656-0065		(888)-685-8480		(800)-480-6065		(888)-685-8480										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2654	805	0	1	01	01	H2654_805_0	2	2009.01	UNITED HEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H2654	805	0	2009	MedicareComplete Retiree Plan	St. Louis		1	2				2						(800)-656-0065		(888)-685-8480		(800)-480-6065	(800)-480-6065	(800)-387-1074		(800)-656-0065	(800)-656-0065	(888)-685-8480		(800)-480-6065	(800)-480-6065	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2654	806	0	1	01	01	H2654_806_0	2	2009.01	UNITED HEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H2654	806	0	2009	MedicareComplete Retiree Plan	St. Louis Area		1	2				2						(800)-656-0065		(888)-685-8480		(800)-480-6065		(888)-685-8480										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2654	807	0	1	01	01	H2654_807_0	2	2009.01	UNITED HEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H2654	807	0	2009	MedicareComplete Retiree Plan	Springfield Area		1	2				2						(800)-656-0065		(888)-685-8480		(800)-480-6065	(800)-480-6065	(800)-387-1074		(800)-656-0065	(800)-656-0065	(888)-685-8480		(800)-480-6065	(800)-480-6065	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2654	808	0	1	01	01	H2654_808_0	2	2009.01	UNITED HEALTHCARE OF THE MIDWEST, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H2654	808	0	2009	MedicareComplete Retiree Plan	Springfield Area		1	2				2						(800)-656-0065		(888)-685-8480		(800)-480-6065		(888)-685-8480										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2663	002	0	1	01	01	H2663_002_0	12	2009.01	GROUP HEALTH PLAN, INC.	Group Health Plan, Inc.	www.ghpmedicare.com	01	01		1		H2663	002	0	2009	Advantra Option 2	St. Louis MO Metro Area		2	2			6553	2						(800)-533-0367	(800)-533-0367	(877)-231-0573		(800)-533-0362	(800)-533-0362	(877)-231-0573		(866)-291-8628	(866)-291-8628	(866)-236-1069		(800)-533-0362	(800)-533-0362	(877)-231-0573		www.ghpmedicare.com	www.ghpmedicare.com
H2663	005	0	1	01	01	H2663_005_0	11	2009.01	GROUP HEALTH PLAN, INC.	Group Health Plan, Inc.	www.ghpmedicare.com	01	01		1		H2663	005	0	2009	Gold Advantage Option 1	St. Louis MO Metro Area		2	2			6011	2						(800)-533-0367	(800)-533-0367	(877)-231-0573		(800)-533-0362	(800)-533-0362	(877)-231-0573		(866)-291-8628	(866)-291-8628	(866)-236-1069		(800)-533-0362	(800)-533-0362	(877)-231-0573		www.ghpmedicare.com	www.ghpmedicare.com
H2663	006	0	1	01	01	H2663_006_0	7	2009.01	GROUP HEALTH PLAN, INC.	Group Health Plan, Inc.	www.ghpmedicare.com	01	01		1		H2663	006	0	2009	Advantra Option 1	St. Louis MO Metro Area		2	2			3827	2						(800)-533-0367	(800)-533-0367	(877)-231-0573		(800)-533-0362	(800)-533-0362	(877)-231-0573		(866)-291-8628	(866)-291-8628	(866)-236-1069		(800)-533-0362	(800)-533-0362	(877)-231-0573		www.ghpmedicare.com	www.ghpmedicare.com
H2663	007	0	1	01	01	H2663_007_0	10	2009.01	GROUP HEALTH PLAN, INC.	Group Health Plan, Inc.	www.ghpmedicare.com	01	01		1		H2663	007	0	2009	Gold Advantage Option 2	St. Louis MO Metro Area		2	2			1319	2						(800)-533-0367	(800)-533-0367	(877)-231-0573		(800)-533-0362	(800)-533-0362	(877)-231-0573		(866)-291-8628	(866)-291-8628	(866)-236-1069		(800)-533-0362	(800)-533-0362	(877)-231-0573		www.ghpmedicare.com	www.ghpmedicare.com
H2663	008	0	1	01	01	H2663_008_0	8	2009.01	GROUP HEALTH PLAN, INC.	Group Health Plan, Inc.	www.ghpmedicare.com	01	01		1		H2663	008	0	2009	AdvantraExtra 1 Diabetes	St. Louis MO Metro Area		2	1	4		3204	2			1		0000000010000000000000000000	(800)-533-0367	(800)-533-0367	(877)-231-0573		(800)-533-0362	(800)-533-0362	(877)-231-0573		(866)-291-8628	(866)-291-8628	(866)-236-1069		(800)-533-0362	(800)-533-0362	(877)-231-0573		www.ghpmedicare.com	www.ghpmedicare.com
H2663	009	0	1	01	01	H2663_009_0	8	2009.01	GROUP HEALTH PLAN, INC.	Group Health Plan, Inc.	www.ghpmedicare.com	01	01		1		H2663	009	0	2009	AdvantraExtra 2 Diabetes	St. Louis MO Metro Area		2	1	4		1606	2			1		0000000010000000000000000000	(800)-533-0367	(800)-533-0367	(877)-231-0573		(800)-533-0362	(800)-533-0362	(877)-231-0573		(866)-291-8628	(866)-291-8628	(866)-236-1069		(800)-533-0362	(800)-533-0362	(877)-231-0573		www.ghpmedicare.com	www.ghpmedicare.com
H2663	010	0	1	01	01	H2663_010_0	7	2009.01	GROUP HEALTH PLAN, INC.	Group Health Plan, Inc.	www.ghpmedicare.com	01	01		1		H2663	010	0	2009	AdvantraExtra 3 Cholesterol	St. Louis MO Metro Area		2	1	4		535	2			1		0000000001000000000000000000	(800)-533-0367	(800)-533-0367	(877)-231-0573		(800)-533-0362	(800)-533-0362	(877)-231-0573		(866)-291-8628	(866)-291-8628	(866)-236-1069		(800)-533-0362	(800)-533-0362	(877)-231-0573		www.ghpmedicare.com	www.ghpmedicare.com
H2663	011	0	1	01	01	H2663_011_0	6	2009.01	GROUP HEALTH PLAN, INC.	Group Health Plan, Inc.	www.ghpmedicare.com	01	01		1		H2663	011	0	2009	AdvantraExtra 4 Cholesterol	St. Louis MO Metro Area		2	1	4		262	2			1		0000000001000000000000000000	(800)-533-0367	(800)-533-0367	(877)-231-0573		(800)-533-0362	(800)-533-0362	(877)-231-0573		(866)-291-8628	(866)-291-8628	(866)-236-1069		(800)-533-0362	(800)-533-0362	(877)-231-0573		www.ghpmedicare.com	www.ghpmedicare.com
H2663	012	0	1	01	01	H2663_012_0	8	2009.01	GROUP HEALTH PLAN, INC.	Group Health Plan, Inc.	www.ghpmedicare.com	01	01		1		H2663	012	0	2009	Advantra Option 3	St. Louis MO Metro Area		2	2			665	2						(800)-533-0367	(800)-533-0367	(877)-231-0573		(800)-533-0362	(800)-533-0362	(877)-231-0573		(866)-291-8628	(866)-291-8628	(866)-236-1069		(800)-533-0362	(800)-533-0362	(877)-231-0573		www.ghpmedicare.com	www.ghpmedicare.com
H2663	802	0	1	01	01	H2663_802_0	5	2009.01	GROUP HEALTH PLAN, INC.	Group Health Plan, Inc.	www.ghpmedicare.com	01	01		1		H2663	802	0	2009	Employer Group Calendar Rx Premier	St. Louis MO Metro Area - Employer Group		1	2			3634	2						(800)-533-0367	(800)-533-0367	(877)-231-0573		(800)-533-0362	(800)-533-0362	(877)-231-0573		(866)-291-8628	(866)-291-8628	(866)-236-1069		(800)-533-0362	(800)-533-0362	(877)-231-0573		www.ghpmedicare.com	www.ghpmedicare.com
H2663	804	0	1	01	01	H2663_804_0	5	2009.01	GROUP HEALTH PLAN, INC.	Group Health Plan, Inc.	www.ghpmedicare.com	01	01		1		H2663	804	0	2009	Employer Group Non Calendar Rx Premier	St. Louis MO Metro Area - Employer Group		1	2			1023	2						(800)-533-0367	(800)-533-0367	(877)-231-0573		(800)-533-0362	(800)-533-0362	(877)-231-0573		(866)-291-8628	(866)-291-8628	(866)-236-1069		(800)-533-0362	(800)-533-0362	(877)-231-0573		www.ghpmedicare.com	www.ghpmedicare.com
H2663	805	0	1	01	01	H2663_805_0	5	2009.01	GROUP HEALTH PLAN, INC.	Group Health Plan, Inc.	www.ghpmedicare.com	01	01		1		H2663	805	0	2009	Employer Group Calendar No Rx	St. Louis MO Metro Area - Employer Group		1	2			129	2						(800)-533-0367	(800)-533-0367	(877)-231-0573		(800)-533-0362	(800)-533-0362	(877)-231-0573										www.ghpmedicare.com	www.ghpmedicare.com
H2667	001	0	1	01	01	H2667_001_0	9	2009.01	MERCY HEALTH PLANS OF MISSOURI INC.	Mercy Health Plans of Missouri, Inc.	www.medicare.mercyhealthplans.com	01	01		1		H2667	001	0	2009	Mercy MedicareADVANTAGE HMO	Southwest MO		2	2				2						(417)-837-0266	(800)-481-4466	(417)-837-0249	(800)-446-1468	(417)-837-0266	(800)-481-4466	(417)-837-0249	(800)-446-1468	(314)-214-8040	(800)-280-1602	(314)-214-8094	(800)-468-4418	(417)-837-0266	(800)-481-4466	(417)-837-0249	(800)-446-1468	http://www.medicare.mercyhealthplans.com/about/products/medicarepartd.aspx	www.medicare.mercyhealthplans.com
H2667	003	0	1	01	01	H2667_003_0	15	2009.01	MERCY HEALTH PLANS OF MISSOURI INC.	Mercy Health Plans of Missouri, Inc.	www.medicare.mercyhealthplans.com	01	01		1		H2667	003	0	2009	Mercy MedicareADVANTAGE HMO	St. Louis Metro		2	2				2						(314)-214-8040	(800)-280-1602	(314)-214-8094	(800)-468-4418	(314)-214-8040	(800)-280-1602	(314)-214-8094	(800)-468-4418	(314)-214-8040	(800)-280-1602	(314)-214-8094	(800)-468-4418	(314)-214-8040	(800)-280-1602	(314)-214-8094	(800)-468-4418	http://www.medicare.mercyhealthplans.com/about/products/medicarepartd.aspx	www.medicare.mercyhealthplans.com
H2667	012	0	1	01	01	H2667_012_0	8	2009.01	MERCY HEALTH PLANS OF MISSOURI INC.	Mercy Health Plans of Missouri, Inc.	www.medicare.mercyhealthplans.com	01	01		1		H2667	012	0	2009	Mercy MedicareADVANTAGE HMO (no drug)	Southwest Missouri		2	2				2						(417)-837-0266	(800)-481-4466	(417)-837-0249	(800)-446-1468	(417)-837-0266	(800)-481-4466	(417)-837-0249	(800)-446-1468									http://www.medicare.mercyhealthplans.com/about/products/medicarepartd.aspx	www.medicare.mercyhealthplans.com
H2667	013	0	1	01	01	H2667_013_0	9	2009.01	MERCY HEALTH PLANS OF MISSOURI INC.	Mercy Health Plans of Missouri, Inc.	www.medicare.mercyhealthplans.com	01	01		1		H2667	013	0	2009	Mercy MedicareADVANTAGE HMO (no RX)	St. Louis Metro		2	2				2						(314)-214-8040	(800)-280-1602	(314)-214-8094	(800)-468-4418	(314)-214-8040	(800)-280-1602	(314)-214-8094	(800)-468-4418									http://www.medicare.mercyhealthplans.com/about/products/medicarepartd.aspx	www.medicare.mercyhealthplans.com
H2667	803	0	1	01	01	H2667_803_0	4	2009.01	MERCY HEALTH PLANS OF MISSOURI INC.	Mercy Health Plans of Missouri, Inc.	www.medicare.mercyhealthplans.com	01	01		1		H2667	803	0	2009	Mercy MedicareADVANTAGE HMO for Employers	Southwest Missouri		1	2				2						(417)-837-0266	(800)-481-4466	(417)-837-0249	(800)-446-1468	(417)-836-0200	(800)-330-8449	(417)-837-0249	(800)-446-1468	(314)-214-8040	(800)-280-1602	(314)-214-8094	(800)-468-4418	(417)-836-0200	(800)-330-8449	(417)-837-0249	(800)-446-1468	http://www.medicare.mercyhealthplans.com/about/products/medicarepartd.aspx	www.medicare.mercyhealthplans.com
H2667	804	0	1	01	01	H2667_804_0	4	2009.01	MERCY HEALTH PLANS OF MISSOURI INC.	Mercy Health Plans of Missouri, Inc.	www.medicare.mercyhealthplans.com	01	01		1		H2667	804	0	2009	Mercy MedicareADVANTAGE HMO for Employers	St. Louis Metro		1	2				2						(314)-214-8040	(800)-280-1602	(314)-214-8094	(800)-468-4418	(314)-214-8040	(800)-280-1602	(314)-214-8094	(800)-468-4418	(314)-214-8040	(800)-280-1602	(314)-214-8094	(800)-468-4418	(314)-214-8040	(800)-280-1602	(314)-214-8094	(800)-468-4418	http://www.medicare.mercyhealthplans.com/about/products/medicarepartd.aspx	www.medicare.mercyhealthplans.com
H2667	807	0	1	01	01	H2667_807_0	4	2009.01	MERCY HEALTH PLANS OF MISSOURI INC.	Mercy Health Plans of Missouri, Inc.	www.medicare.mercyhealthplans.com	01	01		1		H2667	807	0	2009	Mercy MedicareADVANTAGE HMO for Employers RX CY	Southwest Missouri		1	2				2						(417)-837-0266	(800)-481-4466	(417)-837-0249	(800)-446-1468	(417)-836-0200	(800)-330-8449	(417)-837-0249	(800)-446-1468	(417)-837-0266	(800)-481-4466	(417)-837-0249	(800)-446-1468	(417)-836-0200	(800)-330-8449	(417)-837-0249	(800)-446-1468	http://www.medicare.mercyhealthplans.com/about/products/medicarepartd.aspx	www.medicare.mercyhealthplans.com
H2667	808	0	1	01	01	H2667_808_0	4	2009.01	MERCY HEALTH PLANS OF MISSOURI INC.	Mercy Health Plans of Missouri, Inc.	www.medicare.mercyhealthplans.com	01	01		1		H2667	808	0	2009	Mercy MedicareADVANTAGE HMO for Emp no RX CY	Southwest Missouri		1	2				2						(417)-837-0266	(800)-481-4466	(417)-837-0249	(800)-446-1468	(417)-836-0200	(800)-330-8449	(417)-837-0249	(800)-446-1468									http://www.medicare.mercyhealthplans.com/about/products/medicarepartd.aspx	www.medicare.mercyhealthplans.com
H2667	809	0	1	01	01	H2667_809_0	4	2009.01	MERCY HEALTH PLANS OF MISSOURI INC.	Mercy Health Plans of Missouri, Inc.	www.medicare.mercyhealthplans.com	01	01		1		H2667	809	0	2009	Mercy MedicareADVANTAGE HMO for Employers RX CY	St. Louis Metro		1	2				2						(314)-214-8040	(800)-280-1602	(314)-214-8094	(800)-468-4418	(314)-214-8040	(800)-280-1602	(314)-214-8094	(800)-468-4418	(314)-214-8040	(800)-280-1602	(314)-214-8094	(800)-468-4418	(314)-214-8040	(800)-280-1602	(314)-214-8094	(800)-468-4418	http://www.medicare.mercyhealthplans.com/about/products/medicarepartd.aspx	www.medicare.mercyhealthplans.com
H2667	810	0	1	01	01	H2667_810_0	4	2009.01	MERCY HEALTH PLANS OF MISSOURI INC.	Mercy Health Plans of Missouri, Inc.	www.medicare.mercyhealthplans.com	01	01		1		H2667	810	0	2009	Mercy MedicareADVANTAGE HMO for Employers no RX CY	St. Louis Metro		1	2				2						(314)-214-8040	(800)-280-1602	(314)-214-8094	(800)-468-4418	(314)-214-8040	(800)-280-1602	(314)-214-8094	(800)-468-4418									http://www.medicare.mercyhealthplans.com/about/products/medicarepartd.aspx	www.medicare.mercyhealthplans.com
H2672	001	0	1	01	01	H2672_001_0	7	2009.01	COVENTRY HEALTH CARE OF KANSAS, INC.	Coventry Health Care of Kansas, Inc.	www.kc.chcadvantra.com	01	01		1		H2672	001	0	2009	Advantra Advantage	Kansas City Metro Area		2	2			8000	2						(800)-727-9712	(800)-727-9712	(866)-347-2459		(866)-533-5160	(866)-533-5160	(866)-347-2459		(866)-505-6162	(866)-505-6162	(866)-236-1069	(866)-236-1069	(866)-533-5160	(866)-533-5160	(866)-347-2459		www.kc.chcadvantra.com	
H2672	003	0	1	01	01	H2672_003_0	7	2009.01	COVENTRY HEALTH CARE OF KANSAS, INC.	Coventry Health Care of Kansas, Inc.	www.kc.chcadvantra.com	01	01		1		H2672	003	0	2009	Advantra Advantage	Wichita Metro Area		2	2			200	2						(800)-727-9712	(800)-727-9712	(866)-347-2459		(866)-533-5160	(866)-533-5160	(866)-347-2459		(866)-505-6162	(866)-505-6162	(866)-236-1069	(866)-236-1069	(866)-533-5160	(866)-533-5160	(866)-347-2459		www.kc.chcadvantra.com	
H2672	008	0	1	01	01	H2672_008_0	7	2009.01	COVENTRY HEALTH CARE OF KANSAS, INC.	Coventry Health Care of Kansas, Inc.	www.kc.chcadvantra.com	01	01		1		H2672	008	0	2009	Advantra Advantage	Wyandotte County		2	2			300	2						(800)-727-9712	(800)-727-9712	(866)-347-2459		(866)-533-5160	(866)-533-5160	(866)-347-2459		(866)-505-6162	(866)-505-6162	(866)-236-1069	(866)-236-1069	(866)-533-5160	(866)-533-5160	(866)-347-2459		www.kc.chcadvantra.com	
H2672	801	0	1	01	01	H2672_801_0	3	2009.01	COVENTRY HEALTH CARE OF KANSAS, INC.	Coventry Health Care of Kansas, Inc.	www.kc.chcadvantra.com	01	01		1		H2672	801	0	2009	Advantra Employer Group	Coventry Healthcare of Kansas, Inc		1	2			300	2						(800)-727-9712	(800)-727-9712	(866)-347-2459		(866)-533-5160	(866)-533-5160	(866)-347-2459		(866)-505-6162	(866)-505-6162	(866)-236-1069	(866)-236-1069	(866)-533-5160	(866)-533-5160	(866)-347-2459		www.kc.chcadvantra.com	
H2672	802	0	1	01	01	H2672_802_0	3	2009.01	COVENTRY HEALTH CARE OF KANSAS, INC.	Coventry Health Care of Kansas, Inc.	www.kc.chcadvantra.com	01	01		1		H2672	802	0	2009	Advantra Employer Group	Coventry Health Care of Kansas, Inc		1	2			300	2						(800)-727-9712	(800)-727-9712	(866)-347-2459		(866)-533-5160	(866)-533-5160	(866)-347-2459		(866)-505-6162	(866)-505-6162	(866)-236-1069	(866)-236-1069	(866)-533-5160	(866)-533-5160	(866)-347-2459		www.kc.chcadvantra.com	
H2672	803	0	1	01	01	H2672_803_0	5	2009.01	COVENTRY HEALTH CARE OF KANSAS, INC.	Coventry Health Care of Kansas, Inc.	www.kc.chcadvantra.com	01	01		1		H2672	803	0	2009	Advantra Employer Group	Coventry Health Care of Kansas, Inc.		1	2			300	2						(800)-727-9712	(800)-727-9712	(866)-347-2459		(866)-533-5160	(866)-533-5160	(866)-347-2459										www.kc.chcadvantra.com	
H2699	001	0	1	20	08	H2699_001_0	1	2009.01	LIFE AT HOME, LLC	Life at Home, LLC	www.genesishcc.com	08	20		1		H2699	001	0	2009	Life at Home LLC	Chester and Delaware Counties, PA		2	2				2														(610)-461-3593	(866)-745-2273			(610)-461-3593	(866)-745-2273			www.genesishcc.com	
H2699	002	0	1	20	08	H2699_002_0	1	2009.01	LIFE AT HOME, LLC	Life at Home, LLC	www.genesishcc.com	08	20		1		H2699	002	0	2009	Life at Home LLC	Delaware and Chester Counties, PA		2	2				2														(610)-925-4270	(866)-745-2273			(610)-461-3593	(866)-745-2273			www.genesishcc.com	
H2701	001	0	1	04	01	H2701_001_0	5	2009.01	NEW WEST HEALTH SERVICES	New West Health Services	www.newwesthealth.com	01	04		1		H2701	001	0	2009	New West Medicare Enhanced	Selected Counties Montana		2	2			1318	2						(406)-751-3375	(888)-873-8049	(406)-751-3365	(888)-290-3658	(406)-751-3375	(888)-873-8049	(406)-751-3365	(888)-290-3658	(406)-751-3375	(888)-873-8049	(406)-751-3365	(888)-290-3658	(406)-751-3375	(888)-873-8049	(406)-751-3365	(888)-290-3658	WWW.NEWWESTHEALTH.COM	www.newwesthealth.com
H2701	003	0	1	04	01	H2701_003_0	6	2009.01	NEW WEST HEALTH SERVICES	New West Health Services	www.newwesthealth.com	01	04		1		H2701	003	0	2009	New West Medicare	Selected Counties Montana		2	2			38	2						(406)-751-3375	(888)-873-8049	(406)-751-3365	(888)-290-3658	(406)-751-3375	(888)-873-8049	(406)-751-3365	(888)-290-3658	(406)-751-3375	(888)-873-8049	(406)-751-3365	(888)-290-3658	(406)-751-3375	(888)-873-8049	(406)-751-3365	(888)-290-3658	WWW.NEWWESTHEALTH.COM	www.newwesthealth.com
H2701	805	0	1	04	01	H2701_805_0	6	2009.01	NEW WEST HEALTH SERVICES	New West Health Services	www.newwesthealth.com	01	04		1		H2701	805	0	2009	New West Medicare Group	National		1	2			48	2						(406)-751-3375	(888)-873-8049	(406)-751-3365	(888)-290-3658	(406)-751-3375	(888)-873-8049	(406)-751-3365	(888)-290-3658									WWW.NEWWESTHEALTH.COM	www.newwesthealth.com
H2701	806	0	1	04	01	H2701_806_0	6	2009.01	NEW WEST HEALTH SERVICES	New West Health Services	www.newwesthealth.com	01	04		1		H2701	806	0	2009	New West Medicare Group Plus	National		1	2			48	2						(406)-751-3375	(888)-873-8049	(406)-751-3365	(888)-290-3658	(406)-751-3375	(888)-873-8049	(406)-751-3365	(888)-290-3658	(406)-751-3375	(888)-873-8049	(406)-751-3365	(888)-290-3658	(406)-751-3375	(888)-873-8049	(406)-751-3365	(888)-290-3658	WWW.NEWWESTHEALTH.COM	www.newwesthealth.com
H2701	807	0	1	04	01	H2701_807_0	6	2009.01	NEW WEST HEALTH SERVICES	New West Health Services	www.newwesthealth.com	01	04		1		H2701	807	0	2009	New West Medicare Group Plus	National		1	2			48	2						(406)-751-3375	(888)-873-8049	(406)-751-3365	(888)-290-3658	(406)-751-3375	(888)-873-8049	(406)-751-3365	(888)-290-3658	(406)-751-3375	(888)-873-8049	(406)-751-3365	(888)-290-3658	(406)-751-3375	(888)-873-8049	(406)-751-3365	(888)-290-3658	WWW.NEWWESTHEALTH.COM	www.newwesthealth.com
H2762	012	0	1	09	04	H2762_012_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	012	0	2009	CIGNA Medicare Access Plan One	select counties in select states		2	2			613	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314									http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	013	0	1	09	04	H2762_013_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	013	0	2009	CIGNA Medicare Access Plan One	select counties in select states		2	2			398	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314									http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	014	0	1	09	04	H2762_014_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	014	0	2009	CIGNA Medicare Access Plan One	select counties in select states		2	2			228	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314									http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	015	0	1	09	04	H2762_015_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	015	0	2009	CIGNA Medicare Access Plan One	select counties in select states		2	2			314	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314									http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	016	0	1	09	04	H2762_016_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	016	0	2009	CIGNA Medicare Access Plan Three	select counties in select states		2	2			204	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314									http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	017	0	1	09	04	H2762_017_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	017	0	2009	CIGNA Medicare Access Plan Three	select counties in select states		2	2			114	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314									http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	018	0	1	09	04	H2762_018_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	018	0	2009	CIGNA Medicare Access Plan Three	select counties in select states		2	2			80	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314									http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	019	0	1	09	04	H2762_019_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	019	0	2009	CIGNA Medicare Access Plan Three	select counties in select states		2	2			179	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314									http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	020	0	1	09	04	H2762_020_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	020	0	2009	CIGNA Medicare Access Plan One	select counties in select states		2	2			1208	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314									http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	021	0	1	09	04	H2762_021_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	021	0	2009	CIGNA Medicare Access Plan One	select counties in select states		2	2			140	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314									http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	022	0	1	09	04	H2762_022_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	022	0	2009	CIGNA Medicare Access Plan One	select counties in select states		2	2			92	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314									http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	023	0	1	09	04	H2762_023_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	023	0	2009	CIGNA Medicare Access Plan One	select counties in select states		2	2			212	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314									http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	024	0	1	09	04	H2762_024_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	024	0	2009	CIGNA Medicare Access Plan Three	select counties in select states		2	2			403	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314									http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	025	0	1	09	04	H2762_025_0	8	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	025	0	2009	CIGNA Medicare Access Plan Three	select counties in select states		2	2			40	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314									http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	026	0	1	09	04	H2762_026_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	026	0	2009	CIGNA Medicare Access Plan Three	select counties in select states		2	2			26	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314									http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	027	0	1	09	04	H2762_027_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	027	0	2009	CIGNA Medicare Access Plan Three	select counties in select states		2	2			121	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314									http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	028	0	1	09	04	H2762_028_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	028	0	2009	CIGNA Medicare Access Plus RX Plan Two	select counties in select states		2	2			334	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	029	0	1	09	04	H2762_029_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	029	0	2009	CIGNA Medicare Access Plus RX Plan Two	select counties in select states		2	2			484	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	030	0	1	09	04	H2762_030_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	030	0	2009	CIGNA Medicare Access Plus RX Plan Two	select counties in select states		2	2			211	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	031	0	1	09	04	H2762_031_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	031	0	2009	CIGNA Medicare Access Plus RX Plan Two	select counties in select states		2	2			188	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	032	0	1	09	04	H2762_032_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	032	0	2009	CIGNA Medicare Access Plus RX Plan Two	select counties in select states		2	2			76	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	033	0	1	09	04	H2762_033_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	033	0	2009	CIGNA Medicare Access Plus RX Plan Two	select counties in select states		2	2			134	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	034	0	1	09	04	H2762_034_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	034	0	2009	CIGNA Medicare Access Plus RX Plan Two	select counties in select states		2	2			165	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	035	0	1	09	04	H2762_035_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	035	0	2009	CIGNA Medicare Access Plus RX Plan Two	select counties in select states		2	2			225	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	036	0	1	09	04	H2762_036_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	036	0	2009	CIGNA Medicare Access Plus RX Plan Four	select counties in select states		2	2			167	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	037	0	1	09	04	H2762_037_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	037	0	2009	CIGNA Medicare Access Plus RX Plan Four	select counties in select states		2	2			242	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	038	0	1	09	04	H2762_038_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	038	0	2009	CIGNA Medicare Access Plus RX Plan Four	select counties in select states		2	2			120	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	039	0	1	09	04	H2762_039_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	039	0	2009	CIGNA Medicare Access Plus RX Plan Four	select counties in select states		2	2			107	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	040	0	1	09	04	H2762_040_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	040	0	2009	CIGNA Medicare Access Plus RX Plan Four	select counties in select states		2	2			44	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	041	0	1	09	04	H2762_041_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	041	0	2009	CIGNA Medicare Access Plus RX Plan Four	select counties in select states		2	2			77	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	042	0	1	09	04	H2762_042_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	042	0	2009	CIGNA Medicare Access Plus RX Plan Two	select counties in select states		2	2			1282	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	043	0	1	09	04	H2762_043_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	043	0	2009	CIGNA Medicare Access Plus RX Plan Two	select counties in select states		2	2			329	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	044	0	1	09	04	H2762_044_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	044	0	2009	CIGNA Medicare Access Plus RX Plan Two	select counties in select states		2	2			111	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	045	0	1	09	04	H2762_045_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	045	0	2009	CIGNA Medicare Access Plus RX Plan Two	select counties in select states		2	2			29	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	046	0	1	09	04	H2762_046_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	046	0	2009	CIGNA Medicare Access Plus RX Plan Two	select counties in select states		2	2			79	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	047	0	1	09	04	H2762_047_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	047	0	2009	CIGNA Medicare Access Plus RX Plan Two	select counties in select states		2	2			13	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	048	0	1	09	04	H2762_048_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	048	0	2009	CIGNA Medicare Access Plus RX Plan Two	select counties in select states		2	2			103	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	049	0	1	09	04	H2762_049_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	049	0	2009	CIGNA Medicare Access Plus RX Plan Two	select counties in select states		2	2			169	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	050	0	1	09	04	H2762_050_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	050	0	2009	CIGNA Medicare Access Plus RX Plan Four	select counties in select states		2	2			641	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	051	0	1	09	04	H2762_051_0	4	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	051	0	2009	CIGNA Medicare Access Plus RX Plan Four	select counties in select states		2	2			165	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	052	0	1	09	04	H2762_052_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	052	0	2009	CIGNA Medicare Access Plus RX Plan Four	select counties in select states		2	2			64	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	053	0	1	09	04	H2762_053_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	053	0	2009	CIGNA Medicare Access Plus RX Plan Four	select counties in select states		2	2			16	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	054	0	1	09	04	H2762_054_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	054	0	2009	CIGNA Medicare Access Plus RX Plan Four	select counties in select states		2	2			45	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	055	0	1	09	04	H2762_055_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	055	0	2009	CIGNA Medicare Access Plus RX Plan Four	select counties in select states		2	2			7	2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-577-9409	(800)-577-9409	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	802	0	1	09	04	H2762_802_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	802	0	2009	CIGNA Medicare Access - ER	Employer National Service Area		1	2				2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-669-2340	(800)-669-2340	(800)-576-1314	(800)-576-1314									http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	803	0	1	09	04	H2762_803_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	803	0	2009	CIGNA Medicare Access Plus Rx - ER CY	Employer National Service Area		1	2				2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-669-2340	(800)-669-2340	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-669-2340	(800)-669-2340	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2762	804	0	1	09	04	H2762_804_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Access	www.CIGNAMedicare.com	04	09	2	1		H2762	804	0	2009	CIGNA Medicare Access Plus Rx - ER NCY	Employer National Service Area		1	2				2						(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-669-2340	(800)-669-2340	(800)-576-1314	(800)-576-1314	(800)-577-9410	(800)-577-9410	(800)-576-1314	(800)-576-1314	(800)-669-2340	(800)-669-2340	(800)-576-1314	(800)-576-1314	http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
H2775	001	0	1	04	01	H2775_001_0	2	2009.01	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.todaysoptions.com	01	04		1		H2775	001	0	2009	Today's Options PPO Select	Adams, Lancaster, York Counties		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	www.todaysoptions.com
H2775	002	0	1	04	01	H2775_002_0	2	2009.01	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.todaysoptions.com	01	04		1		H2775	002	0	2009	Today's Options PPO Select	Lycoming County		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	www.todaysoptions.com
H2775	003	0	1	04	01	H2775_003_0	2	2009.01	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.todaysoptions.com	01	04		1		H2775	003	0	2009	Today's Options PPO Select	Erie County		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	www.todaysoptions.com
H2775	004	0	1	04	01	H2775_004_0	3	2009.01	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.todaysoptions.com	01	04		1		H2775	004	0	2009	Today's Options PPO Select powered by CCRx	Adams, Lancaster, York Counties		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H2775	005	0	1	04	01	H2775_005_0	3	2009.01	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.todaysoptions.com	01	04		1		H2775	005	0	2009	Today's Options PPO Select powered by CCRx	Lycoming County		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H2775	006	0	1	04	01	H2775_006_0	3	2009.01	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.todaysoptions.com	01	04		1		H2775	006	0	2009	Today's Options PPO Select powered by CCRx	Erie County		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H2775	007	0	1	04	01	H2775_007_0	4	2009.01	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.todaysoptions.com	01	04		1		H2775	007	0	2009	Today's Options PPO Complete powered by CCRx	Adams, Lancaster, York Counties		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H2775	008	0	1	04	01	H2775_008_0	6	2009.01	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.todaysoptions.com	01	04		1		H2775	008	0	2009	Today's Options PPO Complete powered by CCRx	Lycoming County		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H2775	009	0	1	04	01	H2775_009_0	4	2009.01	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.todaysoptions.com	01	04		1		H2775	009	0	2009	Today's Options PPO Complete powered by CCRx	Erie County		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H2775	801	0	1	04	01	H2775_801_0	5	2009.01	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.todaysoptions.com	01	04		1		H2775	801	0	2009	Today's Options PPO - MA Group Plan	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	www.todaysoptions.com
H2775	802	0	1	04	01	H2775_802_0	5	2009.01	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.todaysoptions.com	01	04		1		H2775	802	0	2009	Today's Options PPO - MAPD Group Plan	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H2775	803	0	1	04	01	H2775_803_0	5	2009.01	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.todaysoptions.com	01	04		1		H2775	803	0	2009	Today's Options PPO - MAPD Group Plan -NCY	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H2788	801	0	1	09	04	H2788_801_0	8	2009.01	GROUP HOSPITALIZATION AND MEDICAL SERVICES, INC.	Medi-CareFirst BlueCross BlueShield	www.medi-carefirst.com	04	09	2	1		H2788	801	0	2009	AdvantageBlue PFFS with Rx (Calendar)	National		1	2			5333	2						(866)-675-8636	(866)-675-8636	(800)-988-0668	(800)-988-0668	(866)-675-8636	(866)-675-8636	(800)-988-0668	(800)-988-0668	(888)-720-0090	(888)-720-0090			(866)-675-8636	(866)-675-8636	(800)-988-0668	(800)-988-0668	http://www.medi-carefirst.com	
H2788	802	0	1	09	04	H2788_802_0	5	2009.01	GROUP HOSPITALIZATION AND MEDICAL SERVICES, INC.	Medi-CareFirst BlueCross BlueShield	www.medi-carefirst.com	04	09	2	1		H2788	802	0	2009	AdvantageBlue PFFS with Rx (Non-Calendar)	National		1	2			667	2						(866)-675-8636	(866)-675-8636	(800)-988-0668	(800)-988-0668	(866)-675-8636	(866)-675-8636	(800)-988-0668	(800)-988-0668	(888)-720-0090	(888)-720-0090			(866)-675-8636	(866)-675-8636	(800)-988-0668	(800)-988-0668	http://www.medi-carefirst.com	
H2788	803	0	1	09	04	H2788_803_0	5	2009.01	GROUP HOSPITALIZATION AND MEDICAL SERVICES, INC.	Medi-CareFirst BlueCross BlueShield	www.medi-carefirst.com	04	09	2	1		H2788	803	0	2009	AdvantageBlue PFFS (Calendar)	National		1	2			5333	2						(866)-675-8636	(866)-675-8636	(800)-988-0668	(800)-988-0668	(866)-675-8636	(866)-675-8636	(800)-988-0668	(800)-988-0668									http://www.medi-carefirst.com	
H2788	804	0	1	09	04	H2788_804_0	5	2009.01	GROUP HOSPITALIZATION AND MEDICAL SERVICES, INC.	Medi-CareFirst BlueCross BlueShield	www.medi-carefirst.com	04	09	2	1		H2788	804	0	2009	AdvantageBlue PFFS (Non-Calendar)	National		1	2			667	2						(866)-675-8636	(866)-675-8636	(800)-988-0668	(800)-988-0668	(866)-675-8636	(866)-675-8636	(800)-988-0668	(800)-988-0668									http://www.medi-carefirst.com	
H2802	001	0	1	01	01	H2802_001_0	6	2009.01	UNITED HEALTHCARE OF THE MIDLANDS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H2802	001	0	2009	AARP MedicareComplete Plan 1	Douglas and Pottawattamie Counties		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2802	005	0	1	01	01	H2802_005_0	5	2009.01	UNITED HEALTHCARE OF THE MIDLANDS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H2802	005	0	2009	Evercare Plan IH	Pottawattamie, Douglas and Sarpy Counties		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2803	001	0	1	02	01	H2803_001_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H2803	001	0	2009	AARP MedicareComplete Plus Plan1	Douglas and Pottawattamie Counties		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2803	002	0	1	02	01	H2803_002_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H2803	002	0	2009	AARP MedicareComplete Plus Plan1	Select rural counties in Nebraska and Iowa		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2803	010	0	1	02	01	H2803_010_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H2803	010	0	2009	Evercare Plan DH-POS	Omaha, NE and Council Bluffs, IA area		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2803	011	0	1	02	01	H2803_011_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H2803	011	0	2009	Evercare Plan IH-POS	Polk, Dallas and Warren Counties		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2803	012	0	1	02	01	H2803_012_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H2803	012	0	2009	Evercare Plan DH-POS	Polk, Dallas and Warren Counties		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2803	014	0	1	02	01	H2803_014_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H2803	014	0	2009	Evercare Plan MH-POS	Omaha, NE and Council Bluffs, IA area		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2803	015	0	1	02	01	H2803_015_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H2803	015	0	2009	Evercare Plan MH-POS	Polk, Dallas and Warren Counties		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2803	801	0	1	02	01	H2803_801_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H2803	801	0	2009	MedicareComplete Plus Retiree Plan	Select Counties in Nebraska and Iowa		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2803	803	0	1	02	01	H2803_803_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H2803	803	0	2009	MedicareComplete Retiree Plan	Select counties in Iowa and Nebraska		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2803	804	0	1	02	01	H2803_804_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H2803	804	0	2009	MedicareComplete Retiree Plan	NE/IA Select Counties		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2803	805	0	1	02	01	H2803_805_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H2803	805	0	2009	MedicareComplete Retiree Plan	NE/IA Select Counties		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H2815	001	0	1	20	08	H2815_001_0	1	2009.01	VOLUNTEERS OF AMERICA NATIONAL SERVICES	Senior CommUnity Care of Colorado	www.voa.org	08	20		1		H2815	001	0	2009	Senior CommUnity Care of Colorado	Senior CommUnity Care of Colorado		2	2				2														(952)-983-4244	(800)-111-1111			(952)-983-4244	(800)-111-1111			www.voa.org	
H2815	002	0	1	20	08	H2815_002_0	1	2009.01	VOLUNTEERS OF AMERICA NATIONAL SERVICES	Senior CommUnity Care of Colorado	www.voa.org	08	20		1		H2815	002	0	2009	Senior CommUnity Care of Colorado	Senior CommUnity Care of Colorado		2	2				2														(952)-983-4244	(800)-111-1111			(952)-983-4244	(800)-111-1111			www.voa.org	
H2869	001	0	1	04	01	H2869_001_0	2	2009.01	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.todaysoptions.com	01	04		1		H2869	001	0	2009	Today's Options PPO Select	Androscoggin, Cumberland, Kennebec Counties		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083									http://todaysoptions.com	www.todaysoptions.com
H2869	002	0	1	04	01	H2869_002_0	3	2009.01	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.todaysoptions.com	01	04		1		H2869	002	0	2009	Today's Options PPO Select powered by CCRx	Androscoggin, Cumberland, Kennebec Counties		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://todaysoptions.com	www.todaysoptions.com
H2869	003	0	1	04	01	H2869_003_0	7	2009.01	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.todaysoptions.com	01	04		1		H2869	003	0	2009	Today's Options PPO Complete powered by CCRx	Androscoggin, Cumberland, Kennebec Counties		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://todaysoptions.com	www.todaysoptions.com
H2869	801	0	1	04	01	H2869_801_0	4	2009.01	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.todaysoptions.com	01	04		1		H2869	801	0	2009	Today's Options PPO - MA Group Plan	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083									http://todaysoptions.com	www.todaysoptions.com
H2869	802	0	1	04	01	H2869_802_0	4	2009.01	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.todaysoptions.com	01	04		1		H2869	802	0	2009	Today's Options PPO - MAPD Group Plan	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://todaysoptions.com	www.todaysoptions.com
H2869	803	0	1	04	01	H2869_803_0	4	2009.01	AMERICAN PROGRESSIVE LIFE  HEALTH INSURANCE OF NY	Universal American	www.todaysoptions.com	01	04		1		H2869	803	0	2009	Today's Options PPO - Group Plan- NCY	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://todaysoptions.com	www.todaysoptions.com
H2899	001	0	1	01	01	H2899_001_0	18	2009.01	ARCADIAN HEALTH PLAN OF NORTH CAROLINA, INC.	Southeast Community Care	www.southeastcommunitycare.com	01	01		1		H2899	001	0	2009	Southeast Community Care - Plus	Eastern North Carolina		2	2			60739	2						(919)-781-4402	(800)-573-8597	(866)-573-8591	(866)-573-8591	(919)-781-4402	(877)-268-3866	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(919)-781-4402	(877)-268-3866	(866)-573-8613	(866)-573-8613	www.southeastcommunitycare.com	
H2899	002	0	1	01	01	H2899_002_0	15	2009.01	ARCADIAN HEALTH PLAN OF NORTH CAROLINA, INC.	Southeast Community Care	www.southeastcommunitycare.com	01	01		1		H2899	002	0	2009	Southeast Community Care - Dual Plus	Eastern North Carolina		2	1	3		6543	2			1	1		(919)-781-4402	(800)-573-8597	(866)-573-8591	(866)-573-8591	(919)-781-4402	(877)-268-3866	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(919)-781-4402	(877)-268-3866	(866)-573-8613	(866)-573-8613	www.southeastcommunitycare.com	
H2899	801	0	1	01	01	H2899_801_0	9	2009.01	ARCADIAN HEALTH PLAN OF NORTH CAROLINA, INC.	Southeast Community Care	www.southeastcommunitycare.com	01	01		1		H2899	801	0	2009	Southeast Community Care EGWP (NC)	North Carolina		1	2			0	2						(919)-781-4402	(800)-573-8597	(866)-573-8591	(866)-573-8591	(919)-781-4402	(877)-268-3866	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(919)-781-4402	(877)-268-3866	(866)-573-8613	(866)-573-8613	www.southeastcommunitycare.com	
H2905	001	0	1	04	01	H2905_001_0	9	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	http://www.sierraspectrumppo.com	01	04		1		H2905	001	0	2009	Sierra Spectrum	All NV counties and select counties in AZ and UT		2	2				2						(702)-562-8021	(877)-559-4512	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	(702)-562-8021	(877)-559-4512	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	http://www.sierraspectrumppo.com	http://www.sierraspectrumppo.com
H2905	801	0	1	04	01	H2905_801_0	4	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	http://www.sierraspectrumppo.com	01	04		1		H2905	801	0	2009	Basic Group (with Drug) Coverage	All of Nevada and select counties in AZ and UT		1	2				2						(702)-562-8021	(877)-559-4512	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	(702)-562-8021	(877)-559-4512	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	http://www.sierraspectrumppo.com	http://www.sierraspectrumppo.com
H2905	802	0	1	04	01	H2905_802_0	4	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	http://www.sierraspectrumppo.com	01	04		1		H2905	802	0	2009	Basic Group MA Only Coverage	All of Nevada and select counties in AZ and UT		1	2				2						(702)-562-8021	(877)-559-4512	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538									http://www.sierraspectrumppo.com	http://www.sierraspectrumppo.com
H2905	803	0	1	04	01	H2905_803_0	4	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	http://www.sierraspectrumppo.com	01	04		1		H2905	803	0	2009	(NCY) Basic Group (With Drug) Coverage	All of Nevada and select counties in AZ and UT		1	2				2						(702)-562-8021	(877)-559-4512	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	(702)-562-8021	(877)-559-4512	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	http://www.sierraspectrumppo.com	http://www.sierraspectrumppo.com
H2906	003	0	1	04	01	H2906_003_0	7	2009.01	HOMETOWN HEALTH PLAN	Senior Care Plus	SeniorCarePlus.com	01	04		1		H2906	003	0	2009	Senior Care Plus: Freedom Rx Premier Plan	Washoe County, NV		2	2			200	2						(775)-982-3112	(800)-336-0123	(775)-982-3240		(775)-982-3158	(800)-336-0123	(775)-982-3240		(775)-982-3112	(888)-341-8579		(888)-206-8041	(775)-982-3158	(800)-336-0123	(775)-982-3240		http://www.hometownhealth.com/SCPlus/scp_m_prescriptions.asp	http://www.SeniorCarePlus.com
H2914	001	0	1	04	01	H2914_001_0	2	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H2914	001	0	2009	Today's Options PPO Select	Oklahoma County		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	www.todaysoptions.com
H2914	002	0	1	04	01	H2914_002_0	2	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H2914	002	0	2009	Today's Options PPO Select	Rogers, Tulsa Counties		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	www.todaysoptions.com
H2914	003	0	1	04	01	H2914_003_0	3	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H2914	003	0	2009	Today's Options PPO Select powered by CCRx	Oklahoma County		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H2914	004	0	1	04	01	H2914_004_0	3	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H2914	004	0	2009	Today's Options PPO Select powered by CCRx	Rogers, Tulsa Counties		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H2914	801	0	1	04	01	H2914_801_0	5	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H2914	801	0	2009	Today's Options PPO - MA Group Plan	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	www.todaysoptions.com
H2914	802	0	1	04	01	H2914_802_0	5	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H2914	802	0	2009	Today's Options PPO - MAPD Group Plan	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H2914	803	0	1	04	01	H2914_803_0	5	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H2914	803	0	2009	Today's Options PPO - MAPD Group Plan - NCY	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H2926	001	0	1	01	01	H2926_001_0	5	2009.01	PRIMEWEST HEALTH SYSTEM	PrimeWest Health System	http://www.primewest.org	01	01		1		H2926	001	0	2009	Prime Health Complete	West Central and Southwest Minnesota		2	1	3		400	2			1	1		(320)-335-5243	(877)-600-4913	(800)-627-3529	(800)-627-3529	(320)-335-5243	(877)-600-4913	(800)-627-3529	(800)-627-3529	(320)-335-5243	(877)-600-4913	(800)-627-3529	(800)-627-3529	(320)-335-5243	(877)-600-4913	(800)-627-3529	(800)-627-3529	http://www.myrxassistant.com	http://www.primewest.org/find_doctor.xml
H2931	002	0	1	02	01	H2931_002_0	8	2009.01	HEALTH PLAN OF NEVADA, INC.	Health Plan of Nevada, Inc.	www.seniordimensions.com	01	02		1		H2931	002	0	2009	Senior Dimensions Southern Nevada Plan	Clark, Esmeralda and Nye counties		2	2				2						(702)-242-7301	(800)-650-6232	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	(702)-242-7301	(800)-650-6232	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	www.seniordimensions.com	www.seniordimensions.com
H2931	004	0	1	01	01	H2931_004_0	8	2009.01	HEALTH PLAN OF NEVADA, INC.	Health Plan of Nevada, Inc.	www.seniordimensions.com	01	01		1		H2931	004	0	2009	Senior Dimensions Greater Nevada  Plan	Lyon and Mineral counties		2	2				2						(702)-242-7301	(800)-650-6232	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	(702)-242-7301	(800)-650-6232	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	www.seniordimensions.com	www.seniordimensions.com
H2931	006	0	1	02	01	H2931_006_0	9	2009.01	HEALTH PLAN OF NEVADA, INC.	Health Plan of Nevada, Inc.	www.seniordimensions.com	01	02		1		H2931	006	0	2009	Senior Dimensions Northern Nevada Plan	Portions of  Washoe county		2	2				2						(702)-242-7301	(800)-650-6232	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	(702)-242-7301	(800)-650-6232	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	www.seniordimensions.com	www.seniordimensions.com
H2931	015	0	1	01	01	H2931_015_0	6	2009.01	HEALTH PLAN OF NEVADA, INC.	Health Plan of Nevada, Inc.	www.sierravillagehealth.com	01	01		1		H2931	015	0	2009	Sierra VillageHealth	Clark, Nye and Portions of Washoe County		2	1	4			2			1		0000000000000000000000001100	(866)-421-4386	(866)-421-4386	(866)-525-7833	(866)-525-7833	(866)-421-4386	(866)-421-4386	(866)-525-7833	(866)-525-7833	(866)-421-4386	(866)-421-4386	(866)-525-7833	(866)-525-7833	(866)-421-4386	(866)-421-4386	(866)-525-7833	(866)-525-7833	www.seniordimensions.com	www.seniordimensions.com
H2931	801	0	1	01	01	H2931_801_0	5	2009.01	HEALTH PLAN OF NEVADA, INC.	Health Plan of Nevada, Inc.	www.seniordimensions.com	01	01		1		H2931	801	0	2009	Basic Group (with Drug) Coverage	Counties: Clk, Esmrld, Ny, Lyn, Mnrl, parts of Wsh		1	2				2						(702)-242-7301	(800)-650-6232	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	(702)-242-7301	(800)-650-6232	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	www.seniordimensions.com	www.seniordimensions.com
H2931	803	0	1	01	01	H2931_803_0	7	2009.01	HEALTH PLAN OF NEVADA, INC.	Health Plan of Nevada, Inc.	www.seniordimensions.com	01	01		1		H2931	803	0	2009	Basic Group MA Only Coverage	Counties: Clk, Esmrld, Ny, Lyn, Mnrl, parts of Wsh		1	2				2						(702)-242-7301	(800)-650-6232	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538									www.seniordimensions.com	www.seniordimensions.com
H2931	804	0	1	01	01	H2931_804_0	5	2009.01	HEALTH PLAN OF NEVADA, INC.	Health Plan of Nevada, Inc.	www.seniordimensions.com	01	01		1		H2931	804	0	2009	(NCY) Basic Group (With Drug) Coverage	Counties: Clk, Esmrld, Ny, Lyn, Mnrl, parts of Wsh		1	2				2						(702)-242-7301	(800)-650-6232	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	(702)-242-7301	(800)-650-6232	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	www.seniordimensions.com	www.seniordimensions.com
H2936	001	0	1	20	08	H2936_001_0	2	2009.01	LIFECIRCLES	LIFECIRCLES	www.lifecircles-pace.org	08	20		1		H2936	001	0	2009	LifeCircles	Muskegon, Ottawa		2	2				2														(231)-733-8686	(231)-733-8686			(231)-733-8686	(231)-733-8686			www.lifecircles-pace.org	
H2936	002	0	1	20	08	H2936_002_0	1	2009.01	LIFECIRCLES	LIFECIRCLES	www.lifecircles-pace.org	08	20		1		H2936	002	0	2009	002 - Medicare Only	002 - Medicare Only		2	2				2														(231)-733-8686	(231)-733-8686			(231)-733-8686	(231)-733-8686			www.lifecircles-pace.org	
H2941	001	0	1	20	08	H2941_001_0	1	2009.01	SENTARA LIFE CARE CORPORATION, INC	Sentara Senior Community Care	www.sentara.com	08	20		1		H2941	001	0	2009	Sentara Senior Community Care Dual	Chesapeake, Norfolk, Portsmouth and Virginia Beach		2	2				2														(757)-502-7800	(800)-736-8272			(757)-502-7800	(800)-736-8272			www.sentara.com	
H2941	002	0	1	20	08	H2941_002_0	1	2009.01	SENTARA LIFE CARE CORPORATION, INC	Sentara Senior Community Care	www.sentara.com	08	20		1		H2941	002	0	2009	Sentara Senior Community Care Private	Chesapeake, Norfolk, Portsmouth and Virginia Beach		2	2				2														(757)-502-7800	(800)-736-8272			(757)-502-7800	(800)-736-8272			www.sentara.com	
H2947	001	0	1	04	01	H2947_001_0	10	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Advantra	www.va.chcadvantra.com	01	04		1		H2947	001	0	2009	Advantra Silver	Roanoke Area		2	2			84	2						(866)-731-9573	(866)-731-9573	(866)-784-4931	(866)-784-4931	(888)-541-2694	(888)-541-2694	(888)-541-2694	(888)-541-2694	(888)-698-0577	(888)-698-0577	(866)-236-1069	(866)-236-1069	(888)-541-2694	(888)-541-2694	(888)-541-2694	(888)-541-2694	www.chcadvantra.com	
H2947	002	0	1	04	01	H2947_002_0	7	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Advantra	www.va.chcadvantra.com	01	04		1		H2947	002	0	2009	Advantra Gold	Roanoke Area		2	2			337	2						(866)-731-9573	(866)-731-9573	(866)-784-4931	(866)-784-4931	(888)-541-2694	(888)-541-2694	(888)-541-2694	(888)-541-2694	(888)-698-0577	(888)-698-0577	(866)-236-1069	(866)-236-1069	(888)-541-2694	(888)-541-2694	(888)-541-2694	(888)-541-2694	www.chcadvantra.com	
H2947	801	0	1	04	01	H2947_801_0	4	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Advantra	www.va.chcadvantra.com	01	04		1		H2947	801	0	2009	Advantra	VA		1	2			88	2						(866)-731-9573	(866)-731-9573	(866)-784-4931	(866)-784-4931	(888)-541-2694	(888)-541-2694	(888)-541-2694	(888)-541-2694									www.chcadvantra.com	
H2947	802	0	1	04	01	H2947_802_0	4	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Advantra	www.va.chcadvantra.com	01	04		1		H2947	802	0	2009	Advantra	VA		1	2			88	2						(866)-731-9573	(866)-731-9573	(866)-784-4931	(866)-784-4931	(888)-541-2694	(888)-541-2694	(888)-541-2694	(888)-541-2694	(888)-698-0577	(888)-698-0577	(866)-236-1069	(866)-236-1069	(888)-541-2694	(888)-541-2694	(888)-541-2694	(888)-541-2694	www.chcadvantra.com	
H2947	803	0	1	04	01	H2947_803_0	4	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Advantra	www.va.chcadvantra.com	01	04		1		H2947	803	0	2009	Advantra	VA		1	2			88	2						(866)-731-9573	(866)-731-9573	(866)-784-4931	(866)-784-4931	(888)-541-2694	(888)-541-2694	(888)-541-2694	(888)-541-2694	(888)-698-0577	(888)-698-0577	(866)-236-1069	(866)-236-1069	(888)-541-2694	(888)-541-2694	(888)-541-2694	(888)-541-2694	www.chcadvantra.com	
H2949	002	0	1	01	01	H2949_002_0	8	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H2949	002	0	2009	Humana Gold Plus HMO H2949-002	Clark County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2949	007	0	1	01	01	H2949_007_0	6	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H2949	007	0	2009	Humana Gold Plus HMO H2949-007	Nye County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2949	009	0	1	01	01	H2949_009_0	6	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H2949	009	0	2009	Humana Gold Plus HMO H2949-009	Clark County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2949	011	0	1	01	01	H2949_011_0	7	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H2949	011	0	2009	Humana Gold Plus HMO H2949-011	Nye County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2949	012	0	1	01	01	H2949_012_0	6	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H2949	012	0	2009	Humana Gold Plus HMO H2949-012	Clark County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2949	805	0	1	01	01	H2949_805_0	1	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H2949	805	0	2009	Humana Employer Sponsored	Select counties in Nevada		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2949	807	0	1	01	01	H2949_807_0	1	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H2949	807	0	2009	Humana Employer Sponsored	Select counties in Nevada		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2949	808	0	1	01	01	H2949_808_0	1	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H2949	808	0	2009	Humana Employer Sponsored Non-CY	Select counties in Nevada		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2949	810	0	1	01	01	H2949_810_0	1	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H2949	810	0	2009	Humana Employer Sponsored Non-CY	Select counties in Nevada		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H2960	004	0	1	01	01	H2960_004_0	7	2009.01	HOMETOWN HEALTH PLAN	Senior Care Plus	www.SeniorCarePlus.com	01	01		1		H2960	004	0	2009	Senior Care Plus: Value Rx Enhanced Plan	Washoe County, NV		2	2			500	2						(775)-982-3112	(800)-336-0123	(775)-982-3240		(775)-982-3158	(800)-336-0123	(775)-982-3240		(775)-982-3112	(888)-341-8576		(888)-206-8041	(775)-982-3158	(800)-336-0123	(775)-982-3240		http://www.hometownhealth.com/scplus/scp_m_prescriptions.asp	http://www.SeniorCarePlus.com
H2960	009	0	1	01	01	H2960_009_0	5	2009.01	HOMETOWN HEALTH PLAN	Senior Care Plus	www.SeniorCarePlus.com	01	01		1		H2960	009	0	2009	Senior Care Plus: Value Basic Plan	Washoe County, NV		2	2			500	2						(775)-982-3112	(800)-336-0123	(775)-982-3240		(775)-982-3158	(800)-336-0123	(775)-982-3240										http://www.hometownhealth.com/scplus/scp_m_prescriptions.asp	http://www.SeniorCarePlus.com
H2960	010	0	1	01	01	H2960_010_0	7	2009.01	HOMETOWN HEALTH PLAN	Senior Care Plus	www.SeniorCarePlus.com	01	01		1		H2960	010	0	2009	Senior Care Plus: Value Rx Premier Plan	Washoe County, NV		2	2			500	2						(775)-982-3112	(800)-336-0123	(775)-982-3240		(775)-982-3158	(800)-336-0123	(775)-982-3240		(775)-982-3112	(888)-341-8576		(888)-206-8041	(775)-982-3158	(800)-336-0123	(775)-982-3240		http://www.hometownhealth.com/scplus/scp_m_prescriptions.asp	http://www.SeniorCarePlus.com
H2960	012	0	1	01	01	H2960_012_0	7	2009.01	HOMETOWN HEALTH PLAN	Senior Care Plus	www.SeniorCarePlus.com	01	01		1		H2960	012	0	2009	Senior Care Plus: Value Rx Plan	Washoe County, NV		2	2			500	2						(775)-982-3112	(800)-336-0123	(775)-982-3240		(775)-982-3158	(800)-336-0123	(775)-982-3240		(775)-982-3112	(888)-341-8576		(888)-206-8041	(775)-982-3158	(800)-336-0123	(775)-982-3240		http://www.hometownhealth.com/scplus/scp_m_prescriptions.asp	http://www.SeniorCarePlus.com
H2960	803	0	1	01	01	H2960_803_0	2	2009.01	HOMETOWN HEALTH PLAN	Senior Care Plus	www.SeniorCarePlus.com	01	01		1		H2960	803	0	2009	Senior Care Plus: Value Group Plan	Washoe County, Nevada		1	2			500	2						(775)-982-3112	(800)-336-0123	(775)-982-3240		(775)-982-3158	(800)-336-0123	(775)-982-3240		(775)-982-3112	(888)-341-8576		(888)-206-8041	(775)-982-3158	(800)-336-0123	(775)-982-3240		http://www.hometownhealth.com/scplus/scp_m_prescriptions.asp	http://www.SeniorCarePlus.com
H2961	002	0	1	02	01	H2961_002_0	12	2009.01	HEALTH PLAN OF NEVADA, INC.	Health Plan of Nevada, Inc.	www.seniordimensions.com	01	02		1		H2961	002	0	2009	Senior Dimensions Southern Nevada Plan	Clark and Nye counties		2	2				2						(702)-242-7301	(800)-650-6232	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	(702)-242-7301	(800)-650-6232	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	www.seniordimensions.com	www.seniordimensions.com
H2961	011	0	1	02	01	H2961_011_0	9	2009.01	HEALTH PLAN OF NEVADA, INC.	Health Plan of Nevada, Inc.	www.seniordimensions.com	01	02		1		H2961	011	0	2009	Senior Dimensions Northern Nevada Plan	Portions of Washoe county		2	2				2						(702)-242-7301	(800)-650-6232	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	(702)-242-7301	(800)-650-6232	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	www.seniordimensions.com	www.seniordimensions.com
H2961	801	0	1	01	01	H2961_801_0	6	2009.01	HEALTH PLAN OF NEVADA, INC.	Health Plan of Nevada, Inc.	www.seniordimensions.com	01	01		1		H2961	801	0	2009	Basic Group (with Drug) Coverage	Clark, Nye and portions of Washoe county		1	2				2						(702)-242-7301	(800)-650-6232	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	(702)-242-7301	(800)-650-6232	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	www.seniordimensions.com	www.seniordimensions.com
H2961	805	0	1	01	01	H2961_805_0	6	2009.01	HEALTH PLAN OF NEVADA, INC.	Health Plan of Nevada, Inc.	www.seniordimensions.com	01	01		1		H2961	805	0	2009	Basic Group MA Only Coverage	Clark, Nye and portions of Washoe county		1	2				2						(702)-242-7301	(800)-650-6232	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538									www.seniordimensions.com	www.seniordimensions.com
H2961	806	0	1	01	01	H2961_806_0	5	2009.01	HEALTH PLAN OF NEVADA, INC.	Health Plan of Nevada, Inc.	www.seniordimensions.com	01	01		1		H2961	806	0	2009	(NCY) Basic Group (With Drug) Coverage	Clark, Nye and portions of Washoe county		1	2				2						(702)-242-7301	(800)-650-6232	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	(702)-242-7301	(800)-650-6232	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	www.seniordimensions.com	www.seniordimensions.com
H2997	001	0	1	04	01	H2997_001_0	8	2009.01	ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	04		1		H2997	001	0	2009	Anthem Medicare Preferred Premier	Clark and Washoe Counties		2	2			786	2						(866)-754-3077	(866)-754-3077	(800)-425-5705	(800)-425-5705	(888)-949-5384	(888)-949-5384	(800)-297-1538	(800)-297-1538	(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(888)-949-5384	(888)-949-5384	(800)-297-1538	(800)-297-1538	www.anthem.com	
H3011	001	0	1	09	04	H3011_001_0	5	2009.01	BLUE CROSS AND BLUE SHIELD OF MASS. HMO BLUE, INC.	Blue Cross and Blue Shield of Massachusetts	www.bluecrossma.com/medicare	04	09	2	1		H3011	001	0	2009	Blue Medicare PFFS PlusRx	Commonwealth of Massachusetts		2	2			839	2						(800)-200-4255		(800)-522-1254		(800)-678-2265		(800)-522-1254		(800)-200-4255	(800)-200-4255	(800)-522-1254		(800)-678-2265	(800)-678-2265	(800)-522-1254		http://www.bluecrossma.com/Medicare/audience/Already_A_Member/pharmacy/index.html	
H3011	801	0	1	09	04	H3011_801_0	3	2009.01	BLUE CROSS AND BLUE SHIELD OF MASS. HMO BLUE, INC.	Blue Cross and Blue Shield of Massachusetts	www.bluecrossma.com/medicare	04	09	2	1		H3011	801	0	2009	Blue Medicare PFFS	United States		1	2			95	2						(800)-200-4255		(800)-522-1254		(800)-678-2265		(800)-522-1254		(800)-200-4255	(800)-200-4255	(800)-522-1254		(800)-678-2265	(800)-678-2265	(800)-522-1254		http://www.bluecrossma.com/Medicare/audience/Already_A_Member/pharmacy/index.html	
H3011	802	0	1	09	04	H3011_802_0	3	2009.01	BLUE CROSS AND BLUE SHIELD OF MASS. HMO BLUE, INC.	Blue Cross and Blue Shield of Massachusetts	www.bluecrossma.com/medicare	04	09	2	1		H3011	802	0	2009	Blue Medicare PFFS	United States		1	2			95	2						(800)-200-4255		(800)-522-1254		(800)-678-2265		(800)-522-1254										http://www.bluecrossma.com/Medicare/audience/Already_A_Member/pharmacy/index.html	
H3028	001	0	1	01	01	H3028_001_0	6	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H3028	001	0	2009	Humana Gold Plus HMO (H3028-001)	Albuquerque		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H3028	801	0	1	01	01	H3028_801_0	1	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H3028	801	0	2009	Humana Employer Sponsored	Select counties in New Mexico		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H3028	803	0	1	01	01	H3028_803_0	1	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H3028	803	0	2009	Humana Employer Sponsored	Select counties in New Mexico		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H3028	804	0	1	01	01	H3028_804_0	1	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H3028	804	0	2009	Humana Employer Sponsored Non-CY	Select counties in New Mexico		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H3028	805	0	1	01	01	H3028_805_0	1	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H3028	805	0	2009	Humana Employer Sponsored Non-CY	Select counties in New Mexico		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H3044	001	0	1	01	01	H3044_001_0	9	2009.01	NHP OF INDIANA, LLC	Welborn Health Plans	www.welbornhealthplans.com	01	01		1		H3044	001	0	2009	WHP Silver Rx	Eight Southwestern Indiana Counties		2	2			700	2						(812)-773-0372	(800)-521-0265	(800)-743-3333		(812)-773-0372	(800)-521-0265	(800)-743-3333		(812)-773-0372	(800)-521-0265	(800)-743-3333		(812)-773-0372	(800)-521-0265	(800)-743-3333		www.welbornhealthplans.com	www.welbornhealthplans.com
H3044	002	0	1	01	01	H3044_002_0	6	2009.01	NHP OF INDIANA, LLC	Welborn Health Plans	www.welbornhealthplans.com	01	01		1		H3044	002	0	2009	WHP Silver	Eight Southwestern Indiana Counties		2	2			700	2						(812)-773-0372	(800)-521-0265	(800)-743-3333		(812)-773-0372	(800)-521-0265	(800)-743-3333										www.welbornhealthplans.com	www.welbornhealthplans.com
H3044	003	0	1	01	01	H3044_003_0	9	2009.01	NHP OF INDIANA, LLC	Welborn Health Plans	www.welbornhealthplans.com	01	01		1		H3044	003	0	2009	WHP Platinum Rx	Eight Southern Indiana Counties		2	2			500	2						(812)-773-0372	(800)-521-0265	(800)-743-3333		(812)-773-0372	(800)-521-0265	(800)-743-3333		(812)-773-0372	(800)-521-0265	(800)-743-3333		(812)-773-0372	(800)-521-0265	(800)-743-3333		www.welbornhealthplans.com	www.welbornhealthplans.com
H3057	001	1	1	09	04	H3057_001_1	4	2009.01	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION,	Tufts Health Plan	www.tuftshealthplan.com	04	09	2	1		H3057	001	1	2009	Tufts Medicare Preferred PFFS Prime Rx Plus	All of Massachusetts	Essex, Suffolk, Worcester counties	2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	http://www.tuftshealthplan.com/medicare	
H3057	001	2	1	09	04	H3057_001_2	4	2009.01	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION,	Tufts Health Plan	www.tuftshealthplan.com	04	09	2	1		H3057	001	2	2009	Tufts Medicare Preferred PFFS Prime Rx Plus	All of Massachusetts	All counties except Essex, Suffolk, Worcester	2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	http://www.tuftshealthplan.com/medicare	
H3057	002	1	1	09	04	H3057_002_1	4	2009.01	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION,	Tufts Health Plan	www.tuftshealthplan.com	04	09	2	1		H3057	002	1	2009	Tufts Medicare Preferred PFFS Prime Rx	All of Massachusetts	Essex, Suffolk, Worcester counties	2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	http://www.tuftshealthplan.com/medicare	
H3057	002	2	1	09	04	H3057_002_2	4	2009.01	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION,	Tufts Health Plan	www.tuftshealthplan.com	04	09	2	1		H3057	002	2	2009	Tufts Medicare Preferred PFFS Prime Rx	All of Massachusetts	All counties except Essex, Suffolk, Worcester	2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	http://www.tuftshealthplan.com/medicare	
H3057	003	1	1	09	04	H3057_003_1	3	2009.01	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION,	Tufts Health Plan	www.tuftshealthplan.com	04	09	2	1		H3057	003	1	2009	Tufts Medicare Preferred PFFS Prime	All of Massachusetts	Essex, Suffolk, Worcester counties	2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977									http://www.tuftshealthplan.com/medicare	
H3057	003	2	1	09	04	H3057_003_2	3	2009.01	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION,	Tufts Health Plan	www.tuftshealthplan.com	04	09	2	1		H3057	003	2	2009	Tufts Medicare Preferred PFFS Prime	All of Massachusetts	All counties except Essex, Suffolk, Worcester	2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977									http://www.tuftshealthplan.com/medicare	
H3057	007	0	1	09	04	H3057_007_0	4	2009.01	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION,	Tufts Health Plan	www.tuftshealthplan.com	04	09	2	1		H3057	007	0	2009	Tufts Medicare Preferred PFFS Basic Rx Plus	All of Massachusetts		2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	http://www.tuftshealthplan.com/medicare	
H3057	008	0	1	09	04	H3057_008_0	4	2009.01	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION,	Tufts Health Plan	www.tuftshealthplan.com	04	09	2	1		H3057	008	0	2009	Tufts Medicare Preferred PFFS Basic Rx	All of Massachusetts		2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	http://www.tuftshealthplan.com/medicare	
H3057	009	0	1	09	04	H3057_009_0	3	2009.01	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION,	Tufts Health Plan	www.tuftshealthplan.com	04	09	2	1		H3057	009	0	2009	Tufts Medicare Preferred PFFS Basic	All of Massachusetts		2	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977									http://www.tuftshealthplan.com/medicare	
H3057	801	0	1	09	04	H3057_801_0	4	2009.01	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION,	Tufts Health Plan	www.tuftshealthplan.com	04	09	2	1		H3057	801	0	2009	Tufts Medicare Preferred PFFS Rx	All of Massachusetts and the US		1	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	http://www.tuftshealthplan.com/medicare	
H3057	802	0	1	09	04	H3057_802_0	4	2009.01	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION,	Tufts Health Plan	www.tuftshealthplan.com	04	09	2	1		H3057	802	0	2009	Tufts Medicare Preferred PFFS	All of Massachusetts and the US		1	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977									http://www.tuftshealthplan.com/medicare	
H3057	803	0	1	09	04	H3057_803_0	5	2009.01	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION,	Tufts Health Plan	www.tuftshealthplan.com	04	09	2	1		H3057	803	0	2009	Tufts Medicare Preferred PFFS Rx	All of Massachusetts and the US		1	2				2						(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	(800)-701-9000	(800)-701-9000	(800)-208-9562	(800)-208-9562	(800)-254-2475	(800)-254-2475	(888)-899-8977	(888)-899-8977	http://www.tuftshealthplan.com/medicare	
H3059	001	0	1	01	01	H3059_001_0	3	2009.01	PHYSICIANS HEALTH CHOICE OF NEW MEXICO	PHYSICIANS HEALTH CHOICE OF NEW MEXICO	WWW.PHYSICIANSHEALTHCHOICE.COM	01	01		1		H3059	001	0	2009	Physicians Health Choice Basic	Dona Ana and Otero Counties		2	2			733	2						(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659									http://www.physicianshealthchoice.com/members-formulary.html	WWW.PHYSICIANSHEALTHCHOICE.COM
H3059	002	0	1	01	01	H3059_002_0	6	2009.01	PHYSICIANS HEALTH CHOICE OF NEW MEXICO	PHYSICIANS HEALTH CHOICE OF NEW MEXICO	WWW.PHYSICIANSHEALTHCHOICE.COM	01	01		1		H3059	002	0	2009	Physicians Health Choice Standard	Dona Ana and Otero Counties		2	2			7033	2						(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	http://www.physicianshealthchoice.com/members-formulary.html	WWW.PHYSICIANSHEALTHCHOICE.COM
H3059	004	0	1	01	01	H3059_004_0	3	2009.01	PHYSICIANS HEALTH CHOICE OF NEW MEXICO	PHYSICIANS HEALTH CHOICE OF NEW MEXICO	WWW.PHYSICIANSHEALTHCHOICE.COM	01	01		1		H3059	004	0	2009	Physicians Health Choice Select	Dona Ana and Otero Counties		2	1	3		6886	2			1	3		(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	http://www.physicianshealthchoice.com/members-formulary.html	WWW.PHYSICIANSHEALTHCHOICE.COM
H3107	004	0	1	02	01	H3107_004_0	4	2009.01	OXFORD HEALTH PLANS (NJ), INC.	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	02		1		H3107	004	0	2009	AARP MedicareComplete Plus Plan 1	Northern and Central New Jersey and Morris		2	2				2						(800)-665-4654	(800)-665-4654	(800)-201-4874		(800)-547-5514	(800)-547-5514	(888)-685-8480		(800)-665-4654	(800)-665-4654	(800)-201-4874		(800)-547-5514	(800)-547-5514	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3107	005	0	1	02	01	H3107_005_0	6	2009.01	OXFORD HEALTH PLANS (NJ), INC.	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	02		1		H3107	005	0	2009	AARP MedicareComplete Balance Plus	Northern and Central New Jersey, Morris		2	2				2						(800)-665-4654	(800)-665-4654	(800)-201-4874		(800)-547-5514	(800)-547-5514	(888)-685-8480		(800)-665-4654	(800)-665-4654	(800)-201-4874		(800)-547-5514	(800)-547-5514	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3107	008	0	1	02	01	H3107_008_0	2	2009.01	OXFORD HEALTH PLANS (NJ), INC.	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	02		1		H3107	008	0	2009	AARP MedicareComplete Plus Plan 2	Northern and Central New Jersey, Morris		2	2				2						(800)-234-1228	(800)-234-1228	(800)-201-4874		(800)-547-5514	(800)-547-5514	(888)-685-8480										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3107	801	0	1	01	01	H3107_801_0	3	2009.01	OXFORD HEALTH PLANS (NJ), INC.	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H3107	801	0	2009	MedicareComplete Retiree Plan	State of New Jersey Counties		1	2				2						(800)-234-1228		(800)-201-4874		(800)-303-6720		(800)-201-4874		(800)-234-1228	(800)-234-1228	(800)-201-4874		(800)-303-6720	(800)-303-6720	(800)-201-4874		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3107	803	0	1	01	01	H3107_803_0	3	2009.01	OXFORD HEALTH PLANS (NJ), INC.	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H3107	803	0	2009	MedicareComplete Essential Retiree Plan	State of New Jersey Counties		1	2				2						(800)-234-1228		(800)-201-4874		(800)-303-6720		(800)-201-4874										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3107	804	0	1	01	01	H3107_804_0	3	2009.01	OXFORD HEALTH PLANS (NJ), INC.	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H3107	804	0	2009	MedicareComplete Retiree Plan	Morris NJ		1	2				2						(800)-234-1228		(800)-201-4874		(800)-303-6720		(800)-201-4874		(800)-234-1228	(800)-234-1228	(800)-201-4874		(800)-303-6720	(800)-303-6720	(800)-201-4874		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3107	805	0	1	01	01	H3107_805_0	3	2009.01	OXFORD HEALTH PLANS (NJ), INC.	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H3107	805	0	2009	MedicareComplete Retiree Plan	Morris NJ		1	2				2						(800)-234-1228		(800)-201-4874		(800)-303-6720		(800)-201-4874										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3113	001	0	1	01	01	H3113_001_0	9	2009.01	OXFORD HEALTH PLANS OF NEW JERSEY, INC	Evercare Health Plans	www.EvercareHealthPlans.com	01	01		1		H3113	001	0	2009	Evercare Plan IH	Bergen,Essex,Hudson,Morris,Passaic,Somerset, Union		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H3113	002	0	1	01	01	H3113_002_0	4	2009.01	OXFORD HEALTH PLANS OF NEW JERSEY, INC	Evercare Health Plans	www.EvercareHealthPlans.com	01	01		1		H3113	002	0	2009	Evercare Plan MH	Bergen,Essex,Hudson,Morris,Passaic,Somerset, Union		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H3113	003	0	1	01	01	H3113_003_0	7	2009.01	OXFORD HEALTH PLANS OF NEW JERSEY, INC	Evercare Health Plans	www.EvercareHealthPlans.com	01	01		1		H3113	003	0	2009	Evercare Plan DH	Bergen,Essex,Hudson,Morris,Passaic,Somerset, Union		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H3132	001	0	1	01	01	H3132_001_0	6	2009.01	AIDS HEALTHCARE FOUNDATION MCO OF FLORIDA, INC.	Positive Healthcare Partners	www.positivehealthcare.org	01	01		1		H3132	001	0	2009	POSITIVE HEALTHCARE PARTNERS	AHF MCO OF FLORIDA BROWARD/MIAMI-DADE COUNTIES		2	1	4		700	2			1		0000000000010000000000000000	(954)-522-3132	(888)-456-4715	(800)-955-8771	(800)-955-8771	(954)-522-3132	(888)-456-4715	(800)-955-8771	(800)-955-8771	(954)-522-3132	(888)-456-4715	(800)-955-8771	(800)-955-8771	(954)-522-3132	(888)-456-4715	(800)-955-8771	(800)-955-8771	https://www.catalystrx.com/www/MedicareD/index.jsp?src=ahf	www.positivehealthcare.org
H3152	022	0	1	01	01	H3152_022_0	6	2009.01	AETNA HEALTH, INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3152	022	0	2009	Aetna Golden Medicare Standard Plan	Southern New Jersey		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3152	041	0	1	01	01	H3152_041_0	3	2009.01	AETNA HEALTH, INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3152	041	0	2009	Aetna Golden Medicare Value Plan	Southern New Jersey		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3152	045	0	1	01	01	H3152_045_0	3	2009.01	AETNA HEALTH, INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3152	045	0	2009	Aetna Golden Medicare Basic Plan	Northern New Jersey		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3152	046	0	1	01	01	H3152_046_0	4	2009.01	AETNA HEALTH, INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3152	046	0	2009	Aetna Golden Medicare Value Plan	Northern New Jersey		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3152	047	0	1	01	01	H3152_047_0	4	2009.01	AETNA HEALTH, INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3152	047	0	2009	Aetna Golden Medicare Standard Plan	Northern New Jersey		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3152	048	0	1	01	01	H3152_048_0	4	2009.01	AETNA HEALTH, INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3152	048	0	2009	Aetna Golden Medicare Premier Plan	Northern New Jersey		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3152	053	0	1	01	01	H3152_053_0	6	2009.01	AETNA HEALTH, INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3152	053	0	2009	Aetna Golden Medicare Premier Plan	Southern New Jersey		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3152	073	0	1	01	01	H3152_073_0	7	2009.01	AETNA HEALTH, INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3152	073	0	2009	Aetna Golden Medicare Dual Advantage Plan	Burlington, Camden, Gloucester and Mercer Counties		2	1	3			2			1	2		(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3152	074	0	1	01	01	H3152_074_0	6	2009.01	AETNA HEALTH, INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3152	074	0	2009	Aetna Golden Medicare Dual Advantage Plan	Northern New Jersey		2	1	3			2			1	2		(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3152	801	0	1	01	01	H3152_801_0	4	2009.01	AETNA HEALTH, INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3152	801	0	2009	Aetna Golden Medicare Plan	New Jersey		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3152	804	0	1	01	01	H3152_804_0	4	2009.01	AETNA HEALTH, INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3152	804	0	2009	Aetna Golden Medicare Plan w/Rx CY	New Jersey		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3154	004	0	1	01	01	H3154_004_0	6	2009.01	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com/medicare	01	01		1		H3154	004	0	2009	Horizon Medicare Blue Value w/ Rx Std	New Jersey		2	2				2						(800)-365-2223		(800)-855-2881		(800)-224-1234	(800)-224-1234	(800)-852-7899		(866)-236-7376	(866)-236-7376	(866)-236-1069		(800)-224-1234	(800)-224-1234	(800)-852-7899		http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	www.horizonblue.com
H3154	005	0	1	02	01	H3154_005_0	3	2009.01	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com/medicare	01	02		1		H3154	005	0	2009	Horizon Medicare Blue Access	New Jersey		2	2				2						(800)-365-2223		(800)-855-2881		(800)-224-1234	(800)-224-1234	(800)-852-7899										http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	www.horizonblue.com
H3154	006	0	1	02	01	H3154_006_0	7	2009.01	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com/medicare	01	02		1		H3154	006	0	2009	Horizon Medicare Blue Access w/Rx Enhanced	New Jersey		2	2				2						(800)-365-2223		(800)-855-2881		(800)-224-1234	(800)-224-1234	(800)-852-7899		(866)-236-7376	(866)-236-7376	(866)-236-1069		(800)-224-1234	(800)-224-1234	(800)-852-7899		http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	www.horizonblue.com
H3154	012	0	1	02	01	H3154_012_0	3	2009.01	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com/medicare	01	02		1		H3154	012	0	2009	Horizon Medicare Blue Access w/ Rx Std	New Jersey		2	2				2						(800)-365-2223		(800)-855-2881		(800)-224-1234	(800)-224-1234	(800)-852-7899		(866)-236-7376	(866)-236-7376	(866)-236-1069		(800)-224-1234	(800)-224-1234	(800)-852-7899		http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	www.horizonblue.com
H3154	013	0	1	01	01	H3154_013_0	3	2009.01	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com/medicare	01	01		1		H3154	013	0	2009	Horizon Medicare Blue Value	New Jersey		2	2				2						(800)-365-2223		(800)-855-2881		(800)-224-1234	(800)-224-1234	(800)-852-7899										http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	www.horizonblue.com
H3154	014	0	1	01	01	H3154_014_0	4	2009.01	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com/medicare	01	01		1		H3154	014	0	2009	Horizon Medicare Blue Solutions	New Jersey		2	1	3			2			1	2		(800)-365-2223		(800)-855-2881		(800)-224-1234	(800)-224-1234	(800)-852-7899		(866)-236-7376	(866)-236-7376	(866)-236-1069		(800)-224-1234	(800)-224-1234	(800)-852-7899		http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	www.horizonblue.com
H3154	015	0	1	02	01	H3154_015_0	7	2009.01	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com/medicare	01	02		1		H3154	015	0	2009	Horizon Medicare Blue Access w/ Rx Plus	New Jersey		2	2				2						(800)-365-2223		(800)-855-2881		(800)-224-1234	(800)-224-1234	(800)-852-7899		(866)-236-7376	(866)-236-7376	(866)-236-1069		(800)-224-1234	(800)-224-1234	(800)-852-7899		http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	www.horizonblue.com
H3154	016	0	1	01	01	H3154_016_0	4	2009.01	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com/medicare	01	01		1		H3154	016	0	2009	Horizon Medicare Blue Value w/ Rx Enhanced	New Jersey		2	2				2						(800)-365-2223		(800)-855-2881		(800)-224-1234	(800)-224-1234	(800)-852-7899		(866)-236-7376	(866)-236-7376	(866)-236-1069		(800)-224-1234	(800)-224-1234	(800)-852-7899		http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	www.horizonblue.com
H3154	017	0	1	01	01	H3154_017_0	8	2009.01	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com/medicare	01	01		1		H3154	017	0	2009	Horizon Medicare Blue Value w/ Rx Plus	New Jersey		2	2				2						(800)-365-2223		(800)-855-2881		(800)-224-1234	(800)-224-1234	(800)-852-7899		(866)-236-7376	(866)-236-7376	(866)-236-1069		(800)-224-1234	(800)-224-1234	(800)-852-7899		http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	www.horizonblue.com
H3154	801	0	1	02	01	H3154_801_0	3	2009.01	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www,horizonblue.com/medicare	01	02		1		H3154	801	0	2009	Horizon Medicare Blue Access Group	New Jersey		1	2				2						(800)-365-2223		(800)-855-2881		(800)-224-1234	(800)-224-1234	(800)-852-7899										http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	www.horizonblue.com
H3154	802	0	1	02	01	H3154_802_0	3	2009.01	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www,horizonblue.com/medicare	01	02		1		H3154	802	0	2009	Horizon Medicare Blue Access Grp w/ Rx Std	New Jersey		1	2				2						(800)-365-2223		(800)-855-2881		(800)-224-1234	(800)-224-1234	(800)-852-7899		(866)-236-7376	(866)-236-7376	(866)-236-1069		(800)-224-1234	(800)-224-1234	(800)-852-7899		http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	www.horizonblue.com
H3154	805	0	1	02	01	H3154_805_0	2	2009.01	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com/medicare	01	02		1		H3154	805	0	2009	Horizon Medicare Blue Access Grp w/ Rx Std	New Jersey		1	2				2						(800)-365-2223		(800)-855-2881		(800)-224-1234	(800)-224-1234	(800)-852-7899		(866)-236-7376	(866)-236-7376	(866)-236-1069		(800)-224-1234	(800)-224-1234	(800)-852-7899		http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	www.horizonblue.com
H3154	807	0	1	02	01	H3154_807_0	2	2009.01	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com/medicare	01	02		1		H3154	807	0	2009	Horizon Medicare Blue Access Group Plus	National		1	2				2						(800)-365-2223		(800)-855-2881		(800)-224-1234	(800)-224-1234	(800)-852-7899										http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	www.horizonblue.com
H3154	808	0	1	02	01	H3154_808_0	1	2009.01	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www,horizonblue.com/medicare	01	02		1		H3154	808	0	2009	Horizon Medicare Blue Access Grp Plus w/Rx Std	National		1	2				2						(800)-365-2223		(800)-855-2881		(800)-224-1234	(800)-224-1234	(800)-852-7899		(866)-236-7376	(866)-236-7376	(866)-236-1069		(800)-224-1234	(800)-224-1234	(800)-852-7899		http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	www.horizonblue.com
H3154	809	0	1	02	01	H3154_809_0	1	2009.01	HORIZON HEALTHCARE OF NEW JERSEY, INC.	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com/medicare	01	02		1		H3154	809	0	2009	Horizon Medicare Blue Access Grp Plus w/RX Std	National		1	2				2						(800)-365-2223		(800)-855-2881		(800)-224-1234	(800)-224-1234	(800)-852-7899		(866)-236-7376	(866)-236-7376	(866)-236-1069		(800)-224-1234	(800)-224-1234	(800)-852-7899		http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	www.horizonblue.com
H3156	021	0	1	02	01	H3156_021_0	3	2009.01	AMERIHEALTH HMO_INC	AmeriHealth 65	www.amerihealth65.com	01	02		1		H3156	021	0	2009	AmeriHealth 65 NJ Plus Rx	Salem, Burlington, Camden, Cumberland, Gloucester		2	2				2						(800)-645-3965	(800)-645-3965	(888)-857-4816		(800)-898-3492		(877)-219-5457		(800)-645-3965	(800)-645-3965	(888)-857-4816		(800)-898-3492	(800)-898-3492	(877)-219-5457		http://www.amerihealth.com/amerihealth65/2008/nj/drug_formulary/index.html	
H3156	024	0	1	02	01	H3156_024_0	2	2009.01	AMERIHEALTH HMO_INC	AmeriHealth 65	www.amerihealth65.com	01	02		1		H3156	024	0	2009	AmeriHealth 65 NJ Plus Medical Only	Burlington,Camden,Cumberland, Gloucester, Salem		2	2				2						(800)-645-3965	(800)-645-3965	(888)-857-4816		(800)-898-3492		(877)-219-5457										http://www.amerihealth.com/amerihealth65/2008/nj/drug_formulary/index.html	
H3156	025	0	1	01	01	H3156_025_0	2	2009.01	AMERIHEALTH HMO_INC	AmeriHealth 65	www.amerihealth65.com	01	01		1		H3156	025	0	2009	AmeriHealth 65 NJ Preferred Medical Only	Salem, Burlington, Camden, Cumberland, Gloucester		2	2				2						(800)-645-3965	(800)-645-3965	(888)-857-4816		(800)-898-3492		(877)-219-5457										http://www.amerihealth.com/amerihealth65/2008/nj/drug_formulary/index.html	
H3156	026	0	1	01	01	H3156_026_0	3	2009.01	AMERIHEALTH HMO_INC	AmeriHealth 65	www.amerihealth65.com	01	01		1		H3156	026	0	2009	AmeriHealth 65 NJ Preferred Rx	Salem, Burlington, Camden, Cumberland, Gloucester		2	2				2						(800)-645-3965	(800)-645-3965	(888)-857-4816		(800)-898-3492		(877)-219-5457		(800)-645-3965	(800)-645-3965	(888)-857-4816		(800)-898-3492	(800)-898-3492	(877)-219-5457		http://www.amerihealth.com/amerihealth65/2008/nj/drug_formulary/index.html	
H3156	027	0	1	01	01	H3156_027_0	2	2009.01	AMERIHEALTH HMO_INC	AmeriHealth 65	www.amerihealth65.com	01	01		1		H3156	027	0	2009	AmeriHealth 65 NJ Value Medical Only	Salem, Burlington, Camden, Cumberland, Gloucester		2	2				2						(800)-645-3965	(800)-645-3965	(888)-857-4816		(800)-898-3492		(877)-219-5457										http://www.amerihealth.com/amerihealth65/2008/nj/drug_formulary/index.html	
H3156	028	0	1	01	01	H3156_028_0	3	2009.01	AMERIHEALTH HMO_INC	AmeriHealth 65	www.amerihealth65.com	01	01		1		H3156	028	0	2009	AmeriHealth 65 NJ Value Rx	Salem, Burlington, Camden, Cumberland, Gloucester		2	2				2						(800)-645-3965	(800)-645-3965	(888)-857-4816		(800)-898-3492		(877)-219-5457		(800)-645-3965	(800)-645-3965	(888)-857-4816		(800)-898-3492	(800)-898-3492	(877)-219-5457		http://www.amerihealth.com/amerihealth65/2008/nj/drug_formulary/index.html	
H3156	801	0	1	01	01	H3156_801_0	3	2009.01	AMERIHEALTH HMO_INC	AmeriHealth 65	www.amerihealth65.com	01	01		1		H3156	801	0	2009	AmeriHealth 65 NJ Group Medical Only	State of New Jersey		1	2				2						(800)-645-3965	(800)-645-3965	(888)-857-4816		(800)-898-3492		(877)-219-5457										http://www.amerihealth.com/amerihealth65/2008/nj/drug_formulary/index.html	
H3156	803	0	1	01	01	H3156_803_0	3	2009.01	AMERIHEALTH HMO_INC	AmeriHealth 65	www.amerihealth65.com	01	01		1		H3156	803	0	2009	AmeriHealth 65 NJ Group Rx	State of New Jersey		1	2				2						(800)-645-3965	(800)-645-3965	(888)-857-4816		(800)-898-3492		(877)-219-5457		(800)-645-3965	(800)-645-3965	(888)-857-4816		(800)-898-3492	(800)-898-3492	(877)-219-5457		http://www.amerihealth.com/amerihealth65/2008/nj/drug_formulary/index.html	
H3164	003	0	1	01	01	H3164_003_0	5	2009.01	AMERICHOICE OF NEW JERSEY, INC	AmeriChoice Personal Care Plus	www.americhoice.com	01	01		1		H3164	003	0	2009	AmeriChoice Personal Care Plus	Northern, Central, and Southern New Jersey		2	1	3			2			1	2		(973)-297-5546		(800)-421-1220		(973)-565-5221		(800)-421-1220		(973)-297-5546	(800)-514-4911	(800)-421-1220		(973)-565-5221	(877)-289-1915	(800)-421-1220		www.americhoice.com	www.AmeriChoice.com
H3195	001	0	1	04	01	H3195_001_0	7	2009.01	PAN AMERICAN LIFE INSURANCE CO. OF PUERTO RICO INC	Pan America Life Insurance Company of Puerto Rico	www.panamericanlife.com	01	04		1		H3195	001	0	2009	PALIC-PR Medicare Advantage	Puerto Rico		2	2			800	2						(888)-725-4262	(888)-725-4262	(888)-725-4261	(888)-725-4261	(888)-725-4262	(888)-725-4262	(888)-725-4261	(888)-725-4261	(888)-725-4262	(888)-725-4262	(888)-725-4261	(888)-725-4261	(888)-725-4262	(888)-725-4262	(888)-725-4261	(888)-725-4261	www.panamericanlife.com	
H3204	001	0	1	01	01	H3204_001_0	5	2009.01	PRESBYTERIAN HEALTH PLAN	Presbyterian Senior Care	www.phs.org	01	01		1		H3204	001	0	2009	Presbyterian Senior Care Plan 2 with Rx	Greater Albuquerque Area		2	2			11200	2						(505)-923-6060	(800)-797-5343	(888)-625-8818		(505)-923-5565	(800)-347-4766	(888)-625-6429		(505)-923-6060	(800)-797-5343	(888)-625-8818		(505)-923-5565	(800)-347-4766	(888)-625-6429		http://www.phs.org/resources/documents/psc2007_formulary.pdf	
H3204	007	0	1	01	01	H3204_007_0	5	2009.01	PRESBYTERIAN HEALTH PLAN	Presbyterian Senior Care	www.phs.org	01	01		1		H3204	007	0	2009	Presbyterian Senior Care Plan 3 with Rx	Greater Albuquerque Area		2	2			6170	2						(505)-923-6060	(800)-797-5343	(888)-625-8818		(505)-923-5565	(800)-347-4766	(888)-625-6429		(505)-923-6060	(800)-797-5343	(888)-625-8818		(505)-923-5565	(800)-347-4766	(888)-625-6429		http://www.phs.org/resources/documents/psc2007_formulary.pdf	
H3204	008	0	1	01	01	H3204_008_0	4	2009.01	PRESBYTERIAN HEALTH PLAN	Presbyterian Senior Care	www.phs.org	01	01		1		H3204	008	0	2009	Presbyterian Senior Care Plan 1	Greater Albuquerque Area		2	2			11200	2						(505)-923-6060	(800)-797-5343	(888)-625-8818		(505)-923-5565	(800)-347-4766	(888)-625-6429										http://www.phs.org/resources/documents/psc2007_formulary.pdf	
H3204	801	0	1	01	01	H3204_801_0	4	2009.01	PRESBYTERIAN HEALTH PLAN	Presbyterian Senior Care	www.phs.org	01	01		1		H3204	801	0	2009	Pres Senior Care Emp Group Plan 2 with Rx	Greater Albuquerque Area		1	2			1520	2						(505)-923-6060	(800)-797-5343	(888)-625-8818		(505)-923-5565	(800)-347-4766	(888)-625-6429		(505)-923-6060	(800)-797-5343	(888)-625-8818		(505)-923-5565	(800)-347-4766	(888)-625-6429		http://www.phs.org/resources/documents/psc2007_formulary.pdf	
H3204	802	0	1	01	01	H3204_802_0	4	2009.01	PRESBYTERIAN HEALTH PLAN	Presbyterian Senior Care	www.phs.org	01	01		1		H3204	802	0	2009	Pres Senior Care Emp Group Plan 1	Greater Albuquerque Area		1	2			500	2						(505)-923-6060	(800)-797-5343	(888)-625-8818		(505)-923-5565	(800)-347-4766	(888)-625-6429										http://www.phs.org/resources/documents/psc2007_formulary.pdf	
H3204	803	0	1	01	01	H3204_803_0	4	2009.01	PRESBYTERIAN HEALTH PLAN	Presbyterian Senior Care	www.phs.org	01	01		1		H3204	803	0	2009	Pres Senior Care Emp Group Plan 2 w/ Rx NC	Greater Albuquerque Area		1	2			500	2						(505)-923-6060	(800)-797-5343	(888)-625-8818		(505)-923-5565	(800)-347-4766	(888)-625-6429		(505)-923-6060	(800)-797-5343	(888)-625-8818		(505)-923-5565	(800)-347-4766	(888)-625-6429		http://www.phs.org/resources/documents/psc2007_formulary.pdf	
H3204	804	0	1	01	01	H3204_804_0	4	2009.01	PRESBYTERIAN HEALTH PLAN	Presbyterian Senior Care	www.phs.org	01	01		1		H3204	804	0	2009	Pres Senior Care Emp Group Plan 1 NC	Greater Albuquerque Area		1	2			500	2						(505)-923-6060	(800)-797-5343	(888)-625-8818		(505)-923-5565	(800)-347-4766	(888)-625-6429										http://www.phs.org/resources/documents/psc2007_formulary.pdf	
H3206	001	0	1	04	01	H3206_001_0	5	2009.01	PRESBYTERIAN INSURANCE COMPANY, INC.	Presbyterian MediCare PPO	www.phs.org	01	04		1		H3206	001	0	2009	Presbyterian MediCare PPO Plan 2 with Rx	New Mexico		2	2			2120	2						(505)-923-6060	(800)-797-5343	(888)-625-8818		(505)-923-5565	(800)-347-4766	(888)-625-6429		(505)-923-6060	(800)-797-5343	(888)-625-8818		(505)-923-5565	(800)-347-4766	(888)-625-6429		http://www.phs.org/resources/documents/ppo2007_formulary.pdf	
H3206	002	0	1	04	01	H3206_002_0	5	2009.01	PRESBYTERIAN INSURANCE COMPANY, INC.	Presbyterian MediCare PPO	www.phs.org	01	04		1		H3206	002	0	2009	Presbyterian MediCare PPO Plan 3 with Rx	New Mexico		2	2			1110	2						(505)-923-6060	(800)-797-5343	(888)-625-8818		(505)-923-5565	(800)-347-4766	(888)-625-6429		(505)-923-6060	(800)-797-5343	(888)-625-8818		(505)-923-5565	(800)-347-4766	(888)-625-6429		http://www.phs.org/resources/documents/ppo2007_formulary.pdf	
H3206	003	0	1	04	01	H3206_003_0	3	2009.01	PRESBYTERIAN INSURANCE COMPANY, INC.	Presbyterian MediCare PPO	www.phs.org	01	04		1		H3206	003	0	2009	Presbyterian MediCare PPO Plan 1	New Mexico		2	2			340	2						(505)-923-6060	(800)-797-5343	(888)-625-8818		(505)-923-5565	(800)-347-4766	(888)-625-6429										http://www.phs.org/resources/documents/ppo2007_formulary.pdf	
H3206	801	0	1	04	01	H3206_801_0	3	2009.01	PRESBYTERIAN INSURANCE COMPANY, INC.	Presbyterian MediCare PPO	www.phs.org	01	04		1		H3206	801	0	2009	Pres MediCare PPO Emp Group Plan 2 with Rx	New Mexico		1	2			1010	2						(505)-923-6060	(800)-797-5343	(888)-625-8818		(505)-923-5565	(800)-347-4766	(888)-625-6429		(505)-923-6060	(800)-797-5343	(888)-625-8818		(505)-923-5565	(800)-347-4766	(888)-625-6429		http://www.phs.org/resources/documents/ppo2007_formulary.pdf	
H3206	802	0	1	04	01	H3206_802_0	3	2009.01	PRESBYTERIAN INSURANCE COMPANY, INC.	Presbyterian MediCare PPO	www.phs.org	01	04		1		H3206	802	0	2009	Pres Medicare PPO Employer Group Plan 1	New Mexico		1	2			200	2						(505)-923-6060	(800)-797-5343	(888)-625-8818		(505)-923-5565	(800)-347-4766	(888)-625-6429										http://www.phs.org/resources/documents/ppo2007_formulary.pdf	
H3206	803	0	1	04	01	H3206_803_0	3	2009.01	PRESBYTERIAN INSURANCE COMPANY, INC.	Presbyterian MediCare PPO	www.phs.org	01	04		1		H3206	803	0	2009	Pres MediCare PPO Empl Group Plan 2 +Rx NC	New Mexico		1	2			200	2						(505)-923-6060	(800)-797-5343	(888)-625-8818		(505)-923-5565	(800)-347-4766	(888)-625-6429		(505)-923-6060	(800)-797-5343	(888)-625-8818		(505)-923-5565	(800)-347-4766	(888)-625-6429		http://www.phs.org/resources/documents/ppo2007_formulary.pdf	
H3206	804	0	1	04	01	H3206_804_0	2	2009.01	PRESBYTERIAN INSURANCE COMPANY, INC.	Presbyterian MediCare PPO	www.phs.org	01	04		1		H3206	804	0	2009	Pres MediCare PPO Employer Group Plan 1 NC	New Mexico		1	2			200	2						(505)-923-6060	(800)-797-5343	(888)-625-8818		(505)-923-5565	(800)-347-4766	(888)-625-6429										http://www.phs.org/resources/documents/ppo2007_formulary.pdf	
H3207	001	0	1	04	01	H3207_001_0	11	2009.01	LOVELACE INSURANCE COMPANY	Lovelace Insurance Company	www.lovelaceseniorplan.com	01	04		1		H3207	001	0	2009	Premier Choice	Central NM		2	2			57	2						(505)-232-1883	(800)-808-7363	(800)-659-8331	(800)-659-8331	(505)-262-3757	(800)-262-3757	(800)-659-8331	(800)-659-8331	(505)-232-1883	(800)-808-7363	(800)-659-8331	(800)-659-8331	(505)-262-3757	(800)-262-3757	(800)-659-8331	(800)-659-8331	www.lovelaceseniorplan.com	www.lovelaceseniorplan.com
H3207	002	0	1	04	01	H3207_002_0	11	2009.01	LOVELACE INSURANCE COMPANY	Lovelace Insurance Company	www.lovelaceseniorplan.com	01	04		1		H3207	002	0	2009	Premier Choice	Northern and Southern NM		2	2			212	2						(505)-232-1883	(800)-808-7363	(800)-659-8331	(800)-659-8331	(505)-262-3757	(800)-262-3757	(800)-659-8331	(800)-659-8331	(505)-232-1883	(800)-808-7363	(800)-659-8331	(800)-659-8331	(505)-262-3757	(800)-262-3757	(800)-659-8331	(800)-659-8331	www.lovelaceseniorplan.com	www.lovelaceseniorplan.com
H3207	003	0	1	04	01	H3207_003_0	9	2009.01	LOVELACE INSURANCE COMPANY	Lovelace Insurance Company	Lovelaceseniorplan.com	01	04		1		H3207	003	0	2009	Premier Choice	Northern and Southern  NM		2	2			85	2						(505)-232-1883	(800)-808-7363	(800)-659-8331	(800)-659-8331	(505)-262-3757	(800)-262-3757	(800)-659-8331	(800)-659-8331	(505)-232-1883	(800)-808-7363	(800)-659-8331	(800)-659-8331	(505)-262-3757	(800)-262-3757	(800)-659-8331	(800)-659-8331	www.lovelaceseniorplan.com	www.lovelaceseniorplan.com
H3207	004	0	1	04	01	H3207_004_0	10	2009.01	LOVELACE INSURANCE COMPANY	Lovelace Insurance Company	Lovelaceseniorplan.com	01	04		1		H3207	004	0	2009	Premier Choice	Central NM		2	2			60	2						(505)-232-1883	(800)-808-7363	(800)-659-8331	(800)-659-8331	(505)-262-3757	(800)-262-3757	(800)-659-8331	(800)-659-8331	(505)-232-1883	(800)-808-7363	(800)-659-8331	(800)-659-8331	(505)-262-3757	(800)-262-3757	(800)-659-8331	(800)-659-8331	www.lovelaceseniorplan.com	www.lovelaceseniorplan.com
H3208	001	0	1	04	01	H3208_001_0	10	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of New Mexico	www.bcbsnm.com	01	04		1		H3208	001	0	2009	Blue Medicare PPO - Advantage	State of New Mexico - all counties		2	2				2						(800)-718-2031	(800)-718-2031	(888)-844-5530	(888)-844-5530	(866)-308-4781	(866)-308-4781	(800)-538-0380	(800)-538-0380	(888)-277-5507	(888)-277-5507		(800)-693-3816	(888)-285-2254	(888)-285-2254		(888)-844-3757	https://qa.myrxassistant.com/MyRxAssistant/formulary/HISC/NM/MAPD	www.bcbsnm.com
H3208	003	0	1	04	01	H3208_003_0	7	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of New Mexico	www.bcbsnm.com	01	04		1		H3208	003	0	2009	Blue Medicare PPO - Value	State of New Mexico - all counties		2	2				2						(800)-718-2031	(800)-718-2031	(888)-844-5530	(888)-844-5530	(866)-308-4781	(866)-308-4781	(800)-538-0380	(800)-538-0380	(888)-277-5507	(888)-277-5507		(800)-693-3816	(888)-285-2254	(888)-285-2254		(888)-844-3757	https://qa.myrxassistant.com/MyRxAssistant/formulary/HISC/NM/MAPD	www.bcbsnm.com
H3208	004	0	1	04	01	H3208_004_0	10	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of New Mexico	www.bcbsnm.com	01	04		1		H3208	004	0	2009	Blue Medicare PPO - Premier	State of New Mexico - all counties		2	2				2						(800)-718-2031	(800)-718-2031	(888)-844-5530	(888)-844-5530	(866)-308-4781	(866)-308-4781	(800)-538-0380	(800)-538-0380	(888)-277-5507	(888)-277-5507		(800)-693-3816	(888)-285-2254	(888)-285-2254		(888)-844-3757	https://qa.myrxassistant.com/MyRxAssistant/formulary/HISC/NM/MAPD	www.bcbsnm.com
H3208	801	0	1	04	01	H3208_801_0	5	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of New Mexico	www.bcbsnm.com	01	04		1		H3208	801	0	2009	Blue Medicare PPO	State of New Mexico - all counties		1	2				2						(800)-718-2031		(888)-844-5530		(866)-308-4781		(800)-538-0380		(800)-718-2031	(800)-718-2031			(866)-308-4781	(866)-308-4781			https://qa.myrxassistant.com/MyRxAssistant/formulary/HISC/NM/MAPD	www.bcbsnm.com
H3208	802	0	1	04	01	H3208_802_0	5	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of New Mexico	www.bcbsnm.com	01	04		1		H3208	802	0	2009	Blue Medicare PPO	State of New Mexico		1	2				2						(800)-718-2031		(888)-844-5530		(866)-308-4781		(800)-538-0380		(800)-718-2031	(800)-718-2031			(866)-308-4781	(866)-308-4781			https://qa.myrxassistant.com/MyRxAssistant/formulary/HISC/NM/MAPD	www.bcbsnm.com
H3208	803	0	1	04	01	H3208_803_0	5	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of New Mexico	www.bcbsnm.com	01	04		1		H3208	803	0	2009	Blue Medicare PPO	State of New Mexico		1	2				2						(800)-718-2031		(888)-844-5530		(866)-308-4781		(800)-538-0380										https://qa.myrxassistant.com/MyRxAssistant/formulary/HISC/NM/MAPD	www.bcbsnm.com
H3208	804	0	1	04	01	H3208_804_0	5	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of New Mexico	www.bcbsnm.com	01	04		1		H3208	804	0	2009	Blue Medicare PPO	State of New Mexico		1	2				2						(800)-718-2031		(888)-844-5530		(866)-308-4781		(800)-538-0380										https://qa.myrxassistant.com/MyRxAssistant/formulary/HISC/NM/MAPD	www.bcbsnm.com
H3208	805	0	1	04	01	H3208_805_0	5	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of New Mexico	www.bcbsnm.com	01	04		1		H3208	805	0	2009	Blue Medicare PPO	National service area		1	2				2						(800)-718-2031		(888)-844-5530		(866)-308-4781		(800)-538-0380		(800)-718-2031	(800)-718-2031			(866)-308-4781	(866)-308-4781			https://qa.myrxassistant.com/MyRxAssistant/formulary/HISC/NM/MAPD	www.bcbsnm.com
H3208	806	0	1	04	01	H3208_806_0	5	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of New Mexico	www.bcbsnm.com	01	04		1		H3208	806	0	2009	Blue Medicare PPO	National service area		1	2				2						(800)-718-2031		(888)-844-5530		(866)-308-4781		(800)-538-0380		(800)-718-2031	(800)-718-2031			(866)-308-4781	(866)-308-4781			https://qa.myrxassistant.com/MyRxAssistant/formulary/HISC/NM/MAPD	www.bcbsnm.com
H3208	807	0	1	04	01	H3208_807_0	5	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of New Mexico	www.bcbsnm.com	01	04		1		H3208	807	0	2009	Blue Medicare PPO	National service area		1	2				2						(800)-718-2031		(888)-844-5530		(866)-308-4781		(800)-538-0380										https://qa.myrxassistant.com/MyRxAssistant/formulary/HISC/NM/MAPD	www.bcbsnm.com
H3209	001	0	1	04	01	H3209_001_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H3209	001	0	2009	Evercare Plan IP	Bernalillo County		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H3209	002	0	1	04	01	H3209_002_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H3209	002	0	2009	Evercare Plan DP	Bernalillo, Sandoval, Santa Fe,  Valencia Counties		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H3209	003	0	1	04	01	H3209_003_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H3209	003	0	2009	Evercare Plan MP	Bernalillo, Sandoval, Santa Fe, Valencia Counties		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H3240	008	0	1	01	01	H3240_008_0	5	2009.01	AMERIGROUP NEW JERSEY, INC.	AMERIGROUP Community Care	http://www.amerigroupcorp.com/members/	01	01		1		H3240	008	0	2009	AMERIVANTAGE Classic + Rx	Eastern / Central New Jersey		2	2			751	2						(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		http://www.amerigroupcorp.com/Members/amerivantage/_documents	https://www.amerigroupcorp.com/Members/providers.asp
H3240	009	0	1	01	01	H3240_009_0	5	2009.01	AMERIGROUP NEW JERSEY, INC.	AMERIGROUP Community Care	http://www.amerigroupcorp.com/members/	01	01		1		H3240	009	0	2009	AMERIVANTAGE Classic + Rx	Middlesex / Monmouth Counties		2	2			199	2						(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		http://www.amerigroupcorp.com/Members/amerivantage/_documents	https://www.amerigroupcorp.com/Members/providers.asp
H3240	010	0	1	01	01	H3240_010_0	6	2009.01	AMERIGROUP NEW JERSEY, INC.	AMERIGROUP Community Care	http://www.amerigroupcorp.com/members/	01	01		1		H3240	010	0	2009	AMERIVANTAGE Balance + Rx	Eastern / Central New Jersey		2	2			238	2						(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		http://www.amerigroupcorp.com/Members/amerivantage/_documents	https://www.amerigroupcorp.com/Members/providers.asp
H3240	013	0	1	01	01	H3240_013_0	4	2009.01	AMERIGROUP NEW JERSEY, INC.	AMERIGROUP Community Care	http://www.amerigroupcorp.com/members/	01	01		1		H3240	013	0	2009	AMERIVANTAGE Specialty + Rx	Eastern / Central New Jersey		2	1	3		1950	2			1	1		(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		http://www.amerigroupcorp.com/Members/amerivantage/_documents	https://www.amerigroupcorp.com/Members/providers.asp
H3240	014	0	1	02	01	H3240_014_0	3	2009.01	AMERIGROUP NEW JERSEY, INC.	AMERIGROUP Community Care	http://www.amerigroupcorp.com/members/	01	02		1		H3240	014	0	2009	AMERIVANTAGE Choice + Rx	Eastern/Central New Jersey		2	2			188	2						(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		http://www.amerigroupcorp.com/Members/amerivantage/_documents	https://www.amerigroupcorp.com/Members/providers.asp
H3240	015	0	1	02	01	H3240_015_0	3	2009.01	AMERIGROUP NEW JERSEY, INC.	AMERIGROUP Community Care	http://www.amerigroupcorp.com/members/	01	02		1		H3240	015	0	2009	AMERIVANTAGE Choice + Rx	Middlesex  Monmouth Counties		2	2			50	2						(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		http://www.amerigroupcorp.com/Members/amerivantage/_documents	https://www.amerigroupcorp.com/Members/providers.asp
H3251	002	0	1	01	01	H3251_002_0	8	2009.01	LOVELACE HEALTH SYSTEM, INC.	Lovelace Senior Plan	Lovelaceseniorplan.com	01	01		1		H3251	002	0	2009	Lovelace Senior Plan -- Standard Plan	Greater Albuquerque / Santa Fe Area		2	2			14000	2						(505)-232-1883	(800)-808-7363	(800)-659-8331	(800)-659-8331	(505)-262-3757	(800)-262-3757	(800)-659-8331	(800)-659-8331	(505)-232-1883	(800)-808-7363	(800)-659-8331	(800)-659-8331	(505)-262-3757	(800)-262-3757	(800)-659-8331	(800)-659-8331	www.lovelaceseniorplan.com	www.lovelaceseniorplan.com
H3251	021	0	1	01	01	H3251_021_0	8	2009.01	LOVELACE HEALTH SYSTEM, INC.	Lovelace Senior Plan	www.lovelaceseniorplan.com	01	01		1		H3251	021	0	2009	Lovelace Senior Plan -- Enhanced Plan	Greater Albuquerque / Santa Fe Area		2	2			5672	2						(505)-232-1883	(800)-808-7363	(800)-659-8331	(800)-659-8331	(505)-262-3757	(800)-262-3757	(800)-659-8331	(800)-659-8331	(505)-232-1883	(800)-808-7363	(800)-659-8331	(800)-659-8331	(505)-262-3757	(800)-262-3757	(800)-659-8331	(800)-659-8331	www.lovelaceseniorplan.com	www.lovelaceseniorplan.com
H3251	023	0	1	01	01	H3251_023_0	6	2009.01	LOVELACE HEALTH SYSTEM, INC.	Lovelace Senior Plan	www.lovelaceseniorplan.com	01	01		1		H3251	023	0	2009	Lovelace Senior Plan - Medical Only	Greater Albuquerque / Santa Fe Area		2	2			275	2						(505)-232-1883	(800)-808-7363	(800)-659-8331	(800)-659-8331	(505)-262-3757	(800)-262-3757	(800)-659-8331	(800)-659-8331									www.lovelaceseniorplan.com	www.lovelaceseniorplan.com
H3251	804	0	1	01	01	H3251_804_0	4	2009.01	LOVELACE HEALTH SYSTEM, INC.	Lovelace Senior Plan	www.Lovelaceseniorplan.com	01	01		1		H3251	804	0	2009	Lovelace Employer Group Senior Plan	New Mexico Statewide		1	2			5920	2						(505)-232-1883	(800)-808-7363	(800)-659-8331	(800)-659-8331	(505)-262-3757	(800)-262-3757	(800)-659-8331	(800)-659-8331	(505)-232-1883	(800)-808-7363	(800)-659-8331	(800)-659-8331	(505)-262-3757	(800)-262-3757	(800)-659-8331	(800)-659-8331	www.lovelaceseniorplan.com	www.lovelaceseniorplan.com
H3251	805	0	1	01	01	H3251_805_0	4	2009.01	LOVELACE HEALTH SYSTEM, INC.	Lovelace Senior Plan	www.lovelaceseniorplan,.com	01	01		1		H3251	805	0	2009	Lovelace Employer Group Senior Plan Medical Only	New Mexico Statewide		1	2			250	2						(505)-232-1883	(800)-808-7363	(800)-659-8331	(800)-659-8331	(505)-262-3757	(800)-262-3757	(800)-659-8331	(800)-659-8331									www.lovelaceseniorplan.com	www.lovelaceseniorplan.com
H3305	007	0	1	01	01	H3305_007_0	9	2009.01	ROCHESTER AREA HMO/ DBA PREFERRED CARE	Preferred Care Gold	www.preferredcare.org	01	01		1		H3305	007	0	2009	Preferred Care Gold	Rochester and Western New York		2	2			23820	2						(585)-327-2480	(800)-665-7924	(585)-325-2629	(800)-252-2452	(585)-327-5760	(888)-280-6205	(585)-325-2629	(800)-252-2452									http://www.preferredcare.org/ourplans/medicarepartd/documents/FB909834_PCComp_4Tier.5.pdf	www.preferredcare.org
H3305	011	0	1	01	01	H3305_011_0	13	2009.01	ROCHESTER AREA HMO/ DBA PREFERRED CARE	Preferred Care Gold	www.preferredcare.org	01	01		1		H3305	011	0	2009	Preferred Care Gold Rx	Rochester and Western New York		2	2			6000	2						(585)-327-2480	(800)-665-7924	(585)-325-2629	(800)-252-2452	(585)-327-5760	(888)-280-6205	(585)-325-2629	(800)-252-2452	(585)-327-2480	(800)-665-7924	(585)-325-2629	(800)-252-2452	(585)-327-5760	(888)-280-6205	(585)-325-2629	(800)-252-2452	http://www.preferredcare.org/ourplans/medicarepartd/documents/FB909834_PCComp_4Tier.5.pdf	www.preferredcare.org
H3305	801	0	1	01	01	H3305_801_0	11	2009.01	ROCHESTER AREA HMO/ DBA PREFERRED CARE	Preferred Care Gold	www.preferredcare.org	01	01		1		H3305	801	0	2009	Preferred Care Gold - Employer Group	Rochester and Western New York		1	2			4118	2						(585)-327-2480	(800)-665-7924	(585)-325-2629	(800)-252-2452	(585)-327-5760	(888)-280-6205	(585)-325-2629	(800)-252-2452									http://www.preferredcare.org/ourplans/medicarepartd/documents/FB909834_PCComp_4Tier.5.pdf	www.preferredcare.org
H3305	803	0	1	01	01	H3305_803_0	14	2009.01	ROCHESTER AREA HMO/ DBA PREFERRED CARE	Preferred Care Gold	www.preferredcare.org	01	01		1		H3305	803	0	2009	Preferred Care Gold Rx -Employer Group	Rochester and Western New York		1	2			37062	2						(585)-327-2480	(800)-665-7924	(585)-325-2629	(800)-252-2452	(585)-327-5760	(888)-280-6205	(585)-325-2629	(800)-252-2452	(585)-327-2480	(800)-665-7924	(585)-325-2629	(800)-252-2452	(585)-327-5760	(888)-280-6205	(585)-325-2629	(800)-252-2452	http://www.preferredcare.org/ourplans/medicarepartd/documents/FB909834_PCComp_4Tier.5.pdf	www.preferredcare.org
H3307	002	0	1	01	01	H3307_002_0	7	2009.01	OXFORD HEALTH PLANS (NY) INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3307	002	0	2009	AARP MedicareComplete Plan 1	New York Metropolitan Area		2	2				2						(800)-665-4654	(800)-665-4654	(800)-201-4874		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-665-4654	(800)-665-4654	(800)-201-4874		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3307	011	0	1	01	01	H3307_011_0	5	2009.01	OXFORD HEALTH PLANS (NY) INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3307	011	0	2009	AARP MedicareComplete Balance	Kings, New York, Queens, and Richmond Counties		2	2				2						(800)-665-4654	(800)-665-4654	(800)-201-4874		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-665-4654	(800)-665-4654	(800)-201-4874		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3307	012	0	1	01	01	H3307_012_0	6	2009.01	OXFORD HEALTH PLANS (NY) INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3307	012	0	2009	AARP MedicareComplete	Westchester, Orange and Rockland Counties		2	2				2						(800)-665-4654	(800)-665-4654	(800)-201-4874		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-665-4654	(800)-665-4654	(800)-201-4874		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3307	013	0	1	01	01	H3307_013_0	5	2009.01	OXFORD HEALTH PLANS (NY) INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3307	013	0	2009	AARP MedicareComplete Balance	Westchester, Orange and Rockland Counties		2	2				2						(800)-665-4654	(800)-665-4654	(800)-201-4874		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-665-4654	(800)-665-4654	(800)-201-4874		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3307	015	0	1	01	01	H3307_015_0	6	2009.01	OXFORD HEALTH PLANS (NY) INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3307	015	0	2009	AARP MedicareComplete Mosaic	New York Metropolitan Area		2	2				2						(800)-665-4654	(800)-665-4654	(800)-201-4874		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-665-4654	(800)-665-4654	(800)-201-4874		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3307	018	0	1	01	01	H3307_018_0	5	2009.01	OXFORD HEALTH PLANS (NY) INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3307	018	0	2009	AARP MedicareComplete Essential	New York City Metro Area		2	2				2						(800)-665-4654	(800)-665-4654	(800)-201-4874		(800)-547-5514	(800)-547-5514	(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3307	019	0	1	01	01	H3307_019_0	4	2009.01	OXFORD HEALTH PLANS (NY) INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3307	019	0	2009	AARP MedicareComplete Essential	Westchester, Orange and Rockland Counties		2	2				2						(800)-665-4654	(800)-665-4654	(800)-201-4874		(800)-547-5514	(800)-547-5514	(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3307	020	0	1	01	01	H3307_020_0	7	2009.01	OXFORD HEALTH PLANS (NY) INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3307	020	0	2009	Evercare Plan DH	Bronx,Kings,New York,Queens and Richmond Counties		2	1	3			2			2	2		(800)-234-1228	(800)-234-1228	(800)-201-4874		(800)-834-3721	(888)-834-3721	(888)-685-8480		(800)-234-1228	(800)-234-1228	(800)-201-4874		(888)-834-3721	(888)-834-3721	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3307	021	0	1	01	01	H3307_021_0	7	2009.01	OXFORD HEALTH PLANS (NY) INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3307	021	0	2009	AARP MedicareComplete Plan 4	Bronx and Kings Counties		2	2				2						(800)-665-4654	(800)-665-4654	(800)-201-4874		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-665-4654	(800)-665-4654	(800)-201-4874		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3307	802	0	1	01	01	H3307_802_0	3	2009.01	OXFORD HEALTH PLANS (NY) INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3307	802	0	2009	MedicareComplete Retiree Plan	New York Metropolitan Area		1	2				2						(800)-665-4654	(800)-665-4654	(800)-201-4874		(800)-303-6720		(800)-201-4874		(800)-665-4654	(800)-665-4654	(800)-201-4874		(800)-303-6720	(800)-303-6720	(800)-201-4874		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3307	804	0	1	01	01	H3307_804_0	3	2009.01	OXFORD HEALTH PLANS (NY) INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3307	804	0	2009	MedicareComplete Essential Retiree Plan	New York Metropolitan Area		1	2				2						(800)-665-4654	(800)-665-4654	(800)-201-4874		(800)-303-6720		(800)-201-4874										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3307	805	0	1	01	01	H3307_805_0	3	2009.01	OXFORD HEALTH PLANS (NY) INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3307	805	0	2009	MedicareComplete Retiree Plan	State of New York		1	2				2						(800)-665-4654	(800)-665-4654	(800)-201-4874		(800)-303-6720		(800)-201-4874		(800)-665-4654	(800)-665-4654	(800)-201-4874		(800)-303-6720	(800)-303-6720	(800)-201-4874		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3307	806	0	1	01	01	H3307_806_0	3	2009.01	OXFORD HEALTH PLANS (NY) INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3307	806	0	2009	MedicareComplete Retiree Plan	State of New York		1	2				2						(800)-665-4654	(800)-665-4654	(800)-201-4874		(800)-303-6720		(800)-201-4874										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3312	002	0	1	01	01	H3312_002_0	5	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3312	002	0	2009	Aetna Golden Medicare Value Plan	Bronx and Kings Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3312	018	0	1	01	01	H3312_018_0	5	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3312	018	0	2009	Aetna Golden Medicare Value Plan	Hudson Valley		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3312	025	0	1	01	01	H3312_025_0	5	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3312	025	0	2009	Aetna Golden Medicare Standard Plan	New York,  Queens and Richmond Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3312	028	0	1	01	01	H3312_028_0	4	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3312	028	0	2009	Aetna Golden Medicare Premier Plan	Bronx and Kings Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3312	036	0	1	01	01	H3312_036_0	2	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3312	036	0	2009	Aetna Golden Medicare Basic Plan	Bronx and Kings Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3312	037	0	1	01	01	H3312_037_0	4	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3312	037	0	2009	Aetna Golden Medicare Standard Plan	Bronx and Kings Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3312	040	0	1	01	01	H3312_040_0	2	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3312	040	0	2009	Aetna Golden Medicare Basic Plan	Hudson Valley		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3312	043	0	1	01	01	H3312_043_0	5	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3312	043	0	2009	Aetna Golden Medicare Value Plan	New York, Queens and Richmond Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3312	044	0	1	01	01	H3312_044_0	5	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3312	044	0	2009	Aetna Golden Medicare Premier Plan	New York, Queens and Richmond Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3312	048	0	1	01	01	H3312_048_0	5	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3312	048	0	2009	Aetna Golden Medicare Value Plan	Upstate New York		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3312	050	0	1	01	01	H3312_050_0	7	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3312	050	0	2009	Aetna Golden Medicare Standard Plan	Upstate New York		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3312	052	0	1	01	01	H3312_052_0	7	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3312	052	0	2009	Aetna Golden Medicare Premier Plan	Hudson Valley		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3312	053	0	1	01	01	H3312_053_0	3	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3312	053	0	2009	Aetna Golden Medicare Basic Plan	New York, Queens, and Richmond Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3312	054	0	1	01	01	H3312_054_0	3	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3312	054	0	2009	Aetna Golden Medicare Basic Plan	Upstate New York		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3312	055	0	1	01	01	H3312_055_0	8	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3312	055	0	2009	Aetna Golden Medicare Premier Plan	Upstate New York		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3312	056	0	1	01	01	H3312_056_0	2	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3312	056	0	2009	Aetna Golden Medicare Basic Plan	Long Island		2	2				2						(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3312	057	0	1	01	01	H3312_057_0	5	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3312	057	0	2009	Aetna Golden Medicare Value Plan	Long Island		2	2				2						(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3312	058	0	1	01	01	H3312_058_0	5	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3312	058	0	2009	Aetna Golden Medicare Premier Plan	Long Island		2	2				2						(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3312	801	0	1	01	01	H3312_801_0	4	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3312	801	0	2009	Aetna Golden Medicare Plan	New York		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3312	804	0	1	01	01	H3312_804_0	4	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3312	804	0	2009	Aetna Golden Medicare Plan w/Rx CY	New York		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3321	001	0	1	20	08	H3321_001_0	1	2009.01	INDEPENDENT LIVING SRVCS OF CENTRAL NY	Independent Living Srvcs Of Central Ny	www.loretto-cny.org	08	20		1		H3321	001	0	2009	Loretto Independent Living Services, Inc	Onondaga County		2	2				2														(315)-452-5800	(877)-208-5284			(315)-452-5800	(877)-208-5284			Independent Living Services of Central New York, Inc	
H3321	003	0	1	20	08	H3321_003_0	1	2009.01	INDEPENDENT LIVING SRVCS OF CENTRAL NY	Independent Living Srvcs Of Central Ny	www.loretto-cny.org	08	20		1		H3321	003	0	2009	Loretto Independent Living Services, Inc	Onondaga county		2	2				2														(315)-452-5800	(877)-208-5284			(315)-452-5800	(877)-208-5284			Independent Living Services of Central New York, Inc	
H3322	001	0	1	20	08	H3322_001_0	1	2009.01	SENIOR CARE CONNECTION, INC.	Senior Care Connection, Inc.	www.nehealth.com	08	20		1		H3322	001	0	2009	Senior Care Connection dba Eddy SeniorCare	Schenectady County, Albany County, NY		2	2				2														(518)-382-3290	(518)-382-3290			(518)-382-3290	(518)-382-3290			www.northeasthealth.com	
H3322	002	0	1	20	08	H3322_002_0	1	2009.01	SENIOR CARE CONNECTION, INC.	Senior Care Connection, Inc.	www.nehealth.com	08	20		1		H3322	002	0	2009	Senior Care Connection	Schenectady County, Albany County		2	2				2														(518)-382-3290	(518)-382-3290			(518)-382-3290	(518)-382-3290			www.northeasthealth.com	
H3327	001	0	1	01	01	H3327_001_0	15	2009.01	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	https://www.touchstone-health.com/	01	01		1		H3327	001	0	2009	Touchstone Health Medicare Power	New York City  and NYC Northern Metro HMO		2	2			68788	2						(888)-777-0204	(888)-777-0204	(888)-777-0301		(866)-484-9872	(866)-484-9872	(888)-777-0368		(888)-777-0204	(888)-777-0204	(888)-777-0301		(866)-484-9872	(866)-484-9872	(888)-777-0368		https://www.touchstone-health.com/search/formulary/	http://www.touchstone-health.com
H3327	002	0	1	01	01	H3327_002_0	17	2009.01	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	https://www.touchstone-health.com/	01	01		1		H3327	002	0	2009	Touchstone Health Medicare Total	New York City - HMO		2	2			26329	2						(888)-777-0204	(888)-777-0204	(888)-777-0301		(866)-484-9872	(866)-484-9872	(888)-777-0368		(888)-777-0204	(888)-777-0204	(888)-777-0301		(866)-484-9872	(866)-484-9872	(888)-777-0368		https://www.touchstone-health.com/search/formulary/	http://www.touchstone-health.com
H3327	003	0	1	02	01	H3327_003_0	15	2009.01	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	https://www.touchstone-health.com/	01	02		1		H3327	003	0	2009	Touchstone Health Medicare Freedom	NYC and NYC Northern Metro HMO-POS		2	2			3977	2						(888)-777-0204	(888)-777-0204	(888)-777-0301		(866)-484-9872	(866)-484-9872	(888)-777-0368		(888)-777-0204	(888)-777-0204	(888)-777-0301		(866)-484-9872	(866)-484-9872	(888)-777-0368		https://www.touchstone-health.com/search/formulary/	http://www.touchstone-health.com
H3327	014	0	1	01	01	H3327_014_0	12	2009.01	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	https://www.touchstone-health.com/	01	01		1		H3327	014	0	2009	Touchstone Health Medicare Clear	New York City and NYC Northern Metro HMO		2	2			6891	2						(888)-777-0204	(888)-777-0204	(888)-777-0301		(866)-484-9872	(866)-484-9872	(888)-777-0368										https://www.touchstone-health.com/search/formulary/	http://www.touchstone-health.com
H3327	021	0	1	01	01	H3327_021_0	15	2009.01	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	https://www.touchstone-health.com/	01	01		1		H3327	021	0	2009	Touchstone Health Medicare Power	Central NY - HMO		2	2			5537	2						(888)-777-0204	(888)-777-0204	(888)-777-0301		(866)-484-9872	(866)-484-9872	(888)-777-0368		(888)-777-0204	(888)-777-0204	(888)-777-0301		(866)-484-9872	(866)-484-9872	(888)-777-0368		https://www.touchstone-health.com/search/formulary/	http://www.touchstone-health.com
H3327	022	0	1	02	01	H3327_022_0	11	2009.01	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	https://www.touchstone-health.com/	01	02		1		H3327	022	0	2009	Touchstone Health Medicare Clear	Central NY - HMOPOS		2	2			4329	2						(888)-777-0204	(888)-777-0204	(888)-777-0301		(866)-484-9872	(866)-484-9872	(888)-777-0368										https://www.touchstone-health.com/search/formulary/	http://www.touchstone-health.com
H3327	023	0	1	02	01	H3327_023_0	14	2009.01	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	https://www.touchstone-health.com/	01	02		1		H3327	023	0	2009	Touchstone Health Medicare Freedom	Central NY - HMOPOS		2	2			7613	2						(888)-777-0204	(888)-777-0204	(888)-777-0301		(866)-484-9872	(866)-484-9872	(888)-777-0368		(888)-777-0204	(888)-777-0204	(888)-777-0301		(866)-484-9872	(866)-484-9872	(888)-777-0368		https://www.touchstone-health.com/search/formulary/	http://www.touchstone-health.com
H3327	026	0	1	01	01	H3327_026_0	13	2009.01	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	https://www.touchstone-health.com/	01	01		1		H3327	026	0	2009	Touchstone Health Medicare Prestige	SNP - NYC		2	1	3		57308	2			1	1		(888)-777-0204	(877)-870-7065	(888)-777-0301		(866)-484-9872	(888)-777-0370	(888)-777-0368		(877)-870-7065	(877)-870-7065	(888)-777-0301		(212)-294-6550	(888)-777-0370	(888)-777-0368		https://www.touchstone-health.com/search/formulary/	http://www.touchstone-health.com
H3327	027	0	1	01	01	H3327_027_0	9	2009.01	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	https://www.touchstone-health.com/	01	01		1		H3327	027	0	2009	Touchstone Health Medicare Prestige	SNP - Central		2	1	3		5208	2			1	1		(888)-777-0204	(877)-870-7065	(888)-777-0301		(866)-484-9872	(888)-777-0370	(888)-777-0368		(877)-870-7065	(877)-870-7065	(888)-777-0301		(212)-294-6550	(888)-777-0370	(888)-777-0368		https://www.touchstone-health.com/search/formulary/	http://www.touchstone-health.com
H3327	028	0	1	01	01	H3327_028_0	15	2009.01	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	https://www.touchstone-health.com/	01	01		1		H3327	028	0	2009	Touchstone Health Medicare Lunar Plan 1	New York City HMO		2	2			8521	2						(888)-889-2398	(888)-889-2398	(888)-777-0301		(888)-889-3933	(888)-889-3933	(888)-777-0368		(888)-889-2398	(888)-889-2398	(888)-777-0301		(888)-889-3933	(888)-889-3933	(888)-777-0368		https://www.touchstone-health.com/search/formulary/	http://www.touchstone-health.com
H3327	029	0	1	01	01	H3327_029_0	13	2009.01	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	https://www.touchstone-health.com/	01	01		1		H3327	029	0	2009	Touchstone Health Medicare Lunar Plan 2	SNP - NYC		2	1	3		4934	2			1	1		(888)-777-0204	(877)-870-7065	(888)-777-0301		(866)-484-9872	(888)-777-0370	(888)-777-0368		(877)-870-7065	(877)-870-7065	(888)-777-0301		(212)-294-6550	(888)-777-0370	(888)-777-0368		https://www.touchstone-health.com/search/formulary/	http://www.touchstone-health.com
H3327	030	0	1	01	01	H3327_030_0	11	2009.01	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	https://www.touchstone-health.com/	01	01		1		H3327	030	0	2009	Touchstone Health Medicare Prestige	SNP - Northern Metro		2	1	3		272	2			1	1		(888)-777-0204	(877)-870-7065	(888)-777-0301		(866)-484-9872	(888)-777-0370	(888)-777-0368		(877)-870-7065	(877)-870-7065	(888)-777-0301		(212)-294-6550	(888)-777-0370	(888)-777-0368		https://www.touchstone-health.com/search/formulary/	http://www.touchstone-health.com
H3327	801	0	1	01	01	H3327_801_0	12	2009.01	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	www.touchstone-health.com	01	01		1		H3327	801	0	2009	Touchstone Health Medicare Power	Employer - New York		1	2			500	2						(888)-777-0204	(877)-870-7065	(888)-777-0301		(866)-484-9872	(888)-777-0370	(888)-777-0368		(877)-870-7065	(877)-870-7065	(888)-777-0301		(212)-294-6550	(888)-777-0370	(888)-777-0368		https://www.touchstone-health.com/search/formulary/	http://www.touchstone-health.com
H3327	802	0	1	01	01	H3327_802_0	11	2009.01	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	www.touchstone-health.com	01	01		1		H3327	802	0	2009	Touchstone Health Medicare Clear	Employer - New York		1	2			500	2						(888)-777-0204	(877)-870-7065	(888)-777-0301		(866)-484-9872	(888)-777-0370	(888)-777-0368										https://www.touchstone-health.com/search/formulary/	http://www.touchstone-health.com
H3327	803	0	1	01	01	H3327_803_0	13	2009.01	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	www.touchstone-health.com	01	01		1		H3327	803	0	2009	Touchstone Health Medicare Power	Employer - New York		1	2			500	2						(888)-777-0204	(877)-870-7065	(888)-777-0301		(866)-484-9872	(888)-777-0370	(888)-777-0368		(877)-870-7065	(877)-870-7065	(888)-777-0301		(212)-294-6550	(888)-777-0370	(888)-777-0368		https://www.touchstone-health.com/search/formulary/	http://www.touchstone-health.com
H3327	805	0	1	01	01	H3327_805_0	11	2009.01	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	www.touchstone-health.com	01	01		1		H3327	805	0	2009	Touchstone Health Medicare Freedom	Employer - New York		1	2			500	2						(888)-777-0204	(877)-870-7065	(888)-777-0301		(866)-484-9872	(888)-777-0370	(888)-777-0368		(877)-870-7065	(877)-870-7065	(888)-777-0301		(212)-294-6550	(888)-777-0370	(888)-777-0368		https://www.touchstone-health.com/search/formulary/	http://www.touchstone-health.com
H3327	806	0	1	01	01	H3327_806_0	12	2009.01	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	www.touchstone-health.com	01	01		1		H3327	806	0	2009	Touchstone Health Medicare Clear	Employer - New York		1	2			500	2						(888)-777-0204	(877)-870-7065	(888)-777-0301		(866)-484-9872	(888)-777-0370	(888)-777-0368										https://www.touchstone-health.com/search/formulary/	http://www.touchstone-health.com
H3327	807	0	1	01	01	H3327_807_0	12	2009.01	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	www.touchstone-health.com	01	01		1		H3327	807	0	2009	Touchstone Health Medicare Freedom	Employer - New York		1	2			500	2						(888)-777-0204	(877)-870-7065	(888)-777-0301		(866)-484-9872	(888)-777-0370	(888)-777-0368		(877)-870-7065	(877)-870-7065	(888)-777-0301		(212)-294-6550	(888)-777-0370	(888)-777-0368		https://www.touchstone-health.com/search/formulary/	http://www.touchstone-health.com
H3328	001	0	1	02	01	H3328_001_0	11	2009.01	NEW YORK STATE CATHOLIC HLTH PLAN INC	Fidelis Care	www.fideliscare.org	01	02		1		H3328	001	0	2009	Fidelis Medicare Advantage without Rx	NY Counties		2	2			318	2						(800)-247-1447		(800)-695-8544		(800)-860-8707		(800)-558-1125										www.fideliscare.org	http://www.fideliscare.org/en/providersearch.aspx
H3328	002	0	1	01	01	H3328_002_0	8	2009.01	NEW YORK STATE CATHOLIC HLTH PLAN INC	Fidelis Care	www.fideliscare.org	01	01		1		H3328	002	0	2009	Fidelis Dual Advantage	NY Counties		2	1	3		1142	2			1	3		(800)-247-1447		(800)-695-8544		(800)-860-8707		(800)-558-1125		(800)-247-1447	(800)-247-1447			(800)-860-8707	(800)-860-8707	(800)-558-1125	(800)-558-1125	www.fideliscare.org	http://www.fideliscare.org/en/providersearch.aspx
H3328	003	0	1	02	01	H3328_003_0	14	2009.01	NEW YORK STATE CATHOLIC HLTH PLAN INC	Fidelis Care	www.fideliscare.org	01	02		1		H3328	003	0	2009	Fidelis Medicare Advantage Flex Plan	NY Counties		2	2			1698	2						(800)-247-1447		(800)-695-8544		(800)-860-8707		(800)-558-1125		(800)-247-1447	(800)-247-1447			(800)-860-8707	(800)-860-8707	(800)-558-1125	(800)-558-1125	www.fideliscare.org	http://www.fideliscare.org/en/providersearch.aspx
H3328	012	0	1	02	01	H3328_012_0	13	2009.01	NEW YORK STATE CATHOLIC HLTH PLAN INC	Fidelis Care	www.fideliscare.org	01	02		1		H3328	012	0	2009	Fidelis Medicare Advantage	NY Counties		2	2			1323	2						(800)-247-1447		(800)-695-8544		(800)-860-8707		(800)-558-1125		(800)-247-1447	(800)-247-1447			(800)-860-8707	(800)-860-8707	(800)-558-1125	(800)-558-1125	www.fideliscare.org	http://www.fideliscare.org/en/providersearch.aspx
H3328	013	0	1	01	01	H3328_013_0	9	2009.01	NEW YORK STATE CATHOLIC HLTH PLAN INC	Fidelis Care	www.fideliscare.org	01	01		1		H3328	013	0	2009	Fidelis Dual Advantage Flex Plan	NY Counties		2	1	3		844	2			1	1		(800)-247-1447		(800)-695-8544		(800)-860-8707		(800)-558-1125		(800)-247-1447	(800)-247-1447			(800)-860-8707	(800)-860-8707	(800)-558-1125	(800)-558-1125	www.fideliscare.org	http://www.fideliscare.org/en/providersearch.aspx
H3328	014	0	1	02	01	H3328_014_0	10	2009.01	NEW YORK STATE CATHOLIC HLTH PLAN INC	Fidelis Care	www.fideliscare.org	01	02		1		H3328	014	0	2009	Fidelis Medicare Advantage Part B Reduction	NY Counties		2	2			349	2						(800)-247-1447		(800)-695-8544		(800)-860-8707		(800)-558-1125		(800)-247-1447	(800)-247-1447			(800)-860-8707	(800)-860-8707	(800)-558-1125	(800)-558-1125	www.fideliscare.org	http://www.fideliscare.org/en/providersearch.aspx
H3329	001	0	1	20	08	H3329_001_0	1	2009.01	COMPREHENSIVE CARE MANAGEMENT CORP.	Comprehensive Care Management Corp.	www.ccmny.org	08	20		1		H3329	001	0	2009	CCMC PACE Dual Eligible	NYC  and Westchester Counties		2	2				2														(718)-515-8600	(877)-226-8500			(718)-515-8600	(877)-226-8500			N/A	
H3329	002	0	1	20	08	H3329_002_0	1	2009.01	COMPREHENSIVE CARE MANAGEMENT CORP.	Comprehensive Care Management Corp.	www.ccmny.org	08	20		1		H3329	002	0	2009	CCMC - PACE - Medicare only	NYC and Westchester Counties		2	2				2														(718)-515-8600	(877)-226-8500			(718)-515-8600	(877)-226-8500			N/A	
H3330	021	1	1	01	01	H3330_021_1	6	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	021	1	2009	HIP VIP Medicare	Greater New York Metropolitan Area	New York City	2	2				2						(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833		(800)-447-8255	(800)-447-8255	(888)-447-4833		(646)-447-6979	(866)-447-6979	(888)-447-4833		hipusa.com	
H3330	021	2	1	01	01	H3330_021_2	7	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	021	2	2009	HIP VIP Medicare	Greater New York Metropolitan Area	Nassau County	2	2				2						(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833		(800)-447-8255	(800)-447-8255	(888)-447-4833		(646)-447-6979	(866)-447-6979	(888)-447-4833		hipusa.com	
H3330	021	3	1	01	01	H3330_021_3	6	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	021	3	2009	HIP VIP Medicare	Greater New York Metropolitan Area	Suffolk and Westchester Counties	2	2				2						(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833		(800)-447-8255	(800)-447-8255	(888)-447-4833		(646)-447-6979	(866)-447-6979	(888)-447-4833		hipusa.com	
H3330	023	1	1	01	01	H3330_023_1	4	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	023	1	2009	HIP VIP Plus	Greater New York Metropolitan Area	New York City	2	2				2						(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833		(800)-447-8255	(800)-447-8255	(888)-447-4833		(646)-447-6979	(866)-447-6979	(888)-447-4833		hipusa.com	
H3330	023	2	1	01	01	H3330_023_2	5	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	023	2	2009	HIP VIP Plus	Greater New York Metropolitan Area	Nassau County	2	2				2						(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833		(800)-447-8255	(800)-447-8255	(888)-447-4833		(646)-447-6979	(866)-447-6979	(888)-447-4833		hipusa.com	
H3330	023	3	1	01	01	H3330_023_3	4	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	023	3	2009	HIP VIP Plus	Greater New York Metropolitan Area	Suffolk and Westchester Counties	2	2				2						(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833		(800)-447-8255	(800)-447-8255	(888)-447-4833		(646)-447-6979	(866)-447-6979	(888)-447-4833		hipusa.com	
H3330	025	1	1	01	01	H3330_025_1	2	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	025	1	2009	HIP VIP Rx Carveout	Greater New York Metropolitan Area	New York City	2	2				2						(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833										hipusa.com	
H3330	025	2	1	01	01	H3330_025_2	2	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	025	2	2009	HIP VIP Rx Carveout	Greater New York Metropolitan Area	Nassau County	2	2				2						(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833										hipusa.com	
H3330	025	3	1	01	01	H3330_025_3	3	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	025	3	2009	HIP VIP Rx Carveout	Greater New York Metropolitan Area	Suffolk and Westchester Counties	2	2				2						(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833										hipusa.com	
H3330	029	0	1	01	01	H3330_029_0	7	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	029	0	2009	HIP VIP Dual Eligible	Greater New York Metropolitan Area		2	1	3			2			1	2		(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833		(800)-447-8255	(800)-447-8255	(888)-447-4833		(646)-447-6979	(866)-447-6979	(888)-447-4833		hipusa.com	
H3330	030	1	1	01	01	H3330_030_1	8	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	030	1	2009	HIP VIP Care Improvement	Greater New York Metropolitan Area	New York City	2	1	4			2			1		0000000010000000000000000000	(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833		(800)-447-8255	(800)-447-8255	(888)-447-4833		(646)-447-6979	(866)-447-6979	(888)-447-4833		hipusa.com	
H3330	030	2	1	01	01	H3330_030_2	9	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	030	2	2009	HIP VIP Care Improvement	Greater New York Metropolitan Area	Nassau County	2	1	4			2			1		0000000010000000000000000000	(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833		(800)-447-8255	(800)-447-8255	(888)-447-4833		(646)-447-6979	(866)-447-6979	(888)-447-4833		hipusa.com	
H3330	030	3	1	01	01	H3330_030_3	8	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	030	3	2009	HIP VIP Care Improvement	Greater New York Metropolitan Area	Suffolk and Westchester Counties	2	1	4			2			1		0000000010000000000000000000	(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833		(800)-447-8255	(800)-447-8255	(888)-447-4833		(646)-447-6979	(866)-447-6979	(888)-447-4833		hipusa.com	
H3330	031	1	1	01	01	H3330_031_1	6	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	031	1	2009	HIP VIP Medicaid Advantage	HIP of Greater New York	Greater New York Metroplitan Area	2	1	3			2			1	1		(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833		(800)-447-8255	(800)-447-8255	(888)-447-4833		(646)-447-6979	(866)-447-6979	(888)-447-4833		hipusa.com	
H3330	031	2	1	01	01	H3330_031_2	8	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	031	2	2009	HIP VIP Medicaid Advantage	HIP of Greater New York	Long Island - Upper Counties	2	1	3			2			1	1		(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833		(800)-447-8255	(800)-447-8255	(888)-447-4833		(646)-447-6979	(866)-447-6979	(888)-447-4833		hipusa.com	
H3330	802	1	1	01	01	H3330_802_1	4	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	802	1	2009	HIP VIP Premier Medicare Calendar Employer	Greater New York Metropolitain Area	New York City	1	2				2						(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833		(646)-447-8255	(800)-447-8255	(888)-447-4833		(646)-447-6979	(800)-447-6979	(888)-447-4833		hipusa.com	
H3330	802	2	1	01	01	H3330_802_2	4	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	802	2	2009	HIP VIP Premier Medicare Calendar Employer	Greater New York Metropolitain Area	Nassau County	1	2				2						(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833		(646)-447-8255	(800)-447-8255	(888)-447-4833		(646)-447-6979	(800)-447-6979	(888)-447-4833		hipusa.com	
H3330	802	3	1	01	01	H3330_802_3	4	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	802	3	2009	HIP VIP Premier Medicare Calendar Employer	Greater New York Metropolitain Area	Suffolk and Westchester Counties	1	2				2						(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833		(646)-447-8255	(800)-447-8255	(888)-447-4833		(646)-447-6979	(800)-447-6979	(888)-447-4833		hipusa.com	
H3330	806	1	1	01	01	H3330_806_1	3	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	806	1	2009	HIP VIP Rx Carveout Calendar Employer	Greater New York Metropolitan Area	New York City	1	2				2						(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833										hipusa.com	
H3330	806	2	1	01	01	H3330_806_2	3	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	806	2	2009	HIP VIP Rx Carveout Calendar Employer	Greater New York Metropolitan Area	Nassau County	1	2				2						(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833										hipusa.com	
H3330	806	3	1	01	01	H3330_806_3	3	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	806	3	2009	HIP VIP Rx Carveout Calendar Employer	Greater New York Metropolitan Area	Suffolk and Westchester Counties	1	2				2						(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833										hipusa.com	
H3330	808	0	2	01	01	H3330_808_0	4	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		2		H3330	808	0	2009	HIP Part A Payers Calendar Employer	Greater New York Metropolitan Area		1	2				2		1				(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833		(646)-447-8255	(800)-447-8255	(888)-447-4833		(646)-447-6979	(800)-447-6979	(888)-447-4833		hipusa.com	
H3330	810	0	1	01	01	H3330_810_0	3	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	810	0	2009	HIP VIP Dual Eligible Employer	Greater New York Metropolitan Area		1	1	3			2			1	2		(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833		(646)-447-8255	(800)-447-8255	(888)-447-4833		(646)-447-6979	(800)-447-6979	(888)-447-4833		hipusa.com	
H3330	811	1	1	01	01	H3330_811_1	3	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	811	1	2009	HIP VIP Care Improvement Employer	Greater New York Metropolitan Area	New York City	1	1	4			2			1		0000000010000000000000000000	(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833		(646)-447-8255	(800)-447-8255	(888)-447-4833		(646)-447-6979	(866)-447-6979	(888)-447-4833		hipusa.com	
H3330	811	2	1	01	01	H3330_811_2	3	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	811	2	2009	HIP VIP Care Improvement Employer	Greater New York Metropolitan Area	Nassau County	1	1	4			2			1		0000000010000000000000000000	(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833		(646)-447-8255	(800)-447-8255	(888)-447-4833		(646)-447-6979	(866)-447-6979	(888)-447-4833		hipusa.com	
H3330	811	3	1	01	01	H3330_811_3	3	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	811	3	2009	HIP VIP Care Improvement Employer	Greater New York Metropolitan Area	Suffolk and Westchester Counties	1	1	4			2			1		0000000010000000000000000000	(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833		(646)-447-8255	(800)-447-8255	(888)-447-4833		(646)-447-6979	(866)-447-6979	(888)-447-4833		hipusa.com	
H3330	812	0	1	01	01	H3330_812_0	4	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	812	0	2009	HIP VIP National Rx Carveout	United States		1	2				2						(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-9169	(800)-447-9169	(888)-447-4833										hipusa.com	
H3330	813	0	1	01	01	H3330_813_0	4	2009.01	HIP OF GREATER NEW YORK	HIP Health Plan of Greater New York	HIPUSA.com	01	01		1		H3330	813	0	2009	HIP VIP National	United States		1	2				2						(800)-447-8255	(800)-447-8255	(888)-447-4833		(800)-447-8255	(800)-447-8255	(888)-447-4833		(646)-447-8255	(800)-447-8255	(888)-447-4833		(646)-447-6979	(800)-447-6979	(888)-447-4833		hipusa.com	
H3331	001	0	1	20	08	H3331_001_0	1	2009.01	INDEPENDENT LIVING FOR SENIORS, INC.	Independent Living For Seniors, Inc.	www.independentlivingforseniors.org	08	20		1		H3331	001	0	2009	Living for Seniors Dually Eligible	Monroe County		2	2				2														(585)-922-2831	(585)-922-2800			(585)-922-2836	(585)-922-2800			www.viahealth.org/body_senior.cfm?id=65	
H3331	002	0	1	20	08	H3331_002_0	1	2009.01	INDEPENDENT LIVING FOR SENIORS, INC.	Independent Living For Seniors, Inc.	www.independentlivingforseniors.org	08	20		1		H3331	002	0	2009	Independent Living for Seniors Care only	Monroe County		2	2				2														(585)-922-2831	(585)-922-2800			(585)-922-2836	(585)-922-2800			www.viahealth.org/body_senior.cfm?id=65	
H3333	031	0	1	09	04	H3333_031_0	2	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	031	0	2009	Today's Options Premier	Northeast 1		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H3333	032	0	1	09	04	H3333_032_0	2	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	032	0	2009	Today's Options Premier	Northeast 2		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H3333	033	0	1	09	04	H3333_033_0	2	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	033	0	2009	Today's Options Premier	Northeast 3		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H3333	034	0	1	09	04	H3333_034_0	2	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	034	0	2009	Today's Options Premier	Northeast 4		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H3333	035	0	1	09	04	H3333_035_0	2	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	035	0	2009	Today's Options Premier	Northeast 5		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H3333	036	0	1	09	04	H3333_036_0	2	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	036	0	2009	Today's Options Premier	Northeast 6		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H3333	037	0	1	09	04	H3333_037_0	2	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	037	0	2009	Today's Options Value	Northeast 1		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H3333	038	0	1	09	04	H3333_038_0	2	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	038	0	2009	Today's Options Value	Northeast 2		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H3333	039	0	1	09	04	H3333_039_0	2	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	039	0	2009	Today's Options Value	Northeast 3		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H3333	040	0	1	09	04	H3333_040_0	2	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	040	0	2009	Today's Options Value	Northeast 4		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H3333	041	0	1	09	04	H3333_041_0	2	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	041	0	2009	Today's Options Value	Northeast 5		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H3333	042	0	1	09	04	H3333_042_0	2	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	042	0	2009	Today's Options Value	Northeast 6		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H3333	049	0	1	09	04	H3333_049_0	4	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	049	0	2009	Today's Options Premier powered by CCRx	Northeast 1		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H3333	050	0	1	09	04	H3333_050_0	4	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	050	0	2009	Today's Options Premier powered by CCRx	Northeast 2		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H3333	051	0	1	09	04	H3333_051_0	4	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	051	0	2009	Today's Options Premier powered by CCRx	Northeast 3		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H3333	052	0	1	09	04	H3333_052_0	4	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	052	0	2009	Today's Options Premier powered by CCRx	Northeast 4		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H3333	053	0	1	09	04	H3333_053_0	4	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	053	0	2009	Today's Options Premier powered by CCRx	Northeast 5		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H3333	054	0	1	09	04	H3333_054_0	4	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	054	0	2009	Today's Options Premier powered by CCRx	Northeast 6		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H3333	055	0	1	09	04	H3333_055_0	4	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	055	0	2009	Today's Options Value powered by CCRx	Northeast 1		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H3333	056	0	1	09	04	H3333_056_0	4	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	056	0	2009	Today's Options Value powered by CCRx	Northeast 2		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H3333	057	0	1	09	04	H3333_057_0	4	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	057	0	2009	Today's Options Value powered by CCRx	Northeast 3		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H3333	058	0	1	09	04	H3333_058_0	4	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	058	0	2009	Today's Options Value powered by CCRx	Northeast 4		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H3333	059	0	1	09	04	H3333_059_0	4	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	059	0	2009	Today's Options Value powered by CCRx	Northeast 5		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H3333	060	0	1	09	04	H3333_060_0	4	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	060	0	2009	Today's Options Value powered by CCRx	Northeast 6		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H3333	100	0	1	09	04	H3333_100_0	4	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	100	0	2009	Today's Options Access powered by CCRx	New York and Pennsylvania		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H3333	801	0	1	09	04	H3333_801_0	7	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	801	0	2009	Today's Options Group	National		1	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H3333	805	0	1	09	04	H3333_805_0	7	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	805	0	2009	Today's Options Group Plus	National		1	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H3333	806	0	1	09	04	H3333_806_0	7	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	806	0	2009	Today's Options Group Plus NCY	National		1	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H3333	807	0	1	09	04	H3333_807_0	7	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	807	0	2009	Today 's Options Group Medco	National		1	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H3333	808	0	1	09	04	H3333_808_0	7	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	808	0	2009	Today 's Options Group Plus Medco	National		1	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H3333	809	0	1	09	04	H3333_809_0	7	2009.01	AMERICAN PROGRESSIVE LIFE/HLTH INS.	Universal American	www.todaysoptions.com	04	09	2	1		H3333	809	0	2009	Today 's Options Group Plus NCY Medco	National		1	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H3335	002	0	1	04	01	H3335_002_0	7	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	002	0	2009	Univera Medicare PPO 102	Western New York		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	005	0	1	04	01	H3335_005_0	7	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	005	0	2009	Medicare Blue PPO - TWO	Utica-Rome Metro		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	006	0	1	04	01	H3335_006_0	7	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	006	0	2009	Medicare Blue PPO - THREE	Utica-Rome Metro		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	008	0	1	04	01	H3335_008_0	7	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	008	0	2009	Medicare Blue PPO - TWO	Southern Tier of NY State		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	009	0	1	04	01	H3335_009_0	7	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	009	0	2009	Medicare Blue PPO - THREE	Southern Tier of NY State		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	014	0	1	04	01	H3335_014_0	7	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	014	0	2009	Medicare Blue PPO - TWO	Metro Syracuse		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	015	0	1	04	01	H3335_015_0	7	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	015	0	2009	Medicare Blue PPO - THREE	Metro Syracuse		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	017	0	1	04	01	H3335_017_0	7	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	017	0	2009	Medicare Blue PPO - TWO	Central Leatherstocking		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	018	0	1	04	01	H3335_018_0	7	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	018	0	2009	Medicare Blue PPO - THREE	Central Leatherstocking		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	020	0	1	04	01	H3335_020_0	7	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	020	0	2009	Medicare Blue PPO - TWO	North Country		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	021	0	1	04	01	H3335_021_0	7	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	021	0	2009	Medicare Blue PPO - THREE	North Country		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	032	0	1	04	01	H3335_032_0	8	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	032	0	2009	Medicare Blue PPO - Plan 201	Rochester Metro Area		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	036	0	1	04	01	H3335_036_0	9	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	036	0	2009	Medicare Blue PPO Plan ONE	Utica-Rome Metro		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	037	0	1	04	01	H3335_037_0	9	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	037	0	2009	Medicare Blue PPO Plan ONE	Southern Tier of NY State		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	038	0	1	04	01	H3335_038_0	9	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	038	0	2009	Medicare Blue PPO Plan ONE	Metro Syracuse		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	039	0	1	04	01	H3335_039_0	9	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	039	0	2009	Medicare Blue PPO Plan ONE	Central Leatherstocking		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	040	0	1	04	01	H3335_040_0	10	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	040	0	2009	Medicare Blue PPO Plan ONE	North Country		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	041	0	1	04	01	H3335_041_0	4	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	041	0	2009	Medicare Blue PPO Plan FOUR	Utica-Rome Metro		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220										www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	042	0	1	04	01	H3335_042_0	5	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	042	0	2009	Medicare Blue PPO Plan FOUR	Southern Tier of NY State		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220										www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	043	0	1	04	01	H3335_043_0	5	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	043	0	2009	Medicare Blue PPO Plan FOUR	Metro Syracuse		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220										www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	044	0	1	04	01	H3335_044_0	5	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	044	0	2009	Medicare Blue PPO Plan FOUR	Central Leatherstocking		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220										www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	045	0	1	04	01	H3335_045_0	5	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	045	0	2009	Medicare Blue PPO Plan FOUR	North Country		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220										www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	046	0	1	04	01	H3335_046_0	8	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	046	0	2009	Medicare Blue PPO Plan FIVE	Utica-Rome Metro		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	047	0	1	04	01	H3335_047_0	9	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	047	0	2009	Medicare Blue PPO Plan FIVE	Southern Tier of NY State		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	048	0	1	04	01	H3335_048_0	9	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	048	0	2009	Medicare Blue PPO Plan FIVE	Metro Syracuse		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	049	0	1	04	01	H3335_049_0	9	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	049	0	2009	Medicare Blue PPO Plan FIVE	Central Leatherstocking		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	050	0	1	04	01	H3335_050_0	9	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	050	0	2009	Medicare Blue PPO Plan FIVE	North Country		2	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	801	0	1	04	01	H3335_801_0	4	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	801	0	2009	Univera Medicare PPO Group	Western New York		1	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	811	0	1	04	01	H3335_811_0	3	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	811	0	2009	Medicare Blue PPO - Group	Rochester Metro Area		1	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	813	0	1	04	01	H3335_813_0	4	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	813	0	2009	Univera Medicare PPO - Group	Western New York		1	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220										www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	819	0	1	04	01	H3335_819_0	3	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	819	0	2009	Medicare Blue PPO - Group	Rochester Metro		1	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220										www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	820	0	1	04	01	H3335_820_0	3	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	820	0	2009	Medicare Blue PPO Group Non-Calendar	Upstate New York		1	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3335	822	0	1	04	01	H3335_822_0	4	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	04		1		H3335	822	0	2009	Univera Medicare PPO Group Non-Calendar	Western New York		1	2				2						(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-509-6350	(800)-509-6350	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3336	001	0	1	01	01	H3336_001_0	6	2009.01	NEIGHBORHOOD HEALTH PROVIDERS LLC	Neighborhood Health Providers	www.getnhp.com	01	01		1		H3336	001	0	2009	Neighborhood Medicare Plus Rx	Bronx, Kings, New York, Queens		2	2			1400	1	1					(866)-345-0013	(866)-345-0013	(800)-662-1220	(800)-662-1220	(866)-345-0013	(866)-345-0013	(800)-662-1220	(800)-662-1220	(866)-345-0013	(866)-345-0013	(800)-662-1220	(800)-662-1220	(866)-345-0013	(866)-345-0013	(800)-662-1220	(800)-662-1220	http://www.getnhp.com/mpd_medicarepd.html	
H3336	003	0	1	01	01	H3336_003_0	6	2009.01	NEIGHBORHOOD HEALTH PROVIDERS LLC	Neighborhood Health Providers	www.getnhp.com	01	01		1		H3336	003	0	2009	Neighborhood Medicare Supreme	Bronx, Kings, New York, Queens		2	1	3		600	1	1		1	3		(866)-345-0013	(866)-345-0013	(800)-662-1220	(800)-662-1220	(866)-345-0013	(866)-345-0013	(800)-662-1220	(800)-662-1220	(866)-345-0013	(866)-345-0013	(800)-662-1220	(800)-662-1220	(866)-345-0013	(866)-345-0013	(800)-662-1220	(800)-662-1220	http://www.getnhp.com/mpd_medicarepd.html	
H3336	004	0	1	01	01	H3336_004_0	7	2009.01	NEIGHBORHOOD HEALTH PROVIDERS LLC	Neighborhood Health Providers	www.getnhp.com	01	01		1		H3336	004	0	2009	Neighborhood Medicare Plus	Bronx, Kings, New York, Queens		2	2			100	1	1					(866)-345-0013	(866)-345-0013	(800)-662-1220	(800)-662-1220	(866)-345-0013	(866)-345-0013	(800)-662-1220	(800)-662-1220									http://www.getnhp.com/mpd_medicarepd.html	
H3336	006	0	1	01	01	H3336_006_0	6	2009.01	NEIGHBORHOOD HEALTH PROVIDERS LLC	Neighborhood Health Providers	www.getnhp.com	01	01		1		H3336	006	0	2009	Neighborhood Medicare Platinum with Rx	Bronx, Kings, New York, Queens		2	2			1400	1	1					(866)-345-0013	(866)-345-0013	(800)-662-1220	(800)-662-1220	(866)-345-0013	(866)-345-0013	(800)-662-1220	(800)-662-1220	(866)-345-0013	(866)-345-0013	(800)-662-1220	(800)-662-1220	(866)-345-0013	(866)-345-0013	(800)-662-1220	(800)-662-1220	http://www.getnhp.com/mpd_medicarepd.html	
H3336	010	0	1	01	01	H3336_010_0	4	2009.01	NEIGHBORHOOD HEALTH PROVIDERS LLC	Neighborhood Health Providers	www.getnhp.com	01	01		1		H3336	010	0	2009	Neighborhood Extended Care	Kings and Queens		2	1	3		100	1	1		1	1		(888)-324-9890	(888)-324-9890	(800)-662-1220	(800)-662-1220	(888)-324-9890	(888)-324-9890	(800)-662-1220	(800)-662-1220	(888)-324-9890	(888)-324-9890	(800)-662-1220	(800)-662-1220	(888)-324-9890	(888)-324-9890	(800)-662-1220	(800)-662-1220	http://www.getnhp.com/mpd_medicarepd.html	
H3337	001	0	1	01	01	H3337_001_0	7	2009.01	LIBERTY HEALTH ADVANTAGE, INC.	Liberty Health Advantage	www.libertyhealthadvantage.com	01	01		1		H3337	001	0	2009	Liberty Health Advantage Preferred Choice	Bronx, Kings, New York, Queens, Richmond, Nassau		2	2			4944	2						(866)-542-4269	(866)-542-4269	(800)-662-1220		(866)-542-4269	(866)-542-4269	(800)-662-1220		(800)-546-5677	(800)-546-5677			(866)-542-4269	(866)-542-4269	(800)-662-1220		http://www.libertyhealthadvantage.com/pharmacy_formulary.cfm	www.libertyhealthadvantage.com
H3337	002	0	1	01	01	H3337_002_0	7	2009.01	LIBERTY HEALTH ADVANTAGE, INC.	Liberty Health Advantage	www.libertyhealthadvantage.com	01	01		1		H3337	002	0	2009	Liberty Health Advantage Dual Power - Nassau	Nassau		2	1	3		219	2			1	3		(866)-542-4269	(866)-542-4269	(800)-662-1220		(866)-542-4269	(866)-542-4269	(800)-662-1220		(800)-546-5677	(800)-546-5677			(866)-542-4269	(866)-542-4269	(800)-662-1220		http://www.libertyhealthadvantage.com/pharmacy_formulary.cfm	www.libertyhealthadvantage.com
H3337	003	0	1	01	01	H3337_003_0	7	2009.01	LIBERTY HEALTH ADVANTAGE, INC.	Liberty Health Advantage	www.libertyhealthadvantage.com	01	01		1		H3337	003	0	2009	Liberty Health Advantage Dual Power - NYC	NYC - Bronx, Kings, New York, Queens, Richmond		2	1	3		2116	2			1	3		(866)-542-4269	(866)-542-4269	(800)-662-1220		(866)-542-4269	(866)-542-4269	(800)-662-1220		(800)-546-5677	(800)-546-5677			(866)-542-4269	(866)-542-4269	(800)-662-1220		http://www.libertyhealthadvantage.com/pharmacy_formulary.cfm	www.libertyhealthadvantage.com
H3337	004	0	1	01	01	H3337_004_0	8	2009.01	LIBERTY HEALTH ADVANTAGE, INC.	Liberty Health Advantage	www.libertyhealthadvantage.com	01	01		1		H3337	004	0	2009	Liberty Health Advantage Secure Choice	Bronx, Kings, New York, Queens, Richmond, Nassau		2	1	1	1	18	2			1			(866)-542-4269	(866)-542-4269	(800)-662-1220		(866)-542-4269	(866)-542-4269	(800)-662-1220		(800)-546-5677	(800)-546-5677			(866)-542-4269	(866)-542-4269	(800)-662-1220		http://www.libertyhealthadvantage.com/pharmacy_formulary.cfm	www.libertyhealthadvantage.com
H3342	001	0	1	04	01	H3342_001_0	7	2009.01	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com	01	04		1		H3342	001	0	2009	MediBlue PPO Plus	New York City and Nassau		2	2			3204	2						(866)-395-5175	(866)-395-5175	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894		(866)-395-5175	(866)-395-5175	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894		www.empireblue.com	www.empireblue.com
H3342	002	0	1	04	01	H3342_002_0	9	2009.01	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com	01	04		1		H3342	002	0	2009	MediBlue PPO Plus	Rockland, Westchester, Mid-Hudson, Capital Region		2	2			858	2						(866)-395-5175	(866)-395-5175	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894		(866)-395-5175	(866)-395-5175	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894		www.empireblue.com	www.empireblue.com
H3342	004	0	1	04	01	H3342_004_0	8	2009.01	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com	01	04		1		H3342	004	0	2009	MediBlue PPO Plus	Suffolk County		2	2			692	2						(866)-395-5175	(866)-395-5175	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894		(866)-395-5175	(866)-395-5175	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894		www.empireblue.com	www.empireblue.com
H3342	012	0	1	04	01	H3342_012_0	9	2009.01	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com	01	04		1		H3342	012	0	2009	MediBlue PPO Value	NYC, Long Island, Mid-Hudson and Capital Region		2	2			230	2						(866)-395-5175	(866)-395-5175	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894		(866)-395-5175	(866)-395-5175	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894		www.empireblue.com	www.empireblue.com
H3344	001	0	1	04	01	H3344_001_0	9	2009.01	INDEPENDENT HEALTH BENEFITS CORP	Independent Health	www.independenthealth.com	01	04		1		H3344	001	0	2009	Independent Health Medicare Passport PPO	Western New York		2	2			500	2						(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840		(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840		www.independenthealth.com	www.independenthealth.com
H3344	003	0	1	04	01	H3344_003_0	9	2009.01	INDEPENDENT HEALTH BENEFITS CORP	Independent Health	www.independenthealth.com	01	04		1		H3344	003	0	2009	Independent Health Medicare PPO Premier	Western New York		2	2			1700	2						(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840		(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840		www.independenthealth.com	www.independenthealth.com
H3344	801	0	1	04	01	H3344_801_0	7	2009.01	INDEPENDENT HEALTH BENEFITS CORP	Independent Health	www.independenthealth.com	01	04		1		H3344	801	0	2009	Independent Health Medicare PPO Base	IH Network and Medicare Deemed Network		1	2			975	1	1					(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840		(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840		www.independenthealth.com	www.independenthealth.com
H3344	803	0	1	04	01	H3344_803_0	7	2009.01	INDEPENDENT HEALTH BENEFITS CORP	Independent Health	www.independenthealth.com	01	04		1		H3344	803	0	2009	Independent Health Medicare PPO Base	IH Network and Medicare Deemed Network		1	2			500	1	1					(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840		(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840		www.independenthealth.com	www.independenthealth.com
H3344	804	0	1	04	01	H3344_804_0	7	2009.01	INDEPENDENT HEALTH BENEFITS CORP	Independent Health	www.independenthealth.com	01	04		1		H3344	804	0	2009	Independent Health Medicare PPO Base	IH Network and Medicare Deemed Network		1	2			500	1	1					(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840										www.independenthealth.com	www.independenthealth.com
H3346	001	0	1	04	01	H3346_001_0	9	2009.01	ROCHESTER AREA HEALTH MAINTENANCE ORG.	Preferred Care GoldAnywhere	www.preferredcare.org	01	04		1		H3346	001	0	2009	Preferred Care GoldAnywhere	Rochester and Western New York		2	2			397	2						(585)-327-2480	(800)-665-7924	(585)-325-2629	(800)-252-2452	(585)-327-5760	(888)-280-6205	(585)-325-2629	(800)-252-2452									http://www.preferredcare.org/ourplans/medicarepartd/documents/FB909834_PCComp_4Tier.5.pdf	www.preferredcare.org
H3346	002	0	1	04	01	H3346_002_0	14	2009.01	ROCHESTER AREA HEALTH MAINTENANCE ORG.	Preferred Care GoldAnywhere	www.preferredcare.org	01	04		1		H3346	002	0	2009	Preferred Care GoldAnywhere Rx	Rochester and Western New York		2	2			397	2						(585)-327-2480	(800)-665-7924	(585)-325-2629	(800)-252-2452	(585)-327-5760	(888)-280-6205	(585)-325-2629	(800)-252-2452	(585)-327-2480	(800)-665-7924	(585)-325-2629	(800)-252-2452	(585)-327-5760	(888)-280-6205	(585)-325-2629	(800)-252-2452	http://www.preferredcare.org/ourplans/medicarepartd/documents/FB909834_PCComp_4Tier.5.pdf	www.preferredcare.org
H3346	802	0	1	04	01	H3346_802_0	10	2009.01	ROCHESTER AREA HEALTH MAINTENANCE ORG.	Preferred Care GoldAnywhere	www.preferredcare.org	01	04		1		H3346	802	0	2009	Preferred Care GoldAnywhere Rx - Employer Group	Rochester and Western New York		1	2			340	2						(585)-327-2480	(800)-665-7924	(585)-325-2629	(800)-252-2452	(585)-327-5760	(888)-280-6205	(585)-325-2629	(800)-252-2452	(585)-327-2480	(800)-665-7924	(585)-325-2629	(800)-252-2452	(585)-327-5760	(888)-280-6205	(585)-325-2629	(800)-252-2452	http://www.preferredcare.org/ourplans/medicarepartd/documents/FB909834_PCComp_4Tier.5.pdf	www.preferredcare.org
H3347	001	0	1	01	01	H3347_001_0	7	2009.01	ELDERPLAN, INC.	Elderplan, Inc.	www.Elderplan.org	01	01		1		H3347	001	0	2009	Elderplan Classic	New York City Metropolitan Area		2	1	1	2		2			2			(718)-921-7898	(800)-353-3765	(800)-662-1220	(800)-662-1220	(866)-695-8101	(866)-695-8101	(800)-662-1220	(800)-662-1220	(718)-921-7898	(800)-353-3765	(800)-662-1220	(800)-662-1220	(866)-695-8101	(866)-695-8101	(800)-662-1220	(800)-662-1220	www.elderplan.org	www.Elderplan.org
H3347	002	0	1	01	01	H3347_002_0	6	2009.01	ELDERPLAN, INC.	Elderplan, Inc.	www.Elderplan.org	01	01		1		H3347	002	0	2009	Elderplan Access	New York City Metropolitan Area		2	1	3			2			1	1		(718)-921-7898	(800)-353-3765	(800)-662-1220	(800)-662-1220	(866)-695-8101	(866)-695-8101	(800)-662-1220	(800)-662-1220	(718)-921-7898	(800)-353-3765	(800)-662-1220	(800)-662-1220	(866)-695-8101	(866)-695-8101	(800)-662-1220	(800)-662-1220	www.elderplan.org	www.Elderplan.org
H3347	003	0	1	01	01	H3347_003_0	6	2009.01	ELDERPLAN, INC.	Elderplan, Inc.	www.Elderplan.org	01	01		1		H3347	003	0	2009	Elderplan Advantage	New York City Metropolitan Area		2	1	1	1		2			1			(718)-921-7898	(800)-353-3765	(800)-662-1220	(800)-662-1220	(866)-695-8101	(866)-695-8101	(800)-662-1220	(800)-662-1220	(718)-921-7898	(800)-353-3765	(800)-662-1220	(800)-662-1220	(866)-695-8101	(866)-695-8101	(800)-662-1220	(800)-662-1220	www.elderplan.org	www.Elderplan.org
H3347	004	0	1	01	01	H3347_004_0	4	2009.01	ELDERPLAN, INC.	Elderplan, Inc.	www.Elderplan.org	01	01		1		H3347	004	0	2009	Elderplan Extra	New York City Metropolitan Area		2	2				2						(718)-921-7898	(800)-353-3765	(800)-662-1220	(800)-662-1220	(866)-695-8101	(866)-695-8101	(800)-662-1220	(800)-662-1220	(718)-921-7898	(800)-353-3765	(800)-662-1220	(800)-662-1220	(866)-695-8101	(866)-695-8101	(800)-662-1220	(800)-662-1220	www.elderplan.org	www.Elderplan.org
H3347	005	0	1	01	01	H3347_005_0	6	2009.01	ELDERPLAN, INC.	Elderplan, Inc.	www.Elderplan.org	01	01		1		H3347	005	0	2009	Elderplan Classic II	New York City Metropolitan Area		2	2				2						(718)-921-7898	(800)-353-3765	(800)-662-1220	(800)-662-1220	(866)-695-8101	(866)-695-8101	(800)-662-1220	(800)-662-1220	(718)-921-7898	(800)-353-3765	(800)-662-1220	(800)-662-1220	(866)-695-8101	(866)-695-8101	(800)-662-1220	(800)-662-1220	www.elderplan.org	www.Elderplan.org
H3347	006	0	1	01	01	H3347_006_0	8	2009.01	ELDERPLAN, INC.	Elderplan, Inc.	www.Elderplan.org	01	01		1		H3347	006	0	2009	Elderplan Classic III	New York City Metropolitan Area		2	2				2						(718)-921-7898	(800)-353-3765	(800)-662-1220	(800)-662-1220	(866)-695-8101	(866)-695-8101	(800)-662-1220	(800)-662-1220	(718)-921-7898	(800)-353-3765	(800)-662-1220	(800)-662-1220	(866)-695-8101	(866)-695-8101	(800)-662-1220	(800)-662-1220	www.elderplan.org	www.Elderplan.org
H3347	802	0	1	01	01	H3347_802_0	6	2009.01	ELDERPLAN, INC.	Elderplan, Inc.	www.Elderplan.org	01	01		1		H3347	802	0	2009	Elderplan Retiree Health Solutions I	New York State/National		1	2				2						(718)-921-7898	(800)-353-3765	(800)-662-1220	(800)-662-1220	(866)-809-3496	(866)-809-3496	(800)-662-1220	(800)-662-1220	(718)-921-7898	(800)-353-3765	(800)-662-1220	(800)-662-1220	(866)-809-3496	(866)-809-3496	(800)-662-1220	(800)-662-1220	www.elderplan.org	www.Elderplan.org
H3347	805	0	1	01	01	H3347_805_0	6	2009.01	ELDERPLAN, INC.	Elderplan, Inc.	www.Elderplan.org	01	01		1		H3347	805	0	2009	Elderplan Retiree Health Solutions II	New York State/National		1	2				2						(718)-921-7898	(800)-353-3765	(800)-662-1220	(800)-662-1220	(866)-809-3496	(866)-809-3496	(800)-662-1220	(800)-662-1220	(718)-921-7898	(800)-353-3765	(800)-662-1220	(800)-662-1220	(866)-809-3496	(866)-809-3496	(800)-662-1220	(800)-662-1220	www.elderplan.org	www.Elderplan.org
H3347	806	0	1	01	01	H3347_806_0	6	2009.01	ELDERPLAN, INC.	Elderplan, Inc.	www.Elderplan.org	01	01		1		H3347	806	0	2009	Elderplan Retiree Health Solutions III	New York State/National		1	2				2						(718)-921-7898	(800)-353-3765	(800)-662-1220	(800)-662-1220	(866)-809-3496	(866)-809-3496	(800)-662-1220	(800)-662-1220									www.elderplan.org	www.Elderplan.org
H3351	001	0	1	01	01	H3351_001_0	4	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	01		1		H3351	001	0	2009	SeniorChoice Select	Western New York		2	2				2						(800)-558-4320	(800)-558-4320	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220										www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3351	002	0	1	01	01	H3351_002_0	7	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	01		1		H3351	002	0	2009	SeniorChoice Secure	Western New York		2	2				2						(800)-558-4320	(800)-558-4320	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(877)-883-9577	(877)-883-9577	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3351	006	0	1	01	01	H3351_006_0	7	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	01		1		H3351	006	0	2009	Medicare Blue Choice Optimum	Metro Rochester and Finger Lakes Region		2	2				2						(800)-558-4320	(800)-558-4320	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(877)-883-9577	(877)-883-9577	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3351	007	0	1	01	01	H3351_007_0	4	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	01		1		H3351	007	0	2009	Medicare Blue Choice Platinum	Metro Rochester and Finger Lakes Region		2	2				2						(800)-558-4320	(800)-558-4320	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220										www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3351	010	0	1	01	01	H3351_010_0	6	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	01		1		H3351	010	0	2009	SeniorChoice Value	Western New York		2	2				2						(800)-558-4320	(800)-558-4320	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(877)-883-9577	(877)-883-9577	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3351	011	0	1	01	01	H3351_011_0	6	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	01		1		H3351	011	0	2009	Medicare Blue Choice Value	Metro Rochester		2	2				2						(800)-558-4320	(800)-558-4320	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(877)-883-9577	(877)-883-9577	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3351	012	0	1	01	01	H3351_012_0	6	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	01		1		H3351	012	0	2009	SeniorChoice HMO Value Plus	Western New York		2	2				2						(800)-558-4320	(800)-558-4320	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(877)-883-9577	(877)-883-9577	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3351	013	0	1	01	01	H3351_013_0	6	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	01		1		H3351	013	0	2009	Medicare Blue Choice HMO Value Plus	Metro Rochester		2	2				2						(800)-558-4320	(800)-558-4320	(800)-421-1220		(800)-558-4320	(800)-558-4320	(800)-421-1220		(877)-883-9577	(877)-883-9577	(800)-421-1220		(800)-558-4320	(800)-558-4320	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3351	801	0	1	01	01	H3351_801_0	5	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	01		1		H3351	801	0	2009	SeniorChoice - Group	Western New York		1	2				2						(800)-558-4320	(800)-558-4320	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(877)-883-9577	(877)-883-9577	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3351	802	0	1	01	01	H3351_802_0	5	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	01		1		H3351	802	0	2009	Medicare Blue Choice - Group	Metro Rochester		1	2				2						(800)-558-4320	(800)-558-4320	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(877)-883-9577	(877)-883-9577	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3351	803	0	1	01	01	H3351_803_0	5	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	01		1		H3351	803	0	2009	SeniorChoice - Group	Western New York		1	2				2						(800)-558-4320	(800)-558-4320	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220										www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3351	804	0	1	01	01	H3351_804_0	5	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	01		1		H3351	804	0	2009	Medicare Blue Choice - Group	Metro Rochester		1	2				2						(800)-558-4320	(800)-558-4320	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220										www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3351	805	0	1	01	01	H3351_805_0	5	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	01		1		H3351	805	0	2009	SeniorChoice Group Non-Calendar	Western New York		1	2				2						(800)-558-4320	(800)-558-4320	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(877)-883-9577	(877)-883-9577	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3351	806	0	1	01	01	H3351_806_0	5	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellus.com	01	01		1		H3351	806	0	2009	Medicare Blue Choice Group Non-Calendar	Metro Rochester		1	2				2						(800)-558-4320	(800)-558-4320	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(877)-883-9577	(877)-883-9577	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com and www.univerahealthcare.com	www.excellus.com
H3356	001	0	1	18	06	H3356_001_0	5	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	06	18		1		H3356	001	0	2009	Blue Choice Senior	Metro Rochester and Finger Lakes area		2	2				2						(800)-462-0108	(800)-462-0108	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		(800)-462-0108	(800)-462-0108	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com	
H3356	801	0		18	06	H3356_801_0	1	2009.01	EXCELLUS HEALTH PLAN, INC.	Excellus Health Plan, Inc	www.excellusbcbs.com	06	18				H3356	801	0	2009	Blue Choice Senior - Group	Metro Rochester		1	2										(800)-462-0108	(800)-462-0108	(800)-421-1220			(800)-659-1986	(800)-421-1220		(800)-462-0108	(800)-462-0108	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.excellusbcbs.com	
H3359	001	0	1	01	01	H3359_001_0	7	2009.01	MANAGED HEALTH, INC.	Healthfirst Medicare Plan	www.healthfirstny.com	01	01		1		H3359	001	0	2009	Healthfirst 65 Plus Plan	NYC and LI Counties		2	2			16345	2						(888)-260-1010	(888)-260-1010	(800)-662-1220		(877)-237-1303	(877)-237-1303	(800)-662-1220		(877)-697-7244	(877)-697-7244	(800)-899-2114	(800)-899-2114	(877)-237-1303	(877)-237-1303	(800)-662-1220		www.healthfirstny.com	www.healthfirstny.com
H3359	019	0	1	01	01	H3359_019_0	8	2009.01	MANAGED HEALTH, INC.	Healthfirst Medicare Plan	www.healthfirstny.com	01	01		1		H3359	019	0	2009	Healthfirst Increased Benefits Plan	NYC, LI and Westchester Counties		2	2			23724	2						(888)-260-1010	(888)-260-1010	(800)-662-1220		(877)-237-1303	(877)-237-1303	(800)-662-1220		(877)-697-7244	(877)-697-7244	(800)-899-2114	(800)-899-2114	(877)-237-1303	(877)-237-1303	(800)-662-1220		www.healthfirstny.com	www.healthfirstny.com
H3359	021	0	1	01	01	H3359_021_0	8	2009.01	MANAGED HEALTH, INC.	Healthfirst Medicare Plan	www.healthfirstny.com	01	01		1		H3359	021	0	2009	Healthfirst Life Improvement Plan	NYC, LI and Westchester Counties		2	1	3		44030	2			1	2		(888)-260-1010	(888)-260-1010	(800)-662-1220		(877)-237-1303	(877)-237-1303	(800)-662-1220		(877)-697-7244	(877)-697-7244	(800)-899-2114	(800)-899-2114	(877)-237-1303	(877)-237-1303	(800)-662-1220		www.healthfirstny.com	www.healthfirstny.com
H3359	026	0	1	01	01	H3359_026_0	8	2009.01	MANAGED HEALTH, INC.	Healthfirst Medicare Plan	www.healthfirstny.com	01	01		1		H3359	026	0	2009	Healthfirst Maximum Plan	New York Metropolitan Area		2	1	3		62	2			1	2		(888)-260-1010	(888)-260-1010	(800)-662-1220		(877)-237-1303	(877)-237-1303	(800)-662-1220		(877)-697-7244	(877)-697-7244	(800)-899-2114	(800)-899-2114	(877)-237-1303	(877)-237-1303	(800)-662-1220		www.healthfirstny.com	www.healthfirstny.com
H3359	027	0	1	01	01	H3359_027_0	6	2009.01	MANAGED HEALTH, INC.	Healthfirst Medicare Plan	www.healthfirstny.com	01	01		1		H3359	027	0	2009	Healthfirst Coordinated Benefits Plan	New York Metropolitan Area		2	2			2022	2						(888)-260-1010	(888)-260-1010	(800)-662-1220		(877)-237-1303	(877)-237-1303	(800)-662-1220										www.healthfirstny.com	www.healthfirstny.com
H3359	031	0	1	01	01	H3359_031_0	7	2009.01	MANAGED HEALTH, INC.	Healthfirst Medicare Plan	www.healthfirstny.com	01	01		1		H3359	031	0	2009	Healthfirst Medicare Plus Plan	Westchester County		2	2			56	2						(888)-260-1010	(888)-260-1010	(800)-662-1220		(877)-237-1303	(877)-237-1303	(800)-662-1220		(877)-697-7244	(877)-697-7244	(800)-899-2114	(800)-899-2114	(877)-237-1303	(877)-237-1303	(800)-662-1220		www.healthfirstny.com	www.healthfirstny.com
H3359	804	0	1	01	01	H3359_804_0	6	2009.01	MANAGED HEALTH, INC.	Healthfirst Medicare Plan	www.healthfirstny.com	01	01		1		H3359	804	0	2009	Employer Group 1	All New York State Counties		1	2			100	2						(888)-260-1010	(888)-260-1010	(800)-662-1220		(877)-237-1303	(877)-237-1303	(800)-662-1220		(877)-697-7244	(877)-697-7244	(800)-899-2114	(800)-899-2114	(877)-237-1303	(877)-237-1303	(800)-662-1220		www.healthfirstny.com	www.healthfirstny.com
H3359	805	0	1	01	01	H3359_805_0	7	2009.01	MANAGED HEALTH, INC.	Healthfirst Medicare Plan	www.healthfirstny.com	01	01		1		H3359	805	0	2009	Employer Group 2	All New York State Counties		1	2			100	2						(888)-260-1010	(888)-260-1010	(800)-662-1220		(877)-237-1303	(877)-237-1303	(800)-662-1220										www.healthfirstny.com	www.healthfirstny.com
H3359	806	0	1	01	01	H3359_806_0	7	2009.01	MANAGED HEALTH, INC.	Healthfirst Medicare Plan	www.healthfirstny.com	01	01		1		H3359	806	0	2009	Employer Group 3	All New York State Counties		1	2			50	2						(888)-260-1010	(888)-260-1010	(800)-662-1220		(877)-237-1303	(877)-237-1303	(800)-662-1220		(877)-697-7244	(877)-697-7244	(800)-899-2114	(800)-899-2114	(877)-237-1303	(877)-237-1303	(800)-662-1220		www.healthfirstny.com	www.healthfirstny.com
H3359	807	0	1	01	01	H3359_807_0	6	2009.01	MANAGED HEALTH, INC.	Healthfirst Medicare Plan	www.healthfirstny.com	01	01		1		H3359	807	0	2009	Employer Group 4	All New York State Counties		1	2			50	2						(888)-260-1010	(888)-260-1010	(800)-662-1220		(877)-237-1303	(877)-237-1303	(800)-662-1220										www.healthfirstny.com	www.healthfirstny.com
H3361	020	0	1	02	01	H3361_020_0	6	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	02		1		H3361	020	0	2009	WellCare Choice	Bronx  County		2	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	021	0	1	02	01	H3361_021_0	6	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	02		1		H3361	021	0	2009	WellCare Choice	Dutchess County		2	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	024	0	1	02	01	H3361_024_0	6	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	02		1		H3361	024	0	2009	WellCare Choice	Queens County		2	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	027	0	1	02	01	H3361_027_0	6	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	02		1		H3361	027	0	2009	WellCare Choice	Orange and Rockland Counties		2	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	031	0	1	01	01	H3361_031_0	7	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	01		1		H3361	031	0	2009	WellCare Access	Bronx County		2	1	3			2			1	1		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	039	0	1	01	01	H3361_039_0	5	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	01		1		H3361	039	0	2009	WellCare Dividend	Bronx, Kings, New York, and Queens Counties		2	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272										www.wellcare.com	
H3361	043	0	1	02	01	H3361_043_0	7	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	02		1		H3361	043	0	2009	WellCare Select	Bronx, Kings, New York, and Queens Counties		2	1	3			2			1	2		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	047	0	1	01	01	H3361_047_0	7	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	01		1		H3361	047	0	2009	WellCare Liberty	Albany County		2	1	3			2			1	3		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	050	0	1	01	01	H3361_050_0	7	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	01		1		H3361	050	0	2009	WellCare Liberty	New York County		2	1	3			2			1	3		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	051	0	1	02	01	H3361_051_0	6	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	02		1		H3361	051	0	2009	WellCare Passport	Bronx, Kings, New York, and Queens Counties		2	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	056	0	1	01	01	H3361_056_0	5	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	01		1		H3361	056	0	2009	WellCare Advance	Orange, Rockland, and Westchester Counties		2	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272										www.wellcare.com	
H3361	059	0	1	01	01	H3361_059_0	5	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	01		1		H3361	059	0	2009	WellCare Advance	Albany, Rensselaer, and Schenectady Counties		2	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272										www.wellcare.com	
H3361	065	0	1	01	01	H3361_065_0	6	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	01		1		H3361	065	0	2009	WellCare Access	Upstate New York		2	1	3			2			1	1		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	077	0	1	01	01	H3361_077_0	5	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	01		1		H3361	077	0	2009	WellCare Advance	Greene and Ulster Counties		2	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272										www.wellcare.com	
H3361	084	0	1	02	01	H3361_084_0	6	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	02		1		H3361	084	0	2009	WellCare Select	Monroe and Wayne Counties		2	1	3			2			1	2		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	098	0	1	02	01	H3361_098_0	6	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	02		1		H3361	098	0	2009	WellCare Select	Upstate New York		2	1	3			2			1	2		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	099	0	1	02	01	H3361_099_0	6	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	02		1		H3361	099	0	2009	WellCare Value	Albany, Rensselaer, and Schenectady Counties		2	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	101	0	1	01	01	H3361_101_0	5	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	01		1		H3361	101	0	2009	WellCare Advance	Monroe and Wayne Counties		2	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272										www.wellcare.com	
H3361	102	0	1	02	01	H3361_102_0	6	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	02		1		H3361	102	0	2009	WellCare Value	Monroe and Wayne Counties		2	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	104	0	1	02	01	H3361_104_0	6	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	02		1		H3361	104	0	2009	WellCare Value	Greene and Ulster Counties		2	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	105	0	1	01	01	H3361_105_0	7	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	01		1		H3361	105	0	2009	WellCare Advocate Complete	Bronx, Kings, New York and Queens County		2	1	3			2			1	4		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	106	0	1	02	01	H3361_106_0	6	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	02		1		H3361	106	0	2009	WellCare Choice	Kings County		2	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	107	0	1	02	01	H3361_107_0	6	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	02		1		H3361	107	0	2009	WellCare Choice	New York County		2	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	109	0	1	01	01	H3361_109_0	8	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	01		1		H3361	109	0	2009	WellCare Access	New York County		2	1	3			2			1	1		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	110	0	1	01	01	H3361_110_0	8	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	01		1		H3361	110	0	2009	WellCare Access	Kings County		2	1	3			2			1	1		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	111	0	1	01	01	H3361_111_0	9	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	01		1		H3361	111	0	2009	WellCare Access	Queens County		2	1	3			2			1	1		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	112	0	1	02	01	H3361_112_0	6	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	02		1		H3361	112	0	2009	WellCare Choice	Nassau County		2	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	113	0	1	02	01	H3361_113_0	6	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	02		1		H3361	113	0	2009	WellCare Value	Erie County		2	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	115	0	1	02	01	H3361_115_0	6	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	02		1		H3361	115	0	2009	WellCare Value	Onondaga County		2	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	116	0	1	01	01	H3361_116_0	6	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	01		1		H3361	116	0	2009	WellCare Access	Nassau County		2	1	3			2			1	1		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	117	0	1	02	01	H3361_117_0	6	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	02		1		H3361	117	0	2009	WellCare Select	Nassau County		2	1	3			2			1	2		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	119	0	1	01	01	H3361_119_0	5	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	01		1		H3361	119	0	2009	WellCare Advance	Onondaga County		2	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272										www.wellcare.com	
H3361	120	0	1	01	01	H3361_120_0	5	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	01		1		H3361	120	0	2009	WellCare Dividend Plus	New York, Bronx, Queens, Kings Counties		2	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272										www.wellcare.com	
H3361	124	0	1	01	01	H3361_124_0	5	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	01		1		H3361	124	0	2009	WellCare Dividend	Erie County		2	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272										www.wellcare.com	
H3361	125	0	1	02	01	H3361_125_0	7	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	02		1		H3361	125	0	2009	WellCare Olympic	Bronx, Kings, New York and Queens Counties		2	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	801	0	1	02	01	H3361_801_0	3	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	02		1		H3361	801	0	2009	WellCare Employer NY1	Nationwide		1	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	802	0	1	02	01	H3361_802_0	3	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	02		1		H3361	802	0	2009	WellCare Employer NY2	Nationwide		1	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272										www.wellcare.com	
H3361	803	0	1	02	01	H3361_803_0	3	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	02		1		H3361	803	0	2009	WellCare Employer NY3	Nationwide		1	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272		www.wellcare.com	
H3361	804	0	1	02	01	H3361_804_0	3	2009.01	WELLCARE_OF NEW YORK, INC.	WellCare	www.wellcare.com	01	02		1		H3361	804	0	2009	WellCare Employer NY4	Nationwide		1	2				2						(800)-278-5155	(800)-278-5155	(877)-247-6272		(866)-238-4258	(866)-238-4258	(877)-247-6272										www.wellcare.com	
H3362	003	0	1	01	01	H3362_003_0	8	2009.01	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	www.independenthealth.com	01	01		1		H3362	003	0	2009	Independent Health Encompass 65	Western New York		2	2			9500	2						(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840		(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840		www.independenthealth.com	www.independenthealth.com
H3362	004	0	1	01	01	H3362_004_0	7	2009.01	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	www.independenthealth.com	01	01		1		H3362	004	0	2009	Independent Health Encompass 65 Extra	Western New York		2	2			10600	2						(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840		(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840		www.independenthealth.com	www.independenthealth.com
H3362	016	0	1	01	01	H3362_016_0	4	2009.01	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	www.independenthealth.com	01	01		1		H3362	016	0	2009	Independent Health Encompass 65	Western New York		2	2			10500	2						(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840										www.independenthealth.com	www.independenthealth.com
H3362	017	0	1	01	01	H3362_017_0	8	2009.01	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	www.independenthealth.com	01	01		1		H3362	017	0	2009	Independent Health Encompass 65 Basic	Western New York		2	2			1400	2						(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840		(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840		www.independenthealth.com	www.independenthealth.com
H3362	018	0	1	01	01	H3362_018_0	4	2009.01	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	www.independenthealth.com	01	01		1		H3362	018	0	2009	Independent Health Encompass 65 Basic	Western New York		2	2			400	2						(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840										www.independenthealth.com	www.independenthealth.com
H3362	020	0	1	01	01	H3362_020_0	8	2009.01	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	www.independenthealth.com	01	01		1		H3362	020	0	2009	Independent Health Medicare Family Choice	Erie and Niagara Counties		2	1	1	1	1200	2			1			(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840		(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840		www.independenthealth.com	www.independenthealth.com
H3362	801	0	1	01	01	H3362_801_0	3	2009.01	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	www.independenthealth.com	01	01		1		H3362	801	0	2009	Independent Health Medicare Encompass	New York State		1	2			1924	2						(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840		(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840		www.independenthealth.com	www.independenthealth.com
H3362	807	0	1	02	01	H3362_807_0	3	2009.01	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	www.independenthealth.com	01	02		1		H3362	807	0	2009	Independent Health Medicare Encompass POS	IH Network and Medicare Deemed Network		1	2			11875	1	1					(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840		(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840		www.independenthealth.com	www.independenthealth.com
H3362	817	0	1	02	01	H3362_817_0	3	2009.01	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	www.independenthealth.com	01	02		1		H3362	817	0	2009	Independent Health Medicare Encompass POS	IH Network and Medicare Deemed Network		1	2			8000	1	1					(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840		(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840		www.independenthealth.com	www.independenthealth.com
H3362	819	0	1	02	01	H3362_819_0	3	2009.01	INDEPENDENT HEALTH ASSOCIATION, INC.	Independent Health	www.independenthealth.com	01	02		1		H3362	819	0	2009	Independent Health Medicare Encompass POS	IH Network and Medicare Deemed Network		1	2			8000	1	1					(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-635-4900	(800)-958-4405	(716)-635-4840										www.independenthealth.com	www.independenthealth.com
H3366	022	0	1	01	01	H3366_022_0	12	2009.01	TOUCHSTONE HEALTH HMO, INC.	Touchstone Health	https://www.touchstone-health.com/	01	01		1		H3366	022	0	2009	Touchstone Grand	New York City		2	1	3		13708	2			1	2		(888)-777-0204	(877)-870-7065	(888)-777-0301		(866)-848-9872	(888)-777-0370	(888)-777-0368		(877)-870-7065	(877)-870-7065	(888)-777-0301		(212)-294-6550	(888)-777-0370	(888)-777-0368		https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.touchstone-health.com
H3370	001	0	1	01	01	H3370_001_0	11	2009.01	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield HMO	www.empireblue.com	01	01		1		H3370	001	0	2009	MediBlue HMO Plus	New York City		2	2			27931	2						(800)-499-9554	(800)-499-9554	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894		(800)-499-9554	(800)-499-9554	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894		www.empireblue.com	www.empireblue.com
H3370	002	0	1	01	01	H3370_002_0	13	2009.01	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield HMO	www.empireblue.com	01	01		1		H3370	002	0	2009	MediBlue HMO Select	Rockland, Westchester and Mid-Hudson Valley		2	2			14676	2						(800)-499-9554	(800)-499-9554	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894		(800)-499-9554	(800)-499-9554	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894		www.empireblue.com	www.empireblue.com
H3370	003	0	1	01	01	H3370_003_0	8	2009.01	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield HMO	www.empireblue.com	01	01		1		H3370	003	0	2009	MediBlue HMO Plus	Nassau County		2	2			7820	2						(800)-499-9554	(800)-499-9554	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894		(800)-499-9554	(800)-499-9554	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894		www.empireblue.com	www.empireblue.com
H3370	004	0	1	01	01	H3370_004_0	5	2009.01	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield HMO	www.empireblue.com	01	01		1		H3370	004	0	2009	MediBlue HMO Plus	Suffolk County		2	2			17385	2						(800)-499-9554	(800)-499-9554	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894		(800)-499-9554	(800)-499-9554	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894		www.empireblue.com	www.empireblue.com
H3370	009	0	1	01	01	H3370_009_0	4	2009.01	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield HMO	www.empireblue.com	01	01		1		H3370	009	0	2009	MediBlue HMO Essential	Suffolk County		2	2			2348	2						(800)-499-9554	(800)-499-9554	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894										www.empireblue.com	www.empireblue.com
H3370	010	0	1	01	01	H3370_010_0	5	2009.01	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield HMO	www.empireblue.com	01	01		1		H3370	010	0	2009	MediBlue HMO Essential	Rockland, Westchester, and Mid Hudson Valley		2	2			584	2						(800)-499-9554	(800)-499-9554	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894										www.empireblue.com	www.empireblue.com
H3370	014	0	1	01	01	H3370_014_0	8	2009.01	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield HMO	www.empireblue.com	01	01		1		H3370	014	0	2009	MediBlue HMO Plus	Albany, Rensselaer, Saratoga and Schenectady		2	2			691	2						(800)-499-9554	(800)-499-9554	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894		(800)-499-9554	(800)-499-9554	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894		www.empireblue.com	www.empireblue.com
H3370	018	0	1	01	01	H3370_018_0	7	2009.01	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield HMO	www.empireblue.com	01	01		1		H3370	018	0	2009	MediBlue Total Solutions	NYC, Long Island, Mid-Hudson and Capital Region		2	1	3		358	2			1	2		(800)-499-9554	(800)-499-9554	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894		(800)-499-9554	(800)-499-9554	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894		www.empireblue.com	www.empireblue.com
H3370	019	0	1	01	01	H3370_019_0	4	2009.01	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield HMO	www.empireblue.com	01	01		1		H3370	019	0	2009	MediBlue HMO Essential	New York City, Nassau, and Capital Region		2	2			771	2						(800)-499-9554	(800)-499-9554	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894										www.empireblue.com	www.empireblue.com
H3370	801	0	1	01	01	H3370_801_0	4	2009.01	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield HMO	www.empireblue.com	01	01		1		H3370	801	0	2009	MediBlue HMO Plus	New York State		1	2			4613	2						(800)-499-9554	(800)-499-9554	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894		(800)-499-9554	(800)-499-9554	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894		www.empireblue.com	www.empireblue.com
H3370	803	0	1	01	01	H3370_803_0	4	2009.01	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield HMO	www.empireblue.com	01	01		1		H3370	803	0	2009	MediBlue HMO Essential	New York State		1	2			10	2						(800)-499-9554	(800)-499-9554	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894										www.empireblue.com	www.empireblue.com
H3370	805	0	1	01	01	H3370_805_0	4	2009.01	EMPIRE HEALTHCHOICE HMO, INC.	Empire BlueCross BlueShield HMO	www.empireblue.com	01	01		1		H3370	805	0	2009	MediBlue HMO Plus	New York State		1	2			10	2						(800)-499-9554	(800)-499-9554	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894		(800)-499-9554	(800)-499-9554	(800)-241-6894		(800)-809-7328	(800)-809-7328	(800)-241-6894		www.empireblue.com	www.empireblue.com
H3379	001	0	1	01	01	H3379_001_0	5	2009.01	UNITED HEALTHCARE OF NEW YORK, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3379	001	0	2009	AARP MedicareComplete Plan 2	New York Metropolitan Area		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3379	002	0	1	01	01	H3379_002_0	6	2009.01	UNITED HEALTHCARE OF NEW YORK, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3379	002	0	2009	Evercare Plan IH	New York Metropolitan Area		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3379	005	0	1	01	01	H3379_005_0	5	2009.01	UNITED HEALTHCARE OF NEW YORK, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3379	005	0	2009	AARP MedicareComplete Plan 3	Kings, New York, Queens Counties		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3379	007	0	1	01	01	H3379_007_0	5	2009.01	UNITED HEALTHCARE OF NEW YORK, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3379	007	0	2009	AARP MedicareComplete	Oneida and Onondaga Counties		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3379	022	0	1	01	01	H3379_022_0	6	2009.01	UNITED HEALTHCARE OF NEW YORK, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3379	022	0	2009	Evercare Plan IH	Upstate New York		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3379	036	0	1	01	01	H3379_036_0	5	2009.01	UNITED HEALTHCARE OF NEW YORK, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3379	036	0	2009	Evercare Plan DH-U	Bronx,Kings,New York,Queens and Richmond Counties		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(888)-685-8480		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3384	013	0	1	01	01	H3384_013_0	8	2009.01	HEALTHNOW NEW YORK INC	Senior Blue	www.bsneny.com	01	01		1		H3384	013	0	2009	Senior Blue 652 PartD	Northeastern New York		2	2			3730	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)
H3384	015	0	1	01	01	H3384_015_0	5	2009.01	HEALTHNOW NEW YORK INC	Senior Blue	www.bsneny.com	01	01		1		H3384	015	0	2009	Senior Blue 601	Northeastern New York		2	2			5480	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918									http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)
H3384	019	0	1	01	01	H3384_019_0	7	2009.01	HEALTHNOW NEW YORK INC	Senior Blue	www.bcbswny.com	01	01		1		H3384	019	0	2009	Senior Blue 651 PartD	Western New York		2	2			4680	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)
H3384	022	0	1	01	01	H3384_022_0	8	2009.01	HEALTHNOW NEW YORK INC	Senior Blue	www.bcbswny.com	01	01		1		H3384	022	0	2009	Senior Blue 601	Western New York		2	2			8920	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710									http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)
H3384	040	0	1	01	01	H3384_040_0	5	2009.01	HEALTHNOW NEW YORK INC	Senior Blue	www.bsneny.com	01	01		1		H3384	040	0	2009	Senior Blue 653 PartD	Northeastern New York		2	2			1350	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)
H3384	041	0	1	01	01	H3384_041_0	7	2009.01	HEALTHNOW NEW YORK INC	Senior Blue	www.bcbswny.com	01	01		1		H3384	041	0	2009	Senior Blue 653 PartD	Western New York		2	2			3070	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)
H3384	044	0	1	01	01	H3384_044_0	4	2009.01	HEALTHNOW NEW YORK INC	Senior Blue	www.bsneny.com	01	01		1		H3384	044	0	2009	Senior Blue 600	Northeastern New York		2	1	3		102	2			1	3		(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)
H3384	045	0	1	01	01	H3384_045_0	4	2009.01	HEALTHNOW NEW YORK INC	Senior Blue	www.bcbswny.com	01	01		1		H3384	045	0	2009	Senior Blue 600	Western NewYork		2	1	3		255	2			1	3		(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)
H3384	051	0	1	01	01	H3384_051_0	8	2009.01	HEALTHNOW NEW YORK INC	Senior Blue	www.bcbswny.com	01	01		1		H3384	051	0	2009	Senior Blue 602	Western New York		2	2			520	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710									http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)
H3384	052	0	1	01	01	H3384_052_0	8	2009.01	HEALTHNOW NEW YORK INC	Senior Blue	www.bcbswny.com	01	01		1		H3384	052	0	2009	Senior Blue 652 PartD	Western New York		2	2			1770	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)
H3384	053	0	1	01	01	H3384_053_0	4	2009.01	HEALTHNOW NEW YORK INC	Senior Blue	www.bsneny.com	01	01		1		H3384	053	0	2009	Senior Blue 651 PartD	Northeastern New York		2	2			200	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)
H3384	054	0	1	01	01	H3384_054_0	10	2009.01	HEALTHNOW NEW YORK INC	Senior Blue	www.bcbswny.com	01	01		1		H3384	054	0	2009	Senior Blue 654 Part D	BlueCross BlueShield of Western New York		2	2			940	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)
H3384	801	0	1	01	01	H3384_801_0	6	2009.01	HEALTHNOW NEW YORK INC	Senior Blue	www.bsneny.com	01	01		1		H3384	801	0	2009	Senior Blue Group (MA) Calendar Year	Northeastern New York		1	2			1056	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918									http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)
H3384	802	0	1	01	01	H3384_802_0	7	2009.01	HEALTHNOW NEW YORK INC	Senior Blue	www.bsneny.com	01	01		1		H3384	802	0	2009	Senior Blue Group (MA-PD) - Calendar Year	Northeastern New York		1	2			1	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918									http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)
H3384	803	0	1	01	01	H3384_803_0	7	2009.01	HEALTHNOW NEW YORK INC	Senior Blue	www.bcbswny.com	01	01		1		H3384	803	0	2009	Senior Blue Group (MA) Non-calendar Year	Western New York		1	2			3860	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)
H3384	804	0	1	01	01	H3384_804_0	7	2009.01	HEALTHNOW NEW YORK INC	Senior Blue	www.bcbswny.com	01	01		1		H3384	804	0	2009	Senior Blue Group (MA-PD) Non-calendar	Western New York		1	2			100	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	http://www.bcbswny.com (for Western NY members) and http://www.bsneny.com (for Northeast NY member)
H3387	005	0	1	01	01	H3387_005_0	6	2009.01	AMERICHOICE OF NEW YORK, INC	AmeriChoice Personal Care Plus	www.americhoice.com	01	01		1		H3387	005	0	2009	AmeriChoice Personal Care Plus	Kings, Queens, and Bronx Counties		2	1	3			2			1	2		(800)-514-4912		(800)-421-1220		(800)-514-4912		(800)-421-1220		(800)-514-4912	(800)-514-4912	(800)-421-1220		(800)-514-4912	(800)-514-4912	(800)-421-1220		http://www.americhoice.com	www.americhoice.com
H3388	001	0	1	01	01	H3388_001_0	7	2009.01	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	CDPHP Medicare Choices	www.cdphp.com	01	01		1		H3388	001	0	2009	CDPHP Choice	Capital Region of New York State		2	2			4127	2						(518)-641-3950	(888)-248-6522	(518)-641-4000	(877)-261-1164	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164									http://www.cdphp.com/images/medicare/Medicare_Formulary_2009.pdf	www.cdphp.com
H3388	002	0	1	01	01	H3388_002_0	9	2009.01	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	CDPHP Medicare Choices	www.cdphp.com	01	01		1		H3388	002	0	2009	CDPHP Choice Rx	Capital Region of New York State		2	2			8391	2						(518)-641-3950	(888)-248-6522	(518)-641-4000	(877)-261-1164	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164	(518)-641-3950	(866)-289-2319	(518)-641-4000	(866)-236-1069	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164	http://www.cdphp.com/images/medicare/Medicare_Formulary_2009.pdf	www.cdphp.com
H3388	003	0	1	01	01	H3388_003_0	6	2009.01	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	CDPHP Medicare Choices	www.cdphp.com	01	01		1		H3388	003	0	2009	CDPHP Value	Capital Region of New York State		2	2			269	2						(518)-641-3950	(888)-248-6522	(518)-641-4000	(877)-261-1164	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164									http://www.cdphp.com/images/medicare/Medicare_Formulary_2009.pdf	www.cdphp.com
H3388	004	0	1	01	01	H3388_004_0	8	2009.01	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	CDPHP Medicare Choices	www.cdphp.com	01	01		1		H3388	004	0	2009	CDPHP Value Rx	Capital Region of New York State		2	2			953	2						(518)-641-3950	(888)-248-6522	(518)-641-4000	(877)-261-1164	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164	(518)-641-3950	(866)-289-2319	(518)-641-4000	(866)-236-1069	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164	http://www.cdphp.com/images/medicare/Medicare_Formulary_2009.pdf	www.cdphp.com
H3388	009	0	1	01	01	H3388_009_0	5	2009.01	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	CDPHP Medicare Choices	www.cdphp.com	01	01		1		H3388	009	0	2009	CDPHP Premier	Capital Region of New York State		2	2			89	2						(518)-641-3950	(888)-248-6522	(518)-641-4000	(877)-261-1164	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164									http://www.cdphp.com/images/medicare/Medicare_Formulary_2009.pdf	www.cdphp.com
H3388	010	0	1	01	01	H3388_010_0	6	2009.01	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	CDPHP Medicare Choices	www.cdphp.com	01	01		1		H3388	010	0	2009	CDPHP Premier Rx	Capital Region of New York State		2	2			190	2						(518)-641-3950	(888)-248-6522	(518)-641-4000	(877)-261-1164	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164	(518)-641-3950	(866)-289-2319	(518)-641-4000	(866)-236-1069	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164	http://www.cdphp.com/images/medicare/Medicare_Formulary_2009.pdf	www.cdphp.com
H3388	801	0	1	01	01	H3388_801_0	5	2009.01	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	CDPHP Medicare Choices	www.cdphp.com	01	01		1		H3388	801	0	2009	CDPHP Group Choice Rx	Upstate New York Region		1	2			125	2						(518)-641-3950	(888)-248-6522	(518)-641-4000	(877)-261-1164	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164	(518)-641-3950	(866)-289-2319	(518)-641-4000	(866)-236-1069	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164	http://www.cdphp.com/images/medicare/Medicare_Formulary_2009.pdf	www.cdphp.com
H3388	803	0	1	01	01	H3388_803_0	5	2009.01	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	CDPHP Medicare Choices	www.cdphp.com	01	01		1		H3388	803	0	2009	CDPHP Group Choice Rx	Upstate New York Region		1	2			5300	2						(518)-641-3950	(888)-248-6522	(518)-641-4000	(877)-261-1164	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164	(518)-641-3950	(866)-289-2319	(518)-641-4000	(866)-236-1069	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164	http://www.cdphp.com/images/medicare/Medicare_Formulary_2009.pdf	www.cdphp.com
H3388	804	0	1	01	01	H3388_804_0	5	2009.01	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	CDPHP Medicare Choices	www.cdphp.com	01	01		1		H3388	804	0	2009	CDPHP Group Choice	Upstate New York Region		1	2			600	2						(518)-641-3950	(888)-248-6522	(518)-641-4000	(877)-261-1164	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164									http://www.cdphp.com/images/medicare/Medicare_Formulary_2009.pdf	www.cdphp.com
H3404	001	0	1	04	01	H3404_001_0	4	2009.01	PARTNERS NATIONAL HEALTH PLANS OF NC INC	PARTNERS National Health Plans, a BCBSNC company	www.bcbsnc.com/member/medicare	01	04		1		H3404	001	0	2009	Blue Medicare PPO Enhanced	Select North Carolina Counties		2	2				2						(877)-494-7647	(877)-494-7647	(888)-451-9957		(800)-665-8037	(800)-665-8037	(888)-451-9957		(877)-494-7647	(877)-494-7647		(888)-451-9957	(800)-665-8037	(800)-665-8037		(888)-451-9957	http://www.bcbsnc.com/member/medicare/formulary/index.jsp	www.bcbsnc.com/member/medicare
H3404	002	0	1	04	01	H3404_002_0	4	2009.01	PARTNERS NATIONAL HEALTH PLANS OF NC INC	PARTNERS National Health Plans, a BCBSNC company	www.bcbsnc.com/member/medicare	01	04		1		H3404	002	0	2009	Blue Medicare PPO Enhanced Plus	Select North Carolina Counties		2	2				2						(877)-494-7647	(877)-494-7647	(888)-451-9957		(800)-665-8037	(800)-665-8037	(888)-451-9957		(877)-494-7647	(877)-494-7647		(888)-451-9957	(800)-665-8037	(800)-665-8037		(888)-451-9957	http://www.bcbsnc.com/member/medicare/formulary/index.jsp	www.bcbsnc.com/member/medicare
H3404	801	0	1	04	01	H3404_801_0	4	2009.01	PARTNERS NATIONAL HEALTH PLANS OF NC INC	PARTNERS National Health Plans, a BCBSNC company	www.bcbsnc.com/member/medicare	01	04		1		H3404	801	0	2009	Blue Medicare PPO EGWP Medical Only	North Carolina Employer Groups		1	2				2						(877)-494-7647	(877)-494-7647	(888)-451-9957		(800)-665-8037	(800)-665-8037	(888)-451-9957										http://www.bcbsnc.com/member/medicare/formulary/index.jsp	www.bcbsnc.com/member/medicare
H3404	803	0	1	04	01	H3404_803_0	4	2009.01	PARTNERS NATIONAL HEALTH PLANS OF NC INC	PARTNERS National Health Plans, a BCBSNC company	www.bcbsnc.com/member/medicare	01	04		1		H3404	803	0	2009	Blue Medicare PPO EGWP	North Carolina Employer Groups		1	2				2						(877)-494-7647	(877)-494-7647	(888)-451-9957		(800)-665-8037	(800)-665-8037	(888)-451-9957		(877)-494-7647	(877)-494-7647		(888)-451-9957	(800)-665-8037	(800)-665-8037		(888)-451-9957	http://www.bcbsnc.com/member/medicare/formulary/index.jsp	www.bcbsnc.com/member/medicare
H3404	807	0	1	04	01	H3404_807_0	4	2009.01	PARTNERS NATIONAL HEALTH PLANS OF NC INC	PARTNERS National Health Plans, a BCBSNC company	www.bcbsnc.com/member/medicare	01	04		1		H3404	807	0	2009	Blue Medicare PPO NC+ EGWP	South Atlantic		1	2				2						(877)-494-7647	(877)-494-7647	(888)-451-9957		(800)-665-8037	(800)-665-8037	(888)-451-9957		(877)-494-7647	(877)-494-7647		(888)-451-9957	(800)-665-8037	(800)-665-8037		(888)-451-9957	http://www.bcbsnc.com/member/medicare/formulary/index.jsp	www.bcbsnc.com/member/medicare
H3404	808	0	1	04	01	H3404_808_0	4	2009.01	PARTNERS NATIONAL HEALTH PLANS OF NC INC	PARTNERS National Health Plans, a BCBSNC company	www.bcbsnc.com/member/medicare	01	04		1		H3404	808	0	2009	Blue Medicare PPO NC+ EGWP Med Only	South Atlantic		1	2				2						(877)-494-7647	(877)-494-7647	(888)-451-9957		(800)-665-8037	(800)-665-8037	(888)-451-9957										http://www.bcbsnc.com/member/medicare/formulary/index.jsp	www.bcbsnc.com/member/medicare
H3405	001	0	1	04	01	H3405_001_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H3405	001	0	2009	HumanaChoicePPO PPO H3405-001	Durham, Orange and Wake Counties		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H3405	002	0	1	04	01	H3405_002_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H3405	002	0	2009	HumanaChoicePPO PPO H3405-002	Greensboro and Winston-Salem Metro Areas		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H3405	801	0	1	04	01	H3405_801_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H3405	801	0	2009	Humana Employer Sponsored	Durham, Orange, and Wake Counties		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H3405	802	0	1	04	01	H3405_802_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H3405	802	0	2009	Humana Employer Sponsored	Durham, Orange, and Wake Counties		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H3405	803	0	1	04	01	H3405_803_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H3405	803	0	2009	Humana Employer Sponsored Non-CY	Durham, Orange, and Wake Counties		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H3405	804	0	1	04	01	H3405_804_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H3405	804	0	2009	Humana Employer Sponsored Non-CY	Durham, Orange, and Wake Counties		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H3415	001	0	1	04	01	H3415_001_0	7	2009.01	DAVITA VILLAGEHEALTH, INC.	DaVita VillageHealth Insurance of Alabama, Inc.	www.villagehealth.com	01	04		1		H3415	001	0	2009	DaVita VillageHealth, Inc.	Jefferson County		2	1	4		109	2			1		0000000000000000000000000100	(866)-838-1962	(866)-838-1962	(000)-000-0711		(866)-838-1962	(866)-838-1962	(000)-000-0711		(866)-838-1962	(866)-838-1962	(000)-000-0711		(866)-838-1962	(866)-838-1962	(000)-000-0711		www.villagehealth.com	www.villagehealth.com
H3430	001	0	1	20	08	H3430_001_0	3	2009.01	NEIGHBORLY CARE NETWORK, INC.	Neighborly Care PACE Center	www.neighborly.org	08	20		1		H3430	001	0	2009	Neighborly Care PACE Center	Neighborly Care PACE Center		2	2			50	2														(272)-573-9444	(866)-859-3378	(272)-573-9444	(866)-859-3378	(272)-573-9444	(866)-859-3378	(272)-573-9444	(866)-859-3378	http://www.neighborly.org/	
H3430	002	0	1	20	08	H3430_002_0	2	2009.01	NEIGHBORLY CARE NETWORK, INC.	Neighborly Care PACE Center	www.neighborly.org	08	20		1		H3430	002	0	2009	Neighborly Care PACE Center	Neighborly Plan PACE Center		2	2			50	2														(272)-573-9444	(866)-859-3378	(272)-573-9444	(866)-859-3378	(272)-573-9444	(866)-859-3378	(272)-573-9444	(866)-859-3378	http://www.neighborly.org/	
H3435	001	0	1	37	05	H3435_001_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.ericksonadvantage.com	05	37		1		H3435	001	0	2009	Erickson Advantage Signature with Drugs	DuPage and Lake Counties		2	2				2						(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.ericksonadvantage.com
H3435	002	0	1	37	05	H3435_002_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.ericksonadvantage.com	05	37		1		H3435	002	0	2009	Erickson Advantage Signature without Drugs	DuPage and Lake Counties		2	2				2						(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480										http://www.ericksonadvantage.com/formulary.asp	www.ericksonadvantage.com
H3435	003	0	1	37	05	H3435_003_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.ericksonadvantage.com	05	37		1		H3435	003	0	2009	Erickson Advantage Champion	DuPage and Lake Counties		2	1	4			2			2		1111111110000000100000000001	(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.ericksonadvantage.com
H3437	001	0	1	04	01	H3437_001_0	2	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H3437	001	0	2009	Today's Options PPO Select	Greater Omaha Market		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	www.todaysoptions.com
H3437	002	0	1	04	01	H3437_002_0	3	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H3437	002	0	2009	Today's Options PPO Select powered by CCRx	Greater Omaha Market		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H3437	003	0	1	04	01	H3437_003_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H3437	003	0	2009	Today's Options PPO Complete powered by CCRx	Greater Omaha Market		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H3437	801	0	1	04	01	H3437_801_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H3437	801	0	2009	Today's Options PPO - MA Group Plan	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	www.todaysoptions.com
H3437	802	0	1	04	01	H3437_802_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H3437	802	0	2009	Today's Options PPO - MAPD Group Plan	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H3437	803	0	1	04	01	H3437_803_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H3437	803	0	2009	Today's Options PPO - MAPD Group Plan - NCY	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H3449	005	0	1	01	01	H3449_005_0	5	2009.01	PARTNERS NATIONAL HEALTH PLANS OF NC, INC.	PARTNERS National Health Plans, a BCBSNC company	www.bcbsnc.com/member/medicare	01	01		1		H3449	005	0	2009	Blue Medicare HMO Enhanced	Select North Carolina Counties		2	2				2						(888)-310-4110	(888)-310-4110	(888)-451-9957		(800)-665-8037	(800)-665-8037	(888)-451-9957		(888)-310-4110	(888)-310-4110		(888)-451-9957	(800)-665-8037	(800)-665-8037		(888)-451-9957	http://www.bcbsnc.com/member/medicare/formulary/index.jsp	www.bcbsnc.com/member/medicare
H3449	012	0	1	01	01	H3449_012_0	2	2009.01	PARTNERS NATIONAL HEALTH PLANS OF NC, INC.	PARTNERS National Health Plans, a BCBSNC company	www.bcbsnc.com/member/medicare	01	01		1		H3449	012	0	2009	Blue Medicare HMO Medical Only	Select North Carolina Counties		2	2				2						(888)-310-4110	(888)-310-4110	(888)-451-9957		(800)-665-8037	(800)-665-8037	(888)-451-9957										http://www.bcbsnc.com/member/medicare/formulary/index.jsp	www.bcbsnc.com/member/medicare
H3449	013	0	1	01	01	H3449_013_0	5	2009.01	PARTNERS NATIONAL HEALTH PLANS OF NC, INC.	PARTNERS National Health Plans, a BCBSNC company	www.bcbsnc.com/member/medicare	01	01		1		H3449	013	0	2009	Blue Medicare HMO Standard	Select North Carolina Counties		2	2				2						(888)-310-4110	(888)-310-4110	(888)-451-9957		(800)-665-8037	(800)-665-8037	(888)-451-9957		(888)-310-4110	(888)-310-4110		(888)-451-9957	(800)-665-8037	(800)-665-8037		(888)-451-9957	http://www.bcbsnc.com/member/medicare/formulary/index.jsp	www.bcbsnc.com/member/medicare
H3449	801	0	1	01	01	H3449_801_0	2	2009.01	PARTNERS NATIONAL HEALTH PLANS OF NC, INC.	PARTNERS National Health Plans, a BCBSNC company	www.bcbsnc.com/member/medicare	01	01		1		H3449	801	0	2009	Blue Medicare HMO EGWP	North Carolina Employer Groups		1	2				2						(888)-310-4110	(888)-310-4110	(888)-451-9957		(800)-665-8037	(800)-665-8037	(888)-451-9957		(888)-310-4110	(888)-310-4110		(888)-451-9957	(800)-665-8037	(800)-665-8037		(888)-451-9957	http://www.bcbsnc.com/member/medicare/formulary/index.jsp	www.bcbsnc.com/member/medicare
H3449	805	0	1	01	01	H3449_805_0	2	2009.01	PARTNERS NATIONAL HEALTH PLANS OF NC, INC.	PARTNERS National Health Plans, a BCBSNC company	www.bcbsnc.com/member/medicare	01	01		1		H3449	805	0	2009	Blue Medicare HMO EGWP Medical Only	North Carolina Employer Groups		1	2				2						(888)-310-4110	(888)-310-4110	(888)-451-9957		(800)-665-8037	(800)-665-8037	(888)-451-9957										http://www.bcbsnc.com/member/medicare/formulary/index.jsp	www.bcbsnc.com/member/medicare
H3449	810	0	1	01	01	H3449_810_0	2	2009.01	PARTNERS NATIONAL HEALTH PLANS OF NC, INC.	PARTNERS National Health Plans, a BCBSNC company	www.bcbsnc.com/member/medicare	01	01		1		H3449	810	0	2009	Blue Medicare HMO (RAI)	North Carolina Empolyer Groups		1	2				2						(888)-310-4110	(888)-310-4110	(888)-451-9957		(800)-665-8037	(800)-665-8037	(888)-451-9957		(888)-310-4110	(888)-310-4110		(888)-451-9957	(800)-665-8037	(800)-665-8037		(888)-451-9957	http://www.bcbsnc.com/member/medicare/formulary/index.jsp	www.bcbsnc.com/member/medicare
H3449	811	0	1	01	01	H3449_811_0	2	2009.01	PARTNERS NATIONAL HEALTH PLANS OF NC, INC.	PARTNERS National Health Plans, a BCBSNC company	www.bcbsnc.com/member/medicare	01	01		1		H3449	811	0	2009	Blue Medicare EGWP (RAI Medical Only)	RAI		1	2				2						(888)-310-4110	(888)-310-4110	(888)-451-9957		(800)-665-8037	(800)-665-8037	(888)-451-9957										http://www.bcbsnc.com/member/medicare/formulary/index.jsp	www.bcbsnc.com/member/medicare
H3456	001	0	1	02	01	H3456_001_0	4	2009.01	UNITED HEALTHCARE OF NORTH CAROLINA	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H3456	001	0	2009	AARP MedicareComplete Plus Plan 1	Select Counties in North Carolina		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3456	010	0	1	01	01	H3456_010_0	6	2009.01	UNITED HEALTHCARE OF NORTH CAROLINA	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3456	010	0	2009	Evercare Plan IH	Select Counties in North Carolina		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3456	016	0	1	01	01	H3456_016_0	8	2009.01	UNITED HEALTHCARE OF NORTH CAROLINA	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3456	016	0	2009	Evercare Plan DH	Select Counties in North Carolina		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3456	020	0	1	02	01	H3456_020_0	3	2009.01	UNITED HEALTHCARE OF NORTH CAROLINA	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H3456	020	0	2009	AARP MedicareComplete Plus Plan 2	Select Counties in North Carolina		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3456	022	0	1	01	01	H3456_022_0	4	2009.01	UNITED HEALTHCARE OF NORTH CAROLINA	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3456	022	0	2009	Evercare Plan MH	Select Counties in North Carolina		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(888)-685-8480		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3456	801	0	1	01	01	H3456_801_0	3	2009.01	UNITED HEALTHCARE OF NORTH CAROLINA	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3456	801	0	2009	MedicareComplete Retiree Plan	Select Counties in North Carolina		1	2				2						(888)-867-5548		(888)-685-8480		(888)-886-7554		(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3456	803	0	1	01	01	H3456_803_0	3	2009.01	UNITED HEALTHCARE OF NORTH CAROLINA	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3456	803	0	2009	MedicareComplete Retiree Plan	Select Counties in NC		1	2				2						(888)-867-5548		(888)-685-8480		(888)-886-7554		(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3493	001	0	1	20	08	H3493_001_0	3	2009.01	LIFE AT LOURDES, INC.	LIFE at Lourdes	www.lourdesmed.org	08	20		1		H3493	001	0	2009	LIFE at Lourdes, Inc	LIFE at Lourdes		2	2				2														(856)-482-4923	(800)-000-0000			(856)-482-4923	(800)-000-0000			www.lourdesmed.org	
H3493	002	0	1	20	08	H3493_002_0	3	2009.01	LIFE AT LOURDES, INC.	LIFE at Lourdes	www.lourdesmed.org	08	20		1		H3493	002	0	2009	LIFE at Lourdes, Inc	LIFE at Lourdes		2	2				2														(856)-482-4923	(800)-000-0000			(856)-482-4923	(800)-000-0000			www.lourdesmed.org	
H3518	001	0	1	09	04	H3518_001_0	6	2009.01	BLUE CROSS BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.bcbsfl.com/	04	09	2	1		H3518	001	0	2009	BlueMedicare PFFS	State of Florida		2	2				2						(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	www.myrxassistant.com	
H3518	801	0	1	09	04	H3518_801_0	4	2009.01	BLUE CROSS BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.bcbsfl.com/	04	09	2	1		H3518	801	0	2009	BlueMedicare Group PFFS	State of Florida		1	2				2						(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	www.myrxassistant.com	
H3518	802	0	1	09	04	H3518_802_0	3	2009.01	BLUE CROSS BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.bcbsfl.com/	04	09	2	1		H3518	802	0	2009	BlueMedicare Group PFFS	State of Florida		1	2				2						(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	www.myrxassistant.com	
H3518	803	0	1	09	04	H3518_803_0	3	2009.01	BLUE CROSS BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.bcbsfl.com/	04	09	2	1		H3518	803	0	2009	BlueMedicare Group PFFS	State of Florida with National Coverage		1	2				2						(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339									www.myrxassistant.com	
H3528	001	0	1	01	01	H3528_001_0	6	2009.01	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com/medicare	01	01		1		H3528	001	0	2009	ConnectiCare VIP Prime 1	State of Connecticut		2	2			1730	2						(800)-224-2273	(800)-224-2273	(800)-842-9710		(877)-224-8220	(877)-224-8220	(800)-842-9710		(800)-224-2273	(800)-224-2273	(800)-842-9710		(877)-224-8220	(877)-224-8220	(800)-842-9710		www.connecticare.com	www.connecticare.com
H3528	002	0	1	01	01	H3528_002_0	5	2009.01	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com/medicare	01	01		1		H3528	002	0	2009	ConnectiCare VIP Prime 3	State of Connecticut		2	2			2076	2						(800)-224-2273	(800)-224-2273	(800)-842-9710		(877)-224-8220	(877)-224-8220	(800)-842-9710		(800)-224-2273	(800)-224-2273	(800)-842-9710		(877)-224-8220	(877)-224-8220	(800)-842-9710		www.connecticare.com	www.connecticare.com
H3528	003	0	1	01	01	H3528_003_0	3	2009.01	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com/medicare	01	01		1		H3528	003	0	2009	ConnectiCare VIP Prime 4	State of Connecticut		2	2			346	2						(800)-224-2273	(800)-224-2273	(800)-842-9710		(877)-224-8220	(877)-224-8220	(800)-842-9710										www.connecticare.com	www.connecticare.com
H3528	004	0	1	01	01	H3528_004_0	5	2009.01	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com/medicare	01	01		1		H3528	004	0	2009	ConnectiCare VIP Custom 1	State of Connecticut		2	1	4		1384	2			1		0000000010000000000000000000	(800)-224-2273	(800)-224-2273	(800)-842-9710		(877)-224-8220	(877)-224-8220	(800)-842-9710		(800)-224-2273	(800)-224-2273	(800)-842-9710		(877)-224-8220	(877)-224-8220	(800)-842-9710		www.connecticare.com	www.connecticare.com
H3528	005	0	1	01	01	H3528_005_0	5	2009.01	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com/medicare	01	01		1		H3528	005	0	2009	ConnectiCare VIP Prime 2	State of Connecticut		2	2			346	2						(800)-224-2273	(800)-224-2273	(800)-842-9710		(877)-224-8220	(877)-224-8220	(800)-842-9710		(800)-224-2273	(800)-224-2273	(800)-842-9710		(877)-224-8220	(877)-224-8220	(800)-842-9710		www.connecticare.com	www.connecticare.com
H3528	006	0	1	02	01	H3528_006_0	4	2009.01	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com/medicare	01	02		1		H3528	006	0	2009	ConnectiCare VIP Option1	State of Connecticut		2	2			396	2						(800)-224-2273	(800)-224-2273	(800)-842-9710		(877)-224-8220	(877)-224-8220	(800)-842-9710		(800)-224-2273	(800)-224-2273	(800)-842-9710		(877)-224-8220	(877)-224-8220	(800)-842-9710		www.connecticare.com	www.connecticare.com
H3528	007	0	1	02	01	H3528_007_0	2	2009.01	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com/medicare	01	02		1		H3528	007	0	2009	ConnectiCare VIP Flex 2	State of Connecticut		2	2			198	2						(800)-224-2273	(800)-224-2273	(800)-842-9710		(877)-224-8220	(877)-224-8220	(800)-842-9710										www.connecticare.com	www.connecticare.com
H3528	801	0	1	01	01	H3528_801_0	3	2009.01	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com/medicare	01	01		1		H3528	801	0	2009	ConnectiCare VIP	State of Connecticut		1	2			100	2						(800)-224-2273	(800)-224-2273	(800)-842-9710		(877)-224-8220	(877)-224-8220	(800)-842-9710		(800)-224-2273	(800)-224-2273	(800)-842-9710		(877)-224-8220	(877)-224-8220	(800)-842-9710		www.connecticare.com	www.connecticare.com
H3528	805	0	1	01	01	H3528_805_0	3	2009.01	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com/medicare	01	01		1		H3528	805	0	2009	ConnectiCare VIP	State of Connecticut		1	2			100	2						(800)-224-2273	(800)-224-2273	(800)-842-9710		(877)-224-8220	(877)-224-8220	(800)-842-9710										www.connecticare.com	www.connecticare.com
H3528	806	0	1	02	01	H3528_806_0	3	2009.01	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com/medicare	01	02		1		H3528	806	0	2009	ConnectiCare VIP	State of Connecticut		1	2			100	2						(800)-224-2273	(800)-224-2273	(800)-842-9710		(877)-224-8220	(877)-224-8220	(800)-842-9710		(800)-224-2273	(800)-224-2273	(800)-842-9710		(877)-224-8220	(877)-224-8220	(800)-842-9710		www.connecticare.com	www.connecticare.com
H3528	807	0	1	02	01	H3528_807_0	3	2009.01	CONNECTICARE, INC.	ConnectiCare, Inc.	www.connecticare.com/medicare	01	02		1		H3528	807	0	2009	ConnectiCare VIP	State of Connecticut		1	2			100	2						(800)-224-2273	(800)-224-2273	(800)-842-9710		(877)-224-8220	(877)-224-8220	(800)-842-9710										www.connecticare.com	www.connecticare.com
H3533	001	0	1	01	01	H3533_001_0	9	2009.01	ARCADIAN HEALTH PLAN OF NEW YORK, INC.	Northeast Community Care	www.NortheastCommunityCare.com	01	01		1		H3533	001	0	2009	Northeast Community Care	Syracuse		2	2			10509	2						(800)-573-8597		(866)-573-8591	(866)-573-8591	(888)-888-8888		(888)-888-8888	(888)-888-8888	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(888)-888-8888	(888)-888-8888			www.northeastcommunitycare.com	
H3533	801	0	1	01	01	H3533_801_0	10	2009.01	ARCADIAN HEALTH PLAN OF NEW YORK, INC.	Northeast Community Care	www.NortheastCommunityCare.com	01	01		1		H3533	801	0	2009	Northeast Community Care EGWP (NY)	Onondaga		1	2			0	2						(800)-573-8597		(866)-573-8591	(866)-573-8591	(888)-888-8888		(888)-888-8888	(888)-888-8888	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(888)-888-8888	(888)-888-8888			www.northeastcommunitycare.com	
H3597	001	0	1	01	01	H3597_001_0	5	2009.01	AETNA HEALTH	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3597	001	0	2009	Aetna Golden Medicare Value Plan	Cumberland, Penobscot and York Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3597	002	0	1	01	01	H3597_002_0	5	2009.01	AETNA HEALTH	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3597	002	0	2009	Aetna Golden Medicare Standard Plan	Cumberland, Penobscot and York Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3597	003	0	1	01	01	H3597_003_0	3	2009.01	AETNA HEALTH	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3597	003	0	2009	Aetna Golden Medicare Basic Plan	Cumberland, Penobscot and York Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3597	004	0	1	01	01	H3597_004_0	6	2009.01	AETNA HEALTH	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3597	004	0	2009	Aetna Golden Medicare Premier Plan	Cumberland, Penobscot and York Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3597	801	0	1	01	01	H3597_801_0	4	2009.01	AETNA HEALTH	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3597	801	0	2009	Aetna Golden Medicare Plan	Cumberland, Penobscot, York Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3597	802	0	1	01	01	H3597_802_0	4	2009.01	AETNA HEALTH	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3597	802	0	2009	Aetna Golden Medicare Plan w/Rx CY	Cumberland, Penobscot, York Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3613	001	0	1	20	08	H3613_001_0	1	2009.01	CONCORDIA CARE	Concordia Care	concordiacareohio.org	08	20		1		H3613	001	0	2009	Concordia Care Duel Eligibles	Concordia Care Cuyahoga County		2	2				2														(216)-791-3580	(216)-791-3580			(216)-791-3580	(216)-791-3580			concordiacareohio.org	
H3613	002	0	1	20	08	H3613_002_0	1	2009.01	CONCORDIA CARE	Concordia Care	concordiacareohio.org	08	20		1		H3613	002	0	2009	Concordia Care Medicare Only Eligibles	Concordia Care Cuyahoga County		2	2				2														(216)-791-3580	(216)-791-3580			(216)-791-3580	(216)-791-3580			concordiacareohio.org	
H3614	001	0	1	20	08	H3614_001_0	1	2009.01	TRIHEALTH SENIORLINK	Trihealth Seniorlink	www.trihealthseniorshealth.com	08	20		1		H3614	001	0	2009	Medicare Part D	Cincinnati Metropolitan Area		2	2				2														(513)-531-5100	(180)-000-0000			(513)-531-5100	(000)-000-0000			www.trihealthseniorshealth.com	
H3614	002	0	1	20	08	H3614_002_0	1	2009.01	TRIHEALTH SENIORLINK	Trihealth Seniorlink	www.trihealthseniorshealth.com	08	20		1		H3614	002	0	2009	Medicare Part D	Cincinnati Metropolitan Area		2	2				2														(513)-531-5100	(000)-000-0000			(513)-531-5100	(180)-000-0000			www.trihealthseniorshealth.com	
H3619	001	0	1	04	01	H3619_001_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H3619	001	0	2009	HumanaChoicePPO PPO H3619-001	Cincinnati and Dayton Metro Areas		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H3619	004	0	1	04	01	H3619_004_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H3619	004	0	2009	HumanaChoicePPO PPO H3619-004	Cleveland Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H3619	012	0	1	04	01	H3619_012_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H3619	012	0	2009	HumanaChoicePPO PPO H3619-012	Columbus Metro Areas		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H3619	801	0	1	04	01	H3619_801_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H3619	801	0	2009	Humana Employer Sponsored	Select counties in OH		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H3619	804	0	1	04	01	H3619_804_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H3619	804	0	2009	Humana Employer Sponsored	Select counties in Ohio		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H3619	806	0	1	04	01	H3619_806_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H3619	806	0	2009	Humana Employer Sponsored Non-CY	Select counties in Ohio		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H3619	807	0	1	04	01	H3619_807_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H3619	807	0	2009	Humana Employer Sponsored Non-CY	Select counties in Ohio		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H3620	001	0	1	04	01	H3620_001_0	9	2009.01	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	01	04		1		H3620	001	0	2009	PrimeTime Health Plan Prime PPO	Stark, Tusc., Wayne, Holmes, and Carroll counties		2	2			600	2						(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	https://www.aultcare.com/pls/portal30/docs/folder/Medicare_RX/formulary.pdf	www.primetimehealthplan.com
H3620	801	0	1	04	01	H3620_801_0	5	2009.01	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	01	04		1		H3620	801	0	2009	Employer Group PPO / CY	All Ohio Counties		1	2			200	2						(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	https://www.aultcare.com/pls/portal30/docs/folder/Medicare_RX/formulary.pdf	www.primetimehealthplan.com
H3620	802	0	1	04	01	H3620_802_0	5	2009.01	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	01	04		1		H3620	802	0	2009	Employer Group PPO / MA Only CY	All Ohio Counties		1	2			0	2						(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446									https://www.aultcare.com/pls/portal30/docs/folder/Medicare_RX/formulary.pdf	www.primetimehealthplan.com
H3620	803	0	1	04	01	H3620_803_0	5	2009.01	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	01	04		1		H3620	803	0	2009	Employer Group PPO / Non CY	All Ohio Counties		1	2			0	2						(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	https://www.aultcare.com/pls/portal30/docs/folder/Medicare_RX/formulary.pdf	www.primetimehealthplan.com
H3620	804	0	1	04	01	H3620_804_0	5	2009.01	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	01	04		1		H3620	804	0	2009	Employer Group PPO / MA Only NCY	All Ohio Counties		1	2			0	2						(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446									https://www.aultcare.com/pls/portal30/docs/folder/Medicare_RX/formulary.pdf	www.primetimehealthplan.com
H3623	001	0	1	01	01	H3623_001_0	5	2009.01	AETNA HEALTH,  INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3623	001	0	2009	Aetna Golden Medicare Value Plan	Delaware, Franklin and Hamilton Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3623	002	0	1	01	01	H3623_002_0	5	2009.01	AETNA HEALTH,  INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3623	002	0	2009	Aetna Golden Medicare Standard Plan	Delaware, Franklin, and Hamilton Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3623	003	0	1	01	01	H3623_003_0	6	2009.01	AETNA HEALTH,  INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3623	003	0	2009	Aetna Golden Medicare Premier Plan	Delaware, Franklin and Hamilton Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3623	004	0	1	01	01	H3623_004_0	5	2009.01	AETNA HEALTH,  INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3623	004	0	2009	Aetna Golden Medicare Value Plan	Cuyahoga, Lucas and Summit Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3623	005	0	1	01	01	H3623_005_0	5	2009.01	AETNA HEALTH,  INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3623	005	0	2009	Aetna Golden Medicare Standard Plan	Cuyahoga, Lucas, and Summit Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3623	006	0	1	01	01	H3623_006_0	5	2009.01	AETNA HEALTH,  INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3623	006	0	2009	Aetna Golden Medicare Premier Plan	Cuyahoga, Lucas and Summit Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3623	013	0	1	01	01	H3623_013_0	2	2009.01	AETNA HEALTH,  INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3623	013	0	2009	Aetna Golden Medicare Basic Plan	Delaware, Franklin and Hamilton Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3623	014	0	1	01	01	H3623_014_0	2	2009.01	AETNA HEALTH,  INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3623	014	0	2009	Aetna Golden Medicare Basic Plan	Cuyahoga, Lucas and Summit Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3623	801	0	1	01	01	H3623_801_0	4	2009.01	AETNA HEALTH,  INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3623	801	0	2009	Aetna Golden Medicare Plan	Cuyahoga,Franklin,Hamilton, Lucas, Summit Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3623	802	0	1	01	01	H3623_802_0	4	2009.01	AETNA HEALTH,  INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3623	802	0	2009	Aetna Golden Medicare Plan w/Rx CY	Cuyahoga,Franklin,Hamilton, Lucas, Summit Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3624	001	0	1	04	01	H3624_001_0	5	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H3624	001	0	2009	Aetna Golden Choice Standard Plan	Delaware, Franklin and Hamilton Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3624	002	0	1	04	01	H3624_002_0	5	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H3624	002	0	2009	Aetna Golden Choice Standard Plan	Cuyahoga, Lucas and Summit Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3624	801	0	1	04	01	H3624_801_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H3624	801	0	2009	Aetna Golden Choice Plan	Cuyahoga,Franklin,Hamilton,Lucas,Summit Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3624	802	0	1	04	01	H3624_802_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H3624	802	0	2009	Aetna Golden Choice Plan w/Rx CY	Cuyahoga,Franklin,Hamilton,Lucas,Summit Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3653	004	0	1	01	01	H3653_004_0	7	2009.01	PARAMOUNT CARE, INC	Paramount Elite	www.paramounthealthcare.com	01	01		1		H3653	004	0	2009	Paramount Elite - Enhanced Medical and Drug	Paramount Elite - Enhanced (NW Ohio / SE Mich)		2	2			12778	2						(800)-462-3589		(888)-740-5670		(800)-462-3589		(888)-740-5670		(800)-462-3589	(800)-462-3589	(888)-740-5670		(800)-462-3589	(800)-462-3589	(888)-740-5670		http://www.paramounthealthcare.com/blank.cfm?id=1612	http://www.paramounthealthcare.com
H3653	015	0	1	01	01	H3653_015_0	7	2009.01	PARAMOUNT CARE, INC	Paramount Elite	www.paramounthealthcare.com	01	01		1		H3653	015	0	2009	Paramount Elite - Standard Medical and Drug	Paramount Elite - Standard (NW Ohio / SE Mich)		2	2			354	2						(800)-462-3589		(888)-740-5670		(800)-462-3589		(888)-740-5670		(800)-462-3589	(800)-462-3589	(888)-740-5670		(800)-462-3589	(800)-462-3589	(888)-740-5670		http://www.paramounthealthcare.com/blank.cfm?id=1612	http://www.paramounthealthcare.com
H3653	018	0	1	01	01	H3653_018_0	5	2009.01	PARAMOUNT CARE, INC	Paramount Elite	www.paramounthealthcare.com	01	01		1		H3653	018	0	2009	Paramount Elite - Enhanced Medical only	Paramount Elite - Medical Only (NW Ohio / SE Mich)		2	2			136	2						(800)-462-3589		(888)-740-5670		(800)-462-3589		(888)-740-5670										http://www.paramounthealthcare.com/blank.cfm?id=1612	http://www.paramounthealthcare.com
H3653	020	0	1	01	01	H3653_020_0	7	2009.01	PARAMOUNT CARE, INC	Paramount Elite	www.paramounthealthcare.com	01	01		1		H3653	020	0	2009	Paramount Elite Plus - Special Needs Plan	Paramount Elite Plus (NW Ohio)		2	1	3		273	2			1	2		(800)-462-3589		(888)-740-5670		(800)-462-3589		(888)-740-5670		(800)-462-3589	(800)-462-3589	(888)-740-5670		(800)-462-3589	(800)-462-3589	(888)-740-5670		http://www.paramounthealthcare.com/blank.cfm?id=1612	http://www.paramounthealthcare.com
H3653	021	0	1	01	01	H3653_021_0	5	2009.01	PARAMOUNT CARE, INC	Paramount Elite	www.paramounthealthcare.com	01	01		1		H3653	021	0	2009	Paramount Elite Standard Medical only	NW Ohio and SE Michigan		2	2			2	2						(800)-462-3589		(888)-740-5670		(800)-462-3589		(888)-740-5670										http://www.paramounthealthcare.com/blank.cfm?id=1612	http://www.paramounthealthcare.com
H3653	803	0	1	01	01	H3653_803_0	4	2009.01	PARAMOUNT CARE, INC	Paramount Elite	www.paramounthealthcare.com	01	01		1		H3653	803	0	2009	Paramount Elite - Emp Group A/B No Rx	Paramount Elite - Emp Group A/B No Rx		1	2			1207	2						(800)-462-3589		(888)-740-5670		(800)-462-3589		(888)-740-5670										http://www.paramounthealthcare.com/blank.cfm?id=1612	http://www.paramounthealthcare.com
H3653	806	0	2	01	01	H3653_806_0	4	2009.01	PARAMOUNT CARE, INC	Paramount Elite	www.paramounthealthcare.com	01	01		2		H3653	806	0	2009	Paramount Elite - Emp Group B only No Rx	Paramount Elite - Emp Group B only No Rx		1	2			6	2		1				(800)-462-3589		(888)-740-5670		(800)-462-3589		(888)-740-5670										http://www.paramounthealthcare.com/blank.cfm?id=1612	http://www.paramounthealthcare.com
H3653	809	0	1	01	01	H3653_809_0	4	2009.01	PARAMOUNT CARE, INC	Paramount Elite	www.paramounthealthcare.com	01	01		1		H3653	809	0	2009	Paramount Elite-Emp Group A/B Rx	Paramount Elite-Emp Group A/B Rx		1	2			48	2						(800)-462-3589		(888)-740-5670		(800)-462-3589		(888)-740-5670		(800)-462-3589	(800)-462-3589	(888)-740-5670		(800)-462-3589	(800)-462-3589	(888)-740-5670		http://www.paramounthealthcare.com/blank.cfm?id=1612	http://www.paramounthealthcare.com
H3653	810	0	2	01	01	H3653_810_0	3	2009.01	PARAMOUNT CARE, INC	Paramount Elite	www.paramounthealthcare.com	01	01		2		H3653	810	0	2009	Paramount Elite - Emp Group B only Rx.	Paramount Elite - Emp Group B only Rx.		1	2			6	2		1				(800)-462-3589		(888)-740-5670		(800)-462-3589		(888)-740-5670		(800)-462-3589	(800)-462-3589	(888)-740-5670		(800)-462-3589	(800)-462-3589	(888)-740-5670		http://www.paramounthealthcare.com/blank.cfm?id=1612	http://www.paramounthealthcare.com
H3655	013	0	1	01	01	H3655_013_0	8	2009.01	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H3655	013	0	2009	Anthem Senior Advantage Basic	Ohio - Select Counties		2	2			65783	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
H3655	023	0	1	01	01	H3655_023_0	9	2009.01	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H3655	023	0	2009	Anthem Senior Advantage Enhanced	Ohio - Select Counties		2	2			11171	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
H3655	801	0	1	01	01	H3655_801_0	4	2009.01	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H3655	801	0	2009	Anthem Senior Advantage Group	Ohio		1	2			6829	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
H3655	803	0	1	01	01	H3655_803_0	4	2009.01	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H3655	803	0	2009	Anthem Senior Advantage Group	Ohio		1	2			39	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754									www.anthem.com	www.anthem.com
H3655	804	0	1	01	01	H3655_804_0	4	2009.01	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H3655	804	0	2009	Anthem Senior Advantage Group	Ohio		1	2			10	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
H3659	001	0	1	02	01	H3659_001_0	4	2009.01	UNITED HEALTHCARE OF OHIO, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H3659	001	0	2009	AARP MedicareComplete Plus	Cincinnati, Columbus and Dayton area Counties		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3659	003	0	1	01	01	H3659_003_0	5	2009.01	UNITED HEALTHCARE OF OHIO, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3659	003	0	2009	AARP MedicareComplete Plan 1	Cuyahoga, Mahoning and Trumbull Counties		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3659	031	0	1	01	01	H3659_031_0	5	2009.01	UNITED HEALTHCARE OF OHIO, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3659	031	0	2009	AARP MedicareComplete Plan 2	Select Counties in Ohio		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3659	054	0	1	01	01	H3659_054_0	4	2009.01	UNITED HEALTHCARE OF OHIO, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3659	054	0	2009	AARP MedicareComplete Essential	Select Ohio Counties		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3659	056	0	1	01	01	H3659_056_0	8	2009.01	UNITED HEALTHCARE OF OHIO, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3659	056	0	2009	Evercare Plan DH	Select Counties in Ohio		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3659	057	0	1	01	01	H3659_057_0	5	2009.01	UNITED HEALTHCARE OF OHIO, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3659	057	0	2009	Evercare Plan IH	Lake, Lorain and Lucas counties		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3659	058	0	1	01	01	H3659_058_0	5	2009.01	UNITED HEALTHCARE OF OHIO, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3659	058	0	2009	Evercare Plan IH	Clark, Greene and Warren Counties		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3659	059	0	1	01	01	H3659_059_0	4	2009.01	UNITED HEALTHCARE OF OHIO, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3659	059	0	2009	Evercare Plan MH	Select Counties in Ohio		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3659	060	0	1	01	01	H3659_060_0	6	2009.01	UNITED HEALTHCARE OF OHIO, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3659	060	0	2009	AARP MedicareComplete Plan 2	Boone, Campbell and Kenton KY		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3659	801	0	1	01	01	H3659_801_0	3	2009.01	UNITED HEALTHCARE OF OHIO, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3659	801	0	2009	MedicareComplete Retiree Plan	OH Employer Sponsored Plan Service Area		1	2				2						(800)-711-6080		(888)-685-8480		(800)-504-4848		(888)-685-8480		(800)-711-6080	(800)-711-6080	(888)-685-8480		(800)-504-4848	(800)-504-4848	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3659	802	0	1	01	01	H3659_802_0	3	2009.01	UNITED HEALTHCARE OF OHIO, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3659	802	0	2009	MedicareComplete Essential Retiree Plan	OH Employer Sponsored Plan Service Area		1	2				2						(800)-711-6080		(888)-685-8480		(800)-504-4848		(888)-685-8480										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3659	803	0	1	01	01	H3659_803_0	3	2009.01	UNITED HEALTHCARE OF OHIO, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3659	803	0	2009	MedicareComplete Retiree Plan	OH Employer Sponsored Plan Service Area		1	2				2						(800)-711-6080		(888)-685-8480		(800)-504-4848		(888)-685-8480		(800)-711-6080	(800)-711-6080	(888)-685-8480		(800)-504-4848	(800)-504-4848	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3659	804	0	1	01	01	H3659_804_0	3	2009.01	UNITED HEALTHCARE OF OHIO, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3659	804	0	2009	MedicareComplete Retiree Plan	OH Employer Sponsored Plan Service Area		1	2				2						(800)-711-6080		(888)-685-8480		(800)-504-4848		(888)-685-8480										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3659	805	0	1	01	01	H3659_805_0	3	2009.01	UNITED HEALTHCARE OF OHIO, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3659	805	0	2009	MedicareComplete Retiree Plan	Boone, Campbell, and Kenton KY		1	2				2						(800)-711-6080		(888)-685-8480		(800)-504-4848		(888)-685-8480		(800)-711-6080	(800)-711-6080	(888)-685-8480		(800)-504-4848	(800)-504-4848	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3660	028	0	1	02	01	H3660_028_0	7	2009.01	SUMMACARE INC.	SummaCare	www.summacare.com	01	02		1		H3660	028	0	2009	SummaCare Secure Gold Plus	Northeastern Ohio		2	2			5912	2						(330)-996-8885	(800)-996-6250	(800)-750-0750		(330)-996-8440	(888)-464-8440	(800)-750-0750		(300)-996-8885	(800)-996-6250	(800)-750-0750	(800)-750-0750	(800)-996-8440	(888)-464-8440	(800)-750-0750		http://www.summacare.com/media/7919/2185.pdf	www.summacare.com
H3660	029	0	1	02	01	H3660_029_0	8	2009.01	SUMMACARE INC.	SummaCare	www.summacare.com	01	02		1		H3660	029	0	2009	SummaCare Secure Silver Plus	Northeastern Ohio Area		2	2			7700	2						(330)-996-8885	(800)-996-6250	(800)-750-0750		(330)-996-8440	(888)-464-8440	(800)-750-0750		(300)-996-8885	(800)-996-6250	(800)-750-0750	(800)-750-0750	(800)-996-8440	(888)-464-8440	(800)-750-0750		http://www.summacare.com/media/7919/2185.pdf	www.summacare.com
H3660	032	0	1	02	01	H3660_032_0	7	2009.01	SUMMACARE INC.	SummaCare	www.summacare.com	01	02		1		H3660	032	0	2009	SummaCare Secure Platinum	Northeastern Ohio Area		2	2			1295	2						(330)-996-8885	(800)-996-6250	(800)-750-0750		(330)-996-8440	(888)-464-8440	(800)-750-0750		(300)-996-8885	(800)-996-6250	(800)-750-0750	(800)-750-0750	(800)-996-8440	(888)-464-8440	(800)-750-0750		http://www.summacare.com/media/7919/2185.pdf	www.summacare.com
H3660	801	0	1	01	01	H3660_801_0	4	2009.01	SUMMACARE INC.	SummaCare	www.summacare.com	01	01		1		H3660	801	0	2009	SummaCare Secure Employer Plan HMO- PD	Northeastern Ohio Area		1	2			103	2						(330)-996-8885	(800)-996-6250	(800)-750-0750		(330)-996-8440	(888)-464-8440	(800)-750-0750		(300)-996-8885	(800)-996-6250	(800)-750-0750	(800)-750-0750	(800)-996-8440	(888)-464-8440	(800)-750-0750		http://www.summacare.com/media/7919/2185.pdf	www.summacare.com
H3660	802	0	1	01	01	H3660_802_0	3	2009.01	SUMMACARE INC.	SummaCare	www.summacare.com	01	01		1		H3660	802	0	2009	SummaCare Secure Employer Plan -HMO- No D	Northeastern Ohio Area		1	2			54	2						(330)-996-8885	(800)-996-6250	(800)-750-0750		(330)-996-8440	(888)-464-8440	(800)-750-0750										http://www.summacare.com/media/7919/2185.pdf	www.summacare.com
H3660	805	0	1	02	01	H3660_805_0	4	2009.01	SUMMACARE INC.	SummaCare	www.summacare.com	01	02		1		H3660	805	0	2009	SummaCare Secure POS Employer Plan with D	Northeastern Ohio Area		1	2			503	2						(330)-996-8885	(800)-996-6250	(800)-750-0750		(330)-996-8440	(888)-464-8440	(800)-750-0750		(300)-996-8885	(800)-996-6250	(800)-750-0750	(800)-750-0750	(800)-996-8440	(888)-464-8440	(800)-750-0750		http://www.summacare.com/media/7919/2185.pdf	www.summacare.com
H3660	806	0	1	02	01	H3660_806_0	3	2009.01	SUMMACARE INC.	SummaCare	www.summacare.com	01	02		1		H3660	806	0	2009	SummaCare Secure POS Employer Plan - No D	Northeastern Ohio Area		1	2			103	2						(330)-996-8885	(800)-996-6250	(800)-750-0750		(330)-996-8440	(888)-464-8440	(800)-750-0750										http://www.summacare.com/media/7919/2185.pdf	www.summacare.com
H3664	001	0	1	02	01	H3664_001_0	5	2009.01	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	01	02		1		H3664	001	0	2009	PrimeTime Health Plan Plus	Stark, Tusc, Wayne, Holmes, and Carroll Counties		2	2			5500	2						(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	https://www.aultcare.com/pls/portal30/docs/folder/Medicare_RX/formulary.pdf	www.primetimehealthplan.com
H3664	011	0	1	02	01	H3664_011_0	6	2009.01	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	01	02		1		H3664	011	0	2009	PrimeTime Health Plan Standard	Stark, Tusc, Wayne, Holmes, and Carroll Counties		2	2			6000	2						(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	https://www.aultcare.com/pls/portal30/docs/folder/Medicare_RX/formulary.pdf	www.primetimehealthplan.com
H3664	012	0	1	02	01	H3664_012_0	5	2009.01	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	01	02		1		H3664	012	0	2009	PrimeTime Health Plan Premier	Stark, Tusc, Wayne, Holmes, and Carroll Counties		2	2			400	2						(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	https://www.aultcare.com/pls/portal30/docs/folder/Medicare_RX/formulary.pdf	www.primetimehealthplan.com
H3664	014	0	1	02	01	H3664_014_0	2	2009.01	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	01	02		1		H3664	014	0	2009	PrimeTime Health Plan Basic - MA Only	Stark, Tusc, Wayne, Holmes, and Carroll Counties		2	2			900	2						(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446									https://www.aultcare.com/pls/portal30/docs/folder/Medicare_RX/formulary.pdf	www.primetimehealthplan.com
H3664	016	0	1	02	01	H3664_016_0	6	2009.01	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	01	02		1		H3664	016	0	2009	PrimeTime Health Plan Essential	Carroll, Holmes, Stark, Tuscarawas, Wayne		2	2			100	2						(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	https://www.aultcare.com/pls/portal30/docs/folder/Medicare_RX/formulary.pdf	www.primetimehealthplan.com
H3664	801	0	1	02	01	H3664_801_0	1	2009.01	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	01	02		1		H3664	801	0	2009	EGHP HMO  - CY	All Ohio Counties		1	2			3400	2						(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	https://www.aultcare.com/pls/portal30/docs/folder/Medicare_RX/formulary.pdf	www.primetimehealthplan.com
H3664	802	0	1	02	01	H3664_802_0	1	2009.01	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	01	02		1		H3664	802	0	2009	PrimeTime Employer Group HMO MA-Only	All Ohio Counties		1	2			200	2						(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446									https://www.aultcare.com/pls/portal30/docs/folder/Medicare_RX/formulary.pdf	www.primetimehealthplan.com
H3664	803	0	1	02	01	H3664_803_0	1	2009.01	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	01	02		1		H3664	803	0	2009	PrimeTime EGHP - Non CY	All Ohio Counties		1	2			0	2						(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	https://www.aultcare.com/pls/portal30/docs/folder/Medicare_RX/formulary.pdf	www.primetimehealthplan.com
H3664	804	0	1	02	01	H3664_804_0	1	2009.01	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	01	02		1		H3664	804	0	2009	PrimeTime EGHP / MA Only - Non CY	All Ohio Counties		1	2			0	2						(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446									https://www.aultcare.com/pls/portal30/docs/folder/Medicare_RX/formulary.pdf	www.primetimehealthplan.com
H3668	005	0	1	01	01	H3668_005_0	3	2009.01	MT. CARMEL HEALTH PLAN, INC.	MediGold	www.medigold.com	01	01		1		H3668	005	0	2009	MediGold Classic	Greater Central Ohio and Dayton Area		2	2			25000	2						(614)-546-3110	(800)-240-3851	(614)-546-3122		(800)-964-4525	(800)-964-4525	(614)-546-3122		(614)-546-3110	(800)-240-3851	(614)-546-3122		(800)-964-4525	(800)-964-4525	(614)-546-3122		www.medigold.com	www.medigold.com
H3668	011	0	1	01	01	H3668_011_0	5	2009.01	MT. CARMEL HEALTH PLAN, INC.	MediGold	www.medigold.com	01	01		1		H3668	011	0	2009	MediGold Basic	Greater Central Ohio and Dayton Area		2	2			1200	2						(614)-546-3110	(800)-240-3851	(614)-546-3122		(800)-964-4525	(800)-964-4525	(614)-546-3122		(614)-546-3110	(800)-240-3851	(614)-546-3122		(800)-964-4525	(800)-964-4525	(614)-546-3122		www.medigold.com	www.medigold.com
H3668	013	0	1	01	01	H3668_013_0	3	2009.01	MT. CARMEL HEALTH PLAN, INC.	MediGold	www.medigold.com	01	01		1		H3668	013	0	2009	MediGold Medical Only	Central Ohio, Dayton and Springfield region		2	2			370	2						(614)-546-3110	(800)-240-3851	(614)-546-3122		(800)-964-4525	(800)-964-4525	(614)-546-3122										www.medigold.com	www.medigold.com
H3668	801	0	1	01	01	H3668_801_0	3	2009.01	MT. CARMEL HEALTH PLAN, INC.	MediGold	www.medigold.com	01	01		1		H3668	801	0	2009	EGWP MediGold HMO Medical Only	Greater Central Ohio and Dayton Area		1	2			250	2						(614)-546-3110	(800)-240-3851	(614)-546-3122		(800)-964-4525	(800)-964-4525	(614)-546-3122										www.medigold.com	www.medigold.com
H3668	802	0	1	01	01	H3668_802_0	2	2009.01	MT. CARMEL HEALTH PLAN, INC.	MediGold	www.medigold.com	01	01		1		H3668	802	0	2009	EGWP MediGold HMO	Central Ohio, Dayton and Springfield region		1	2			15	2						(614)-546-3110	(800)-240-3851	(614)-546-3122		(800)-964-4525	(800)-964-4525	(614)-546-3122		(614)-546-3110	(800)-240-3851	(614)-546-3122		(800)-964-4525	(800)-964-4525	(614)-546-3122		www.medigold.com	www.medigold.com
H3672	013	0	1	01	01	H3672_013_0	5	2009.01	HOMETOWN HEALTH PLAN	The Health Plan	www.healthplan.org	01	01		1		H3672	013	0	2009	Health Plan SecureCare	East Central Ohio		2	2			6940	2						(330)-837-6580	(877)-236-2296	(877)-236-2291		(877)-236-2290	(877)-236-2290	(877)-236-2291		(330)-837-6880	(877)-236-2296	(877)-236-2291	(877)-236-2291	(877)-236-2290	(877)-236-2290	(877)-236-2291		www.healthplan.org/pharmacy.shtml	www.healthplan.org
H3672	014	0	1	01	01	H3672_014_0	3	2009.01	HOMETOWN HEALTH PLAN	The Health Plan	www.healthplan.org	01	01		1		H3672	014	0	2009	Health Plan SecureCare	East Central Ohio		2	2			802	2						(330)-837-6580	(877)-236-2296	(877)-236-2291		(877)-236-2290	(877)-236-2290	(877)-236-2291										www.healthplan.org/pharmacy.shtml	www.healthplan.org
H3672	804	0	1	01	01	H3672_804_0	4	2009.01	HOMETOWN HEALTH PLAN	The Health Plan	www.healthplan.org	01	01		1		H3672	804	0	2009	Health Plan SecureCare	East Central Ohio		1	2			6	2						(330)-837-6580	(877)-236-2296	(877)-236-2291		(877)-236-2290	(877)-236-2290	(877)-236-2291										www.healthplan.org/pharmacy.shtml	www.healthplan.org
H3672	805	0	1	01	01	H3672_805_0	4	2009.01	HOMETOWN HEALTH PLAN	The Health Plan	www.healthplan.org	01	01		1		H3672	805	0	2009	Health Plan SecureCare	East Central Ohio		1	2			573	2						(330)-837-6580	(877)-236-2296	(877)-236-2291		(877)-236-2290	(877)-236-2290	(877)-236-2291		(330)-837-6880	(877)-236-2296	(877)-236-2291		(877)-236-2290	(877)-236-2290	(877)-236-2291		www.healthplan.org/pharmacy.shtml	www.healthplan.org
H3706	001	0	1	01	01	H3706_001_0	3	2009.01	GLOBALHEALTH, INC.	Generations Healthcare	www.generationshealthcare.cc	01	01		1		H3706	001	0	2009	Generations Healthcare Classic powered by CCRx	Oklahoma City Area		2	2			5949	2						(405)-280-5400	(866)-547-3060	(866)-338-4681	(866)-338-4681	(866)-618-4074	(866)-618-4074	(866)-338-4681	(866)-338-4681	(405)-280-5400	(866)-547-3060	(866)-338-4681	(866)-338-4681	(866)-618-4074	(866)-618-4074	(866)-338-4681	(866)-338-4681	http://www.globalhealth.cc/formulary	
H3706	006	0	1	01	01	H3706_006_0	3	2009.01	GLOBALHEALTH, INC.	Generations Healthcare	www.generationshealthcare.cc	01	01		1		H3706	006	0	2009	Generations Healthcare Classic powered by CCRx	Tulsa Area		2	2			1377	2						(405)-280-5400	(866)-547-3060	(866)-338-4681	(866)-338-4681	(866)-618-4074	(866)-618-4074	(866)-338-4681	(866)-338-4681	(405)-280-5400	(866)-547-3060	(866)-338-4681	(866)-338-4681	(866)-618-4074	(866)-618-4074	(866)-338-4681	(866)-338-4681	http://www.globalhealth.cc/formulary	
H3706	009	0	1	01	01	H3706_009_0	3	2009.01	GLOBALHEALTH, INC.	Generations Healthcare	www.generationshealthcare.cc	01	01		1		H3706	009	0	2009	Generations Healthcare Value	Oklahoma City Area		2	2			537	2						(405)-280-5400	(866)-547-3060	(866)-338-4681	(866)-338-4681	(866)-618-4074	(866)-618-4074	(866)-338-4681	(866)-338-4681									http://www.globalhealth.cc/formulary	
H3706	010	0	1	01	01	H3706_010_0	3	2009.01	GLOBALHEALTH, INC.	Generations Healthcare	www.generationshealthcare.cc	01	01		1		H3706	010	0	2009	Generations Healthcare Value	Tulsa Area		2	2			455	2						(405)-280-5400	(866)-547-3060	(866)-338-4681	(866)-338-4681	(866)-618-4074	(866)-618-4074	(866)-338-4681	(866)-338-4681									http://www.globalhealth.cc/formulary	
H3706	014	0	1	01	01	H3706_014_0	3	2009.01	GLOBALHEALTH, INC.	Generations Healthcare	www.generationshealthcare.cc	01	01		1		H3706	014	0	2009	Generations Healthcare Premier powered by CCRx	Tulsa Area		2	2			362	2						(405)-280-5400	(866)-547-3060	(866)-338-4681	(866)-338-4681	(866)-618-4074	(866)-618-4074	(866)-338-4681	(866)-338-4681	(405)-280-5400	(866)-547-3060	(866)-338-4681	(866)-338-4681	(866)-618-4074	(866)-618-4074	(866)-338-4681	(866)-338-4681	http://www.globalhealth.cc/formulary	
H3706	015	0	1	01	01	H3706_015_0	4	2009.01	GLOBALHEALTH, INC.	Generations Healthcare	www.generationshealthcare.cc	01	01		1		H3706	015	0	2009	Generations Healthcare Star powered CCRx	Oklahoma City Area		2	2			537	2						(405)-280-5400	(866)-547-3060	(866)-338-4681	(866)-338-4681	(866)-618-4074	(866)-618-4074	(866)-338-4681	(866)-338-4681	(405)-280-5400	(866)-547-3060	(866)-338-4681	(866)-338-4681	(866)-618-4074	(866)-618-4074	(866)-338-4681	(866)-338-4681	http://www.globalhealth.cc/formulary	
H3706	016	0	1	01	01	H3706_016_0	4	2009.01	GLOBALHEALTH, INC.	Generations Healthcare	www.generationshealthcare.cc	01	01		1		H3706	016	0	2009	Generations Healthcare Star powered CCRx	Tulsa Area		2	2			540	2						(405)-280-5400	(866)-547-3060	(866)-338-4681	(866)-338-4681	(866)-618-4074	(866)-618-4074	(866)-338-4681	(866)-338-4681	(405)-280-5400	(866)-547-3060	(866)-338-4681	(866)-338-4681	(866)-618-4074	(866)-618-4074	(866)-338-4681	(866)-338-4681	http://www.globalhealth.cc/formulary	
H3706	017	0	1	01	01	H3706_017_0	3	2009.01	GLOBALHEALTH, INC.	Generations Healthcare	www.generationshealthcare.cc	01	01		1		H3706	017	0	2009	Generations Healthcare Premier powered by CCRx	Oklahoma City		2	2			537	2						(405)-280-5400	(866)-547-3060	(866)-338-4681	(866)-338-4681	(866)-618-4074	(866)-618-4074	(866)-338-4681	(866)-338-4681	(405)-280-5400	(866)-547-3060	(866)-338-4681	(866)-338-4681	(866)-618-4074	(866)-618-4074	(866)-338-4681	(866)-338-4681	http://www.globalhealth.cc/formulary	
H3706	803	0	1	01	01	H3706_803_0	3	2009.01	GLOBALHEALTH, INC.	Generations Healthcare	www.generationshealthcare.cc	01	01		1		H3706	803	0	2009	Generations Healthcare EGHP CY	Oklahoma City and Tulsa Metro Areas		1	2			700	2						(405)-280-5400	(866)-547-3060	(866)-338-4681	(866)-338-4681	(866)-618-4074	(866)-618-4074	(866)-338-4681	(866)-338-4681	(405)-280-5400	(866)-547-3060	(866)-338-4681	(866)-338-4681	(866)-618-4074	(866)-618-4074	(866)-338-4681	(866)-338-4681	http://www.globalhealth.cc/formulary	
H3706	804	0	1	01	01	H3706_804_0	3	2009.01	GLOBALHEALTH, INC.	Generations Healthcare	www.generationshealthcare.cc	01	01		1		H3706	804	0	2009	Generations Healthcare EGHP Non CY	Oklahoma City and Tulsa Metro Areas		1	2			50	2						(405)-280-5400	(866)-547-3060	(866)-338-4681	(866)-338-4681	(866)-618-4074	(866)-618-4074	(866)-338-4681	(866)-338-4681	(405)-280-5400	(866)-547-3060	(866)-338-4681	(866)-338-4681	(866)-618-4074	(866)-618-4074	(866)-338-4681	(866)-338-4681	http://www.globalhealth.cc/formulary	
H3706	807	0	1	01	01	H3706_807_0	3	2009.01	GLOBALHEALTH, INC.	Generations Healthcare	www.generationshealthcare.cc	01	01		1		H3706	807	0	2009	Generations Healthcare EGHP MA only	Oklahoma City and Tulsa Metro Areas		1	2			50	2						(405)-280-5400	(866)-547-3060	(866)-338-4681	(866)-338-4681	(866)-618-4074	(866)-618-4074	(866)-338-4681	(866)-338-4681									http://www.globalhealth.cc/formulary	
H3708	001	0	1	01	01	H3708_001_0	7	2009.01	SELECTCARE OF OKLAHOMA, INC.	SelectCare of Oklahoma	www.scoklahoma.com	01	01		1		H3708	001	0	2009	Tribute powered by CCRx	Greater Ardmore and Surrounding Area		2	1	1	2		2			1			(800)-817-3515	(800)-817-3515	(888)-338-4681	(888)-338-4681	(866)-556-4607	(866)-556-4607	(866)-338-4681	(866)-338-4681	(800)-817-3515	(800)-817-3515	(888)-338-4681	(888)-338-4681	(866)-556-4607	(866)-556-4607	(866)-338-4681	(866)-338-4681	http://www.scoklahoma.com/PresentFormulary	www.scoklahoma.com
H3709	001	0	1	04	01	H3709_001_0	8	2009.01	HCSC INSURANCE SERVICES COMPANY	Blue Cross And Blue Shield Of Oklahoma	www.bcbsok.com	01	04		1		H3709	001	0	2009	Medicare Blue PPO	Central and northeastern Oklahoma		2	2				2						(800)-642-8065	(800)-642-8065	(800)-722-0353	(800)-722-0353	(866)-303-2583	(866)-303-2583	(800)-722-0353	(800)-722-0353	(800)-642-8065	(800)-642-8065	(800)-722-0353	(800)-722-0353	(866)-303-2583	(866)-303-2583	(800)-722-0353		www.ccok.com/rxformulary?BusUnit=07	http://www.hisc.net/okmember/2007/provider.htm
H3709	003	0	1	04	01	H3709_003_0	5	2009.01	HCSC INSURANCE SERVICES COMPANY	Blue Cross And Blue Shield Of Oklahoma	www.bcbsok.com	01	04		1		H3709	003	0	2009	Medicare Blue PPO Basic	Central and northeastern Oklahoma		2	2				2						(800)-642-8065	(800)-642-8065	(800)-722-0353	(800)-722-0353	(866)-303-2583	(866)-303-2583	(800)-722-0353	(800)-722-0353									www.ccok.com/rxformulary?BusUnit=07	http://www.hisc.net/okmember/2007/provider.htm
H3709	801	0	1	04	01	H3709_801_0	5	2009.01	HCSC INSURANCE SERVICES COMPANY	Blue Cross And Blue Shield Of Oklahoma	www.bcbsok.com	01	04		1		H3709	801	0	2009	Medicare Blue PPO Group Plan	Central and northeastern Oklahoma		1	2				2						(800)-642-8065	(800)-642-8065	(800)-722-0353	(800)-722-0353	(866)-303-2583	(866)-303-2583	(800)-722-0353	(800)-722-0353	(800)-642-8065	(800)-642-8065	(800)-722-0353	(800)-722-0353	(866)-303-2583	(866)-303-2583	(800)-722-0353	(800)-722-0353	www.ccok.com/rxformulary?BusUnit=07	http://www.hisc.net/okmember/2007/provider.htm
H3709	802	0	1	04	01	H3709_802_0	4	2009.01	HCSC INSURANCE SERVICES COMPANY	Blue Cross And Blue Shield Of Oklahoma	www.bcbsok.com	01	04		1		H3709	802	0	2009	Medicare Blue PPO Basic Group Plan	Central and northeastern Oklahoma		1	2				2						(800)-642-8065	(800)-642-8065	(800)-722-0353	(800)-722-0353	(866)-303-2583	(866)-303-2583	(800)-722-0353	(800)-722-0353									www.ccok.com/rxformulary?BusUnit=07	http://www.hisc.net/okmember/2007/provider.htm
H3709	803	0	1	04	01	H3709_803_0	4	2009.01	HCSC INSURANCE SERVICES COMPANY	Blue Cross And Blue Shield Of Oklahoma	www.bcbsok.com	01	04		1		H3709	803	0	2009	Medicare Blue PPO Group Plan	Central and northeastern Oklahoma		1	2				2						(800)-642-8065	(800)-642-8065	(800)-722-0353	(800)-722-0353	(866)-303-2583	(866)-303-2583	(800)-722-0353	(800)-722-0353	(800)-642-8065	(800)-642-8065	(800)-722-0353	(800)-722-0353	(866)-303-2583	(866)-303-2583	(800)-722-0353	(800)-722-0353	www.ccok.com/rxformulary?BusUnit=07	http://www.hisc.net/okmember/2007/provider.htm
H3709	804	0	1	04	01	H3709_804_0	4	2009.01	HCSC INSURANCE SERVICES COMPANY	Blue Cross And Blue Shield Of Oklahoma	www.bcbsok.com	01	04		1		H3709	804	0	2009	Medicare Blue PPO Basic Group Plan	Central and northeastern Oklahoma		1	2				2						(800)-642-8065	(800)-642-8065	(800)-722-0353	(800)-722-0353	(866)-303-2583	(866)-303-2583	(800)-722-0353	(800)-722-0353									www.ccok.com/rxformulary?BusUnit=07	http://www.hisc.net/okmember/2007/provider.htm
H3709	805	0	1	04	01	H3709_805_0	4	2009.01	HCSC INSURANCE SERVICES COMPANY	Blue Cross And Blue Shield Of Oklahoma	www.bcbsok.com	01	04		1		H3709	805	0	2009	Medicare Blue PPO Group Plan	National service area		1	2				2						(800)-642-8065	(800)-642-8065	(800)-722-0353	(800)-722-0353	(866)-303-2583	(866)-303-2583	(800)-722-0353	(800)-722-0353	(800)-642-8065	(800)-642-8065	(800)-722-0353	(800)-722-0353	(866)-303-2583	(866)-303-2583	(800)-722-0353	(800)-722-0353	www.ccok.com/rxformulary?BusUnit=07	http://www.hisc.net/okmember/2007/provider.htm
H3709	806	0	1	04	01	H3709_806_0	4	2009.01	HCSC INSURANCE SERVICES COMPANY	Blue Cross And Blue Shield Of Oklahoma	www.bcbsok.com	01	04		1		H3709	806	0	2009	Medicare Blue PPO Group Plan	National service area		1	2				2						(800)-642-8065	(800)-642-8065	(800)-722-0353	(800)-722-0353	(866)-303-2583	(866)-303-2583	(800)-722-0353	(800)-722-0353	(800)-642-8065	(800)-642-8065	(800)-722-0353	(800)-722-0353	(866)-303-2583	(866)-303-2583	(800)-722-0353	(800)-722-0353	www.ccok.com/rxformulary?BusUnit=07	http://www.hisc.net/okmember/2007/provider.htm
H3709	807	0	1	04	01	H3709_807_0	4	2009.01	HCSC INSURANCE SERVICES COMPANY	Blue Cross And Blue Shield Of Oklahoma	www.bcbsok.com	01	04		1		H3709	807	0	2009	Medicare Blue PPO Basic Group Plan	National service area		1	2				2						(800)-642-8065	(800)-642-8065	(800)-722-0353	(800)-722-0353	(866)-303-2583	(866)-303-2583	(800)-722-0353	(800)-722-0353									www.ccok.com/rxformulary?BusUnit=07	http://www.hisc.net/okmember/2007/provider.htm
H3749	001	0	1	01	01	H3749_001_0	6	2009.01	PACIFICARE OF OKLAHOMA, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3749	001	0	2009	AARP MedicareComplete	Oklahoma City Area		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3749	004	0	1	01	01	H3749_004_0	5	2009.01	PACIFICARE OF OKLAHOMA, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3749	004	0	2009	AARP MedicareComplete Plan 1	Tulsa Area		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3749	011	0	1	01	01	H3749_011_0	7	2009.01	PACIFICARE OF OKLAHOMA, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3749	011	0	2009	Evercare Plan DH	Oklahoma City Area		2	1	3			2			2	2		(866)-846-2762	(866)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(866)-846-2762	(866)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3749	012	0	1	01	01	H3749_012_0	9	2009.01	PACIFICARE OF OKLAHOMA, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3749	012	0	2009	Evercare Plan DH	Creek, Rogers and Tulsa Counties		2	1	3			2			2	2		(866)-846-2762	(866)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(866)-846-2762	(866)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3749	013	0	1	01	01	H3749_013_0	6	2009.01	PACIFICARE OF OKLAHOMA, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3749	013	0	2009	Evercare Plan IH	Oklahoma City Area		2	1	1	1		2			1			(866)-846-2762	(866)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(866)-846-2762	(866)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3749	014	0	1	01	01	H3749_014_0	6	2009.01	PACIFICARE OF OKLAHOMA, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3749	014	0	2009	Evercare Plan MH	Oklahoma City Area		2	1	4			2			2		1111111110000000100000000001	(866)-846-2762	(866)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(866)-846-2762	(866)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3749	015	0	1	01	01	H3749_015_0	6	2009.01	PACIFICARE OF OKLAHOMA, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3749	015	0	2009	Evercare Plan IH	Creek, Rogers, and Tulsa Counties		2	1	1	1		2			1			(866)-846-2762	(866)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(866)-846-2762	(866)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074	(888)-685-8480	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3749	016	0	1	01	01	H3749_016_0	6	2009.01	PACIFICARE OF OKLAHOMA, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3749	016	0	2009	Evercare Plan MH	Creek, Rogers and Tulsa Counties		2	1	4			2			2		1111111110000000100000000001	(866)-846-2762	(866)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(866)-846-2762	(866)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3749	017	0	1	01	01	H3749_017_0	5	2009.01	PACIFICARE OF OKLAHOMA, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3749	017	0	2009	AARP MedicareComplete Plan 2	Tulsa		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3749	801	0	1	01	01	H3749_801_0	3	2009.01	PACIFICARE OF OKLAHOMA, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3749	801	0	2009	MedicareComplete Retiree Plan	OK Employer Sponsored Plan Service Area		1	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074									www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3749	802	0	1	01	01	H3749_802_0	4	2009.01	PACIFICARE OF OKLAHOMA, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3749	802	0	2009	MedicareComplete Retiree Plan	OK Employer Sponsored Plan Service Area		1	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074									www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3749	803	0	1	01	01	H3749_803_0	3	2009.01	PACIFICARE OF OKLAHOMA, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3749	803	0	2009	MedicareComplete Retiree Plan	OK Employer Sponsored Plan Service Area		1	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3749	804	0	1	01	01	H3749_804_0	3	2009.01	PACIFICARE OF OKLAHOMA, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H3749	804	0	2009	MedicareComplete Retiree Plan	OK Employer Sponsored Plan Service Area		1	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3755	001	0	1	01	01	H3755_001_0	5	2009.01	COMMUNITY CARE HMO, INC	CommunityCare Senior Health Plan	www.ccok.com	01	01		1		H3755	001	0	2009	Senior Health Plan Platinum	Tulsa Metro Area		2	2			15135	2						(800)-642-8065		(800)-722-0353		(800)-642-8065		(800)-722-0353		(800)-642-8065	(800)-642-8065	(800)-722-0353		(800)-642-8065	(800)-642-8065	(800)-722-0353		http://www.ccok.com/rxformulary?Switch=2	www.ccok.com
H3755	002	0	1	01	01	H3755_002_0	3	2009.01	COMMUNITY CARE HMO, INC	CommunityCare Senior Health Plan	www.ccok.com	01	01		1		H3755	002	0	2009	Senior Health Plan Silver	Tulsa Metro Area		2	2			5000	2						(800)-642-8065		(800)-722-0353		(800)-642-8065		(800)-722-0353										http://www.ccok.com/rxformulary?Switch=2	www.ccok.com
H3755	004	0	1	01	01	H3755_004_0	5	2009.01	COMMUNITY CARE HMO, INC	CommunityCare Senior Health Plan	www.ccok.com	01	01		1		H3755	004	0	2009	Senior Health Plan Platinum Plus	Tulsa Metro Area		2	2			5000	2						(800)-642-8065		(800)-722-0353		(800)-642-8065		(800)-722-0353		(800)-642-8065	(800)-642-8065	(800)-722-0353		(800)-642-8065	(800)-642-8065	(800)-722-0353		http://www.ccok.com/rxformulary?Switch=2	www.ccok.com
H3755	801	0	1	01	01	H3755_801_0	3	2009.01	COMMUNITY CARE HMO, INC	CommunityCare Senior Health Plan	www.ccok.com	01	01		1		H3755	801	0	2009	Senior Health EGHP+D	Tulsa Metro Area		1	2				2						(800)-642-8065		(800)-722-0353		(800)-642-8065		(800)-722-0353		(800)-642-8065	(800)-642-8065	(800)-722-0353		(800)-642-8065	(800)-642-8065	(800)-722-0353		http://www.ccok.com/rxformulary?Switch=2	www.ccok.com
H3805	001	0	1	01	01	H3805_001_0	5	2009.01	PACIFICARE OF OREGON, INC.	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H3805	001	0	2009	AARP MedicareComplete	Northern Oregon		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3805	007	0	1	01	01	H3805_007_0	6	2009.01	PACIFICARE OF OREGON, INC.	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H3805	007	0	2009	AARP MedicareComplete	Southern Oregon		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3805	011	0	1	01	01	H3805_011_0	5	2009.01	PACIFICARE OF OREGON, INC.	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H3805	011	0	2009	AARP MedicareComplete Essential	Select counties in Oregon		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3805	801	0	1	01	01	H3805_801_0	2	2009.01	PACIFICARE OF OREGON, INC.	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H3805	801	0	2009	MedicareComplete Retiree Plan	OR Employer Sponsored Plan Service Area		1	2				2						(800)-533-2743	(800)-533-2743	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074									www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3805	802	0	1	01	01	H3805_802_0	2	2009.01	PACIFICARE OF OREGON, INC.	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H3805	802	0	2009	MedicareComplete Retiree Plan	OR Employer Sponsored Plan Service Area		1	2				2						(800)-533-2743	(800)-533-2743	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074									www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3805	803	0	1	01	01	H3805_803_0	2	2009.01	PACIFICARE OF OREGON, INC.	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H3805	803	0	2009	MedicareComplete Retiree Plan	OR Employer Sponsored Plan Service Area		1	2				2						(800)-533-2743	(800)-533-2743	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	(800)-533-2743	(800)-533-2743	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3805	804	0	1	01	01	H3805_804_0	2	2009.01	PACIFICARE OF OREGON, INC.	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H3805	804	0	2009	MedicareComplete Retiree Plan	OR Employer Sponsored Plan Service Area		1	2				2						(800)-533-2743	(800)-533-2743	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	(800)-533-2743	(800)-533-2743	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3809	001	0	1	20	08	H3809_001_0	1	2009.01	PROVIDENCE HEALTH SYSTEM - OREGON	Providence ElderPlace Portland	www.providence.org/elderplace	08	20		1		H3809	001	0	2009	Providence ElderPlace Portland (dual)	Multnomah County		2	2				2														(503)-215-6556	(503)-215-6556			(503)-215-6556	(503)-215-6556			http://www.providence.org/oregon/Programs_and_Services/ElderPlace/formularies.htm	
H3809	002	0	1	20	08	H3809_002_0	1	2009.01	PROVIDENCE HEALTH SYSTEM - OREGON	Providence ElderPlace Portland	www.providence.org/elderplace	08	20		1		H3809	002	0	2009	Providence ElderPlace Portland (pvt pay)	Multnomah County		2	2				2														(503)-215-6556	(503)-215-6556			(503)-215-6556	(503)-215-6556			http://www.providence.org/oregon/Programs_and_Services/ElderPlace/formularies.htm	
H3810	001	0	1	01	01	H3810_001_0	3	2009.01	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	http://www.caresourcehp.com	01	01		1		H3810	001	0	2009	CareSource Gold	Counties:  JO, JA*, DO*, CO, CU.		2	2			562	2						(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900									http://www.caresourcehp.com/plans/formularies/formularyindex.php	http://www.caresourcehp.com/prov_net/index.php
H3810	002	0	1	01	01	H3810_002_0	5	2009.01	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	http://www.caresourcehp.com	01	01		1		H3810	002	0	2009	CareSource - SNP	Counties: Jackson, Josephine, Douglas*		2	1	3		1267	2			1	2		(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	http://www.caresourcehp.com/plans/formularies/formularyindex.php	http://www.caresourcehp.com/prov_net/index.php
H3810	003	0	1	01	01	H3810_003_0	6	2009.01	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	http://www.caresourcehp.com	01	01		1		H3810	003	0	2009	CareSource Gold Plus Rx	Counties: JO, JA*, DO*, CO, CU.		2	2			1745	2						(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	http://www.caresourcehp.com/plans/formularies/formularyindex.php	http://www.caresourcehp.com/prov_net/index.php
H3810	004	0	1	02	01	H3810_004_0	3	2009.01	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	http://www.caresourcehp.com	01	02		1		H3810	004	0	2009	CareSource Platinum	Counties: JO, JA*, DO*, CO, CU.		2	2			16	2						(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900									http://www.caresourcehp.com/plans/formularies/formularyindex.php	http://www.caresourcehp.com/prov_net/index.php
H3810	005	0	1	02	01	H3810_005_0	6	2009.01	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	http://www.caresourcehp.com	01	02		1		H3810	005	0	2009	CareSource Platinum Plus Rx	Counties: JO, JA*, DO*, CO, CU.		2	2			103	2						(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	http://www.caresourcehp.com/plans/formularies/formularyindex.php	http://www.caresourcehp.com/prov_net/index.php
H3810	006	0	1	01	01	H3810_006_0	5	2009.01	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	http://www.caresourcehp.com	01	01		1		H3810	006	0	2009	CareSource Silver	Counties: JO, JA*, DO*, CU.		2	2			28	2						(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900									http://www.caresourcehp.com/plans/formularies/formularyindex.php	http://www.caresourcehp.com/prov_net/index.php
H3810	007	0	1	01	01	H3810_007_0	8	2009.01	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	http://www.caresourcehp.com	01	01		1		H3810	007	0	2009	CareSource Silver Plus Rx	Counties: JO, JA*, DO*, CU.		2	2			99	2						(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	http://www.caresourcehp.com/plans/formularies/formularyindex.php	http://www.caresourcehp.com/prov_net/index.php
H3810	008	0	1	01	01	H3810_008_0	4	2009.01	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	http://www.caresourcehp.com	01	01		1		H3810	008	0	2009	CareSource Gold	Jackson County* Excl Rogue River OR, Gold Hill OR		2	2			168	2						(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900									http://www.caresourcehp.com/plans/formularies/formularyindex.php	http://www.caresourcehp.com/prov_net/index.php
H3810	010	0	1	01	01	H3810_010_0	6	2009.01	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	http://www.caresourcehp.com	01	01		1		H3810	010	0	2009	CareSource Gold Plus Rx	Jackson County* Excl Rogue River OR, Gold Hill OR.		2	2			490	2						(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	http://www.caresourcehp.com/plans/formularies/formularyindex.php	http://www.caresourcehp.com/prov_net/index.php
H3810	011	0	1	02	01	H3810_011_0	4	2009.01	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	http://www.caresourcehp.com	01	02		1		H3810	011	0	2009	CareSource Platinum	Jackson County* Excl Rogue River OR, Gold Hill OR.		2	2			6	2						(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900									http://www.caresourcehp.com/plans/formularies/formularyindex.php	http://www.caresourcehp.com/prov_net/index.php
H3810	012	0	1	02	01	H3810_012_0	6	2009.01	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	http://www.caresourcehp.com	01	02		1		H3810	012	0	2009	CareSource Platinum Plus Rx	Jackson County* Excl Rogue River OR, Gold Hill OR		2	2			9	2						(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	http://www.caresourcehp.com/plans/formularies/formularyindex.php	http://www.caresourcehp.com/prov_net/index.php
H3810	013	0	1	01	01	H3810_013_0	4	2009.01	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	http://www.caresourcehp.com	01	01		1		H3810	013	0	2009	CareSource Silver	Jackson County* Excl Rogue River OR, Gold Hill OR.		2	2			24	2						(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900									http://www.caresourcehp.com/plans/formularies/formularyindex.php	http://www.caresourcehp.com/prov_net/index.php
H3810	014	0	1	01	01	H3810_014_0	6	2009.01	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	http://www.caresourcehp.com	01	01		1		H3810	014	0	2009	CareSource Silver Plus Rx	Jackson County* Excl Rogue River OR, Gold Hill OR.		2	2			51	2						(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	http://www.caresourcehp.com/plans/formularies/formularyindex.php	http://www.caresourcehp.com/prov_net/index.php
H3810	015	0	1	01	01	H3810_015_0	4	2009.01	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	http://www.caresourcehp.com	01	01		1		H3810	015	0	2009	CareSource Silver - Coos County	Counties: Coos		2	2			50	2						(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900									http://www.caresourcehp.com/plans/formularies/formularyindex.php	http://www.caresourcehp.com/prov_net/index.php
H3810	016	0	1	01	01	H3810_016_0	6	2009.01	MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION	CareSource	http://www.caresourcehp.com	01	01		1		H3810	016	0	2009	CareSource Silver  Plus Rx - Coos County	Counties: Coos		2	2			1050	2						(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	(541)-471-4106	(888)-460-0185	(800)-735-1232	(800)-735-2900	http://www.caresourcehp.com/plans/formularies/formularyindex.php	http://www.caresourcehp.com/prov_net/index.php
H3811	001	0	1	01	01	H3811_001_0	5	2009.01	SAMARITAN HEALTH PLANS, INC.	Samaritan Advantage Health Plan	www.samaritanadvantage.com	01	01		1		H3811	001	0	2009	Samaritan Advantage Conventional Plan	Benton, Lincoln and Linn county		2	2			350	2						(541)-768-4550	(800)-317-7489	(800)-735-2900	(800)-735-2900	(541)-768-4550	(800)-317-7489	(800)-735-2900	(800)-735-2900									www.samaritanadvantage.com	www.samaritanadvantage.com
H3811	002	0	1	01	01	H3811_002_0	6	2009.01	SAMARITAN HEALTH PLANS, INC.	Samaritan Advantage Health Plan	www.samaritanadvantage.com	01	01		1		H3811	002	0	2009	Samaritan Advantage Premier Plan	Benton, Lincoln and Linn county		2	2			1000	2						(541)-768-4550	(800)-317-7489	(800)-735-2900	(800)-735-2900	(541)-768-4550	(800)-317-7489	(800)-735-2900	(800)-735-2900	(541)-768-4550	(800)-317-7489	(800)-735-2900	(800)-735-2900	(541)-768-4550	(800)-317-7489	(800)-735-2900	(800)-735-2900	www.samaritanadvantage.com	www.samaritanadvantage.com
H3811	003	0	1	01	01	H3811_003_0	3	2009.01	SAMARITAN HEALTH PLANS, INC.	Samaritan Advantage Health Plan	www.samaritanadvantage.com	01	01		1		H3811	003	0	2009	Samaritan Advantage Special Needs Plan	Benton and Linn counties		2	1	3		1600	2			1	2		(541)-768-4550	(800)-317-7489	(800)-735-2900	(800)-735-2900	(541)-768-4550	(800)-317-7489	(800)-735-2900	(800)-735-2900	(541)-768-4550	(800)-317-7489	(800)-735-2900	(800)-735-2900	(541)-768-4550	(800)-317-7489	(800)-735-2900	(800)-735-2900	www.samaritanadvantage.com	www.samaritanadvantage.com
H3811	009	0	1	01	01	H3811_009_0	5	2009.01	SAMARITAN HEALTH PLANS, INC.	Samaritan Advantage Health Plan	www.samaritanadvantage.com	01	01		1		H3811	009	0	2009	Samaritan Advantage Premier Plan Plus	Benton, Lincoln, and Linn Counties		2	2			1100	2						(541)-768-4550	(800)-317-7489	(800)-735-2900	(800)-735-2900	(541)-768-4550	(800)-317-7489	(800)-735-2900	(800)-735-2900	(541)-768-4550	(800)-317-7489	(800)-735-2900	(800)-735-2900	(541)-768-4550	(800)-317-7489	(800)-735-2900	(800)-735-2900	www.samaritanadvantage.com	www.samaritanadvantage.com
H3812	001	0	1	04	01	H3812_001_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H3812	001	0	2009	AARP MedicareComplete Choice	Clackamas, Multnomah, Marion, Washington Counties		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3812	005	0	1	04	01	H3812_005_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H3812	005	0	2009	Evercare Plan IP	Clackamas, Lane, Multnomah and Washington Counties		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3812	007	0	1	04	01	H3812_007_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H3812	007	0	2009	Evercare Plan MP	Clackamas, Lane, Multnomah and Washington Counties		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(888)-685-8480		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3812	801	0	1	04	01	H3812_801_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H3812	801	0	2009	MedicareComplete Choice Retiree Plan	Clackamas, Multnomah, Marion, Washington Counties		1	2				2						(866)-480-0073		(888)-685-8480		(866)-289-3831		(888)-685-8480		(866)-480-0073	(866)-480-0073	(888)-685-8480		(866)-289-3831	(866)-289-3831	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3812	803	0	1	04	01	H3812_803_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H3812	803	0	2009	Medicare Complete Retiree Plan	Select Counties in OR		1	2				2						(866)-480-0073		(888)-685-8480		(866)-289-3831		(888)-685-8480		(866)-480-0073	(866)-480-0073	(888)-685-8480		(866)-289-3831	(866)-289-3831	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H3813	001	0	1	04	01	H3813_001_0	9	2009.01	ODS HEALTH PLAN, INC.	ODS Health Plan, Inc.	www.odscompanies.com/odsadvantage	01	04		1		H3813	001	0	2009	ODS Advantage PPO	State of Oregon		2	2			3000	2						(503)-265-4762	(877)-299-9062	(503)-243-3958	(800)-433-6313	(503)-265-2975	(888)-217-2375	(503)-243-3958	(800)-433-6313									www.odscompanies.com/odsadvantage	www.odscompanies.com/odsadvantage
H3813	002	0	1	04	01	H3813_002_0	10	2009.01	ODS HEALTH PLAN, INC.	ODS Health Plan, Inc.	www.odscompanies.com/odsadvantage	01	04		1		H3813	002	0	2009	ODS Advantage PPORX	State of Oregon		2	2			3000	2						(503)-265-4762	(877)-299-9062	(503)-243-3958	(800)-433-6313	(503)-265-2975	(888)-217-2375	(503)-243-3958	(800)-433-6313	(503)-265-4709	(888)-786-7509	(503)-243-3958	(800)-433-6313	(503)-265-2975	(888)-217-2375	(503)-243-3958	(800)-433-6313	www.odscompanies.com/odsadvantage	www.odscompanies.com/odsadvantage
H3813	003	0	1	04	01	H3813_003_0	9	2009.01	ODS HEALTH PLAN, INC.	ODS Health Plan, Inc.	www.odscompanies.com/odsadvantage	01	04		1		H3813	003	0	2009	ODS Advantage PPORX Select	State of Oregon		2	2			3000	2						(503)-265-4762	(877)-299-9062	(503)-243-3958	(800)-433-6313	(503)-265-2975	(888)-217-2375	(503)-243-3958	(800)-433-6313	(503)-265-4709	(888)-786-7509	(503)-243-3958	(800)-433-6313	(503)-265-2975	(888)-217-2375	(503)-243-3958	(800)-433-6313	www.odscompanies.com/odsadvantage	www.odscompanies.com/odsadvantage
H3813	801	0	1	04	01	H3813_801_0	3	2009.01	ODS HEALTH PLAN, INC.	ODS Health Plan, Inc.	www.odscompanies.com/odsadvantage	01	04		1		H3813	801	0	2009	ODS Advantage PPO Employer Option	State of Oregon		1	2			3000	2						(503)-265-4761	(877)-299-9061	(503)-243-3958	(800)-433-6313	(503)-265-2975	(888)-217-2375	(503)-243-3958	(800)-433-6313									www.odscompanies.com/odsadvantage	www.odscompanies.com/odsadvantage
H3813	802	0	1	04	01	H3813_802_0	3	2009.01	ODS HEALTH PLAN, INC.	ODS Health Plan, Inc.	www.odscompanies.com/odsadvantage	01	04		1		H3813	802	0	2009	ODS Advantage PPORX Employer Option	State of Oregon		1	2			3000	2						(503)-265-4762	(877)-299-9062	(503)-243-3958	(800)-433-6313	(503)-265-2975	(888)-217-2375	(503)-243-3958	(800)-433-6313	(503)-265-4709	(888)-786-7509	(503)-243-3958	(800)-433-6313	(503)-265-2975	(888)-217-2375	(503)-243-3958	(800)-433-6313	www.odscompanies.com/odsadvantage	www.odscompanies.com/odsadvantage
H3814	004	0	1	01	01	H3814_004_0	8	2009.01	ATRIO HEALTH PLANS	ATRIO MyAdvantage	www.atriohp.com	01	01		1		H3814	004	0	2009	ATRIO MyAdvantage I Rx	Douglas and Klamath Counties		2	2			130	2						(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	http://www.atriohp.com/pharmacy_information.php	www.atriohp.com
H3814	005	0	1	01	01	H3814_005_0	6	2009.01	ATRIO HEALTH PLANS	ATRIO MyAdvantage	www.atriohp.com	01	01		1		H3814	005	0	2009	ATRIO MyAdvantage II	Douglas and Klamath Counties		2	2			410	2						(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900									http://www.atriohp.com/pharmacy_information.php	www.atriohp.com
H3814	006	0	1	01	01	H3814_006_0	9	2009.01	ATRIO HEALTH PLANS	ATRIO MyAdvantage	www.atriohp.com	01	01		1		H3814	006	0	2009	ATRIO MyAdvantage II Rx	Douglas and Klamath Counties		2	2			410	2						(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	http://www.atriohp.com/pharmacy_information.php	www.atriohp.com
H3814	007	0	1	01	01	H3814_007_0	9	2009.01	ATRIO HEALTH PLANS	ATRIO MyAdvantage	www.atriohp.com	01	01		1		H3814	007	0	2009	ATRIO MyAdvantage SNP	Douglas and Klamath Counties		2	1	3		1800	2			1	3		(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	http://www.atriohp.com/pharmacy_information.php	www.atriohp.com
H3814	008	0	1	01	01	H3814_008_0	9	2009.01	ATRIO HEALTH PLANS	ATRIO MyAdvantage	www.atriohp.com	01	01		1		H3814	008	0	2009	ATRIO MyAdvantage II Rx Plus	Douglas and Klamath Counties		2	2			410	2						(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	http://www.atriohp.com/pharmacy_information.php	www.atriohp.com
H3814	011	0	1	01	01	H3814_011_0	5	2009.01	ATRIO HEALTH PLANS	ATRIO MyAdvantage	www.atriohp.com	01	01		1		H3814	011	0	2009	ATRIO MyAdvantage Active	Douglas and Klamath Counties		2	2			175	2						(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900									http://www.atriohp.com/pharmacy_information.php	www.atriohp.com
H3814	012	0	1	01	01	H3814_012_0	8	2009.01	ATRIO HEALTH PLANS	ATRIO MyAdvantage	www.atriohp.com	01	01		1		H3814	012	0	2009	ATRIO MyAdvantage Active Rx	Douglas and Klamath Counties		2	2			175	2						(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	http://www.atriohp.com/pharmacy_information.php	www.atriohp.com
H3814	015	0	1	02	01	H3814_015_0	8	2009.01	ATRIO HEALTH PLANS	ATRIO MyAdvantage	www.atriohp.com	01	02		1		H3814	015	0	2009	ATRIO MyAdvantage Elite Rx	Douglas and Klamath Counties		2	2			325	2						(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	http://www.atriohp.com/pharmacy_information.php	www.atriohp.com
H3814	016	0	1	02	01	H3814_016_0	9	2009.01	ATRIO HEALTH PLANS	ATRIO MyAdvantage	www.atriohp.com	01	02		1		H3814	016	0	2009	ATRIO MyAdvantage Elite Rx Plus	Douglas and Klamath Counties		2	2			325	2						(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	http://www.atriohp.com/pharmacy_information.php	www.atriohp.com
H3814	018	0	1	01	01	H3814_018_0	5	2009.01	ATRIO HEALTH PLANS	ATRIO MyAdvantage	www.atriohp.com	01	01		1		H3814	018	0	2009	ATRIO MyAdvantage II	Washington County		2	2			410	2						(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900									http://www.atriohp.com/pharmacy_information.php	www.atriohp.com
H3814	019	0	1	01	01	H3814_019_0	8	2009.01	ATRIO HEALTH PLANS	ATRIO MyAdvantage	www.atriohp.com	01	01		1		H3814	019	0	2009	ATRIO MyAdvantage II Rx	Washington County		2	2			410	2						(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	http://www.atriohp.com/pharmacy_information.php	www.atriohp.com
H3814	021	0	1	02	01	H3814_021_0	8	2009.01	ATRIO HEALTH PLANS	ATRIO MyAdvantage	www.atriohp.com	01	02		1		H3814	021	0	2009	ATRIO MyAdvantage Elite Rx	Washington County		2	2			325	2						(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	http://www.atriohp.com/pharmacy_information.php	www.atriohp.com
H3814	023	0	1	01	01	H3814_023_0	5	2009.01	ATRIO HEALTH PLANS	ATRIO MyAdvantage	www.atriohp.com	01	01		1		H3814	023	0	2009	ATRIO MyAdvantage Active	Washington County		2	2			175	2						(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900									http://www.atriohp.com/pharmacy_information.php	www.atriohp.com
H3814	024	0	1	01	01	H3814_024_0	8	2009.01	ATRIO HEALTH PLANS	ATRIO MyAdvantage	www.atriohp.com	01	01		1		H3814	024	0	2009	ATRIO MyAdvantage Active Rx	Washington County		2	2			175	2						(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	http://www.atriohp.com/pharmacy_information.php	www.atriohp.com
H3814	025	0	1	01	01	H3814_025_0	10	2009.01	ATRIO HEALTH PLANS	ATRIO MyAdvantage	www.atriohp.com	01	01		1		H3814	025	0	2009	ATRIO MyAdvantage Companion	Washington County		2	2			1800	2						(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	(541)-672-8620	(877)-672-8620	(541)-735-2900	(800)-735-2900	http://www.atriohp.com/pharmacy_information.php	www.atriohp.com
H3815	001	0	1	01	01	H3815_001_0	9	2009.01	CITIZENS CHOICE HEALTHPLAN	Citizens Choice Healthplan	www.citizenschoicehealth.com	01	01		1		H3815	001	0	2009	Citizens Choice Healthplan	Los Angeles and Orange Counties, CA		2	2			250	2						(323)-728-7232	(866)-634-2247	(866)-516-9366	(866)-516-9366	(323)-728-7232	(866)-646-2247	(866)-516-9366	(866)-516-9366	(323)-728-7232	(866)-634-2247	(866)-516-9366	(866)-516-9366	(323)-728-7232	(866)-646-2247	(866)-516-9366	(866)-516-9366	www.citizenschoicehealth.com	www.citizenschoicehealth.com
H3817	001	0	1	04	01	H3817_001_0	6	2009.01	REGENCE BLUECROSS BLUESHIELD OF OR	Regence BlueCross BlueShield of Oregon	http://www.or.regence.com	01	04		1		H3817	001	0	2009	Regence MedAdvantage	Select Counties in Oregon/Clark Co, WA		2	2				2						(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003										www.or.regence.com	http://www.or.regence.com/provider/directory/
H3817	002	0	1	04	01	H3817_002_0	6	2009.01	REGENCE BLUECROSS BLUESHIELD OF OR	Regence BlueCross BlueShield of Oregon	http://www.or.regence.com	01	04		1		H3817	002	0	2009	Regence MedAdvantage + Rx Classic	Select Counties in Oregon/Clark Co, WA		2	2				2						(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003		(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003		www.or.regence.com	http://www.or.regence.com/provider/directory/
H3817	003	0	1	04	01	H3817_003_0	9	2009.01	REGENCE BLUECROSS BLUESHIELD OF OR	Regence BlueCross BlueShield of Oregon	http://www.or.regence.com	01	04		1		H3817	003	0	2009	Regence MedAdvantage + Rx Enhanced	Select Counties in Oregon/Clark Co,Wa		2	2				2						(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003		(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003		www.or.regence.com	http://www.or.regence.com/provider/directory/
H3817	006	0	1	04	01	H3817_006_0	6	2009.01	REGENCE BLUECROSS BLUESHIELD OF OR	Regence BlueCross BlueShield of Oregon	http://www.or.regence.com	01	04		1		H3817	006	0	2009	Regence MedAdvantage + Rx Core	Select Counties in OR / Clark Co., WA		2	2				2						(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003		(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003		www.or.regence.com	http://www.or.regence.com/provider/directory/
H3818	001	0	1	01	01	H3818_001_0	7	2009.01	FAMILYCARE HEALTH PLANS, INC.	FamilyCare Health Plans, Inc.	www.familycareinc.org	01	01		1		H3818	001	0	2009	PremierCare  Advantage Rx	Portland Metro Clatsop Morrow Umatilla Counties		2	2				2						(503)-345-5702	(866)-798-2273	(800)-735-2900		(503)-345-5701	(866)-225-2273	(800)-735-2900		(503)-345-5702	(866)-798-2273	(800)-735-2900		(503)-345-5701	(866)-225-2273	(800)-735-2900		http://www.familycareinc.org	www.familycareinc.org
H3818	002	0	1	01	01	H3818_002_0	5	2009.01	FAMILYCARE HEALTH PLANS, INC.	FamilyCare Health Plans, Inc.	www.familycareinc.org	01	01		1		H3818	002	0	2009	PremierCare Plus	Portland Metro Clatsop Morrow Umatilla Counties		2	1	3			2			1	3		(503)-345-5702	(866)-798-2273	(800)-735-2900		(503)-345-5701	(866)-225-2273	(800)-735-2900		(503)-345-5702	(866)-798-2273	(800)-735-2900		(503)-345-5701	(866)-225-2273	(800)-735-2900		http://www.familycareinc.org	www.familycareinc.org
H3818	003	0	1	01	01	H3818_003_0	7	2009.01	FAMILYCARE HEALTH PLANS, INC.	FamilyCare Health Plans, Inc.	www.familycareinc.org	01	01		1		H3818	003	0	2009	PremierCare Choice Rx	Portland Metro Clatsop Morrow Umatilla Counties		2	2				2						(503)-345-5702	(866)-798-2273	(800)-735-2900		(503)-345-5701	(866)-225-2273	(800)-735-2900		(503)-345-5702	(866)-798-2273	(800)-735-2900		(503)-345-5701	(866)-225-2273	(800)-735-2900		http://www.familycareinc.org	www.familycareinc.org
H3818	004	0	1	01	01	H3818_004_0	2	2009.01	FAMILYCARE HEALTH PLANS, INC.	FamilyCare Health Plans, Inc.	www.familycareinc.org	01	01		1		H3818	004	0	2009	PremierCare Choice	Portland Metro Clatsop Morrow Umatilla Counties		2	2				2						(503)-345-5702	(866)-798-2273	(800)-735-2900		(503)-345-5701	(866)-225-2273	(800)-735-2900										http://www.familycareinc.org	www.familycareinc.org
H3864	001	0	1	01	01	H3864_001_0	3	2009.01	CLEAR CHOICE HEALTH PLANS, INC.	Clear Choice Health Plans	www.clearchoicehp.com	01	01		1		H3864	001	0	2009	Clear Choice Traditional Plan	Central, Eastern Oregon and Mid-Columbia Gorge		2	2			1983	2						(541)-385-5315	(888)-863-3637	(800)-735-2900		(541)-385-5315	(888)-863-3637	(800)-735-2900										www.clearchoicehp.com/MedicareRxList	http://www.clearchoicehp.com
H3864	002	0	1	01	01	H3864_002_0	3	2009.01	CLEAR CHOICE HEALTH PLANS, INC.	Clear Choice Health Plans	www.clearchoicehp.com	01	01		1		H3864	002	0	2009	Clear Choice Value Plan	Central, Eastern Oregon and Mid-Columbia Gorge		2	2			703	2						(541)-385-5315	(888)-863-3637	(800)-735-2900		(541)-385-5315	(888)-863-3637	(800)-735-2900										www.clearchoicehp.com/MedicareRxList	http://www.clearchoicehp.com
H3864	006	0	1	01	01	H3864_006_0	6	2009.01	CLEAR CHOICE HEALTH PLANS, INC.	Clear Choice Health Plans	www.clearchoicehp.com	01	01		1		H3864	006	0	2009	Clear Choice Value Advantage	Central, Eastern Oregon and Mid-Columbia Gorge		2	2			3157	2						(541)-385-5315	(888)-863-3637	(800)-735-2900		(541)-385-5315	(888)-863-3637	(800)-735-2900		(800)-570-1673	(800)-570-1673		(800)-735-2900	(800)-570-1673	(800)-570-1673		(800)-735-2900	www.clearchoicehp.com/MedicareRxList	http://www.clearchoicehp.com
H3864	007	0	1	02	01	H3864_007_0	7	2009.01	CLEAR CHOICE HEALTH PLANS, INC.	Clear Choice Health Plans	www.clearchoicehp.com	01	02		1		H3864	007	0	2009	Clear Choice Traditional Advantage	Central, Eastern Oregon and Mid-Columbia Gorge		2	2			4550	2						(541)-385-5315	(888)-863-3637	(800)-735-2900		(541)-385-5315	(888)-863-3637	(800)-735-2900		(800)-570-1673	(800)-570-1673		(800)-735-2900	(800)-570-1673	(800)-570-1673		(800)-735-2900	www.clearchoicehp.com/MedicareRxList	http://www.clearchoicehp.com
H3864	801	0	1	01	01	H3864_801_0	3	2009.01	CLEAR CHOICE HEALTH PLANS, INC.	Clear Choice Health Plans	www.clearchoicehp.com	01	01		1		H3864	801	0	2009	Clear Choice  PERS Traditional	Central, Eastern Oregon and Mid-Columbia Gorge		1	2			1284	2						(541)-385-5315	(888)-863-3637	(800)-735-2900		(541)-385-5315	(888)-863-3637	(800)-735-2900										www.clearchoicehp.com/MedicareRxList	http://www.clearchoicehp.com
H3887	001	0	1	02	01	H3887_001_0	7	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	02		1		H3887	001	0	2009	Evercare Plan IH-POS	Cook, Du Page, Kane and Lake Counties		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H3887	002	0	1	02	01	H3887_002_0	6	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	02		1		H3887	002	0	2009	Evercare Plan DH-POS	Cook, Du Page, Kane and Lake Counties		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H3887	003	0	1	02	01	H3887_003_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	02		1		H3887	003	0	2009	AARP MedicareComplete Plus Plan1	Cook, Kane and Will Counties		2	2				2						(800)-711-6088	(800)-711-6088	(888)-865-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		(800)-711-6088	(800)-711-6088	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H3887	004	0	1	02	01	H3887_004_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	02		1		H3887	004	0	2009	AARP MedicareComplete Plus Plan2	Cook, Kane and Will Counties		2	2				2						(800)-711-6088	(800)-711-6088	(888)-865-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074										https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H3887	005	0	1	02	01	H3887_005_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	02		1		H3887	005	0	2009	Evercare Plan MH-POS	Cook, Du Page, Kane and Lake Counties		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H3887	801	0	1	02	01	H3887_801_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	02		1		H3887	801	0	2009	MedicareComplete Plus Plan 1 Retiree Plan	IL Employer Sponsored Plan Service Area		1	2				2						(888)-867-5580	(888)-867-5580	(888)-865-8480		(888)-867-5580	(888)-867-5580	(888)-685-8480		(888)-867-5580	(888)-867-5580	(888)-685-8480		(888)-867-5580	(888)-867-5580	(888)-685-8480		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H3887	802	0	1	02	01	H3887_802_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	02		1		H3887	802	0	2009	MedicareComplete Plus Plan 2 Retiree Plan	IL Employer Sponsored Plan Service Area		1	2				2						(888)-867-5580		(888)-685-8480		(888)-867-5580	(888)-867-5580	(888)-865-8480										https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H3887	803	0	1	02	01	H3887_803_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	02		1		H3887	803	0	2009	MedicareComplete Retiree Plan	IL Employer Sponsored Plan Service Area		1	2				2						(888)-867-5580	(888)-867-5580	(888)-865-8480		(888)-867-5580	(888)-867-5580	(888)-685-8480		(888)-867-5580	(888)-867-5580	(888)-685-8480		(888)-867-5580	(888)-867-5580	(888)-685-8480		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H3887	804	0	1	02	01	H3887_804_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	02		1		H3887	804	0	2009	MedicareComplete Retiree Plan	IL Employer Sponsored Plan Service Area		1	2				2						(888)-867-5580		(888)-685-8480		(888)-867-5580	(888)-867-5580	(888)-865-8480										https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H3907	002	0	1	01	01	H3907_002_0	2	2009.01	UNIVERSITY OF PITTSBURGH MEDICAL CENTER	UPMC Health Plan	www.upmchealthplan.com	01	01		1		H3907	002	0	2009	UPMC for Life HMO	Western Pennsylvania		2	2			12000	2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629									http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H3907	006	0	1	01	01	H3907_006_0	4	2009.01	UNIVERSITY OF PITTSBURGH MEDICAL CENTER	UPMC Health Plan	www.upmchealthplan.com	01	01		1		H3907	006	0	2009	UPMC for Life HMO Rx Enhanced	Western Pennsylvania		2	2			13000	2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H3907	020	0	1	01	01	H3907_020_0	5	2009.01	UNIVERSITY OF PITTSBURGH MEDICAL CENTER	UPMC Health Plan	www.upmchealthplan.com	01	01		1		H3907	020	0	2009	UPMC for Life Specialty Plan	Western Pennsylvania		2	1	3		16000	2			1	3		(800)-606-8648	(800)-606-8648	(866)-407-8762	(866)-407-8762	(866)-405-8762	(866)-405-8762	(866)-407-8762	(866)-407-8762	(800)-606-8648	(800)-606-8648	(866)-407-8762	(866)-407-8762	(866)-405-8762	(866)-405-8762	(866)-407-8762	(866)-407-8762	http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H3907	029	0	1	01	01	H3907_029_0	5	2009.01	UNIVERSITY OF PITTSBURGH MEDICAL CENTER	UPMC Health Plan	www.upmchealthplan.com	01	01		1		H3907	029	0	2009	UPMC for Life HMO Rx	Western Pennsylvania		2	2			15000	2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H3907	801	0	1	01	01	H3907_801_0	2	2009.01	UNIVERSITY OF PITTSBURGH MEDICAL CENTER	UPMC Health Plan	www.upmchealthplan.com	01	01		1		H3907	801	0	2009	UPMC Employer Group	Western Pennsylvania		1	2				2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629									http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H3907	802	0	1	01	01	H3907_802_0	2	2009.01	UNIVERSITY OF PITTSBURGH MEDICAL CENTER	UPMC Health Plan	www.upmchealthplan.com	01	01		1		H3907	802	0	2009	UPMC Employer Group - D (CY)	Western Pennsylvania		1	2				2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H3907	803	0	1	01	01	H3907_803_0	2	2009.01	UNIVERSITY OF PITTSBURGH MEDICAL CENTER	UPMC Health Plan	www.upmchealthplan.com	01	01		1		H3907	803	0	2009	UPMC Employer Group - D (FY)	Western Pennsylvania		1	2				2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H3908	001	0	1	20	08	H3908_001_0	1	2009.01	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA	Trustees Of The University Of Pennsylvania	www.LIFEUPenn.org	08	20		1		H3908	001	0	2009	Trustees of the University of Pennsylvania	Philadelphia, PA		2	2				2														(215)-573-7200	(215)-573-7200			(215)-573-7200	(215)-573-7200			www.LIFEUPENN.org	
H3908	002	0	1	20	08	H3908_002_0	1	2009.01	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA	Trustees Of The University Of Pennsylvania	www.LIFEUPenn.org	08	20		1		H3908	002	0	2009	Trustees of the University of Pennsylvania	Philadelphia, PA		2	2				2														(215)-573-7200	(215)-573-7200			(215)-573-7200	(215)-573-7200			www.LIFEUPENN.org	
H3909	001	0	1	04	01	H3909_001_0	8	2009.01	INDEPENDENCE BLUE CROSS	Personal Choice 65	www.site65.com	01	04		1		H3909	001	0	2009	Personal Choice 65 Standard Rx	Phila, Bucks, Chester, Delaware and Montgomery Cty		2	2				2						(888)-718-3333	(888)-718-3333	(888)-857-4816		(877)-393-6733	(877)-393-6733	(877)-219-5457		(888)-718-3333	(888)-718-3333	(888)-857-4816		(877)-393-6733	(877)-393-6733	(877)-219-5457		http://www.site65.com/drug_formulary/formulary/all_plans.html	www.site65.com
H3909	007	0	1	04	01	H3909_007_0	6	2009.01	INDEPENDENCE BLUE CROSS	Personal Choice 65	www.site65.com	01	04		1		H3909	007	0	2009	Personal Choice 65 Standard Medical Only	Counties:Bucks,Chester,Delaware,Montgomery,Phila		2	2				2						(888)-718-3333	(888)-718-3333	(888)-857-4816		(877)-393-6733	(877)-393-6733	(877)-219-5457										http://www.site65.com/drug_formulary/formulary/all_plans.html	www.site65.com
H3909	801	0	1	04	01	H3909_801_0	7	2009.01	INDEPENDENCE BLUE CROSS	Personal Choice 65	www.site65.com	01	04		1		H3909	801	0	2009	Personal Choice 65 Group Medical Only	County: Bucks, Chester, Delaware, Montgomery,Phila		1	2				2						(888)-718-3333	(888)-718-3333	(888)-857-4816		(877)-393-6733	(877)-393-6733	(877)-219-5457										http://www.site65.com/drug_formulary/formulary/all_plans.html	www.site65.com
H3909	802	0	1	04	01	H3909_802_0	6	2009.01	INDEPENDENCE BLUE CROSS	Personal Choice 65	www.site65.com	01	04		1		H3909	802	0	2009	Personal Choice 65 Group Rx	County: Bucks, Chester, Delaware, Montgomery,Phila		1	2				2						(888)-718-3333	(888)-718-3333	(888)-857-4816		(877)-393-6733	(877)-393-6733	(877)-219-5457		(888)-718-3333	(888)-718-3333	(888)-857-4816		(877)-393-6733	(877)-393-6733	(877)-219-5457		http://www.site65.com/drug_formulary/formulary/all_plans.html	www.site65.com
H3912	001	0	1	04	01	H3912_001_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H3912	001	0	2009	Evercare Plan IP	Philadelphia,Harrisburg,York and Surrounding Areas		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H3912	005	0	1	04	01	H3912_005_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H3912	005	0	2009	Evercare Plan DP	Lancaster and York Counties		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H3912	006	0	1	04	01	H3912_006_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H3912	006	0	2009	Evercare Plan DP	Bucks, Chester and Philadelphia Counties		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H3912	007	0	1	04	01	H3912_007_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H3912	007	0	2009	Evercare Plan DP	Lehigh and Northampton		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H3912	008	0	1	04	01	H3912_008_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H3912	008	0	2009	Evercare Plan MP	Lancaster and York Counties		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H3912	009	0	1	04	01	H3912_009_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H3912	009	0	2009	Evercare Plan MP	Bucks, Chester and Philadelphia Counties		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H3912	011	0	1	04	01	H3912_011_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H3912	011	0	2009	Evercare Plan MP	Lehigh and Northampton Counties		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H3916	001	0	1	04	01	H3916_001_0	7	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	01	04		1		H3916	001	0	2009	FreedomBlue PPO Classic	Southwestern PA		2	2				2						(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmark.com
H3916	002	0	1	04	01	H3916_002_0	7	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	01	04		1		H3916	002	0	2009	FreedomBlue PPO Classic	West Central PA		2	2				2						(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmark.com
H3916	003	0	1	04	01	H3916_003_0	7	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	01	04		1		H3916	003	0	2009	FreedomBlue PPO Classic	Crawford, Erie, and Mercer Counties PA		2	2				2						(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmark.com
H3916	005	0	1	04	01	H3916_005_0	7	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	01	04		1		H3916	005	0	2009	FreedomBlue PPO Deluxe	Central and Northeastern PA		2	2				2						(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-511-0589	(800)-511-0589	(800)-227-8210	(800)-227-8210	(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-511-0589	(800)-511-0589	(800)-227-8210	(800)-227-8210	http://highmark.medicare-approvedformularies.com/	www.highmark.com
H3916	012	0	1	04	01	H3916_012_0	5	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	01	04		1		H3916	012	0	2009	FreedomBlue PPO Value	Central and Northeastern PA		2	2				2						(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-511-0589	(800)-511-0589	(800)-227-8210	(800)-227-8210									http://highmark.medicare-approvedformularies.com/	www.highmark.com
H3916	015	0	1	04	01	H3916_015_0	7	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	01	04		1		H3916	015	0	2009	FreedomBlue PPO Standard	Central and Northeastern PA		2	2				2						(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-511-0589	(800)-511-0589	(800)-227-8210	(800)-227-8210	(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-511-0589	(800)-511-0589	(800)-227-8210	(800)-227-8210	http://highmark.medicare-approvedformularies.com/	www.highmark.com
H3916	018	0	1	04	01	H3916_018_0	7	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	01	04		1		H3916	018	0	2009	FreedomBlue PPO Basic Rx	Central and Northeastern PA		2	2				2						(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-511-0589	(800)-511-0589	(800)-227-8210	(800)-227-8210	(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-511-0589	(800)-511-0589	(800)-227-8210	(800)-227-8210	http://highmark.medicare-approvedformularies.com/	www.highmark.com
H3916	019	0	1	04	01	H3916_019_0	7	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	01	04		1		H3916	019	0	2009	FreedomBlue PPO HD Rx	Southwestern PA		2	2				2						(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmark.com
H3916	020	0	1	04	01	H3916_020_0	7	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	01	04		1		H3916	020	0	2009	FreedomBlue PPO HD Rx	West Central PA		2	2				2						(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmark.com
H3916	021	0	1	04	01	H3916_021_0	7	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	01	04		1		H3916	021	0	2009	FreedomBlue PPO HD Rx	Crawford, Erie and Mercer Counties PA		2	2				2						(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmark.com
H3916	022	0	1	04	01	H3916_022_0	7	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	01	04		1		H3916	022	0	2009	FreedomBlue PPO Select	Southwestern PA		2	2				2						(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmark.com
H3916	023	0	1	04	01	H3916_023_0	7	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	01	04		1		H3916	023	0	2009	FreedomBlue PPO Select	Erie, Crawford and Mercer counties		2	2				2						(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmark.com
H3916	024	0	1	04	01	H3916_024_0	7	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	01	04		1		H3916	024	0	2009	FreedomBlue PPO Select	West Central PA		2	2				2						(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmark.com
H3916	025	0	1	04	01	H3916_025_0	7	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	01	04		1		H3916	025	0	2009	FreedomBlue PPO HD Rx	East Central PA counties		2	2				2						(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-511-0589	(800)-511-0589	(800)-227-8210	(800)-227-8210	(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-511-0589	(800)-511-0589	(800)-227-8210	(800)-227-8210	http://highmark.medicare-approvedformularies.com/	www.highmark.com
H3916	026	0	1	04	01	H3916_026_0	7	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	01	04		1		H3916	026	0	2009	FreedomBlue PPO Platinum	Southwestern Pennsylvania counties		2	2				2						(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmark.com
H3916	027	0	1	04	01	H3916_027_0	7	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	01	04		1		H3916	027	0	2009	FreedomBlue PPO Platinum	West Central PA		2	2				2						(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmark.com
H3916	028	0	1	04	01	H3916_028_0	7	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	01	04		1		H3916	028	0	2009	FreedomBlue PPO Platinum	Crawford, Erie, Mercer		2	2				2						(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmark.com
H3916	801	0	1	04	01	H3916_801_0	5	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	01	04		1		H3916	801	0	2009	FreedomBlue PPO MA Pennsylvania	Pennsylvania		1	2				2						(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709									http://highmark.medicare-approvedformularies.com/	www.highmark.com
H3916	802	0	1	04	01	H3916_802_0	5	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	01	04		1		H3916	802	0	2009	FreedomBlue PPO MA-PD Pennsylvania	Pennsylvania		1	2				2						(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmark.com
H3916	804	0	1	04	01	H3916_804_0	5	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	01	04		1		H3916	804	0	2009	FreedomBlue PPO MA-PD PA Non-Calendar	Pennsylvania		1	2				2						(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	(800)-550-8722	(800)-550-8722	(800)-988-0668	(800)-988-0668	(800)-350-1973	(800)-350-1973	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmark.com
H3917	001	0	1	20	08	H3917_001_0	1	2009.01	PITTSBURGH CARE PARTNERSHIP, INC.	Community LIFE	www.commlife.org	08	20		1		H3917	001	0	2009	Pittsburgh Care Partnership, Inc.	Pittsburgh Metro Area		2	2				2														(412)-675-3100	(412)-675-3100			(412)-436-1320	(866)-419-1693			www.commlife.org	
H3917	002	0	1	20	08	H3917_002_0	1	2009.01	PITTSBURGH CARE PARTNERSHIP, INC.	Community LIFE	www.commlife.org	08	20		1		H3917	002	0	2009	Pittsburgh Care Partnership, Inc.	Pittsburgh Metro Area		2	2				2														(412)-675-3100	(412)-675-3100			(412)-436-1320	(866)-419-1693			www.commlife.org	
H3918	001	0	1	20	08	H3918_001_0	2	2009.01	LIVING INDEPENDENCE FOR THE ELDERLY	LIFE Pittsburgh	LIFEPittsburgh.org	08	20		1		H3918	001	0	2009	LIFE Pittsburgh Dual Eligibles Pharmacy	Partial Allegheny*		2	2			300	2														(412)-388-8042	(412)-388-8042			(412)-388-8042	(412)-388-8042			not applicable -- no formulary	
H3918	002	0	1	20	08	H3918_002_0	1	2009.01	LIVING INDEPENDENCE FOR THE ELDERLY	LIFE Pittsburgh	LIFEPittsburgh.org	08	20		1		H3918	002	0	2009	LIFE Pittsburgh Medicare Only Pharmacy	Allegheny *		2	2			5	2														(412)-388-8042	(412)-388-8042			(412)-388-8042	(412)-388-8042			not applicable -- no formulary	
H3919	001	0	1	20	08	H3919_001_0	1	2009.01	ST AGNES MEDICAL CENTER	Mercy LIFE	www.mercyhealth.org/life	08	20		1		H3919	001	0	2009	Mercy LIFE	Philadelphia		2	2				2														(215)-339-4747	(800)-820-4512			(215)-339-4747	(800)-820-4512			www.stagnesphila.org	
H3919	002	0	1	20	08	H3919_002_0	1	2009.01	ST AGNES MEDICAL CENTER	Mercy LIFE	www.mercyhealth.org/life	08	20		1		H3919	002	0	2009	Mercy LIFE	Philadelphia		2	2				2														(215)-339-4747	(800)-820-4512			(215)-339-4747	(800)-820-4512			www.stagnesphila.org	
H3920	001	0	1	01	01	H3920_001_0	10	2009.01	UNISON HEALTH PLAN OF PENNSYLVANIA, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H3920	001	0	2009	Unison Advantage Choice	Select counties in Pennsylvania		2	2				2						(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	http://www.unisonhealthplan.com	www.unisonhealthplan.com
H3920	002	0	1	01	01	H3920_002_0	8	2009.01	UNISON HEALTH PLAN OF PENNSYLVANIA, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H3920	002	0	2009	Unison Advantage Preferred	Select counties in Pennsylvania		2	2				2						(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	http://www.unisonhealthplan.com	www.unisonhealthplan.com
H3920	003	0	1	01	01	H3920_003_0	8	2009.01	UNISON HEALTH PLAN OF PENNSYLVANIA, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H3920	003	0	2009	Unison Advantage Plus	Select counties in Pennsylvania		2	1	3			2			1	2		(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	http://www.unisonhealthplan.com	www.unisonhealthplan.com
H3920	007	0	1	01	01	H3920_007_0	8	2009.01	UNISON HEALTH PLAN OF PENNSYLVANIA, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H3920	007	0	2009	Unison Advantage Basic	Select counties in Pennsylvania		2	2				2						(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021									http://www.unisonhealthplan.com	www.unisonhealthplan.com
H3920	801	0	1	01	01	H3920_801_0	2	2009.01	UNISON HEALTH PLAN OF PENNSYLVANIA, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H3920	801	0	2009	Unison Advantage Basic Group	Select counties in Pennsylvania		1	2				2						(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021									http://www.unisonhealthplan.com	www.unisonhealthplan.com
H3920	802	0	1	01	01	H3920_802_0	2	2009.01	UNISON HEALTH PLAN OF PENNSYLVANIA, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H3920	802	0	2009	Unison Advantage Choice Group	Select counties in Pennsylvania		1	2				2						(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	http://www.unisonhealthplan.com	www.unisonhealthplan.com
H3921	001	0	1	04	01	H3921_001_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	04		1		H3921	001	0	2009	SecureHorizons MedicareComplete Choice	York		2	2				2						(800)-711-6088	(800)-711-6088	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		(800)-711-6088	(800)-711-6088	(888)-685-8480		(800)-555-5757	(800)-387-1074	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H3921	003	0	1	04	01	H3921_003_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	04		1		H3921	003	0	2009	SecureHorizons MedicareComplete Choice	Lancaster		2	2				2						(800)-711-6088	(800)-711-6088	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		(800)-711-6088	(800)-711-6088	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H3921	008	0	1	04	01	H3921_008_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	04		1		H3921	008	0	2009	AARP MedicareComplete Choice	Erie, Lehigh, Northampton		2	2				2						(800)-711-6088	(800)-711-6088	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		(800)-711-6088	(800)-711-6088	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H3921	801	0	1	04	01	H3921_801_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	04		1		H3921	801	0	2009	MedicareComplete Choice Retiree Plan	PA Employer Sponsored Plan Service Area		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H3921	803	0	1	04	01	H3921_803_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	04		1		H3921	803	0	2009	MedicareComplete Choice Retiree Plan	PA Employer Sponsored Plan Service Area		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480										https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H3921	804	0	1	04	01	H3921_804_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	04		1		H3921	804	0	2009	Medicare Complete Retiree Plan	PA Employer Sponsored Plan Service Area		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H3921	805	0	1	04	01	H3921_805_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	04		1		H3921	805	0	2009	Medicare Complete Retiree Plan	PA Employer Sponsored Plan Service Area		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480										https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H3923	009	0	1	04	01	H3923_009_0	8	2009.01	CAPITAL ADVANTAGE INSURANCE COMPANY	Capital Advantage Insurance Company	seniorblueppo.capbluecross.com	01	04		1		H3923	009	0	2009	SeniorBlue PPO - Option 4	21 Counties in Central PA		2	2			58	2						(866)-987-4213	(866)-987-4213	(800)-779-6961	(800)-779-6961	(800)-990-4201	(800)-990-4201	(800)-779-6961	(800)-779-6961									https://seniorblueppo.capbluecross.com/PharmacyInformation/	
H3923	013	0	1	04	01	H3923_013_0	9	2009.01	CAPITAL ADVANTAGE INSURANCE COMPANY	Capital Advantage Insurance Company	seniorblueppo.capbluecross.com	01	04		1		H3923	013	0	2009	SeniorBlue PPO - Option 2	21 Counties in Central PA		2	2			1617	2						(866)-987-4213	(866)-987-4213	(800)-779-6961	(800)-779-6961	(800)-990-4201	(800)-990-4201	(800)-779-6961	(800)-779-6961	(866)-987-4213	(866)-987-4213	(800)-779-6961	(800)-779-6961	(800)-990-4201	(800)-990-4201	(800)-779-6961	(800)-779-6961	https://seniorblueppo.capbluecross.com/PharmacyInformation/	
H3923	017	0	1	04	01	H3923_017_0	8	2009.01	CAPITAL ADVANTAGE INSURANCE COMPANY	Capital Advantage Insurance Company	seniorblueppo.capbluecross.com	01	04		1		H3923	017	0	2009	SeniorBlue PPO - Option 1	21 Counties in Central PA		2	2			3824	2						(866)-987-4213	(866)-987-4213	(800)-779-6961	(800)-779-6961	(800)-990-4201	(800)-990-4201	(800)-779-6961	(800)-779-6961	(866)-987-4213	(866)-987-4213	(800)-779-6961	(800)-779-6961	(800)-990-4201	(800)-990-4201	(800)-779-6961	(800)-779-6961	https://seniorblueppo.capbluecross.com/PharmacyInformation/	
H3923	021	0	1	04	01	H3923_021_0	9	2009.01	CAPITAL ADVANTAGE INSURANCE COMPANY	Capital Advantage Insurance Company	seniorblueppo.capbluecross.com	01	04		1		H3923	021	0	2009	SeniorBlue PPO - Option 3	21 Counties in Central PA		2	2			601	2						(866)-987-4213	(866)-987-4213	(800)-779-6961	(800)-779-6961	(800)-990-4201	(800)-990-4201	(800)-779-6961	(800)-779-6961	(866)-987-4213	(866)-987-4213	(800)-779-6961	(800)-779-6961	(800)-990-4201	(800)-990-4201	(800)-779-6961	(800)-779-6961	https://seniorblueppo.capbluecross.com/PharmacyInformation/	
H3923	801	0	1	04	01	H3923_801_0	11	2009.01	CAPITAL ADVANTAGE INSURANCE COMPANY	Capital Advantage Insurance Company	seniorblueppo.capbluecross.com	01	04		1		H3923	801	0	2009	MA PPO - ER with Rx	National		1	2			2297	2						(866)-987-4213	(866)-987-4213	(800)-779-6961	(800)-779-6961	(800)-990-4201	(800)-990-4201	(800)-779-6961	(800)-779-6961	(866)-987-4213	(866)-987-4213	(800)-779-6961	(800)-779-6961	(800)-990-4201	(800)-990-4201	(800)-779-6961	(800)-779-6961	https://seniorblueppo.capbluecross.com/PharmacyInformation/	
H3923	802	0	1	04	01	H3923_802_0	10	2009.01	CAPITAL ADVANTAGE INSURANCE COMPANY	Capital Advantage Insurance Company	seniorblueppo.capbluecross.com	01	04		1		H3923	802	0	2009	MA PPO - ER w/o Rx	National		1	2			87	2						(866)-987-4213	(866)-987-4213	(800)-779-6961	(800)-779-6961	(800)-990-4201	(800)-990-4201	(800)-779-6961	(800)-779-6961									https://seniorblueppo.capbluecross.com/PharmacyInformation/	
H3923	803	0	1	04	01	H3923_803_0	10	2009.01	CAPITAL ADVANTAGE INSURANCE COMPANY	Capital Advantage Insurance Company	seniorblueppo.capbluecross.com	01	04		1		H3923	803	0	2009	MA PPO - ER Non-Calendar w Rx	National		1	2			50	2						(866)-987-4213	(866)-987-4213	(800)-779-6961	(800)-779-6961	(800)-990-4201	(800)-990-4201	(800)-779-6961	(800)-779-6961	(866)-987-4213	(866)-987-4213	(800)-779-6961	(800)-779-6961	(800)-990-4201	(800)-990-4201	(800)-779-6961	(800)-779-6961	https://seniorblueppo.capbluecross.com/PharmacyInformation/	
H3924	001	0	1	04	01	H3924_001_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	001	0	2009	Geisinger Gold Preferred	Counties: Cli, Col, Lyc, Mont, Pot, Sch, Sny, Uni		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	002	0	1	04	01	H3924_002_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	002	0	2009	Geisinger Gold Preferred Standard Rx	Counties: Cli, Col, Lyc, Mon, Pot, Sch, Sny, Uni		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	003	0	1	04	01	H3924_003_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	003	0	2009	Geisinger Gold Preferred $0 Deductible Rx	Counties: Cli, Col, Lyc, Mon, Pot, Sch, Sny, Uni		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	005	0	1	04	01	H3924_005_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	005	0	2009	Geisinger Gold Preferred	Wyoming County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	006	0	1	04	01	H3924_006_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	006	0	2009	Geisinger Gold Preferred Standard Rx	Wyoming County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	007	0	1	04	01	H3924_007_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	007	0	2009	Geisinger Gold Preferred $0 Deductible Rx	Wyoming County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	009	0	1	04	01	H3924_009_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	009	0	2009	Geisinger Gold Preferred	Lackawanna County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	010	0	1	04	01	H3924_010_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	010	0	2009	Geisinger Gold Preferred Standard Rx	Lackawanna County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	011	0	1	04	01	H3924_011_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	011	0	2009	Geisinger Gold Preferred $0 Deductible Rx	Lackawanna County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	013	0	1	04	01	H3924_013_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	013	0	2009	Geisinger Gold Preferred	Luzerne County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	014	0	1	04	01	H3924_014_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	014	0	2009	Geisinger Gold Preferred Standard Rx	Luzerne County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	015	0	1	04	01	H3924_015_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	015	0	2009	Geisinger Gold Preferred $0 Deductible Rx	Luzerne County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	017	0	1	04	01	H3924_017_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	017	0	2009	Geisinger Gold Preferred	Centre, Clearfield, Jefferson and Mifflin Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	018	0	1	04	01	H3924_018_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	018	0	2009	Geisinger Gold Preferred Standard Rx	Centre, Clearfield, Jefferson and Mifflin Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	019	0	1	04	01	H3924_019_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	019	0	2009	Geisinger Gold Preferred $0 Deductible Rx	Centre, Clearfield, Jefferson and Mifflin Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	021	0	1	04	01	H3924_021_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	021	0	2009	Geisinger Gold Preferred	Counties: Adams, Dauphin, Lancaster, Lebanon, York		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	022	0	1	04	01	H3924_022_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	022	0	2009	Geisinger Gold Preferred Standard Rx	Counties: Adams, Dauphin, Lancaster, Lebanon, York		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	023	0	1	04	01	H3924_023_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	023	0	2009	Geisinger Gold Preferred $0 Deductible Rx	Counties: Adams, Dauphin, Lancaster, Lebanon, York		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	025	0	1	04	01	H3924_025_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	025	0	2009	Geisinger Gold Preferred	Counties: Blair, Cambria, Huntingdon, Juniata		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	026	0	1	04	01	H3924_026_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	026	0	2009	Geisinger Gold Preferred Standard Rx	Counties: Blair, Cambria, Huntingdon, Juniata		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	027	0	1	04	01	H3924_027_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	027	0	2009	Geisinger Gold Preferred $0 Deductible Rx	Counties: Blair, Cambria, Huntingdon, Juniata		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	029	0	1	04	01	H3924_029_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	029	0	2009	Geisinger Gold Preferred	Carbon, Monroe, Pike and Wayne Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	030	0	1	04	01	H3924_030_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	030	0	2009	Geisinger Gold Preferred Standard Rx	Carbon, Monroe, Pike and Wayne Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	031	0	1	04	01	H3924_031_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	031	0	2009	Geisinger Gold Preferred $0 Deductible Rx	Carbon, Monroe, Pike and Wayne Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	033	0	1	04	01	H3924_033_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	033	0	2009	Geisinger Gold Preferred	Northumberland County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833									https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	034	0	1	04	01	H3924_034_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	034	0	2009	Geisinger Gold Preferred Standard Rx	Northumberland County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	035	0	1	04	01	H3924_035_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	035	0	2009	Geisinger Gold Preferred $0 Deductible Rx	Northumberland County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	036	0	1	04	01	H3924_036_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	036	0	2009	Geisinger Gold Preferred	Cumberland and Perry Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833									https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	037	0	1	04	01	H3924_037_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	037	0	2009	Geisinger Gold Preferred Standard Rx	Cumberland and Perry Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	038	0	1	04	01	H3924_038_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	038	0	2009	Geisinger Gold Preferred $0 Deductible Rx	Cumberland and Perry Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	039	0	1	04	01	H3924_039_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	039	0	2009	Geisinger Gold Preferred	Berks, Lehigh and Northampton Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833									https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	040	0	1	04	01	H3924_040_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	040	0	2009	Geisinger Gold Preferred Standard Rx	Berks, Lehigh and Northampton Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	041	0	1	04	01	H3924_041_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	041	0	2009	Geisinger Gold Preferred $0 Deductible Rx	Berks, Lehigh and Northampton Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	042	0	1	04	01	H3924_042_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	042	0	2009	Geisinger Gold Preferred	Sullivan and Susquehanna Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833									https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	043	0	1	04	01	H3924_043_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	043	0	2009	Geisinger Gold Preferred Standard Rx	Sullivan and Susquehanna Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	044	0	1	04	01	H3924_044_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	044	0	2009	Geisinger Gold Preferred $0 Deductible Rx	Sullivan and Susquehanna Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	801	0	1	04	01	H3924_801_0	2	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	801	0	2009	Geisinger Gold Preferred (Employer Group)	Pennsylvania		1	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833									https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3924	802	0	1	04	01	H3924_802_0	2	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	01	04		1		H3924	802	0	2009	Geisinger Gold Preferred Rx (Employer Group)	Pennsylvania		1	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	www.geisingergold.com
H3925	001	0	1	20	08	H3925_001_0	1	2009.01	PENNSYLVANIA PACE, INC.	Senior LIFE Johnstown	www.seniorlifejohnstown.com	08	20		1		H3925	001	0	2009	PA PACE 001	Cambria Somerset PACE Senior LIFE JTown		2	2			170	2														(412)-963-0700	(800)-523-5076			(412)-963-0700	(800)-523-5076			NA	
H3925	002	0	1	20	08	H3925_002_0	1	2009.01	PENNSYLVANIA PACE, INC.	Senior LIFE Johnstown	www.seniorlifejohnstown.com	08	20		1		H3925	002	0	2009	PA PACE 002	Cambria Somerset PACE Senior LIFE JTown		2	2			2	2														(412)-963-0700	(800)-523-5076			(412)-963-0700	(800)-523-5076			NA	
H3931	004	0	1	01	01	H3931_004_0	6	2009.01	AETNA HEALTH INC	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3931	004	0	2009	Aetna Golden Medicare Premier Plan	Bucks, Chester, Delaware and Montgomery Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3931	054	0	1	01	01	H3931_054_0	4	2009.01	AETNA HEALTH INC	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3931	054	0	2009	Aetna Golden Medicare Value Plan	Philadelphia County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3931	055	0	1	01	01	H3931_055_0	4	2009.01	AETNA HEALTH INC	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3931	055	0	2009	Aetna Golden Medicare Value Plan	Bucks, Chester, Delaware and Montgomery Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3931	058	0	1	01	01	H3931_058_0	5	2009.01	AETNA HEALTH INC	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3931	058	0	2009	Aetna Golden Medicare Premier Plan	Philadelphia County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3931	064	0	1	01	01	H3931_064_0	7	2009.01	AETNA HEALTH INC	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3931	064	0	2009	Aetna Golden Medicare Standard Plan	Bucks, Chester, Delaware and Montgomery Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3931	065	0	1	01	01	H3931_065_0	7	2009.01	AETNA HEALTH INC	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3931	065	0	2009	Aetna Golden Medicare Standard Plan	Philadelphia County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3931	069	0	1	01	01	H3931_069_0	7	2009.01	AETNA HEALTH INC	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3931	069	0	2009	Aetna Golden Medicare Dual Advantage Plan	SE, Central and NE PA		2	1	3			2			1	2		(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3931	070	0	1	01	01	H3931_070_0	6	2009.01	AETNA HEALTH INC	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3931	070	0	2009	Aetna Golden Medicare Standard Plan	Central and NE PA		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3931	071	0	1	01	01	H3931_071_0	5	2009.01	AETNA HEALTH INC	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3931	071	0	2009	Aetna Golden Medicare Premier Plus Plan	Central and NE PA		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3931	074	0	1	01	01	H3931_074_0	4	2009.01	AETNA HEALTH INC	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3931	074	0	2009	Aetna Golden Medicare Value Plan	Western PA		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3931	075	0	1	01	01	H3931_075_0	6	2009.01	AETNA HEALTH INC	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3931	075	0	2009	Aetna Golden Medicare Standard Plan	Western PA		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3931	076	0	1	01	01	H3931_076_0	5	2009.01	AETNA HEALTH INC	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3931	076	0	2009	Aetna Golden Medicare Premier Plus Plan	Western PA		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3931	077	0	1	01	01	H3931_077_0	5	2009.01	AETNA HEALTH INC	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3931	077	0	2009	Aetna Golden Medicare Premier Plan	Central and NE PA		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3931	078	0	1	01	01	H3931_078_0	5	2009.01	AETNA HEALTH INC	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3931	078	0	2009	Aetna Golden Medicare Premier Plan	Western PA		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3931	079	0	1	01	01	H3931_079_0	5	2009.01	AETNA HEALTH INC	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3931	079	0	2009	Aetna Golden Medicare Value Plan	Central and NE PA		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3931	801	0	1	01	01	H3931_801_0	3	2009.01	AETNA HEALTH INC	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3931	801	0	2009	Aetna Golden Medicare Plan	Pennsylvania		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3931	804	0	1	01	01	H3931_804_0	3	2009.01	AETNA HEALTH INC	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H3931	804	0	2009	Aetna Golden Medicare Plan w/Rx CY	Pennsylvania		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H3942	001	0	1	20	08	H3942_001_0	1	2009.01	ELDERHAUS INC.	Elderhaus PACE	http://www.elderhaus.com	08	20		1		H3942	001	0	2009	Elderhaus PACE	Elderhaus PACE		2	2				2														(910)-343-8209	(888)-343-8209			(910)-343-8209	(888)-343-8209			www.elderhaus.com	
H3942	002	0	1	20	08	H3942_002_0	1	2009.01	ELDERHAUS INC.	Elderhaus PACE	http://www.elderhaus.com	08	20		1		H3942	002	0	2009	Elderhaus PACE	Elderhaus PACE		2	2				2														(910)-343-8209	(888)-343-8209			(910)-343-8209	(888)-343-8209			www.elderhaus.com	
H3949	002	0	1	01	01	H3949_002_0	2	2009.01	BRAVO HEALTH PENNSYLVANIA INC.	Bravo Health	www.mybravohealth.com	01	01		1		H3949	002	0	2009	Bravo Classic	Philadelphia, Bucks, Delaware Montgomery Cntys		2	2				2						(800)-291-0396	(800)-291-0396	(800)-964-2561	(800)-964-2561	(866)-464-0703	(866)-464-0703	(800)-964-2561	(800)-964-2561	(800)-291-0396	(800)-291-0396	(800)-964-2561	(800)-964-2561	(866)-464-0703	(866)-464-0703	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H3949	009	0	1	01	01	H3949_009_0	2	2009.01	BRAVO HEALTH PENNSYLVANIA INC.	Bravo Health	www.mybravohealth.com	01	01		1		H3949	009	0	2009	Bravo Select	Allegheny, Philadelphia and surrounding Counties		2	1	3			2			1	2		(800)-291-0396	(800)-291-0396	(800)-964-2561	(800)-964-2561	(866)-464-0703	(866)-464-0703	(800)-964-2561	(800)-964-2561	(800)-291-0396	(800)-291-0396	(800)-964-2561	(800)-964-2561	(866)-464-0703	(866)-464-0703	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H3949	012	0	1	01	01	H3949_012_0	2	2009.01	BRAVO HEALTH PENNSYLVANIA INC.	Bravo Health	www.mybravohealth.com	01	01		1		H3949	012	0	2009	Bravo Classic	Pittsburgh and Surrounding Counties		2	2				2						(800)-291-0396	(800)-291-0396	(800)-964-2561	(800)-964-2561	(866)-464-0703	(866)-464-0703	(800)-964-2561	(800)-964-2561	(800)-291-0396	(800)-291-0396	(800)-964-2561	(800)-964-2561	(866)-464-0703	(866)-464-0703	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H3949	013	0	1	01	01	H3949_013_0	2	2009.01	BRAVO HEALTH PENNSYLVANIA INC.	Bravo Health	www.mybravohealth.com	01	01		1		H3949	013	0	2009	Bravo Premier	Philadelphia, Bucks, Delaware and Montgomery Cntys		2	2				2						(800)-291-0396	(800)-291-0396	(800)-964-2561	(800)-964-2561	(866)-464-0703	(866)-464-0703	(800)-964-2561	(800)-964-2561	(800)-291-0396	(800)-291-0396	(800)-964-2561	(800)-964-2561	(866)-464-0703	(866)-464-0703	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H3949	015	0	1	02	01	H3949_015_0	2	2009.01	BRAVO HEALTH PENNSYLVANIA INC.	Bravo Health	www.mybravohealth.com	01	02		1		H3949	015	0	2009	Bravo Premier Plus	Pittsburgh and Surrounding Counties		2	2				2						(800)-291-0396	(800)-291-0396	(800)-964-2561	(800)-964-2561	(866)-464-0703	(866)-464-0703	(800)-964-2561	(800)-964-2561	(800)-291-0396	(800)-291-0396	(800)-964-2561	(800)-964-2561	(866)-464-0703	(866)-464-0703	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H3949	016	0	1	01	01	H3949_016_0	2	2009.01	BRAVO HEALTH PENNSYLVANIA INC.	Bravo Health	www.mybravohealth.com	01	01		1		H3949	016	0	2009	Bravo Traditions	Philadelphia, Bucks, Delaware and Montgomery Cnty		2	1	1	1		2			1			(800)-291-0396	(800)-291-0396	(800)-964-2561	(800)-964-2561	(866)-464-0703	(866)-464-0703	(800)-964-2561	(800)-964-2561	(800)-291-0396	(800)-291-0396	(800)-964-2561	(800)-964-2561	(866)-464-0703	(866)-464-0703	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H3949	017	0	1	01	01	H3949_017_0	2	2009.01	BRAVO HEALTH PENNSYLVANIA INC.	Bravo Health	www.mybravohealth.com	01	01		1		H3949	017	0	2009	Bravo Healthy Heart	Philadelphia Metro Area		2	1	4			2			2		0000000000000000000000000001	(800)-291-0396	(800)-291-0396	(800)-964-2561	(800)-964-2561	(866)-464-0703	(866)-464-0703	(800)-964-2561	(800)-964-2561	(800)-291-0396	(800)-291-0396	(800)-964-2561	(800)-964-2561	(866)-464-0703	(866)-464-0703	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H3949	019	0	1	01	01	H3949_019_0	2	2009.01	BRAVO HEALTH PENNSYLVANIA INC.	Bravo Health	www.mybravohealth.com	01	01		1		H3949	019	0	2009	Bravo Gold	Pittsburgh and Surrounding Counties		2	2				2						(800)-291-0396	(800)-291-0396	(800)-964-2561	(800)-964-2561	(866)-464-0703	(866)-464-0703	(800)-964-2561	(800)-964-2561									www.mybravohealth.com/formulary	www.mybravohealth.com
H3949	020	0	1	01	01	H3949_020_0	2	2009.01	BRAVO HEALTH PENNSYLVANIA INC.	Bravo Health	www.mybravohealth.com	01	01		1		H3949	020	0	2009	Bravo Healthy Heart	Pittsburgh		2	1	4			2			2		0000000000000000000000000001	(800)-291-0396	(800)-291-0396	(800)-964-2561	(800)-964-2561	(866)-464-0703	(866)-464-0703	(800)-964-2561	(800)-964-2561	(800)-291-0396	(800)-291-0396	(800)-964-2561	(800)-964-2561	(866)-464-0703	(866)-464-0703	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H3949	021	0	1	01	01	H3949_021_0	2	2009.01	BRAVO HEALTH PENNSYLVANIA INC.	Bravo Health	www.mybravohealth.com	01	01		1		H3949	021	0	2009	Bravo Silver	Washington PA and Westmoreland PA		2	2				2						(800)-291-0396	(800)-291-0396	(800)-964-2561	(800)-964-2561	(866)-464-0703	(866)-464-0703	(800)-964-2561	(800)-964-2561	(800)-291-0396	(800)-291-0396	(800)-964-2561	(800)-964-2561	(866)-464-0703	(866)-464-0703	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H3949	801	0	1	01	01	H3949_801_0	4	2009.01	BRAVO HEALTH PENNSYLVANIA INC.	Bravo Health	www.mybravohealth.com	01	01		1		H3949	801	0	2009	Bravo Employer Group #1	Select Pennsylvania Counties		1	2				2						(800)-291-0396	(800)-291-0396	(800)-964-2561	(800)-964-2561	(866)-464-0703	(866)-464-0703	(800)-964-2561	(800)-964-2561	(800)-291-0396	(800)-291-0396	(800)-964-2561	(800)-964-2561	(866)-464-0703	(866)-464-0703	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H3949	802	0	1	01	01	H3949_802_0	4	2009.01	BRAVO HEALTH PENNSYLVANIA INC.	Bravo Health	www.mybravohealth.com	01	01		1		H3949	802	0	2009	Bravo Employer Group #2	Select Pennsylvania Counties		1	2				2						(800)-291-0396	(800)-291-0396	(800)-964-2561	(800)-964-2561	(866)-464-0703	(866)-464-0703	(800)-964-2561	(800)-964-2561	(800)-291-0396	(800)-291-0396	(800)-964-2561	(800)-964-2561	(866)-464-0703	(866)-464-0703	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H3952	008	0	1	01	01	H3952_008_0	6	2009.01	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65	www.site65.com	01	01		1		H3952	008	0	2009	Keystone 65 Preferred Medical Only	Bucks,Chester,Delaware,Montgomery,Phila  Counties		2	2				2						(800)-645-3965	(800)-645-3965	(888)-857-4816		(877)-393-6733	(877)-393-6733	(877)-219-5457	(877)-219-5457									http://www.site65.com/drug_formulary/formulary/all_plans.html	www.site65.com
H3952	018	0	1	01	01	H3952_018_0	5	2009.01	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65	www.site65.com	01	01		1		H3952	018	0	2009	Keystone 65 Complete	Bucks,Chester,Delaware,Montgomery and Phila Cty		2	1	3			2			1	1		(888)-457-3018	(888)-457-3018	(888)-857-4816		(877)-393-6733	(877)-393-6733	(877)-219-5457	(877)-219-5457	(888)-457-3018	(888)-457-3018	(888)-857-4816		(877)-393-6733	(877)-393-6733	(877)-219-5457	(877)-219-5457	http://www.site65.com/drug_formulary/formulary/all_plans.html	www.site65.com
H3952	020	0	1	01	01	H3952_020_0	6	2009.01	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65	www.site65.com	01	01		1		H3952	020	0	2009	Keystone 65 Preferred Rx	Bucks,Chester,Delaware,Montgomery,and Phila Cty		2	2				2						(800)-645-3965	(800)-645-3965	(888)-857-4816		(877)-393-6733	(877)-393-6733	(877)-219-5457	(877)-219-5457	(800)-645-3965	(800)-645-3965	(888)-857-4816		(877)-393-6733	(877)-393-6733	(877)-219-5457		http://www.site65.com/drug_formulary/formulary/all_plans.html	www.site65.com
H3952	026	0	1	01	01	H3952_026_0	7	2009.01	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65	www.site65.com	01	01		1		H3952	026	0	2009	Keystone 65 Value Medical Only	Bucks,Chester,Delaware, Montgomery,Phila Counties		2	2				2						(800)-645-3965	(800)-645-3965	(888)-857-4816		(877)-393-6733	(877)-393-6733	(877)-219-5457	(877)-219-5457									http://www.site65.com/drug_formulary/formulary/all_plans.html	www.site65.com
H3952	040	0	1	01	01	H3952_040_0	7	2009.01	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65	www.site65.com	01	01		1		H3952	040	0	2009	Keystone 65 Value Rx	Bucks,Chester,Delaware,Montgomery,and Phila Cty		2	2				2						(800)-645-3965	(800)-645-3965	(888)-857-4816		(877)-393-6733	(877)-393-6733	(877)-219-5457	(877)-219-5457	(800)-645-3965	(800)-645-3965	(888)-857-4816		(877)-393-6733	(877)-393-6733	(877)-219-5457		http://www.site65.com/drug_formulary/formulary/all_plans.html	www.site65.com
H3952	042	0	1	01	01	H3952_042_0	5	2009.01	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65	www.site65.com	01	01		1		H3952	042	0	2009	Keystone 65 Advantage Medical Only	Bucks,Chester,Delaware,Montgomery,Phila  Counties		2	2				2						(800)-645-3965	(800)-645-3965	(888)-857-4816		(877)-393-6733	(877)-393-6733	(877)-219-5457	(877)-219-5457									http://www.site65.com/drug_formulary/formulary/all_plans.html	www.site65.com
H3952	043	0	1	01	01	H3952_043_0	6	2009.01	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65	www.site65.com	01	01		1		H3952	043	0	2009	Keystone 65 Advantage Rx	Bucks,Chester,Delaware,Montgomery,Phila  Counties		2	2				2						(800)-645-3965	(800)-645-3965	(888)-857-4816		(877)-393-6733	(877)-393-6733	(877)-219-5457	(877)-219-5457	(800)-645-3965	(800)-645-3965	(888)-857-4816		(877)-393-6733	(877)-393-6733	(877)-219-5457		http://www.site65.com/drug_formulary/formulary/all_plans.html	www.site65.com
H3952	802	0	1	01	01	H3952_802_0	5	2009.01	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65	www.site65.com	01	01		1		H3952	802	0	2009	Keystone 65 Group Medical Only	Bucks,Chester,Delaware,Montgomery,Phila Cty		1	2				2						(800)-645-3965	(800)-645-3965	(888)-857-4816		(877)-393-6733	(877)-393-6733	(877)-219-5457	(877)-219-5457									http://www.site65.com/drug_formulary/formulary/all_plans.html	www.site65.com
H3952	804	0	1	01	01	H3952_804_0	5	2009.01	KEYSTONE HEALTH PLAN EAST, INC.	Keystone 65	www.site65.com	01	01		1		H3952	804	0	2009	Keystone 65 Group Rx	Bucks,Chester,Delaware, Montgomery,Phila Cty		1	2				2						(800)-645-3965	(800)-645-3965	(888)-857-4816		(877)-393-6733	(877)-393-6733	(877)-219-5457	(877)-219-5457	(800)-645-3965	(800)-645-3965	(888)-857-4816		(877)-393-6733	(877)-393-6733	(877)-219-5457		http://www.site65.com/drug_formulary/formulary/all_plans.html	www.site65.com
H3954	003	0	1	01	01	H3954_003_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	003	0	2009	Geisinger Gold Classic 1	Counties: Cli, Col, Lyc, Mont, Pot, Sch, Sny, Uni		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	004	0	1	01	01	H3954_004_0	2	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	004	0	2009	Geisinger Gold Classic 1	Wyoming County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	005	0	1	01	01	H3954_005_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	005	0	2009	Geisinger Gold Classic 1	Lackawanna and Luzerne County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	007	0	1	01	01	H3954_007_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	007	0	2009	Geisinger Gold Classic 1	Counties:  Cen, Cle, Dau, Lan, Leb, Jef, Mif		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	009	0	1	01	01	H3954_009_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	009	0	2009	Geisinger Gold Classic 2	Counties: Cli, Col, Lyc, Mont, Pot, Sch, Sny, Uni		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	010	0	1	01	01	H3954_010_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	010	0	2009	Geisinger Gold Classic 2	Wyoming County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	011	0	1	01	01	H3954_011_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	011	0	2009	Geisinger Gold Classic 2	Lackawanna County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	012	0	1	01	01	H3954_012_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	012	0	2009	Geisinger Gold Classic 2	Luzerne County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	013	0	1	01	01	H3954_013_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	013	0	2009	Geisinger Gold Classic 2	Counties:  Cen, Cle, Dau, Lan, Leb, Jef, Mif		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	015	0	1	01	01	H3954_015_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	015	0	2009	Geisinger Gold Classic 2	Blair, Cambria, Huntingdon and Juniata Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	018	0	1	01	01	H3954_018_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	018	0	2009	Geisinger Gold Classic 2	Carbon, Monroe, Pike and Wayne Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	019	0	1	01	01	H3954_019_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	019	0	2009	Geisinger Gold Classic 2	Northumberland County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	020	0	1	01	01	H3954_020_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	020	0	2009	Geisinger Gold Classic 1 Standard Rx	Counties: Cli, Col, Lyc, Mont, Pot, Sch, Sny, Uni		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	021	0	1	01	01	H3954_021_0	5	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	021	0	2009	Geisinger Gold Classic 1 $0 Deductible Rx	Counties: Cli, Col, Lyc, Mont, Pot, Sch, Sny, Uni		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	023	0	1	01	01	H3954_023_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	023	0	2009	Geisinger Gold Classic 1 Standard Rx	Wyoming County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	024	0	1	01	01	H3954_024_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	024	0	2009	Geisinger Gold Classic 1 $0 Deductible Rx	Wyoming County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	026	0	1	01	01	H3954_026_0	5	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	026	0	2009	Geisinger Gold Classic 1 Standard Rx	Lackawanna and Luzerne County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	027	0	1	01	01	H3954_027_0	5	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	027	0	2009	Geisinger Gold Classic 1 $0 Deductible Rx	Lackawanna and Luzerne County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	032	0	1	01	01	H3954_032_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	032	0	2009	Geisinger Gold Classic 1 Standard Rx	Counties:  Cen, Cle, Dau, Lan, Leb, Jef, Mif		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	033	0	1	01	01	H3954_033_0	5	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	033	0	2009	Geisinger Gold Classic 1 $0 Deductible Rx	Counties:  Cen, Cle, Dau, Lan, Leb, Jef, Mif		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	038	0	1	01	01	H3954_038_0	5	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	038	0	2009	Geisinger Gold Classic 2 Standard Rx	Counties: Cli, Col, Lyc, Mont, Pot, Sch, Sny, Uni		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	039	0	1	01	01	H3954_039_0	5	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	039	0	2009	Geisinger Gold Classic 2 $0 Deductible Rx	Counties: Cli, Col, Lyc, Mont, Pot, Sch, Sny, Uni		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	041	0	1	01	01	H3954_041_0	5	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	041	0	2009	Geisinger Gold Classic 2 Standard Rx	Wyoming County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	042	0	1	01	01	H3954_042_0	5	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	042	0	2009	Geisinger Gold Classic 2 $0 Deductible Rx	Wyoming County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	044	0	1	01	01	H3954_044_0	5	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	044	0	2009	Geisinger Gold Classic 2 Standard Rx	Lackawanna County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	045	0	1	01	01	H3954_045_0	5	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	045	0	2009	Geisinger Gold Classic 2 $0 Deductible Rx	Lackawanna County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	047	0	1	01	01	H3954_047_0	5	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	047	0	2009	Geisinger Gold Classic 2 Standard Rx	Luzerne County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	048	0	1	01	01	H3954_048_0	5	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	048	0	2009	Geisinger Gold Classic 2 $0 Deductible Rx	Luzerne County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	050	0	1	01	01	H3954_050_0	5	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	050	0	2009	Geisinger Gold Classic 2 Standard Rx	Counties:  Cen, Cle, Dau, Lan, Leb, Jef, Mif		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	051	0	1	01	01	H3954_051_0	5	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	051	0	2009	Geisinger Gold Classic 2 $0 Deductible Rx	Counties:  Cen, Cle, Dau, Lan, Leb, Jef, Mif		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	056	0	1	01	01	H3954_056_0	5	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	056	0	2009	Geisinger Gold Classic 2 Standard Rx	Blair, Cambria, Huntingdon and Juniata Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	057	0	1	01	01	H3954_057_0	8	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	057	0	2009	Geisinger Gold Classic 2 $0 Deductible Rx	Blair, Cambria, Huntingdon and Juniata Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	059	0	1	01	01	H3954_059_0	5	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	059	0	2009	Geisinger Gold Classic 2 Standard Rx	Carbon, Monroe, Pike and Wayne Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	060	0	1	01	01	H3954_060_0	7	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	060	0	2009	Geisinger Gold Classic 2 $0 Deductible Rx	Carbon, Monroe, Pike and Wayne Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	062	0	1	01	01	H3954_062_0	5	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	062	0	2009	Geisinger Gold Classic 2 Standard Rx	Northumberland County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	063	0	1	01	01	H3954_063_0	7	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	063	0	2009	Geisinger Gold Classic 2 $0 Deductible Rx	Northumberland County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	065	0	1	01	01	H3954_065_0	4	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	065	0	2009	Geisinger Gold Classic 2	Cumberland and Perry Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	066	0	1	01	01	H3954_066_0	5	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	066	0	2009	Geisinger Gold Classic 2 Standard Rx	Cumberland and Perry Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	067	0	1	01	01	H3954_067_0	4	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	067	0	2009	Geisinger Gold Classic 2 $0 Deductible Rx	Cumberland and Perry Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	077	0	1	01	01	H3954_077_0	4	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	077	0	2009	Geisinger Gold Classic 2	Berks, Lehigh and Northampton Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	078	0	1	01	01	H3954_078_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	078	0	2009	Geisinger Gold Classic 2 Standard Rx	Berks, Lehigh and Northampton Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	079	0	1	01	01	H3954_079_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	079	0	2009	Geisinger Gold Classic 2 $0 Deductible Rx	Berks, Lehigh and Northampton Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	089	0	1	01	01	H3954_089_0	4	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	089	0	2009	Geisinger Gold Classic 2	Sullivan and Susquehanna Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	090	0	1	01	01	H3954_090_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	090	0	2009	Geisinger Gold Classic 2 Standard Rx	Sullivan and Susquehanna Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	091	0	1	01	01	H3954_091_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	091	0	2009	Geisinger Gold Classic 2 $0 Deductible Rx	Sullivan and Susquehanna Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	097	0	1	01	01	H3954_097_0	4	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	097	0	2009	Geisinger Gold Secure 1	Central Pennsylvania		2	1	3			2			1	2		(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	098	0	1	01	01	H3954_098_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	098	0	2009	Geisinger Gold Classic 3	Central Pennsylvania		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	099	0	1	01	01	H3954_099_0	2	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	099	0	2009	Geisinger Gold Classic 3 Standard Rx	Central Pennsylvania		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	100	0	1	01	01	H3954_100_0	2	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	100	0	2009	Geisinger Gold Classic 3 $0 Deductible Rx	Central Pennsylvania		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	106	0	1	01	01	H3954_106_0	2	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	106	0	2009	Geisinger Gold Secure 2	Central Pennsylvania		2	1	1	1		2			1			(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	107	0	1	01	01	H3954_107_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	107	0	2009	Geisinger Gold Classic 1	Cumberland and Perry Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	108	0	1	01	01	H3954_108_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	108	0	2009	Geisinger Gold Classic 1 Standard Rx	Cumberland and Perry Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	109	0	1	01	01	H3954_109_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	109	0	2009	Geisinger Gold Classic 1 $0 Deductible Rx	Cumberland and Perry Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	110	0	1	01	01	H3954_110_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	110	0	2009	Geisinger Gold Classic 1	Sullivan and Susquehanna Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	111	0	1	01	01	H3954_111_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	111	0	2009	Geisinger Gold Classic 1 Standard Rx	Sullivan and Susquehanna Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	112	0	1	01	01	H3954_112_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	112	0	2009	Geisinger Gold Classic 1 $0 Deductible Rx	Sullivan and Susquehanna Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	113	0	1	01	01	H3954_113_0	2	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	113	0	2009	Geisinger Gold Classic 1	Northumberland County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	114	0	1	01	01	H3954_114_0	2	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	114	0	2009	Geisinger Gold Classic 1 Standard Rx	Northumberland County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	115	0	1	01	01	H3954_115_0	2	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	115	0	2009	Geisinger Gold Classic 1 $0 Deductible Rx	Northumberland County		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	119	0	1	01	01	H3954_119_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	119	0	2009	Geisinger Gold Classic 1	Berks, Lehigh and Northampton Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	120	0	1	01	01	H3954_120_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	120	0	2009	Geisinger Gold Classic 1 Standard Rx	Berks, Lehigh and Northampton Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	121	0	1	01	01	H3954_121_0	2	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	121	0	2009	Geisinger Gold Classic 1 $0 Deductible Rx	Berks, Lehigh and Northampton Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	122	0	1	01	01	H3954_122_0	2	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	122	0	2009	Geisinger Gold Classic 1	Blair, Cambria, Huntingdon and Juniata Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	123	0	1	01	01	H3954_123_0	2	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	123	0	2009	Geisinger Gold Classic 1 Standard Rx	Blair, Cambria, Huntingdon and Juniata Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	124	0	1	01	01	H3954_124_0	2	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	124	0	2009	Geisinger Gold Classic 1 $0 Deductible Rx	Blair, Cambria, Huntingdon and Juniata Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	125	0	1	01	01	H3954_125_0	2	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	125	0	2009	Geisinger Gold Classic 1	Carbon, Monroe, Pike and Wayne Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	126	0	1	01	01	H3954_126_0	2	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	126	0	2009	Geisinger Gold Classic 1 Standard Rx	Carbon, Monroe, Pike and Wayne Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	127	0	1	01	01	H3954_127_0	2	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	127	0	2009	Geisinger Gold Classic 1 $0 Deductible Rx	Carbon, Monroe, Pike and Wayne Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	128	0	1	01	01	H3954_128_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	128	0	2009	Geisinger Gold Classic 1	Adams and York Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	129	0	1	01	01	H3954_129_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	129	0	2009	Geisinger Gold Classic 1 Standard Rx	Adams and York Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	130	0	1	01	01	H3954_130_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	130	0	2009	Geisinger Gold Classic 1 $0 Deductible Rx	Adams and York Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	131	0	1	01	01	H3954_131_0	4	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	131	0	2009	Geisinger Gold Classic 2	Adams and York Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	132	0	1	01	01	H3954_132_0	4	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	132	0	2009	Geisinger Gold Classic 2 Standard Rx	Adams and York Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	133	0	1	01	01	H3954_133_0	4	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	133	0	2009	Geisinger Gold Classic 2 $0 Deductible Rx	Adams and York Counties		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	801	0	1	01	01	H3954_801_0	2	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	801	0	2009	Geisinger Gold Classic (Employer Group)	Pennsylvania		1	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3954	802	0	1	01	01	H3954_802_0	3	2009.01	GEISINGER HEALTH PLAN	Geisinger Gold	www.geisingergold.com	01	01		1		H3954	802	0	2009	Geisinger Gold Classic Rx (Employer Group)	Central Pennsylvania		1	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	http://www.geisingergold.com/formulary/index.cfm	https://www.thehealthplan.com/providersearch/selectsearch.cfm
H3957	003	0	1	01	01	H3957_003_0	9	2009.01	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	01	01		1		H3957	003	0	2009	SecurityBlue HMO Standard	Southwestern PA		2	2				2						(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709	(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com
H3957	006	0	1	01	01	H3957_006_0	8	2009.01	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	01	01		1		H3957	006	0	2009	SecurityBlue HMO Standard	Bedford, Blair, and Somerset Counties		2	2				2						(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709	(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com
H3957	016	0	1	01	01	H3957_016_0	8	2009.01	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	01	01		1		H3957	016	0	2009	SecurityBlue HMO Standard	Crawford, Erie, Mercer Counties		2	2				2						(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709	(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com
H3957	020	0	1	01	01	H3957_020_0	7	2009.01	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	01	01		1		H3957	020	0	2009	SecurityBlue HMO Deluxe	Southwest		2	2				2						(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709	(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com
H3957	021	0	1	01	01	H3957_021_0	7	2009.01	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	01	01		1		H3957	021	0	2009	SecurityBlue HMO Deluxe	Bedford, Blair and Somerset Counties		2	2				2						(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709	(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com
H3957	022	0	1	01	01	H3957_022_0	7	2009.01	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	01	01		1		H3957	022	0	2009	SecurityBlue HMO Deluxe	Crawford, Erie, Mercer Counties		2	2				2						(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709	(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com
H3957	024	0	1	01	01	H3957_024_0	4	2009.01	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	01	01		1		H3957	024	0	2009	SecurityBlue HMO Value	Southwestern PA		2	2				2						(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709									http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com
H3957	025	0	1	01	01	H3957_025_0	4	2009.01	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	01	01		1		H3957	025	0	2009	SecurityBlue HMO Value	Bedford, Blair and Somerset Counties		2	2				2						(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709									http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com
H3957	026	0	1	01	01	H3957_026_0	4	2009.01	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	01	01		1		H3957	026	0	2009	SecurityBlue HMO Value	Crawford, Erie and Mercer Counties		2	2				2						(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709									http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com
H3957	030	0	1	01	01	H3957_030_0	7	2009.01	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	01	01		1		H3957	030	0	2009	SecurityBlue HMO Care	Western Region		2	1	3			2			1	3		(800)-652-9491	(800)-652-9491	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709	(800)-652-9491	(800)-652-9491	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com
H3957	031	0	1	01	01	H3957_031_0	9	2009.01	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	01	01		1		H3957	031	0	2009	SecurityBlue HMO Basic	Southwest		2	2				2						(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709	(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com
H3957	032	0	1	01	01	H3957_032_0	10	2009.01	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	01	01		1		H3957	032	0	2009	SecurityBlue HMO Basic	Bedford, Blair and Somerset counties		2	2				2						(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709	(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com
H3957	033	0	1	01	01	H3957_033_0	10	2009.01	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	01	01		1		H3957	033	0	2009	SecurityBlue HMO Basic	Crawford, Erie and Mercer counties		2	2				2						(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709	(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com
H3957	805	0	1	01	01	H3957_805_0	2	2009.01	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	01	01		1		H3957	805	0	2009	SecurityBlue HMO MA	Western PA		1	2				2						(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709									http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com
H3957	806	0	1	01	01	H3957_806_0	3	2009.01	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	01	01		1		H3957	806	0	2009	SecurityBlue HMO MA-PD	Western PA		1	2				2						(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709	(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com
H3957	808	0	1	01	01	H3957_808_0	2	2009.01	KEYSTONE HEALTH PLAN WEST, INC.	Keystone Health Plan West, Inc.	www.highmarkbcbs.com	01	01		1		H3957	808	0	2009	SecurityBlue HMO MA-PD Non-Calendar	Western PA		1	2				2						(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709	(800)-935-2583	(800)-935-2583	(800)-988-0668	(800)-988-0668	(800)-576-6343	(800)-576-6343	(800)-862-0709	(800)-862-0709	http://highmark.medicare-approvedformularies.com/	www.highmarkbcbs.com
H3959	001	0	1	01	01	H3959_001_0	8	2009.01	HEALTHAMERICA PENNSYLVANIA, INC.	HealthAmerica Advantra	http://www.pa.chcadvantra.com	01	01		1		H3959	001	0	2009	Advantra Gold	Allegheny County		2	2				2						(800)-290-0190		(800)-207-1262		(800)-470-4272		(800)-207-1262		(866)-290-6660	(866)-290-6660	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.pa.chcadvantra.com/home.asp?community=Member	www.chcadvantra.com
H3959	002	0	1	01	01	H3959_002_0	8	2009.01	HEALTHAMERICA PENNSYLVANIA, INC.	HealthAmerica Advantra	http://www.pa.chcadvantra.com	01	01		1		H3959	002	0	2009	Advantra Gold	Western and Northwestern Pennsylvania		2	2				2						(800)-290-0190		(800)-207-1262		(800)-470-4272		(800)-207-1262		(866)-290-6660	(866)-290-6660	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.pa.chcadvantra.com/home.asp?community=Member	www.chcadvantra.com
H3959	006	0	1	01	01	H3959_006_0	7	2009.01	HEALTHAMERICA PENNSYLVANIA, INC.	HealthAmerica Advantra	http://www.pa.chcadvantra.com	01	01		1		H3959	006	0	2009	Advantra Gold	Central Pennsylvania		2	2				2						(800)-290-0190		(800)-207-1262		(800)-470-4272		(800)-207-1262		(866)-290-6660	(866)-290-6660	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.pa.chcadvantra.com/home.asp?community=Member	www.chcadvantra.com
H3959	010	0	1	01	01	H3959_010_0	8	2009.01	HEALTHAMERICA PENNSYLVANIA, INC.	HealthAmerica Advantra	http://www.pa.chcadvantra.com	01	01		1		H3959	010	0	2009	Advantra Silver	Allegheny County		2	2				2						(800)-290-0190		(800)-207-1262		(800)-470-4272		(800)-207-1262		(866)-290-6660	(866)-290-6660	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.pa.chcadvantra.com/home.asp?community=Member	www.chcadvantra.com
H3959	011	0	1	01	01	H3959_011_0	8	2009.01	HEALTHAMERICA PENNSYLVANIA, INC.	HealthAmerica Advantra	http://www.pa.chcadvantra.com	01	01		1		H3959	011	0	2009	Advantra Silver	Central and Western Pennsylvania		2	2				2						(800)-290-0190		(800)-207-1262		(800)-470-4272		(800)-207-1262		(866)-290-6660	(866)-290-6660	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.pa.chcadvantra.com/home.asp?community=Member	www.chcadvantra.com
H3959	013	0	1	01	01	H3959_013_0	5	2009.01	HEALTHAMERICA PENNSYLVANIA, INC.	HealthAmerica Advantra	http://www.pa.chcadvantra.com	01	01		1		H3959	013	0	2009	Advantra MA Only	Central and Western Pennsylvania		2	2				2						(800)-290-0190		(800)-207-1262		(800)-470-4272		(800)-207-1262										http://www.pa.chcadvantra.com/home.asp?community=Member	www.chcadvantra.com
H3959	023	0	1	01	01	H3959_023_0	6	2009.01	HEALTHAMERICA PENNSYLVANIA, INC.	HealthAmerica Advantra	http://www.pa.chcadvantra.com	01	01		1		H3959	023	0	2009	Advantra Bronze	Allegheny County		2	2				2						(800)-290-0190		(800)-207-1262		(800)-470-4272		(800)-207-1262		(866)-290-6660	(866)-290-6660	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.pa.chcadvantra.com/home.asp?community=Member	www.chcadvantra.com
H3959	026	0	1	01	01	H3959_026_0	4	2009.01	HEALTHAMERICA PENNSYLVANIA, INC.	HealthAmerica Advantra	http://www.pa.chcadvantra.com	01	01		1		H3959	026	0	2009	AdvantraOne	Central and Western Pennsylvania		2	1	3			2			1	2		(800)-290-0190		(800)-207-1262		(800)-470-4272		(800)-207-1262		(866)-290-6660	(866)-290-6660	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.pa.chcadvantra.com/home.asp?community=Member	www.chcadvantra.com
H3959	027	0	1	01	01	H3959_027_0	7	2009.01	HEALTHAMERICA PENNSYLVANIA, INC.	HealthAmerica Advantra	http://www.pa.chcadvantra.com	01	01		1		H3959	027	0	2009	AdvantraExtra - Cholesterol SNP	Allegheny County		2	1	4			2			1		0000000000000000000000000001	(800)-290-0190		(800)-207-1262		(800)-470-4272		(800)-207-1262		(866)-290-6660	(866)-290-6660	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.pa.chcadvantra.com/home.asp?community=Member	www.chcadvantra.com
H3959	028	0	1	01	01	H3959_028_0	7	2009.01	HEALTHAMERICA PENNSYLVANIA, INC.	HealthAmerica Advantra	http://www.pa.chcadvantra.com	01	01		1		H3959	028	0	2009	AdvantraExtra - Cholesterol SNP	Western and Northwestern Pennsylvania		2	1	4			2			1		0000000000000000000000000001	(800)-290-0190		(800)-207-1262		(800)-470-4272		(800)-207-1262		(866)-290-6660	(866)-290-6660	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.pa.chcadvantra.com/home.asp?community=Member	www.chcadvantra.com
H3959	029	0	1	01	01	H3959_029_0	6	2009.01	HEALTHAMERICA PENNSYLVANIA, INC.	HealthAmerica Advantra	http://www.pa.chcadvantra.com	01	01		1		H3959	029	0	2009	AdvantraExtra - Diabetes SNP	Allegheny County		2	1	4			2			1		0000000010000000000000000000	(800)-290-0190		(800)-207-1262		(800)-470-4272		(800)-207-1262		(866)-290-6660	(866)-290-6660	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.pa.chcadvantra.com/home.asp?community=Member	www.chcadvantra.com
H3959	030	0	1	01	01	H3959_030_0	6	2009.01	HEALTHAMERICA PENNSYLVANIA, INC.	HealthAmerica Advantra	http://www.pa.chcadvantra.com	01	01		1		H3959	030	0	2009	AdvantraExtra - Diabetes SNP	Western and Northwestern Pennsylvania		2	1	4			2			1		0000000010000000000000000000	(800)-290-0190		(800)-207-1262		(800)-470-4272		(800)-207-1262		(866)-290-6660	(866)-290-6660	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.pa.chcadvantra.com/home.asp?community=Member	www.chcadvantra.com
H3959	803	0	1	01	01	H3959_803_0	2	2009.01	HEALTHAMERICA PENNSYLVANIA, INC.	HealthAmerica Advantra	http://www.pa.chcadvantra.com	01	01		1		H3959	803	0	2009	Advantra HMO MA Only	Pennsylvania		1	2				2						(800)-290-0190		(800)-207-1262		(800)-470-4272		(800)-207-1262										http://www.pa.chcadvantra.com/home.asp?community=Member	www.chcadvantra.com
H3959	804	0	1	01	01	H3959_804_0	2	2009.01	HEALTHAMERICA PENNSYLVANIA, INC.	HealthAmerica Advantra	http://www.pa.chcadvantra.com	01	01		1		H3959	804	0	2009	Advantra HMO Gold	Pennsylvania		1	2				2						(800)-290-0190		(800)-207-1262		(800)-470-4272		(800)-207-1262		(866)-290-6660	(866)-290-6660	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.pa.chcadvantra.com/home.asp?community=Member	www.chcadvantra.com
H3959	806	0	1	01	01	H3959_806_0	2	2009.01	HEALTHAMERICA PENNSYLVANIA, INC.	HealthAmerica Advantra	http://www.pa.chcadvantra.com	01	01		1		H3959	806	0	2009	Advantra HMO Gold	Pennsylvania		1	2				2						(800)-290-0190		(800)-207-1262		(800)-470-4272		(800)-207-1262		(866)-290-6660	(866)-290-6660	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.pa.chcadvantra.com/home.asp?community=Member	www.chcadvantra.com
H3962	001	0	1	01	01	H3962_001_0	9	2009.01	KEYSTONE HEALTH PLAN CENTRAL,INC.	Keystone Health Plan Central, Inc.	seniorblue.capbluecross.com	01	01		1		H3962	001	0	2009	SeniorBlue Option 1	16 Counties in Central PA		2	2			12283	2						(800)-779-6962	(800)-779-6962	(800)-779-6961	(800)-779-6961	(800)-990-4201	(800)-990-4201	(800)-779-6961	(800)-779-6961	(800)-779-6962	(800)-779-6962	(800)-779-6961	(800)-779-6961	(800)-990-4201	(800)-990-4201	(800)-779-6961	(800)-779-6961	https://seniorblue.capbluecross.com/PharmacyInformation/	seniorblue.capbluecross.com
H3962	004	0	1	01	01	H3962_004_0	9	2009.01	KEYSTONE HEALTH PLAN CENTRAL,INC.	Keystone Health Plan Central, Inc.	seniorblue.capbluecross.com	01	01		1		H3962	004	0	2009	SeniorBlue Option 2	16 Counties in Central PA		2	2			1002	2						(800)-779-6962	(800)-779-6962	(800)-779-6961	(800)-779-6961	(800)-990-4201	(800)-990-4201	(800)-779-6961	(800)-779-6961	(800)-779-6962	(800)-779-6962	(800)-779-6961	(800)-779-6961	(800)-990-4201	(800)-990-4201	(800)-779-6961	(800)-779-6961	https://seniorblue.capbluecross.com/PharmacyInformation/	seniorblue.capbluecross.com
H3962	007	0	1	01	01	H3962_007_0	9	2009.01	KEYSTONE HEALTH PLAN CENTRAL,INC.	Keystone Health Plan Central, Inc.	seniorblue.capbluecross.com	01	01		1		H3962	007	0	2009	Senior Blue Option 3	16 Counties in Central PA		2	2			255	2						(800)-779-6962	(800)-779-6962	(800)-779-6961	(800)-779-6961	(800)-990-4201	(800)-990-4201	(800)-779-6961	(800)-779-6961	(800)-779-6962	(800)-779-6962	(800)-779-6961	(800)-779-6961	(800)-990-4201	(800)-990-4201	(800)-779-6961	(800)-779-6961	https://seniorblue.capbluecross.com/PharmacyInformation/	seniorblue.capbluecross.com
H3962	010	0	1	01	01	H3962_010_0	8	2009.01	KEYSTONE HEALTH PLAN CENTRAL,INC.	Keystone Health Plan Central, Inc.	seniorblue.capbluecross.com	01	01		1		H3962	010	0	2009	Senior Blue Option 4	16 Counties in Central PA		2	2			222	2						(800)-779-6962	(800)-779-6962	(800)-779-6961	(800)-779-6961	(800)-990-4201	(800)-990-4201	(800)-779-6961	(800)-779-6961									https://seniorblue.capbluecross.com/PharmacyInformation/	seniorblue.capbluecross.com
H3962	801	0	1	01	01	H3962_801_0	10	2009.01	KEYSTONE HEALTH PLAN CENTRAL,INC.	Keystone Health Plan Central, Inc.	seniorblue.capbluecross.com	01	01		1		H3962	801	0	2009	Senior Blue ER - With Rx	National		1	2			3764	2						(800)-779-6962		(800)-779-6961		(800)-990-4201		(800)-779-6961		(800)-779-6962	(800)-779-6962	(800)-779-6961		(800)-990-4201	(800)-990-4201	(800)-779-6961		https://seniorblue.capbluecross.com/PharmacyInformation/	seniorblue.capbluecross.com
H3962	802	0	1	01	01	H3962_802_0	10	2009.01	KEYSTONE HEALTH PLAN CENTRAL,INC.	Keystone Health Plan Central, Inc.	seniorblue.capbluecross.com	01	01		1		H3962	802	0	2009	Senior Blue ER - w/o Rx	National		1	2			859	2						(800)-779-6962		(800)-779-6961		(800)-990-4201		(800)-779-6961										https://seniorblue.capbluecross.com/PharmacyInformation/	seniorblue.capbluecross.com
H3962	803	0	1	01	01	H3962_803_0	10	2009.01	KEYSTONE HEALTH PLAN CENTRAL,INC.	Keystone Health Plan Central, Inc.	seniorblue.capbluecross.com	01	01		1		H3962	803	0	2009	Senior Blue ER - Non-Calendar - with Rx	National		1	2			50	2						(800)-779-6962		(800)-779-6961		(800)-990-4201		(800)-779-6961		(800)-779-6962	(800)-779-6962	(800)-779-6961		(800)-990-4201	(800)-990-4201	(800)-779-6961		https://seniorblue.capbluecross.com/PharmacyInformation/	seniorblue.capbluecross.com
H3964	001	0	1	01	01	H3964_001_0	2	2009.01	SENIOR PARTNERS BY BRAVO HEALTH	Senior Partners	www.mybravohealth.com	01	01		1		H3964	001	0	2009	Senior Partners Gold	Philadelphia County		2	2				2						(888)-667-7367	(888)-667-7367	(800)-964-2561	(800)-964-2561	(888)-776-9466	(888)-776-9466	(800)-964-2561	(800)-964-2561									www.mybravohealth.com/formulary	www.mybravohealth.com
H3964	002	0	1	01	01	H3964_002_0	2	2009.01	SENIOR PARTNERS BY BRAVO HEALTH	Senior Partners	www.mybravohealth.com	01	01		1		H3964	002	0	2009	Senior Partners Silver	Philadelphia, Bucks and Montgomery Counties		2	1	3			2			1	2		(888)-667-7367	(888)-667-7367	(800)-964-2561	(800)-964-2561	(888)-776-9466	(888)-776-9466	(800)-964-2561	(800)-964-2561	(888)-667-7367	(888)-667-7367	(800)-964-2561	(800)-964-2561	(888)-776-9466	(888)-776-9466	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H3964	003	0	1	01	01	H3964_003_0	3	2009.01	SENIOR PARTNERS BY BRAVO HEALTH	Senior Partners	www.mybravohealth.com	01	01		1		H3964	003	0	2009	Senior Partners Gold Rx	Philadelphia County		2	2				2						(888)-667-7367	(888)-667-7367	(800)-964-2561	(800)-964-2561	(888)-776-9466	(888)-776-9466	(800)-964-2561	(800)-964-2561	(888)-667-7367	(888)-667-7367	(800)-964-2561	(800)-964-2561	(888)-776-9466	(888)-776-9466	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H4003	001	0	1	01	01	H4003_001_0	3	2009.01	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.medicareymuchomas.com	01	01		1		H4003	001	0	2009	Medicare y Mucho Mas - BASICO	Puerto Rico		2	2				2						(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	www.medicareymuchomas.com	www.medicareymuchomas.com
H4003	009	0	1	01	01	H4003_009_0	4	2009.01	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.medicareymuchomas.com	01	01		1		H4003	009	0	2009	Medicare y Mucho Mas - SUPREMO	Puerto Rico		2	1	4			2			1		1111111110000000000000000001	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	www.medicareymuchomas.com	www.medicareymuchomas.com
H4003	010	0	1	01	01	H4003_010_0	3	2009.01	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.medicareymuchomas.com	01	01		1		H4003	010	0	2009	Medicare y Mucho Mas - DIAMANTE	Puerto Rico		2	1	3			2			2	3		(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	www.medicareymuchomas.com	www.medicareymuchomas.com
H4003	015	0	1	01	01	H4003_015_0	5	2009.01	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.medicareymuchomas.com	01	01		1		H4003	015	0	2009	Medicare y Mucho Mas - BASICO SELECT	Puerto Rico		2	2				2						(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	www.medicareymuchomas.com	www.medicareymuchomas.com
H4003	016	0	1	01	01	H4003_016_0	4	2009.01	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.medicareymuchomas.com	01	01		1		H4003	016	0	2009	Medicare y Mucho Mas - DIAMANTE CARE	Puerto Rico		2	1	3			2			2	3		(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	www.medicareymuchomas.com	www.medicareymuchomas.com
H4003	017	0	1	01	01	H4003_017_0	4	2009.01	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.medicareymuchomas.com	01	01		1		H4003	017	0	2009	Medicare y Mucho Mas - DIAMANTE CHOICE	Puerto Rico		2	1	3			2			2	3		(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	www.medicareymuchomas.com	www.medicareymuchomas.com
H4003	018	0	1	01	01	H4003_018_0	2	2009.01	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.medicareymuchomas.com	01	01		1		H4003	018	0	2009	Medicare y Mucho Mas - Original	Medicare y Mucho Mas - Original		2	2				2						(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469									www.medicareymuchomas.com	www.medicareymuchomas.com
H4003	801	0	1	01	01	H4003_801_0	3	2009.01	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.medicareymuchomas.com	01	01		1		H4003	801	0	2009	Medicare y Mucho Mas - MA FLEX	Puerto Rico		1	2				2						(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469									www.medicareymuchomas.com	www.medicareymuchomas.com
H4003	803	0	1	01	01	H4003_803_0	3	2009.01	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.medicareymuchomas.com	01	01		1		H4003	803	0	2009	Medicare y Mucho Mas - MAPD FLEX	Puerto Rico		1	2				2						(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	www.medicareymuchomas.com	www.medicareymuchomas.com
H4003	804	0	1	01	01	H4003_804_0	3	2009.01	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.medicareymuchomas.com	01	01		1		H4003	804	0	2009	Medicare y Mucho Mas - MAPD FLEX I	Puerto Rico		1	2				2						(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	www.medicareymuchomas.com	www.medicareymuchomas.com
H4003	805	0	1	01	01	H4003_805_0	3	2009.01	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.medicareymuchomas.com	01	01		1		H4003	805	0	2009	Medicare y Mucho Mas - MA Flex II	Puerto Rico		1	2				2						(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469									www.medicareymuchomas.com	www.medicareymuchomas.com
H4003	806	0	1	01	01	H4003_806_0	3	2009.01	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.medicareymuchomas.com	01	01		1		H4003	806	0	2009	Medicare y Mucho Mas - MAPD Flex II	Puerto Rico		1	2				2						(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	www.medicareymuchomas.com	www.medicareymuchomas.com
H4003	807	0	1	01	01	H4003_807_0	3	2009.01	MMM HEALTHCARE, INC.	Medicare y Mucho Ms	www.medicareymuchomas.com	01	01		1		H4003	807	0	2009	Medicare y Mucho Mas - MAPD Flex III	Puerto Rico		1	2				2						(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	(787)-622-0490	(866)-333-5470	(866)-333-5469	(866)-333-5469	www.medicareymuchomas.com	www.medicareymuchomas.com
H4004	001	0	1	01	01	H4004_001_0	3	2009.01	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	01	01		1		H4004	001	0	2009	Premier Plus	Puerto Rico		2	1	3			2			1	3		(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	http://www.pmcpr.org	
H4004	015	0	1	01	01	H4004_015_0	3	2009.01	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	01	01		1		H4004	015	0	2009	Dorado Plus	Puerto Rico		2	2				2						(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	http://www.pmcpr.org	
H4004	025	0	1	01	01	H4004_025_0	2	2009.01	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	01	01		1		H4004	025	0	2009	Dorado	Puerto Rico		2	2				2						(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701									http://www.pmcpr.org	
H4004	035	0	1	01	01	H4004_035_0	3	2009.01	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	01	01		1		H4004	035	0	2009	Medicare en el Hogar Plus	Puerto Rico		2	1	1	1		2			1			(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	http://www.pmcpr.org	
H4004	047	0	1	01	01	H4004_047_0	4	2009.01	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	01	01		1		H4004	047	0	2009	Premier Select	Puerto Rico		2	1	3			2			1	3		(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	http://www.pmcpr.org	
H4004	048	0	1	01	01	H4004_048_0	5	2009.01	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	01	01		1		H4004	048	0	2009	Premier Preferred	Puerto Rico		2	1	3			2			1	3		(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	http://www.pmcpr.org	
H4004	049	0	1	01	01	H4004_049_0	5	2009.01	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	01	01		1		H4004	049	0	2009	Dorado Select	Puerto Rico		2	2				2						(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	http://www.pmcpr.org	
H4005	001	0	1	04	01	H4005_001_0	3	2009.01	TRIPLE-S, INC.	Triple-S, Inc.	www.ssspr.com	01	04		1		H4005	001	0	2009	Triple-S Medicare Optimo	Island of Puerto Rico		2	2				2						(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457									www.ssspr.com	http://www.ssspr.com/SSSPortal/ProviderSearch.aspx
H4005	003	0	1	04	01	H4005_003_0	7	2009.01	TRIPLE-S, INC.	Triple-S, Inc.	www.ssspr.com	01	04		1		H4005	003	0	2009	Triple-S Medicare Optimo Superior	Island of Puerto Rico		2	2				2						(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	www.ssspr.com	http://www.ssspr.com/SSSPortal/ProviderSearch.aspx
H4005	004	0	1	04	01	H4005_004_0	6	2009.01	TRIPLE-S, INC.	Triple-S, Inc.	www.ssspr.com	01	04		1		H4005	004	0	2009	Triple-S Medicare Optimo Plus	Island of Puerto Rico		2	2				2						(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	www.ssspr.com	http://www.ssspr.com/SSSPortal/ProviderSearch.aspx
H4005	801	0	1	04	01	H4005_801_0	5	2009.01	TRIPLE-S, INC.	Triple-S, Inc.	www.ssspr.com	01	04		1		H4005	801	0	2009	Triple-S Medicare Optimo	Island of Puerto Rico		1	2				2						(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457									www.ssspr.com	http://www.ssspr.com/SSSPortal/ProviderSearch.aspx
H4005	802	0	1	04	01	H4005_802_0	4	2009.01	TRIPLE-S, INC.	Triple-S, Inc.	www.ssspr.com	01	04		1		H4005	802	0	2009	Triple-S Medicare Optimo Plus A	Island of Puerto Rico		1	2				2						(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	www.ssspr.com	http://www.ssspr.com/SSSPortal/ProviderSearch.aspx
H4005	804	0	1	04	01	H4005_804_0	4	2009.01	TRIPLE-S, INC.	Triple-S, Inc.	www.ssspr.com	01	04		1		H4005	804	0	2009	Triple-S Medicare Optimo Plus B	Island of Puerto Rico		1	2				2						(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	www.ssspr.com	http://www.ssspr.com/SSSPortal/ProviderSearch.aspx
H4006	001	0	1	01	01	H4006_001_0	4	2009.01	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	01	01		1		H4006	001	0	2009	MCS Classicare MA	Puerto Rico		2	2			1200	2						(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182									www.mcsclassicare.com	www.mcsclassicare.com
H4006	007	0	1	01	01	H4006_007_0	6	2009.01	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	01	01		1		H4006	007	0	2009	MCS Classicare Premium A	Puerto Rico		2	2			21000	2						(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	www.mcsclassicare.com	www.mcsclassicare.com
H4006	008	0	1	02	01	H4006_008_0	6	2009.01	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	01	02		1		H4006	008	0	2009	MCS Classicare Premium B	Puerto Rico		2	2			5000	2						(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	www.mcsclassicare.com	www.mcsclassicare.com
H4006	013	0	1	01	01	H4006_013_0	7	2009.01	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	01	01		1		H4006	013	0	2009	MCS Classicare Ideal D	Puerto Rico		2	1	3		417	2			1	3		(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	www.mcsclassicare.com	www.mcsclassicare.com
H4006	015	0	1	01	01	H4006_015_0	7	2009.01	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	01	01		1		H4006	015	0	2009	MCS Classicare Ideal C	Puerto Rico		2	1	3		417	2			1	3		(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	www.mcsclassicare.com	www.mcsclassicare.com
H4006	018	0	1	01	01	H4006_018_0	7	2009.01	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	01	01		1		H4006	018	0	2009	MCS Classicare Ideal E	Puerto Rico		2	1	3		417	2			1	3		(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	www.mcsclassicare.com	www.mcsclassicare.com
H4006	020	0	1	01	01	H4006_020_0	6	2009.01	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	01	01		1		H4006	020	0	2009	MCS Classicare Access	Puerto Rico		2	2			400	2						(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	www.mcsclassicare.com	www.mcsclassicare.com
H4006	022	0	1	01	01	H4006_022_0	6	2009.01	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	01	01		1		H4006	022	0	2009	MCS Classicare Ideal	Puerto Rico		2	2			500	2						(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	www.mcsclassicare.com	www.mcsclassicare.com
H4006	803	0	1	01	01	H4006_803_0	2	2009.01	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	01	01		1		H4006	803	0	2009	MCS Classicare MA Group	Puerto Rico		1	2			80	2						(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182									www.mcsclassicare.com	www.mcsclassicare.com
H4006	807	0	1	01	01	H4006_807_0	2	2009.01	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	01	01		1		H4006	807	0	2009	MCS Classicare MA-PD Group (C)	Puerto Rico		1	2			1000	2						(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	www.mcsclassicare.com	www.mcsclassicare.com
H4006	809	0	1	01	01	H4006_809_0	2	2009.01	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	01	01		1		H4006	809	0	2009	MCS Classicare MA-PD Group 25 (C)	Puerto Rico		1	2			90	2						(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	www.mcsclassicare.com	www.mcsclassicare.com
H4006	811	0	1	01	01	H4006_811_0	2	2009.01	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	01	01		1		H4006	811	0	2009	MCS Classicare MA-PD Group 50 (C)	Puerto Rico		1	2			6317	2						(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	www.mcsclassicare.com	www.mcsclassicare.com
H4006	813	0	1	01	01	H4006_813_0	2	2009.01	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	01	01		1		H4006	813	0	2009	MCS Classicare MA-PD Group 94 (C)	Puerto Rico		1	2			80	2						(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	www.mcsclassicare.com	www.mcsclassicare.com
H4006	815	0	1	01	01	H4006_815_0	2	2009.01	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	01	01		1		H4006	815	0	2009	MCS Classicare MA Group 25	Puerto Rico		1	2			80	2						(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182									www.mcsclassicare.com	www.mcsclassicare.com
H4007	002	0	1	01	01	H4007_002_0	3	2009.01	HUMANA HEALTH PLANS OF PUERTO RICO INC	Humana Health Plans Of Puerto Rico Inc	www.humana-medicare.com	01	01		1		H4007	002	0	2009	Humana Gold Plus HMO SNP-DE H4007-002	Puerto Rico Island Wide		2	1	3			2			2	2		(866)-773-5959	(866)-773-5959	(800)-218-2560	(800)-218-2560	(800)-681-3625	(800)-681-3625	(800)-722-2850	(800)-722-2850	(866)-773-5959	(866)-773-5959		(800)-218-2560	(800)-681-3625	(800)-681-3625		(800)-722-2850	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4007	005	0	1	01	01	H4007_005_0	3	2009.01	HUMANA HEALTH PLANS OF PUERTO RICO INC	Humana Health Plans Of Puerto Rico Inc	www.humana-medicare.com	01	01		1		H4007	005	0	2009	Humana Gold Plus HMO SNP-DE H4007-005	Puerto Rico Island Wide		2	1	3			2			2	2		(866)-773-5959	(866)-773-5959	(800)-218-2560	(800)-218-2560	(800)-681-3625	(800)-681-3625	(800)-722-2850	(800)-722-2850	(866)-773-5959	(866)-773-5959		(800)-218-2560	(800)-681-3625	(800)-681-3625		(800)-722-2850	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4007	008	0	1	01	01	H4007_008_0	4	2009.01	HUMANA HEALTH PLANS OF PUERTO RICO INC	Humana Health Plans Of Puerto Rico Inc	www.humana-medicare.com	01	01		1		H4007	008	0	2009	Humana Gold Plus HMO SNP-DE H4007-008	Puerto Rico Island Wide		2	1	3			2			2	2		(866)-773-5959	(866)-773-5959	(800)-218-2560	(800)-218-2560	(800)-681-3625	(800)-681-3625	(800)-722-2850	(800)-722-2850	(866)-773-5959	(866)-773-5959		(800)-218-2560	(800)-681-3625	(800)-681-3625		(800)-722-2850	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4007	010	0	1	01	01	H4007_010_0	4	2009.01	HUMANA HEALTH PLANS OF PUERTO RICO INC	Humana Health Plans Of Puerto Rico Inc	www.humana-medicare.com	01	01		1		H4007	010	0	2009	Humana Gold Plus HMO H4007-010	Puerto Rico Island Wide		2	2				2						(866)-773-5959	(866)-773-5959	(800)-218-2560	(800)-218-2560	(800)-681-3625	(800)-681-3625	(800)-722-2850	(800)-722-2850	(866)-773-5959	(866)-773-5959		(800)-218-2560	(800)-681-3625	(800)-681-3625		(800)-722-2850	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4007	012	0	1	01	01	H4007_012_0	3	2009.01	HUMANA HEALTH PLANS OF PUERTO RICO INC	Humana Health Plans Of Puerto Rico Inc	www.humana-medicare.com	01	01		1		H4007	012	0	2009	Humana Gold Plus HMO H4007-012	Puerto Rico Island Wide		2	2				2						(866)-773-5959	(866)-773-5959	(800)-218-2560	(800)-218-2560	(800)-681-3625	(800)-681-3625	(800)-722-2850	(800)-722-2850	(866)-773-5959	(866)-773-5959		(800)-218-2560	(800)-681-3625	(800)-681-3625		(800)-722-2850	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4007	801	0	1	01	01	H4007_801_0	4	2009.01	HUMANA HEALTH PLANS OF PUERTO RICO INC	Humana Health Plans Of Puerto Rico Inc	www.humana-medicare.com	01	01		1		H4007	801	0	2009	Humana Employer Sponsored	Puerto Rico Island Wide		1	2				2						(866)-773-5959	(866)-773-5959	(800)-218-2560	(800)-218-2560	(800)-681-3625	(800)-681-3625	(800)-722-2850	(800)-722-2850	(866)-773-5959	(866)-773-5959		(800)-218-2560	(800)-681-3625	(800)-681-3625		(800)-722-2850	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4007	802	0	1	01	01	H4007_802_0	4	2009.01	HUMANA HEALTH PLANS OF PUERTO RICO INC	Humana Health Plans Of Puerto Rico Inc	www.humana-medicare.com	01	01		1		H4007	802	0	2009	Humana Employer Sponsored	Puerto Rico Island Wide		1	2				2						(866)-773-5959	(866)-773-5959	(800)-218-2560	(800)-218-2560	(800)-681-3625	(800)-681-3625	(800)-722-2850	(800)-722-2850									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4007	803	0	1	01	01	H4007_803_0	4	2009.01	HUMANA HEALTH PLANS OF PUERTO RICO INC	Humana Health Plans Of Puerto Rico Inc	www.humana-medicare.com	01	01		1		H4007	803	0	2009	Humana Employer Sponsored Non-CY	Puerto Rico Island Wide		1	2				2						(866)-773-5959	(866)-773-5959	(800)-218-2560	(800)-218-2560	(800)-681-3625	(800)-681-3625	(800)-722-2850	(800)-722-2850	(866)-773-5959	(866)-773-5959		(800)-218-2560	(800)-681-3625	(800)-681-3625		(800)-722-2850	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4007	804	0	1	01	01	H4007_804_0	4	2009.01	HUMANA HEALTH PLANS OF PUERTO RICO INC	Humana Health Plans Of Puerto Rico Inc	www.humana-medicare.com	01	01		1		H4007	804	0	2009	Humana Employer Sponsored Non-CY	Puerto Rico Island Wide		1	2				2						(866)-773-5959	(866)-773-5959	(800)-218-2560	(800)-218-2560	(800)-681-3625	(800)-681-3625	(800)-722-2850	(800)-722-2850									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4008	001	0	1	09	04	H4008_001_0	4	2009.01	HUMANA INSURANCE OF PUERTO RICO, INC	Humana Insurance Of Puerto Rico, Inc	www.humana-medicare.com	04	09	2	1		H4008	001	0	2009	Humana Gold Choice PFFS H4008-001	Puerto Rico Island Wide		2	2				2						(866)-773-5959	(866)-773-5959	(800)-218-2560	(800)-218-2560	(800)-681-3625	(800)-681-3625	(800)-722-2850	(800)-722-2850	(866)-773-5959	(866)-773-5959		(800)-218-2560	(800)-681-3625	(800)-681-3625		(800)-722-2850	http://www.humana.com/member/tools/prescription_tools/medicare_drug_list.asp	
H4008	801	0	1	09	04	H4008_801_0	3	2009.01	HUMANA INSURANCE OF PUERTO RICO, INC	Humana Insurance Of Puerto Rico, Inc	www.humana-medicare.com	04	09	2	1		H4008	801	0	2009	Humana Employer Sponsored	Nationwide		1	2				2						(866)-773-5959	(866)-773-5959	(800)-218-2560	(800)-218-2560	(800)-681-3625	(800)-681-3625	(800)-722-2850	(800)-722-2850	(866)-773-5959	(866)-773-5959		(800)-218-2560	(800)-681-3625	(800)-681-3625		(800)-722-2850	http://www.humana.com/member/tools/prescription_tools/medicare_drug_list.asp	
H4008	802	0	1	09	04	H4008_802_0	3	2009.01	HUMANA INSURANCE OF PUERTO RICO, INC	Humana Insurance Of Puerto Rico, Inc	www.humana-medicare.com	04	09	2	1		H4008	802	0	2009	Humana Employer Sponsored	Nationwide		1	2				2						(866)-773-5959	(866)-773-5959	(800)-218-2560	(800)-218-2560	(800)-681-3625	(800)-681-3625	(800)-722-2850	(800)-722-2850									http://www.humana.com/member/tools/prescription_tools/medicare_drug_list.asp	
H4008	803	0	1	09	04	H4008_803_0	3	2009.01	HUMANA INSURANCE OF PUERTO RICO, INC	Humana Insurance Of Puerto Rico, Inc	www.humana-medicare.com	04	09	2	1		H4008	803	0	2009	Humana Employer Sponsored Non-CY	Nationwide		1	2				2						(866)-773-5959	(866)-773-5959	(800)-218-2560	(800)-218-2560	(800)-681-3625	(800)-681-3625	(800)-722-2850	(800)-722-2850	(866)-773-5959	(866)-773-5959		(800)-218-2560	(800)-681-3625	(800)-681-3625		(800)-722-2850	http://www.humana.com/member/tools/prescription_tools/medicare_drug_list.asp	
H4008	804	0	1	09	04	H4008_804_0	3	2009.01	HUMANA INSURANCE OF PUERTO RICO, INC	Humana Insurance Of Puerto Rico, Inc	www.humana-medicare.com	04	09	2	1		H4008	804	0	2009	Humana Employer Sponsored Non-CY	Nationwide		1	2				2						(866)-773-5959	(866)-773-5959	(800)-218-2560	(800)-218-2560	(800)-681-3625	(800)-681-3625	(800)-722-2850	(800)-722-2850									http://www.humana.com/member/tools/prescription_tools/medicare_drug_list.asp	
H4008	805	0	2	09	04	H4008_805_0	4	2009.01	HUMANA INSURANCE OF PUERTO RICO, INC	Humana Insurance Of Puerto Rico, Inc	www.humana-medicare.com	04	09	2	2		H4008	805	0	2009	Humana Employer Sponsored	Nationwide		1	2				2		2				(866)-773-5959	(866)-773-5959	(800)-218-2560	(800)-218-2560	(800)-681-3625	(800)-681-3625	(800)-722-2850	(800)-722-2850	(866)-773-5959	(866)-773-5959		(800)-218-2560	(800)-681-3625	(800)-681-3625		(800)-722-2850	http://www.humana.com/member/tools/prescription_tools/medicare_drug_list.asp	
H4008	806	0	2	09	04	H4008_806_0	4	2009.01	HUMANA INSURANCE OF PUERTO RICO, INC	Humana Insurance Of Puerto Rico, Inc	www.humana-medicare.com	04	09	2	2		H4008	806	0	2009	Humana Employer Sponsored	Nationwide		1	2				2		2				(866)-773-5959	(866)-773-5959	(800)-218-2560	(800)-218-2560	(800)-681-3625	(800)-681-3625	(800)-722-2850	(800)-722-2850									http://www.humana.com/member/tools/prescription_tools/medicare_drug_list.asp	
H4008	807	0	2	09	04	H4008_807_0	4	2009.01	HUMANA INSURANCE OF PUERTO RICO, INC	Humana Insurance Of Puerto Rico, Inc	www.humana-medicare.com	04	09	2	2		H4008	807	0	2009	Humana Employer Sponsored Non-CY	Nationwide		1	2				2		2				(866)-773-5959	(866)-773-5959	(800)-218-2560	(800)-218-2560	(800)-681-3625	(800)-681-3625	(800)-722-2850	(800)-722-2850	(866)-773-5959	(866)-773-5959		(800)-218-2560	(800)-681-3625	(800)-681-3625		(800)-722-2850	http://www.humana.com/member/tools/prescription_tools/medicare_drug_list.asp	
H4008	808	0	2	09	04	H4008_808_0	4	2009.01	HUMANA INSURANCE OF PUERTO RICO, INC	Humana Insurance Of Puerto Rico, Inc	www.humana-medicare.com	04	09	2	2		H4008	808	0	2009	Humana Employer Sponsored Non-CY	Nationwide		1	2				2		2				(866)-773-5959	(866)-773-5959	(800)-218-2560	(800)-218-2560	(800)-681-3625	(800)-681-3625	(800)-722-2850	(800)-722-2850									http://www.humana.com/member/tools/prescription_tools/medicare_drug_list.asp	
H4011	001	0	1	04	01	H4011_001_0	7	2009.01	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	01	04		1		H4011	001	0	2009	First+Plus Advantage	Entire Island Puerto Rico		2	2				2						(787)-625-9557	(888)-767-7717	(877)-672-4242	(877)-672-4242	(787)-625-9557	(877)-662-4242	(877)-672-4242	(877)-672-4242									http://www.firstpluspr.com	www.firstpluspr.com
H4011	003	0	1	04	01	H4011_003_0	9	2009.01	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	01	04		1		H4011	003	0	2009	First+Plus Advantage Plus	Enitre Island Puerto Rico		2	2				2						(787)-625-9557	(888)-767-7717	(877)-672-4242	(877)-672-4242	(787)-625-9557	(877)-662-4242	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	http://www.firstpluspr.com	www.firstpluspr.com
H4011	004	0	1	04	01	H4011_004_0	9	2009.01	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	01	04		1		H4011	004	0	2009	First+Plus Advantage Premium	Entire Island Puerto Rico		2	2				2						(787)-625-9557	(888)-767-7717	(877)-672-4242	(877)-672-4242	(787)-625-9557	(877)-662-4242	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	http://www.firstpluspr.com	www.firstpluspr.com
H4011	801	0	1	04	01	H4011_801_0	5	2009.01	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	01	04		1		H4011	801	0	2009	Employer Group Plan 1	Entire Island Puerto Rico		1	2				2						(787)-625-9557	(888)-767-7717	(877)-672-4242	(877)-672-4242	(787)-625-9557	(877)-662-4242	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	http://www.firstpluspr.com	www.firstpluspr.com
H4011	802	0	1	04	01	H4011_802_0	5	2009.01	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	01	04		1		H4011	802	0	2009	Employer Group Plan 2	Entire Island Puerto Rico		1	2				2						(787)-625-9557	(888)-767-7717	(877)-672-4242	(877)-672-4242	(787)-625-9557	(877)-662-4242	(877)-672-4242	(877)-672-4242									http://www.firstpluspr.com	www.firstpluspr.com
H4011	803	0	1	04	01	H4011_803_0	6	2009.01	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	01	04		1		H4011	803	0	2009	Employer Group Plan 3	Entire Island Puerto Rico		1	2				2						(787)-625-9557	(888)-767-7717	(877)-672-4242	(877)-672-4242	(787)-625-9557	(877)-662-4242	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	http://www.firstpluspr.com	www.firstpluspr.com
H4011	805	0	1	04	01	H4011_805_0	6	2009.01	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	01	04		1		H4011	805	0	2009	Employer Group Plan 5	Entire Island Puerto Rico		1	2				2						(787)-625-9557	(888)-767-7717	(877)-672-4242	(877)-672-4242	(787)-625-9557	(877)-662-4242	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	http://www.firstpluspr.com	www.firstpluspr.com
H4011	806	0	1	04	01	H4011_806_0	5	2009.01	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	01	04		1		H4011	806	0	2009	Employer Group Plan 6	Entire Island Puerto Rico		1	2				2						(787)-625-9557	(888)-767-7717	(877)-672-4242	(877)-672-4242	(787)-625-9557	(877)-662-4242	(877)-672-4242	(877)-672-4242									http://www.firstpluspr.com	www.firstpluspr.com
H4011	807	0	1	04	01	H4011_807_0	5	2009.01	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	01	04		1		H4011	807	0	2009	Employer Group Plan 7	Entire Island Puerto Rico		1	2				2						(787)-625-9557	(888)-767-7717	(877)-672-4242	(877)-672-4242	(787)-625-9557	(877)-662-4242	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	http://www.firstpluspr.com	www.firstpluspr.com
H4011	809	0	1	04	01	H4011_809_0	5	2009.01	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	01	04		1		H4011	809	0	2009	Employer Group Plan 9	Entire Island Puerto Rico		1	2				2						(787)-625-9557	(888)-767-7717	(877)-672-4242	(877)-672-4242	(787)-625-9557	(877)-662-4242	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	http://www.firstpluspr.com	www.firstpluspr.com
H4011	810	0	1	04	01	H4011_810_0	5	2009.01	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	01	04		1		H4011	810	0	2009	Employer Group Plan 10	Entire Island Puerto Rico		1	2				2						(787)-625-9557	(888)-767-7717	(877)-672-4242	(877)-672-4242	(787)-625-9557	(877)-662-4242	(877)-672-4242	(877)-672-4242									http://www.firstpluspr.com	www.firstpluspr.com
H4011	811	0	1	04	01	H4011_811_0	5	2009.01	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	01	04		1		H4011	811	0	2009	Employer Group Plan 11	Entire Island Puerto Rico		1	2				2						(787)-625-9557	(888)-767-7717	(877)-672-4242	(877)-672-4242	(787)-625-9557	(877)-662-4242	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	http://www.firstpluspr.com	www.firstpluspr.com
H4011	813	0	1	04	01	H4011_813_0	5	2009.01	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	01	04		1		H4011	813	0	2009	Employer Group Plan 13	Entire Island Puerto Rico		1	2				2						(787)-625-9557	(888)-767-7717	(877)-672-4242	(877)-672-4242	(787)-625-9557	(877)-662-4242	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	http://www.firstpluspr.com	www.firstpluspr.com
H4011	814	0	1	04	01	H4011_814_0	5	2009.01	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	01	04		1		H4011	814	0	2009	Employer Group Plan 14	Entire Island Puerto Rico		1	2				2						(787)-625-9557	(888)-767-7717	(877)-672-4242	(877)-672-4242	(787)-625-9557	(877)-662-4242	(877)-672-4242	(877)-672-4242									http://www.firstpluspr.com	www.firstpluspr.com
H4011	815	0	1	04	01	H4011_815_0	5	2009.01	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	01	04		1		H4011	815	0	2009	Employer Group Plan 15	Entire Island Puerto Rico		1	2				2						(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	(787)-625-9557	(877)-662-4242	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	http://www.firstpluspr.com	www.firstpluspr.com
H4011	817	0	1	04	01	H4011_817_0	5	2009.01	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	01	04		1		H4011	817	0	2009	Employer Group Plan 17	Entire Island Puerto Rico		1	2				2						(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	(787)-625-9557	(877)-662-4242	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	http://www.firstpluspr.com	www.firstpluspr.com
H4011	818	0	1	04	01	H4011_818_0	5	2009.01	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	01	04		1		H4011	818	0	2009	Employer Group Plan 18	Entire Island Puerto Rico		1	2				2						(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	(787)-625-9557	(877)-662-4242	(877)-672-4242	(877)-672-4242									http://www.firstpluspr.com	www.firstpluspr.com
H4011	819	0	1	04	01	H4011_819_0	5	2009.01	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	01	04		1		H4011	819	0	2009	Employer Group Plan 19	Entire Island Puerto Rico		1	2				2						(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	(787)-625-9557	(877)-662-4242	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	http://www.firstpluspr.com	www.firstpluspr.com
H4012	001	0	1	01	01	H4012_001_0	6	2009.01	TRIPLE-S, INC.	Triple-S, Inc.	www.ssspr.com	01	01		1		H4012	001	0	2009	Triple-S Medicare Selecto	Island of Puerto Rico		2	1	3			2			2	3		(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	www.ssspr.com	
H4012	003	0	1	01	01	H4012_003_0	7	2009.01	TRIPLE-S, INC.	Triple-S, Inc.	www.ssspr.com	01	01		1		H4012	003	0	2009	Triple-S Medicare Selecto Superior	Island of Puerto Rico		2	1	3			2			2	3		(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	www.ssspr.com	
H4012	004	0	1	01	01	H4012_004_0	6	2009.01	TRIPLE-S, INC.	Triple-S, Inc.	www.ssspr.com	01	01		1		H4012	004	0	2009	Triple-S Medicare Selecto Plus	Island of Puerto Rico		2	1	3			2			2	3		(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	www.ssspr.com	
H4012	005	0	1	01	01	H4012_005_0	7	2009.01	TRIPLE-S, INC.	Triple-S, Inc.	www.ssspr.com	01	01		1		H4012	005	0	2009	Triple-S Medicare Selecto 2	Island of Puerto Rico		2	1	3			2			2	3		(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	www.ssspr.com	
H4036	001	0	1	04	01	H4036_001_0	10	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	04		1		H4036	001	0	2009	Anthem Medicare Preferred Standard	Wisconsin - Select Counties		2	2			355	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
H4036	801	0	1	04	01	H4036_801_0	3	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	04		1		H4036	801	0	2009	Anthem Medicare Preferred Group	Wisconsin		1	2			125	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
H4036	802	0	1	04	01	H4036_802_0	3	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	04		1		H4036	802	0	2009	Anthem Medicare Preferred Group	Wisconsin		1	2			50	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754									www.anthem.com	www.anthem.com
H4036	803	0	1	04	01	H4036_803_0	3	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	04		1		H4036	803	0	2009	Anthem Medicare Preferred Group	Wisconsin		1	2			25	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
H4102	001	0	1	01	01	H4102_001_0	5	2009.01	UNITED HEALTH PLANS OF NEW ENGLAND, INC.	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H4102	001	0	2009	AARP Medicare Complete Rx	State of Rhode Island		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4102	025	0	1	01	01	H4102_025_0	5	2009.01	UNITED HEALTH PLANS OF NEW ENGLAND, INC.	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H4102	025	0	2009	AARP Medicare Complete	State of Rhode Island		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4102	801	0	1	01	01	H4102_801_0	2	2009.01	UNITED HEALTH PLANS OF NEW ENGLAND, INC.	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H4102	801	0	2009	MedicareComplete Retiree Plan	State of Rhode Island		1	2				2						(888)-867-5548		(888)-685-8480		(800)-962-8251		(888)-685-8480		(800)-643-4845	(800)-643-4845	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4102	802	0	1	01	01	H4102_802_0	2	2009.01	UNITED HEALTH PLANS OF NEW ENGLAND, INC.	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H4102	802	0	2009	MedicareComplete Essential Retiree Plan	Rhode Island		1	2				2						(888)-867-5548		(888)-685-8480		(800)-962-8251		(888)-685-8480										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4102	803	0	1	01	01	H4102_803_0	2	2009.01	UNITED HEALTH PLANS OF NEW ENGLAND, INC.	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H4102	803	0	2009	MedicareComplete Retiree Plan	Select counties in RI		1	2				2						(888)-867-5548		(888)-685-8480		(800)-962-8251		(888)-685-8480		(800)-643-4845	(800)-643-4845	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4102	804	0	1	01	01	H4102_804_0	2	2009.01	UNITED HEALTH PLANS OF NEW ENGLAND, INC.	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	01		1		H4102	804	0	2009	MedicareComplete Retiree Plan	Select counties in RI		1	2				2						(888)-867-5548		(888)-685-8480		(800)-962-8251		(888)-685-8480										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4105	001	0	1	20	08	H4105_001_0	1	2009.01	PACE ORGANIZATION OF RHODE ISLAND	Pace Organization Of Rhode Island	www.pace-ri.org	08	20		1		H4105	001	0	2009	PACE Organization of Rhode Island	PACE Organization of Rhode Island		2	2				2														(401)-490-6566	(401)-490-6566	(401)-490-4597	(866)-883-1631	(401)-490-6566	(401)-490-6566	(401)-490-4597	(866)-883-1631	www.pace-ri.org	
H4105	002	0	1	20	08	H4105_002_0	1	2009.01	PACE ORGANIZATION OF RHODE ISLAND	Pace Organization Of Rhode Island	www.pace-ri.org	08	20		1		H4105	002	0	2009	PACE Organization of Rhode Island	PACE Organization of Rhode Island		2	2				2														(401)-490-6566	(401)-490-6566	(401)-490-4597	(866)-883-1631	(401)-490-6566	(401)-490-6566	(401)-490-4597	(866)-883-1631	www.pace-ri.org	
H4106	001	0	1	01	01	H4106_001_0	8	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	01		1		H4106	001	0	2009	Evercare Plan DH	Bristol, Kent, Providence and Washington Counties		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H4106	002	0	1	01	01	H4106_002_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	01		1		H4106	002	0	2009	Evercare Plan MH	Bristol, Kent, Providence and Washington Counties		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H4125	001	0	1	01	01	H4125_001_0	9	2009.01	ARCADIAN HEALTH PLAN	Arcadian Health Plan	www.ahpofok.com	01	01		1		H4125	001	0	2009	Arcadian Health Plan-Plus (OK/Fort Smith)	Fort Smith - OK		2	2			8345	2						(501)-223-9088	(800)-573-8597	(866)-573-8591	(866)-573-8591	(501)-223-9088	(800)-705-0766	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(501)-223-9088	(800)-705-0766	(866)-573-8613	(866)-573-8613	www.arcadianhealthplanoklahoma.com	
H4125	002	0	1	01	01	H4125_002_0	8	2009.01	ARCADIAN HEALTH PLAN	Arcadian Health Plan	www.ahpofok.com	01	01		1		H4125	002	0	2009	Arcadian Health Plan-Plus (OK/Texarkana)	Texarkana - OK		2	2			1016	2						(501)-223-9088	(800)-573-8597	(866)-573-8591	(866)-573-8591	(501)-223-9088	(800)-705-0766	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(501)-223-9088	(800)-705-0766	(866)-573-8613	(866)-573-8613	www.arcadianhealthplanoklahoma.com	
H4125	003	0	1	01	01	H4125_003_0	9	2009.01	ARCADIAN HEALTH PLAN	Arcadian Health Plan	www.ahpofok.com	01	01		1		H4125	003	0	2009	Arcadian Health Plan-Plus(OK/Fayetteville)	OK/Fayetteville		2	2			1549	2						(501)-223-9088	(800)-573-8597	(866)-573-8591	(866)-573-8591	(501)-223-9088	(800)-705-0766	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(501)-223-9088	(800)-705-0766	(866)-573-8613	(866)-573-8613	www.arcadianhealthplanoklahoma.com	
H4125	005	0	1	01	01	H4125_005_0	11	2009.01	ARCADIAN HEALTH PLAN	Arcadian Health Plan	www.ahpofok.com	01	01		1		H4125	005	0	2009	Arcadian Health Plan - Dual Plus	Oklahoma		2	1	3		552	2			1	1		(501)-223-9088	(800)-573-8597	(866)-573-8591	(866)-573-8591	(501)-223-9088	(800)-705-0766	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(501)-223-9088	(800)-705-0766	(866)-573-8613	(866)-573-8613	www.arcadianhealthplanoklahoma.com	
H4142	001	0	1	20	08	H4142_001_0	1	2009.01	CHEROKEE NATION COMPREHENSIVE CARE AGENCY	Cherokee Elder Care	eldercare.cherokee.org	08	20		1		H4142	001	0	2009	Cherokee Elder Care	Cherokee,Delaware,Mayes,Muskogee counties		2	2				2														(918)-453-5554	(800)-256-0671			(918)-453-5554	(800)-256-0671			eldercare.cherokee.org	
H4142	002	0	1	20	08	H4142_002_0	1	2009.01	CHEROKEE NATION COMPREHENSIVE CARE AGENCY	Cherokee Elder Care	eldercare.cherokee.org	08	20		1		H4142	002	0	2009	Cherokee Elder Care	Cherokee,Delaware,Mayes, Muskogee counties		2	2				2														(918)-453-5554	(800)-256-0671			(918)-453-5554	(800)-256-0671			eldercare.cherokee.org	
H4152	004	0	1	01	01	H4152_004_0	4	2009.01	BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND	Blue Cross  Blue Shield of Rhode Island	www.bcbsri.com	01	01		1		H4152	004	0	2009	BlueCHiP for Medicare Core	State of Rhode Island		2	2			2945	2						(401)-277-2958	(800)-267-0439	(401)-831-2202	(877)-232-8432	(401)-351-2583	(800)-505-2583	(401)-831-2202	(877)-232-8432									www.bcbsri.com	www.bcbsri.com
H4152	005	0	1	01	01	H4152_005_0	6	2009.01	BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND	Blue Cross  Blue Shield of Rhode Island	www.bcbsri.com	01	01		1		H4152	005	0	2009	BlueCHiP for Medicare Plus	State of Rhode Island		2	2			10201	2						(401)-277-2958	(800)-267-0439	(401)-831-2202	(877)-232-8432	(401)-351-2583	(800)-505-2583	(401)-831-2202	(877)-232-8432	(401)-277-2958	(800)-267-0439	(401)-831-2202	(877)-232-8432	(401)-351-2583	(800)-505-2583	(401)-831-2202	(877)-232-8432	www.bcbsri.com	www.bcbsri.com
H4152	007	0	1	02	01	H4152_007_0	6	2009.01	BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND	Blue Cross  Blue Shield of Rhode Island	www.bcbsri.com	01	02		1		H4152	007	0	2009	BlueCHiP for Medicare Preferred	State of Rhode Island		2	2			8837	2						(401)-277-2958	(800)-267-0439	(401)-831-2202	(877)-232-8432	(401)-351-2583	(800)-505-2583	(401)-831-2202	(877)-232-8432	(401)-277-2958	(800)-267-0439	(401)-831-2202	(877)-232-8432	(401)-351-2583	(800)-505-2583	(401)-831-2202	(877)-232-8432	www.bcbsri.com	www.bcbsri.com
H4152	012	0	1	01	01	H4152_012_0	6	2009.01	BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND	Blue Cross  Blue Shield of Rhode Island	www.bcbsri.com	01	01		1		H4152	012	0	2009	BlueCHiP for Medicare Optima	State of Rhode Island		2	1	3		3427	2			1	1		(401)-277-2958	(800)-267-0439	(401)-831-2202	(877)-232-8432	(401)-351-2583	(800)-505-2583	(401)-831-2202	(877)-232-8432	(401)-277-2958	(800)-267-0439	(401)-831-2202	(877)-232-8432	(401)-351-2583	(800)-505-2583	(401)-831-2202	(877)-232-8432	www.bcbsri.com	www.bcbsri.com
H4152	013	0	1	01	01	H4152_013_0	6	2009.01	BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND	Blue Cross  Blue Shield of Rhode Island	www.bcbsri.com	01	01		1		H4152	013	0	2009	BlueCHiP for Medicare Standard with Drugs	State of Rhode Island		2	2			12859	2						(401)-277-2958	(800)-267-0439	(401)-831-2202	(877)-232-8432	(401)-351-2583	(800)-505-2583	(401)-831-2202	(877)-232-8432	(401)-277-2958	(800)-267-0439	(401)-831-2202	(877)-232-8432	(401)-351-2583	(800)-505-2583	(401)-831-2202	(877)-232-8432	www.bcbsri.com	www.bcbsri.com
H4152	815	0	1	02	01	H4152_815_0	3	2009.01	BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND	Blue Cross  Blue Shield of Rhode Island	www.bcbsri.com	01	02		1		H4152	815	0	2009	BlueCHiP for Medicare Group Preferred	State of Rhode Island		1	2			1377	2						(401)-277-2958	(800)-267-0439	(401)-831-2202	(877)-232-8432	(401)-351-2583	(800)-505-2583	(401)-831-2202	(877)-232-8432	(401)-277-2958	(800)-267-0439	(401)-831-2202	(877)-232-8432	(401)-351-2583	(800)-505-2583	(401)-831-2202	(877)-232-8432	www.bcbsri.com	www.bcbsri.com
H4152	817	0	1	01	01	H4152_817_0	3	2009.01	BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND	Blue Cross  Blue Shield of Rhode Island	www.bcbsri.com	01	01		1		H4152	817	0	2009	BlueCHiP for Medicare Group Plus	State of Rhode Island		1	2			310	2						(401)-277-2958	(800)-267-0439	(401)-831-2202	(877)-232-8432	(401)-351-2583	(800)-505-2583	(401)-831-2202	(877)-232-8432	(401)-277-2958	(800)-267-0439	(401)-831-2202	(877)-232-8432	(401)-351-2583	(800)-505-2583	(401)-831-2202	(877)-232-8432	www.bcbsri.com	www.bcbsri.com
H4152	818	0	1	01	01	H4152_818_0	3	2009.01	BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND	Blue Cross  Blue Shield of Rhode Island	www.bcbsri.com	01	01		1		H4152	818	0	2009	Group Core - MA only	State of Rhode Island		1	2			100	2						(401)-277-2958	(800)-267-0439	(401)-831-2202	(877)-232-8432	(401)-351-2583	(800)-505-2583	(401)-831-2202	(877)-232-8432									www.bcbsri.com	www.bcbsri.com
H4152	819	0	1	01	01	H4152_819_0	3	2009.01	BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND	Blue Cross  Blue Shield of Rhode Island	www.bcbsri.com	01	01		1		H4152	819	0	2009	BlueCHiP for Medicare Group Plus	State of Rhode Island		1	2			100	2						(401)-277-2958	(800)-267-0439	(401)-831-2202	(877)-232-8432	(401)-351-2583	(800)-505-2583	(401)-831-2202	(877)-232-8432	(401)-277-2958	(800)-267-0439	(401)-831-2202	(877)-232-8432	(401)-351-2583	(800)-505-2583	(401)-831-2202	(877)-232-8432	www.bcbsri.com	www.bcbsri.com
H4152	820	0	1	02	01	H4152_820_0	3	2009.01	BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND	Blue Cross  Blue Shield of Rhode Island	www.bcbsri.com	01	02		1		H4152	820	0	2009	BlueCHiP for Medicare Group Preferred	State of Rhode Island		1	2			100	2						(401)-277-2958	(800)-267-0439	(401)-831-2202	(877)-232-8432	(401)-351-2583	(800)-505-2583	(401)-831-2202	(877)-232-8432	(401)-277-2958	(800)-267-0439	(401)-831-2202	(877)-232-8432	(401)-351-2583	(800)-505-2583	(401)-831-2202	(877)-232-8432	www.bcbsri.com	www.bcbsri.com
H4203	001	0	1	20	08	H4203_001_0	1	2009.01	PALMETTO HEALTH ALLIANCE	Palmetto SeniorCare	www.palmettohealth.org	08	20		1		H4203	001	0	2009	Palmetto Health - Palmetto SeniorCare	Richland and  Lexington Counties		2	2			352	2														(803)-931-8175	(803)-931-8175			(803)-931-8175	(803)-931-8175			n/a	
H4203	002	0	1	20	08	H4203_002_0	1	2009.01	PALMETTO HEALTH ALLIANCE	Palmetto SeniorCare	www.palmettohealth.org	08	20		1		H4203	002	0	2009	Palmetto Health - Palmetto SeniorCare	Richland and Lexington Counties		2	2			352	2														(803)-931-8175	(803)-931-8175			(803)-931-8175	(803)-931-8175			n/a	
H4204	002	0	1	09	04	H4204_002_0	4	2009.01	INSTIL HEALTH INSURANCE COMPANY	InStil Health Insurance Company	www.myinstil.com	04	09	2	1		H4204	002	0	2009	InStil InCare	Select GA and SC counties		2	2				2						(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118									www.myinstil.com/internet/tric/ins/instild.nsf/0/134036AB0CAC0B7085257082006120C3?OpenDocument	
H4204	022	0	1	09	04	H4204_022_0	4	2009.01	INSTIL HEALTH INSURANCE COMPANY	InStil Health Insurance Company	www.myinstil.com	04	09	2	1		H4204	022	0	2009	InStil InCare	Select GA and SC counties		2	2				2						(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118									www.myinstil.com/internet/tric/ins/instild.nsf/0/134036AB0CAC0B7085257082006120C3?OpenDocument	
H4204	023	0	1	09	04	H4204_023_0	4	2009.01	INSTIL HEALTH INSURANCE COMPANY	InStil Health Insurance Company	www.myinstil.com	04	09	2	1		H4204	023	0	2009	InStil InCare Enriched	Georgia and Select SC counties		2	2				2						(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118									www.myinstil.com/internet/tric/ins/instild.nsf/0/134036AB0CAC0B7085257082006120C3?OpenDocument	
H4204	024	0	1	09	04	H4204_024_0	4	2009.01	INSTIL HEALTH INSURANCE COMPANY	InStil Health Insurance Company	www.myinstil.com	04	09	2	1		H4204	024	0	2009	InStil InCare Enriched	Midlands / Central SC		2	2				2						(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118									www.myinstil.com/internet/tric/ins/instild.nsf/0/134036AB0CAC0B7085257082006120C3?OpenDocument	
H4204	026	0	1	09	04	H4204_026_0	4	2009.01	INSTIL HEALTH INSURANCE COMPANY	InStil Health Insurance Company	www.myinstil.com	04	09	2	1		H4204	026	0	2009	InStil InTrust	GA and SC select counties		2	2				2						(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118									www.myinstil.com/internet/tric/ins/instild.nsf/0/134036AB0CAC0B7085257082006120C3?OpenDocument	
H4204	028	0	1	09	04	H4204_028_0	6	2009.01	INSTIL HEALTH INSURANCE COMPANY	InStil Health Insurance Company	www.myinstil.com	04	09	2	1		H4204	028	0	2009	InStil InCare MAPD	Select GA and SC counties		2	2				2						(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	www.myinstil.com/internet/tric/ins/instild.nsf/0/134036AB0CAC0B7085257082006120C3?OpenDocument	
H4204	029	0	1	09	04	H4204_029_0	6	2009.01	INSTIL HEALTH INSURANCE COMPANY	InStil Health Insurance Company	www.myinstil.com	04	09	2	1		H4204	029	0	2009	InStil InCare MAPD	Select GA and SC counties		2	2				2						(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	www.myinstil.com/internet/tric/ins/instild.nsf/0/134036AB0CAC0B7085257082006120C3?OpenDocument	
H4204	030	0	1	09	04	H4204_030_0	5	2009.01	INSTIL HEALTH INSURANCE COMPANY	InStil Health Insurance Company	www.myinstil.com	04	09	2	1		H4204	030	0	2009	InStil InCare Enriched MAPD	Georgia and Select SC counties		2	2				2						(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	www.myinstil.com/internet/tric/ins/instild.nsf/0/134036AB0CAC0B7085257082006120C3?OpenDocument	
H4204	031	0	1	09	04	H4204_031_0	5	2009.01	INSTIL HEALTH INSURANCE COMPANY	InStil Health Insurance Company	www.myinstil.com	04	09	2	1		H4204	031	0	2009	InStil InCare Enriched MAPD	Midlands / Central SC		2	2				2						(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	www.myinstil.com/internet/tric/ins/instild.nsf/0/134036AB0CAC0B7085257082006120C3?OpenDocument	
H4204	801	0	1	09	04	H4204_801_0	3	2009.01	INSTIL HEALTH INSURANCE COMPANY	InStil Health Insurance Company	www.myinstil.com	04	09	2	1		H4204	801	0	2009	InStil Senior Group PFFS	Georgia and SC		1	2				2						(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118									www.myinstil.com/internet/tric/ins/instild.nsf/0/134036AB0CAC0B7085257082006120C3?OpenDocument	
H4204	802	0	1	09	04	H4204_802_0	3	2009.01	INSTIL HEALTH INSURANCE COMPANY	InStil Health Insurance Company	www.myinstil.com	04	09	2	1		H4204	802	0	2009	InStil Senior Group PFFS	Georgia and SC		1	2				2						(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118									www.myinstil.com/internet/tric/ins/instild.nsf/0/134036AB0CAC0B7085257082006120C3?OpenDocument	
H4204	803	0	1	09	04	H4204_803_0	3	2009.01	INSTIL HEALTH INSURANCE COMPANY	InStil Health Insurance Company	www.myinstil.com	04	09	2	1		H4204	803	0	2009	InStil Senior Group PFFS MAPD	Georgia and SC		1	2				2						(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	www.myinstil.com/internet/tric/ins/instild.nsf/0/134036AB0CAC0B7085257082006120C3?OpenDocument	
H4204	804	0	1	09	04	H4204_804_0	3	2009.01	INSTIL HEALTH INSURANCE COMPANY	InStil Health Insurance Company	www.myinstil.com	04	09	2	1		H4204	804	0	2009	InStil Senior Group PFFS MAPD	Georgia and SC		1	2				2						(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	www.myinstil.com/internet/tric/ins/instild.nsf/0/134036AB0CAC0B7085257082006120C3?OpenDocument	
H4205	002	0	1	09	04	H4205_002_0	5	2009.01	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	http://www.southcarolinablues.com/pffs08	04	09	2	1		H4205	002	0	2009	Medicare Blue Private	Upstate and Midlands SC		2	2				2						(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-3453	(800)-760-1790	(888)-899-4219	(888)-899-4219									www.southcarolinablues.cm/medb08	
H4205	004	0	1	09	04	H4205_004_0	5	2009.01	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	http://www.southcarolinablues.com/pffs08	04	09	2	1		H4205	004	0	2009	Medicare Blue Private	SC Coast		2	2				2						(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-3453	(800)-760-1790	(888)-899-4219	(888)-899-4219									www.southcarolinablues.cm/medb08	
H4205	005	0	1	09	04	H4205_005_0	6	2009.01	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	http://www.southcarolinablues.com/pffs08	04	09	2	1		H4205	005	0	2009	Medicare Blue Private	SC Upstate and Midlands		2	2				2						(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-3453	(800)-760-1790	(888)-899-4219	(888)-899-4219	(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-3453	(800)-760-1790	(888)-899-4219	(888)-899-4219	www.southcarolinablues.cm/medb08	
H4205	006	0	1	09	04	H4205_006_0	6	2009.01	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	http://www.southcarolinablues.com/pffs08	04	09	2	1		H4205	006	0	2009	Medicare Blue Private	SC Coast		2	2				2						(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-3453	(800)-760-1790	(888)-899-4219	(888)-899-4219	(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	www.southcarolinablues.cm/medb08	
H4205	007	0	1	09	04	H4205_007_0	6	2009.01	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	http://www.southcarolinablues.com/pffs08	04	09	2	1		H4205	007	0	2009	Blue Private Plus	Upstate and Midlands		2	2				2						(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-3453	(800)-760-1790	(888)-899-4219	(888)-899-4219	(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-3453	(800)-760-1790	(888)-899-4219	(888)-899-4219	www.southcarolinablues.cm/medb08	
H4205	008	0	1	09	04	H4205_008_0	6	2009.01	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	http://www.southcarolinablues.com/pffs08	04	09	2	1		H4205	008	0	2009	Blue Private Plus	SC Coast		2	2				2						(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-3453	(800)-760-1790	(888)-899-4219	(888)-899-4219	(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-3453	(800)-760-1790	(888)-899-4219	(888)-899-4219	www.southcarolinablues.cm/medb08	
H4205	801	0	1	09	04	H4205_801_0	3	2009.01	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	http://www.southcarolinablues.com/pffs08	04	09	2	1		H4205	801	0	2009	Group Blue Private	South Carolina		1	2				2						(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-3453	(800)-760-1790	(888)-899-4219	(888)-899-4219									www.southcarolinablues.cm/medb08	
H4205	802	0	1	09	04	H4205_802_0	3	2009.01	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	http://www.southcarolinablues.com/pffs08	04	09	2	1		H4205	802	0	2009	Group Blue Private	South Carolina		1	2				2						(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-3453	(800)-760-1790	(888)-899-4219	(888)-899-4219									www.southcarolinablues.cm/medb08	
H4205	803	0	1	09	04	H4205_803_0	3	2009.01	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	http://www.southcarolinablues.com/pffs08	04	09	2	1		H4205	803	0	2009	Group Blue Private MAPD	South Carolina		1	2				2						(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-3453	(800)-760-1790	(888)-899-4219	(888)-899-4219	(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-3453	(800)-760-1790	(888)-899-4219	(888)-899-4219	www.southcarolinablues.cm/medb08	
H4205	804	0	1	09	04	H4205_804_0	3	2009.01	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	http://www.southcarolinablues.com/pffs08	04	09	2	1		H4205	804	0	2009	Group Blue Private MAPD	South Carolina		1	2				2						(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-3453	(800)-760-1790	(888)-899-4219	(888)-899-4219	(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-3453	(800)-760-1790	(888)-899-4219	(888)-899-4219	www.southcarolinablues.cm/medb08	
H4209	001	0	1	04	01	H4209_001_0	5	2009.01	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.southcarolinablues.com/medb08	01	04		1		H4209	001	0	2009	Medicare Blue	Upstate South Carolina		2	2				2						(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-9482	(800)-930-2912	(800)-681-3846	(800)-681-3846	(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-9482	(800)-930-2912	(800)-681-3846	(800)-681-3846	www.southcarolinablues.com/medb08	www.southcarolinablues.com/medb08
H4209	003	0	1	04	01	H4209_003_0	5	2009.01	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.southcarolinablues.com/medb08	01	04		1		H4209	003	0	2009	Medicare Blue	Coastal South Carolina		2	2				2						(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-9482	(800)-930-2912	(800)-681-3846	(800)-681-3846	(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-9482	(800)-930-2912	(800)-681-3846	(800)-681-3846	www.southcarolinablues.com/medb08	www.southcarolinablues.com/medb08
H4209	004	0	1	04	01	H4209_004_0	5	2009.01	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.southcarolinablues.com/medb08	01	04		1		H4209	004	0	2009	Medicare Blue Plus	Upstate South Carolina		2	2				2						(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-9482	(800)-930-2912	(800)-681-3846	(800)-681-3846	(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-9482	(800)-930-2912	(800)-681-3846	(800)-681-3846	www.southcarolinablues.com/medb08	www.southcarolinablues.com/medb08
H4209	006	0	1	04	01	H4209_006_0	5	2009.01	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.southcarolinablues.com/medb08	01	04		1		H4209	006	0	2009	Medicare Blue Plus	Coastal South Carolina		2	2				2						(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-9482	(800)-930-2912	(800)-681-3846	(800)-681-3846	(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-9482	(800)-930-2912	(800)-681-3846	(800)-681-3846	www.southcarolinablues.com/medb08	www.southcarolinablues.com/medb08
H4209	809	0	1	04	01	H4209_809_0	4	2009.01	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.southcarolinablues.com/medb08	01	04		1		H4209	809	0	2009	Group Blue	South Carolina		1	2				2						(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-9482	(800)-930-2912	(800)-681-3846	(888)-300-7215	(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-9482	(800)-930-2912	(800)-681-3846	(888)-300-7215	www.southcarolinablues.com/medb08	www.southcarolinablues.com/medb08
H4209	810	0	1	04	01	H4209_810_0	4	2009.01	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.southcarolinablues.com/medb08	01	04		1		H4209	810	0	2009	Group Blue	South Carolina		1	2				2						(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-9482	(800)-930-2912	(800)-681-3846	(888)-300-7215	(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-9482	(800)-930-2912	(800)-681-3846	(888)-300-7215	www.southcarolinablues.com/medb08	www.southcarolinablues.com/medb08
H4209	811	0	1	04	01	H4209_811_0	4	2009.01	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.southcarolinablues.com/medb08	01	04		1		H4209	811	0	2009	Group Blue	South Carolina		1	2				2						(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-9482	(800)-930-2912	(800)-681-3846	(888)-300-7215									www.southcarolinablues.com/medb08	www.southcarolinablues.com/medb08
H4209	812	0	1	04	01	H4209_812_0	4	2009.01	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.southcarolinablues.com/medb08	01	04		1		H4209	812	0	2009	Group Blue	South Carolina		1	2				2						(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-9482	(800)-930-2912	(800)-681-3846	(888)-300-7215									www.southcarolinablues.com/medb08	www.southcarolinablues.com/medb08
H4270	001	0	1	02	01	H4270_001_0	2	2009.01	UCARE WISCONSIN INSURANCE	UCare	www.ucare.org	01	02		1		H4270	001	0	2009	UCare for Seniors Value	Western Wisconsin - 26 Counties		2	2				2						(612)-676-3600	(877)-523-1515	(612)-676-6810	(800)-688-2534	(612)-676-3500	(877)-523-1518	(612)-676-6810	(800)-688-2534									www.ucare.org	www.ucare.org
H4270	002	0	1	02	01	H4270_002_0	5	2009.01	UCARE WISCONSIN, INC.	UCare	www.ucare.org	01	02		1		H4270	002	0	2009	UCare for Seniors Classic	Western Wisconsin - 26 Counties		2	2				2						(612)-676-3600	(877)-523-1515	(612)-676-6810	(800)-688-2534	(612)-676-3500	(877)-523-1518	(612)-676-6810	(800)-688-2534	(612)-676-3600	(877)-523-1515	(612)-676-6810	(800)-688-2534	(612)-676-3500	(877)-523-1518	(612)-676-6810	(800)-688-2534	www.ucare.org	www.ucare.org
H4270	003	0	1	02	01	H4270_003_0	5	2009.01	UCARE WISCONSIN, INC.	UCare	www.ucare.org	01	02		1		H4270	003	0	2009	UCare for Seniors Value Plus	Western Wisconsin - 26 Counties		2	2				2						(612)-676-3600	(877)-523-1515	(612)-676-6810	(800)-688-2534	(612)-676-3500	(877)-523-1518	(612)-676-6810	(800)-688-2534	(612)-676-3600	(877)-523-1515	(612)-676-6810	(800)-688-2534	(612)-676-3500	(877)-523-1518	(612)-676-6810	(800)-688-2534	www.ucare.org	www.ucare.org
H4270	801	0	1	02	01	H4270_801_0	2	2009.01	UCARE WISCONSIN INSURANCE	UCare	www.ucare.org	01	02		1		H4270	801	0	2009	UCare for Seniors Employers Non Calendar	Minnesota and Western Wisconsin		1	2				2						(612)-676-6840	(877)-447-4385	(612)-676-6810	(800)-688-2534	(612)-676-6900	(877)-598-6574	(612)-676-6810	(800)-688-2534	(612)-676-6840	(877)-447-4385	(612)-676-6810	(800)-688-2534	(612)-676-6900	(877)-598-6574	(612)-676-6810	(800)-688-2534	www.ucare.org	www.ucare.org
H4270	802	0	1	02	01	H4270_802_0	2	2009.01	UCARE WISCONSIN INSURANCE	UCare	www.ucare.org	01	02		1		H4270	802	0	2009	UCare for Seniors Employer Group Calendar	Minnesota and Western Wisconsin		1	2				2						(612)-676-3600	(877)-523-1515	(612)-676-6810	(800)-688-2534	(612)-676-6900	(877)-598-6574	(612)-676-6810	(800)-688-2534	(612)-676-3600	(877)-523-1515	(612)-676-6810	(800)-688-2534	(612)-676-6900	(877)-598-6574	(612)-676-6810	(800)-688-2534	www.ucare.org	www.ucare.org
H4305	001	0	1	20	08	H4305_001_0	1	2009.01	TOTAL LIFE HEALTHCARE	Total Life Healthcare	www.totallifehealthcare.org	08	20		1		H4305	001	0	2009	Total Life Healthcare Dual	Counties: Craighead Cross Greene Law MS Poin Rand		2	2				2														(870)-336-5000	(800)-336-5000			(870)-336-5000	(800)-336-5000			www.allcareofarkansas.org	
H4305	002	0	1	20	08	H4305_002_0	1	2009.01	TOTAL LIFE HEALTHCARE	Total Life Healthcare	www.totallifehealthcare.org	08	20		1		H4305	002	0	2009	Total Life Healthcare Medicare only	Counties:Craighead Cross Greene Law MS Poin Rand		2	2				2														(870)-336-5000	(800)-336-5000			(870)-336-5000	(800)-336-5000			www.allcareofarkansas.org	
H4362	001	0	1	04	01	H4362_001_0	5	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H4362	001	0	2009	Aetna Golden Choice Select Plan	Clark County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H4362	002	0	1	04	01	H4362_002_0	5	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H4362	002	0	2009	Aetna Golden Choice Premier Plan	Clark County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H4362	801	0	1	04	01	H4362_801_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H4362	801	0	2009	Aetna Golden Choice Plan	Clark County		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H4362	802	0	1	04	01	H4362_802_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H4362	802	0	2009	Aetna Golden Choice Plan w/Rx CY	Clark County		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H4393	001	0	1	20	08	H4393_001_0	2	2009.01	CATHOLIC MANAGED LONG TERM CARE, INC.	ArchCare Senior Life	http://www.archcare.org/	08	20		1		H4393	001	0	2009	ArchCare Senior Life - Dual	New York and Bronx counties		2	2				2														(212)-752-2404	(212)-752-2404			(212)-752-2404	(212)-752-2404			www.archcare.org	
H4393	002	0	1	20	08	H4393_002_0	2	2009.01	CATHOLIC MANAGED LONG TERM CARE, INC.	ArchCare Senior Life	http://www.archcare.org/	08	20		1		H4393	002	0	2009	ArchCare Senior Life - Medicare only	New York and Bronx counties		2	2				2														(212)-752-2404	(212)-752-2404			(212)-752-2404	(212)-752-2404			www.archcare.org	
H4402	001	0	1	20	08	H4402_001_0	1	2009.01	ALEXIAN BROTHERS COMMUNITY SERVICES	Alexian Brothers Community Services	WWW.alexianbrotherssoutheast.com.com	08	20		1		H4402	001	0	2009	Alexian Brothers Community Services	Hamilton County Area		2	2				2														(423)-698-0802	(800)-443-8883			(423)-698-0802	(800)-443-8883			None	
H4402	002	0	1	20	08	H4402_002_0	1	2009.01	ALEXIAN BROTHERS COMMUNITY SERVICES	Alexian Brothers Community Services	WWW.alexianbrotherssoutheast.com.com	08	20		1		H4402	002	0	2009	Alexian Brothers Community Services	Hamilton County Area		2	2				2														(423)-698-0802	(800)-441-8883			(423)-698-0802	(800)-441-8883			None	
H4406	001	0	1	02	01	H4406_001_0	7	2009.01	UNITED HEALTHCARE OF TENNESSEE, INC.	AARP MedicareComplete from SecureHorizons	www.AARPMedicareComplete.com	01	02		1		H4406	001	0	2009	AARP MedicareComplete Plus	Davidson, DeKalb, Hickman and Rutherford Counties		2	2				2						(800)-853-2904		(888)-685-8480		(800)-547-5514		(866)-832-8671		(800)-853-2904	(800)-853-2904	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		https://www.securehorizons.com/ourplans/searchformulary.html	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4406	801	0	1	01	01	H4406_801_0	2	2009.01	UNITED HEALTHCARE OF TENNESSEE, INC.	AARP MedicareComplete from SecureHorizons	www.AARPMedicareComplete.com	01	01		1		H4406	801	0	2009	MedicareComplete Retiree Plan	Davidson,DeKalb,Hickman and Rutherford Counties		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		https://www.securehorizons.com/ourplans/searchformulary.html	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4406	803	0	1	01	01	H4406_803_0	2	2009.01	UNITED HEALTHCARE OF TENNESSEE, INC.	AARP MedicareComplete from SecureHorizons	www.AARPMedicareComplete.com	01	01		1		H4406	803	0	2009	MedicareComplete Retiree Plan	Davidson,DeKalb,Hickman and Rutherford Counties		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480										https://www.securehorizons.com/ourplans/searchformulary.html	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4406	804	0	1	01	01	H4406_804_0	2	2009.01	UNITED HEALTHCARE OF TENNESSEE, INC.	AARP MedicareComplete from SecureHorizons	www.AARPMedicareComplete.com	01	01		1		H4406	804	0	2009	Medicare Complete Retiree Plan	Select counties in TN		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		https://www.securehorizons.com/ourplans/searchformulary.html	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4406	805	0	1	01	01	H4406_805_0	2	2009.01	UNITED HEALTHCARE OF TENNESSEE, INC.	AARP MedicareComplete from SecureHorizons	www.AARPMedicareComplete.com	01	01		1		H4406	805	0	2009	Medicare Complete Retiree Plan	Select counties in TN		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480										https://www.securehorizons.com/ourplans/searchformulary.html	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4407	001	0	1	01	01	H4407_001_0	5	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	01	01		1		H4407	001	0	2009	HealthSpring HeathyAdv. Preferred NMS	Northern Counties		2	2			341	2						(888)-501-3965	(888)-501-3965	(866)-206-5565	(866)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806	(888)-501-3965	(888)-501-3965	(866)-206-5565	(866)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H4407	002	0	1	01	01	H4407_002_0	5	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	01	01		1		H4407	002	0	2009	HealthSpring HealthyAdvantage Plus	Southern		2	2			1429	2						(888)-201-4963	(888)-201-4963	(877)-262-9090	(877)-262-9090	(888)-767-1879	(888)-767-1879	(877)-262-9090	(877)-262-9090	(888)-501-3965	(888)-501-3965	(866)-206-5565	(866)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H4407	003	0	1	01	01	H4407_003_0	6	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	01	01		1		H4407	003	0	2009	HealthSpring TotalCare NMS	Northern Counties		2	1	3		196	2			1	2		(888)-501-3965	(888)-501-3965	(866)-206-5565	(866)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806	(888)-501-3965	(888)-501-3965	(866)-206-5565	(866)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H4407	004	0	1	01	01	H4407_004_0	5	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	01	01		1		H4407	004	0	2009	HealthSpring TotalCare	Southern		2	1	3		1182	2			1	2		(888)-201-4963	(888)-201-4963	(877)-262-9090	(877)-262-9090	(888)-767-1879	(888)-767-1879	(877)-262-9090	(877)-262-9090	(888)-501-3965	(888)-501-3965	(866)-206-5565	(866)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H4407	005	0	1	01	01	H4407_005_0	5	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	01	01		1		H4407	005	0	2009	HealthSpring HealthyAdvantage NMS	Northern Counties		2	2			55	2						(888)-501-3965	(888)-501-3965	(866)-206-5565	(866)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806									www.healthspring.com	www.healthspring.com
H4407	007	0	1	01	01	H4407_007_0	4	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	01	01		1		H4407	007	0	2009	HealthSpring OptimaCare NMS	Northern Mississippi Counties		2	1	4		20	1	1		1		0000001010000000000000000001	(888)-501-3965	(888)-501-3965	(866)-206-5565	(866)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806	(888)-501-3965	(888)-501-3965	(866)-206-5565	(866)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H4407	009	0	1	01	01	H4407_009_0	5	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	01	01		1		H4407	009	0	2009	HealthSpring HealthyLiving NMS	Northern Counties		2	2			20	2						(888)-501-3965	(888)-501-3965	(866)-206-5565	(866)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806	(888)-501-3965	(888)-501-3965	(866)-206-5565	(866)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H4407	011	0	1	01	01	H4407_011_0	6	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	01	01		1		H4407	011	0	2009	HealthSpring HealthyAdvantage	Southern		2	2			56	2						(888)-201-4963	(888)-201-4963	(877)-262-9090	(877)-262-9090	(888)-767-1879	(888)-767-1879	(877)-262-9090	(877)-262-9090									www.healthspring.com	www.healthspring.com
H4407	012	0	1	01	01	H4407_012_0	5	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	01	01		1		H4407	012	0	2009	HealthSpring HealthyLiving Plus	Southern		2	2			46	2						(888)-201-4963	(888)-201-4963	(877)-262-9090	(877)-262-9090	(888)-767-1879	(888)-767-1879	(877)-262-9090	(877)-262-9090	(888)-501-3965	(888)-501-3965	(866)-206-5565	(866)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H4407	013	0	1	01	01	H4407_013_0	4	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	01	01		1		H4407	013	0	2009	HealthSpring OptimaCare	South		2	1	4		13	2			1		0000001010000000000000000001	(888)-201-4963	(888)-201-4963	(877)-262-9090	(877)-262-9090	(888)-767-1879	(888)-767-1879	(877)-262-9090	(877)-262-9090	(888)-501-3965	(888)-501-3965	(866)-206-5565	(866)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H4407	015	0	1	01	01	H4407_015_0	5	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	01	01		1		H4407	015	0	2009	HealthSpring TotalCare South	South		2	1	3		401	2			1	2		(888)-201-4963	(888)-201-4963	(877)-262-9090	(877)-262-9090	(888)-767-1879	(888)-767-1879	(877)-262-9090	(877)-262-9090	(888)-501-3965	(888)-501-3965	(866)-206-5565	(866)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H4407	018	0	1	01	01	H4407_018_0	5	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	01	01		1		H4407	018	0	2009	HealthSpring OptimaCare South	South		2	1	4		17	2			1		0000001010000000000000000001	(888)-201-4963	(888)-201-4963	(877)-262-9090	(877)-262-9090	(888)-767-1879	(888)-767-1879	(877)-262-9090	(877)-262-9090	(888)-501-3965	(888)-501-3965	(866)-206-5565	(866)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H4407	019	0	1	01	01	H4407_019_0	6	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	01	01		1		H4407	019	0	2009	HealthSpring HealthyLiving Elite NMS	Northern MS		2	2				1	1					(888)-501-3965	(888)-501-3965	(866)-206-5565	(866)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806	(888)-501-3965	(888)-501-3965	(866)-206-5565	(866)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H4407	020	0	1	01	01	H4407_020_0	5	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	01	01		1		H4407	020	0	2009	HealthSpring HealthyLiving Premier	Southern Ms		2	2			1429	2						(888)-201-4963	(888)-201-4963	(877)-262-9090	(877)-262-9090	(888)-767-1879	(888)-767-1879	(877)-262-9090	(877)-262-9090	(888)-501-3965	(888)-501-3965	(866)-206-5565	(866)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H4407	802	0	1	01	01	H4407_802_0	2	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	01	01		1		H4407	802	0	2009	HealthSpring Retiree Adv. Care-Cal Yr	Mississippi		1	2			42	2						(888)-501-3965	(888)-501-3965	(866)-206-5565	(866)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806									www.healthspring.com	www.healthspring.com
H4407	807	0	1	01	01	H4407_807_0	2	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	01	01		1		H4407	807	0	2009	HealthSpring Retiree Adv. Plus-Cal. Yr	Mississippi		1	2			42	2						(888)-501-3965	(888)-501-3965	(866)-206-5565	(866)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806	(888)-501-3965	(888)-501-3965	(866)-206-5565	(866)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H4407	808	0	1	01	01	H4407_808_0	2	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	01	01		1		H4407	808	0	2009	HealthSpring Retiree Adv. Care-Cont. Yr	Mississippi		1	2			42	2						(888)-501-3965	(888)-501-3965	(866)-206-5565	(866)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806									www.healthspring.com	www.healthspring.com
H4407	809	0	1	01	01	H4407_809_0	2	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring, Inc.	www.healthspring.com	01	01		1		H4407	809	0	2009	HealthSpring Retiree Adv. Plus-Cont. Yr	Mississippi		1	2			42	2						(888)-501-3965	(888)-501-3965	(866)-206-5565	(866)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806	(888)-501-3965	(888)-501-3965	(866)-206-5565	(866)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H4408	001	0	1	04	01	H4408_001_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4408	001	0	2009	HumanaChoicePPO PPO H4408-001	Memphis Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4408	002	0	1	04	01	H4408_002_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4408	002	0	2009	HumanaChoicePPO PPO H4408-002	Nashville Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4408	006	0	1	04	01	H4408_006_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4408	006	0	2009	HumanaChoicePPO PPO H4408-006	Chattanooga Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4408	007	0	1	04	01	H4408_007_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4408	007	0	2009	HumanaChoicePPO PPO H4408-007	Knoxville Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4408	801	0	1	04	01	H4408_801_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4408	801	0	2009	Humana Employer Sponsored	Memphis and Nashville Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4408	803	0	1	04	01	H4408_803_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4408	803	0	2009	Humana Employer Sponsored	Memphis and Nashville Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4408	804	0	1	04	01	H4408_804_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4408	804	0	2009	Humana Employer Sponsored Non-CY	Memphis and Nashville Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4408	805	0	1	04	01	H4408_805_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4408	805	0	2009	Humana Employer Sponsored Non-CY	Memphis and Nashville Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4449	008	0	1	09	04	H4449_008_0	3	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierraoptima.com	04	09	2	1		H4449	008	0	2009	Sierra Optima Choice	Counties:King,Kittitas,Snohomish,Spokane,Whatcom		2	2				2						(888)-274-2207	(888)-274-2207	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538									www.sierraoptima.com	
H4449	011	0	1	09	04	H4449_011_0	5	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierraoptima.com	04	09	2	1		H4449	011	0	2009	Sierra Optima Select	Some AZ and all NV, UT and ID counties		2	2				2						(888)-274-2207	(888)-274-2207	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538									www.sierraoptima.com	
H4449	012	0	1	09	04	H4449_012_0	2	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierraoptima.com	04	09	2	1		H4449	012	0	2009	Sierra Optima Choice Plus	Counties:King,Kittitas,Snohomish,Spokane,Whatcom		2	2				2						(888)-274-2207	(888)-274-2207	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538									www.sierraoptima.com	
H4449	013	0	1	09	04	H4449_013_0	8	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierraoptima.com	04	09	2	1		H4449	013	0	2009	Sierra Optima Select Rx	Some AZ and all NV, UT and ID counties		2	2				2						(888)-274-2207	(888)-274-2207	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	(888)-274-2207	(888)-274-2207	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	www.sierraoptima.com	
H4454	002	0	1	01	01	H4454_002_0	3	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	01	01		1		H4454	002	0	2009	HealthSpring HealthyAdvantage Preferred	Middle and South East Tennessee		2	2			29406	1	1					(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806	(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	healthspring.com
H4454	007	0	1	01	01	H4454_007_0	3	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	01	01		1		H4454	007	0	2009	HealthSpring HealthyLiving Preferred	Middle and South East Tennessee		2	2			400	1	1					(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806	(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	healthspring.com
H4454	008	0	1	01	01	H4454_008_0	3	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	01	01		1		H4454	008	0	2009	HealthSpring TotalCare West	West Tennessee		2	1	3		2782	2			1	2		(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806	(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	healthspring.com
H4454	012	0	1	01	01	H4454_012_0	3	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	01	01		1		H4454	012	0	2009	HealthSpring HealthyAdvantage	Middle, South East and West Tennessee		2	2			3970	2						(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806									www.healthspring.com	healthspring.com
H4454	013	0	1	01	01	H4454_013_0	4	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	01	01		1		H4454	013	0	2009	HealthSpring SpecialCare	Middle, South East and West Tennessee		2	1	1	1	500	2			1			(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806	(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	healthspring.com
H4454	018	0	1	01	01	H4454_018_0	2	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	01	01		1		H4454	018	0	2009	HealthSpring OptimaCare Preferred	Middle Tennessee		2	1	4		3600	1	1		1		0000001010000000000000000001	(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806	(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	healthspring.com
H4454	019	0	1	01	01	H4454_019_0	3	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	01	01		1		H4454	019	0	2009	HealthSpring HealthyAdv. Preferred West	West Tennessee		2	2			3183	2						(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806	(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	healthspring.com
H4454	020	0	1	01	01	H4454_020_0	3	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	01	01		1		H4454	020	0	2009	HealthSpring TotalCare	Middle Tennessee		2	1	3		4092	2			1	2		(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806	(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	healthspring.com
H4454	021	0	1	01	01	H4454_021_0	3	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	01	01		1		H4454	021	0	2009	HealthSpring HealthyAdvantage Select	Middle Tennessee		2	2			5683	1	1					(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806	(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	healthspring.com
H4454	022	0	1	01	01	H4454_022_0	2	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	01	01		1		H4454	022	0	2009	HealthSpring HealthyLiving Select	Middle Tennessee		2	2			400	1	1					(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806	(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	healthspring.com
H4454	023	0	1	01	01	H4454_023_0	2	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	01	01		1		H4454	023	0	2009	HealthSpring OptimaCare Select	Middle Tennessee		2	1	4		400	2			1		0000001010000000000000000001	(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806	(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	healthspring.com
H4454	024	0	1	01	01	H4454_024_0	2	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	01	01		1		H4454	024	0	2009	HealthSpring HealthyLiving West	West Tennessee		2	2			400	2						(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806	(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	healthspring.com
H4454	025	0	1	01	01	H4454_025_0	2	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	01	01		1		H4454	025	0	2009	HealthSpring OptimaCare East  West	South East and West Tennessee		2	1	4		437	1	1		1		0000001010000000000000000001	(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806	(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	healthspring.com
H4454	027	0	1	01	01	H4454_027_0	6	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	01	01		1		H4454	027	0	2009	HealthSpring HealthyLiving Elite	Tennessee		2	2				1	1					(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806	(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	www.healthspring.com	healthspring.com
H4454	028	0	1	01	01	H4454_028_0	3	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	01	01		1		H4454	028	0	2009	HealthSpring HealthyAdv Primary Plan	South East Tennessee		2	2			1262	2						(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806	(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	healthspring.com
H4454	803	0	1	01	01	H4454_803_0	2	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	01	01		1		H4454	803	0	2009	HealthSpring Retiree Adv. Care-Cal. Yr	Tennessee		1	2			159	2						(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806									www.healthspring.com	healthspring.com
H4454	805	0	1	01	01	H4454_805_0	4	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	01	01		1		H4454	805	0	2009	HealthSpring Retiree Adv. Plus-Cal Yr	Tennessee		1	2			1151	2						(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806	(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	healthspring.com
H4454	806	0	1	01	01	H4454_806_0	2	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	01	01		1		H4454	806	0	2009	HealthSpring Retiree Adv. Care-Cont.Yr	Tennessee		1	2			20	2						(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806									www.healthspring.com	healthspring.com
H4454	807	0	1	01	01	H4454_807_0	2	2009.01	HEALTHSPRING OF TENNESSEE, INC.	Healthspring	www.healthspring.com	01	01		1		H4454	807	0	2009	HealthSpring Retiree Adv. Plus-Cont. Yr	Tennessee		1	2			20	2						(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(866)-593-4468	(866)-593-4468	(800)-391-9806	(800)-391-9806	(888)-501-3965	(888)-501-3965	(886)-206-5565	(886)-206-5565	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	healthspring.com
H4456	010	0	1	01	01	H4456_010_0	5	2009.01	UNITED HEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4456	010	0	2009	AARP MedicareComplete Plan 1	Select counties in Illinois		2	2				2						(800)-435-1989	(800)-435-1989	(800)-884-4327		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-435-1989	(800)-435-1989	(800)-884-4327		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4456	013	0	1	01	01	H4456_013_0	5	2009.01	UNITED HEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4456	013	0	2009	AARP MedicareComplete Plan 1	Eastern Tennessee and Southwestern Virginia		2	2				2						(800)-435-1989	(800)-435-1989	(800)-884-4327		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-435-1989	(800)-435-1989	(800)-884-4327		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4456	015	0	1	01	01	H4456_015_0	5	2009.01	UNITED HEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4456	015	0	2009	AARP MedicareComplete Plan 2	Select counties in Iowa and Illinois		2	2				2						(800)-435-1989	(800)-435-1989	(800)-884-4327		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-435-1989	(800)-435-1989	(800)-884-4327		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4456	016	0	1	01	01	H4456_016_0	4	2009.01	UNITED HEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4456	016	0	2009	AARP MedicareComplete Essential	Select counties in Iowa and Illinois		2	2				2						(800)-435-1989	(800)-435-1989	(800)-884-4327		(800)-547-5514	(800)-547-5514	(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4456	017	0	1	01	01	H4456_017_0	6	2009.01	UNITED HEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4456	017	0	2009	AARP MedicareComplete Plan 3	Select counties in Iowa and Illinois		2	2				2						(800)-435-1989	(800)-435-1989	(800)-884-4327		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-435-1989	(800)-435-1989	(800)-884-4327		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4456	019	0	1	01	01	H4456_019_0	5	2009.01	UNITED HEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4456	019	0	2009	AARP MedicareComplete Plan 2	Eastern Tennessee and Southwestern Virginia		2	2				2						(800)-435-1989	(800)-435-1989	(800)-884-4327		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-435-1989	(800)-435-1989	(800)-884-4327		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4456	020	0	1	01	01	H4456_020_0	3	2009.01	UNITED HEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4456	020	0	2009	AARP MedicareComplete Essential	Eastern Tennessee and Southwestern Virginia		2	2				2						(800)-435-1989	(800)-435-1989	(800)-884-4327		(800)-547-5514	(800)-547-5514	(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4456	021	0	1	01	01	H4456_021_0	5	2009.01	UNITED HEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4456	021	0	2009	AARP MedicareComplete Plan 3	Eastern Tennessee and Southwestern Virginia		2	2				2						(800)-435-1989	(800)-435-1989	(800)-884-4327		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-435-1989	(800)-435-1989	(800)-884-4327		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4456	024	0	1	02	01	H4456_024_0	5	2009.01	UNITED HEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H4456	024	0	2009	Evercare Plan IH-POS	Bradley, Hamilton and McMinn Counties		2	1	1	1		2			1			(866)-846-2762	(866)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(866)-846-2762	(866)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4456	025	0	1	01	01	H4456_025_0	4	2009.01	UNITED HEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4456	025	0	2009	AARP MedicareComplete Plan 1	Counties in IA		2	2				2						(800)-435-1989	(800)-435-1989	(800)-884-4327		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-435-1989	(800)-435-1989	(800)-884-4327		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4456	026	0	1	02	01	H4456_026_0	6	2009.01	UNITED HEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H4456	026	0	2009	AARP MedicareComplete Plus Plan 1	Knox		2	2				2						(800)-435-1989	(800)-435-1989	(800)-884-4327		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-435-1989	(800)-435-1989	(800)-884-4327		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4456	027	0	1	02	01	H4456_027_0	3	2009.01	UNITED HEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H4456	027	0	2009	AARP MedicareComplete Plus Plan 2	Select Counties in TN		2	2				2						(800)-435-1989	(800)-435-1989	(800)-884-4327		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-435-1989	(800)-435-1989	(800)-884-4327		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4456	028	0	1	02	01	H4456_028_0	3	2009.01	UNITED HEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H4456	028	0	2009	AARP MedicareComplete Plus Plan 3	Select Counties in TN		2	2				2						(800)-435-1989	(800)-435-1989	(800)-884-4327		(800)-547-5514	(800)-547-5514	(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4456	801	0	1	01	01	H4456_801_0	2	2009.01	UNITED HEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4456	801	0	2009	MedicareComplete Retiree Plan	Eastern Tennessee and Southwestern Virginia		1	2				2						(800)-435-1989		(800)-884-4327		(800)-962-4709		(866)-832-8671		(800)-435-1989	(800)-435-1989	(800)-884-4327		(800)-962-4709	(800)-962-4709	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4456	805	0	1	01	01	H4456_805_0	2	2009.01	UNITED HEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4456	805	0	2009	MedicareComplete Retiree Plan	Eastern Tennessee and Southwestern Virginia		1	2				2						(800)-435-1989		(800)-884-4327		(800)-962-4709		(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4456	810	0	1	01	01	H4456_810_0	2	2009.01	UNITED HEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4456	810	0	2009	MedicareComplete Retiree Plan	Select counties in IL		1	2				2						(800)-435-1989		(800)-884-4327		(800)-962-4709		(866)-832-8671		(800)-435-1989	(800)-435-1989	(800)-884-4327		(800)-962-4709	(800)-962-4709	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4456	811	0	1	01	01	H4456_811_0	2	2009.01	UNITED HEALTHCARE PLAN OF THE RIVER VALLEY, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4456	811	0	2009	MedicareComplete Retiree Plan	Select Counties in VA		1	2				2						(800)-435-1989		(800)-884-4327		(800)-962-4709		(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4461	001	0	1	01	01	H4461_001_0	7	2009.01	CARITEN HEALTH PLAN IN	Cariten Senior Health	http://www.caritenseniorhealth.com/	01	01		1		H4461	001	0	2009	Cariten Senior Health-Advantage Plus	East Tennessee		2	2			25000	2						(865)-670-7790	(888)-817-5838	(865)-470-8409	(800)-396-2150	(865)-670-7780	(888)-285-2599	(865)-470-8409	(800)-396-2150	(865)-670-7790	(888)-817-5838	(865)-470-8409	(800)-396-2150	(865)-670-7780	(888)-285-2599	(865)-470-8409	(800)-396-2150	http://www.caritenseniorhealth.com/cfml/pharmacy/formulary/default.cfm	http://www.caritenseniorhealth.com
H4461	004	0	1	01	01	H4461_004_0	6	2009.01	CARITEN HEALTH PLAN IN	Cariten Senior Health	http://www.caritenseniorhealth.com/	01	01		1		H4461	004	0	2009	Cariten Senior Health-Advantage	East Tennessee		2	2			25000	2						(865)-670-7790	(888)-817-5838	(865)-470-8409	(800)-396-2150	(865)-670-7780	(888)-285-2599	(865)-470-8409	(800)-396-2150									http://www.caritenseniorhealth.com/cfml/pharmacy/formulary/default.cfm	http://www.caritenseniorhealth.com
H4461	007	0	1	01	01	H4461_007_0	4	2009.01	CARITEN HEALTH PLAN IN	Cariten Senior Health	http://www.caritenseniorhealth.com/	01	01		1		H4461	007	0	2009	Cariten Senior Health-Advantage Hamilton	Hamilton County		2	2			25000	2						(865)-670-7790	(888)-817-5838	(865)-470-8409	(800)-396-2150	(865)-670-7780	(888)-285-2599	(865)-470-8409	(800)-396-2150									http://www.caritenseniorhealth.com/cfml/pharmacy/formulary/default.cfm	http://www.caritenseniorhealth.com
H4461	011	0	1	01	01	H4461_011_0	9	2009.01	CARITEN HEALTH PLAN IN	Cariten Senior Health	http://www.caritenseniorhealth.com/	01	01		1		H4461	011	0	2009	Cariten Senior Health Complete	East Tennessee		2	1	3		25000	2			1	3		(865)-670-7790	(888)-817-5838	(865)-470-8409	(800)-396-2150	(865)-670-7780	(888)-285-2599	(865)-470-8409	(800)-396-2150	(865)-670-7790	(888)-817-5838	(865)-470-8409	(800)-396-2150	(865)-670-7780	(888)-285-2599	(865)-470-8409	(800)-396-2150	http://www.caritenseniorhealth.com/cfml/pharmacy/formulary/default.cfm	http://www.caritenseniorhealth.com
H4461	012	0	1	01	01	H4461_012_0	7	2009.01	CARITEN HEALTH PLAN IN	Cariten Senior Health	http://www.caritenseniorhealth.com/	01	01		1		H4461	012	0	2009	CSH Advantage Plus Hamilton	Hamilton County, Tennessee		2	2			25000	2						(865)-670-7790	(888)-817-5838	(865)-470-8409	(800)-396-2150	(865)-670-7780	(888)-285-2599	(865)-470-8409	(800)-396-2150	(865)-670-7790	(888)-817-5838	(865)-470-8409	(800)-396-2150	(865)-670-7780	(888)-285-2599	(865)-470-8409	(800)-396-2150	http://www.caritenseniorhealth.com/cfml/pharmacy/formulary/default.cfm	http://www.caritenseniorhealth.com
H4461	014	0	1	01	01	H4461_014_0	9	2009.01	CARITEN HEALTH PLAN IN	Cariten Senior Health	http://www.caritenseniorhealth.com/	01	01		1		H4461	014	0	2009	Cariten Senior Health Value	East Tennessee		2	2			25000	2						(865)-670-7790	(888)-817-5838	(865)-470-8409	(800)-396-2150	(865)-670-7780	(888)-285-2599	(865)-470-8409	(800)-396-2150									http://www.caritenseniorhealth.com/cfml/pharmacy/formulary/default.cfm	http://www.caritenseniorhealth.com
H4461	015	0	1	01	01	H4461_015_0	11	2009.01	CARITEN HEALTH PLAN IN	Cariten Senior Health	http://www.caritenseniorhealth.com/	01	01		1		H4461	015	0	2009	Cariten Senior Health Value Plus	East Tennessee		2	2			25000	2						(865)-670-7790	(888)-817-5838	(865)-470-8409	(800)-396-2150	(865)-670-7780	(888)-285-2599	(865)-470-8409	(800)-396-2150	(865)-670-7790	(888)-817-5838	(865)-470-8409	(800)-396-2150	(865)-670-7780	(888)-285-2599	(865)-470-8409	(800)-396-2150	http://www.caritenseniorhealth.com/cfml/pharmacy/formulary/default.cfm	http://www.caritenseniorhealth.com
H4461	016	0	1	01	01	H4461_016_0	10	2009.01	CARITEN HEALTH PLAN IN	Cariten Senior Health	http://www.caritenseniorhealth.com/	01	01		1		H4461	016	0	2009	Cariten Senior Health Adv  Elite	East Tennessee		2	2			25000	2						(865)-670-7790	(888)-817-5838	(865)-470-8409	(800)-396-2150	(865)-670-7780	(888)-285-2599	(865)-470-8409	(800)-396-2150	(865)-670-7790	(888)-817-5838	(865)-470-8409	(800)-396-2150	(865)-670-7780	(888)-285-2599	(865)-470-8409	(800)-396-2150	http://www.caritenseniorhealth.com/cfml/pharmacy/formulary/default.cfm	http://www.caritenseniorhealth.com
H4461	017	0	1	01	01	H4461_017_0	10	2009.01	CARITEN HEALTH PLAN IN	Cariten Senior Health	http://www.caritenseniorhealth.com/	01	01		1		H4461	017	0	2009	Cariten Senior Health Value Elite	East Tennessee		2	2			25000	2						(865)-670-7790	(888)-817-5838	(865)-470-8409	(800)-396-2150	(865)-670-7780	(888)-285-2599	(865)-470-8409	(800)-396-2150	(865)-670-7790	(888)-817-5838	(865)-470-8409	(800)-396-2150	(865)-670-7780	(888)-285-2599	(865)-470-8409	(800)-396-2150	http://www.caritenseniorhealth.com/cfml/pharmacy/formulary/default.cfm	http://www.caritenseniorhealth.com
H4506	003	0	1	01	01	H4506_003_0	5	2009.01	SELECTCARE OF TEXAS, L.L.C.	SelectCare of Texas, LLC	www.sctexas.com	01	01		1		H4506	003	0	2009	TexanPlus Classic powered by CCRx	Greater Houston Metro Area		2	2				2						(866)-230-2513	(866)-230-2513	(888)-685-8480	(888)-685-8480	(866)-556-4607	(866)-556-4607	(866)-338-4681	(866)-338-4681	(866)-230-2513	(866)-230-2513	(888)-685-8480	(888)-685-8480	(866)-556-4607	(866)-556-4607	(866)-338-4681	(866)-338-4681	http://www.sctexas.com/PresentFormulary	www.sctexas.com
H4506	010	0	1	01	01	H4506_010_0	3	2009.01	SELECTCARE OF TEXAS, L.L.C.	SelectCare of Texas, LLC	www.sctexas.com	01	01		1		H4506	010	0	2009	TexanPlus Classic	Greater Houston Metro Area		2	2				2						(866)-230-2513	(866)-230-2513	(888)-685-8480	(888)-685-8480	(866)-556-4607	(866)-556-4607	(866)-338-4681	(866)-338-4681									http://www.sctexas.com/PresentFormulary	www.sctexas.com
H4506	023	0	1	01	01	H4506_023_0	6	2009.01	SELECTCARE OF TEXAS, L.L.C.	SelectCare of Texas, LLC	www.sctexas.com	01	01		1		H4506	023	0	2009	TexanPlus Star powered by CCRx	Greater Houston Metro Area		2	2				2						(866)-230-2513	(866)-230-2513	(888)-685-8480	(888)-685-8480	(866)-556-4607	(866)-556-4607	(866)-338-4681	(866)-338-4681	(866)-230-2513	(866)-230-2513	(888)-685-8480	(888)-685-8480	(866)-556-4607	(866)-556-4607	(866)-338-4681	(866)-338-4681	http://www.sctexas.com/PresentFormulary	www.sctexas.com
H4506	025	0	1	01	01	H4506_025_0	6	2009.01	SELECTCARE OF TEXAS, L.L.C.	SelectCare of Texas, LLC	www.sctexas.com	01	01		1		H4506	025	0	2009	TexanPlus Premier powered by CCRx	The Golden Triangle		2	2				2						(866)-230-2513	(866)-230-2513	(888)-685-8480	(888)-685-8480	(866)-556-4607	(866)-556-4607	(866)-338-4681	(866)-338-4681	(866)-230-2513	(866)-230-2513	(888)-685-8480	(888)-685-8480	(866)-556-4607	(866)-556-4607	(866)-338-4681	(866)-338-4681	http://www.sctexas.com/PresentFormulary	www.sctexas.com
H4506	801	0	1	01	01	H4506_801_0	2	2009.01	SELECTCARE OF TEXAS, L.L.C.	SelectCare of Texas, LLC	www.sctexas.com	01	01		1		H4506	801	0	2009	H4506 - Retiree - MA-PD non-CY	TexanPlus-Employer Group (MAPD nonCY)		1	2				2						(866)-230-2513	(866)-230-2513	(888)-685-8480	(888)-685-8480	(866)-556-4607	(866)-556-4607	(866)-338-4681	(866)-338-4681	(866)-230-2513	(866)-230-2513	(888)-685-8480	(888)-685-8480	(866)-556-4607	(866)-556-4607	(866)-338-4681	(866)-338-4681	http://www.sctexas.com/PresentFormulary	www.sctexas.com
H4506	806	0	1	01	01	H4506_806_0	2	2009.01	SELECTCARE OF TEXAS, L.L.C.	SelectCare of Texas, LLC	www.sctexas.com	01	01		1		H4506	806	0	2009	H4506 - Retiree - MA-PD CY	TexanPlus-Employer Group (MAPD CY)		1	2				2						(866)-230-2513	(866)-230-2513	(888)-685-8480	(888)-685-8480	(866)-556-4607	(866)-556-4607	(866)-338-4681	(866)-338-4681	(866)-230-2513	(866)-230-2513	(888)-685-8480	(888)-685-8480	(866)-556-4607	(866)-556-4607	(866)-338-4681	(866)-338-4681	http://www.sctexas.com/PresentFormulary	www.sctexas.com
H4506	808	0	1	01	01	H4506_808_0	2	2009.01	SELECTCARE OF TEXAS, L.L.C.	SelectCare of Texas, LLC	www.sctexas.com	01	01		1		H4506	808	0	2009	H4506 - Retiree MA	TexanValue-Employer Group (MA Only)		1	2				2						(866)-230-2513	(866)-230-2513	(888)-685-8480	(888)-685-8480	(866)-556-4607	(866)-556-4607	(866)-338-4681	(866)-338-4681									http://www.sctexas.com/PresentFormulary	www.sctexas.com
H4510	012	0	1	01	01	H4510_012_0	7	2009.01	HUMANA HEALTH PLAN OF TEXAS,INC.	Humana Health Plan of Texas, Inc.	www.humana-medicare.com	01	01		1		H4510	012	0	2009	Humana Gold Plus HMO H4510-012	Corpus Christi Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tool/medicare_drug_list.asp	
H4510	015	0	1	01	01	H4510_015_0	7	2009.01	HUMANA HEALTH PLAN OF TEXAS,INC.	Humana Health Plan of Texas, Inc.	www.humana-medicare.com	01	01		1		H4510	015	0	2009	Humana Gold Plus HMO H4510-015	San Antonio Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tool/medicare_drug_list.asp	
H4510	017	0	1	01	01	H4510_017_0	4	2009.01	HUMANA HEALTH PLAN OF TEXAS,INC.	Humana Health Plan of Texas, Inc.	www.humana-medicare.com	01	01		1		H4510	017	0	2009	Humana Gold Plus HMO SNP-DE H4510-017	Bexar and Nueces County		2	1	3			2			1	2		(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tool/medicare_drug_list.asp	
H4510	018	0	1	01	01	H4510_018_0	5	2009.01	HUMANA HEALTH PLAN OF TEXAS,INC.	Humana Health Plan of Texas, Inc.	www.humana-medicare.com	01	01		1		H4510	018	0	2009	Humana Gold Plus HMO H4510-018	Dallas, Rockwall		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tool/medicare_drug_list.asp	
H4510	019	0	1	01	01	H4510_019_0	4	2009.01	HUMANA HEALTH PLAN OF TEXAS,INC.	Humana Health Plan of Texas, Inc.	www.humana-medicare.com	01	01		1		H4510	019	0	2009	Humana Gold Plus HMO SNP-DE H4510-019	Dallas County		2	1	3			2			1	2		(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tool/medicare_drug_list.asp	
H4510	801	0	1	01	01	H4510_801_0	4	2009.01	HUMANA HEALTH PLAN OF TEXAS,INC.	Humana Health Plan of Texas, Inc.	www.humana-medicare.com	01	01		1		H4510	801	0	2009	Humana Employer sponsored	Bexar, Aransas, Nueces and San Patricio counties		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tool/medicare_drug_list.asp	
H4510	802	0	1	01	01	H4510_802_0	4	2009.01	HUMANA HEALTH PLAN OF TEXAS,INC.	Humana Health Plan of Texas, Inc.	www.humana-medicare.com	01	01		1		H4510	802	0	2009	Humana Employer Sponsored	Bexar, Aransas, Nueces and San Patricio counties		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tool/medicare_drug_list.asp	
H4510	803	0	1	01	01	H4510_803_0	4	2009.01	HUMANA HEALTH PLAN OF TEXAS,INC.	Humana Health Plan of Texas, Inc.	www.humana-medicare.com	01	01		1		H4510	803	0	2009	Humana Employer Sponsored Non-CY	Select Texas Counties		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tool/medicare_drug_list.asp	
H4510	804	0	1	01	01	H4510_804_0	4	2009.01	HUMANA HEALTH PLAN OF TEXAS,INC.	Humana Health Plan of Texas, Inc.	www.humana-medicare.com	01	01		1		H4510	804	0	2009	Humana Employer Sponsored Non-CY	Select Texas Counties		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tool/medicare_drug_list.asp	
H4513	001	0	1	01	01	H4513_001_0	3	2009.01	TEXAS HEALTHSPRING LLC	Texas HealthSpring	www.healthspring.com	01	01		1		H4513	001	0	2009	TXHS HealthyAdvantage Plus	Upper Gulf Coast and East Texas		2	2			25870	2						(832)-553-3480	(800)-280-8888	(877)-893-1504	(877)-893-1504	(800)-846-2098	(800)-846-2098	(877)-893-1504	(877)-893-1504	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
H4513	009	0	1	01	01	H4513_009_0	3	2009.01	TEXAS HEALTHSPRING LLC	Texas HealthSpring	www.healthspring.com	01	01		1		H4513	009	0	2009	TXHS HealthyAdvantage True Choice	Upper Gulf Coast and East Texas		2	2			1224	2						(832)-553-3480	(800)-280-8888	(877)-893-1504	(877)-893-1504	(800)-846-2098	(800)-846-2098	(877)-893-1504	(877)-893-1504									www.healthspring.com	
H4513	010	0	1	01	01	H4513_010_0	3	2009.01	TEXAS HEALTHSPRING LLC	Texas HealthSpring	www.healthspring.com	01	01		1		H4513	010	0	2009	Texas HealthSpring TotalCare	Texas HealthSpring Counties		2	1	3		7887	2			1	2		(832)-553-3480	(800)-280-8888	(877)-893-1504	(877)-893-1504	(800)-846-2098	(800)-846-2098	(877)-893-1504	(877)-893-1504	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
H4513	014	0	1	01	01	H4513_014_0	3	2009.01	TEXAS HEALTHSPRING LLC	Texas HealthSpring	www.healthspring.com	01	01		1		H4513	014	0	2009	TXHS HealthyAdvantage Valley	Valley Counties		2	2			1329	2						(832)-553-3480	(800)-280-8888	(877)-893-1504	(877)-893-1504	(800)-846-2098	(800)-846-2098	(877)-893-1504	(877)-893-1504	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
H4513	015	0	1	01	01	H4513_015_0	3	2009.01	TEXAS HEALTHSPRING LLC	Texas HealthSpring	www.healthspring.com	01	01		1		H4513	015	0	2009	Texas HealthSpring SpecialCare	Texas HealthSpring Counties		2	1	1	1	98	2			1			(832)-553-3480	(800)-280-8888	(877)-893-1504	(877)-893-1504	(800)-846-2098	(800)-846-2098	(877)-893-1504	(877)-893-1504	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
H4513	019	0	1	01	01	H4513_019_0	3	2009.01	TEXAS HEALTHSPRING LLC	Texas HealthSpring	www.healthspring.com	01	01		1		H4513	019	0	2009	Texas HealthSpring OptimaCare	Texas HealthSpring Counties		2	1	4		4240	2			1		0000001010000000000000000001	(832)-553-3480	(800)-280-8888	(877)-893-1504	(877)-893-1504	(800)-846-2098	(800)-846-2098	(877)-893-1504	(877)-893-1504	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
H4513	020	0	1	01	01	H4513_020_0	3	2009.01	TEXAS HEALTHSPRING LLC	Texas HealthSpring	www.healthspring.com	01	01		1		H4513	020	0	2009	TXHS HealthyAdvantage Sadler	Upper Gulf Coast and East Texas		2	2			1901	2						(832)-553-3480	(800)-280-8888	(877)-893-1504	(877)-893-1504	(800)-846-2098	(800)-846-2098	(877)-893-1504	(877)-893-1504	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
H4513	021	0	1	01	01	H4513_021_0	4	2009.01	TEXAS HEALTHSPRING LLC	Texas HealthSpring	www.healthspring.com	01	01		1		H4513	021	0	2009	TXHS HealthyAdvantage Sadler Premier	Upper Gulf Coast   and East Texas		2	2			209	2						(832)-553-3480	(800)-280-8888	(877)-893-1504	(877)-893-1504	(800)-846-2098	(800)-846-2098	(877)-893-1504	(877)-893-1504	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
H4513	802	0	1	01	01	H4513_802_0	2	2009.01	TEXAS HEALTHSPRING LLC	Texas HealthSpring	www.healthspring.com	01	01		1		H4513	802	0	2009	TXHS Retiree Advantage Care-Calendar Yr	Texas		1	2			760	2						(832)-553-3480	(800)-280-8888	(877)-893-1504	(877)-893-1504	(800)-846-2098	(800)-846-2098	(877)-893-1504	(877)-893-1504									www.healthspring.com	
H4513	804	0	1	01	01	H4513_804_0	2	2009.01	TEXAS HEALTHSPRING LLC	Texas HealthSpring	www.healthspring.com	01	01		1		H4513	804	0	2009	TXHS Retiree Advantage Plus-Calendar Yr	Texas		1	2			760	2						(832)-553-3480	(800)-280-8888	(877)-893-1504	(877)-893-1504	(800)-846-2098	(800)-846-2098	(877)-893-1504	(877)-893-1504	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
H4513	805	0	1	01	01	H4513_805_0	2	2009.01	TEXAS HEALTHSPRING LLC	Texas HealthSpring	www.healthspring.com	01	01		1		H4513	805	0	2009	TXHS Retiree Advantage Care-Contract Yr	Texas		1	2			760	2						(832)-553-3480	(800)-280-8888	(877)-893-1504	(877)-893-1504	(800)-846-2098	(800)-846-2098	(877)-893-1504	(877)-893-1504									www.healthspring.com	
H4513	806	0	1	01	01	H4513_806_0	2	2009.01	TEXAS HEALTHSPRING LLC	Texas HealthSpring	www.healthspring.com	01	01		1		H4513	806	0	2009	TXHS Retiree Advantage Plus-Contract Yr	Texas		1	2			760	2						(832)-553-3480	(800)-280-8888	(877)-893-1504	(877)-893-1504	(800)-846-2098	(800)-846-2098	(877)-893-1504	(877)-893-1504	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
H4514	001	0	1	01	01	H4514_001_0	6	2009.01	EVERCARE OF TEXAS, LLC	Evercare Health Plans	www.EvercareHealthPlans.com	01	01		1		H4514	001	0	2009	Evercare Plan DH	Houston and Austin Surrounding Counties		2	1	3			2			2	2		(888)-834-3737	(888)-834-3737	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(888)-834-3737	(888)-834-3737	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H4514	004	0	1	01	01	H4514_004_0	4	2009.01	EVERCARE OF TEXAS, LLC	Evercare Health Plans	www.EvercareHealthPlans.com	01	01		1		H4514	004	0	2009	Evercare Plan MH	Houston and Austin Surrounding Counties		2	1	4			2			2		1111111110000000100000000001	(888)-834-3737	(888)-834-3737	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(888)-834-3737	(888)-834-3737	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H4514	005	0	1	01	01	H4514_005_0	5	2009.01	EVERCARE OF TEXAS, LLC	Evercare Health Plans	www.EvercareHealthPlans.com	01	01		1		H4514	005	0	2009	Evercare Plan IH	Travis and Williamson Counties		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H4514	007	0	1	01	01	H4514_007_0	5	2009.01	EVERCARE OF TEXAS, LLC	Evercare Health Plans	www.EvercareHealthPlans.com	01	01		1		H4514	007	0	2009	AARP MedicareComplete	Houston,Central Texas, Jefferso,Austin,Liberty,Har		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H4514	010	0	1	01	01	H4514_010_0	5	2009.01	EVERCARE OF TEXAS, LLC	Evercare Health Plans	www.EvercareHealthPlans.com	01	01		1		H4514	010	0	2009	SecureHorizons MedicareComplete	Bell, Travis, Austin, Hardin, Williamson Counties		2	2				2						(800)-711-6088	(800)-711-6088	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		(800)-711-6088	(800)-711-6088	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H4514	801	0	1	01	01	H4514_801_0	2	2009.01	EVERCARE OF TEXAS, LLC	Evercare Health Plans	www.EvercareHealthPlans.com	01	01		1		H4514	801	0	2009	MedicareComplete Retiree Plan	TX Employer Sponsored Plan Service Area		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H4514	803	0	1	01	01	H4514_803_0	2	2009.01	EVERCARE OF TEXAS, LLC	Evercare Health Plans	www.EvercareHealthPlans.com	01	01		1		H4514	803	0	2009	MedicareComplete Retiree Plan	TX  Employer Sponsored Plan Service Area		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480										http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H4514	806	0	1	01	01	H4514_806_0	2	2009.01	EVERCARE OF TEXAS, LLC	Evercare Health Plans	www.EvercareHealthPlans.com	01	01		1		H4514	806	0	2009	MedicareComplete Retiree Plan	TX Employer Sponsored Plan Service Area		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H4514	807	0	1	01	01	H4514_807_0	2	2009.01	EVERCARE OF TEXAS, LLC	Evercare Health Plans	www.EvercareHealthPlans.com	01	01		1		H4514	807	0	2009	MedicareComplete Retiree Plan	TX Employer Sponsored Plan Service Area		1	2				2						(888)-867-5548		(888)-685-8480		(888)-867-5548		(888)-685-8480										http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H4517	001	0	1	20	08	H4517_001_0	1	2009.01	AMARILLO MULTISVC CTR FR THE AGING INC	Amarillo Multisvc Ctr For The Aging Inc	alanac@amaonline.com	08	20		1		H4517	001	0	2009	DUAL ELIGIBLE	Potter, TX and Randall, TX Counties		2	2				2														(806)-374-5516	(888)-299-6401			(806)-374-5516	(888)-299-6401			N/A	
H4517	002	0	1	20	08	H4517_002_0	2	2009.01	AMARILLO MULTISVC CTR FR THE AGING INC	Amarillo Multisvc Ctr For The Aging Inc	alanac@amaonline.com	08	20		1		H4517	002	0	2009	MEDICARE ONLY	Potter, TX and Randall, TX Counties		2	2				2														(806)-374-5516	(888)-299-6401			(806)-374-5516	(888)-299-6401			N/A	
H4518	001	0	1	20	08	H4518_001_0	1	2009.01	BIENVIVIR SENIOR HEALTH SERVICES	Bienvivir Senior Health Services	www.Bienvivir.org	08	20		1		H4518	001	0	2009	BSHS Part D, Dual Eligibles	El Paso, Texas and El Paso County		2	2				2														(915)-562-3444	(915)-562-3444			(915)-562-3444	(915)-562-3444			hmajeed@bienvivir.org	
H4518	002	0	1	20	08	H4518_002_0	1	2009.01	BIENVIVIR SENIOR HEALTH SERVICES	Bienvivir Senior Health Services	www.Bienvivir.org	08	20		1		H4518	002	0	2009	BSHS Part D, Medicare Only	El Paso, Texas and El Paso County		2	2				2														(915)-562-3444	(915)-562-3444			(915)-562-3444	(915)-562-3444			hmajeed@bienvivir.org	
H4520	001	0	1	04	01	H4520_001_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4520	001	0	2009	HumanaChoicePPO PPO H4520-001	Bexar, Comal, Guadalupe, Kendall, Medina Counties		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tool/medicare_drug_list.asp	
H4520	002	0	1	04	01	H4520_002_0	10	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4520	002	0	2009	HumanaChoicePPO PPO H4520-002	Aransas, Nueces, San Patricio Counties		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tool/medicare_drug_list.asp	
H4520	003	0	1	04	01	H4520_003_0	9	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4520	003	0	2009	HumanaChoicePPO PPO H4520-003	Austin Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tool/medicare_drug_list.asp	
H4520	005	0	1	04	01	H4520_005_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4520	005	0	2009	HumanaChoicePPO PPO H4520-005	Fort Bend, Harris, Montgomery Counties		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tool/medicare_drug_list.asp	
H4520	006	0	1	04	01	H4520_006_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4520	006	0	2009	HumanaChoicePPO PPO H4520-006	Dallas, Hood, Johnson, and Tarrant counties		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tool/medicare_drug_list.asp	
H4520	016	0	1	04	01	H4520_016_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4520	016	0	2009	HumanaChoicePPO PPO H4520-016	Miller (AR), Bowie, Cass, Morris, Titus (TX)		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tool/medicare_drug_list.asp	
H4520	018	0	1	04	01	H4520_018_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4520	018	0	2009	HumanaChoicePPO PPO H4520-018	Hardin, Jefferson, Liberty, Orange		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tool/medicare_drug_list.asp	
H4520	801	0	1	04	01	H4520_801_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4520	801	0	2009	Humana Employer Sponsored	Southeast Texas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tool/medicare_drug_list.asp	
H4520	804	0	1	04	01	H4520_804_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4520	804	0	2009	Humana Employer Sponsored	Southeast Texas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tool/medicare_drug_list.asp	
H4520	805	0	1	04	01	H4520_805_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4520	805	0	2009	Humana Employer Sponsored Non-CY	Southeast Texas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tool/medicare_drug_list.asp	
H4520	806	0	1	04	01	H4520_806_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4520	806	0	2009	Humana Employer Sponsored Non-CY	Southeast Texas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tool/medicare_drug_list.asp	
H4521	001	0	1	01	01	H4521_001_0	6	2009.01	VALLEY BAPTIST INSURANCE COMPANY	Valley Baptist Health Plans	www.valleybaptisthealthplans.com	01	01		1		H4521	001	0	2009	Valley Advantage Gold	Counties: HI, CA, WI		2	2			700	2						(800)-829-6440	(800)-829-6440	(800)-562-5259	(800)-562-5259	(800)-829-6440	(800)-829-6440	(800)-562-5259	(800)-562-5259	(800)-829-6440	(800)-829-6440	(800)-562-5259	(800)-562-5259	(800)-829-6440	(800)-829-6440	(800)-562-5259	(800)-562-5259	www.valleybaptisthealthplans.com	www.valleybaptisthealthplans.com
H4521	002	0	1	01	01	H4521_002_0	4	2009.01	VALLEY BAPTIST INSURANCE COMPANY	Valley Baptist Health Plans	www.valleybaptisthealthplans.com	01	01		1		H4521	002	0	2009	Valley Advantage Select	Counties: HI, CA, WI		2	1	3		3000	2			1	2		(800)-829-6440	(800)-829-6440	(800)-562-5259	(800)-562-5259	(800)-829-6440	(800)-829-6440	(800)-562-5259	(800)-562-5259	(800)-829-6440	(800)-829-6440	(800)-562-5259	(800)-562-5259	(800)-829-6440	(800)-829-6440	(800)-562-5259	(800)-562-5259	www.valleybaptisthealthplans.com	www.valleybaptisthealthplans.com
H4521	004	0	1	01	01	H4521_004_0	4	2009.01	VALLEY BAPTIST INSURANCE COMPANY	Valley Baptist Health Plans	www.valleybaptisthealthplans.com	01	01		1		H4521	004	0	2009	Valley Advantage Silver	Counties: HI, CA, WI		2	2			100	2						(800)-829-6440	(800)-829-6440	(800)-562-5259	(800)-562-5259	(800)-829-6440	(800)-829-6440	(800)-562-5259	(800)-562-5259	(800)-829-6440	(800)-829-6440	(800)-562-5259	(800)-562-5259	(800)-829-6440	(800)-829-6440	(800)-562-5259	(800)-562-5259	www.valleybaptisthealthplans.com	www.valleybaptisthealthplans.com
H4521	005	0	1	01	01	H4521_005_0	2	2009.01	VALLEY BAPTIST INSURANCE COMPANY	Valley Baptist Health Plans	www.valleybaptisthealthplans.com	01	01		1		H4521	005	0	2009	Valley Advantage Bronze	Counties HI, CA, WI		2	2			100	2						(800)-829-6440	(800)-829-6440	(800)-562-5259	(800)-562-5259	(800)-829-6440	(800)-829-6440	(800)-562-5259	(800)-562-5259									www.valleybaptisthealthplans.com	www.valleybaptisthealthplans.com
H4521	801	0	1	01	01	H4521_801_0	2	2009.01	VALLEY BAPTIST INSURANCE COMPANY	Valley Baptist Health Plans	www.valleybaptisthealthplans.com	01	01		1		H4521	801	0	2009	Valley Advantage Employer	State of Texas		1	2			100	2						(800)-829-6440	(800)-829-6440	(800)-562-5259	(800)-562-5259	(800)-829-6440	(800)-829-6440	(800)-562-5259	(800)-562-5259									www.valleybaptisthealthplans.com	www.valleybaptisthealthplans.com
H4521	802	0	1	01	01	H4521_802_0	2	2009.01	VALLEY BAPTIST INSURANCE COMPANY	Valley Baptist Health Plans	www.valleybaptisthealthplans.com	01	01		1		H4521	802	0	2009	Valley Advantage Employer 2	State of Texas		1	2			100	2						(800)-829-6440	(800)-829-6440	(800)-562-5259	(800)-562-5259	(800)-829-6440	(800)-829-6440	(800)-562-5259	(800)-562-5259	(800)-829-6440	(800)-829-6440	(800)-562-5259	(800)-562-5259	(800)-829-6440	(800)-829-6440	(800)-562-5259	(800)-562-5259	www.valleybaptisthealthplans.com	www.valleybaptisthealthplans.com
H4522	001	0	1	04	01	H4522_001_0	6	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	04		1		H4522	001	0	2009	AARP  MedicareComplete Choice	El Paso and southwestern New Mexico		2	2				2						(800)-711-6088	(800)-711-6088	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		(800)-711-6088	(800)-711-6088	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H4522	007	0	1	04	01	H4522_007_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	04		1		H4522	007	0	2009	Evercare Plan DP	Dona Ana, Grant, Hidalgo, Luna and Sierra Counties		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H4522	008	0	1	04	01	H4522_008_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	04		1		H4522	008	0	2009	Evercare Plan MP	Dona Ana, Grant, Hidalgo, Luna and Sierra Counties		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H4522	801	0	1	04	01	H4522_801_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	04		1		H4522	801	0	2009	MedicareComplete Choice Retiree Plan	TX  Employer Sponsored Plan Service Area		1	2				2						(866)-288-3389		(888)-685-8480		(800)-330-1601		(888)-685-8480		(866)-288-3389	(866)-288-3389	(888)-685-8480		(800)-330-1601	(800)-330-1601	(888)-685-8480		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H4522	803	0	1	04	01	H4522_803_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	04		1		H4522	803	0	2009	MedicareComplete Choice Retiree Plan	TX  Employer Sponsored Plan Service Area		1	2				2						(866)-288-3389		(888)-685-8480		(800)-330-1601		(888)-685-8480										https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H4522	804	0	1	04	01	H4522_804_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	04		1		H4522	804	0	2009	MedicareComplete Retiree Plan	TX  Employer Sponsored Plan Service Area		1	2				2						(866)-288-3389		(888)-685-8480		(800)-330-1601		(888)-685-8480		(866)-288-3389	(866)-288-3389	(888)-685-8480		(800)-330-1601	(800)-330-1601	(888)-685-8480		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H4522	805	0	1	04	01	H4522_805_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	04		1		H4522	805	0	2009	MedicareComplete Retiree Plan	TX  Employer Sponsored Plan Service Area		1	2				2						(866)-288-3389		(888)-685-8480		(800)-330-1601		(888)-685-8480										https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H4523	001	0	1	01	01	H4523_001_0	5	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H4523	001	0	2009	Aetna Golden Medicare Premier Plan	Bexar		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H4523	005	0	1	01	01	H4523_005_0	5	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H4523	005	0	2009	Aetna Golden Medicare Value Plan	Dallas and Tarrant Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H4523	009	0	1	01	01	H4523_009_0	4	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H4523	009	0	2009	Aetna Golden Medicare Premier Plan	Nueces County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H4523	010	0	1	01	01	H4523_010_0	6	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H4523	010	0	2009	Aetna Golden Medicare Value Plan	El Paso County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H4523	012	0	1	01	01	H4523_012_0	6	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H4523	012	0	2009	Aetna Golden Medicare Value Plan	Travis and Williamson Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H4523	014	0	1	01	01	H4523_014_0	5	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H4523	014	0	2009	Aetna Golden Medicare Dual Advantage Plan	Bexar County		2	1	3			2			1	2		(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H4523	015	0	1	01	01	H4523_015_0	4	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H4523	015	0	2009	Aetna Golden Medicare Premier Plan	Harris and Montgomery Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H4523	801	0	1	01	01	H4523_801_0	3	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H4523	801	0	2009	Aetna Golden Medicare Plan	Texas		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H4523	802	0	1	01	01	H4523_802_0	3	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H4523	802	0	2009	Aetna Golden Medicare Plan w/Rx CY	Texas		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H4524	001	0	1	04	01	H4524_001_0	7	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.Aetnamedicare.com	01	04		1		H4524	001	0	2009	Aetna Golden Choice Value Plan	Bexar County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind
H4524	002	0	1	04	01	H4524_002_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.Aetnamedicare.com	01	04		1		H4524	002	0	2009	Aetna Golden Choice Premier Plan	Bexar County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind
H4524	003	0	1	04	01	H4524_003_0	7	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.Aetnamedicare.com	01	04		1		H4524	003	0	2009	Aetna Golden Choice Value Plan	El Paso County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind
H4524	005	0	1	04	01	H4524_005_0	7	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.Aetnamedicare.com	01	04		1		H4524	005	0	2009	Aetna Golden Choice Value Plan	Comal County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind
H4524	007	0	1	04	01	H4524_007_0	7	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.Aetnamedicare.com	01	04		1		H4524	007	0	2009	Aetna Golden Choice Value Plan	Dallas and Tarrant Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind
H4524	008	0	1	04	01	H4524_008_0	5	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.Aetnamedicare.com	01	04		1		H4524	008	0	2009	Aetna Golden Choice Premier Plan	Dallas and Tarrant Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind
H4524	009	0	1	04	01	H4524_009_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.Aetnamedicare.com	01	04		1		H4524	009	0	2009	Aetna Golden Choice Value Plan	Travis and Williamson Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind
H4524	011	0	1	04	01	H4524_011_0	5	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.Aetnamedicare.com	01	04		1		H4524	011	0	2009	Aetna Golden Choice Value Plan	Nueces County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind
H4524	012	0	1	04	01	H4524_012_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.Aetnamedicare.com	01	04		1		H4524	012	0	2009	Aetna Golden Choice Premier Plan	Nueces County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind
H4524	013	0	1	04	01	H4524_013_0	5	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.Aetnamedicare.com	01	04		1		H4524	013	0	2009	Aetna Golden Choice Value Plan	Harris and Montgomery Co.'s		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind
H4524	014	0	1	04	01	H4524_014_0	5	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.Aetnamedicare.com	01	04		1		H4524	014	0	2009	Aetna Golden Choice Premier Plan	Harris and Montgomery Co.'s		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind
H4524	801	0	1	04	01	H4524_801_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.Aetnamedicare.com	01	04		1		H4524	801	0	2009	Aetna Golden Choice Plan	Texas		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind
H4524	802	0	1	04	01	H4524_802_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.Aetnamedicare.com	01	04		1		H4524	802	0	2009	Aetna Golden Choice Plan w/Rx CY	Texas		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind
H4524	804	0	1	04	01	H4524_804_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.Aetnamedicare.com	01	04		1		H4524	804	0	2009	Aetna Golden Choice Plan w/RX NCY	Texas		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind
H4525	001	0	1	01	01	H4525_001_0	5	2009.01	SHA, L.L.C	FirstCare Advantage	www.firstcare.com/advantage	01	01		1		H4525	001	0	2009	FirstCare Advantage Gold	FirstCare Advantage Gold (Abilene Region)		2	2			50	2						(866)-229-4969	(866)-229-4969	(800)-562-5259	(800)-562-5259	(800)-562-5275	(800)-562-5275	(800)-562-5259	(800)-562-5259	(866)-229-4969	(866)-229-4969	(800)-562-5259	(800)-562-5259	(800)-562-5275	(800)-562-5275	(800)-562-5259	(800)-562-5259	http://www.firstcare.com/advantage	www.firstcare.com/advantage
H4525	002	0	1	01	01	H4525_002_0	6	2009.01	SHA, L.L.C	FirstCare Advantage	www.firstcare.com/advantage	01	01		1		H4525	002	0	2009	FirstCare Advantage Gold	FirstCare Advantage Gold (Lubbock Region)		2	2			50	2						(866)-229-4969	(866)-229-4969	(800)-562-5259	(800)-562-5259	(800)-562-5275	(800)-562-5275	(800)-562-5259	(800)-562-5259	(866)-229-4969	(866)-229-4969	(800)-562-5259	(800)-562-5259	(800)-562-5275	(800)-562-5275	(800)-562-5259	(800)-562-5259	http://www.firstcare.com/advantage	www.firstcare.com/advantage
H4525	003	0	1	01	01	H4525_003_0	6	2009.01	SHA, L.L.C	FirstCare Advantage	www.firstcare.com/advantage	01	01		1		H4525	003	0	2009	FirstCare Advantage Select	FirstCare Advantage Select (Lubbock Region)		2	1	3		1400	2			1	2		(866)-229-4969	(866)-229-4969	(800)-562-5259	(800)-562-5259	(800)-562-5275	(800)-562-5275	(800)-562-5259	(800)-562-5259	(866)-229-4969	(866)-229-4969	(800)-562-5259	(800)-562-5259	(800)-562-5275	(800)-562-5275	(800)-562-5259	(800)-562-5259	http://www.firstcare.com/advantage	www.firstcare.com/advantage
H4525	004	0	1	01	01	H4525_004_0	4	2009.01	SHA, L.L.C	FirstCare Advantage	www.firstcare.com/advantage	01	01		1		H4525	004	0	2009	FirstCare Advantage Silver	FirstCare Advantage Silver (Abilene Region)		2	2			50	2						(866)-229-4969	(866)-229-4969	(800)-562-5259	(800)-562-5259	(800)-562-5275	(800)-562-5275	(800)-562-5259	(800)-562-5259									http://www.firstcare.com/advantage	www.firstcare.com/advantage
H4525	005	0	1	01	01	H4525_005_0	3	2009.01	SHA, L.L.C	FirstCare Advantage	www.firstcare.com/advantage	01	01		1		H4525	005	0	2009	FirstCare Advantage Silver	FirstCare Advantage Silver (Lubbock Region)		2	2			50	2						(866)-229-4969	(866)-229-4969	(800)-562-5259	(800)-562-5259	(800)-562-5275	(800)-562-5275	(800)-562-5259	(800)-562-5259									http://www.firstcare.com/advantage	www.firstcare.com/advantage
H4525	006	0	1	01	01	H4525_006_0	6	2009.01	SHA, L.L.C	FirstCare Advantage	www.firstcare.com/advantage	01	01		1		H4525	006	0	2009	FirstCare Advantage Platinum	FirstCare Advantage Platinum (Abilene Region)		2	2			60	2						(866)-229-4969	(866)-229-4969	(800)-562-5259	(800)-562-5259	(800)-562-5275	(800)-562-5275	(800)-562-5259	(800)-562-5259	(866)-229-4969	(866)-229-4969	(800)-562-5259	(800)-562-5259	(800)-562-5275	(800)-562-5275	(800)-562-5259	(800)-562-5259	http://www.firstcare.com/advantage	www.firstcare.com/advantage
H4525	007	0	1	01	01	H4525_007_0	5	2009.01	SHA, L.L.C	FirstCare Advantage	www.firstcare.com/advantage	01	01		1		H4525	007	0	2009	FirstCare Advantage Platinum	FirstCare Advantage Platinum (Lubbock Region)		2	2			60	2						(866)-229-4969	(866)-229-4969	(800)-562-5259	(800)-562-5259	(800)-562-5275	(800)-562-5275	(800)-562-5259	(800)-562-5259	(866)-229-4969	(866)-229-4969	(800)-562-5259	(800)-562-5259	(800)-562-5275	(800)-562-5275	(800)-562-5259	(800)-562-5259	http://www.firstcare.com/advantage	www.firstcare.com/advantage
H4525	008	0	1	01	01	H4525_008_0	5	2009.01	SHA, L.L.C	FirstCare Advantage	www.firstcare.com/advantage	01	01		1		H4525	008	0	2009	FirstCare Advantage Elite	FirstCare Advantage Elite (Abilene)		2	2			100	2						(866)-229-4969	(866)-229-4969	(800)-562-5259	(800)-562-5259	(800)-562-5275	(800)-562-5275	(800)-562-5259	(800)-562-5259	(866)-229-4969	(866)-229-4969	(800)-562-5259	(800)-562-5259	(800)-562-5275	(800)-562-5275	(800)-562-5259	(800)-562-5259	http://www.firstcare.com/advantage	www.firstcare.com/advantage
H4525	009	0	1	01	01	H4525_009_0	6	2009.01	SHA, L.L.C	FirstCare Advantage	www.firstcare.com/advantage	01	01		1		H4525	009	0	2009	FirstCare Advantage Elite	FirstCare Advantage Elite (Lubbock)		2	2			100	2						(866)-229-4969	(866)-229-4969	(800)-562-5259	(800)-562-5259	(800)-562-5275	(800)-562-5275	(800)-562-5259	(800)-562-5259	(866)-229-4969	(866)-229-4969	(800)-562-5259	(800)-562-5259	(800)-562-5275	(800)-562-5275	(800)-562-5259	(800)-562-5259	http://www.firstcare.com/advantage	www.firstcare.com/advantage
H4525	802	0	1	01	01	H4525_802_0	1	2009.01	SHA, L.L.C	FirstCare Advantage	www.firstcare.com/advantage	01	01		1		H4525	802	0	2009	FirstCare Advantage Employer (D)	FirstCare Advantage Employer (D)		1	2			100	2						(866)-229-4969	(866)-229-4969	(800)-562-5259	(800)-562-5259	(800)-562-5275	(800)-562-5275	(800)-562-5259	(800)-562-5259	(866)-229-4969	(866)-229-4969	(800)-562-5259	(800)-562-5259	(800)-562-5275	(800)-562-5275	(800)-562-5259	(800)-562-5259	http://www.firstcare.com/advantage	www.firstcare.com/advantage
H4527	001	0	1	01	01	H4527_001_0	4	2009.01	PSO HEALTH SERVICES, LLC	PHYSICIANS HEALTH CHOICE	www.physicianshealthchoice.com	01	01		1		H4527	001	0	2009	Physicians Health Choice Standard	Nueces, San Patricio, and Aransas Counties		2	2			48538	2						(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/providers-providerdirectory.html
H4527	002	0	1	01	01	H4527_002_0	4	2009.01	PSO HEALTH SERVICES, LLC	PHYSICIANS HEALTH CHOICE	www.physicianshealthchoice.com	01	01		1		H4527	002	0	2009	Physicians Health Choice Standard	Travis, Hays, and Williamson Counties		2	2			20969	2						(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/providers-providerdirectory.html
H4527	003	0	1	01	01	H4527_003_0	2	2009.01	PSO HEALTH SERVICES, LLC	PHYSICIANS HEALTH CHOICE	www.physicianshealthchoice.com	01	01		1		H4527	003	0	2009	Physicians Health Choice Select	Travis, Hays, and Williamson Counties		2	1	3		16896	2			1	2		(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/providers-providerdirectory.html
H4527	004	0	1	01	01	H4527_004_0	2	2009.01	PSO HEALTH SERVICES, LLC	PHYSICIANS HEALTH CHOICE	www.physicianshealthchoice.com	01	01		1		H4527	004	0	2009	Physicians Health Choice Select	Nueces, San Patricio, and Aransas Counties		2	1	3		39204	2			1	2		(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/providers-providerdirectory.html
H4527	005	0	1	01	01	H4527_005_0	4	2009.01	PSO HEALTH SERVICES, LLC	PHYSICIANS HEALTH CHOICE	www.physicianshealthchoice.com	01	01		1		H4527	005	0	2009	Physicians Health Choice Standard	El Paso County		2	2			19876	2						(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/providers-providerdirectory.html
H4527	006	0	1	01	01	H4527_006_0	2	2009.01	PSO HEALTH SERVICES, LLC	PHYSICIANS HEALTH CHOICE	www.physicianshealthchoice.com	01	01		1		H4527	006	0	2009	Physicians Health Choice Select	El Paso County		2	1	3		20317	2			1	2		(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/providers-providerdirectory.html
H4527	008	0	1	01	01	H4527_008_0	4	2009.01	PSO HEALTH SERVICES, LLC	PHYSICIANS HEALTH CHOICE	www.physicianshealthchoice.com	01	01		1		H4527	008	0	2009	Physicians Health Choice Wellness	Nueces, San Patricio and Aransas Counties		2	1	4		2800	2			1		0000000000000000000000000001	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/providers-providerdirectory.html
H4527	011	0	1	01	01	H4527_011_0	4	2009.01	PSO HEALTH SERVICES, LLC	PHYSICIANS HEALTH CHOICE	www.physicianshealthchoice.com	01	01		1		H4527	011	0	2009	Physicians Health Choice Wellness	El Paso County		2	1	4		2650	2			1		0000000010000000000000000000	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/providers-providerdirectory.html
H4527	012	0	1	01	01	H4527_012_0	3	2009.01	PSO HEALTH SERVICES, LLC	PHYSICIANS HEALTH CHOICE	www.physicianshealthchoice.com	01	01		1		H4527	012	0	2009	Physicians Health Choice Basic	Cameron, Hidalgo, and Willacy Counties		2	2			776	2						(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659									http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/providers-providerdirectory.html
H4527	013	0	1	01	01	H4527_013_0	5	2009.01	PSO HEALTH SERVICES, LLC	PHYSICIANS HEALTH CHOICE	www.physicianshealthchoice.com	01	01		1		H4527	013	0	2009	Physicians Health Choice Standard	Cameron, Hidalgo, and Willacy Counties		2	2			10601	2						(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/providers-providerdirectory.html
H4527	014	0	1	01	01	H4527_014_0	5	2009.01	PSO HEALTH SERVICES, LLC	PHYSICIANS HEALTH CHOICE	www.physicianshealthchoice.com	01	01		1		H4527	014	0	2009	Physicians Health Choice Extra	Cameron, Hidalgo, and Willacy Counties		2	2			3103	2						(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/providers-providerdirectory.html
H4527	015	0	1	01	01	H4527_015_0	3	2009.01	PSO HEALTH SERVICES, LLC	PHYSICIANS HEALTH CHOICE	www.physicianshealthchoice.com	01	01		1		H4527	015	0	2009	Physicians Health Choice Select	Cameron County		2	1	3		11377	2			1	2		(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/providers-providerdirectory.html
H4527	016	0	1	01	01	H4527_016_0	1	2009.01	PSO HEALTH SERVICES, LLC	PHYSICIANS HEALTH CHOICE	www.physicianshealthchoice.com	01	01		1		H4527	016	0	2009	Physicians Health Choice Basic	North Texas		2	2			584	2						(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659									http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/providers-providerdirectory.html
H4527	017	0	1	01	01	H4527_017_0	4	2009.01	PSO HEALTH SERVICES, LLC	PHYSICIANS HEALTH CHOICE	www.physicianshealthchoice.com	01	01		1		H4527	017	0	2009	Physicians Health Choice Standard	North Texas		2	2			2532	2						(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/providers-providerdirectory.html
H4527	018	0	1	01	01	H4527_018_0	5	2009.01	PSO HEALTH SERVICES, LLC	PHYSICIANS HEALTH CHOICE	www.physicianshealthchoice.com	01	01		1		H4527	018	0	2009	Physicians Health Choice Extra	North Texas		2	2			5455	2						(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/providers-providerdirectory.html
H4527	019	0	1	01	01	H4527_019_0	2	2009.01	PSO HEALTH SERVICES, LLC	PHYSICIANS HEALTH CHOICE	www.physicianshealthchoice.com	01	01		1		H4527	019	0	2009	Physicians Health Choice Select	North Texas		2	1	3		10909	2			1	2		(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/providers-providerdirectory.html
H4527	020	0	1	01	01	H4527_020_0	1	2009.01	PSO HEALTH SERVICES, LLC	PHYSICIANS HEALTH CHOICE	www.physicianshealthchoice.com	01	01		1		H4527	020	0	2009	Physicians Health Choice Basic	Nueces, San Patricio, and Aransas Counties		2	2			2800	2						(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659									http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/providers-providerdirectory.html
H4527	022	0	1	01	01	H4527_022_0	1	2009.01	PSO HEALTH SERVICES, LLC	PHYSICIANS HEALTH CHOICE	www.physicianshealthchoice.com	01	01		1		H4527	022	0	2009	Physicians Health Choice Basic	Travis, Hays, and Williamson Counties		2	2			923	2						(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659									http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/providers-providerdirectory.html
H4527	023	0	1	01	01	H4527_023_0	3	2009.01	PSO HEALTH SERVICES, LLC	PHYSICIANS HEALTH CHOICE	www.physicianshealthchoice.com	01	01		1		H4527	023	0	2009	Physicians Health Choice Extra	Travis, Hays and Williamson Counties		2	2			1672	2						(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/providers-providerdirectory.html
H4527	024	0	1	01	01	H4527_024_0	1	2009.01	PSO HEALTH SERVICES, LLC	PHYSICIANS HEALTH CHOICE	www.physicianshealthchoice.com	01	01		1		H4527	024	0	2009	Physicians Health Choice Basic	El Paso County		2	2			1325	2						(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659									http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/providers-providerdirectory.html
H4528	001	0	1	02	01	H4528_001_0	2	2009.01	BRAVO HEALTH TEXAS, INC.	Bravo Health	www.mybravohealth.com	01	02		1		H4528	001	0	2009	Bravo Classic Plus	Select Texas Counties		2	2				2						(888)-353-3789	(888)-353-3789	(800)-964-2561	(800)-964-2561	(888)-318-2827	(888)-318-2827	(800)-964-2561	(800)-964-2561	(888)-353-3789	(888)-353-3789	(800)-964-2561	(800)-964-2561	(888)-318-2827	(888)-318-2827	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H4528	002	0	1	01	01	H4528_002_0	2	2009.01	BRAVO HEALTH TEXAS, INC.	Bravo Health	www.mybravohealth.com	01	01		1		H4528	002	0	2009	Bravo Select	El Paso and Harris Counties		2	1	3			2			1	2		(888)-353-3789	(888)-353-3789	(800)-964-2561	(800)-964-2561	(888)-318-2827	(888)-318-2827	(800)-964-2561	(800)-964-2561	(888)-353-3789	(888)-353-3789	(800)-964-2561	(800)-964-2561	(888)-318-2827	(888)-318-2827	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H4528	005	0	1	02	01	H4528_005_0	2	2009.01	BRAVO HEALTH TEXAS, INC.	Bravo Health	www.mybravohealth.com	01	02		1		H4528	005	0	2009	Bravo Classic Plus	Bexar County		2	2				2						(888)-353-3789	(888)-353-3789	(800)-964-2561	(800)-964-2561	(888)-318-2827	(888)-318-2827	(800)-964-2561	(800)-964-2561	(888)-353-3789	(888)-353-3789	(800)-964-2561	(800)-964-2561	(888)-318-2827	(888)-318-2827	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H4528	006	0	1	01	01	H4528_006_0	2	2009.01	BRAVO HEALTH TEXAS, INC.	Bravo Health	www.mybravohealth.com	01	01		1		H4528	006	0	2009	Bravo Select	Bexar County		2	1	3			2			1	2		(888)-353-3789	(888)-353-3789	(800)-964-2561	(800)-964-2561	(888)-318-2827	(888)-318-2827	(800)-964-2561	(800)-964-2561	(888)-353-3789	(888)-353-3789	(800)-964-2561	(800)-964-2561	(888)-318-2827	(888)-318-2827	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H4528	009	0	1	01	01	H4528_009_0	2	2009.01	BRAVO HEALTH TEXAS, INC.	Bravo Health	www.mybravohealth.com	01	01		1		H4528	009	0	2009	Bravo Healthy Heart	El Paso and Harris Counties		2	1	4			2			2		0000000000000000000000000001	(888)-353-3789	(888)-353-3789	(800)-964-2561	(800)-964-2561	(888)-318-2827	(888)-318-2827	(800)-964-2561	(800)-964-2561	(888)-353-3789	(888)-353-3789	(800)-964-2561	(800)-964-2561	(888)-318-2827	(888)-318-2827	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H4528	010	0	1	01	01	H4528_010_0	2	2009.01	BRAVO HEALTH TEXAS, INC.	Bravo Health	www.mybravohealth.com	01	01		1		H4528	010	0	2009	Bravo Healthy Heart	Bexar County		2	1	4			2			2		0000001000000000000000000000	(888)-353-3789	(888)-353-3789	(800)-964-2561	(800)-964-2561	(888)-318-2827	(888)-318-2827	(800)-964-2561	(800)-964-2561	(888)-353-3789	(888)-353-3789	(800)-964-2561	(800)-964-2561	(888)-318-2827	(888)-318-2827	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H4528	011	0	1	01	01	H4528_011_0	2	2009.01	BRAVO HEALTH TEXAS, INC.	Bravo Health	www.mybravohealth.com	01	01		1		H4528	011	0	2009	Bravo Silver	Select Texas Counties		2	2				2						(888)-353-3789	(888)-353-3789	(800)-964-2561	(800)-964-2561	(888)-318-2827	(888)-318-2827	(800)-964-2561	(800)-964-2561	(888)-353-3789	(888)-353-3789	(800)-964-2561	(800)-964-2561	(888)-318-2827	(888)-318-2827	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	www.mybravohealth.com
H4529	002	0	1	01	01	H4529_002_0	9	2009.01	ARCADIAN HEALTH PLAN, INC.	Texas Community Care	www.texascommunitycare.com	01	01		1		H4529	002	0	2009	Texas Comm. Care- Plus (EL Paso)	El Paso County		2	2			74119	2						(915)-843-4043	(800)-573-8597	(866)-573-8591	(866)-573-8591	(915)-843-4043	(800)-573-8597	(866)-573-8591	(866)-573-8591	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(915)-843-4043	(800)-658-5161	(866)-573-8613	(866)-573-8613	http://www.texascommunitycare.com/el_paso/formulary.html	
H4529	004	0	1	01	01	H4529_004_0	11	2009.01	ARCADIAN HEALTH PLAN, INC.	Texas Community Care	www.texascommunitycare.com	01	01		1		H4529	004	0	2009	Texas Comm. Care- Plus (Travis)	Travis  and Williamson County		2	2			28059	2						(512)-795-8092	(800)-573-8597	(866)-573-8591	(866)-573-8591	(512)-795-8092	(800)-658-3704	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(512)-795-8092	(800)-658-3704	(866)-573-8613	(866)-573-8613	http://www.texascommunitycare.com/el_paso/formulary.html	
H4529	007	0	1	01	01	H4529_007_0	8	2009.01	ARCADIAN HEALTH PLAN, INC.	Texas Community Care	www.texascommunitycare.com	01	01		1		H4529	007	0	2009	Texas Commun. Care- Dual Plus (El Paso)	El Paso County		2	1	3		14387	2			1	1		(915)-843-4043	(800)-573-8597	(866)-573-8591	(866)-573-8591	(915)-843-4043	(800)-658-5161	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(915)-843-4043	(800)-658-5161	(866)-573-8613	(866)-573-8613	http://www.texascommunitycare.com/el_paso/formulary.html	
H4529	014	0	1	01	01	H4529_014_0	12	2009.01	ARCADIAN HEALTH PLAN, INC.	Texas Community Care	www.texascommunitycare.com	01	01		1		H4529	014	0	2009	Texas Comm. Care -  Plus (East Texas)	East Texas		2	2			57687	2						(512)-795-8092	(800)-573-8597	(866)-573-8591	(866)-573-8591	(512)-795-8092	(800)-658-3704	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(512)-795-8092	(800)-658-3704	(866)-573-8613	(866)-573-8613	http://www.texascommunitycare.com/el_paso/formulary.html	
H4529	801	0	1	01	01	H4529_801_0	9	2009.01	ARCADIAN HEALTH PLAN, INC.	Texas Community Care	www.texascommunitycare.com	01	01		1		H4529	801	0	2009	Texas Community Care EGWP (TX)	Texas		1	2			0	2						(915)-843-4043	(800)-573-8597	(866)-573-8591	(866)-573-8591	(915)-843-4043	(800)-573-8597	(866)-573-8591	(866)-573-8591	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(915)-843-4043	(800)-658-5161	(866)-573-8613	(866)-573-8613	http://www.texascommunitycare.com/el_paso/formulary.html	
H4531	001	0	1	04	01	H4531_001_0	9	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of Texas	www.bcbstx.com	01	04		1		H4531	001	0	2009	Blue Medicare PPO - Advantage	El Paso county, Houston Metro area		2	2				2						(800)-718-2031	(800)-718-2031	(888)-844-5530	(888)-844-5530	(866)-308-4781	(866)-308-4781	(800)-538-0380	(800)-538-0380	(888)-277-5507	(888)-277-5507	(800)-693-3816	(800)-693-3816	(888)-579-9373	(888)-579-9373	(888)-579-9375	(888)-579-9375	https://qa.myrxassistant.com/MyRxAssistant/formulary/HISC/TX/MAPD	www.bcbstx.com
H4531	003	0	1	04	01	H4531_003_0	7	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of Texas	www.bcbstx.com	01	04		1		H4531	003	0	2009	Blue Medicare PPO - Value	El Paso county, Houston Metro area		2	2				2						(800)-718-2031	(800)-718-2031	(888)-844-5530	(888)-844-5530	(866)-308-4781	(866)-308-4781	(800)-538-0380	(800)-538-0380	(888)-277-5507	(888)-277-5507	(800)-693-3816	(800)-693-3816	(888)-579-9373	(888)-579-9373	(888)-579-9375	(888)-579-9375	https://qa.myrxassistant.com/MyRxAssistant/formulary/HISC/TX/MAPD	www.bcbstx.com
H4531	004	0	1	04	01	H4531_004_0	8	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of Texas	www.bcbstx.com	01	04		1		H4531	004	0	2009	Blue Medicare PPO - Premier	El Paso county, Houston Metro area		2	2				2						(800)-718-2031	(800)-718-2031	(888)-844-5530	(888)-844-5530	(866)-308-4781	(866)-308-4781	(800)-538-0380	(800)-538-0380	(888)-277-5507	(888)-277-5507	(800)-693-3816	(800)-693-3816	(888)-579-9373	(888)-579-9373	(888)-579-9375	(888)-579-9375	https://qa.myrxassistant.com/MyRxAssistant/formulary/HISC/TX/MAPD	www.bcbstx.com
H4531	802	0	1	04	01	H4531_802_0	5	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of Texas	www.bcbstx.com	01	04		1		H4531	802	0	2009	Blue Medicare PPO	State of Texas		1	2				2						(800)-718-2031		(888)-844-5530		(866)-308-4781		(800)-538-0380		(800)-718-2031	(800)-718-2031			(866)-308-4781	(866)-308-4781			https://qa.myrxassistant.com/MyRxAssistant/formulary/HISC/TX/MAPD	www.bcbstx.com
H4531	803	0	1	04	01	H4531_803_0	5	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of Texas	www.bcbstx.com	01	04		1		H4531	803	0	2009	Blue Medicare PPO	State of Texas		1	2				2						(800)-718-2031		(888)-844-5530		(866)-308-4781		(800)-538-0380		(800)-718-2031	(800)-718-2031			(866)-308-4781	(866)-308-4781			https://qa.myrxassistant.com/MyRxAssistant/formulary/HISC/TX/MAPD	www.bcbstx.com
H4531	804	0	1	04	01	H4531_804_0	5	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of Texas	www.bcbstx.com	01	04		1		H4531	804	0	2009	Blue Medicare PPO	State of Texas		1	2				2						(800)-718-2031		(888)-844-5530		(800)-718-2031		(888)-844-5530										https://qa.myrxassistant.com/MyRxAssistant/formulary/HISC/TX/MAPD	www.bcbstx.com
H4531	805	0	1	04	01	H4531_805_0	5	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of Texas	www.bcbstx.com	01	04		1		H4531	805	0	2009	Blue Medicare PPO	State of Texas		1	2				2						(800)-718-2031		(888)-844-5530		(800)-718-2031		(888)-844-5530										https://qa.myrxassistant.com/MyRxAssistant/formulary/HISC/TX/MAPD	www.bcbstx.com
H4531	806	0	1	04	01	H4531_806_0	5	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of Texas	www.bcbstx.com	01	04		1		H4531	806	0	2009	Blue Medicare PPO	National service area		1	2				2						(800)-718-2031		(888)-844-5530		(866)-308-4781		(800)-538-0380		(800)-718-2031	(800)-718-2031			(866)-308-4781	(866)-308-4781			https://qa.myrxassistant.com/MyRxAssistant/formulary/HISC/TX/MAPD	www.bcbstx.com
H4531	807	0	1	04	01	H4531_807_0	5	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of Texas	www.bcbstx.com	01	04		1		H4531	807	0	2009	Blue Medicare PPO	National service area		1	2				2						(800)-718-2031		(888)-844-5530		(866)-308-4781		(800)-538-0380		(800)-718-2031	(800)-718-2031			(866)-308-4781	(866)-308-4781			https://qa.myrxassistant.com/MyRxAssistant/formulary/HISC/TX/MAPD	www.bcbstx.com
H4531	808	0	1	04	01	H4531_808_0	5	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of Texas	www.bcbstx.com	01	04		1		H4531	808	0	2009	Blue Medicare PPO	National service area		1	2				2						(800)-718-2031		(888)-844-5530		(800)-718-2031		(888)-844-5530										https://qa.myrxassistant.com/MyRxAssistant/formulary/HISC/TX/MAPD	www.bcbstx.com
H4564	001	0	1	18	06	H4564_001_0	8	2009.01	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	http//www.swhp.org	06	18		1		H4564	001	0	2009	SeniorCare Sr Preferred Plus - Basic Rx	Central Texas		2	2				2						(254)-298-3141	(866)-334-3141	(254)-724-2832		(254)-298-3366	(800)-782-5068	(254)-724-2832		(254)-298-3141	(866)-334-3141	(254)-724-2832		(254)-298-3141	(866)-334-3141	(254)-724-2832		http://www.sw.org/sw/iwcontent/public/swhp/en_us/pdf/swhp_srcr_formulary.pdf	
H4564	002	0	1	18	06	H4564_002_0	8	2009.01	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	http//www.swhp.org	06	18		1		H4564	002	0	2009	SeniorCare Sr Preferred - Basic Rx	Central Texas		2	2				2						(254)-298-3141	(866)-334-3141	(254)-724-2832		(254)-298-3366	(800)-782-5068	(254)-724-2832		(254)-298-3141	(866)-334-3141	(254)-724-2832		(254)-298-3141	(866)-334-3141	(254)-724-2832		http://www.sw.org/sw/iwcontent/public/swhp/en_us/pdf/swhp_srcr_formulary.pdf	
H4564	003	0	1	18	06	H4564_003_0	8	2009.01	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	http//www.swhp.org	06	18		1		H4564	003	0	2009	SeniorCare Sr Select - Basic Rx	Central Texas		2	2				2						(254)-298-3141	(866)-334-3141	(254)-724-2832		(254)-298-3366	(800)-782-5068	(254)-724-2832		(254)-298-3141	(866)-334-3141	(254)-724-2832		(254)-298-3141	(866)-334-3141	(254)-724-2832		http://www.sw.org/sw/iwcontent/public/swhp/en_us/pdf/swhp_srcr_formulary.pdf	
H4564	004	0	1	18	06	H4564_004_0	8	2009.01	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	http//www.swhp.org	06	18		1		H4564	004	0	2009	SeniorCare Sr Preferred Plus - Enhanced Rx	Central Texas		2	2				2						(254)-298-3141	(866)-334-3141	(254)-724-2832		(254)-298-3366	(800)-782-5068	(254)-724-2832		(254)-298-3141	(866)-334-3141	(254)-724-2832		(254)-298-3141	(866)-334-3141	(254)-724-2832		http://www.sw.org/sw/iwcontent/public/swhp/en_us/pdf/swhp_srcr_formulary.pdf	
H4564	005	0	1	18	06	H4564_005_0	8	2009.01	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	http//www.swhp.org	06	18		1		H4564	005	0	2009	SeniorCare Sr Preferred - Enhanced Rx	Central Texas		2	2				2						(254)-298-3141	(866)-334-3141	(254)-724-2832		(254)-298-3366	(800)-782-5068	(254)-724-2832		(254)-298-3141	(866)-334-3141	(254)-724-2832		(254)-298-3141	(866)-334-3141	(254)-724-2832		http://www.sw.org/sw/iwcontent/public/swhp/en_us/pdf/swhp_srcr_formulary.pdf	
H4564	006	0	1	18	06	H4564_006_0	8	2009.01	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	http//www.swhp.org	06	18		1		H4564	006	0	2009	SeniorCare Sr Select - Enhanced Rx	Central Texas		2	2				2						(254)-298-3141	(866)-334-3141	(254)-724-2832		(254)-298-3366	(800)-782-5068	(254)-724-2832		(254)-298-3141	(866)-334-3141	(254)-724-2832		(254)-298-3141	(866)-334-3141	(254)-724-2832		http://www.sw.org/sw/iwcontent/public/swhp/en_us/pdf/swhp_srcr_formulary.pdf	
H4564	010	0	1	18	06	H4564_010_0	3	2009.01	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	http//www.swhp.org	06	18		1		H4564	010	0	2009	SeniorCare Sr Preferred Plus-Medical Only	Central Texas		2	2				2						(254)-298-3141	(866)-334-3141	(254)-724-2832		(254)-298-3366	(800)-782-5068	(254)-724-2832										http://www.sw.org/sw/iwcontent/public/swhp/en_us/pdf/swhp_srcr_formulary.pdf	
H4564	011	0	1	18	06	H4564_011_0	3	2009.01	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	http//www.swhp.org	06	18		1		H4564	011	0	2009	SeniorCare Sr Preferred-Medical Only	Central Texas		2	2				2						(254)-298-3141	(866)-334-3141	(254)-724-2832		(254)-298-3366	(800)-782-5068	(254)-724-2832										http://www.sw.org/sw/iwcontent/public/swhp/en_us/pdf/swhp_srcr_formulary.pdf	
H4564	012	0	1	18	06	H4564_012_0	3	2009.01	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	http//www.swhp.org	06	18		1		H4564	012	0	2009	SeniorCare Sr Select-Medical Only	Central Texas		2	2				2						(254)-298-3141	(866)-334-3141	(254)-724-2832		(254)-298-3366	(800)-782-5068	(254)-724-2832										http://www.sw.org/sw/iwcontent/public/swhp/en_us/pdf/swhp_srcr_formulary.pdf	
H4564	013	0	1	18	06	H4564_013_0	8	2009.01	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	http//www.swhp.org	06	18		1		H4564	013	0	2009	SeniorCare Sr Preferred Plus - Value Rx	Central Texas		2	2				2						(254)-298-3141	(866)-334-3141	(254)-724-2832		(254)-298-3366	(800)-782-5068	(254)-724-2832		(254)-298-3141	(866)-334-3141	(254)-724-2832		(254)-298-3141	(866)-334-3141	(254)-724-2832		http://www.sw.org/sw/iwcontent/public/swhp/en_us/pdf/swhp_srcr_formulary.pdf	
H4564	014	0	1	18	06	H4564_014_0	8	2009.01	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	http//www.swhp.org	06	18		1		H4564	014	0	2009	SeniorCare Sr Preferred - Value Rx	Central Texas		2	2				2						(254)-298-3141	(866)-334-3141	(254)-724-2832		(254)-298-3366	(800)-782-5068	(254)-724-2832		(254)-298-3141	(866)-334-3141	(254)-724-2832		(254)-298-3141	(866)-334-3141	(254)-724-2832		http://www.sw.org/sw/iwcontent/public/swhp/en_us/pdf/swhp_srcr_formulary.pdf	
H4564	015	0	1	18	06	H4564_015_0	8	2009.01	SCOTT AND WHITE HEALTH PLAN	Scott and White Health Plan SeniorCare	http//www.swhp.org	06	18		1		H4564	015	0	2009	SeniorCare Sr Select - Value Rx	Central Texas		2	2				2						(254)-298-3141	(866)-334-3141	(254)-724-2832		(254)-298-3366	(800)-782-5068	(254)-724-2832		(254)-298-3141	(866)-334-3141	(254)-724-2832		(254)-298-3141	(866)-334-3141	(254)-724-2832		http://www.sw.org/sw/iwcontent/public/swhp/en_us/pdf/swhp_srcr_formulary.pdf	
H4577	003	0	1	09	04	H4577_003_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	003	0	2009	Melody	Multi-State Area 6, 7, and 8		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	012	0	1	09	04	H4577_012_0	6	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	012	0	2009	Concert	Multi-State Area 6		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	www.wellcarepffs.com/member	
H4577	016	0	1	09	04	H4577_016_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	016	0	2009	Prelude	Multi-State Area 6		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	020	0	1	09	04	H4577_020_0	6	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	020	0	2009	Sonata	Multi-State Area 6		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	021	0	1	09	04	H4577_021_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	021	0	2009	Sonata	Multi-State Area 7		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	022	0	1	09	04	H4577_022_0	6	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	022	0	2009	Sonata	Multi-State Area 8		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	023	0	1	09	04	H4577_023_0	6	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	023	0	2009	Sonata	Multi-State Area 9		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	026	0	1	09	04	H4577_026_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	026	0	2009	Melody	Multi-State Area 9		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	027	0	1	09	04	H4577_027_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	027	0	2009	Melody	Multi-State Area 10		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	029	0	1	09	04	H4577_029_0	7	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	029	0	2009	Concert	Multi-State Area 7		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	www.wellcarepffs.com/member	
H4577	030	0	1	09	04	H4577_030_0	7	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	030	0	2009	Concert	Multi-State Area 8		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	www.wellcarepffs.com/member	
H4577	031	0	1	09	04	H4577_031_0	7	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	031	0	2009	Concert	Multi-State Area 9		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	www.wellcarepffs.com/member	
H4577	032	0	1	09	04	H4577_032_0	7	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	032	0	2009	Concert	Multi-State Area 10		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	www.wellcarepffs.com/member	
H4577	033	0	1	09	04	H4577_033_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	033	0	2009	Serenade	Multi-State Area 6		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	034	0	1	09	04	H4577_034_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	034	0	2009	Serenade	Multi-State Area 7		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	035	0	1	09	04	H4577_035_0	6	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	035	0	2009	Serenade	Multi-State Area 8		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	036	0	1	09	04	H4577_036_0	6	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	036	0	2009	Serenade	Multi-State Area 9		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	037	0	1	09	04	H4577_037_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	037	0	2009	Quartet	Multi-State Area 6		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	038	0	1	09	04	H4577_038_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	038	0	2009	Sonata Plus	Benton, AR		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	039	0	1	09	04	H4577_039_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	039	0	2009	Sonata Plus	Madison, AR		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	040	0	1	09	04	H4577_040_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	040	0	2009	Sonata Plus	Washington, AR		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	041	0	1	09	04	H4577_041_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	041	0	2009	Sonata Plus	Fresno, CA		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	042	0	1	09	04	H4577_042_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	042	0	2009	Sonata Plus	Santa Barbara, CA		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	043	0	1	09	04	H4577_043_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	043	0	2009	Sonata Plus	Tulare, CA		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	044	0	1	09	04	H4577_044_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	044	0	2009	Melody Plus	Benton, AR		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	045	0	1	09	04	H4577_045_0	6	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	045	0	2009	Melody Plus	Madison, AR		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	046	0	1	09	04	H4577_046_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	046	0	2009	Melody Plus	Washington, AR		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	047	0	1	09	04	H4577_047_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	047	0	2009	Melody Plus	Fresno, CA		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	048	0	1	09	04	H4577_048_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	048	0	2009	Melody Plus	Santa Barbara, CA		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	049	0	1	09	04	H4577_049_0	5	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	049	0	2009	Melody Plus	Tulare, CA		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	801	0	1	09	04	H4577_801_0	3	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	801	0	2009	Employer Plan 3	Nationwide		1	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	www.wellcarepffs.com/member	
H4577	802	0	1	09	04	H4577_802_0	3	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	802	0	2009	Employer Plan 4	Nationwide		1	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	www.wellcarepffs.com/member	
H4577	803	0	1	09	04	H4577_803_0	3	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	803	0	2009	Employer Plan 9	Nationwide		1	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4577	804	0	1	09	04	H4577_804_0	3	2009.01	WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H4577	804	0	2009	Employer Plan 10	Nationwide		1	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H4590	010	0	1	01	01	H4590_010_0	9	2009.01	PACIFICARE OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4590	010	0	2009	AARP MedicareComplete	San Antonio Area		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4590	012	0	1	01	01	H4590_012_0	7	2009.01	PACIFICARE OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4590	012	0	2009	AARP MedicareComplete	Dallas/Fort Worth Metroplex		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4590	020	0	1	01	01	H4590_020_0	7	2009.01	PACIFICARE OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4590	020	0	2009	Evercare Plan DH	Dallas-Fort Worth Metroplex		2	1	3			2			2	2		(866)-846-2762	(866)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(866)-846-2762	(866)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4590	022	0	1	01	01	H4590_022_0	7	2009.01	PACIFICARE OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4590	022	0	2009	Evercare Plan DH	San Antonio Area		2	1	3			2			2	2		(866)-846-2762	(866)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(866)-846-2762	(866)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4590	025	0	1	01	01	H4590_025_0	7	2009.01	PACIFICARE OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4590	025	0	2009	AARP MedicareComplete	Corpus Christi Area		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4590	027	0	1	01	01	H4590_027_0	5	2009.01	PACIFICARE OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4590	027	0	2009	AARP MedicareComplete Essential	Dallas/Ft Worth Metroplex		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4590	029	0	1	01	01	H4590_029_0	3	2009.01	PACIFICARE OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4590	029	0	2009	AARP MedicareComplete Essential	San Antonio Area		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4590	031	0	1	01	01	H4590_031_0	5	2009.01	PACIFICARE OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4590	031	0	2009	Evercare Plan IH	Bexar, Guadalupe and Kendall Counties		2	1	1	1		2			1			(866)-846-2762	(866)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(866)-846-2762	(866)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4590	033	0	1	01	01	H4590_033_0	7	2009.01	PACIFICARE OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4590	033	0	2009	Evercare Plan DH	Corpus Christi Area		2	1	3			2			2	2		(866)-846-2762	(866)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(866)-846-2762	(866)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4590	034	0	1	01	01	H4590_034_0	6	2009.01	PACIFICARE OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4590	034	0	2009	Evercare Plan IH	Collin, Dallas, Denton and Tarrant Counties		2	1	1	1		2			1			(866)-846-2762	(866)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(886)-846-2762	(886)-846-2762	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4590	035	0	1	01	01	H4590_035_0	6	2009.01	PACIFICARE OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4590	035	0	2009	Evercare Plan MH	Dallas-Fort Worth Metroplex		2	1	4			2			2		1111111110000000100000000001	(888)-834-3737	(888)-834-3737	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(888)-834-3737	(888)-834-3737	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4590	036	0	1	01	01	H4590_036_0	7	2009.01	PACIFICARE OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4590	036	0	2009	Evercare Plan MH	Corpus Christi Area		2	1	4			2			2		1111111110000000100000000001	(888)-834-3737	(888)-834-3737	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(888)-834-3737	(888)-834-3737	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4590	037	0	1	01	01	H4590_037_0	5	2009.01	PACIFICARE OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4590	037	0	2009	Evercare Plan MH	San Antonio Area		2	1	4			2			2		1111111110000000100000000001	(888)-834-3737	(888)-834-3737	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(888)-834-3737	(888)-834-3737	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4590	801	0	1	01	01	H4590_801_0	2	2009.01	PACIFICARE OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4590	801	0	2009	MedicareComplete Retiree Plan	TX Employer Sponsored Plan Service Area		1	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074									www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4590	802	0	1	01	01	H4590_802_0	2	2009.01	PACIFICARE OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4590	802	0	2009	MedicareComplete Retiree Plan	TX Employer Sponsored Plan Service Area		1	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074									www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4590	803	0	1	01	01	H4590_803_0	2	2009.01	PACIFICARE OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4590	803	0	2009	MedicareComplete Retiree Plan	TX Employer Sponsored Plan Service Area		1	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4590	804	0	1	01	01	H4590_804_0	2	2009.01	PACIFICARE OF TEXAS, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4590	804	0	2009	MedicareComplete Retiree Plan	TX Employer Sponsored Plan Service Area		1	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	(800)-950-9355	(800)-950-9355	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4604	003	0	1	02	01	H4604_003_0	3	2009.01	UNITEDHEALTHCARE OF UTAH, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H4604	003	0	2009	AARP MedicareComplete Plus Plan1	BoxElder/Davis/Morgan/SltLake/Summit/Wasatch/Weber		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4604	005	0	1	02	01	H4604_005_0	3	2009.01	UNITEDHEALTHCARE OF UTAH, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H4604	005	0	2009	AARP MedicareComplete Plus Plan2	BoxElder/Davis/Morgan/SltLake/Summit/Wasatch/Weber		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4604	006	0	1	02	01	H4604_006_0	3	2009.01	UNITEDHEALTHCARE OF UTAH, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H4604	006	0	2009	Evercare Plan DH-POS	Salt Lake and Ogden Surrounding Counties		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4604	007	0	1	02	01	H4604_007_0	3	2009.01	UNITEDHEALTHCARE OF UTAH, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H4604	007	0	2009	Evercare Plan IH-POS	Salt Lake and Weber Counties		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4604	008	0	1	02	01	H4604_008_0	3	2009.01	UNITEDHEALTHCARE OF UTAH, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H4604	008	0	2009	Evercare Plan MH-POS	Salt Lake and Ogden Surrounding Counties		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4604	009	0	1	02	01	H4604_009_0	3	2009.01	UNITEDHEALTHCARE OF UTAH, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H4604	009	0	2009	AARP MedicareComplete Plus Plan1	Cache and Utah UT		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4604	801	0	1	01	01	H4604_801_0	2	2009.01	UNITEDHEALTHCARE OF UTAH, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4604	801	0	2009	MedicareComplete Retiree Plan	Salt Lake and Surrounding Counties		1	2				2						(800)-853-3084		(888)-685-8480		(800)-691-0008		(888)-685-8480		(800)-853-3084	(800)-853-3084	(888)-685-8480		(800)-691-0008	(800)-691-0008	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4604	803	0	1	01	01	H4604_803_0	2	2009.01	UNITEDHEALTHCARE OF UTAH, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4604	803	0	2009	MedicareComplete Retiree Plan	Select Counties In UT		1	2				2						(800)-853-3084		(888)-685-8480		(800)-691-0008		(888)-685-8480		(800)-853-3084	(800)-853-3084	(888)-685-8480		(800)-691-0008	(800)-691-0008	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4604	804	0	1	01	01	H4604_804_0	2	2009.01	UNITEDHEALTHCARE OF UTAH, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H4604	804	0	2009	MedicareComplete Retiree Plan	Cache and Utah UT		1	2				2						(800)-853-3084		(888)-685-8480		(800)-691-0008		(888)-685-8480		(800)-853-3084	(800)-853-3084	(888)-685-8480		(800)-691-0008	(800)-691-0008	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H4605	001	0	1	04	01	H4605_001_0	4	2009.01	REGENCE BLUECROSS BLUESHIELD OF UT	Regence BlueCross BlueShield of Utah	www.ut.regence.com	01	04		1		H4605	001	0	2009	Regence MedAdvantage	Select Counties in Utah		2	2				2						(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003										www.ut.regence.com	http://www.ut.regence.com/member/doctor/
H4605	002	0	1	04	01	H4605_002_0	6	2009.01	REGENCE BLUECROSS BLUESHIELD OF UT	Regence BlueCross BlueShield of Utah	www.ut.regence.com	01	04		1		H4605	002	0	2009	Regence MedAdvantage + Rx Classic	Select Counties in Utah		2	2				2						(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003		(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003		www.ut.regence.com	http://www.ut.regence.com/member/doctor/
H4605	004	0	1	04	01	H4605_004_0	7	2009.01	REGENCE BLUECROSS BLUESHIELD OF UT	Regence BlueCross BlueShield of Utah	www.ut.regence.com	01	04		1		H4605	004	0	2009	Regence MedAdvantage + Rx Enhanced	Select Counties in Utah		2	2				2						(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003		(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003		www.ut.regence.com	http://www.ut.regence.com/member/doctor/
H4605	006	0	1	04	01	H4605_006_0	5	2009.01	REGENCE BLUECROSS BLUESHIELD OF UT	Regence BlueCross BlueShield of Utah	www.ut.regence.com	01	04		1		H4605	006	0	2009	Regence MedAdvantage + Rx Core	Select Counties in Utah		2	2				2						(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003		(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003		www.ut.regence.com	http://www.ut.regence.com/member/doctor/
H4606	001	0	1	04	01	H4606_001_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4606	001	0	2009	HumanaChoicePPO PPO H4606-001	Salt Lake City Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4606	004	0	1	04	01	H4606_004_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4606	004	0	2009	HumanaChoicePPO PPO H4606-004	Salt Lake City Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4606	801	0	1	04	01	H4606_801_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4606	801	0	2009	Humana Employer Sponsored	Salt Lake City and St George Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4606	802	0	1	04	01	H4606_802_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4606	802	0	2009	Humana Employer Sponsored	Salt Lake City and St. George Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4606	803	0	1	04	01	H4606_803_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4606	803	0	2009	Humana Employer Sponsored Non-CY	Salt Lake City and St. George Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4606	804	0	1	04	01	H4606_804_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4606	804	0	2009	Humana Employer Sponsored Non-CY	Salt Lake City and St. George Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4720	001	0	1	09	04	H4720_001_0	7	2009.01	UNITED HEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons MedicareDirect	www.securehorizons.com	04	09	2	1		H4720	001	0	2009	SecureHorizons MedicareDirect Rx Plan 52	Select counties in NY		2	2				2						(800)-711-6088	(800)-711-6088	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		(800)-711-6088	(800)-711-6088	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	
H4720	002	0	1	09	04	H4720_002_0	6	2009.01	UNITED HEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons MedicareDirect	www.securehorizons.com	04	09	2	1		H4720	002	0	2009	SecureHorizons MedicareDirect Plan 4	Select counties in NY		2	2				2						(800)-711-6088	(800)-711-6088	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074										https://www.securehorizons.com/ourplans/searchformulary.html	
H4720	801	0	1	09	04	H4720_801_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons MedicareDirect	www.securehorizons.com	04	09	2	1		H4720	801	0	2009	SecureHorizons MedicareDirect	National		1	2				2						(866)-579-8774		(888)-844-5530		(800)-555-5757		(800)-387-1074										https://www.securehorizons.com/ourplans/searchformulary.html	
H4720	803	0	1	09	04	H4720_803_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons MedicareDirect	www.securehorizons.com	04	09	2	1		H4720	803	0	2009	SecureHorizons MedicareDirect Rx	National		1	2				2						(866)-579-8774		(888)-844-5530		(800)-555-5757		(800)-387-1074		(866)-272-0407	(866)-272-0407	(888)-844-5530		(800)-555-5757	(800)-555-5757	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	
H4779	001	0	1	37	05	H4779_001_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.ericksonadvantage.com	05	37		1		H4779	001	0	2009	Erickson Advantage Signature with Drugs	Collin and Harris Counties		2	2				2						(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.ericksonadvantage.com
H4779	002	0	1	37	05	H4779_002_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.ericksonadvantage.com	05	37		1		H4779	002	0	2009	Erickson Advantage Signature without Drugs	Collin and Harris Counties		2	2				2						(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480										http://www.ericksonadvantage.com/formulary.asp	www.ericksonadvantage.com
H4779	003	0	1	37	05	H4779_003_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.ericksonadvantage.com	05	37		1		H4779	003	0	2009	Erickson Advantage Champion	Collin and Harris Counties		2	1	4			2			2		1111111110000000100000000001	(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.ericksonadvantage.com
H4781	001	0	1	04	01	H4781_001_0	7	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H4781	001	0	2009	Aetna Golden Choice Value Plan	Oklahoma County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H4781	002	0	1	04	01	H4781_002_0	7	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H4781	002	0	2009	Aetna Golden Choice Value Plan	Tulsa County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H4781	801	0	1	04	01	H4781_801_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H4781	801	0	2009	Aetna Golden Choice Plan	Canadian,Cleveland,Logan,Oklahoma,Tulsa Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H4781	802	0	1	04	01	H4781_802_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H4781	802	0	2009	Aetna Golden Choice Plan w/Rx CY	Canadian,Cleveland,Logan,Oklahoma,Tulsa Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H4836	001	0	1	09	04	H4836_001_0	2	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plan from Medical Mutual of Ohio	www.Advantage-Plan.com	04	09	2	1		H4836	001	0	2009	Advantage Plan PFFS Standard	Ohio		2	2				2						(866)-575-5260	(866)-575-5260	(888)-844-5530	(888)-844-5530	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109									www.medmutual.com	
H4836	002	0	1	09	04	H4836_002_0	10	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plan from Medical Mutual of Ohio	www.Advantage-Plan.com	04	09	2	1		H4836	002	0	2009	Advantage Plan PFFS Premium	Ohio		2	2				2						(866)-575-5260	(866)-575-5260	(888)-844-5530	(888)-844-5530	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	(877)-722-2679	(877)-722-2679	(800)-716-3231	(800)-716-3231	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	www.medmutual.com	
H4836	801	0	1	09	04	H4836_801_0	3	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plan from Medical Mutual of Ohio	www.Advantage-Plan.com	04	09	2	1		H4836	801	0	2009	Employer PFFS CY with PD	US		1	2				2						(800)-982-3117	(800)-982-3117	(800)-982-8109	(800)-982-8109	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	(800)-935-9952	(800)-935-9952	(800)-716-3231	(800)-716-3231	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	www.medmutual.com	
H4836	802	0	1	09	04	H4836_802_0	4	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plan from Medical Mutual of Ohio	www.Advantage-Plan.com	04	09	2	1		H4836	802	0	2009	Employer PFFS CY without PD	US		1	2				2						(800)-982-3117	(800)-982-3117	(800)-982-8109	(800)-982-8109	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109									www.medmutual.com	
H4836	803	0	1	09	04	H4836_803_0	4	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plan from Medical Mutual of Ohio	www.Advantage-Plan.com	04	09	2	1		H4836	803	0	2009	Employer PFFS non-CY with PD	US		1	2				2						(800)-982-3117	(800)-982-3117	(800)-982-8109	(800)-982-8109	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	(800)-935-9952	(800)-935-9952	(800)-716-3231	(800)-716-3231	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	www.medmutual.com	
H4836	804	0	1	09	04	H4836_804_0	3	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plan from Medical Mutual of Ohio	www.Advantage-Plan.com	04	09	2	1		H4836	804	0	2009	Employer PFFS non-CY without PD	US		1	2				2						(800)-982-3117	(800)-982-3117	(800)-982-8109	(800)-982-8109	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109									www.medmutual.com	
H4837	001	0	1	01	01	H4837_001_0	5	2009.01	UNITEDHEALTHCARE OF WISCONSIN	UnitedHealthcare of WI/Personal Care Plus	www.americhoice.com	01	01		1		H4837	001	0	2009	UnitedHealthcare of Wisconsin	Milwaukee		2	1	3			2			1	3		(800)-504-9660		(800)-421-1220		(800)-504-9660		(800)-421-1220		(800)-504-9660	(800)-504-9660			(800)-504-9660	(800)-504-9660			www.americhoice.com	www.americhoice.com
H4908	001	0	1	04	01	H4908_001_0	3	2009.01	OPTIMA HEALTH INSURANCE COMPANY	Optima Medicare	www.optimahealth.com	01	04		1		H4908	001	0	2009	Optima Medicare Preferred	Optima Medicare Preferred		2	2			243	2						(757)-687-6160	(800)-927-6048	(757)-552-7120	(800)-225-7784	(757)-687-6160	(800)-927-6048	(757)-552-7120	(800)-225-7784									www.optimahealth.com/OptimaHealth/Members/Unsecured/Resources/Pages/OptimaMedicareDrugList.htm	www.optimahealth.com
H4908	002	0	1	04	01	H4908_002_0	4	2009.01	OPTIMA HEALTH INSURANCE COMPANY	Optima Medicare	www.optimahealth.com	01	04		1		H4908	002	0	2009	Optima Medicare Preferred Plus	Optima Medicare Preferred Plus		2	2			2768	2						(757)-687-6160	(800)-927-6048	(757)-552-7120	(800)-225-7784	(757)-687-6160	(800)-927-6048	(757)-552-7120	(800)-225-7784	(757)-687-6160	(800)-927-6048	(757)-552-7120	(800)-225-7784	(757)-687-6160	(800)-927-6048	(757)-552-7120	(800)-225-7784	www.optimahealth.com/OptimaHealth/Members/Unsecured/Resources/Pages/OptimaMedicareDrugList.htm	www.optimahealth.com
H4908	005	0	1	04	01	H4908_005_0	3	2009.01	OPTIMA HEALTH INSURANCE COMPANY	Optima Medicare	www.optimahealth.com	01	04		1		H4908	005	0	2009	Optima Medicare Value	Optima Medicare Value		2	2			148	2						(757)-687-6160	(800)-927-6048	(757)-552-7120	(800)-225-7784	(757)-687-6160	(800)-927-6048	(757)-552-7120	(800)-225-7784									www.optimahealth.com/OptimaHealth/Members/Unsecured/Resources/Pages/OptimaMedicareDrugList.htm	www.optimahealth.com
H4908	006	0	1	04	01	H4908_006_0	5	2009.01	OPTIMA HEALTH INSURANCE COMPANY	Optima Medicare	www.optimahealth.com	01	04		1		H4908	006	0	2009	Optima Medicare Value Plus	Optima Medicare Value Plus		2	2			2768	2						(757)-687-6160	(800)-927-6048	(757)-552-7120	(800)-225-7784	(757)-687-6160	(800)-927-6048	(757)-552-7120	(800)-225-7784	(757)-687-6160	(800)-927-6048	(757)-552-7120	(800)-225-7784	(757)-687-6160	(800)-927-6048	(757)-552-7120	(800)-225-7784	www.optimahealth.com/OptimaHealth/Members/Unsecured/Resources/Pages/OptimaMedicareDrugList.htm	www.optimahealth.com
H4909	001	0	1	04	01	H4909_001_0	12	2009.01	ANTHEM HEALTH PLANS OF VIRGINIA, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	04		1		H4909	001	0	2009	Anthem Medicare Preferred Standard	Virginia - Select Counties		2	2			668	2						(866)-827-9866	(866)-827-9866	(888)-853-7754	(888)-853-7754	(800)-916-2583	(800)-916-2583	(800)-241-6894	(800)-241-6894	(866)-827-9866	(866)-827-9866	(888)-853-7754	(888)-853-7754	(800)-916-2583	(800)-916-2583	(800)-241-6894	(800)-241-6894	www.anthem.com	www.anthem.com
H4909	004	0	1	04	01	H4909_004_0	13	2009.01	ANTHEM HEALTH PLANS OF VIRGINIA, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	04		1		H4909	004	0	2009	Anthem Medicare Preferred Premier	Virginia - Select Counties		2	2			858	2						(866)-827-9866	(866)-827-9866	(888)-853-7754	(888)-853-7754	(800)-916-2583	(800)-916-2583	(800)-241-6894	(800)-241-6894	(866)-827-9866	(866)-827-9866	(888)-853-7754	(888)-853-7754	(800)-916-2583	(800)-916-2583	(800)-241-6894	(800)-241-6894	www.anthem.com	www.anthem.com
H4909	804	0	1	04	01	H4909_804_0	3	2009.01	ANTHEM HEALTH PLANS OF VIRGINIA, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	04		1		H4909	804	0	2009	Anthem Medicare Preferred Group	Virginia, Select counties		1	2			125	2						(866)-827-9866	(866)-827-9866	(888)-853-7754	(888)-853-7754	(800)-916-2583	(800)-916-2583	(800)-241-6894	(800)-241-6894	(866)-827-9866	(866)-827-9866	(888)-853-7754	(888)-853-7754	(800)-916-2583	(800)-916-2583	(800)-241-6894	(800)-241-6894	www.anthem.com	www.anthem.com
H4909	805	0	1	04	01	H4909_805_0	3	2009.01	ANTHEM HEALTH PLANS OF VIRGINIA, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	04		1		H4909	805	0	2009	Anthem Medicare Preferred Group	Virginia, Select Counties		1	2			50	2						(866)-827-9866	(866)-827-9866	(888)-853-7754	(888)-853-7754	(800)-916-2583	(800)-916-2583	(800)-241-6894	(800)-241-6894									www.anthem.com	www.anthem.com
H4909	806	0	1	04	01	H4909_806_0	3	2009.01	ANTHEM HEALTH PLANS OF VIRGINIA, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	04		1		H4909	806	0	2009	Anthem Medicare Preferred Group	Virginia, Select Counties		1	2			25	2						(866)-827-9866	(866)-827-9866	(888)-853-7754	(888)-853-7754	(800)-916-2583	(800)-916-2583	(800)-241-6894	(800)-241-6894	(866)-827-9866	(866)-827-9866	(888)-853-7754	(888)-853-7754	(800)-916-2583	(800)-916-2583	(800)-241-6894	(800)-241-6894	www.anthem.com	www.anthem.com
H4910	002	0	1	01	01	H4910_002_0	5	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H4910	002	0	2009	Aetna Golden Medicare Premier Plus Plan	Fairfax County and Surrounding Area		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H4910	004	0	1	01	01	H4910_004_0	6	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H4910	004	0	2009	Aetna Golden Medicare Standard Plan	Fairfax County and Surrounding Area		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H4910	005	0	1	01	01	H4910_005_0	6	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H4910	005	0	2009	Aetna Golden Medicare Premier Plan	Fairfax County and Surrounding Area		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H4910	801	0	1	01	01	H4910_801_0	3	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H4910	801	0	2009	Aetna Golden Medicare Plan	Fairfax County and Surrounding Area		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H4910	802	0	1	01	01	H4910_802_0	3	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H4910	802	0	2009	Aetna Golden Medicare Plan w/Rx CY	Fairfax County and Surrounding Area		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H4911	002	0	1	04	01	H4911_002_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H4911	002	0	2009	Aetna Golden Choice Premier Plan	Fairfax County and Surrounding Area		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind
H4911	003	0	1	04	01	H4911_003_0	7	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H4911	003	0	2009	Aetna Golden Choice Standard Plan	Fairfax County and Surrounding Area		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind
H4911	801	0	1	04	01	H4911_801_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H4911	801	0	2009	Aetna Golden Choice Plan	Fairfax County and Surrounding Area		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind
H4911	802	0	1	04	01	H4911_802_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H4911	802	0	2009	Aetna Golden Choice Plan w/Rx CY	Fairfax County and Surrounding Area		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind
H4911	804	0	1	04	01	H4911_804_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H4911	804	0	2009	Aetna Golden Choice Plan w/RX NCY	Fairfax County and Surrounding Area		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind
H4917	001	0	1	09	04	H4917_001_0	11	2009.01	GUARDIAN HEALTHCARE,INC.	Guardian Healthcare, Inc.	To be created	04	09	2	1		H4917	001	0	2009	Guardian Tribute	South Carolina		2	2			1500	2						(864)-313-2140	(877)-554-8273	(864)-313-2140		(864)-313-2140	(877)-554-8273	(864)-313-2140		(864)-313-2140	(877)-554-8273			(864)-313-2140	(877)-554-8273			www.guardianhealthcare.com	
H4917	002	0	1	09	04	H4917_002_0	10	2009.01	GUARDIAN HEALTHCARE,INC.	Guardian Healthcare, Inc.	To be created	04	09	2	1		H4917	002	0	2009	Guardian Tribute Enhanced	South Carolina		2	2			1800	2						(864)-313-2140	(877)-554-8273	(864)-313-2140		(864)-313-2140	(877)-554-8273	(864)-313-2140		(864)-313-2140	(877)-554-8273			(864)-313-2140	(877)-554-8273			www.guardianhealthcare.com	
H4956	001	0	1	04	01	H4956_001_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4956	001	0	2009	HumanaChoicePPO PPO H4956-001	Gulf Coast and Biloxi Metro Areas		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-833-2364			(800)-457-4708	(800)-833-2364			http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4956	002	0	1	04	01	H4956_002_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4956	002	0	2009	HumanaChoicePPO PPO H4956-002	Jackson Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-833-2364			(800)-457-4708	(800)-833-2364			http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4956	801	0	1	04	01	H4956_801_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4956	801	0	2009	Humana Employer Sponsored	Select counties in MS		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4956	802	0	1	04	01	H4956_802_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4956	802	0	2009	Humana Employer Sponsored	Select counties in MS		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4956	803	0	1	04	01	H4956_803_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4956	803	0	2009	Humana Employer Sponsored Non-CY	Select counties in MS		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4956	804	0	1	04	01	H4956_804_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H4956	804	0	2009	Humana Employer Sponsored Non-CY	Select counties in MS		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H4971	001	0	1	02	01	H4971_001_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	02		1		H4971	001	0	2009	SecureHorizons MedicareComplete Plus	Allegan, Kent and Ottawa Counties		2	2				2						(800)-711-6088	(800)-711-6088	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		(800)-711-6088	(800)-711-6088	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H4971	801	0	1	02	01	H4971_801_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	02		1		H4971	801	0	2009	MedicareComplete Retiree Plan	Allegan, Kent, and Ottawa Counties		1	2				2						(800)-555-5757		(800)-387-1074		(800)-555-5757		(800)-387-1074		(800)-555-5757	(800)-555-5757	(800)-387-1074		(800)-555-5757	(800)-555-5757	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H4971	802	0	1	02	01	H4971_802_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	02		1		H4971	802	0	2009	MedicareComplete Retiree Plan	Allegan, Kent, and Ottawa Counties		1	2				2						(800)-555-5757		(800)-387-1074		(800)-555-5757		(800)-387-1074										https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H4971	803	0	1	02	01	H4971_803_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	02		1		H4971	803	0	2009	MedicareComplete Retiree Plan	Allegan, Kent and Ottawa Counties		1	2				2						(800)-555-5757		(800)-387-1074		(800)-555-5757		(800)-387-1074		(800)-555-5757	(800)-555-5757	(800)-387-1074		(800)-555-5757	(800)-555-5757	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H4971	804	0	1	02	01	H4971_804_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	01	02		1		H4971	804	0	2009	MedicareComplete Retiree Plan	Allegan, Kent,and Ottawa Counties		1	2				2						(800)-555-5757		(800)-387-1074		(800)-555-5757		(800)-387-1074										https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
H4979	001	1	1	09	04	H4979_001_1	4	2009.01	BLUECROSS BLUESHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	04	09	2	1		H4979	001	1	2009	BlueAdvantage PFFS Basic	State of Tennessee	Middle and Western Tennessee	2	2			300	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-664-6422	(877)-664-6422										
H4979	001	2	1	09	04	H4979_001_2	3	2009.01	BLUECROSS BLUESHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	04	09	2	1		H4979	001	2	2009	BlueAdvantage PFFS Basic	State of Tennessee	Southeast and Northeast Tennessee	2	2			300	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-664-6422	(877)-664-6422										
H4979	002	1	1	09	04	H4979_002_1	3	2009.01	BLUECROSS BLUESHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	04	09	2	1		H4979	002	1	2009	BlueAdvantage PFFS Value	State of Tennessee	Middle and Western Tennessee	2	2			300	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-664-6422	(877)-664-6422										
H4979	002	2	1	09	04	H4979_002_2	3	2009.01	BLUECROSS BLUESHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	04	09	2	1		H4979	002	2	2009	BlueAdvantage PFFS Value	State of Tennessee	Southeast and Northeast Tennessee	2	2			300	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-664-6422	(877)-664-6422										
H4979	003	1	1	09	04	H4979_003_1	3	2009.01	BLUECROSS BLUESHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	04	09	2	1		H4979	003	1	2009	BlueAdvantage PFFS Classic	State of Tennessee	Middle and Western Tennessee	2	2			300	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-664-6422	(877)-664-6422										
H4979	003	2	1	09	04	H4979_003_2	3	2009.01	BLUECROSS BLUESHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	04	09	2	1		H4979	003	2	2009	BlueAdvantage PFFS Classic	State of Tennessee	Southeast and Northeast Tennessee	2	2			300	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-664-6422	(877)-664-6422										
H4979	801	0	1	09	04	H4979_801_0	6	2009.01	BLUECROSS BLUESHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	04	09	2	1		H4979	801	0	2009	BlueAdvantage PFFS	National		1	2			35	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-664-6422	(877)-664-6422										
H5005	001	0	1	01	01	H5005_001_0	5	2009.01	PACIFICARE OF WASHINGTON, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H5005	001	0	2009	AARP MedicareComplete Plan 1	Central Washington		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5005	010	0	1	01	01	H5005_010_0	5	2009.01	PACIFICARE OF WASHINGTON, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H5005	010	0	2009	AARP MedicareComplete Plan 1	Southern Washington		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5005	011	0	1	01	01	H5005_011_0	5	2009.01	PACIFICARE OF WASHINGTON, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H5005	011	0	2009	AARP MedicareComplete Plan 1	Northern Washington		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5005	015	0	1	01	01	H5005_015_0	4	2009.01	PACIFICARE OF WASHINGTON, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H5005	015	0	2009	AARP MedicareComplete Essential	Central Washington		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5005	018	0	1	01	01	H5005_018_0	8	2009.01	PACIFICARE OF WASHINGTON, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H5005	018	0	2009	AARP MedicareComplete Essential	Cowlitz, Island, Snohomish, and Clark counties		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5005	019	0	1	01	01	H5005_019_0	5	2009.01	PACIFICARE OF WASHINGTON, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H5005	019	0	2009	AARP MedicareComplete Plan 3	Select Washington Counties		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5005	024	0	1	01	01	H5005_024_0	5	2009.01	PACIFICARE OF WASHINGTON, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H5005	024	0	2009	AARP MedicareComplete Plan 2	King County		2	2				2						(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-950-9355	(800)-950-9355	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5005	801	0	1	01	01	H5005_801_0	2	2009.01	PACIFICARE OF WASHINGTON, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H5005	801	0	2009	MedicareComplete Retiree Plan	WA Employer Sponsored Plan Service Area		1	2				2						(800)-533-2743	(800)-533-2743	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074									www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5005	802	0	1	01	01	H5005_802_0	2	2009.01	PACIFICARE OF WASHINGTON, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H5005	802	0	2009	MedicareComplete Retiree Plan	WA Employer Sponsored Plan Service Area		1	2				2						(800)-533-2743	(800)-533-2743	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074									www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5005	803	0	1	01	01	H5005_803_0	2	2009.01	PACIFICARE OF WASHINGTON, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H5005	803	0	2009	MedicareComplete Retiree Plan	WA Employer Sponsored Plan Service Area		1	2				2						(800)-533-2743	(800)-533-2743	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	(800)-533-2743	(800)-533-2743	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5005	804	0	1	01	01	H5005_804_0	2	2009.01	PACIFICARE OF WASHINGTON, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H5005	804	0	2009	MedicareComplete Retiree Plan	WA Employer Sponsored Plan Service Area		1	2				2						(800)-533-2743	(800)-533-2743	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	(800)-533-2743	(800)-533-2743	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5006	014	1	1	09	04	H5006_014_1	2	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	04	09	2	1		H5006	014	1	2009	Sterling Option I	Multi-State Area	Segment 1	2	2				2						(888)-858-8551	(888)-858-8551	(888)-858-8567	(888)-858-8567	(888)-858-8572	(888)-858-8572	(888)-858-8567	(888)-858-8567									http://www.sterlingplans.com	
H5006	014	2	1	09	04	H5006_014_2	2	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	04	09	2	1		H5006	014	2	2009	Sterling Option I	Multi-State Area	Segment 2	2	2				2						(888)-858-8551	(888)-858-8551	(888)-858-8567	(888)-858-8567	(888)-858-8572	(888)-858-8572	(888)-858-8567	(888)-858-8567									http://www.sterlingplans.com	
H5006	014	3	1	09	04	H5006_014_3	2	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	04	09	2	1		H5006	014	3	2009	Sterling Option I	Multi-State Area	Segment 3	2	2				2						(888)-858-8551	(888)-858-8551	(888)-858-8567	(888)-858-8567	(888)-858-8572	(888)-858-8572	(888)-858-8567	(888)-858-8567									http://www.sterlingplans.com	
H5006	015	1	1	09	04	H5006_015_1	2	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	04	09	2	1		H5006	015	1	2009	Sterling Option III	Multi-State Area	Segment 1	2	2				2						(888)-858-8551	(888)-858-8551	(888)-858-8567	(888)-858-8567	(888)-858-8572	(888)-858-8572	(888)-858-8567	(888)-858-8567									http://www.sterlingplans.com	
H5006	015	2	1	09	04	H5006_015_2	2	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	04	09	2	1		H5006	015	2	2009	Sterling Option III	Multi-State Area	Segment 2	2	2				2						(888)-858-8551	(888)-858-8551	(888)-858-8567	(888)-858-8567	(888)-858-8572	(888)-858-8572	(888)-858-8567	(888)-858-8567									http://www.sterlingplans.com	
H5006	015	3	1	09	04	H5006_015_3	2	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	04	09	2	1		H5006	015	3	2009	Sterling Option III	Multi-State Area	Segment 3	2	2				2						(888)-858-8551	(888)-858-8551	(888)-858-8567	(888)-858-8567	(888)-858-8572	(888)-858-8572	(888)-858-8567	(888)-858-8567									http://www.sterlingplans.com	
H5006	016	1	1	09	04	H5006_016_1	3	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	04	09	2	1		H5006	016	1	2009	Sterling Option IV	Multi-State Area	Segment 1	2	2				2						(888)-858-8551	(888)-858-8551	(888)-858-8567	(888)-858-8567	(888)-858-8572	(888)-858-8572	(888)-858-8567	(888)-858-8567	(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
H5006	016	2	1	09	04	H5006_016_2	3	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	04	09	2	1		H5006	016	2	2009	Sterling Option IV	Multi-State Area	Segment 2	2	2				2						(888)-858-8551	(888)-858-8551	(888)-858-8567	(888)-858-8567	(888)-858-8572	(888)-858-8572	(888)-858-8567	(888)-858-8567	(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
H5006	016	3	1	09	04	H5006_016_3	3	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	04	09	2	1		H5006	016	3	2009	Sterling Option IV	Multi-State Area	Segment 3	2	2				2						(888)-858-8551	(888)-858-8551	(888)-858-8567	(888)-858-8567	(888)-858-8572	(888)-858-8572	(888)-858-8567	(888)-858-8567	(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
H5006	017	1	1	09	04	H5006_017_1	3	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	04	09	2	1		H5006	017	1	2009	Sterling Option II	Multi-State Area	Segment 1	2	2				2						(888)-858-8551	(888)-858-8551	(888)-858-8567	(888)-858-8567	(888)-858-8572	(888)-858-8572	(888)-858-8567	(888)-858-8567	(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
H5006	017	2	1	09	04	H5006_017_2	3	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	04	09	2	1		H5006	017	2	2009	Sterling Option II	Multi-State Area	Segment 2	2	2				2						(888)-858-8551	(888)-858-8551	(888)-858-8567	(888)-858-8567	(888)-858-8572	(888)-858-8572	(888)-858-8567	(888)-858-8567	(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
H5006	017	3	1	09	04	H5006_017_3	4	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	04	09	2	1		H5006	017	3	2009	Sterling Option II	Multi-State Area	Segment 3	2	2				2						(888)-858-8551	(888)-858-8551	(888)-858-8567	(888)-858-8567	(888)-858-8572	(888)-858-8572	(888)-858-8567	(888)-858-8567	(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
H5006	018	1	1	09	04	H5006_018_1	2	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	04	09	2	1		H5006	018	1	2009	Sterling Basic	Multi-State Area	Segment 1	2	2				2						(888)-858-8551	(888)-858-8551	(888)-858-8567	(888)-858-8567	(888)-858-8572	(888)-858-8572	(888)-858-8567	(888)-858-8567									http://www.sterlingplans.com	
H5006	018	2	1	09	04	H5006_018_2	3	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	04	09	2	1		H5006	018	2	2009	Sterling Basic	Multi-State Area	Segment 2	2	2				2						(888)-858-8551	(888)-858-8551	(888)-858-8567	(888)-858-8567	(888)-858-8572	(888)-858-8572	(888)-858-8567	(888)-858-8567									http://www.sterlingplans.com	
H5006	801	0	1	09	04	H5006_801_0	2	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	04	09	2	1		H5006	801	0	2009	Sterling Retiree Options	Nationwide		1	2				2						(888)-858-8551	(888)-858-8551	(888)-858-8567	(888)-858-8567	(888)-858-8572	(888)-858-8572	(888)-858-8567	(888)-858-8567									http://www.sterlingplans.com	
H5007	001	0	1	20	08	H5007_001_0	1	2009.01	PROVIDENCE HEALTH SYSTEM	Providence Health System	www.providence.org/longtermcare/elderplace	08	20		1		H5007	001	0	2009	Providence ElderPlace - Seattle	Seattle - King County Washington		2	2				2														(206)-320-5325	(000)-000-0000			(206)-320-5325	(000)-000-0000			www.providence.org/longtermcare/elderplace	
H5007	002	0	1	20	08	H5007_002_0	1	2009.01	PROVIDENCE HEALTH SYSTEM	Providence Health System	www.providence.org/longtermcare/elderplace	08	20		1		H5007	002	0	2009	Providence ElderPlace - Seattle	Seattle - King County Washington		2	2				2														(206)-320-5325	(000)-000-0000			(206)-320-5325	(000)-000-0000			www.providence.org/longtermcare/elderplace	
H5008	001	0	1	01	01	H5008_001_0	8	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	01		1		H5008	001	0	2009	Evercare Plan IH	King,Kitsap,Pierce,Snohomish and Whatcom Counties		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H5008	002	0	1	01	01	H5008_002_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	01		1		H5008	002	0	2009	Evercare Plan DH	King,Kitsap,Pierce,Snohomish and Whatcom Counties		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H5008	003	0	1	01	01	H5008_003_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	01		1		H5008	003	0	2009	Evercare Plan DH	Spokane County		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H5008	004	0	1	01	01	H5008_004_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	01		1		H5008	004	0	2009	Evercare Plan MH	King,Kitsap,Pierce,Snohomish and Whatcom Counties		2	1	4			2			2		1110000000000000000000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H5008	005	0	1	01	01	H5008_005_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	01		1		H5008	005	0	2009	Evercare Plan IH	Spokane County		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H5008	006	0	1	01	01	H5008_006_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	01		1		H5008	006	0	2009	Evercare Plan MH	Spokane County		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H5009	001	0	1	04	01	H5009_001_0	4	2009.01	REGENCE BLUESHIELD	Regence BlueShield	www.wa.regence.com	01	04		1		H5009	001	0	2009	Regence MedAdvantage	Select Counties in Washington		2	2				2						(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003										www.wa.regenece.com	http://www.wa.regence.com/member/doctor/
H5009	002	0	1	04	01	H5009_002_0	7	2009.01	REGENCE BLUESHIELD	Regence BlueShield	www.wa.regence.com	01	04		1		H5009	002	0	2009	Regence MedAdvantage + Rx Classic	Select Counties in Washington		2	2				2						(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003		(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003		www.wa.regenece.com	http://www.wa.regence.com/member/doctor/
H5009	004	0	1	04	01	H5009_004_0	6	2009.01	REGENCE BLUESHIELD	Regence BlueShield	www.wa.regence.com	01	04		1		H5009	004	0	2009	Regence MedAdvantage + Rx Enhanced	Select Counties in Washington		2	2				2						(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003		(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003		www.wa.regenece.com	http://www.wa.regence.com/member/doctor/
H5009	006	0	1	04	01	H5009_006_0	5	2009.01	REGENCE BLUESHIELD	Regence BlueShield	www.wa.regence.com	01	04		1		H5009	006	0	2009	Regence MedAdvantage + Rx Core	Select Counties in Washington		2	2				2						(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003		(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003		www.wa.regenece.com	http://www.wa.regence.com/member/doctor/
H5010	001	0	1	04	01	H5010_001_0	4	2009.01	ASURIS NORTHWEST HEALTH	Asuris Northwest Health	www.asurisnorthwesthealth.com	01	04		1		H5010	001	0	2009	Asuris TruAdvantage	Select Counties in Eastern Washington		2	2				2						(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003										www.asuris.com	http://www.asuris.com/doctor/index.html
H5010	002	0	1	04	01	H5010_002_0	7	2009.01	ASURIS NORTHWEST HEALTH	Asuris Northwest Health	www.asurisnorthwesthealth.com	01	04		1		H5010	002	0	2009	Asuris TruAdvantage + Rx Classic	Select Counties in Eastern Washington		2	2				2						(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003		(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003		www.asuris.com	http://www.asuris.com/doctor/index.html
H5010	004	0	1	04	01	H5010_004_0	8	2009.01	ASURIS NORTHWEST HEALTH	Asuris Northwest Health	www.asurisnorthwesthealth.com	01	04		1		H5010	004	0	2009	Asuris TruAdvantage + Rx Enhanced	Select Counties in Eastern Washington		2	2				2						(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003		(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003		www.asuris.com	http://www.asuris.com/doctor/index.html
H5010	006	0	1	04	01	H5010_006_0	5	2009.01	ASURIS NORTHWEST HEALTH	Asuris Northwest Health	www.asurisnorthwesthealth.com	01	04		1		H5010	006	0	2009	Asuris TruAdvantage + Rx Core	Select Counties in Eastern Washington		2	2				2						(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003		(800)-541-8981	(800)-541-8981	(800)-382-1003		(888)-734-3623	(888)-734-3623	(800)-382-1003		www.asuris.com	http://www.asuris.com/doctor/index.html
H5031	001	0	1	04	01	H5031_001_0	6	2009.01	DAVITA VILLAGEHEALTH, INC.	DaVita VillageHealth of DC, Inc.	www.villagehealth.com	01	04		1		H5031	001	0	2009	DaVita VillageHealth, Inc.	District of Columbia, DC		2	1	4		123	2			1		0000000000000000000000000100	(866)-838-1962	(866)-838-1962	(000)-000-0711		(866)-838-1962	(866)-838-1962	(000)-000-0711		(866)-838-1962	(866)-838-1962	(000)-000-0711		(866)-838-1962	(866)-838-1962	(000)-000-0711		www.villagehealth.com	www.villagehealth.com
H5037	001	0	1	20	08	H5037_001_0	1	2009.01	MOUNTAIN EMPIRE OLDER CITIZENS, INCX.	Mountain Empire PACE	www.meoc.org	08	20		1		H5037	001	0	2009	Mountain Empire PACE - Dual	Lee, Scott, Wise Counties and Norton City		2	2			60	2														(276)-523-0599	(866)-793-7223			(276)-523-0599	(866)-793-7223			www.meoc.org	
H5037	002	0	1	20	08	H5037_002_0	1	2009.01	MOUNTAIN EMPIRE OLDER CITIZENS, INCX.	Mountain Empire PACE	www.meoc.org	08	20		1		H5037	002	0	2009	Mountain Empire PACE  - Medicare only	Lee, Scott, Wise Counties and Norton City		2	2			1	2														(276)-523-0599	(866)-793-7223			(276)-523-0599	(866)-793-7223			www.meoc.org	
H5041	001	0	1	04	01	H5041_001_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5041	001	0	2009	HumanaChoice PPO PPO H5041-001	Charleston-Huntington Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5041	801	0	1	04	01	H5041_801_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5041	801	0	2009	Humana Employer Sponsored	Select counties in WV		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5041	802	0	1	04	01	H5041_802_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5041	802	0	2009	Humana Employer Sponsored	Select counties in WV		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5041	803	0	1	04	01	H5041_803_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5041	803	0	2009	Humana Employer Sponsored Non-CY	Select counties in WV		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5041	804	0	1	04	01	H5041_804_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5041	804	0	2009	Humana Employer Sponsored Non-CY	Select counties in WV		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5042	001	0	1	04	01	H5042_001_0	8	2009.01	CDPHP UNIVERSAL BENEFITS, INC.	CDPHP Medicare Choices	www.cdphp.com	01	04		1		H5042	001	0	2009	CDPHP Classic PPO Rx	Hudson Valley, Southern Tier, Central/Northern NYS		2	2			1325	2						(518)-641-3950	(888)-248-6522	(518)-641-4000	(877)-261-1164	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164	(518)-641-3950	(888)-831-3039	(518)-641-4000	(866)-236-1069	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164	http://www.cdphp.com/images/medicare/Medicare_Formulary_2009.pdf	www.cdphp.com
H5042	002	0	1	04	01	H5042_002_0	6	2009.01	CDPHP UNIVERSAL BENEFITS, INC.	CDPHP Medicare Choices	www.cdphp.com	01	04		1		H5042	002	0	2009	CDPHP Core PPO	Hudson Valley, Southern Tier, Central/Northern NYS		2	2			463	2						(518)-641-3950	(888)-248-6522	(518)-641-4000	(877)-261-1164	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164									http://www.cdphp.com/images/medicare/Medicare_Formulary_2009.pdf	www.cdphp.com
H5042	004	0	1	04	01	H5042_004_0	6	2009.01	CDPHP UNIVERSAL BENEFITS, INC.	CDPHP Medicare Choices	www.cdphp.com	01	04		1		H5042	004	0	2009	CDPHP Classic PPO	Hudson Valley, Southern Tier, Central/Northern NYS		2	2			72	2						(518)-641-3950	(888)-248-6522	(518)-641-4000	(877)-261-1164	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164									http://www.cdphp.com/images/medicare/Medicare_Formulary_2009.pdf	www.cdphp.com
H5042	005	0	1	04	01	H5042_005_0	8	2009.01	CDPHP UNIVERSAL BENEFITS, INC.	CDPHP Medicare Choices	www.cdphp.com	01	04		1		H5042	005	0	2009	CDPHP Core PPO Rx	Hudson Valley, Southern Tier, Central/Northern NYS		2	2			245	2						(518)-641-3950	(888)-248-6522	(518)-641-4000	(877)-261-1164	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164	(518)-641-3950	(888)-831-3039	(518)-641-4000	(866)-236-1069	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164	http://www.cdphp.com/images/medicare/Medicare_Formulary_2009.pdf	www.cdphp.com
H5042	006	0	1	04	01	H5042_006_0	6	2009.01	CDPHP UNIVERSAL BENEFITS, INC.	CDPHP Medicare Choices	www.cdphp.com	01	04		1		H5042	006	0	2009	CDPHP Prime PPO	Hudson Valley, Southern Tier, Central/Northern NYS		2	2			9	2						(518)-641-3950	(888)-248-6522	(518)-641-4000	(877)-261-1164	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164									http://www.cdphp.com/images/medicare/Medicare_Formulary_2009.pdf	www.cdphp.com
H5042	007	0	1	04	01	H5042_007_0	8	2009.01	CDPHP UNIVERSAL BENEFITS, INC.	CDPHP Medicare Choices	www.cdphp.com	01	04		1		H5042	007	0	2009	CDPHP Prime PPO Rx	Hudson Valley, Southern Tier, Central/Northern NYS		2	2			49	2						(518)-641-3950	(888)-248-6522	(518)-641-4000	(877)-261-1164	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164	(518)-641-3950	(888)-831-3039	(518)-641-4000	(866)-236-1069	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164	http://www.cdphp.com/images/medicare/Medicare_Formulary_2009.pdf	www.cdphp.com
H5042	801	0	1	04	01	H5042_801_0	6	2009.01	CDPHP UNIVERSAL BENEFITS, INC.	CDPHP Medicare Choices	www.cdphp.com	01	04		1		H5042	801	0	2009	CDPHP Group PPO Rx	Upstate New York Region		1	2			20	2						(518)-641-3950	(888)-248-6522	(518)-641-4000	(877)-261-1164	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164	(518)-641-3950	(888)-831-3039	(518)-641-4000	(866)-236-1069	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164	http://www.cdphp.com/images/medicare/Medicare_Formulary_2009.pdf	www.cdphp.com
H5042	802	0	1	04	01	H5042_802_0	6	2009.01	CDPHP UNIVERSAL BENEFITS, INC.	CDPHP Medicare Choices	www.cdphp.com	01	04		1		H5042	802	0	2009	CDPHP Group PPO Rx	Upstate New York Region		1	2			60	2						(518)-641-3950	(888)-248-6522	(518)-641-4000	(877)-261-1164	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164	(518)-641-3950	(888)-831-3039	(518)-641-4000	(866)-236-1069	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164	http://www.cdphp.com/images/medicare/Medicare_Formulary_2009.pdf	www.cdphp.com
H5042	803	0	1	04	01	H5042_803_0	6	2009.01	CDPHP UNIVERSAL BENEFITS, INC.	CDPHP Medicare Choices	www.cdphp.com	01	04		1		H5042	803	0	2009	CDPHP Group PPO	Upstate New York Region		1	2			10	2						(518)-641-3950	(888)-248-6522	(518)-641-4000	(877)-261-1164	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164									http://www.cdphp.com/images/medicare/Medicare_Formulary_2009.pdf	www.cdphp.com
H5050	001	0	1	01	01	H5050_001_0	3	2009.01	GROUP HEALTH COOPERATIVE	Group Health Cooperative	www.ghc.org/medicare	01	01		1		H5050	001	0	2009	Clear Care Basic	All Counties Served by Group Health Cooperative		2	2			11447	2						(206)-901-4600	(888)-901-4600	(800)-833-6388		(800)-446-8882	(800)-446-8882	(800)-833-6388										www.ghc.org/health_plans/index.jhtml?reposid=/common/healthPlans/Medicare/aboutPartDFormulary.html	www.ghc.org/medicare
H5050	004	0	1	01	01	H5050_004_0	6	2009.01	GROUP HEALTH COOPERATIVE	Group Health Cooperative	www.ghc.org/medicare	01	01		1		H5050	004	0	2009	Clear Care Optimal	All Counties Served by Group Health Cooperative		2	2			8180	2						(206)-901-4600	(888)-901-4600	(800)-833-6388		(800)-446-8882	(800)-446-8882	(800)-833-6388		(206)-901-4600	(888)-901-4600	(800)-833-6388		(800)-446-8882	(800)-446-8882	(800)-833-6388		www.ghc.org/health_plans/index.jhtml?reposid=/common/healthPlans/Medicare/aboutPartDFormulary.html	www.ghc.org/medicare
H5050	009	0	1	01	01	H5050_009_0	6	2009.01	GROUP HEALTH COOPERATIVE	Group Health Cooperative	www.ghc.org/medicare	01	01		1		H5050	009	0	2009	Clear Care Essential	All Counties Served by Group Health Cooperative		2	2			13231	2						(206)-901-4600	(888)-901-4600	(800)-833-6388		(800)-446-8882	(800)-446-8882	(800)-833-6388		(206)-901-4600	(888)-901-4600	(800)-833-6388		(800)-446-8882	(800)-446-8882	(800)-833-6388		www.ghc.org/health_plans/index.jhtml?reposid=/common/healthPlans/Medicare/aboutPartDFormulary.html	www.ghc.org/medicare
H5050	012	0	1	01	01	H5050_012_0	6	2009.01	GROUP HEALTH COOPERATIVE	Group Health Cooperative	www.ghc.org/medicare	01	01		1		H5050	012	0	2009	Clear Care Sound	King/Pierce		2	1	4		323	2			1		0000000010000000000000000000	(206)-901-4600	(888)-901-4600	(800)-833-6388		(800)-446-8882	(800)-446-8882	(800)-833-6388		(206)-901-4600	(888)-901-4600	(800)-833-6388		(800)-446-8882	(800)-446-8882	(800)-833-6388		www.ghc.org/health_plans/index.jhtml?reposid=/common/healthPlans/Medicare/aboutPartDFormulary.html	www.ghc.org/medicare
H5050	801	0	1	01	01	H5050_801_0	3	2009.01	GROUP HEALTH COOPERATIVE	Group Health Cooperative	www.ghc.org/medicare	01	01		1		H5050	801	0	2009	Clear Care Employer Group	All Counties Served by Group Health Cooperative		1	2			17305	2						(206)-901-4600	(888)-901-4600	(800)-833-6388		(800)-446-8882	(800)-446-8882	(800)-833-6388										www.ghc.org/health_plans/index.jhtml?reposid=/common/healthPlans/Medicare/aboutPartDFormulary.html	www.ghc.org/medicare
H5050	802	0	1	01	01	H5050_802_0	2	2009.01	GROUP HEALTH COOPERATIVE	Group Health Cooperative	www.ghc.org/medicare	01	01		1		H5050	802	0	2009	Clear Care Employer Group with Part D	All Counties Served by Group Health Cooperative		1	2			17305	2						(206)-901-4600	(888)-901-4600	(800)-833-6388		(800)-446-8882	(800)-446-8882	(800)-833-6388		(206)-901-4600	(888)-901-4600	(800)-833-6388		(800)-446-8882	(800)-446-8882	(800)-833-6388		www.ghc.org/health_plans/index.jhtml?reposid=/common/healthPlans/Medicare/aboutPartDFormulary.html	www.ghc.org/medicare
H5087	001	0	1	01	01	H5087_001_0	12	2009.01	EASY CHOICE HEALTH PLAN INC.	Easy Choice Health Plan	easychoicehealthplan.com	01	01		1		H5087	001	0	2009	Freedom	L.A. Dual SNP		2	1	3		150	1	1		1	3		(949)-999-3945	(866)-999-3945	(800)-735-2929		(949)-999-3945	(866)-999-3945	(800)-735-2929		(949)-999-3945	(866)-999-3945		(800)-735-2929	(949)-999-3945	(866)-999-3945	(800)-735-2929		easychoicehealthplan.com	easychoicehealthplan.com
H5087	002	0	1	01	01	H5087_002_0	11	2009.01	EASY CHOICE HEALTH PLAN INC.	Easy Choice Health Plan	easychoicehealthplan.com	01	01		1		H5087	002	0	2009	Plus	Orange County Dual		2	2			250	2						(949)-999-3945	(866)-999-3945	(800)-735-2929		(949)-999-3945	(866)-999-3945	(800)-735-2929		(949)-999-3945	(866)-999-3945		(800)-735-2929	(949)-999-3945	(866)-999-3945	(800)-735-2929		easychoicehealthplan.com	easychoicehealthplan.com
H5087	005	0	1	01	01	H5087_005_0	14	2009.01	EASY CHOICE HEALTH PLAN INC.	Easy Choice Health Plan	easychoicehealthplan.com	01	01		1		H5087	005	0	2009	Best	LA/OC Traditional		2	2			100	2						(949)-999-3945	(866)-999-3945	(800)-735-2929		(949)-999-3945	(866)-999-3945	(800)-735-2929		(949)-999-3945	(866)-999-3945		(800)-735-2929	(949)-999-3945	(866)-999-3945	(800)-735-2929		easychoicehealthplan.com	easychoicehealthplan.com
H5106	013	0	1	04	01	H5106_013_0	7	2009.01	HIGHMARK HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	01	04		1		H5106	013	0	2009	FreedomBlue PPO Standard	West Virginia Region 1 counties		2	2				2						(888)-459-4020	(888)-459-4020	(800)-855-1155	(800)-855-1155	(866)-856-6032	(866)-856-6032	(800)-227-8210	(800)-227-8210	(888)-459-4020	(888)-459-4020	(800)-855-1155	(800)-855-1155	(866)-856-6032	(866)-856-6032	(800)-227-8210	(800)-227-8210	http://highmark.medicare-approvedformularies.com/search.asp	www.highmarkhealth.com
H5106	014	0	1	04	01	H5106_014_0	7	2009.01	HIGHMARK HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	01	04		1		H5106	014	0	2009	FreedomBlue PPO Deluxe	West Virginia Region 1 counties		2	2				2						(888)-459-4020	(888)-459-4020	(800)-855-1155	(800)-855-1155	(866)-856-6032	(866)-856-6032	(800)-227-8210	(800)-227-8210	(888)-459-4020	(888)-459-4020	(800)-716-3231	(800)-716-3231	(866)-856-6032	(866)-856-6032	(800)-227-8210	(800)-227-8210	http://highmark.medicare-approvedformularies.com/search.asp	www.highmarkhealth.com
H5106	015	0	1	04	01	H5106_015_0	7	2009.01	HIGHMARK HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	01	04		1		H5106	015	0	2009	FreedomBlue PPO Standard	West Virginia Region 2 counties		2	2				2						(888)-459-4020	(888)-459-4020	(800)-855-1155	(800)-855-1155	(866)-856-6032	(866)-856-6032	(800)-227-8210	(800)-227-8210	(888)-459-4020	(888)-459-4020	(800)-716-3231	(800)-716-3231	(866)-856-6032	(866)-856-6032	(800)-227-8210	(800)-227-8210	http://highmark.medicare-approvedformularies.com/search.asp	www.highmarkhealth.com
H5106	016	0	1	04	01	H5106_016_0	7	2009.01	HIGHMARK HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	01	04		1		H5106	016	0	2009	FreedomBlue PPO Deluxe	West Virginia Region 2 counties		2	2				2						(888)-459-4020	(888)-459-4020	(800)-855-1155	(800)-855-1155	(866)-856-6032	(866)-856-6032	(800)-227-8210	(800)-227-8210	(888)-459-4020	(888)-459-4020	(800)-716-3231	(800)-716-3231	(866)-856-6032	(866)-856-6032	(800)-227-8210	(800)-227-8210	http://highmark.medicare-approvedformularies.com/search.asp	www.highmarkhealth.com
H5106	017	0	1	04	01	H5106_017_0	6	2009.01	HIGHMARK HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	01	04		1		H5106	017	0	2009	FreedomBlue PPO Value	West Virginia Region 1 counties		2	2				2						(888)-459-4020	(888)-459-4020	(800)-855-1155	(800)-855-1155	(866)-856-6032	(866)-856-6032	(800)-227-8210	(800)-227-8210									http://highmark.medicare-approvedformularies.com/search.asp	www.highmarkhealth.com
H5106	018	0	1	04	01	H5106_018_0	6	2009.01	HIGHMARK HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	01	04		1		H5106	018	0	2009	FreedomBlue PPO Value	West Virginia Region 2 counties		2	2				2						(888)-459-4020	(888)-459-4020	(800)-855-1155	(800)-855-1155	(866)-856-6032	(866)-856-6032	(800)-227-8210	(800)-227-8210									http://highmark.medicare-approvedformularies.com/search.asp	www.highmarkhealth.com
H5106	806	0	1	04	01	H5106_806_0	5	2009.01	HIGHMARK HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	01	04		1		H5106	806	0	2009	FreedomBlue PPO MA-PDP WV Non-Calendar	ALL WV COUNTIES		1	2				2						(888)-459-4020	(888)-459-4020	(800)-855-1155	(800)-855-1155	(866)-856-6032	(866)-856-6032	(800)-227-8210	(800)-227-8210	(888)-459-4020	(888)-459-4020	(800)-855-1155	(800)-855-1155	(866)-856-6032	(866)-856-6032	(800)-227-8210	(800)-227-8210	http://highmark.medicare-approvedformularies.com/search.asp	www.highmarkhealth.com
H5106	807	0	1	04	01	H5106_807_0	5	2009.01	HIGHMARK HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	01	04		1		H5106	807	0	2009	FreedomBlue PPO MA WV	ALL WV COUNTIES		1	2				2						(888)-459-4020	(888)-459-4020	(800)-855-1155	(800)-855-1155	(866)-856-6032	(866)-856-6032	(800)-227-8210	(800)-227-8210									http://highmark.medicare-approvedformularies.com/search.asp	www.highmarkhealth.com
H5106	808	0	1	04	01	H5106_808_0	5	2009.01	HIGHMARK HEALTH INSURANCE COMPANY	Highmark Health Insurance Company	www.highmarkhealth.com	01	04		1		H5106	808	0	2009	FreedomBlue PPO MA-PDP WV	ALL WV COUNTIES		1	2				2						(888)-459-4020	(888)-459-4020	(800)-855-1155	(800)-855-1155	(866)-856-6032	(866)-856-6032	(800)-227-8210	(800)-227-8210	(888)-459-4020	(888)-459-4020	(800)-855-1155	(800)-855-1155	(866)-856-6032	(866)-856-6032	(800)-227-8210	(800)-227-8210	http://highmark.medicare-approvedformularies.com/search.asp	www.highmarkhealth.com
H5144	001	0	1	04	01	H5144_001_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetna.com/members/medicare/	01	04		1		H5144	001	0	2009	Aetna Golden Choice Standard Plan	Denver and Surrounding Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	hhtp://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5144	801	0	1	04	01	H5144_801_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetna.com/members/medicare/	01	04		1		H5144	801	0	2009	Aetna Golden Choice Plan	Denver and Surrounding Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									hhtp://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5144	802	0	1	04	01	H5144_802_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetna.com/members/medicare/	01	04		1		H5144	802	0	2009	Aetna Golden Choice Plan w/ RX CY	Denver and Surrounding Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	hhtp://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5151	002	0	1	01	01	H5151_002_0	6	2009.01	HEALTH PLAN OF THE UPPER OHIO VALLEY	The Health Plan	www.healthplan.org	01	01		1		H5151	002	0	2009	Health Plan SecureCare	East Ohio, Northern WV		2	2			7476	2						(740)-695-7907	(877)-847-7907	(740)-695-7919	(800)-622-3925	(740)-695-7915	(877)-847-7915	(740)-695-7919	(800)-622-3925	(740)-695-7907	(877)-847-7907	(740)-695-7919	(800)-622-3925	(740)-695-7915	(877)-847-7915	(740)-695-7919	(800)-622-3925	http://www.healthplan.org/pharmacy.shtml	www.healthplan.org
H5151	004	0	1	01	01	H5151_004_0	3	2009.01	HEALTH PLAN OF THE UPPER OHIO VALLEY	The Health Plan	www.healthplan.org	01	01		1		H5151	004	0	2009	Health Plan SecureCare	East Ohio, Northern WV		2	2			699	2						(740)-695-7907	(877)-847-7907	(740)-695-7919	(800)-622-3925	(740)-695-7915	(877)-847-7915	(740)-695-7919	(800)-622-3925									http://www.healthplan.org/pharmacy.shtml	www.healthplan.org
H5151	802	0	1	01	01	H5151_802_0	4	2009.01	HEALTH PLAN OF THE UPPER OHIO VALLEY	The Health Plan	www.healthplan.org	01	01		1		H5151	802	0	2009	Health Plan SecureCare	Southeast Ohio, Northern West Virginia		1	2			12	2						(740)-695-7907	(877)-847-7907	(740)-695-7919	(800)-622-3925	(740)-695-7915	(877)-847-7915	(740)-695-7919	(800)-622-3925									http://www.healthplan.org/pharmacy.shtml	www.healthplan.org
H5151	803	0	1	01	01	H5151_803_0	4	2009.01	HEALTH PLAN OF THE UPPER OHIO VALLEY	The Health Plan	www.healthplan.org	01	01		1		H5151	803	0	2009	Health Plan SecureCare	Southeast Ohio, Northern West Virginia		1	2			1423	2						(740)-695-7907	(877)-847-7907	(740)-695-7919	(800)-622-3925	(740)-695-7915	(877)-847-7915	(740)-695-7919	(800)-622-3925	(740)-695-7907	(877)-847-7907	(740)-695-7919	(800)-622-3925	(740)-695-7915	(877)-847-7915	(740)-695-7919	(800)-622-3925	http://www.healthplan.org/pharmacy.shtml	www.healthplan.org
H5167	001	0	1	20	08	H5167_001_0	1	2009.01	ROCKY MOUNTAIN HEALTH CARE SERVICES	Rocky Mountain PACE	www.rockymountainhealth.org	08	20		1		H5167	001	0	2009	Rocky Mountain PACE	Colorado Springs Metro Area		2	2				2														(719)-314-2327	(866)-519-5849			(719)-314-2327	(866)-519-5849			www.rockymountainhealth.org	
H5167	002	0	1	20	08	H5167_002_0	1	2009.01	ROCKY MOUNTAIN HEALTH CARE SERVICES	Rocky Mountain PACE	www.rockymountainhealth.org	08	20		1		H5167	002	0	2009	Rocky Mountain PACE	Colorado Springs Metro Area		2	2				2														(719)-314-2327	(866)-519-5849			(719)-314-2327	(866)-519-5849			www.rockymountainhealth.org	
H5179	001	0	1	09	04	H5179_001_0	4	2009.01	CIGNA HEALTHCARE OF ARIZONA, INC.	CIGNA Medicare Access	www.cignamedicare.com	04	09	2	1		H5179	001	0	2009	CIGNA Medicare Access Plus RX Plan Two	Maricopa Greenlee Apache Coconino Navajo Counties		2	2				2						(800)-627-7534	(800)-627-7534	(800)-987-8816	(800)-987-8816	(800)-592-9231	(800)-592-9231	(800)-987-8816	(800)-987-8816	(800)-627-7534	(800)-627-7534	(800)-987-8816	(800)-987-8816	(800)-592-9231	(800)-592-9231	(800)-987-8816	(800)-987-8816	www.cignamedicare.com	
H5179	002	0	1	09	04	H5179_002_0	4	2009.01	CIGNA HEALTHCARE OF ARIZONA, INC.	CIGNA Medicare Access	www.cignamedicare.com	04	09	2	1		H5179	002	0	2009	CIGNA Medicare Access Plus RX Plan Two	Pima Graham SantaCruz Cochise Yavapai Mohave LaPaz		2	2				2						(800)-627-7534	(800)-627-7534	(800)-987-8816	(800)-987-8816	(800)-592-9231	(800)-592-9231	(800)-987-8816	(800)-987-8816	(800)-627-7534	(800)-627-7534	(800)-987-8816	(800)-987-8816	(800)-592-9231	(800)-592-9231	(800)-987-8816	(800)-987-8816	www.cignamedicare.com	
H5179	004	0	1	09	04	H5179_004_0	3	2009.01	CIGNA HEALTHCARE OF ARIZONA, INC.	CIGNA Medicare Access	www.cignamedicare.com	04	09	2	1		H5179	004	0	2009	CIGNA Medicare Access Plan One	Maricopa Coconino Apache Navajo Greenlee		2	2				2						(800)-627-7534	(800)-627-7534	(800)-987-8816	(800)-987-8816	(800)-592-9231	(800)-592-9231	(800)-987-8816	(800)-987-8816									www.cignamedicare.com	
H5179	005	0	1	09	04	H5179_005_0	5	2009.01	CIGNA HEALTHCARE OF ARIZONA, INC.	CIGNA Medicare Access	www.cignamedicare.com	04	09	2	1		H5179	005	0	2009	CIGNA Medicare Access Plan One	PIMA GRAHM STCRUZ COCHSE YAVAP MOHVE LAPZ		2	2				2						(800)-627-7534	(800)-627-7534	(800)-987-8816	(800)-987-8816	(800)-592-9231	(800)-592-9231	(800)-987-8816	(800)-987-8816									www.cignamedicare.com	
H5179	006	0	1	09	04	H5179_006_0	6	2009.01	CIGNA HEALTHCARE OF ARIZONA, INC.	CIGNA Medicare Access	www.cignamedicare.com	04	09	2	1		H5179	006	0	2009	CIGNA Medicare Access Plus RX Plan Four	PIMA GRAHM STCRUZ COCHSE YAVAP MOHVE LPAZ		2	2				2						(800)-627-7534	(800)-627-7534	(800)-987-8816	(800)-987-8816	(800)-592-9231	(800)-592-9231	(800)-987-8816	(800)-987-8816	(800)-627-7534	(800)-627-7534	(800)-987-8816	(800)-987-8816	(800)-592-9231	(800)-592-9231	(800)-987-8816	(800)-987-8816	www.cignamedicare.com	
H5189	001	0	1	01	01	H5189_001_0	7	2009.01	UNISON HEALTH PLAN OF TENNESSEE, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H5189	001	0	2009	Unison Advantage Choice	Northeast Arkansas		2	2				2						(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	http://www.unisonhealthplan.com	www.unisonhealthplan.com
H5189	002	0	1	01	01	H5189_002_0	7	2009.01	UNISON HEALTH PLAN OF TENNESSEE, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H5189	002	0	2009	Unison Advantage Preferred	Northeast Arkansas		2	2				2						(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	http://www.unisonhealthplan.com	www.unisonhealthplan.com
H5189	003	0	1	01	01	H5189_003_0	9	2009.01	UNISON HEALTH PLAN OF TENNESSEE, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H5189	003	0	2009	Unison Advantage Plus	Northeast Arkansas		2	1	3			2			1	3		(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	http://www.unisonhealthplan.com	www.unisonhealthplan.com
H5189	004	0	1	01	01	H5189_004_0	5	2009.01	UNISON HEALTH PLAN OF TENNESSEE, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H5189	004	0	2009	Unison Advantage Basic	Northeast Arkansas		2	2				2						(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021									http://www.unisonhealthplan.com	www.unisonhealthplan.com
H5189	801	0	1	01	01	H5189_801_0	3	2009.01	UNISON HEALTH PLAN OF TENNESSEE, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H5189	801	0	2009	Unison Advantage Basic Group	Northeast Arkansas		1	2				2						(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021									http://www.unisonhealthplan.com	www.unisonhealthplan.com
H5189	802	0	1	01	01	H5189_802_0	3	2009.01	UNISON HEALTH PLAN OF TENNESSEE, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H5189	802	0	2009	Unison Advantage Choice Group	Northeast Arkansas		1	2				2						(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	(412)-858-4000	(800)-290-4009	(888)-616-0021	(888)-616-0021	http://www.unisonhealthplan.com	www.unisonhealthplan.com
H5206	002	0	1	01	01	H5206_002_0	3	2009.01	PARTNERSHIP HEALTH PLAN, INC.	Community Health Partnership	www.communityhealthpartnership.com	01	01		1		H5206	002	0	2009	Community Health Partnership	Chippewa, Dunn and Eau Claire Counties		2	1	3		1710	2			1	1		(715)-838-2900	(800)-842-1814	(715)-838-2900	(800)-842-1814	(715)-838-2900	(800)-842-1814	(715)-838-2900	(800)-842-1814	(715)-838-2900	(800)-842-1814	(715)-838-2900	(800)-842-1814	(715)-838-2900	(800)-842-1814	(715)-838-2900	(800)-842-1814	http://www.communityhealthpartnership.com/members/php/formulary.php	http://www.communityhealthpartnership.com/providerdir.aspx
H5206	003	0	1	01	01	H5206_003_0	3	2009.01	PARTNERSHIP HEALTH PLAN, INC.	Community Health Partnership	www.communityhealthpartnership.com	01	01		1		H5206	003	0	2009	Community Health Partnership	Pierce and St. Croix Counties		2	1	3		1710	2			1	1		(715)-838-2900	(800)-842-1814	(715)-838-2900	(800)-842-1814	(715)-838-2900	(800)-842-1814	(715)-838-2900	(800)-842-1814	(715)-838-2900	(800)-842-1814	(715)-838-2900	(800)-842-1814	(715)-838-2900	(800)-842-1814	(715)-838-2900	(800)-842-1814	http://www.communityhealthpartnership.com/members/php/formulary.php	http://www.communityhealthpartnership.com/providerdir.aspx
H5207	001	0	1	01	01	H5207_001_0	6	2009.01	COMMUNITY CARE HEALTH PLAN, INC	Community Care	www.CommunityCareInc.org	01	01		1		H5207	001	0	2009	Community Care's Partnership Program	Kenosha, Milwaukee, Racine and Waukesha Counties		2	1	3		343	2			1	1		(414)-385-6600	(866)-992-6600	(414)-385-6626		(414)-385-6600	(866)-992-6600	(414)-385-6626		(414)-385-6600	(866)-992-6600	(414)-385-6626		(414)-385-6600	(866)-992-6600	(414)-385-6626		www.communitycareinc.org/Assets/Formulary.pdf	www.CommunityCareInc.org
H5209	002	0	1	01	01	H5209_002_0	4	2009.01	CARE WISCONSIN HEALTH PLAN, INC.	Care Wisconsin Health Plan, Inc.	www.carewischealthplan.org	01	01		1		H5209	002	0	2009	Partnership	Dane County, Wisconsin		2	1	3		1236	2			1	1		(608)-240-0035	(800)-963-0035	(800)-947-3529	(800)-947-3529	(608)-245-3075	(800)-963-0035	(800)-947-3529	(800)-947-3529	(608)-240-0035	(800)-963-0035	(800)-947-3529	(800)-947-3529	(608)-245-3075	(800)-963-0035	(800)-947-3529	(800)-947-3529	www.carewischealthplan.org	www.carewischealthplan.org
H5211	001	0	1	02	01	H5211_001_0	7	2009.01	SECURITY HEALTH PLAN OF WISCONSIN, INC	Security Health Plan Of Wisconsin, Inc	www.securityhealth.org	01	02		1		H5211	001	0	2009	Advocare Spirit	Central, Northern and Western Wisconsin		2	2			7063	2						(715)-221-9897	(877)-998-0998	(877)-727-2232		(715)-221-9897	(877)-998-0998	(877)-727-2232										http://www.securityhealth.org/members/pages/default.aspx?page=advocare_advocareRx_drugFormulary	www.securityhealth.org
H5211	002	0	1	02	01	H5211_002_0	9	2009.01	SECURITY HEALTH PLAN OF WISCONSIN, INC	Security Health Plan Of Wisconsin, Inc	www.securityhealth.org	01	02		1		H5211	002	0	2009	Advocare Essence Rx	Central, Northern and Western Wisconsin		2	2			2640	2						(715)-221-9897	(877)-998-0998	(877)-727-2232		(715)-221-9897	(877)-998-0998	(877)-727-2232		(715)-221-9897	(877)-998-0998	(877)-727-2232		(715)-221-9897	(877)-998-0998	(877)-727-2232		http://www.securityhealth.org/members/pages/default.aspx?page=advocare_advocareRx_drugFormulary	www.securityhealth.org
H5211	003	0	1	02	01	H5211_003_0	8	2009.01	SECURITY HEALTH PLAN OF WISCONSIN, INC	Security Health Plan Of Wisconsin, Inc	www.securityhealth.org	01	02		1		H5211	003	0	2009	Advocare Essence	Central, Northern and Western Wisconsin		2	2			1120	2						(715)-221-9897	(877)-998-0998	(877)-727-2232		(715)-221-9897	(877)-998-0998	(877)-727-2232										http://www.securityhealth.org/members/pages/default.aspx?page=advocare_advocareRx_drugFormulary	www.securityhealth.org
H5211	004	0	1	02	01	H5211_004_0	9	2009.01	SECURITY HEALTH PLAN OF WISCONSIN, INC	Security Health Plan Of Wisconsin, Inc	www.securityhealth.org	01	02		1		H5211	004	0	2009	Advocare Spirit Rx	Central, Northern and Western Wisconsin		2	2			7485	2						(715)-221-9897	(877)-998-0998	(877)-727-2232		(715)-221-9897	(877)-998-0998	(877)-727-2232		(715)-221-9897	(877)-998-0998	(877)-727-2232		(715)-221-9897	(877)-998-0998	(877)-727-2232		http://www.securityhealth.org/members/pages/default.aspx?page=advocare_advocareRx_drugFormulary	www.securityhealth.org
H5211	005	0	1	02	01	H5211_005_0	8	2009.01	SECURITY HEALTH PLAN OF WISCONSIN, INC	Security Health Plan Of Wisconsin, Inc	www.securityhealth.org	01	02		1		H5211	005	0	2009	Advocare Vitality Rx	Central, Northern and Western Wisconsin		2	2			2513	2						(715)-221-9897	(877)-998-0998	(877)-727-2232		(715)-221-9897	(877)-998-0998	(877)-727-2232		(715)-221-9897	(877)-998-0998	(877)-727-2232		(715)-221-9897	(877)-998-0998	(877)-727-2232		http://www.securityhealth.org/members/pages/default.aspx?page=advocare_advocareRx_drugFormulary	www.securityhealth.org
H5211	006	0	1	02	01	H5211_006_0	6	2009.01	SECURITY HEALTH PLAN OF WISCONSIN, INC	Security Health Plan Of Wisconsin, Inc	www.securityhealth.org	01	02		1		H5211	006	0	2009	Advocare Vitality	Central, Northern and Western Wisconsin		2	2			1195	2						(715)-221-9897	(877)-998-0998	(877)-727-2232		(715)-221-9897	(877)-998-0998	(877)-727-2232										http://www.securityhealth.org/members/pages/default.aspx?page=advocare_advocareRx_drugFormulary	www.securityhealth.org
H5212	001	0	1	20	08	H5212_001_0	1	2009.01	COMMUNITY CARE, INC.	Community Care	www.CommunityCareInc.org	08	20		1		H5212	001	0	2009	Community Care's PACE Program	Milwaukee County, Waukesha County		2	2				2														(414)-385-6600	(866)-992-6600	(414)-385-6626		(414)-385-6600	(866)-992-6600	(414)-385-6626		www.CommunityCareInc.org	
H5212	002	0	1	20	08	H5212_002_0	1	2009.01	COMMUNITY CARE, INC.	Community Care	www.CommunityCareInc.org	08	20		1		H5212	002	0	2009	Community Care's PACE Program	Milwaukee County, Waukesha County		2	2				2														(414)-385-6600	(866)-992-6600	(414)-385-6626		(414)-385-6600	(866)-992-6600	(414)-385-6626		www.CommunityCareInc.org	
H5213	001	0	1	20	08	H5213_001_0	1	2009.01	TOTAL COMMUNITY CARE, L.L.C.	Total Community Care	www.TotalCommunityCare.org	08	20		1		H5213	001	0	2009	Total Community Care	Albuquerque Metro Area		2	2				2														(505)-924-2608	(505)-924-2608			(303)-869-4664	(877)-277-6163			www.TotalCommunityCare.org	
H5213	002	0	1	20	08	H5213_002_0	1	2009.01	TOTAL COMMUNITY CARE, L.L.C.	Total Community Care	www.TotalCommunityCare.org	08	20		1		H5213	002	0	2009	Total Community Care	Albuquerque Metro Area		2	2				2														(505)-924-2608	(505)-924-2608			(303)-869-4664	(505)-924-2608			www.TotalCommunityCare.org	
H5214	003	0	1	04	01	H5214_003_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5214	003	0	2009	HumanaChoicePPO PPO H5214-003	Atlanta Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5214	004	0	1	04	01	H5214_004_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5214	004	0	2009	HumanaChoicePPO PPO H5214-004	Aiken and Augusta Metro Areas		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5214	801	0	1	04	01	H5214_801_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5214	801	0	2009	Humana Employer Sponsored	Atlanta Metro Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5214	803	0	1	04	01	H5214_803_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5214	803	0	2009	Humana Employer Sponsored	Atlanta Metro Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5214	804	0	1	04	01	H5214_804_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5214	804	0	2009	Humana Employer Sponsored Non-CY	Atlanta Metro Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5214	805	0	1	04	01	H5214_805_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5214	805	0	2009	Humana Employer Sponsored Non-CY	Atlanta Metro Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5215	001	0	1	04	01	H5215_001_0	6	2009.01	NETWORK HEALTH INSURANCE CORPORATION	NHIC Medicare Products	www.nppdrugplans.com	01	04		1		H5215	001	0	2009	Network PlatinumPlus	East Central Wisconsin		2	2				2						(920)-720-1345	(800)-378-5234	(800)-947-3529	(800)-947-3529	(920)-720-1280	(800)-983-7587	(800)-947-3529	(800)-947-3529									http://www.nppdrugplans.com/cgi-bin/phase2/formulary/index.pl	www.nppdrugplans.com
H5215	002	0	1	04	01	H5215_002_0	8	2009.01	NETWORK HEALTH INSURANCE CORPORATION	NHIC Medicare Products	www.nppdrugplans.com	01	04		1		H5215	002	0	2009	Network PlatinumPlus Pharmacy	East Central Wisconsin		2	2				2						(920)-720-1345	(800)-378-5234	(800)-947-3529	(800)-947-3529	(920)-720-1280	(800)-983-7587	(800)-947-3529	(800)-947-3529	(920)-720-1345	(800)-378-5234	(800)-947-3529	(800)-947-3529	(920)-720-1280	(800)-983-7587	(800)-947-3529	(800)-947-3529	http://www.nppdrugplans.com/cgi-bin/phase2/formulary/index.pl	www.nppdrugplans.com
H5215	005	0	1	04	01	H5215_005_0	8	2009.01	NETWORK HEALTH INSURANCE CORPORATION	NHIC Medicare Products	www.nppdrugplans.com	01	04		1		H5215	005	0	2009	Network PlatinumPremier Pharmacy	East Central Wisconsin		2	2				2						(920)-720-1345	(800)-378-5234	(800)-947-3529	(800)-947-3529	(920)-720-1280	(800)-983-7587	(800)-947-3529	(800)-947-3529	(920)-720-1345	(800)-378-5234	(800)-947-3529	(800)-947-3529	(920)-720-1280	(800)-983-7587	(800)-947-3529	(800)-947-3529	http://www.nppdrugplans.com/cgi-bin/phase2/formulary/index.pl	www.nppdrugplans.com
H5215	006	0	1	04	01	H5215_006_0	6	2009.01	NETWORK HEALTH INSURANCE CORPORATION	NHIC Medicare Products	www.nppdrugplans.com	01	04		1		H5215	006	0	2009	Network PlatinumPremier	East Central Wisconsin		2	2				2						(920)-720-1345	(800)-378-5234	(800)-947-3529	(800)-947-3529	(920)-720-1280	(800)-983-7587	(800)-947-3529	(800)-947-3529									http://www.nppdrugplans.com/cgi-bin/phase2/formulary/index.pl	www.nppdrugplans.com
H5215	007	0	1	04	01	H5215_007_0	6	2009.01	NETWORK HEALTH INSURANCE CORPORATION	NHIC Medicare Products	www.nppdrugplans.com	01	04		1		H5215	007	0	2009	Network Cares	East Central Wisconsin		2	1	3			2			1	2		(920)-720-1345	(800)-378-5234	(800)-947-3529	(800)-947-3529	(920)-720-1280	(800)-983-7587	(800)-947-3529	(800)-947-3529	(920)-720-1345	(800)-378-5234	(800)-947-3529	(800)-947-3529	(920)-720-1280	(800)-983-7587	(800)-947-3529	(800)-947-3529	http://www.nppdrugplans.com/cgi-bin/phase2/formulary/index.pl	www.nppdrugplans.com
H5215	008	0	1	04	01	H5215_008_0	7	2009.01	NETWORK HEALTH INSURANCE CORPORATION	NHIC Medicare Products	www.nppdrugplans.com	01	04		1		H5215	008	0	2009	Network PlatinumSelect	East Central and Northeast Wisconsin		2	2				2						(920)-720-1345	(800)-378-5234	(800)-947-3529	(800)-947-3529	(920)-720-1280	(800)-983-7587	(800)-947-3529	(800)-947-3529	(920)-720-1345	(800)-378-5234	(800)-947-3529	(800)-947-3529	(920)-720-1280	(800)-983-7587	(800)-947-3529	(800)-947-3529	http://www.nppdrugplans.com/cgi-bin/phase2/formulary/index.pl	www.nppdrugplans.com
H5215	801	0	1	04	01	H5215_801_0	4	2009.01	NETWORK HEALTH INSURANCE CORPORATION	NHIC Medicare Products	www.nppdrugplans.com	01	04		1		H5215	801	0	2009	Network PlatinumPlus Pharmacy Emp Plan	East Central Wisconsin		1	2				2						(920)-720-1345	(800)-378-5234	(800)-947-3529	(800)-947-3529	(920)-720-1280	(800)-983-7587	(800)-947-3529	(800)-947-3529	(920)-720-1345	(800)-378-5234	(800)-947-3529	(800)-947-3529	(920)-720-1280	(800)-983-7587	(800)-947-3529	(800)-947-3529	http://www.nppdrugplans.com/cgi-bin/phase2/formulary/index.pl	www.nppdrugplans.com
H5215	804	0	1	04	01	H5215_804_0	5	2009.01	NETWORK HEALTH INSURANCE CORPORATION	NHIC Medicare Products	www.nppdrugplans.com	01	04		1		H5215	804	0	2009	Network PlatinumPlus Employer Plan	East Central Wisconsin		1	2				2						(920)-720-1345	(800)-378-5234	(800)-947-3529	(800)-947-3529	(920)-720-1280	(800)-983-7587	(800)-947-3529	(800)-947-3529									http://www.nppdrugplans.com/cgi-bin/phase2/formulary/index.pl	www.nppdrugplans.com
H5215	805	0	1	04	01	H5215_805_0	5	2009.01	NETWORK HEALTH INSURANCE CORPORATION	NHIC Medicare Products	www.nppdrugplans.com	01	04		1		H5215	805	0	2009	Network PlatinumPremier Emp Group	East Central Wisconsin		1	2				2						(920)-720-1345	(800)-378-5234	(800)-947-3529	(800)-947-3529	(920)-720-1280	(800)-983-7587	(800)-947-3529	(800)-947-3529	(920)-720-1345	(800)-378-5234	(800)-947-3529	(800)-947-3529	(920)-720-1280	(800)-983-7587	(800)-947-3529	(800)-947-3529	http://www.nppdrugplans.com/cgi-bin/phase2/formulary/index.pl	www.nppdrugplans.com
H5216	001	0	1	04	01	H5216_001_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5216	001	0	2009	HumanaChoicePPO PPO H5216-001	Milwaukee, Ozaukee, Racine, and Waukesha Counties		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5216	003	0	1	04	01	H5216_003_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5216	003	0	2009	HumanaChoicePPO PPO H5216-003	Green Bay Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5216	801	0	1	04	01	H5216_801_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5216	801	0	2009	Humana Employer Sponsored	Milwaukee Metro Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5216	802	0	1	04	01	H5216_802_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5216	802	0	2009	Humana Employer Sponsored	Milwaukee Metro Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5216	803	0	1	04	01	H5216_803_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5216	803	0	2009	Humana Employer Sponsored Non-CY	Milwaukee Metro Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5216	804	0	1	04	01	H5216_804_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5216	804	0	2009	Humana Employer Sponsored Non-CY	Milwaukee Metro Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5227	001	0	1	09	04	H5227_001_0	9	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H5227	001	0	2009	Advantra Freedom-Freedom 5	Select counties in several states		2	2			17528	2						(866)-386-2330	(866)-386-2330	(866)-386-2335	(866)-386-2335	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010	(800)-690-5924	(800)-690-5924	(866)-236-1069	(866)-236-1069	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010	http://advantrafreedom.com/templates/editorial.asp?itemID=14958	
H5227	002	0	1	09	04	H5227_002_0	5	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H5227	002	0	2009	Advantra Freedom-Freedom 5	Select counties in Multiple States		2	2			7512	2						(866)-386-2330	(866)-386-2330	(866)-386-2335	(866)-386-2335	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010	(800)-690-5924	(800)-690-5924	(866)-236-1069	(866)-236-1069	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010	http://advantrafreedom.com/templates/editorial.asp?itemID=14958	
H5227	004	0	1	09	04	H5227_004_0	5	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H5227	004	0	2009	Advantra Freedom-Freedom 5 Plus	Select counties in multiple states		2	2			100	2						(866)-386-2330	(866)-386-2330	(866)-386-2335	(866)-386-2335	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010	(800)-690-5924	(800)-690-5924	(866)-236-1069	(866)-236-1069	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010	http://advantrafreedom.com/templates/editorial.asp?itemID=14958	
H5227	005	0	1	09	04	H5227_005_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H5227	005	0	2009	Advantra Freedom-Freedom 5 Plus	Select counties in multiple states		2	2			100	2						(866)-386-2330	(866)-386-2330	(866)-386-2335	(866)-386-2335	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010	(800)-690-5924	(800)-690-5924	(866)-236-1069	(866)-236-1069	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010	http://advantrafreedom.com/templates/editorial.asp?itemID=14958	
H5227	801	0	1	09	04	H5227_801_0	7	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H5227	801	0	2009	Advantra Freedom-EGO MAPD-CY	United States and Territories		1	2			2827	2						(866)-386-2330	(866)-386-2330	(866)-386-2335	(866)-386-2335	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010	(800)-690-5924	(800)-690-5924	(866)-236-1069	(866)-236-1069	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010	http://advantrafreedom.com/templates/editorial.asp?itemID=14958	
H5227	802	0	1	09	04	H5227_802_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H5227	802	0	2009	Advantra Freedom-EGO MAPD-Non-CY	United States and Territories		1	2			54930	2						(866)-386-2330	(866)-386-2330	(866)-386-2335	(866)-386-2335	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010	(800)-690-5924	(800)-690-5924	(866)-236-1069	(866)-236-1069	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010	http://advantrafreedom.com/templates/editorial.asp?itemID=14958	
H5227	803	0	1	09	04	H5227_803_0	4	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H5227	803	0	2009	Advantra Freedom-EGO MA Only-CY and non-CY	United States and Territories		1	2			88	2						(866)-386-2330	(866)-386-2330	(866)-386-2335	(866)-386-2335	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010									http://advantrafreedom.com/templates/editorial.asp?itemID=14958	
H5253	004	0	1	02	01	H5253_004_0	5	2009.01	UNITED HEALTHCARE OF WISCONSIN, INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H5253	004	0	2009	AARP MedicareComplete Plus Plan1	Milwaukee,Ozaukee,Wash,Waukesha,Racine Counties		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5253	007	0	1	02	01	H5253_007_0	9	2009.01	UNITED HEALTHCARE OF WISCONSIN, INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H5253	007	0	2009	Evercare Plan IH-POS	Appleton,GreenBay,LaCrosse,Milwaukee,Madison areas		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5253	011	0	1	02	01	H5253_011_0	5	2009.01	UNITED HEALTHCARE OF WISCONSIN, INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H5253	011	0	2009	AARP MedicareComplete Plus Plan1	Green Bay and Lacrosse Area Counties		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5253	021	0	1	02	01	H5253_021_0	5	2009.01	UNITED HEALTHCARE OF WISCONSIN, INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H5253	021	0	2009	AARP MedicareComplete Plus Plan2	Milwaukee,Ozaukee,Wash,Waukesha,Racine Counties		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5253	024	0	1	02	01	H5253_024_0	5	2009.01	UNITED HEALTHCARE OF WISCONSIN, INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H5253	024	0	2009	Evercare Plan DH-POS	Appleton,GreenBay,LaCrosse,Milwaukee,Madison areas		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5253	027	0	1	02	01	H5253_027_0	4	2009.01	UNITED HEALTHCARE OF WISCONSIN, INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H5253	027	0	2009	Evercare Plan MH-POS	Appleton,GreenBay,LaCrosse,Milwaukee,Madison areas		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-384-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-384-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5253	801	0	1	01	01	H5253_801_0	2	2009.01	UNITED HEALTHCARE OF WISCONSIN, INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H5253	801	0	2009	MedicareComplete Retiree Plan	Milwaukee and Green Bay Area Counties		1	2				2						(800)-524-2448		(888)-685-8480		(800)-524-2478		(888)-685-8480		(800)-524-2448	(800)-524-2448	(888)-685-8480		(800)-524-2478	(800)-524-2478	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5253	802	0	1	01	01	H5253_802_0	2	2009.01	UNITED HEALTHCARE OF WISCONSIN, INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H5253	802	0	2009	MedicareComplete Essential Retiree Plan	Milwaukee and Green Bay Area Counties		1	2				2						(800)-524-2448		(888)-685-8480		(800)-524-2478		(888)-685-8480										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5253	805	0	1	01	01	H5253_805_0	2	2009.01	UNITED HEALTHCARE OF WISCONSIN, INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H5253	805	0	2009	MedicareComplete Retiree Plan	Select Counties in WI		1	2				2						(800)-524-2448	(800)-524-2448	(888)-685-8480		(800)-524-2478		(888)-685-8480		(800)-524-2448	(800)-524-2448	(888)-685-8480		(800)-524-2478	(800)-524-2478	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5253	806	0	1	01	01	H5253_806_0	2	2009.01	UNITED HEALTHCARE OF WISCONSIN, INC	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H5253	806	0	2009	MedicareComplete Retiree Plan	Select Counties in WI		1	2				2						(800)-524-2448		(888)-685-8480		(800)-524-2478		(888)-685-8480										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5256	001	0	1	18	06	H5256_001_0	1	2009.01	MEDICAL ASSOCIATES CLINIC HEALTH PLAN	Medical Associates Clinic Health Plan of Wisconsin	mahealthcare.com	06	18		1		H5256	001	0	2009	Medical Associates Advantage Plan	Southwest Wisconsin		2	2			2240	2						(866)-821-1365		(800)-735-2943		(800)-747-8900		(800)-735-2943											
H5256	002	0	1	18	06	H5256_002_0	1	2009.01	MEDICAL ASSOCIATES CLINIC HEALTH PLAN	Medical Associates Clinic Health Plan of Wisconsin	mahealthcare.com	06	18		1		H5256	002	0	2009	MAHP Medicare Community Plan	Southwest Wisconsin		2	2			202	2						(866)-821-1365		(800)-735-2943		(800)-747-8900		(800)-735-2943											
H5256	004	0	1	18	06	H5256_004_0	2	2009.01	MEDICAL ASSOCIATES CLINIC HEALTH PLAN	Medical Associates Clinic Health Plan of Wisconsin	mahealthcare.com	06	18		1		H5256	004	0	2009	Medical Associates Freedom Plan	Southwest Wisconsin		2	2			41	2						(866)-821-1365		(800)-735-2943		(800)-747-8900		(800)-735-2943											
H5262	001	0	1	01	01	H5262_001_0	4	2009.01	GUNDERSEN LUTHERAN HEALTH PLAN	Gundersen Lutheran Health Plan, Inc.	www.glhealthplan.org	01	01		1		H5262	001	0	2009	Gundersen Lutheran Senior Pref. Elite w/RX	La Crosse and Southwestern Wisconsin		2	2			6159	2						(608)-775-8077	(800)-394-5566	(800)-947-3529		(608)-775-5877	(800)-370-9718	(800)-947-3529		(800)-394-5566	(800)-394-5566	(800)-947-3529		(800)-370-9718	(800)-370-9718	(800)-947-3529		http://www.seniorpreferred.com/web/hpln/home.nsf/doc/spmembers@3000	http://apps.glhealthplan.org:81/ProvDB/dirSPMainFrame.jsp?screenSize=large
H5262	003	0	1	01	01	H5262_003_0	4	2009.01	GUNDERSEN LUTHERAN HEALTH PLAN	Gundersen Lutheran Health Plan, Inc.	www.glhealthplan.org	01	01		1		H5262	003	0	2009	Gundersen Lutheran Senior Pref. Value w/RX	La Crosee and SW Wisconsin		2	2			254	2						(608)-775-8077	(800)-394-5566	(800)-947-3529		(608)-775-5877	(800)-370-9718	(800)-947-3529		(800)-394-5566	(800)-394-5566	(800)-947-3529		(800)-370-9718	(800)-370-9718	(800)-947-3529		http://www.seniorpreferred.com/web/hpln/home.nsf/doc/spmembers@3000	http://apps.glhealthplan.org:81/ProvDB/dirSPMainFrame.jsp?screenSize=large
H5262	004	0	1	01	01	H5262_004_0	2	2009.01	GUNDERSEN LUTHERAN HEALTH PLAN	Gundersen Lutheran Health Plan, Inc.	www.glhealthplan.org	01	01		1		H5262	004	0	2009	Gundersen Lutheran Sr. Pref. Value (no RX)	La Crosse and SW Wisconsin		2	2			171	2						(608)-775-8077	(800)-394-5566	(800)-947-3529		(608)-775-5877	(800)-370-9718	(800)-947-3529										http://www.seniorpreferred.com/web/hpln/home.nsf/doc/spmembers@3000	http://apps.glhealthplan.org:81/ProvDB/dirSPMainFrame.jsp?screenSize=large
H5262	005	0	1	01	01	H5262_005_0	2	2009.01	GUNDERSEN LUTHERAN HEALTH PLAN	Gundersen Lutheran Health Plan, Inc.	www.glhealthplan.org	01	01		1		H5262	005	0	2009	Gundersen Lutheran Sr. Pref. Elite (no RX)	La Crosse and SW Wisconsin		2	2			4096	2						(608)-775-8077	(800)-394-5566	(800)-947-3529		(608)-775-5877	(800)-370-9718	(800)-947-3529										http://www.seniorpreferred.com/web/hpln/home.nsf/doc/spmembers@3000	http://apps.glhealthplan.org:81/ProvDB/dirSPMainFrame.jsp?screenSize=large
H5264	002	0	1	18	06	H5264_002_0	2	2009.01	DEAN HEALTH PLAN, INC.	Dean Health Plan, Inc.	www.deancare.com	06	18		1		H5264	002	0	2009	DeanCare Gold Enhanced	DeanCare Gold		2	2			15100	2						(608)-827-4372	(888)-422-3326	(877)-733-6456		(608)-827-4372	(888)-422-3326	(877)-733-6456											
H5264	003	0	1	18	06	H5264_003_0	2	2009.01	DEAN HEALTH PLAN, INC.	Dean Health Plan, Inc.	www.deancare.com	06	18		1		H5264	003	0	2009	DeanCare Gold Basic	DeanCare Gold		2	2			100	2						(608)-827-4372	(888)-422-3326	(877)-733-6456		(608)-827-4372	(888)-422-3326	(877)-733-6456											
H5264	005	0	1	18	06	H5264_005_0	2	2009.01	DEAN HEALTH PLAN, INC.	Dean Health Plan, Inc.	www.deancare.com	06	18		1		H5264	005	0	2009	DeanCare Gold Shared Value	DeanCare Gold		2	2			100	2						(608)-827-4372	(888)-422-3326	(877)-733-6456		(608)-827-4372	(888)-422-3326	(877)-733-6456											
H5270	001	0	1	01	01	H5270_001_0	6	2009.01	PAN AMERICAN LIFE INSURANCE COMPANY OF PUERTO RICO	Pan American Life Insurance Company of Puerto Rico	www.panamericanlife.com	01	01		1		H5270	001	0	2009	PALIC-PR Medicare Advantage	Puerto Rico		2	2			1200	2						(888)-725-4262	(888)-725-4262	(888)-725-4261	(888)-725-4261	(888)-725-4262	(888)-725-4262	(888)-725-4261	(888)-725-4261	(888)-725-4262	(888)-725-4262	(888)-725-4261	(888)-725-4261	(888)-725-4262	(888)-725-4262	(888)-725-4261	(888)-725-4261	www.panamericanlife.com	
H5291	001	0	1	01	01	H5291_001_0	7	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H5291	001	0	2009	Humana Gold Plus HMO H5291-001	Denver Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5291	801	0	1	01	01	H5291_801_0	3	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H5291	801	0	2009	Humana Employer Sponsored	Colorado		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5291	802	0	1	01	01	H5291_802_0	3	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H5291	802	0	2009	Humana Employer Sponsored	Colorado		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5291	803	0	1	01	01	H5291_803_0	3	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H5291	803	0	2009	Humana Employer Sponsored Non-CY	Colorado		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5291	804	0	1	01	01	H5291_804_0	3	2009.01	HUMANA HEALTH PLAN, INC.	Humana Health Plan, Inc.	www.humana-medicare.com	01	01		1		H5291	804	0	2009	Humana Employer Sponsored Non-CY	Colorado		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5294	001	0	1	01	01	H5294_001_0	7	2009.01	SUPERIOR HEALTH PLAN, INC.	Advantage by SuperiorHealthPlan	https://www.superiorhealthplan.com/portal/public/s	01	01		1		H5294	001	0	2009	Superior HealthPlan	Superior HealthPlan		2	1	3		900	2			1	3		(512)-692-1465	(800)-218-7453	(877)-248-1744		(512)-692-1465	(800)-218-7453	(877)-248-1744		(512)-692-1465	(800)-218-7453	(877)-248-1744		(512)-692-1465	(800)-218-7453	(877)-248-1744		to be determined	https://www.superiorhealthplan.com/portal/public/superior
H5301	002	0	1	38	05	H5301_002_0	3	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Fresenius Medical Care Health Plan	www.fmchp.com	05	38	3	1		H5301	002	0	2009	Fresenius Medical Care Health Plan	Selected Counties in Alabama and Tennessee		2	2			10	2						(866)-660-4728	(866)-660-4728	(866)-338-4681	(866)-338-4681	(866)-307-3625	(866)-307-3625	(866)-338-4681	(866)-338-4681									http://www.fmchp.com/Formulary_Search_2006.shtml	www.fmchp.com
H5301	003	0	1	38	05	H5301_003_0	2	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Fresenius Medical Care Health Plan	www.fmchp.com	05	38	3	1		H5301	003	0	2009	Fresenius Medical Care Health Plan	Selected Counties in California		2	2			10	2						(866)-660-4728	(866)-660-4728	(866)-338-4681	(866)-338-4681	(866)-307-3625	(866)-307-3625	(866)-338-4681	(866)-338-4681									http://www.fmchp.com/Formulary_Search_2006.shtml	www.fmchp.com
H5301	004	0	1	38	05	H5301_004_0	2	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Fresenius Medical Care Health Plan	www.fmchp.com	05	38	3	1		H5301	004	0	2009	Fresenius Medical Care Health Plan	Selected Counties in Illinois		2	2			10	2						(866)-660-4728	(866)-660-4728	(866)-338-4681	(866)-338-4681	(866)-307-3625	(866)-307-3625	(866)-338-4681	(866)-338-4681									http://www.fmchp.com/Formulary_Search_2006.shtml	www.fmchp.com
H5301	005	0	1	38	05	H5301_005_0	2	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Fresenius Medical Care Health Plan	www.fmchp.com	05	38	3	1		H5301	005	0	2009	Fresenius Medical Care Health Plan	Selected Counties in Minnesota		2	2			10	2						(866)-660-4728	(866)-660-4728	(866)-338-4681	(866)-338-4681	(866)-307-3625	(866)-307-3625	(866)-338-4681	(866)-338-4681									http://www.fmchp.com/Formulary_Search_2006.shtml	www.fmchp.com
H5301	007	0	1	38	05	H5301_007_0	2	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Fresenius Medical Care Health Plan	www.fmchp.com	05	38	3	1		H5301	007	0	2009	Fresenius Medical Care Health Plan	Selected Counties in Texas		2	2			10	2						(866)-660-4728	(866)-660-4728	(866)-338-4681	(866)-338-4681	(866)-307-3625	(866)-307-3625	(866)-338-4681	(866)-338-4681									http://www.fmchp.com/Formulary_Search_2006.shtml	www.fmchp.com
H5302	003	0	1	02	01	H5302_003_0	6	2009.01	COVENTRY HEALTH CARE OF GEORGIA, INC.	Advantra	www.ga.advantraplans.com	01	02		1		H5302	003	0	2009	Advantra Silver	Savannah and Metro Atlanta area		2	2			100	2						(866)-613-4977	(866)-613-4977	(866)-347-2459	(866)-347-2459	(800)-303-1745	(800)-303-1745	(888)-788-4010	(888)-788-4010	(800)-690-3412	(800)-690-3412	(866)-236-1069	(866)-236-1069	(800)-690-3412	(800)-690-3412	(866)-236-1069	(866)-236-1069	http://www.ga.chcadvantra.com/	www.ga.chcadvantra.com
H5302	004	0	1	02	01	H5302_004_0	7	2009.01	COVENTRY HEALTH CARE OF GEORGIA, INC.	Advantra	www.ga.advantraplans.com	01	02		1		H5302	004	0	2009	Advantra Gold	Savannah and Metro Atlanta area		2	2			100	2						(866)-613-4977	(866)-613-4977	(866)-347-2459	(866)-347-2459	(800)-303-1745	(800)-303-1745	(888)-788-4010	(888)-788-4010	(800)-690-3412	(800)-690-3412	(866)-236-1069	(866)-236-1069	(800)-690-3412	(800)-690-3412	(866)-236-1069	(866)-236-1069	http://www.ga.chcadvantra.com/	www.ga.chcadvantra.com
H5302	809	0	1	02	01	H5302_809_0	4	2009.01	COVENTRY HEALTH CARE OF GEORGIA, INC.	Advantra	www.ga.advantraplans.com	01	02		1		H5302	809	0	2009	Advantra	Georgia		1	2			15	2						(866)-613-4977	(866)-613-4977	(866)-347-2459	(866)-347-2459	(800)-303-1745	(800)-303-1745	(888)-788-4010	(888)-788-4010									http://www.ga.chcadvantra.com/	www.ga.chcadvantra.com
H5302	810	0	1	02	01	H5302_810_0	4	2009.01	COVENTRY HEALTH CARE OF GEORGIA, INC.	Advantra	www.ga.advantraplans.com	01	02		1		H5302	810	0	2009	Advantra	GA		1	2			15	2						(866)-613-4977	(866)-613-4977	(866)-347-2459	(866)-347-2459	(800)-303-1745	(800)-303-1745	(888)-788-4010	(888)-788-4010	(800)-690-3412	(800)-690-3412	(866)-236-1069	(866)-236-1069	(800)-690-3412	(800)-690-3412	(866)-236-1069	(866)-236-1069	http://www.ga.chcadvantra.com/	www.ga.chcadvantra.com
H5302	811	0	1	02	01	H5302_811_0	4	2009.01	COVENTRY HEALTH CARE OF GEORGIA, INC.	Advantra	www.ga.advantraplans.com	01	02		1		H5302	811	0	2009	Advantra	GA		1	2			15	2						(866)-613-4977	(866)-613-4977	(866)-347-2459	(866)-347-2459	(800)-303-1745	(800)-303-1745	(888)-788-4010	(888)-788-4010	(800)-690-3412	(800)-690-3412	(866)-236-1069	(866)-236-1069	(800)-690-3412	(800)-690-3412	(866)-236-1069	(866)-236-1069	http://www.ga.chcadvantra.com/	www.ga.chcadvantra.com
H5304	002	0	1	09	04	H5304_002_0	6	2009.01	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com	04	09	2	1		H5304	002	0	2009	SmartValue Classic	New York, Select Counties		2	2			17	2						(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(800)-809-7328	(800)-809-7328	(877)-247-1657										www://seniorplandirectppoplus.medicareplanrx.com	
H5304	005	0	1	09	04	H5304_005_0	6	2009.01	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com	04	09	2	1		H5304	005	0	2009	SmartValue Essential	New York, Select Counties		2	2			67	2						(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(800)-809-7328	(800)-809-7328	(877)-247-1657										www://seniorplandirectppoplus.medicareplanrx.com	
H5304	006	0	1	09	04	H5304_006_0	8	2009.01	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com	04	09	2	1		H5304	006	0	2009	SmartValue Essential Plus	New York, Select Counties		2	2			76	2						(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(800)-809-7328	(800)-809-7328	(877)-247-1657		(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(800)-809-7328	(800)-809-7328	(877)-247-1657		www://seniorplandirectppoplus.medicareplanrx.com	
H5304	007	0	1	09	04	H5304_007_0	10	2009.01	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com	04	09	2	1		H5304	007	0	2009	SmartValue Plus	New York - Select Counties		2	2			8	2						(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(800)-809-7328	(800)-809-7328	(877)-247-1657		(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(800)-809-7328	(800)-809-7328	(877)-247-1657		www://seniorplandirectppoplus.medicareplanrx.com	
H5304	801	0	1	09	04	H5304_801_0	4	2009.01	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com	04	09	2	1		H5304	801	0	2009	SmartValue Group Plan I	NY with Nationwide Group Coverage		1	2			4071	2						(866)-395-5175	(888)-445-8916	(888)-844-5530	(888)-844-5530	(800)-809-7328	(800)-809-7328	(877)-247-1657		(888)-445-8916	(888)-445-8916	(888)-844-5530		(800)-809-7328	(800)-809-7328	(877)-247-1657		www://seniorplandirectppoplus.medicareplanrx.com	
H5304	802	0	1	09	04	H5304_802_0	4	2009.01	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com	04	09	2	1		H5304	802	0	2009	SmartValue Group Plan II	NY with Nationwide Group Coverage		1	2			4071	2						(866)-395-5175	(888)-445-8916	(888)-844-5530	(888)-844-5530	(800)-809-7328	(800)-809-7328	(877)-247-1657										www://seniorplandirectppoplus.medicareplanrx.com	
H5304	804	0	1	09	04	H5304_804_0	4	2009.01	EMPIRE HEALTHCHOICE ASSURANCE, INC.	Empire BlueCross BlueShield	www.empireblue.com	04	09	2	1		H5304	804	0	2009	SmartValue Group Plan III	NY with Nationwide Group Coverage		1	2			4071	2						(866)-395-5175	(888)-445-8916	(888)-844-5530	(888)-844-5530	(800)-809-7328	(800)-809-7328	(877)-247-1657		(888)-445-8916	(888)-445-8916	(888)-844-5530		(800)-809-7328	(800)-809-7328	(877)-247-1657		www://seniorplandirectppoplus.medicareplanrx.com	
H5324	001	0	1	20	08	H5324_001_0	1	2009.01	HALE MAKUA	Maui PACE	PACEMaui.org	08	20		1		H5324	001	0	2009	Maui PACE Dual	Maui, Hawaii		2	2				2														(808)-442-4551	(877)-521-7223	(877)-447-5990	(877)-447-5990	(808)-442-4551	(877)-521-7223	(877)-447-5990	(877)-447-5990	PACEMaui.org	
H5324	002	0	1	20	08	H5324_002_0	1	2009.01	HALE MAKUA	Maui PACE	PACEMaui.org	08	20		1		H5324	002	0	2009	Maui PACE - Medicare only	Maui, Hawaii		2	2				2														(808)-442-4551	(877)-521-7223	(877)-447-5990	(877)-447-5990	(808)-442-4551	(877)-521-7223	(877)-447-5990	(877)-447-5990	PACEMaui.org	
H5378	001	0	1	04	01	H5378_001_0	2	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H5378	001	0	2009	Today's Options PPO Select	SE Texas		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	www.todaysoptions.com
H5378	002	0	1	04	01	H5378_002_0	2	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H5378	002	0	2009	Today's Options PPO Select	North Texas		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	www.todaysoptions.com
H5378	003	0	1	04	01	H5378_003_0	2	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H5378	003	0	2009	Today's Options PPO Select	Cherokee,Henderson,Smith,Van Zandt,Wood Counties		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	www.todaysoptions.com
H5378	004	0	1	04	01	H5378_004_0	3	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H5378	004	0	2009	Today's Options PPO Select powered by CCRx	SE Texas		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H5378	005	0	1	04	01	H5378_005_0	3	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H5378	005	0	2009	Today's Options PPO Select powered by CCRx	North Texas		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H5378	006	0	1	04	01	H5378_006_0	3	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H5378	006	0	2009	Today's Options PPO Select powered by CCRx	Cherokee,Henderson,Smith,Van Zandt,Wood Counties		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H5378	801	0	1	04	01	H5378_801_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H5378	801	0	2009	Today's Options PPO - MA Group Plan	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	www.todaysoptions.com
H5378	802	0	1	04	01	H5378_802_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H5378	802	0	2009	Today's Options PPO - MAPD Group Plan	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H5378	803	0	1	04	01	H5378_803_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H5378	803	0	2009	Today's Options PPO - MAPD Group Plan - NCY	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H5402	007	0	1	01	01	H5402_007_0	6	2009.01	QUALITY HEALTH PLANS, INC.	Quality Health Plans	www.qualityhealthplans.com	01	01		1		H5402	007	0	2009	Advantage Silver	Central Florida		2	2			4925	2						(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	http://www.qualityhealthplans.com/medicareformulary.html	www.qualityhealthplans.com
H5402	010	0	1	01	01	H5402_010_0	6	2009.01	QUALITY HEALTH PLANS, INC.	Quality Health Plans	www.qualityhealthplans.com	01	01		1		H5402	010	0	2009	Advantage Premium	North and Central Florida		2	2			2350	2						(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	http://www.qualityhealthplans.com/medicareformulary.html	www.qualityhealthplans.com
H5402	032	0	1	01	01	H5402_032_0	6	2009.01	QUALITY HEALTH PLANS, INC.	Quality Health Plans	www.qualityhealthplans.com	01	01		1		H5402	032	0	2009	Advantage Silver South	South Florida		2	2			1500	2						(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	http://www.qualityhealthplans.com/medicareformulary.html	www.qualityhealthplans.com
H5402	034	0	1	01	01	H5402_034_0	6	2009.01	QUALITY HEALTH PLANS, INC.	Quality Health Plans	www.qualityhealthplans.com	01	01		1		H5402	034	0	2009	Advantage South	South Florida		2	2			1500	2						(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	http://www.qualityhealthplans.com/medicareformulary.html	www.qualityhealthplans.com
H5402	035	0	1	01	01	H5402_035_0	9	2009.01	QUALITY HEALTH PLANS, INC.	Quality Health Plans	www.qualityhealthplans.com	01	01		1		H5402	035	0	2009	Advantage Health Florida	Various Counties in Florida		2	1	4		750	2			1		0000001010000000000000000001	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	http://www.qualityhealthplans.com/medicareformulary.html	www.qualityhealthplans.com
H5402	036	0	1	01	01	H5402_036_0	7	2009.01	QUALITY HEALTH PLANS, INC.	Quality Health Plans	www.qualityhealthplans.com	01	01		1		H5402	036	0	2009	Advantage Silver -  East	East Coast of Florida		2	2			5000	2						(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	http://www.qualityhealthplans.com/medicareformulary.html	www.qualityhealthplans.com
H5402	038	0	1	01	01	H5402_038_0	6	2009.01	QUALITY HEALTH PLANS, INC.	Quality Health Plans	www.qualityhealthplans.com	01	01		1		H5402	038	0	2009	Advantage Silver North and Central	North and Central Florida		2	2			1750	2						(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	http://www.qualityhealthplans.com/medicareformulary.html	www.qualityhealthplans.com
H5402	039	0	1	01	01	H5402_039_0	7	2009.01	QUALITY HEALTH PLANS, INC.	Quality Health Plans	www.qualityhealthplans.com	01	01		1		H5402	039	0	2009	Advantage	Various Counties in Florida		2	2			4150	2						(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	http://www.qualityhealthplans.com/medicareformulary.html	www.qualityhealthplans.com
H5402	040	0	1	01	01	H5402_040_0	7	2009.01	QUALITY HEALTH PLANS, INC.	Quality Health Plans	www.qualityhealthplans.com	01	01		1		H5402	040	0	2009	Advantage Value Florida	Various Counties in Florida		2	2			300	2						(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010									http://www.qualityhealthplans.com/medicareformulary.html	www.qualityhealthplans.com
H5402	041	0	1	01	01	H5402_041_0	8	2009.01	QUALITY HEALTH PLANS, INC.	Quality Health Plans	www.qualityhealthplans.com	01	01		1		H5402	041	0	2009	Value One Florida	Various Counties in Florida		2	1	3		750	2			1	2		(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	http://www.qualityhealthplans.com/medicareformulary.html	www.qualityhealthplans.com
H5403	001	0	1	20	08	H5403_001_0	1	2009.01	ON LOK SENIORHEALTH	On Lok Lifeways	www.onlok.org	08	20		1		H5403	001	0	2009	On Lok Lifeways (Dual Eligibles)	San Francisco and Alameda Counties		2	2				2														(415)-292-8796	(888)-996-6565	(415)-292-8898		(415)-292-8784	(888)-886-6565	(415)-292-8898		n/a	
H5403	002	0	1	20	08	H5403_002_0	1	2009.01	ON LOK SENIORHEALTH	On Lok Lifeways	www.onlok.org	08	20		1		H5403	002	0	2009	On Lok Lifeways (Medicare Only)	San Francisco and Alameda Counties		2	2				2														(415)-292-8796	(888)-996-6565	(415)-292-8898		(415)-292-8784	(888)-886-6565	(415)-292-8898		n/a	
H5404	001	0	1	01	01	H5404_001_0	7	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	001	0	2009	Medicare Masterpiece	Hernando County		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	002	0	1	01	01	H5404_002_0	7	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	002	0	2009	Medicare Masterpiece	Manatee County		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	003	0	1	01	01	H5404_003_0	8	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	003	0	2009	Medicare Masterpiece	Sarasota County		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	004	0	1	01	01	H5404_004_0	7	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	004	0	2009	Medicare Masterpiece	Capitol Counties		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	013	0	1	01	01	H5404_013_0	7	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	013	0	2009	Medicare Masterpiece	Polk County		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	016	0	1	01	01	H5404_016_0	7	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	016	0	2009	Medicare Masterpiece	Hillsborough County		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	022	0	1	01	01	H5404_022_0	7	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	022	0	2009	Medicare Masterpiece	Pinellas County		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	025	0	1	01	01	H5404_025_0	7	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	025	0	2009	Medicare Masterpiece	Charlotte and Lee Counties		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	028	0	1	01	01	H5404_028_0	7	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	028	0	2009	Medicare Masterpiece	Central Florida Counties		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	034	0	1	01	01	H5404_034_0	8	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	034	0	2009	Medicare Masterpiece	Okechobee County		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	037	0	1	01	01	H5404_037_0	7	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	037	0	2009	Medicare Masterpiece	Pasco County		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	043	0	1	01	01	H5404_043_0	7	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	043	0	2009	Medicare Masterpiece	Saint Lucie County		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	053	0	1	01	01	H5404_053_0	8	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	053	0	2009	Medicare Masterpiece	Dade County		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	086	0	1	02	01	H5404_086_0	10	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	02		1		H5404	086	0	2009	Medicare Masterpiece Plus	West Coast, Gulf Coast and First Coast		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	094	0	1	01	01	H5404_094_0	7	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	094	0	2009	Medicare Masterpiece	Collier County		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	110	0	1	01	01	H5404_110_0	7	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	110	0	2009	Universal DP	Broward, Dade and Palm Beach Counties		2	1	3			2			1	2		(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	111	0	1	01	01	H5404_111_0	7	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	111	0	2009	Universal DP	Tampa Bay Area		2	1	3			2			1	2		(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	112	0	1	01	01	H5404_112_0	7	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	112	0	2009	Universal IP	South Florida		2	1	1	2		2			1			(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	113	0	1	01	01	H5404_113_0	8	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	113	0	2009	Universal IP	Tampa Bay Area		2	1	1	2		2			1			(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	114	0	1	01	01	H5404_114_0	7	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	114	0	2009	Medicare Masterpiece	Orange, Osceola and Seminole Counties		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	116	0	1	01	01	H5404_116_0	7	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	116	0	2009	Medicare Masterpiece MA Only	Hernando County		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177									http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	117	0	1	01	01	H5404_117_0	5	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	117	0	2009	Medicare Masterpiece MA Only	Manatee County		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177									http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	118	0	1	01	01	H5404_118_0	5	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	118	0	2009	Medicare Masterpiece MA Only	Sarasota County		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177									http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	119	0	1	01	01	H5404_119_0	6	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	119	0	2009	Medicare Masterpiece MA Only	Capitol Counties		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177									http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	120	0	1	01	01	H5404_120_0	6	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	120	0	2009	Medicare Masterpiece MA Only	Polk County		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177									http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	121	0	1	01	01	H5404_121_0	5	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	121	0	2009	Medicare Masterpiece MA Only	Hillsborough County		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177									http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	122	0	1	01	01	H5404_122_0	6	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	122	0	2009	Medicare Masterpiece MA Only	Pinellas County		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177									http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	123	0	1	01	01	H5404_123_0	5	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	123	0	2009	Medicare Masterpiece MA Only	Charlotte and Lee Counties		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177									http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	124	0	1	01	01	H5404_124_0	5	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	124	0	2009	Medicare Masterpiece MA Only	Central Florida Counties		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177									http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	125	0	1	01	01	H5404_125_0	5	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	125	0	2009	Medicare Masterpiece MA Only	Orange, Osceola and Seminole Counties		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177									http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	127	0	1	01	01	H5404_127_0	6	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	127	0	2009	Medicare Masterpiece MA Only	Pasco County		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177									http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	128	0	1	01	01	H5404_128_0	5	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	128	0	2009	Medicare Masterpiece MA Only	Miami Dade County		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177									http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	131	0	1	01	01	H5404_131_0	6	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	131	0	2009	Medicare Masterpiece MA Only	Collier County		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177									http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	133	0	1	01	01	H5404_133_0	5	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	133	0	2009	Medicare Masterpiece MA Only	Okeechobee County		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177									http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5404	134	0	1	01	01	H5404_134_0	5	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	http://www.univhc.com	01	01		1		H5404	134	0	2009	Medicare Masterpiece MA Only	Saint Lucie County		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177									http://www.univhc.com/Formulary/Plans_mp.asp	http://www.univhc.com
H5405	001	0	1	20	08	H5405_001_0	1	2009.01	CENTER FOR ELDERS INDEPENDENCE	Center For Elders Independence	www.cei.elders.org	08	20		1		H5405	001	0	2009	Center for Elders Independence - Part D	Alameda and Contra Costa Counties		2	2				2														(510)-433-1150	(510)-433-1150			(510)-433-1150	(510)-433-1150			www.cei.elders.org	
H5405	002	0	1	20	08	H5405_002_0	2	2009.01	CENTER FOR ELDERS INDEPENDENCE	Center For Elders Independence	www.cei.elders.org	08	20		1		H5405	002	0	2009	Center for Elders-Part D/MediCare, only	Alameda and Contra Costa Counties		2	2				2														(510)-433-1150	(510)-433-1150			(510)-433-1150	(510)-433-1150			www.cei.elders.org	
H5406	001	0	1	20	08	H5406_001_0	2	2009.01	SUTTER HEALTH SACRAMENTO SIERRA REGION	Sutter SeniorCare	http://checksutterfirst.org/seniorservices/seniorc	08	20		1		H5406	001	0	2009	Sutter SeniorCare	San Francisco, California		2	2				2														(916)-424-8412	(916)-424-8412	(916)-446-4124		(916)-424-8412	(916)-424-8412	(916)-446-4124		sutterseniorcare.org	
H5406	002	0	1	20	08	H5406_002_0	2	2009.01	SUTTER HEALTH SACRAMENTO SIERRA REGION	Sutter SeniorCare	http://checksutterfirst.org/seniorservices/seniorc	08	20		1		H5406	002	0	2009	Sutter SeniorCare	San Francisco, California		2	2				2														(916)-424-8412	(916)-424-8412	(916)-446-4124		(916)-424-8412	(916)-424-8412	(916)-446-4124		sutterseniorcare.org	
H5407	001	0	1	02	01	H5407_001_0	5	2009.01	CITRUS HEALTH CARE, INC.	Citrus Health Care, Inc.	www.citrushc.com	01	02		1		H5407	001	0	2009	CitrusCare	Central Gulf Coast and Central Florida Region		2	2			6461	2						(813)-490-8230	(877)-624-8787	(888)-248-7875		(813)-490-8919	(866)-769-1157	(888)-248-7875		(402)-965-8800	(800)-546-5677		(866)-706-4757	(813)-490-8919	(877)-769-1157		(866)-706-4757	http://citrushc.com/our_services/citruscare/formularies.php	www.citrushc.com
H5407	004	0	1	02	01	H5407_004_0	4	2009.01	CITRUS HEALTH CARE, INC.	Citrus Health Care, Inc.	www.citrushc.com	01	02		1		H5407	004	0	2009	CitrusCare	POLK COUNTY		2	2			864	2						(813)-490-8230	(877)-624-8787	(888)-248-7875		(813)-490-8919	(866)-769-1157	(888)-248-7875		(402)-965-8800	(800)-546-5677		(866)-706-4757	(813)-490-8919	(877)-769-1157		(866)-706-4757	http://citrushc.com/our_services/citruscare/formularies.php	www.citrushc.com
H5407	005	0	1	02	01	H5407_005_0	5	2009.01	CITRUS HEALTH CARE, INC.	Citrus Health Care, Inc.	www.citrushc.com	01	02		1		H5407	005	0	2009	Citrus Saver	Polk County		2	2			1680	2						(813)-490-8230	(877)-624-8787	(888)-248-7875		(813)-490-8919	(866)-769-1157	(888)-248-7875		(402)-965-8800	(800)-546-5677		(866)-706-4757	(813)-490-8919	(877)-769-1157		(866)-706-4757	http://citrushc.com/our_services/citruscare/formularies.php	www.citrushc.com
H5407	006	0	1	02	01	H5407_006_0	4	2009.01	CITRUS HEALTH CARE, INC.	Citrus Health Care, Inc.	www.citrushc.com	01	02		1		H5407	006	0	2009	CitrusCare	DADE AND BROWARD COUNTIES		2	2			700	2						(813)-490-8230	(877)-624-8787	(888)-248-7875		(813)-490-8919	(866)-769-1157	(888)-248-7875		(402)-965-8800	(800)-546-5677		(866)-706-4757	(813)-490-8919	(877)-769-1157		(866)-706-4757	http://citrushc.com/our_services/citruscare/formularies.php	www.citrushc.com
H5407	007	0	1	02	01	H5407_007_0	4	2009.01	CITRUS HEALTH CARE, INC.	Citrus Health Care, Inc.	www.citrushc.com	01	02		1		H5407	007	0	2009	CitrusCare	Palm Bch  St Lucie Counties		2	2			352	2						(813)-490-8230	(877)-624-8787	(888)-248-7875		(813)-490-8919	(866)-769-1157	(888)-248-7875		(402)-965-8800	(800)-546-5677		(866)-706-4757	(813)-490-8919	(877)-769-1157		(866)-706-4757	http://citrushc.com/our_services/citruscare/formularies.php	www.citrushc.com
H5407	009	0	1	02	01	H5407_009_0	5	2009.01	CITRUS HEALTH CARE, INC.	Citrus Health Care, Inc.	www.citrushc.com	01	02		1		H5407	009	0	2009	Citrus Platinum Plus	Central Gulf Coast and Central Florida Region		2	2			5268	2						(813)-490-8230	(877)-624-8787	(888)-248-7875		(813)-490-8919	(866)-769-1157	(888)-248-7875		(402)-965-8800	(800)-546-5677		(866)-706-4757	(813)-490-8919	(877)-769-1157		(866)-706-4757	http://citrushc.com/our_services/citruscare/formularies.php	www.citrushc.com
H5407	011	0	1	01	01	H5407_011_0	6	2009.01	CITRUS HEALTH CARE, INC.	Citrus Health Care, Inc.	www.citrushc.com	01	01		1		H5407	011	0	2009	Citrus Special Needs Plan	BRO DAD HIL ORA OSC PAL PAS PIN POL VOL STL SEM FL		2	1	3		20170	2			1	2		(813)-490-8230	(877)-624-8787	(888)-248-7875		(813)-490-8919	(866)-769-1157	(888)-248-7875		(402)-965-8800	(800)-546-5677		(866)-706-4757	(813)-490-8919	(877)-769-1157		(866)-706-4757	http://citrushc.com/our_services/citruscare/formularies.php	www.citrushc.com
H5407	014	0	1	02	01	H5407_014_0	5	2009.01	CITRUS HEALTH CARE, INC.	Citrus Health Care, Inc.	www.citrushc.com	01	02		1		H5407	014	0	2009	Citrus Saver	Central Gulf Coast and Central Florida Region		2	2			10250	2						(813)-490-8230	(877)-624-8787	(888)-248-7875		(813)-490-8919	(866)-769-1157	(888)-248-7875		(402)-965-8800	(800)-546-5677		(866)-706-4757	(813)-490-8919	(877)-769-1157		(866)-706-4757	http://citrushc.com/our_services/citruscare/formularies.php	www.citrushc.com
H5407	015	0	1	02	01	H5407_015_0	5	2009.01	CITRUS HEALTH CARE, INC.	Citrus Health Care, Inc.	www.citrushc.com	01	02		1		H5407	015	0	2009	Citrus Saver	BROWARD AND DADE COUNTIES		2	2			1100	2						(813)-490-8230	(877)-624-8787	(888)-248-7875		(813)-490-8919	(866)-769-1157	(888)-248-7875		(402)-965-8800	(800)-546-5677		(866)-706-4757	(813)-490-8919	(877)-769-1157		(866)-706-4757	http://citrushc.com/our_services/citruscare/formularies.php	www.citrushc.com
H5407	016	0	1	02	01	H5407_016_0	5	2009.01	CITRUS HEALTH CARE, INC.	Citrus Health Care, Inc.	www.citrushc.com	01	02		1		H5407	016	0	2009	Citrus Saver	PALM BCH    ST LUCIE COUNTIES		2	2			700	2						(813)-490-8230	(877)-624-8787	(888)-248-7875		(813)-490-8919	(866)-769-1157	(888)-248-7875		(402)-965-8800	(800)-546-5677		(866)-706-4757	(813)-490-8919	(877)-769-1157		(866)-706-4757	http://citrushc.com/our_services/citruscare/formularies.php	www.citrushc.com
H5407	021	0	1	02	01	H5407_021_0	5	2009.01	CITRUS HEALTH CARE, INC.	Citrus Health Care, Inc.	www.citrushc.com	01	02		1		H5407	021	0	2009	Citrus Platinum Plus	PALM BCH ST LUCIE COUNTIES		2	2			293	2						(813)-490-8230	(877)-624-8787	(888)-248-7875		(813)-490-8919	(866)-769-1157	(888)-248-7875		(402)-965-8800	(800)-546-5677		(866)-706-4757	(813)-490-8919	(877)-769-1157		(866)-706-4757	http://citrushc.com/our_services/citruscare/formularies.php	www.citrushc.com
H5407	022	0	1	02	01	H5407_022_0	5	2009.01	CITRUS HEALTH CARE, INC.	Citrus Health Care, Inc.	www.citrushc.com	01	02		1		H5407	022	0	2009	Citrus Platinum Plus	Polk County		2	2			932	2						(813)-490-8230	(877)-624-8787	(888)-248-7875		(813)-490-8919	(866)-769-1157	(888)-248-7875		(402)-965-8800	(800)-546-5677		(866)-706-4757	(813)-490-8919	(877)-769-1157		(866)-706-4757	http://citrushc.com/our_services/citruscare/formularies.php	www.citrushc.com
H5407	024	0	1	01	01	H5407_024_0	4	2009.01	CITRUS HEALTH CARE, INC.	Citrus Health Care, Inc.	www.citrushc.com	01	01		1		H5407	024	0	2009	Citrus Advantage	Florida HMO Service Area		2	2			932	2						(813)-490-8230	(877)-624-8787	(888)-248-7875		(813)-490-8919	(866)-769-1157	(888)-248-7875										http://citrushc.com/our_services/citruscare/formularies.php	www.citrushc.com
H5410	001	0	1	01	01	H5410_001_0	6	2009.01	LEON MEDICAL CENTERS HEALTH PLANS, INC	Leon Medical Centers Health Plans, Inc.	www.lmchealthplans.com	01	01		1		H5410	001	0	2009	Leon Medical Centers Health Plans - Leon Cares	Miami-Dade county		2	2			28648	2						(305)-559-5366	(866)-393-5366	(305)-220-5752		(305)-559-5366	(866)-393-5366	(305)-220-5752		(305)-559-5366	(866)-393-5366	(305)-220-5752		(305)-559-5366	(866)-393-5366	(305)-220-5752		www.lmchealthplans.com	
H5410	003	0	1	01	01	H5410_003_0	8	2009.01	LEON MEDICAL CENTERS HEALTH PLANS, INC	Leon Medical Centers Health Plans, Inc.	www.lmchealthplans.com	01	01		1		H5410	003	0	2009	HealthSpring HealthyLiving Premier	Pensacola county		2	2			515	2						(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(888)-767-1879	(888)-767-1879	(877)-262-9090	(877)-262-9090	(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.lmchealthplans.com	
H5410	004	0	1	01	01	H5410_004_0	3	2009.01	LEON MEDICAL CENTERS HEALTH PLANS, INC	Leon Medical Centers Health Plans, Inc.	www.lmchealthplans.com	01	01		1		H5410	004	0	2009	HealthSpring HealthyAdvantage	Pensacola county		2	2			21	2						(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(888)-767-1879	(888)-767-1879	(877)-262-9090	(877)-262-9090									www.lmchealthplans.com	
H5410	005	0	1	01	01	H5410_005_0	6	2009.01	LEON MEDICAL CENTERS HEALTH PLANS, INC	Leon Medical Centers Health Plans, Inc.	www.lmchealthplans.com	01	01		1		H5410	005	0	2009	HealthSpring HealthyAdvantage Plus	Pensacola county		2	2			21	2						(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(888)-767-1879	(888)-767-1879	(877)-262-9090	(877)-262-9090	(800)-952-1992	(800)-952-1992	(877)-262-9090	(877)-262-9090	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.lmchealthplans.com	
H5414	002	0	1	01	01	H5414_002_0	4	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5414	002	0	2009	Aetna Golden Medicare Standard Plan	Jacksonville, Orlando, Tampa, and Surrounding Co.		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5414	004	0	1	01	01	H5414_004_0	4	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5414	004	0	2009	Aetna Golden Medicare Premier Plan	Jacksonville, Orlando, Tampa, and Surrounding Co.		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5414	009	0	1	01	01	H5414_009_0	6	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5414	009	0	2009	Aetna Golden Medicare Value Plan	Jacksonville, Orlando, Tampa, and Surrounding Co.		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5414	010	0	1	01	01	H5414_010_0	5	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5414	010	0	2009	Aetna Golden Medicare Value Plan	Broward and Palm Beach Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5414	011	0	1	01	01	H5414_011_0	4	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5414	011	0	2009	Aetna Golden Medicare Premier Plan	Broward and Palm Beach Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5414	012	0	1	01	01	H5414_012_0	4	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5414	012	0	2009	Aetna Golden Medicare Standard Plan	Broward and Palm Beach Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5414	013	0	1	01	01	H5414_013_0	6	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5414	013	0	2009	Aetna Golden Medicare Basic Plan	Jacksonville, Orlando, Tampa, and Surrounding Co.		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5414	014	0	1	01	01	H5414_014_0	5	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5414	014	0	2009	Aetna Golden Medicare Value Plan	Miami-Dade County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5414	015	0	1	01	01	H5414_015_0	4	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5414	015	0	2009	Aetna Golden Medicare Standard Plan	Miami-Dade County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5414	016	0	1	01	01	H5414_016_0	4	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5414	016	0	2009	Aetna Golden Medicare Premier Plan	Miami-Dade County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5414	017	0	1	01	01	H5414_017_0	4	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5414	017	0	2009	Aetna Golden Medicare Basic Plan	Miami-Dade County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5414	018	0	1	01	01	H5414_018_0	5	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5414	018	0	2009	Aetna Golden Medicare Basic Plan	Broward and Palm Beach Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5414	801	0	1	01	01	H5414_801_0	4	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5414	801	0	2009	Aetna Golden Medicare Plan	Florida		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5414	803	0	1	01	01	H5414_803_0	4	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5414	803	0	2009	Aetna Golden Medicare Plan w/Rx CY	Florida		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5415	039	0	1	04	01	H5415_039_0	3	2009.01	HUMANA HEALTH INSURANCE COMPANY OF FL, INC.	Humana Health Insurance Company Of Fl, Inc.	www.humana-medicare.com	01	04		1		H5415	039	0	2009	HumanaChoicePPO PPO H5415-039	Flagler and Volusia Counties		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5415	801	0	1	04	01	H5415_801_0	3	2009.01	HUMANA HEALTH INSURANCE COMPANY OF FL, INC.	Humana Health Insurance Company Of Fl, Inc.	www.humana-medicare.com	01	04		1		H5415	801	0	2009	Humana Employer Sponsored	Select Florida Counties		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5415	803	0	1	04	01	H5415_803_0	3	2009.01	HUMANA HEALTH INSURANCE COMPANY OF FL, INC.	Humana Health Insurance Company Of Fl, Inc.	www.humana-medicare.com	01	04		1		H5415	803	0	2009	Humana Employer Sponsored	Select Florida Counties		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5415	804	0	1	04	01	H5415_804_0	3	2009.01	HUMANA HEALTH INSURANCE COMPANY OF FL, INC.	Humana Health Insurance Company Of Fl, Inc.	www.humana-medicare.com	01	04		1		H5415	804	0	2009	Humana Employer Sponsored Non-CY	Florida Select Counties		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5415	805	0	1	04	01	H5415_805_0	3	2009.01	HUMANA HEALTH INSURANCE COMPANY OF FL, INC.	Humana Health Insurance Company Of Fl, Inc.	www.humana-medicare.com	01	04		1		H5415	805	0	2009	Humana Employer Sponsored Non-CY	Florida Select Counties		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5416	001	0	1	01	01	H5416_001_0	8	2009.01	ARCADIAN HEALTH PLAN	Spokane Community Care	www.spokanecommunitycare.com	01	01		1		H5416	001	0	2009	Spokane Community Care - Premier	Spokane County		2	2			11256	2						(509)-325-8004	(800)-573-8597	(866)-573-8591	(866)-573-8591	(509)-325-8004	(800)-573-8609	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(509)-325-8004	(800)-573-8609	(866)-573-8613	(866)-573-8613	http://www.spokanecommunitycare.com/formulary.html	
H5416	002	0	1	01	01	H5416_002_0	9	2009.01	ARCADIAN HEALTH PLAN	Spokane Community Care	www.spokanecommunitycare.com	01	01		1		H5416	002	0	2009	Spokane Community Care - Plus	Spokane County		2	2			16401	2						(509)-325-8004	(800)-573-8597	(866)-573-8591	(866)-573-8591	(509)-325-8004	(800)-573-8609	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(509)-325-8004	(800)-573-8609	(866)-573-8613	(866)-573-8613	http://www.spokanecommunitycare.com/formulary.html	
H5416	003	0	1	01	01	H5416_003_0	5	2009.01	ARCADIAN HEALTH PLAN	Spokane Community Care	www.spokanecommunitycare.com	01	01		1		H5416	003	0	2009	Spokane Community Care - Basic	Spokane County		2	2			4502	2						(509)-325-8004	(800)-573-8597	(866)-573-8591	(866)-573-8591	(509)-325-8004	(800)-573-8609	(866)-573-8613	(866)-573-8613									http://www.spokanecommunitycare.com/formulary.html	
H5416	004	0	1	01	01	H5416_004_0	9	2009.01	ARCADIAN HEALTH PLAN	Spokane Community Care	www.spokanecommunitycare.com	01	01		1		H5416	004	0	2009	Columbia Community Care - Plus ( Benton/Franklin)	Benton/ Franklin		2	2			7410	2						(509)-735-6002	(800)-573-8597	(866)-573-8591	(866)-573-8591	(509)-735-6002	(800)-658-2313	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(509)-735-6002	(800)-658-2313	(866)-573-8613	(866)-573-8613	http://www.spokanecommunitycare.com/formulary.html	
H5416	009	0	1	01	01	H5416_009_0	9	2009.01	ARCADIAN HEALTH PLAN	Spokane Community Care	www.spokanecommunitycare.com	01	01		1		H5416	009	0	2009	Columbia Community Care - Plus (Yakima)	Yakima		2	2			5275	2						(509)-735-6002	(800)-573-8597	(866)-573-8591	(866)-573-8591	(509)-735-6002	(800)-658-2313	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(509)-735-6002	(800)-658-2313	(866)-573-8613	(866)-573-8613	http://www.spokanecommunitycare.com/formulary.html	
H5416	010	0	1	02	01	H5416_010_0	11	2009.01	ARCADIAN HEALTH PLAN	Spokane Community Care	www.spokanecommunitycare.com	01	02		1		H5416	010	0	2009	Columbia Community Care - POS	Yakima ( POS)		2	2			5275	2						(509)-735-6002	(800)-573-8597	(866)-573-8591	(866)-573-8591	(509)-735-6002	(800)-658-2313	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(509)-735-6002	(800)-658-2313	(866)-573-8613	(866)-573-8613	http://www.spokanecommunitycare.com/formulary.html	
H5417	001	0	1	04	01	H5417_001_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H5417	001	0	2009	Evercare Plan IP	Panhandle, Jax, Tampa, Orlando,  Southern FL areas		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H5417	005	0	1	04	01	H5417_005_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H5417	005	0	2009	Evercare Plan MP	Panhandle, Jax, Tampa and Orlando areas		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H5417	006	0	1	04	01	H5417_006_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	04		1		H5417	006	0	2009	AARP MedicareCompleteChoicePlan1	Broward and Palm Beach Counties		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H5419	001	0	1	09	04	H5419_001_0	6	2009.01	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca	04	09	2	1		H5419	001	0	2009	SmartValue Classic	California - Select Counties		2	2			3214	2						(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538									http://medicarerx.anthem.com	
H5419	004	0	1	09	04	H5419_004_0	9	2009.01	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca	04	09	2	1		H5419	004	0	2009	SmartValue Plus	California - Select Counties		2	2			2759	2						(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538	(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538	http://medicarerx.anthem.com	
H5419	805	0	1	09	04	H5419_805_0	4	2009.01	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca	04	09	2	1		H5419	805	0	2009	SmartValue Group Plan I	CA with Nationwide Group Coverage		1	2			4071	2						(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538	(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538	http://medicarerx.anthem.com	
H5419	806	0	1	09	04	H5419_806_0	4	2009.01	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca	04	09	2	1		H5419	806	0	2009	SmartValue Group Plan II	CA with Nationwide Group Coverage		1	2			4071	2						(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538									http://medicarerx.anthem.com	
H5419	808	0	1	09	04	H5419_808_0	4	2009.01	BLUE CROSS OF CALIFORNIA	Anthem Blue Cross	www.anthem.com/ca	04	09	2	1		H5419	808	0	2009	SmartValue Group Plan III	CA with Nationwide Group Coverage		1	2			4071	2						(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538	(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538	http://medicarerx.anthem.com	
H5420	001	0	1	05	01	H5420_001_0	6	2009.01	MEDICA HEALTHCARE PLANS, INC.	Medica HealthCare Plans, Inc.	www.medicaplans.com	01	05		1		H5420	001	0	2009	Medica HealthCare Plans MedicareMax	Miami-Dade County		2	2			11396	2						(305)-421-1244	(800)-407-9069	(305)-421-1251	(800)-517-6923	(305)-267-5267	(800)-507-0544	(305)-448-3407	(800)-865-4057	(305)-421-1244	(800)-407-9069	(305)-421-1251	(800)-517-6923	(305)-267-5267	(800)-507-0544	(305)-448-3407	(800)-865-4057	www.medicaplans.com	www.medicaplans.com
H5420	003	0	1	05	01	H5420_003_0	6	2009.01	MEDICA HEALTHCARE PLANS, INC.	Medica HealthCare Plans, Inc.	www.medicaplans.com	01	05		1		H5420	003	0	2009	Medica HealthCare Plans MedicareMax	Broward County		2	2			915	2						(800)-407-9069		(800)-517-6923		(800)-719-4570		(954)-962-7675		(800)-407-9069	(800)-407-9069		(800)-517-6923	(800)-719-4570	(800)-719-4570	(954)-962-7675		www.medicaplans.com	www.medicaplans.com
H5420	004	0	1	05	01	H5420_004_0	5	2009.01	MEDICA HEALTHCARE PLANS, INC.	Medica HealthCare Plans, Inc.	www.medicaplans.com	01	05		1		H5420	004	0	2009	Medica HealthCare Plans MedicareMax Direct	Miami-Dade County		2	2			204	2						(305)-421-1244	(800)-407-9069	(305)-421-1251	(800)-517-6923	(305)-267-5267	(800)-507-0544	(305)-448-3407	(800)-865-4057	(305)-421-1244	(800)-407-9069	(305)-421-1251	(800)-517-6923	(305)-267-5267	(800)-507-0544	(305)-448-3407	(800)-865-4057	www.medicaplans.com	www.medicaplans.com
H5420	005	0	1	05	01	H5420_005_0	5	2009.01	MEDICA HEALTHCARE PLANS, INC.	Medica HealthCare Plans, Inc.	www.medicaplans.com	01	05		1		H5420	005	0	2009	Medica HealthCare Plans MedicareMax Direct	Broward County		2	2			274	2						(800)-407-9069		(800)-517-6923		(800)-719-4570		(954)-962-7675		(800)-407-9069	(800)-407-9069		(800)-517-6923	(800)-719-4570	(800)-719-4570	(954)-962-7675		www.medicaplans.com	www.medicaplans.com
H5420	006	0	1	05	01	H5420_006_0	5	2009.01	MEDICA HEALTHCARE PLANS, INC.	Medica HealthCare Plans, Inc.	www.medicaplans.com	01	05		1		H5420	006	0	2009	Medica HealthCare Plans MedicareMax Plus	Miami-Dade and Broward County		2	1	3		1075	2			1	2		(305)-421-1244	(800)-407-9069	(305)-421-1251	(800)-517-6923	(800)-507-0544		(800)-865-4057		(800)-407-9069	(800)-407-9069		(800)-517-6923	(800)-507-0544	(800)-507-0544		(800)-865-4057	www.medicaplans.com	www.medicaplans.com
H5420	007	0	1	05	01	H5420_007_0	2	2009.01	MEDICA HEALTHCARE PLANS, INC.	Medica HealthCare Plans, Inc.	www.medicaplans.com	01	05		1		H5420	007	0	2009	Medica HealthCare Plans MedicareMax Value	Miami-Dade County		2	2			66	2						(305)-421-1244	(800)-407-9069	(305)-421-1251	(800)-517-6923	(305)-267-5267	(800)-507-0544	(305)-448-3407	(800)-865-4057									www.medicaplans.com	www.medicaplans.com
H5420	008	0	1	05	01	H5420_008_0	4	2009.01	MEDICA HEALTHCARE PLANS, INC.	Medica HealthCare Plans, Inc.	www.medicaplans.com	01	05		1		H5420	008	0	2009	Medica HealthCare Plans MedicareMax Value	Broward County		2	2			120	2						(800)-407-9069		(800)-517-6923		(800)-719-4570		(954)-962-7675										www.medicaplans.com	www.medicaplans.com
H5420	009	0	1	05	01	H5420_009_0	5	2009.01	MEDICA HEALTHCARE PLANS, INC.	Medica HealthCare Plans, Inc.	www.medicaplans.com	01	05		1		H5420	009	0	2009	Medica HealthCare Plans MedicareMax Value RX	Miami-Dade and Broward County		2	2			224	2						(305)-421-1244	(800)-407-9069	(305)-421-1251	(800)-517-6923	(800)-507-0544		(800)-865-4057		(800)-407-9069	(800)-407-9069		(800)-517-6923	(800)-507-0544	(800)-507-0544		(800)-865-4057	www.medicaplans.com	www.medicaplans.com
H5421	046	0	1	09	04	H5421_046_0	2	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	046	0	2009	Today's Options Premier	West/ Midwest/ South 1		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H5421	047	0	1	09	04	H5421_047_0	2	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	047	0	2009	Today's Options Premier	West/ Midwest/ South 2		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H5421	048	0	1	09	04	H5421_048_0	2	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	048	0	2009	Today's Options Premier	West/ Midwest/ South 3		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H5421	049	0	1	09	04	H5421_049_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	049	0	2009	Today's Options Premier	West/ Midwest/ South 4		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H5421	050	0	1	09	04	H5421_050_0	2	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	050	0	2009	Today's Options Premier	West/ Midwest/ South 5		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H5421	051	0	1	09	04	H5421_051_0	2	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	051	0	2009	Today's Options Premier	West/ Midwest/ South 6		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H5421	052	0	1	09	04	H5421_052_0	2	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	052	0	2009	Today's Options Value	West/ Midwest/ South 1		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H5421	053	0	1	09	04	H5421_053_0	2	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	053	0	2009	Today's Options Value	West/ Midwest/ South 2		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H5421	054	0	1	09	04	H5421_054_0	2	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	054	0	2009	Today's Options Value	West/ Midwest/ South 3		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H5421	055	0	1	09	04	H5421_055_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	055	0	2009	Today's Options Value	West/ Midwest/ South 4		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H5421	056	0	1	09	04	H5421_056_0	2	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	056	0	2009	Today's Options Value	West/ Midwest/ South 5		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H5421	057	0	1	09	04	H5421_057_0	2	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	057	0	2009	Today's Options Value	West/ Midwest/ South 6		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H5421	064	0	1	09	04	H5421_064_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	064	0	2009	Today's Options Premier powered by CCRx	West/ Midwest/ South 1		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	065	0	1	09	04	H5421_065_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	065	0	2009	Today's Options Premier powered by CCRx	West/ Midwest/ South 2		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	066	0	1	09	04	H5421_066_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	066	0	2009	Today's Options Premier powered by CCRx	West/ Midwest/ South 3		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	067	0	1	09	04	H5421_067_0	6	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	067	0	2009	Today's Options Premier powered by CCRx	West/ Midwest/ South 4		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	068	0	1	09	04	H5421_068_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	068	0	2009	Today's Options Premier powered by CCRx	West/ Midwest/ South 5		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	069	0	1	09	04	H5421_069_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	069	0	2009	Today's Options Premier powered by CCRx	West/ Midwest/ South 6		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	070	0	1	09	04	H5421_070_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	070	0	2009	Today's Options Value powered by CCRx	West/ Midwest/ South 1		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	071	0	1	09	04	H5421_071_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	071	0	2009	Today's Options Value powered by CCRx	West/ Midwest/ South 2		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	072	0	1	09	04	H5421_072_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	072	0	2009	Today's Options Value powered by CCRx	West/ Midwest/ South 3		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	073	0	1	09	04	H5421_073_0	6	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	073	0	2009	Today's Options Value powered by CCRx	West/ Midwest/ South 4		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	074	0	1	09	04	H5421_074_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	074	0	2009	Today's Options Value powered by CCRx	West/ Midwest/ South 5		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	075	0	1	09	04	H5421_075_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	075	0	2009	Today's Options Value powered by CCRx	West/ Midwest/ South 6		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	100	0	1	09	04	H5421_100_0	3	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	100	0	2009	Today's Options Premier	Galveston, TX and Surrounding Counties		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H5421	101	0	1	09	04	H5421_101_0	3	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	101	0	2009	Today's Options Value	Galveston, TX and Surrounding Counties		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H5421	103	0	1	09	04	H5421_103_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	103	0	2009	Today's Options Premier powered by CCRx	Galveston, TX and Surrounding Counties		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	104	0	1	09	04	H5421_104_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	104	0	2009	Today's Options Value powered by CCRx	Galveston, TX and Surrounding Counties		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	106	0	1	09	04	H5421_106_0	5	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	106	0	2009	Today's Options Premier	Dallas, TX and Surrounding Counties		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H5421	107	0	1	09	04	H5421_107_0	5	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	107	0	2009	Today's Options Value	Dallas, TX and Surrounding Counties		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H5421	109	0	1	09	04	H5421_109_0	6	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	109	0	2009	Today's Options Premier powered by CCRx	Dallas, TX and Surrounding Counties		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	110	0	1	09	04	H5421_110_0	6	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	110	0	2009	Today's Options Value powered by CCRx	Dallas, TX and Surrounding Counties		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	112	0	1	09	04	H5421_112_0	3	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	112	0	2009	Today's Options Premier	Milwaukee, WI and Surrounding Counties		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H5421	113	0	1	09	04	H5421_113_0	3	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	113	0	2009	Today's Options Value	Milwaukee, WI and Surrounding Counties		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H5421	115	0	1	09	04	H5421_115_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	115	0	2009	Today's Options Premier powered by CCRx	Milwaukee, WI and Surrounding Counties		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	116	0	1	09	04	H5421_116_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	116	0	2009	Today's Options Value powered by CCRx	Milwaukee, WI and Surrounding Counties		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	124	0	1	09	04	H5421_124_0	3	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	124	0	2009	Today's Options Premier	Tulsa, OK and Surrounding Counties		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H5421	125	0	1	09	04	H5421_125_0	3	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	125	0	2009	Today's Options Value	Tulsa, OK and Surrounding Counties		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H5421	127	0	1	09	04	H5421_127_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	127	0	2009	Today's Options Premier powered by CCRx	Tulsa, OK and Surrounding Counties		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	128	0	1	09	04	H5421_128_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	128	0	2009	Today's Options Value powered by CCRx	Tulsa, OK and Surrounding Counties		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	130	0	1	09	04	H5421_130_0	3	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	130	0	2009	Avera Advantage Premier	Select South Dakota and Nebraska Counties		2	2				2						(866)-414-0048	(866)-414-0048	(866)-420-7633	(866)-420-7633	(866)-414-0048	(866)-414-0048	(866)-420-7633	(866)-420-7633									http://www.todaysoptions.com	
H5421	131	0	1	09	04	H5421_131_0	3	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	131	0	2009	Avera Advantage Value	Select South Dakota and Nebraska Counties		2	2				2						(866)-414-0048	(866)-414-0048	(866)-420-7633	(866)-420-7633	(866)-414-0048	(866)-414-0048	(866)-420-7633	(866)-420-7633									http://www.todaysoptions.com	
H5421	133	0	1	09	04	H5421_133_0	5	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	133	0	2009	Avera Advantage Premier Plus	Select South Dakota and Nebraska Counties		2	2				2						(866)-414-0048	(866)-414-0048	(866)-420-7633	(866)-420-7633	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-414-0048	(866)-414-0048	(866)-420-7633	(866)-420-7633	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	134	0	1	09	04	H5421_134_0	5	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	134	0	2009	Avera Advantage Value Plus	Select South Dakota and Nebraska Counties		2	2				2						(866)-414-0048	(866)-414-0048	(866)-420-7633	(866)-420-7633	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-414-0048	(866)-414-0048	(866)-420-7633	(866)-420-7633	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	136	0	1	09	04	H5421_136_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	136	0	2009	Today's Options Access powered by CCRx	North Carolina		2	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	801	0	1	09	04	H5421_801_0	6	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	801	0	2009	Today's Options Group	National		1	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H5421	804	0	1	09	04	H5421_804_0	6	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	804	0	2009	Today's Options Group Plus	National		1	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	805	0	1	09	04	H5421_805_0	6	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	805	0	2009	Today's Options Group Plus NCY	National		1	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	806	0	1	09	04	H5421_806_0	6	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	806	0	2009	Today 's Options Group Medco	National		1	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	
H5421	807	0	1	09	04	H5421_807_0	6	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	807	0	2009	Today 's Options Group Plus Medco	National		1	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5421	808	0	1	09	04	H5421_808_0	6	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	04	09	3	1		H5421	808	0	2009	Today 's Options Group Plus NCY Medco	National		1	2				2						(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	(866)-568-8921	(866)-568-8921	(800)-958-2692	(800)-958-2692	(800)-996-8867	(800)-996-8867	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	
H5422	002	0	1	01	01	H5422_002_0	10	2009.01	BLUE CROSS BLUE SHIELD OF GEORGIA	Blue Cross Blue Shield Healthcare Plan of Georgia	www.bcbsga.com	01	01		1		H5422	002	0	2009	BlueValue Secure	GA Select Counties		2	2			2286	2						(866)-438-9968	(866)-438-9968	(877)-247-1657	(877)-247-1657	(888)-211-9817	(888)-211-9817	(800)-297-1538	(800)-297-1538	(866)-438-9968	(866)-438-9968	(877)-247-1657	(877)-247-1657	(888)-211-9817	(888)-211-9817	(800)-297-1538	(800)-297-1538	www.bcbsga.com	
H5422	006	0	1	01	01	H5422_006_0	10	2009.01	BLUE CROSS BLUE SHIELD OF GEORGIA	Blue Cross Blue Shield Healthcare Plan of Georgia	www.bcbsga.com	01	01		1		H5422	006	0	2009	BlueValue Basic	GA Select Counties		2	2			571	2						(866)-438-9968	(866)-438-9968	(877)-247-1657	(877)-247-1657	(888)-211-9817	(888)-211-9817	(800)-297-1538	(800)-297-1538	(866)-438-9968	(866)-438-9968	(877)-247-1657	(877)-247-1657	(888)-211-9817	(888)-211-9817	(800)-297-1538	(800)-297-1538	www.bcbsga.com	
H5422	803	0	1	01	01	H5422_803_0	4	2009.01	BLUE CROSS BLUE SHIELD OF GEORGIA	Blue Cross Blue Shield Healthcare Plan of Georgia	www.bcbsga.com	01	01		1		H5422	803	0	2009	BlueValue Secure Group Plan I	Georgia Select Counties		1	2			50	2						(866)-438-9968	(866)-438-9968	(877)-247-1657	(877)-247-1657	(888)-211-9817	(888)-211-9817	(800)-297-1538	(800)-297-1538									www.bcbsga.com	
H5422	804	0	1	01	01	H5422_804_0	4	2009.01	BLUE CROSS BLUE SHIELD OF GEORGIA	Blue Cross Blue Shield Healthcare Plan of Georgia	www.bcbsga.com	01	01		1		H5422	804	0	2009	BlueValue Secure Group Plan	Georgia - Select Counties		1	2			125	2						(866)-438-9968	(866)-438-9968	(877)-247-1657	(877)-247-1657	(888)-211-9817	(888)-211-9817	(800)-297-1538	(800)-297-1538	(866)-438-9968	(866)-438-9968	(877)-247-1657	(877)-247-1657	(888)-211-9817	(888)-211-9817	(800)-297-1538	(800)-297-1538	www.bcbsga.com	
H5422	805	0	1	01	01	H5422_805_0	4	2009.01	BLUE CROSS BLUE SHIELD OF GEORGIA	Blue Cross Blue Shield Healthcare Plan of Georgia	www.bcbsga.com	01	01		1		H5422	805	0	2009	BlueValue Secure Group Plan	Georgia - Select Counties		1	2			25	2						(866)-438-9968	(866)-438-9968	(877)-247-1657	(877)-247-1657	(888)-211-9817	(888)-211-9817	(800)-297-1538	(800)-297-1538	(866)-438-9968	(866)-438-9968	(877)-247-1657	(877)-247-1657	(888)-211-9817	(888)-211-9817	(800)-297-1538	(800)-297-1538	www.bcbsga.com	
H5424	001	0	1	04	01	H5424_001_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H5424	001	0	2009	AARP MedicareCompleteChoicePlan1	Honolulu County		2	2				2						(888)-736-7435	(888)-736-7435	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(888)-736-7435	(888)-736-7435	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5424	003	0	1	04	01	H5424_003_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H5424	003	0	2009	AARP MedicareCompleteChoicePlan2	Honolulu County		2	2				2						(888)-736-7435	(888)-736-7435	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5424	005	0	1	04	01	H5424_005_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H5424	005	0	2009	Evercare Plan DP	Honolulu County		2	1	3			2			2	2		(866)-622-8054	(866)-622-8054	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(866)-622-8054	(866)-622-8054	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5424	801	0	1	04	01	H5424_801_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H5424	801	0	2009	MedicareComplete Choice Retiree Plan	Honolulu County		1	2				2						(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5424	803	0	1	04	01	H5424_803_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H5424	803	0	2009	MedicareComplete Retiree Plan	Honolulu, HI		1	2				2						(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5425	001	0	1	01	01	H5425_001_0	8	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H5425	001	0	2009	SCAN Health Plan	SCAN Classic - Ventura		2	2				2						(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	www.scanhealthplan.com
H5425	003	0	1	01	01	H5425_003_0	10	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H5425	003	0	2009	SCAN Health Plan	SCAN Classic - Kern		2	2				2						(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	www.scanhealthplan.com
H5425	004	0	1	01	01	H5425_004_0	11	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H5425	004	0	2009	SCAN Health Plan	SCAN Signature - San Diego		2	2				2						(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	www.scanhealthplan.com
H5425	005	0	1	01	01	H5425_005_0	11	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H5425	005	0	2009	SCAN Health Plan	SCAN Classic - San Diego		2	2				2						(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	www.scanhealthplan.com
H5425	006	0	1	01	01	H5425_006_0	8	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H5425	006	0	2009	SCAN Health Plan	SCAN Classic - Los Angeles		2	2				2						(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	www.scanhealthplan.com
H5425	007	0	1	01	01	H5425_007_0	9	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H5425	007	0	2009	SCAN Health Plan	SCAN Classic - Orange		2	2				2						(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	www.scanhealthplan.com
H5425	008	0	1	01	01	H5425_008_0	8	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H5425	008	0	2009	SCAN Health Plan	SCAN Classic - Riverside		2	2				2						(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	www.scanhealthplan.com
H5425	009	0	1	01	01	H5425_009_0	9	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H5425	009	0	2009	SCAN Health Plan	SCAN Classic - San Bernardino		2	2				2						(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	www.scanhealthplan.com
H5425	010	0	1	01	01	H5425_010_0	9	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H5425	010	0	2009	SCAN Health Plan	SCAN - Los Angeles Medicare-MediCal		2	1	3			2			1	1		(866)-722-6725	(866)-722-6725	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(866)-722-6725	(866)-722-6725	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	www.scanhealthplan.com
H5425	011	0	1	01	01	H5425_011_0	9	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H5425	011	0	2009	SCAN Health Plan	SCAN - Riverside Medicare-MediCal		2	1	3			2			1	1		(866)-722-6725	(866)-722-6725	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(866)-722-6725	(866)-722-6725	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	www.scanhealthplan.com
H5425	012	0	1	01	01	H5425_012_0	9	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H5425	012	0	2009	SCAN Health Plan	SCAN - San Bernardino Medicare-MediCal		2	1	3			2			1	1		(866)-722-6725	(866)-722-6725	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(866)-722-6725	(866)-722-6725	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	www.scanhealthplan.com
H5425	013	0	1	01	01	H5425_013_0	10	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H5425	013	0	2009	SCAN Health Plan	SCAN Options - Los Angeles		2	2				2						(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	www.scanhealthplan.com
H5425	014	0	1	01	01	H5425_014_0	10	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H5425	014	0	2009	SCAN Health Plan	SCAN Options - Orange		2	2				2						(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	www.scanhealthplan.com
H5425	015	0	1	01	01	H5425_015_0	11	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H5425	015	0	2009	SCAN Health Plan	SCAN Options - Riverside		2	2				2						(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	www.scanhealthplan.com
H5425	016	0	1	01	01	H5425_016_0	11	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H5425	016	0	2009	SCAN Health Plan	SCAN Options - San Bernardino		2	2				2						(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	www.scanhealthplan.com
H5425	801	0	1	01	01	H5425_801_0	4	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H5425	801	0	2009	SCAN Employer Group	SCAN Employer Group		1	2				2						(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929									http://www.scanhealthplan.com	www.scanhealthplan.com
H5425	802	0	1	01	01	H5425_802_0	4	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H5425	802	0	2009	SCAN Employer Group	SCAN Employer Group		1	2				2						(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929									http://www.scanhealthplan.com	www.scanhealthplan.com
H5425	803	0	1	01	01	H5425_803_0	4	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H5425	803	0	2009	SCAN Employer Group	SCAN Employer Group		1	2				2						(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	www.scanhealthplan.com
H5425	804	0	1	01	01	H5425_804_0	4	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H5425	804	0	2009	SCAN Employer Group	SCAN Employer Group		1	2				2						(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	www.scanhealthplan.com
H5426	001	0	1	02	01	H5426_001_0	8	2009.01	METCARE HEALTH PLANS, INC.	AdvantageCare	www.advantagecare.com	01	02		1		H5426	001	0	2009	AdvantageCare Choice	Treasure Coast Market		2	2				2						(877)-874-1234	(877)-874-1234	(800)-955-8771	(800)-955-8771	(877)-692-3822	(877)-692-3822	(800)-955-8771	(800)-955-8771	(877)-874-1234	(877)-874-1234	(800)-955-8771	(800)-955-8771	(877)-692-3822	(877)-692-3822	(800)-955-8771	(800)-955-8771	www.myadvantagecare.com	www.advantagecare.com
H5426	002	0	1	02	01	H5426_002_0	8	2009.01	METCARE HEALTH PLANS, INC.	AdvantageCare	www.advantagecare.com	01	02		1		H5426	002	0	2009	AdvantageCare Choice	Gulf  Coast and Central Markets		2	2				2						(877)-874-1234	(877)-874-1234	(800)-955-8771	(800)-955-8771	(877)-692-3822	(877)-692-3822	(800)-955-8771	(800)-955-8771	(877)-874-1234	(877)-874-1234	(800)-955-8771	(800)-955-8771	(877)-692-3822	(877)-692-3822	(800)-955-8771	(800)-955-8771	www.myadvantagecare.com	www.advantagecare.com
H5426	007	0	1	02	01	H5426_007_0	9	2009.01	METCARE HEALTH PLANS, INC.	AdvantageCare	www.advantagecare.com	01	02		1		H5426	007	0	2009	AdvantageCare Essential	Treasure Coast		2	2				2						(877)-874-1234	(877)-874-1234	(800)-955-8771	(800)-955-8771	(877)-692-3822	(877)-692-3822	(800)-955-8771	(800)-955-8771	(877)-874-1234	(877)-874-1234	(800)-955-8771	(800)-955-8771	(877)-692-3822	(877)-692-3822	(800)-955-8771	(800)-955-8771	www.myadvantagecare.com	www.advantagecare.com
H5426	008	0	1	02	01	H5426_008_0	9	2009.01	METCARE HEALTH PLANS, INC.	AdvantageCare	www.advantagecare.com	01	02		1		H5426	008	0	2009	AdvantageCare Essential	Gulf Coast and Central Markets		2	2				2						(877)-874-1234	(877)-874-1234	(800)-955-8771	(800)-955-8771	(877)-692-3822	(877)-692-3822	(800)-955-8771	(800)-955-8771	(877)-874-1234	(877)-874-1234	(800)-955-8771	(800)-955-8771	(877)-692-3822	(877)-692-3822	(800)-955-8771	(800)-955-8771	www.myadvantagecare.com	www.advantagecare.com
H5426	013	0	1	01	01	H5426_013_0	6	2009.01	METCARE HEALTH PLANS, INC.	AdvantageCare	www.advantagecare.com	01	01		1		H5426	013	0	2009	AdvantageCare Total-Assist	Treasure Coast		2	1	3			2			1	2		(877)-874-1234	(877)-874-1234	(800)-955-8771	(800)-955-8771	(877)-692-3822	(877)-692-3822	(800)-955-8771	(800)-955-8771	(877)-874-1234	(877)-874-1234	(800)-955-8771	(800)-955-8771	(877)-692-3822	(877)-692-3822	(800)-955-8771	(800)-955-8771	www.myadvantagecare.com	www.advantagecare.com
H5426	014	0	1	01	01	H5426_014_0	6	2009.01	METCARE HEALTH PLANS, INC.	AdvantageCare	www.advantagecare.com	01	01		1		H5426	014	0	2009	AdvantageCare Total-Assist	Gulf Coast		2	1	3			2			1	2		(877)-874-1234	(877)-874-1234	(800)-955-8771	(800)-955-8771	(877)-692-3822	(877)-692-3822	(800)-955-8771	(800)-955-8771	(877)-874-1234	(877)-874-1234	(800)-955-8771	(800)-955-8771	(877)-692-3822	(877)-692-3822	(800)-955-8771	(800)-955-8771	www.myadvantagecare.com	www.advantagecare.com
H5426	015	0	1	01	01	H5426_015_0	6	2009.01	METCARE HEALTH PLANS, INC.	AdvantageCare	www.advantagecare.com	01	01		1		H5426	015	0	2009	AdvantageCare Total-Assist	Central Florida Market		2	1	3			2			1	2		(877)-874-1234	(877)-874-1234	(800)-955-8771	(800)-955-8771	(877)-692-3822	(877)-692-3822	(800)-955-8771	(800)-955-8771	(877)-874-1234	(877)-874-1234	(800)-955-8771	(800)-955-8771	(877)-692-3822	(877)-692-3822	(800)-955-8771	(800)-955-8771	www.myadvantagecare.com	www.advantagecare.com
H5427	052	0	1	02	01	H5427_052_0	7	2009.01	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	01	02		1		H5427	052	0	2009	Freedom Savings Plan	Select Counties in Florida		2	2			1867	2						(800)-401-2740	(800)-401-2740	(800)-955-8771		(888)-796-0946	(888)-796-0946	(800)-955-8771										http://www.freedomusa.com/partd.html	http://www.FreedomHealth.com
H5427	053	0	1	02	01	H5427_053_0	11	2009.01	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	01	02		1		H5427	053	0	2009	Freedom Savings Plan Rx	Select Counties in Florida		2	2			709	2						(800)-401-2740	(800)-401-2740	(800)-955-8771		(888)-796-0946	(888)-796-0946	(800)-955-8771		(800)-777-0074	(800)-777-0074	(800)-955-8771		(888)-796-0946	(888)-796-0946	(800)-955-8771		http://www.freedomusa.com/partd.html	http://www.FreedomHealth.com
H5427	054	0	1	02	01	H5427_054_0	11	2009.01	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	01	02		1		H5427	054	0	2009	Freedom Savings Plan Rx	Select Counties in Florida		2	2			9428	2						(800)-401-2740	(800)-401-2740	(800)-955-8771		(888)-796-0946	(888)-796-0946	(800)-955-8771		(800)-777-0074	(800)-777-0074	(800)-955-8771		(888)-796-0946	(888)-796-0946	(800)-955-8771		http://www.freedomusa.com/partd.html	http://www.FreedomHealth.com
H5427	056	0	1	02	01	H5427_056_0	11	2009.01	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	01	02		1		H5427	056	0	2009	Freedom Savings Plan Rx	Select Counties in Florida		2	2			653	2						(800)-401-2740	(800)-401-2740	(800)-955-8771		(888)-796-0946	(888)-796-0946	(800)-955-8771		(800)-777-0074	(800)-777-0074	(800)-955-8771		(888)-796-0946	(888)-796-0946	(800)-955-8771		http://www.freedomusa.com/partd.html	http://www.FreedomHealth.com
H5427	058	0	1	02	01	H5427_058_0	5	2009.01	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	01	02		1		H5427	058	0	2009	Freedom Medicare Plan	Select Counties in Florida		2	2			709	2						(800)-401-2740	(800)-401-2740	(800)-955-8771		(888)-796-0946	(888)-796-0946	(800)-955-8771										http://www.freedomusa.com/partd.html	http://www.FreedomHealth.com
H5427	059	0	1	02	01	H5427_059_0	9	2009.01	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	01	02		1		H5427	059	0	2009	Freedom Medicare Plan Rx	Select Counties in Florida		2	2			607	2						(800)-401-2740	(800)-401-2740	(800)-955-8771		(888)-796-0946	(888)-796-0946	(800)-955-8771		(800)-777-0074	(800)-777-0074	(800)-955-8771		(888)-796-0946	(888)-796-0946	(800)-955-8771		http://www.freedomusa.com/partd.html	http://www.FreedomHealth.com
H5427	060	0	1	02	01	H5427_060_0	9	2009.01	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	01	02		1		H5427	060	0	2009	Freedom Medicare Plan Rx	Select Counties in Florida		2	2			709	2						(800)-401-2740	(800)-401-2740	(800)-955-8771		(888)-796-0946	(888)-796-0946	(800)-955-8771		(800)-777-0074	(800)-777-0074	(800)-955-8771		(888)-796-0946	(888)-796-0946	(800)-955-8771		http://www.freedomusa.com/partd.html	http://www.FreedomHealth.com
H5427	062	0	1	02	01	H5427_062_0	8	2009.01	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	01	02		1		H5427	062	0	2009	Freedom Medicare Plan Rx	Select Counties in Florida		2	2			372	2						(800)-401-2740	(800)-401-2740	(800)-955-8771		(888)-796-0946	(888)-796-0946	(800)-955-8771		(800)-777-0074	(800)-777-0074	(800)-955-8771		(888)-796-0946	(888)-796-0946	(800)-955-8771		http://www.freedomusa.com/partd.html	http://www.FreedomHealth.com
H5427	068	0	1	01	01	H5427_068_0	7	2009.01	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	01	01		1		H5427	068	0	2009	Freedom Medi-Medi Plan	Select Counties in Florida		2	1	3		3520	2			1	2		(800)-401-2740	(800)-401-2740	(800)-955-8771		(888)-796-0946	(888)-796-0946	(800)-955-8771		(800)-777-0074	(800)-777-0074	(800)-955-8771		(888)-796-0946	(888)-796-0946	(800)-955-8771		http://www.freedomusa.com/partd.html	http://www.FreedomHealth.com
H5427	070	0	1	01	01	H5427_070_0	8	2009.01	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	01	01		1		H5427	070	0	2009	Freedom VIP Care	Select Counties in Florida		2	1	4		709	2			1		0000010010000000001000000001	(800)-401-2740	(800)-401-2740	(800)-955-8771		(888)-796-0946	(888)-796-0946	(800)-955-8771		(800)-777-0074	(800)-777-0074	(800)-955-8771		(888)-796-0946	(888)-796-0946	(800)-955-8771		http://www.freedomusa.com/partd.html	http://www.FreedomHealth.com
H5427	072	0	1	01	01	H5427_072_0	11	2009.01	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	01	01		1		H5427	072	0	2009	Freedom VIP Care Savings	Select Counties in Florida		2	1	4		709	2			1		0000010010000000001000000001	(800)-401-2740	(800)-401-2740	(800)-955-8771		(888)-796-0946	(888)-796-0946	(800)-955-8771		(800)-777-0074	(800)-777-0074	(800)-955-8771		(888)-796-0946	(888)-796-0946	(800)-955-8771		http://www.freedomusa.com/partd.html	http://www.FreedomHealth.com
H5427	075	0	1	02	01	H5427_075_0	11	2009.01	FREEDOM HEALTH PLAN, INC.	Freedom Health, Inc.	www.FreedomHealth.com	01	02		1		H5427	075	0	2009	Freedom Choice	Select Counties in Florida		2	2			9428	2						(800)-401-2740	(800)-401-2740	(800)-955-8771		(888)-796-0946	(888)-796-0946	(800)-955-8771		(800)-777-0074	(800)-777-0074	(800)-955-8771		(888)-796-0946	(888)-796-0946	(800)-955-8771		http://www.freedomusa.com/partd.html	http://www.FreedomHealth.com
H5428	001	0	1	01	01	H5428_001_0	3	2009.01	SAN MATEO HEALTH COMMISSION	Health Plan of San Mateo	http://www.hpsm.org/Members.aspx?DocID=276	01	01		1		H5428	001	0	2009	HPSM CareAdvantage	San Mateo County		2	1	3		7200	2			1	1		(650)-616-2174	(866)-880-0606	(800)-735-2929		(650)-616-2174	(866)-880-0606	(800)-735-2929		(650)-616-2174	(866)-880-0606	(800)-735-2929		(650)-616-2174	(866)-880-0606	(800)-735-2929		http://www.hpsm.org/Members.aspx/139.htm	www.hpsm.org
H5429	001	0	1	04	01	H5429_001_0	11	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	www.univhc.com	01	04		1		H5429	001	0	2009	Medicare Masterpiece PPO	Tampa Bay, Hernando, Manatee, Sarasota, Polk		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_ppo.asp	www.univhc.com
H5429	005	0	1	04	01	H5429_005_0	10	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	www.univhc.com	01	04		1		H5429	005	0	2009	Medicare Masterpiece PPO	Capitol and Central Florida		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_ppo.asp	www.univhc.com
H5429	015	0	1	04	01	H5429_015_0	10	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	www.univhc.com	01	04		1		H5429	015	0	2009	Medicare Masterpiece PPO	Brevard County		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_ppo.asp	www.univhc.com
H5429	020	0	1	04	01	H5429_020_0	11	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	www.univhc.com	01	04		1		H5429	020	0	2009	Medicare Masterpiece PPO	Charlotte, Lee and Collier Counties		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_ppo.asp	www.univhc.com
H5429	053	0	1	04	01	H5429_053_0	8	2009.01	UNIVERSAL HEALTH CARE, INC.	Universal Health Care, Inc.	www.univhc.com	01	04		1		H5429	053	0	2009	Medicare Masterpiece MA Only PPO	Tampa Bay Counties		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177									http://www.univhc.com/Formulary/Plans_ppo.asp	www.univhc.com
H5430	001	0	1	01	01	H5430_001_0	4	2009.01	CARE1ST HEALTH PLAN OF ARIZONA	ONECare by Care1st Health Plan Of Arizona	www.care1st.com/az	01	01		1		H5430	001	0	2009	ONECare by Care1st Health Plan Arizona	County: Maricopa		2	1	3		1500	2			1	2		(602)-778-8345	(877)-778-1855	(800)-367-8939	(800)-367-8939	(602)-778-8340	(877)-778-1855	(800)-367-8939	(800)-367-8939	(602)-778-8345	(877)-778-1855	(800)-367-8939	(800)-367-8939	(602)-778-8340	(877)-778-1855	(800)-367-8939	(800)-367-8939	http://64.3.118.5/az/http://64.3.118.5/az/healthplans/onecare.asp?section=ONECare	http://64.3.118.5/az/healthplans/onecare.asp?section=ONECare
H5431	001	0	1	01	01	H5431_001_0	7	2009.01	HEALTHSUN HEALTH PLANS, INC.	HealthSun Health Plans, Inc.	www.health-sun.com	01	01		1		H5431	001	0	2009	SunPlus Advantage Plan	Miami-Dade		2	2			2945	2						(305)-234-9292	(877)-207-4900	(877)-206-0500		(305)-234-9292	(877)-207-4900	(877)-206-0500	(877)-206-0500	(305)-234-9292	(877)-207-4900	(877)-206-0500	(877)-206-0500	(305)-234-9292	(877)-207-4900	(877)-206-0500	(877)-206-0500	www.health-sun.com	
H5431	002	0	1	01	01	H5431_002_0	6	2009.01	HEALTHSUN HEALTH PLANS, INC.	HealthSun Health Plans, Inc.	www.health-sun.com	01	01		1		H5431	002	0	2009	SunPlus Advantage Plan	Broward		2	2			279	2						(305)-234-9292	(877)-207-4900	(877)-206-0500		(305)-234-9292	(877)-207-4900	(877)-206-0500	(877)-206-0500	(305)-234-9292	(877)-207-4900	(877)-206-0500	(877)-206-0500	(305)-234-9292	(877)-207-4900	(877)-206-0500	(877)-206-0500	www.health-sun.com	
H5431	005	0	1	01	01	H5431_005_0	8	2009.01	HEALTHSUN HEALTH PLANS, INC.	HealthSun Health Plans, Inc.	www.Healthsun.com	01	01		1		H5431	005	0	2009	Healthy Advantage Plan	Miami-Dade		2	2			250	2						(305)-234-9292	(877)-207-4900	(877)-206-0500		(305)-234-9292	(877)-207-4900	(877)-206-0500	(877)-206-0500	(305)-234-9292	(877)-207-4900	(877)-206-0500	(877)-206-0500	(305)-234-9292	(877)-207-4900	(877)-206-0500	(877)-206-0500	www.health-sun.com	
H5433	001	0	1	01	01	H5433_001_0	5	2009.01	ORANGE COUNTY HEALTH AUTHORITY	OneCare	www.caloptima.org	01	01		1		H5433	001	0	2009	OneCare	OneCare (serves only Orange County)		2	1	3		8000	2			1	1		(877)-412-2734	(877)-412-2734	(714)-246-8496		(877)-412-2734	(877)-412-2734	(714)-246-8496		(877)-412-2734	(877)-412-2734	(714)-246-8496		(877)-412-2734	(877)-412-2734	(714)-246-8496		http://www.caloptima.org/onecare/documents/ocRXDrugFormulary.pdf	www.caloptima.org
H5434	001	0	1	04	01	H5434_001_0	7	2009.01	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.bcbsfl.com	01	04		1		H5434	001	0	2009	BlueMedicare PPO	Broward and Palm Beach Counties		2	2				2						(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	www.myrxassistant.com	www.bcbsfl.com
H5434	002	0	1	04	01	H5434_002_0	5	2009.01	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.bcbsfl.com	01	04		1		H5434	002	0	2009	BlueMedicare PPO	Hillsborough, Pinellas and Pasco Counties		2	2				2						(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	www.myrxassistant.com	www.bcbsfl.com
H5434	014	0	1	04	01	H5434_014_0	6	2009.01	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.bcbsfl.com	01	04		1		H5434	014	0	2009	BlueMedicare PPO	Lee, Manatee and Sarasota Counties		2	2				2						(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	www.myrxassistant.com	www.bcbsfl.com
H5434	015	0	1	04	01	H5434_015_0	5	2009.01	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.bcbsfl.com	01	04		1		H5434	015	0	2009	BlueMedicare PPO	Escambia, Highlands, and Polk Counties		2	2				2						(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	www.myrxassistant.com	www.bcbsfl.com
H5434	016	0	1	04	01	H5434_016_0	5	2009.01	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.bcbsfl.com	01	04		1		H5434	016	0	2009	BlueMedicare PPO	Marion County		2	2				2						(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	www.myrxassistant.com	www.bcbsfl.com
H5434	018	0	1	04	01	H5434_018_0	5	2009.01	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.bcbsfl.com	01	04		1		H5434	018	0	2009	BlueMedicare PPO	Alachua, Charlotte, Col, Hern, Oka, Osc Counties		2	2				2						(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	www.myrxassistant.com	www.bcbsfl.com
H5434	801	0	1	04	01	H5434_801_0	5	2009.01	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.bcbsfl.com	01	04		1		H5434	801	0	2009	BlueMedicare Group PPO	State of Florida		1	2				2						(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	www.myrxassistant.com	www.bcbsfl.com
H5434	802	0	1	04	01	H5434_802_0	5	2009.01	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.bcbsfl.com	01	04		1		H5434	802	0	2009	BlueMedicare Group PPO	State of Florida		1	2				2						(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	www.myrxassistant.com	www.bcbsfl.com
H5434	803	0	1	04	01	H5434_803_0	5	2009.01	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.bcbsfl.com	01	04		1		H5434	803	0	2009	BlueMedicare Group PPO	State of Florida		1	2				2						(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339									www.myrxassistant.com	www.bcbsfl.com
H5434	804	0	1	04	01	H5434_804_0	6	2009.01	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.bcbsfl.com	01	04		1		H5434	804	0	2009	BlueMedicare Group PPO	National PPO		1	2				2						(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	www.myrxassistant.com	www.bcbsfl.com
H5434	805	0	1	04	01	H5434_805_0	6	2009.01	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.bcbsfl.com	01	04		1		H5434	805	0	2009	BlueMedicare Group PPO	National PPO		1	2				2						(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	www.myrxassistant.com	www.bcbsfl.com
H5435	001	0	1	09	04	H5435_001_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons MedicareDirect	www.securehorizons.com	04	09	2	1		H5435	001	0	2009	SecureHorizons MedicareDirect Plan 1	Select counties nationwide		2	2				2						(866)-579-8774	(866)-579-8774	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074										https://www.securehorizons.com/ourplans/searchformulary.html	
H5435	002	0	1	09	04	H5435_002_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons MedicareDirect	www.securehorizons.com	04	09	2	1		H5435	002	0	2009	SecureHorizons MedicareDirect Plan 2	Select counties nationwide		2	2				2						(866)-579-8774	(866)-579-8774	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074										https://www.securehorizons.com/ourplans/searchformulary.html	
H5435	003	0	1	09	04	H5435_003_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons MedicareDirect	www.securehorizons.com	04	09	2	1		H5435	003	0	2009	SecureHorizons MedicareDirect Plan 3	Select counties nationwide		2	2				2						(866)-579-8774	(866)-579-8774	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074										https://www.securehorizons.com/ourplans/searchformulary.html	
H5435	013	0	1	09	04	H5435_013_0	6	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons MedicareDirect	www.securehorizons.com	04	09	2	1		H5435	013	0	2009	SecureHorizons MedicareDirect Rx Plan 54	Select counties nationwide		2	2				2						(866)-579-8774	(866)-579-8774	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		(866)-579-8774	(866)-579-8774	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	
H5435	014	0	1	09	04	H5435_014_0	6	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons MedicareDirect	www.securehorizons.com	04	09	2	1		H5435	014	0	2009	SecureHorizons MedicareDirect Rx Plan 51	Select counties nationwide		2	2				2						(866)-579-8774	(866)-579-8774	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		(866)-579-8774	(866)-579-8774	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	
H5435	017	0	1	09	04	H5435_017_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons MedicareDirect	www.securehorizons.com	04	09	2	1		H5435	017	0	2009	SecureHorizons MedicareDirect Plan 1A	Select counties nationwide		2	2				2						(866)-579-8774	(866)-579-8774	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074										https://www.securehorizons.com/ourplans/searchformulary.html	
H5435	018	0	1	09	04	H5435_018_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons MedicareDirect	www.securehorizons.com	04	09	2	1		H5435	018	0	2009	SecureHorizons MedicareDirect Plan 5	Select counties nationwide		2	2				2						(866)-579-8774	(866)-579-8774	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074										https://www.securehorizons.com/ourplans/searchformulary.html	
H5435	019	0	1	09	04	H5435_019_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons MedicareDirect	www.securehorizons.com	04	09	2	1		H5435	019	0	2009	SecureHorizons MedicareDirect Plan 6	Select counties nationwide		2	2				2						(866)-579-8774	(866)-579-8774	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074										https://www.securehorizons.com/ourplans/searchformulary.html	
H5435	020	0	1	09	04	H5435_020_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons MedicareDirect	www.securehorizons.com	04	09	2	1		H5435	020	0	2009	SecureHorizons MedicareDirect Plan 100	Select counties nationwide		2	2				2						(866)-579-8774	(866)-579-8774	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074										https://www.securehorizons.com/ourplans/searchformulary.html	
H5435	022	0	1	09	04	H5435_022_0	6	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons MedicareDirect	www.securehorizons.com	04	09	2	1		H5435	022	0	2009	SecureHorizons MedicareDirect Rx Plan 51A	Select States		2	2				2						(866)-579-8774	(866)-579-8774	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		(866)-579-8774	(866)-579-8774	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	
H5435	023	0	1	09	04	H5435_023_0	7	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons MedicareDirect	www.securehorizons.com	04	09	2	1		H5435	023	0	2009	SecureHorizons MedicareDirect Rx Plan 53	Select States		2	2				2						(866)-579-8774	(866)-579-8774	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		(866)-579-8774	(866)-579-8774	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	
H5435	024	0	1	09	04	H5435_024_0	7	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons MedicareDirect	www.securehorizons.com	04	09	2	1		H5435	024	0	2009	SecureHorizons MedicareDirect Rx Plan 55	Select States		2	2				2						(866)-579-8774	(866)-579-8774	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		(866)-579-8774	(866)-579-8774	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	
H5435	025	0	1	09	04	H5435_025_0	6	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons MedicareDirect	www.securehorizons.com	04	09	2	1		H5435	025	0	2009	SecureHorizons MedicareDirect Rx Plan 56	Select States		2	2				2						(866)-579-8774	(866)-579-8774	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		(866)-579-8774	(866)-579-8774	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	
H5435	027	0	1	09	04	H5435_027_0	6	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons MedicareDirect	www.securehorizons.com	04	09	2	1		H5435	027	0	2009	SecureHorizons MedicareDirect Rx Plan 150	Select States		2	2				2						(866)-579-8774	(866)-579-8774	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		(866)-579-8774	(866)-579-8774	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	
H5435	030	0	1	09	04	H5435_030_0	6	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons MedicareDirect	www.securehorizons.com	04	09	2	1		H5435	030	0	2009	SecureHorizons MedicareDirect Rx Plan 58	Select States		2	2				2						(866)-579-8774	(866)-579-8774	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		(866)-579-8774	(866)-579-8774	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	
H5435	849	0	1	09	04	H5435_849_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons MedicareDirect	www.securehorizons.com	04	09	2	1		H5435	849	0	2009	SecureHorizons MedicareDirect Retiree Plan	EGHP PFFS National Service Area		1	2				2						(866)-525-6437	(866)-525-6437	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074										https://www.securehorizons.com/ourplans/searchformulary.html	
H5435	850	0	1	09	04	H5435_850_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons MedicareDirect	www.securehorizons.com	04	09	2	1		H5435	850	0	2009	SecureHorizons MedicareDirect Retiree Plan	EGHP PFFS National Service Area		1	2				2						(866)-525-6437	(866)-525-6437	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074										https://www.securehorizons.com/ourplans/searchformulary.html	
H5435	869	0	1	09	04	H5435_869_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons MedicareDirect	www.securehorizons.com	04	09	2	1		H5435	869	0	2009	SecureHorizons MedicareDirect Retiree Plan	EGHP PFFS National Service Area		1	2				2						(866)-525-6437	(866)-525-6437	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		(866)-525-6437	(866)-525-6437	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	
H5435	870	0	1	09	04	H5435_870_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons MedicareDirect	www.securehorizons.com	04	09	2	1		H5435	870	0	2009	SecureHorizons MedicareDirect Retiree Plan	EGHP PFFS National Service Area		1	2				2						(866)-525-6437	(866)-525-6437	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		(866)-525-6437	(866)-525-6437	(888)-685-8480		(800)-555-5757	(800)-555-5757	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	
H5436	001	0	1	04	01	H5436_001_0	8	2009.01	AVMED, INC.	AvMed Medicare Preferred PPO	www.avmed.org	01	04		1		H5436	001	0	2009	AvMed Medicare Preferred PPO	Dade County Local PPO		2	2			62	2						(800)-782-8633		(877)-442-8633		(800)-250-9243		(877)-442-8633		(800)-782-8633	(800)-782-8633	(877)-442-8633		(800)-250-9243	(800)-250-9243	(877)-442-8633		http://www.avmed.org/medicare/drug-list.asp	www.avmed.org
H5436	002	0	1	04	01	H5436_002_0	8	2009.01	AVMED, INC.	AvMed Medicare Preferred PPO	www.avmed.org	01	04		1		H5436	002	0	2009	AvMed Medicare Preferred PPO	Broward County Local PPO		2	2			31	2						(800)-782-8633		(877)-442-8633		(800)-250-9243		(877)-442-8633		(800)-782-8633	(800)-782-8633	(877)-442-8633		(800)-250-9243	(800)-250-9243	(877)-442-8633		http://www.avmed.org/medicare/drug-list.asp	www.avmed.org
H5437	001	0	1	04	01	H5437_001_0	7	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5437	001	0	2009	Aetna Golden Choice Standard Plan	Jacksonville, Orlando, Tampa, and Surrounding Co.		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5437	003	0	1	04	01	H5437_003_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5437	003	0	2009	Aetna Golden Choice Standard Plan	Broward and Palm Beach Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5437	004	0	1	04	01	H5437_004_0	7	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5437	004	0	2009	Aetna Golden Choice Premier Plan	Broward and Palm Beach Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5437	005	0	1	04	01	H5437_005_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5437	005	0	2009	Aetna Golden Choice Premier Plan	Jacksonville, Orlando, Tampa, and Surrounding Co.		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5437	006	0	1	04	01	H5437_006_0	7	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5437	006	0	2009	Aetna Golden Choice Standard Plan	Miami-Dade County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5437	007	0	1	04	01	H5437_007_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5437	007	0	2009	Aetna Golden Choice Premier Plan	Miami-Dade County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5437	801	0	1	04	01	H5437_801_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5437	801	0	2009	Aetna Golden Choice Plan	Florida		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5437	802	0	1	04	01	H5437_802_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5437	802	0	2009	Aetna Golden Choice Plan w/Rx CY	Florida		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5437	804	0	1	04	01	H5437_804_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5437	804	0	2009	Aetna Golden Choice Plan w/RX NCY	Florida		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5439	001	0	1	04	01	H5439_001_0	5	2009.01	HEALTH NET LIFE INSURANCE COMPANY	Health Net Life Insurance Company	www.healthnet.com	01	04		1		H5439	001	0	2009	Health Net Medicare Advantage PPO with Rx	San Diego county		2	2			550	2						(800)-960-4638	(800)-960-4638	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	(800)-960-4638	(800)-960-4638	(800)-929-9955	(800)-929-9955	(800)-935-6565	(800)-935-6565	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H5440	001	0	1	01	01	H5440_001_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Evercare Health Plans	www.EvercareHealthPlans.com	01	01		1		H5440	001	0	2009	Evercare Plan DH	Orlando and Tampa areas plus Broward County		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		http://evercarehealthplans.com/prescription_drug_coverage.jsp	www.EvercareHealthPlans.com
H5449	001	0	1	04	01	H5449_001_0	6	2009.01	DAVITA VILLAGE HEALTH, INC.	DaVita VillageHealth of Virginia, Inc.	www.villagehealth.com	01	04		1		H5449	001	0	2009	DaVita VillageHealth, Inc.	Northern Virginia area		2	1	4		43	2			1		0000000000000000000000000100	(866)-838-1962	(866)-838-1962	(000)-000-0711		(866)-838-1962	(866)-838-1962	(000)-000-0711		(866)-838-1962	(866)-838-1962	(000)-000-0711		(866)-838-1962	(866)-838-1962	(000)-000-0711		www.villagehealth.com	www.villagehealth.com
H5470	002	0	1	04	01	H5470_002_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5470	002	0	2009	HumanaChoicePPO  PPO H5470-002	Allegan, Calhoun, Kalamazoo, Van Buren		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	www.humana-medicare.com/member/tools/prescription_tools/medicare_drug_list.asp	
H5470	801	0	1	04	01	H5470_801_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5470	801	0	2009	Humana Employer Sponsored	Kalamazoo and Battle Creek Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	www.humana-medicare.com/member/tools/prescription_tools/medicare_drug_list.asp	
H5470	802	0	1	04	01	H5470_802_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5470	802	0	2009	Humana Employer Sponsored	Kalamazoo and Battle Creek Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									www.humana-medicare.com/member/tools/prescription_tools/medicare_drug_list.asp	
H5470	803	0	1	04	01	H5470_803_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5470	803	0	2009	Humana Employer Sponsored Non-CY	Kalamazoo and Battle Creek Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	www.humana-medicare.com/member/tools/prescription_tools/medicare_drug_list.asp	
H5470	804	0	1	04	01	H5470_804_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5470	804	0	2009	Humana Employer Sponsored Non-CY	Kalamazoo and Battle Creek Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									www.humana-medicare.com/member/tools/prescription_tools/medicare_drug_list.asp	
H5485	001	0	1	09	04	H5485_001_0	11	2009.01	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	04	09	2	1		H5485	001	0	2009	PrimeTime Health Plan Prime PFFS Select	Tusc, Wayne, Holmes, Carroll, Colum, Summit		2	2			50	2						(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	https://www.aultcare.com/pls/portal30/docs/folder/Medicare_RX/formulary.pdf	
H5485	801	0	1	09	04	H5485_801_0	6	2009.01	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	04	09	2	1		H5485	801	0	2009	EGHP Prime PFFS Select	All Ohio Counties		1	2			3000	2						(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	https://www.aultcare.com/pls/portal30/docs/folder/Medicare_RX/formulary.pdf	
H5485	802	0	1	09	04	H5485_802_0	6	2009.01	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	04	09	2	1		H5485	802	0	2009	EGHP Prime PFFS Select - Non CY	All Ohio Counties		1	2			0	2						(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	https://www.aultcare.com/pls/portal30/docs/folder/Medicare_RX/formulary.pdf	
H5485	803	0	1	09	04	H5485_803_0	6	2009.01	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	04	09	2	1		H5485	803	0	2009	Prime PFFS Select / EGHP MA Only - CY	All Ohio Counties		1	2			0	2						(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446									https://www.aultcare.com/pls/portal30/docs/folder/Medicare_RX/formulary.pdf	
H5485	804	0	1	09	04	H5485_804_0	5	2009.01	MCKINLEY LIFE INSURANCE COMPANY	PrimeTime Health Plan	www.primetimehealthplan.com	04	09	2	1		H5485	804	0	2009	Prime PFFS Select EGHP - Non CY	All Ohio Counties		1	2			0	2						(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446	(330)-363-7407	(800)-577-5084	(330)-580-6460	(800)-617-7446									https://www.aultcare.com/pls/portal30/docs/folder/Medicare_RX/formulary.pdf	
H5501	001	0	1	04	01	H5501_001_0	11	2009.01	TENET CHOICES, INC. / PEOPLES HEALTH NETWORK	Peoples Health	www.peopleshealth.com	01	04		1		H5501	001	0	2009	HealthCare Select	New Orleans Metro area		2	2			800	2						(504)-849-4500	(800)-631-8443	(866)-654-9800	(866)-654-9800	(504)-849-4500	(800)-631-8443	(866)-654-9800	(866)-654-9800	(504)-849-4500	(800)-631-8443	(866)-654-9800	(866)-654-9800	(504)-849-4500	(800)-631-8443	(866)-654-9800	(866)-654-9800	www.peopleshealth.com/formulary	www.peopleshealth.com
H5507	001	0	1	04	01	H5507_001_0	4	2009.01	UNITED HEALTHCARE INS. COMPANY, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H5507	001	0	2009	AARP MedicareComplete Choice	St. Louis Area counties		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5508	001	0	1	04	01	H5508_001_0	4	2009.01	ADVANTAGE HEALTH SOLUTIONS, INC.	Advantage Health Solutions, Inc.	www.advpreferredplus.com	01	04		1		H5508	001	0	2009	ADVANTAGE Preferred Plus Part D Enhanced	Central Indiana, Allen and St. Joseph Counties		2	2				2						(317)-573-7950	(800)-523-7533	(800)-743-3333	(800)-743-3333	(800)-201-8342	(800)-201-8342	(800)-579-4990	(800)-579-4990	(866)-533-3633	(866)-533-3633	(866)-547-0773	(866)-547-0773	(800)-201-8342	(800)-201-8342	(800)-579-4990	(800)-579-4990	http://www.advantageplan.com/	www.advpreferredplus.com
H5508	002	0	1	04	01	H5508_002_0	2	2009.01	ADVANTAGE HEALTH SOLUTIONS, INC.	Advantage Health Solutions, Inc.	www.advpreferredplus.com	01	04		1		H5508	002	0	2009	ADVANTAGE Preferred Plus	Central Indiana, Allen and St. Joseph Counties		2	2				2						(317)-573-7950	(800)-523-7533	(800)-743-3333	(800)-743-3333	(800)-201-8342	(800)-201-8342	(800)-579-4990	(800)-579-4990									http://www.advantageplan.com/	www.advpreferredplus.com
H5508	003	0	1	04	01	H5508_003_0	4	2009.01	ADVANTAGE HEALTH SOLUTIONS, INC.	Advantage Health Solutions, Inc.	www.advpreferredplus.com	01	04		1		H5508	003	0	2009	ADVANTAGE Preferred Plus Part D Basic	Central Indiana, Allen and St. Joseph's Counties		2	2				2						(317)-573-7950	(800)-523-7533	(800)-743-3333	(800)-743-3333	(800)-201-8342	(800)-201-8342	(800)-579-4990	(800)-579-4990	(866)-533-3633	(866)-533-3633	(866)-547-0773	(866)-547-0773	(800)-201-8342	(800)-201-8342	(800)-579-4990	(800)-579-4990	http://www.advantageplan.com/	www.advpreferredplus.com
H5508	801	0	1	04	01	H5508_801_0	3	2009.01	ADVANTAGE HEALTH SOLUTIONS, INC.	Advantage Health Solutions, Inc.	www.advpreferredplus.com	01	04		1		H5508	801	0	2009	ADVANTAGE Preferred Plus Employer	Indiana		1	2				2						(317)-573-7950	(800)-523-7533	(800)-743-3333	(800)-743-3333	(800)-201-8342	(800)-201-8342	(800)-579-4990	(800)-579-4990	(866)-533-3633	(866)-533-3633	(866)-547-0773	(866)-547-0773	(800)-201-8342	(800)-201-8342	(800)-579-4990	(800)-579-4990	http://www.advantageplan.com/	www.advpreferredplus.com
H5509	001	0	1	04	01	H5509_001_0	7	2009.01	COVENTRY HEALTH AND LIFE INS. COMPANY	Coventry Health And Life Ins. Company	www.kc.chcadvantra.com	01	04		1		H5509	001	0	2009	Advantra Freedom	Kansas City Metro Area		2	2			9000	2						(800)-727-9712	(800)-727-9712	(866)-347-2459	(866)-347-2459	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	(866)-294-9803	(866)-294-9803	(866)-236-1069	(866)-236-1069	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	www.kc.chcadvantra.com	
H5509	003	0	1	04	01	H5509_003_0	6	2009.01	COVENTRY HEALTH AND LIFE INS. COMPANY	Coventry Health And Life Ins. Company	www.kc.chcadvantra.com	01	04		1		H5509	003	0	2009	Advantra Freedom	Wichita Metro Area		2	2			1200	2						(800)-727-9712	(800)-727-9712	(866)-347-2459	(866)-347-2459	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	(866)-294-9803	(866)-294-9803	(866)-236-1069	(866)-236-1069	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	www.kc.chcadvantra.com	
H5509	004	0	1	04	01	H5509_004_0	7	2009.01	COVENTRY HEALTH AND LIFE INS. COMPANY	Coventry Health And Life Ins. Company	www.kc.chcadvantra.com	01	04		1		H5509	004	0	2009	AdvantraExtra - Diabetes	Kansas City Metro Area		2	1	4		600	2			1		0000000010000000000000000000	(800)-727-9712	(800)-727-9712	(866)-347-2459	(866)-347-2459	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	(866)-294-9803	(866)-294-9803	(866)-236-1069	(866)-236-1069	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	www.kc.chcadvantra.com	
H5509	005	0	1	04	01	H5509_005_0	6	2009.01	COVENTRY HEALTH AND LIFE INS. COMPANY	Coventry Health And Life Ins. Company	www.kc.chcadvantra.com	01	04		1		H5509	005	0	2009	AdvantraExtra - Diabetes	Wichita Metro Area		2	1	4		300	2			1		0000000010000000000000000000	(800)-727-9712	(800)-727-9712	(866)-347-2459	(866)-347-2459	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	(866)-294-9803	(866)-294-9803	(866)-236-1069	(866)-236-1069	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	www.kc.chcadvantra.com	
H5509	006	0	1	04	01	H5509_006_0	8	2009.01	COVENTRY HEALTH AND LIFE INS. COMPANY	Coventry Health And Life Ins. Company	www.kc.chcadvantra.com	01	04		1		H5509	006	0	2009	AdvantraExtra - Diabetes	Southwest Missouri - Joplin		2	1	4		200	2			1		0000000010000000000000000000	(800)-727-9712	(800)-727-9712	(866)-347-2459	(866)-347-2459	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	(866)-294-9803	(866)-294-9803	(866)-236-1069	(866)-236-1069	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	www.kc.chcadvantra.com	
H5509	007	0	1	04	01	H5509_007_0	7	2009.01	COVENTRY HEALTH AND LIFE INS. COMPANY	Coventry Health And Life Ins. Company	www.kc.chcadvantra.com	01	04		1		H5509	007	0	2009	AdvantraExtra - Cholesterol	Kansas City Metro Area		2	1	4		150	2			1		0000000001000000000000000000	(800)-727-9712	(800)-727-9712	(866)-347-2459	(866)-347-2459	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	(866)-294-9803	(866)-294-9803	(866)-236-1069	(866)-236-1069	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	www.kc.chcadvantra.com	
H5509	008	0	1	04	01	H5509_008_0	7	2009.01	COVENTRY HEALTH AND LIFE INS. COMPANY	Coventry Health And Life Ins. Company	www.kc,chcadvantra.com	01	04		1		H5509	008	0	2009	Advantra Extra - Cholesterol	Wichita Metro Area		2	1	4		200	2			1		0000000001000000000000000000	(800)-727-9712	(800)-727-9712	(866)-347-2459	(866)-347-2459	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	(866)-294-9803	(866)-294-9803	(866)-236-1069	(866)-236-1069	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	www.kc.chcadvantra.com	
H5509	009	0	1	04	01	H5509_009_0	9	2009.01	COVENTRY HEALTH AND LIFE INS. COMPANY	Coventry Health And Life Ins. Company	www.kc.chcadvantra.com	01	04		1		H5509	009	0	2009	AdvantraExtra - Cholesterol	Southwest Missouri - Joplin		2	1	4		150	2			1		0000000001000000000000000000	(800)-727-9712	(800)-727-9712	(866)-347-2459	(866)-347-2459	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	(866)-294-9803	(866)-294-9803	(866)-236-1069	(866)-236-1069	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	www.kc.chcadvantra.com	
H5509	010	0	1	04	01	H5509_010_0	7	2009.01	COVENTRY HEALTH AND LIFE INS. COMPANY	Coventry Health And Life Ins. Company	www.kc.chcadvantra.com	01	04		1		H5509	010	0	2009	Advantra Freedom	Southwest Missouri - Joplin		2	2			6000	2						(800)-727-9712	(800)-727-9712	(866)-347-2459	(866)-347-2459	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	(866)-294-9803	(866)-294-9803	(866)-236-1069	(866)-236-1069	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	www.kc.chcadvantra.com	
H5509	011	0	1	04	01	H5509_011_0	7	2009.01	COVENTRY HEALTH AND LIFE INS. COMPANY	Coventry Health And Life Ins. Company	www.kc.chcadvantra,com	01	04		1		H5509	011	0	2009	Advantra Freedom	Springfield Metro Area		2	2			600	2						(800)-727-9712	(800)-727-9712	(866)-347-2459	(866)-347-2459	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	(866)-294-9803	(866)-294-9803	(866)-236-1069	(866)-236-1069	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	www.kc.chcadvantra.com	
H5509	012	0	1	04	01	H5509_012_0	7	2009.01	COVENTRY HEALTH AND LIFE INS. COMPANY	Coventry Health And Life Ins. Company	www.kc.chcadvantra.com	01	04		1		H5509	012	0	2009	Advantra Freedom	Topeka Metro Area		2	2			200	2						(800)-727-9712	(800)-727-9712	(866)-347-2459	(866)-347-2459	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	(866)-294-9803	(866)-294-9803	(866)-236-1069	(866)-236-1069	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	www.kc.chcadvantra.com	
H5509	013	0	1	04	01	H5509_013_0	6	2009.01	COVENTRY HEALTH AND LIFE INS. COMPANY	Coventry Health And Life Ins. Company	www.kc.chcadvantra.com	01	04		1		H5509	013	0	2009	Advantra Freedom	Kansas City Metro Area		2	2			500	2						(800)-727-9712	(800)-727-9712	(866)-347-2459	(866)-347-2459	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	(866)-294-9803	(866)-294-9803	(866)-236-1069	(866)-236-1069	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	www.kc.chcadvantra.com	
H5509	801	0	1	04	01	H5509_801_0	6	2009.01	COVENTRY HEALTH AND LIFE INS. COMPANY	Coventry Health And Life Ins. Company	www.kc.chcadvantra.com	01	04		1		H5509	801	0	2009	Advantra Freedom Employer Group	Coventry Health and Life Insurance Company		1	2			1000	2						(800)-727-9712	(800)-727-9712	(866)-347-2459	(866)-347-2459	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	(866)-294-9803	(866)-294-9803	(866)-236-1069	(866)-236-1069	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	www.kc.chcadvantra.com	
H5509	802	0	1	04	01	H5509_802_0	6	2009.01	COVENTRY HEALTH AND LIFE INS. COMPANY	Coventry Health And Life Ins. Company	www.kc.chcadvantra.com	01	04		1		H5509	802	0	2009	Advantra Freedom Employer Group	Coventry Health and Life Insurance Company		1	2			1000	2						(800)-727-9712	(800)-727-9712	(866)-347-2459	(866)-347-2459	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459									www.kc.chcadvantra.com	
H5509	803	0	1	04	01	H5509_803_0	6	2009.01	COVENTRY HEALTH AND LIFE INS. COMPANY	Coventry Health And Life Ins. Company	www.kc.chcadvantra.com	01	04		1		H5509	803	0	2009	Advantra Freedom Employer Group	Coventry Health and Life Insurance Company		1	2			1000	2						(800)-727-9712	(800)-727-9712	(866)-347-2459	(866)-347-2459	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	(866)-294-9803	(866)-294-9803	(866)-236-1069	(866)-236-1069	(866)-533-5160	(866)-533-5160	(866)-347-2459	(866)-347-2459	www.kc.chcadvantra.com	
H5510	002	0	1	04	01	H5510_002_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5510	002	0	2009	Aetna Golden Choice Premier Plan	Baltimore and Surrounding Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5510	003	0	1	04	01	H5510_003_0	8	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5510	003	0	2009	Aetna Golden Choice Standard Plan	Baltimore and Surrounding Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5510	005	0	1	04	01	H5510_005_0	8	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5510	005	0	2009	Aetna Golden Choice Standard Plan	Baltimore City		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5510	006	0	1	04	01	H5510_006_0	7	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5510	006	0	2009	Aetna Golden Choice Premier Plan	Baltimore City		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5510	801	0	1	04	01	H5510_801_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5510	801	0	2009	Aetna Golden Choice Plan	Maryland		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5510	802	0	1	04	01	H5510_802_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5510	802	0	2009	Aetna Golden Choice Plan w/Rx CY	Maryland		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5510	804	0	1	04	01	H5510_804_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5510	804	0	2009	Aetna Golden Choice Plan w/RX NCY	Maryland		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5512	001	0	1	04	01	H5512_001_0	7	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5512	001	0	2009	Aetna Golden Choice Standard Plan	Northern New Jersey		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5512	002	0	1	04	01	H5512_002_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5512	002	0	2009	Aetna Golden Choice Premier Plan	Northern New Jersey		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5512	008	0	1	04	01	H5512_008_0	7	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5512	008	0	2009	Aetna Golden Choice Standard Plan	Southern New Jersey		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5512	009	0	1	04	01	H5512_009_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5512	009	0	2009	Aetna Golden Choice Premier Plan	Southern New Jersey		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5512	801	0	1	04	01	H5512_801_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5512	801	0	2009	Aetna Golden Choice Plan	New Jersey		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5512	802	0	1	04	01	H5512_802_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5512	802	0	2009	Aetna Golden Choice Plan w/Rx CY	New Jersey		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5516	001	0	1	04	01	H5516_001_0	5	2009.01	UNITED HEALTHCARE INS. COMPANY, INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H5516	001	0	2009	AARP MedicareComplete Choice	Select North Carolina Counties		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	
H5517	002	0	1	04	01	H5517_002_0	6	2009.01	COVENTRY HEALTH AND LIFE INS. COMPANY	Carelink Advantra PPO	www.wv.chcadvantra.com	01	04		1		H5517	002	0	2009	Advantra Platinum	West Virginia and Eastern Ohio		2	2			816	2						(877)-843-1938	(877)-843-1938	(800)-207-1262		(888)-271-7647	(888)-271-7647	(888)-788-4010	(888)-788-4010	(866)-291-5518	(866)-291-5518	(866)-236-1069	(866)-236-1069	(888)-271-7647	(888)-271-7647	(888)-788-4010		http://www.wv.chcadvantra.com	www.wv.chcadvantra.com
H5517	003	0	1	04	01	H5517_003_0	4	2009.01	COVENTRY HEALTH AND LIFE INS. COMPANY	Carelink Advantra PPO	www.wv.chcadvantra.com	01	04		1		H5517	003	0	2009	Advantra Silver	West Virginia and Eastern Ohio		2	2			345	2						(877)-843-1938	(877)-843-1938	(800)-207-1262		(888)-271-7647	(888)-271-7647	(888)-788-4010	(888)-788-4010	(866)-291-5518	(866)-291-5518	(866)-236-1069	(866)-236-1069	(888)-271-7647	(888)-271-7647	(888)-788-4010		http://www.wv.chcadvantra.com	www.wv.chcadvantra.com
H5517	004	0	1	04	01	H5517_004_0	7	2009.01	COVENTRY HEALTH AND LIFE INS. COMPANY	Carelink Advantra PPO	www.wv.chcadvantra.com	01	04		1		H5517	004	0	2009	AdvantraOne	West Virginia		2	1	3		155	2			1	2		(877)-843-1938	(877)-843-1938	(800)-207-1262		(888)-271-7647	(888)-271-7647	(888)-788-4010	(888)-788-4010	(866)-291-5518	(866)-291-5518	(866)-236-1069	(866)-236-1069	(888)-271-7647	(888)-271-7647	(888)-788-4010		http://www.wv.chcadvantra.com	www.wv.chcadvantra.com
H5517	005	0	1	04	01	H5517_005_0	5	2009.01	COVENTRY HEALTH AND LIFE INS. COMPANY	Carelink Advantra PPO	www.wv.chcadvantra.com	01	04		1		H5517	005	0	2009	Advantra Capital	Capital region		2	2			174	2						(877)-843-1938	(877)-843-1938	(800)-207-1262		(888)-271-7647	(888)-271-7647	(888)-788-4010	(888)-788-4010	(866)-291-5518	(866)-291-5518	(866)-236-1069	(866)-236-1069	(888)-271-7647	(888)-271-7647	(888)-788-4010		http://www.wv.chcadvantra.com	www.wv.chcadvantra.com
H5517	802	0	1	04	01	H5517_802_0	5	2009.01	COVENTRY HEALTH AND LIFE INS. COMPANY	Carelink Advantra PPO	www.wv.chcadvantra.com	01	04		1		H5517	802	0	2009	Advantra PPO MA Employer Group	West Virginia and Eastern Ohio		1	2			1	2						(877)-843-1938	(877)-843-1938	(800)-207-1262		(888)-271-7647	(888)-271-7647	(888)-788-4010	(888)-788-4010									http://www.wv.chcadvantra.com	www.wv.chcadvantra.com
H5517	804	0	1	04	01	H5517_804_0	5	2009.01	COVENTRY HEALTH AND LIFE INS. COMPANY	Carelink Advantra PPO	www.wv.chcadvantra.com	01	04		1		H5517	804	0	2009	Advantra PPO MAPD CY	West Virginia and Eastern Ohio		1	2			1168	2						(877)-843-1938	(877)-843-1938	(800)-207-1262		(888)-271-7647	(888)-271-7647	(888)-788-4010	(888)-788-4010	(866)-291-5518	(866)-291-5518	(866)-236-1069	(866)-236-1069	(888)-271-7647	(888)-271-7647	(888)-788-4010		http://www.wv.chcadvantra.com	www.wv.chcadvantra.com
H5517	805	0	1	04	01	H5517_805_0	5	2009.01	COVENTRY HEALTH AND LIFE INS. COMPANY	Carelink Advantra PPO	www.wv.chcadvantra.com	01	04		1		H5517	805	0	2009	Advantra PPO MAPD NCY	West Virginia and Eastern Ohio		1	2			1	2						(877)-843-1938	(877)-843-1938	(800)-207-1262		(888)-271-7647	(888)-271-7647	(888)-788-4010	(888)-788-4010	(866)-291-5518	(866)-291-5518	(866)-236-1069	(866)-236-1069	(888)-271-7647	(888)-271-7647	(888)-788-4010		http://www.wv.chcadvantra.com	www.wv.chcadvantra.com
H5520	001	0	1	04	01	H5520_001_0	3	2009.01	HEALTH NET LIFE INSURANCE COMPANY	Health Net Medicare Advantage	www.abettercecision.com	01	04		1		H5520	001	0	2009	Health Net Aqua	Portland, Salem, MidVly, OR and Clark WA		2	2				2						(888)-445-8913	(888)-445-8913	(800)-929-9955	(800)-929-9955	(800)-822-7698	(800)-822-7698	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	www.healthnet.com
H5520	002	0	1	04	01	H5520_002_0	6	2009.01	HEALTH NET LIFE INSURANCE COMPANY	Health Net Medicare Advantage	www.abettercecision.com	01	04		1		H5520	002	0	2009	Health Net Violet Option 1	Portland, Salem, MidVly, OR and Clark WA		2	2			14000	2						(888)-445-8913	(888)-445-8913	(800)-929-9955	(800)-929-9955	(800)-822-7698	(800)-822-7698	(800)-929-9955	(800)-929-9955	(888)-445-8913	(888)-445-8913	(800)-929-9955	(800)-929-9955	(800)-822-7698	(800)-822-7698	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	www.healthnet.com
H5520	003	0	1	04	01	H5520_003_0	3	2009.01	HEALTH NET LIFE INSURANCE COMPANY	Health Net Medicare Advantage	www.abettercecision.com	01	04		1		H5520	003	0	2009	Health Net Aqua	Douglas, Jackson and Josephine Counties, OR		2	2				2						(888)-445-8913	(888)-445-8913	(800)-929-9955	(800)-929-9955	(800)-822-7698	(800)-822-7698	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	www.healthnet.com
H5520	004	0	1	04	01	H5520_004_0	5	2009.01	HEALTH NET LIFE INSURANCE COMPANY	Health Net Medicare Advantage	www.abettercecision.com	01	04		1		H5520	004	0	2009	Health Net Violet Option 1	Douglas, Jackson and Josephine Counties, OR		2	2			14000	2						(888)-445-8913	(888)-445-8913	(800)-929-9955	(800)-929-9955	(800)-822-7698	(800)-822-7698	(800)-929-9955	(800)-929-9955	(888)-445-8913	(888)-445-8913	(800)-929-9955	(800)-929-9955	(800)-822-7698	(800)-822-7698	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	www.healthnet.com
H5520	005	0	1	04	01	H5520_005_0	5	2009.01	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	01	04		1		H5520	005	0	2009	Health Net Violet Option 2	Portland, Salem, MidVly, OR and Clark WA		2	2				2						(888)-445-8913	(888)-445-8913	(800)-929-9955	(800)-929-9955	(800)-822-7698	(800)-822-7698	(800)-929-9955	(800)-929-9955	(888)-445-8913	(888)-445-8913	(800)-929-9955	(800)-929-9955	(800)-822-7698	(800)-822-7698	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H5520	006	0	1	04	01	H5520_006_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	01	04		1		H5520	006	0	2009	Health Net Violet Option 2	Douglas, Jackson and Josephine Counties, OR		2	2				2						(888)-445-8913	(888)-445-8913	(800)-929-9955	(800)-929-9955	(800)-822-7698	(800)-822-7698	(800)-929-9955	(800)-929-9955	(888)-445-8913	(888)-445-8913	(800)-929-9955	(800)-929-9955	(800)-822-7698	(800)-822-7698	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
H5520	007	0	1	04	01	H5520_007_0	5	2009.01	HEALTH NET LIFE INSURANCE COMPANY	Health Net Medicare Advantage	www.abettercecision.com	01	04		1		H5520	007	0	2009	Health Net Sage	Portland, Salem, MidVly, OR and Clark WA		2	1	4		14000	2			1		0000000001000000000000000000	(888)-445-8913	(888)-445-8913	(800)-929-9955	(800)-929-9955	(800)-822-7698	(800)-822-7698	(800)-929-9955	(800)-929-9955	(888)-445-8913	(888)-445-8913	(800)-929-9955	(800)-929-9955	(800)-822-7698	(800)-822-7698	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	www.healthnet.com
H5520	008	0	1	04	01	H5520_008_0	5	2009.01	HEALTH NET LIFE INSURANCE COMPANY	Health Net Medicare Advantage	www.abettercecision.com	01	04		1		H5520	008	0	2009	Health Net Sage	Jackson and Josephine Counties, OR		2	1	4		14000	2			1		0000000001000000000000000000	(888)-445-8913	(888)-445-8913	(800)-929-9955	(800)-929-9955	(800)-822-7698	(800)-822-7698	(800)-929-9955	(800)-929-9955	(888)-445-8913	(888)-445-8913	(800)-929-9955	(800)-929-9955	(800)-822-7698	(800)-822-7698	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	www.healthnet.com
H5521	005	0	1	04	01	H5521_005_0	8	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5521	005	0	2009	Aetna Golden Choice Standard Plan	Bucks, Chester, Delaware and Montgomery Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5521	006	0	1	04	01	H5521_006_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5521	006	0	2009	Aetna Golden Choice Premier Plan	Bucks, Chester, Delaware and Montgomery Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5521	008	0	1	04	01	H5521_008_0	7	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5521	008	0	2009	Aetna Golden Choice Standard Plan	Philadelphia County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5521	009	0	1	04	01	H5521_009_0	8	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5521	009	0	2009	Aetna Golden Choice Premier Plan	Philadelphia County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5521	011	0	1	04	01	H5521_011_0	9	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5521	011	0	2009	Aetna Golden Choice Standard Plan	Central and NE PA		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5521	012	0	1	04	01	H5521_012_0	8	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5521	012	0	2009	Aetna Golden Choice Premier Plan	Central and NE PA		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5521	801	0	1	04	01	H5521_801_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5521	801	0	2009	Aetna Golden Choice Plan	Pennsylvania		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5521	802	0	1	04	01	H5521_802_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5521	802	0	2009	Aetna Golden Choice Plan w/Rx CY	Pennsylvania		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5521	804	0	1	04	01	H5521_804_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5521	804	0	2009	Aetna Golden Choice Plan w/ RX NCY	Pennsylvania		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5522	001	0	1	04	01	H5522_001_0	8	2009.01	HEALTH ASSURANCE PENNSYLVANIA, INC.	Advantra PPO	www.chcadvantra.com	01	04		1		H5522	001	0	2009	Advantra PPO Gold	Allegheny County		2	2				2						(800)-290-0190		(800)-207-1262		(800)-470-4272	(800)-470-4272	(800)-207-1262		(866)-291-5221	(866)-291-5221	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.pa.chcadvantra.com/templates/editorial.asp?itemID=13409	www.chcadvantra.com
H5522	002	0	1	04	01	H5522_002_0	7	2009.01	HEALTH ASSURANCE PENNSYLVANIA, INC.	Advantra PPO	www.chcadvantra.com	01	04		1		H5522	002	0	2009	Advantra PPO Gold	Central Pennsylvania		2	2				2						(800)-290-0190		(800)-207-1262		(800)-470-4272		(800)-207-1262		(866)-291-5221	(866)-291-5221	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.pa.chcadvantra.com/templates/editorial.asp?itemID=13409	www.chcadvantra.com
H5522	003	0	1	04	01	H5522_003_0	7	2009.01	HEALTH ASSURANCE PENNSYLVANIA, INC.	Advantra PPO	www.chcadvantra.com	01	04		1		H5522	003	0	2009	Advantra PPO Gold	Western and Northwestern Pennsylvania		2	2				2						(800)-290-0190		(800)-207-1262		(800)-470-4272		(800)-207-1262		(866)-291-5221	(866)-291-5221	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.pa.chcadvantra.com/templates/editorial.asp?itemID=13409	www.chcadvantra.com
H5522	004	0	1	04	01	H5522_004_0	5	2009.01	HEALTH ASSURANCE PENNSYLVANIA, INC.	Advantra PPO	www.chcadvantra.com	01	04		1		H5522	004	0	2009	Advantra PPO Silver	Central Pennsylvania		2	2				2						(800)-290-0190		(800)-207-1262		(800)-470-4272		(800)-207-1262		(866)-291-5221	(866)-291-5221	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.pa.chcadvantra.com/templates/editorial.asp?itemID=13409	www.chcadvantra.com
H5522	005	0	1	04	01	H5522_005_0	5	2009.01	HEALTH ASSURANCE PENNSYLVANIA, INC.	Advantra PPO	www.chcadvantra.com	01	04		1		H5522	005	0	2009	Advantra PPO Silver	Western and Northwestern Pennsylvania		2	2				2						(800)-290-0190		(800)-207-1262		(800)-470-4272		(800)-207-1262		(866)-290-6660	(866)-290-6660	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.pa.chcadvantra.com/templates/editorial.asp?itemID=13409	www.chcadvantra.com
H5522	006	0	1	04	01	H5522_006_0	7	2009.01	HEALTH ASSURANCE PENNSYLVANIA, INC.	Advantra PPO	www.chcadvantra.com	01	04		1		H5522	006	0	2009	Advantra PPO Diamond	Central Pennsylvania		2	2				2						(800)-290-0190		(800)-207-1262		(800)-470-4272		(800)-207-1262		(866)-290-6660	(866)-290-6660	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.pa.chcadvantra.com/templates/editorial.asp?itemID=13409	www.chcadvantra.com
H5522	802	0	1	04	01	H5522_802_0	4	2009.01	HEALTH ASSURANCE PENNSYLVANIA, INC.	Advantra PPO	www.chcadvantra.com	01	04		1		H5522	802	0	2009	Advantra PPO MA Only	Pennsylvania		1	2				2						(800)-290-0190		(800)-207-1262		(800)-470-4272	(800)-470-4272	(800)-207-1262										http://www.pa.chcadvantra.com/templates/editorial.asp?itemID=13409	www.chcadvantra.com
H5522	803	0	1	04	01	H5522_803_0	4	2009.01	HEALTH ASSURANCE PENNSYLVANIA, INC.	Advantra PPO	www.chcadvantra.com	01	04		1		H5522	803	0	2009	Advantra PPO Gold	Pennsylvania		1	2				2						(800)-290-0190		(800)-207-1262		(800)-470-4272	(800)-470-4272	(800)-207-1262		(866)-291-5221	(866)-291-5221	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.pa.chcadvantra.com/templates/editorial.asp?itemID=13409	www.chcadvantra.com
H5522	805	0	1	04	01	H5522_805_0	3	2009.01	HEALTH ASSURANCE PENNSYLVANIA, INC.	Advantra PPO	www.chcadvantra.com	01	04		1		H5522	805	0	2009	Advantra PPO Gold	Pennsylvania		1	2				2						(800)-290-0190		(800)-207-1262		(800)-470-4272	(800)-470-4272	(800)-207-1262		(866)-291-5221	(866)-291-5221	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.pa.chcadvantra.com/templates/editorial.asp?itemID=13409	www.chcadvantra.com
H5523	001	0	1	04	01	H5523_001_0	20	2009.01	CARITEN INSURANCE COMPANY	Cariten Senior Health (PPO)	www.Caritenseniorhealth.com	01	04		1		H5523	001	0	2009	Cariten Senior Health PPO	East Tennessee		2	2			45	2						(865)-470-7735	(888)-817-5838	(865)-470-8409	(800)-396-2150	(865)-470-7750	(888)-285-2599	(865)-470-8409	(800)-396-2150	(865)-470-7735	(888)-817-5838	(865)-470-8409	(800)-396-2150	(865)-470-7750	(888)-285-2599	(865)-470-8409	(800)-396-2150	http://www.caritenseniorhealth.com/cfml/pharmacy/formulary/default.cfm	www.caritenseniorhealth.com
H5525	001	0	1	04	01	H5525_001_0	4	2009.01	OSF HEALTHPLANS, INC.	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5525	001	0	2009	HumanaChoicePPO PPO H5525-001	North and Central Illinois Metro Areas		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5525	002	0	1	04	01	H5525_002_0	3	2009.01	OSF HEALTHPLANS, INC.	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5525	002	0	2009	HumanaChoicePPO PPO H5525-002	North and Central Illinois Metro Areas		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5525	004	0	1	04	01	H5525_004_0	5	2009.01	OSF HEALTHPLANS, INC.	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5525	004	0	2009	HumanaChoicePPO PPO H5525-004	North and Central Illinois Metro Areas		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5525	801	0	1	04	01	H5525_801_0	3	2009.01	OSF HEALTHPLANS, INC.	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5525	801	0	2009	Humana Employer Sponsored	North and Central Illinois Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5525	802	0	1	04	01	H5525_802_0	3	2009.01	OSF HEALTHPLANS, INC.	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5525	802	0	2009	Humana Employer Sponsored	North and Central Illinois Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5525	805	0	1	04	01	H5525_805_0	4	2009.01	OSF HEALTHPLANS, INC.	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5525	805	0	2009	Humana Employer Sponsored Non-CY	North and Central Illinois Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5525	808	0	1	04	01	H5525_808_0	3	2009.01	OSF HEALTHPLANS, INC.	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5525	808	0	2009	Humana Employer Sponsored Non-CY	North and Central Illinois Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5526	001	0	1	04	01	H5526_001_0	8	2009.01	HEALTHNOW NEW YORK INC.	Traditional Blue Medicare PPO	www.bsneny.com	01	04		1		H5526	001	0	2009	Traditional Blue Medicare PPO 701	BlueShield of Northeastern New York		2	2			325	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918									http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com (Western New York) or www.bsneny.com (Northeastern New York)
H5526	002	0	1	04	01	H5526_002_0	7	2009.01	HEALTHNOW NEW YORK INC.	Traditional Blue Medicare PPO	www.bcbswny.com	01	04		1		H5526	002	0	2009	Traditional Blue Medicare PPO 701	BlueCross BlueShield of Western New York		2	2			3150	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710									http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com (Western New York) or www.bsneny.com (Northeastern New York)
H5526	003	0	1	04	01	H5526_003_0	10	2009.01	HEALTHNOW NEW YORK INC.	Traditional Blue Medicare PPO	www.bsneny.com	01	04		1		H5526	003	0	2009	Traditional Blue Medicare PPO 751 PartD	BlueShield of Northeastern New York		2	2			840	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com (Western New York) or www.bsneny.com (Northeastern New York)
H5526	004	0	1	04	01	H5526_004_0	9	2009.01	HEALTHNOW NEW YORK INC.	Traditional Blue Medicare PPO	www.bcbswny.com	01	04		1		H5526	004	0	2009	Traditional Blue Medicare PPO 751 PartD	BlueCross BlueShield of Western New York		2	2			3200	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com (Western New York) or www.bsneny.com (Northeastern New York)
H5526	007	0	1	04	01	H5526_007_0	7	2009.01	HEALTHNOW NEW YORK INC.	Traditional Blue Medicare PPO	www.bsneny.com	01	04		1		H5526	007	0	2009	Traditional Blue Medicare PPO 752 PartD	Northeastern New York		2	2			1350	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com (Western New York) or www.bsneny.com (Northeastern New York)
H5526	008	0	1	04	01	H5526_008_0	9	2009.01	HEALTHNOW NEW YORK INC.	Traditional Blue Medicare PPO	www.bcbswny.com	01	04		1		H5526	008	0	2009	Traditional Blue Medicare PPO 752 PartD	Western New York		2	2			3300	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com (Western New York) or www.bsneny.com (Northeastern New York)
H5526	010	0	1	04	01	H5526_010_0	7	2009.01	HEALTHNOW NEW YORK INC.	Traditional Blue Medicare PPO	www.bcbswny.com	01	04		1		H5526	010	0	2009	Traditional Blue Medicare PPO 755 Part D	Western New York		2	2			500	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-248-9296	(800)-248-9296	(877)-286-5710	(877)-286-5710	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com (Western New York) or www.bsneny.com (Northeastern New York)
H5526	801	0	1	04	01	H5526_801_0	8	2009.01	HEALTHNOW NEW YORK INC.	Traditional Blue Medicare PPO	www.bsneny.com	01	04		1		H5526	801	0	2009	Traditional Blue Medicare PPO Group (MA Only)	Northeastern New York		1	2			3225	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918									http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com (Western New York) or www.bsneny.com (Northeastern New York)
H5526	802	0	1	04	01	H5526_802_0	8	2009.01	HEALTHNOW NEW YORK INC.	Traditional Blue Medicare PPO	www.bsneny.com	01	04		1		H5526	802	0	2009	Traditional Blue Medicare PPO Group (MA-PD)	Northeastern New York		1	2			1625	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918									http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com (Western New York) or www.bsneny.com (Northeastern New York)
H5526	803	0	1	04	01	H5526_803_0	8	2009.01	HEALTHNOW NEW YORK INC.	Traditional Blue Medicare PPO	www.bcbswny.com	01	04		1		H5526	803	0	2009	Traditional Blue Medicare PPO Group (MA only)	Western New York		1	2			3225	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com (Western New York) or www.bsneny.com (Northeastern New York)
H5526	804	0	1	04	01	H5526_804_0	8	2009.01	HEALTHNOW NEW YORK INC.	Traditional Blue Medicare PPO	www.bcbswny.com	01	04		1		H5526	804	0	2009	Traditional Blue Medicare PPO Group (MA-PD)	Western New York		1	2			3225	2						(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	(800)-329-2792	(800)-329-2792	(877)-834-6918	(877)-834-6918	http://www.bcbswny.com/pharmacy  http://www.bsneny.com/pharmacy	www.bcbswny.com (Western New York) or www.bsneny.com (Northeastern New York)
H5528	001	0	1	04	01	H5528_001_0	2	2009.01	GROUP HEALTH INCORPORATED	GHI Medicare Choice PPO	www.ghi.com	01	04		1		H5528	001	0	2009	GHI Medicare PPO I	Counties of New York City		2	2				2						(866)-557-7300		(866)-248-0640		(800)-611-8454		(866)-248-0640										http://www.ghi.com/default.aspx?page=453	
H5528	002	0	1	04	01	H5528_002_0	4	2009.01	GROUP HEALTH INCORPORATED	GHI Medicare Choice PPO	www.ghi.com	01	04		1		H5528	002	0	2009	GHI Medicare PPO II	Counties of NYC		2	2				2						(866)-557-7300		(866)-248-0640		(800)-611-8454		(866)-248-0640		(866)-557-7300	(866)-557-7300			(800)-611-8454	(800)-611-8454			http://www.ghi.com/default.aspx?page=453	
H5528	003	0	1	04	01	H5528_003_0	4	2009.01	GROUP HEALTH INCORPORATED	GHI Medicare Choice PPO	www.ghi.com	01	04		1		H5528	003	0	2009	GHI Medicare PPO III	Counties of NYC		2	2				2						(866)-557-7300		(866)-248-0640		(800)-611-8454		(866)-248-0640		(866)-557-7300	(866)-557-7300			(800)-611-8454	(800)-611-8454			http://www.ghi.com/default.aspx?page=453	
H5528	004	0	1	04	01	H5528_004_0	2	2009.01	GROUP HEALTH INCORPORATED	GHI Medicare Choice PPO	www.ghi.com	01	04		1		H5528	004	0	2009	GHI Medicare PPO I	Hudson Valley and Long Island counties		2	2				2						(866)-557-7300		(866)-248-0640		(800)-611-8454		(866)-248-0640										http://www.ghi.com/default.aspx?page=453	
H5528	005	0	1	04	01	H5528_005_0	3	2009.01	GROUP HEALTH INCORPORATED	GHI Medicare Choice PPO	www.ghi.com	01	04		1		H5528	005	0	2009	GHI Medicare PPO II	Hudson Valley and Long Island counties		2	2				2						(866)-557-7300		(866)-248-0640		(800)-611-8454		(866)-248-0640		(866)-557-7300	(866)-557-7300			(800)-611-8454	(800)-611-8454			http://www.ghi.com/default.aspx?page=453	
H5528	008	0	1	04	01	H5528_008_0	4	2009.01	GROUP HEALTH INCORPORATED	GHI Medicare Choice PPO	www.ghi.com	01	04		1		H5528	008	0	2009	GHI Medicare PPO III	Hudson Valley and Long Island Counties		2	2				2						(866)-557-7300		(866)-248-0640		(800)-611-8454		(866)-248-0640		(866)-557-7300	(866)-557-7300			(800)-611-8454	(800)-611-8454			http://www.ghi.com/default.aspx?page=453	
H5528	009	0	1	04	01	H5528_009_0	2	2009.01	GROUP HEALTH INCORPORATED	GHI Medicare Choice PPO	www.ghi.com	01	04		1		H5528	009	0	2009	GHI Medicare PPO I	Putnam and Suffolk Counties		2	2				2						(866)-557-7300		(866)-248-0640		(800)-611-8454		(866)-248-0640										http://www.ghi.com/default.aspx?page=453	
H5528	010	0	1	04	01	H5528_010_0	3	2009.01	GROUP HEALTH INCORPORATED	GHI Medicare Choice PPO	www.ghi.com	01	04		1		H5528	010	0	2009	GHI Medicare PPO II	Putnam and Suffolk Counties		2	2				2						(866)-557-7300		(866)-248-0640		(800)-611-8454		(866)-248-0640		(866)-557-7300	(866)-557-7300			(800)-611-8454	(800)-611-8454			http://www.ghi.com/default.aspx?page=453	
H5528	011	0	1	04	01	H5528_011_0	4	2009.01	GROUP HEALTH INCORPORATED	GHI Medicare Choice PPO	www.ghi.com	01	04		1		H5528	011	0	2009	GHI Medicare PPO III	Putnam and Suffolk Counties		2	2				2						(866)-557-7300		(866)-248-0640		(800)-611-8454		(866)-248-0640		(866)-557-7300	(866)-557-7300			(800)-611-8454	(800)-611-8454			http://www.ghi.com/default.aspx?page=453	
H5528	012	0	1	04	01	H5528_012_0	4	2009.01	GROUP HEALTH INCORPORATED	GHI Medicare Choice PPO	www.ghi.com	01	04		1		H5528	012	0	2009	GHI Medicare PPO Select	Hudson Valley and Long Island Counties		2	2			750	2						(866)-557-7300		(866)-248-0640		(800)-611-8454		(866)-248-0640		(866)-557-7300	(866)-557-7300			(800)-611-8454	(800)-611-8454			http://www.ghi.com/default.aspx?page=453	
H5528	013	0	1	04	01	H5528_013_0	3	2009.01	GROUP HEALTH INCORPORATED	GHI Medicare Choice PPO	www.ghi.com	01	04		1		H5528	013	0	2009	GHI Medicare PPO Value	Counties of New York City		2	1	3		1200	2			1	3		(866)-557-7300		(866)-248-0640		(800)-611-8454		(866)-248-0640		(866)-557-7300	(866)-557-7300			(800)-611-8454	(800)-611-8454			http://www.ghi.com/default.aspx?page=453	
H5528	014	0	1	04	01	H5528_014_0	3	2009.01	GROUP HEALTH INCORPORATED	GHI Medicare Choice PPO	www.ghi.com	01	04		1		H5528	014	0	2009	GHI Medicare PPO Value	Westchester and Rockland Counties		2	1	3		1000	2			1	3		(866)-557-7300		(866)-248-0640		(800)-611-8454		(866)-248-0640		(866)-557-7300	(866)-557-7300			(800)-611-8454	(800)-611-8454			http://www.ghi.com/default.aspx?page=453	
H5528	015	0	1	04	01	H5528_015_0	4	2009.01	GROUP HEALTH INCORPORATED	GHI Medicare Choice PPO	www.ghi.com	01	04		1		H5528	015	0	2009	GHI Medicare PPO IV	Counties of New York City		2	2				2						(866)-557-7300		(866)-248-0640		(800)-611-8454		(866)-248-0640		(866)-557-7300	(866)-557-7300			(800)-611-8454	(800)-611-8454			http://www.ghi.com/default.aspx?page=453	
H5528	016	0	1	04	01	H5528_016_0	4	2009.01	GROUP HEALTH INCORPORATED	GHI Medicare Choice PPO	www.ghi.com	01	04		1		H5528	016	0	2009	GHI Medicare PPO IV	Hudson Valley and Long Island Counties		2	2				2						(866)-557-7300		(866)-248-0640		(800)-611-8454		(866)-248-0640		(866)-557-7300	(866)-557-7300			(800)-611-8454	(800)-611-8454			http://www.ghi.com/default.aspx?page=453	
H5528	017	0	1	04	01	H5528_017_0	4	2009.01	GROUP HEALTH INCORPORATED	GHI Medicare Choice PPO	www.ghi.com	01	04		1		H5528	017	0	2009	GHI Medicare PPO IV	Putnam and Suffolk Counties		2	2				2						(866)-557-7300		(866)-248-0640		(800)-611-8454		(866)-248-0640		(866)-557-7300	(866)-557-7300			(800)-611-8454	(800)-611-8454			http://www.ghi.com/default.aspx?page=453	
H5528	802	0	1	04	01	H5528_802_0	3	2009.01	GROUP HEALTH INCORPORATED	GHI Medicare Choice PPO	www.ghi.com	01	04		1		H5528	802	0	2009	GHI Medicare NYC Group Access	Counties of New York City		1	2				2						(866)-557-7300		(866)-248-0640		(800)-611-8454		(866)-248-0640										http://www.ghi.com/default.aspx?page=453	
H5528	804	0	1	04	01	H5528_804_0	3	2009.01	GROUP HEALTH INCORPORATED	GHI Medicare Choice PPO	www.ghi.com	01	04		1		H5528	804	0	2009	GHI Medicare NY Group Access	National except NYC, Putnam, NY and Suffolk,NY		1	2				2						(866)-557-7300		(866)-248-0640		(800)-611-8454		(866)-248-0640										http://www.ghi.com/default.aspx?page=453	
H5528	806	0	1	04	01	H5528_806_0	3	2009.01	GROUP HEALTH INCORPORATED	GHI Medicare Choice PPO	www.ghi.com	01	04		1		H5528	806	0	2009	GHI Medicare NYC Group Access Rx	Counties of New York City		1	2				2						(866)-557-7300		(866)-248-0640		(800)-611-8454		(866)-248-0640		(866)-557-7300	(866)-557-7300			(800)-611-8454	(800)-611-8454			http://www.ghi.com/default.aspx?page=453	
H5528	807	0	1	04	01	H5528_807_0	3	2009.01	GROUP HEALTH INCORPORATED	GHI Medicare Choice PPO	www.ghi.com	01	04		1		H5528	807	0	2009	GHI Medicare NY Group Access Rx	National except NYC, Putnam,NY and Suffolk,NY		1	2				2						(866)-557-7300		(866)-248-0640		(800)-611-8454		(866)-248-0640		(866)-557-7300	(866)-557-7300			(800)-611-8454	(800)-611-8454			http://www.ghi.com/default.aspx?page=453	
H5528	809	0	1	04	01	H5528_809_0	2	2009.01	GROUP HEALTH INCORPORATED	GHI Medicare Choice PPO	www.ghi.com	01	04		1		H5528	809	0	2009	GHI Medicare Group Access	Putnam and Suffolk Counties		1	2				2						(866)-557-7300		(866)-248-0640		(800)-611-8454		(866)-248-0640										http://www.ghi.com/default.aspx?page=453	
H5528	810	0	1	04	01	H5528_810_0	2	2009.01	GROUP HEALTH INCORPORATED	GHI Medicare Choice PPO	www.ghi.com	01	04		1		H5528	810	0	2009	GHI Medicare Group Access Rx	Putnam and Suffolk counties		1	2				2						(866)-557-7300		(866)-248-0640		(800)-611-8454		(866)-248-0640		(866)-557-7300	(866)-557-7300			(800)-611-8454	(800)-611-8454			http://www.ghi.com/default.aspx?page=453	
H5529	001	0	1	04	01	H5529_001_0	7	2009.01	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	www.anthem.com	01	04		1		H5529	001	0	2009	Anthem Medicare Preferred Standard	Ohio - Select Counties		2	2			11758	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
H5530	001	0	1	04	01	H5530_001_0	9	2009.01	ANTHEM HEALTH PLANS OF KENTUCKY, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	04		1		H5530	001	0	2009	Anthem Medicare Preferred Standard	Kentucky - Select Counties		2	2			2201	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
H5531	001	0	1	04	01	H5531_001_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5531	001	0	2009	Aetna Golden Choice Standard Plan	Hudson Valley		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5531	002	0	1	04	01	H5531_002_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5531	002	0	2009	Aetna Golden Choice Premier Plan	Hudson Valley		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5531	003	0	1	04	01	H5531_003_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5531	003	0	2009	Aetna Golden Choice Standard Plan	Upstate New York		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5531	004	0	1	04	01	H5531_004_0	5	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5531	004	0	2009	Aetna Golden Choice Premier Plan	Upstate New York		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5531	005	0	1	04	01	H5531_005_0	5	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5531	005	0	2009	Aetna Golden Choice Standard Plan	New York, Queens and Richmond Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5531	006	0	1	04	01	H5531_006_0	5	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5531	006	0	2009	Aetna Golden Choice Premier Plan	New York, Queens and Richmond Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5531	007	0	1	04	01	H5531_007_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5531	007	0	2009	Aetna Golden Choice Standard Plan	Bronx and Kings Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5531	008	0	1	04	01	H5531_008_0	5	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5531	008	0	2009	Aetna Golden Choice Premier Plan	Bronx and Kings Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5531	009	0	1	04	01	H5531_009_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5531	009	0	2009	Aetna Golden Choice Standard Plan	Long Island		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5531	010	0	1	04	01	H5531_010_0	5	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5531	010	0	2009	Aetna Golden Choice Premier Plan	Long Island		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5531	801	0	1	04	01	H5531_801_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5531	801	0	2009	Aetna Golden Choice Plan	New York		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5531	802	0	1	04	01	H5531_802_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H5531	802	0	2009	Aetna Golden Choice Plan w/Rx CY	New York		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5532	001	0	1	04	01	H5532_001_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	04		1		H5532	001	0	2009	AARP MedicareComplete Choice	Charlotte,Hernando,Hillsborough,Lee,Pasco,Pinellas		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H5533	002	0	1	04	01	H5533_002_0	5	2009.01	UPMC HEALTH NETWORK	UPMC Health Plan	www.upmchealthplan.com	01	04		1		H5533	002	0	2009	UPMC for Life PPO Rx Enhanced	Western Pennsylvania		2	2			1300	2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H5533	801	0	1	04	01	H5533_801_0	3	2009.01	UPMC HEALTH NETWORK	UPMC Health Plan	www.upmchealthplan.com	01	04		1		H5533	801	0	2009	UPMC Employer Group PPO	Western Pennsylvania		1	2				2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629									http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H5533	802	0	1	04	01	H5533_802_0	3	2009.01	UPMC HEALTH NETWORK	UPMC Health Plan	www.upmchealthplan.com	01	04		1		H5533	802	0	2009	UPMC Employer Group PPO - D (CY)	Western Pennsylvania		1	2				2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H5533	803	0	1	04	01	H5533_803_0	3	2009.01	UPMC HEALTH NETWORK	UPMC Health Plan	www.upmchealthplan.com	01	04		1		H5533	803	0	2009	UPMC Employer Group PPO - D (FY)	Western Pennsylvania		1	2				2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H5549	001	0	1	01	01	H5549_001_0	6	2009.01	VNS CHOICE	VNS CHOICE Medicare	www.vnschoice.org	01	01		1		H5549	001	0	2009	VNS CHOICE Medicare Option I	Bronx, Kings, New York, Queens and Richmond County		2	1	3		1337	2			1	2		(212)-609-5600	(866)-783-1444	(888)-844-5530		(212)-609-5600	(866)-867-0047	(888)-844-5530		(212)-609-5600	(866)-783-1444	(888)-844-5530		(212)-609-5600	(866)-783-1444	(888)-844-5530		http://www.vnschoice.org/formulary_search.html	
H5549	002	0	1	01	01	H5549_002_0	5	2009.01	VNS CHOICE	VNS CHOICE Medicare	www.vnschoice.org	01	01		1		H5549	002	0	2009	VNS CHOICE Medicare Option II	Bronx, Kings, New York, Queens, Richmond Counties		2	1	3		1301	2			1	2		(212)-609-5600	(866)-783-1444	(888)-844-5530		(212)-609-5600	(866)-867-0047	(888)-844-5530		(212)-609-5600	(866)-783-1444	(888)-844-5530		(212)-609-5600	(866)-783-1444	(888)-844-5530		http://www.vnschoice.org/formulary_search.html	
H5549	003	0	1	01	01	H5549_003_0	6	2009.01	VNS CHOICE	VNS CHOICE Medicare	www.vnschoice.org	01	01		1		H5549	003	0	2009	VNS CHOICE Managed Long Term Care Plus	Bronx, Kings, New York, Queens, Richmond Counties		2	1	3		180	2			1	1		(212)-609-5600	(866)-597-6674	(888)-844-5530		(212)-609-5600	(866)-597-6674	(888)-844-5530		(212)-609-5600	(866)-597-6674	(888)-844-5530		(212)-609-5600	(866)-597-6674	(888)-844-5530		http://www.vnschoice.org/formulary_search.html	
H5554	001	0	1	01	01	H5554_001_0	5	2009.01	SANTA CLARA COUNTY HEALTH AUTHORITY	Santa Clara Family Health Plan	www.scfhp.com	01	01		1		H5554	001	0	2009	Healthy Generations	Santa Clara County		2	1	3		4584	2			1	3		(408)-376-2000	(866)-472-3691	(800)-735-2929		(408)-376-2000	(888)-355-5557	(800)-735-2929		(408)-376-2000	(866)-472-3691	(800)-735-2929		(408)-376-2000	(888)-355-5557	(800)-735-2929		www.scfhp.com/bp/HG/docs/Formulary/Formulary.pdf	www.scfhp.com
H5575	005	0	1	01	01	H5575_005_0	7	2009.01	FIDELIS SECURECARE OF NORTH CAROLINA	Fidelis SecureCare of North Carolina	www.fidelissc.com	01	01		1		H5575	005	0	2009	Fidelis Secure Comfort	North Carolina		2	1	1	1		2			1			(877)-372-8085		(888)-844-5530		(877)-372-8085		(888)-844-5530		(877)-372-7948	(877)-372-7948	(888)-844-5530		(877)-372-7948	(877)-372-7948	(888)-844-5530		http://www.fidelissc.com/ourplans/nc_partD.asp	www.fidelissc.com
H5575	006	0	1	01	01	H5575_006_0	5	2009.01	FIDELIS SECURECARE OF NORTH CAROLINA	Fidelis SecureCare of North Carolina	www.fidelissc.com	01	01		1		H5575	006	0	2009	Fidelis Secure Comfort Plus	North Carolina		2	1	1	1		2			1			(877)-372-8085		(888)-844-5530		(877)-372-8085		(888)-844-5530		(877)-372-7948	(877)-372-7948	(888)-844-5530		(877)-372-7948	(877)-372-7948	(888)-844-5530		http://www.fidelissc.com/ourplans/nc_partD.asp	www.fidelissc.com
H5575	007	0	1	01	01	H5575_007_0	6	2009.01	FIDELIS SECURECARE OF NORTH CAROLINA	Fidelis SecureCare of North Carolina	www.fidelissc.com	01	01		1		H5575	007	0	2009	Fidelis Secure Independence	North Carolina		2	1	1	2		2			1			(877)-372-8085		(888)-844-5530		(877)-372-8085		(888)-844-5530		(877)-372-7948	(877)-372-7948	(888)-844-5530		(877)-372-7948	(877)-372-7948	(888)-844-5530		http://www.fidelissc.com/ourplans/nc_partD.asp	www.fidelissc.com
H5576	005	0	1	02	01	H5576_005_0	5	2009.01	VANTAGE  HEALTH PLAN, INC.	Vantage Health Plan, Inc.	http://www.vhp-medicare.com	01	02		1		H5576	005	0	2009	AAA2 Vantage BASIC	North Louisiana, Central Louisiana and Baton Rouge		2	2				2						(318)-361-0900	(888)-823-1910	(318)-361-2131	(866)-524-5144	(318)-361-0900	(888)-823-1910	(318)-361-2131	(866)-524-5144	(318)-361-0900	(888)-823-1910	(318)-361-2131		(318)-361-0900	(888)-823-1910	(318)-361-2131		www.vhp-medicare.com	www.vhp-medicare.com
H5576	006	0	1	02	01	H5576_006_0	5	2009.01	VANTAGE  HEALTH PLAN, INC.	Vantage Health Plan, Inc.	http://www.vhp-medicare.com	01	02		1		H5576	006	0	2009	AAA3 Vantage PREMIUM	North Louisiana, Central Louisiana and Baton Rouge		2	2				2						(318)-361-0900	(888)-823-1910	(318)-361-2131	(866)-524-5144	(318)-361-0900	(888)-823-1910	(318)-361-2131	(866)-524-5144	(318)-361-0900	(888)-823-1910	(318)-361-2131		(318)-361-0900	(888)-823-1910	(318)-361-2131		www.vhp-medicare.com	www.vhp-medicare.com
H5576	007	0	1	02	01	H5576_007_0	7	2009.01	VANTAGE  HEALTH PLAN, INC.	Vantage Health Plan, Inc.	http://www.vhp-medicare.com	01	02		1		H5576	007	0	2009	AAA0 Vantage ZERO	North Louisiana, Central Louisiana and Baton Rouge		2	2				2						(318)-361-0900	(888)-823-1910	(318)-361-2131	(866)-524-5144	(318)-361-0900	(888)-823-1910	(318)-361-2131	(866)-524-5144	(318)-361-0900	(888)-823-1910	(318)-361-2131		(318)-361-0900	(888)-823-1910	(318)-361-2131		www.vhp-medicare.com	www.vhp-medicare.com
H5576	008	0	1	02	01	H5576_008_0	4	2009.01	VANTAGE  HEALTH PLAN, INC.	Vantage Health Plan, Inc.	http://www.vhp-medicare.com	01	02		1		H5576	008	0	2009	AAA4 Vantage TRADITIONAL PLUS	North Louisiana, Central Louisiana and Baton Rouge		2	2				2						(318)-361-0900	(888)-823-1910	(318)-361-2131	(866)-524-5144	(318)-361-0900	(888)-823-1910	(318)-361-2131	(866)-524-5144	(318)-361-0900	(888)-823-1910	(318)-361-2131		(318)-361-0900	(888)-823-1910	(318)-361-2131		www.vhp-medicare.com	www.vhp-medicare.com
H5576	009	0	1	02	01	H5576_009_0	5	2009.01	VANTAGE  HEALTH PLAN, INC.	Vantage Health Plan, Inc.	http://www.vhp-medicare.com	01	02		1		H5576	009	0	2009	AAA1 Vantage VALUE	North Louisiana, Central Louisiana and Baton Rouge		2	2				2						(318)-361-0900	(888)-823-1910	(318)-361-2131	(866)-524-5144	(318)-361-0900	(888)-823-1910	(318)-361-2131	(866)-524-5144	(318)-361-0900	(888)-823-1910	(318)-361-2131		(318)-361-0900	(888)-823-1910	(318)-361-2131		www.vhp-medicare.com	www.vhp-medicare.com
H5576	801	0	1	02	01	H5576_801_0	5	2009.01	VANTAGE  HEALTH PLAN, INC.	Vantage Health Plan, Inc.	http://www.vhp-medicare.com	01	02		1		H5576	801	0	2009	Vantage - MAPD Employer Calendar	Louisiana		1	2				2						(318)-361-0900	(888)-823-1910	(318)-361-2131	(866)-524-5144	(318)-361-0900	(888)-823-1910	(318)-361-2131	(866)-524-5144	(318)-361-0900	(888)-823-1910	(318)-361-2131		(318)-361-0900	(888)-823-1910	(318)-361-2131		www.vhp-medicare.com	www.vhp-medicare.com
H5576	802	0	1	02	01	H5576_802_0	3	2009.01	VANTAGE  HEALTH PLAN, INC.	Vantage Health Plan, Inc.	http://www.vhp-medicare.com	01	02		1		H5576	802	0	2009	Vantage - MAPD Emp Non-Calendar	Louisiana		1	2				2						(318)-361-0900	(888)-823-1910	(318)-361-2131	(866)-524-5144	(318)-361-0900	(888)-823-1910	(318)-361-2131	(866)-524-5144	(318)-361-0900	(888)-823-1910	(318)-361-2131		(318)-361-0900	(888)-823-1910	(318)-361-2131		www.vhp-medicare.com	www.vhp-medicare.com
H5576	803	0	1	02	01	H5576_803_0	3	2009.01	VANTAGE  HEALTH PLAN, INC.	Vantage Health Plan, Inc.	http://www.vhp-medicare.com	01	02		1		H5576	803	0	2009	Vantage - MA Employer Calendar	Louisiana		1	2				2						(318)-361-0900	(888)-823-1910	(318)-361-2131	(866)-524-5144	(318)-361-0900	(888)-823-1910	(318)-361-2131	(866)-524-5144									www.vhp-medicare.com	www.vhp-medicare.com
H5577	002	0	1	01	01	H5577_002_0	7	2009.01	MCS ADVANTAGE INC.	MCS Classicare	www.mcsclassicare.com	01	01		1		H5577	002	0	2009	MCS Classicare Especial	Puerto Rico		2	1	3		32000	2			2	3		(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	www.mcsclassicare.com	www.mcsclassicare.com
H5578	002	0	1	01	01	H5578_002_0	19	2009.01	ARCADIAN HEALTH PLAN OF GEORGIA, INC.	Southeast Community Care	www.southeastcommunitycare.com	01	01		1		H5578	002	0	2009	Southeast Community Care - Plus	Savannah Market		2	2			11323	2						(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(800)-573-8597	(888)-998-3055	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(800)-573-8597	(888)-998-3055	(866)-573-8613	(866)-573-8613	www.southeastcommunitycare.com	
H5578	006	0	1	01	01	H5578_006_0	19	2009.01	ARCADIAN HEALTH PLAN OF GEORGIA, INC.	Southeast Community Care	www.southeastcommunitycare.com	01	01		1		H5578	006	0	2009	Southeast Community Care - Plus	Athens, Columbus, Macon		2	2			30811	2						(478)-474-2678	(800)-573-8597	(866)-573-8591	(866)-573-8591	(478)-474-2678	(888)-701-2678	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(478)-474-2678	(888)-701-2678	(866)-573-8613	(866)-573-8613	www.southeastcommunitycare.com	
H5578	007	0	1	01	01	H5578_007_0	17	2009.01	ARCADIAN HEALTH PLAN OF GEORGIA, INC.	Southeast Community Care	www.southeastcommunitycare.com	01	01		1		H5578	007	0	2009	Southeast Community Care - Dual Plus	Athens, Columbus, Macon		2	1	3		16136	2			1	1		(478)-474-2678	(800)-573-8597	(866)-573-8591	(866)-573-8591	(478)-474-2678	(888)-701-2678	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(478)-474-2678	(888)-701-2678	(866)-573-8613	(866)-573-8613	www.southeastcommunitycare.com	
H5578	801	0	1	01	01	H5578_801_0	7	2009.01	ARCADIAN HEALTH PLAN OF GEORGIA, INC.	Southeast Community Care	www.southeastcommunitycare.com	01	01		1		H5578	801	0	2009	Southeast Community Care EGWP (GA)	Georgia		1	2			0	2						(478)-474-2678	(800)-573-8597	(866)-573-8591	(866)-573-8591	(478)-474-2678	(888)-701-2678	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(478)-474-2678	(888)-701-2678	(866)-573-8613	(866)-573-8613	www.southeastcommunitycare.com	
H5580	001	0	1	01	01	H5580_001_0	5	2009.01	SOUTHWEST CATHOLIC HEALTH NETWORK CORPORATION	Mercy Care Advantage	www.mercycareadvantage.com	01	01		1		H5580	001	0	2009	Mercy Care Advantage	Maricopa, Pima and Santa Cruz Counties		2	1	3			2			1	3		(602)-263-3000	(800)-624-3879	(602)-248-9273	(866)-602-1982	(602)-263-3000	(800)-624-3879	(602)-248-9273	(866)-602-1982	(602)-263-3000	(800)-624-3879	(602)-248-9273	(866)-602-1982	(602)-263-3000	(800)-624-3879	(602)-248-9273	(866)-602-1982	http://www.mercycareadvantage.com/AdvantageDrug.html	http://www.mercycareadvantage.com
H5587	001	0	1	01	01	H5587_001_0	5	2009.01	HEALTH CHOICE ARIZONA, INC.	Health Choice Generations	HCGenerations.com	01	01		1		H5587	001	0	2009	Health Choice Generations	Northern AZ, Maricopa,Pima,Pinal and Gila Counties		2	1	3		3400	2			1	3		(800)-656-8991	(800)-656-8991	(800)-842-4681	(800)-842-4681	(800)-656-8991	(800)-656-8991	(800)-842-4681	(800)-842-4681	(800)-656-8991	(800)-656-8991	(800)-842-4681	(800)-842-4681	(800)-656-8991	(800)-656-8991	(800)-842-4681	(800)-842-4681	http://www.hcgenerations.com/index.asp?page=formulary.aspf=partd	https://www.HCGenerations.com
H5588	001	0	1	01	01	H5588_001_0	7	2009.01	MOLINA HEALTHCARE OF NEVADA, INC.	Molina Healthcare of Nevada	www.molinamedicare.com	01	01		1		H5588	001	0	2009	Molina Medicare Options Plus	Clark and Washoe counties		2	1	3			2			1	1		(801)-858-0446	(800)-665-3086	(800)-346-4128	(800)-346-4128	(801)-858-0446	(866)-403-8293	(800)-346-4128	(800)-346-4128	(801)-858-0446	(800)-665-3086	(800)-346-4128	(800)-346-4128	(801)-858-0446	(866)-403-8293	(800)-346-4128	(800)-346-4128	www.molinahealthcare.com	https://eportal.molinahealthcare.com/eportal/providers/ProviderSearchAdv.aspx
H5588	002	0	1	01	01	H5588_002_0	7	2009.01	MOLINA HEALTHCARE OF NEVADA, INC.	Molina Healthcare of Nevada	www.molinamedicare.com	01	01		1		H5588	002	0	2009	Molina Medicare Options	Clark and Washoe counties		2	2				2						(801)-858-0446	(800)-665-3086	(800)-346-4128	(800)-346-4128	(801)-858-0446	(866)-403-8293	(800)-346-4128	(800)-346-4128	(801)-858-0446	(800)-665-3086	(800)-346-4128	(800)-346-4128	(801)-858-0446	(866)-403-8293	(800)-346-4128	(800)-346-4128	www.molinahealthcare.com	https://eportal.molinahealthcare.com/eportal/providers/ProviderSearchAdv.aspx
H5590	001	0	1	01	01	H5590_001_0	7	2009.01	BRIDGEWAY HEALTH SOLUTIONS	Advantage by Bridgeway Health Solutions	www.bridgewayhs.com	01	01		1		H5590	001	0	2009	Bridgeway Health Solutions	Bridgeway Health Solutions		2	1	3		700	2			1	3		(866)-475-3129	(866)-475-3129	(877)-613-2076		(866)-475-3129	(866)-475-3129	(877)-613-2076		(866)-475-3129	(866)-475-3129	(877)-613-2076		(866)-475-3129	(866)-475-3129	(877)-613-2076		to be developed	www.bridgewayhs.com
H5591	001	0	1	02	01	H5591_001_0	11	2009.01	MARTINS POINT GENERATIONS, LLC	Martin's Point Generations Advantage	www.martinspoint.org	01	02		1		H5591	001	0	2009	Martin's Point Generations Advantage Prime	Counties: AN,AR,CU,FR,KEN,KNX,LI,OX,PEN,SA,WAL,YK		2	2				2						(866)-544-7504	(866)-544-7504	(866)-544-7503	(866)-544-7503	(888)-640-4423	(888)-640-4423	(866)-544-7502	(866)-544-7502	(866)-544-7504	(866)-544-7504	(866)-544-7503	(866)-544-7503	(888)-640-4423	(888)-640-4423	(866)-544-7502	(866)-544-7502	www.martinspoint.org	www.martinspoint.org
H5591	002	0	1	01	01	H5591_002_0	8	2009.01	MARTINS POINT GENERATIONS, LLC	Martin's Point Generations Advantage	www.martinspoint.org	01	01		1		H5591	002	0	2009	Martin's Point Generations Advantage ValuePlus	Counties: AN,AR,CU,FR,KEN,KNX,LI,OX,PEN,SA,WAL,YK		2	2				2						(866)-544-7504	(866)-544-7504	(866)-544-7503	(866)-544-7503	(888)-640-4423	(888)-640-4423	(866)-544-7502	(866)-544-7502	(866)-544-7504	(866)-544-7504	(866)-544-7503	(866)-544-7503	(888)-640-4423	(888)-640-4423	(866)-544-7502	(866)-544-7502	www.martinspoint.org	www.martinspoint.org
H5591	003	0	1	01	01	H5591_003_0	6	2009.01	MARTINS POINT GENERATIONS, LLC	Martin's Point Generations Advantage	www.martinspoint.org	01	01		1		H5591	003	0	2009	Martin's Point Generations Advantage Value	Counties: AN,AR,CU,FR,KEN,KNX,LI,OX,PEN,SA,WAL,YK		2	2				2						(866)-544-7504	(866)-544-7504	(866)-544-7503	(866)-544-7503	(888)-640-4423	(888)-640-4423	(866)-544-7502	(866)-544-7502									www.martinspoint.org	www.martinspoint.org
H5594	001	0	1	02	01	H5594_001_0	8	2009.01	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthCare.com	01	02		1		H5594	001	0	2009	Optimum Gold Plan	Select Counties in Florida		2	2			3701	2						(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	www.youroptimumhealthcare.com	www.YourOptimumHealthCare.com
H5594	002	0	1	02	01	H5594_002_0	8	2009.01	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthCare.com	01	02		1		H5594	002	0	2009	Optimum Platinum Plan	Select Counties in Florida		2	2			709	2						(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	www.youroptimumhealthcare.com	www.YourOptimumHealthCare.com
H5594	004	0	1	01	01	H5594_004_0	9	2009.01	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthCare.com	01	01		1		H5594	004	0	2009	Optimum Emerald Plan	Select Counties in Florida		2	1	3		2472	2			1	2		(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	www.youroptimumhealthcare.com	www.YourOptimumHealthCare.com
H5594	005	0	1	02	01	H5594_005_0	8	2009.01	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthCare.com	01	02		1		H5594	005	0	2009	Optimum Gold Plan	Select Counties in Florida		2	2			9428	2						(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	www.youroptimumhealthcare.com	www.YourOptimumHealthCare.com
H5594	006	0	1	02	01	H5594_006_0	8	2009.01	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthCare.com	01	02		1		H5594	006	0	2009	Optimum Platinum Plan	Select Counties in Florida		2	2			709	2						(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	www.youroptimumhealthcare.com	www.YourOptimumHealthCare.com
H5594	007	0	1	02	01	H5594_007_0	9	2009.01	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthCare.com	01	02		1		H5594	007	0	2009	Optimum Gold Plan	Select Counties in Florida		2	2			709	2						(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	www.youroptimumhealthcare.com	www.YourOptimumHealthCare.com
H5594	008	0	1	02	01	H5594_008_0	9	2009.01	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthCare.com	01	02		1		H5594	008	0	2009	Optimum Platinum Plan	Select Counties in Florida		2	2			709	2						(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	www.youroptimumhealthcare.com	www.YourOptimumHealthCare.com
H5594	009	0	1	02	01	H5594_009_0	10	2009.01	OPTIMUM HEALTHCARE, INC.	Optimum HealthCare, Inc.	www.YourOptimumHealthCare.com	01	02		1		H5594	009	0	2009	Optimum Choice	Select counties in FL		2	2			3734	2						(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	(352)-688-9131	(866)-245-5360	(800)-662-1220	(800)-662-1220	www.youroptimumhealthcare.com	www.YourOptimumHealthCare.com
H5606	001	0	1	38	05	H5606_001_0	3	2009.01	STERLING LIFE INSURANCE COMPANY	Fresenius Medical Health Plan, Inc. - Pennsylvania	www.FMCHP.com	05	38	3	1		H5606	001	0	2009	FRESENIUS MEDICAL CARE HEALTH PLAN	Pennsylvania		2	2				2						(888)-270-0762	(888)-270-0762	(888)-858-8567	(888)-858-8567	(866)-307-3625	(866)-307-3625	(888)-858-8567	(888)-858-8567										
H5608	001	0	1	01	01	H5608_001_0	8	2009.01	DENVER HEALTH MEDICAL PLAN, INC.	Denver Health Medical Plan	www.denverhealth.org	01	01		1		H5608	001	0	2009	Denver Health Medicare Choice	Denver County		2	1	3		1177	2			1	2		(720)-956-2111		(720)-956-2370		(720)-956-2111		(720)-956-2370		(720)-956-2111	(877)-956-2111	(720)-956-2370		(720)-956-2111	(877)-956-2111	(720)-956-2370		http://denverhealth.medicareplanrx.org	http://www.denverhealth.org/DhMedicalPlan/Default.aspx
H5608	002	0	1	01	01	H5608_002_0	13	2009.01	DENVER HEALTH MEDICAL PLAN, INC.	Denver Health Medical Plan	www.denverhealth.org	01	01		1		H5608	002	0	2009	Denver Health Medicare Select	Denver County		2	2			1160	2						(720)-956-2111		(720)-956-2370		(720)-956-2173		(720)-956-2370		(720)-956-2173	(866)-417-2173	(720)-956-2370		(720)-956-2173	(866)-417-2173	(720)-956-2370		http://denverhealth.medicareplanrx.org	http://www.denverhealth.org/DhMedicalPlan/Default.aspx
H5608	003	0	1	01	01	H5608_003_0	7	2009.01	DENVER HEALTH MEDICAL PLAN, INC.	Denver Health Medical Plan	www.denverhealth.org	01	01		1		H5608	003	0	2009	Denver Health Medicare Premium Plus	Denver County		2	2			236	2						(720)-956-2111		(720)-956-2370		(720)-956-2173		(720)-956-2370		(720)-956-2173	(866)-417-2173	(720)-956-2370		(720)-956-2173	(866)-417-2173	(720)-956-2370		http://denverhealth.medicareplanrx.org	http://www.denverhealth.org/DhMedicalPlan/Default.aspx
H5608	801	0	1	01	01	H5608_801_0	4	2009.01	DENVER HEALTH MEDICAL PLAN, INC.	Denver Health Medical Plan	www.denverhealth.org	01	01		1		H5608	801	0	2009	Denver Health Employer Group Plan	Arapahoe, Denver, Jefferson, Adams Counties		1	2			195	2						(720)-956-2174	(866)-417-2174	(720)-956-2370		(720)-956-2174	(866)-417-2174	(720)-956-2370		(720)-956-2174	(866)-417-2174	(720)-956-2370		(720)-956-2174	(866)-417-2174	(720)-956-2370		http://denverhealth.medicareplanrx.org	http://www.denverhealth.org/DhMedicalPlan/Default.aspx
H5609	001	0	1	01	01	H5609_001_0	11	2009.01	GEMCARE HEALTH PLAN INC.	GEMCARE Health Plan	www.gemcarehealthplan.com	01	01		1		H5609	001	0	2009	GEMCare Medicare Plus	Kern County		2	2			5500	2						(661)-716-8800	(877)-697-2464	(888)-833-9312		(661)-716-8800	(877)-697-2464	(888)-833-9312		(661)-716-8800	(877)-697-2464	(888)-833-9312		(661)-716-8800	(877)-697-2464	(888)-833-9312		www.gemcarehealthplan.com	www.gemcarehealthplan.com
H5609	801	0	1	01	01	H5609_801_0	2	2009.01	GEMCARE HEALTH PLAN INC.	GEMCARE Health Plan	www.gemcarehealthplan.com	01	01		1		H5609	801	0	2009	GEMCARE Medicare Plus ES Plan	Kern County		1	2			170	2						(661)-716-8800	(877)-697-2464	(888)-833-9312		(661)-716-8800	(877)-697-2464	(888)-833-9312		(661)-716-8800	(877)-697-2464	(888)-833-9312		(661)-716-8800	(877)-697-2464	(888)-833-9312		www.gemcarehealthplan.com	www.gemcarehealthplan.com
H5610	001	0	1	20	08	H5610_001_0	1	2009.01	CARE RESOURCES, INC.	Care Resources	www.care-resources.org	08	20		1		H5610	001	0	2009	Care Resources	Kent County		2	2				2														(616)-954-1537	(800)-447-3007			(616)-954-1537	(800)-447-3007			www.care-resources.org	
H5610	003	0	1	20	08	H5610_003_0	1	2009.01	CARE RESOURCES, INC.	Care Resources	www.care-resources.org	08	20		1		H5610	003	0	2009	Care Resources	Kent County		2	2				2														(616)-954-1537	(800)-447-3007			(616)-954-1537	(800)-447-3007			www.care-resources.org	
H5619	001	0	1	01	01	H5619_001_0	8	2009.01	ARCADIAN HEALTH PLAN, INC.	Northeast Community Care	www.northeastcommunitycare.com	01	01		1		H5619	001	0	2009	Northeast Community Care - Southern Maine	Southern Maine		2	2			28079	2						(207)-773-3920	(800)-573-8597	(866)-573-8591	(866)-573-8591	(207)-773-3920	(800)-998-3056	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(207)-773-3920	(800)-998-3056	(866)-573-8613	(866)-573-8613	www.northeastcommunitycare.com	
H5619	003	0	1	01	01	H5619_003_0	9	2009.01	ARCADIAN HEALTH PLAN, INC.	Northeast Community Care	www.northeastcommunitycare.com	01	01		1		H5619	003	0	2009	Northeast Community Care - Dual Plus	Cumberland, York, Lewiston, and Bangor		2	1	3		8140	2			1	1		(207)-773-3920	(800)-573-8597	(866)-573-8591	(866)-573-8591	(207)-773-3920	(800)-998-3056	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(207)-773-3920	(800)-998-3056	(866)-573-8613	(866)-573-8613	www.northeastcommunitycare.com	
H5619	004	0	1	01	01	H5619_004_0	8	2009.01	ARCADIAN HEALTH PLAN, INC.	Northeast Community Care	www.northeastcommunitycare.com	01	01		1		H5619	004	0	2009	Northeast Community Care - Northern Maine	Nothern Maine		2	2			3425	2						(207)-773-3920	(800)-573-8597	(866)-573-8591	(866)-573-8591	(207)-773-3920	(800)-998-3056	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(207)-773-3920	(800)-998-3056	(866)-573-8613	(866)-573-8613	www.northeastcommunitycare.com	
H5619	007	0	1	01	01	H5619_007_0	8	2009.01	ARCADIAN HEALTH PLAN, INC.	Northeast Community Care	www.northeastcommunitycare.com	01	01		1		H5619	007	0	2009	Northeast Community Care - Mid-Maine	Mid- Maine		2	2			91	2						(207)-773-3920	(800)-573-8597	(866)-573-8591	(866)-573-8591	(207)-773-3920	(800)-998-3056	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(207)-773-3920	(800)-998-3056	(866)-573-8613	(866)-573-8613	www.northeastcommunitycare.com	
H5619	008	0	1	01	01	H5619_008_0	9	2009.01	ARCADIAN HEALTH PLAN, INC.	Northeast Community Care	www.northeastcommunitycare.com	01	01		1		H5619	008	0	2009	Northeast Community Care- Additional Maine	Additional Maine		2	2			1091	2						(207)-773-3920	(800)-573-8597	(866)-573-8591	(866)-573-8591	(207)-773-3920	(800)-998-3056	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(207)-773-3920	(800)-998-3056	(866)-573-8613	(866)-573-8613	www.northeastcommunitycare.com	
H5619	801	0	1	01	01	H5619_801_0	7	2009.01	ARCADIAN HEALTH PLAN, INC.	Northeast Community Care	www.southeastcommunitycare.com	01	01		1		H5619	801	0	2009	Northeast Comunity Care - EGWP	Maine		1	2			0	2						(207)-773-3920	(800)-573-8597	(866)-573-8591	(866)-573-8591	(207)-773-3920	(800)-998-3056	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(207)-773-3920	(800)-998-3056	(866)-573-8613	(866)-573-8613	www.northeastcommunitycare.com	
H5628	001	0	1	01	01	H5628_001_0	6	2009.01	MOLINA HEALTHCARE OF UTAH, INC.	Molina Healthcare of Utah	www.molinamedicare.com	01	01		1		H5628	001	0	2009	Molina Medicare Options Plus	Davis, Iron, Salt Lake, Utah, Washington, Weber		2	1	3			2			1	1		(801)-858-0446	(888)-665-1328	(800)-346-4128	(800)-346-4128	(801)-858-0446	(866)-403-8293	(800)-346-4128	(800)-346-4128	(801)-858-0446	(888)-665-1328	(800)-346-4128	(800)-346-4128	(801)-858-0446	(866)-403-8293	(800)-346-4128	(800)-346-4128	www.molinahealthcare.com	https://eportal.molinahealthcare.com/eportal/providers/ProviderSearchAdv.aspx
H5628	002	0	1	01	01	H5628_002_0	8	2009.01	MOLINA HEALTHCARE OF UTAH, INC.	Molina Healthcare of Utah	www.molinamedicare.com	01	01		1		H5628	002	0	2009	Molina Medicare Options	Davis, Iron, Salt Lake, Utah, Washington and Weber		2	2				2						(801)-858-0446	(888)-665-1328	(800)-346-4128	(800)-346-4128	(801)-858-0446	(866)-403-8293	(800)-346-4128	(800)-346-4128	(801)-858-0446	(888)-665-1328	(800)-346-4128	(800)-346-4128	(801)-858-0446	(866)-403-8293	(800)-346-4128	(800)-346-4128	www.molinahealthcare.com	https://eportal.molinahealthcare.com/eportal/providers/ProviderSearchAdv.aspx
H5628	006	0	1	01	01	H5628_006_0	5	2009.01	MOLINA HEALTHCARE OF UTAH, INC.	Molina Healthcare of Utah	www.molinamedicare.com	01	01		1		H5628	006	0	2009	Healthy Advantage	Davis, Iron, Salt Lake, Utah, Washington, Weber		2	1	3			2			1	1		(801)-858-0446	(888)-665-1328	(800)-346-4128	(800)-346-4128	(801)-858-0446	(866)-403-8293	(800)-346-4128	(800)-346-4128	(801)-858-0446	(888)-665-1328	(800)-346-4128	(800)-346-4128	(801)-858-0446	(866)-403-8293	(800)-346-4128	(800)-346-4128	www.molinahealthcare.com	https://eportal.molinahealthcare.com/eportal/providers/ProviderSearchAdv.aspx
H5629	001	0	1	20	08	H5629_001_0	1	2009.01	COMMUNITY ELDERCARE OF  SAN DIEGO	St. Paul's PACE	stpaulseniors.org	08	20		1		H5629	001	0	2009	St. Paul's PACE	San Diego Metro Area		2	2				2														(619)-239-6900	(619)-239-6900			(619)-239-6900	(619)-239-6900			stpaulspace.org	
H5629	002	0	1	20	08	H5629_002_0	1	2009.01	COMMUNITY ELDERCARE OF  SAN DIEGO	St. Paul's PACE	stpaulseniors.org	08	20		1		H5629	002	0	2009	St. Paul's PACE	San Diego Metro Area		2	2				2														(619)-239-6900	(619)-239-6900			(619)-239-6900	(619)-239-6900			stpaulspace.org	
H5640	001	0	1	01	01	H5640_001_0	7	2009.01	IEHP HEALTH ACCESS	IEHP Medicare DualChoice	www.iehp.org	01	01		1		H5640	001	0	2009	IEHP Medicare DualChoice	Riverside and San Bernardino Counties		2	1	3		2500	2			1	1		(909)-890-2000	(877)-273-4347	(800)-718-4347		(909)-890-2000	(877)-273-4347	(800)-718-4347		(909)-890-2000	(877)-273-4347	(800)-718-4347		(909)-890-2000	(877)-273-4347	(800)-718-4347		www.iehp.org	www.iehp.org
H5649	001	0	1	01	01	H5649_001_0	7	2009.01	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Central Health Medicare Plan	http://www.centralhealthplan.com	01	01		1		H5649	001	0	2009	Central Health Medicare Plan	Los Angeles and Partial San Bernardino County		2	2				2						(626)-388-2390	(866)-314-2427	(626)-388-2391	(888)-205-7671	(626)-388-2390	(866)-314-2427	(626)-388-2391	(888)-205-7671	(626)-388-2390	(866)-314-2427	(626)-388-2391	(888)-205-7671	(626)-388-2390	(866)-314-2427	(626)-388-2391	(888)-205-7671	http://www.centralhealthplan.com/Benefits/Formulary.aspx	http://www.centralhealthplan.com/ProviderDirectory.html
H5649	002	0	1	01	01	H5649_002_0	8	2009.01	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Central Health Medicare Plan	http://www.centralhealthplan.com	01	01		1		H5649	002	0	2009	Central Health Medi-Medi Plan	Los Angeles and Partial San Bernardino County		2	1	3			2			1	2		(626)-388-2390	(866)-314-2427	(626)-388-2391	(888)-205-7671	(626)-388-2390	(866)-314-2427	(626)-388-2391	(888)-205-7671	(626)-388-2390	(866)-314-2427	(626)-388-2391	(888)-205-7671	(626)-388-2390	(866)-314-2427	(626)-388-2391	(888)-205-7671	http://www.centralhealthplan.com/Benefits/Formulary.aspx	http://www.centralhealthplan.com/ProviderDirectory.html
H5652	001	0	1	37	05	H5652_001_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.ericksonadvantage.com	05	37		1		H5652	001	0	2009	Erickson Advantage Signature with Drugs	Baltimore, Montgomery and Prince Georges Counties		2	2				2						(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.ericksonadvantage.com
H5652	002	0	1	37	05	H5652_002_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.ericksonadvantage.com	05	37		1		H5652	002	0	2009	Erickson Advantage Signature without Drugs	Baltimore, Montgomery and Prince Georges Counties		2	2				2						(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480										http://www.ericksonadvantage.com/formulary.asp	www.ericksonadvantage.com
H5652	003	0	1	37	05	H5652_003_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.ericksonadvantage.com	05	37		1		H5652	003	0	2009	Erickson Advantage Guardian	Baltimore, Montgomery and Prince Georges Counties		2	1	1	1		2			1			(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.ericksonadvantage.com
H5652	004	0	1	37	05	H5652_004_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.ericksonadvantage.com	05	37		1		H5652	004	0	2009	Erickson Advantage Champion	Baltimore, Montgomery and Prince Georges Counties		2	1	4			2			2		1111111110000000100000000001	(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.ericksonadvantage.com
H5656	001	0	1	01	01	H5656_001_0	5	2009.01	SELECTCARE HEALTH PLANS, INC.	TexasFirst Health Plans	www.texas-first.com	01	01		1		H5656	001	0	2009	TexanPlus Classic powered by CCRx	North Texas		2	2				2						(800)-958-2707	(800)-958-2707	(866)-338-4681	(866)-338-4681	(866)-245-4143	(866)-245-4143	(866)-338-4681	(866)-338-4681	(800)-958-2707	(800)-958-2707	(866)-338-4681	(866)-338-4681	(866)-245-4143	(866)-245-4143	(866)-338-4681	(866)-338-4681	http://www.texas-first.com/PresentFormulary	www.texas-first.com
H5656	003	0	1	01	01	H5656_003_0	3	2009.01	SELECTCARE HEALTH PLANS, INC.	TexasFirst Health Plans	www.texas-first.com	01	01		1		H5656	003	0	2009	TexanPlus Classic	North Texas		2	2				2						(800)-958-2707	(800)-958-2707	(866)-338-4681	(866)-338-4681	(866)-245-4143	(866)-245-4143	(866)-338-4681	(866)-338-4681									http://www.texas-first.com/PresentFormulary	www.texas-first.com
H5656	004	0	1	01	01	H5656_004_0	6	2009.01	SELECTCARE HEALTH PLANS, INC.	TexasFirst Health Plans	www.texas-first.com	01	01		1		H5656	004	0	2009	TexanPlus Star powered by CCRx	North Texas		2	2				2						(800)-958-2707	(800)-958-2707	(866)-338-4681	(866)-338-4681	(866)-245-4143	(866)-245-4143	(866)-338-4681	(866)-338-4681	(800)-958-2707	(800)-958-2707	(866)-338-4681	(866)-338-4681	(866)-245-4143	(866)-245-4143	(866)-338-4681	(866)-338-4681	http://www.texas-first.com/PresentFormulary	www.texas-first.com
H5656	009	0	1	01	01	H5656_009_0	6	2009.01	SELECTCARE HEALTH PLANS, INC.	TexasFirst Health Plans	www.texas-first.com	01	01		1		H5656	009	0	2009	TexanPlus Premier powered by CCRx	North Texas		2	2				2						(800)-958-2707	(800)-958-2707	(866)-338-4681	(866)-338-4681	(866)-245-4143	(866)-245-4143	(866)-338-4681	(866)-338-4681	(800)-958-2707	(800)-958-2707	(866)-338-4681	(866)-338-4681	(866)-245-4143	(866)-245-4143	(866)-338-4681	(866)-338-4681	http://www.texas-first.com/PresentFormulary	www.texas-first.com
H5656	801	0	1	01	01	H5656_801_0	2	2009.01	SELECTCARE HEALTH PLANS, INC.	TexasFirst Health Plans	www.texas-first.com	01	01		1		H5656	801	0	2009	Retiree - MA-PD CY	Employer Group--North Texas (MAPD--CY)		1	2				2						(800)-958-2707	(800)-958-2707	(866)-338-4681	(866)-338-4681	(866)-245-4143	(866)-245-4143	(866)-338-4681	(866)-338-4681	(800)-958-2707	(800)-958-2707	(866)-338-4681	(866)-338-4681	(866)-245-4143	(866)-245-4143	(866)-338-4681	(866)-338-4681	http://www.texas-first.com/PresentFormulary	www.texas-first.com
H5656	802	0	1	01	01	H5656_802_0	2	2009.01	SELECTCARE HEALTH PLANS, INC.	TexasFirst Health Plans	www.texas-first.com	01	01		1		H5656	802	0	2009	Retiree - MA-PD non-CY	Employer Group--North Texas (MAPD--non-CY)		1	2				2						(800)-958-2707	(800)-958-2707	(866)-338-4681	(866)-338-4681	(866)-245-4143	(866)-245-4143	(866)-338-4681	(866)-338-4681	(800)-958-2707	(800)-958-2707	(866)-338-4681	(866)-338-4681	(866)-245-4143	(866)-245-4143	(866)-338-4681	(866)-338-4681	http://www.texas-first.com/PresentFormulary	www.texas-first.com
H5656	803	0	1	01	01	H5656_803_0	2	2009.01	SELECTCARE HEALTH PLANS, INC.	TexasFirst Health Plans	www.texas-first.com	01	01		1		H5656	803	0	2009	Retiree - MA	Employer Group--North Texas (MA--CY)		1	2				2						(800)-958-2707	(800)-958-2707	(866)-338-4681	(866)-338-4681	(866)-245-4143	(866)-245-4143	(866)-338-4681	(866)-338-4681									http://www.texas-first.com/PresentFormulary	www.texas-first.com
H5657	004	0	1	09	04	H5657_004_0	3	2009.01	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	04	09	2	1		H5657	004	0	2009	Humana Gold Choice PFFS H5657-004	Select Counites in New York		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5657	005	0	1	09	04	H5657_005_0	4	2009.01	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	04	09	2	1		H5657	005	0	2009	Humana Gold Choice PFFS H5657-005	Select Counties in New York		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5657	006	0	1	09	04	H5657_006_0	4	2009.01	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	04	09	2	1		H5657	006	0	2009	Humana Gold Choice PFFS H5657-006	Select Counties in New York		2	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5657	805	0	1	09	04	H5657_805_0	2	2009.01	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	04	09	2	1		H5657	805	0	2009	Humana Employer Sponsored	Nationwide		1	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5657	806	0	1	09	04	H5657_806_0	2	2009.01	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	04	09	2	1		H5657	806	0	2009	Humana Employer Sponsored	Nationwide		1	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5657	807	0	1	09	04	H5657_807_0	2	2009.01	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	04	09	2	1		H5657	807	0	2009	Humana Employer Sponsored Non-CY	Nationwide		1	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5657	808	0	1	09	04	H5657_808_0	2	2009.01	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	04	09	2	1		H5657	808	0	2009	Humana Employer Sponsored Non-CY	Nationwide		1	2				2						(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5657	809	0	2	09	04	H5657_809_0	4	2009.01	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	04	09	2	2		H5657	809	0	2009	Humana Employer Sponsored	Nationwide		1	2				2		2				(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5657	810	0	2	09	04	H5657_810_0	4	2009.01	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	04	09	2	2		H5657	810	0	2009	Humana Employer Sponsored	Nationwide		1	2				2		2				(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5657	811	0	2	09	04	H5657_811_0	4	2009.01	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	04	09	2	2		H5657	811	0	2009	Humana Employer Sponsored Non-CY	Nationwide		1	2				2		2				(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486	(877)-511-5000	(877)-511-5000		(800)-833-3301	(800)-833-2312	(800)-833-2312		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5657	812	0	2	09	04	H5657_812_0	4	2009.01	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	04	09	2	2		H5657	812	0	2009	Humana Employer Sponsored Non-CY	Nationwide		1	2				2		2				(877)-511-5000	(877)-511-5000	(800)-833-3301	(800)-833-3301	(800)-833-2312	(800)-833-2312	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5665	002	0	1	01	01	H5665_002_0	9	2009.01	CARE IMPROVEMENT PLUS  OF MARYLAND, INC.	Care Improvement Plus	www.careimprovementplus.com	01	01		1		H5665	002	0	2009	Care Improvement Plus Gold Rx	Maryland		2	1	4			2			1		1110000010000000000000000001	(800)-204-1002	(800)-204-1002	(800)-713-1603	(800)-713-1603	(800)-711-1656	(800)-711-1656	(800)-713-1603	(800)-713-1603	(866)-270-3977	(866)-270-3977	(866)-236-1069	(866)-236-1069	(800)-711-1656	(800)-711-1656	(800)-713-1603	(800)-713-1603	http://careimprovementplus.com/members/maryland/medicarePartD/formulary.aspx	www.careimprovementplus.com
H5678	001	0	1	37	05	H5678_001_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.ericksonadvantage.com	05	37		1		H5678	001	0	2009	Erickson Advantage Signature with Drugs	Fairfax County		2	2				2						(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.ericksonadvantage.com
H5678	002	0	1	37	05	H5678_002_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.ericksonadvantage.com	05	37		1		H5678	002	0	2009	Erickson Advantage Signature without Drugs	Fairfax County		2	2				2						(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480										http://www.ericksonadvantage.com/formulary.asp	www.ericksonadvantage.com
H5678	003	0	1	37	05	H5678_003_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.ericksonadvantage.com	05	37		1		H5678	003	0	2009	Erickson Advantage Guardian	Fairfax County		2	1	1	1		2			2			(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.ericksonadvantage.com
H5678	004	0	1	37	05	H5678_004_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.ericksonadvantage.com	05	37		1		H5678	004	0	2009	Erickson Advantage Champion	Fairfax County		2	1	4			2			2		1111111110000000100000000001	(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.ericksonadvantage.com
H5679	001	0	1	01	01	H5679_001_0	8	2009.01	HMO COLORADO, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H5679	001	0	2009	SureValue Basic	Denver Metro Area		2	2			315	2						(866)-408-7086	(866)-408-7086	(711)-000-0000	(711)-000-0000	(888)-211-9815	(888)-211-9815	(800)-297-1538	(800)-297-1538	(866)-408-7086	(866)-408-7086	(800)-297-1538	(800)-297-1538	(888)-211-9815	(888)-211-9815	(800)-297-1538	(800)-297-1538	www.anthem.com	www.anthem.com
H5679	002	0	1	01	01	H5679_002_0	8	2009.01	HMO COLORADO, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H5679	002	0	2009	SureValue Enhanced	Denver Metro Area		2	2			79	2						(866)-408-7086	(866)-408-7086	(711)-000-0000	(711)-000-0000	(888)-211-9815	(888)-211-9815	(800)-297-1538	(800)-297-1538	(866)-408-7086	(866)-408-7086	(800)-297-1538	(800)-297-1538	(888)-211-9815	(888)-211-9815	(800)-297-1538	(800)-297-1538	www.anthem.com	www.anthem.com
H5679	801	0	1	01	01	H5679_801_0	4	2009.01	HMO COLORADO, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H5679	801	0	2009	SureValue Group Plan	Denver Metro Area		1	2			125	2						(866)-408-7086	(866)-408-7086	(711)-000-0000	(711)-000-0000	(888)-211-9815	(888)-211-9815	(800)-297-1538	(800)-297-1538	(866)-408-7086	(866)-408-7086	(800)-297-1538	(800)-297-1538	(888)-211-9815	(888)-211-9815	(800)-297-1538	(800)-297-1538	www.anthem.com	www.anthem.com
H5679	802	0	1	01	01	H5679_802_0	4	2009.01	HMO COLORADO, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H5679	802	0	2009	SureValue Group Plan	Denver Metro Area		1	2			50	2						(866)-408-7086	(866)-408-7086	(711)-000-0000	(711)-000-0000	(888)-211-9815	(888)-211-9815	(800)-297-1538	(800)-297-1538									www.anthem.com	www.anthem.com
H5679	803	0	1	01	01	H5679_803_0	4	2009.01	HMO COLORADO, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H5679	803	0	2009	SureValue Group Plan	Denver Metro Area		1	2			25	2						(866)-408-7086	(866)-408-7086	(711)-000-0000	(711)-000-0000	(888)-211-9815	(888)-211-9815	(800)-297-1538	(800)-297-1538	(866)-408-7086	(866)-408-7086	(800)-297-1538	(800)-297-1538	(888)-211-9815	(888)-211-9815	(800)-297-1538	(800)-297-1538	www.anthem.com	www.anthem.com
H5685	001	0	1	01	01	H5685_001_0	4	2009.01	MIDWEST HEALTH PLAN, INC.	Midwest Advantage	www.midwestadvantage.org	01	01		1		H5685	001	0	2009	Midwest  Advantage	Midwest Advantage of Wayne and Oakland Counties		2	1	3		638	2			1	3		(313)-581-3700	(888)-654-0706	(800)-649-3777	(800)-649-3777	(313)-581-3700	(888)-654-0706	(800)-649-3777	(800)-649-3777	(313)-875-6000	(866)-800-0671	(800)-649-3777	(800)-649-3777	(313)-581-3700	(888)-654-0706	(800)-649-3777	(800)-649-3777	www.midwestadvantage.org	www.midwestadvantage.org
H5696	001	0	1	01	01	H5696_001_0	9	2009.01	PHYSICIANS UNITED PLAN, INC.	Physicians United Plan	www.pupcorp.com	01	01		1		H5696	001	0	2009	PUP Easy	Polk County		2	2			1700	2						(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	www.pupcorp.com	www.pupcorp.com
H5696	002	0	1	01	01	H5696_002_0	10	2009.01	PHYSICIANS UNITED PLAN, INC.	Physicians United Plan	www.pupcorp.com	01	01		1		H5696	002	0	2009	PUP Rewards	Polk County		2	2			5500	2						(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	www.pupcorp.com	www.pupcorp.com
H5696	003	0	1	01	01	H5696_003_0	8	2009.01	PHYSICIANS UNITED PLAN, INC.	Physicians United Plan	www.pupcorp.com	01	01		1		H5696	003	0	2009	PUP Easy	Central Florida		2	2			3030	2						(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	www.pupcorp.com	www.pupcorp.com
H5696	004	0	1	01	01	H5696_004_0	9	2009.01	PHYSICIANS UNITED PLAN, INC.	Physicians United Plan	www.pupcorp.com	01	01		1		H5696	004	0	2009	PUP Rewards	Central Florida		2	2			3510	2						(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	www.pupcorp.com	www.pupcorp.com
H5696	018	0	1	01	01	H5696_018_0	5	2009.01	PHYSICIANS UNITED PLAN, INC.	Physicians United Plan	www.pupcorp.com	01	01		1		H5696	018	0	2009	PUP Carefree	Central Florida		2	2			500	2						(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693									www.pupcorp.com	www.pupcorp.com
H5696	019	0	1	01	01	H5696_019_0	6	2009.01	PHYSICIANS UNITED PLAN, INC.	Physicians United Plan	www.pupcorp.com	01	01		1		H5696	019	0	2009	PUP Perks	Central Florida		2	2			500	2						(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693									www.pupcorp.com	www.pupcorp.com
H5696	021	0	1	01	01	H5696_021_0	7	2009.01	PHYSICIANS UNITED PLAN, INC.	Physicians United Plan	www.pupcorp.com	01	01		1		H5696	021	0	2009	PUP Extra	Central Florida		2	1	3		540	2			1	2		(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	www.pupcorp.com	www.pupcorp.com
H5696	022	0	1	01	01	H5696_022_0	12	2009.01	PHYSICIANS UNITED PLAN, INC.	Physicians United Plan	www.pupcorp.com	01	01		1		H5696	022	0	2009	PUP Assist	Central Florida		2	1	4		105	2			1		1110000010000000000000000001	(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	(407)-571-0693	(866)-571-0693	(866)-671-0693	(866)-671-0693	www.pupcorp.com	www.pupcorp.com
H5697	001	0	1	37	05	H5697_001_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.ericksonadvantage.com	05	37		1		H5697	001	0	2009	Erickson Advantage Signature with Drugs	Bucks and Delaware Counties		2	2				2						(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.ericksonadvantage.com
H5697	002	0	1	37	05	H5697_002_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.ericksonadvantage.com	05	37		1		H5697	002	0	2009	Erickson Advantage Signature without Drugs	Bucks and Delaware Counties		2	2				2						(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480										http://www.ericksonadvantage.com/formulary.asp	www.ericksonadvantage.com
H5697	003	0	1	37	05	H5697_003_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.ericksonadvantage.com	05	37		1		H5697	003	0	2009	Erickson Advantage Champion	Bucks and Delaware Counties		2	1	4			2			2		1111111110000000100000000001	(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.ericksonadvantage.com
H5697	004	0	1	37	05	H5697_004_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.ericksonadvantage.com	05	37		1		H5697	004	0	2009	Erickson Advantage Guardian	Bucks		2	1	1	1		2			1			(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.ericksonadvantage.com
H5698	002	0	1	01	01	H5698_002_0	4	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	002	0	2009	Windsor Medicare Extra Gold Plan	Middle Tennessee and Alabama		2	2			406	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	003	0	1	01	01	H5698_003_0	8	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	003	0	2009	Windsor Medicare Extra Comprehensive Plan	Middle Tennessee and Jefferson County, AL		2	1	3		4574	2			1	2		(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	005	0	1	01	01	H5698_005_0	5	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	005	0	2009	Windsor Medicare Extra Gold Plan	West Tennessee and North Mississippi		2	2			800	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	006	0	1	01	01	H5698_006_0	3	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	006	0	2009	Windsor Medicare Extra Silver Plan	Middle Tennessee and Alabama		2	2			240	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298									www.windsorextra.com	www.windsorextra.com
H5698	007	0	1	01	01	H5698_007_0	4	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	007	0	2009	Windsor Medicare Extra Silver Plan	West Tennessee and North Mississippi		2	2			199	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298									www.windsorextra.com	www.windsorextra.com
H5698	009	0	1	01	01	H5698_009_0	9	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	009	0	2009	Windsor Medicare Extra Comprehensive Plan	West Tennessee and North Mississippi		2	1	3		4805	2			1	2		(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	017	0	1	01	01	H5698_017_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	017	0	2009	Windsor Medicare Extra Platinum Plan	Middle Tennessee and Alabama		2	2			1260	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	018	0	1	01	01	H5698_018_0	7	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	018	0	2009	Windsor Medicare Extra Platinum Plan	West Tennessee and North Mississippi		2	2			619	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	019	0	1	01	01	H5698_019_0	3	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	019	0	2009	Windsor Medicare Extra Silver Plan	Central and Northeast Arkansas		2	2			204	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298									www.windsorextra.com	www.windsorextra.com
H5698	020	0	1	01	01	H5698_020_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	020	0	2009	Windsor Medicare Extra Gold Plan	Central and Northeast Arkansas		2	2			808	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	021	0	1	01	01	H5698_021_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	021	0	2009	Windsor Medicare Extra Platinum Plan	Central and Northeast Arkansas		2	2			781	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	022	0	1	01	01	H5698_022_0	8	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	022	0	2009	Windsor Medicare Extra Comprehensive Plan	Central and Northeast Arkansas		2	1	3		2252	2			1	2		(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	027	0	1	01	01	H5698_027_0	4	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	027	0	2009	Windsor Medicare Extra Silver Plan	Central Mississippi		2	2			296	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298									www.windsorextra.com	www.windsorextra.com
H5698	028	0	1	01	01	H5698_028_0	5	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	028	0	2009	Windsor Medicare Extra Gold Plan	Central Mississippi		2	2			1784	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	029	0	1	01	01	H5698_029_0	7	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	029	0	2009	Windsor Medicare Extra Platinum Plan	Central Mississippi		2	2			1011	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	030	0	1	01	01	H5698_030_0	8	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	030	0	2009	Windsor Medicare Extra Comprehensive Plan	Central Mississippi		2	1	3		3135	2			1	2		(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	035	0	1	01	01	H5698_035_0	3	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	035	0	2009	Windsor Medicare Extra Silver Plan	East Tennessee and South Carolina		2	2			162	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298									www.windsorextra.com	www.windsorextra.com
H5698	036	0	1	01	01	H5698_036_0	4	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	036	0	2009	Windsor Medicare Extra Gold Plan	East Tennessee and South Carolina		2	2			925	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	037	0	1	01	01	H5698_037_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	037	0	2009	Windsor Medicare Extra Platinum Plan	East Tennessee and South Carolina		2	2			720	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	038	0	1	01	01	H5698_038_0	8	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	038	0	2009	Windsor Medicare Extra Comprehensive Plan	East Tennessee and Greenville/Spartanburg, SC		2	1	3		1394	2			1	2		(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	055	0	1	01	01	H5698_055_0	3	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	055	0	2009	Windsor Medicare Extra Silver Plan	Northwest Arkansas		2	2			162	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298									www.windsorextra.com	www.windsorextra.com
H5698	056	0	1	01	01	H5698_056_0	4	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	056	0	2009	Windsor Medicare Extra Gold Plan	Northwest Arkansas		2	2			155	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	057	0	1	01	01	H5698_057_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	057	0	2009	Windsor Medicare Extra Platinum Plan	Northwest Arkansas		2	2			300	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	058	0	1	01	01	H5698_058_0	8	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	058	0	2009	Windsor Medicare Extra Comprehensive Plan	Northwest Arkansas		2	1	3		58	2			1	2		(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	059	0	1	01	01	H5698_059_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	059	0	2009	Windsor Medicare Extra  Emerald Plan	West Tennessee and North Mississippi		2	2			164	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	060	0	1	01	01	H5698_060_0	5	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	060	0	2009	Windsor Medicare Extra  Emerald Plan	Middle Tennessee and Alabama		2	2			578	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	061	0	1	01	01	H5698_061_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	061	0	2009	Windsor Medicare Extra  Emerald Plan	Central Mississippi		2	2			320	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	062	0	1	01	01	H5698_062_0	5	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	062	0	2009	Windsor Medicare Extra  Emerald Plan	East Tennessee		2	2			272	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	063	0	1	01	01	H5698_063_0	5	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	063	0	2009	Windsor Medicare Extra  Emerald Plan	Central and Northeast Arkansas		2	2			346	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	064	0	1	01	01	H5698_064_0	5	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	064	0	2009	Windsor Medicare Extra  Emerald Plan	Northwest Arkansas		2	2			58	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	065	0	1	01	01	H5698_065_0	5	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	065	0	2009	Windsor Medicare Extra Diamond Plan	West Tennessee and North Mississippi		2	2			133	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	066	0	1	01	01	H5698_066_0	4	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	066	0	2009	Windsor Medicare Extra Diamond Plan	Middle Tennessee and Alabama		2	2			348	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	067	0	1	01	01	H5698_067_0	5	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	067	0	2009	Windsor Medicare Extra Diamond Plan	Central Mississippi		2	2			1337	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	068	0	1	01	01	H5698_068_0	4	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	068	0	2009	Windsor Medicare Extra Diamond Plan	East Tennessee		2	2			724	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	069	0	1	01	01	H5698_069_0	4	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	069	0	2009	Windsor Medicare Extra Diamond Plan	Central and Northeast Arkansas		2	2			849	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	070	0	1	01	01	H5698_070_0	4	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	070	0	2009	Windsor Medicare Extra Diamond Plan	Northwest Arkansas		2	2			252	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	071	0	1	01	01	H5698_071_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	071	0	2009	Windsor Medicare Extra Spc Care Fusion	Northwest Arkansas		2	1	4		11	2			1		0000000000000000000000000001	(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	072	0	1	01	01	H5698_072_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	072	0	2009	Windsor Medicare Extra Spc Care Fusion	Central and Northeast Arkansas		2	1	4		18	2			1		0000000000000000000000000001	(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	073	0	1	01	01	H5698_073_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	073	0	2009	Windsor Medicare Extra Spc Care Fusion	West Tennessee and North Mississippi		2	1	4		23	2			1		0000000000000000000000000001	(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	074	0	1	01	01	H5698_074_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	074	0	2009	Windsor Medicare Extra Spc Care Fusion	Central Misssissippi		2	1	4		14	2			1		0000000000000000000000000001	(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	075	0	1	01	01	H5698_075_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	075	0	2009	Windsor Medicare Extra Spc Care Fusion	Middle Tennessee and Jefferson County Alabama		2	1	4		29	2			1		0000000000000000000000000001	(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	076	0	1	01	01	H5698_076_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	076	0	2009	Windsor Medicare Extra Spc Care Fusion	East Tennessee and Greenville/Spartanburg, SC		2	1	4		20	2			1		0000000000000000000000000001	(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	077	0	1	01	01	H5698_077_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	077	0	2009	Windsor Medicare Extra Spc Care FusionPlus	Northwest Arkansas		2	1	4		11	2			1		0000000000000000000000000001	(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	078	0	1	01	01	H5698_078_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	078	0	2009	Windsor Medicare Extra Spc Care FusionPlus	Central and Northeast Arkansas		2	1	4		18	2			1		0000000000000000000000000001	(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	079	0	1	01	01	H5698_079_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	079	0	2009	Windsor Medicare Extra Spc Care FusionPlus	West Tennessee and North Mississippi		2	1	4		23	2			1		0000000000000000000000000001	(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	080	0	1	01	01	H5698_080_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	080	0	2009	Windsor Medicare Extra Spc Care FusionPlus	Central Mississippi		2	1	4		14	2			1		0000000000000000000000000001	(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	081	0	1	01	01	H5698_081_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	081	0	2009	Windsor Medicare Extra Spc Care FusionPlus	Middle Tennessee and Jefferson County Alabama		2	1	4		29	2			1		0000000000000000000000000001	(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	082	0	1	01	01	H5698_082_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	082	0	2009	Windsor Medicare Extra Spc Care FusionPlus	East Tennessee and Greenville/Spartanburg, SC		2	1	4		21	2			1		0000000000000000000000000001	(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	086	0	1	01	01	H5698_086_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	086	0	2009	Windsor Medicare Extra Special Care COPD	Central and Northeast Arkansas		2	1	4		15	2			1		1110000000000000000000000000	(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	087	0	1	01	01	H5698_087_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	087	0	2009	Windsor Medicare Extra Spc Care Diabetes	Central and Northeast Arkansas		2	1	4		9	2			1		0000000010000000000000000000	(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	088	0	1	01	01	H5698_088_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	088	0	2009	Windsor Medicare Extra Special Care CHF	Central and Northeast Arkansas		2	1	4		9	2			1		0000000000000000000000000001	(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	089	0	1	01	01	H5698_089_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	089	0	2009	Windsor Medicare Extra Special Care COPD	West Tennessee and North Mississippi		2	1	4		11	2			1		1110000000000000000000000000	(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	090	0	1	01	01	H5698_090_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	090	0	2009	Windsor Medicare Extra Spc Care Diabetes	West Tennessee and North Mississippi		2	1	4		11	2			1		0000000010000000000000000000	(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	091	0	1	01	01	H5698_091_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	091	0	2009	Windsor Medicare Extra Special Care CHF	West Tennessee and North Mississippi		2	1	4		11	2			1		0000000000000000000000000001	(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	092	0	1	01	01	H5698_092_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	092	0	2009	Windsor Medicare Extra Special Care COPD	Central Mississippi		2	1	4		7	2			1		1110000000000000000000000000	(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	093	0	1	01	01	H5698_093_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	093	0	2009	Windsor Medicare Extra Spc Care Diabetes	Central Mississippi		2	1	4		7	2			1		0000000010000000000000000000	(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	094	0	1	01	01	H5698_094_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	094	0	2009	Windsor Medicare Extra Special Care CHF	Central Mississippi		2	1	4		7	2			1		0000000000000000000000000001	(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	095	0	1	01	01	H5698_095_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	095	0	2009	Windsor Medicare Extra Special Care COPD	Middle Tennessee and Jefferson County, AL		2	1	4		9	2			1		1110000000000000000000000000	(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	096	0	1	01	01	H5698_096_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	096	0	2009	Windsor Medicare Extra Spc Care Diabetes	Middle Tennessee and Jefferson County, AL		2	1	4		15	2			1		0000000010000000000000000000	(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	097	0	1	01	01	H5698_097_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	01		1		H5698	097	0	2009	Windsor Medicare Extra Special Care CHF	Middle Tennessee and Jefferson County, AL		2	1	4		16	2			1		0000000000000000000000000001	(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	111	0	1	02	01	H5698_111_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	02		1		H5698	111	0	2009	Windsor Medicare Extra Gold POS Plan	MidSouth		2	2			800	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	112	0	1	02	01	H5698_112_0	6	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	02		1		H5698	112	0	2009	Windsor Medicare Extra Diamond POS Plan	MidSouth		2	2			133	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	113	0	1	02	01	H5698_113_0	5	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	02		1		H5698	113	0	2009	Windsor Medicare Extra Gold POS Plan	Middle Tennessee and Alabama		2	2			406	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5698	114	0	1	02	01	H5698_114_0	5	2009.01	WINDSOR HEALTH PLANS, INC.	Windsor Medicare Extra	www.windsorextra.com	01	02		1		H5698	114	0	2009	Windsor Medicare Extra Diamond POS Plan	Middle Tennessee and Alabama		2	2			348	2						(615)-782-7878	(800)-316-2273	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	(615)-782-7878	(800)-316-2273		(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorextra.com	www.windsorextra.com
H5700	002	0	1	01	01	H5700_002_0	19	2009.01	ARKANSAS COMMUNITY CARE	Arkansas Community Care, Inc.	www.arkansascommunitycare.com	01	01		1		H5700	002	0	2009	Arkansas Comm. Care -  Plus (Northwest)	Northwest Arkansas		2	2			8540	2						(501)-223-9088	(800)-573-8597	(866)-573-8591	(866)-573-8591	(501)-223-9088	(800)-705-0766	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(501)-223-9088	(800)-705-0766	(866)-573-8613	(866)-573-8613	http://www.arkansascommunitycare.com/central/formulary.html	
H5700	005	0	1	01	01	H5700_005_0	9	2009.01	ARKANSAS COMMUNITY CARE	Arkansas Community Care, Inc.	www.arkansascommunitycare.com	01	01		1		H5700	005	0	2009	Arkansas Comm. Care - Plus (Central)	Central Arkansas		2	2			45988	2						(501)-223-9088	(800)-573-8597	(866)-573-8591	(866)-573-8591	(501)-223-9088	(800)-705-0766	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(501)-223-9088	(800)-705-0766	(866)-573-8613	(866)-573-8613	http://www.arkansascommunitycare.com/central/formulary.html	
H5700	009	0	1	01	01	H5700_009_0	20	2009.01	ARKANSAS COMMUNITY CARE	Arkansas Community Care, Inc.	www.arkansascommunitycare.com	01	01		1		H5700	009	0	2009	Arkansas Comm. Care - Plus (Fort Smith)	Fort Smith		2	2			9677	2						(501)-223-9088	(800)-573-8597	(866)-573-8591	(866)-573-8591	(501)-223-9088	(800)-705-0766	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(501)-223-9088	(800)-705-0766	(866)-573-8613	(866)-573-8613	http://www.arkansascommunitycare.com/central/formulary.html	
H5700	018	0	1	01	01	H5700_018_0	7	2009.01	ARKANSAS COMMUNITY CARE	Arkansas Community Care, Inc.	www.arkansascommunitycare.com	01	01		1		H5700	018	0	2009	Arkansas Comm. Care -Dual Plus	Arkansas		2	1	3		7824	2			1	1		(501)-223-9088	(800)-573-8597	(866)-573-8591	(866)-573-8591	(501)-223-9088	(800)-705-0766	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(501)-223-9088	(800)-705-0766	(866)-573-8613	(866)-573-8613	http://www.arkansascommunitycare.com/central/formulary.html	
H5700	020	0	1	01	01	H5700_020_0	18	2009.01	ARKANSAS COMMUNITY CARE	Arkansas Community Care, Inc.	www.arkansascommunitycare.com	01	01		1		H5700	020	0	2009	Texarkana Comm. Care - Plus	Texarkana		2	2			24656	2						(501)-223-9088	(800)-573-8597	(866)-573-8591	(866)-573-8591	(501)-223-9088	(800)-705-0766	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(501)-223-9088	(800)-705-0766	(866)-573-8613	(866)-573-8613	http://www.arkansascommunitycare.com/central/formulary.html	
H5700	025	0	1	02	01	H5700_025_0	21	2009.01	ARKANSAS COMMUNITY CARE	Arkansas Community Care, Inc.	www.arkansascommunitycare.com	01	02		1		H5700	025	0	2009	Arkansas Community Care POS (Fort Smith)	Fort Smith		2	2			9677	2						(501)-223-9088	(800)-573-8597	(866)-573-8591	(866)-573-8591	(501)-223-9088	(800)-705-0766	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(501)-223-9088	(800)-705-0766	(866)-573-8613	(866)-573-8613	http://www.arkansascommunitycare.com/central/formulary.html	
H5700	801	0	1	01	01	H5700_801_0	8	2009.01	ARKANSAS COMMUNITY CARE	Arkansas Community Care, Inc.	www.arkansascommunitycare.com	01	01		1		H5700	801	0	2009	Arkansas Community Care EGWP	Arkansas		1	2			0	2						(501)-223-9088	(800)-573-8597	(866)-573-8591	(866)-573-8591	(501)-223-9088	(800)-705-0766	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(501)-223-9088	(800)-705-0766	(866)-573-8613	(866)-573-8613	http://www.arkansascommunitycare.com/central/formulary.html	
H5703	001	0	1	01	01	H5703_001_0	6	2009.01	SOUTH COUNTRY HEALTH ALLIANCE	South Country Health Alliance	www.mnscha.org	01	01		1		H5703	001	0	2009	AbilityCare	Select Counties in Minnesota		2	1	3		700	2			1	1		(866)-477-1601	(866)-477-1601	(888)-878-0137	(888)-878-0137	(866)-477-1601	(866)-477-1601	(888)-878-0137	(888)-878-0137	(866)-477-1601	(866)-477-1601	(888)-878-0137	(888)-878-0137	(866)-477-1601	(866)-477-1601	(888)-878-0137	(888)-878-0137	https://www.myrxassistant.com/MyRxAssistant/app?service=external/FormularyHomesp=SSCHA	www.mnscha.org
H5721	001	0	1	09	04	H5721_001_0	2	2009.01	HEALTH NET INSURANCE OF NEW YORK, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5721	001	0	2009	Health Net Pearl NY MA Low Tier 1	Portions of New York		2	2			164	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-949-2515	(800)-949-2515	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
H5721	002	0	1	09	04	H5721_002_0	2	2009.01	HEALTH NET INSURANCE OF NEW YORK, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5721	002	0	2009	Health Net Pearl NY MA Low Tier 2	Portions of New York		2	2			19	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-949-2515	(800)-949-2515	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
H5721	003	0	1	09	04	H5721_003_0	1	2009.01	HEALTH NET INSURANCE OF NEW YORK, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5721	003	0	2009	Health Net Pearl NY MA High Tier 1	Portions of New York		2	2			155	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-949-2515	(800)-949-2515	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
H5721	004	0	1	09	04	H5721_004_0	4	2009.01	HEALTH NET INSURANCE OF NEW YORK, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5721	004	0	2009	Health Net Pearl NY MAPD	Portions of New York		2	2			19	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-949-2515	(800)-949-2515	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-949-2515	(800)-949-2515	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
H5721	006	0	1	09	04	H5721_006_0	1	2009.01	HEALTH NET INSURANCE OF NEW YORK, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5721	006	0	2009	Health Net Pearl NY MA High Tier 2	Portions of NY		2	2			6	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-949-2515	(800)-949-2515	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
H5721	802	0	1	09	04	H5721_802_0	3	2009.01	HEALTH NET INSURANCE OF NEW YORK, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5721	802	0	2009	Health Net Pearl EG	National		1	2				2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-949-2515	(800)-949-2515	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
H5721	804	0	1	09	04	H5721_804_0	3	2009.01	HEALTH NET INSURANCE OF NEW YORK, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5721	804	0	2009	Health Net Pearl EG	National		1	2				2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-949-2515	(800)-949-2515	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
H5721	807	0	1	09	04	H5721_807_0	3	2009.01	HEALTH NET INSURANCE OF NEW YORK, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5721	807	0	2009	Health Net Pearl EG	National		1	2				2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-949-2515	(800)-949-2515	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-949-2515	(800)-949-2515	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
H5721	808	0	1	09	04	H5721_808_0	4	2009.01	HEALTH NET INSURANCE OF NEW YORK, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5721	808	0	2009	Health Net Pearl EG	United States		1	2				2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-949-2515	(800)-949-2515	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-949-2515	(800)-949-2515	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
H5732	001	0	1	01	01	H5732_001_0	4	2009.01	AUXILIO PLATINO, INC.	Triple-S, INC.	www.ssspr.com	01	01		1		H5732	001	0	2009	Auxilio Platino Clsico	Puerto Rico		2	2				2						(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	www.auxilioplatino.com/ParteD	
H5732	002	0	1	01	01	H5732_002_0	5	2009.01	AUXILIO PLATINO, INC.	Triple-S, INC.	www.ssspr.com	01	01		1		H5732	002	0	2009	Auxilio Platino Premier	Puerto Rico		2	2			200	2						(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	www.auxilioplatino.com/ParteD	
H5736	002	0	1	09	04	H5736_002_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	1		H5736	002	0	2009	Aetna Medicare Open Value Plan w/Rx	Select Counties in Multiple States - 2		2	2				2						(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	
H5736	003	0	1	09	04	H5736_003_0	5	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	1		H5736	003	0	2009	Aetna Medicare Open Basic Plan w/Rx	Select Counties in Multiple States - 3		2	2				2						(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	
H5736	007	0	1	09	04	H5736_007_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	1		H5736	007	0	2009	Aetna Medicare Open Basic Plan w/Rx	Select Counties in Multiple States - 5		2	2				2						(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	
H5736	011	0	1	09	04	H5736_011_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	1		H5736	011	0	2009	Aetna Medicare Open Value Plan	Select Counties in Multiple States - 1		2	2				2						(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	
H5736	012	0	1	09	04	H5736_012_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	1		H5736	012	0	2009	Aetna Medicare Open Value Plan w/Rx	Select Counties in Multiple States - 1		2	2				2						(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	
H5736	013	0	1	09	04	H5736_013_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	1		H5736	013	0	2009	Aetna Medicare Open Premier Plan	Select Counties in Multiple States - 1		2	2				2						(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	
H5736	014	0	1	09	04	H5736_014_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	1		H5736	014	0	2009	Aetna Medicare Open Premier Plan w/Rx	Select Counties in Multiple States - 1		2	2				2						(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	
H5736	015	0	1	09	04	H5736_015_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	1		H5736	015	0	2009	Aetna Medicare Open Value Plan	Select Counties in Multiple States - 2		2	2				2						(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	
H5736	016	0	1	09	04	H5736_016_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	1		H5736	016	0	2009	Aetna Medicare Open Premier Plan	Select Counties in Multiple States - 2		2	2				2						(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	
H5736	017	0	1	09	04	H5736_017_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	1		H5736	017	0	2009	Aetna Medicare Open Premier Plan w/Rx	Select Counties in Multiple States - 2		2	2				2						(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	
H5736	018	0	1	09	04	H5736_018_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	1		H5736	018	0	2009	Aetna Medicare Open Basic Plan	Select Counties in Multiple States - 3		2	2				2						(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	
H5736	019	0	1	09	04	H5736_019_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	1		H5736	019	0	2009	Aetna Medicare Open Standard Plan	Select Counties in Multiple States - 3		2	2				2						(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	
H5736	020	0	1	09	04	H5736_020_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	1		H5736	020	0	2009	Aetna Medicare Open Basic Plan	Select Counties in Multiple States - 4		2	2				2						(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	
H5736	021	0	1	09	04	H5736_021_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	1		H5736	021	0	2009	Aetna Medicare Open Standard Plan	Select Counties in Multiple States - 4		2	2				2						(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	
H5736	022	0	1	09	04	H5736_022_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	1		H5736	022	0	2009	Aetna Medicare Open Basic Plan	Select Counties in Multiple States - 5		2	2				2						(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	
H5736	023	0	1	09	04	H5736_023_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	1		H5736	023	0	2009	Aetna Medicare Open Standard Plan	Select Counties in Multiple States - 5		2	2				2						(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	
H5736	024	0	1	09	04	H5736_024_0	5	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	1		H5736	024	0	2009	Aetna Medicare Open Standard Plan w/Rx	Select Counties in Multiple States - 3		2	2				2						(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	
H5736	025	0	1	09	04	H5736_025_0	5	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	1		H5736	025	0	2009	Aetna Medicare Open Basic Plan w/Rx	Select Counties in Multiple States - 4		2	2				2						(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	
H5736	026	0	1	09	04	H5736_026_0	5	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	1		H5736	026	0	2009	Aetna Medicare Open Standard Plan w/Rx	Select Counties in Multiple States - 4		2	2				2						(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	
H5736	027	0	1	09	04	H5736_027_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	1		H5736	027	0	2009	Aetna Medicare Open Standard Plan w/ RX	Select Counties in Multiple States - 5		2	2				2						(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	
H5736	801	0	1	09	04	H5736_801_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	1		H5736	801	0	2009	Aetna Medicare Open Plan	National		1	2				2						(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	
H5736	802	0	1	09	04	H5736_802_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	1		H5736	802	0	2009	Aetna Medicare Open Plan w/Rx	National		1	2				2						(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	
H5736	808	0	2	09	04	H5736_808_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	2		H5736	808	0	2009	Aetna Medicare Open Part B Only Plan	National		1	2				2		2				(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	
H5736	809	0	2	09	04	H5736_809_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	2		H5736	809	0	2009	Aetna Medicare Open Part B Only Plan w/Rx	National		1	2				2		2				(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	
H5736	810	0	1	09	04	H5736_810_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	1		H5736	810	0	2009	Aetna Medicare Open Plan w/ RX NCY	National		1	2				2						(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	
H5736	811	0	2	09	04	H5736_811_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	04	09	2	2		H5736	811	0	2009	Aetna Medicare Open Part B Only Plan  w/RX NCY	National		1	2				2		2				(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(866)-785-7337	(866)-785-7337	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	
H5746	006	0	1	01	01	H5746_006_0	4	2009.01	AMERIGROUP NEW MEXICO, INC.	AMERIGROUP Community Care of New Mexico	https://www.amerigroupcorp.com/Members/	01	01		1		H5746	006	0	2009	AMERIVANTAGE Specialty + Rx	Bernalillo County		2	1	3		750	2			1	1		(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		http://www.amerigroupcorp.com/Members/amerivantage/_documents	https://www.amerigroupcorp.com/Members/providers.asp
H5746	007	0	1	01	01	H5746_007_0	4	2009.01	AMERIGROUP NEW MEXICO, INC.	AMERIGROUP Community Care of New Mexico	https://www.amerigroupcorp.com/Members/	01	01		1		H5746	007	0	2009	AMERIVANTAGE Classic + Rx	Albuquerque Metro Area		2	2			700	2						(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		http://www.amerigroupcorp.com/Members/amerivantage/_documents	https://www.amerigroupcorp.com/Members/providers.asp
H5746	011	0	1	01	01	H5746_011_0	4	2009.01	AMERIGROUP NEW MEXICO, INC.	AMERIGROUP Community Care of New Mexico	https://www.amerigroupcorp.com/Members/	01	01		1		H5746	011	0	2009	AMERIVANTAGE Balance + Rx	Albuquerque Metro Area		2	2			175	2						(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		http://www.amerigroupcorp.com/Members/amerivantage/_documents	https://www.amerigroupcorp.com/Members/providers.asp
H5746	012	0	1	02	01	H5746_012_0	7	2009.01	AMERIGROUP NEW MEXICO, INC.	AMERIGROUP Community Care of New Mexico	https://www.amerigroupcorp.com/Members/	01	02		1		H5746	012	0	2009	AMERIVANTAGE Choice + Rx	Albuquerque Metro Area		2	2			175	2						(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		(866)-805-4589	(866)-805-4589	(800)-855-2880		http://www.amerigroupcorp.com/Members/amerivantage/_documents	https://www.amerigroupcorp.com/Members/providers.asp
H5749	001	0	1	02	01	H5749_001_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	02		1		H5749	001	0	2009	AARP MedicareComplete Plus Plan 1	Johnson, Cass, Jackson,Lafayette, Counties		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	
H5749	801	0	1	02	01	H5749_801_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	02		1		H5749	801	0	2009	MedicareComplete Retiree Plan	Johnson, Cass, Jackson, and Lafayette Counties		1	2				2						(800)-945-0150		(888)-685-8480		(800)-555-5757		(800)-387-1074		(888)-685-8480	(800)-945-5015			(800)-555-5757	(800)-555-5757			www.aarpmedicarecomplete.com	
H5749	802	0	1	02	01	H5749_802_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	02		1		H5749	802	0	2009	MedicareComplete Retiree Plan	Johnson, Cass, Jackson, and Lafayette Counties		1	2				2						(800)-945-0150		(888)-685-8480		(800)-555-5757		(800)-387-1074										www.aarpmedicarecomplete.com	
H5749	803	0	1	02	01	H5749_803_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	02		1		H5749	803	0	2009	MedicareComplete Retiree Plan	Johnson , Cass, Jackson, LaFayette Counties		1	2				2						(800)-945-0150		(888)-685-8480		(800)-555-5757		(800)-387-1074		(888)-685-8480	(800)-945-5015			(800)-555-5757	(800)-555-5757			www.aarpmedicarecomplete.com	
H5749	804	0	1	02	01	H5749_804_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	AARP MedicareComplete from SecureHorizons	www.aarpmedicarecomplete.com	01	02		1		H5749	804	0	2009	MedicareComplete Retiree Plan	Johnson, Cass, Jackson and LaFayette Counties		1	2				2						(800)-945-0150		(888)-685-8480		(800)-555-5757		(800)-387-1074										www.aarpmedicarecomplete.com	
H5750	001	0	1	02	01	H5750_001_0	6	2009.01	METROPOLITAN HEALTH PLAN	North Star Advantage / North Star Advantage Plus	www.mhpnorthstarplans.org	01	02		1		H5750	001	0	2009	MHP North Star Advantage Plus	Minnesota		2	2			269	2						(888)-562-8000	(888)-562-8000	(800)-627-3529		(866)-897-9958	(866)-897-9958	(800)-627-3529		(888)-562-8000	(888)-562-8000	(800)-627-3529	(800)-627-3529	(866)-897-9958	(866)-897-9958	(800)-627-3529	(800)-627-3529	www.mhpnorthstarplans.org	northstaradvantage.org
H5750	002	0	1	02	01	H5750_002_0	3	2009.01	METROPOLITAN HEALTH PLAN	North Star Advantage / North Star Advantage Plus	www.mhpnorthstarplans.org	01	02		1		H5750	002	0	2009	MHP North Star Advantage	Minnesota		2	2			28	2						(888)-562-8000	(888)-562-8000	(800)-627-3529	(800)-627-3529	(866)-897-9958	(866)-897-9958	(800)-627-3529	(800)-627-3529									www.mhpnorthstarplans.org	northstaradvantage.org
H5750	003	0	1	02	01	H5750_003_0	6	2009.01	METROPOLITAN HEALTH PLAN	North Star Advantage / North Star Advantage Plus	www.mhpnorthstarplans.org	01	02		1		H5750	003	0	2009	MHP North Star Advantage Basic	Minnesota		2	2			28	2						(888)-562-8000	(888)-562-8000	(800)-627-3529	(800)-627-3529	(866)-897-9958	(866)-897-9958	(800)-627-3529	(800)-627-3529	(888)-562-8000	(888)-562-8000	(800)-627-3529	(800)-627-3529	(866)-897-9958	(866)-897-9958	(800)-627-3529	(800)-627-3529	www.mhpnorthstarplans.org	northstaradvantage.org
H5750	004	0	1	01	01	H5750_004_0	5	2009.01	METROPOLITAN HEALTH PLAN	North Star Advantage / North Star Advantage Plus	MHP4LIFE.ORG	01	01		1		H5750	004	0	2009	MHP Integrated Care Initiative SNP	Hennepin County		2	1	3		106	2			1	1		(866)-903-4733	(866)-903-4733	(800)-627-3529	(800)-627-3529	(866)-601-8962	(866)-601-8962	(800)-627-3529	(800)-627-3529	(866)-903-4733	(866)-903-4733	(800)-627-3529	(800)-627-3529	(866)-601-8962	(866)-601-8962	(800)-627-3529	(800)-627-3529	www.mhpnorthstarplans.org	northstaradvantage.org
H5754	001	0	1	37	05	H5754_001_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.EricksonAdvantage.com	05	37		1		H5754	001	0	2009	Erickson Advantage Signature with Drugs	Essex and Plymouth Counties		2	2				2						(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.EricksonAdvantage.com
H5754	002	0	1	37	05	H5754_002_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.EricksonAdvantage.com	05	37		1		H5754	002	0	2009	Erickson Advantage Signature without Drugs	Essex and Plymouth Counties		2	2				2						(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480										http://www.ericksonadvantage.com/formulary.asp	www.EricksonAdvantage.com
H5754	003	0	1	37	05	H5754_003_0	6	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.EricksonAdvantage.com	05	37		1		H5754	003	0	2009	Erickson Advantage Guardian	Essex County		2	1	1	1		2			1			(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.EricksonAdvantage.com
H5754	004	0	1	37	05	H5754_004_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.EricksonAdvantage.com	05	37		1		H5754	004	0	2009	Erickson Advantage Champion	Essex and Plymouth Counties		2	1	4			2			2		1111111110000000100000000001	(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.EricksonAdvantage.com
H5760	001	0	1	02	01	H5760_001_0	1	2009.01	COOPERATIVA DE SEGUROS DE VIDA DE PUERTO RICO	CosviMed Care	www.cosvi.com	01	02		1		H5760	001	0	2009	CosviMed Care	Puerto Rico		2	2			5	2						(787)-751-5656	(877)-311-0012	(877)-311-0018		(787)-751-5656	(877)-311-0013	(877)-311-0014										http://www.cosvi.com	http://www.cosvi.com
H5760	003	0	1	02	01	H5760_003_0	11	2009.01	COOPERATIVA DE SEGUROS DE VIDA DE PUERTO RICO	CosviMed Care	www.cosvi.com	01	02		1		H5760	003	0	2009	CosviMed Care RmaX	Puerto Rico		2	2			300	2						(787)-751-5656	(877)-311-0012	(877)-311-0018		(787)-751-5656	(877)-311-0013	(877)-311-0014		(787)-751-5656	(877)-311-0017	(877)-311-0018		(787)-751-5656	(877)-311-0013	(877)-311-0014		http://www.cosvi.com	http://www.cosvi.com
H5760	004	0	1	02	01	H5760_004_0	8	2009.01	COOPERATIVA DE SEGUROS DE VIDA DE PUERTO RICO	CosviMed Care	www.cosvi.com	01	02		1		H5760	004	0	2009	CosviMed Care Platino+	Puerto Rico		2	1	3		600	2			1	3		(787)-751-5656	(877)-311-0012	(877)-311-0018		(787)-751-5656	(877)-311-0013	(877)-311-0014		(787)-751-5656	(877)-311-0017	(877)-311-0018		(787)-751-5656	(877)-311-0013	(877)-311-0014		http://www.cosvi.com	http://www.cosvi.com
H5760	007	0	1	02	01	H5760_007_0	6	2009.01	COOPERATIVA DE SEGUROS DE VIDA DE PUERTO RICO	CosviMed Care	www.cosvi.com	01	02		1		H5760	007	0	2009	CosviMed Care Freedom	Puerto Rico		2	2			100	2						(787)-751-5656	(877)-311-0012	(877)-311-0018		(787)-751-5656	(877)-311-0013	(877)-311-0014		(787)-751-5656	(877)-311-0017	(877)-311-0018		(787)-751-5656	(877)-311-0013	(877)-311-0014		http://www.cosvi.com	http://www.cosvi.com
H5760	802	0	1	02	01	H5760_802_0	6	2009.01	COOPERATIVA DE SEGUROS DE VIDA DE PUERTO RICO	CosviMed Care	www.cosvi.com	01	02		1		H5760	802	0	2009	Cosvimed Care Group	Puerto Rico		1	2			100	2						(787)-751-5656	(877)-311-0012	(877)-311-0018		(787)-751-5656	(877)-311-0013	(877)-311-0014		(787)-751-5656	(877)-311-0017	(877)-311-0018		(787)-751-5656	(877)-311-0013	(877)-311-0014		http://www.cosvi.com	http://www.cosvi.com
H5760	803	0	1	02	01	H5760_803_0	6	2009.01	COOPERATIVA DE SEGUROS DE VIDA DE PUERTO RICO	CosviMed Care	www.cosvi.com	01	02		1		H5760	803	0	2009	CosviMed Care Group	Puerto Rico		1	2			100	2						(787)-751-5656	(877)-311-0012	(877)-311-0018		(787)-751-5656	(877)-311-0013	(877)-311-0014		(787)-751-5656	(877)-311-0017	(877)-311-0018		(787)-751-5656	(877)-311-0013	(877)-311-0014		http://www.cosvi.com	http://www.cosvi.com
H5774	003	0	1	01	01	H5774_003_0	7	2009.01	AMERICAN HEALTH, INC.	American Health Medicare	www.ahmpr.com	01	01		1		H5774	003	0	2009	AHM_Basic	Puerto Rico		2	2			276	2						(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520									www.caremark.com	www.ahmpr.com
H5774	005	0	1	01	01	H5774_005_0	9	2009.01	AMERICAN HEALTH, INC.	American Health Medicare	www.ahmpr.com	01	01		1		H5774	005	0	2009	AHM_Standard	Puerto Rico		2	2			576	2						(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520	(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520	www.caremark.com	www.ahmpr.com
H5774	006	0	1	01	01	H5774_006_0	9	2009.01	AMERICAN HEALTH, INC.	American Health Medicare	www.ahmpr.com	01	01		1		H5774	006	0	2009	AHM_Premier	Puerto Rico		2	2			86	2						(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520	(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520	www.caremark.com	www.ahmpr.com
H5774	008	0	1	01	01	H5774_008_0	8	2009.01	AMERICAN HEALTH, INC.	American Health Medicare	www.ahmpr.com	01	01		1		H5774	008	0	2009	AHM_Classic	Puerto Rico		2	2			3231	2						(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520	(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520	www.caremark.com	www.ahmpr.com
H5774	009	0	1	01	01	H5774_009_0	9	2009.01	AMERICAN HEALTH, INC.	American Health Medicare	www.ahmpr.com	01	01		1		H5774	009	0	2009	AHM_Classic Plus	Puerto Rico		2	1	4		2851	2			2		0000000010000000000000000000	(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520	(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520	www.caremark.com	www.ahmpr.com
H5774	014	0	1	01	01	H5774_014_0	9	2009.01	AMERICAN HEALTH, INC.	American Health Medicare	www.ahmpr.com	01	01		1		H5774	014	0	2009	AHM_Opal	Puerto Rico		2	2			2731	2						(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520	(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520	www.caremark.com	www.ahmpr.com
H5774	016	0	1	01	01	H5774_016_0	10	2009.01	AMERICAN HEALTH, INC.	American Health Medicare	www.ahmpr.com	01	01		1		H5774	016	0	2009	AHM_Platino	Puerto RIco		2	1	3		13477	2			2	3		(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520	(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520	www.caremark.com	www.ahmpr.com
H5774	017	0	1	01	01	H5774_017_0	6	2009.01	AMERICAN HEALTH, INC.	American Health Medicare	www.ahmpr.com	01	01		1		H5774	017	0	2009	AHM_Basic 2	Puerto Rico		2	2			138	2						(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520									www.caremark.com	www.ahmpr.com
H5774	019	0	1	01	01	H5774_019_0	10	2009.01	AMERICAN HEALTH, INC.	American Health Medicare	www.ahmpr.com	01	01		1		H5774	019	0	2009	AHM_Platino Plus	Puerto Rico		2	1	3		13477	2			2	3		(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520	(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520	www.caremark.com	www.ahmpr.com
H5774	020	0	1	01	01	H5774_020_0	10	2009.01	AMERICAN HEALTH, INC.	American Health Medicare	www.ahmpr.com	01	01		1		H5774	020	0	2009	AHM_Platino Premium	Puerto Rico		2	1	3		13477	2			2	3		(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520	(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520	www.caremark.com	www.ahmpr.com
H5774	021	0	1	01	01	H5774_021_0	10	2009.01	AMERICAN HEALTH, INC.	American Health Medicare	www.ahmpr.com	01	01		1		H5774	021	0	2009	AHM_Opal Metro	Puerto Rico Metro		2	2			500	2						(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520	(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520	www.caremark.com	www.ahmpr.com
H5774	802	0	1	01	01	H5774_802_0	5	2009.01	AMERICAN HEALTH, INC.	American Health Medicare	www.ahmpr.com	01	01		1		H5774	802	0	2009	AHM_Executive Group	Puerto Rico		1	2			13477	2						(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520									www.caremark.com	www.ahmpr.com
H5774	806	0	1	01	01	H5774_806_0	7	2009.01	AMERICAN HEALTH, INC.	American Health Medicare	www.ahmpr.com	01	01		1		H5774	806	0	2009	AHM_ELA Premier	Puerto Rico		1	2			230	2						(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520	(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520	www.caremark.com	www.ahmpr.com
H5774	808	0	1	01	01	H5774_808_0	5	2009.01	AMERICAN HEALTH, INC.	American Health Medicare	www.ahmpr.com	01	01		1		H5774	808	0	2009	AHM_Executive Group Plus	Puerto Rico		1	2			13477	2						(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(888)-620-1919	(888)-620-1919	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520	(866)-620-2420	(866)-620-2420	(866)-620-2520	(866)-620-2520	www.caremark.com	www.ahmpr.com
H5782	001	0	1	01	01	H5782_001_0	4	2009.01	SOLANO-NAPA-YOLO COMMISSION ON MEDICAL CARE	Partnership HealthPlan of California	www.partnershiphp.org	01	01		1		H5782	001	0	2009	PartnershipAdvantage	Napa, Solano, and Yolo Counties		2	1	3		3500	2			1	1		(866)-264-3626	(866)-264-3626	(800)-226-2140		(866)-249-9933	(866)-249-9933	(800)-226-2140		(866)-264-3626	(866)-264-3626	(800)-226-2140		(866)-249-9933	(866)-249-9933	(800)-226-2140		www.partnershiphp.org	www.partnershiphp.org
H5783	002	0	1	01	01	H5783_002_0	8	2009.01	ARCADIAN HEALTH PLAN, INC.	Southeast Community Care	www.southeastcommunitycare.com	01	01		1		H5783	002	0	2009	Southeast Comm. Care- Plus (Charleston)	Charleston		2	2			47238	2						(843)-746-9990	(800)-573-8597	(866)-573-8591	(866)-573-8591	(843)-746-9990	(888)-998-3055	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(843)-746-9990	(888)-998-3055	(866)-573-8613	(866)-573-8613	www.southeastcommunitycare.com	
H5783	006	0	1	01	01	H5783_006_0	20	2009.01	ARCADIAN HEALTH PLAN, INC.	Southeast Community Care	www.southeastcommunitycare.com	01	01		1		H5783	006	0	2009	Southeast Comm. Care - Plus (Greenville)	Greenville, Pickens, and Spartanburg		2	2			28115	2						(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(888)-998-3055	(888)-998-3055	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(888)-998-3055	(888)-998-3055	(866)-573-8613	(866)-573-8613	www.southeastcommunitycare.com	
H5783	008	0	1	01	01	H5783_008_0	21	2009.01	ARCADIAN HEALTH PLAN, INC.	Southeast Community Care	www.southeastcommunitycare.com	01	01		1		H5783	008	0	2009	Southeast Comm. Care-Dual Plus(Greenville)	Greenville, Pickens, Spartanburg		2	1	3		16383	2			1	1		(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(888)-998-3055	(888)-998-3055	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(888)-998-3055	(888)-998-3055	(866)-573-8613	(866)-573-8613	www.southeastcommunitycare.com	
H5783	009	0	1	01	01	H5783_009_0	16	2009.01	ARCADIAN HEALTH PLAN, INC.	Southeast Community Care	www.southeastcommunitycare.com	01	01		1		H5783	009	0	2009	Southeast Comm. Care- Plus (Allendale)	Allendale County		2	2			446	2						(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(888)-998-3055	(888)-998-3055	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(888)-998-3055	(888)-998-3055	(866)-573-8613	(866)-573-8613	www.southeastcommunitycare.com	
H5783	801	0	1	01	01	H5783_801_0	8	2009.01	ARCADIAN HEALTH PLAN, INC.	Southeast Community Care	www.southeastcommunitycare.com	01	01		1		H5783	801	0	2009	Southeast Community Care EGWP (SC)	South Carolina		1	2			0	2						(843)-746-9990	(800)-573-8597	(866)-573-8591	(866)-573-8591	(843)-746-9990	(888)-998-3055	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(843)-746-9990	(888)-998-3055	(866)-573-8613	(866)-573-8613	www.southeastcommunitycare.com	
H5793	001	0	1	01	01	H5793_001_0	5	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5793	001	0	2009	Aetna Golden Medicare Value Plan	Connecticut		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind
H5793	003	0	1	01	01	H5793_003_0	4	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5793	003	0	2009	Aetna Golden Medicare Premier Plan	Connecticut		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind
H5793	007	0	1	01	01	H5793_007_0	3	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5793	007	0	2009	Aetna Golden Medicare Basic Plan	Connecticut		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind
H5793	008	0	1	01	01	H5793_008_0	4	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5793	008	0	2009	Aetna Golden Medicare Standard Plan	Connecticut		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind
H5793	801	0	1	01	01	H5793_801_0	4	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5793	801	0	2009	Aetna Golden Medicare Plan	Fairfield, Hartford,Litchfield, New Haven Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind
H5793	802	0	1	01	01	H5793_802_0	5	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5793	802	0	2009	Aetna Golden Medicare Plan w/Rx CY	Fairfield, Hartford,Litchfield, New Haven Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind
H5810	001	0	1	01	01	H5810_001_0	6	2009.01	MOLINA HEALTHCARE OF CALIFORNIA	Molina Healthcare of California	www.molinamedicare.com	01	01		1		H5810	001	0	2009	Molina Medicare Options Plus	LA, San Diego, parts of Riverside, San Bernardino		2	1	3			2			1	1		(562)-435-3666	(800)-665-0898	(800)-346-4128	(800)-346-4128	(562)-435-3666	(866)-403-8293	(800)-346-4128	(800)-346-4128	(562)-435-3666	(800)-665-0898	(800)-346-4128	(800)-346-4128	(562)-435-3666	(866)-403-8293	(800)-346-4128	(800)-346-4128	www.molinahealthcare.com	https://eportal.molinahealthcare.com/eportal/providers/ProviderSearchAdv.aspx
H5810	002	0	1	01	01	H5810_002_0	7	2009.01	MOLINA HEALTHCARE OF CALIFORNIA	Molina Healthcare of California	www.molinamedicare.com	01	01		1		H5810	002	0	2009	Molina Medicare Options	LA, San Diego, parts of Riverside, San Bernardino		2	2				2						(562)-435-3666	(800)-665-0898	(800)-346-4128	(800)-346-4128	(562)-435-3666	(866)-403-8293	(800)-346-4128	(800)-346-4128	(562)-435-3666	(800)-665-0898	(800)-346-4128	(800)-346-4128	(562)-435-3666	(866)-403-8293	(800)-346-4128	(800)-346-4128	www.molinahealthcare.com	https://eportal.molinahealthcare.com/eportal/providers/ProviderSearchAdv.aspx
H5811	001	0	1	01	01	H5811_001_0	6	2009.01	MEDCORE HP	Medcore HP	www.medcorehp.com	01	01		1		H5811	001	0	2009	Medcore Gold	San Joaquin County		2	2			22500	2						(209)-320-2650	(800)-320-5688	(209)-320-2601	(800)-258-6810	(209)-320-2650	(800)-320-5688	(209)-320-2601	(800)-258-6810	(209)-320-2650	(800)-320-5688	(209)-320-2601	(800)-258-6810	(209)-320-2650	(800)-320-5688	(209)-320-2601	(800)-258-6810	http://www.medcorehp.com/rx/rx.asp	www.medcorehp.com
H5811	002	0	1	01	01	H5811_002_0	4	2009.01	MEDCORE HP	Medcore HP	www.medcorehp.com	01	01		1		H5811	002	0	2009	Medcore Gold Select (Medicare and Medi-Cal)	San Joaquin County		2	1	3		16279	2			1	3		(209)-320-2650	(800)-320-5688	(209)-320-2601	(800)-258-6810	(209)-320-2650	(800)-320-5688	(209)-320-2601	(800)-258-6810	(209)-320-2650	(800)-320-5688	(209)-320-2601	(800)-258-6810	(209)-320-2650	(800)-320-5688	(209)-320-2601	(800)-258-6810	http://www.medcorehp.com/rx/rx.asp	www.medcorehp.com
H5811	003	0	1	01	01	H5811_003_0	3	2009.01	MEDCORE HP	Medcore HP	www.medcorehp.com	01	01		1		H5811	003	0	2009	Medcore Silver	San Joaquin County		2	2			926	2						(209)-320-2650	(800)-320-5688	(209)-320-2601	(800)-258-6810	(209)-320-2650	(800)-320-5688	(209)-320-2601	(800)-258-6810									http://www.medcorehp.com/rx/rx.asp	www.medcorehp.com
H5812	012	0	1	09	04	H5812_012_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	04	09	2	1		H5812	012	0	2009	Geisinger Gold Open 2 $0 Deductible Rx	PA - Region 1		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	
H5812	030	0	1	09	04	H5812_030_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	04	09	2	1		H5812	030	0	2009	Geisinger Gold Open 2 $0 Deductible Rx	PA - Region 1		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	
H5812	044	0	1	09	04	H5812_044_0	5	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	04	09	2	1		H5812	044	0	2009	Geisinger Gold Open 3	PA -  Region 1		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	
H5812	054	0	1	09	04	H5812_054_0	5	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	04	09	2	1		H5812	054	0	2009	Geisinger Gold Open 3	PA - Region 2		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	
H5812	055	0	1	09	04	H5812_055_0	5	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	04	09	2	1		H5812	055	0	2009	Geisinger Gold Open 3	PA - Region 3		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	
H5812	056	0	1	09	04	H5812_056_0	5	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	04	09	2	1		H5812	056	0	2009	Geisinger Gold Open 3	PA - Region 4		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	
H5812	057	0	1	09	04	H5812_057_0	5	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	04	09	2	1		H5812	057	0	2009	Geisinger Gold Open 5	PA - Region 1		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833									https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	
H5812	058	0	1	09	04	H5812_058_0	5	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	04	09	2	1		H5812	058	0	2009	Geisinger Gold Open 5	PA - Region 2		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833									https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	
H5812	059	0	1	09	04	H5812_059_0	5	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	04	09	2	1		H5812	059	0	2009	Geisinger Gold Open 5	PA - Region 3		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833									https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	
H5812	060	0	1	09	04	H5812_060_0	5	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	04	09	2	1		H5812	060	0	2009	Geisinger Gold Open 5	PA - Region 4		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833									https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	
H5812	061	0	1	09	04	H5812_061_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	04	09	2	1		H5812	061	0	2009	Geisinger Gold Open 2 $0 Deductible Rx	PA - Region 2		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	
H5812	062	0	1	09	04	H5812_062_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	04	09	2	1		H5812	062	0	2009	Geisinger Gold Open 2 $0 Deductible Rx	PA - Region 3		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	
H5812	063	0	1	09	04	H5812_063_0	3	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	04	09	2	1		H5812	063	0	2009	Geisinger Gold Open 2 $0 Deductible	PA - Region 4		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	
H5812	801	0	1	09	04	H5812_801_0	4	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	04	09	2	1		H5812	801	0	2009	Geisinger Gold Open (Employer Group)	Pennsylvania		1	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833									https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	
H5812	802	0	1	09	04	H5812_802_0	4	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	04	09	2	1		H5812	802	0	2009	Geisinger Gold Open Rx (Employer Group)	Pennsylvania		1	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	https://www.thehealthplan.com/non_members/GoldFormularyInfo.cfm	
H5813	003	0	1	01	01	H5813_003_0	6	2009.01	AETNA HEALTH, INC	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5813	003	0	2009	Aetna Golden Medicare Standard Plan	New Castle County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5813	004	0	1	01	01	H5813_004_0	7	2009.01	AETNA HEALTH, INC	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5813	004	0	2009	Aetna Golden Medicare Premier Plus Plan	New Castle County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5813	005	0	1	01	01	H5813_005_0	7	2009.01	AETNA HEALTH, INC	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5813	005	0	2009	Aetna Golden Medicare Dual Advantage Plan	New Castle County		2	1	3			2			1	2		(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5813	006	0	1	01	01	H5813_006_0	7	2009.01	AETNA HEALTH, INC	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5813	006	0	2009	Aetna Golden Medicare Premier Plan	New Castle County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5813	801	0	1	01	01	H5813_801_0	3	2009.01	AETNA HEALTH, INC	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5813	801	0	2009	Aetna Golden Medicare Plan	New Castle County		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5813	802	0	1	01	01	H5813_802_0	3	2009.01	AETNA HEALTH, INC	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5813	802	0	2009	Aetna Golden Medicare Plan w/Rx CY	New Castle County		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5817	009	0	1	01	01	H5817_009_0	3	2009.01	AMERIGROUP TEXAS, INC.	AMERIGROUP Community Care	www.myamerigroup.com	01	01		1		H5817	009	0	2009	AMERIVANTAGE Specialty + Rx	Houston  Metro Area		2	1	3		7250	2			1	1		(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	https://www.amerigroupcorp.com/members/amerivantage/_documents/Amvtg_FORMULARY.pdf	www.myamerigroup.com
H5817	010	0	1	01	01	H5817_010_0	4	2009.01	AMERIGROUP TEXAS, INC.	AMERIGROUP Community Care	www.myamerigroup.com	01	01		1		H5817	010	0	2009	AMERIVANTAGE Classic + Rx	Houston Metro Area		2	2			475	2						(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	https://www.amerigroupcorp.com/members/amerivantage/_documents/Amvtg_FORMULARY.pdf	www.myamerigroup.com
H5817	011	0	1	01	01	H5817_011_0	7	2009.01	AMERIGROUP TEXAS, INC.	AMERIGROUP Community Care	www.myamerigroup.com	01	01		1		H5817	011	0	2009	AMERIVANTAGE Balance + Rx	Houston / San Antonio		2	2			159	2						(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	https://www.amerigroupcorp.com/members/amerivantage/_documents/Amvtg_FORMULARY.pdf	www.myamerigroup.com
H5817	014	0	1	01	01	H5817_014_0	4	2009.01	AMERIGROUP TEXAS, INC.	AMERIGROUP Community Care	www.myamerigroup.com	01	01		1		H5817	014	0	2009	AMERIVANTAGE Classic + Rx	Bexar County (San Antonio)		2	2			161	2						(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	https://www.amerigroupcorp.com/members/amerivantage/_documents/Amvtg_FORMULARY.pdf	www.myamerigroup.com
H5817	015	0	1	01	01	H5817_015_0	5	2009.01	AMERIGROUP TEXAS, INC.	AMERIGROUP Community Care	www.myamerigroup.com	01	01		1		H5817	015	0	2009	AMERIVANTAGE Specialty + Rx	Bexar County (San Antonio)		2	1	3		850	2			1	1		(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	https://www.amerigroupcorp.com/members/amerivantage/_documents/Amvtg_FORMULARY.pdf	www.myamerigroup.com
H5817	016	0	1	02	01	H5817_016_0	3	2009.01	AMERIGROUP TEXAS, INC.	AMERIGROUP Community Care	www.myamerigroup.com	01	02		1		H5817	016	0	2009	AMERIVANTAGE Choice + Rx	Houston Metro Area		2	2			119	2						(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	https://www.amerigroupcorp.com/members/amerivantage/_documents/Amvtg_FORMULARY.pdf	www.myamerigroup.com
H5817	017	0	1	02	01	H5817_017_0	3	2009.01	AMERIGROUP TEXAS, INC.	AMERIGROUP Community Care	www.myamerigroup.com	01	02		1		H5817	017	0	2009	AMERIVANTAGE Choice + Rx	San Antonio		2	2			40	2						(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	https://www.amerigroupcorp.com/members/amerivantage/_documents/Amvtg_FORMULARY.pdf	www.myamerigroup.com
H5820	002	0	1	09	04	H5820_002_0	7	2009.01	UNIVERSAL HEALTH CARE INSURANCE COMPANY	UNIVERSAL HEALTH CARE INSURANCE COMPANY, INC.	http://www.univhc.com	04	09	2	1		H5820	002	0	2009	Any, Any, Any Gold 1	National PFFS		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	
H5820	003	0	1	09	04	H5820_003_0	7	2009.01	UNIVERSAL HEALTH CARE INSURANCE COMPANY	UNIVERSAL HEALTH CARE INSURANCE COMPANY, INC.	http://www.univhc.com	04	09	2	1		H5820	003	0	2009	Any, Any, Any Gold 2	National PFFS		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	
H5820	004	0	1	09	04	H5820_004_0	7	2009.01	UNIVERSAL HEALTH CARE INSURANCE COMPANY	UNIVERSAL HEALTH CARE INSURANCE COMPANY, INC.	http://www.univhc.com	04	09	2	1		H5820	004	0	2009	Any, Any, Any Gold 3	National PFFS		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	
H5820	008	0	1	09	04	H5820_008_0	7	2009.01	UNIVERSAL HEALTH CARE INSURANCE COMPANY	UNIVERSAL HEALTH CARE INSURANCE COMPANY, INC.	http://www.univhc.com	04	09	2	1		H5820	008	0	2009	Any, Any, Any Platinum 1	National PFFS		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	
H5820	009	0	1	09	04	H5820_009_0	7	2009.01	UNIVERSAL HEALTH CARE INSURANCE COMPANY	UNIVERSAL HEALTH CARE INSURANCE COMPANY, INC.	http://www.univhc.com	04	09	2	1		H5820	009	0	2009	Any, Any, Any Platinum 2	National PFFS		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	
H5820	010	0	1	09	04	H5820_010_0	8	2009.01	UNIVERSAL HEALTH CARE INSURANCE COMPANY	UNIVERSAL HEALTH CARE INSURANCE COMPANY, INC.	http://www.univhc.com	04	09	2	1		H5820	010	0	2009	Any, Any, Any Platinum 3	National PFFS		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	
H5820	011	0	1	09	04	H5820_011_0	7	2009.01	UNIVERSAL HEALTH CARE INSURANCE COMPANY	UNIVERSAL HEALTH CARE INSURANCE COMPANY, INC.	http://www.univhc.com	04	09	2	1		H5820	011	0	2009	Any, Any, Any Gold 4	National PFFS		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	
H5820	013	0	1	09	04	H5820_013_0	7	2009.01	UNIVERSAL HEALTH CARE INSURANCE COMPANY	UNIVERSAL HEALTH CARE INSURANCE COMPANY, INC.	http://www.univhc.com	04	09	2	1		H5820	013	0	2009	Any, Any ,Any Platinum 4	National PFFS		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	
H5820	026	0	1	09	04	H5820_026_0	5	2009.01	UNIVERSAL HEALTH CARE INSURANCE COMPANY	UNIVERSAL HEALTH CARE INSURANCE COMPANY, INC.	http://www.univhc.com	04	09	2	1		H5820	026	0	2009	Any, Any, Any MA Only 1	National PFFS		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177									http://www.univhc.com/Formulary/Plans_mp.asp	
H5820	027	0	1	09	04	H5820_027_0	5	2009.01	UNIVERSAL HEALTH CARE INSURANCE COMPANY	UNIVERSAL HEALTH CARE INSURANCE COMPANY, INC.	http://www.univhc.com	04	09	2	1		H5820	027	0	2009	Any, Any, Any MA Only 2	National PFFS		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177									http://www.univhc.com/Formulary/Plans_mp.asp	
H5820	028	0	1	09	04	H5820_028_0	5	2009.01	UNIVERSAL HEALTH CARE INSURANCE COMPANY	UNIVERSAL HEALTH CARE INSURANCE COMPANY, INC.	http://www.univhc.com	04	09	2	1		H5820	028	0	2009	Any, Any, Any MA Only 3	National PFFS		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177									http://www.univhc.com/Formulary/Plans_mp.asp	
H5820	029	0	1	09	04	H5820_029_0	5	2009.01	UNIVERSAL HEALTH CARE INSURANCE COMPANY	UNIVERSAL HEALTH CARE INSURANCE COMPANY, INC.	http://www.univhc.com	04	09	2	1		H5820	029	0	2009	Any, Any, Any MA Only 4	National PFFS		2	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177									http://www.univhc.com/Formulary/Plans_mp.asp	
H5820	801	0	1	09	04	H5820_801_0	5	2009.01	UNIVERSAL HEALTH CARE INSURANCE COMPANY	UNIVERSAL HEALTH CARE INSURANCE COMPANY, INC.	http://www.univhc.com	04	09	2	1		H5820	801	0	2009	Universal EGWP	National PFFS		1	2				2						(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	(727)-822-3446	(866)-690-4842	(800)-617-0177	(800)-617-0177	http://www.univhc.com/Formulary/Plans_mp.asp	
H5821	001	0	1	02	01	H5821_001_0	5	2009.01	MAPFRE LIFE INSURANCE COMPANY	MAPFRE LIFE INSURANCE COMPANY	www.mapfremedicare.com	01	02		1		H5821	001	0	2009	MAPFRE Medicare Excel	State of Puerto Rico		2	2			220	2						(787)-250-5288	(888)-750-5288	(866)-479-6677		(787)-250-5288	(888)-750-5288	(866)-479-6677		(787)-250-5288	(888)-750-5288	(866)-479-6677		(787)-250-5288	(888)-750-5288	(866)-479-6677		http://ww2.mapfremedicare.com/MAPFREMedicare/Formularios	www.mapfremedicare.com
H5821	004	0	1	02	01	H5821_004_0	5	2009.01	MAPFRE LIFE INSURANCE COMPANY	MAPFRE LIFE INSURANCE COMPANY	www.mapfremedicare.com	01	02		1		H5821	004	0	2009	MAPFRE Medicare Excel Premier	State of Puerto Rico		2	2			1825	2						(787)-250-5288	(888)-750-5288	(866)-479-6677		(787)-250-5288	(888)-750-5288	(866)-479-6677		(787)-250-5288	(888)-750-5288	(866)-479-6677		(787)-250-5288	(888)-750-5288	(866)-479-6677		http://ww2.mapfremedicare.com/MAPFREMedicare/Formularios	www.mapfremedicare.com
H5821	013	0	1	02	01	H5821_013_0	5	2009.01	MAPFRE LIFE INSURANCE COMPANY	MAPFRE LIFE INSURANCE COMPANY	www.mapfremedicare.com	01	02		1		H5821	013	0	2009	MAPFRE Medicare Excel Extended	State of Puerto Rico		2	2			5909	2						(787)-250-5288	(888)-750-5288	(866)-479-6677		(787)-250-5288	(888)-750-5288	(866)-479-6677		(787)-250-5288	(888)-750-5288	(866)-479-6677		(787)-250-5288	(888)-750-5288	(866)-479-6677		http://ww2.mapfremedicare.com/MAPFREMedicare/Formularios	www.mapfremedicare.com
H5821	015	0	1	02	01	H5821_015_0	6	2009.01	MAPFRE LIFE INSURANCE COMPANY	MAPFRE LIFE INSURANCE COMPANY	www.mapfremedicare.com	01	02		1		H5821	015	0	2009	MAPFRE Medicare Excel Extended Plus	State of Puerto Rico		2	1	4		500	2			2		0000000000000000000000000001	(787)-250-5288	(888)-750-5288	(866)-479-6677		(787)-250-5288	(888)-750-5288	(866)-479-6677		(787)-250-5288	(888)-750-5288	(866)-479-6677		(787)-250-5288	(888)-750-5288	(866)-479-6677		http://ww2.mapfremedicare.com/MAPFREMedicare/Formularios	www.mapfremedicare.com
H5821	017	0	1	02	01	H5821_017_0	7	2009.01	MAPFRE LIFE INSURANCE COMPANY	MAPFRE LIFE INSURANCE COMPANY	www.mapfremedicare.com	01	02		1		H5821	017	0	2009	MAPFRE Medicare Excel Platino	State of Puerto Rico		2	1	3		10417	2			2	3		(787)-250-5288	(888)-750-5288	(866)-479-6677		(787)-250-5288	(888)-750-5288	(866)-479-6677		(787)-250-5288	(888)-750-5288	(866)-479-6677		(787)-250-5288	(888)-750-5288	(866)-479-6677		http://ww2.mapfremedicare.com/MAPFREMedicare/Formularios	www.mapfremedicare.com
H5821	804	0	1	02	01	H5821_804_0	3	2009.01	MAPFRE LIFE INSURANCE COMPANY	MAPFRE LIFE INSURANCE COMPANY	www.mapfremedicare.com	01	02		1		H5821	804	0	2009	MAPFRE Medicare Excel Employer Plan	State of Puerto Rico		1	2			1124	2						(787)-250-5288	(888)-750-5288	(866)-479-6677		(787)-250-5288	(888)-750-5288	(866)-479-6677		(787)-250-5288	(888)-750-5288	(866)-479-6677		(787)-250-5288	(888)-750-5288	(866)-479-6677		http://ww2.mapfremedicare.com/MAPFREMedicare/Formularios	www.mapfremedicare.com
H5822	001	0	1	20	08	H5822_001_0	1	2009.01	MIDLAND CARE CONNECTION	Midland PACE	www.midlandcc.org	08	20		1		H5822	001	0	2009	Midland Care Connection - Dual Eligibles	Counties: DG, JA, JF, OS, PT, SN, WB		2	2			75	2														(785)-232-2044	(800)-491-3691			(785)-232-2044	(800)-491-3691			www.midlandcc.org	
H5822	002	0	1	20	08	H5822_002_0	2	2009.01	MIDLAND CARE CONNECTION	Midland PACE	www.midlandcc.org	08	20		1		H5822	002	0	2009	Midland Care Connection - Medicare Only	Counties: DG, JA, JF, OS, PT, SN, WB		2	2			15	2														(785)-232-2044	(800)-491-3691			(785)-232-2044	(800)-491-3691			www.midlandcc.org	
H5823	001	0	1	01	01	H5823_001_0	4	2009.01	MOLINA HEALTHCARE OF WASHINGTON, INC.	Molina Healthcare of Washington, Inc.	www.molinamedicare.com	01	01		1		H5823	001	0	2009	Molina Medicare Options Plus	Central Puget Sound and Spokane area		2	1	3			2			1	1		(425)-424-1100	(800)-665-1029	(800)-346-4128	(800)-346-4128	(425)-424-1100	(866)-403-8293	(800)-346-4128	(800)-346-4128	(425)-424-1100	(800)-665-1029	(800)-346-4128	(800)-346-4128	(425)-424-1100	(866)-403-8293	(800)-346-4128	(800)-346-4128	www.molinahealthcare.com	https://eportal.molinahealthcare.com/eportal/providers/ProviderSearchAdv.aspx
H5823	002	0	1	01	01	H5823_002_0	7	2009.01	MOLINA HEALTHCARE OF WASHINGTON, INC.	Molina Healthcare of Washington, Inc.	www.molinamedicare.com	01	01		1		H5823	002	0	2009	Molina Medicare Options	King, Pierce, Snohomish, Spokane area		2	2				2						(425)-424-1100	(800)-665-1029	(800)-346-4128	(800)-346-4128	(425)-424-1100	(866)-403-8293	(800)-346-4128	(800)-346-4128	(425)-424-1100	(800)-665-1029	(800)-346-4128	(800)-346-4128	(425)-424-1100	(866)-403-8293	(800)-346-4128	(800)-346-4128	www.molinahealthcare.com	https://eportal.molinahealthcare.com/eportal/providers/ProviderSearchAdv.aspx
H5826	005	0	1	01	01	H5826_005_0	11	2009.01	COMMUNITY HEALTH PLAN OF WASHINGTON	Community HealthFirst Medicare Advantage Plan	www.healthfirst.chpw.org	01	01		1		H5826	005	0	2009	Community HealthFirst Medicare Complete Plus	Eastern and Western Washington State		2	1	3			2			1	3		(800)-942-0247	(800)-942-0247	(866)-816-2479	(866)-816-2479	(800)-944-1247		(866)-816-2479	(866)-816-2479	(800)-942-0247	(800)-942-0247	(866)-816-2479	(866)-816-2479	(800)-944-1247	(800)-944-1247	(866)-816-2479	(866)-816-2479	www.chpw.org	www.healthfirst.chpw.org
H5826	006	0	1	01	01	H5826_006_0	9	2009.01	COMMUNITY HEALTH PLAN OF WASHINGTON	Community HealthFirst Medicare Advantage Plan	www.healthfirst.chpw.org	01	01		1		H5826	006	0	2009	Community HealthFirst Medicare Complete	Western Washington, Spokane and Yakima Counties		2	2				2						(800)-942-0247	(800)-942-0247	(866)-816-2479	(866)-816-2479	(800)-944-1247		(866)-816-2479	(866)-816-2479									www.chpw.org	www.healthfirst.chpw.org
H5826	007	0	1	01	01	H5826_007_0	15	2009.01	COMMUNITY HEALTH PLAN OF WASHINGTON	Community HealthFirst Medicare Advantage Plan	www.healthfirst.chpw.org	01	01		1		H5826	007	0	2009	Community HealthFirst Medicare Complete	Eastern and Western Washington State		2	2				2						(800)-942-0247	(800)-942-0247	(866)-816-2479	(866)-816-2479	(800)-944-1247		(866)-816-2479	(866)-816-2479									www.chpw.org	www.healthfirst.chpw.org
H5826	008	0	1	01	01	H5826_008_0	11	2009.01	COMMUNITY HEALTH PLAN OF WASHINGTON	Community HealthFirst Medicare Advantage Plan	www.healthfirst.chpw.org	01	01		1		H5826	008	0	2009	Community HealthFirst Medicare Complete Rx	Western Washington, Spokane and Yakima Counties		2	2				2						(800)-942-0247	(800)-942-0247	(866)-816-2479	(866)-816-2479	(800)-944-1247		(866)-816-2479	(866)-816-2479	(800)-942-0247	(800)-942-0247	(866)-816-2479	(866)-816-2479	(800)-944-1247	(800)-944-1247	(866)-816-2479	(866)-816-2479	www.chpw.org	www.healthfirst.chpw.org
H5826	009	0	1	01	01	H5826_009_0	14	2009.01	COMMUNITY HEALTH PLAN OF WASHINGTON	Community HealthFirst Medicare Advantage Plan	www.healthfirst.chpw.org	01	01		1		H5826	009	0	2009	Community HealthFirst Medicare Complete Rx	Eastern and Western Washington State		2	2				2						(800)-942-0247	(800)-942-0247	(866)-816-2479	(866)-816-2479	(800)-944-1247		(866)-816-2479	(866)-816-2479	(800)-942-0247	(800)-942-0247	(866)-816-2479	(866)-816-2479	(800)-944-1247	(800)-944-1247	(866)-816-2479	(866)-816-2479	www.chpw.org	www.healthfirst.chpw.org
H5826	010	0	1	01	01	H5826_010_0	9	2009.01	COMMUNITY HEALTH PLAN OF WASHINGTON	Community HealthFirst Medicare Advantage Plan	www.healthfirst.chpw.org	01	01		1		H5826	010	0	2009	Community HealthFirst Medicare Complete Value	Western Washington, Spokane and Yakima Counties		2	2				2						(800)-942-0247	(800)-942-0247	(866)-816-2479	(866)-816-2479	(800)-944-1247		(866)-816-2479	(866)-816-2479	(800)-942-0247	(800)-942-0247	(866)-816-2479	(866)-816-2479	(800)-944-1247	(800)-944-1247	(866)-816-2479	(866)-816-2479	www.chpw.org	www.healthfirst.chpw.org
H5832	001	0	1	01	01	H5832_001_0	6	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5832	001	0	2009	Aetna Golden Medicare Value Plan	Oklahoma County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5832	002	0	1	01	01	H5832_002_0	8	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5832	002	0	2009	Aetna Golden Medicare Value Plan	Tulsa Co.		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5832	801	0	1	01	01	H5832_801_0	3	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5832	801	0	2009	Aetna Golden Medicare Plan	Cleveland, Oklahoma and Tulsa Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5832	802	0	1	01	01	H5832_802_0	3	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H5832	802	0	2009	Aetna Golden Medicare Plan w/Rx CY	Cleveland, Oklahoma and Tulsa Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5839	001	0	1	09	04	H5839_001_0	4	2009.01	STERLING LIFE INSURANCE COMPANY (MT)	Sterling Life Insurance Company	www.sterlingplans.com	04	09	1	1		H5839	001	0	2009	Sterling Partners - Montana	Montana		2	2				2						(888)-858-8551	(888)-858-8551	(888)-858-8567	(888)-858-8567	(888)-858-8572	(888)-858-8572	(888)-858-8567	(888)-858-8567	(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
H5849	003	1	1	09	04	H5849_003_1	5	2009.01	ARKANSAS BLUE CROSS AND BLUE SHIELD, A MUTUAL INS.	Arkansas Blue Cross  - Medi-Pak Advantage	www.arkansasbluecross.com	04	09	2	1		H5849	003	1	2009	AR Blue Cross - Medi-Pak Advantage MA	Arkansas All Counties	Northwest Counties	2	2			586	2						(866)-390-3369	(866)-390-3369	(888)-844-5530	(888)-844-5530	(501)-378-2937	(800)-634-6314	(800)-370-5869	(800)-370-5869									http://www.arbcbs.com/Medi-PakChoice/medi_pak_advantage.aspx	
H5849	003	2	1	09	04	H5849_003_2	5	2009.01	ARKANSAS BLUE CROSS AND BLUE SHIELD, A MUTUAL INS.	Arkansas Blue Cross  - Medi-Pak Advantage	www.arkansasbluecross.com	04	09	2	1		H5849	003	2	2009	AR Blue Cross - Medi-Pak Advantage MA	Arkansas All Counties	Southwest and Central Counties	2	2			391	2						(866)-390-3369	(866)-390-3369	(888)-844-5530	(888)-844-5530	(501)-378-2937	(800)-634-6314	(800)-370-5869	(800)-370-5869									http://www.arbcbs.com/Medi-PakChoice/medi_pak_advantage.aspx	
H5849	003	3	1	09	04	H5849_003_3	5	2009.01	ARKANSAS BLUE CROSS AND BLUE SHIELD, A MUTUAL INS.	Arkansas Blue Cross  - Medi-Pak Advantage	www.arkansasbluecross.com	04	09	2	1		H5849	003	3	2009	AR Blue Cross - Medi-Pak Advantage MA	Arkansas All Counties	Eastern Counties	2	2			49	2						(866)-390-3369	(866)-390-3369	(888)-844-5530	(888)-844-5530	(501)-378-2937	(800)-634-6314	(800)-370-5869	(800)-370-5869									http://www.arbcbs.com/Medi-PakChoice/medi_pak_advantage.aspx	
H5849	005	0	1	09	04	H5849_005_0	5	2009.01	ARKANSAS BLUE CROSS AND BLUE SHIELD, A MUTUAL INS.	Arkansas Blue Cross  - Medi-Pak Advantage	www.arkansasbluecross.com	04	09	2	1		H5849	005	0	2009	AR Blue Cross - Medi-Pak Advantage MA-PD	Northwest, some Eastern and Southern AR counties		2	2			1322	2						(866)-390-3369	(866)-390-3369	(888)-844-5530	(888)-844-5530	(501)-378-2937	(800)-634-6314	(800)-370-5869	(800)-370-5869	(866)-390-3369	(866)-390-3369	(888)-844-5530	(888)-844-5530	(501)-378-2937	(800)-634-6314	(800)-370-5869	(800)-370-5869	http://www.arbcbs.com/Medi-PakChoice/medi_pak_advantage.aspx	
H5849	006	0	1	09	04	H5849_006_0	5	2009.01	ARKANSAS BLUE CROSS AND BLUE SHIELD, A MUTUAL INS.	Arkansas Blue Cross  - Medi-Pak Advantage	www.arkansasbluecross.com	04	09	2	1		H5849	006	0	2009	AR Blue Cross - Medi-Pak Advantage MA-PD	Some Central, Southern, Eastern  Arkansas Counties		2	2			685	2						(866)-390-3369	(866)-390-3369	(888)-844-5530	(888)-844-5530	(501)-378-2937	(800)-634-6314	(800)-370-5869	(800)-370-5869	(866)-390-3369	(866)-390-3369	(888)-844-5530	(888)-844-5530	(501)-378-2937	(800)-634-6314	(800)-370-5869	(800)-370-5869	http://www.arbcbs.com/Medi-PakChoice/medi_pak_advantage.aspx	
H5849	007	0	1	09	04	H5849_007_0	5	2009.01	ARKANSAS BLUE CROSS AND BLUE SHIELD, A MUTUAL INS.	Arkansas Blue Cross  - Medi-Pak Advantage	www.arkansasbluecross.com	04	09	2	1		H5849	007	0	2009	AR Blue Cross - Medi-Pak Advantage MA-PD	Some Northeast, Central and Southern AR counties		2	2			171	2						(866)-390-3369	(866)-390-3369	(888)-844-5530	(888)-844-5530	(501)-378-2937	(800)-634-6314	(800)-370-5869	(800)-370-5869	(866)-390-3369	(866)-390-3369	(888)-844-5530	(888)-844-5530	(501)-378-2937	(800)-634-6314	(800)-370-5869	(800)-370-5869	http://www.arbcbs.com/Medi-PakChoice/medi_pak_advantage.aspx	
H5850	001	0	1	01	01	H5850_001_0	5	2009.01	SUMMIT HEALTH PLAN, INC.	Summit Health Plan, Inc.	www.summithealthplan.com	01	01		1		H5850	001	0	2009	Summit Ideal Plan	Miami-Dade County		2	2			4500	2						(800)-847-3995	(800)-847-3995	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704	(866)-797-8648	(866)-797-8648	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704	www.summithealthplan.com/static/plansbenefits.aspx	www.summithealthplan.com
H5850	002	0	1	01	01	H5850_002_0	5	2009.01	SUMMIT HEALTH PLAN, INC.	Summit Health Plan, Inc.	www.summithealthplan.com	01	01		1		H5850	002	0	2009	Summit Maximum Plan	Dade, Broward, Palm Beach, Martin and St. Lucie		2	1	3		3300	2			1	2		(800)-847-3995	(800)-847-3995	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704	(866)-797-8648	(866)-797-8648	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704	www.summithealthplan.com/static/plansbenefits.aspx	www.summithealthplan.com
H5850	003	0	1	01	01	H5850_003_0	5	2009.01	SUMMIT HEALTH PLAN, INC.	Summit Health Plan, Inc.	www.summithealthplan.com	01	01		1		H5850	003	0	2009	Summit Ideal Plan	Broward County		2	2			2500	2						(800)-847-3995	(800)-847-3995	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704	(866)-797-8648	(866)-797-8648	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704	www.summithealthplan.com/static/plansbenefits.aspx	www.summithealthplan.com
H5850	004	0	1	01	01	H5850_004_0	6	2009.01	SUMMIT HEALTH PLAN, INC.	Summit Health Plan, Inc.	www.summithealthplan.com	01	01		1		H5850	004	0	2009	Summit Ideal Plan	Palm Beach County		2	2			300	2						(800)-847-3995	(800)-847-3995	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704	(866)-797-8648	(866)-797-8648	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704	www.summithealthplan.com/static/plansbenefits.aspx	www.summithealthplan.com
H5850	005	0	1	01	01	H5850_005_0	5	2009.01	SUMMIT HEALTH PLAN, INC.	Summit Health Plan, Inc.	www.summithealthplan.com	01	01		1		H5850	005	0	2009	Summit Ideal Plan	Martin County		2	2			300	2						(800)-847-3995	(800)-847-3995	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704	(866)-797-8648	(866)-797-8648	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704	www.summithealthplan.com/static/plansbenefits.aspx	www.summithealthplan.com
H5850	006	0	1	01	01	H5850_006_0	5	2009.01	SUMMIT HEALTH PLAN, INC.	Summit Health Plan, Inc.	www.summithealthplan.com	01	01		1		H5850	006	0	2009	Summit Plus Plan	Dade County		2	2			600	2						(800)-847-3995	(800)-847-3995	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704	(866)-797-8648	(866)-797-8648	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704	www.summithealthplan.com/static/plansbenefits.aspx	www.summithealthplan.com
H5850	007	0	1	01	01	H5850_007_0	5	2009.01	SUMMIT HEALTH PLAN, INC.	Summit Health Plan, Inc.	www.summithealthplan.com	01	01		1		H5850	007	0	2009	Summit Ideal Plan	St. Lucie County		2	2			1500	2						(800)-847-3995	(800)-847-3995	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704	(866)-797-8648	(866)-797-8648	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704	www.summithealthplan.com/static/plansbenefits.aspx	www.summithealthplan.com
H5850	010	0	1	01	01	H5850_010_0	7	2009.01	SUMMIT HEALTH PLAN, INC.	Summit Health Plan, Inc.	www.summithealthplan.com	01	01		1		H5850	010	0	2009	Summit Plus Plan	Broward County		2	2			200	2						(800)-847-3995	(800)-847-3995	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704	(866)-797-8648	(866)-797-8648	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704	www.summithealthplan.com/static/plansbenefits.aspx	www.summithealthplan.com
H5850	012	0	1	01	01	H5850_012_0	5	2009.01	SUMMIT HEALTH PLAN, INC.	Summit Health Plan, Inc.	www.summithealthplan.com	01	01		1		H5850	012	0	2009	Summit Ideal One Plan	Miami-Dade County		2	2			1000	2						(800)-847-3995	(800)-847-3995	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704	(866)-797-8648	(866)-797-8648	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704	www.summithealthplan.com/static/plansbenefits.aspx	www.summithealthplan.com
H5850	013	0	1	01	01	H5850_013_0	5	2009.01	SUMMIT HEALTH PLAN, INC.	Summit Health Plan, Inc.	www.summithealthplan.com	01	01		1		H5850	013	0	2009	Summit Ideal One Plan	Broward County		2	2			700	2						(800)-847-3995	(800)-847-3995	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704	(866)-797-8648	(866)-797-8648	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704	www.summithealthplan.com/static/plansbenefits.aspx	www.summithealthplan.com
H5850	014	0	1	01	01	H5850_014_0	3	2009.01	SUMMIT HEALTH PLAN, INC.	Summit Health Plan, Inc.	www.summithealthplan.com	01	01		1		H5850	014	0	2009	Summit Value Plan	Martin and St. Lucie counties		2	2			150	2						(800)-847-3995	(800)-847-3995	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704									www.summithealthplan.com/static/plansbenefits.aspx	www.summithealthplan.com
H5850	015	0	1	01	01	H5850_015_0	5	2009.01	SUMMIT HEALTH PLAN, INC.	Summit Health Plan, Inc.	www.summithealthplan.com	01	01		1		H5850	015	0	2009	Advantra Gold Plus Plan	Pinellas County		2	2			100	2						(800)-847-3995	(800)-847-3995	(800)-490-7704	(800)-490-7704	(866)-988-7506	(866)-988-7506	(888)-788-4010	(888)-788-4010	(866)-797-8648	(866)-797-8648	(800)-490-7704	(800)-490-7704	(866)-988-7506	(866)-988-7506	(888)-788-4010	(888)-788-4010	www.summithealthplan.com/static/plansbenefits.aspx	www.summithealthplan.com
H5850	016	0	1	01	01	H5850_016_0	5	2009.01	SUMMIT HEALTH PLAN, INC.	Summit Health Plan, Inc.	www.summithealthplan.com	01	01		1		H5850	016	0	2009	Advantra Gold Plan	Hernando, Hillsborough, and Pasco counties		2	2			200	2						(800)-847-3995	(800)-847-3995	(800)-490-7704	(800)-490-7704	(866)-988-7506	(866)-988-7506	(888)-788-4010	(888)-788-4010	(866)-797-8648	(866)-797-8648	(800)-490-7704	(800)-490-7704	(866)-988-7506	(866)-988-7506	(888)-788-4010	(888)-788-4010	www.summithealthplan.com/static/plansbenefits.aspx	www.summithealthplan.com
H5850	017	0	1	01	01	H5850_017_0	5	2009.01	SUMMIT HEALTH PLAN, INC.	Summit Health Plan, Inc.	www.summithealthplan.com	01	01		1		H5850	017	0	2009	Advantra Diamond Plan	Hernando, Hillsborough, Pasco and Pinellas		2	2			100	2						(800)-847-3995	(800)-847-3995	(800)-490-7704	(800)-490-7704	(866)-988-7506	(866)-988-7506	(888)-788-4010	(888)-788-4010	(866)-797-8648	(866)-797-8648	(800)-490-7704	(800)-490-7704	(866)-988-7506	(866)-988-7506	(888)-788-4010	(888)-788-4010	www.summithealthplan.com/static/plansbenefits.aspx	www.summithealthplan.com
H5850	018	0	1	02	01	H5850_018_0	6	2009.01	SUMMIT HEALTH PLAN, INC.	Summit Health Plan, Inc.	www.summithealthplan.com	01	02		1		H5850	018	0	2009	Advantra Platinum Plan	Hernando, Hillsborough, Pasco and Pinellas		2	2			100	2						(800)-847-3995	(800)-847-3995	(800)-490-7704	(800)-490-7704	(866)-988-7506	(866)-988-7506	(888)-788-4010	(888)-788-4010	(866)-797-8648	(866)-797-8648	(800)-490-7704	(800)-490-7704	(866)-988-7506	(866)-988-7506	(888)-788-4010	(888)-788-4010	www.summithealthplan.com/static/plansbenefits.aspx	www.summithealthplan.com
H5850	019	0	1	01	01	H5850_019_0	5	2009.01	SUMMIT HEALTH PLAN, INC.	Summit Health Plan, Inc.	www.summithealthplan.com	01	01		1		H5850	019	0	2009	Advantra Plus Plan	Hernando, Hillsborough, Pasco and Pinellas		2	2			100	2						(800)-847-3995	(800)-847-3995	(800)-490-7704	(800)-490-7704	(866)-988-7506	(866)-988-7506	(888)-788-4010	(888)-788-4010	(866)-797-8648	(866)-797-8648	(800)-490-7704	(800)-490-7704	(866)-988-7506	(866)-988-7506	(888)-788-4010	(888)-788-4010	www.summithealthplan.com/static/plansbenefits.aspx	www.summithealthplan.com
H5850	802	0	1	01	01	H5850_802_0	4	2009.01	SUMMIT HEALTH PLAN, INC.	Summit Health Plan, Inc.	www.summithealthplan.com	01	01		1		H5850	802	0	2009	Advantra Employer Group - (CY)	All Counties		1	2			250	2						(800)-847-3995	(800)-847-3995	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704	(866)-797-8648	(866)-797-8648	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704	www.summithealthplan.com/static/plansbenefits.aspx	www.summithealthplan.com
H5850	803	0	1	01	01	H5850_803_0	4	2009.01	SUMMIT HEALTH PLAN, INC.	Summit Health Plan, Inc.	www.summithealthplan.com	01	01		1		H5850	803	0	2009	Advantra Employer Group - MA Only (CY)	National		1	2			250	2						(800)-847-3995	(800)-847-3995	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704									www.summithealthplan.com/static/plansbenefits.aspx	www.summithealthplan.com
H5850	804	0	1	01	01	H5850_804_0	4	2009.01	SUMMIT HEALTH PLAN, INC.	Summit Health Plan, Inc.	www.summithealthplan.com	01	01		1		H5850	804	0	2009	Advantra Employer Group - MA Only (Non-Cal Yr)	National		1	2			250	2						(800)-847-3995	(800)-847-3995	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704									www.summithealthplan.com/static/plansbenefits.aspx	www.summithealthplan.com
H5850	805	0	1	01	01	H5850_805_0	4	2009.01	SUMMIT HEALTH PLAN, INC.	Summit Health Plan, Inc.	www.summithealthplan.com	01	01		1		H5850	805	0	2009	Advantra Employer Group - (Non-Cal Yr)	National		1	2			250	2						(800)-847-3995	(800)-847-3995	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704	(866)-797-8648	(866)-797-8648	(800)-490-7704	(800)-490-7704	(800)-556-0960	(800)-556-0960	(800)-490-7704	(800)-490-7704	www.summithealthplan.com/static/plansbenefits.aspx	www.summithealthplan.com
H5852	001	0	1	01	01	H5852_001_0	6	2009.01	AIDS HEALTHCARE FOUNDATION	POSITIVE HEALTHCARE PARTNERS	WWW.POSITIVEHEALTHCARE.ORG	01	01		1		H5852	001	0	2009	POSITIVE HEALTHCARE PARTNERS	LOS ANGELES COUNTY		2	1	4		700	2			1		0000000000010000000000000000	(800)-263-0067	(800)-263-0067	(800)-735-2929	(800)-735-2929	(800)-263-0067	(800)-263-0067	(800)-735-2929	(800)-735-2929	(800)-263-0067	(800)-263-0067	(800)-735-2929	(800)-735-2929	(800)-263-0067	(800)-263-0067	(800)-735-2929	(800)-735-2929	https://www.catalystrx.com/www/MedicareD/index.jsp?src=ahf	WWW.POSITIVEHEALTHCARE .ORG
H5854	002	0	1	01	01	H5854_002_0	7	2009.01	ANTHEM HEALTH PLANS, INC	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H5854	002	0	2009	MediBlue HMO Plus	Fairfield, Hartford and New Haven counties		2	2			1126	2						(866)-673-4157	(866)-673-4157	(800)-241-6894		(800)-238-1143	(800)-238-1143	(800)-241-6894		(866)-673-4157	(866)-673-4157	(800)-241-6894		(800)-238-1143	(800)-238-1143	(800)-241-6894		www.anthem.com	www.anthem.com
H5854	003	0	1	01	01	H5854_003_0	7	2009.01	ANTHEM HEALTH PLANS, INC	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H5854	003	0	2009	MediBlue HMO Select	Fairfield, Hartford and New Haven counties		2	2			1018	2						(866)-673-4157	(866)-673-4157	(800)-241-6894		(800)-238-1143		(800)-241-6894		(866)-673-4157	(866)-673-4157	(800)-241-6894		(800)-238-1143	(800)-238-1143	(800)-241-6894		www.anthem.com	www.anthem.com
H5854	004	0	1	01	01	H5854_004_0	5	2009.01	ANTHEM HEALTH PLANS, INC	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H5854	004	0	2009	MediBlue HMO Essential	Fairfield, Hartford and New Haven counties		2	2			284	2						(866)-673-4157	(866)-673-4157	(800)-241-6894		(800)-238-1143		(800)-241-6894										www.anthem.com	www.anthem.com
H5854	005	0	1	01	01	H5854_005_0	7	2009.01	ANTHEM HEALTH PLANS, INC	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H5854	005	0	2009	MediBlue HMO Value	Fairfield, Hartford and New Haven counties		2	2			270	2						(866)-673-4157	(866)-673-4157	(800)-241-6894		(800)-238-1143	(800)-238-1143	(800)-241-6894		(866)-673-4157	(866)-673-4157	(800)-241-6894		(800)-238-1143	(800)-238-1143	(800)-241-6894		www.anthem.com	www.anthem.com
H5854	801	0	1	01	01	H5854_801_0	3	2009.01	ANTHEM HEALTH PLANS, INC	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H5854	801	0	2009	MediBlue HMO Plus	Connecticut		1	2			125	2						(866)-673-4157	(866)-673-4157	(800)-241-6894		(800)-238-1143		(800)-241-6894		(866)-673-4157	(866)-673-4157	(800)-241-6894		(800)-238-1143	(800)-238-1143	(800)-241-6894		www.anthem.com	www.anthem.com
H5854	803	0	1	01	01	H5854_803_0	3	2009.01	ANTHEM HEALTH PLANS, INC	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H5854	803	0	2009	MediBlue HMO Essential	Connecticut		1	2			50	2						(866)-673-4157	(866)-673-4157	(800)-241-6894		(800)-238-1143		(800)-241-6894										www.anthem.com	www.anthem.com
H5854	805	0	1	01	01	H5854_805_0	3	2009.01	ANTHEM HEALTH PLANS, INC	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H5854	805	0	2009	MediBlue HMO Plus	Connecticut		1	2			25	2						(866)-673-4157	(866)-673-4157	(800)-241-6894		(800)-238-1143		(800)-241-6894		(866)-673-4157	(866)-673-4157	(800)-241-6894		(800)-238-1143	(800)-238-1143	(800)-241-6894		www.anthem.com	www.anthem.com
H5859	001	0	1	01	01	H5859_001_0	7	2009.01	HEALTH PLAN OF CAREOREGON, INC.	CareOregon Advantage	http://www.careoregonadvantage.org	01	01		1		H5859	001	0	2009	CareOregon Advantage Plus	Portland/Salem Area, Northwest and Southern Oregon		2	1	3		6096	2			1	3		(503)-416-4100	(800)-224-4840	(503)-416-3700	(877)-416-4161	(503)-416-4100	(800)-224-4840	(503)-416-3700	(877)-416-4161	(503)-416-4100	(800)-224-4840	(503)-416-3700	(877)-416-4161	(503)-416-4100	(800)-224-4840	(503)-416-3700	(877)-416-4161	http://www.careoregon.org/medicare/formulary.html	http://www.careoregonadvantage.org
H5859	003	0	1	01	01	H5859_003_0	5	2009.01	HEALTH PLAN OF CAREOREGON, INC.	CareOregon Advantage	http://www.careoregonadvantage.org	01	01		1		H5859	003	0	2009	CareOregon Advantage Star	Portland/Salem Area, Northwest and Southern Oregon		2	2			285	2						(503)-416-4100	(800)-224-4840	(503)-416-3700	(877)-416-4161	(503)-416-4100	(800)-224-4840	(503)-416-3700	(877)-416-4161	(503)-416-4100	(800)-224-4840	(503)-416-3700	(877)-416-4161	(503)-416-4100	(800)-224-4840	(503)-416-3700	(877)-416-4161	http://www.careoregon.org/medicare/formulary.html	http://www.careoregonadvantage.org
H5862	001	0	1	09	04	H5862_001_0	15	2009.01	BLUE CROSS OF IDAHO HEALTH SERVICES, INC.	Blue Cross Of Idaho Hlth Services Inc	www.bcidaho.com	04	09	2	1		H5862	001	0	2009	Flexi Blue	State of Idaho		2	2			500	2						(208)-395-8200	(866)-588-6167	(800)-377-1363	(800)-377-1363	(208)-387-6673	(888)-492-2583	(800)-377-1363	(800)-377-1363	(208)-395-8200	(866)-588-6167	(800)-377-1363	(800)-377-1363	(208)-387-6673	(888)-492-2583	(800)-377-1363	(800)-377-1363	http://www.bcidaho.com/pharmacy_info/medAdv_formulary_index.asp	
H5862	801	0	1	09	04	H5862_801_0	12	2009.01	BLUE CROSS OF IDAHO HEALTH SERVICES, INC.	Blue Cross Of Idaho Hlth Services Inc	www.bcidaho.com	04	09	2	1		H5862	801	0	2009	Flexi Blue	State of Idaho		1	2			345	2						(208)-395-8200	(866)-588-6167	(800)-377-1363	(800)-377-1363	(208)-387-6673	(888)-492-2583	(800)-377-1363	(800)-377-1363	(208)-395-8200	(866)-588-6167	(800)-377-1363	(800)-377-1363	(208)-387-6673	(888)-492-2583	(800)-377-1363	(800)-377-1363	http://www.bcidaho.com/pharmacy_info/medAdv_formulary_index.asp	
H5868	001	0	1	04	01	H5868_001_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5868	001	0	2009	HumanaChoicePPO PPO H5868-001	Dallas, Guthrie, Polk, Warren Counties		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5868	003	0	1	04	01	H5868_003_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5868	003	0	2009	HumanaChoicePPO PPO H5868-003	Linn County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5868	801	0	1	04	01	H5868_801_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5868	801	0	2009	Humana Employer Sponsored	Des Moines Metro Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5868	802	0	1	04	01	H5868_802_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5868	802	0	2009	Humana Employer Sponsored	Des Moines Metro Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5868	803	0	1	04	01	H5868_803_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5868	803	0	2009	Humana Employer Sponsored Non-CY	Des Moines Metro Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5868	804	0	1	04	01	H5868_804_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H5868	804	0	2009	Humana Employer Sponsored Non-CY	Des Moines Metro Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H5883	001	1	1	01	01	H5883_001_1	6	2009.01	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.MiBCN.com/medicare	01	01		1		H5883	001	1	2009	BCN Advantage	Option 1	Cnty: Kent, Newaygo, Ottawa, Musk, Allegan	2	2				2						(800)-450-3680		(800)-430-3211		(866)-966-2583		(800)-431-7944										http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicareproviders
H5883	001	2	1	01	01	H5883_001_2	6	2009.01	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.MiBCN.com/medicare	01	01		1		H5883	001	2	2009	BCN Advantage	Option 1	Cnty: Clin, Eat, Ing, Kzoo, Barry, Grat, Ion, Mid	2	2				2						(800)-450-3680		(800)-430-3211		(866)-966-2583		(800)-431-7944										http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicareproviders
H5883	001	3	1	01	01	H5883_001_3	6	2009.01	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.MiBCN.com/medicare	01	01		1		H5883	001	3	2009	BCN Advantage	Option 1	Cnty: Calh, Jack, Liv, Monroe, Mont, Wash	2	2				2						(800)-450-3680		(800)-430-3211		(866)-966-2583		(800)-431-7944										http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicareproviders
H5883	001	4	1	01	01	H5883_001_4	6	2009.01	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.MiBCN.com/medicare	01	01		1		H5883	001	4	2009	BCN Advantage	Option 1	Cnty: Bay, Gen, Lap, Sag, Shia, Tus	2	2				2						(800)-450-3680		(800)-430-3211		(866)-966-2583		(800)-431-7944										http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicareproviders
H5883	001	5	1	01	01	H5883_001_5	6	2009.01	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.MiBCN.com/medicare	01	01		1		H5883	001	5	2009	BCN Advantage	Option 1	Macomb, Oakland, St. Clair, Wayne counties	2	2				2						(800)-450-3680		(800)-430-3211		(866)-966-2583		(800)-431-7944										http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicareproviders
H5883	002	1	1	01	01	H5883_002_1	9	2009.01	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.MiBCN.com/medicare	01	01		1		H5883	002	1	2009	BCN Advantage	Option 2	Cnty: Kent, Newaygo, Ottawa, Musk, Allegan	2	2				2						(800)-450-3680		(800)-430-3211		(866)-966-2583		(800)-431-7944		(800)-450-3680	(800)-450-3680	(800)-430-3211		(866)-966-2583	(866)-966-2583	(800)-431-7944		http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicareproviders
H5883	002	2	1	01	01	H5883_002_2	9	2009.01	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.MiBCN.com/medicare	01	01		1		H5883	002	2	2009	BCN Advantage	Option 2	Cnty: Clin, Eat, Ing, Kzoo, Barry, Grat, Ion, Mid	2	2				2						(800)-450-3680		(800)-430-3211		(866)-966-2583		(800)-431-7944		(800)-450-3680	(800)-450-3680	(800)-430-3211		(866)-966-2583	(866)-966-2583	(800)-431-7944		http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicareproviders
H5883	002	3	1	01	01	H5883_002_3	9	2009.01	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.MiBCN.com/medicare	01	01		1		H5883	002	3	2009	BCN Advantage	Option 2	Cnty: Calh, Jack, Liv, Monroe, Mont, Wash	2	2				2						(800)-450-3680		(800)-430-3211		(866)-966-2583		(800)-431-7944		(800)-450-3680	(800)-450-3680	(800)-430-3211		(866)-966-2583	(866)-966-2583	(800)-431-7944		http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicareproviders
H5883	002	4	1	01	01	H5883_002_4	9	2009.01	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.MiBCN.com/medicare	01	01		1		H5883	002	4	2009	BCN Advantage	Option 2	Cnty: Bay, Gen, Lap, Sag, Shia, Tus	2	2				2						(800)-450-3680		(800)-430-3211		(866)-966-2583		(800)-431-7944		(800)-450-3680	(800)-450-3680	(800)-430-3211		(866)-966-2583	(866)-966-2583	(800)-431-7944		http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicareproviders
H5883	002	7	1	01	01	H5883_002_7	8	2009.01	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.MiBCN.com/medicare	01	01		1		H5883	002	7	2009	BCN Advantage	Option 2	Macomb, Oakland, St. Clair, Wayne counties	2	2				2						(800)-450-3680		(800)-430-3211		(866)-966-2583		(800)-431-7944		(800)-450-3680	(800)-450-3680	(800)-430-3211		(866)-966-2583	(866)-966-2583	(800)-431-7944		http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicareproviders
H5883	003	1	1	01	01	H5883_003_1	9	2009.01	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.MiBCN.com/medicare	01	01		1		H5883	003	1	2009	BCN Advantage	Option 3	Cnty: Kent, Newaygo, Ottawa, Musk, Allegan	2	2				2						(800)-450-3680		(800)-430-3211		(866)-966-2583		(800)-431-7944		(800)-450-3680	(800)-450-3680	(800)-430-3211		(866)-966-2583	(866)-966-2583	(800)-431-7944		http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicareproviders
H5883	003	2	1	01	01	H5883_003_2	9	2009.01	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.MiBCN.com/medicare	01	01		1		H5883	003	2	2009	BCN Advantage	Option 3	Cnty: Clin, Eat, Ing, Kzoo, Barry, Grat, Ion, Mid	2	2				2						(800)-450-3680		(800)-430-3211		(866)-966-2583		(800)-431-7944		(800)-450-3680	(800)-450-3680	(800)-430-3211		(866)-966-2583	(866)-966-2583	(800)-431-7944		http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicareproviders
H5883	003	3	1	01	01	H5883_003_3	9	2009.01	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.MiBCN.com/medicare	01	01		1		H5883	003	3	2009	BCN Advantage	Option 3	Cnty: Calh, Jack, Liv, Monroe, Mont, Wash	2	2				2						(800)-450-3680		(800)-430-3211		(866)-966-2583		(800)-431-7944		(800)-450-3680	(800)-450-3680	(800)-430-3211		(866)-966-2583	(866)-966-2583	(800)-431-7944		http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicareproviders
H5883	003	4	1	01	01	H5883_003_4	9	2009.01	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.MiBCN.com/medicare	01	01		1		H5883	003	4	2009	BCN Advantage	Option 3	Cnty: Bay, Gen, Lap, Sag, Shia, Tus	2	2				2						(800)-450-3680		(800)-430-3211		(866)-966-2583		(800)-431-7944		(800)-450-3680	(800)-450-3680	(800)-430-3211		(866)-966-2583	(866)-966-2583	(800)-431-7944		http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicareproviders
H5883	003	5	1	01	01	H5883_003_5	9	2009.01	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.MiBCN.com/medicare	01	01		1		H5883	003	5	2009	BCN Advantage	Option 3	Macomb, Oakland, St. Clair, Wayne counties	2	2				2						(800)-450-3680		(800)-430-3211		(866)-966-2583		(800)-431-7944		(800)-450-3680	(800)-450-3680	(800)-430-3211		(866)-966-2583	(866)-966-2583	(800)-431-7944		http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicareproviders
H5883	801	0	1	01	01	H5883_801_0	6	2009.01	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.MiBCN.com/medicare	01	01		1		H5883	801	0	2009	BCN Advantage	Employer Group		1	2				2						(800)-450-3680		(800)-430-3211		(866)-966-2583		(800)-431-7944										http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicareproviders
H5883	805	0	1	01	01	H5883_805_0	6	2009.01	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.MiBCN.com/medicare	01	01		1		H5883	805	0	2009	BCN Advantage	Employer Group		1	2				2						(800)-450-3680		(800)-430-3211		(866)-966-2583		(800)-431-7944		(800)-450-3680	(800)-450-3680	(800)-430-3211		(866)-966-2583	(866)-966-2583	(800)-431-7944		http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicareproviders
H5883	807	0	1	01	01	H5883_807_0	6	2009.01	BLUE CARE NETWORK OF MICHIGAN	Blue Care Network	www.MiBCN.com/medicare	01	01		1		H5883	807	0	2009	BCN Advantage	Employer Group		1	2				2						(800)-450-3680		(800)-430-3211		(866)-966-2583		(800)-431-7944		(800)-450-3680	(800)-450-3680	(800)-430-3211		(866)-966-2583	(866)-966-2583	(800)-431-7944		http://www.mibcn.com/medicareformulary	http://www.mibcn.com/medicareproviders
H5884	001	1	1	09	04	H5884_001_1	4	2009.01	BLUECROSS BLUESHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	04	09	2	1		H5884	001	1	2009	BlueAdvantage PFFS MA2	State of Tennessee	Middle and Western Tennessee	2	2			114	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-664-6422	(877)-664-6422									http://www.bcbst-medicare.com/2008/New%20Member%20PDFS/Group/H5884.H7917.S1030_BA08_FOR.pdf	
H5884	001	2	1	09	04	H5884_001_2	4	2009.01	BLUECROSS BLUESHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	04	09	2	1		H5884	001	2	2009	BlueAdvantage PFFS MA2	State of Tennessee	Southeast and Northeast Tennessee	2	2			263	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-664-6422	(877)-664-6422									http://www.bcbst-medicare.com/2008/New%20Member%20PDFS/Group/H5884.H7917.S1030_BA08_FOR.pdf	
H5884	002	1	1	09	04	H5884_002_1	6	2009.01	BLUECROSS BLUESHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	04	09	2	1		H5884	002	1	2009	BlueAdvantage PFFS Silver	State of Tennessee	Middle and Western Tennessee	2	2			287	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-664-6422	(877)-664-6422	(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	http://www.bcbst-medicare.com/2008/New%20Member%20PDFS/Group/H5884.H7917.S1030_BA08_FOR.pdf	
H5884	002	2	1	09	04	H5884_002_2	6	2009.01	BLUECROSS BLUESHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	04	09	2	1		H5884	002	2	2009	BlueAdvantage PFFS Silver	State of Tennessee	Southeast and Northeast Tennessee	2	2			300	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-664-6422	(877)-664-6422	(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	http://www.bcbst-medicare.com/2008/New%20Member%20PDFS/Group/H5884.H7917.S1030_BA08_FOR.pdf	
H5884	003	1	1	09	04	H5884_003_1	6	2009.01	BLUECROSS BLUESHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	04	09	2	1		H5884	003	1	2009	BlueAdvantage PFFS Gold	State of Tennessee	Middle and Western Tennessee	2	2			936	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-664-6422	(877)-664-6422	(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	http://www.bcbst-medicare.com/2008/New%20Member%20PDFS/Group/H5884.H7917.S1030_BA08_FOR.pdf	
H5884	003	2	1	09	04	H5884_003_2	6	2009.01	BLUECROSS BLUESHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	04	09	2	1		H5884	003	2	2009	BlueAdvantage PFFS Gold	State of Tennessee	Southeast and Northeast Tennessee	2	2			1550	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-664-6422	(877)-664-6422	(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	http://www.bcbst-medicare.com/2008/New%20Member%20PDFS/Group/H5884.H7917.S1030_BA08_FOR.pdf	
H5884	004	1	1	09	04	H5884_004_1	6	2009.01	BLUECROSS BLUESHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	04	09	2	1		H5884	004	1	2009	BlueAdvantage PFFS Platinum	State of Tennessee	Middle and Western Tennessee	2	2			4292	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-664-6422	(877)-664-6422	(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	http://www.bcbst-medicare.com/2008/New%20Member%20PDFS/Group/H5884.H7917.S1030_BA08_FOR.pdf	
H5884	004	2	1	09	04	H5884_004_2	6	2009.01	BLUECROSS BLUESHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	04	09	2	1		H5884	004	2	2009	BlueAdvantage PFFS Platinum	State of Tennessee	Southeast and Northeast Tennessee	2	2			8531	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-664-6422	(877)-664-6422	(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	http://www.bcbst-medicare.com/2008/New%20Member%20PDFS/Group/H5884.H7917.S1030_BA08_FOR.pdf	
H5884	006	1	1	09	04	H5884_006_1	4	2009.01	BLUECROSS BLUESHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	04	09	2	1		H5884	006	1	2009	BlueAdvantage PFFS MA3	State of Tennessee	Middle and Western Tennessee	2	2			131	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-664-6422	(877)-664-6422									http://www.bcbst-medicare.com/2008/New%20Member%20PDFS/Group/H5884.H7917.S1030_BA08_FOR.pdf	
H5884	006	2	1	09	04	H5884_006_2	4	2009.01	BLUECROSS BLUESHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	04	09	2	1		H5884	006	2	2009	BlueAdvantage PFFS MA3	State of Tennessee	Southeast and Northeast Tennessee	2	2			286	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-664-6422	(877)-664-6422									http://www.bcbst-medicare.com/2008/New%20Member%20PDFS/Group/H5884.H7917.S1030_BA08_FOR.pdf	
H5884	802	0	1	09	04	H5884_802_0	5	2009.01	BLUECROSS BLUESHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	04	09	2	1		H5884	802	0	2009	BlueAdvantage Plus PFFS	National		1	2			3800	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-664-6422	(877)-664-6422	(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	http://www.bcbst-medicare.com/2008/New%20Member%20PDFS/Group/H5884.H7917.S1030_BA08_FOR.pdf	
H5884	803	0	1	09	04	H5884_803_0	4	2009.01	BLUECROSS BLUESHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	04	09	2	1		H5884	803	0	2009	BlueAdvantage PFFS	National		1	2			800	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-664-6422	(877)-664-6422									http://www.bcbst-medicare.com/2008/New%20Member%20PDFS/Group/H5884.H7917.S1030_BA08_FOR.pdf	
H5884	804	0	1	09	04	H5884_804_0	4	2009.01	BLUECROSS BLUESHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	04	09	2	1		H5884	804	0	2009	BlueAdvantage Plus PFFS	National		1	2			400	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-664-6422	(877)-664-6422	(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	http://www.bcbst-medicare.com/2008/New%20Member%20PDFS/Group/H5884.H7917.S1030_BA08_FOR.pdf	
H5887	001	0	1	01	01	H5887_001_0	10	2009.01	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	01	01		1		H5887	001	0	2009	First Care+Plus	Entire Island Puerto Rico		2	2				2						(787)-625-9557	(888)-767-7717	(877)-672-4242	(877)-672-4242	(787)-625-9557	(877)-662-4242	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	http://www.firstpluspr.com	www.firstpluspr.com
H5887	006	0	1	01	01	H5887_006_0	10	2009.01	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	01	01		1		H5887	006	0	2009	First+Plus Platino	Entire Island Puerto Rico		2	1	3			2			2	3		(787)-625-9557	(888)-767-7717	(877)-672-4242	(877)-672-4242	(787)-625-9557	(877)-662-4242	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	http://www.firstpluspr.com	www.firstpluspr.com
H5887	007	0	1	01	01	H5887_007_0	10	2009.01	FIRST MEDICAL HEALTH PLAN, INC.	First Medical Health Plan, Inc.	www.firstpluspr.com	01	01		1		H5887	007	0	2009	First+Plus Complete	Entire Island Puerto Rico		2	1	4			2			1		0000000010000000000000000000	(787)-625-9557	(888)-767-7717	(877)-672-4242	(877)-672-4242	(787)-625-9557	(877)-662-4242	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	http://www.firstpluspr.com	www.firstpluspr.com
H5895	001	0	1	01	01	H5895_001_0	6	2009.01	CONTRA COSTA CO MED SVCS DBA CONTRA COSTA HEALTH	Contra Costa Health Plan	www.contracostahealthplan.org	01	01		1		H5895	001	0	2009	SelectCare	Contra Costa County		2	1	3		85	2			1	3		(925)-313-6000	(877)-661-6230	(800)-735-2929		(925)-313-6000	(877)-661-6230	(800)-735-2929		(925)-313-6000	(877)-661-6230	(800)-735-2929		(925)-313-6000	(877)-661-6230	(800)-735-2929		http://www.contracostahealthplan.org	
H5896	007	0	1	01	01	H5896_007_0	6	2009.01	AMERIGROUP MARYLAND, INC.	AMERIGROUP Community Care	www.myamerigroup.com	01	01		1		H5896	007	0	2009	AMERIVANTAGE Specialty + Rx	Central Maryland		2	1	3		1100	2			1	1		(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	https://www.amerigroupcorp.com/members/Amerivantage/_documents/Amvtg_Formulary	www.myamerigroup.com
H5896	008	0	1	01	01	H5896_008_0	4	2009.01	AMERIGROUP MARYLAND, INC.	AMERIGROUP Community Care	www.myamerigroup.com	01	01		1		H5896	008	0	2009	AMERIVANTAGE Classic + Rx	Central Maryland		2	2			453	2						(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	https://www.amerigroupcorp.com/members/Amerivantage/_documents/Amvtg_Formulary	www.myamerigroup.com
H5896	009	0	1	01	01	H5896_009_0	4	2009.01	AMERIGROUP MARYLAND, INC.	AMERIGROUP Community Care	www.myamerigroup.com	01	01		1		H5896	009	0	2009	AMERIVANTAGE Balance + Rx	Central Maryland		2	2			113	2						(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	https://www.amerigroupcorp.com/members/Amerivantage/_documents/Amvtg_Formulary	www.myamerigroup.com
H5896	012	0	1	02	01	H5896_012_0	3	2009.01	AMERIGROUP MARYLAND, INC.	AMERIGROUP Community Care	www.myamerigroup.com	01	02		1		H5896	012	0	2009	AMERIVANTAGE Choice + Rx	Central Maryland		2	2			113	2						(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	https://www.amerigroupcorp.com/members/Amerivantage/_documents/Amvtg_Formulary	www.myamerigroup.com
H5908	003	0	1	09	04	H5908_003_0	6	2009.01	SUN HEALTH MEDISUN, INC.	MediSun Private Fee For Service	www.medisun.com	04	09	1	1		H5908	003	0	2009	MediSun Care Options	Northwest Maricopa County		2	2			50	2						(623)-974-7430	(800)-446-8331	(623)-974-7440		(623)-974-7430	(800)-446-8331	(623)-974-7440		(623)-974-7430	(800)-446-8331	(623)-974-7440		(623)-974-7430	(800)-446-8331	(623)-974-7440		http://medisun.com/drug_plan/index.cfm?content=formulary_form	
H5908	004	0	1	09	04	H5908_004_0	2	2009.01	SUN HEALTH MEDISUN, INC.	MediSun Private Fee For Service	www.medisun.com	04	09	1	1		H5908	004	0	2009	MediSun Care Options	Northwest Maricopa County		2	2			50	2						(623)-974-7430	(800)-446-8331	(623)-974-7440		(623)-974-7430	(800)-446-8331	(623)-974-7440										http://medisun.com/drug_plan/index.cfm?content=formulary_form	
H5909	001	0	1	38	05	H5909_001_0	2	2009.01	AMERICAN PROGRESSIVE LIFE AND HEALTH OF NEW YORK	Fresenius Medical Care Health Plan	www.fmchp.com	05	38	3	1		H5909	001	0	2009	Fresenius Medical Care Health Plan	Selected Counties in Conn-Mass-R.I.		2	2			10	2						(866)-660-4728	(866)-660-4728	(866)-338-4681	(866)-338-4681	(866)-307-3625	(866)-307-3625	(866)-338-4681	(866)-338-4681										
H5909	005	0	1	38	05	H5909_005_0	2	2009.01	AMERICAN PROGRESSIVE LIFE AND HEALTH OF NEW YORK	Fresenius Medical Care Health Plan	www.fmchp.com	05	38	3	1		H5909	005	0	2009	Fresenius Medical Care Health Plan	Selected Counties in New York		2	2			10	2						(866)-660-4728	(866)-660-4728	(866)-338-4681	(866)-338-4681	(866)-307-3625	(866)-307-3625	(866)-338-4681	(866)-338-4681										
H5918	001	0	1	37	05	H5918_001_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.EricksonAdvantage.com	05	37		1		H5918	001	0	2009	Erickson Advantage Signature with Drugs	Monmouth and Morris Counties		2	2				2						(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.EricksonAdvantage.com
H5918	002	0	1	37	05	H5918_002_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.EricksonAdvantage.com	05	37		1		H5918	002	0	2009	Erickson Advantage Signature without Drugs	Monmouth and Morris Counties		2	2				2						(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480										http://www.ericksonadvantage.com/formulary.asp	www.EricksonAdvantage.com
H5918	003	0	1	37	05	H5918_003_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.EricksonAdvantage.com	05	37		1		H5918	003	0	2009	Erickson Advantage Guardian	Monmouth and Morris Counties		2	1	1	1		2			1			(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.EricksonAdvantage.com
H5918	004	0	1	37	05	H5918_004_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.EricksonAdvantage.com	05	37		1		H5918	004	0	2009	Erickson Advantage Champion	Monmouth and Morris Counties		2	1	4			2			2		1111111110000000100000000001	(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.EricksonAdvantage.com
H5926	001	0	1	01	01	H5926_001_0	5	2009.01	MOLINA HEALTHCARE OF MICHIGAN	Molina Healthcare of Michigan	www.molinamedicare.com	01	01		1		H5926	001	0	2009	Molina Medicare Options Plus	Detroit/Flint Metro and Grand Rapids Metro area		2	1	3			2			1	1		(248)-925-1700	(800)-665-3072	(800)-346-4128	(800)-346-4128	(248)-925-1700	(866)-403-8293	(800)-346-4128	(800)-346-4128	(248)-925-1700	(800)-665-3072	(800)-346-4128	(800)-346-4128	(248)-925-1700	(866)-403-8293	(800)-346-4128	(800)-346-4128	www.molinahealthcare.com	https://eportal.molinahealthcare.com/eportal/providers/ProviderSearchAdv.aspx
H5926	002	0	1	01	01	H5926_002_0	8	2009.01	MOLINA HEALTHCARE OF MICHIGAN	Molina Healthcare of Michigan	www.molinamedicare.com	01	01		1		H5926	002	0	2009	Molina Medicare Options	Genesee, Kent, Macomb, Oakland, Wayne area		2	2				2						(248)-925-1700	(800)-665-3072	(800)-346-4128	(800)-346-4128	(248)-925-1700	(866)-403-8293	(800)-346-4128	(800)-346-4128	(248)-925-1700	(800)-665-3072	(800)-346-4128	(800)-346-4128	(248)-925-1700	(866)-403-8293	(800)-346-4128	(800)-346-4128	www.molinahealthcare.com	https://eportal.molinahealthcare.com/eportal/providers/ProviderSearchAdv.aspx
H5928	001	0	1	01	01	H5928_001_0	5	2009.01	CARE1ST HEALTH PLAN	Care1st Medicare Advantage Plan	www.care1st.com	01	01		1		H5928	001	0	2009	Care1st Dual Plus Value Plan	Care1st Health Plan Los Angeles County		2	1	3			1	1		1	2		(800)-544-0088	(800)-544-0088	(800)-735-2929		(800)-847-1222	(800)-847-1222	(800)-735-2929	(800)-735-2929	(800)-544-0088	(800)-544-0088	(800)-735-2929		(800)-847-1222	(800)-847-1222	(800)-735-2929	(800)-735-2929	www.care1st.com	www.care1st.com
H5928	002	0	1	01	01	H5928_002_0	4	2009.01	CARE1ST HEALTH PLAN	Care1st Medicare Advantage Plan	www.care1st.com	01	01		1		H5928	002	0	2009	Care1st Medicare Advantage Value Plan	Care1st Health Plan Los Angeles County		2	2				1	1					(800)-544-0088	(800)-544-0088	(800)-735-2929		(800)-847-1222	(800)-847-1222	(800)-735-2929	(800)-735-2929	(800)-544-0088	(800)-544-0088	(800)-735-2929		(800)-847-1222	(800)-847-1222	(800)-735-2929	(800)-735-2929	www.care1st.com	www.care1st.com
H5928	004	0	1	01	01	H5928_004_0	6	2009.01	CARE1ST HEALTH PLAN	Care1st Medicare Advantage Plan	www.care1st.com	01	01		1		H5928	004	0	2009	Care1st Medicare Advantage Platinum Plan	Care1st Health Plan Los Angeles County		2	2				1	1					(800)-544-0088	(800)-544-0088	(800)-735-2929		(800)-847-1222	(800)-847-1222	(800)-735-2929	(800)-735-2929	(800)-544-0088	(800)-544-0088	(800)-735-2929		(800)-847-1222	(800)-847-1222	(800)-735-2929	(800)-735-2929	www.care1st.com	www.care1st.com
H5928	005	0	1	01	01	H5928_005_0	5	2009.01	CARE1ST HEALTH PLAN	Care1st Medicare Advantage Plan	www.care1st.com	01	01		1		H5928	005	0	2009	Care1st Dual Plus Plan	Care1st Health Plan Orange County		2	1	3			1	1		1	2		(800)-544-0088	(800)-544-0088	(800)-735-2929		(800)-847-1222	(800)-847-1222	(800)-735-2929	(800)-735-2929	(800)-544-0088	(800)-544-0088	(800)-735-2929		(800)-847-1222	(800)-847-1222	(800)-735-2929	(800)-735-2929	www.care1st.com	www.care1st.com
H5928	006	0	1	01	01	H5928_006_0	5	2009.01	CARE1ST HEALTH PLAN	Care1st Medicare Advantage Plan	www.care1st.com	01	01		1		H5928	006	0	2009	Care1st Medicare Advantage Value Plus Plan	Care1st Health Plan Orange County		2	2				1	1					(800)-544-0088	(800)-544-0088	(800)-735-2929		(800)-847-1222	(800)-847-1222	(800)-735-2929	(800)-735-2929	(800)-544-0088	(800)-544-0088	(800)-735-2929		(800)-847-1222	(800)-847-1222	(800)-735-2929	(800)-735-2929	www.care1st.com	www.care1st.com
H5928	007	0	1	01	01	H5928_007_0	5	2009.01	CARE1ST HEALTH PLAN	Care1st Medicare Advantage Plan	www.care1st.com	01	01		1		H5928	007	0	2009	Care1st Dual Plus Plan	Care1st Health Plan San Bernardino County		2	1	3			1	1		1	2		(800)-544-0088	(800)-544-0088	(800)-735-2929		(800)-847-1222	(800)-847-1222	(800)-735-2929	(800)-735-2929	(800)-544-0088	(800)-544-0088	(800)-735-2929		(800)-847-1222	(800)-847-1222	(800)-735-2929	(800)-735-2929	www.care1st.com	www.care1st.com
H5928	008	0	1	01	01	H5928_008_0	6	2009.01	CARE1ST HEALTH PLAN	Care1st Medicare Advantage Plan	www.care1st.com	01	01		1		H5928	008	0	2009	Care1st Medicare Advantage Plan	Care1st Health Plan San Bernardino County		2	2				1	1					(800)-544-0088	(800)-544-0088	(800)-735-2929		(800)-847-1222	(800)-847-1222	(800)-735-2929	(800)-735-2929	(800)-544-0088	(800)-544-0088	(800)-735-2929		(800)-847-1222	(800)-847-1222	(800)-735-2929	(800)-735-2929	www.care1st.com	www.care1st.com
H5928	009	0	1	01	01	H5928_009_0	6	2009.01	CARE1ST HEALTH PLAN	Care1st Medicare Advantage Plan	www.care1st.com	01	01		1		H5928	009	0	2009	Care1st Dual Plus Value Plan	Care1st Health Plan San Diego County		2	1	3			1	1		1	2		(800)-544-0088	(800)-544-0088	(800)-735-2929		(800)-847-1222	(800)-847-1222	(800)-735-2929	(800)-735-2929	(800)-544-0088	(800)-544-0088	(800)-735-2929		(800)-847-1222	(800)-847-1222	(800)-735-2929	(800)-735-2929	www.care1st.com	www.care1st.com
H5928	010	0	1	01	01	H5928_010_0	5	2009.01	CARE1ST HEALTH PLAN	Care1st Medicare Advantage Plan	www.care1st.com	01	01		1		H5928	010	0	2009	Care1st Medicare Advantage Value Plan	Care1st Health Plan San Diego County		2	2				1	1					(800)-544-0088	(800)-544-0088	(800)-735-2929		(800)-847-1222	(800)-847-1222	(800)-735-2929	(800)-735-2929	(800)-544-0088	(800)-544-0088	(800)-735-2929		(800)-847-1222	(800)-847-1222	(800)-735-2929	(800)-735-2929	www.care1st.com	www.care1st.com
H5928	011	0	1	01	01	H5928_011_0	5	2009.01	CARE1ST HEALTH PLAN	Care1st Medicare Advantage Plan	www.care1st.com	01	01		1		H5928	011	0	2009	Care1st Private Label Plan	Care1st Health Plan Los Angeles County		2	2				1	1					(800)-544-0088	(800)-544-0088	(800)-735-2929		(800)-847-1222	(800)-847-1222	(800)-735-2929	(800)-735-2929	(800)-544-0088	(800)-544-0088	(800)-735-2929		(800)-847-1222	(800)-847-1222	(800)-735-2929	(800)-735-2929	www.care1st.com	www.care1st.com
H5928	012	0	1	01	01	H5928_012_0	4	2009.01	CARE1ST HEALTH PLAN	Care1st Medicare Advantage Plan	www.care1st.com	01	01		1		H5928	012	0	2009	Care1st Medicare Advantage Value Plan	Care1st Health Plan Riverside County		2	2				1	1					(800)-544-0088	(800)-544-0088	(800)-735-2929		(800)-847-1222	(800)-847-1222	(800)-735-2929	(800)-735-2929	(800)-544-0088	(800)-544-0088	(800)-735-2929		(800)-847-1222	(800)-847-1222	(800)-735-2929	(800)-735-2929	www.care1st.com	www.care1st.com
H5932	001	0	1	01	01	H5932_001_0	4	2009.01	GATEWAY HEALTH PLAN, INC.	Gateway Health Plan Medicare Assured	www.gatewayhealthplan.com	01	01		1		H5932	001	0	2009	Gateway Health Plan Medicare Assured	Pennsylvania		2	1	3		26059	2			1	1		(412)-255-1323	(800)-685-5209	(800)-654-5988	(800)-654-5988	(412)-255-1323	(877)-428-3929	(800)-654-5988	(800)-654-5988	(412)-255-1323	(800)-685-5209	(800)-654-5988	(800)-654-5988	(412)-255-1323	(877)-428-3929	(800)-654-5988	(800)-654-5988	www.gatewayhealthplan.com	www.gatewayhealthplan.com
H5934	001	0	1	20	08	H5934_001_0	1	2009.01	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	Hope Select Care	hopehospice.org	08	20		1		H5934	001	0	2009	Hope Select Care	Lee County Florida		2	2				2														(239)-985-6400	(186)-665-9722			(239)-985-6400	(186)-665-9722			hopehospice.org	
H5934	002	0	1	20	08	H5934_002_0	1	2009.01	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	Hope Select Care	hopehospice.org	08	20		1		H5934	002	0	2009	Hope Select  Care	Lee County Florida		2	2				2														(239)-985-6400	(186)-665-9722			(239)-985-6400	(186)-665-9722			hopehospice.org	
H5938	001	0	1	01	01	H5938_001_0	7	2009.01	CAPITAL HEALTH PLAN	Capital Health Plan	www.capitalhealth.com/medicare	01	01		1		H5938	001	0	2009	Capital Health Plan Advantage Plus	Leon, Gadsden, Wakulla, Jefferson counties		2	2				2						(850)-523-7441	(877)-247-6512	(850)-383-3534	(800)-955-8771	(850)-523-7441	(877)-247-6512	(850)-383-3534	(800)-955-8771	(850)-523-7441	(877)-247-6512	(850)-383-3534	(800)-955-8771	(850)-523-7441	(877)-247-6512	(850)-383-3534	(800)-955-8771	www.capitalhealth.com/medicare	www.capitalhealth.com/medicare
H5938	006	0	1	01	01	H5938_006_0	7	2009.01	CAPITAL HEALTH PLAN	Capital Health Plan	www.capitalhealth.com/medicare	01	01		1		H5938	006	0	2009	Capital Health Plan Preferred Advantage	Gadsden, Jefferson, Leon, Wakulla Counties		2	2				2						(850)-523-7441	(877)-247-6512	(850)-383-3534	(800)-955-8771	(850)-523-7441	(877)-247-6512	(850)-383-3534	(800)-955-8771	(850)-523-7441	(877)-247-6512	(850)-383-3534	(800)-955-8771	(850)-523-7441	(877)-247-6512	(850)-383-3534	(800)-955-8771	www.capitalhealth.com/medicare	www.capitalhealth.com/medicare
H5938	802	0	1	01	01	H5938_802_0	4	2009.01	CAPITAL HEALTH PLAN	Capital Health Plan	www.capitalhealth.com/medicare	01	01		1		H5938	802	0	2009	Capital Health Plan Retiree Advantage	Leon, Gadsden, Wakulla, Jefferson		1	2				2						(850)-523-7441	(877)-247-6512	(850)-383-3534	(800)-955-8771	(850)-523-7441	(877)-247-6512	(850)-383-3534	(800)-955-8771	(850)-523-7441	(877)-247-6512	(850)-383-3534	(800)-955-8771	(850)-523-7441	(877)-247-6512	(850)-383-3534	(800)-955-8771	www.capitalhealth.com/medicare	www.capitalhealth.com/medicare
H5938	803	0	1	01	01	H5938_803_0	4	2009.01	CAPITAL HEALTH PLAN	Capital Health Plan	www.capitalhealth.com/medicare	01	01		1		H5938	803	0	2009	Capital Health Plan Retiree Advantage	Leon, Gadsden, Wakulla, Jefferson		1	2				2						(850)-523-7441	(877)-247-6512	(850)-383-3534	(800)-955-8771	(850)-523-7441	(877)-247-6512	(850)-383-3534	(800)-955-8771									www.capitalhealth.com/medicare	www.capitalhealth.com/medicare
H5938	804	0	1	01	01	H5938_804_0	4	2009.01	CAPITAL HEALTH PLAN	Capital Health Plan	www.capitalhealth.com/medicare	01	01		1		H5938	804	0	2009	Capital Health Plan Retiree Advantage	Leon, Gadsden, Wakulla, Jefferson		1	2				2						(850)-523-7441	(877)-247-6512	(850)-383-3534	(800)-955-8771	(850)-523-7441	(877)-247-6512	(850)-383-3534	(800)-955-8771	(850)-523-7441	(877)-247-6512	(850)-383-3534	(800)-955-8771	(850)-523-7441	(877)-247-6512	(850)-383-3534	(800)-955-8771	www.capitalhealth.com/medicare	www.capitalhealth.com/medicare
H5943	001	0	1	39	05	H5943_001_0	6	2009.01	SCAN HEALTH PLAN	VillageHealth	www.villagehealthca.com	05	39		1		H5943	001	0	2009	VillageHealth	VillageHealth		2	1	4			2			1		0000000000000000000000000100	(877)-586-1648	(877)-586-1648	(866)-525-7833	(866)-525-7833	(877)-916-1234	(877)-916-1234	(866)-525-7833	(866)-525-7833	(877)-586-1648	(877)-586-1648	(866)-525-7833	(866)-525-7833	(877)-916-1234	(877)-916-1234	(866)-525-7833	(866)-525-7833	http://www.scanhealthplan.com	www.villagehealthca.com
H5948	001	0	1	01	01	H5948_001_0	4	2009.01	ARTA MEDICARE HEALTH PLAN, INC.	Arta Medicare Health Plan	www.artamedicare.com	01	01		1		H5948	001	0	2009	Arta Gold	Arta Gold Orange County		2	2				2						(949)-260-6596	(866)-376-8294	(800)-735-2922	(800)-735-2922	(949)-260-6593	(866)-844-2170	(800)-735-2922	(800)-735-2922	(800)-256-0362	(800)-256-0362	(800)-735-2922	(800)-735-2922	(949)-260-6593	(866)-844-2170	(800)-735-2922	(800)-735-2922	www.artamedicare.com	www.artamedicare.com
H5948	002	0	1	01	01	H5948_002_0	4	2009.01	ARTA MEDICARE HEALTH PLAN, INC.	Arta Medicare Health Plan	www.artamedicare.com	01	01		1		H5948	002	0	2009	Arta Select	Arta Select		2	1	3			2			1	1		(949)-260-6510	(866)-578-3789	(800)-735-2922	(800)-735-2922	(949)-260-6593	(866)-844-2170	(800)-735-2922	(800)-735-2922	(800)-256-0362	(800)-256-0362	(800)-735-2922	(800)-735-2922	(949)-260-6593	(866)-844-2170	(800)-735-2922	(800)-735-2922	www.artamedicare.com	www.artamedicare.com
H5948	003	0	1	01	01	H5948_003_0	4	2009.01	ARTA MEDICARE HEALTH PLAN, INC.	Arta Medicare Health Plan	www.artamedicare.com	01	01		1		H5948	003	0	2009	Arta Gold	Arta Gold Riverside County		2	2				2						(949)-260-6596	(866)-376-8294	(800)-735-2922	(800)-735-2922	(949)-260-6593	(866)-844-2170	(800)-735-2922	(800)-735-2922	(800)-256-0362	(800)-256-0362	(800)-735-2922	(800)-735-2922	(949)-260-6593	(866)-844-2170	(800)-735-2922	(800)-735-2922	www.artamedicare.com	www.artamedicare.com
H5950	001	0	1	01	01	H5950_001_0	5	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www. aetnamedicare.com	01	01		1		H5950	001	0	2009	Aetna Golden Medicare Value Plan	Memphis and Nashville		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5950	002	0	1	01	01	H5950_002_0	4	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www. aetnamedicare.com	01	01		1		H5950	002	0	2009	Aetna Golden Medicare Standard Plan	Memphis and Nashville		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5950	003	0	1	01	01	H5950_003_0	5	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www. aetnamedicare.com	01	01		1		H5950	003	0	2009	Aetna Golden Medicare Premier Plan	Memphis and Nashville		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5950	004	0	1	01	01	H5950_004_0	4	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www. aetnamedicare.com	01	01		1		H5950	004	0	2009	Aetna Golden Medicare Basic Plan	Memphis and Nashville		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5950	801	0	1	01	01	H5950_801_0	4	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www. aetnamedicare.com	01	01		1		H5950	801	0	2009	Aetna Golden Medicare Plan	Shelby County		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5950	802	0	1	01	01	H5950_802_0	4	2009.01	AETNA HEALTH INC.	Aetna Medicare	http://www. aetnamedicare.com	01	01		1		H5950	802	0	2009	Aetna Golden Medicare Plan w/Rx CY	Shelby County		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H5952	001	0	1	09	04	H5952_001_0	8	2009.01	CAMBRIDGE LIFE INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H5952	001	0	2009	Advantra Freedom-Freedom 4	Select counties in New York State		2	2			521	2						(866)-386-2330	(866)-386-2330	(866)-386-2335	(866)-386-2335	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010	(800)-690-4028	(800)-690-4028	(866)-236-1069	(866)-236-1069	(800)-711-1607	(800)-711-1607	(888)-788-4010	(888)-788-4010	http://www.advantrafreedom.com/	
H5952	801	0	1	09	04	H5952_801_0	6	2009.01	CAMBRIDGE LIFE INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H5952	801	0	2009	Advantra Freedom-EGO MAPD-CY	United States and Territories		1	2			88	2						(866)-714-9291	(866)-714-9291	(866)-386-2335	(866)-386-2335	(866)-714-9291	(866)-714-9291	(866)-386-2335	(866)-386-2335	(800)-690-4028	(800)-690-4028	(866)-236-1069	(866)-236-1069	(866)-714-9291	(866)-714-9291	(866)-386-2335	(866)-386-2335	http://www.advantrafreedom.com/	
H5952	802	0	1	09	04	H5952_802_0	6	2009.01	CAMBRIDGE LIFE INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H5952	802	0	2009	Advantra Freedom-EGO MAPD-Non-CY	United States and Territories		1	2			88	2						(866)-714-9291	(866)-714-9291	(866)-386-2335	(866)-386-2335	(866)-714-9291	(866)-714-9291	(866)-386-2335	(866)-386-2335	(800)-690-4028	(800)-690-4028	(866)-236-1069	(866)-236-1069	(866)-714-9291	(866)-714-9291	(866)-386-2335	(866)-386-2335	http://www.advantrafreedom.com/	
H5952	803	0	1	09	04	H5952_803_0	6	2009.01	CAMBRIDGE LIFE INSURANCE COMPANY	Advantra Freedom	www.advantrafreedom.com	04	09	2	1		H5952	803	0	2009	Advantra Freedom-EGO MA Only-CY and non-CY	United States and Territories		1	2			88	2						(866)-714-9291	(866)-714-9291	(866)-386-2335	(866)-386-2335	(866)-714-9291	(866)-714-9291	(866)-386-2335	(866)-386-2335									http://www.advantrafreedom.com/	
H5962	001	0	1	38	05	H5962_001_0	3	2009.01	STERLING LIFE INSURANCE COMPANY	Fresenius Medical Care Health Plan, Inc. - Texas	www.FMCHP.com	05	38	3	1		H5962	001	0	2009	FRESENIUS MEDICAL CARE HEALTH PLAN	Texas		2	2				2						(888)-270-0762	(888)-270-0762	(888)-858-8567	(888)-858-8567	(866)-307-3625	(866)-307-3625	(888)-858-8567	(888)-858-8567										
H5969	001	0	1	01	01	H5969_001_0	6	2009.01	ALOHACARE	AlohaCare	http://alohacare.org/advantage/	01	01		1		H5969	001	0	2009	AlohaCare Advantage	State of Hawaii		2	2			1396	2						(808)-973-6395	(866)-973-6395	(877)-447-5990	(877)-447-5990	(808)-973-6395	(866)-973-6395	(877)-447-5990	(877)-447-5990	(808)-973-6395	(866)-973-6395	(877)-447-5990	(877)-447-5990	(808)-973-6395	(866)-973-6395	(877)-447-5990	(877)-447-5990	http://www.AlohaCareHawaii.org	
H5969	002	0	1	01	01	H5969_002_0	6	2009.01	ALOHACARE	AlohaCare	http://alohacare.org/advantageplus/	01	01		1		H5969	002	0	2009	AlohaCare Advantage Plus	State of Hawaii		2	1	3		922	2			1	3		(808)-973-6395	(866)-973-6395	(877)-447-5990	(877)-447-5990	(808)-973-6395	(866)-973-6395	(877)-447-5990	(877)-447-5990	(808)-973-6395	(866)-973-6395	(877)-447-5990	(877)-447-5990	(808)-973-6395	(866)-973-6395	(877)-447-5990	(877)-447-5990	http://www.AlohaCareHawaii.org	
H5978	001	0	1	20	08	H5978_001_0	1	2009.01	PHI LIFE	PHI LIFE	www.phihomes.org	08	20		1		H5978	001	0	2009	PHI LIFE	Northampton and Lehigh counties		2	2				2														(610)-782-8425	(800)-382-1385			(610)-782-8425	(800)-382-1385			www.phihomes.org	
H5978	002	0	1	20	08	H5978_002_0	1	2009.01	PHI LIFE	PHI LIFE	www.phihomes.org	08	20		1		H5978	002	0	2009	PHI LIFE	Lehigh and Northampton counties		2	2				2														(610)-782-8425	(800)-382-1385			(610)-782-8425	(800)-382-1385			www.phihomes.org	
H5980	005	0	1	01	01	H5980_005_0	7	2009.01	FIDELIS SECURECARE OF TEXAS, INC.	Fidelis SecureCare of Texas, Inc.	www.fidelissc.com	01	01		1		H5980	005	0	2009	Fidelis Secure Comfort	Texas Area		2	1	1	1		2			1			(877)-372-8085		(888)-844-5530		(877)-372-8085		(888)-844-5530		(877)-372-7948	(877)-372-7948	(888)-844-5530		(877)-372-7948	(877)-372-7948	(888)-844-5530		http://www.fidelissc.com/ourplans/t_partD.asp	
H5980	006	0	1	01	01	H5980_006_0	5	2009.01	FIDELIS SECURECARE OF TEXAS, INC.	Fidelis SecureCare of Texas, Inc.	www.fidelissc.com	01	01		1		H5980	006	0	2009	Fidelis Secure Comfort Plus	Texas Area		2	1	1	1		2			1			(877)-372-8085		(888)-844-5530		(877)-372-8085		(888)-844-5530		(877)-372-7948	(877)-372-7948	(888)-844-5530		(877)-372-7948	(877)-372-7948	(888)-844-5530		http://www.fidelissc.com/ourplans/t_partD.asp	
H5980	007	0	1	01	01	H5980_007_0	7	2009.01	FIDELIS SECURECARE OF TEXAS, INC.	Fidelis SecureCare of Texas, Inc.	www.fidelissc.com	01	01		1		H5980	007	0	2009	Fidelis Secure Independence	Texas Area		2	1	1	2		2			1			(877)-372-8085		(888)-844-5530		(877)-372-8085		(888)-844-5530		(877)-372-7948	(877)-372-7948	(888)-844-5530		(877)-372-7948	(877)-372-7948	(888)-844-5530		http://www.fidelissc.com/ourplans/t_partD.asp	
H5985	001	0	1	01	01	H5985_001_0	5	2009.01	ABRAZO ADVANTAGE HEALTH PLAN	Abrazo Advantage Health Plan	AbrazoAdvantage.com	01	01		1		H5985	001	0	2009	Abrazo Advantage	Central Arizona		2	2			244	2						(602)-824-3900	(888)-864-1114	(602)-824-3909	(800)-489-1472	(602)-824-3900	(888)-864-1114	(602)-824-3909	(800)-489-1472	(602)-824-3900	(888)-864-1114	(602)-824-3909	(800)-489-1472	(602)-824-3900	(888)-864-1114	(602)-824-3909	(800)-489-1472	AbrazoAdvantage.com	http://www.abrazoadvantage.com/providersDirectory.htm
H5985	002	0	1	01	01	H5985_002_0	5	2009.01	ABRAZO ADVANTAGE HEALTH PLAN	Abrazo Advantage Health Plan	AbrazoAdvantage.com	01	01		1		H5985	002	0	2009	Abrazo Advantage Plus	Central Arizona		2	1	3		3575	2			1	3		(602)-824-3900	(888)-864-1114	(602)-824-3909	(800)-489-1472	(602)-824-3900	(888)-864-1114	(602)-824-3909	(800)-489-1472	(602)-824-3900	(888)-864-1114	(602)-824-3909	(800)-489-1472	(602)-824-3900	(888)-864-1114	(602)-824-3909	(800)-489-1472	AbrazoAdvantage.com	http://www.abrazoadvantage.com/providersDirectory.htm
H5989	002	0	1	01	01	H5989_002_0	7	2009.01	COMPREHENSIVE CARE MANAGEMENT CORP.	Comprehensive Care Management Corp.	www.ccmny.org	01	01		1		H5989	002	0	2009	CCM Direct Complete Plan	New York City Metro Area and Westchester County		2	1	1	1	563	2			1			(718)-515-8600	(877)-226-8500	(800)-650-2774		(877)-226-8500		(800)-650-2774		(877)-226-8500	(877)-226-8500			(877)-226-8500	(877)-226-8500			http://www.ccmny.org	www.ccmny.org
H5989	003	0	1	01	01	H5989_003_0	6	2009.01	COMPREHENSIVE CARE MANAGEMENT CORP.	Comprehensive Care Management Corp.	www.ccmny.org	01	01		1		H5989	003	0	2009	CCM Direct Advantage Plan	New York City Metro Area and Westchester County		2	1	1	1	136	2			1			(877)-226-8500		(800)-650-2774		(877)-226-8500		(800)-650-2774		(877)-226-8500	(877)-226-8500			(877)-226-8500	(877)-226-8500			http://www.ccmny.org	www.ccmny.org
H5989	004	0	1	01	01	H5989_004_0	9	2009.01	COMPREHENSIVE CARE MANAGEMENT CORP.	Comprehensive Care Management Corp.	www.ccmny.org	01	01		1		H5989	004	0	2009	CCM Direct Value Plan	New York City Metro Area and Westchester County		2	2			79	2						(718)-515-8600	(877)-226-8500	(800)-650-2774		(877)-226-8500		(800)-650-2774		(877)-226-8500	(877)-226-8500			(877)-226-8500	(877)-226-8500			http://www.ccmny.org	www.ccmny.org
H5989	005	0	1	01	01	H5989_005_0	11	2009.01	COMPREHENSIVE CARE MANAGEMENT CORP.	Comprehensive Care Management Corp.	www.ccmny.org	01	01		1		H5989	005	0	2009	CCM Direct Choice Plan	New York City Metro Area and Westchester County		2	2			159	2						(718)-515-8600	(877)-226-8500	(800)-650-2774		(877)-226-8500		(800)-650-2774		(877)-226-8500	(877)-226-8500			(877)-226-8500	(877)-226-8500			http://www.ccmny.org	www.ccmny.org
H5991	001	0	1	01	01	H5991_001_0	7	2009.01	AFFINITY HEALTH PLAN, INC.	Affinity Health Plan	www.affinityplan.org	01	01		1		H5991	001	0	2009	Affinity Medicare Ultimate	New York City (5 Boroughs)		2	1	3			2			1	3		(877)-234-4499		(800)-662-1220		(877)-234-4499		(800)-662-1220		(800)-417-3367	(800)-417-3367		(800)-899-2114	(877)-234-4499	(877)-234-4499	(800)-662-1220		www.affinityplan.org	https://www.affinityplan.org/medicare.asp
H5991	002	0	1	01	01	H5991_002_0	7	2009.01	AFFINITY HEALTH PLAN, INC.	Affinity Health Plan	www.affinityplan.org	01	01		1		H5991	002	0	2009	Affinity Medicare Solutions	New York City (5 Boroughs)		2	1	3			2			1	2		(877)-234-4499		(800)-662-1220		(877)-234-4499		(800)-662-1220		(800)-417-3367	(800)-417-3367		(800)-899-2114	(877)-234-4499	(877)-234-4499	(800)-662-1220		www.affinityplan.org	https://www.affinityplan.org/medicare.asp
H5992	001	0	1	01	01	H5992_001_0	8	2009.01	SENIOR WHOLE HEALTH, LLC	Senior Whole Health of New York	www.seniorwholehealth.com	01	01		1		H5992	001	0	2009	Senior Whole Health of New York	Capital District, Ulster Co., Duchess Co.		2	1	3		1216	2			1	3		(617)-494-5353	(866)-211-1777	(888)-749-6455	(888)-749-6455	(617)-494-5353	(866)-211-1777	(888)-749-6455	(888)-749-6455	(518)-472-5200	(866)-211-1777	(866)-404-9507	(866)-404-9507	(617)-494-5353	(888)-794-7268	(888)-749-6455	(888)-749-6455	www.seniorwholehealth.com	www.seniorwholehealth.com
H5992	002	0	1	01	01	H5992_002_0	7	2009.01	SENIOR WHOLE HEALTH, LLC	Senior Whole Health of New York	www.seniorwholehealth.com	01	01		1		H5992	002	0	2009	Senior Whole Health PLUS of New York	Capital District, Ulster Co., Duchess Co.		2	1	3		304	2			1	3		(617)-494-5353	(866)-211-1777	(888)-749-6455	(888)-749-6455	(617)-494-5353	(866)-211-1777	(888)-749-6455	(888)-749-6455	(518)-472-5200	(866)-211-1777	(866)-404-9507	(866)-404-9507	(617)-494-5353	(888)-794-7268	(888)-749-6455	(888)-749-6455	www.seniorwholehealth.com	www.seniorwholehealth.com
H5992	003	0	1	01	01	H5992_003_0	5	2009.01	SENIOR WHOLE HEALTH, LLC	Senior Whole Health of New York	www.seniorwholehealth.com	01	01		1		H5992	003	0	2009	Senior Whole Health	Capital District, Dutchess , Ulster		2	2			300	2						(617)-494-5353	(866)-211-1777	(888)-749-6455	(888)-749-6455	(617)-494-5353	(866)-211-1777	(888)-749-6455	(888)-749-6455	(617)-494-5353	(866)-211-1777	(888)-749-6455	(888)-749-6455	(617)-494-5353	(866)-211-1777	(888)-749-6455	(888)-749-6455	www.seniorwholehealth.com	www.seniorwholehealth.com
H5995	001	0	1	01	01	H5995_001_0	3	2009.01	MARION POLK COMMUNITY HEALTH PLAN ADVANTAGE, INC.	Marion Polk Community Health Plan Advantage, Inc.	www.mpchpa.org	01	01		1		H5995	001	0	2009	Marion Polk Community Health Plan Advantage	Marion and Polk Counties In Oregon		2	1	3		3300	2			1	3		(503)-584-2177	(866)-869-1514	(503)-584-2180	(800)-471-7944	(503)-584-2130	(866)-869-1514	(503)-584-2180	(800)-471-7944	(503)-584-2177	(866)-869-1514	(503)-584-2180	(800)-471-7944	(503)-584-2130	(866)-869-1514	(503)-584-2180	(800)-471-7944	www.mpchpa.org	http://www.physicianschoiceadvantage.com/mpchp/providersearch.php
H5995	002	0	1	01	01	H5995_002_0	4	2009.01	MARION POLK COMMUNITY HEALTH PLAN ADVANTAGE, INC.	Marion Polk Community Health Plan Advantage, Inc.	www.physicianschoiceadvantage.com	01	01		1		H5995	002	0	2009	Physicians Choice Advantage + Rx	Marion and Polk Counties in Oregon		2	2			810	2						(503)-584-4210	(888)-462-2708	(503)-584-2180	(800)-471-7944	(888)-236-2496	(888)-236-2496	(800)-735-2900	(800)-735-2900	(503)-584-4210	(888)-462-2708	(503)-584-2180	(800)-471-7944	(888)-236-2496	(888)-236-2496	(800)-735-2900	(800)-735-2900	www.mpchpa.org	http://www.physicianschoiceadvantage.com/mpchp/providersearch.php
H5995	003	0	1	01	01	H5995_003_0	2	2009.01	MARION POLK COMMUNITY HEALTH PLAN ADVANTAGE, INC.	Marion Polk Community Health Plan Advantage, Inc.	www.physicianschoiceadvantage.com	01	01		1		H5995	003	0	2009	Physicians Choice Advantage	Marion and Polk Counties in Oregon		2	2			254	2						(503)-584-4210	(888)-462-2708	(503)-584-2180	(800)-471-7944	(888)-236-2496	(888)-236-2496	(800)-735-2900	(800)-735-2900									www.mpchpa.org	http://www.physicianschoiceadvantage.com/mpchp/providersearch.php
H5996	001	0	1	09	04	H5996_001_0	5	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	001	0	2009	Health Net Pearl VA Option 1	Portions of VA		2	2			286	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	002	0	1	09	04	H5996_002_0	6	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	002	0	2009	Health Net Pearl MA High T1	Portions of TX		2	2				2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
H5996	003	0	1	09	04	H5996_003_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	003	0	2009	Health Net Pearl WA Option 2	Portions of  WA		2	2			3164	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	005	0	1	09	04	H5996_005_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	005	0	2009	Health Net Pearl MA High Tier 1	Portions of  NM		2	2				2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
H5996	006	0	1	09	04	H5996_006_0	6	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	006	0	2009	Health Net Pearl CA Option 1	Portions of CA		2	2			5729	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	007	0	1	09	04	H5996_007_0	3	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	007	0	2009	Health Net Pearl MA Supp T2	Portions of  TX		2	2			499	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
H5996	011	0	1	09	04	H5996_011_0	6	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	011	0	2009	Health Net Pearl GA Option 8 w/ Drug	Portions of GA		2	2			25	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	
H5996	012	0	1	09	04	H5996_012_0	6	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	012	0	2009	Health Net Pearl GA Option 9 w/ Drug	Portions of GA		2	2			14	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	
H5996	013	0	1	09	04	H5996_013_0	6	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	013	0	2009	Health Net Pearl NM Option 5 w/ Drug	Portions of NM		2	2				2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	
H5996	014	0	1	09	04	H5996_014_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	014	0	2009	Health Net Pearl NC Option 1	Portions of NC		2	2			64	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	015	0	1	09	04	H5996_015_0	6	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	015	0	2009	Health Net Pearl GA Option 10 w/ Drug	Portions of GA		2	2			4	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	
H5996	016	0	1	09	04	H5996_016_0	5	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	016	0	2009	Health Net Pearl TX Option 2	Portions of TX		2	2			0	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	017	0	1	09	04	H5996_017_0	5	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	017	0	2009	Health Net Pearl CA Option 2	Portions of CA		2	2			3164	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	018	0	1	09	04	H5996_018_0	9	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	018	0	2009	Health Net Pearl CA Option 7 w/ Drug	Portions of CA		2	2			3164	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	
H5996	019	0	1	09	04	H5996_019_0	6	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	019	0	2009	Health Net Pearl NM Option 6 w/ Drug	Portions of  NM		2	2			0	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	
H5996	020	0	1	09	04	H5996_020_0	6	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	020	0	2009	Health Net Pearl TX Option 7 w/ Drug	Portions of TX		2	2				2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	
H5996	022	0	1	09	04	H5996_022_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	022	0	2009	Health Net Pearl NM Option 1	Portions of NM		2	2				2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	023	0	1	09	04	H5996_023_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	023	0	2009	Health Net Pearl MA Supp T1	Portions of NM		2	2			988	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
H5996	024	0	1	09	04	H5996_024_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	024	0	2009	Health Net Pearl MA Supp T2	Portions of NM		2	2			988	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
H5996	025	0	1	09	04	H5996_025_0	6	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	025	0	2009	Health Net Pearl CA Option 4	Portions of CA		2	2			5729	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	026	0	1	09	04	H5996_026_0	11	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	026	0	2009	Health Net Pearl CA Option 5 w/ Drug	Portions of CA		2	2			5729	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	
H5996	027	0	1	09	04	H5996_027_0	9	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	027	0	2009	Health Net Pearl CA Option 6 w/ Drug	Portions of CA		2	2			5729	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	
H5996	028	0	1	09	04	H5996_028_0	7	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	028	0	2009	Health Net Pearl CA Option 3	Portions of CA		2	2			5729	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	029	0	1	09	04	H5996_029_0	9	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	029	0	2009	Health Net Pearl CA Option 8 w/ Drug	Portions of CA		2	2			5729	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	
H5996	030	0	1	09	04	H5996_030_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	030	0	2009	Health Net Pearl TX Option 1	Portions of TX		2	2			988	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	031	0	1	09	04	H5996_031_0	6	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	031	0	2009	Health Net Pearl TX Option 6 w/ Drug	Portions of TX		2	2			988	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	
H5996	032	0	1	09	04	H5996_032_0	3	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	032	0	2009	Health Net Pearl MA Supp T1	Portions of TX		2	2			499	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
H5996	033	0	1	09	04	H5996_033_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	033	0	2009	Health Net Pearl WA Option 1	Portions of WA		2	2			3164	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	034	0	1	09	04	H5996_034_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	034	0	2009	Health Net Pearl WA Option 3	Portions of WA		2	2			3164	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	035	0	1	09	04	H5996_035_0	6	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	035	0	2009	Health Net Pearl WA Option 4 w/ Drug	Portions of WA		2	2			3164	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	
H5996	036	0	1	09	04	H5996_036_0	6	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	036	0	2009	Health Net Pearl WA Option 5 w/ Drug	Portions of WA		2	2			3164	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	
H5996	037	0	1	09	04	H5996_037_0	6	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	037	0	2009	Health Net Pearl WA Option 6 w/ Drug	Portions of WA		2	2			3164	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	
H5996	038	0	1	09	04	H5996_038_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	038	0	2009	Health Net Pearl OR Option 1	Portions of OR		2	2			3164	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	039	0	1	09	04	H5996_039_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	039	0	2009	Health Net Pearl OR Option 2	Portions of OR		2	2			3164	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	040	0	1	09	04	H5996_040_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	040	0	2009	Health Net Pearl OR Option 3	Portions of OR		2	2			3164	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	041	0	1	09	04	H5996_041_0	6	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	041	0	2009	Health Net Pearl OR Option 4 w/Drug	Portions of OR		2	2			3164	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	
H5996	042	0	1	09	04	H5996_042_0	6	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	042	0	2009	Health Net Pearl OR Option 5 w/Drug	Portions of OR		2	2			3164	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	
H5996	043	0	1	09	04	H5996_043_0	6	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	043	0	2009	Health Net Pearl OR Option 6 w/Drug	Portions of OR		2	2			3164	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	
H5996	044	0	1	09	04	H5996_044_0	5	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	044	0	2009	Health Net Pearl VA Option 2	Portions of VA		2	2			34	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	045	0	1	09	04	H5996_045_0	5	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	045	0	2009	Health Net Pearl VA Option 3	Portions of VA		2	2			2	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	046	0	1	09	04	H5996_046_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	046	0	2009	Health Net Pearl VA Option 4	Portions of VA		2	2			55	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	047	0	1	09	04	H5996_047_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	047	0	2009	Health Net Pearl VA Option 5	Portions of VA		2	2			22	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	048	0	1	09	04	H5996_048_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	048	0	2009	Health Net Pearl VA Option 6	Portions of VA		2	2			4	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	049	0	1	09	04	H5996_049_0	7	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	049	0	2009	Health Net Pearl VA Option 7 w/ Drug	Portions of VA		2	2			93	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	
H5996	050	0	1	09	04	H5996_050_0	7	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	050	0	2009	Health Net Pearl VA Option 8 w/ Drug	Portions of VA		2	2			16	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	
H5996	051	0	1	09	04	H5996_051_0	7	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	051	0	2009	Health Net Pearl VA Option 9 w/ Drug	Portions of VA		2	2			3	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	
H5996	052	0	1	09	04	H5996_052_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	052	0	2009	Health Net Pearl GA Option 1	Portions of GA		2	2			81	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	053	0	1	09	04	H5996_053_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	053	0	2009	Health Net Pearl GA Option 2	Portions of GA		2	2			25	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	054	0	1	09	04	H5996_054_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	054	0	2009	Health Net Pearl GA Option 3	Portions of GA		2	2			42	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	055	0	1	09	04	H5996_055_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	055	0	2009	Health Net Pearl GA Option 4	Portions of GA		2	2			48	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	056	0	1	09	04	H5996_056_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	056	0	2009	Health Net Pearl GA Option 5	Portions of GA		2	2			20	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	057	0	1	09	04	H5996_057_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	057	0	2009	Health Net Pearl GA Option 6	Portions of GA		2	2			4	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	058	0	1	09	04	H5996_058_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	058	0	2009	Health Net Pearl GA Option 7	Portions of GA		2	2			1	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	059	0	1	09	04	H5996_059_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	059	0	2009	Health Net Pearl NC Option 2	Portions of NC		2	2			12	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	060	0	1	09	04	H5996_060_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	060	0	2009	Health Net Pearl NC Option 3	Portions of NC		2	2			51	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	061	0	1	09	04	H5996_061_0	5	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	061	0	2009	Health Net Pearl NC Option 4	Portions of NC		2	2			17	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	062	0	1	09	04	H5996_062_0	5	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	062	0	2009	Health Net Pearl NC Option 5	Portions of NC		2	2			17	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	063	0	1	09	04	H5996_063_0	5	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	063	0	2009	Health Net Pearl NC Option 6	Portions of NC		2	2			50	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	064	0	1	09	04	H5996_064_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	064	0	2009	Health Net Pearl MA Option 1	Portions of MA		2	2			27	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	065	0	1	09	04	H5996_065_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	065	0	2009	Health Net Pearl MA Option 2	Portions of MA		2	2			2	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	066	0	1	09	04	H5996_066_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	066	0	2009	Health Net Pearl MA Option 3	Portions of MA		2	2			15	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	067	0	1	09	04	H5996_067_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	067	0	2009	Health Net Pearl MA Option 4	Portions of MA		2	2			2	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	068	0	1	09	04	H5996_068_0	5	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	068	0	2009	Health Net Pearl HI Option 1	Hawaii		2	2			5729	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/formulary.htm	
H5996	069	0	1	09	04	H5996_069_0	9	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	069	0	2009	Health Net Pearl HI Option 2 w/ Drug	Hawaii		2	2			5729	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/formulary.htm	
H5996	801	0	1	09	04	H5996_801_0	3	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	801	0	2009	Health Net Pearl EG	National		1	2				2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
H5996	802	0	1	09	04	H5996_802_0	3	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	802	0	2009	Health Net Pearl EG	National		1	2			135	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
H5996	803	0	1	09	04	H5996_803_0	3	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	803	0	2009	Health Net Pearl EG	National		1	2			135	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
H5996	804	0	1	09	04	H5996_804_0	3	2009.01	HEALTH NET LIFE INSURANCE COMPANY, INC.	Health Net Pearl	www.healthnet.com	04	09	2	1		H5996	804	0	2009	Health Net Pearl EG	National		1	2			135	2						(800)-977-8221	(800)-977-8221	(800)-929-9955	(800)-929-9955	(800)-200-0410	(800)-200-0410	(800)-929-9955	(800)-929-9955									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
H5998	001	0	1	01	01	H5998_001_0	8	2009.01	UNISON HEALTH PLAN OF TENNESSEE, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H5998	001	0	2009	Unison Advantage Choice	Southwest Tennessee		2	2				2						(800)-290-4009	(800)-290-4009	(888)-616-0021	(888)-616-0021	(800)-290-4009	(800)-290-4009	(888)-616-0021	(888)-616-0021	(800)-290-4009	(800)-290-4009	(888)-616-0021	(888)-616-0021	(800)-290-4009	(800)-290-4009	(888)-616-0021	(888)-616-0021	http://www.unisonhealthplan.com	www.unisonhealthplan.com
H5998	002	0	1	01	01	H5998_002_0	6	2009.01	UNISON HEALTH PLAN OF TENNESSEE, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H5998	002	0	2009	Unison Advantage Preferred	Southwest Tennessee		2	2				2						(800)-290-4009	(800)-290-4009	(888)-616-0021	(888)-616-0021	(800)-290-4009	(800)-290-4009	(888)-616-0021	(888)-616-0021	(800)-290-4009	(800)-290-4009	(888)-616-0021	(888)-616-0021	(800)-290-4009	(800)-290-4009	(888)-616-0021	(888)-616-0021	http://www.unisonhealthplan.com	www.unisonhealthplan.com
H5998	003	0	1	01	01	H5998_003_0	6	2009.01	UNISON HEALTH PLAN OF TENNESSEE, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H5998	003	0	2009	Unison Advantage Plus	Southwest Tennessee		2	1	3			2			1	3		(800)-290-4009	(800)-290-4009	(888)-616-0021	(888)-616-0021	(800)-290-4009	(800)-290-4009	(888)-616-0021	(888)-616-0021	(800)-290-4009	(800)-290-4009	(888)-616-0021	(888)-616-0021	(800)-290-4009	(800)-290-4009	(888)-616-0021	(888)-616-0021	http://www.unisonhealthplan.com	www.unisonhealthplan.com
H5998	004	0	1	01	01	H5998_004_0	4	2009.01	UNISON HEALTH PLAN OF TENNESSEE, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H5998	004	0	2009	Unison Advantage Basic	Southwest Tennessee		2	2				2						(800)-290-4009	(800)-290-4009	(888)-616-0021	(888)-616-0021	(800)-290-4009	(800)-290-4009	(888)-616-0021	(888)-616-0021									http://www.unisonhealthplan.com	www.unisonhealthplan.com
H5998	801	0	1	01	01	H5998_801_0	2	2009.01	UNISON HEALTH PLAN OF TENNESSEE, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H5998	801	0	2009	Unison Advantage Basic Group	Southwest Tennessee		1	2				2						(800)-290-4009	(800)-290-4009	(888)-616-0021	(888)-616-0021	(800)-290-4009	(800)-290-4009	(888)-616-0021	(888)-616-0021									http://www.unisonhealthplan.com	www.unisonhealthplan.com
H5998	802	0	1	01	01	H5998_802_0	2	2009.01	UNISON HEALTH PLAN OF TENNESSEE, INC.	Unison Advantage	www.unisonhealthplan.com	01	01		1		H5998	802	0	2009	Unison Advantage Choice Group	Southwest Tennessee		1	2				2						(800)-290-4009	(800)-290-4009	(888)-616-0021	(888)-616-0021	(800)-290-4009	(800)-290-4009	(888)-616-0021	(888)-616-0021	(800)-290-4009	(800)-290-4009	(888)-616-0021	(888)-616-0021	(800)-290-4009	(800)-290-4009	(888)-616-0021	(888)-616-0021	http://www.unisonhealthplan.com	www.unisonhealthplan.com
H6013	801	0	1	09	04	H6013_801_0	4	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK  TX	www.hisc.net	04	09	2	1		H6013	801	0	2009	Blue Medicare PFFS	Illinois, New Mexico, Oklahoma, and Texas		1	2				2						(800)-718-2031		(888)-844-5530		(866)-308-4781		(800)-538-0380		(800)-718-2031	(800)-718-2031			(866)-308-4781	(866)-308-4781			https://qa.myrxassistant.com	
H6013	802	0	1	09	04	H6013_802_0	4	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK  TX	www.hisc.net	04	09	2	1		H6013	802	0	2009	Blue Medicare PFFS	Illinois, New Mexico, Oklahoma, and Texas		1	2				2						(800)-718-2031		(888)-844-5530		(866)-308-4781		(800)-538-0380		(800)-718-2031	(800)-718-2031			(866)-308-4781	(866)-308-4781			https://qa.myrxassistant.com	
H6013	803	0	1	09	04	H6013_803_0	4	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK  TX	www.hisc.net	04	09	2	1		H6013	803	0	2009	Blue Medicare PFFS	Illinois, New Mexico, Oklahoma, and Texas		1	2				2						(800)-718-2031		(888)-844-5530		(866)-308-4781		(800)-538-0380										https://qa.myrxassistant.com	
H6013	804	0	1	09	04	H6013_804_0	4	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, NM, OK  TX	www.hisc.net	04	09	2	1		H6013	804	0	2009	Blue Medicare PFFS	Illinois, New Mexico, Oklahoma, and Texas		1	2				2						(800)-718-2031		(888)-844-5530		(866)-308-4781		(800)-538-0380										https://qa.myrxassistant.com	
H6120	001	0	1	01	01	H6120_001_0	1	2009.01	PHYSICIANS HEALTH CHOICE OF FLORIDA	PHYSICIANS HEALTH CHOICE	physicianshealthchoice.com	01	01		1		H6120	001	0	2009	Physicians Health Choice Basic	Broward County		2	2			733	2						(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659									http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/products-findadoctor.html
H6120	002	0	1	01	01	H6120_002_0	6	2009.01	PHYSICIANS HEALTH CHOICE OF FLORIDA	PHYSICIANS HEALTH CHOICE	physicianshealthchoice.com	01	01		1		H6120	002	0	2009	Physicians Health Choice Standard	Broward County		2	2			26704	2						(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/products-findadoctor.html
H6120	003	0	1	01	01	H6120_003_0	6	2009.01	PHYSICIANS HEALTH CHOICE OF FLORIDA	PHYSICIANS HEALTH CHOICE	physicianshealthchoice.com	01	01		1		H6120	003	0	2009	Physicians Health Choice Extra	Broward County		2	2			5455	2						(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/products-findadoctor.html
H6145	001	0	1	04	01	H6145_001_0	6	2009.01	DAVITA VILLAGEHEALTH, INC.	DaVita VillageHealth of Georgia, Inc.	www.villagehealth.com	01	04		1		H6145	001	0	2009	DaVita VillageHealth, Inc.	Clayton, DeKalb and Fulton counties		2	1	4		246	2			1		0000000000000000000000000100	(866)-838-1962	(866)-838-1962	(000)-000-0711		(866)-838-1962	(866)-838-1962	(000)-000-0711		(866)-838-1962	(866)-838-1962	(000)-000-0711		(866)-838-1962	(866)-838-1962	(000)-000-0711		www.villagehealth.com	www.villagehealth.com
H6178	001	0	1	01	01	H6178_001_0	6	2009.01	CARESOURCE	CareSource	www.caresourceadvantage.com	01	01		1		H6178	001	0	2009	CareSource Advantage	17 counties in the most populated areas of Ohio		2	1	3		835	2			1	3		(800)-708-8729	(800)-708-8729	(800)-750-0750	(800)-750-0750	(800)-708-8729	(800)-708-8729	(800)-750-0750	(800)-750-0750	(800)-708-8729	(800)-708-8729	(800)-750-0750	(800)-750-0750	(800)-708-8729	(800)-708-8729	(800)-750-0750	(800)-750-0750	www.caresource-ohio.com	www.caresourceadvantage.com
H6181	007	0	1	01	01	H6181_007_0	5	2009.01	AMERIGROUP NEW YORK, LLC	AMERIGROUP Community Care	https://www.amerigroupcorp.com/Members	01	01		1		H6181	007	0	2009	AMERIVANTAGE Specialty + Rx	New York City Area		2	1	3		1600	2			1	1		(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	http://www.amerigroupcorp.com/Members/amerivantage/_documents	https://www.amerigroupcorp.com/Members/providers.asp
H6181	008	0	1	01	01	H6181_008_0	4	2009.01	AMERIGROUP NEW YORK, LLC	AMERIGROUP Community Care	https://www.amerigroupcorp.com/Members	01	01		1		H6181	008	0	2009	AMERIVANTAGE Classic + Rx	New York City Area		2	2			697	2						(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	http://www.amerigroupcorp.com/Members/amerivantage/_documents	https://www.amerigroupcorp.com/Members/providers.asp
H6181	009	0	1	01	01	H6181_009_0	4	2009.01	AMERIGROUP NEW YORK, LLC	AMERIGROUP Community Care	https://www.amerigroupcorp.com/Members	01	01		1		H6181	009	0	2009	AMERIVANTAGE Balance + Rx	New York City Area		2	2			200	2						(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	http://www.amerigroupcorp.com/Members/amerivantage/_documents	https://www.amerigroupcorp.com/Members/providers.asp
H6181	013	0	1	02	01	H6181_013_0	3	2009.01	AMERIGROUP NEW YORK, LLC	AMERIGROUP Community Care	https://www.amerigroupcorp.com/Members	01	02		1		H6181	013	0	2009	AMERIVANTAGE Choice + Rx	New York CIty Area		2	2			174	2						(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	http://www.amerigroupcorp.com/Members/amerivantage/_documents	https://www.amerigroupcorp.com/Members/providers.asp
H6184	001	0	1	01	01	H6184_001_0	9	2009.01	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H6184	001	0	2009	Anthem Senior Advantage Enhanced	Wisconsin - Select Counties		2	2			112	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
H6184	803	0	1	01	01	H6184_803_0	3	2009.01	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H6184	803	0	2009	Anthem Senior Advantage Group	Wisconsin - Select Counties		1	2			125	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
H6184	804	0	1	01	01	H6184_804_0	3	2009.01	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H6184	804	0	2009	Anthem Senior Advantage Group	Wisconsin - Select Counties		1	2			50	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754									www.anthem.com	www.anthem.com
H6184	805	0	1	01	01	H6184_805_0	3	2009.01	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H6184	805	0	2009	Anthem Senior Advantage Group	Wisconsin - Select Counties		1	2			25	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
H6228	001	0	1	37	05	H6228_001_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.EricksonAdvantage.com	05	37		1		H6228	001	0	2009	Erickson Advantage Signature with Drugs	Douglas County		2	2				2						(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.EricksonAdvantage.com
H6228	002	0	1	37	05	H6228_002_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.EricksonAdvantage.com	05	37		1		H6228	002	0	2009	Erickson Advantage Signature without Drugs	Douglas County		2	2				2						(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480										http://www.ericksonadvantage.com/formulary.asp	www.EricksonAdvantage.com
H6228	003	0	1	37	05	H6228_003_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.EricksonAdvantage.com	05	37		1		H6228	003	0	2009	Erickson Advantage Champion	Douglas County		2	1	4			2			2		1111111110000000100000000001	(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.EricksonAdvantage.com
H6231	001	0	1	20	08	H6231_001_0	1	2009.01	FRANCISCAN PACE, INC.	PACE Baton Rouge	www.fmolhs.org	08	20		1		H6231	001	0	2009	Franciscan PACE, Inc.	PACE Baton Rouge		2	2				2														(225)-765-8255	(800)-789-2863			(225)-765-8255	(800)-789-2863			www.ololrmc.com	
H6231	002	0	1	20	08	H6231_002_0	1	2009.01	FRANCISCAN PACE, INC.	PACE Baton Rouge	www.fmolhs.org	08	20		1		H6231	002	0	2009	Franciscan PACE, Inc.	PACE Baton Rouge		2	2				2														(225)-765-8255	(800)-789-2863			(225)-765-8255	(800)-789-2863			www.ololrmc.com	
H6264	001	0	1	01	01	H6264_001_0	2	2009.01	HEALTHPLUS PHSP, INC.	HealthPlus Elite	www.healthplus-ny.org	01	01		1		H6264	001	0	2009	HealthPlus Elite	New York City and Nassau		2	2			1650	2						(718)-369-5400	(800)-450-8753	(800)-662-1229	(800)-662-1229	(718)-369-5400	(888)-809-8009	(800)-662-1229	(800)-662-1229	(718)-369-5400	(800)-450-8753	(800)-662-1229	(800)-662-1229	(718)-369-5400	(888)-809-8009	(800)-662-1229	(800)-662-1229	https://mp.medimpact.com/pharmacyportal/public/Login.jsp?viewtype=mi	www.healthplus-ny.org
H6328	001	0	1	04	01	H6328_001_0	10	2009.01	CARE N' CARE INSURANCE COMPANY, INC.	Care N' Care Health Plan	www.cnchealthplan.com	01	04		1		H6328	001	0	2009	Care N' Care Health Plan I	Tarrant County		2	2			1349	2						(817)-529-5267		(817)-529-5268		(817)-810-5213		(817)-529-5268		(800)-960-1844	(800)-960-1844		(866)-547-0773	(800)-960-1844	(800)-960-1844		(866)-547-0773	www.cnchealthplan.com	www.cnchealthplan.com
H6328	002	0	1	04	01	H6328_002_0	8	2009.01	CARE N' CARE INSURANCE COMPANY, INC.	Care N' Care Health Plan	www.cnchealthplan.com	01	04		1		H6328	002	0	2009	Care N' Care Health Plan II	Tarrant County		2	2			450	2						(817)-529-5267		(817)-529-5268		(817)-810-5213		(817)-529-5268		(800)-960-1844	(800)-960-1844			(800)-960-1844	(800)-960-1844			www.cnchealthplan.com	www.cnchealthplan.com
H6360	001	0	1	18	06	H6360_001_0	7	2009.01	KAISER FOUNDATION HP OF OHIO	Kaiser Foundation Health Plan of Ohio	www.kp.org	06	18		1		H6360	001	0	2009	Kaiser Permanente Medicare Plus I	Counties: Cuy, Gea, Lak, Lor, Med, Por, Sum		2	2			9430	2						(216)-621-7100	(800)-493-6004	(216)-479-5003	(866)-513-9966	(800)-551-5353	(800)-551-5353	(877)-479-5741	(877)-479-5741	(216)-621-7100	(800)-493-6004	(216)-479-5003	(866)-513-9966	(800)-551-5353	(800)-551-5353	(877)-479-5741	(877)-479-5741	www.kp.org/seniormedrx	
H6360	002	0	1	18	06	H6360_002_0	6	2009.01	KAISER FOUNDATION HP OF OHIO	Kaiser Foundation Health Plan of Ohio	www.kp.org	06	18		1		H6360	002	0	2009	Kaiser Permanente Medicare Plus II	Counties: Cuy, Gea, Lak, Lor, Med, Por, Sum		2	2			1972	2						(216)-621-7100	(800)-493-6004	(216)-479-5003	(866)-513-9966	(800)-551-5353	(800)-551-5353	(877)-479-5741	(877)-479-5741	(216)-621-7100	(800)-493-6004	(216)-479-5003	(866)-513-9966	(800)-551-5353	(800)-551-5353	(877)-479-5741	(877)-479-5741	www.kp.org/seniormedrx	
H6360	004	0	1	18	06	H6360_004_0	4	2009.01	KAISER FOUNDATION HP OF OHIO	Kaiser Foundation Health Plan of Ohio	www.kp.org	06	18		1		H6360	004	0	2009	Kaiser Permanente Medicare Plus Basic	Counties: Cuy, Gea, Lak, Lor, Med, Por, Sum		2	2			49	2						(216)-621-7100	(800)-493-6004	(216)-479-5003	(866)-513-9966	(800)-551-5353	(800)-551-5353	(877)-479-5741	(877)-479-5741									www.kp.org/seniormedrx	
H6360	006	0	1	18	06	H6360_006_0	7	2009.01	KAISER FOUNDATION HP OF OHIO	Kaiser Foundation Health Plan of Ohio	www.kp.org	06	18		1		H6360	006	0	2009	Kaiser Permanente Medicare Plus III	Counties: Cuy,Gea,Lak,Lor,Med,Por,Sum		2	2			254	2						(216)-621-7100	(800)-493-6004	(216)-479-5003	(866)-513-9966	(800)-551-5353	(800)-551-5353	(877)-479-5741	(877)-479-5741	(216)-621-7100	(800)-493-6004	(216)-479-5003	(866)-513-9966	(800)-551-5353	(800)-551-5353	(877)-479-5741	(877)-479-5741	www.kp.org/seniormedrx	
H6360	007	0	1	18	06	H6360_007_0	6	2009.01	KAISER FOUNDATION HP OF OHIO	Kaiser Foundation Health Plan of Ohio	www.kp.org	06	18		1		H6360	007	0	2009	Kaiser Permanente Medicare Plus Basic II	Counties: Cuy,Gea,Lak,Lor,Med,Por,Sum		2	2			46	2						(216)-621-7100	(800)-493-6004	(216)-479-5003	(866)-513-9966	(800)-551-5353	(800)-551-5353	(877)-479-5741	(877)-479-5741									www.kp.org/seniormedrx	
H6360	008	0	1	18	06	H6360_008_0	4	2009.01	KAISER FOUNDATION HP OF OHIO	Kaiser Foundation Health Plan of Ohio	www.kp.org	06	18		1		H6360	008	0	2009	Kaiser Permanente Medicare Plus Basic III	Counties: Cuy,Gea,Lak,Lor,Med,Por,Sum		2	2			14	2						(216)-621-7100	(800)-493-6004	(216)-479-5003	(866)-513-9966	(800)-551-5353	(800)-551-5353	(877)-479-5741	(877)-479-5741									www.kp.org/seniormedrx	
H6360	009	0	2	18	06	H6360_009_0	5	2009.01	KAISER FOUNDATION HP OF OHIO	Kaiser Foundation Health Plan of Ohio	www.kp.org	06	18		2		H6360	009	0	2009	Kaiser Permanente Medicare Plus I - B only	Counties: Cuy, Gea, Lak, Lor, Med, Por, Sum		2	2			5	2		1				(216)-621-7100	(800)-493-6004	(216)-479-5003	(866)-513-9966	(800)-551-5353	(800)-551-5353	(877)-479-5741	(877)-479-5741	(216)-621-7100	(800)-493-6004	(216)-479-5003	(866)-513-9966	(800)-551-5353	(800)-551-5353	(877)-479-5741	(877)-479-5741	www.kp.org/seniormedrx	
H6360	801	0		18	06	H6360_801_0	3	2009.01	KAISER FOUNDATION HP OF OHIO	Kaiser Foundation Health Plan of Ohio	www.kp.org	06	18				H6360	801	0	2009	Kaiser Permanente Medicare Plus Group	Ohio		1	2										(216)-621-7100	(800)-493-6004	(216)-479-5003	(866)-513-9966		(800)-551-5353	(877)-479-5741	(877)-479-5741	(216)-621-7100	(800)-493-6004	(216)-479-5003	(866)-513-9966	(800)-551-5353	(800)-551-5353	(877)-479-5741	(877)-479-5741	www.kp.org/seniormedrx	
H6360	805	0		18	06	H6360_805_0	3	2009.01	KAISER FOUNDATION HP OF OHIO	Kaiser Foundation Health Plan of Ohio	www.kp.org	06	18				H6360	805	0	2009	Kaiser Permanente Medicare Plus Group - B only	Ohio		1	2										(216)-621-7100	(800)-493-6004	(216)-479-5003	(866)-513-9966		(800)-551-5353	(877)-479-5741	(877)-479-5741	(216)-621-7100	(800)-493-6004	(216)-479-5003	(866)-513-9966	(800)-551-5353	(800)-551-5353	(877)-479-5741	(877)-479-5741	www.kp.org/seniormedrx	
H6360	806	0		18	06	H6360_806_0	3	2009.01	KAISER FOUNDATION HP OF OHIO	Kaiser Foundation Health Plan of Ohio	www.kp.org	06	18				H6360	806	0	2009	FEHB AB with D	Ohio		1	2										(216)-621-7100	(800)-493-6004	(216)-479-5003	(866)-513-9966		(800)-551-5353	(877)-479-5741	(877)-479-5741	(216)-621-7100	(800)-493-6004	(216)-479-5003	(866)-513-9966	(800)-551-5353	(800)-551-5353	(877)-479-5741	(877)-479-5741	www.kp.org/seniormedrx	
H6360	807	0		18	06	H6360_807_0	3	2009.01	KAISER FOUNDATION HP OF OHIO	Kaiser Foundation Health Plan of Ohio	www.kp.org	06	18				H6360	807	0	2009	FEHB B only with D	Ohio		1	2										(216)-621-7100	(800)-493-6004	(216)-479-5003	(866)-513-9966		(800)-551-5353	(877)-479-5741	(877)-479-5741	(216)-621-7100	(800)-493-6004	(216)-479-5003	(866)-513-9966	(800)-551-5353	(800)-551-5353	(877)-479-5741	(877)-479-5741	www.kp.org/seniormedrx	
H6411	002	0	1	04	01	H6411_002_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H6411	002	0	2009	HumanaChoicePPO PPO H6411-002	Dona Ana, Luna, Otero (NM), El Paso (TX)		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H6411	801	0	1	04	01	H6411_801_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H6411	801	0	2009	Humana Employer Sponsored	Las Cruces Metro Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H6411	802	0	1	04	01	H6411_802_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H6411	802	0	2009	Humana Employer Sponsored	Las Cruces Metro Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H6411	803	0	1	04	01	H6411_803_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H6411	803	0	2009	Humana Employer Sponsored Non-CY	Las Cruces Metro Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H6411	804	0	1	04	01	H6411_804_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H6411	804	0	2009	Humana Employer Sponsored Non-CY	Las Cruces Metro Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H6421	003	0	1	09	04	H6421_003_0	3	2009.01	BRAVO HEALTH MID- ATLANTIC INC.	Bravo  Health	www.mybravohealth.com	04	09	2	1		H6421	003	0	2009	Bravo Liberty II	Select Maryland and Delaware Counties		2	2				2						(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(888)-326-2827	(888)-326-2827	(800)-964-2561	(800)-964-2561									www.mybravohealth.com/formulary	
H6421	007	0	1	09	04	H6421_007_0	3	2009.01	BRAVO HEALTH MID- ATLANTIC INC.	Bravo  Health	www.mybravohealth.com	04	09	2	1		H6421	007	0	2009	Bravo Liberty II Rx	District of Columbia		2	2				2						(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(888)-326-2827	(888)-326-2827	(800)-964-2561	(800)-964-2561	(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(888)-326-2827	(888)-326-2827	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
H6421	009	0	1	09	04	H6421_009_0	3	2009.01	BRAVO HEALTH MID- ATLANTIC INC.	Bravo  Health	www.mybravohealth.com	04	09	2	1		H6421	009	0	2009	Bravo Liberty II	District of Columbia		2	2				2						(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(888)-326-2827	(888)-326-2827	(800)-964-2561	(800)-964-2561									www.mybravohealth.com/formulary	
H6421	010	0	1	09	04	H6421_010_0	3	2009.01	BRAVO HEALTH MID- ATLANTIC INC.	Bravo  Health	www.mybravohealth.com	04	09	2	1		H6421	010	0	2009	Bravo Liberty Silver	Select MD, DE counties and District of Columbia		2	2				2						(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(888)-326-2827	(888)-326-2827	(800)-964-2561	(800)-964-2561									www.mybravohealth.com/formulary	
H6421	011	0	1	09	04	H6421_011_0	3	2009.01	BRAVO HEALTH MID- ATLANTIC INC.	Bravo  Health	www.mybravohealth.com	04	09	2	1		H6421	011	0	2009	Bravo Liberty Bell	District of Columbia		2	2				2						(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(888)-326-2827	(888)-326-2827	(800)-964-2561	(800)-964-2561	(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(888)-326-2827	(888)-326-2827	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
H6421	012	0	1	09	04	H6421_012_0	3	2009.01	BRAVO HEALTH MID- ATLANTIC INC.	Bravo  Health	www.mybravohealth.com	04	09	2	1		H6421	012	0	2009	Bravo Liberty II Rx	Select Maryland and Delaware Counties		2	2				2						(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(888)-326-2827	(888)-326-2827	(800)-964-2561	(800)-964-2561	(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(888)-326-2827	(888)-326-2827	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
H6499	005	0	1	09	04	H6499_005_0	6	2009.01	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H6499	005	0	2009	Melody	Multi-State Area 11, 12, and 13		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H6499	014	0	1	09	04	H6499_014_0	7	2009.01	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H6499	014	0	2009	Concert	Multi-State Area 11		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	www.wellcarepffs.com/member	
H6499	015	0	1	09	04	H6499_015_0	8	2009.01	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H6499	015	0	2009	Concert	Multi-State Area 12		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	www.wellcarepffs.com/member	
H6499	017	0	1	09	04	H6499_017_0	6	2009.01	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H6499	017	0	2009	Prelude	Multi-State Area 11		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H6499	021	0	1	09	04	H6499_021_0	5	2009.01	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H6499	021	0	2009	Sonata	Multi-State Area 11		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H6499	022	0	1	09	04	H6499_022_0	5	2009.01	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H6499	022	0	2009	Sonata	Multi-State Area 12		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H6499	023	0	1	09	04	H6499_023_0	7	2009.01	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H6499	023	0	2009	Sonata	Multi-State Area 13		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H6499	028	0	1	09	04	H6499_028_0	6	2009.01	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H6499	028	0	2009	Melody	Multi-State Area 14		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H6499	030	0	1	09	04	H6499_030_0	8	2009.01	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H6499	030	0	2009	Concert	Multi-State Area 13		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	www.wellcarepffs.com/member	
H6499	032	0	1	09	04	H6499_032_0	7	2009.01	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H6499	032	0	2009	Concert	Multi-State Area 14		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	www.wellcarepffs.com/member	
H6499	033	0	1	09	04	H6499_033_0	5	2009.01	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H6499	033	0	2009	Serenade	Multi-State Area 11		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H6499	034	0	1	09	04	H6499_034_0	7	2009.01	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H6499	034	0	2009	Serenade	Multi-State Area 12		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H6499	035	0	1	09	04	H6499_035_0	5	2009.01	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H6499	035	0	2009	Serenade	Multi-State Area 13		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H6499	036	0	1	09	04	H6499_036_0	5	2009.01	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H6499	036	0	2009	Quartet	Multi-State Area  11		2	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H6499	801	0	1	09	04	H6499_801_0	3	2009.01	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H6499	801	0	2009	Employer Plan 5	Nationwide		1	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	www.wellcarepffs.com/member	
H6499	802	0	1	09	04	H6499_802_0	3	2009.01	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H6499	802	0	2009	Employer Plan 6	Nationwide		1	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	www.wellcarepffs.com/member	
H6499	803	0	1	09	04	H6499_803_0	3	2009.01	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H6499	803	0	2009	Employer Plan 11	Nationwide		1	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H6499	804	0	1	09	04	H6499_804_0	3	2009.01	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	WellCare	www.wellcarepffs.com	04	09	2	1		H6499	804	0	2009	Employer Plan 12	Nationwide		1	2				2						(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265	(866)-238-9898	(866)-238-9898	(866)-239-6265	(866)-239-6265									www.wellcarepffs.com/member	
H6504	801	0	1	09	04	H6504_801_0	2	2009.01	CONNECTICARE INSURANCE COMPANY, INC.	ConnectiCare Insurance Company, Inc.	www.connecticare.com/medicare	04	09	2	1		H6504	801	0	2009	ConnectiCare VIP	State of Connecticut		1	2			100	2						(800)-224-2273	(800)-224-2273	(800)-842-9710		(877)-224-8220	(877)-224-8220	(800)-842-9710		(800)-224-2273	(800)-224-2273	(800)-842-9710		(877)-224-8220	(877)-224-8220	(800)-842-9710		www.connecticare.com	
H6504	803	0	1	09	04	H6504_803_0	2	2009.01	CONNECTICARE INSURANCE COMPANY, INC.	ConnectiCare Insurance Company, Inc.	www.connecticare.com/medicare	04	09	2	1		H6504	803	0	2009	ConnectiCare VIP	State of Connecticut		1	2			100	2						(800)-224-2273	(800)-224-2273	(800)-842-9710		(877)-224-8220	(877)-224-8220	(800)-842-9710										www.connecticare.com	
H6528	001	0	1	04	01	H6528_001_0	8	2009.01	CARE IMPROVEMENT PLUS OF SOUTH CENTRAL INSURANCE	Care Improvement Plus	www.careimprovementplus.com	01	04		1		H6528	001	0	2009	Care Improvement Plus of Arkansas	Arkansas		2	2				2						(866)-769-1415	(866)-769-1415	(866)-769-1505	(866)-769-1505	(866)-769-1513	(866)-769-1513	(866)-769-1505	(866)-769-1505	(800)-690-6033	(800)-690-6033	(866)-236-1069	(866)-236-1069	(866)-769-1513	(866)-769-1513	(866)-769-1505	(866)-769-1505	http://www.careimprovementplus.com/members/arkansas/medicarePartD/formulary.aspx	http://www.careimprovementplus.com
H6621	001	0	1	09	04	H6621_001_0	5	2009.01	THP INSURANCE COMPANY	Health Plan SecureFreedom	www.healthplan.org	04	09	2	1		H6621	001	0	2009	SecureFreedom	Ohio, Pennsylvania and West Virginia		2	2			26	2						(740)-695-7907	(877)-847-7907	(740)-695-7919	(800)-622-3925	(740)-695-7915	(877)-847-7915	(740)-695-7919	(800)-622-3925	(740)-695-7907	(877)-847-7907	(740)-695-7919	(800)-622-3925	(740)-695-7915	(877)-847-7915	(740)-695-7919	(800)-622-3925	http://www.healthplan.org/pharmacy.shtml	
H6621	002	0	1	09	04	H6621_002_0	3	2009.01	THP INSURANCE COMPANY	Health Plan SecureFreedom	www.healthplan.org	04	09	2	1		H6621	002	0	2009	SecureFreedom	Ohio, Pennsylvania and West Virginia		2	2			2	2						(740)-695-7907	(877)-847-7907	(740)-695-7919	(800)-622-3925	(740)-695-7915	(877)-847-7915	(740)-695-7919	(800)-622-3925									http://www.healthplan.org/pharmacy.shtml	
H6621	801	0	1	09	04	H6621_801_0	3	2009.01	THP INSURANCE COMPANY	Health Plan SecureFreedom	www.healthplan.org	04	09	2	1		H6621	801	0	2009	SecureFreedom	Ohio, Pennsylvania and West Virginia		1	2			2	2						(740)-695-7907	(877)-847-7907	(740)-695-7919	(800)-622-3925	(740)-695-7915	(877)-847-7915	(740)-695-7919	(800)-622-3925	(740)-695-7907	(877)-847-7907	(740)-695-7919	(800)-622-3925	(740)-695-7915	(877)-847-7915	(740)-695-7919	(800)-622-3925	http://www.healthplan.org/pharmacy.shtml	
H6621	802	0	1	09	04	H6621_802_0	3	2009.01	THP INSURANCE COMPANY	Health Plan SecureFreedom	www.healthplan.org	04	09	2	1		H6621	802	0	2009	SecureFreedom	Ohio, Pennsylvania and West Virginia		1	2			2	2						(740)-695-7907	(877)-847-7907	(740)-695-7919	(800)-622-3925	(740)-695-7915	(877)-847-7915	(740)-695-7919	(800)-622-3925									http://www.healthplan.org/pharmacy.shtml	
H6793	001	0	1	37	05	H6793_001_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.EricksonAdvantage.com	05	37		1		H6793	001	0	2009	Erickson Advantage Signature with Drugs	Johnson County		2	2				2						(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.EricksonAdvantage.com
H6793	002	0	1	37	05	H6793_002_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.EricksonAdvantage.com	05	37		1		H6793	002	0	2009	Erickson Advantage Signature without Drugs	Johnson County		2	2				2						(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480										http://www.ericksonadvantage.com/formulary.asp	www.EricksonAdvantage.com
H6793	003	0	1	37	05	H6793_003_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	Erickson Advantage	www.EricksonAdvantage.com	05	37		1		H6793	003	0	2009	Erickson Advantage Champion	Johnson County		2	1	4			2			2		1111111110000000100000000001	(866)-314-8188	(866)-314-8188	(888)-685-8480		(800)-704-7839	(800)-704-7839	(888)-685-8480		(866)-314-8188	(866)-314-8188	(888)-685-8480		(888)-834-3721	(888)-834-3721	(888)-685-8480		http://www.ericksonadvantage.com/formulary.asp	www.EricksonAdvantage.com
H6806	802	0	1	09	04	H6806_802_0	7	2009.01	ROCHESTER AREA HEALTH MAINTENANCE ORGANIZATION	USACare	www.preferredcare.org	04	09	2	1		H6806	802	0	2009	USACare Rx	National Employer Group		1	2			19000	2						(585)-327-2480	(800)-665-7924	(585)-325-2629	(800)-252-2452	(585)-327-5760	(888)-280-6205	(585)-325-2629	(800)-252-2452	(585)-327-2480	(800)-665-7924	(585)-325-2629	(800)-252-2452	(585)-327-5760	(888)-280-6205	(585)-325-2629	(800)-252-2452	http://www.preferredcare.org	
H6864	001	0	1	02	01	H6864_001_0	5	2009.01	GUILDNET, INC.	GuildNet	www.jgb.org/guildnet	01	02		1		H6864	001	0	2009	GuildNet Gold	Kings, Queens, New York and the Bronx counties		2	1	3		518	2			1	1		(212)-769-7855	(800)-932-4703	(800)-662-1220		(212)-769-7855	(800)-932-4703	(800)-662-1220		(212)-769-7855	(877)-444-3973	(800)-662-1220		(212)-769-7855	(800)-932-4703	(800)-662-1220		http://www.jgb.org/guildnet	www.jgb.org/guildnet
H6900	001	0	1	04	01	H6900_001_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H6900	001	0	2009	HumanaChoice PPO PPO H6900-001	North Central Metro Areas		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H6900	002	0	1	04	01	H6900_002_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H6900	002	0	2009	HumanaChoice PPO PPO H6900-002	Erie, PA		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H6900	801	0	1	04	01	H6900_801_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H6900	801	0	2009	Humana Employer Sponsored	Select counties in PA		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H6900	802	0	1	04	01	H6900_802_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H6900	802	0	2009	Humana Employer Sponsored	Select counties in PA		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H6900	803	0	1	04	01	H6900_803_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H6900	803	0	2009	Humana Employer Sponsored Non-CY	Select counties in PA		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H6900	804	0	1	04	01	H6900_804_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H6900	804	0	2009	Humana Employer Sponsored Non-CY	Select counties in PA		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H6923	001	0	1	01	01	H6923_001_0	6	2009.01	AETNA HEALTH	Aetna Medicare	http://www.aetna.com/members/medicare/	01	01		1		H6923	001	0	2009	Aetna Golden Medicare Value Plan	Denver and Surrounding Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/home.do
H6923	002	0	1	01	01	H6923_002_0	5	2009.01	AETNA HEALTH	Aetna Medicare	http://www.aetna.com/members/medicare/	01	01		1		H6923	002	0	2009	Aetna Golden Medicare Standard Plan	Denver and Surrounding Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/home.do
H6923	003	0	1	01	01	H6923_003_0	5	2009.01	AETNA HEALTH	Aetna Medicare	http://www.aetna.com/members/medicare/	01	01		1		H6923	003	0	2009	Aetna Golden Medicare Premier Plan	Denver and Surrounding Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/home.do
H6923	004	0	1	01	01	H6923_004_0	4	2009.01	AETNA HEALTH	Aetna Medicare	http://www.aetna.com/members/medicare/	01	01		1		H6923	004	0	2009	Aetna Golden Medicare Basic Plan	Denver and Surrounding Counties		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/home.do
H6923	801	0	1	01	01	H6923_801_0	3	2009.01	AETNA HEALTH	Aetna Medicare	http://www.aetna.com/members/medicare/	01	01		1		H6923	801	0	2009	Aetna Golden Medicare Plan	Denver and Surrounding Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/home.do
H6923	802	0	1	01	01	H6923_802_0	3	2009.01	AETNA HEALTH	Aetna Medicare	http://www.aetna.com/members/medicare/	01	01		1		H6923	802	0	2009	Aetna Golden Medicare Plan w/ RX CY	Denver and Surrounding Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/home.do
H6934	001	0	1	01	01	H6934_001_0	6	2009.01	UAHC HEALTH PLAN OF TENNESSEE, INC.	UAHC Gold	www.uahcgold.com	01	01		1		H6934	001	0	2009	UAHC Gold Plus	Shelby County		2	1	3		1500	2			1	3		(866)-407-3065	(866)-407-3065	(800)-876-9763		(866)-407-3065	(866)-407-3065	(800)-876-9763		(866)-407-3065	(866)-407-3065	(800)-876-9763		(866)-407-3065	(866)-407-3065	(800)-876-9763		www.uahcgold.com	www.uahcgold.com
H6934	002	0	1	01	01	H6934_002_0	9	2009.01	UAHC HEALTH PLAN OF TENNESSEE, INC.	UAHC Gold	www.uahcgold.com	01	01		1		H6934	002	0	2009	UAHC Gold Choice	Shelby County		2	2			500	2						(866)-407-3065	(866)-407-3065	(800)-876-9763		(866)-407-3065	(866)-407-3065	(800)-876-9763		(866)-407-3065	(866)-407-3065	(800)-876-9763		(866)-407-3065	(866)-407-3065	(800)-876-9763		www.uahcgold.com	www.uahcgold.com
H6952	001	0	1	01	01	H6952_001_0	5	2009.01	GREAT LAKES HEALTH PLAN, INC.	Great Lakes Personal Care Plus	http://www.glhp.com	01	01		1		H6952	001	0	2009	Great Lakes Health Plan	Macomb, Oakland and Wayne Counties		2	1	3			2			1	3		(888)-903-7587	(888)-903-7587	(800)-649-3777		(888)-903-7587	(888)-903-7587	(800)-649-3777		(888)-903-7587	(888)-903-7587	(800)-649-3777		(888)-903-7587	(888)-903-7587	(800)-649-3777		www.glhp.com	http://www.glhp.com/ProviderDirectory.aspx
H7002	001	0	1	04	01	H7002_001_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H7002	001	0	2009	Humana MyCare	New Orleans - North Shore Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-833-2364	(800)-833-2364			(800)-833-2364	(800)-457-4708			http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H7015	001	0	1	01	01	H7015_001_0	10	2009.01	HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC.	Healthfirst NJ	www.healthfirstnj.com	01	01		1		H7015	001	0	2009	Healthfirst NJ Medicare Plus Plan	Bergen, Essex, Hudson, Passaic, Union Counties		2	2			491	2						(877)-464-4365	(877)-464-4365	(800)-852-7897	(800)-852-7897	(877)-464-4365	(877)-464-4365	(800)-852-7897	(800)-852-7897	(877)-266-1484	(877)-266-1484	(800)-899-2114	(800)-899-2114	(877)-464-4365	(877)-464-4365	(800)-852-7897	(800)-852-7897	www.healthfirstnj.com	
H7015	002	0	1	01	01	H7015_002_0	8	2009.01	HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC.	Healthfirst NJ	www.healthfirstnj.com	01	01		1		H7015	002	0	2009	Healthfirst NJ Increased Benefits Plan	Bergen, Essex, Hudson, Passaic, Union  Counties		2	2			2863	2						(877)-464-4365	(877)-464-4365	(800)-852-7897	(800)-852-7897	(877)-464-4365	(877)-464-4365	(800)-852-7897	(800)-852-7897	(877)-266-1484	(877)-266-1484	(800)-899-2114	(800)-899-2114	(877)-464-4365	(877)-464-4365	(800)-852-7897	(800)-852-7897	www.healthfirstnj.com	
H7015	003	0	1	01	01	H7015_003_0	6	2009.01	HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC.	Healthfirst NJ	www.healthfirstnj.com	01	01		1		H7015	003	0	2009	Healthfirst NJ Coordinated Benefits Plan	Bergen, Essex, Hudson, Passaic, Union Counties		2	2			491	2						(877)-464-4365	(877)-464-4365	(800)-852-7897	(800)-852-7897	(877)-464-4365	(877)-464-4365	(800)-852-7897	(800)-852-7897									www.healthfirstnj.com	
H7015	004	0	1	01	01	H7015_004_0	8	2009.01	HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC.	Healthfirst NJ	www.healthfirstnj.com	01	01		1		H7015	004	0	2009	Healthfirst NJ Maximum Plan	Bergen, Essex, Hudson, Passaic, Union Counties		2	1	3		3167	2			1	2		(877)-464-4365	(877)-464-4365	(800)-852-7897	(800)-852-7897	(877)-464-4365	(877)-464-4365	(800)-852-7897	(800)-852-7897	(877)-266-1484	(877)-266-1484	(800)-899-2114	(800)-899-2114	(877)-464-4365	(877)-464-4365	(800)-852-7897	(800)-852-7897	www.healthfirstnj.com	
H7015	005	0	1	01	01	H7015_005_0	8	2009.01	HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC.	Healthfirst NJ	www.healthfirstnj.com	01	01		1		H7015	005	0	2009	Healthfirst NJ Life Improvement Plan	Bergen, Essex, Hudson, Passaic, Union Counties		2	2			1168	2						(877)-464-4365	(877)-464-4365	(800)-852-7897	(800)-852-7897	(877)-464-4365	(877)-464-4365	(800)-852-7897	(800)-852-7897	(877)-266-1484	(877)-266-1484	(800)-899-2114	(800)-899-2114	(877)-464-4365	(877)-464-4365	(800)-852-7897	(800)-852-7897	www.healthfirstnj.com	
H7086	001	0	1	01	01	H7086_001_0	3	2009.01	COMMUNITY HEALTH GROUP	Community Health Group	www.chgsd.com	01	01		1		H7086	001	0	2009	CommuniCare Advantage	San Diego County California		2	1	3			2			1	3		(619)-422-0422	(888)-244-4430	(800)-735-2929	(800)-735-2929	(619)-422-0422	(888)-244-4430	(800)-735-2929	(800)-735-2929	(619)-422-0422	(888)-244-4430	(800)-735-2929	(800)-735-2929	(619)-422-0422	(888)-244-4430	(800)-735-2929	(800)-735-2929	www.chgsd.com	www.chgsd.com/CHGSDphysHospFinder/physicianFinderLite.aspx
H7146	001	0	1	01	01	H7146_001_0	3	2009.01	SAN MIGUEL HEALTH PLAN, INC.	San Miguel Health Plan	sanmiguelhealthplan.com	01	01		1		H7146	001	0	2009	San Miguel Health Plan, Select	Los Angeles County		2	2				2						(562)-435-3400	(888)-946-4040	(888)-978-7070	(888)-978-7070	(562)-435-3400	(888)-946-4040	(888)-978-7070	(888)-978-7070	(562)-435-3400	(888)-946-4040	(888)-978-7070	(888)-978-7070	(562)-435-3400	(888)-946-4040	(888)-978-7070	(888)-978-7070	www.sanmiguelhealthplan.com	www.sanmiguelhealthplan.com
H7146	002	0	1	01	01	H7146_002_0	4	2009.01	SAN MIGUEL HEALTH PLAN, INC.	San Miguel Health Plan	sanmiguelhealthplan.com	01	01		1		H7146	002	0	2009	San Miguel Health Plan, Preferred	Los Angeles County		2	1	3			2			1	3		(562)-435-3400	(888)-946-4040	(888)-978-7070	(888)-978-7070	(562)-435-3400	(888)-946-4040	(888)-978-7070	(888)-978-7070	(562)-435-3400	(888)-946-4040	(888)-978-7070	(888)-978-7070	(562)-435-3400	(888)-946-4040	(888)-978-7070	(888)-978-7070	www.sanmiguelhealthplan.com	www.sanmiguelhealthplan.com
H7149	001	0	1	01	01	H7149_001_0	10	2009.01	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Coventry Health Care of Nebraska Advantra	www.advantraplans.com	01	01		1		H7149	001	0	2009	Advantra Silver	Partial State of Nebraska		2	2			20986	2						(866)-784-4917	(866)-784-4917	(877)-231-0573	(877)-231-0573	(866)-642-7245	(866)-642-7245	(877)-231-0573	(877)-231-0573	(800)-707-7051	(800)-707-7051	(877)-231-0573	(877)-231-0573	(866)-363-4692	(866)-363-4692	(866)-784-4931		www.tbd.com	www.ne.chcadvantra.com
H7149	002	0	1	01	01	H7149_002_0	10	2009.01	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Coventry Health Care of Nebraska Advantra	www.advantraplans.com	01	01		1		H7149	002	0	2009	Advantra Gold	Partial State of Nebraska		2	2			4973	2						(866)-784-4917	(866)-784-4917	(877)-231-0573	(877)-231-0573	(866)-642-7245	(866)-642-7245	(877)-231-0573	(877)-231-0573	(800)-707-7051	(800)-707-7051	(866)-236-1069	(866)-236-1069	(866)-363-4692	(866)-363-4692	(877)-231-0573		www.tbd.com	www.ne.chcadvantra.com
H7149	801	0	1	01	01	H7149_801_0	8	2009.01	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Coventry Health Care of Nebraska Advantra	www.advantraplans.com	01	01		1		H7149	801	0	2009	Advantra Gold Employee Plan	Nebraska		1	2			404	2						(866)-784-4917	(866)-784-4917	(877)-231-0573	(811)-231-0573	(866)-642-7245	(866)-642-7245	(877)-231-0573	(877)-231-0573									www.tbd.com	www.ne.chcadvantra.com
H7149	802	0	1	01	01	H7149_802_0	8	2009.01	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Coventry Health Care of Nebraska Advantra	www.advantraplans.com	01	01		1		H7149	802	0	2009	Advantra Gold Rx CY Employee Plan	Nebraska		1	2			404	2						(866)-784-4917	(866)-784-4917	(877)-231-0573	(877)-231-0573	(866)-642-7245	(866)-642-7245	(877)-231-0573	(877)-231-0573	(800)-707-7051	(800)-707-7051	(877)-231-0573	(877)-231-0573	(866)-363-4692	(866)-363-4692	(877)-231-0573		www.tbd.com	www.ne.chcadvantra.com
H7149	803	0	1	01	01	H7149_803_0	8	2009.01	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Coventry Health Care of Nebraska Advantra	www.advantraplans.com	01	01		1		H7149	803	0	2009	Advantra Gold Rx Employee Plan	Nebraska		1	2			404	2						(866)-784-4917	(866)-784-4917	(877)-231-0573	(877)-231-0573	(866)-642-7245	(866)-642-7245	(877)-231-0573	(877)-231-0573	(800)-707-7051	(800)-707-7051	(877)-231-0573	(877)-231-0573	(866)-363-4692	(866)-363-4692	(877)-231-0573		www.tbd.com	www.ne.chcadvantra.com
H7179	001	0	1	01	01	H7179_001_0	9	2009.01	ARCADIAN HEALTH PLAN OF LOUISIANA, INC.	Arcadian Community Care	www.arcadiancommunitycare.com	01	01		1		H7179	001	0	2009	Arcadian Community Care - Plus (Lake Charles)	Lake Charles		2	2			12436	2						(318)-865-1061	(800)-573-8597	(866)-573-8591	(866)-573-8591	(318)-865-1061	(888)-261-1061	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(318)-865-1061	(888)-261-1061	(866)-573-8613	(866)-573-8613	www.arcadianhealthplanlouisiana.com	www.arcadiancommunitycare.com
H7179	002	0	1	01	01	H7179_002_0	7	2009.01	ARCADIAN HEALTH PLAN OF LOUISIANA, INC.	Arcadian Community Care	www.arcadiancommunitycare.com	01	01		1		H7179	002	0	2009	Arcadian Community Care - Plus (Monroe)	Shreveport/Monroe		2	2			14266	2						(318)-865-1061	(800)-573-8597	(866)-573-8591	(866)-573-8591	(318)-865-1061	(888)-261-1061	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(318)-865-1061	(888)-261-1061	(866)-573-8613	(866)-573-8613	www.arcadianhealthplanlouisiana.com	www.arcadiancommunitycare.com
H7179	003	0	1	01	01	H7179_003_0	6	2009.01	ARCADIAN HEALTH PLAN OF LOUISIANA, INC.	Arcadian Community Care	www.arcadiancommunitycare.com	01	01		1		H7179	003	0	2009	Arcadian Community Care - Dual Plus	Shreveport, Monroe and Lake Charles		2	1	3		12345	2			1	1		(318)-865-1061	(800)-573-8597	(866)-573-8591	(866)-573-8591	(318)-865-1061	(888)-261-1061	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(318)-865-1061	(888)-261-1061	(866)-573-8613	(866)-573-8613	www.arcadianhealthplanlouisiana.com	www.arcadiancommunitycare.com
H7179	006	0	1	01	01	H7179_006_0	5	2009.01	ARCADIAN HEALTH PLAN OF LOUISIANA, INC.	Arcadian Community Care	www.arcadiancommunitycare.com	01	01		1		H7179	006	0	2009	Arcadian Community Care - Basic (Monroe)	Monroe		2	2			6156	2						(318)-865-1061	(800)-573-8597	(866)-573-8591	(866)-573-8591	(318)-865-1061	(888)-261-1061	(866)-573-8613	(866)-573-8613									www.arcadianhealthplanlouisiana.com	www.arcadiancommunitycare.com
H7179	007	0	1	01	01	H7179_007_0	7	2009.01	ARCADIAN HEALTH PLAN OF LOUISIANA, INC.	Arcadian Community Care	www.arcadiancommunitycare.com	01	01		1		H7179	007	0	2009	Arcadian Community Care - Plus (Shreveport)	Shreveport		2	2			9209	2						(318)-865-1061	(800)-573-8597	(866)-573-8591	(866)-573-8591	(318)-865-1061	(888)-261-1061	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(318)-865-1061	(888)-261-1061	(866)-573-8613	(866)-573-8613	www.arcadianhealthplanlouisiana.com	www.arcadiancommunitycare.com
H7179	008	0	1	01	01	H7179_008_0	4	2009.01	ARCADIAN HEALTH PLAN OF LOUISIANA, INC.	Arcadian Community Care	www.arcadiancommunitycare.com	01	01		1		H7179	008	0	2009	Arcadian Community Care - Basic (Shreveport)	Shreveport		2	2			3070	2						(318)-865-1061	(800)-573-8597	(866)-573-8591	(866)-573-8591	(318)-865-1061	(888)-261-1061	(866)-573-8613	(866)-573-8613									www.arcadianhealthplanlouisiana.com	www.arcadiancommunitycare.com
H7179	009	0	1	02	01	H7179_009_0	9	2009.01	ARCADIAN HEALTH PLAN OF LOUISIANA, INC.	Arcadian Community Care	www.arcadiancommunitycare.com	01	02		1		H7179	009	0	2009	Arcadian Community Care - POS (Shreveport)	Shreveport		2	2			7940	2						(318)-865-1061	(800)-573-8597	(866)-573-8591	(866)-573-8591	(318)-865-1061	(888)-261-1061	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(318)-865-1061	(888)-261-1061	(866)-573-8613	(866)-573-8613	www.arcadianhealthplanlouisiana.com	www.arcadiancommunitycare.com
H7179	801	0	1	01	01	H7179_801_0	9	2009.01	ARCADIAN HEALTH PLAN OF LOUISIANA, INC.	Arcadian Community Care	www.arcadiancommunitycare.com	01	01		1		H7179	801	0	2009	Arcadian Community Care EGWP (LA)	Louisiana		1	2			0	2						(318)-865-1061	(800)-573-8597	(866)-573-8591	(866)-573-8591	(318)-865-1061	(888)-261-1061	(866)-573-8613	(866)-573-8613	(800)-573-8597	(800)-573-8597	(866)-573-8591	(866)-573-8591	(318)-865-1061	(888)-261-1061	(866)-573-8613	(866)-573-8613	www.arcadianhealthplanlouisiana.com	www.arcadiancommunitycare.com
H7187	001	0	1	02	01	H7187_001_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H7187	001	0	2009	Evercare Plan IH-POS	Arlington County		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	
H7187	002	0	1	02	01	H7187_002_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H7187	002	0	2009	Evercare Plan DH-POS	Chesterfld,Goochlnd,Hanover,Henrico,Richmond City		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	
H7187	003	0	1	02	01	H7187_003_0	10	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H7187	003	0	2009	AARP MedicareComplete Plus	Chesterfield,Gooch,Hanover,Henrico,Richmond Cty,DC		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	
H7187	005	0	1	02	01	H7187_005_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H7187	005	0	2009	Evercare Plan DH-POS	Arlington County		2	1	3			2			2	2		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	
H7187	006	0	1	02	01	H7187_006_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H7187	006	0	2009	Evercare Plan MH-POS	Arlington County		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	
H7187	007	0	1	02	01	H7187_007_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H7187	007	0	2009	Evercare Plan IH-POS	Chesterfld,Goochlnd,Hanover,Henrico,Richmond City		2	1	1	1		2			1			(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	
H7187	008	0	1	02	01	H7187_008_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H7187	008	0	2009	Evercare Plan MH-POS	Chesterfld,Goochlnd,Hanover,Henrico,Richmond City		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	
H7187	009	0	1	02	01	H7187_009_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H7187	009	0	2009	AARP MedicareComplete Plus	Select Counties in VA		2	2				1	1					(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	
H7187	801	0	1	02	01	H7187_801_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H7187	801	0	2009	MedicareComplete Retiree Plan	Chest.,Goochl.,Hanover,Henrico,Richmond City Cos		1	2				2						(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		www.aarpmedicarecomplete.com	
H7187	803	0	1	02	01	H7187_803_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H7187	803	0	2009	MedicareComplete Retiree Plan	Chest.,Goochl.,Hanover,Henrico,Richmond City Cos		1	2				2						(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480										www.aarpmedicarecomplete.com	
H7187	804	0	1	02	01	H7187_804_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H7187	804	0	2009	MedicareComplete Retiree Plan	Select Counties in VA		1	2				2						(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		www.aarpmedicarecomplete.com	
H7187	805	0	1	02	01	H7187_805_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H7187	805	0	2009	MedicareComplete Retiree Plan	Select Counties in VA		1	2				2						(888)-867-5548	(888)-867-5548	(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480										www.aarpmedicarecomplete.com	
H7188	001	0	1	04	01	H7188_001_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H7188	001	0	2009	HumanaChoicePPO PPO H7188-001	Little Rock Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H7188	003	0	1	04	01	H7188_003_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H7188	003	0	2009	HumanaChoicePPO PPO H7188-003	Northwest Arkansas		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H7188	801	0	1	04	01	H7188_801_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H7188	801	0	2009	Humana Employer Sponsored	Northwest Arkansas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H7188	802	0	1	04	01	H7188_802_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H7188	802	0	2009	Humana Employer Sponsored	Northwest Arkansas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H7188	803	0	1	04	01	H7188_803_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H7188	803	0	2009	Humana Employer Sponsored Non-CY	Northwest Arkansas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H7188	804	0	1	04	01	H7188_804_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H7188	804	0	2009	Humana Employer Sponsored Non-CY	Northwest Arkansas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H7195	001	0	1	20	08	H7195_001_0	1	2009.01	NORTHLAND PACE PROGRAM	Northland PACE Program	www.northlandhealth.com	08	20		1		H7195	001	0	2009	Northland PACE - Dual	Burleigh, Morton, and Stark Counties		2	2				2														(701)-751-3050	(800)-574-3567			(701)-751-3050	(800)-574-3567			n/a	
H7195	002	0	1	20	08	H7195_002_0	1	2009.01	NORTHLAND PACE PROGRAM	Northland PACE Program	www.northlandhealth.com	08	20		1		H7195	002	0	2009	Northland PACE - Medicare Only	Burleigh, Morton, and Stark Counties		2	2				2														(701)-751-3050	(800)-574-3567			(701)-751-3050	(800)-574-3567			n/a	
H7200	006	0	1	01	01	H7200_006_0	4	2009.01	AMERIGROUP TENNESSEE, INC.	AMERIGROUP Community Care	https://www.amerigroupcorp.com/Members	01	01		1		H7200	006	0	2009	AMERIVANTAGE Specialty + Rx	Nashville		2	1	3		1650	2			1	1		(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	http://www.amerigroupcorp.com/Members/amerivantage/_documents	https://www.amerigroupcorp.com/Members/providers.asp
H7200	007	0	1	01	01	H7200_007_0	8	2009.01	AMERIGROUP TENNESSEE, INC.	AMERIGROUP Community Care	https://www.amerigroupcorp.com/Members	01	01		1		H7200	007	0	2009	AMERIVANTAGE Classic + Rx	Nashville Metro Area		2	2			687	2						(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	http://www.amerigroupcorp.com/Members/amerivantage/_documents	https://www.amerigroupcorp.com/Members/providers.asp
H7200	011	0	1	02	01	H7200_011_0	4	2009.01	AMERIGROUP TENNESSEE, INC.	AMERIGROUP Community Care	https://www.amerigroupcorp.com/Members	01	02		1		H7200	011	0	2009	AMERIVANTAGE Choice + Rx	Nashville Metro Area		2	2			172	2						(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	http://www.amerigroupcorp.com/Members/amerivantage/_documents	https://www.amerigroupcorp.com/Members/providers.asp
H7206	001	0	1	07	02	H7206_001_0	2	2009.01	FIRST HEALTH  LIFE AND HEALTH INSURANCE CO	Advantra Savings	www.advantrasavings.com	02	07	2	1		H7206	001	0	2009	Advantra Savings-Plan 1	Select counties in multiple states		2	2			400	2						(877)-359-5331	(877)-359-5331	(866)-386-2335	(866)-386-2335	(800)-474-5993	(800)-474-5993	(888)-788-4010	(888)-788-4010										
H7206	002	0	1	07	02	H7206_002_0	2	2009.01	FIRST HEALTH  LIFE AND HEALTH INSURANCE CO	Advantra Savings	www.advantrasavings.com	02	07	2	1		H7206	002	0	2009	Advantra Savings-Plan 2	Select counties in multiple states		2	2			200	2						(877)-359-5331	(877)-359-5331	(866)-386-2335	(866)-386-2335	(800)-474-5993	(800)-474-5993	(888)-788-4010	(888)-788-4010										
H7206	004	0	1	07	02	H7206_004_0	2	2009.01	FIRST HEALTH  LIFE AND HEALTH INSURANCE CO	Advantra Savings	www.advantrasavings.com	02	07	2	1		H7206	004	0	2009	Advantra Savings-Plan 3	Select counties in multiple states		2	2			400	2						(877)-359-5331	(877)-359-5331	(866)-386-2335	(866)-386-2335	(800)-474-5993	(800)-474-5993	(888)-788-4010	(888)-788-4010										
H7206	802	0	1	07	02	H7206_802_0	2	2009.01	FIRST HEALTH  LIFE AND HEALTH INSURANCE CO	Advantra Savings	www.advantrasavings.com	02	07	2	1		H7206	802	0	2009	Advantra Savings-EGO-MSA CY and Non-CY	US Counties and Territories		1	2			125	2						(877)-359-5331	(877)-359-5331	(866)-386-2335	(866)-386-2335	(877)-359-5331	(877)-359-5331	(866)-386-2335	(866)-386-2335										
H7206	803	0	1	07	02	H7206_803_0	2	2009.01	FIRST HEALTH  LIFE AND HEALTH INSURANCE CO	Advantra Savings	www.advantrasavings.com	02	07	2	1		H7206	803	0	2009	Advantra Savings-EGO-MSA CY and Non-CY	US Counties and Territories		1	2			125	2						(877)-359-5331	(877)-359-5331	(866)-386-2335	(866)-386-2335	(877)-359-5331	(877)-359-5331	(866)-386-2335	(866)-386-2335										
H7206	804	0	1	07	02	H7206_804_0	2	2009.01	FIRST HEALTH  LIFE AND HEALTH INSURANCE CO	Advantra Savings	www.advantrasavings.com	02	07	2	1		H7206	804	0	2009	Advantra Savings-EGO-MSA CY and Non-CY	US Counties and Territories		1	2			125	2						(877)-359-5331	(877)-359-5331	(866)-386-2335	(866)-386-2335	(877)-359-5331	(877)-359-5331	(866)-386-2335	(866)-386-2335										
H7220	001	0	1	01	01	H7220_001_0	5	2009.01	CLARIAN HEALTH PARTNERS, INC.	Clarian Health Plans, Inc	www.clarianhealthplans.org	01	01		1		H7220	001	0	2009	Clarian Medicare Value	Central Indiana		2	2			20	2						(317)-580-4520	(800)-878-8802	(317)-580-4680		(317)-580-4520	(800)-878-8802	(317)-580-4680										www.clarianhealthplans.org	
H7220	002	0	1	01	01	H7220_002_0	6	2009.01	CLARIAN HEALTH PARTNERS, INC.	Clarian Health Plans, Inc	www.clarianhealthplans.org	01	01		1		H7220	002	0	2009	Clarian Medicare Select	Central Indiana		2	2			100	2						(317)-580-4520	(800)-878-8802	(317)-580-4680		(317)-580-4520	(800)-878-8802	(317)-580-4680										www.clarianhealthplans.org	
H7220	003	0	1	01	01	H7220_003_0	9	2009.01	CLARIAN HEALTH PARTNERS, INC.	Clarian Health Plans, Inc	www.clarianhealthplans.org	01	01		1		H7220	003	0	2009	Clarian Medicare Select Plus	Central Indiana		2	2			1000	2						(317)-580-4520	(800)-878-8802	(317)-580-4680		(317)-580-4520	(800)-878-8802	(317)-580-4680		(317)-580-4520	(800)-878-8802	(317)-580-4680		(317)-580-4520	(800)-878-8802	(317)-580-4680		www.clarianhealthplans.org	
H7220	004	0	1	02	01	H7220_004_0	11	2009.01	CLARIAN HEALTH PARTNERS, INC.	Clarian Health Plans, Inc	www.clarianhealthplans.org	01	02		1		H7220	004	0	2009	Clarian Medicare Choice	Central Indiana		2	2			5000	2						(317)-580-4520	(800)-878-8802	(317)-580-4680		(317)-580-4520	(800)-878-8802	(317)-580-4680		(317)-580-4520	(800)-878-8802	(317)-580-4680		(317)-580-4520	(800)-878-8802	(317)-580-4680		www.clarianhealthplans.org	
H7226	001	0	1	09	04	H7226_001_0	5	2009.01	HARVARD PILGRIM HEALTH CARE INC.	HARVARD PILGRIM HEALTH CARE INC.	http://www.harvardpilgrim.org	04	09	2	1		H7226	001	0	2009	First Seniority Freedom Plus - Drug	Select Counties in MA, NH and ME		2	2				2						(800)-421-3550	(800)-421-3550	(800)-421-3599	(800)-421-3599	(800)-779-7723	(800)-779-7723	(888)-259-8276	(888)-259-8276	(800)-421-3550	(800)-421-3550	(800)-421-3599	(800)-421-3599	(800)-779-7723	(800)-779-7723	(888)-259-8276	(888)-259-8276	http://www.harvardpilgrim.org/fsformulary	
H7226	002	0	1	09	04	H7226_002_0	8	2009.01	HARVARD PILGRIM HEALTH CARE INC.	HARVARD PILGRIM HEALTH CARE INC.	http://www.harvardpilgrim.org	04	09	2	1		H7226	002	0	2009	First Seniority Freedom - Drug	Select Counties in MA, NH and ME		2	2				2						(800)-421-3550	(800)-421-3550	(800)-421-3599	(800)-421-3599	(800)-779-7723	(800)-779-7723	(888)-259-8276	(888)-259-8276	(800)-421-3550	(800)-421-3550	(800)-421-3599	(800)-421-3599	(800)-779-7723	(800)-779-7723	(888)-259-8276	(888)-259-8276	http://www.harvardpilgrim.org/fsformulary	
H7226	006	0	1	09	04	H7226_006_0	3	2009.01	HARVARD PILGRIM HEALTH CARE INC.	HARVARD PILGRIM HEALTH CARE INC.	http://www.harvardpilgrim.org	04	09	2	1		H7226	006	0	2009	First Seniority Freedom - No Drug	Select Counties in MA, NH and ME		2	2				2						(800)-421-3550	(800)-421-3550	(800)-421-3599	(800)-421-3599	(800)-779-7723	(800)-779-7723	(888)-259-8276	(888)-259-8276									http://www.harvardpilgrim.org/fsformulary	
H7226	007	0	1	09	04	H7226_007_0	6	2009.01	HARVARD PILGRIM HEALTH CARE INC.	HARVARD PILGRIM HEALTH CARE INC.	http://www.harvardpilgrim.org	04	09	2	1		H7226	007	0	2009	First Seniority Freedom Plus - Drug	Essex, Middlesex, Norfolk, Suffolk Counties, MA		2	2				2						(800)-421-3550	(800)-421-3550	(800)-421-3599	(800)-421-3599	(800)-779-7723	(800)-779-7723	(888)-259-8276	(888)-259-8276	(800)-421-3550	(800)-421-3550	(800)-421-3599	(800)-421-3599	(800)-779-7723	(800)-779-7723	(888)-259-8276	(888)-259-8276	http://www.harvardpilgrim.org/fsformulary	
H7226	008	0	1	09	04	H7226_008_0	7	2009.01	HARVARD PILGRIM HEALTH CARE INC.	HARVARD PILGRIM HEALTH CARE INC.	http://www.harvardpilgrim.org	04	09	2	1		H7226	008	0	2009	First Seniority Freedom - Drug	Essex,Middlesex,Norfolk, Suffolk Counties, MA		2	2				2						(800)-421-3550	(800)-421-3550	(800)-421-3599	(800)-421-3599	(800)-779-7723	(800)-779-7723	(888)-259-8276	(888)-259-8276	(800)-421-3550	(800)-421-3550	(800)-421-3599	(800)-421-3599	(800)-779-7723	(800)-779-7723	(888)-259-8276	(888)-259-8276	http://www.harvardpilgrim.org/fsformulary	
H7226	009	0	1	09	04	H7226_009_0	4	2009.01	HARVARD PILGRIM HEALTH CARE INC.	HARVARD PILGRIM HEALTH CARE INC.	http://www.harvardpilgrim.org	04	09	2	1		H7226	009	0	2009	First Seniority Freedom - No Drug	Essex,Middlesex,Norfolk, Suffolk Counties, MA		2	2				2						(800)-421-3550	(800)-421-3550	(800)-421-3599	(800)-421-3599	(800)-779-7723	(800)-779-7723	(888)-259-8276	(888)-259-8276									http://www.harvardpilgrim.org/fsformulary	
H7226	011	0	1	09	04	H7226_011_0	4	2009.01	HARVARD PILGRIM HEALTH CARE INC.	HARVARD PILGRIM HEALTH CARE INC.	http://www.harvardpilgrim.org	04	09	2	1		H7226	011	0	2009	First Seniority Freedom Plus - Drug	Select Counties in MA, NH and ME		2	2				2						(800)-421-3550	(800)-421-3550	(800)-421-3599	(800)-421-3599	(800)-779-7723	(800)-779-7723	(888)-259-8276	(888)-259-8276	(800)-421-3550	(800)-421-3550	(800)-421-3599	(800)-421-3599	(800)-779-7723	(800)-779-7723	(888)-259-8276	(888)-259-8276	http://www.harvardpilgrim.org/fsformulary	
H7226	013	0	1	09	04	H7226_013_0	7	2009.01	HARVARD PILGRIM HEALTH CARE INC.	HARVARD PILGRIM HEALTH CARE INC.	http://www.harvardpilgrim.org	04	09	2	1		H7226	013	0	2009	First Seniority Freedom - Drug	Select Counties in MA, NH and ME		2	2				2						(800)-421-3550	(800)-421-3550	(800)-421-3599	(800)-421-3599	(800)-779-7723	(800)-779-7723	(888)-259-8276	(888)-259-8276	(800)-421-3550	(800)-421-3550	(800)-421-3599	(800)-421-3599	(800)-779-7723	(800)-779-7723	(888)-259-8276	(888)-259-8276	http://www.harvardpilgrim.org/fsformulary	
H7226	014	0	1	09	04	H7226_014_0	3	2009.01	HARVARD PILGRIM HEALTH CARE INC.	HARVARD PILGRIM HEALTH CARE INC.	http://www.harvardpilgrim.org	04	09	2	1		H7226	014	0	2009	First Seniority Freedom - No Drug	Select Counties in MA, NH and ME		2	2				2						(800)-421-3550	(800)-421-3550	(800)-421-3599	(800)-421-3599	(800)-779-7723	(800)-779-7723	(888)-259-8276	(888)-259-8276									http://www.harvardpilgrim.org/fsformulary	
H7226	015	0	1	09	04	H7226_015_0	3	2009.01	HARVARD PILGRIM HEALTH CARE INC.	HARVARD PILGRIM HEALTH CARE INC.	http://www.harvardpilgrim.org	04	09	2	1		H7226	015	0	2009	First Seniority Freedom - No Drug	Select Counties in MA, NH and ME		2	2				2						(800)-421-3550	(800)-421-3550	(800)-421-3599	(800)-421-3599	(800)-779-7723	(800)-779-7723	(888)-259-8276	(888)-259-8276									http://www.harvardpilgrim.org/fsformulary	
H7226	807	0	1	09	04	H7226_807_0	1	2009.01	HARVARD PILGRIM HEALTH CARE INC.	HARVARD PILGRIM HEALTH CARE INC.	http://www.harvardpilgrim.org	04	09	2	1		H7226	807	0	2009	First Seniority Freedom Premier - Drug	Nationwide		1	2				2						(800)-421-3550	(800)-421-3550	(800)-421-3599	(800)-421-3599	(800)-779-7723	(800)-779-7723	(888)-259-8276	(888)-259-8276	(800)-421-3550	(800)-421-3550	(800)-421-3599	(800)-421-3599	(800)-779-7723	(800)-779-7723	(888)-259-8276	(888)-259-8276	http://www.harvardpilgrim.org/fsformulary	
H7252	001	0	1	01	01	H7252_001_0	2	2009.01	PHYSICIANS HEALTH CHOICE OF ARKANSAS	Physicians Health Choice	physicianshealthchoice.com	01	01		1		H7252	001	0	2009	Physicians Health Choice Basic	Little Rock, AR		2	2			733	2						(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659									http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/products-findadoctor.html
H7252	002	0	1	01	01	H7252_002_0	6	2009.01	PHYSICIANS HEALTH CHOICE OF ARKANSAS	Physicians Health Choice	physicianshealthchoice.com	01	01		1		H7252	002	0	2009	Physicians Health Choice Standard	Little Rock, AR		2	2			23347	2						(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/products-findadoctor.html
H7252	003	0	1	01	01	H7252_003_0	6	2009.01	PHYSICIANS HEALTH CHOICE OF ARKANSAS	Physicians Health Choice	physicianshealthchoice.com	01	01		1		H7252	003	0	2009	Physicians Health Choice Extra	Little Rock, AR		2	2			5455	2						(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	(866)-550-4736	(866)-550-4736	(866)-858-0659	(866)-858-0659	http://www.physicianshealthchoice.com/members-formulary.html	http://www.physicianshealthchoice.com/products-findadoctor.html
H7292	001	0	1	01	01	H7292_001_0	5	2009.01	ALAMEDA ALLIANCE JOINT POWERS AUTHORITY (JPA)	Alliance for Health	www.alliancecompletecare.org	01	01		1		H7292	001	0	2009	Alliance CompleteCare	Alameda County		2	1	3			2			1	1		(510)-747-4560	(877)-585-7526	(510)-747-4561	(888)-747-1574	(510)-747-4560	(877)-585-7526	(510)-747-4561	(888)-747-1574	(510)-747-4560	(877)-585-7526	(510)-747-4561	(888)-747-1574	(510)-747-4560	(877)-585-7526	(510)-747-4561	(888)-747-1574	http://www.alliancecompletecare.org	http://www.alliancecompletecare.org
H7301	001	0	1	04	01	H7301_001_0	4	2009.01	PERSONAL CARE INSURANCE OF ILLINOIS	PersonalCare Advantra	www.pcadvantra.com	01	04		1		H7301	001	0	2009	PersonalCare Advantra Gold	Central and Northern Illinois		2	2			188	1	1					(866)-784-4916	(866)-784-4916	(866)-784-4931	(866)-784-4931	(888)-690-7894	(888)-690-7894	(888)-788-4010		(800)-707-9372	(800)-707-9372	(866)-236-1069		(800)-707-9372	(800)-707-9372	(000)-000-0000	(000)-000-0000	www.pcadvantra.com	www.pcadvantra.com
H7301	002	0	1	04	01	H7301_002_0	3	2009.01	PERSONAL CARE INSURANCE OF ILLINOIS	PersonalCare Advantra	www.pcadvantra.com	01	04		1		H7301	002	0	2009	PersonalCare Advantra Silver	Central and Northern Illinois		2	2			1017	2						(866)-784-4916	(866)-784-4916	(866)-784-4931	(866)-784-4931	(888)-690-7894	(888)-690-7894	(888)-788-4010		(800)-707-9372	(800)-707-9372	(866)-236-1069		(800)-707-9372	(800)-707-9372	(000)-000-0000	(000)-000-0000	www.pcadvantra.com	www.pcadvantra.com
H7301	801	0	1	04	01	H7301_801_0	4	2009.01	PERSONAL CARE INSURANCE OF ILLINOIS	PersonalCare Advantra	www.pcadvantra.com	01	04		1		H7301	801	0	2009	PersonalCare MA Integrated Calendar	Central and Northern Illinois		1	2			130	2						(866)-784-4916	(866)-784-4916	(866)-784-4931		(888)-690-7894	(888)-690-7894	(888)-788-4010		(800)-707-9372	(800)-707-9372	(866)-236-1069		(800)-707-9372	(800)-707-9372	(000)-000-0000	(000)-000-0000	www.pcadvantra.com	www.pcadvantra.com
H7301	802	0	1	04	01	H7301_802_0	4	2009.01	PERSONAL CARE INSURANCE OF ILLINOIS	PersonalCare Advantra	www.pcadvantra.com	01	04		1		H7301	802	0	2009	PersonalCare MA Integrated Non-Calendar	Central and Northern Illinois		1	2			130	2						(866)-784-4916	(866)-784-4916	(866)-784-4931		(888)-690-7894	(888)-690-7894	(888)-788-4010		(800)-707-9372	(800)-707-9372	(866)-236-1069		(800)-707-9372	(800)-707-9372	(000)-000-0000	(000)-000-0000	www.pcadvantra.com	www.pcadvantra.com
H7301	803	0	1	04	01	H7301_803_0	4	2009.01	PERSONAL CARE INSURANCE OF ILLINOIS	PersonalCare Advantra	www.pcadvantra.com	01	04		1		H7301	803	0	2009	PersonalCare MA Only	Central and Northern Illinois		1	2			130	2						(866)-784-4916	(866)-784-4916	(866)-784-4931		(888)-690-7894	(888)-690-7894	(888)-788-4010										www.pcadvantra.com	www.pcadvantra.com
H7306	001	0	1	04	01	H7306_001_0	9	2009.01	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	Coventry Advantra	www.tx.chcadvantra.com	01	04		1		H7306	001	0	2009	Advantra	Dallas Metro/Houston Metro/El Paso		2	2			4013	2						(866)-731-9571	(866)-731-9571	(866)-784-4931	(866)-784-4931	(888)-215-9725	(888)-215-9725	(888)-215-9725	(888)-215-9725	(888)-698-0576	(888)-698-0576	(866)-236-1069	(866)-236-1069	(888)-215-9725	(888)-215-9725	(888)-215-9725	(888)-215-9725	www.chcadvantra.com	
H7306	002	0	1	04	01	H7306_002_0	9	2009.01	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	Coventry Advantra	www.tx.chcadvantra.com	01	04		1		H7306	002	0	2009	Advantra Premium	Dallas Metro/Houston Metro/El Paso		2	2			4013	2						(866)-731-9571	(866)-731-9571	(866)-784-4931	(866)-784-4931	(888)-215-9725	(888)-215-9725	(888)-215-9725	(888)-215-9725	(888)-698-0576	(888)-698-0576	(866)-236-1069	(866)-236-1069	(888)-215-9725	(888)-215-9725	(888)-215-9725	(888)-215-9725	www.chcadvantra.com	
H7306	801	0	1	04	01	H7306_801_0	8	2009.01	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	Coventry Advantra	www.tx.chcadvantra.com	01	04		1		H7306	801	0	2009	Advantra	Texas		1	2				2						(866)-731-9571	(866)-731-9571	(866)-784-4931	(866)-784-4931	(888)-215-9725	(888)-215-9725	(888)-215-9725	(888)-215-9725									www.chcadvantra.com	
H7306	803	0	1	04	01	H7306_803_0	8	2009.01	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	Coventry Advantra	www.tx.chcadvantra.com	01	04		1		H7306	803	0	2009	Advantra	Texas		1	2				2						(866)-731-9571	(866)-731-9571	(866)-784-4931	(866)-784-4931	(888)-215-9725	(888)-215-9725	(888)-215-9725	(888)-215-9725	(888)-698-0576	(888)-698-0576	(866)-236-1069	(866)-236-1069	(888)-215-9725	(888)-215-9725	(888)-215-9725	(888)-215-9725	www.chcadvantra.com	
H7306	804	0	1	04	01	H7306_804_0	8	2009.01	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	Coventry Advantra	www.tx.chcadvantra.com	01	04		1		H7306	804	0	2009	Advantra	Texas		1	2				2						(866)-731-9571	(866)-731-9571	(866)-784-4931	(866)-784-4931	(888)-215-9725	(888)-215-9725	(888)-215-9725	(888)-215-9725	(888)-698-0576	(888)-698-0576	(866)-236-1069	(866)-236-1069	(888)-215-9725	(888)-215-9725	(888)-215-9725	(888)-215-9725	www.chcadvantra.com	
H7352	002	0	1	01	01	H7352_002_0	2	2009.01	UPH/MIHS VENTURES L.L.C.	University Physicians/Maricopa Care Advantage	www.upcareaz.com and www.mcareaz.com	01	01		1		H7352	002	0	2009	University Physicians Care Advantage	Pima County		2	1	3			2			1	2		(520)-874-3930	(877)-874-3930	(866)-327-8877		(520)-874-3938	(877)-874-3938	(866)-327-8877		(520)-874-3930	(877)-874-3930	(866)-327-8877		(520)-874-3938	(877)-874-3938	(866)-327-8877		www.express-scripts.com	www.upcareaz.com and www.mcareaz.com
H7352	003	0	1	01	01	H7352_003_0	2	2009.01	UPH/MIHS VENTURES L.L.C.	University Physicians/Maricopa Care Advantage	www.upcareaz.com and www.mcareaz.com	01	01		1		H7352	003	0	2009	Maricopa Care Advantage	Maricopa County		2	1	3			2			1	2		(520)-874-3935	(877)-874-3935	(866)-327-8877		(520)-874-3938	(877)-874-3938	(866)-327-8877		(520)-874-3935	(877)-874-3935	(866)-327-8877		(520)-874-3938	(877)-874-3938	(866)-327-8877		www.express-scripts.com	www.upcareaz.com and www.mcareaz.com
H7406	001	0	1	09	04	H7406_001_0	3	2009.01	BRAVO HEALTH INSURANCE COMPANY,  INC.	Bravo Health	www.mybravohealth.com	04	09	2	1		H7406	001	0	2009	Bravo Liberty II Rx	Select Texas and Pennsylvania Counties		2	2				2						(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(866)-464-0705	(866)-464-0705	(800)-964-2561	(800)-964-2561	(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(866)-464-0705	(866)-464-0705	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
H7406	003	0	1	09	04	H7406_003_0	3	2009.01	BRAVO HEALTH INSURANCE COMPANY,  INC.	Bravo Health	www.mybravohealth.com	04	09	2	1		H7406	003	0	2009	Bravo Liberty II	Select Texas and Pennsylvania Counties		2	2				2						(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(866)-464-0705	(866)-464-0705	(800)-964-2561	(800)-964-2561									www.mybravohealth.com/formulary	
H7406	004	0	1	09	04	H7406_004_0	3	2009.01	BRAVO HEALTH INSURANCE COMPANY,  INC.	Bravo Health	www.mybravohealth.com	04	09	2	1		H7406	004	0	2009	Bravo Liberty II Rx	Select Texas and Pennsylvania Counties		2	2				2						(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(866)-464-0705	(866)-464-0705	(800)-964-2561	(800)-964-2561	(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(866)-464-0705	(866)-464-0705	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
H7406	006	0	1	09	04	H7406_006_0	3	2009.01	BRAVO HEALTH INSURANCE COMPANY,  INC.	Bravo Health	www.mybravohealth.com	04	09	2	1		H7406	006	0	2009	Bravo Liberty I	Select Texas and Pennsylvania Counties		2	2				2						(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(866)-464-0705	(866)-464-0705	(800)-964-2561	(800)-964-2561									www.mybravohealth.com/formulary	
H7406	007	0	1	09	04	H7406_007_0	3	2009.01	BRAVO HEALTH INSURANCE COMPANY,  INC.	Bravo Health	www.mybravohealth.com	04	09	2	1		H7406	007	0	2009	Bravo Liberty II Rx	Select Texas and Pennsylvania Counties		2	2				2						(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(866)-464-0705	(866)-464-0705	(800)-964-2561	(800)-964-2561	(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(866)-464-0705	(866)-464-0705	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
H7406	008	0	1	09	04	H7406_008_0	3	2009.01	BRAVO HEALTH INSURANCE COMPANY,  INC.	Bravo Health	www.mybravohealth.com	04	09	2	1		H7406	008	0	2009	Bravo Liberty II	Select Texas and Pennsylvania Counties		2	2				2						(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(866)-464-0705	(866)-464-0705	(800)-964-2561	(800)-964-2561									www.mybravohealth.com/formulary	
H7406	009	0	1	09	04	H7406_009_0	3	2009.01	BRAVO HEALTH INSURANCE COMPANY,  INC.	Bravo Health	www.mybravohealth.com	04	09	2	1		H7406	009	0	2009	Bravo Liberty Bell	Select Texas Counties		2	2				2						(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(866)-464-0705	(866)-464-0705	(800)-964-2561	(800)-964-2561	(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(866)-464-0705	(866)-464-0705	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
H7406	010	0	1	09	04	H7406_010_0	3	2009.01	BRAVO HEALTH INSURANCE COMPANY,  INC.	Bravo Health	www.mybravohealth.com	04	09	2	1		H7406	010	0	2009	Bravo Liberty Bell	Select Pennsylvania Counties		2	2				2						(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(866)-464-0705	(866)-464-0705	(800)-964-2561	(800)-964-2561	(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(866)-464-0705	(866)-464-0705	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
H7406	011	0	1	09	04	H7406_011_0	3	2009.01	BRAVO HEALTH INSURANCE COMPANY,  INC.	Bravo Health	www.mybravohealth.com	04	09	2	1		H7406	011	0	2009	Bravo Liberty Silver	Select Texas and Pennsylvania Counties		2	2				2						(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(866)-464-0705	(866)-464-0705	(800)-964-2561	(800)-964-2561									www.mybravohealth.com/formulary	
H7406	801	0	1	09	04	H7406_801_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY,  INC.	Bravo Health	www.mybravohealth.com	04	09	2	1		H7406	801	0	2009	Bravo Employer Group #3	Nationwide		1	2				2						(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(866)-464-0705	(866)-464-0705	(800)-964-2561	(800)-964-2561	(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(866)-464-0705	(866)-464-0705	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
H7406	802	0	1	09	04	H7406_802_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY,  INC.	Bravo Health	www.mybravohealth.com	04	09	2	1		H7406	802	0	2009	Bravo Employer Group #4	Nationwide		1	2				2						(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(866)-464-0705	(866)-464-0705	(800)-964-2561	(800)-964-2561	(866)-464-0701	(866)-464-0701	(800)-964-2561	(800)-964-2561	(866)-464-0705	(866)-464-0705	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
H7475	001	0	1	01	01	H7475_001_0	3	2009.01	CARE WISCONSIN HEALTH PLAN, INC.	Care Wisconsin Health Plan, Inc.	www.carewischealthplan.org	01	01		1		H7475	001	0	2009	Partnership	Columbia, Dodge, Jefferson and Sauk Counties		2	1	3		273	2			1	1		(608)-240-0035	(800)-963-0035	(800)-947-3529	(800)-947-3529	(608)-245-3075	(800)-963-0035	(800)-947-3529	(800)-947-3529	(608)-240-0035	(800)-963-0035	(800)-947-3529	(800)-947-3529	(608)-245-3075	(800)-963-0035	(800)-947-3529	(800)-947-3529	www.carewischealthplan.org	www.carewischealthplan.org
H7526	001	0	1	01	01	H7526_001_0	11	2009.01	MEDICA HEALTH PLAN	Medica Health Plans	www.medica.com	01	01		1		H7526	001	0	2009	Medica Complete Solution	Specific Minnesota Counties		2	1	4		392	2			1		1111111110000000100000000001	(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2030	(800)-266-2157	(952)-992-3650	(800)-234-8819	(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2030	(800)-266-2157	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	https://www.medica.com/C11/FindADoctor/default.aspx
H7526	002	0	1	01	01	H7526_002_0	8	2009.01	MEDICA HEALTH PLAN	Medica Health Plans	www.medica.com	01	01		1		H7526	002	0	2009	Medica Access Ability	Select Minnesota Counties		2	1	3		179	2			1	1		(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2030	(800)-266-2157	(952)-992-3650	(800)-234-8819	(952)-992-2300	(800)-234-8755	(952)-992-3650	(800)-234-8819	(952)-992-2030	(800)-266-2157	(952)-992-3650	(800)-234-8819	http://www.medica.com/C12/DrugFormularyPartD/default.aspx	https://www.medica.com/C11/FindADoctor/default.aspx
H7568	001	0	1	04	01	H7568_001_0	6	2009.01	DAVITA VILLAGEHEALTH, INC.	DaVita VillageHealth of Ohio, Inc.	www.villagehealth.com	01	04		1		H7568	001	0	2009	DaVita VillageHealth, Inc.	Hamilton County		2	1	4		78	2			1		0000000000000000000000000100	(866)-838-1962	(866)-838-1962	(000)-000-0711		(866)-838-1962	(866)-838-1962	(000)-000-0711		(866)-838-1962	(866)-838-1962	(000)-000-0711		(866)-838-1962	(866)-838-1962	(000)-000-0711		www.villagehealth.com	www.villagehealth.com
H7660	001	0	1	20	08	H7660_001_0	1	2009.01	LUTHERAN SENIORLIFE LIFE-BEAVER COUNTY	LIFE-Beaver County	www.Lutheran SeniorLife.org	08	20		1		H7660	001	0	2009	LIFE Beaver-Dual	LIFE-Beaver County		2	2				2														(724)-776-1100	(724)-776-1100			(724)-776-1100	(724)-776-1100			www.lutheranseniorlife.org	
H7660	002	0	1	20	08	H7660_002_0	1	2009.01	LUTHERAN SENIORLIFE LIFE-BEAVER COUNTY	LIFE-Beaver County	www.Lutheran SeniorLife.org	08	20		1		H7660	002	0	2009	LIFE Beaver-Medicare only	LIFE Beaver County		2	2				2														(724)-776-1100	(724)-776-1100			(724)-776-1100	(724)-776-1100			www.lutheranseniorlife.org	
H7678	001	0	1	01	01	H7678_001_0	5	2009.01	MOLINA HEALTHCARE OF TEXAS, INC.	Molina Healthcare of Texas, Inc.	www.molinamedicare.com	01	01		1		H7678	001	0	2009	Molina Medicare Options Plus	Bexar, Galveston, and Harris counties		2	1	3			2			1	1		(972)-343-3600	(866)-440-0012	(800)-346-4128	(800)-346-4128	(972)-343-3600	(866)-403-8293	(800)-346-4128	(800)-346-4128	(972)-343-3600	(866)-440-0012	(800)-346-4128	(800)-346-4128	(972)-343-3600	(866)-403-8293	(800)-346-4128	(800)-346-4128	www.molinahealthcare.com	https://eportal.molinahealthcare.com/eportal/providers/ProviderSearchAdv.aspx
H7678	002	0	1	01	01	H7678_002_0	6	2009.01	MOLINA HEALTHCARE OF TEXAS, INC.	Molina Healthcare of Texas, Inc.	www.molinamedicare.com	01	01		1		H7678	002	0	2009	Molina Medicare Options	Bexar, Galveston, Harris counties		2	2				2						(972)-343-3600	(866)-440-0012	(800)-346-4128	(800)-346-4128	(972)-343-3600	(866)-403-8293	(800)-346-4128	(800)-346-4128	(972)-343-3600	(866)-440-0012	(800)-346-4128	(800)-346-4128	(972)-343-3600	(866)-403-8293	(800)-346-4128	(800)-346-4128	www.molinahealthcare.com	https://eportal.molinahealthcare.com/eportal/providers/ProviderSearchAdv.aspx
H7692	001	0	1	04	01	H7692_001_0	9	2009.01	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	Coventry Advantra	www.az.chcadvantra.com	01	04		1		H7692	001	0	2009	Advantra	Maricopa County		2	2			1747	2						(866)-731-9570	(866)-731-9570	(866)-784-4931	(866)-784-4931	(888)-215-1129	(888)-215-1129	(888)-215-1129	(888)-215-1129	(888)-698-0574	(888)-698-0574	(866)-236-1069	(866)-236-1069	(888)-215-1129	(888)-215-1129	(888)-215-1129	(888)-215-1129	www.chcadvantra.com	
H7692	801	0	1	04	01	H7692_801_0	8	2009.01	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	Coventry Advantra	www.az.chcadvantra.com	01	04		1		H7692	801	0	2009	Advantra	Arizona		1	2				2						(866)-731-9570	(866)-731-9570	(866)-784-4931	(866)-784-4931	(888)-215-1129	(888)-215-1129	(888)-215-1129	(888)-215-1129									www.chcadvantra.com	
H7692	802	0	1	04	01	H7692_802_0	8	2009.01	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	Coventry Advantra	www.az.chcadvantra.com	01	04		1		H7692	802	0	2009	Advantra	Arizona		1	2				2						(866)-731-9570	(866)-731-9570	(866)-784-4931	(866)-784-4931	(888)-215-1129	(888)-215-1129	(888)-215-1129	(888)-215-1129	(888)-698-0574	(888)-698-0574	(866)-236-1069	(866)-236-1069	(888)-215-1129	(888)-215-1129	(888)-215-1129	(888)-215-1129	www.chcadvantra.com	
H7692	803	0	1	04	01	H7692_803_0	8	2009.01	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	Coventry Advantra	www.az.chcadvantra.com	01	04		1		H7692	803	0	2009	Advantra	Arizona		1	2				2						(866)-731-9570	(866)-731-9570	(866)-784-4931	(866)-784-4931	(888)-215-1129	(888)-215-1129	(888)-215-1129	(888)-215-1129	(888)-698-0574	(888)-698-0574	(866)-236-1069	(866)-236-1069	(888)-215-1129	(888)-215-1129	(888)-215-1129	(888)-215-1129	www.chcadvantra.com	
H7731	001	0	1	01	01	H7731_001_0	7	2009.01	MD CARE, INC.	MD Care Inc	www.mdcareadvantage.com	01	01		1		H7731	001	0	2009	MD Care Advantage I	Los Angeles, Orange, Riverside Counties		2	2				2						(562)-344-3400	(888)-327-2730	(800)-735-2929	(800)-735-2929	(562)-344-3400	(888)-327-2730	(800)-735-2929	(800)-735-2929	(888)-816-7978	(888)-816-7978	(866)-236-1069	(866)-236-1069	(562)-344-3400	(888)-327-2730	(800)-735-2929	(800)-735-2929	MDCareAdvantage.com	MDCareAdvantage.com
H7731	007	0	1	01	01	H7731_007_0	4	2009.01	MD CARE, INC.	MD Care Inc	www.mdcareadvantage.com	01	01		1		H7731	007	0	2009	MD Care Advantage Select	Los Angeles, Orange, Riverside Counties		2	2				2						(562)-344-3400	(888)-327-2730	(800)-735-2929	(800)-735-2929	(562)-344-3400	(888)-327-2730	(800)-735-2929	(800)-735-2929									MDCareAdvantage.com	MDCareAdvantage.com
H7787	001	0	1	04	01	H7787_001_0	3	2009.01	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Medicare Advantage	www.healthspring.com	01	04		1		H7787	001	0	2009	NTX HealthyAdvantage Plus PPO	North Texas		2	2			1746	2						(800)-280-8888	(800)-280-8888	(877)-893-1504	(877)-893-1504	(800)-846-4896	(800)-846-4896	(877)-893-1504	(877)-893-1504	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H7787	002	0	1	04	01	H7787_002_0	3	2009.01	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Medicare Advantage	www.healthspring.com	01	04		1		H7787	002	0	2009	NTX HealthyAdvantage PPO	North Texas		2	2			174	2						(800)-280-8888	(800)-280-8888	(877)-893-1504	(877)-893-1504	(800)-846-4896	(800)-846-4896	(877)-893-1504	(877)-893-1504									www.healthspring.com	www.healthspring.com
H7787	003	0	1	04	01	H7787_003_0	4	2009.01	HEALTHSPRING LIFE  HEALTH INSURANCE COMPANY, INC.	HealthSpring Medicare Advantage	www.healthspring.com	01	04		1		H7787	003	0	2009	NTX HealthyAdvantage Premier PPO	Lubbock County		2	2			1746	2						(800)-280-8888	(800)-280-8888	(877)-893-1504	(877)-893-1504	(800)-846-4896	(800)-846-4896	(877)-893-1504	(877)-893-1504	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	www.healthspring.com
H7908	001	0	1	01	01	H7908_001_0	5	2009.01	AETNA HEALTH	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H7908	001	0	2009	Aetna Golden Medicare Select Plan	Clark County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	www.aetnapharmacy.com	http://www.aetna.com/docfind/
H7908	002	0	1	01	01	H7908_002_0	4	2009.01	AETNA HEALTH	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H7908	002	0	2009	Aetna Golden Medicare Premier Plan	Clark County		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	www.aetnapharmacy.com	http://www.aetna.com/docfind/
H7908	801	0	1	01	01	H7908_801_0	3	2009.01	AETNA HEALTH	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H7908	801	0	2009	Aetna Golden Medicare Plan	Clark County		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									www.aetnapharmacy.com	http://www.aetna.com/docfind/
H7908	802	0	1	01	01	H7908_802_0	3	2009.01	AETNA HEALTH	Aetna Medicare	http://www.aetnamedicare.com	01	01		1		H7908	802	0	2009	Aetna Golden Medicare Plan w/Rx CY	Clark County		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	www.aetnapharmacy.com	http://www.aetna.com/docfind/
H7917	004	0	1	04	01	H7917_004_0	7	2009.01	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	01	04		1		H7917	004	0	2009	BlueAdvantage PPO Sapphire	West Tennessee		2	2			42	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	http://www.bcbst-medicare.com/2008/New%20Member%20PDFS/Group/H5884.H7917.S1030_BA08_FOR.pdf	www.bcbst-medicare.com
H7917	005	0	1	04	01	H7917_005_0	7	2009.01	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	01	04		1		H7917	005	0	2009	BlueAdvantage PPO Sapphire	Middle Tennessee		2	2			21	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	http://www.bcbst-medicare.com/2008/New%20Member%20PDFS/Group/H5884.H7917.S1030_BA08_FOR.pdf	www.bcbst-medicare.com
H7917	006	0	1	04	01	H7917_006_0	7	2009.01	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	01	04		1		H7917	006	0	2009	BlueAdvantage PPO Sapphire	Southeast Tennessee		2	2			66	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	http://www.bcbst-medicare.com/2008/New%20Member%20PDFS/Group/H5884.H7917.S1030_BA08_FOR.pdf	www.bcbst-medicare.com
H7917	007	0	1	04	01	H7917_007_0	6	2009.01	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	01	04		1		H7917	007	0	2009	BlueAdvantage PPO Sapphire	Northeast Tennessee		2	2			15	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	http://www.bcbst-medicare.com/2008/New%20Member%20PDFS/Group/H5884.H7917.S1030_BA08_FOR.pdf	www.bcbst-medicare.com
H7917	008	0	1	04	01	H7917_008_0	7	2009.01	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	01	04		1		H7917	008	0	2009	BlueAdvantage PPO Diamond	West Tennessee		2	2			168	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	http://www.bcbst-medicare.com/2008/New%20Member%20PDFS/Group/H5884.H7917.S1030_BA08_FOR.pdf	www.bcbst-medicare.com
H7917	009	0	1	04	01	H7917_009_0	7	2009.01	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	01	04		1		H7917	009	0	2009	BlueAdvantage PPO Diamond	Middle Tennessee		2	2			83	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	http://www.bcbst-medicare.com/2008/New%20Member%20PDFS/Group/H5884.H7917.S1030_BA08_FOR.pdf	www.bcbst-medicare.com
H7917	010	0	1	04	01	H7917_010_0	7	2009.01	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	01	04		1		H7917	010	0	2009	BlueAdvantage PPO Diamond	Southeast Tennessee		2	2			265	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	http://www.bcbst-medicare.com/2008/New%20Member%20PDFS/Group/H5884.H7917.S1030_BA08_FOR.pdf	www.bcbst-medicare.com
H7917	011	0	1	04	01	H7917_011_0	7	2009.01	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	01	04		1		H7917	011	0	2009	BlueAdvantage PPO Diamond	Northeast Tennessee		2	2			60	2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	http://www.bcbst-medicare.com/2008/New%20Member%20PDFS/Group/H5884.H7917.S1030_BA08_FOR.pdf	www.bcbst-medicare.com
H7917	801	0	1	04	01	H7917_801_0	6	2009.01	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	01	04		1		H7917	801	0	2009	BlueAdvantage Plus PPO	22 County Region		1	2				2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	http://www.bcbst-medicare.com/2008/New%20Member%20PDFS/Group/H5884.H7917.S1030_BA08_FOR.pdf	www.bcbst-medicare.com
H7917	802	0	1	04	01	H7917_802_0	8	2009.01	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	01	04		1		H7917	802	0	2009	BlueAdvantage Plus PPO	22 County Region		1	2				2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422	http://www.bcbst-medicare.com/2008/New%20Member%20PDFS/Group/H5884.H7917.S1030_BA08_FOR.pdf	www.bcbst-medicare.com
H7917	803	0	1	04	01	H7917_803_0	7	2009.01	BLUE CROSS BLUE SHIELD OF TENNESSEE	BlueCross BlueShield of Tennessee	www.bcbst-medicare.com	01	04		1		H7917	803	0	2009	BlueAdvantage PPO	22 County Region		1	2				2						(800)-841-7434	(800)-841-7434	(888)-423-9490	(888)-423-9490	(800)-292-5146	(800)-292-5146	(877)-646-6422	(877)-646-6422									http://www.bcbst-medicare.com/2008/New%20Member%20PDFS/Group/H5884.H7917.S1030_BA08_FOR.pdf	www.bcbst-medicare.com
H7949	801	0	1	01	01	H7949_801_0	2	2009.01	PACIFICARE/UHC OF NEVADA	Pacificare/UHC of Nevada	www.aarpmedicarecomplete.com	01	01		1		H7949	801	0	2009	MedicareComplete Retiree Plan	NV Employer Sponsored Plan Service Area		1	2				2						(800)-533-2743	(800)-533-2743	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074									www.aarpmedicarecomplete.com	
H7949	802	0	1	01	01	H7949_802_0	2	2009.01	PACIFICARE/UHC OF NEVADA	Pacificare/UHC of Nevada	www.aarpmedicarecomplete.com	01	01		1		H7949	802	0	2009	MedicareComplete Retiree Plan	NV Employer Sponsored Plan Service Area		1	2				2						(800)-533-2743	(800)-533-2743	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074									www.aarpmedicarecomplete.com	
H7949	803	0	1	01	01	H7949_803_0	2	2009.01	PACIFICARE/UHC OF NEVADA	Pacificare/UHC of Nevada	www.aarpmedicarecomplete.com	01	01		1		H7949	803	0	2009	MedicareComplete Retiree Plan	NV Employer Sponsored Plan Service Area		1	2				2						(800)-533-2743	(800)-533-2743	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	(800)-533-2743	(800)-533-2743	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	
H7949	804	0	1	01	01	H7949_804_0	2	2009.01	PACIFICARE/UHC OF NEVADA	Pacificare/UHC of Nevada	www.aarpmedicarecomplete.com	01	01		1		H7949	804	0	2009	MedicareComplete Retiree Plan	NV Employer Sponsored Plan Service Area		1	2				2						(800)-533-2743	(800)-533-2743	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	(800)-533-2743	(800)-533-2743	(888)-685-8480	(888)-685-8480	(800)-610-2660	(800)-610-2660	(800)-387-1074	(800)-387-1074	www.aarpmedicarecomplete.com	
H7981	802	0	1	09	04	H7981_802_0	3	2009.01	MCS LIFE INSURANCE COMPANY	MCS Classicare	www.mcsclassicare.com	04	09	2	1		H7981	802	0	2009	MCS Classicare PFFS PR Group	Puerto Rico		1	2			3	2						(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	www.mcsclassicare.com	
H8031	001	0	1	01	01	H8031_001_0	4	2009.01	GATEWAY HEALTH PLAN OF OHIO, INC.	Gateway Health Plan Medicare Assured	www.gatewayhealthplan.com	01	01		1		H8031	001	0	2009	Gateway Health Plan Medicare Assured	Ohio		2	1	3		216	2			1	1		(412)-255-7258	(888)-447-4505	(800)-654-5988	(800)-654-5988	(412)-255-7258	(877)-428-3929	(800)-654-5988	(800)-654-5988	(412)-255-7258	(888)-447-4505	(800)-654-5988	(800)-654-5988	(412)-255-7258	(877)-428-3929	(800)-654-5988	(800)-654-5988	www.gatewayhealthplan.com	www.gatewayhealthplan.com
H8096	001	0	1	20	08	H8096_001_0	2	2009.01	CENTRA HEALTH, INC.	Centra PACE	www.centrahealth.com	08	20		1		H8096	001	0	2009	Centra PACE - Dual	Centra PACE - Lynchburg		2	2				2														(434)-200-4190	(434)-200-4190	(434)-200-4190	(434)-200-4190	(434)-200-4190	(434)-200-4190	(434)-200-4190	(434)-200-4190	http:\\www.centrahealth.com	
H8096	002	0	1	20	08	H8096_002_0	2	2009.01	CENTRA HEALTH, INC.	Centra PACE	www.centrahealth.com	08	20		1		H8096	002	0	2009	Centra PACE - Medicare only	Centra PACE - Lynchburg		2	2				2														(434)-200-4190	(434)-200-4190	(434)-200-4190	(434)-200-4190	(434)-200-4190	(434)-200-4190	(434)-200-4190	(434)-200-4190	http:\\www.centrahealth.com	
H8172	001	0	1	04	01	H8172_001_0	2	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H8172	001	0	2009	Today's Options PPO Select	Milwaukee, Ozaukee, Racine, Waukesha Counties		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	www.todaysoptions.com
H8172	002	0	1	04	01	H8172_002_0	2	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H8172	002	0	2009	Today's Options PPO Select	Brown, Outagamie, Shawano, Winnebago Counties		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	www.todaysoptions.com
H8172	003	0	1	04	01	H8172_003_0	3	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H8172	003	0	2009	Today's Options PPO Select powered by CCRx	Milwaukee, Ozaukee, Racine, Waukesha Counties		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H8172	004	0	1	04	01	H8172_004_0	3	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H8172	004	0	2009	Today's Options PPO Select powered by CCRx	Brown, Outagamie, Shawano, Winnebago Counties		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H8172	005	0	1	04	01	H8172_005_0	6	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H8172	005	0	2009	Today's Options PPO Complete powered by CCRx	Milwaukee, Ozaukee, Racine, Waukesha Counties		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H8172	006	0	1	04	01	H8172_006_0	6	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H8172	006	0	2009	Today's Options PPO Complete powered by CCRx	Brown, Outagamie, Shawano, Winnebago Counties		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H8172	801	0	1	04	01	H8172_801_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H8172	801	0	2009	Today's Options PPO - MA Group Plan	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	www.todaysoptions.com
H8172	802	0	1	04	01	H8172_802_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H8172	802	0	2009	Today's Options PPO - MAPD Group Plan	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H8172	803	0	1	04	01	H8172_803_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H8172	803	0	2009	Today's Options PPO - MAPD Group Plan - NCY	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H8189	001	0	1	01	01	H8189_001_0	6	2009.01	MANAGED HEALTH SERVICES, WISCONSIN	Advantage by Managed Health Services	https://www.mhswi.com/portal/public/mhs_wi	01	01		1		H8189	001	0	2009	Managed Health Services	Managed Health Services		2	1	3		90	2			1	3		(414)-345-4600	(888)-713-6180	(414)-345-4621		(414)-345-4600	(888)-713-6180	(414)-345-4621		(414)-345-4600	(888)-713-6180	(414)-345-4621		(414)-345-4600	(888)-713-6180	(414)-345-4621		to be determined	https://www.mhswi.com/portal/public/mhs_wi
H8239	001	0	1	04	01	H8239_001_0	11	2009.01	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	Coventry Advantra	www.nm.chcadvantra.com	01	04		1		H8239	001	0	2009	Advantra	Curry, Lincoln, Quay, Rio Arriba, Socorro counties		2	2			86	2						(866)-731-9572	(866)-731-9572	(866)-784-4931	(866)-784-4931	(888)-554-8052	(888)-554-8052	(888)-554-8052	(888)-554-8052	(888)-698-0575	(888)-698-0575	(866)-236-1069	(866)-236-1069	(888)-554-8052	(888)-554-8052	(888)-554-8052	(888)-554-8052	www.chcadvantra.com	
H8239	801	0	1	04	01	H8239_801_0	9	2009.01	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	Coventry Advantra	www.nm.chcadvantra.com	01	04		1		H8239	801	0	2009	Advantra	New Mexico		1	2				2						(866)-731-9572	(866)-731-9572	(866)-784-4931	(866)-784-4931	(888)-554-8052	(888)-554-8052	(888)-554-8052	(888)-554-8052									www.chcadvantra.com	
H8239	802	0	1	04	01	H8239_802_0	9	2009.01	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	Coventry Advantra	www.nm.chcadvantra.com	01	04		1		H8239	802	0	2009	Advantra	New Mexico		1	2				2						(866)-731-9572	(866)-731-9572	(866)-784-4931	(866)-784-4931	(888)-554-8052	(888)-554-8052	(888)-554-8052	(888)-554-8052	(888)-698-0575	(888)-698-0575	(866)-236-1069	(866)-236-1069	(888)-554-8052	(888)-554-8052	(888)-554-8052	(888)-554-8052	www.chcadvantra.com	
H8239	803	0	1	04	01	H8239_803_0	9	2009.01	FIRST HEALTH LIFE  HEALTH INSURANCE COMPANY	Coventry Advantra	www.nm.chcadvantra.com	01	04		1		H8239	803	0	2009	Advantra	New Mexico		1	2				2						(866)-731-9572	(866)-731-9572	(866)-784-4931	(866)-784-4931	(888)-554-8052	(888)-554-8052	(888)-554-8052	(888)-554-8052	(888)-698-0575	(888)-698-0575	(866)-236-1069	(866)-236-1069	(888)-554-8052	(888)-554-8052	(888)-554-8052	(888)-554-8052	www.chcadvantra.com	
H8393	001	0	1	04	01	H8393_001_0	10	2009.01	COVENTRY HEALTH AND LIFE INSURANCE CO. (NEBRASKA)	Coventry Health and Life Insurance Company	www.advantraplans.com	01	04		1		H8393	001	0	2009	Advantra Platinum PPO	Partial State of Nebraska		2	2			4767	2						(866)-784-4917	(866)-784-4917	(877)-231-0573	(877)-231-0573	(866)-642-7245	(866)-642-7245	(877)-231-0573		(800)-707-7051	(800)-707-7051	(877)-231-0573	(877)-231-0573	(866)-363-4692	(866)-363-4692	(877)-231-0573		www.tbd.com	www.chcnebraska.com
H8393	801	0	1	04	01	H8393_801_0	9	2009.01	COVENTRY HEALTH AND LIFE INSURANCE CO. (NEBRASKA)	Coventry Health and Life Insurance Company	www.advantraplans.com	01	04		1		H8393	801	0	2009	Advantra Platinum PPO Employee Plan	State of Nebraska		1	2			404	2						(866)-784-4917	(866)-784-4917	(877)-231-0573	(877)-231-0573	(866)-642-7245	(866)-642-7245	(877)-231-0573										www.tbd.com	www.chcnebraska.com
H8393	802	0	1	04	01	H8393_802_0	10	2009.01	COVENTRY HEALTH AND LIFE INSURANCE CO. (NEBRASKA)	Coventry Health and Life Insurance Company	www.advantraplans.com	01	04		1		H8393	802	0	2009	Advantra Platinum PPO Rx CY Employee Plan	State of Nebraska		1	2			404	2						(866)-784-4917	(866)-784-4917	(877)-231-0573	(877)-231-0573	(866)-642-7245	(866)-642-7245	(877)-231-0573		(800)-707-7051	(800)-707-7051	(877)-231-0573	(877)-231-0573	(866)-363-4692	(866)-363-4692	(877)-231-0573		www.tbd.com	www.chcnebraska.com
H8393	803	0	1	04	01	H8393_803_0	10	2009.01	COVENTRY HEALTH AND LIFE INSURANCE CO. (NEBRASKA)	Coventry Health and Life Insurance Company	www.advantraplans.com	01	04		1		H8393	803	0	2009	Advantra Platinum PPO Rx Employee Plan	State of Nebraska		1	2			404	2						(866)-784-4917	(866)-784-4917	(877)-231-0573	(877)-231-0573	(866)-642-7245	(866)-642-7245	(877)-231-0573		(800)-707-7051	(800)-707-7051	(877)-231-0573	(877)-231-0573	(866)-363-4692	(866)-363-4692	(877)-231-0573		www.tbd.com	www.chcnebraska.com
H8424	001	0	1	20	08	H8424_001_0	1	2009.01	SIOUXLAND PACE, INC.	SIOUXLAND PACE, INC.	www.siouxlandpace.org	08	20		1		H8424	001	0	2009	Siouxland PACE, INC	Siouxland PACE, INC		2	2				2														(712)-233-4144	(800)-383-4545			(712)-233-4144	(800)-383-4545			www.siouxlandpace.org	
H8424	002	0	1	20	08	H8424_002_0	1	2009.01	SIOUXLAND PACE, INC.	SIOUXLAND PACE, INC.	www.siouxlandpace.org	08	20		1		H8424	002	0	2009	Siouxland PACE, INC	Siouxland PACE, INC		2	2				2														(712)-233-4144	(800)-383-4545			(712)-233-4144	(800)-383-4545			www.siouxlandpace.org	
H8468	001	0	1	07	02	H8468_001_0	2	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	02	07	2	1		H8468	001	0	2009	Geisinger Gold Reserve 1	PA - Region 1		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833										
H8468	002	0	1	07	02	H8468_002_0	2	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	02	07	2	1		H8468	002	0	2009	Geisinger Gold Reserve 2	PA - Region 2		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833										
H8468	003	0	1	07	02	H8468_003_0	2	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	02	07	2	1		H8468	003	0	2009	Geisinger Gold Reserve 3	PA - Region 3		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833										
H8468	004	0	1	07	02	H8468_004_0	2	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	02	07	2	1		H8468	004	0	2009	Geisinger Gold Reserve 4	PA - Region 4		2	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833										
H8468	801	0	1	07	02	H8468_801_0	1	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	02	07	2	1		H8468	801	0	2009	Geisinger Gold Reserve 1 (Employer Group)	PA - Region 1		1	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833										
H8468	802	0	1	07	02	H8468_802_0	1	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	02	07	2	1		H8468	802	0	2009	Geisinger Gold Reserve 2 (Employer Group)	PA - Region 2		1	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833										
H8468	803	0	1	07	02	H8468_803_0	1	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	02	07	2	1		H8468	803	0	2009	Geisinger Gold Reserve 3 (Employer Group)	PA - Region 3		1	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833										
H8468	804	0	1	07	02	H8468_804_0	1	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	02	07	2	1		H8468	804	0	2009	Geisinger Gold Reserve 4 (Employer Group)	PA - Region 4		1	2				2						(570)-271-8771	(800)-498-9731	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833										
H8578	001	0	1	01	01	H8578_001_0	7	2009.01	HEALTH NEW ENGLAND, INC.	Health New England, Inc.	www.hne.com	01	01		1		H8578	001	0	2009	HNE Medicare Premium Rx Enhanced	HNE Medicare Premium Rx Enhanced		2	2			237	2						(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	www.hne.com	www.hne.com
H8578	002	0	1	01	01	H8578_002_0	7	2009.01	HEALTH NEW ENGLAND, INC.	Health New England, Inc.	www.hne.com	01	01		1		H8578	002	0	2009	HNE Medicare Premium Rx	HNE Medicare Premium Rx		2	2			474	2						(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	www.hne.com	www.hne.com
H8578	003	0	1	01	01	H8578_003_0	3	2009.01	HEALTH NEW ENGLAND, INC.	Health New England, Inc.	www.hne.com	01	01		1		H8578	003	0	2009	HNE Medicare Premium	HNE Medicare Premium		2	2			12	2						(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370									www.hne.com	www.hne.com
H8578	004	0	1	01	01	H8578_004_0	7	2009.01	HEALTH NEW ENGLAND, INC.	Health New England, Inc.	www.hne.com	01	01		1		H8578	004	0	2009	HNE Medicare Plus Rx Enhanced	HNE Medicare Plus Rx Enhanced		2	2			474	2						(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	www.hne.com	www.hne.com
H8578	005	0	1	01	01	H8578_005_0	7	2009.01	HEALTH NEW ENGLAND, INC.	Health New England, Inc.	www.hne.com	01	01		1		H8578	005	0	2009	HNE Medicare Plus Rx	HNE Medicare Plus Rx		2	2			947	2						(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	www.hne.com	www.hne.com
H8578	006	0	1	01	01	H8578_006_0	3	2009.01	HEALTH NEW ENGLAND, INC.	Health New England, Inc.	www.hne.com	01	01		1		H8578	006	0	2009	HNE Medicare Plus	HNE Medicare Plus		2	2			24	2						(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370									www.hne.com	www.hne.com
H8578	007	0	1	01	01	H8578_007_0	7	2009.01	HEALTH NEW ENGLAND, INC.	Health New England, Inc.	www.hne.com	01	01		1		H8578	007	0	2009	HNE Medicare Basic Rx Enhanced	HNE Medicare Basic Rx Enhanced		2	2			190	2						(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	www.hne.com	www.hne.com
H8578	008	0	1	01	01	H8578_008_0	6	2009.01	HEALTH NEW ENGLAND, INC.	Health New England, Inc.	www.hne.com	01	01		1		H8578	008	0	2009	HNE Medicare Basic Rx	HNE Medicare Basic Rx		2	2			379	2						(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	www.hne.com	www.hne.com
H8578	009	0	1	01	01	H8578_009_0	3	2009.01	HEALTH NEW ENGLAND, INC.	Health New England, Inc.	www.hne.com	01	01		1		H8578	009	0	2009	HNE Medicare Basic	HNE Medicare Basic		2	2			12	2						(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370									www.hne.com	www.hne.com
H8578	801	0	1	01	01	H8578_801_0	1	2009.01	HEALTH NEW ENGLAND, INC.	Health New England, Inc.	www.hne.com	01	01		1		H8578	801	0	2009	HNE Medicare Employer Group RX	HNE Medicare Employer Group RX		1	2			47	2						(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	www.hne.com	www.hne.com
H8578	802	0	1	01	01	H8578_802_0	1	2009.01	HEALTH NEW ENGLAND, INC.	Health New England, Inc.	www.hne.com	01	01		1		H8578	802	0	2009	HNE Medicare Employer Group Calendar	HNE Medicare Employer Group Calendar		1	2			38	2						(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370									www.hne.com	www.hne.com
H8578	803	0	1	01	01	H8578_803_0	1	2009.01	HEALTH NEW ENGLAND, INC.	Health New England, Inc.	www.hne.com	01	01		1		H8578	803	0	2009	HNE Medicare Employer Group Non-Calendar	HNE Medicare Employer Group Non-Calendar		1	2			10	2						(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	(413)-787-0010	(877)-443-3314	(800)-439-2370	(800)-439-2370	www.hne.com	www.hne.com
H8604	001	0	1	04	01	H8604_001_0	7	2009.01	THP INSURANCE COMPANY	Health Plan SecureChoice	www.healthplan.org	01	04		1		H8604	001	0	2009	SecureChoice	East Central Ohio		2	2			49	2						(740)-695-7907	(877)-847-7907	(740)-695-7919	(800)-622-3925	(740)-695-7915	(877)-847-7915	(740)-695-7919	(800)-622-3925	(740)-695-7907	(877)-847-7907	(740)-695-7919	(800)-622-3925	(740)-695-7915	(877)-847-7915	(740)-695-7919	(800)-622-3925	http://www.healthplan.org/pharmacy.shtml	www.healthplan.org/directory.shtml
H8604	002	0	1	04	01	H8604_002_0	5	2009.01	THP INSURANCE COMPANY	Health Plan SecureChoice	www.healthplan.org	01	04		1		H8604	002	0	2009	SecureChoice	East Central Ohio		2	2			3	2						(740)-695-7907	(877)-847-7907	(740)-695-7919	(800)-622-3925	(740)-695-7915	(877)-847-7915	(740)-695-7919	(800)-622-3925									http://www.healthplan.org/pharmacy.shtml	www.healthplan.org/directory.shtml
H8604	003	0	1	04	01	H8604_003_0	7	2009.01	THP INSURANCE COMPANY	Health Plan SecureChoice	www.healthplan.org	01	04		1		H8604	003	0	2009	SecureChoice	Eastern Ohio and Northern West Virginia		2	2			50	2						(740)-695-7907	(877)-847-7907	(740)-695-7919	(800)-622-3925	(740)-695-7915	(877)-847-7915	(740)-695-7919	(800)-622-3925	(740)-695-7907	(877)-847-7907	(740)-695-7919	(800)-622-3925	(740)-695-7915	(877)-847-7915	(740)-695-7919	(800)-622-3925	http://www.healthplan.org/pharmacy.shtml	www.healthplan.org/directory.shtml
H8604	004	0	1	04	01	H8604_004_0	5	2009.01	THP INSURANCE COMPANY	Health Plan SecureChoice	www.healthplan.org	01	04		1		H8604	004	0	2009	SecureChoice	Eastern Ohio and Northern West Virginia		2	2			4	2						(740)-695-7907	(877)-847-7907	(740)-695-7919	(800)-622-3925	(740)-695-7915	(877)-847-7915	(740)-695-7919	(800)-622-3925									http://www.healthplan.org/pharmacy.shtml	www.healthplan.org/directory.shtml
H8604	801	0	1	04	01	H8604_801_0	5	2009.01	THP INSURANCE COMPANY	Health Plan SecureChoice	www.healthplan.org	01	04		1		H8604	801	0	2009	SecureChoice	Eastern Ohio and Northern West Virginia		1	2			12	2						(740)-695-7907	(877)-847-7907	(740)-695-7919	(800)-622-3925	(740)-695-7915	(877)-847-7915	(740)-695-7919	(800)-622-3925	(740)-695-7907	(877)-847-7907	(740)-695-7919	(800)-622-3925	(740)-695-7915	(877)-847-7915	(740)-695-7919	(800)-622-3925	http://www.healthplan.org/pharmacy.shtml	www.healthplan.org/directory.shtml
H8604	802	0	1	04	01	H8604_802_0	5	2009.01	THP INSURANCE COMPANY	Health Plan SecureChoice	www.healthplan.org	01	04		1		H8604	802	0	2009	SecureChoice	Eastern Ohio and Northern West Virginia		1	2			2	2						(740)-695-7907	(877)-847-7907	(740)-695-7919	(800)-622-3925	(740)-695-7915	(877)-847-7915	(740)-695-7919	(800)-622-3925									http://www.healthplan.org/pharmacy.shtml	www.healthplan.org/directory.shtml
H8644	001	0	1	04	01	H8644_001_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H8644	001	0	2009	HumanaChoicePPO PPO H8644-001	Oklahoma City Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H8644	003	0	1	04	01	H8644_003_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H8644	003	0	2009	HumanaChoicePPO PPO H8644-003	Tulsa Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H8644	801	0	1	04	01	H8644_801_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H8644	801	0	2009	Humana Employer Sponsored	Oklahoma City Metro Areas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H8644	802	0	1	04	01	H8644_802_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H8644	802	0	2009	Humana Employer Sponsored	Oklahoma City Metros Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H8644	803	0	1	04	01	H8644_803_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H8644	803	0	2009	Humana Employer Sponsored Non-CY	Oklahoma City Metro Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H8644	804	0	1	04	01	H8644_804_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H8644	804	0	2009	Humana Employer Sponsored Non-CY	Oklahoma City Metro Area		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H8649	001	0	1	02	01	H8649_001_0	4	2009.01	ALTIUS HEALTH PLANS, INC. (UTAH)	Altius Advantra	www.altiusadvantra.com	01	02		1		H8649	001	0	2009	Altius Advantra Gold	Northern Utah		2	2			1300	2						(866)-784-4918	(866)-784-4918	(866)-784-4931		(888)-271-7641		(888)-788-4010		(800)-708-3650	(800)-708-3650	(866)-236-1069		(888)-271-7641	(888)-271-7641	(888)-788-4010		www.altiusadvantra.com	www.altiusadvantra.com
H8649	002	0	1	02	01	H8649_002_0	4	2009.01	ALTIUS HEALTH PLANS, INC. (UTAH)	Altius Advantra	www.altiusadvantra.com	01	02		1		H8649	002	0	2009	Altius Advantra Silver	Northern Utah		2	2			280	2						(866)-784-4918	(866)-784-4918	(866)-784-4931		(888)-271-7641		(888)-788-4010		(800)-708-3650	(800)-708-3650	(866)-236-1069		(888)-271-7641	(888)-271-7641	(888)-788-4010		www.altiusadvantra.com	www.altiusadvantra.com
H8649	003	0	1	02	01	H8649_003_0	4	2009.01	ALTIUS HEALTH PLANS, INC. (UTAH)	Altius Advantra	www.altiusadvantra.com	01	02		1		H8649	003	0	2009	Altius Advantra Bronze	Northern Utah		2	2			700	2						(866)-784-4918	(866)-784-4918	(866)-784-4931		(888)-271-7641		(888)-788-4010		(800)-708-3650	(800)-708-3650	(866)-236-1069		(888)-271-7641	(888)-271-7641	(888)-788-4010		www.altiusadvantra.com	www.altiusadvantra.com
H8649	004	0	1	02	01	H8649_004_0	5	2009.01	ALTIUS HEALTH PLANS, INC. (UTAH)	Altius Advantra	www.altiusadvantra.com	01	02		1		H8649	004	0	2009	Altius Advantra Gold South	Washington County, Utah		2	2			166	2						(866)-784-4918	(866)-784-4918	(866)-784-4931		(888)-271-7641		(888)-788-4010		(800)-708-3650	(800)-708-3650	(866)-236-1069		(888)-271-7641	(888)-271-7641	(888)-788-4010		www.altiusadvantra.com	www.altiusadvantra.com
H8649	005	0	1	02	01	H8649_005_0	4	2009.01	ALTIUS HEALTH PLANS, INC. (UTAH)	Altius Advantra	www.altiusadvantra.com	01	02		1		H8649	005	0	2009	Altius Advantra Silver South	Washington County, Utah		2	2			166	2						(866)-784-4918	(866)-784-4918	(866)-784-4931		(888)-271-7641		(888)-788-4010		(800)-708-3650	(800)-708-3650	(866)-236-1069		(888)-271-7641	(888)-271-7641	(888)-788-4010		www.altiusadvantra.com	www.altiusadvantra.com
H8649	006	0	1	02	01	H8649_006_0	4	2009.01	ALTIUS HEALTH PLANS, INC. (UTAH)	Altius Advantra	www.altiusadvantra.com	01	02		1		H8649	006	0	2009	Altius Advantra Bronze South	Washington County, Utah		2	2			700	2						(866)-784-4918	(866)-784-4918	(866)-784-4931		(888)-271-7641		(888)-788-4010		(800)-708-3650	(800)-708-3650	(866)-236-1069		(888)-271-7641	(888)-271-7641	(888)-788-4010		www.altiusadvantra.com	www.altiusadvantra.com
H8649	801	0	1	02	01	H8649_801_0	1	2009.01	ALTIUS HEALTH PLANS, INC. (UTAH)	Altius Advantra	www.altiusadvantra.com	01	02		1		H8649	801	0	2009	Altius Advantra Emp Calendar Year	State of Utah		1	2			100	2						(866)-784-4918	(866)-784-4918	(866)-784-4931		(888)-271-7641		(888)-788-4010		(800)-708-3650	(800)-708-3650	(866)-236-1069		(888)-271-7641	(888)-271-7641	(888)-788-4010		www.altiusadvantra.com	www.altiusadvantra.com
H8649	802	0	1	02	01	H8649_802_0	1	2009.01	ALTIUS HEALTH PLANS, INC. (UTAH)	Altius Advantra	www.altiusadvantra.com	01	02		1		H8649	802	0	2009	Altius Advantra Emp Non-Calendar Year	State of Utah		1	2			100	2						(866)-784-4918	(866)-784-4918	(866)-784-4931		(888)-271-7641		(888)-788-4010		(800)-708-3650	(800)-708-3650	(866)-236-1069		(888)-271-7641	(888)-271-7641	(888)-788-4010		www.altiusadvantra.com	www.altiusadvantra.com
H8649	803	0	1	02	01	H8649_803_0	1	2009.01	ALTIUS HEALTH PLANS, INC. (UTAH)	Altius Advantra	www.altiusadvantra.com	01	02		1		H8649	803	0	2009	Altius Advantra Emp MA Only	State of Utah		1	2			100	2						(866)-784-4918	(866)-784-4918	(866)-784-4931		(888)-271-7641		(888)-788-4010										www.altiusadvantra.com	www.altiusadvantra.com
H8655	001	0	1	20	08	H8655_001_0	1	2009.01	RIVERSIDE RETIREMENT SERVICES, INC.	Riverside PACE	www.riversideonline.com	08	20		1		H8655	001	0	2009	Riverside PACE	Virginia Peninsula		2	2				2														(757)-875-2050	(800)-675-6368			(757)-875-2050	(800)-675-6368			N/A - no formulary	
H8655	002	0	1	20	08	H8655_002_0	1	2009.01	RIVERSIDE RETIREMENT SERVICES, INC.	Riverside PACE	www.riversideonline.com	08	20		1		H8655	002	0	2009	Riverside PACE	Virginia Peninsula		2	2				2														(757)-875-2050	(800)-675-6368			(757)-875-2050	(800)-675-6368			N/A - no formulary	
H8707	001	0	1	04	01	H8707_001_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H8707	001	0	2009	HumanaChoicePPO PPO H8707-001	Berkeley and Charleston Counties		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H8707	003	0	1	04	01	H8707_003_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H8707	003	0	2009	HumanaChoicePPO PPO H8707-003	Spartanburg Metro Area		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H8707	005	0	1	04	01	H8707_005_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H8707	005	0	2009	HumanaChoicePPO PPO H8707-005	Richland County		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H8707	801	0	1	04	01	H8707_801_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H8707	801	0	2009	Humana Employer Sponsored	Spartanburg County		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H8707	802	0	1	04	01	H8707_802_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H8707	802	0	2009	Humana Employer Sponsored	Spartanburg County		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H8707	803	0	1	04	01	H8707_803_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H8707	803	0	2009	Humana Employer Sponsored Non-CY	Spartanburg County		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H8707	804	0	1	04	01	H8707_804_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H8707	804	0	2009	Humana Employer Sponsored Non-CY	Spartanburg County		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H8742	001	0	1	01	01	H8742_001_0	6	2009.01	ABRI HEALTH PLAN, INC	Today's Health	www.todayshealthwi.com	01	01		1		H8742	001	0	2009	Today's Health Classic powered by CCRx	Greater Milwaukee Metro Area		2	2			0	2						(800)-958-2710	(800)-958-2710	(866)-338-4681	(866)-338-4681	(800)-958-2704	(800)-958-2704	(866)-338-4681	(866)-338-4681	(800)-958-2710	(800)-958-2710	(866)-338-4681	(866)-338-4681	(800)-958-2704	(800)-958-2704	(866)-338-4681	(866)-338-4681	http://www.todayshealthwi.com/PresentFormulary	www.todayshealthwi.com
H8742	003	0	1	01	01	H8742_003_0	5	2009.01	ABRI HEALTH PLAN, INC	Today's Health	www.todayshealthwi.com	01	01		1		H8742	003	0	2009	Today's Health Classic	Greater Milwaukee Metro Area		2	2			0	2						(800)-958-2710	(800)-958-2710	(866)-338-4681	(866)-338-4681	(800)-958-2704	(800)-958-2704	(866)-338-4681	(866)-338-4681									http://www.todayshealthwi.com/PresentFormulary	www.todayshealthwi.com
H8742	008	0	1	01	01	H8742_008_0	7	2009.01	ABRI HEALTH PLAN, INC	Today's Health	www.todayshealthwi.com	01	01		1		H8742	008	0	2009	Today's Health Premier powered by CCRx	Greater Milwaukee Metro Area		2	2			50	2						(800)-958-2710	(800)-958-2710	(866)-338-4681	(866)-338-4681	(800)-958-2704	(800)-958-2704	(866)-338-4681	(866)-338-4681	(800)-958-2710	(800)-958-2710	(866)-338-4681	(866)-338-4681	(800)-958-2704	(800)-958-2704	(866)-338-4681	(866)-338-4681	http://www.todayshealthwi.com/PresentFormulary	www.todayshealthwi.com
H8742	010	0	1	01	01	H8742_010_0	7	2009.01	ABRI HEALTH PLAN, INC	Today's Health	www.todayshealthwi.com	01	01		1		H8742	010	0	2009	Today's Health Star powered by CCRx	Greater Milwaukee Metro Area		2	2				2						(800)-958-2710	(800)-958-2710	(866)-338-4681	(866)-338-4681	(800)-958-2704	(800)-958-2704	(866)-338-4681	(866)-338-4681	(800)-958-2710	(800)-958-2710	(866)-338-4681	(866)-338-4681	(800)-958-2704	(800)-958-2704	(866)-338-4681	(866)-338-4681	http://www.todayshealthwi.com/PresentFormulary	www.todayshealthwi.com
H8742	801	0	1	01	01	H8742_801_0	4	2009.01	ABRI HEALTH PLAN, INC	Today's Health	www.todayshealthwi.com	01	01		1		H8742	801	0	2009	Retiree MA-PD CY	Today's Health Employer Group (MAPD--CY)		1	2				2						(800)-958-2710	(800)-958-2710	(866)-338-4681	(866)-338-4681	(800)-958-2704	(800)-958-2704	(866)-338-4681	(866)-338-4681	(800)-958-2710	(800)-958-2710	(866)-338-4681	(866)-338-4681	(800)-958-2704	(800)-958-2704	(866)-338-4681	(866)-338-4681	http://www.todayshealthwi.com/PresentFormulary	www.todayshealthwi.com
H8742	802	0	1	01	01	H8742_802_0	4	2009.01	ABRI HEALTH PLAN, INC	Today's Health	www.todayshealthwi.com	01	01		1		H8742	802	0	2009	Retiree MA-PD non-CY	Today's Health Employer Group (MAPD--non-CY)		1	2				2						(800)-958-2710	(800)-958-2710	(866)-338-4681	(866)-338-4681	(800)-958-2704	(800)-958-2704	(866)-338-4681	(866)-338-4681	(800)-958-2710	(800)-958-2710	(866)-338-4681	(866)-338-4681	(800)-958-2704	(800)-958-2704	(866)-338-4681	(866)-338-4681	http://www.todayshealthwi.com/PresentFormulary	www.todayshealthwi.com
H8742	803	0	1	01	01	H8742_803_0	4	2009.01	ABRI HEALTH PLAN, INC	Today's Health	www.todayshealthwi.com	01	01		1		H8742	803	0	2009	Retiree MA	Today's Health Employer Group (MA--CY)		1	2				2						(800)-958-2710	(800)-958-2710	(866)-338-4681	(866)-338-4681	(800)-958-2704	(800)-958-2704	(866)-338-4681	(866)-338-4681									http://www.todayshealthwi.com/PresentFormulary	www.todayshealthwi.com
H8748	001	0	1	02	01	H8748_001_0	6	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.securehorizons.com	01	02		1		H8748	001	0	2009	AARP MedicareComplete Plus	York County		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(888)-702-8400	(888)-702-8400	(800)-387-1074		(888)-702-8400	(888)-702-8400	(800)-387-1074		www.rxsolutions.com	www.securehorizons.com
H8748	002	0	1	02	01	H8748_002_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.securehorizons.com	01	02		1		H8748	002	0	2009	AARP MedicareComplete Plus	Greenville SC		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(888)-702-8400	(888)-702-8400	(800)-387-1074		(888)-702-8400	(888)-702-8400	(800)-387-1074		www.rxsolutions.com	www.securehorizons.com
H8748	003	0	1	02	01	H8748_003_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.securehorizons.com	01	02		1		H8748	003	0	2009	AARP MedicareComplete Plus	Beaufort SC		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(888)-702-8400	(888)-702-8400	(800)-387-1074		(888)-702-8400	(888)-702-8400	(800)-387-1074		www.rxsolutions.com	www.securehorizons.com
H8748	004	0	1	02	01	H8748_004_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.securehorizons.com	01	02		1		H8748	004	0	2009	AARP MedicareComplete Plus	Charleston SC		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(888)-702-8400	(888)-702-8400	(800)-387-1074		(888)-702-8400	(888)-702-8400	(800)-387-1074		www.rxsolutions.com	www.securehorizons.com
H8748	801	0	1	02	01	H8748_801_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.securehorizons.com	01	02		1		H8748	801	0	2009	Medicare Complete Retiree Plan	Select Counties in SC		1	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(888)-702-8400	(888)-702-8400	(800)-387-1074		(888)-702-8400	(888)-702-8400	(800)-387-1074		www.rxsolutions.com	www.securehorizons.com
H8748	802	0	1	02	01	H8748_802_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.securehorizons.com	01	02		1		H8748	802	0	2009	Medicare Complete Retiree Plan	Select Counties in SC		1	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671										www.rxsolutions.com	www.securehorizons.com
H8748	803	0	1	02	01	H8748_803_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.securehorizons.com	01	02		1		H8748	803	0	2009	Medicare Complete Retiree Plan	Select Counties in SC		1	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(888)-702-8400	(888)-702-8400	(800)-387-1074		(888)-702-8400	(888)-702-8400	(800)-387-1074		www.rxsolutions.com	www.securehorizons.com
H8748	804	0	1	02	01	H8748_804_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.securehorizons.com	01	02		1		H8748	804	0	2009	Medicare Complete Retiree Plan	Select Counties in SC		1	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671										www.rxsolutions.com	www.securehorizons.com
H8778	001	0	1	01	01	H8778_001_0	9	2009.01	ESSENCE L.L.P.	Essence Healthcare	www.essencehealthcare.com	01	01		1		H8778	001	0	2009	Essence Advantage	Lexington Louisville Service Area		2	2			5146	2						(502)-896-0333	(888)-896-0333	(866)-597-9561	(866)-597-9561	(502)-896-0333	(888)-896-0333	(866)-597-9561	(866)-597-9561	(502)-896-0333	(888)-896-0333	(866)-597-9561	(866)-597-9561	(502)-896-0333	(888)-896-0333	(866)-597-9561	(866)-597-9561	www.essencehealthcare.com	www.essencehealthcare.com
H8778	801	0	1	01	01	H8778_801_0	1	2009.01	ESSENCE L.L.P.	Essence Healthcare	www.essencehealthcare.com	01	01		1		H8778	801	0	2009	Essence Advantage Employer Group Plan non-calendar	Lexington Louisville Service Area		1	2			50	2						(502)-896-0333	(888)-896-0333	(866)-597-9561	(866)-597-9561	(502)-896-0333	(888)-896-0333	(866)-597-9561	(866)-597-9561	(502)-896-0333	(888)-896-0333	(866)-597-9561	(866)-597-9561	(502)-896-0333	(888)-896-0333	(866)-597-9561	(866)-597-9561	www.essencehealthcare.com	www.essencehealthcare.com
H8778	802	0	1	01	01	H8778_802_0	1	2009.01	ESSENCE L.L.P.	Essence Healthcare	www.essencehealthcare.com	01	01		1		H8778	802	0	2009	Essence Advantage Employer Group Plan	Lexington Louisville Service Area		1	2			50	2						(502)-896-0333	(888)-896-0333	(866)-597-9561	(866)-597-9561	(502)-896-0333	(888)-896-0333	(866)-597-9561	(866)-597-9561	(502)-896-0333	(888)-896-0333	(866)-597-9561	(866)-597-9561	(502)-896-0333	(888)-896-0333	(866)-597-9561	(866)-597-9561	www.essencehealthcare.com	www.essencehealthcare.com
H8800	001	0	1	20	08	H8800_001_0	1	2009.01	TOTAL SENIOR CARE, INC.	Total Senior Care, Inc.	homecare-hospice.org	08	20		1		H8800	001	0	2009	Total Senior Care - Dual	Total Senior Care, Inc.		2	2				2														(716)-372-2106	(800)-719-7129			(716)-372-2106	(800)-719-7129			www.homecare-hospice.org	
H8800	002	0	1	20	08	H8800_002_0	1	2009.01	TOTAL SENIOR CARE, INC.	Total Senior Care, Inc.	homecare-hospice.org	08	20		1		H8800	002	0	2009	Total Senior Care - Medicare Small Only	Total Senior Care, Inc.		2	2				2														(716)-372-2106	(800)-719-7129			(716)-372-2106	(800)-719-7129			www.homecare-hospice.org	
H8805	001	0	1	04	01	H8805_001_0	9	2009.01	ELDERPLAN, INC.	Elderplan, Inc.	www.Elderplan.org	01	04		1		H8805	001	0	2009	Metropolitan Health Options	New York City Metropolitan Area		2	2				2						(718)-921-7898	(800)-353-3765	(800)-662-1220	(800)-662-1220	(866)-695-8101	(866)-695-8101	(800)-662-1220	(800)-662-1220	(718)-921-7898	(800)-353-3765	(800)-662-1220	(800)-662-1220	(866)-695-8101	(866)-695-8101	(800)-662-1220	(800)-662-1220	www.elderplan.org	www.Elderplan.org
H8805	805	0	1	04	01	H8805_805_0	4	2009.01	ELDERPLAN, INC.	Elderplan, Inc.	www.Elderplan.org	01	04		1		H8805	805	0	2009	Elderplan Retiree Health Solutions IV	New York State		1	2				2						(718)-921-7898	(800)-353-3765	(800)-662-1220	(800)-662-1220	(866)-695-8101	(866)-695-8101	(800)-662-1220	(800)-662-1220	(718)-921-7898	(800)-353-3765	(800)-662-1220	(800)-662-1220	(866)-695-8101	(866)-695-8101	(800)-662-1220	(800)-662-1220	www.elderplan.org	www.Elderplan.org
H8822	001	0	1	01	01	H8822_001_0	8	2009.01	ADVANTAGE HEALTH SOLUTIONS, INC.	ADVANTAGE Preferred Plus	www.advpreferredplus.com	01	01		1		H8822	001	0	2009	ADVANTAGE Wishard Preferred Basic	Marion County		2	2				2						(317)-573-7950	(800)-523-7533	(800)-743-3333	(800)-743-3333	(800)-201-8342	(800)-201-8342	(800)-579-4990	(800)-579-4990	(866)-533-3633	(866)-533-3633	(866)-547-0773	(866)-547-0773	(800)-201-8342	(800)-201-8342	(800)-579-4990	(800)-579-4990	www.advpreferredplus.com	www.advpreferredplus.com
H8822	002	0	1	01	01	H8822_002_0	5	2009.01	ADVANTAGE HEALTH SOLUTIONS, INC.	ADVANTAGE Preferred Plus	www.advpreferredplus.com	01	01		1		H8822	002	0	2009	ADVANTAGE Wishard Preferred Enhanced	Marion County		2	2				2						(317)-573-7950	(800)-523-7533	(800)-743-3333	(800)-743-3333	(800)-201-8342	(800)-201-8342	(800)-579-4990	(800)-579-4990	(866)-533-3633	(866)-533-3633	(866)-547-0773	(866)-547-0773	(800)-201-8342	(800)-201-8342	(800)-579-4990	(800)-579-4990	www.advpreferredplus.com	www.advpreferredplus.com
H8822	003	0	1	01	01	H8822_003_0	6	2009.01	ADVANTAGE HEALTH SOLUTIONS, INC.	ADVANTAGE Preferred Plus	www.advpreferredplus.com	01	01		1		H8822	003	0	2009	ADVANTAGE Preferred Network Basic	Central Indiana		2	2				2						(317)-573-7950	(800)-523-7533	(800)-743-3333	(800)-743-3333	(800)-201-8342	(800)-201-8342	(800)-579-4990	(800)-579-4990	(866)-533-3633	(866)-533-3633	(866)-547-0773	(866)-547-0773	(800)-201-8342	(800)-201-8342	(800)-579-4990	(800)-579-4990	www.advpreferredplus.com	www.advpreferredplus.com
H8822	004	0	1	01	01	H8822_004_0	6	2009.01	ADVANTAGE HEALTH SOLUTIONS, INC.	ADVANTAGE Preferred Plus	www.advpreferredplus.com	01	01		1		H8822	004	0	2009	ADVANTAGE Preferred Network Enhanced	Central Indiana		2	2				2						(317)-573-7950	(800)-523-7533	(800)-743-3333	(800)-743-3333	(800)-201-8342	(800)-201-8342	(800)-579-4990	(800)-579-4990	(866)-533-3633	(866)-533-3633	(866)-547-0773	(866)-547-0773	(800)-201-8342	(800)-201-8342	(800)-579-4990	(800)-579-4990	www.advpreferredplus.com	www.advpreferredplus.com
H8836	001	0	1	08	03	H8836_001_0	7	2009.01	MENNONITE MUTUAL AID ASSOCIATION	Mennonite Mutual Aid Association	www.mma-online.org	03	08	2	1		H8836	001	0	2009	Team Care Advantage Rx	Multi-state		2	2			4500	2						(866)-445-9790	(866)-445-9790	(888)-858-8567	(888)-858-8567	(574)-533-9511	(800)-348-7468	(574)-533-9511	(800)-348-7468	(888)-816-7980	(888)-816-7980	(866)-236-1069	(866)-236-1069	(574)-533-9511	(800)-348-7468	(574)-533-9511	(800)-348-7468	www.mma-online.org	
H8836	002	0	1	08	03	H8836_002_0	5	2009.01	MENNONITE MUTUAL AID ASSOCIATION	Mennonite Mutual Aid Association	www.mma-online.org	03	08	2	1		H8836	002	0	2009	Team Care Advantage	Multi-state		2	2			2600	2						(866)-445-9790	(866)-445-9790	(888)-858-8567	(888)-858-8567	(574)-533-9511	(800)-348-7468	(574)-533-9511	(800)-348-7468									www.mma-online.org	
H8980	001	0	1	04	01	H8980_001_0	7	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Advantra	www.chcadvantra.com	01	04		1		H8980	001	0	2009	Advantra PPO Gold	Columbiana, Mahoning, Trumbull Counties		2	2				2						(800)-290-0190		(800)-207-1262		(800)-470-4272		(800)-207-1262		(888)-620-1743	(888)-620-1743	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.oh.chcadvantra.com/framesetdef.asp?Community=Member	www.chcadvantra.com
H8980	002	0	1	04	01	H8980_002_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Advantra	www.chcadvantra.com	01	04		1		H8980	002	0	2009	Advantra PPO Silver	Columbiana, Mahoning, Trumbull Counties		2	2				2						(800)-290-0190		(800)-207-1262		(800)-470-4272		(800)-207-1262		(888)-620-1743	(888)-620-1743	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.oh.chcadvantra.com/framesetdef.asp?Community=Member	www.chcadvantra.com
H8980	801	0	1	04	01	H8980_801_0	2	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Advantra	www.chcadvantra.com	01	04		1		H8980	801	0	2009	Advantra PPO MA Only	Ohio		1	2				2						(800)-290-0190	(800)-290-0190	(800)-207-1262		(800)-470-4272	(800)-470-4272	(800)-207-1262										http://www.oh.chcadvantra.com/framesetdef.asp?Community=Member	www.chcadvantra.com
H8980	802	0	1	04	01	H8980_802_0	2	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Advantra	www.chcadvantra.com	01	04		1		H8980	802	0	2009	Advantra PPO Gold	Ohio		1	2				2						(800)-290-0190	(800)-290-0190	(800)-207-1262		(800)-470-4272	(800)-470-4272	(800)-207-1262		(888)-620-1743	(888)-620-1743	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.oh.chcadvantra.com/framesetdef.asp?Community=Member	www.chcadvantra.com
H8980	803	0	1	04	01	H8980_803_0	2	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Advantra	www.chcadvantra.com	01	04		1		H8980	803	0	2009	Advantra PPO Gold	Ohio		1	2				2						(800)-290-0190		(800)-207-1262		(800)-470-4272		(800)-207-1262		(888)-620-1743	(888)-620-1743	(866)-236-1069		(800)-470-4272	(800)-470-4272	(800)-207-1262		http://www.oh.chcadvantra.com/framesetdef.asp?Community=Member	www.chcadvantra.com
H8991	011	0	1	01	01	H8991_011_0	5	2009.01	AMERIGROUP FLORIDA, INC.	AMERIGROUP Community Care	https://www.amerigroupcorp.com/Members	01	01		1		H8991	011	0	2009	AMERIVANTAGE Specialty + Rx	South Florida		2	1	3		1155	2			1	1		(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	http://www.amerigroupcorp.com/Members/amerivantage/_documents	https://www.amerigroupcorp.com/Members/providers.asp
H8991	012	0	1	01	01	H8991_012_0	4	2009.01	AMERIGROUP FLORIDA, INC.	AMERIGROUP Community Care	https://www.amerigroupcorp.com/Members	01	01		1		H8991	012	0	2009	AMERIVANTAGE Classic + Rx	South Florida - Miami/Dade County		2	2			108	2						(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	http://www.amerigroupcorp.com/Members/amerivantage/_documents	https://www.amerigroupcorp.com/Members/providers.asp
H8991	017	0	1	01	01	H8991_017_0	7	2009.01	AMERIGROUP FLORIDA, INC.	AMERIGROUP Community Care	https://www.amerigroupcorp.com/Members	01	01		1		H8991	017	0	2009	AMERIVANTAGE Specialty + Rx	Central Florida		2	1	3		595	2			1	1		(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	http://www.amerigroupcorp.com/Members/amerivantage/_documents	https://www.amerigroupcorp.com/Members/providers.asp
H8991	018	0	1	01	01	H8991_018_0	5	2009.01	AMERIGROUP FLORIDA, INC.	AMERIGROUP Community Care	https://www.amerigroupcorp.com/Members	01	01		1		H8991	018	0	2009	AMERIVANTAGE Classic + Rx	Central Florida		2	2			1021	2						(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	http://www.amerigroupcorp.com/Members/amerivantage/_documents	https://www.amerigroupcorp.com/Members/providers.asp
H8991	019	0	1	01	01	H8991_019_0	4	2009.01	AMERIGROUP FLORIDA, INC.	AMERIGROUP Community Care	https://www.amerigroupcorp.com/Members	01	01		1		H8991	019	0	2009	AMERIVANTAGE Balance + Rx	South  Central Florida		2	2			378	2						(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	http://www.amerigroupcorp.com/Members/amerivantage/_documents	https://www.amerigroupcorp.com/Members/providers.asp
H8991	022	0	1	01	01	H8991_022_0	4	2009.01	AMERIGROUP FLORIDA, INC.	AMERIGROUP Community Care	https://www.amerigroupcorp.com/Members	01	01		1		H8991	022	0	2009	AMERIVANTAGE Classic + Rx	South Florida - Broward County		2	2			240	2						(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	http://www.amerigroupcorp.com/Members/amerivantage/_documents	https://www.amerigroupcorp.com/Members/providers.asp
H8991	027	0	1	01	01	H8991_027_0	5	2009.01	AMERIGROUP FLORIDA, INC.	AMERIGROUP Community Care	https://www.amerigroupcorp.com/Members	01	01		1		H8991	027	0	2009	AMERIVANTAGE Classic + Rx	South Florida - Palm Beach County		2	2			145	2						(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	(866)-805-4589	(866)-805-4589	(800)-855-2880	(800)-855-2880	http://www.amerigroupcorp.com/Members/amerivantage/_documents	https://www.amerigroupcorp.com/Members/providers.asp
H9001	001	0	1	01	01	H9001_001_0	4	2009.01	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	01	01		1		H9001	001	0	2009	Fallon Senior Plan Standard	WORC county,parts of FRK,HMD,HPS,MSEX,NOF counties		2	2			1873	2						(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677									http://www.fchp.org/Extranet/Seniors/OnlineDrugFormulary.htm	http://www.fchp.org/findPhysician/name.aspx
H9001	006	0	1	01	01	H9001_006_0	7	2009.01	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	01	01		1		H9001	006	0	2009	Fallon Senior Plan Plus Basic Rx	WORC county,parts of FRK,HMD,HPS,MSEX,NOF counties		2	2			3177	2						(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677	(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677	http://www.fchp.org/Extranet/Seniors/OnlineDrugFormulary.htm	http://www.fchp.org/findPhysician/name.aspx
H9001	010	0	1	01	01	H9001_010_0	5	2009.01	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	01	01		1		H9001	010	0	2009	Fallon Senior Plan Saver	WORC county,parts of FRK,HMD,HPS,MSEX,NOF counties		2	2			1462	2						(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677									http://www.fchp.org/Extranet/Seniors/OnlineDrugFormulary.htm	http://www.fchp.org/findPhysician/name.aspx
H9001	011	0	1	01	01	H9001_011_0	7	2009.01	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	01	01		1		H9001	011	0	2009	Fallon Senior Plan Saver Basic Rx	WORC county,parts of FRK,HMD,HPS,MSEX,NOF counties		2	2			3326	2						(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677	(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677	http://www.fchp.org/Extranet/Seniors/OnlineDrugFormulary.htm	http://www.fchp.org/findPhysician/name.aspx
H9001	012	0	1	01	01	H9001_012_0	5	2009.01	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	01	01		1		H9001	012	0	2009	Fallon Senior Plan Value 1	WORC county,parts of FRK,HMD,HPS,MSEX,NOF counties		2	1	3		847	2			1	2		(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677	(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677	http://www.fchp.org/Extranet/Seniors/OnlineDrugFormulary.htm	http://www.fchp.org/findPhysician/name.aspx
H9001	013	0	1	01	01	H9001_013_0	6	2009.01	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	01	01		1		H9001	013	0	2009	Fallon Senior Plan Saver Enhanced Rx	WORC county,parts of FRK,HMD,HPS,MSEX,NOF counties		2	2			4494	2						(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677	(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677	http://www.fchp.org/Extranet/Seniors/OnlineDrugFormulary.htm	http://www.fchp.org/findPhysician/name.aspx
H9001	014	0	1	01	01	H9001_014_0	7	2009.01	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	01	01		1		H9001	014	0	2009	Fallon Senior Plan Standard Basic Rx	WORC county,parts of FRK,HMD,HPS,MSEX,NOF counties		2	2			3045	2						(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677	(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677	http://www.fchp.org/Extranet/Seniors/OnlineDrugFormulary.htm	http://www.fchp.org/findPhysician/name.aspx
H9001	015	0	1	01	01	H9001_015_0	6	2009.01	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	01	01		1		H9001	015	0	2009	Fallon Senior Plan Standard Enhanced Rx	WORC county,parts of FRK,HMD,HPS,MSEX,NOF counties		2	2			3040	2						(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677	(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677	http://www.fchp.org/Extranet/Seniors/OnlineDrugFormulary.htm	http://www.fchp.org/findPhysician/name.aspx
H9001	016	0	1	01	01	H9001_016_0	5	2009.01	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	01	01		1		H9001	016	0	2009	Fallon Senior Plan Plus	WORC county,parts of FRK,HMD,HPS,MSEX,NOF counties		2	2			81	2						(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677									http://www.fchp.org/Extranet/Seniors/OnlineDrugFormulary.htm	http://www.fchp.org/findPhysician/name.aspx
H9001	017	0	1	01	01	H9001_017_0	6	2009.01	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	01	01		1		H9001	017	0	2009	Fallon Senior Plan Plus Enhanced Rx	WORC county,parts of FRK,HMD,HPS,MSEX,NOF counties		2	2			2229	2						(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677	(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677	http://www.fchp.org/Extranet/Seniors/OnlineDrugFormulary.htm	http://www.fchp.org/findPhysician/name.aspx
H9001	018	0	1	01	01	H9001_018_0	7	2009.01	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	01	01		1		H9001	018	0	2009	Fallon Senior Plan Value 2	WORC county		2	1	3		46	2			1	3		(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677	(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677	http://www.fchp.org/Extranet/Seniors/OnlineDrugFormulary.htm	http://www.fchp.org/findPhysician/name.aspx
H9001	801	0	1	01	01	H9001_801_0	6	2009.01	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	01	01		1		H9001	801	0	2009	HMO MA Only	Full Service Area - Employer Groups		1	2			1181	2						(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677									http://www.fchp.org/Extranet/Seniors/OnlineDrugFormulary.htm	http://www.fchp.org/findPhysician/name.aspx
H9001	803	0	1	01	01	H9001_803_0	5	2009.01	FALLON COMMUNITY HEALTH PLAN	Fallon Community Health Plan	www.fchp.org	01	01		1		H9001	803	0	2009	HMO MA RX Coinsurance - Calendar Year	Full Service Area - Employer Groups		1	2			5354	2						(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677	(800)-868-5200	(800)-868-5200	(877)-608-7677	(877)-608-7677	(888)-377-1980	(888)-377-1980	(877)-608-7677	(877)-608-7677	http://www.fchp.org/Extranet/Seniors/OnlineDrugFormulary.htm	http://www.fchp.org/findPhysician/name.aspx
H9003	001	0	1	01	01	H9003_001_0	7	2009.01	KAISER FOUNDATION HP OF THE N W	Kaiser Permanente Senior Advantage	www.kp.org	01	01		1		H9003	001	0	2009	Senior Advantage	Portland-Vancouver Metro, Salem OR, Longview WA		2	2				2						(877)-221-8221		(800)-735-2900		(877)-221-8221		(800)-735-2900		(877)-221-8221	(877)-221-8221	(800)-735-2900		(877)-221-8221	(877)-221-8221	(800)-735-2900		www.kp.org/seniorrx	www.kp.org
H9003	006	0	1	01	01	H9003_006_0	3	2009.01	KAISER FOUNDATION HP OF THE N W	Kaiser Permanente Senior Advantage	www.kp.org	01	01		1		H9003	006	0	2009	Senior Advantage Basic	Portland-Vancouver Metro, Salem OR, Longview WA		2	2				2						(877)-221-8221		(800)-735-2900		(877)-221-8221		(800)-735-2900		(877)-221-8221	(877)-221-8221	(800)-735-2900		(877)-221-8221	(877)-221-8221	(800)-735-2900		www.kp.org/seniorrx	www.kp.org
H9003	801	0	1	01	01	H9003_801_0	3	2009.01	KAISER FOUNDATION HP OF THE N W	Kaiser Permanente Senior Advantage	www.kp.org	01	01		1		H9003	801	0	2009	Employer Group Only with Part D	Portland-Vancouver Metro, Salem OR, Longview WA		1	2				2						(877)-221-8221		(800)-735-2900		(877)-221-8221		(800)-735-2900		(877)-221-8221	(877)-221-8221	(800)-735-2900		(877)-221-8221	(877)-221-8221	(800)-735-2900		www.kp.org/seniorrx	www.kp.org
H9003	802	0	1	01	01	H9003_802_0	3	2009.01	KAISER FOUNDATION HP OF THE N W	Kaiser Permanente Senior Advantage	www.kp.org	01	01		1		H9003	802	0	2009	Employer Group Only without Part D	Portland-Vancouver Metro, Salem OR, Longview WA		1	2				2						(877)-221-8221		(800)-735-2900		(877)-221-8221		(800)-735-2900										www.kp.org/seniorrx	www.kp.org
H9003	805	0	1	01	01	H9003_805_0	5	2009.01	KAISER FOUNDATION HP OF THE N W	Kaiser Permanente Senior Advantage	www.kp.org	01	01		1		H9003	805	0	2009	FEHB AB with D	Portland-Vancouver Metro, Salem OR, Longview WA		1	2				2						(877)-221-8221		(800)-735-2900		(877)-221-8221		(800)-735-2900		(877)-221-8221	(877)-221-8221	(800)-735-2900		(877)-221-8221	(877)-221-8221	(800)-735-2900		www.kp.org/seniorrx	www.kp.org
H9005	007	0	1	01	01	H9005_007_0	5	2009.01	GROUP HEALTH PLAN, INC.	HealthPartners Classic Plan	healthpartners.com/medicare	01	01		1		H9005	007	0	2009	HealthPartners Classic	MN Twin Cities Metro Area		2	2				2						(952)-883-7676	(866)-233-8734	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156	(952)-883-7676	(866)-233-8734	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156	healthpartners.com/portal/3212.html	healthpartners.com/medicare
H9005	804	0	1	01	01	H9005_804_0	3	2009.01	GROUP HEALTH PLAN, INC.	HealthPartners Classic Plan	healthpartners.com/medicare	01	01		1		H9005	804	0	2009	HealthPartners Classic Group	MN Twin Cities Metro Area		1	2				2						(952)-883-7676	(866)-233-8734	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156	(952)-883-7676	(866)-233-8734	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156	healthpartners.com/formulary/medicare.do	healthpartners.com/medicare
H9011	003	0	1	01	01	H9011_003_0	5	2009.01	UNITED HEALTHCARE OF FLORIDA INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H9011	003	0	2009	AARP MedicareComplete Plan 1	Miami-Dade County		2	2				2						(800)-643-4845		(888)-685-8480		(800)-547-5514		(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H9011	011	0	1	01	01	H9011_011_0	5	2009.01	UNITED HEALTHCARE OF FLORIDA INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H9011	011	0	2009	Evercare Plan DH	Miami-Dade County		2	1	3			2			2	2		(877)-702-5110		(888)-685-8480		(888)-834-3721		(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H9011	016	0	1	02	01	H9011_016_0	4	2009.01	UNITED HEALTHCARE OF FLORIDA INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	02		1		H9011	016	0	2009	AARP MedicareComplete Plus	Miami-Dade FL		2	2				2						(800)-643-4845		(888)-685-8480		(800)-547-5514		(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H9011	801	0	1	01	01	H9011_801_0	2	2009.01	UNITED HEALTHCARE OF FLORIDA INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H9011	801	0	2009	MedicareComplete Retiree Plan	Broward, Dade and Palm Beach Counties		1	2				2						(800)-642-7552		(888)-685-8480		(800)-221-6746		(888)-685-8480		(800)-642-7552	(800)-642-7552	(888)-685-8480		(800)-221-6746	(800)-221-6746	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H9011	802	0	1	01	01	H9011_802_0	2	2009.01	UNITED HEALTHCARE OF FLORIDA INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H9011	802	0	2009	MedicareComplete Essential Retiree Plan	Broward, Dade and Palm Beach Counties		1	2				2						(800)-642-7552		(888)-685-8480		(800)-221-6746		(888)-685-8480										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H9011	803	0	1	01	01	H9011_803_0	2	2009.01	UNITED HEALTHCARE OF FLORIDA INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H9011	803	0	2009	MedicareComplete Retiree Plan	Select Counties in FL		1	2				2						(800)-642-7552		(888)-685-8480		(800)-221-6746		(888)-685-8480		(800)-642-7552	(800)-642-7552	(888)-685-8480		(800)-221-6746	(800)-221-6746	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H9011	804	0	1	01	01	H9011_804_0	3	2009.01	UNITED HEALTHCARE OF FLORIDA INC.	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	01	01		1		H9011	804	0	2009	MedicareComplete Retiree Plan	Select Counties in FL		1	2				2						(800)-642-7552		(888)-685-8480		(800)-221-6746		(888)-685-8480										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
H9047	001	0	1	01	01	H9047_001_0	6	2009.01	PROVIDENCE HEALTH PLAN	Providence Health Plan	www.providence.org/healthplans	01	01		1		H9047	001	0	2009	Providence Medicare Extra Plan 1 + RX	Portland Metro, Willamette Valley, Clark County		2	2			14806	2						(503)-574-8000	(800)-603-2340	(503)-574-8702	(888)-244-6642	(503)-574-5000	(800)-988-0088	(503)-574-8702	(888)-244-6642	(503)-574-8000	(800)-603-2340	(503)-574-8702	(888)-244-6642	(503)-574-5000	(800)-988-0088	(503)-574-8702	(888)-244-6642	http://www.providence.org/resources/healthplans/images/PME_DrugFormulary.pdf	www.providence.org/Health Plans/Members/Directories.htm
H9047	013	0	2	01	01	H9047_013_0	6	2009.01	PROVIDENCE HEALTH PLAN	Providence Health Plan	www.providence.org/healthplans	01	01		2		H9047	013	0	2009	Providence Medicare Extra Part B Only + RX	Portland Metro and Willamette Valley		2	2			6	2		2				(503)-574-8000	(800)-603-2340	(503)-574-8702	(888)-244-6642	(503)-574-5000	(800)-988-0088	(503)-574-8702	(888)-244-6642	(503)-574-8000	(800)-603-2340	(503)-574-8702	(888)-244-6642	(503)-574-5000	(800)-988-0088	(503)-574-8702	(888)-244-6642	http://www.providence.org/resources/healthplans/images/PME_DrugFormulary.pdf	www.providence.org/Health Plans/Members/Directories.htm
H9047	024	0	1	02	01	H9047_024_0	7	2009.01	PROVIDENCE HEALTH PLAN	Providence Health Plan	www.providence.org/healthplans	01	02		1		H9047	024	0	2009	Providence Medicare Choice + RX	Portland Metro, Willamette Valley, Clark County		2	2			3209	2						(503)-574-8000	(800)-603-2340	(503)-574-8702	(888)-244-6642	(503)-574-5000	(800)-988-0088	(503)-574-8702	(888)-244-6642	(503)-574-8000	(800)-603-2340	(503)-574-8702	(888)-244-6642	(503)-574-5000	(800)-988-0088	(503)-574-8702	(888)-244-6642	http://www.providence.org/resources/healthplans/images/PME_DrugFormulary.pdf	www.providence.org/Health Plans/Members/Directories.htm
H9047	033	0	1	01	01	H9047_033_0	6	2009.01	PROVIDENCE HEALTH PLAN	Providence Health Plan	www.providence.org/healthplans	01	01		1		H9047	033	0	2009	Providence Medicare Extra Plan 1	Portland Metro, Willamette Valley, Clark County		2	2			3242	2						(503)-574-8000	(800)-603-2340	(503)-574-8702	(888)-244-6642	(503)-574-5000	(800)-988-0088	(503)-574-8702	(888)-244-6642									http://www.providence.org/resources/healthplans/images/PME_DrugFormulary.pdf	www.providence.org/Health Plans/Members/Directories.htm
H9047	035	0	1	02	01	H9047_035_0	6	2009.01	PROVIDENCE HEALTH PLAN	Providence Health Plan	www.providence.org/healthplans	01	02		1		H9047	035	0	2009	Providence Medicare Choice	Portland Metro, Willamette Valley, Clark County		2	2			418	2						(503)-574-8000	(800)-603-2340	(503)-574-8702	(888)-244-6642	(503)-574-5000	(800)-988-0088	(503)-574-8702	(888)-244-6642									http://www.providence.org/resources/healthplans/images/PME_DrugFormulary.pdf	www.providence.org/Health Plans/Members/Directories.htm
H9047	801	0	1	01	01	H9047_801_0	5	2009.01	PROVIDENCE HEALTH PLAN	Providence Health Plan	www.providence.org/healthplans	01	01		1		H9047	801	0	2009	Providence Medicare Extra Group Plan	Portland Metro, Willamette Valley, Clark County		1	2			12250	2						(503)-574-8000	(800)-603-2340	(503)-574-8702	(888)-244-6642	(503)-574-5000	(800)-988-0088	(503)-574-8702	(888)-244-6642									http://www.providence.org/resources/healthplans/images/PME_DrugFormulary.pdf	www.providence.org/Health Plans/Members/Directories.htm
H9047	804	0	1	01	01	H9047_804_0	4	2009.01	PROVIDENCE HEALTH PLAN	Providence Health Plan	www.providence.org/healthplans	01	01		1		H9047	804	0	2009	Providence Medicare Extra Group Plan + RX	Portland Metro, Willamette Valley, Clark County		1	2			1480	2						(503)-574-8000	(800)-603-2340	(503)-574-8702	(888)-244-6642	(503)-574-5000	(800)-988-0088	(503)-574-8702	(888)-244-6642	(503)-574-8000	(800)-603-2340	(503)-574-8702	(888)-244-6642	(503)-574-5000	(800)-988-0088	(503)-574-8702	(888)-244-6642	http://www.providence.org/resources/healthplans/images/PME_DrugFormulary.pdf	www.providence.org/Health Plans/Members/Directories.htm
H9047	805	0	1	02	01	H9047_805_0	5	2009.01	PROVIDENCE HEALTH PLAN	Providence Health Plan	www.providence.org/healthplans	01	02		1		H9047	805	0	2009	Providence Medicare Choice Group Plan + RX	Portland Metro, Willamette Valley, Clark County		1	2			20	2						(503)-574-8000	(800)-603-2340	(503)-574-8702	(888)-244-6642	(503)-574-5000	(800)-988-0088	(503)-574-8702	(888)-244-6642	(503)-574-8000	(800)-603-2340	(503)-574-8702	(888)-244-6642	(503)-574-5000	(800)-988-0088	(503)-574-8702	(888)-244-6642	http://www.providence.org/resources/healthplans/images/PME_DrugFormulary.pdf	www.providence.org/Health Plans/Members/Directories.htm
H9047	806	0	1	02	01	H9047_806_0	4	2009.01	PROVIDENCE HEALTH PLAN	Providence Health Plan	www.providence.org/healthplans	01	02		1		H9047	806	0	2009	Providence Medicare Choice Group Plan	Portland Metro, Willamette Valley, Clark County		1	2			150	2						(503)-574-8000	(800)-603-2340	(503)-574-8702	(888)-244-6642	(503)-574-5000	(800)-988-0088	(503)-574-8702	(888)-244-6642									http://www.providence.org/resources/healthplans/images/PME_DrugFormulary.pdf	www.providence.org/Health Plans/Members/Directories.htm
H9082	001	0	1	01	01	H9082_001_0	5	2009.01	MOLINA HEALTHCARE OF NEW MEXICO, INC.	Molina Healthcare of New Mexico, Inc.	www.molinamedicare.com	01	01		1		H9082	001	0	2009	Molina Medicare Options Plus	Bernalillo,DonaAna,McKinley,Otero,SanJuan,Valencia		2	1	3			2			1	1		(505)-342-4660	(866)-440-0127	(800)-346-4128	(800)-346-4128	(505)-342-4660	(866)-403-8293	(800)-346-4128	(800)-346-4128	(505)-342-4660	(866)-440-0127	(800)-346-4128	(800)-346-4128	(505)-342-4660	(866)-403-8293	(800)-346-4128	(800)-346-4128	www.molinahealthcare.com	https://eportal.molinahealthcare.com/eportal/providers/ProviderSearchAdv.aspx
H9082	002	0	1	01	01	H9082_002_0	5	2009.01	MOLINA HEALTHCARE OF NEW MEXICO, INC.	Molina Healthcare of New Mexico, Inc.	www.molinamedicare.com	01	01		1		H9082	002	0	2009	Molina Medicare Options	Bernalillo,DonaAna,McKinley,Otero,SanJuan,Valencia		2	2				2						(505)-342-4660	(866)-440-0127	(800)-346-4128	(800)-346-4128	(505)-342-4660	(866)-403-8293	(800)-346-4128	(800)-346-4128	(505)-342-4660	(866)-440-0127	(800)-346-4128	(800)-346-4128	(505)-342-4660	(866)-403-8293	(800)-346-4128	(800)-346-4128	www.molinahealthcare.com	https://eportal.molinahealthcare.com/eportal/providers/ProviderSearchAdv.aspx
H9101	007	0	1	01	01	H9101_007_0	7	2009.01	ELDERPLAN, INC.  - SHMO	Elderplan, Inc.	www.Elderplan.org	01	01		1		H9101	007	0	2009	Elderplan, Inc. Classic	New York City Metropolitan Area		2	1	1	2		2			2			(718)-921-7898	(800)-353-3765	(800)-662-1220	(800)-662-1220	(866)-695-8101	(866)-695-8101	(800)-662-1220	(800)-662-1220	(718)-921-7898	(800)-353-3765	(800)-662-1220	(800)-662-1220	(866)-695-8101	(866)-695-8101	(800)-662-1220	(800)-662-1220	www.elderplan.org	http://www.elderplan.org
H9103	001	0	1	01	01	H9103_001_0	4	2009.01	KAISER FOUNDATION HP OF THE N W	Kaiser Permanente Senior Advantage	www.kp.org	01	01		1		H9103	001	0	2009	Senior Advantage II	Portland-Vancouver Metro, Salem OR		2	2				2						(877)-221-8221		(800)-735-2900		(877)-221-8221		(800)-735-2900		(877)-221-8221	(877)-221-8221	(800)-735-2900		(877)-221-8221	(877)-221-8221	(800)-735-2900		www.kp.org/seniorrx	www.kp.org
H9104	006	0	1	01	01	H9104_006_0	11	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H9104	006	0	2009	SCAN Health Plan	SCAN Legacy - Los Angeles		2	1	1	2		2			2			(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	http://www.scanhealthplan.com
H9104	007	0	1	01	01	H9104_007_0	10	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H9104	007	0	2009	SCAN Health Plan	SCAN Legacy - Orange		2	1	1	2		2			2			(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	http://www.scanhealthplan.com
H9104	008	0	1	01	01	H9104_008_0	10	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H9104	008	0	2009	SCAN Health Plan	SCAN Legacy - Riverside		2	1	1	2		2			2			(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	http://www.scanhealthplan.com
H9104	009	0	1	01	01	H9104_009_0	10	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H9104	009	0	2009	SCAN Health Plan	SCAN Legacy - San Bernardino		2	1	1	2		2			2			(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	http://www.scanhealthplan.com
H9104	013	0	1	01	01	H9104_013_0	10	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H9104	013	0	2009	SCAN Health Plan	SCAN - Los Angeles Medicare-MediCal HCBS		2	1	3			2			1	1		(866)-722-6725	(866)-722-6725	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(866)-722-6725	(866)-722-6725	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	http://www.scanhealthplan.com
H9104	014	0	1	01	01	H9104_014_0	10	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H9104	014	0	2009	SCAN Health Plan	SCAN - Riverside Medicare-MediCal HCBS		2	1	3			2			1	1		(866)-722-6725	(866)-722-6725	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(866)-722-6725	(866)-722-6725	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	http://www.scanhealthplan.com
H9104	015	0	1	01	01	H9104_015_0	10	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H9104	015	0	2009	SCAN  Health Plan	SCAN - San Bernardino Medicare-MediCal HCBS		2	1	3			2			1	1		(866)-722-6725	(866)-722-6725	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(866)-722-6725	(866)-722-6725	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	http://www.scanhealthplan.com
H9104	801	0	1	01	01	H9104_801_0	4	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H9104	801	0	2009	SCAN Employer Group	SCAN Employer Group		1	2				2						(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929									http://www.scanhealthplan.com	http://www.scanhealthplan.com
H9104	802	0	1	01	01	H9104_802_0	4	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H9104	802	0	2009	SCAN Employer Group	SCAN Employer Group		1	2				2						(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929									http://www.scanhealthplan.com	http://www.scanhealthplan.com
H9104	803	0	1	01	01	H9104_803_0	4	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H9104	803	0	2009	SCAN Employer Group	SCAN Employer Group		1	2				2						(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	http://www.scanhealthplan.com
H9104	804	0	1	01	01	H9104_804_0	4	2009.01	SCAN HEALTH PLAN	SCAN Health Plan	www.scanhealthplan.com	01	01		1		H9104	804	0	2009	SCAN Employer Group	SCAN Employer Group		1	2				2						(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	(800)-559-3500	(800)-559-3500	(800)-735-2929	(800)-735-2929	(800)-915-7226	(800)-915-7226	(800)-735-2929	(800)-735-2929	http://www.scanhealthplan.com	http://www.scanhealthplan.com
H9149	002	0	1	02	01	H9149_002_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.securehorizons.com	01	02		1		H9149	002	0	2009	SecureHorizons MedicareComplete	East Baton Rouge, LA		2	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-854-4317	(800)-854-4317	(888)-685-8480		(800)-854-4317	(800)-854-4317	(888)-685-8480		www.rxsolutions.com	www.securehorizons.com
H9149	801	0	1	02	01	H9149_801_0	1	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.securehorizons.com	01	02		1		H9149	801	0	2009	Medicare Complete Retiree Plan	Select Counties in LA		1	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-854-4317	(800)-854-4317	(888)-685-8480		(800)-854-4317	(800)-854-4317	(888)-685-8480		www.rxsolutions.com	www.securehorizons.com
H9149	802	0	1	02	01	H9149_802_0	1	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.securehorizons.com	01	02		1		H9149	802	0	2009	Medicare Complete Retiree Plan	Select Counties in LA		1	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671										www.rxsolutions.com	www.securehorizons.com
H9149	803	0	1	02	01	H9149_803_0	1	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.securehorizons.com	01	02		1		H9149	803	0	2009	Medicare Complete Retiree Plan	Select Counties in LA		1	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		(800)-854-4317	(800)-854-4317	(888)-685-8480		(800)-854-4317	(800)-854-4317	(888)-685-8480		www.rxsolutions.com	www.securehorizons.com
H9149	804	0	1	02	01	H9149_804_0	1	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.securehorizons.com	01	02		1		H9149	804	0	2009	Medicare Complete Retiree Plan	Select Counties in LA		1	2				2						(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671										www.rxsolutions.com	www.securehorizons.com
H9266	001	0	1	20	08	H9266_001_0	1	2009.01	PIEDMONT HEALTH SERVICES, INC.	Piedmont Health SeniorCare	www.piedmonthealthseniorcare.org	08	20		1		H9266	001	0	2009	Piedmont Health SeniorCare - Dual	Piedmont Region of NC		2	2				2														(336)-532-0000	(877)-714-2100			(336)-532-0000	(877)-714-2100			www.piedmonthealth.org	
H9266	003	0	1	20	08	H9266_003_0	1	2009.01	PIEDMONT HEALTH SERVICES, INC.	Piedmont Health SeniorCare	www.piedmonthealthseniorcare.org	08	20		1		H9266	003	0	2009	Piedmont Health SeniorCare - Medicare only	Piedmont Region of NC		2	2				2														(336)-532-0000	(877)-714-2100			(336)-532-0000	(877)-714-2100			www.piedmonthealth.org	
H9302	001	0	1	01	01	H9302_001_0	5	2009.01	PUGET SOUND HEALTH PARTNERS, INC.	Puget Sound Health Partners	www.OurPSHP.com	01	01		1		H9302	001	0	2009	Partners Apex Plus Rx	Pierce, Thurston and Snohomish Counties		2	2				2						(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	www.ourphsp.com	http://www.OurPSHP.com
H9302	002	0	1	01	01	H9302_002_0	2	2009.01	PUGET SOUND HEALTH PARTNERS, INC.	Puget Sound Health Partners	www.OurPSHP.com	01	01		1		H9302	002	0	2009	Partners Apex	Pierce, Thurston and Snohomish Counties		2	2				2						(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141									www.ourphsp.com	http://www.OurPSHP.com
H9302	003	0	1	01	01	H9302_003_0	5	2009.01	PUGET SOUND HEALTH PARTNERS, INC.	Puget Sound Health Partners	www.OurPSHP.com	01	01		1		H9302	003	0	2009	Partners Charter Plus Rx	King, Pierce, Thurston and Snohomish Counties		2	2				2						(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	www.ourphsp.com	http://www.OurPSHP.com
H9302	004	0	1	01	01	H9302_004_0	2	2009.01	PUGET SOUND HEALTH PARTNERS, INC.	Puget Sound Health Partners	www.OurPSHP.com	01	01		1		H9302	004	0	2009	Partners Charter	King, Pierce, Thurston and Snohomish Counties		2	2				2						(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141									www.ourphsp.com	http://www.OurPSHP.com
H9302	005	0	1	01	01	H9302_005_0	5	2009.01	PUGET SOUND HEALTH PARTNERS, INC.	Puget Sound Health Partners	www.OurPSHP.com	01	01		1		H9302	005	0	2009	Partners Apex Plus Rx King County	King County		2	2				2						(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	www.ourphsp.com	http://www.OurPSHP.com
H9302	006	0	1	01	01	H9302_006_0	2	2009.01	PUGET SOUND HEALTH PARTNERS, INC.	Puget Sound Health Partners	www.OurPSHP.com	01	01		1		H9302	006	0	2009	Partners Apex King County	King County		2	2				2						(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141									www.ourphsp.com	http://www.OurPSHP.com
H9302	007	0	1	01	01	H9302_007_0	5	2009.01	PUGET SOUND HEALTH PARTNERS, INC.	Puget Sound Health Partners	www.OurPSHP.com	01	01		1		H9302	007	0	2009	Partners Sound Plus Rx	Pierce, Thurston and Snohomish Counties		2	2				2						(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	www.ourphsp.com	http://www.OurPSHP.com
H9302	008	0	1	02	01	H9302_008_0	7	2009.01	PUGET SOUND HEALTH PARTNERS, INC.	Puget Sound Health Partners	www.OurPSHP.com	01	02		1		H9302	008	0	2009	Partners Summit Plus Rx	King, Pierce, Thurston and Snohomish Counties		2	2				2						(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	www.ourphsp.com	http://www.OurPSHP.com
H9302	801	0	1	02	01	H9302_801_0	3	2009.01	PUGET SOUND HEALTH PARTNERS, INC.	Puget Sound Health Partners	www.OurPSHP.com	01	02		1		H9302	801	0	2009	Partners Plus Rx	King, Pierce, Thurston and Snohomish Counties		1	2				2						(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	(253)-779-8830	(866)-789-7747	(253)-284-3900	(866)-264-4141	www.ourphsp.com	http://www.OurPSHP.com
H9313	007	0	1	02	01	H9313_007_0	4	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plans from Medical Mutual of Ohio	www.Advantage-Plan.com	01	02		1		H9313	007	0	2009	Advantage Plan Zero Premium with Rx	Ohio		2	2				2						(800)-982-3117	(800)-982-3117	(800)-982-8109	(800)-982-8109	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	(800)-935-9952	(800)-935-9952	(800)-716-3231	(800)-716-3231	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	www.Advantage-Plan.com	www.Advantage-Plan.com
H9313	008	0	1	02	01	H9313_008_0	2	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plans from Medical Mutual of Ohio	www.Advantage-Plan.com	01	02		1		H9313	008	0	2009	Advantage Plan Zero Premium without Rx	Ohio		2	2				2						(800)-982-3117	(800)-982-3117	(800)-982-8109	(800)-982-8109	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109									www.Advantage-Plan.com	www.Advantage-Plan.com
H9313	009	0	1	02	01	H9313_009_0	2	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plans from Medical Mutual of Ohio	www.Advantage-Plan.com	01	02		1		H9313	009	0	2009	Advantage Plan Premium without Rx	Ohio		2	2				2						(800)-982-3117	(800)-982-3117	(800)-982-8109	(800)-982-8109	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109									www.Advantage-Plan.com	www.Advantage-Plan.com
H9313	010	1	1	01	01	H9313_010_1	4	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plans from Medical Mutual of Ohio	www.Advantage-Plan.com	01	01		1		H9313	010	1	2009	Advantage Plan Standard	State of Ohio	Advantage Metropolitan Service Area	2	2				2						(800)-982-3117	(800)-982-3117	(800)-982-8109	(800)-982-8109	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	(800)-935-9952	(800)-935-9952	(800)-716-3231	(800)-716-3231	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	www.Advantage-Plan.com	www.Advantage-Plan.com
H9313	010	2	1	01	01	H9313_010_2	4	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plans from Medical Mutual of Ohio	www.Advantage-Plan.com	01	01		1		H9313	010	2	2009	Advantage Plan Standard	State of Ohio	Advantage Non Metropolitan Service Area	2	2				2						(800)-982-3117	(800)-982-3117	(800)-982-8109	(800)-982-8109	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	(800)-935-9952	(800)-935-9952	(800)-716-3231	(800)-716-3231	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	www.Advantage-Plan.com	www.Advantage-Plan.com
H9313	011	1	1	02	01	H9313_011_1	4	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plans from Medical Mutual of Ohio	www.Advantage-Plan.com	01	02		1		H9313	011	1	2009	Advantage Plan Value	State of Ohio	Ohio Metropolitan Service Area	2	2				2						(800)-982-3117	(800)-982-3117	(800)-982-8109	(800)-982-8109	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	(800)-935-9952	(800)-935-9952	(800)-716-3231	(800)-716-3231	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	www.Advantage-Plan.com	www.Advantage-Plan.com
H9313	011	2	1	02	01	H9313_011_2	4	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plans from Medical Mutual of Ohio	www.Advantage-Plan.com	01	02		1		H9313	011	2	2009	Advantage Plan Value	State of Ohio	Ohio Non Metropolitan Service Area	2	2				2						(800)-982-3117	(800)-982-3117	(800)-982-8109	(800)-982-8109	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	(800)-935-9952	(800)-935-9952	(800)-716-3231	(800)-716-3231	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	www.Advantage-Plan.com	www.Advantage-Plan.com
H9313	012	1	1	02	01	H9313_012_1	5	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plans from Medical Mutual of Ohio	www.Advantage-Plan.com	01	02		1		H9313	012	1	2009	Advantage Plan Premium	State of Ohio	Ohio Metropolitan Service Area	2	2				2						(800)-982-3117	(800)-982-3117	(800)-982-8109	(800)-982-8109	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	(800)-935-9952	(800)-935-9952	(800)-716-3231	(800)-716-3231	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	www.Advantage-Plan.com	www.Advantage-Plan.com
H9313	012	2	1	02	01	H9313_012_2	5	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plans from Medical Mutual of Ohio	www.Advantage-Plan.com	01	02		1		H9313	012	2	2009	Advantage Plan Premium	State of Ohio	Ohio Non Metropolitan Service Area	2	2				2						(800)-982-3117	(800)-982-3117	(800)-982-8109	(800)-982-8109	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	(800)-935-9952	(800)-935-9952	(800)-716-3231	(800)-716-3231	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	www.Advantage-Plan.com	www.Advantage-Plan.com
H9313	801	0	1	02	01	H9313_801_0	2	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plans from Medical Mutual of Ohio	www.Advantage-Plan.com	01	02		1		H9313	801	0	2009	Employer HMOPOS CY with PD	Ohio		1	2				2						(800)-982-3117	(800)-982-3117	(800)-982-8109	(800)-982-8109	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	(800)-935-9952	(800)-935-9952	(800)-716-3231	(800)-716-3231	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	www.Advantage-Plan.com	www.Advantage-Plan.com
H9313	802	0	1	02	01	H9313_802_0	2	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plans from Medical Mutual of Ohio	www.Advantage-Plan.com	01	02		1		H9313	802	0	2009	Employer HMOPOS non-CY with PD	Ohio		1	2				2						(800)-982-3117	(800)-982-3117	(800)-982-8109	(800)-982-8109	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	(800)-935-9952	(800)-935-9952	(800)-716-3231	(800)-716-3231	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	www.Advantage-Plan.com	www.Advantage-Plan.com
H9313	803	0	1	02	01	H9313_803_0	2	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plans from Medical Mutual of Ohio	www.Advantage-Plan.com	01	02		1		H9313	803	0	2009	Employer HMOPOS CY without PD	Ohio		1	2				2						(800)-982-3117	(800)-982-3117	(800)-982-8109	(800)-982-8109	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109									www.Advantage-Plan.com	www.Advantage-Plan.com
H9313	804	0	1	02	01	H9313_804_0	2	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plans from Medical Mutual of Ohio	www.Advantage-Plan.com	01	02		1		H9313	804	0	2009	Employer HMOPOS non-CY without Pd	Ohio		1	2				2						(800)-982-3117	(800)-982-3117	(800)-982-8109	(800)-982-8109	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109									www.Advantage-Plan.com	www.Advantage-Plan.com
H9313	805	0	1	01	01	H9313_805_0	2	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plans from Medical Mutual of Ohio	www.Advantage-Plan.com	01	01		1		H9313	805	0	2009	Employer HMO CY with PD	Ohio		1	2				2						(800)-982-3117	(800)-982-3117	(800)-982-8109	(800)-982-8109	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	(800)-935-9952	(800)-935-9952	(800)-716-3231	(800)-716-3231	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	www.Advantage-Plan.com	www.Advantage-Plan.com
H9313	806	0	1	01	01	H9313_806_0	2	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plans from Medical Mutual of Ohio	www.Advantage-Plan.com	01	01		1		H9313	806	0	2009	Employer HMO CY without PD	Ohio		1	2				2						(800)-982-3117	(800)-982-3117	(800)-982-8109	(800)-982-8109	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109									www.Advantage-Plan.com	www.Advantage-Plan.com
H9313	807	0	1	01	01	H9313_807_0	2	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plans from Medical Mutual of Ohio	www.Advantage-Plan.com	01	01		1		H9313	807	0	2009	Employer HMO non-CY with PD	Ohio		1	2				2						(800)-982-3117	(800)-982-3117	(800)-982-8109	(800)-982-8109	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	(800)-935-9952	(800)-935-9952	(800)-716-3231	(800)-716-3231	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	www.Advantage-Plan.com	www.Advantage-Plan.com
H9313	808	0	1	01	01	H9313_808_0	2	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plans from Medical Mutual of Ohio	www.Advantage-Plan.com	01	01		1		H9313	808	0	2009	Employer HMO non-CY without PD	Ohio		1	2				2						(800)-982-3117	(800)-982-3117	(800)-982-8109	(800)-982-8109	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109									www.Advantage-Plan.com	www.Advantage-Plan.com
H9385	001	0	1	01	01	H9385_001_0	8	2009.01	SCAN HEALTH PLAN OF ARIZONA	SCAN Health Plan Arizona	www.scanhealthplan.com/arizona/medicare/	01	01		1		H9385	001	0	2009	SCAN Health Plan Arizona	SCAN - Maricopa SNP		2	1	3			2			1	1		(602)-778-3300	(888)-540-7226	(800)-367-8939	(800)-367-8939	(602)-778-3300	(866)-563-7396	(800)-367-8939	(800)-367-8939	(602)-778-3300	(888)-540-7226	(800)-367-8939	(800)-367-8939	(602)-778-3300	(888)-540-7226	(800)-367-8939	(800)-367-8939	http://www.scanhealthplan.com/Arizona/Medicare	www.scanhealthplan.com
H9385	002	0	1	01	01	H9385_002_0	7	2009.01	SCAN HEALTH PLAN OF ARIZONA	SCAN Health Plan Arizona	www.scanhealthplan.com/arizona/medicare/	01	01		1		H9385	002	0	2009	SCAN Health Plan Arizona	SCAN - Maricopa MAPD		2	2				2						(602)-778-3300	(888)-540-7226	(800)-367-8939	(800)-367-8939	(602)-778-3300	(866)-563-7396	(800)-367-8939	(800)-367-8939	(602)-778-3300	(888)-540-7226	(800)-367-8939	(800)-367-8939	(602)-778-3300	(888)-540-7226	(800)-367-8939	(800)-367-8939	http://www.scanhealthplan.com/Arizona/Medicare	www.scanhealthplan.com
H9385	805	0	1	01	01	H9385_805_0	4	2009.01	SCAN HEALTH PLAN OF ARIZONA	SCAN Health Plan Arizona	www.scanhealthplan.com/arizona/medicare/	01	01		1		H9385	805	0	2009	SCAN Employer Group	SCAN - Employer Group Maricopa		1	2				2						(602)-778-3300	(888)-540-7226	(800)-367-8939	(800)-367-8939	(602)-778-3300	(866)-563-7396	(800)-367-8939	(800)-367-8939									http://www.scanhealthplan.com/Arizona/Medicare	www.scanhealthplan.com
H9385	806	0	1	01	01	H9385_806_0	4	2009.01	SCAN HEALTH PLAN OF ARIZONA	SCAN Health Plan Arizona	www.scanhealthplan.com/arizona/medicare/	01	01		1		H9385	806	0	2009	SCAN Employer Group - Maricopa County	SCAN Employer Group - Maricopa County		1	2				2						(602)-778-3300	(888)-540-7226	(800)-367-8939	(800)-367-8939	(602)-778-3300	(866)-563-7396	(800)-367-8939	(800)-367-8939									http://www.scanhealthplan.com/Arizona/Medicare	www.scanhealthplan.com
H9385	807	0	1	01	01	H9385_807_0	5	2009.01	SCAN HEALTH PLAN OF ARIZONA	SCAN Health Plan Arizona	www.scanhealthplan.com/arizona/medicare/	01	01		1		H9385	807	0	2009	SCAN Employer Group - Maricopa County	SCAN Employer Group - Maricopa County		1	2				2						(602)-778-3300	(888)-540-7226	(800)-367-8939	(800)-367-8939	(602)-778-3300	(866)-563-7396	(800)-367-8939	(800)-367-8939	(602)-778-3300	(888)-540-7226	(800)-367-8939	(800)-367-8939	(602)-778-3300	(888)-540-7226	(800)-367-8939	(800)-367-8939	http://www.scanhealthplan.com/Arizona/Medicare	www.scanhealthplan.com
H9385	808	0	1	01	01	H9385_808_0	5	2009.01	SCAN HEALTH PLAN OF ARIZONA	SCAN Health Plan Arizona	www.scanhealthplan.com/arizona/medicare/	01	01		1		H9385	808	0	2009	SCAN Employer Group - Maricopa County	SCAN Employer Group - Maricopa County		1	2				2						(602)-778-3300	(888)-540-7226	(800)-367-8939	(800)-367-8939	(602)-778-3300	(866)-563-7396	(800)-367-8939	(800)-367-8939	(602)-778-3300	(888)-540-7226	(800)-367-8939	(800)-367-8939	(602)-778-3300	(888)-540-7226	(800)-367-8939	(800)-367-8939	http://www.scanhealthplan.com/Arizona/Medicare	www.scanhealthplan.com
H9452	001	0	1	09	04	H9452_001_0	7	2009.01	ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	04	09	2	1		H9452	001	0	2009	SmartValue Classic	Select Counties, NV		2	2			96	2						(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(877)-831-3000	(877)-831-3000	(800)-297-1538	(800)-297-1538									www.anthem.com	
H9452	002	0	1	09	04	H9452_002_0	9	2009.01	ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	04	09	2	1		H9452	002	0	2009	SmartValue Plus	Nevada, Select Counties		2	2			1068	2						(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(877)-831-3000	(877)-831-3000	(800)-297-1538	(800)-297-1538	(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(877)-831-3000	(877)-831-3000	(800)-297-1538	(800)-297-1538	www.anthem.com	
H9452	801	0	1	09	04	H9452_801_0	3	2009.01	ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	04	09	2	1		H9452	801	0	2009	SmartValue Group Plan I	Nevada		1	2			4071	2						(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(888)-949-5384	(888)-949-5384	(800)-297-1538	(800)-297-1538	(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538	www.anthem.com	
H9452	802	0	1	09	04	H9452_802_0	3	2009.01	ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	04	09	2	1		H9452	802	0	2009	SmartValue Group Plan II	Nevada		1	2			4071	2						(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(888)-949-5384	(888)-949-5384	(800)-297-1538	(800)-297-1538									www.anthem.com	
H9452	803	0	1	09	04	H9452_803_0	3	2009.01	ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	04	09	2	1		H9452	803	0	2009	SmartValue Group Plan III	Nevada		1	2			4071	2						(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(888)-949-5384	(888)-949-5384	(800)-297-1538	(800)-297-1538	(888)-445-8916	(888)-445-8916	(800)-425-5705	(800)-425-5705	(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538	www.anthem.com	
H9466	001	0	1	01	01	H9466_001_0	8	2009.01	HMO MISSOURI, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H9466	001	0	2009	Anthem Senior Advantage Enhanced	Missouri - Select Counties		2	2			175	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-652-6387	(800)-652-6387	(800)-297-1538	(800)-297-1538	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-461-8065	(888)-853-7754		www.anthem.com	www.anthem.com
H9466	803	0	1	01	01	H9466_803_0	3	2009.01	HMO MISSOURI, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H9466	803	0	2009	Anthem Senior Advantage Group	Missouri - Select Counties		1	2			125	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-652-6387	(800)-652-6387	(800)-297-1538	(800)-297-1538	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-461-8065	(888)-853-7754		www.anthem.com	www.anthem.com
H9466	804	0	1	01	01	H9466_804_0	3	2009.01	HMO MISSOURI, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H9466	804	0	2009	Anthem Senior Advantage Group	Missouri - Select Counties		1	2			50	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-652-6387	(800)-652-6387	(800)-297-1538	(800)-297-1538									www.anthem.com	www.anthem.com
H9466	805	0	1	01	01	H9466_805_0	3	2009.01	HMO MISSOURI, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	01	01		1		H9466	805	0	2009	Anthem Senior Advantage Group	Missouri - Select Counties		1	2			25	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-652-6387	(800)-652-6387	(800)-297-1538	(800)-297-1538	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-461-8065	(888)-853-7754		www.anthem.com	www.anthem.com
H9503	001	0	1	04	01	H9503_001_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H9503	001	0	2009	HumanaChoicePPO PPO H9503-001	Clark and Nye Counties		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H9503	801	0	1	04	01	H9503_801_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H9503	801	0	2009	Humana Employer Sponsored	Select counties in NV		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H9503	802	0	1	04	01	H9503_802_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H9503	802	0	2009	Humana Employer Sponsored	Select counties in NV		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H9503	803	0	1	04	01	H9503_803_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H9503	803	0	2009	Humana Employer Sponsored Non-CY	Select counties in NV		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H9503	804	0	1	04	01	H9503_804_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	01	04		1		H9503	804	0	2009	Humana Employer Sponsored Non-CY	Select counties in NV		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
H9519	001	0	1	09	04	H9519_001_0	10	2009.01	INDEPENDENT HEALTH BENEFITS CORPORATION	Independent Health	www.independenthealth.com	04	09	2	1		H9519	001	0	2009	Independent Health Medicare Anywhere	New York State		2	2			225	2						(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-625-4900	(800)-958-4405	(716)-635-4840		(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-625-4900	(800)-958-4405	(716)-635-4840		www.independenthealth.com	
H9519	002	0	1	09	04	H9519_002_0	7	2009.01	INDEPENDENT HEALTH BENEFITS CORPORATION	Independent Health	www.independenthealth.com	04	09	2	1		H9519	002	0	2009	Independent Health Medicare Anywhere	New York State		2	2			100	2						(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-625-4900	(800)-958-4405	(716)-635-4840										www.independenthealth.com	
H9519	003	0	1	09	04	H9519_003_0	10	2009.01	INDEPENDENT HEALTH BENEFITS CORPORATION	Independent Health	www.independenthealth.com	04	09	2	1		H9519	003	0	2009	Independent Health Medicare Anywhere Basic	New York State		2	2			25	2						(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-625-4900	(800)-958-4405	(716)-635-4840		(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-625-4900	(800)-958-4405	(716)-635-4840		www.independenthealth.com	
H9519	801	0	1	09	04	H9519_801_0	6	2009.01	INDEPENDENT HEALTH BENEFITS CORPORATION	Independent Health	www.independenthealth.com	04	09	2	1		H9519	801	0	2009	Independent Health Medicare Anywhere Base	Western New York and Deemed Medicare Network		1	2			1025	2						(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-625-4900	(800)-958-4405	(716)-635-4840		(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-625-4900	(800)-958-4405	(716)-635-4840		www.independenthealth.com	
H9519	803	0	1	09	04	H9519_803_0	6	2009.01	INDEPENDENT HEALTH BENEFITS CORPORATION	Independent Health	www.independenthealth.com	04	09	2	1		H9519	803	0	2009	Independent Health Medicare Anywhere Base	Western New York and Medicare Deemed Network		1	2			500	2						(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-625-4900	(800)-958-4405	(716)-635-4840		(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-625-4900	(800)-958-4405	(716)-635-4840		www.independenthealth.com	
H9519	804	0	1	09	04	H9519_804_0	6	2009.01	INDEPENDENT HEALTH BENEFITS CORPORATION	Independent Health	www.independenthealth.com	04	09	2	1		H9519	804	0	2009	Independent Health Medicare Anywhere Base	IH Network and Medicare Deemed Network		1	2			500	2						(716)-250-4401	(800)-665-1502	(716)-631-3108		(716)-625-4900	(800)-958-4405	(716)-635-4840										www.independenthealth.com	
H9615	001	0	1	04	01	H9615_001_0	6	2009.01	MVP HEALTH PLAN, INC.	MVP GoldAnywhere	www.mvphealthcare.com	01	04		1		H9615	001	0	2009	MVP GoldAnywhere	East/Central Region		2	2			2000	2						(800)-209-3945	(800)-209-3945	(800)-662-1220	(800)-662-1220	(800)-671-7504	(800)-671-7504	(800)-662-1220	(800)-662-1220									www.mvphealthcare.com	www.mvphealthcare.com
H9615	002	0	1	04	01	H9615_002_0	8	2009.01	MVP HEALTH PLAN, INC.	MVP GoldAnywhere	www.mvphealthcare.com	01	04		1		H9615	002	0	2009	MVP GoldAnywhere Rx	East/Central Region		2	2			2000	2						(800)-209-3945	(800)-209-3945	(800)-662-1220	(800)-662-1220	(800)-671-7504	(800)-671-7504	(800)-662-1220	(800)-662-1220	(800)-209-3945	(800)-209-3945	(800)-662-1220	(800)-662-1220	(800)-671-7504	(800)-671-7504	(800)-662-1220	(800)-662-1220	www.mvphealthcare.com	www.mvphealthcare.com
H9615	003	0	1	04	01	H9615_003_0	6	2009.01	MVP HEALTH PLAN, INC.	MVP GoldAnywhere	www.mvphealthcare.com	01	04		1		H9615	003	0	2009	MVP GoldAnywhere	Mid-Hudson Region		2	2			2000	2						(800)-209-3945	(800)-209-3945	(800)-662-1220	(800)-662-1220	(800)-671-7504	(800)-671-7504	(800)-662-1220	(800)-662-1220									www.mvphealthcare.com	www.mvphealthcare.com
H9615	004	0	1	04	01	H9615_004_0	9	2009.01	MVP HEALTH PLAN, INC.	MVP GoldAnywhere	www.mvphealthcare.com	01	04		1		H9615	004	0	2009	MVP GoldAnywhere Rx	Mid-Hudson Region		2	2			2000	2						(800)-209-3945	(800)-209-3945	(800)-662-1220	(800)-662-1220	(800)-671-7504	(800)-671-7504	(800)-662-1220	(800)-662-1220	(800)-209-3945	(800)-209-3945	(800)-662-1220	(800)-662-1220	(800)-671-7504	(800)-671-7504	(800)-662-1220	(800)-662-1220	www.mvphealthcare.com	www.mvphealthcare.com
H9615	802	0	1	04	01	H9615_802_0	9	2009.01	MVP HEALTH PLAN, INC.	MVP GoldAnywhere	www.mvphealthcare.com	01	04		1		H9615	802	0	2009	MVP GoldAnywhere Rx - Employer Group	East/Central Region		1	2			982	2						(800)-209-3945	(800)-209-3945	(800)-662-1220	(800)-662-1220	(800)-671-7504	(800)-671-7504	(800)-662-1220	(800)-662-1220	(800)-209-3945	(800)-209-3945	(800)-662-1220	(800)-662-1220	(800)-671-7504	(800)-671-7504	(800)-662-1220	(800)-662-1220	www.mvphealthcare.com	www.mvphealthcare.com
H9615	804	0	1	04	01	H9615_804_0	9	2009.01	MVP HEALTH PLAN, INC.	MVP GoldAnywhere	www.mvphealthcare.com	01	04		1		H9615	804	0	2009	MVP GoldAnywhere Rx - Employer Group	Mid-Hudson Region		1	2			130	2						(800)-209-3945	(800)-209-3945	(800)-662-1220	(800)-662-1220	(800)-671-7504	(800)-671-7504	(800)-662-1220	(800)-662-1220	(800)-209-3945	(800)-209-3945	(800)-662-1220	(800)-662-1220	(800)-671-7504	(800)-671-7504	(800)-662-1220	(800)-662-1220	www.mvphealthcare.com	www.mvphealthcare.com
H9663	001	0	1	04	01	H9663_001_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H9663	001	0	2009	Aetna Golden Choice Standard Plan	Memphis and Nashville		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H9663	002	0	1	04	01	H9663_002_0	5	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H9663	002	0	2009	Aetna Golden Choice Premier Plan	Memphis and Nashville		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H9663	801	0	1	04	01	H9663_801_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H9663	801	0	2009	Aetna Golden Choice Plan	Davidson and Shelby Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H9663	802	0	1	04	01	H9663_802_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	http://www.aetnamedicare.com	01	04		1		H9663	802	0	2009	Aetna Golden Choice Plan w/Rx CY	Davidson and Shelby Counties		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
H9670	001	0	1	04	01	H9670_001_0	6	2009.01	UPMC HEALTH BENEFITS, INC.	UPMC Health Plan	www.upmchealthplan.com	01	04		1		H9670	001	0	2009	UPMC for Life PPO Rx Enhanced (OH)	Ohio		2	2			100	2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H9670	002	0	1	04	01	H9670_002_0	6	2009.01	UPMC HEALTH BENEFITS, INC.	UPMC Health Plan	www.upmchealthplan.com	01	04		1		H9670	002	0	2009	UPMC for Life PPO Rx Enhanced (WV)	West Virginia		2	2			100	2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H9670	801	0	1	04	01	H9670_801_0	4	2009.01	UPMC HEALTH BENEFITS, INC.	UPMC Health Plan	www.upmchealthplan.com	01	04		1		H9670	801	0	2009	UPMC Employer Group PPO	Ohio and West Virginia		1	2				2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629									http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H9670	802	0	1	04	01	H9670_802_0	4	2009.01	UPMC HEALTH BENEFITS, INC.	UPMC Health Plan	www.upmchealthplan.com	01	04		1		H9670	802	0	2009	UPMC Employer Group PPO - D (CY)	Ohio and West Virginia		1	2				2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H9670	803	0	1	04	01	H9670_803_0	4	2009.01	UPMC HEALTH BENEFITS, INC.	UPMC Health Plan	www.upmchealthplan.com	01	04		1		H9670	803	0	2009	UPMC Employer Group PPO - D (FY)	Ohio and West Virginia		1	2				2						(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	www.upmchealthplan.com
H9720	008	0	1	09	04	H9720_008_0	9	2009.01	AMERICA'S 1ST CHOICE HEALTH PLANS, INC.	AMERICA'S 1ST CHOICE HEALTH PLANS, INC.	Americas1stChoice.com	04	09	2	1		H9720	008	0	2009	Patriot Plan	Select Counties in South Carolina		2	2			1000	2						(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961									www.americas1stchoice.com	
H9720	009	0	1	09	04	H9720_009_0	11	2009.01	AMERICA'S 1ST CHOICE HEALTH PLANS, INC.	AMERICA'S 1ST CHOICE HEALTH PLANS, INC.	Americas1stChoice.com	04	09	2	1		H9720	009	0	2009	Patriot Plus Plan	Select Counties in South Carolina		2	2			1000	2						(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	www.americas1stchoice.com	
H9720	010	0	1	09	04	H9720_010_0	8	2009.01	AMERICA'S 1ST CHOICE HEALTH PLANS, INC.	AMERICA'S 1ST CHOICE HEALTH PLANS, INC.	Americas1stChoice.com	04	09	2	1		H9720	010	0	2009	Presidential Plan	Select Counties in South Carolina		2	2			1000	2						(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961									www.americas1stchoice.com	
H9720	011	0	1	09	04	H9720_011_0	9	2009.01	AMERICA'S 1ST CHOICE HEALTH PLANS, INC.	AMERICA'S 1ST CHOICE HEALTH PLANS, INC.	Americas1stChoice.com	04	09	2	1		H9720	011	0	2009	Presidential Plus Plan	Select Counties in South Carolina		2	2			1000	2						(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	www.americas1stchoice.com	
H9720	024	0	1	09	04	H9720_024_0	5	2009.01	AMERICA'S 1ST CHOICE HEALTH PLANS, INC.	AMERICA'S 1ST CHOICE HEALTH PLANS, INC.	Americas1stChoice.com	04	09	2	1		H9720	024	0	2009	Ambassador	Select Counties in South Carolina		2	2			1000	2						(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961									www.americas1stchoice.com	
H9720	025	0	1	09	04	H9720_025_0	8	2009.01	AMERICA'S 1ST CHOICE HEALTH PLANS, INC.	AMERICA'S 1ST CHOICE HEALTH PLANS, INC.	Americas1stChoice.com	04	09	2	1		H9720	025	0	2009	Presidential Plan	Select Counties in South Carolina		2	2			1000	2						(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961									www.americas1stchoice.com	
H9720	026	0	1	09	04	H9720_026_0	11	2009.01	AMERICA'S 1ST CHOICE HEALTH PLANS, INC.	AMERICA'S 1ST CHOICE HEALTH PLANS, INC.	Americas1stChoice.com	04	09	2	1		H9720	026	0	2009	Presidential Plus Plan	Select Counties in South Carolina		2	2			1000	2						(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	www.americas1stchoice.com	
H9720	027	0	1	09	04	H9720_027_0	5	2009.01	AMERICA'S 1ST CHOICE HEALTH PLANS, INC.	AMERICA'S 1ST CHOICE HEALTH PLANS, INC.	Americas1stChoice.com	04	09	2	1		H9720	027	0	2009	Ambassador	Select Counties in South Carolina		2	2			1000	2						(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961	(866)-321-3947	(866)-321-3947	(866)-321-3961	(866)-321-3961									www.americas1stchoice.com	
H9793	001	0	1	09	04	H9793_001_0	9	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	04	09	2	1		H9793	001	0	2009	FreedomBlue PFFS Choice Plus	Region 1		2	2				2						(866)-675-8634	(866)-675-8634	(800)-988-0666	(800)-988-0666	(866)-730-4142	(866)-730-4142	(800)-227-8210	(800)-227-8210	(866)-675-8634	(866)-675-8634	(800)-988-0666	(800)-988-0666	(866)-730-4142	(866)-730-4142	(800)-227-8210	(800)-227-8210	http://highmark.medicare-approvedformularies.com/search.asp	
H9793	002	0	1	09	04	H9793_002_0	4	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	04	09	2	1		H9793	002	0	2009	FreedomBlue PFFS Choice	Region 1		2	2				2						(866)-675-8634	(866)-675-8634	(800)-988-0668	(800)-988-0668	(866)-730-4142	(866)-730-4142	(800)-227-8210	(800)-227-8210									http://highmark.medicare-approvedformularies.com/search.asp	
H9793	003	0	1	09	04	H9793_003_0	9	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	04	09	2	1		H9793	003	0	2009	FreedomBlue PFFS Enhanced	Region 1		2	2				2						(866)-675-8634	(866)-675-8634	(800)-988-0666	(800)-988-0666	(866)-730-4142	(866)-730-4142	(800)-227-8210	(800)-227-8210	(866)-675-8634	(866)-675-8634	(800)-988-0666	(800)-988-0666	(866)-730-4142	(866)-730-4142	(800)-227-8210	(800)-227-8210	http://highmark.medicare-approvedformularies.com/search.asp	
H9793	004	0	1	09	04	H9793_004_0	8	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	04	09	2	1		H9793	004	0	2009	FreedomBlue PFFS Choice Plus	Region 2		2	2				2						(866)-675-8634	(866)-675-8634	(800)-988-0668	(800)-988-0668	(866)-730-4142	(866)-730-4142	(800)-227-8210	(800)-227-8210	(866)-675-8634	(866)-675-8634	(800)-988-0668	(800)-988-0668	(866)-730-4142	(866)-730-4142	(800)-227-8210	(800)-227-8210	http://highmark.medicare-approvedformularies.com/search.asp	
H9793	005	0	1	09	04	H9793_005_0	4	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	04	09	2	1		H9793	005	0	2009	FreedomBlue PFFS Choice	Region 2		2	2				2						(866)-675-8634	(866)-675-8634	(800)-988-0668	(800)-988-0668	(866)-730-4142	(866)-730-4142	(800)-227-8210	(800)-227-8210									http://highmark.medicare-approvedformularies.com/search.asp	
H9793	006	0	1	09	04	H9793_006_0	8	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	04	09	2	1		H9793	006	0	2009	FreedomBlue PFFS Enhanced	Region 2		2	2				2						(866)-675-8634	(866)-675-8634	(800)-988-0668	(800)-988-0668	(866)-730-4142	(866)-730-4142	(800)-227-8210	(800)-227-8210	(866)-675-8634	(866)-675-8634	(800)-988-0668	(800)-988-0668	(866)-730-4142	(866)-730-4142	(800)-227-8210	(800)-227-8210	http://highmark.medicare-approvedformularies.com/search.asp	
H9793	801	0	1	09	04	H9793_801_0	3	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	04	09	2	1		H9793	801	0	2009	FreedomBlue PFFS MA	All Pennsylvania counties		1	2				2						(866)-675-8634	(866)-675-8634	(800)-988-0666	(800)-988-0666	(866)-730-4142	(866)-730-4142	(800)-227-8210	(800)-227-8210									http://highmark.medicare-approvedformularies.com/search.asp	
H9793	802	0	1	09	04	H9793_802_0	3	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	04	09	2	1		H9793	802	0	2009	FreedomBlue PFFS MA-PDP	All Pennsylvania counties		1	2				2						(866)-675-8634	(866)-675-8634	(800)-988-0666	(800)-988-0666	(866)-730-4142	(866)-730-4142	(800)-227-8210	(800)-227-8210	(866)-675-8634	(866)-675-8634	(800)-988-0666	(800)-988-0666	(866)-730-4142	(866)-730-4142	(800)-227-8210	(800)-227-8210	http://highmark.medicare-approvedformularies.com/search.asp	
H9793	804	0	1	09	04	H9793_804_0	3	2009.01	HIGHMARK, INC.	Highmark Inc.	www.highmark.com	04	09	2	1		H9793	804	0	2009	FreedomBlue PFFS MA-PDP Non-Calendar	All Pennsylvania counties		1	2				2						(866)-675-8634	(866)-675-8634	(800)-988-0666	(800)-988-0666	(866)-730-4142	(866)-730-4142	(800)-227-8210	(800)-227-8210	(866)-675-8634	(866)-675-8634	(800)-988-0666	(800)-988-0666	(866)-730-4142	(866)-730-4142	(800)-227-8210	(800)-227-8210	http://highmark.medicare-approvedformularies.com/search.asp	
H9847	001	0	1	04	01	H9847_001_0	5	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Advantra	www.nc.advantraplans.com	01	04		1		H9847	001	0	2009	Advantra	Triangle/Triad region		2	2			1031	2						(866)-731-9574	(866)-731-9574	(866)-784-4931	(866)-784-4931	(888)-880-1266	(888)-880-1266	(888)-880-1266	(888)-880-1266	(888)-698-0573	(888)-698-0573	(866)-236-1069	(866)-236-1069	(888)-880-1266	(888)-880-1266	(888)-880-1266	(888)-880-1266	www.chcadvantra.com	
H9847	801	0	1	04	01	H9847_801_0	5	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Advantra	www.nc.advantraplans.com	01	04		1		H9847	801	0	2009	Advantra	North Carolina		1	2			15	2						(866)-731-9574	(866)-731-9574	(866)-784-4931	(866)-784-4931	(888)-880-1266	(888)-880-1266	(888)-880-1266	(888)-880-1266									www.chcadvantra.com	
H9847	802	0	1	04	01	H9847_802_0	3	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Advantra	www.nc.advantraplans.com	01	04		1		H9847	802	0	2009	Advantra	North Carolina		1	2			15	2						(866)-731-9574	(866)-731-9574	(866)-784-4931	(866)-784-4931	(888)-880-1266	(888)-880-1266	(888)-880-1266	(888)-880-1266	(888)-698-0573	(888)-698-0573	(866)-236-1069	(866)-236-1069	(888)-880-1266	(888)-880-1266	(888)-880-1266	(888)-880-1266	www.chcadvantra.com	
H9847	803	0	1	04	01	H9847_803_0	3	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry Advantra	www.nc.advantraplans.com	01	04		1		H9847	803	0	2009	Advantra	North Carolina		1	2			15	2						(866)-731-9574	(866)-731-9574	(866)-784-4931	(866)-784-4931	(888)-880-1266	(888)-880-1266	(888)-880-1266	(888)-880-1266	(888)-698-0573	(888)-698-0573	(866)-236-1069	(866)-236-1069	(888)-880-1266	(888)-880-1266	(888)-880-1266	(888)-880-1266	www.chcadvantra.com	
H9859	001	0	1	01	01	H9859_001_0	9	2009.01	MVP HEALTH PLAN, INC,	MVP Gold	www.mvphealthcare.com	01	01		1		H9859	001	0	2009	MVP Gold	East/Central Region		2	2			1550	2						(800)-209-3945	(800)-209-3945	(800)-662-1220	(800)-662-1220	(800)-671-7504	(800)-671-7504	(800)-662-1220	(800)-662-1220									www.mvphealthcare.com	www.mvphealthcare.com
H9859	002	0	1	01	01	H9859_002_0	10	2009.01	MVP HEALTH PLAN, INC,	MVP Gold	www.mvphealthcare.com	01	01		1		H9859	002	0	2009	MVP Gold Rx	East/Central Region		2	2			1550	2						(800)-209-3945	(800)-209-3945	(800)-662-1220	(800)-662-1220	(800)-671-7504	(800)-671-7504	(800)-662-1220	(800)-662-1220	(800)-209-3945	(800)-209-3945	(800)-662-1220	(800)-662-1220	(800)-671-7504	(800)-671-7504	(800)-662-1220	(800)-662-1220	www.mvphealthcare.com	www.mvphealthcare.com
H9859	003	0	1	01	01	H9859_003_0	6	2009.01	MVP HEALTH PLAN, INC,	MVP Gold	www.mvphealthcare.com	01	01		1		H9859	003	0	2009	MVP Gold	Mid-Hudson Region		2	2			175	2						(800)-209-3945	(800)-209-3945	(800)-662-1220	(800)-662-1220	(800)-671-7504	(800)-671-7504	(800)-662-1220	(800)-662-1220									www.mvphealthcare.com	www.mvphealthcare.com
H9859	004	0	1	01	01	H9859_004_0	8	2009.01	MVP HEALTH PLAN, INC,	MVP Gold	www.mvphealthcare.com	01	01		1		H9859	004	0	2009	MVP Gold Rx	Mid-Hudson Region		2	2			175	2						(800)-209-3945	(800)-209-3945	(800)-662-1220	(800)-662-1220	(800)-671-7504	(800)-671-7504	(800)-662-1220	(800)-662-1220	(800)-209-3945	(800)-209-3945	(800)-662-1220	(800)-662-1220	(800)-671-7504	(800)-671-7504	(800)-662-1220	(800)-662-1220	www.mvphealthcare.com	www.mvphealthcare.com
H9859	801	0	1	01	01	H9859_801_0	10	2009.01	MVP HEALTH PLAN, INC,	MVP Gold	www.mvphealthcare.com	01	01		1		H9859	801	0	2009	MVP Gold - Employer Group	East/Central Region		1	2			310	2						(800)-209-3945	(800)-209-3945	(800)-662-1220	(800)-662-1220	(800)-671-7504	(800)-671-7504	(800)-662-1220	(800)-662-1220									www.mvphealthcare.com	www.mvphealthcare.com
H9859	802	0	1	01	01	H9859_802_0	9	2009.01	MVP HEALTH PLAN, INC,	MVP Gold	www.mvphealthcare.com	01	01		1		H9859	802	0	2009	MVP Gold Rx - Employer Group	East/Central Region		1	2			2790	2						(800)-209-3945	(800)-209-3945	(800)-662-1220	(800)-662-1220	(800)-671-7504	(800)-671-7504	(800)-662-1220	(800)-662-1220	(800)-209-3945	(800)-209-3945	(800)-662-1220	(800)-662-1220	(800)-671-7504	(800)-671-7504	(800)-662-1220	(800)-662-1220	www.mvphealthcare.com	www.mvphealthcare.com
H9859	803	0	1	01	01	H9859_803_0	9	2009.01	MVP HEALTH PLAN, INC,	MVP Gold	www.mvphealthcare.com	01	01		1		H9859	803	0	2009	MVP Gold Employer Group	Mid-Hudson Region		1	2			35	2						(800)-209-3945	(800)-209-3945	(800)-662-1220	(800)-662-1220	(800)-671-7504	(800)-671-7504	(800)-662-1220	(800)-662-1220									www.mvphealthcare.com	www.mvphealthcare.com
H9859	804	0	1	01	01	H9859_804_0	11	2009.01	MVP HEALTH PLAN, INC,	MVP Gold	www.mvphealthcare.com	01	01		1		H9859	804	0	2009	MVP Gold Rx - Employer Group	Mid-Hudson Region		1	2			315	2						(800)-209-3945	(800)-209-3945	(800)-662-1220	(800)-662-1220	(800)-671-7504	(800)-671-7504	(800)-662-1220	(800)-662-1220	(800)-209-3945	(800)-209-3945	(800)-662-1220	(800)-662-1220	(800)-671-7504	(800)-671-7504	(800)-662-1220	(800)-662-1220	www.mvphealthcare.com	www.mvphealthcare.com
H9882	001	0	1	01	01	H9882_001_0	5	2009.01	VIRGINIA PREMIER HEALTH PLAN, INC.	Virginia Premier Gold	www.vapremiergold.com	01	01		1		H9882	001	0	2009	Virginia Premier Gold	Tidewater, Richmond, Roanoke		2	1	3			2			1	1		(866)-616-1039	(866)-616-1039	(800)-828-1120	(800)-828-1120	(866)-616-1039	(866)-616-1039	(800)-828-1120	(800)-828-1120	(888)-877-5925	(888)-877-5925	(800)-828-1120	(800)-828-1120	(888)-877-5925	(888)-877-5925	(800)-828-1120	(800)-828-1120	www.vapremiergold.com	www.vapremiergold.com
H9882	002	0	1	01	01	H9882_002_0	6	2009.01	VIRGINIA PREMIER HEALTH PLAN, INC.	Virginia Premier Gold	www.vapremiergold.com	01	01		1		H9882	002	0	2009	Virginia Premier Gold Plus	Tidewater, Richmond, Roanoke		2	1	3			2			1	3		(866)-616-1039	(866)-616-1039	(800)-828-1120	(800)-828-1120	(866)-616-1039	(866)-616-1039	(800)-828-1120	(800)-828-1120	(888)-877-5925	(888)-877-5925	(800)-828-1120	(800)-828-1120	(888)-877-5925	(888)-877-5925	(800)-828-1120	(800)-828-1120	www.vapremiergold.com	www.vapremiergold.com
H9930	001	0	1	04	01	H9930_001_0	2	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H9930	001	0	2009	Today's Options PPO Select	Greater Indianapolis Market		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	www.todaysoptions.com
H9930	003	0	1	04	01	H9930_003_0	3	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H9930	003	0	2009	Today's Options PPO Select powered by CCRx	Greater Indianapolis Market		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H9930	009	0	1	04	01	H9930_009_0	4	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H9930	009	0	2009	Today's Options PPO Complete powered by CCRx	Greater Indianapolis Market		2	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H9930	801	0	1	04	01	H9930_801_0	6	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H9930	801	0	2009	Today's Options PPO - MA Group Plan	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083									http://www.todaysoptions.com	www.todaysoptions.com
H9930	802	0	1	04	01	H9930_802_0	6	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H9930	802	0	2009	Todays Options MAPD Group Plan	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H9930	803	0	1	04	01	H9930_803_0	6	2009.01	PYRAMID LIFE INSURANCE COMPANY	Universal American	www.todaysoptions.com	01	04		1		H9930	803	0	2009	Todays Options MAPD Group Plan - NCY	National		1	2				2						(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	(866)-422-5009	(866)-422-5009	(800)-958-2692	(800)-958-2692	(866)-422-1967	(866)-422-1967	(800)-777-9083	(800)-777-9083	http://www.todaysoptions.com	www.todaysoptions.com
H9931	001	0	1	09	04	H9931_001_0	6	2009.01	HEALTHPARTNERS INSURANCE COMPANY	HealthPartners Liberty Medicare	healthpartners.com/Medicare	04	09	2	1		H9931	001	0	2009	HealthPartners Liberty Medicare Rx	Greater Minnesota and Western Wisconsin		2	2			5	2						(952)-883-7676	(866)-233-8734	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156	(952)-883-7676	(866)-233-8734	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(852)-883-6060	(800)-443-0156	healthpartners.com/portal/3212.html	
H9931	801	0	1	09	04	H9931_801_0	5	2009.01	HEALTHPARTNERS INSURANCE COMPANY	HealthPartners Liberty Medicare	healthpartners.com/Medicare	04	09	2	1		H9931	801	0	2009	HealthPartners Liberty Medicare Rx CY	Nationwide		1	2				2						(952)-883-7676	(866)-233-8734	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156	(952)-883-7676	(866)-233-8734	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(852)-883-6060	(800)-443-0156	healthpartners.com/portal/3212.html	
H9951	001	0	1	01	01	H9951_001_0	3	2009.01	FIRSTSOLUTIONS DBA FIRST PLAN OF MINNESOTA	First Plan Blue	www.firstplan.org	01	01		1		H9951	001	0	2009	FirstPlan Blue Basic	Northeastern Minnesota		2	1	3		120	2			1	1		(877)-268-2997	(877)-268-2997	(218)-727-9870		(877)-268-2997	(877)-268-2997	(218)-727-9870		(877)-268-2997	(877)-268-2997	(218)-727-9870		(877)-268-2997	(877)-268-2997	(218)-727-9870		https:..myrxassistant.com/MyRxAssistant/formulary/FirstPlan	www.firstplan.org
R3175	001	0	1	31	11	R3175_001_0	6	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	11	31		1		R3175	001	0	2009	SecureHorizons MedicareCompleteChoicePlan3	State of Hawaii		2	2				2						(866)-238-7220		(888)-685-8480		(800)-555-5757		(800)-387-1074		(866)-238-7220	(866)-238-7220	(800)-387-1074		(800)-555-5757	(800)-555-5757	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
R3175	002	0	1	31	11	R3175_002_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	11	31		1		R3175	002	0	2009	SecureHorizons MedicareCompleteChoicePlan4	State of Hawaii		2	2				2						(866)-238-7220		(888)-685-8480		(800)-555-5757		(800)-387-1074										https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
R3175	003	0	1	31	11	R3175_003_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	11	31		1		R3175	003	0	2009	Evercare Plan RDP	State of Hawaii		2	1	3			2			2	2		(866)-622-8054	(866)-622-8054	(888)-685-8480		(888)-834-3721		(800)-387-1074		(866)-622-8054	(866)-622-8054	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
R3175	004	0	1	31	11	R3175_004_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	11	31		1		R3175	004	0	2009	Evercare Plan RMP	State of Hawaii		2	1	4			2			2		1111111110000000100000000001	(866)-622-8054	(866)-622-8054	(888)-685-8480		(888)-834-3721		(888)-685-8480		(866)-622-8054	(866)-622-8054	(800)-387-1074		(888)-834-3721	(888)-834-3721	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
R3175	801	0	1	31	11	R3175_801_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	11	31		1		R3175	801	0	2009	MedicareComplete Choice Plan 1 Retiree Plan	State of Hawaii		1	2				2						(888)-867-5548		(888)-685-8480		(866)-391-6664		(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		(866)-391-6664	(866)-391-6664	(888)-685-8480		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
R3175	802	0	1	31	11	R3175_802_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	11	31		1		R3175	802	0	2009	MedicareComplete Choice Plan 2 Retiree Plan	State of Hawaii		1	2				2						(888)-867-5548		(888)-685-8480		(866)-391-6664		(888)-685-8480										https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
R3175	803	0	1	31	11	R3175_803_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	11	31		1		R3175	803	0	2009	MedicareComplete Retiree Plan	Hawaii		1	2				2						(888)-867-5548		(888)-685-8480		(866)-391-6664		(888)-685-8480		(888)-867-5548	(888)-867-5548	(888)-685-8480		(866)-391-6664	(866)-391-6664	(888)-685-8480		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
R3175	804	0	1	31	11	R3175_804_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	11	31		1		R3175	804	0	2009	MedicareComplete Retiree Plan	Hawaii		1	2				2						(888)-867-5548		(888)-685-8480		(866)-391-6664		(888)-685-8480										https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
R3444	001	0	1	31	11	R3444_001_0	11	2009.01	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	www.careimprovementplus.com	11	31		1		R3444	001	0	2009	Care Improvement Plus Silver Rx	Arkansas and Missouri		2	1	4			2			1		1110000010000000000000000101	(866)-769-1415	(866)-769-1415	(866)-769-1505	(866)-769-1505	(866)-769-1513	(866)-769-1513	(866)-769-1505	(866)-769-1505	(800)-690-6033	(800)-690-6033	(866)-236-1069	(866)-236-1069	(866)-769-1513	(866)-769-1513	(866)-769-1505	(866)-769-1505	http://careimprovementplus.com/arkansas/medicare/formulary.aspx	www.careimprovementplus.com
R3444	002	0	1	31	11	R3444_002_0	9	2009.01	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	www.careimprovementplus.com	11	31		1		R3444	002	0	2009	Care Improvement Plus Gold Rx	Arkansas and Missouri		2	1	4			2			1		1110000010000000000000000001	(866)-769-1415	(866)-769-1415	(866)-769-1505	(866)-769-1505	(866)-769-1513	(866)-769-1513	(866)-769-1505	(866)-769-1505	(800)-690-6033	(800)-690-6033	(866)-236-1069	(866)-236-1069	(866)-769-1513	(866)-769-1513	(866)-769-1505	(866)-769-1505	http://careimprovementplus.com/arkansas/medicare/formulary.aspx	www.careimprovementplus.com
R3444	003	0	1	31	11	R3444_003_0	8	2009.01	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	www.careimprovementplus.com	11	31		1		R3444	003	0	2009	Care Improvement Plus Platinum Rx	Arkansas and Missouri		2	1	4			2			1		1110000010000000000000000001	(866)-769-1415	(866)-769-1415	(866)-769-1505	(866)-769-1505	(866)-769-1513	(866)-769-1513	(866)-769-1505	(866)-769-1505	(800)-690-6033	(800)-690-6033	(866)-236-1069	(866)-236-1069	(866)-769-1513	(866)-769-1513	(866)-769-1505	(866)-769-1505	http://careimprovementplus.com/arkansas/medicare/formulary.aspx	www.careimprovementplus.com
R3444	004	0	1	31	11	R3444_004_0	8	2009.01	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	www.careimprovementplus.com	11	31		1		R3444	004	0	2009	Care Improvement Plus Gold Rx Premier	Arkansas and Missouri		2	1	4			2			1		1110000010000000000000000001	(866)-769-1415	(866)-769-1415	(866)-769-1505	(866)-769-1505	(866)-769-1513	(866)-769-1513	(866)-769-1505	(866)-769-1505	(800)-690-6033	(800)-690-6033	(866)-236-1069	(866)-236-1069	(866)-769-1513	(866)-769-1513	(866)-769-1505	(866)-769-1505	http://careimprovementplus.com/arkansas/medicare/formulary.aspx	www.careimprovementplus.com
R3444	005	0	1	31	11	R3444_005_0	8	2009.01	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	www.careimprovementplus.com	11	31		1		R3444	005	0	2009	Care Improvement Plus Gold Rx Plus	Arkansas and Missouri		2	1	4			2			1		1110000010000000000000000001	(866)-769-1415	(866)-769-1415	(866)-769-1505	(866)-769-1505	(866)-769-1513	(866)-769-1513	(866)-769-1505	(866)-769-1505	(800)-690-6033	(800)-690-6033	(866)-236-1069	(866)-236-1069	(866)-769-1513	(866)-769-1513	(866)-769-1505	(866)-769-1505	http://careimprovementplus.com/arkansas/medicare/formulary.aspx	www.careimprovementplus.com
R3444	006	0	1	31	11	R3444_006_0	8	2009.01	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	www.careimprovementplus.com	11	31		1		R3444	006	0	2009	Care Improvement Plus Platinum Rx Plus	Arkansas and Missouri		2	1	4			2			1		1110000010000000000000000001	(866)-769-1415	(866)-769-1415	(866)-769-1505	(866)-769-1505	(866)-769-1513	(866)-769-1513	(866)-769-1505	(866)-769-1505	(800)-690-6033	(800)-690-6033	(866)-236-1069	(866)-236-1069	(866)-769-1513	(866)-769-1513	(866)-769-1505	(866)-769-1505	http://careimprovementplus.com/arkansas/medicare/formulary.aspx	www.careimprovementplus.com
R3444	007	0	1	31	11	R3444_007_0	8	2009.01	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Care Improvement Plus	www.careimprovementplus.com	11	31		1		R3444	007	0	2009	Care Improvement Plus Platinum Rx Premier	Arkansas and Missouri		2	1	4			2			1		1110000010000000000000000001	(866)-769-1415	(866)-769-1415	(866)-769-1505	(866)-769-1505	(866)-769-1513	(866)-769-1513	(866)-769-1505	(866)-769-1505	(800)-690-6033	(800)-690-6033	(866)-236-1069	(866)-236-1069	(866)-769-1513	(866)-769-1513	(866)-769-1505	(866)-769-1505	http://careimprovementplus.com/arkansas/medicare/formulary.aspx	www.careimprovementplus.com
R5287	001	0	1	31	11	R5287_001_0	6	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	11	31		1		R5287	001	0	2009	AARP MedicareCompleteChoicePlan2	State of Florida		2	2				2						(800)-643-4845		(888)-685-8480		(800)-547-5514		(866)-832-8671		(800)-643-4845	(800)-643-4845	(888)-685-8480		(800)-547-5514	(800)-547-5514	(866)-832-8671		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
R5287	002	0	1	31	11	R5287_002_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	11	31		1		R5287	002	0	2009	AARP MedicareCompleteChoicePlan3	State of Florida		2	2				2						(800)-643-4845		(888)-685-8480		(800)-547-5514		(866)-832-8671										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
R5287	003	0	1	31	11	R5287_003_0	6	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	11	31		1		R5287	003	0	2009	Evercare Plan RDP	State of Florida		2	1	3			2			2	2		(877)-702-5110		(888)-685-8480		(888)-834-3721		(888)-685-8480		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(888)-685-8480		www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
R5287	801	0	1	31	11	R5287_801_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	11	31		1		R5287	801	0	2009	MedicareComplete Choice Plan 1 Retiree Plan	State of Florida		1	2				2						(888)-867-5548		(888)-685-8480		(800)-973-6467		(888)-685-8480		(888)-867-5548	(888)-867-5548			(800)-973-6467	(800)-973-6467			www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
R5287	802	0	1	31	11	R5287_802_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	11	31		1		R5287	802	0	2009	MedicareComplete Choice Plan 2 Retiree Plan	State of Florida		1	2				2						(888)-867-5548		(888)-685-8480		(800)-973-6467		(888)-685-8480										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
R5287	805	0	1	31	11	R5287_805_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	11	31		1		R5287	805	0	2009	MedicareComplete Retiree Plan	Florida		1	2				2						(888)-867-5548		(888)-685-8480		(800)-973-6467		(888)-685-8480		(888)-867-5548	(888)-867-5548			(800)-973-6467	(800)-973-6467			www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
R5287	806	0	1	31	11	R5287_806_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.aarpmedicarecomplete.com	11	31		1		R5287	806	0	2009	MedicareComplete Retiree Plan	Florida		1	2				2						(888)-867-5548		(888)-685-8480		(800)-973-6467		(888)-685-8480										www.aarpmedicarecomplete.com	https://www.aarpmedicarecomplete.com/ourplans/findaphysician.html
R5342	001	0	1	31	11	R5342_001_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	11	31		1		R5342	001	0	2009	SecureHorizons MedicareCompleteChoicePlan1	State of New York		2	2				2						(800)-711-6088		(888)-685-8480		(800)-555-5757		(800)-387-1074		(800)-711-6088	(800)-711-6088	(800)-387-1074		(800)-555-5757	(800)-555-5757	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
R5342	002	0	1	31	11	R5342_002_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	11	31		1		R5342	002	0	2009	SecureHorizons MedicareCompleteChoicePlan2	State of New York		2	2				2						(800)-711-6088		(888)-685-8480		(800)-555-5757		(800)-387-1074										https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
R5342	003	0	1	31	11	R5342_003_0	6	2009.01	UNITED HEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	11	31		1		R5342	003	0	2009	Evercare Plan RDP	State of New York		2	1	3			2			2	2		(877)-702-5110		(888)-685-8480		(888)-834-3721		(800)-387-1074		(877)-702-5110	(877)-702-5110	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
R5342	004	0	1	31	11	R5342_004_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	11	31		1		R5342	004	0	2009	Evercare Plan RMP	State of New York		2	1	4			2			2		1111111110000000100000000001	(877)-702-5110		(888)-685-8480		(888)-834-3721		(800)-387-1074		(877)-702-5110	(877)-702-5110	(800)-387-1074		(888)-834-3721	(888)-834-3721	(800)-387-1074		https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
R5342	801	0	1	31	11	R5342_801_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	11	31		1		R5342	801	0	2009	MedicareComplete Retiree Plan	State of New York		1	2				2						(888)-867-5548		(888)-685-8480		(800)-348-1760		(888)-685-8480		(888)-867-5548	(888)-867-5548			(800)-348-1760	(800)-348-1760			https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
R5342	802	0	1	31	11	R5342_802_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	11	31		1		R5342	802	0	2009	MedicareComplete Retiree Plan	State of New York		1	2				2						(888)-867-5548		(888)-685-8480		(800)-348-1760		(888)-685-8480										https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
R5342	803	0	1	31	11	R5342_803_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	11	31		1		R5342	803	0	2009	MedicareComplete Retiree Plan	New York		1	2				2						(888)-867-5548		(888)-685-8480		(800)-348-1760		(888)-685-8480		(888)-867-5548	(888)-867-5548			(800)-348-1760	(800)-348-1760			https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
R5342	804	0	1	31	11	R5342_804_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY OF NEW YORK	SecureHorizons by UnitedHealthcare	www.SecureHorizons.com	11	31		1		R5342	804	0	2009	MedicareComplete Retiree Plan	New York		1	2				2						(888)-867-5548		(888)-685-8480		(800)-348-1760		(888)-685-8480										https://www.securehorizons.com/ourplans/searchformulary.html	www.SecureHorizons.com
R5566	005	0	1	31	11	R5566_005_0	6	2009.01	BLUE CROSS BLUE SHIELD NORTHERN PLAINS ALLIANCE	MedicareBlue PPO	www.YourMedicareSolutions.com	11	31		1		R5566	005	0	2009	MedicareBlue PPO	States of IA, MN, MT, NE, ND, SD, WY		2	2			29892	2						(888)-457-3009	(888)-457-3009	(888)-457-3005	(888)-457-3005	(866)-434-2038	(866)-434-2038	(866)-456-1550	(866)-456-1550	(888)-457-3009	(888)-457-3009	(888)-457-3005	(888)-457-3005	(866)-434-2038	(866)-434-2038	(866)-456-1550	(866)-456-1550	www.YourMedicareSolutions.com	www.YourMedicareSolutions.com
R5566	804	0	1	31	11	R5566_804_0	4	2009.01	BLUE CROSS BLUE SHIELD NORTHERN PLAINS ALLIANCE	MedicareBlue PPO	www.YourMedicareSolutions.com	11	31		1		R5566	804	0	2009	Group MedicareBlue PPO	States of IA,MN,MT,ND,NE,SD,WY		1	2			10492	2						(888)-457-3009	(888)-457-3009	(888)-457-3005	(888)-457-3005	(866)-434-2038	(866)-434-2038	(866)-456-1550	(866)-456-1550									www.YourMedicareSolutions.com	www.YourMedicareSolutions.com
R5566	805	0	1	31	11	R5566_805_0	5	2009.01	BLUE CROSS BLUE SHIELD NORTHERN PLAINS ALLIANCE	MedicareBlue PPO	www.YourMedicareSolutions.com	11	31		1		R5566	805	0	2009	Group MedicareBlue PPO Plus Rx	States of IA,MN,MT,ND,NE,SD,WY		1	2			10492	2						(888)-457-3009	(888)-457-3009	(888)-457-3005	(888)-457-3005	(866)-434-2038	(866)-434-2038	(866)-456-1550	(866)-456-1550	(888)-457-3009	(888)-457-3009	(888)-457-3005	(888)-457-3005	(866)-434-2038	(866)-434-2038	(866)-456-1550	(866)-456-1550	www.YourMedicareSolutions.com	www.YourMedicareSolutions.com
R5595	001	0	1	31	11	R5595_001_0	8	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	aetnamedicare.com	11	31		1		R5595	001	0	2009	Aetna Golden Choice Regional  Standard Plan	New Jersey		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
R5595	003	0	1	31	11	R5595_003_0	9	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	aetnamedicare.com	11	31		1		R5595	003	0	2009	Aetna Golden Choice Regional Standard Plan	Mid-Atlantic (Maryland, Delaware and DC)		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
R5595	004	0	1	31	11	R5595_004_0	8	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	aetnamedicare.com	11	31		1		R5595	004	0	2009	Aetna Golden Choice Regional Premier Plan	Mid-Atlantic (Maryland, Delaware and DC)		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
R5595	005	0	1	31	11	R5595_005_0	10	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	aetnamedicare.com	11	31		1		R5595	005	0	2009	Aetna Golden Choice Regional Value Plan	Mid-Atlantic (Maryland, Delaware and DC)		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
R5595	006	0	1	31	11	R5595_006_0	10	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	aetnamedicare.com	11	31		1		R5595	006	0	2009	Aetna Golden Choice Care Advantage Plan	New Jersey		2	1	1	1		2			1			(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
R5595	007	0	1	31	11	R5595_007_0	8	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	aetnamedicare.com	11	31		1		R5595	007	0	2009	Aetna Golden Choice Regional Premier Plan	New Jersey		2	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
R5595	801	0	1	31	11	R5595_801_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	aetnamedicare.com	11	31		1		R5595	801	0	2009	Aetna Golden Choice Regional PPO Plan	New Jersey		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
R5595	802	0	1	31	11	R5595_802_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	aetnamedicare.com	11	31		1		R5595	802	0	2009	Aetna Golden Choice Plan w/Rx CY	New Jersey		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
R5595	803	0	1	31	11	R5595_803_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	aetnamedicare.com	11	31		1		R5595	803	0	2009	Aetna Golden Choice Regional PPO Plan	Mid-Atlantic (Maryland, Delaware and DC)		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323									http://www.aetnamedicare.com	http://www.aetna.com/docfind/
R5595	804	0	1	31	11	R5595_804_0	6	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	aetnamedicare.com	11	31		1		R5595	804	0	2009	Aetna Golden Choice Regional PPO Plan w/Rx	Mid-Atlantic (Maryland, Delaware and DC)		1	2				2						(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	(800)-282-5366	(800)-282-5366	(800)-628-3323	(800)-628-3323	(800)-832-2640	(800)-832-2640	(800)-628-3323	(800)-628-3323	http://www.aetnamedicare.com	http://www.aetna.com/docfind/
R5674	001	0	1	31	11	R5674_001_0	12	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	http://www.sierranevadaspectrum.com	11	31		1		R5674	001	0	2009	Sierra Nevada Spectrum	Nevada		2	2				2						(702)-562-8021	(877)-559-4512	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	(702)-562-8021	(877)-559-4512	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	http://www.sierranevadaspectrum.com	http://www.sierranevadaspectrum.com
R5674	801	0	1	31	11	R5674_801_0	7	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	http://www.sierranevadaspectrum.com	11	31		1		R5674	801	0	2009	Basic Group (with Drug) Coverage	Nevada		1	2				2						(702)-562-8021	(877)-559-4512	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	(702)-562-8021	(877)-559-4512	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	http://www.sierranevadaspectrum.com	http://www.sierranevadaspectrum.com
R5674	802	0	1	31	11	R5674_802_0	7	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	http://www.sierranevadaspectrum.com	11	31		1		R5674	802	0	2009	Basic Group MA Only Coverage	Nevada		1	2				2						(702)-562-8021	(877)-559-4512	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538									http://www.sierranevadaspectrum.com	http://www.sierranevadaspectrum.com
R5674	803	0	1	31	11	R5674_803_0	7	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	http://www.sierranevadaspectrum.com	11	31		1		R5674	803	0	2009	(NCY) Basic Group (With Drug) Coverage	Nevada		1	2				2						(702)-562-8021	(877)-559-4512	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	(702)-562-8021	(877)-559-4512	(702)-242-9214	(800)-349-3538	(702)-821-2300	(800)-274-6648	(702)-242-9214	(800)-349-3538	http://www.sierranevadaspectrum.com	http://www.sierranevadaspectrum.com
R5826	001	0	1	31	11	R5826_001_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	001	0	2009	HumanaChoicePPO PPO R5826-001	States of Alabama and Tennessee		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	002	0	1	31	11	R5826_002_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	002	0	2009	HumanaChoicePPO PPO R5826-002	States of Pennsylvania and West Virginia		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	003	0	1	31	11	R5826_003_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	003	0	2009	HumanaChoicePPO PPO R5826-003	States of North Carolina and Virginia		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	004	0	1	31	11	R5826_004_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	004	0	2009	HumanaChoicePPO PPO R5826-004	States of Georgia and South Carolina		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	005	0	1	31	11	R5826_005_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	005	0	2009	HumanaChoicePPO PPO R5826-005	State of Florida		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	006	0	1	31	11	R5826_006_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	006	0	2009	HumanaChoicePPO PPO R5826-006	State of Michigan		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	007	0	1	31	11	R5826_007_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	007	0	2009	HumanaChoicePPO PPO R5826-007	State of Ohio		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	008	0	1	31	11	R5826_008_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	008	0	2009	HumanaChoicePPO PPO R5826-008	States of Indiana and Kentucky		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	009	0	1	31	11	R5826_009_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	009	0	2009	HumanaChoicePPO PPO R5826-009	States of Illinois and Wisconsin		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	010	0	1	31	11	R5826_010_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	010	0	2009	HumanaChoicePPO PPO R5826-010	States of Arkansas and Missouri		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	011	0	1	31	11	R5826_011_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	011	0	2009	HumanaChoicePPO PPO R5826-011	States of Louisiana and Mississippi		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	012	0	1	31	11	R5826_012_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	012	0	2009	HumanaChoicePPO PPO R5826-012	State of Texas		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	013	0	1	31	11	R5826_013_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	013	0	2009	HumanaChoicePPO PPO R5826-013	States of Kansas and Oklahoma		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	014	0	1	31	11	R5826_014_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	014	0	2009	HumanaChoicePPO PPO R5826-014	State of Arizona		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	018	0	1	31	11	R5826_018_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	018	0	2009	HumanaChoicePPO PPO R5826-018	State of Florida		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	021	0	1	31	11	R5826_021_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	021	0	2009	HumanaChoicePPO PPO R5826-021	State of Ohio		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	023	0	1	31	11	R5826_023_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	023	0	2009	HumanaChoicePPO PPO R5826-023	States of Illinois and Wisconsin		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	026	0	1	31	11	R5826_026_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	026	0	2009	HumanaChoicePPO PPO R5826-026	State of Texas		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	049	0	1	31	11	R5826_049_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	049	0	2009	HumanaChoicePPO PPO SNP-OA R5826-049	States of North Carolina, Virginia		2	1	4			2			1		0000000000000000000000000001	(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	051	0	1	31	11	R5826_051_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	051	0	2009	HumanaChoicePPO PPO SNP-OA R5826-051	State of Florida		2	1	4			2			1		0000000000000000000000000001	(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	053	0	1	31	11	R5826_053_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	053	0	2009	HumanaChoicePPO PPO R5826-053	State of Michigan		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	054	0	1	31	11	R5826_054_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	054	0	2009	HumanaChoicePPO PPO SNP-OA R5826-054	State of Ohio		2	1	4			2			1		0000000000000000000000000001	(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	059	0	1	31	11	R5826_059_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	059	0	2009	HumanaChoicePPO PPO SNP-OA R5826-059	State of Texas		2	1	4			2			1		0000000000000000000000000001	(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	062	0	1	31	11	R5826_062_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	062	0	2009	HumanaChoicePPO PPO R5826-062	States of Pennsylvania and West Virginia		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	063	0	1	31	11	R5826_063_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	063	0	2009	HumanaChoicePPO PPO R5826-063	States of North Carolina and Virginia		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	064	0	1	31	11	R5826_064_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	064	0	2009	HumanaChoicePPO PPO R5826-064	States of Georgia and South Carolina		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	065	0	1	31	11	R5826_065_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	065	0	2009	HumanaChoicePPO PPO R5826-065	States of Alabama and Tennessee		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	066	0	1	31	11	R5826_066_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	066	0	2009	HumanaChoicePPO PPO R5826-066	States of Indiana and Kentucky		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	067	0	1	31	11	R5826_067_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	067	0	2009	HumanaChoicePPO PPO R5826-067	States of Arkansas and Missouri		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	068	0	1	31	11	R5826_068_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	068	0	2009	HumanaChoicePPO PPO R5826-068	States of Louisiana and Mississippi		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	069	0	1	31	11	R5826_069_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	069	0	2009	HumanaChoicePPO PPO R5826-069	States of Kansas and Oklahoma		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	070	0	1	31	11	R5826_070_0	4	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	070	0	2009	HumanaChoicePPO PPO R5826-070	State of Arizona		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	071	0	1	31	11	R5826_071_0	9	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	071	0	2009	HumanaChoicePPO PPO R5826-071	States of Illinois and Wisconsin		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	072	0	1	31	11	R5826_072_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	072	0	2009	HumanaChoicePPO PPO R5826-072	State of Michigan		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	073	0	1	31	11	R5826_073_0	5	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	073	0	2009	HumanaChoicePPO PPO R5826-073	States of Kansas and Oklahoma		2	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	801	0	1	31	11	R5826_801_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	801	0	2009	Humana Employer Sponsored	States of Alabama and Tennessee		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	802	0	1	31	11	R5826_802_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	802	0	2009	Humana Employer Sponsored	States of Pennsylvania and West Virginia		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	803	0	1	31	11	R5826_803_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	803	0	2009	Humana Employer Sponsored	States of North Carolina and Virginia		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	804	0	1	31	11	R5826_804_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	804	0	2009	Humana Employer Sponsored	States of Georgia and South Carolina		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	805	0	1	31	11	R5826_805_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	805	0	2009	Humana Employer Sponsored	State of Florida		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	806	0	1	31	11	R5826_806_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	806	0	2009	Humana Employer Sponsored	State of Michigan		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	807	0	1	31	11	R5826_807_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	807	0	2009	Humana Employer Sponsored	State of Ohio		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	808	0	1	31	11	R5826_808_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	808	0	2009	Humana Employer Sponsored	States of Indiana and Kentucky		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	809	0	1	31	11	R5826_809_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	809	0	2009	Humana Employer Sponsored	States of Illinois and Wisconsin		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	810	0	1	31	11	R5826_810_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	810	0	2009	Humana Employer Sponsored	States of Arkansas and Missouri		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	811	0	1	31	11	R5826_811_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	811	0	2009	Humana Employer Sponsored	States of Louisiana and Mississippi		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	812	0	1	31	11	R5826_812_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	812	0	2009	Humana Employer Sponsored	State of Texas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	813	0	1	31	11	R5826_813_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	813	0	2009	Humana Employer Sponsored	States of Kansas and Oklahoma		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	814	0	1	31	11	R5826_814_0	10	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	814	0	2009	Humana Employer Sponsored	State of Arizona		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	815	0	1	31	11	R5826_815_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	815	0	2009	Humana Employer Sponsored	States of Alabama and Tennessee		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	816	0	1	31	11	R5826_816_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	816	0	2009	Humana Employer Sponsored	States of Pennsylvania and West Virginia		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	817	0	1	31	11	R5826_817_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	817	0	2009	Humana Employer Sponsored	States of North Carolina and Virginia		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	818	0	1	31	11	R5826_818_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	818	0	2009	Humana Employer Sponsored	States of Georgia and South Carolina		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	819	0	1	31	11	R5826_819_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	819	0	2009	Humana Employer Sponsored	State of Florida		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	820	0	1	31	11	R5826_820_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	820	0	2009	Humana Employer Sponsored	State of Michigan		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	821	0	1	31	11	R5826_821_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	821	0	2009	Humana Employer Sponsored	State of Ohio		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	822	0	1	31	11	R5826_822_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	822	0	2009	Humana Employer Sponsored	States of Indiana and Kentucky		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	823	0	1	31	11	R5826_823_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	823	0	2009	Humana Employer Sponsored	States of Illinois and Wisconsin		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	824	0	1	31	11	R5826_824_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	824	0	2009	Humana Employer Sponsored	States of Arkansas and Missouri		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	825	0	1	31	11	R5826_825_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	825	0	2009	Humana Employer Sponsored	States of Louisiana and Mississippi		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	826	0	1	31	11	R5826_826_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	826	0	2009	Humana Employer Sponsored	State of Texas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	827	0	1	31	11	R5826_827_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	827	0	2009	Humana Employer Sponsored	States of Kansas and Oklahoma		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	828	0	1	31	11	R5826_828_0	10	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	828	0	2009	Humana Employer Sponsored	State of Arizona		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	831	0	1	31	11	R5826_831_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	831	0	2009	Humana Employer Sponsored Non-CY	States of Pennsylvania and West Virginia		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	832	0	1	31	11	R5826_832_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	832	0	2009	Humana Employer Sponsored Non-CY	States of North Carolina and Virginia		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	833	0	1	31	11	R5826_833_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	833	0	2009	Humana Employer Sponsored Non-CY	States of Georgia and South Carolina		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	834	0	1	31	11	R5826_834_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	834	0	2009	Humana Employer Sponsored Non-CY	State of Florida		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	835	0	1	31	11	R5826_835_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	835	0	2009	Humana Employer Sponsored Non-CY	States of Alabama and Tennessee		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	836	0	1	31	11	R5826_836_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	836	0	2009	Humana Employer Sponsored Non-CY	State of Michigan		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	837	0	1	31	11	R5826_837_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	837	0	2009	Humana Employer Sponsored Non-CY	State of Ohio		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	838	0	1	31	11	R5826_838_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	838	0	2009	Humana Employer Sponsored Non-CY	States of Indiana and Kentucky		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	839	0	1	31	11	R5826_839_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	839	0	2009	Humana Employer Sponsored Non-CY	States of Illinois and Wisconsin		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	840	0	1	31	11	R5826_840_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	840	0	2009	Humana Employer Sponsored Non-CY	States of Arkansas and Missouri		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	841	0	1	31	11	R5826_841_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	841	0	2009	Humana Employer Sponsored Non-CY	States of Louisiana and Mississippi		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	842	0	1	31	11	R5826_842_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	842	0	2009	Humana Employer Sponsored Non-CY	State of Texas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	843	0	1	31	11	R5826_843_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	843	0	2009	Humana Employer Sponsored Non-CY	States of Kansas and Oklahoma		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	844	0	1	31	11	R5826_844_0	8	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	844	0	2009	Humana Employer Sponsored Non-CY	State of Arizona		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486	(800)-457-4708	(800)-457-4708		(800)-833-3301	(800)-833-2364	(800)-833-2364		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	845	0	1	31	11	R5826_845_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	845	0	2009	Humana Employer Sponsored Non-CY	States of Pennsylvania and West Virginia		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	846	0	1	31	11	R5826_846_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	846	0	2009	Humana Employer Sponsored Non-CY	States of North Carolina and Virginia		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	847	0	1	31	11	R5826_847_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	847	0	2009	Humana Employer Sponsored Non-CY	States of Georgia and South Carolina		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	848	0	1	31	11	R5826_848_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	848	0	2009	Humana Employer Sponsored Non-CY	State of Florida		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	849	0	1	31	11	R5826_849_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	849	0	2009	Humana Employer Sponsored Non-CY	States of Alabama and Tennessee		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	850	0	1	31	11	R5826_850_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	850	0	2009	Humana Employer Sponsored Non-CY	State of Michigan		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	851	0	1	31	11	R5826_851_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	851	0	2009	Humana Employer Sponsored Non-CY	State of Ohio		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	852	0	1	31	11	R5826_852_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	852	0	2009	Humana Employer Sponsored Non-CY	States of Indiana and Kentucky		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	853	0	1	31	11	R5826_853_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	853	0	2009	Humana Employer Sponsored Non-CY	States of Illinois and Wisconsin		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	854	0	1	31	11	R5826_854_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	854	0	2009	Humana Employer Sponsored Non-CY	States of Arkansas and Missouri		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	855	0	1	31	11	R5826_855_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	855	0	2009	Humana Employer Sponsored Non-CY	States of Louisiana and Mississippi		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	856	0	1	31	11	R5826_856_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	856	0	2009	Humana Employer Sponsored Non-CY	State of Texas		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	857	0	1	31	11	R5826_857_0	6	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	857	0	2009	Humana Employer Sponsored Non-CY	States of Kansas and Oklahoma		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5826	858	0	1	31	11	R5826_858_0	7	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	11	31		1		R5826	858	0	2009	Humana Employer Sponsored Non-CY	State of Arizona		1	2				2						(800)-457-4708	(800)-457-4708	(800)-833-3301	(800)-833-3301	(800)-833-2364	(800)-833-2364	(877)-833-4486	(877)-833-4486									http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
R5863	001	0	1	31	11	R5863_001_0	11	2009.01	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	11	31		1		R5863	001	0	2009	Health Net Violet	Arizona		2	2				2						(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757	(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757	https://www.healthnet.com/formulary.htm	www.healthnet.com
R5863	801	0	1	31	11	R5863_801_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	11	31		1		R5863	801	0	2009	Health Net CoCare PPO	Arizona		1	2				2						(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757	(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
R5863	803	0	1	31	11	R5863_803_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	11	31		1		R5863	803	0	2009	Health Net CoCare PPO	Arizona		1	2				2						(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
R5863	804	0	1	31	11	R5863_804_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	11	31		1		R5863	804	0	2009	Health Net CoCare PPO	Arizona		1	2				2						(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757	(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
R5863	806	0	1	31	11	R5863_806_0	4	2009.01	HEALTH NET LIFE INSURANCE COMPANY	Health Net	www.healthnet.com	11	31		1		R5863	806	0	2009	Health Net CoCare PPO	Arizona		1	2				2						(800)-977-7522	(800)-977-7522	(800)-977-6757	(800)-977-6757	(800)-422-7311	(800)-422-7311	(800)-977-6757	(800)-977-6757									https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	www.healthnet.com
R5941	001	0	1	31	11	R5941_001_0	10	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	11	31		1		R5941	001	0	2009	Blue Medicare Access Standard	Ohio		2	2			7355	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
R5941	002	0	1	31	11	R5941_002_0	10	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	11	31		1		R5941	002	0	2009	Blue Medicare Access Premier	Ohio		2	2			1634	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
R5941	003	0	1	31	11	R5941_003_0	7	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	11	31		1		R5941	003	0	2009	Blue Medicare Access Standard	Indiana and Kentucky		2	2			8559	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
R5941	004	0	1	31	11	R5941_004_0	8	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	11	31		1		R5941	004	0	2009	Blue Medicare Access Premier	Indiana and Kentucky		2	2			2556	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
R5941	801	0	1	31	11	R5941_801_0	5	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	11	31		1		R5941	801	0	2009	Blue Medicare Access Group	Ohio		1	2			486	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
R5941	802	0	1	31	11	R5941_802_0	6	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	11	31		1		R5941	802	0	2009	Blue Medicare Access Group	Indiana and Kentucky		1	2			105	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
R5941	805	0	1	31	11	R5941_805_0	5	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	11	31		1		R5941	805	0	2009	Blue Medicare Access Group	Ohio		1	2			10	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754									www.anthem.com	www.anthem.com
R5941	806	0	1	31	11	R5941_806_0	6	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	11	31		1		R5941	806	0	2009	Blue Medicare Access Group	Indiana and Kentucky		1	2			10	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754									www.anthem.com	www.anthem.com
R5941	807	0	1	31	11	R5941_807_0	5	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	11	31		1		R5941	807	0	2009	Blue Medicare Access Group	Ohio		1	2			10	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
R5941	808	0	1	31	11	R5941_808_0	6	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Anthem Blue Cross and Blue Shield	www.anthem.com	11	31		1		R5941	808	0	2009	Blue Medicare Access Group	Indiana and Kentucky		1	2			10	2						(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(866)-803-5153	(866)-803-5153	(888)-853-7754	(888)-853-7754	(800)-467-1199	(800)-467-1199	(888)-853-7754	(888)-853-7754	(800)-467-8065	(800)-467-8065	(888)-853-7754	(888)-853-7754	www.anthem.com	www.anthem.com
R6801	001	0	1	31	11	R6801_001_0	11	2009.01	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	www.careimprovementplus.com	11	31		1		R6801	001	0	2009	Care Improvement Plus Silver Rx	Texas		2	1	4			2			1		1110000010000000000000000101	(866)-648-9847	(866)-648-9847	(866)-679-3052	(866)-679-3052	(877)-625-2207	(877)-625-2207	(866)-679-3052	(866)-679-3052	(800)-690-6016	(800)-690-6016	(866)-236-1069	(866)-236-1069	(877)-625-2207	(877)-625-2207	(866)-679-3052	(866)-679-3052	https://careimprovementplus.com/members/texas/medicarePartD/formulary.aspx	http://www.careimprovementplus.com
R6801	002	0	1	31	11	R6801_002_0	8	2009.01	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	www.careimprovementplus.com	11	31		1		R6801	002	0	2009	Care Improvement Plus Gold Rx	Texas		2	1	4			2			1		1110000010000000000000000001	(866)-648-9847	(866)-648-9847	(866)-679-3052	(866)-679-3052	(877)-625-2207	(877)-625-2207	(866)-679-3052	(866)-679-3052	(800)-690-6016	(800)-690-6016	(866)-236-1069	(866)-236-1069	(877)-625-2207	(877)-625-2207	(866)-679-3052	(866)-679-3052	https://careimprovementplus.com/members/texas/medicarePartD/formulary.aspx	http://www.careimprovementplus.com
R6801	003	0	1	31	11	R6801_003_0	9	2009.01	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	www.careimprovementplus.com	11	31		1		R6801	003	0	2009	Care Improvement Plus Platinum Rx	Texas		2	1	4			2			1		1110000010000000000000000001	(866)-648-9847	(866)-648-9847	(866)-679-3052	(866)-679-3052	(877)-625-2207	(877)-625-2207	(866)-679-3052	(866)-679-3052	(800)-690-6016	(800)-690-6016	(866)-236-1069	(866)-236-1069	(877)-625-2207	(877)-625-2207	(866)-679-3052	(866)-679-3052	https://careimprovementplus.com/members/texas/medicarePartD/formulary.aspx	http://www.careimprovementplus.com
R6801	004	0	1	31	11	R6801_004_0	9	2009.01	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	www.careimprovementplus.com	11	31		1		R6801	004	0	2009	Care Improvement Plus Gold Rx Premier	Texas		2	1	4			2			1		1110000010000000000000000001	(866)-648-9847	(866)-648-9847	(866)-679-3052	(866)-679-3052	(877)-625-2207	(877)-625-2207	(866)-679-3052	(866)-679-3052	(800)-690-6016	(800)-690-6016	(866)-236-1069	(866)-236-1069	(877)-625-2207	(877)-625-2207	(866)-679-3052	(866)-679-3052	https://careimprovementplus.com/members/texas/medicarePartD/formulary.aspx	http://www.careimprovementplus.com
R6801	005	0	1	31	11	R6801_005_0	8	2009.01	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	www.careimprovementplus.com	11	31		1		R6801	005	0	2009	Care Improvement Plus Gold Rx Plus	Texas		2	1	4			2			1		1110000010000000000000000001	(866)-648-9847	(866)-648-9847	(866)-679-3052	(866)-679-3052	(877)-625-2207	(877)-625-2207	(866)-679-3052	(866)-679-3052	(800)-690-6016	(800)-690-6016	(866)-236-1069	(866)-236-1069	(877)-625-2207	(877)-625-2207	(866)-679-3052	(866)-679-3052	https://careimprovementplus.com/members/texas/medicarePartD/formulary.aspx	http://www.careimprovementplus.com
R6801	006	0	1	31	11	R6801_006_0	8	2009.01	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	www.careimprovementplus.com	11	31		1		R6801	006	0	2009	Care Improvement Plus Platinum Rx Plus	Texas		2	1	4			2			1		1110000010000000000000000001	(866)-648-9847	(866)-648-9847	(866)-679-3052	(866)-679-3052	(877)-625-2207	(877)-625-2207	(866)-679-3052	(866)-679-3052	(800)-690-6016	(800)-690-6016	(866)-236-1069	(866)-236-1069	(877)-625-2207	(877)-625-2207	(866)-679-3052	(866)-679-3052	https://careimprovementplus.com/members/texas/medicarePartD/formulary.aspx	http://www.careimprovementplus.com
R6801	007	0	1	31	11	R6801_007_0	8	2009.01	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	Care Improvement Plus	www.careimprovementplus.com	11	31		1		R6801	007	0	2009	Care Improvement Plus Platinum Rx Premier	Texas		2	1	4			2			1		1110000010000000000000000001	(866)-648-9847	(866)-648-9847	(866)-679-3052	(866)-679-3052	(877)-625-2207	(877)-625-2207	(866)-679-3052	(866)-679-3052	(800)-690-6016	(800)-690-6016	(866)-236-1069	(866)-236-1069	(877)-625-2207	(877)-625-2207	(866)-679-3052	(866)-679-3052	https://careimprovementplus.com/members/texas/medicarePartD/formulary.aspx	http://www.careimprovementplus.com
R7444	001	0	1	31	11	R7444_001_0	5	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.securehorizons.com	11	31		1		R7444	001	0	2009	AARP MedicareComplete Choice	Central New England		2	2				2						(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		(800)-393-0993	(800)-393-0993	(888)-685-8480		(888)-834-3721	(888)-834-3721	(800)-387-1074		www.aarpmedicarecomplete.com	www.securehorizons.com
R7444	801	0	1	31	11	R7444_801_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.securehorizons.com	11	31		1		R7444	801	0	2009	MedicareComplete Choice Retiree Plan	Central New England Connecticut, Massachusetts		1	2				2						(800)-854-4317		(888)-685-8480		(800)-303-6720		(800)-201-4874		(800)-234-1228	(800)-234-1228	(800)-201-4874		(800)-303-6720	(800)-303-6720	(800)-201-4874		www.aarpmedicarecomplete.com	www.securehorizons.com
R7444	802	0	1	31	11	R7444_802_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.securehorizons.com	11	31		1		R7444	802	0	2009	MedicareComplete Choice Retiree Plan	Central New England (connecticut, Massachusetts		1	2				2						(800)-854-4317		(888)-685-8480		(800)-303-6720		(800)-201-4874										www.aarpmedicarecomplete.com	www.securehorizons.com
R7444	803	0	1	31	11	R7444_803_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.securehorizons.com	11	31		1		R7444	803	0	2009	MedicareComplete Choice Retiree Plan	Central New England (Connecticut, Massachusetts		1	2				2						(800)-854-4317		(888)-685-8480		(800)-303-6720		(800)-201-4874		(800)-234-1228	(800)-234-1228	(800)-201-4874		(800)-303-6720	(800)-303-6720	(800)-201-4874		www.aarpmedicarecomplete.com	www.securehorizons.com
R7444	804	0	1	31	11	R7444_804_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	SecureHorizons by UnitedHealthcare	www.securehorizons.com	11	31		1		R7444	804	0	2009	MedicareComplete Choice Retiree Plan	Central New England (Connecticut, Massachusetts		1	2				2						(800)-854-4317		(888)-685-8480		(800)-303-6720		(800)-201-4874										www.aarpmedicarecomplete.com	www.securehorizons.com
R9896	001	0	1	31	11	R9896_001_0	11	2009.01	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO	Care Improvement Plus	www.careimprovementplus.com	11	31		1		R9896	001	0	2009	Care Improvement Plus Silver Rx	Georgia and South Carolina		2	1	4			2			1		1110000010000000000000000101	(866)-766-8693	(866)-766-8693	(866)-766-8695	(866)-766-8695	(866)-766-8698	(866)-766-8698	(866)-766-8695	(866)-766-8695	(800)-690-6031	(800)-690-6031	(866)-236-1069	(866)-236-1069	(866)-766-8698	(866)-766-8698	(866)-766-8695	(866)-766-8695	http://careimprovementplus.com/members/southcarolina/medicarePartD/formulary.aspx	http://www.careimprovementplus.com
R9896	002	0	1	31	11	R9896_002_0	8	2009.01	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO	Care Improvement Plus	www.careimprovementplus.com	11	31		1		R9896	002	0	2009	Care Improvement Plus Gold Rx	Georgia and South Carolina		2	1	4			2			1		1110000010000000000000000001	(866)-766-8693	(866)-766-8693	(866)-766-8695	(866)-766-8695	(866)-766-8698	(866)-766-8698	(866)-766-8695	(866)-766-8695	(800)-690-6031	(800)-690-6031	(866)-236-1069	(866)-236-1069	(866)-766-8698	(866)-766-8698	(866)-766-8695	(866)-766-8695	http://careimprovementplus.com/members/southcarolina/medicarePartD/formulary.aspx	http://www.careimprovementplus.com
R9896	003	0	1	31	11	R9896_003_0	8	2009.01	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO	Care Improvement Plus	www.careimprovementplus.com	11	31		1		R9896	003	0	2009	Care Improvement Plus Platinum Rx	Georgia and South Carolina		2	1	4			2			1		1110000010000000000000000001	(866)-766-8693	(866)-766-8693	(866)-766-8695	(866)-766-8695	(866)-766-8698	(866)-766-8698	(866)-766-8695	(866)-766-8695	(800)-690-6031	(800)-690-6031	(866)-236-1069	(866)-236-1069	(866)-766-8698	(866)-766-8698	(866)-766-8695	(866)-766-8695	http://careimprovementplus.com/members/southcarolina/medicarePartD/formulary.aspx	http://www.careimprovementplus.com
R9896	004	0	1	31	11	R9896_004_0	8	2009.01	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO	Care Improvement Plus	www.careimprovementplus.com	11	31		1		R9896	004	0	2009	Care Improvement Plus Gold Rx Premier	Georgia and South Carolina		2	1	4			2			1		1110000010000000000000000001	(866)-766-8693	(866)-766-8693	(866)-766-8695	(866)-766-8695	(866)-766-8698	(866)-766-8698	(866)-766-8695	(866)-766-8695	(800)-690-6031	(800)-690-6031	(866)-236-1069	(866)-236-1069	(866)-766-8698	(866)-766-8698	(866)-766-8695	(866)-766-8695	http://careimprovementplus.com/members/southcarolina/medicarePartD/formulary.aspx	http://www.careimprovementplus.com
R9896	005	0	1	31	11	R9896_005_0	9	2009.01	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO	Care Improvement Plus	www.careimprovementplus.com	11	31		1		R9896	005	0	2009	Care Improvement Plus Gold Rx Plus	Georgia and South Carolina		2	1	4			2			1		1110000010000000000000000001	(866)-766-8693	(866)-766-8693	(866)-766-8695	(866)-766-8695	(866)-766-8698	(866)-766-8698	(866)-766-8695	(866)-766-8695	(800)-690-6031	(800)-690-6031	(866)-236-1069	(866)-236-1069	(866)-766-8698	(866)-766-8698	(866)-766-8695	(866)-766-8695	http://careimprovementplus.com/members/southcarolina/medicarePartD/formulary.aspx	http://www.careimprovementplus.com
R9896	006	0	1	31	11	R9896_006_0	8	2009.01	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO	Care Improvement Plus	www.careimprovementplus.com	11	31		1		R9896	006	0	2009	Care Improvement Plus Platinum Rx Plus	Georgia and South Carolina		2	1	4			2			1		1110000010000000000000000001	(866)-766-8693	(866)-766-8693	(866)-766-8695	(866)-766-8695	(866)-766-8698	(866)-766-8698	(866)-766-8695	(866)-766-8695	(800)-690-6031	(800)-690-6031	(866)-236-1069	(866)-236-1069	(866)-766-8698	(866)-766-8698	(866)-766-8695	(866)-766-8695	http://careimprovementplus.com/members/southcarolina/medicarePartD/formulary.aspx	http://www.careimprovementplus.com
R9896	007	0	1	31	11	R9896_007_0	8	2009.01	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO	Care Improvement Plus	www.careimprovementplus.com	11	31		1		R9896	007	0	2009	Care Improvement Plus Platinum Rx Premier	Georgia and South Carolina		2	1	4			2			1		1110000010000000000000000001	(866)-766-8693	(866)-766-8693	(866)-766-8695	(866)-766-8695	(866)-766-8698	(866)-766-8698	(866)-766-8695	(866)-766-8695	(800)-690-6031	(800)-690-6031	(866)-236-1069	(866)-236-1069	(866)-766-8698	(866)-766-8698	(866)-766-8695	(866)-766-8695	http://careimprovementplus.com/members/southcarolina/medicarePartD/formulary.aspx	http://www.careimprovementplus.com
R9943	001	0	1	31	11	R9943_001_0	14	2009.01	ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO.	Anthem Blue Cross	www.anthem.com/ca	11	31		1		R9943	001	0	2009	Freedom Blue Plan I	California		2	2			38046	2						(877)-811-3107	(877)-811-3107	(877)-247-1657		(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538	(877)-811-3107	(877)-811-3107	(877)-247-1657		(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538	www.bluecrossca.com	
R9943	805	0	1	31	11	R9943_805_0	6	2009.01	ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO.	Anthem Blue Cross	www.anthem.com/ca	11	31		1		R9943	805	0	2009	Freedom Blue Group	California		1	2			125	2						(877)-811-3107	(877)-811-3107	(877)-247-1657		(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538	(877)-811-3107	(877)-811-3107	(877)-247-1657		(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538	www.bluecrossca.com	
R9943	806	0	1	31	11	R9943_806_0	6	2009.01	ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO.	Anthem Blue Cross	www.anthem.com/ca	11	31		1		R9943	806	0	2009	Freedom Blue Group	California		1	2			50	2						(877)-811-3107	(877)-811-3107	(877)-247-1657		(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538									www.bluecrossca.com	
R9943	807	0	1	31	11	R9943_807_0	6	2009.01	ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO.	Anthem Blue Cross	www.anthem.com/ca	11	31		1		R9943	807	0	2009	Freedom Blue Group	California		1	2			25	2						(877)-811-3107	(877)-811-3107	(877)-247-1657		(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538	(877)-811-3107	(877)-811-3107	(877)-247-1657		(888)-211-9813	(888)-211-9813	(800)-297-1538	(800)-297-1538	www.bluecrossca.com	
S0043	009	0		29	10	S0043_009_0	2	2009.01	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	10	29				S0043	009	0	2009	Medi-Max	Puerto Rico		2	2																		(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	http://www.pmcpr.org	
S0043	010	0		29	10	S0043_010_0	4	2009.01	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	10	29				S0043	010	0	2009	Medi Max  Plus	Puerto Rico		2	2																		(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	http://www.pmcpr.org	
S0043	013	0		29	10	S0043_013_0	5	2009.01	PREFERRED MEDICARE CHOICE, INC.	Preferred Medicare Choice, Inc.	http://www.pmcpr.org	10	29				S0043	013	0	2009	Medi-Max Elite	Puerto Rico		2	2																		(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	(866)-516-7700	(866)-516-7700	(866)-516-7701	(866)-516-7701	http://www.pmcpr.org	
S0197	002	0		29	10	S0197_002_0	2	2009.01	CAMBRIDGE LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S0197	002	0	2009	AdvantraRx Value	AdvantraRx Value New York		2	2																		(866)-823-4646	(866)-823-4646	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S0197	003	0		29	10	S0197_003_0	3	2009.01	CAMBRIDGE LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S0197	003	0	2009	AdvantraRx Premier	AdvantraRx Premier New York		2	2																		(866)-823-4646	(866)-823-4646	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S0197	005	0		29	10	S0197_005_0	3	2009.01	CAMBRIDGE LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S0197	005	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus New York		2	2																		(866)-823-4646	(866)-823-4646	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S0197	809	0		29	10	S0197_809_0	1	2009.01	CAMBRIDGE LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S0197	809	0	2009	AdvantraRx Employer Group-9071-CY	AdvantraRx Employer Group-9071-CY		1	2																		(866)-823-4646	(866)-823-4646	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S0197	810	0		29	10	S0197_810_0	1	2009.01	CAMBRIDGE LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S0197	810	0	2009	AdvantraRx Employer Group-9071-NCY	AdvantraRx Employer Group-9071-NCY		1	2																		(866)-823-4646	(866)-823-4646	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S0197	811	0		29	10	S0197_811_0	1	2009.01	CAMBRIDGE LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S0197	811	0	2009	AdvantraRx Employer Group-9069-CY	AdvantraRx Employer Group-9069-CY		1	2																		(866)-823-4646	(866)-823-4646	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S0197	812	0		29	10	S0197_812_0	1	2009.01	CAMBRIDGE LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S0197	812	0	2009	AdvantraRx Employer Group-9069-NCY	AdvantraRx Employer Group-9069-NCY		1	2																		(866)-823-4646	(866)-823-4646	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S0197	813	0		29	10	S0197_813_0	1	2009.01	CAMBRIDGE LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S0197	813	0	2009	AdvantraRx Employer Group-9070-CY	AdvantraRx Employer Group-9070-CY		1	2																		(866)-823-4646	(866)-823-4646	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S0197	814	0		29	10	S0197_814_0	1	2009.01	CAMBRIDGE LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S0197	814	0	2009	AdvantraRx Employer Group-9070-NCY	AdvantraRx Employer Group-9070-NCY		1	2																		(866)-823-4646	(866)-823-4646	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S0197	815	0		29	10	S0197_815_0	1	2009.01	CAMBRIDGE LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S0197	815	0	2009	AdvantraRx Employer Group-9072-CY	AdvantraRx Employer Group-9072-CY		1	2																		(866)-823-4646	(866)-823-4646	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S0197	816	0		29	10	S0197_816_0	1	2009.01	CAMBRIDGE LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S0197	816	0	2009	AdvantraRx Employer Group-9072-NCY	AdvantraRx Employer Group-9072-NCY		1	2																		(866)-823-4646	(866)-823-4646	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S1030	001	0		29	10	S1030_001_0	5	2009.01	BCBS OF ALABAMA AND BCBS OF TENNESSEE	BlueRx	www.BlueRxAlaTenn.com	10	29				S1030	001	0	2009	BlueRx Option II	State of Alabama, State of Tennessee		2	2																		(800)-327-3998	(800)-327-3998	(800)-257-3384		(877)-233-3555	(877)-233-3555	(800)-257-3384		www.bcbsalmedicare.com/2008/tools	
S1030	006	0		29	10	S1030_006_0	4	2009.01	BCBS OF ALABAMA AND BCBS OF TENNESSEE	BlueRx	www.BlueRxAlaTenn.com	10	29				S1030	006	0	2009	BlueRx Option I	State of Alabama, State of Tennessee		2	2																		(800)-327-3998	(800)-327-3998	(800)-257-3384		(877)-233-3555	(877)-233-3555	(800)-257-3384		www.bcbsalmedicare.com/2008/tools	
S1030	801	0		29	10	S1030_801_0	1	2009.01	BCBS OF ALABAMA AND BCBS OF TENNESSEE	BlueRx	www.BlueRxAlaTenn.com	10	29				S1030	801	0	2009	BlueRx Employer Group Plan 801	State of Alabama, State of Tennessee		1	2																		(800)-327-3998	(800)-327-3998	(800)-257-3384		(877)-233-3555	(877)-233-3555	(800)-257-3384		www.bcbsalmedicare.com/2008/tools	
S1030	802	0		29	10	S1030_802_0	1	2009.01	BCBS OF ALABAMA AND BCBS OF TENNESSEE	BlueRx	www.BlueRxAlaTenn.com	10	29				S1030	802	0	2009	BlueRx Employer Group Plan 802	State of Alabama, State of Tennessee		1	2																		(800)-327-3998	(800)-327-3998	(800)-257-3384		(877)-233-3555	(877)-233-3555	(800)-257-3384		www.bcbsalmedicare.com/2008/tools	
S1822	801	0		29	10	S1822_801_0	2	2009.01	HEALTHPARTNERS, INC	HealthPartners National PDP	healthpartners.com/medicare	10	29				S1822	801	0	2009	HealthPartners Prescription Drug Plan CY	Nationwide		1	2																		(952)-883-7373	(877)-816-9539	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156	healthpartners.com/formulary/medicare.do	
S1822	802	0		29	10	S1822_802_0	2	2009.01	HEALTHPARTNERS, INC	HealthPartners National PDP	healthpartners.com/medicare	10	29				S1822	802	0	2009	HealthPartners Prescription Drug Plan NCY	Nationwide		1	2																		(952)-883-7373	(877)-816-9539	(952)-883-6060	(800)-443-0156	(952)-883-5601	(800)-247-7015	(952)-883-6060	(800)-443-0156	healthpartners.com/formulary/medicare.do	
S2321	001	0		29	10	S2321_001_0	5	2009.01	QCC INS CO D/B/A AMERIHEALTH INS CO	AmeriHealth Rx	www.amerihealth65.com	10	29				S2321	001	0	2009	AmeriHealth Rx Option I	Pennsylvania, West Virginia		2	2																		(888)-678-7007	(888)-678-7007		(888)-457-3002	(800)-898-3492	(800)-898-3492		(877)-219-5457	http://www.amerihealth.com/amerihealth65/2008/rx_pa_wv/drug_formulary/index.html:	
S2321	002	0		29	10	S2321_002_0	4	2009.01	QCC INS CO D/B/A AMERIHEALTH INS CO	AmeriHealth Rx	www.amerihealth65.com	10	29				S2321	002	0	2009	AmeriHealth Rx Option II	Pennsylvania, West Virginia		2	2																		(888)-678-7007	(888)-678-7007		(888)-457-3002	(800)-898-3492	(800)-898-3492		(877)-219-5457	http://www.amerihealth.com/amerihealth65/2008/rx_pa_wv/drug_formulary/index.html:	
S2468	001	0		29	10	S2468_001_0	4	2009.01	CA PHYSICIANS' SERVICE DBA BLUE SHIELD OF CA	Blue Shield of California	www.blueshieldca.com	10	29				S2468	001	0	2009	Blue Shield Medicare Rx Enhanced Plan	State of California		2	2																		(888)-239-6469	(888)-239-6469	(888)-239-6482	(888)-239-6482	(800)-488-8000	(800)-488-8000	(888)-595-0000	(888)-595-0000	https://www.blueshieldca.com/medicarepartdplans/formulary/	
S2468	002	0		29	10	S2468_002_0	2	2009.01	CA PHYSICIANS' SERVICE DBA BLUE SHIELD OF CA	Blue Shield of California	www.blueshieldca.com	10	29				S2468	002	0	2009	Blue Shield Medicare Rx Plan	State of California		2	2																		(888)-239-6469	(888)-239-6469	(888)-239-6482	(888)-239-6482	(800)-488-8000	(800)-488-8000	(888)-595-0000	(888)-595-0000	https://www.blueshieldca.com/medicarepartdplans/formulary/	
S2468	801	0		29	10	S2468_801_0	1	2009.01	CA PHYSICIANS' SERVICE DBA BLUE SHIELD OF CA	Blue Shield of California	www.blueshieldca.com	10	29				S2468	801	0	2009	Blue Shield of California Medicare Rx Plan	PDP Employer Group Plan		1	2																		(888)-239-6469	(888)-239-6469	(888)-239-6482	(888)-239-6482	(800)-488-8000	(800)-488-8000	(888)-595-0000	(888)-595-0000	https://www.blueshieldca.com/medicarepartdplans/formulary/	
S2468	802	0		29	10	S2468_802_0	1	2009.01	CA PHYSICIANS' SERVICE DBA BLUE SHIELD OF CA	Blue Shield of California	www.blueshieldca.com	10	29				S2468	802	0	2009	Blue Shield of California Medicare Rx Plan	PDP Employer Group Plan		1	2																		(888)-239-6469	(888)-239-6469	(888)-239-6482	(888)-239-6482	(800)-488-8000	(800)-488-8000	(888)-595-0000	(888)-595-0000	https://www.blueshieldca.com/medicarepartdplans/formulary/	
S2505	001	0		29	10	S2505_001_0	4	2009.01	WINDSOR HEALTH PLAN, INC	Windsor Rx	www.windsorrx.com	10	29				S2505	001	0	2009	Windsor Rx	Alabama and Tennessee		2	2																		(615)-782-7969	(800)-875-4068	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorrx.com	
S2505	003	0		29	10	S2505_003_0	4	2009.01	WINDSOR HEALTH PLAN, INC	Windsor Rx	www.windsorrx.com	10	29				S2505	003	0	2009	Windsor Rx	Arkansas		2	2																		(615)-782-7969	(800)-875-4068	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorrx.com	
S2505	005	0		29	10	S2505_005_0	5	2009.01	WINDSOR HEALTH PLAN, INC	Windsor Rx	www.windsorrx.com	10	29				S2505	005	0	2009	Windsor Rx	Mississippi		2	2																		(615)-782-7969	(800)-875-4068	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorrx.com	
S2505	007	0		29	10	S2505_007_0	5	2009.01	WINDSOR HEALTH PLAN, INC	Windsor Rx	www.windsorrx.com	10	29				S2505	007	0	2009	Windsor Rx	South Carolina		2	2																		(615)-782-7969	(800)-875-4068	(800)-848-0298	(800)-848-0298	(800)-811-8482	(800)-811-8482	(800)-848-0298	(800)-848-0298	www.windsorrx.com	
S2770	001	0		29	10	S2770_001_0	3	2009.01	QCC INS CO D/B/A AMERIHEALTH INS CO	AmeriHealth Advantage	www.amerihealth65.com	10	29				S2770	001	0	2009	AmeriHealth Advantage Rx Option I	Pennsylvania,West Virginia		2	2																		(888)-457-3007	(888)-457-3007		(888)-457-3002	(866)-456-1695	(866)-456-1695		(877)-219-5457	http://www.amerihealth.com/amerihealth65/2008/ahadvantage/formulary.html	
S2873	001	0		29	10	S2873_001_0	2	2009.01	PLAN MEDICO SERVICIOS DE SALUD BELLA VISTA, INC.	Bella Vista MedCare	www.bellavistamedcare.com	10	29				S2873	001	0	2009	Bella Vista MedCare PDP	Puerto Rico		2	2																		(787)-833-8070	(888)-833-8070	(787)-833-8074	(888)-833-8074	(787)-833-8070	(888)-833-8070	(787)-833-8074	(888)-833-8074	www.bellavistamedcare.com	
S2873	002	0		29	10	S2873_002_0	3	2009.01	PLAN MEDICO SERVICIOS DE SALUD BELLA VISTA, INC.	Bella Vista MedCare	www.bellavistamedcare.com	10	29				S2873	002	0	2009	Bella Vista MedCare PDP	Puerto Rico		2	2																		(787)-833-8070	(888)-833-8070	(787)-833-8074	(888)-833-8074	(787)-833-8070	(888)-833-8070	(787)-833-8074	(888)-833-8074	www.bellavistamedcare.com	
S2873	003	0		29	10	S2873_003_0	4	2009.01	PLAN MEDICO SERVICIOS DE SALUD BELLA VISTA, INC.	Bella Vista MedCare	www.bellavistamedcare.com	10	29				S2873	003	0	2009	Bella Vista MedCare PDP-003	Puerto Rico		2	2																		(787)-833-8070	(888)-833-8070	(787)-833-8074	(888)-833-8074	(787)-833-8070	(888)-833-8070	(787)-833-8074	(888)-833-8074	www.bellavistamedcare.com	
S2874	001	0		29	10	S2874_001_0	1	2009.01	HUMANA INSURANCE OF PUERTO RICO, INC	Humana Insurance of Puerto Rico, Inc	www.humana-medicare.com	10	29				S2874	001	0	2009	Humana PDP Standard S2874-001	Puerto Rico - Island Wide		2	2																		(866)-773-5959	(866)-773-5959		(800)-218-2560	(800)-681-3625	(800)-681-3625		(800)-722-2850	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S2874	002	0		29	10	S2874_002_0	2	2009.01	HUMANA INSURANCE OF PUERTO RICO, INC	Humana Insurance of Puerto Rico, Inc	www.humana-medicare.com	10	29				S2874	002	0	2009	Humana PDP Enhanced S2874-002	Puerto Rico - Island Wide		2	2																		(866)-773-5959	(866)-773-5959		(800)-218-2560	(800)-681-3625	(800)-681-3625		(800)-722-2850	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S2874	801	0		29	10	S2874_801_0	1	2009.01	HUMANA INSURANCE OF PUERTO RICO, INC	Humana Insurance of Puerto Rico, Inc	www.humana-medicare.com	10	29				S2874	801	0	2009	Humana PDP Employer Sponsored	Puerto Rico		1	2																		(866)-773-5959	(866)-773-5959		(800)-218-2560	(800)-681-3625	(800)-681-3625		(800)-722-2850	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S2874	802	0		29	10	S2874_802_0	1	2009.01	HUMANA INSURANCE OF PUERTO RICO, INC	Humana Insurance of Puerto Rico, Inc	www.humana-medicare.com	10	29				S2874	802	0	2009	Humana PDP Employer Sponsored Non-CY	Puerto Rico		1	2																		(866)-773-5959	(866)-773-5959		(800)-218-2560	(800)-681-3625	(800)-681-3625		(800)-722-2850	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S2893	001	0		29	10	S2893_001_0	2	2009.01	BLUE MEDICARERX	Blue MedicareRx	www.bmedicarerx.com	10	29				S2893	001	0	2009	Blue MedicareRx Value Plus	Connecticut, Massachusetts, Rhode Island, Vermont		2	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(877)-479-2227	(877)-479-2227	(800)-936-9984	(800)-936-9984	www.bmedicarerx.com	
S2893	003	0		29	10	S2893_003_0	2	2009.01	BLUE MEDICARERX	Blue MedicareRx	www.bmedicarerx.com	10	29				S2893	003	0	2009	Blue MedicareRx Premier	Connecticut, Massachusetts, Rhode Island, Vermont		2	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(877)-479-2227	(877)-479-2227	(800)-936-9984	(800)-936-9984	www.bmedicarerx.com	
S2893	014	0		29	10	S2893_014_0	2	2009.01	BLUE MEDICARERX	Blue MedicareRx	www.bmedicarerx.com	10	29				S2893	014	0	2009	Blue MedicareRx Value	Connecticut, Massachusetts, Rhode Island, Vermont		2	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(877)-479-2227	(877)-479-2227	(800)-936-9984	(800)-936-9984	www.bmedicarerx.com	
S2893	801	0		29	10	S2893_801_0	1	2009.01	BLUE MEDICARERX	Blue MedicareRx	www.bmedicarerx.com	10	29				S2893	801	0	2009	Blue MedicareRx Group	Connecticut, Massachusetts, Rhode Island, Vermont		1	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(877)-479-2227	(877)-479-2227	(800)-936-9984	(800)-936-9984	www.bmedicarerx.com	
S2893	802	0		29	10	S2893_802_0	1	2009.01	BLUE MEDICARERX	Blue MedicareRx	www.bmedicarerx.com	10	29				S2893	802	0	2009	Blue MedicareRx Group	Connecticut, Massachusetts, Rhode Island, Vermont		1	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(877)-479-2227	(877)-479-2227	(800)-936-9984	(800)-936-9984	www.bmedicarerx.com	
S3230	801	0		29	10	S3230_801_0	1	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plans from Medical Mutual of Ohio	www.Advantage-Plan.com	10	29				S3230	801	0	2009	Employer plan	US		1	2																		(800)-935-7198	(800)-935-7198	(800)-716-3231	(800)-716-3231	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	www.Advantage-Plan.com	
S3230	802	0		29	10	S3230_802_0	1	2009.01	MEDICAL MUTUAL OF OHIO	Advantage Plans from Medical Mutual of Ohio	www.Advantage-Plan.com	10	29				S3230	802	0	2009	Employer plan pdp non-calendar year	Ohio		1	2																		(800)-935-7198	(800)-935-7198	(800)-716-3231	(800)-716-3231	(800)-613-2583	(800)-613-2583	(800)-982-8109	(800)-982-8109	www.Advantage-Plan.com	
S3389	005	0		29	10	S3389_005_0	4	2009.01	UPMC HEALTH BENEFITS, INC	UPMC Health Plan	www.upmchealthplan.com	10	29				S3389	005	0	2009	UPMC for Life Prescription Drug Plan	States of Pennsylvania and West Virginia		2	2																		(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	
S3389	802	0		29	10	S3389_802_0	1	2009.01	UPMC HEALTH BENEFITS, INC	UPMC Health Plan	www.upmchealthplan.com	10	29				S3389	802	0	2009	UPMC Employer Group PDP (CY)	States of Pennsylvania and West Virginia		1	2																		(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	
S3389	803	0		29	10	S3389_803_0	1	2009.01	UPMC HEALTH BENEFITS, INC	UPMC Health Plan	www.upmchealthplan.com	10	29				S3389	803	0	2009	UPMC Employer Group PDP (FY)	States of Pennsylvania and West Virginia		1	2																		(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	
S3440	001	0		29	10	S3440_001_0	7	2009.01	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	Alliance Medicare Rx	www.hap.org	10	29				S3440	001	0	2009	Alliance Medicare RX	Alliance Medicare RX - Michigan		2	2																		(313)-664-9064	(800)-765-3436	(313)-664-8000		(800)-868-3153	(800)-868-3153	(313)-664-8000		www.hap.org/medicare	
S3440	002	0		29	10	S3440_002_0	6	2009.01	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	Alliance Medicare Rx	www.hap.org	10	29				S3440	002	0	2009	Alliance Medicare RX	Alliance Medicare RX - Michigan		2	2																		(313)-664-9064	(800)-765-3436	(313)-664-8000		(800)-868-3153	(800)-868-3153	(313)-664-8000		www.hap.org/medicare	
S3440	003	0		29	10	S3440_003_0	5	2009.01	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	Alliance Medicare Rx	www.hap.org	10	29				S3440	003	0	2009	Alliance Medicare RX	Alliance Medicare RX - Michigan		2	2																		(313)-664-9064	(800)-765-3436	(313)-664-8000		(800)-868-3153	(800)-868-3153	(313)-664-8000		www.hap.org/medicare	
S3521	001	0		29	10	S3521_001_0	2	2009.01	EXCELLUS HEALTH PLAN, INC	Simply Prescriptions	www.simplyprescriptions.com	10	29				S3521	001	0	2009	Rx 1	New York State		2	2																		(800)-514-6930	(800)-514-6930	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.simplyprescriptions.com/check_our_drug_list.shtml	
S3521	003	0		29	10	S3521_003_0	4	2009.01	EXCELLUS HEALTH PLAN, INC	Simply Prescriptions	www.simplyprescriptions.com	10	29				S3521	003	0	2009	Rx 3	NY State		2	2																		(800)-514-6930	(800)-514-6930	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.simplyprescriptions.com/check_our_drug_list.shtml	
S3521	801	0		29	10	S3521_801_0	1	2009.01	EXCELLUS HEALTH PLAN, INC	Simply Prescriptions	www.simplyprescriptions.com	10	29				S3521	801	0	2009	Part D - Employer Group	National and US Territories		1	2																		(800)-514-6930	(800)-514-6930	(800)-421-1220		(800)-659-1986	(800)-659-1986	(800)-421-1220		www.simplyprescriptions.com/check_our_drug_list.shtml	
S3994	801	0		29	10	S3994_801_0	1	2009.01	HAWAII MEDICAL SERVICES ASSOCIATION	HMSA's Medicare Rx Plan	http://www.hmsa.com	10	29				S3994	801	0	2009	CY GRx	State of Hawaii		1	2																		(808)-948-6000	(800)-776-4672	(808)-948-6222		(808)-948-5555	(800)-620-4672	(808)-948-6222		http://www.hmsa.com	
S3994	802	0		29	10	S3994_802_0	1	2009.01	HAWAII MEDICAL SERVICES ASSOCIATION	HMSA's Medicare Rx Plan	http://www.hmsa.com	10	29				S3994	802	0	2009	NCY GRx	State of Hawaii		1	2																		(808)-948-6000	(800)-776-4672	(808)-948-6222		(808)-948-5555	(800)-620-4672	(808)-948-6222		http://www.hmsa.com	
S4248	001	0		29	10	S4248_001_0	2	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	10	29				S4248	001	0	2009	Geisinger Gold Rx 1	Pennsylvania and West Virginia		2	2																		(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-514-0138	(800)-514-0138	(800)-447-2833	(800)-447-2833	www.thehealthplan.com	
S4248	801	0		29	10	S4248_801_0	1	2009.01	GEISINGER INDEMNITY INSURANCE COMPANY	Geisinger Gold	www.geisingergold.com	10	29				S4248	801	0	2009	Geisinger Gold Rx (Employer Group)	Pennsylvania and West Virginia		1	2																		(570)-271-8771	(800)-988-4861	(800)-447-2833	(800)-447-2833	(800)-756-1878	(800)-756-1878	(800)-447-2833	(800)-447-2833	www.thehealthplan.com	
S4496	001	0		29	10	S4496_001_0	1	2009.01	AMERIHEALTH HMO, INC.	AmeriHealth Rx	www.amerihealth65.com	10	29				S4496	001	0	2009	AmeriHealth NJ Rx Option I	New Jersey		2	2																		(888)-678-7007	(888)-678-7007	(888)-457-3002		(800)-898-3492	(800)-898-3492	(877)-219-5457		http://www.amerihealth.com/amerihealth65/2008/rx_nj/drug_formulary/index.html	
S4496	003	0		29	10	S4496_003_0	1	2009.01	AMERIHEALTH HMO, INC.	AmeriHealth Rx	www.amerihealth65.com	10	29				S4496	003	0	2009	AmeriHealth NJ Rx Option II	New Jersey		2	2																		(888)-678-7007	(888)-678-7007	(888)-457-3002		(800)-898-3492	(800)-898-3492	(877)-219-5457		http://www.amerihealth.com/amerihealth65/2008/rx_nj/drug_formulary/index.html	
S4496	801	0		29	10	S4496_801_0	1	2009.01	AMERIHEALTH HMO, INC.	AmeriHealth Rx	www.amerihealth65.com	10	29				S4496	801	0	2009	AmeriHealth NJ Rx Option I CY	New Jersey		1	2																		(888)-678-7007	(888)-678-7007	(888)-857-4816		(800)-898-3492	(800)-898-3492	(877)-219-5457		http://www.amerihealth.com/amerihealth65/2008/rx_nj/drug_formulary/index.html	
S4496	802	0		29	10	S4496_802_0	1	2009.01	AMERIHEALTH HMO, INC.	AmeriHealth Rx	www.amerihealth65.com	10	29				S4496	802	0	2009	AmeriHealth NJ Rx Option I Non-CY	New Jersey		1	2																		(888)-678-7007	(888)-678-7007	(888)-857-4816		(800)-898-3492	(800)-898-3492	(877)-219-5457		http://www.amerihealth.com/amerihealth65/2008/rx_nj/drug_formulary/index.html	
S4802	001	0		29	10	S4802_001_0	5	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	001	0	2009	Sterling Rx	Region 4		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	002	0		29	10	S4802_002_0	5	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	002	0	2009	Sterling Rx	Region 5		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	003	0		29	10	S4802_003_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	003	0	2009	Sterling Rx	Region 6		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	004	0		29	10	S4802_004_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	004	0	2009	Sterling Rx	Region 7		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	005	0		29	10	S4802_005_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	005	0	2009	Sterling Rx	Region 8		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	006	0		29	10	S4802_006_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	006	0	2009	Sterling Rx	Region 9		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	007	0		29	10	S4802_007_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	007	0	2009	Sterling Rx	Region 10		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	008	0		29	10	S4802_008_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	008	0	2009	Sterling Rx	Region 11		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	009	0		29	10	S4802_009_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	009	0	2009	Sterling Rx	Region 15		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	010	0		29	10	S4802_010_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	010	0	2009	Sterling Rx	Region 18		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	011	0		29	10	S4802_011_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	011	0	2009	Sterling Rx	Region 19		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	012	0		29	10	S4802_012_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	012	0	2009	Sterling Rx	Region 21		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	013	0		29	10	S4802_013_0	5	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	013	0	2009	Sterling Rx	Region 22		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	014	0		29	10	S4802_014_0	5	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	014	0	2009	Sterling Rx	Region 23		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	015	0		29	10	S4802_015_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	015	0	2009	Sterling Rx	Region 24		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	016	0		29	10	S4802_016_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	016	0	2009	Sterling Rx	Region 26		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	017	0		29	10	S4802_017_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	017	0	2009	Sterling Rx	Region 27		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	018	0		29	10	S4802_018_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	018	0	2009	Sterling Rx	Region 28		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	019	0		29	10	S4802_019_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	019	0	2009	Sterling Rx	Region 29		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	020	0		29	10	S4802_020_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	020	0	2009	Sterling Rx	Region 30		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	021	0		29	10	S4802_021_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	021	0	2009	Sterling Rx	Region 31		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	022	0		29	10	S4802_022_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	022	0	2009	Sterling Rx	Region 1		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	023	0		29	10	S4802_023_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	023	0	2009	Sterling Rx	Region 2		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	024	0		29	10	S4802_024_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	024	0	2009	Sterling Rx	Region 3		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	025	0		29	10	S4802_025_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	025	0	2009	Sterling Rx	Region 13		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	026	0		29	10	S4802_026_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	026	0	2009	Sterling Rx	Region 14		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	027	0		29	10	S4802_027_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	027	0	2009	Sterling Rx	Region 16		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	028	0		29	10	S4802_028_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	028	0	2009	Sterling Rx	Region 17		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	029	0		29	10	S4802_029_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	029	0	2009	Sterling Rx	Region 20		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	030	0		29	10	S4802_030_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	030	0	2009	Sterling Rx	Region 25		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	031	0		29	10	S4802_031_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	031	0	2009	Sterling Rx	Region 33		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	032	0		29	10	S4802_032_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	032	0	2009	Sterling Rx	Region 34		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	033	0		29	10	S4802_033_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	033	0	2009	Sterling Rx	Region 12		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	067	0		29	10	S4802_067_0	6	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	067	0	2009	Sterling Rx	Region 32		2	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(888)-909-1713	(888)-909-1713	(888)-858-8567	(888)-858-8567	http://www.sterlingplans.com	
S4802	801	0		29	10	S4802_801_0	1	2009.01	STERLING LIFE INSURANCE COMPANY	Sterling Life Insurance Company	www.sterlingplans.com	10	29				S4802	801	0	2009	Sterling Retiree Rx	Nationwide		1	2																		(866)-364-8012	(866)-364-8012	(866)-236-1069	(866)-236-1069	(800)-313-7667	(800)-313-7667	(800)-313-7667	(800)-313-7667	http://www.sterlingplans.com	
S4877	002	0		29	10	S4877_002_0	3	2009.01	COOPERATIVE DE SEGUROS DE VIDA DE PUERTO RICO	CosviMed Care	www.cosvi.com	10	29				S4877	002	0	2009	Cosvimed Care DRmaX	Puerto Rico		2	2																		(787)-751-5656	(877)-311-0017	(877)-311-0018		(787)-751-5656	(877)-311-0013	(877)-311-0014		www.cosvi.com	
S4877	003	0		29	10	S4877_003_0	3	2009.01	COOPERATIVE DE SEGUROS DE VIDA DE PUERTO RICO	CosviMed Care	www.cosvi.com	10	29				S4877	003	0	2009	Cosvimed Care Basic D	Puerto Rico		2	2																		(787)-751-5656	(877)-311-0017	(877)-311-0018		(787)-751-5656	(877)-311-0013	(877)-311-0014		www.cosvi.com	
S4877	802	0		29	10	S4877_802_0	4	2009.01	COOPERATIVE DE SEGUROS DE VIDA DE PUERTO RICO	CosviMed Care	www.cosvi.com	10	29				S4877	802	0	2009	CosviMed Care D Rmax Group	Puerto Rico		1	2																		(787)-751-5656	(877)-311-0017	(877)-311-0018		(787)-751-5656	(877)-311-0013	(877)-311-0014		www.cosvi.com	
S4877	803	0		29	10	S4877_803_0	4	2009.01	COOPERATIVE DE SEGUROS DE VIDA DE PUERTO RICO	CosviMed Care	www.cosvi.com	10	29				S4877	803	0	2009	CosviMed Care D Rmax B	CosviMed Care D Rmax B		1	2																		(787)-751-5656	(877)-311-0017	(877)-311-0018		(787)-751-5656	(877)-311-0013	(877)-311-0014		www.cosvi.com	
S5540	002	0		29	10	S5540_002_0	2	2009.01	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	www.bcbsnc.com/member/medicare	10	29				S5540	002	0	2009	Blue Medicare Rx Standard	North Carolina		2	2																		(888)-247-4142	(888)-247-4142	(888)-247-4145	(888)-247-4145	(800)-478-0583	(800)-478-0583	(800)-442-7028	(800)-442-7028	http://www.bcbsnc.com/member/medicare/formulary/index.jsp	
S5540	004	0		29	10	S5540_004_0	2	2009.01	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	www.bcbsnc.com/member/medicare	10	29				S5540	004	0	2009	Blue Medicare Rx Enhanced	North Carolina		2	2																		(888)-247-4142	(888)-247-4142	(888)-247-4145	(888)-247-4145	(800)-478-0583	(800)-478-0583	(800)-442-7028	(800)-442-7028	http://www.bcbsnc.com/member/medicare/formulary/index.jsp	
S5540	801	0		29	10	S5540_801_0	1	2009.01	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	www.bcbsnc.com/member/medicare	10	29				S5540	801	0	2009	Blue Medicare Rx EGWP	National Employer Group Retirees		1	2																		(888)-247-4142	(888)-247-4142	(888)-247-4145	(888)-247-4145	(800)-478-0583	(800)-478-0583	(800)-442-7028	(800)-442-7028	http://www.bcbsnc.com/member/medicare/formulary/index.jsp	
S5552	001	0		29	10	S5552_001_0	2	2009.01	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	10	29				S5552	001	0	2009	Humana PDP Enhanced S5552-001	State of New York		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5552	002	0		29	10	S5552_002_0	2	2009.01	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	10	29				S5552	002	0	2009	Humana PDP Complete S5552-002	State of New York		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5552	003	0		29	10	S5552_003_0	2	2009.01	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	10	29				S5552	003	0	2009	Humana PDP Standard S5552-003	State of New York		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5552	801	0		29	10	S5552_801_0	1	2009.01	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	10	29				S5552	801	0	2009	Humana PDP Employer Sponsored	State of New York		1	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5552	802	0		29	10	S5552_802_0	1	2009.01	HUMANA INSURANCE COMPANY OF NEW YORK	Humana Insurance Company of New York	www.humana-medicare.com	10	29				S5552	802	0	2009	Humana PDP Employer Sponsored Non-CY	State of New York		1	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5555	001	0		29	10	S5555_001_0	4	2009.01	MCS ADVANTAGE, INC.	MCS Classicare	www.mcsclassicare.com	10	29				S5555	001	0	2009	MCS Classicare Rx	Puerto Rico		2	2																		(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	www.mcsclassicare.com	
S5555	003	0		29	10	S5555_003_0	3	2009.01	MCS ADVANTAGE, INC.	MCS Classicare	www.mcsclassicare.com	10	29				S5555	003	0	2009	MCS Classicare Rx Standard	Puerto Rico		2	2																		(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	www.mcsclassicare.com	
S5555	801	0		29	10	S5555_801_0	2	2009.01	MCS ADVANTAGE, INC.	MCS Classicare	www.mcsclassicare.com	10	29				S5555	801	0	2009	MCS Classicare PDP Group (C)	Puerto Rico		1	2																		(866)-627-8183	(866)-627-8183	(866)-627-8182	(866)-627-8182	(866)-627-8181	(866)-627-8181	(866)-627-8182	(866)-627-8182	www.mcsclassicare.com	
S5557	004	0		29	10	S5557_004_0	2	2009.01	FOX INSURANCE COMPANY	Fox Insurance Company	www.foxrxcare.com	10	29				S5557	004	0	2009	Fox Value Plan	Fox Value Plan		2	2																		(212)-400-6101	(888)-369-7979		(866)-369-7373	(212)-400-6101	(888)-369-7979		(866)-369-7373	http://www.foxrxcare.com/formulary.htm	
S5557	006	0		29	10	S5557_006_0	1	2009.01	FOX INSURANCE COMPANY	Fox Insurance Company	www.foxrxcare.com	10	29				S5557	006	0	2009	Fox Value Plan	Fox Value Plan		2	2																		(212)-400-6101	(888)-369-7979		(866)-369-7373	(212)-400-6101	(888)-369-7979		(866)-369-7373	http://www.foxrxcare.com/formulary.htm	
S5557	009	0		29	10	S5557_009_0	5	2009.01	FOX INSURANCE COMPANY	Fox Insurance Company	www.foxrxcare.com	10	29				S5557	009	0	2009	Fox Grand Plan	Fox Grand Plan		2	2																		(212)-400-6101	(888)-369-7979		(866)-369-7373	(212)-400-6101	(888)-369-7979		(866)-369-7373	http://www.foxrxcare.com/formulary.htm	
S5557	011	0		29	10	S5557_011_0	5	2009.01	FOX INSURANCE COMPANY	Fox Insurance Company	www.foxrxcare.com	10	29				S5557	011	0	2009	Fox Grand Plan	Fox Grand Plan		2	2																		(212)-400-6101	(888)-369-7979		(866)-369-7373	(212)-400-6101	(888)-369-7979		(866)-369-7373	http://www.foxrxcare.com/formulary.htm	
S5557	013	0		29	10	S5557_013_0	5	2009.01	FOX INSURANCE COMPANY	Fox Insurance Company	www.foxrxcare.com	10	29				S5557	013	0	2009	Fox Grand Plan	Fox Grand Plan		2	2																		(212)-400-6101	(888)-369-7979		(866)-369-7373	(212)-400-6101	(888)-369-7979		(866)-369-7373	http://www.foxrxcare.com/formulary.htm	
S5557	015	0		29	10	S5557_015_0	5	2009.01	FOX INSURANCE COMPANY	Fox Insurance Company	www.foxrxcare.com	10	29				S5557	015	0	2009	Fox Grand Plan	Fox Grand Plan		2	2																		(212)-400-6101	(888)-369-7979		(866)-369-7373	(212)-400-6101	(888)-369-7979		(866)-369-7373	http://www.foxrxcare.com/formulary.htm	
S5557	017	0		29	10	S5557_017_0	5	2009.01	FOX INSURANCE COMPANY	Fox Insurance Company	www.foxrxcare.com	10	29				S5557	017	0	2009	Fox Grand Plan	Fox Grand Plan		2	2																		(212)-400-6101	(888)-369-7979		(866)-369-7373	(212)-400-6101	(888)-369-7979		(866)-369-7373	http://www.foxrxcare.com/formulary.htm	
S5557	019	0		29	10	S5557_019_0	5	2009.01	FOX INSURANCE COMPANY	Fox Insurance Company	www.foxrxcare.com	10	29				S5557	019	0	2009	Fox Grand Plan	Fox Grand Plan		2	2																		(212)-400-6101	(888)-369-7979		(866)-369-7373	(212)-400-6101	(888)-369-7979		(866)-369-7373	http://www.foxrxcare.com/formulary.htm	
S5557	021	0		29	10	S5557_021_0	5	2009.01	FOX INSURANCE COMPANY	Fox Insurance Company	www.foxrxcare.com	10	29				S5557	021	0	2009	Fox Grand Plan	Fox Grand Plan		2	2																		(212)-400-6101	(888)-369-7979		(866)-369-7373	(212)-400-6101	(888)-369-7979		(866)-369-7373	http://www.foxrxcare.com/formulary.htm	
S5557	023	0		29	10	S5557_023_0	3	2009.01	FOX INSURANCE COMPANY	Fox Insurance Company	www.foxrxcare.com	10	29				S5557	023	0	2009	Fox Value Plan	Fox Value Plan		2	2																		(212)-400-6101	(888)-369-7979		(866)-369-7373	(212)-400-6101	(888)-369-7979		(866)-369-7373	http://www.foxrxcare.com/formulary.htm	
S5557	024	0		29	10	S5557_024_0	3	2009.01	FOX INSURANCE COMPANY	Fox Insurance Company	www.foxrxcare.com	10	29				S5557	024	0	2009	Fox Value Plan	Fox Value Plan		2	2																		(212)-400-6101	(888)-369-7979		(866)-369-7373	(212)-400-6101	(888)-369-7979		(866)-369-7373	http://www.foxrxcare.com/formulary.htm	
S5557	025	0		29	10	S5557_025_0	2	2009.01	FOX INSURANCE COMPANY	Fox Insurance Company	www.foxrxcare.com	10	29				S5557	025	0	2009	Fox Value Plan	Fox Value Plan		2	2																		(212)-400-6101	(888)-369-7979		(866)-369-7373	(212)-400-6101	(888)-369-7979		(866)-369-7373	http://www.foxrxcare.com/formulary.htm	
S5557	028	0		29	10	S5557_028_0	2	2009.01	FOX INSURANCE COMPANY	Fox Insurance Company	www.foxrxcare.com	10	29				S5557	028	0	2009	Fox Value Plan	Fox Value Plan		2	2																		(212)-400-6101	(888)-369-7979		(866)-369-7373	(212)-400-6101	(888)-369-7979		(866)-369-7373	http://www.foxrxcare.com/formulary.htm	
S5557	031	0		29	10	S5557_031_0	3	2009.01	FOX INSURANCE COMPANY	Fox Insurance Company	www.foxrxcare.com	10	29				S5557	031	0	2009	Fox Value Plan	Fox Value Plan		2	2																		(212)-400-6101	(888)-369-7979		(866)-369-7373	(212)-400-6101	(888)-369-7979		(866)-369-7373	http://www.foxrxcare.com/formulary.htm	
S5557	801	0		29	10	S5557_801_0	3	2009.01	FOX INSURANCE COMPANY	Fox Insurance Company	www.foxrxcare.com	10	29				S5557	801	0	2009	Fox Rx Care Prescription Plan	Fox Rx Care Prescription Plan		1	2																		(212)-400-6101	(888)-369-7979		(866)-369-7373	(212)-400-6101	(888)-369-7979		(866)-369-7373	http://www.foxrxcare.com/formulary.htm	
S5566	001	0		29	10	S5566_001_0	1	2009.01	HCSC INSURANCE SERVICES COMPANY	BLUE CROSS AND BLUE SHIELD OF OKLAHOMA	www.bcbsok.com	10	29				S5566	001	0	2009	Medicare Blue Rx Basic	State of Oklahoma Region 23		2	2																		(888)-844-3781	(888)-844-3781			(888)-844-3781	(888)-844-3781	(888)-844-3792	(888)-844-3792	https://www.myrxassistant.com/MyRxAssistant/app?service=external/FormularyHomesp=SBCBSOK	
S5566	002	0		29	10	S5566_002_0	2	2009.01	HCSC INSURANCE SERVICES COMPANY	BLUE CROSS AND BLUE SHIELD OF OKLAHOMA	www.bcbsok.com	10	29				S5566	002	0	2009	Medicare Blue Rx Basic Plus	State of Oklahoma, Region 23		2	2																		(888)-844-3781	(888)-844-3781			(888)-844-3781	(888)-844-3781			https://www.myrxassistant.com/MyRxAssistant/app?service=external/FormularyHomesp=SBCBSOK	
S5566	003	0		29	10	S5566_003_0	3	2009.01	HCSC INSURANCE SERVICES COMPANY	BLUE CROSS AND BLUE SHIELD OF OKLAHOMA	www.bcbsok.com	10	29				S5566	003	0	2009	Medicare Blue Rx Enhanced	State of Oklahoma, Region 23		2	2																		(888)-844-3781	(888)-844-3781			(888)-844-3781	(888)-844-3781			https://www.myrxassistant.com/MyRxAssistant/app?service=external/FormularyHomesp=SBCBSOK	
S5566	802	0		29	10	S5566_802_0	1	2009.01	HCSC INSURANCE SERVICES COMPANY	BLUE CROSS AND BLUE SHIELD OF OKLAHOMA	www.bcbsok.com	10	29				S5566	802	0	2009	Medicare Blue Rx Group	State of Oklahoma Region 23		1	2																		(800)-693-3815	(800)-693-3815			(800)-693-3815	(800)-693-3815			https://www.myrxassistant.com/MyRxAssistant/app?service=external/FormularyHomesp=SBCBSOK	
S5566	803	0		29	10	S5566_803_0	1	2009.01	HCSC INSURANCE SERVICES COMPANY	BLUE CROSS AND BLUE SHIELD OF OKLAHOMA	www.bcbsok.com	10	29				S5566	803	0	2009	Medicare Blue Rx Group	State of Oklahoma Region 23		1	2																		(800)-693-3815	(800)-693-3815			(800)-693-3815	(800)-693-3815			https://www.myrxassistant.com/MyRxAssistant/app?service=external/FormularyHomesp=SBCBSOK	
S5569	003	0		29	10	S5569_003_0	3	2009.01	CAMBRIDGE LIFE INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5569	003	0	2009	First Health Part D-Premier	First Health Part D-Premier-New York		2	2																		(866)-823-4701	(866)-823-4701	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5569	005	0		29	10	S5569_005_0	2	2009.01	CAMBRIDGE LIFE INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5569	005	0	2009	First Health Part D-Secure	First Health Part D- Secure-New York		2	2																		(866)-823-4701	(866)-823-4701	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5580	003	0		29	10	S5580_003_0	1	2009.01	FIRST UNITED AMERICAN LIFE INSURANCE COMPANY	First United American Life Insurance Company	http://www.firstuamedicarepartd.com/	10	29				S5580	003	0	2009	First UA Medicare Part D Prescription Drug	State of New York		2	2																		(866)-524-4171	(866)-524-4171	(866)-524-4172	(866)-524-4172	(866)-524-4171	(866)-524-4171	(866)-524-4172	(866)-524-4172	http://www.firstuamedicarepartd.com/	
S5580	004	0		29	10	S5580_004_0	1	2009.01	FIRST UNITED AMERICAN LIFE INSURANCE COMPANY	First United American Life Insurance Company	http://www.firstuamedicarepartd.com/	10	29				S5580	004	0	2009	First UA Medicare Part D Rx Covg - Silver	State of New York		2	2																		(866)-299-3407	(866)-299-3407	(866)-524-4172	(866)-524-4172	(866)-299-3407	(866)-299-3407	(866)-524-4172	(866)-524-4172	http://www.firstuamedicarepartd.com/	
S5580	801	0		29	10	S5580_801_0	1	2009.01	FIRST UNITED AMERICAN LIFE INSURANCE COMPANY	First United American Life Insurance Company	http://www.firstuamedicarepartd.com/	10	29				S5580	801	0	2009	First UA Employer Calendar Drug Plan	National		1	2																		(866)-412-8499	(866)-412-8499	(866)-524-4172	(866)-524-4172	(866)-412-8499	(866)-412-8499	(866)-524-4172	(866)-524-4172	http://www.firstuamedicarepartd.com/	
S5580	802	0		29	10	S5580_802_0	1	2009.01	FIRST UNITED AMERICAN LIFE INSURANCE COMPANY	First United American Life Insurance Company	http://www.firstuamedicarepartd.com/	10	29				S5580	802	0	2009	First UA Employer Non-Calendar Drug Plan	National		1	2																		(866)-412-8499	(866)-412-8499	(866)-524-4172	(866)-524-4172	(800)-446-0100	(800)-446-0100	(866)-524-4172	(866)-524-4172	http://www.firstuamedicarepartd.com/	
S5584	001	0		29	10	S5584_001_0	5	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	10	29				S5584	001	0	2009	Prescription Blue Option A	State of Michigan		2	2																		(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
S5584	002	0		29	10	S5584_002_0	4	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	10	29				S5584	002	0	2009	Prescription Blue Option B	State of Michigan		2	2																		(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
S5584	801	0		29	10	S5584_801_0	1	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	10	29				S5584	801	0	2009	Prescription Blue Employer Plan CY	State of Michigan		1	2																		(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
S5584	802	0		29	10	S5584_802_0	1	2009.01	BLUE CROSS BLUE SHIELD OF MICHIGAN	Blue Cross Blue Shield of Michigan	www.bcbsm.com	10	29				S5584	802	0	2009	Prescription Blue Employer Plan non-CY	State of Michigan		1	2																		(800)-565-1770	(800)-565-1770	(800)-579-0235	(800)-579-0235	(800)-485-4415	(800)-485-4415	(800)-481-8704	(800)-481-8704	www.bcbsm.com/medicare/formulary.shtml	
S5585	001	0		29	10	S5585_001_0	2	2009.01	HEALTHNOW NEW YORK INC.	HealthNow New York Inc.	http://www.smarthealthrx.com/	10	29				S5585	001	0	2009	SmartHealth RX	State of New York		2	2																		(888)-787-2390	(888)-787-2390	(888)-676-6778	(888)-676-6778	(888)-989-9905	(888)-989-9905	(877)-513-1470	(877)-513-1470	http://www.smarthealthrx.com	
S5588	802	0		29	10	S5588_802_0	3	2009.01	PARAMOUNT INSURANCE COMPANY	Paramount Prescription Drug Plan	www.paramounthealthcare.com	10	29				S5588	802	0	2009	Paramount Std. Prescription Drug Plan Empl	Paramount Standard Prescription Drug Plan (Ohio)		1	2																		(800)-462-3589	(800)-462-3589			(800)-462-3589	(800)-462-3589			http://www.paramounthealthcare.com/blank.cfm?id=1613	
S5588	803	0		29	10	S5588_803_0	3	2009.01	PARAMOUNT INSURANCE COMPANY	Paramount Prescription Drug Plan	www.paramounthealthcare.com	10	29				S5588	803	0	2009	Paramount Enh. Prescription Drug Plan Empl	Paramount Enhanced Prescription Drug Plan (Ohio)		1	2																		(800)-462-3589	(800)-462-3589			(800)-462-3589	(800)-462-3589			http://www.paramounthealthcare.com/blank.cfm?id=1613	
S5593	002	0		29	10	S5593_002_0	7	2009.01	HIGHMARK SENIOR RESOURCES INC.	Highmark Senior Resources Inc.	www.highmark.com	10	29				S5593	002	0	2009	BlueRx Plus	Pennsylvania  and West Virginia		2	2																		(800)-290-3914	(800)-290-3914	(800)-988-0668	(800)-988-0668	(866)-465-4030	(866)-465-4030	(866)-465-4026	(866)-465-4026	http://highmark.medicare-approvedformularies.com/	
S5593	003	0		29	10	S5593_003_0	5	2009.01	HIGHMARK SENIOR RESOURCES INC.	Highmark Senior Resources Inc.	www.highmark.com	10	29				S5593	003	0	2009	BlueRx Complete	Pennsylvania  and West Virginia		2	2																		(800)-290-3914	(800)-290-3914	(800)-988-0668	(800)-988-0668	(866)-465-4030	(866)-465-4030	(866)-465-4026	(866)-465-4026	http://highmark.medicare-approvedformularies.com/	
S5593	004	0		29	10	S5593_004_0	5	2009.01	HIGHMARK SENIOR RESOURCES INC.	Highmark Senior Resources Inc.	www.highmark.com	10	29				S5593	004	0	2009	BlueRx Value	Pennsylvania and West Virginia		2	2																		(800)-290-3914	(800)-290-3914	(800)-988-0668	(800)-988-0668	(866)-465-4030	(866)-465-4030	(866)-465-4026	(866)-465-4026	http://highmark.medicare-approvedformularies.com/	
S5593	801	0		29	10	S5593_801_0	1	2009.01	HIGHMARK SENIOR RESOURCES INC.	Highmark Senior Resources Inc.	www.highmark.com	10	29				S5593	801	0	2009	BlueRx Employer Group Calendar	National		1	2																		(800)-290-3914	(800)-290-3914	(800)-688-0668	(800)-988-0668	(866)-465-4030	(866)-465-4030	(866)-465-4026	(866)-465-4026	http://highmark.medicare-approvedformularies.com/	
S5593	802	0		29	10	S5593_802_0	1	2009.01	HIGHMARK SENIOR RESOURCES INC.	Highmark Senior Resources Inc.	www.highmark.com	10	29				S5593	802	0	2009	BlueRx Employer Group Non-Calendar	National		1	2																		(800)-290-3914	(800)-290-3914	(800)-988-0668	(800)-988-0668	(866)-465-4030	(866)-465-4030	(866)-465-4026	(866)-465-4026	http://highmark.medicare-approvedformularies.com/	
S5596	001	0		29	10	S5596_001_0	3	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	001	0	2009	Blue MedicareRx Value Plus	Maine and New Hampshire		2	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(866)-244-1241	(866)-244-1241	(800)-241-6894	(800)-241-6894	www.bmedicarerx.com	
S5596	003	0		29	10	S5596_003_0	4	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	003	0	2009	Blue MedicareRx Premier	Maine and New Hampshire		2	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(866)-244-1241	(866)-244-1241	(800)-241-6894	(800)-241-6894	www.bmedicarerx.com	
S5596	005	0		29	10	S5596_005_0	3	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	005	0	2009	Blue MedicareRx Value	Virginia		2	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(877)-481-8633	(877)-481-8633	(800)-241-6894	(800)-241-6894	www.bmedicarerx.com	
S5596	006	0		29	10	S5596_006_0	3	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	006	0	2009	Blue MedicareRx Plus	Virginia		2	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(877)-481-8633	(877)-481-8633	(800)-241-6894	(800)-241-6894	www.bmedicarerx.com	
S5596	007	0		29	10	S5596_007_0	3	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	007	0	2009	Blue MedicareRx Premier	Virginia		2	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(877)-481-8633	(877)-481-8633	(800)-241-6894	(800)-241-6894	www.bmedicarerx.com	
S5596	009	0		29	10	S5596_009_0	2	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	009	0	2009	Blue MedicareRx Value	Georgia		2	2																		(800)-928-6201	(800)-928-6201	(877)-247-1657	(877)-247-1657	(866)-892-5331	(866)-892-5331	(800)-241-6894	(800)-241-6894	www.bmedicarerx.com	
S5596	010	0		29	10	S5596_010_0	3	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	010	0	2009	Blue MedicareRx Plus	Georgia		2	2																		(800)-928-6201	(800)-928-6201	(877)-247-1657	(877)-247-1657	(866)-892-5331	(866)-892-5331	(800)-241-6894	(800)-241-6894	www.bmedicarerx.com	
S5596	011	0		29	10	S5596_011_0	4	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	011	0	2009	Blue MedicareRx Premier	Georgia		2	2																		(800)-928-6201	(800)-928-6201	(877)-247-1657	(877)-247-1657	(866)-892-5331	(866)-892-5331	(800)-241-6894	(800)-241-6894	www.bmedicarerx.com	
S5596	013	0		29	10	S5596_013_0	2	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	013	0	2009	Blue MedicareRx Value	Ohio		2	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(800)-243-3363	(800)-243-3363	(888)-853-7754	(888)-853-7754	www.bmedicarerx.com	
S5596	014	0		29	10	S5596_014_0	3	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	014	0	2009	Blue MedicareRx Plus	Ohio		2	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(800)-243-3363	(800)-243-3363	(888)-853-7754	(888)-853-7754	www.bmedicarerx.com	
S5596	015	0		29	10	S5596_015_0	3	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	015	0	2009	Blue MedicareRx Premier	Ohio		2	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(800)-243-3363	(800)-243-3363	(888)-853-7754	(888)-853-7754	www.bmedicarerx.com	
S5596	017	0		29	10	S5596_017_0	2	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	017	0	2009	Blue MedicareRx Value	Indiana and Kentucky		2	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(800)-243-3363	(800)-243-3363	(888)-853-7754	(888)-853-7754	www.bmedicarerx.com	
S5596	018	0		29	10	S5596_018_0	3	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	018	0	2009	Blue MedicareRx Plus	Indiana and Kentucky		2	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(800)-243-3363	(800)-243-3363	(888)-853-7754	(888)-853-7754	www.bmedicarerx.com	
S5596	019	0		29	10	S5596_019_0	3	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	019	0	2009	Blue MedicareRx Premier	Indiana and Kentucky		2	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(800)-243-3363	(800)-243-3363	(888)-853-7754	(888)-853-7754	www.bmedicarerx.com	
S5596	021	0		29	10	S5596_021_0	2	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	021	0	2009	Blue MedicareRx Value	Wisconsin		2	2																		(800)-928-6201	(800)-928-6201	(877)-247-1657	(877)-247-1657	(800)-216-5572	(800)-216-5572	(800)-297-1538	(800)-297-1538	www.bmedicarerx.com	
S5596	022	0		29	10	S5596_022_0	3	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	022	0	2009	Blue MedicareRx Plus	Wisconsin		2	2																		(800)-928-6201	(800)-928-6201	(877)-247-1657	(877)-247-1657	(800)-216-5572	(800)-216-5572	(800)-297-1538	(800)-297-1538	www.bmedicarerx.com	
S5596	023	0		29	10	S5596_023_0	4	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	023	0	2009	Blue MedicareRx Premier	Wisconsin		2	2																		(800)-928-6201	(800)-928-6201	(877)-247-1657	(877)-247-1657	(800)-216-5572	(800)-216-5572	(800)-297-1538	(800)-297-1538	www.bmedicarerx.com	
S5596	025	0		29	10	S5596_025_0	2	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	025	0	2009	Blue MedicareRx Value	Colorado		2	2																		(800)-928-6201	(800)-928-6201	(877)-247-1657	(877)-247-1657	(866)-892-5332	(866)-892-5332	(800)-297-1538	(800)-297-1538	www.bmedicarerx.com	
S5596	026	0		29	10	S5596_026_0	3	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	026	0	2009	Blue MedicareRx Plus	Colorado		2	2																		(800)-928-6201	(800)-928-6201	(877)-247-1657	(877)-247-1657	(866)-892-5332	(866)-892-5332	(800)-297-1538	(800)-297-1538	www.bmedicarerx.com	
S5596	027	0		29	10	S5596_027_0	3	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	027	0	2009	Blue MedicareRx Premier	Colorado		2	2																		(800)-928-6201	(800)-928-6201	(877)-247-1657	(877)-247-1657	(866)-892-5332	(866)-892-5332	(800)-297-1538	(800)-297-1538	www.bmedicarerx.com	
S5596	029	0		29	10	S5596_029_0	2	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	029	0	2009	Blue MedicareRx Value	Nevada		2	2																		(800)-928-6201	(800)-928-6201	(877)-247-1657	(877)-247-1657	(866)-892-5343	(866)-892-5343	(800)-297-1538	(800)-297-1538	www.bmedicarerx.com	
S5596	030	0		29	10	S5596_030_0	3	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	030	0	2009	Blue MedicareRx Plus	Nevada		2	2																		(800)-928-6201	(800)-928-6201	(877)-247-1657	(877)-247-1657	(866)-892-5343	(866)-892-5343	(800)-297-1538	(800)-297-1538	www.bmedicarerx.com	
S5596	031	0		29	10	S5596_031_0	3	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	031	0	2009	Blue MedicareRx Premier	Nevada		2	2																		(800)-928-6201	(800)-928-6201	(877)-247-1657	(877)-247-1657	(866)-892-5343	(866)-892-5343	(800)-297-1538	(800)-297-1538	www.bmedicarerx.com	
S5596	033	0		29	10	S5596_033_0	2	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	http://medicarerx.anthem.com	10	29				S5596	033	0	2009	Blue Cross MedicareRx Value	California		2	2																		(800)-928-6201	(800)-928-6201	(877)-247-1657	(877)-247-1657	(866)-892-5340	(866)-892-5340	(800)-297-1538	(800)-297-1538	www.bmedicarerx.com	
S5596	034	0		29	10	S5596_034_0	3	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	http://medicarerx.anthem.com	10	29				S5596	034	0	2009	Blue Cross MedicareRx Plus	California		2	2																		(800)-928-6201	(800)-928-6201	(877)-247-1657	(877)-247-1657	(866)-892-5340	(866)-892-5340	(800)-297-1538	(800)-297-1538	www.bmedicarerx.com	
S5596	035	0		29	10	S5596_035_0	3	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	http://medicarerx.anthem.com	10	29				S5596	035	0	2009	Blue Cross MedicareRx Gold	California		2	2																		(800)-928-6201	(800)-928-6201	(877)-247-1657	(877)-247-1657	(866)-892-5340	(866)-892-5340	(800)-297-1538	(800)-297-1538	www.bmedicarerx.com	
S5596	043	0		29	10	S5596_043_0	3	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	043	0	2009	Blue MedicareRx Value	Missouri		2	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(800)-243-3363	(800)-243-3363	(888)-853-7754	(888)-853-7754	www.bmedicarerx.com	
S5596	044	0		29	10	S5596_044_0	4	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	044	0	2009	Blue MedicareRx Plus	Missouri		2	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(800)-243-3363	(800)-243-3363	(888)-853-7754	(888)-853-7754	www.bmedicarerx.com	
S5596	045	0		29	10	S5596_045_0	4	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	045	0	2009	Blue MedicareRx Premier	Missouri		2	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(800)-243-3363	(800)-243-3363	(888)-853-7754	(888)-853-7754	www.bmedicarerx.com	
S5596	046	0		29	10	S5596_046_0	2	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	046	0	2009	Blue MedicareRx Value	Maine and New Hampshire		2	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(866)-244-1241	(866)-244-1241	(800)-241-6894	(800)-241-6894	www.bmedicarerx.com	
S5596	801	0		29	10	S5596_801_0	1	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	801	0	2009	Blue MedicareRx Group	New Hampshire and Maine		1	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(866)-244-1241	(866)-244-1241	(800)-241-6894	(800)-241-6894	www.bmedicarerx.com	
S5596	803	0		29	10	S5596_803_0	1	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	803	0	2009	Blue MedicareRx Group	VA GA OH IN KY WI CO NV CA MO ME NH (Nationwide)		1	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(800)-243-3363	(800)-243-3363	(888)-853-7754	(888)-853-7754	www.bmedicarerx.com	
S5596	804	0		29	10	S5596_804_0	1	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	804	0	2009	Blue MedicareRx Group	VA GA OH IN KY WI CO NV CA MO ME NH (Nationwide)		1	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(800)-243-3363	(800)-243-3363	(888)-853-7754	(888)-853-7754	www.bmedicarerx.com	
S5596	843	0		29	10	S5596_843_0	1	2009.01	ANTHEM INSURANCE COMPANIES, INC.	Blue MedicareRx	www.bmedicarerx.com	10	29				S5596	843	0	2009	Blue MedicareRx Group	New Hampshire and Maine		1	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(866)-244-1241	(866)-244-1241	(800)-241-6894	(800)-241-6894	www.bmedicarerx.com	
S5597	034	0		29	10	S5597_034_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	034	0	2009	Universal American Rx Gold	State of New Hampshire and State of Maine		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	035	0		29	10	S5597_035_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	035	0	2009	Universal American Rx Gold	State of CT, MA, RI, VT		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	036	0		29	10	S5597_036_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	036	0	2009	Universal American Rx Gold	State of New Jersey		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	037	0		29	10	S5597_037_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	037	0	2009	Universal American Rx Gold	State of Delaware, District of Columbia, Maryland		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	038	0		29	10	S5597_038_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	038	0	2009	Universal American Rx Gold	State of Pennsylvania and State of West Virginia		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	039	0		29	10	S5597_039_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	039	0	2009	Universal American Rx Gold	State of Virginia		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	040	0		29	10	S5597_040_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	040	0	2009	Universal American Rx Gold	State of North Carolina		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	041	0		29	10	S5597_041_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	041	0	2009	Universal American Rx Gold	State of South Carolina		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	042	0		29	10	S5597_042_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	042	0	2009	Universal American Rx Gold	State of Georgia		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	043	0		29	10	S5597_043_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	043	0	2009	Universal American Rx Gold	State of Florida		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	044	0		29	10	S5597_044_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	044	0	2009	Universal American Rx Gold	State of Alabama and State of Tennessee		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	045	0		29	10	S5597_045_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	045	0	2009	Universal American Rx Gold	State of Michigan		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	046	0		29	10	S5597_046_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	046	0	2009	Universal American Rx Gold	State of Ohio		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	047	0		29	10	S5597_047_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	047	0	2009	Universal American Rx Gold	State of Indiana and State of Kentucky		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	048	0		29	10	S5597_048_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	048	0	2009	Universal American Rx Gold	State of Wisconsin		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	049	0		29	10	S5597_049_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	049	0	2009	Universal American Rx Gold	State of Illinois		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	050	0		29	10	S5597_050_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	050	0	2009	Universal American Rx Gold	State of Missouri		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	051	0		29	10	S5597_051_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	051	0	2009	Universal American Rx Gold	State of Arkansas		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	052	0		29	10	S5597_052_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	052	0	2009	Universal American Rx Gold	State of Mississippi		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	053	0		29	10	S5597_053_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	053	0	2009	Universal American Rx Gold	State of Louisiana		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	054	0		29	10	S5597_054_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	054	0	2009	Universal American Rx Gold	State of Texas		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	055	0		29	10	S5597_055_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	055	0	2009	Universal American Rx Gold	State of Oklahoma		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	056	0		29	10	S5597_056_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	056	0	2009	Universal American Rx Gold	State of Kansas		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	057	0		29	10	S5597_057_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	057	0	2009	Universal American Rx Gold	State of IA, MN, MT, NE, ND, SD, WY		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	058	0		29	10	S5597_058_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	058	0	2009	Universal American Rx Gold	State of New Mexico		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	059	0		29	10	S5597_059_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	059	0	2009	Universal American Rx Gold	State of Colorado		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	060	0		29	10	S5597_060_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	060	0	2009	Universal American Rx Gold	State of Arizona		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	061	0		29	10	S5597_061_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	061	0	2009	Universal American Rx Gold	State of Nevada		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	062	0		29	10	S5597_062_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	062	0	2009	Universal American Rx Gold	State of Oregon and State of Washington		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	063	0		29	10	S5597_063_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	063	0	2009	Universal American Rx Gold	State of Idaho and State of Utah		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	064	0		29	10	S5597_064_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	064	0	2009	Universal American Rx Gold	State of California		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	199	0		29	10	S5597_199_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	199	0	2009	Universal American Rx Platinum	State of New Hampshire and Maine		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	200	0		29	10	S5597_200_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	200	0	2009	Universal American Rx Platinum	Connecticut, Massachusetts, Rhode Island,Vermont		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	201	0		29	10	S5597_201_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	201	0	2009	Universal American Rx Platinum	State of New Jersey		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	202	0		29	10	S5597_202_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	202	0	2009	Universal American Rx Platinum	Delaware, District of Columbia, and Maryland		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	203	0		29	10	S5597_203_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	203	0	2009	Universal American Rx Platinum	Pennsylvania and West Virginia		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	204	0		29	10	S5597_204_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	204	0	2009	Universal American Rx Platinum	Virginia		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	205	0		29	10	S5597_205_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	205	0	2009	Universal American Rx Platinum	North Carolina		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	206	0		29	10	S5597_206_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	206	0	2009	Universal American Rx Platinum	South Carolina		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	207	0		29	10	S5597_207_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	207	0	2009	Universal American Rx Platinum	Georgia		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	208	0		29	10	S5597_208_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	208	0	2009	Universal American Rx Platinum	Florida		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	209	0		29	10	S5597_209_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	209	0	2009	Universal American Rx Platinum	Alabama and Tennessee		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	210	0		29	10	S5597_210_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	210	0	2009	Universal American Rx Platinum	Michigan		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	211	0		29	10	S5597_211_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	211	0	2009	Universal American Rx Platinum	Ohio		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	212	0		29	10	S5597_212_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	212	0	2009	Universal American Rx Platinum	Indiana and Kentucky		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	213	0		29	10	S5597_213_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	213	0	2009	Universal American Rx Platinum	Wisconsin		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	214	0		29	10	S5597_214_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	214	0	2009	Universal American Rx Platinum	Illinois		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	215	0		29	10	S5597_215_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	215	0	2009	Universal American Rx Platinum	Missouri		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	216	0		29	10	S5597_216_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	216	0	2009	Universal American Rx Platinum	Arkansas		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	217	0		29	10	S5597_217_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	217	0	2009	Universal American Rx Platinum	Mississippi		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	218	0		29	10	S5597_218_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	218	0	2009	Universal American Rx Platinum	Louisiana		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	219	0		29	10	S5597_219_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	219	0	2009	Universal American Rx Platinum	Texas		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	220	0		29	10	S5597_220_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	220	0	2009	Universal American Rx Platinum	Oklahoma		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	221	0		29	10	S5597_221_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	221	0	2009	Universal American Rx Platinum	Kansas		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	222	0		29	10	S5597_222_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	222	0	2009	Universal American Rx Platinum	IA, MN, MT, NE, ND, SD, WY		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	223	0		29	10	S5597_223_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	223	0	2009	Universal American Rx Platinum	New Mexico		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	224	0		29	10	S5597_224_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	224	0	2009	Universal American Rx Platinum	Colorado		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	225	0		29	10	S5597_225_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	225	0	2009	Universal American Rx Platinum	Arizona		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	226	0		29	10	S5597_226_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	226	0	2009	Universal American Rx Platinum	Nevada		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	227	0		29	10	S5597_227_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	227	0	2009	Universal American Rx Platinum	Oregon, Washington		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	228	0		29	10	S5597_228_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	228	0	2009	Universal American Rx Platinum	Idaho, Utah		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	229	0		29	10	S5597_229_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	229	0	2009	Universal American Rx Platinum	California		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	230	0		29	10	S5597_230_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	230	0	2009	Universal American Rx Gold	State of Hawaii		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	232	0		29	10	S5597_232_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	232	0	2009	Universal American Rx Platinum	State of Hawaii		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	233	0		29	10	S5597_233_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	233	0	2009	Universal American Rx Gold	State of Alaska		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	235	0		29	10	S5597_235_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	235	0	2009	Universal American Rx Platinum	State of Alaska		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	236	0		29	10	S5597_236_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	236	0	2009	Universal American Rx Bronze	State of New Hampshire and State of Maine		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	237	0		29	10	S5597_237_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	237	0	2009	Universal American Rx Bronze	State of CT, MA, RI, VT		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	238	0		29	10	S5597_238_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	238	0	2009	Universal American Rx Bronze	State of New Jersey		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	239	0		29	10	S5597_239_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	239	0	2009	Universal American Rx Bronze	State of Delaware, District of Columbia,Maryland		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	240	0		29	10	S5597_240_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	240	0	2009	Universal American Rx Bronze	State of Pennsylvania and State of West Virginia		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	241	0		29	10	S5597_241_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	241	0	2009	Universal American Rx Bronze	State of Virginia		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	242	0		29	10	S5597_242_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	242	0	2009	Universal American Rx Bronze	State of North Carolina		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	243	0		29	10	S5597_243_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	243	0	2009	Universal American Rx Bronze	State of South Carolina		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	244	0		29	10	S5597_244_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	244	0	2009	Universal American Rx Bronze	State of Georgia		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	245	0		29	10	S5597_245_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	245	0	2009	Universal American Rx Bronze	State of Florida		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	246	0		29	10	S5597_246_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	246	0	2009	Universal American Rx Bronze	State of Alabama and State of Tennessee		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	247	0		29	10	S5597_247_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	247	0	2009	Universal American Rx Bronze	State of Michigan		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	248	0		29	10	S5597_248_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	248	0	2009	Universal American Rx Bronze	State of Ohio		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	249	0		29	10	S5597_249_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	249	0	2009	Universal American Rx Bronze	State of Indiana and State of Kentucky		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	250	0		29	10	S5597_250_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	250	0	2009	Universal American Rx Bronze	State of Wisconsin		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	251	0		29	10	S5597_251_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	251	0	2009	Universal American Rx Bronze	State of Illinois		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	252	0		29	10	S5597_252_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	252	0	2009	Universal American Rx Bronze	State of Missouri		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	253	0		29	10	S5597_253_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	253	0	2009	Universal American Rx Bronze	State of Arkansas		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	254	0		29	10	S5597_254_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	254	0	2009	Universal American Rx Bronze	State of Mississippi		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	255	0		29	10	S5597_255_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	255	0	2009	Universal American Rx Bronze	State of Louisiana		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	256	0		29	10	S5597_256_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	256	0	2009	Universal American Rx Bronze	State of Texas		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	257	0		29	10	S5597_257_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	257	0	2009	Universal American Rx Bronze	State of Oklahoma		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	258	0		29	10	S5597_258_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	258	0	2009	Universal American Rx Bronze	State of Kansas		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	259	0		29	10	S5597_259_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	259	0	2009	Universal American Rx Bronze	States of IA, MN, MT, NE, ND, SD, WY		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	260	0		29	10	S5597_260_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	260	0	2009	Universal American Rx Bronze	State of New Mexico		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	261	0		29	10	S5597_261_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	261	0	2009	Universal American Rx Bronze	State of Colorado		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	262	0		29	10	S5597_262_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	262	0	2009	Universal American Rx Bronze	State of Arizona		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	263	0		29	10	S5597_263_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	263	0	2009	Universal American Rx Bronze	State of Nevada		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	264	0		29	10	S5597_264_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	264	0	2009	Universal American Rx Bronze	State of Oregon and State of Washington		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	265	0		29	10	S5597_265_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	265	0	2009	Universal American Rx Bronze	State of Idaho and State of Utah		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	266	0		29	10	S5597_266_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	266	0	2009	Universal American Rx Bronze	State of California		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	267	0		29	10	S5597_267_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	267	0	2009	Universal American Rx Bronze	State of Hawaii		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	268	0		29	10	S5597_268_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	268	0	2009	Universal American Rx Bronze	State of Alaska		2	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	802	0		29	10	S5597_802_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	802	0	2009	Universal American Rx  Employer Std Def CY 2	National Plan		1	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	804	0		29	10	S5597_804_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	804	0	2009	Universal American Rx Employer Std Def CY 4	National Plan		1	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	805	0		29	10	S5597_805_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	805	0	2009	Universal American Rx  Employer Std Def CY 5	National Plan		1	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	807	0		29	10	S5597_807_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	807	0	2009	Universal American Rx Employer Std Def NCY 2	National Plan		1	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	809	0		29	10	S5597_809_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	809	0	2009	Universal American Rx Employer Std Def NCY 4	National Plan		1	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5597	810	0		29	10	S5597_810_0	1	2009.01	PENNSYLVANIA LIFE INSURANCE COMPANY	Universal American	www.universalamericanrx.com	10	29				S5597	810	0	2009	Universal American Rx Employer Std Def NCY 5	National Plan		1	2																		(850)-436-2336	(800)-818-0007		(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5601	002	0		29	10	S5601_002_0	9	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	002	0	2009	SilverScript Value	Northern New England SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	003	0		29	10	S5601_003_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	003	0	2009	SilverScript Plus	Northern New England SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	004	0		29	10	S5601_004_0	8	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	004	0	2009	SilverScript Value	Central New England SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	005	0		29	10	S5601_005_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	005	0	2009	SilverScript Plus	Central New England SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	006	0		29	10	S5601_006_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	006	0	2009	SilverScript Value	New York SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	007	0		29	10	S5601_007_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	007	0	2009	SilverScript Plus	New York SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	008	0		29	10	S5601_008_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	008	0	2009	SilverScript Value	New Jersey SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	009	0		29	10	S5601_009_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	009	0	2009	SilverScript Plus	New Jersey SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	010	0		29	10	S5601_010_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	010	0	2009	SilverScript Value	Mid-Atlantic SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	011	0		29	10	S5601_011_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	011	0	2009	SilverScript Plus	Mid-Atlantic SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	012	0		29	10	S5601_012_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	012	0	2009	SilverScript Value	Pennsylvania, West Virginia SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	013	0		29	10	S5601_013_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	013	0	2009	SilverScript Plus	Pennsylvania, West Virginia SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	014	0		29	10	S5601_014_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	014	0	2009	SilverScript Value	Virginia SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	015	0		29	10	S5601_015_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	015	0	2009	SilverScript Plus	Virginia SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	016	0		29	10	S5601_016_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	016	0	2009	SilverScript Value	North Carolina SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	017	0		29	10	S5601_017_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	017	0	2009	SilverScript Plus	North Carolina SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	018	0		29	10	S5601_018_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	018	0	2009	SilverScript Value	South Carolina SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	019	0		29	10	S5601_019_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	019	0	2009	SilverScript Plus	South Carolina SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	020	0		29	10	S5601_020_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	020	0	2009	SilverScript Value	Georgia SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	021	0		29	10	S5601_021_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	021	0	2009	SilverScript Plus	Georgia SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	022	0		29	10	S5601_022_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	022	0	2009	SilverScript Value	Florida SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	023	0		29	10	S5601_023_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	023	0	2009	SilverScript Plus	Florida SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	024	0		29	10	S5601_024_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	024	0	2009	SilverScript Value	Alabama, Tennessee SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	025	0		29	10	S5601_025_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	025	0	2009	SilverScript Plus	Alabama, Tennessee SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	026	0		29	10	S5601_026_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	026	0	2009	SilverScript Value	Michigan SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	027	0		29	10	S5601_027_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	027	0	2009	SilverScript Plus	Michigan SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	028	0		29	10	S5601_028_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	028	0	2009	SilverScript Value	Ohio SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	029	0		29	10	S5601_029_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	029	0	2009	SilverScript Plus	Ohio SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	030	0		29	10	S5601_030_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	030	0	2009	SilverScript Value	Indiana, Kentucky SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	031	0		29	10	S5601_031_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	031	0	2009	SilverScript Plus	Indiana, Kentucky SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	032	0		29	10	S5601_032_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	032	0	2009	SilverScript Value	Wisconsin SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	033	0		29	10	S5601_033_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	033	0	2009	SilverScript Plus	Wisconsin SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	034	0		29	10	S5601_034_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	034	0	2009	SilverScript Value	Illinois SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	035	0		29	10	S5601_035_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	035	0	2009	SilverScript Plus	Illinois SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	036	0		29	10	S5601_036_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	036	0	2009	SilverScript Value	Missouri SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	037	0		29	10	S5601_037_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	037	0	2009	SilverScript Plus	Missouri SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	038	0		29	10	S5601_038_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	038	0	2009	SilverScript Value	Arkansas SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	039	0		29	10	S5601_039_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	039	0	2009	SilverScript Plus	Arkansas SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	040	0		29	10	S5601_040_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	040	0	2009	SilverScript Value	Mississippi SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	041	0		29	10	S5601_041_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	041	0	2009	SilverScript Plus	Mississippi SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	042	0		29	10	S5601_042_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	042	0	2009	SilverScript Value	Louisiana SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	043	0		29	10	S5601_043_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	043	0	2009	SilverScript Plus	Louisiana SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	044	0		29	10	S5601_044_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	044	0	2009	SilverScript Value	Texas SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	045	0		29	10	S5601_045_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	045	0	2009	SilverScript Plus	Texas SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	046	0		29	10	S5601_046_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	046	0	2009	SilverScript Value	Oklahoma SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	047	0		29	10	S5601_047_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	047	0	2009	SilverScript Plus	Oklahoma SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	048	0		29	10	S5601_048_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	048	0	2009	SilverScript Value	Kansas SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	049	0		29	10	S5601_049_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	049	0	2009	SilverScript Plus	Kansas SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	050	0		29	10	S5601_050_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	050	0	2009	SilverScript Value	Upper Midwest and N. Plains SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	051	0		29	10	S5601_051_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	051	0	2009	SilverScript Plus	Upper Midwest and N. Plains SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	052	0		29	10	S5601_052_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	052	0	2009	SilverScript Value	New Mexico SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	053	0		29	10	S5601_053_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	053	0	2009	SilverScript Plus	New Mexico SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	054	0		29	10	S5601_054_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	054	0	2009	SilverScript Value	Colorado SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	055	0		29	10	S5601_055_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	055	0	2009	SilverScript Plus	Colorado SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	056	0		29	10	S5601_056_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	056	0	2009	SilverScript Value	Arizona SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	057	0		29	10	S5601_057_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	057	0	2009	SilverScript Plus	Arizona SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	058	0		29	10	S5601_058_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	058	0	2009	SilverScript Value	Nevada SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	059	0		29	10	S5601_059_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	059	0	2009	SilverScript Plus	Nevada SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	060	0		29	10	S5601_060_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	060	0	2009	SilverScript Value	Oregon, Washington SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	061	0		29	10	S5601_061_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	061	0	2009	SilverScript Plus	Oregon, Washington SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	062	0		29	10	S5601_062_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	062	0	2009	SilverScript Value	Idaho, Utah SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	063	0		29	10	S5601_063_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	063	0	2009	SilverScript Plus	Idaho, Utah SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	064	0		29	10	S5601_064_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	064	0	2009	SilverScript Value	California SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	065	0		29	10	S5601_065_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	065	0	2009	SilverScript Plus	California SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	066	0		29	10	S5601_066_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	066	0	2009	SilverScript Value	Hawaii SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	067	0		29	10	S5601_067_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	067	0	2009	SilverScript Plus	Hawaii SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	068	0		29	10	S5601_068_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	068	0	2009	SilverScript Value	Alaska SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	069	0		29	10	S5601_069_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	069	0	2009	SilverScript Plus	Alaska SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	070	0		29	10	S5601_070_0	7	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	070	0	2009	SilverScript Value	Puerto Rico SilverScript		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	071	0		29	10	S5601_071_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	071	0	2009	SilverScript Plus	Puerto Rico SilverScript Plus		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	072	0		29	10	S5601_072_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	072	0	2009	SilverScript Complete	Northern New England SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	073	0		29	10	S5601_073_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	073	0	2009	SilverScript Complete	Central New England SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	074	0		29	10	S5601_074_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	074	0	2009	SilverScript Complete	New York SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	075	0		29	10	S5601_075_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	075	0	2009	SilverScript Complete	New Jersey SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	076	0		29	10	S5601_076_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	076	0	2009	SilverScript Complete	Mid-Atlantic SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	077	0		29	10	S5601_077_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	077	0	2009	SilverScript Complete	Pennsylvania, West Virginia SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	078	0		29	10	S5601_078_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	078	0	2009	SilverScript Complete	Virginia SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	079	0		29	10	S5601_079_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	079	0	2009	SilverScript Complete	North Carolina SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	080	0		29	10	S5601_080_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	080	0	2009	SilverScript Complete	South Carolina SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	081	0		29	10	S5601_081_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	081	0	2009	SilverScript Complete	Georgia SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	082	0		29	10	S5601_082_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	082	0	2009	SilverScript Complete	Florida SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	083	0		29	10	S5601_083_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	083	0	2009	SilverScript Complete	Alabama, Tennessee SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	084	0		29	10	S5601_084_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	084	0	2009	SilverScript Complete	Michigan SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	085	0		29	10	S5601_085_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	085	0	2009	SilverScript Complete	Ohio SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	086	0		29	10	S5601_086_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	086	0	2009	SilverScript Complete	Indiana, Kentucky SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	087	0		29	10	S5601_087_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	087	0	2009	SilverScript Complete	Wisconsin SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	088	0		29	10	S5601_088_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	088	0	2009	SilverScript Complete	Illinois SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	089	0		29	10	S5601_089_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	089	0	2009	SilverScript Complete	Missouri SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	090	0		29	10	S5601_090_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	090	0	2009	SilverScript Complete	Arkansas SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	091	0		29	10	S5601_091_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	091	0	2009	SilverScript Complete	Mississippi SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	092	0		29	10	S5601_092_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	092	0	2009	SilverScript Complete	Louisiana SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	093	0		29	10	S5601_093_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	093	0	2009	SilverScript Complete	Texas SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	094	0		29	10	S5601_094_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	094	0	2009	SilverScript Complete	Oklahoma SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	095	0		29	10	S5601_095_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	095	0	2009	SilverScript Complete	Kansas SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	096	0		29	10	S5601_096_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	096	0	2009	SilverScript Complete	Upper Midwest- North Plains SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	097	0		29	10	S5601_097_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	097	0	2009	SilverScript Complete	New Mexico SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	098	0		29	10	S5601_098_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	098	0	2009	SilverScript Complete	Colorado SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	099	0		29	10	S5601_099_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	099	0	2009	SilverScript Complete	Arizona SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	100	0		29	10	S5601_100_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	100	0	2009	SilverScript Complete	Nevada SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	101	0		29	10	S5601_101_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	101	0	2009	SilverScript Complete	Oregon, Washington SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	102	0		29	10	S5601_102_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	102	0	2009	SilverScript Complete	Idaho, Utah SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	103	0		29	10	S5601_103_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	103	0	2009	SilverScript Complete	California SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	104	0		29	10	S5601_104_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	104	0	2009	SilverScript Complete	Hawaii SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	105	0		29	10	S5601_105_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	105	0	2009	SilverScript Complete	Alaska SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	106	0		29	10	S5601_106_0	4	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	106	0	2009	SilverScript Complete	Puerto Rico SilverScript Complete		2	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	801	0		29	10	S5601_801_0	1	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	801	0	2009	SilverScript Group - Calendar	National SilverScript Group		1	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5601	802	0		29	10	S5601_802_0	1	2009.01	SILVERSCRIPT INSURANCE COMPANY	SilverScript Insurance Company	www.SilverScript.com	10	29				S5601	802	0	2009	SilverScript Group - Non-Calendar	National SilverScript Group - Non-Calendar		1	2																		(866)-235-5660	(866)-235-5660	(866)-236-1069	(866)-236-1069	(866)-552-6106	(866)-552-6106	(866)-552-6288	(866)-552-6288	www.SilverScript.com	
S5609	001	0		29	10	S5609_001_0	2	2009.01	ASURIS NORTHWEST HEALTH	Asuris Northwest Health	www.asuris.com/medicareScript	10	29				S5609	001	0	2009	Asuris Medicare Script	Region of Oregon and Washington		2	2																		(800)-541-8981	(800)-541-8981	(800)-382-1003	(800)-382-1003	(888)-734-3623	(888)-734-3623	(800)-382-1003	(800)-382-1003	www.asuris.com/medicareScript	
S5609	002	0		29	10	S5609_002_0	2	2009.01	ASURIS NORTHWEST HEALTH	Asuris Northwest Health	www.asuris.com/medicareScript	10	29				S5609	002	0	2009	Asuris Medicare Script Enhanced	Region of Oregon and Washington		2	2																		(800)-541-8981	(800)-541-8981	(800)-382-1003	(800)-382-1003	(888)-734-3623	(888)-734-3623	(800)-382-1003	(800)-382-1003	www.asuris.com/medicareScript	
S5609	802	0		29	10	S5609_802_0	1	2009.01	ASURIS NORTHWEST HEALTH	Asuris Northwest Health	www.asuris.com/medicareScript	10	29				S5609	802	0	2009	Asuris Medicare Script	Region of Oregon and Washington		1	2																		(800)-541-8981	(800)-541-8981	(800)-382-1003	(800)-382-1003	(888)-734-3623	(888)-734-3623	(800)-382-1003	(800)-382-1003	www.asuris.com/medicareScript	
S5617	003	0		29	10	S5617_003_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	003	0	2009	CIGNA Medicare Rx Plan One	States of New Hampshire and Maine		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	005	0		29	10	S5617_005_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	005	0	2009	CIGNA Medicare Rx Plan Two	States of New Hampshire and Maine		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	008	0		29	10	S5617_008_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	008	0	2009	CIGNA Medicare Rx Plan One	States of Connecticut, Massachusetts and Vermont		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	010	0		29	10	S5617_010_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	010	0	2009	CIGNA Medicare Rx Plan Two	States of Connecticut, Massachusetts and Vermont		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	013	0		29	10	S5617_013_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	013	0	2009	CIGNA Medicare Rx  Plan One	State of New York		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	015	0		29	10	S5617_015_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	015	0	2009	CIGNA Medicare Rx Plan Two	State of New York		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	018	0		29	10	S5617_018_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	018	0	2009	CIGNA Medicare Rx  Plan One	State of New Jersey		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	020	0		29	10	S5617_020_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	020	0	2009	CIGNA Medicare Rx Plan Two	State of New Jersey		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	023	0		29	10	S5617_023_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	023	0	2009	CIGNA Medicare Rx  Plan One	States of Delaware and Maryland, and DC		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	025	0		29	10	S5617_025_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	025	0	2009	CIGNA Medicare Rx Plan Two	States of Delaware and Maryland, and DC		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	028	0		29	10	S5617_028_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	028	0	2009	CIGNA Medicare Rx  Plan One	Pennsylvania and West Virginia		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	030	0		29	10	S5617_030_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	030	0	2009	CIGNA Medicare Rx Plan Two	Pennsylvania and West Virginia		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	033	0		29	10	S5617_033_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	033	0	2009	CIGNA Medicare Rx  Plan One	Commonwealth of Virginia		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	035	0		29	10	S5617_035_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	035	0	2009	CIGNA Medicare Rx Plan Two	Commonwealth of Virginia		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	038	0		29	10	S5617_038_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	038	0	2009	CIGNA Medicare Rx  Plan One	State of North Carolina		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	040	0		29	10	S5617_040_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	040	0	2009	CIGNA Medicare Rx Plan Two	State of North Carolina		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	043	0		29	10	S5617_043_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	043	0	2009	CIGNA Medicare Rx  Plan One	State of South Carolina		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	045	0		29	10	S5617_045_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	045	0	2009	CIGNA Medicare Rx Plan Two	State of South Carolina		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	048	0		29	10	S5617_048_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	048	0	2009	CIGNA Medicare Rx  Plan One	State of Georgia		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	050	0		29	10	S5617_050_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	050	0	2009	CIGNA Medicare Rx Plan Two	State of Georgia		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	053	0		29	10	S5617_053_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	053	0	2009	CIGNA Medicare Rx  Plan One	State of Florida		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	055	0		29	10	S5617_055_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	055	0	2009	CIGNA Medicare Rx Plan Two	State of Florida		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	058	0		29	10	S5617_058_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	058	0	2009	CIGNA Medicare Rx  Plan One	States of Alabama and Tennessee		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	060	0		29	10	S5617_060_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	060	0	2009	CIGNA Medicare Rx Plan Two	States of Alabama and Tennessee		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	063	0		29	10	S5617_063_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	063	0	2009	CIGNA Medicare Rx  Plan One	State of Michigan		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	065	0		29	10	S5617_065_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	065	0	2009	CIGNA Medicare Rx Plan Two	State of Michigan		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	068	0		29	10	S5617_068_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	068	0	2009	CIGNA Medicare Rx  Plan One	State of Ohio		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	070	0		29	10	S5617_070_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	070	0	2009	CIGNA Medicare Rx Plan Two	State of Ohio		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	073	0		29	10	S5617_073_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	073	0	2009	CIGNA Medicare Rx  Plan One	Indiana and Kentucky		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	075	0		29	10	S5617_075_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	075	0	2009	CIGNA Medicare Rx Plan Two	Indiana and Kentucky		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	078	0		29	10	S5617_078_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	078	0	2009	CIGNA Medicare Rx  Plan One	State of Wisconsin		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	080	0		29	10	S5617_080_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	080	0	2009	CIGNA Medicare Rx Plan Two	State of Wisconsin		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	083	0		29	10	S5617_083_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	083	0	2009	CIGNA Medicare Rx  Plan One	State of Illinois		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	085	0		29	10	S5617_085_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	085	0	2009	CIGNA Medicare Rx Plan Two	State of Illinois		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	088	0		29	10	S5617_088_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	088	0	2009	CIGNA Medicare Rx  Plan One	State of Missouri		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	090	0		29	10	S5617_090_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	090	0	2009	CIGNA Medicare Rx Plan Two	State of Missouri		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	093	0		29	10	S5617_093_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	093	0	2009	CIGNA Medicare Rx  Plan One	State of Arkansas		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	095	0		29	10	S5617_095_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	095	0	2009	CIGNA Medicare Rx Plan Two	State of Arkansas		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	098	0		29	10	S5617_098_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	098	0	2009	CIGNA Medicare Rx  Plan One	State of Mississippi		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	100	0		29	10	S5617_100_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	100	0	2009	CIGNA Medicare Rx Plan Two	State of Mississippi		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	103	0		29	10	S5617_103_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	103	0	2009	CIGNA Medicare Rx  Plan One	State of Louisiana		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	105	0		29	10	S5617_105_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	105	0	2009	CIGNA Medicare Rx Plan Two	State of Louisiana		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	108	0		29	10	S5617_108_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	108	0	2009	CIGNA Medicare Rx  Plan One	State of Texas		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	110	0		29	10	S5617_110_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	110	0	2009	CIGNA Medicare Rx Plan Two	State of Texas		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	113	0		29	10	S5617_113_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	113	0	2009	CIGNA Medicare Rx  Plan One	State of Oklahoma		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	115	0		29	10	S5617_115_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	115	0	2009	CIGNA Medicare Rx Plan Two	State of Oklahoma		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	118	0		29	10	S5617_118_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	118	0	2009	CIGNA Medicare Rx  Plan One	State of Kansas		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	120	0		29	10	S5617_120_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	120	0	2009	CIGNA Medicare Rx Plan Two	State of Kansas		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	123	0		29	10	S5617_123_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	123	0	2009	CIGNA Medicare Rx  Plan One	States of IA, MN, MT, ND, NE, SD, WY		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	125	0		29	10	S5617_125_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	125	0	2009	CIGNA Medicare Rx Plan Two	States of IA, MN, MT, ND, NE, SD, WY		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	128	0		29	10	S5617_128_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	128	0	2009	CIGNA Medicare Rx  Plan One	State of New Mexico		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	130	0		29	10	S5617_130_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	130	0	2009	CIGNA Medicare Rx Plan Two	State of New Mexico		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	133	0		29	10	S5617_133_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	133	0	2009	CIGNA Medicare Rx  Plan One	State of Colorado		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	135	0		29	10	S5617_135_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	135	0	2009	CIGNA Medicare Rx Plan Two	State of Colorado		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	138	0		29	10	S5617_138_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	138	0	2009	CIGNA Medicare Rx  Plan One	State of Arizona		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	140	0		29	10	S5617_140_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	140	0	2009	CIGNA Medicare Rx Plan Two	State of Arizona		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	143	0		29	10	S5617_143_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	143	0	2009	CIGNA Medicare Rx  Plan One	State of Nevada		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	145	0		29	10	S5617_145_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	145	0	2009	CIGNA Medicare Rx Plan Two	State of Nevada		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	148	0		29	10	S5617_148_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	148	0	2009	CIGNA Medicare Rx  Plan One	States of Oregon and Washington		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	150	0		29	10	S5617_150_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	150	0	2009	CIGNA Medicare Rx Plan Two	States of Oregon and Washington		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	153	0		29	10	S5617_153_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	153	0	2009	CIGNA Medicare Rx  Plan One	States of Idaho and Utah		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	155	0		29	10	S5617_155_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	155	0	2009	CIGNA Medicare Rx Plan Two	States of Idaho and Utah		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	158	0		29	10	S5617_158_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	158	0	2009	CIGNA Medicare Rx  Plan One	State of California		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	160	0		29	10	S5617_160_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	160	0	2009	CIGNA Medicare Rx Plan Two	State of California		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	163	0		29	10	S5617_163_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	163	0	2009	CIGNA Medicare Rx  Plan One	State of Hawaii		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	165	0		29	10	S5617_165_0	3	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	165	0	2009	CIGNA Medicare Rx Plan Two	State of Hawaii		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	168	0		29	10	S5617_168_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	168	0	2009	CIGNA Medicare Rx  Plan One	State of Alaska		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	170	0		29	10	S5617_170_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	170	0	2009	CIGNA Medicare Rx Plan Two	State of Alaska		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	171	0		29	10	S5617_171_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	171	0	2009	CIGNA Medicare Rx Plan Three	States of New Hampshire and Maine		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	172	0		29	10	S5617_172_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	172	0	2009	CIGNA Medicare Rx Plan Three	Connecticut, Massachusetts and Vermont		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	173	0		29	10	S5617_173_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	173	0	2009	CIGNA Medicare Rx Plan Three	State of New York		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	174	0		29	10	S5617_174_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	174	0	2009	CIGNA Medicare Rx Plan Three	State of New Jersey		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	175	0		29	10	S5617_175_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	175	0	2009	CIGNA Medicare Rx Plan Three	States of Delaware and Maryland, and DC		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	176	0		29	10	S5617_176_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	176	0	2009	CIGNA Medicare Rx Plan Three	Pennsylvania and West Virginia		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	177	0		29	10	S5617_177_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	177	0	2009	CIGNA Medicare Rx Plan Three	Commonwealth of Virginia		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	178	0		29	10	S5617_178_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	178	0	2009	CIGNA Medicare Rx Plan Three	State of North Carolina		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	179	0		29	10	S5617_179_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	179	0	2009	CIGNA Medicare Rx Plan Three	State of South Carolina		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	180	0		29	10	S5617_180_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	180	0	2009	CIGNA Medicare Rx Plan Three	State of Georgia		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	181	0		29	10	S5617_181_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	181	0	2009	CIGNA Medicare Rx Plan Three	State of Florida		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	182	0		29	10	S5617_182_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	182	0	2009	CIGNA Medicare Rx Plan Three	States of Alabama and Tennessee		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	183	0		29	10	S5617_183_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	183	0	2009	CIGNA Medicare Rx Plan Three	State of Michigan		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	184	0		29	10	S5617_184_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	184	0	2009	CIGNA Medicare Rx Plan Three	State of Ohio		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	185	0		29	10	S5617_185_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	185	0	2009	CIGNA Medicare Rx Plan Three	Indiana and Kentucky		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	186	0		29	10	S5617_186_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	186	0	2009	CIGNA Medicare Rx Plan Three	State of Wisconsin		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	187	0		29	10	S5617_187_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	187	0	2009	CIGNA Medicare Rx Plan Three	State of Illinois		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	188	0		29	10	S5617_188_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	188	0	2009	CIGNA Medicare Rx Plan Three	State of Missouri		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	189	0		29	10	S5617_189_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	189	0	2009	CIGNA Medicare Rx Plan Three	State of Arkansas		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	190	0		29	10	S5617_190_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	190	0	2009	CIGNA Medicare Rx Plan Three	State of Mississippi		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	191	0		29	10	S5617_191_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	191	0	2009	CIGNA Medicare Rx Plan Three	State of Louisiana		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	192	0		29	10	S5617_192_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	192	0	2009	CIGNA Medicare Rx Plan Three	State of Texas		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	193	0		29	10	S5617_193_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	193	0	2009	CIGNA Medicare Rx Plan Three	State of Oklahoma		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	194	0		29	10	S5617_194_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	194	0	2009	CIGNA Medicare Rx Plan Three	State of Kansas		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	195	0		29	10	S5617_195_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	195	0	2009	CIGNA Medicare Rx Plan Three	States of IA, MN, MT, ND, NE, SD, WY		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	196	0		29	10	S5617_196_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	196	0	2009	CIGNA Medicare Rx Plan Three	State of New Mexico		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	197	0		29	10	S5617_197_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	197	0	2009	CIGNA Medicare Rx Plan Three	State of Colorado		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	198	0		29	10	S5617_198_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	198	0	2009	CIGNA Medicare Rx Plan Three	State of Arizona		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	199	0		29	10	S5617_199_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	199	0	2009	CIGNA Medicare Rx Plan Three	State of Nevada		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	200	0		29	10	S5617_200_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	200	0	2009	CIGNA Medicare Rx Plan Three	States of Oregon and Washington		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	201	0		29	10	S5617_201_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	201	0	2009	CIGNA Medicare Rx Plan Three	States of Idaho and Utah		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	202	0		29	10	S5617_202_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	202	0	2009	CIGNA Medicare Rx Plan Three	State of California		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	203	0		29	10	S5617_203_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	203	0	2009	CIGNA Medicare Rx Plan Three	State of Hawaii		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	204	0		29	10	S5617_204_0	2	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	204	0	2009	CIGNA Medicare Rx Plan Three	State of Alaska		2	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	801	0		29	10	S5617_801_0	1	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	801	0	2009	Employer Plan CY	Nationwide		1	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5617	802	0		29	10	S5617_802_0	1	2009.01	CONNECTICUT GENERAL LIFE INSURANCE COMPANY	CIGNA Medicare Rx	www.cignamedicarerx.com	10	29				S5617	802	0	2009	Employer Plan NCY	Nationwide		1	2																		(800)-222-6700	(800)-222-6700			(800)-735-1459	(800)-735-1459			http://www.cigna.com/sites/cignamedicare/formulary/medicarerx.html	
S5644	004	0		29	10	S5644_004_0	4	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	004	0	2009	Advantage Star Plan by RxAmerica	NY		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	005	0		29	10	S5644_005_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	005	0	2009	Advantage Star Plan by RxAmerica	NJ		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	012	0		29	10	S5644_012_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	012	0	2009	Advantage Star Plan by RxAmerica	AL-TN		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	045	0		29	10	S5644_045_0	4	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	045	0	2009	Advantage Freedom Plan by RxAmerica	ME-NH		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	047	0		29	10	S5644_047_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	047	0	2009	Advantage Freedom Plan by RxAmerica	MA-RI-VT-CT		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	048	0		29	10	S5644_048_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	048	0	2009	Advantage Freedom Plan by RxAmerica	NY		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	049	0		29	10	S5644_049_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	049	0	2009	Advantage Freedom Plan by RxAmerica	NJ		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	050	0		29	10	S5644_050_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	050	0	2009	Advantage Freedom Plan by RxAmerica	DE-MD-DC		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	051	0		29	10	S5644_051_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	051	0	2009	Advantage Freedom Plan by RxAmerica	PA-WV		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	052	0		29	10	S5644_052_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	052	0	2009	Advantage Freedom Plan by RxAmerica	VA		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	053	0		29	10	S5644_053_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	053	0	2009	Advantage Freedom Plan by RxAmerica	NC		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	054	0		29	10	S5644_054_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	054	0	2009	Advantage Freedom Plan by RxAmerica	SC		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	055	0		29	10	S5644_055_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	055	0	2009	Advantage Freedom Plan by RxAmerica	GA		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	056	0		29	10	S5644_056_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	056	0	2009	Advantage Freedom Plan by RxAmerica	AL-TN		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	057	0		29	10	S5644_057_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	057	0	2009	Advantage Freedom Plan by RxAmerica	MI		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	058	0		29	10	S5644_058_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	058	0	2009	Advantage Freedom Plan by RxAmerica	TX		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	059	0		29	10	S5644_059_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	059	0	2009	Advantage Freedom Plan by RxAmerica	IA-MN-MT-NB-ND-SD-WY		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	060	0		29	10	S5644_060_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	060	0	2009	Advantage Freedom Plan by RxAmerica	AZ		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	061	0		29	10	S5644_061_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	061	0	2009	Advantage Freedom Plan by RxAmerica	NV		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	062	0		29	10	S5644_062_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	062	0	2009	Advantage Freedom Plan by RxAmerica	OR-WA		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	063	0		29	10	S5644_063_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	063	0	2009	Advantage Freedom Plan by RxAmerica	UT-ID		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	064	0		29	10	S5644_064_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	064	0	2009	Advantage Freedom Plan by RxAmerica	CA		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	065	0		29	10	S5644_065_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	065	0	2009	Advantage Freedom Plan by RxAmerica	HI		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	067	0		29	10	S5644_067_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	067	0	2009	Advantage Star Plan by RxAmerica	ME-NH		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	068	0		29	10	S5644_068_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	068	0	2009	Advantage Star Plan by RxAmerica	MA-RI-VT-CT		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	071	0		29	10	S5644_071_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	071	0	2009	Advantage Star Plan by RxAmerica	DE-DC-MD		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	072	0		29	10	S5644_072_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	072	0	2009	Advantage Star Plan by RxAmerica	PA-WV		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	073	0		29	10	S5644_073_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	073	0	2009	Advantage Star Plan by RxAmerica	VA		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	074	0		29	10	S5644_074_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	074	0	2009	Advantage Star Plan by RxAmerica	NC		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	075	0		29	10	S5644_075_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	075	0	2009	Advantage Star Plan by RxAmerica	SC		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	076	0		29	10	S5644_076_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	076	0	2009	Advantage Star Plan by RxAmerica	GA		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	078	0		29	10	S5644_078_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	078	0	2009	Advantage Star Plan by RxAmerica	MI		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	079	0		29	10	S5644_079_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	079	0	2009	Advantage Star Plan by RxAmerica	TX		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	080	0		29	10	S5644_080_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	080	0	2009	Advantage Star Plan by RxAmerica	IA-MN-MT-NB-ND-SD-WY		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	081	0		29	10	S5644_081_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	081	0	2009	Advantage Star Plan by RxAmerica	AZ		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	082	0		29	10	S5644_082_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	082	0	2009	Advantage Star Plan by RxAmerica	NV		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	083	0		29	10	S5644_083_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	083	0	2009	Advantage Star Plan by RxAmerica	OR-WA		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	084	0		29	10	S5644_084_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	084	0	2009	Advantage Star Plan by RxAmerica	CA		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	085	0		29	10	S5644_085_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	085	0	2009	Advantage Star Plan by RxAmerica	HI		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	087	0		29	10	S5644_087_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	087	0	2009	Advantage Star Plan by RxAmerica	ID-UT		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	174	0		29	10	S5644_174_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	174	0	2009	Advantage Freedom Plan by RxAmerica	FL		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	175	0		29	10	S5644_175_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	175	0	2009	Advantage Freedom Plan by RxAmerica	OH		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	176	0		29	10	S5644_176_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	176	0	2009	Advantage Freedom Plan by RxAmerica	IN-KY		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	177	0		29	10	S5644_177_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	177	0	2009	Advantage Freedom Plan by RxAmerica	WI		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	178	0		29	10	S5644_178_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	178	0	2009	Advantage Freedom Plan by RxAmerica	IL		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	179	0		29	10	S5644_179_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	179	0	2009	Advantage Freedom Plan by RxAmerica	MO		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	180	0		29	10	S5644_180_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	180	0	2009	Advantage Freedom Plan by RxAmerica	AR		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	181	0		29	10	S5644_181_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	181	0	2009	Advantage Freedom Plan by RxAmerica	MS		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	182	0		29	10	S5644_182_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	182	0	2009	Advantage Freedom Plan by RxAmerica	LA		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	183	0		29	10	S5644_183_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	183	0	2009	Advantage Freedom Plan by RxAmerica	OK		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	184	0		29	10	S5644_184_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	184	0	2009	Advantage Freedom Plan by RxAmerica	KS		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	185	0		29	10	S5644_185_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	185	0	2009	Advantage Freedom Plan by RxAmerica	NM		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	186	0		29	10	S5644_186_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	186	0	2009	Advantage Freedom Plan by RxAmerica	CO		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	187	0		29	10	S5644_187_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	187	0	2009	Advantage Freedom Plan by RxAmerica	AK		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	188	0		29	10	S5644_188_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	188	0	2009	Advantage Star Plan by RxAmerica	FL		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	189	0		29	10	S5644_189_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	189	0	2009	Advantage Star Plan by RxAmerica	OH		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	190	0		29	10	S5644_190_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	190	0	2009	Advantage Star Plan by RxAmerica	IN-KY		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	191	0		29	10	S5644_191_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	191	0	2009	Advantage Star Plan by RxAmerica	WI		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	192	0		29	10	S5644_192_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	192	0	2009	Advantage Star Plan by RxAmerica	IL		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	193	0		29	10	S5644_193_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	193	0	2009	Advantage Star Plan by RxAmerica	MO		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	194	0		29	10	S5644_194_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	194	0	2009	Advantage Star Plan by RxAmerica	AR		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	195	0		29	10	S5644_195_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	195	0	2009	Advantage Star Plan by RxAmerica	MS		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	196	0		29	10	S5644_196_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	196	0	2009	Advantage Star Plan by RxAmerica	LA		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	197	0		29	10	S5644_197_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	197	0	2009	Advantage Star Plan by RxAmerica	OK		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	198	0		29	10	S5644_198_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	198	0	2009	Advantage Star Plan by RxAmerica	KS		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	199	0		29	10	S5644_199_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	199	0	2009	Advantage Star Plan by RxAmerica	NM		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	200	0		29	10	S5644_200_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	200	0	2009	Advantage Star Plan by RxAmerica	CO		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	201	0		29	10	S5644_201_0	3	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	201	0	2009	Advantage Star Plan by RxAmerica	AK		2	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	801	0		29	10	S5644_801_0	2	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	801	0	2009	Advantage Group Calendar Year by RxAmerica	National		1	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5644	802	0		29	10	S5644_802_0	2	2009.01	RXAMERICA, LLC	RxAmerica	www.meds4medicare.com	10	29				S5644	802	0	2009	Advantage Group Non-Calendar Year by RxA	National		1	2																		(800)-429-6686	(800)-429-6686			(800)-429-6686	(800)-429-6686			www.meds4medicare.com	
S5660	001	0		29	10	S5660_001_0	5	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	001	0	2009	Medco Medicare Prescription Plan - Choice	Northern New England		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	003	0		29	10	S5660_003_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	003	0	2009	Medco Medicare Prescription Plan - Choice	Central New England		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	004	0		29	10	S5660_004_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	004	0	2009	Medco Medicare Prescription Plan - Choice	Mid-Atlantic		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	005	0		29	10	S5660_005_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	005	0	2009	Medco Medicare Prescription Plan - Choice	States of Pennsylvania and West Virginia		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	006	0		29	10	S5660_006_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	006	0	2009	Medco Medicare Prescription Plan - Choice	State of Virginia		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	007	0		29	10	S5660_007_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	007	0	2009	Medco Medicare Prescription Plan - Choice	State of North Carolina		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	008	0		29	10	S5660_008_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	008	0	2009	Medco Medicare Prescription Plan - Choice	State of South Carolina		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	009	0		29	10	S5660_009_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	009	0	2009	Medco Medicare Prescription Plan - Choice	State of Georgia		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	010	0		29	10	S5660_010_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	010	0	2009	Medco Medicare Prescription Plan - Choice	State of Florida		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	012	0		29	10	S5660_012_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	012	0	2009	Medco Medicare Prescription Plan - Choice	States of Alabama and Tennessee		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	013	0		29	10	S5660_013_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	013	0	2009	Medco Medicare Prescription Plan - Choice	State of Michigan		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	014	0		29	10	S5660_014_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	014	0	2009	Medco Medicare Prescription Plan - Choice	State of Ohio		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	015	0		29	10	S5660_015_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	015	0	2009	Medco Medicare Prescription Plan - Choice	States of Indiana and Kentucky		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	016	0		29	10	S5660_016_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	016	0	2009	Medco Medicare Prescription Plan - Choice	State of Wisconsin		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	017	0		29	10	S5660_017_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	017	0	2009	Medco Medicare Prescription Plan - Choice	State of Illinois		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	018	0		29	10	S5660_018_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	018	0	2009	Medco Medicare Prescription Plan - Choice	State of Missouri		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	019	0		29	10	S5660_019_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	019	0	2009	Medco Medicare Prescription Plan - Choice	State of Arkansas		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	020	0		29	10	S5660_020_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	020	0	2009	Medco Medicare Prescription Plan - Choice	State of Mississippi		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	021	0		29	10	S5660_021_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	021	0	2009	Medco Medicare Prescription Plan - Choice	State of Louisiana		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	022	0		29	10	S5660_022_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	022	0	2009	Medco Medicare Prescription Plan - Choice	State of Texas		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	023	0		29	10	S5660_023_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	023	0	2009	Medco Medicare Prescription Plan - Choice	State of Oklahoma		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	024	0		29	10	S5660_024_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	024	0	2009	Medco Medicare Prescription Plan - Choice	State of Kansas		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	025	0		29	10	S5660_025_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	025	0	2009	Medco Medicare Prescription Plan - Choice	Upper Midwest and Northern Plains		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	026	0		29	10	S5660_026_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	026	0	2009	Medco Medicare Prescription Plan - Choice	State of New Mexico		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	027	0		29	10	S5660_027_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	027	0	2009	Medco Medicare Prescription Plan - Choice	State of Colorado		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	028	0		29	10	S5660_028_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	028	0	2009	Medco Medicare Prescription Plan - Choice	State of Arizona		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	029	0		29	10	S5660_029_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	029	0	2009	Medco Medicare Prescription Plan - Choice	State of Nevada		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	030	0		29	10	S5660_030_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	030	0	2009	Medco Medicare Prescription Plan - Choice	States of Oregon and Washington		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	031	0		29	10	S5660_031_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	031	0	2009	Medco Medicare Prescription Plan - Choice	States of Idaho and Utah		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	032	0		29	10	S5660_032_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	032	0	2009	Medco Medicare Prescription Plan - Choice	State of California		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	033	0		29	10	S5660_033_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	033	0	2009	Medco Medicare Prescription Plan - Choice	State of Hawaii		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	034	0		29	10	S5660_034_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	034	0	2009	Medco Medicare Prescription Plan - Choice	State of Alaska		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	035	0		29	10	S5660_035_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	035	0	2009	Medco Medicare Prescription Plan - Choice	State of New Jersey		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	103	0		29	10	S5660_103_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	103	0	2009	Medco Medicare Prescription Plan - Choice	Puerto Rico		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	104	0		29	10	S5660_104_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	104	0	2009	Medco Medicare Prescription Plan - Value	Northern New England		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	105	0		29	10	S5660_105_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	105	0	2009	Medco Medicare Prescription Plan - Value	Central New England		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	106	0		29	10	S5660_106_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	106	0	2009	Medco Medicare Prescription Plan - Value	State of New Jersey		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	107	0		29	10	S5660_107_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	107	0	2009	Medco Medicare Prescription Plan - Value	Mid-Atlantic		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	108	0		29	10	S5660_108_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	108	0	2009	Medco Medicare Prescription Plan - Value	States of Pennsylvania and West Virginia		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	109	0		29	10	S5660_109_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	109	0	2009	Medco Medicare Prescription Plan - Value	State of Virginia		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	110	0		29	10	S5660_110_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	110	0	2009	Medco Medicare Prescription Plan - Value	State of North Carolina		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	111	0		29	10	S5660_111_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	111	0	2009	Medco Medicare Prescription Plan - Value	State of South Carolina		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	112	0		29	10	S5660_112_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	112	0	2009	Medco Medicare Prescription Plan - Value	State of Georgia		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	113	0		29	10	S5660_113_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	113	0	2009	Medco Medicare Prescription Plan - Value	State of Florida		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	114	0		29	10	S5660_114_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	114	0	2009	Medco Medicare Prescription Plan - Value	States of Alabama and Tennessee		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	115	0		29	10	S5660_115_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	115	0	2009	Medco Medicare Prescription Plan - Value	State of Michigan		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	116	0		29	10	S5660_116_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	116	0	2009	Medco Medicare Prescription Plan - Value	State of Ohio		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	117	0		29	10	S5660_117_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	117	0	2009	Medco Medicare Prescription Plan - Value	States of Indiana and Kentucky		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	118	0		29	10	S5660_118_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	118	0	2009	Medco Medicare Prescription Plan - Value	State of Wisconsin		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	119	0		29	10	S5660_119_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	119	0	2009	Medco Medicare Prescription Plan - Value	State of Illinois		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	120	0		29	10	S5660_120_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	120	0	2009	Medco Medicare Prescription Plan - Value	State of Missouri		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	121	0		29	10	S5660_121_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	121	0	2009	Medco Medicare Prescription Plan - Value	State of Arkansas		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	122	0		29	10	S5660_122_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	122	0	2009	Medco Medicare Prescription Plan - Value	State of Mississippi		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	123	0		29	10	S5660_123_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	123	0	2009	Medco Medicare Prescription Plan - Value	State of Louisiana		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	124	0		29	10	S5660_124_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	124	0	2009	Medco Medicare Prescription Plan - Value	State of Texas		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	125	0		29	10	S5660_125_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	125	0	2009	Medco Medicare Prescription Plan - Value	State of Oklahoma		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	126	0		29	10	S5660_126_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	126	0	2009	Medco Medicare Prescription Plan - Value	State of Kansas		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	127	0		29	10	S5660_127_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	127	0	2009	Medco Medicare Prescription Plan - Value	Upper Midwest and Northern Plains		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	128	0		29	10	S5660_128_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	128	0	2009	Medco Medicare Prescription Plan - Value	State of New Mexico		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	129	0		29	10	S5660_129_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	129	0	2009	Medco Medicare Prescription Plan - Value	State of Colorado		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	130	0		29	10	S5660_130_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	130	0	2009	Medco Medicare Prescription Plan - Value	State of Arizona		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	131	0		29	10	S5660_131_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	131	0	2009	Medco Medicare Prescription Plan - Value	State of Nevada		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	132	0		29	10	S5660_132_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	132	0	2009	Medco Medicare Prescription Plan - Value	States of Oregon and Washington		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	133	0		29	10	S5660_133_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	133	0	2009	Medco Medicare Prescription Plan - Value	States of Idaho and Utah		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	134	0		29	10	S5660_134_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	134	0	2009	Medco Medicare Prescription Plan - Value	State of California		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	135	0		29	10	S5660_135_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	135	0	2009	Medco Medicare Prescription Plan - Value	State of Hawaii		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	136	0		29	10	S5660_136_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	136	0	2009	Medco Medicare Prescription Plan - Value	State of Alaska		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	137	0		29	10	S5660_137_0	2	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	137	0	2009	Medco Medicare Prescription Plan - Value	Puerto Rico		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	172	0		29	10	S5660_172_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	172	0	2009	Medco Medicare Prescription Plan - Access	Northern New England		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	173	0		29	10	S5660_173_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	173	0	2009	Medco Medicare Prescription Plan - Access	Central New England		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	174	0		29	10	S5660_174_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	174	0	2009	Medco Medicare Prescription Plan - Access	State of New Jersey		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	175	0		29	10	S5660_175_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	175	0	2009	Medco Medicare Prescription Plan - Access	Mid-Atlantic		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	176	0		29	10	S5660_176_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	176	0	2009	Medco Medicare Prescription Plan - Access	States of Pennsylvania and West Virginia		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	177	0		29	10	S5660_177_0	4	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	177	0	2009	Medco Medicare Prescription Plan - Access	State of Virginia		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	178	0		29	10	S5660_178_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	178	0	2009	Medco Medicare Prescription Plan - Access	State of North Carolina		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	179	0		29	10	S5660_179_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	179	0	2009	Medco Medicare Prescription Plan - Access	State of South Carolina		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	180	0		29	10	S5660_180_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	180	0	2009	Medco Medicare Prescription Plan - Access	State of Georgia		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	181	0		29	10	S5660_181_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	181	0	2009	Medco Medicare Prescription Plan - Access	State of Florida		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	182	0		29	10	S5660_182_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	182	0	2009	Medco Medicare Prescription Plan - Access	States of Alabama and Tennessee		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	183	0		29	10	S5660_183_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	183	0	2009	Medco Medicare Prescription Plan - Access	State of Michigan		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	184	0		29	10	S5660_184_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	184	0	2009	Medco Medicare Prescription Plan - Access	State of Ohio		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	185	0		29	10	S5660_185_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	185	0	2009	Medco Medicare Prescription Plan - Access	States of Indiana and Kentucky		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	186	0		29	10	S5660_186_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	186	0	2009	Medco Medicare Prescription Plan - Access	State of Wisconsin		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	187	0		29	10	S5660_187_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	187	0	2009	Medco Medicare Prescription Plan - Access	State of Illinois		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	188	0		29	10	S5660_188_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	188	0	2009	Medco Medicare Prescription Plan - Access	State of Missouri		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	189	0		29	10	S5660_189_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	189	0	2009	Medco Medicare Prescription Plan - Access	State of Arkansas		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	190	0		29	10	S5660_190_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	190	0	2009	Medco Medicare Prescription Plan - Access	State of Mississippi		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	191	0		29	10	S5660_191_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	191	0	2009	Medco Medicare Prescription Plan - Access	State of Louisiana		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	192	0		29	10	S5660_192_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	192	0	2009	Medco Medicare Prescription Plan - Access	State of Texas		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	193	0		29	10	S5660_193_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	193	0	2009	Medco Medicare Prescription Plan - Access	State of Oklahoma		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	194	0		29	10	S5660_194_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	194	0	2009	Medco Medicare Prescription Plan - Access	State of Kansas		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	195	0		29	10	S5660_195_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	195	0	2009	Medco Medicare Prescription Plan - Access	Upper Midwest and Northern Plains		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	196	0		29	10	S5660_196_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	196	0	2009	Medco Medicare Prescription Plan - Access	State of New Mexico		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	197	0		29	10	S5660_197_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	197	0	2009	Medco Medicare Prescription Plan - Access	State of Colorado		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	198	0		29	10	S5660_198_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	198	0	2009	Medco Medicare Prescription Plan - Access	State of Arizona		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	199	0		29	10	S5660_199_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	199	0	2009	Medco Medicare Prescription Plan - Access	State of Nevada		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	200	0		29	10	S5660_200_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	200	0	2009	Medco Medicare Prescription Plan - Access	States of Oregon and Washington		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	201	0		29	10	S5660_201_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	201	0	2009	Medco Medicare Prescription Plan - Access	States of Idaho and Utah		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	202	0		29	10	S5660_202_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	202	0	2009	Medco Medicare Prescription Plan - Access	State of California		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	203	0		29	10	S5660_203_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	203	0	2009	Medco Medicare Prescription Plan - Access	State of Hawaii		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	204	0		29	10	S5660_204_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	204	0	2009	Medco Medicare Prescription Plan - Access	State of Alaska		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	205	0		29	10	S5660_205_0	3	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	205	0	2009	Medco Medicare Prescription Plan - Access	Puerto Rico		2	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	801	0		29	10	S5660_801_0	1	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	801	0	2009	Medco Medicare Prescription Plan	National Plan - Employer, Calendar Year		1	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	802	0		29	10	S5660_802_0	1	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	802	0	2009	Medco Medicare Prescription Plan	National Plan - Employer, Non-Calendar Year		1	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	803	0		29	10	S5660_803_0	1	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	803	0	2009	Medco Medicare Prescription Plan	National Plan K - Calendar Year		1	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	804	0		29	10	S5660_804_0	1	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	804	0	2009	Medco Medicare Prescription Plan	National Plan OF - Calendar Year		1	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	805	0		29	10	S5660_805_0	1	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	805	0	2009	Medco Medicare Prescription Plan	National Plan N1 - Calendar Year		1	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	806	0		29	10	S5660_806_0	1	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	806	0	2009	Medco Medicare Prescription Plan	National Plan N2 - Calendar Year		1	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5660	807	0		29	10	S5660_807_0	1	2009.01	MEDCO CONTAINMENT LIFE INSURANCE COMPANY	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5660	807	0	2009	Medco Medicare Prescription Plan	National Plan K - Non-Calendar Year		1	2																		(800)-758-4574	(800)-758-4574		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5670	027	0		29	10	S5670_027_0	5	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	027	0	2009	AdvantraRx Value	AdvantraRx Value Mid-Atlantic		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	028	0		29	10	S5670_028_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	028	0	2009	AdvantraRx Premier	AdvantraRx Premier Mid-Atlantic		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	030	0		29	10	S5670_030_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	030	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Mid-Atlantic		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	033	0		29	10	S5670_033_0	5	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	033	0	2009	AdvantraRx Value	AdvantraRx Value Pennsylvania, West Virginia		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	034	0		29	10	S5670_034_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	034	0	2009	AdvantraRx Premier	AdvantraRx Premier Pennsylvania, West Virginia		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	036	0		29	10	S5670_036_0	7	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	036	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Pennsylvania, W. Virginia		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	039	0		29	10	S5670_039_0	5	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	039	0	2009	AdvantraRx Value	AdvantraRx Value Virginia		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	040	0		29	10	S5670_040_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	040	0	2009	AdvantraRx Premier	AdvantraRx Premier Virginia		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	042	0		29	10	S5670_042_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	042	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Virginia		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	045	0		29	10	S5670_045_0	5	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	045	0	2009	AdvantraRx Value	AdvantraRx Value North Carolina		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	046	0		29	10	S5670_046_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	046	0	2009	AdvantraRx Premier	AdvantraRx Premier North Carolina		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	048	0		29	10	S5670_048_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	048	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus North Carolina		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	051	0		29	10	S5670_051_0	5	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	051	0	2009	AdvantraRx Value	AdvantraRx Value South Carolina		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	052	0		29	10	S5670_052_0	7	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	052	0	2009	AdvantraRx Premier	AdvantraRx Premier South Carolina		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	054	0		29	10	S5670_054_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	054	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus South Carolina		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	057	0		29	10	S5670_057_0	7	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	057	0	2009	AdvantraRx Value	AdvantraRx Value Georgia		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	058	0		29	10	S5670_058_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	058	0	2009	AdvantraRx Premier	AdvantraRx Premier Georgia		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	060	0		29	10	S5670_060_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	060	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Georgia		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	063	0		29	10	S5670_063_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	063	0	2009	AdvantraRx Value	AdvantraRx Value Alabama, Tennessee		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	064	0		29	10	S5670_064_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	064	0	2009	AdvantraRx Premier	AdvantraRx Premier Alabama, Tennessee		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	066	0		29	10	S5670_066_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	066	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Alabama, Tennessee		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	069	0		29	10	S5670_069_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	069	0	2009	AdvantraRx Value	AdvantraRx Value Michigan		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	070	0		29	10	S5670_070_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	070	0	2009	AdvantraRx Premier	AdvantraRx Premier Michigan		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	072	0		29	10	S5670_072_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	072	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Michigan		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	075	0		29	10	S5670_075_0	5	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	075	0	2009	AdvantraRx Value	AdvantraRx Value Ohio		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	076	0		29	10	S5670_076_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	076	0	2009	AdvantraRx Premier	AdvantraRx Premier Ohio		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	078	0		29	10	S5670_078_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	078	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Ohio		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	081	0		29	10	S5670_081_0	5	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	081	0	2009	AdvantraRx Value	AdvantraRx Value Wisconsin		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	082	0		29	10	S5670_082_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	082	0	2009	AdvantraRx Premier	AdvantraRx Premier Wisconsin		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	084	0		29	10	S5670_084_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	084	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Wisconsin		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	087	0		29	10	S5670_087_0	5	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	087	0	2009	AdvantraRx Value	AdvantraRx Value Illinois		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	088	0		29	10	S5670_088_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	088	0	2009	AdvantraRx Premier	AdvantraRx Premier Illinois		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	090	0		29	10	S5670_090_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	090	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Illinois		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	093	0		29	10	S5670_093_0	7	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	093	0	2009	AdvantraRx Value	AdvantraRx Value Missouri		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	094	0		29	10	S5670_094_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	094	0	2009	AdvantraRx Premier	AdvantraRx Premier Missouri		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	096	0		29	10	S5670_096_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	096	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Missouri		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	099	0		29	10	S5670_099_0	5	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	099	0	2009	AdvantraRx Value	AdvantraRx Value Arkansas		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	100	0		29	10	S5670_100_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	100	0	2009	AdvantraRx Premier	AdvantraRx Premier Arkansas		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	102	0		29	10	S5670_102_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	102	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Arkansas		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	105	0		29	10	S5670_105_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	105	0	2009	AdvantraRx Value	AdvantraRx Value Mississippi		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	106	0		29	10	S5670_106_0	7	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	106	0	2009	AdvantraRx Premier	AdvantraRx Premier Mississippi		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	108	0		29	10	S5670_108_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	108	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Mississippi		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	111	0		29	10	S5670_111_0	5	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	111	0	2009	AdvantraRx Value	AdvantraRx Value Louisiana		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	112	0		29	10	S5670_112_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	112	0	2009	AdvantraRx Premier	AdvantraRx Premier Louisiana		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	114	0		29	10	S5670_114_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	114	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Louisiana		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	117	0		29	10	S5670_117_0	5	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	117	0	2009	AdvantraRx Value	AdvantraRx Value Texas		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	118	0		29	10	S5670_118_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	118	0	2009	AdvantraRx Premier	AdvantraRx Premier Texas		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	120	0		29	10	S5670_120_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	120	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Texas		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	123	0		29	10	S5670_123_0	7	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	123	0	2009	AdvantraRx Value	AdvantraRx Value Oklahoma		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	124	0		29	10	S5670_124_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	124	0	2009	AdvantraRx Premier	AdvantraRx Premier Oklahoma		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	126	0		29	10	S5670_126_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	126	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Oklahoma		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	129	0		29	10	S5670_129_0	5	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	129	0	2009	AdvantraRx Value	AdvantraRx Value Kansas		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	130	0		29	10	S5670_130_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	130	0	2009	AdvantraRx Premier	AdvantraRx Premier Kansas		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	132	0		29	10	S5670_132_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	132	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Kansas		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	135	0		29	10	S5670_135_0	5	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	135	0	2009	AdvantraRx Value	AdvantraRx Value Colorado		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	136	0		29	10	S5670_136_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	136	0	2009	AdvantraRx Premier	AdvantraRx Premier Colorado		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	138	0		29	10	S5670_138_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	138	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Colorado		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	141	0		29	10	S5670_141_0	5	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	141	0	2009	AdvantraRx Value	AdvantraRx Value Arizona		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	142	0		29	10	S5670_142_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	142	0	2009	AdvantraRx Premier	AdvantraRx Premier Arizona		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	144	0		29	10	S5670_144_0	5	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	144	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Arizona		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	147	0		29	10	S5670_147_0	5	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	147	0	2009	AdvantraRx Value	AdvantraRx Value Nevada		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	148	0		29	10	S5670_148_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	148	0	2009	AdvantraRx Premier	AdvantraRx Premier Nevada		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	150	0		29	10	S5670_150_0	6	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	150	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Nevada		2	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	801	0		29	10	S5670_801_0	2	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	801	0	2009	AdvantraRx Employer Group 9071-CY	AdvantraRx Employer Group 9071-CY		1	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	802	0		29	10	S5670_802_0	2	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	802	0	2009	AdvantraRx Employer Group-9071-NCY	AdvantraRx Employer Group-9071-NCY		1	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	803	0		29	10	S5670_803_0	2	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	803	0	2009	AdvantraRx Employer Group-9069-CY	AdvantraRx Employer Group-9069-CY		1	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	804	0		29	10	S5670_804_0	2	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	804	0	2009	AdvantraRx Employer Group-9069-NCY	AdvantraRx Employer Group-9069-NCY		1	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	805	0		29	10	S5670_805_0	2	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	805	0	2009	AdvantraRx Employer Group-9070-CY	AdvantraRx Employer Group-9070-CY		1	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	806	0		29	10	S5670_806_0	2	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	806	0	2009	AdvantraRx Employer Group-9070-NCY	AdvantraRx Employer Group-9070-NCY		1	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	809	0		29	10	S5670_809_0	2	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	809	0	2009	AdvantraRx Employer Group - 9072-CY	AdvantraRx Employer Group - 9072-CY		1	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5670	810	0		29	10	S5670_810_0	2	2009.01	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5670	810	0	2009	AdvantraRx Employer Group-9072-NCY	AdvantraRx Employer Group-9072-NCY		1	2																		(866)-823-5177	(866)-823-5177	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(800)-508-9548	(800)-508-9548	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	002	0		29	10	S5674_002_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	002	0	2009	AdvantraRx Value	AdvantraRx Value Northern New England		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	003	0		29	10	S5674_003_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	003	0	2009	AdvantraRx Premier	AdvantraRx Premier Northern New England		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	005	0		29	10	S5674_005_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	005	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Northern New England		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	008	0		29	10	S5674_008_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	008	0	2009	AdvantraRx Value	AdvantraRx Value Central New England		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	009	0		29	10	S5674_009_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	009	0	2009	AdvantraRx Premier	AdvantraRx Premier Central New England		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	011	0		29	10	S5674_011_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	011	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Central New England		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	014	0		29	10	S5674_014_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	014	0	2009	AdvantraRx Value	AdvantraRx Value New Jersey		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	015	0		29	10	S5674_015_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	015	0	2009	AdvantraRx Premier	AdvantraRx Premier New Jersey		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	017	0		29	10	S5674_017_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	017	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus New Jersey		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	020	0		29	10	S5674_020_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	020	0	2009	AdvantraRx Value	AdvantraRx Value Florida		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	021	0		29	10	S5674_021_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	021	0	2009	AdvantraRx Premier	AdvantraRx Premier Florida		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	023	0		29	10	S5674_023_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	023	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Florida		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	026	0		29	10	S5674_026_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	026	0	2009	AdvantraRx Value	AdvantraRx Value Indiana, Kentucky		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	027	0		29	10	S5674_027_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	027	0	2009	AdvantraRx Premier	AdvantraRx Premier Indiana, Kentucky		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	029	0		29	10	S5674_029_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	029	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Indiana, Kentucky		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	032	0		29	10	S5674_032_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	032	0	2009	AdvantraRx Value	AdvantraRx Value Upper Midwest and Northern Plains		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	033	0		29	10	S5674_033_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	033	0	2009	AdvantraRx Premier	AdvantraRx Premier Upper Midwest and No Plains		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	035	0		29	10	S5674_035_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	035	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Upper Midwest, No Plains		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	038	0		29	10	S5674_038_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	038	0	2009	AdvantraRx Value	AdvantraRx Value New Mexico		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	039	0		29	10	S5674_039_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	039	0	2009	AdvantraRx Premier	AdvantraRx Premier New Mexico		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	041	0		29	10	S5674_041_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	041	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus New Mexico		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	044	0		29	10	S5674_044_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	044	0	2009	AdvantraRx Value	AdvantraRx Value Oregon, Washington		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	045	0		29	10	S5674_045_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	045	0	2009	AdvantraRx Premier	AdvantraRx Premier Oregon, Washington		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	047	0		29	10	S5674_047_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	047	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Oregon, Washington		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	050	0		29	10	S5674_050_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	050	0	2009	AdvantraRx Value	AdvantraRx Value Idaho, Utah		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	051	0		29	10	S5674_051_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	051	0	2009	AdvantraRx Premier	AdvantraRx Premier Idaho, Utah		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	053	0		29	10	S5674_053_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	053	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Idaho, Utah		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	056	0		29	10	S5674_056_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	056	0	2009	AdvantraRx Value	AdvantraRx Value California		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	057	0		29	10	S5674_057_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	057	0	2009	AdvantraRx Premier	AdvantraRx Premier California		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	059	0		29	10	S5674_059_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	059	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus California		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	062	0		29	10	S5674_062_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	062	0	2009	AdvantraRx Value	AdvantraRx Value Hawaii		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	063	0		29	10	S5674_063_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	063	0	2009	AdvantraRx Premier	AdvantraRx Premier Hawaii		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	065	0		29	10	S5674_065_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	065	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Hawaii		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	068	0		29	10	S5674_068_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	068	0	2009	AdvantraRx Value	AdvantraRx Value Alaska		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	069	0		29	10	S5674_069_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	069	0	2009	AdvantraRx Premier	AdvantraRx Premier Alaska		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	071	0		29	10	S5674_071_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	071	0	2009	AdvantraRx Premier Plus	AdvantraRx Premier Plus Alaska		2	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	801	0		29	10	S5674_801_0	1	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	801	0	2009	AdvantraRx Employer Group-9071-CY	AdvantraRx Employer Group-9071-CY		1	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	802	0		29	10	S5674_802_0	1	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	802	0	2009	AdvantraRx Employer Group-9071-NCY	AdvantraRx Employer Group-9071-NCY		1	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	803	0		29	10	S5674_803_0	1	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	803	0	2009	AdvantraRx Employer Group-9069-CY	AdvantraRx Employer Group-9069-CY		1	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	804	0		29	10	S5674_804_0	1	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	804	0	2009	AdvantraRx Employer Group-9069-NCY	AdvantraRx Employer Group-9069-NCY		1	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	805	0		29	10	S5674_805_0	1	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	805	0	2009	AdvantraRx Employer Group-9070-CY	AdvantraRx Employer Group-9070-CY		1	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	806	0		29	10	S5674_806_0	1	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	806	0	2009	AdvantraRx Employer Group-9070-NCY	AdvantraRx Employer Group-9070-NCY		1	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	809	0		29	10	S5674_809_0	1	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	809	0	2009	Advantra RX Employer Group-9072-CY	Advantra RX Employer Group-9072-CY		1	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5674	810	0		29	10	S5674_810_0	1	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	Coventry AdvantraRx	www.advantrarx.com	10	29				S5674	810	0	2009	AdvantraRx Employer Group-9072-NCY	Advantra Rx Employer Group-9072-NCY		1	2																		(866)-823-5178	(866)-823-5178	(866)-236-1068	(866)-236-1068	(800)-882-3822	(800)-882-3822	(888)-788-4010	(888)-788-4010	http://www.advantrarx.com/framesetdef.asp?Community=Member	
S5678	001	0		29	10	S5678_001_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	001	0	2009	Health Net Orange Option 1	Arizona		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	002	0		29	10	S5678_002_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	002	0	2009	Health Net Orange Option 1	California		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	003	0		29	10	S5678_003_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	003	0	2009	Health Net Orange Option 1	New York		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	004	0		29	10	S5678_004_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	004	0	2009	Health Net Orange Option 1	Central New England		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	005	0		29	10	S5678_005_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	005	0	2009	Health Net Orange Option 1	New Jersey		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	006	0		29	10	S5678_006_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	006	0	2009	Health Net Orange Option 1	Oregon, Washington		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	007	0		29	10	S5678_007_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	007	0	2009	Health Net Orange Option 2	Arizona		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	008	0		29	10	S5678_008_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	008	0	2009	Health Net Orange Option 2	California		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	009	0		29	10	S5678_009_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	009	0	2009	Health Net Orange Option 2	New York		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	010	0		29	10	S5678_010_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	010	0	2009	Health Net Orange Option 2	Central New England		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	011	0		29	10	S5678_011_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	011	0	2009	Health Net Orange Option 2	New Jersey		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	012	0		29	10	S5678_012_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	012	0	2009	Health Net Orange Option 2	Oregon, Washington		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	013	0		29	10	S5678_013_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	013	0	2009	Health Net Value Orange Option 2	Northern New England (NH and ME)		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	014	0		29	10	S5678_014_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	014	0	2009	Health Net Orange Option 1	Northern New England (NH and ME)		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	015	0		29	10	S5678_015_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	015	0	2009	Health Net Value Orange Option 2	Mid-Atlantic (DE, DC and MD)		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	016	0		29	10	S5678_016_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	016	0	2009	Health Net Orange Option 1	Mid-Atlantic (DE, DC and MD)		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	017	0		29	10	S5678_017_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	017	0	2009	Health Net Value Orange Option 2	Pennsylvania (WV)		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	018	0		29	10	S5678_018_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	018	0	2009	Health Net Orange Option 1	Pennsylvania (WV)		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	019	0		29	10	S5678_019_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	019	0	2009	Health Net Value Orange Option 2	Virginia		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	020	0		29	10	S5678_020_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	020	0	2009	Health Net Orange Option 1	Virginia		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	021	0		29	10	S5678_021_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	021	0	2009	Health Net Orange Option 2	North Carolina		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	022	0		29	10	S5678_022_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	022	0	2009	Health Net Orange Option 1	North Carolina		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	023	0		29	10	S5678_023_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	023	0	2009	Health Net Value Orange Option 2	South Carolina		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	024	0		29	10	S5678_024_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	024	0	2009	Health Net Orange Option 1	South Carolina		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	025	0		29	10	S5678_025_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	025	0	2009	Health Net Value Orange Option 2	Georgia		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	026	0		29	10	S5678_026_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	026	0	2009	Health Net Orange Option 1	Georgia		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	027	0		29	10	S5678_027_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	027	0	2009	Health Net Orange Option 2	Florida		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	028	0		29	10	S5678_028_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	028	0	2009	Health Net Orange Option 1	Florida		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	029	0		29	10	S5678_029_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	029	0	2009	Health Net Value Orange Option 2	Alabama, Tenessee		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	030	0		29	10	S5678_030_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	030	0	2009	Health Net Orange Option 1	Alabama, Tennessee		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	031	0		29	10	S5678_031_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	031	0	2009	Health Net Value Orange Option 2	Michigan		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	032	0		29	10	S5678_032_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	032	0	2009	Health Net Orange Option 1	Michigan		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	033	0		29	10	S5678_033_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	033	0	2009	Health Net Value Orange Option 2	Ohio		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	034	0		29	10	S5678_034_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	034	0	2009	Health Net Orange Option 1	Ohio		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	035	0		29	10	S5678_035_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	035	0	2009	Health Net Orange Option 2	Indiana, Kentucky		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	036	0		29	10	S5678_036_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	036	0	2009	Health Net Orange Option 1	Indiana, Kentucky		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	037	0		29	10	S5678_037_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	037	0	2009	Health Net Value Orange Option 2	Wisconsin		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	038	0		29	10	S5678_038_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	038	0	2009	Health Net Orange Option 1	Wisconsin		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	039	0		29	10	S5678_039_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	039	0	2009	Health Net Orange Option 2	Illinois		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	040	0		29	10	S5678_040_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	040	0	2009	Health Net Orange Option 1	Illinois		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	041	0		29	10	S5678_041_0	3	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	041	0	2009	Health Net Orange Option 2	Missouri		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	042	0		29	10	S5678_042_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	042	0	2009	Health Net Orange Option 1	Missouri		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	043	0		29	10	S5678_043_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	043	0	2009	Health Net Value Orange Option 2	Arkansas		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	044	0		29	10	S5678_044_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	044	0	2009	Health Net Orange Option 1	Arkansas		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	045	0		29	10	S5678_045_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	045	0	2009	Health Net Value Orange Option 2	Mississippi		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	046	0		29	10	S5678_046_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	046	0	2009	Health Net Orange Option 1	Mississippi		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	047	0		29	10	S5678_047_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	047	0	2009	Health Net Value Orange Option 2	Louisiana		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	048	0		29	10	S5678_048_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	048	0	2009	Health Net Orange Option 1	Louisiana		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	049	0		29	10	S5678_049_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	049	0	2009	Health Net Orange Option 2	Texas		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	050	0		29	10	S5678_050_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	050	0	2009	Health Net Orange Option 1	Texas		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	051	0		29	10	S5678_051_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	051	0	2009	Health Net Value Orange Option 2	Oklahoma		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	052	0		29	10	S5678_052_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	052	0	2009	Health Net Orange Option 1	Oklahoma		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	053	0		29	10	S5678_053_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	053	0	2009	Health Net Value Orange Option 2	Kansas		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	054	0		29	10	S5678_054_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	054	0	2009	Health Net Orange Option 1	Kansas		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	055	0		29	10	S5678_055_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	055	0	2009	Health Net Value Orange Option 2	IA, MN, MT, NE, ND, SD, WY		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	056	0		29	10	S5678_056_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	056	0	2009	Health Net Orange Option 1	IA, MN, MT, NE, ND, SD, WY		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	057	0		29	10	S5678_057_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	057	0	2009	Health Net Orange Option 2	New Mexico		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	058	0		29	10	S5678_058_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	058	0	2009	Health Net Orange Option 1	New Mexico		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	059	0		29	10	S5678_059_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	059	0	2009	Health Net Orange Option 2	Colorado		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	060	0		29	10	S5678_060_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	060	0	2009	Health Net Orange Option 1	Colorado		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	061	0		29	10	S5678_061_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	061	0	2009	Health Net Orange Option 2	Nevada		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	062	0		29	10	S5678_062_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	062	0	2009	Health Net Orange Option 1	Nevada		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	063	0		29	10	S5678_063_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	063	0	2009	Health Net Value Orange Option 2	Idaho, Utah		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	064	0		29	10	S5678_064_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	064	0	2009	Health Net Orange Option 1	Idaho, Utah		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	065	0		29	10	S5678_065_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	065	0	2009	Health Net Orange Option 2	Hawaii		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	066	0		29	10	S5678_066_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	066	0	2009	Health Net Orange Option 1	Hawaii		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	067	0		29	10	S5678_067_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	067	0	2009	Health Net Value Orange Option 2	Alaska		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	068	0		29	10	S5678_068_0	2	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	068	0	2009	Health Net Orange Option 1	Alaska		2	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	801	0		29	10	S5678_801_0	1	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	801	0	2009	Health Net Orange	50 United States and District of Columbia		1	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5678	803	0		29	10	S5678_803_0	1	2009.01	HEALTH NET LIFE INS CO/HEALTH NET INS OF NY	Health Net	www.healthnet.com	10	29				S5678	803	0	2009	Health Net Orange	50 United States and District of Columbia		1	2																		(800)-806-8811	(800)-806-8811	(800)-929-9955	(800)-929-9955	(800)-606-3604	(800)-606-3604	(800)-929-9955	(800)-929-9955	https://www.healthnet.com/portal/medicare/content.do?resource=findADrug.htm	
S5715	001	0		29	10	S5715_001_0	2	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, TX, and NM	www.hisc.net	10	29				S5715	001	0	2009	Blue Medicare Rx - Value	State of Illinois		2	2																		(888)-285-2249	(888)-285-2249	(888)-285-2252	(888)-285-2252	(888)-285-2249	(888)-285-2249	(888)-285-2252	(888)-285-2252	https://qa.myrxassistant.com	
S5715	002	0		29	10	S5715_002_0	2	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, TX, and NM	www.hisc.net	10	29				S5715	002	0	2009	Blue Medicare Rx - Plus	State of Illinois		2	2																		(888)-285-2249	(888)-285-2249	(888)-285-2252	(888)-285-2252	(888)-285-2249	(888)-285-2249	(888)-285-2252	(888)-285-2252	https://qa.myrxassistant.com	
S5715	003	0		29	10	S5715_003_0	2	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, TX, and NM	www.hisc.net	10	29				S5715	003	0	2009	Blue Medicare Rx - Value	State of New Mexico		2	2																		(888)-285-2254	(888)-285-2254	(888)-884-3757	(888)-884-3757	(888)-285-2254	(888)-285-2254	(888)-884-3757	(888)-884-3757	https://qa.myrxassistant.com	
S5715	004	0		29	10	S5715_004_0	2	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, TX, and NM	www.hisc.net	10	29				S5715	004	0	2009	Blue Medicare Rx - Plus	State of New Mexico		2	2																		(888)-285-2254	(888)-285-2254	(888)-884-3757	(888)-884-3757	(888)-285-2254	(888)-285-2254	(888)-884-3757	(888)-884-3757	https://qa.myrxassistant.com	
S5715	005	0		29	10	S5715_005_0	1	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, TX, and NM	www.hisc.net	10	29				S5715	005	0	2009	Blue Medicare Rx - Value	State of Texas		2	2																		(888)-579-9373	(888)-579-9373	(888)-579-9375	(888)-579-9375	(888)-579-9373	(888)-579-9373	(888)-579-9375	(888)-579-9375	https://qa.myrxassistant.com	
S5715	006	0		29	10	S5715_006_0	2	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, TX, and NM	www.hisc.net	10	29				S5715	006	0	2009	Blue Medicare Rx - Plus	State of Texas		2	2																		(888)-579-9373	(888)-579-9373	(888)-579-9375	(888)-579-9375	(888)-579-9373	(888)-579-9373	(888)-579-9375	(888)-579-9375	https://qa.myrxassistant.com	
S5715	007	0		29	10	S5715_007_0	2	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, TX, and NM	www.hisc.net	10	29				S5715	007	0	2009	Blue Medicare Rx - Standard	State of Illinois		2	2																		(888)-285-2249	(888)-285-2249	(888)-285-2252	(888)-285-2252	(888)-285-2249	(888)-285-2249	(888)-285-2252	(888)-285-2252	https://qa.myrxassistant.com	
S5715	008	0		29	10	S5715_008_0	1	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, TX, and NM	www.hisc.net	10	29				S5715	008	0	2009	Blue Medicare Rx - Standard	State of New Mexico		2	2																		(888)-285-2254	(888)-285-2254	(888)-884-3757	(888)-884-3757	(888)-285-2254	(888)-285-2254	(888)-884-3757	(888)-884-3757	https://qa.myrxassistant.com	
S5715	009	0		29	10	S5715_009_0	1	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, TX, and NM	www.hisc.net	10	29				S5715	009	0	2009	Blue Medicare Rx - Standard	State of Texas		2	2																		(888)-579-9373	(888)-579-9373	(888)-579-9375	(888)-579-9375	(888)-579-9373	(888)-579-9373	(888)-579-9375	(888)-579-9375	https://qa.myrxassistant.com	
S5715	801	0		29	10	S5715_801_0	1	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, TX, and NM	www.hisc.net	10	29				S5715	801	0	2009	Blue Medicare Rx	State of Illinois		1	2																		(800)-718-2031	(800)-718-2031	(888)-844-5530		(866)-308-4781	(866)-308-4781			https://qa.myrxassistant.com	
S5715	802	0		29	10	S5715_802_0	1	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, TX, and NM	www.hisc.net	10	29				S5715	802	0	2009	Blue Medicare Rx	State of New Mexico		1	2																		(800)-718-2031	(800)-718-2031	(888)-844-5530		(866)-308-4781	(866)-308-4781			https://qa.myrxassistant.com	
S5715	803	0		29	10	S5715_803_0	1	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, TX, and NM	www.hisc.net	10	29				S5715	803	0	2009	Blue Medicare Rx	State of Texas		1	2																		(800)-718-2031	(800)-718-2031	(888)-844-5530		(866)-308-4781	(866)-308-4781			https://qa.myrxassistant.com	
S5715	804	0		29	10	S5715_804_0	1	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, TX, and NM	www.hisc.net	10	29				S5715	804	0	2009	Blue Medicare Rx	State of Illinois		1	2																		(800)-718-2031	(800)-718-2031	(888)-844-5530		(866)-308-4781	(866)-308-4781			https://qa.myrxassistant.com	
S5715	805	0		29	10	S5715_805_0	1	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, TX, and NM	www.hisc.net	10	29				S5715	805	0	2009	Blue Medicare Rx	State of New Mexico		1	2																		(800)-718-2031	(800)-718-2031	(888)-844-5530		(866)-308-4781	(866)-308-4781			https://qa.myrxassistant.com	
S5715	806	0		29	10	S5715_806_0	1	2009.01	HCSC INSURANCE SERVICES COMPANY	HISC - Blue Cross Blue Shield of IL, TX, and NM	www.hisc.net	10	29				S5715	806	0	2009	Blue Medicare Rx	State of Texas		1	2																		(800)-718-2031	(800)-718-2031	(888)-844-5530		(866)-308-4781	(866)-308-4781			https://qa.myrxassistant.com	
S5726	013	0		29	10	S5726_013_0	2	2009.01	BLUE CROSS BLUE SHIELD OF KANSAS	Blue MedicareRx	www.bmedicarerx.com	10	29				S5726	013	0	2009	Blue MedicareRx Value	Kansas		2	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(877)-471-4121	(877)-471-4121	(800)-766-3777	(800)-766-3777	www.bmedicarerx.com	
S5726	014	0		29	10	S5726_014_0	3	2009.01	BLUE CROSS BLUE SHIELD OF KANSAS	Blue MedicareRx	www.bmedicarerx.com	10	29				S5726	014	0	2009	Blue MedicareRx Plus	Kansas		2	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(877)-471-4121	(877)-471-4121	(800)-766-3777	(800)-766-3777	www.bmedicarerx.com	
S5726	015	0		29	10	S5726_015_0	3	2009.01	BLUE CROSS BLUE SHIELD OF KANSAS	Blue MedicareRx	www.bmedicarerx.com	10	29				S5726	015	0	2009	Blue MedicareRx Premier	Kansas		2	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(877)-471-4121	(877)-471-4121	(800)-766-3777	(800)-766-3777	www.bmedicarerx.com	
S5726	805	0		29	10	S5726_805_0	1	2009.01	BLUE CROSS BLUE SHIELD OF KANSAS	Blue MedicareRx	www.bmedicarerx.com	10	29				S5726	805	0	2009	Blue MedicareRx Group	Kansas		1	2																		(866)-755-2776	(866)-755-2776	(866)-798-7026	(866)-798-7026	(877)-471-4121	(877)-471-4121	(800)-766-3777	(800)-766-3777	www.bmedicarerx.com	
S5741	001	0		29	10	S5741_001_0	3	2009.01	HIP HEALTH PLAN OF NEW YORK	HIP Insurance Company of New York	www.HIPusa.com	10	29				S5741	001	0	2009	HIP Part D New York	New York Metropolitain Area		2	2																		(800)-447-8255	(800)-447-8255	(888)-447-4833		(646)-447-6979	(866)-447-6979	(888)-447-4833		www.HIPusa.com	
S5741	003	0		29	10	S5741_003_0	2	2009.01	HIP HEALTH PLAN OF NEW YORK	HIP Insurance Company of New York	www.HIPusa.com	10	29				S5741	003	0	2009	HIP Enhanced Part D New York	New York State		2	2																		(800)-447-8255	(800)-447-8255	(888)-447-4833		(646)-447-6979	(866)-447-6979	(888)-447-4833		www.HIPusa.com	
S5741	801	0		29	10	S5741_801_0	1	2009.01	HIP HEALTH PLAN OF NEW YORK	HIP Insurance Company of New York	www.HIPusa.com	10	29				S5741	801	0	2009	HIP Part D New York Calendar Employer	Greater New York Metropolitain Area		1	2																		(800)-447-8255	(800)-447-8255	(888)-447-4833		(866)-447-6979	(646)-447-6979	(888)-447-4833		www.HIPusa.com	
S5743	001	0		29	10	S5743_001_0	2	2009.01	BLUE CROSS BLUE SHIELD NORTHERN PLAINS ALLIANCE	MedicareBlue Rx	www.YourMedicareSolutions.com	10	29				S5743	001	0	2009	MedicareBlue Rx Option 1	States of IA, MN, MT, NE, ND, SD, WY		2	2																		(888)-832-0075	(888)-832-0075	(800)-693-3819	(800)-693-3819	(866)-434-2037	(866)-434-2037	(866)-456-1550	(866)-456-1550	www.YourMedicareSolutions.com	
S5743	003	0		29	10	S5743_003_0	5	2009.01	BLUE CROSS BLUE SHIELD NORTHERN PLAINS ALLIANCE	MedicareBlue Rx	www.YourMedicareSolutions.com	10	29				S5743	003	0	2009	MedicareBlue Rx Option 2	States of IA, MN, MT, NE, ND, SD, WY		2	2																		(888)-832-0075	(888)-832-0075	(800)-693-3819	(800)-693-3819	(866)-434-2037	(866)-434-2037	(866)-456-1550	(866)-456-1550	www.YourMedicareSolutions.com	
S5743	004	0		29	10	S5743_004_0	5	2009.01	BLUE CROSS BLUE SHIELD NORTHERN PLAINS ALLIANCE	MedicareBlue Rx	www.YourMedicareSolutions.com	10	29				S5743	004	0	2009	MedicareBlue Rx Option 3	States of IA, MN, MT, NE, ND, SD, WY		2	2																		(888)-832-0075	(888)-832-0075	(800)-693-3819	(800)-693-3819	(866)-434-2037	(866)-434-2037	(866)-456-1550	(866)-456-1550	www.YourMedicareSolutions.com	
S5743	802	0		29	10	S5743_802_0	1	2009.01	BLUE CROSS BLUE SHIELD NORTHERN PLAINS ALLIANCE	MedicareBlue Rx	www.YourMedicareSolutions.com	10	29				S5743	802	0	2009	Group MedicareBlue Rx	Nationwide		1	2																		(888)-832-0075	(888)-832-0075	(800)-693-3819	(800)-693-3819	(866)-434-2037	(866)-434-2037	(866)-456-1550	(866)-456-1550	www.YourMedicareSolutions.com	
S5753	006	0		29	10	S5753_006_0	6	2009.01	WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION	WPS Health Insurance	www.wpsmedicaredrugs.com	10	29				S5753	006	0	2009	WPS MedicareRx Enhanced Plan 1	State of Wisconsin		2	2																		(800)-688-1604	(800)-688-1604	(800)-716-3231	(800)-716-3231	(800)-731-0459	(800)-731-0459	(888)-877-2837	(888)-877-2837	www.wpsmedicaredrugs.com	
S5753	007	0		29	10	S5753_007_0	6	2009.01	WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION	WPS Health Insurance	www.wpsmedicaredrugs.com	10	29				S5753	007	0	2009	WPS MedicareRx Enhanced Plan 2	State of Wisconsin		2	2																		(800)-688-1604	(800)-688-1604	(800)-716-3231	(800)-716-3231	(800)-731-0459	(800)-731-0459	(888)-877-2837	(888)-877-2837	www.wpsmedicaredrugs.com	
S5753	012	0		29	10	S5753_012_0	5	2009.01	WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION	WPS Health Insurance	www.wpsmedicaredrugs.com	10	29				S5753	012	0	2009	WPS MedicareRx Standard Plan	Wisconsin		2	2																		(800)-688-1604	(800)-688-1604	(800)-716-3231	(800)-716-3231	(800)-731-0459	(800)-731-0459	(888)-877-2837	(888)-877-2837	www.wpsmedicaredrugs.com	
S5753	801	0		29	10	S5753_801_0	4	2009.01	WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION	WPS Health Insurance	www.wpsmedicaredrugs.com	10	29				S5753	801	0	2009	WPS Employer Plan - Calendar Year	National		1	2																		(800)-688-1604	(800)-688-1604	(800)-716-3231	(800)-716-3231	(800)-731-0459	(800)-731-0459	(888)-877-2837	(888)-877-2837	www.wpsmedicaredrugs.com	
S5753	803	0		29	10	S5753_803_0	4	2009.01	WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION	WPS Health Insurance	www.wpsmedicaredrugs.com	10	29				S5753	803	0	2009	WPS Employer Plan Non-Calendar Year	National		1	2																		(800)-688-1604	(800)-688-1604	(800)-716-3231	(800)-716-3231	(800)-731-0459	(800)-731-0459	(888)-877-2837	(888)-877-2837	www.wpsmedicaredrugs.com	
S5755	005	0		29	10	S5755_005_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	005	0	2009	UA Medicare Part D Prescription Drug Cov	States of Maine and New Hampshire		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	006	0		29	10	S5755_006_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	006	0	2009	UA Medicare Part D Prescription Drug Cov	States of CT, MA, RI and VT		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	007	0		29	10	S5755_007_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	007	0	2009	UA Medicare Part D Prescription Drug Cov	State of New Jersey		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	008	0		29	10	S5755_008_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	008	0	2009	UA Medicare Part D Prescription Drug Cov	States of Delaware and Maryland plus DC		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	009	0		29	10	S5755_009_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	009	0	2009	UA Medicare Part D Prescription Drug Cov	States of Pennsylvania and West Virginia		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	010	0		29	10	S5755_010_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	010	0	2009	UA Medicare Part D Prescription Drug Cov	State of Virginia		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	011	0		29	10	S5755_011_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	011	0	2009	UA Medicare Part D Prescription Drug Cov	State of North Carolina		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	012	0		29	10	S5755_012_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	012	0	2009	UA Medicare Part D Prescription Drug Cov	State of South Carolina		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	013	0		29	10	S5755_013_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	013	0	2009	UA Medicare Part D Prescription Drug Cov	State of Georgia		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	014	0		29	10	S5755_014_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	014	0	2009	UA Medicare Part D Prescription Drug Cov	State of Florida		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	015	0		29	10	S5755_015_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	015	0	2009	UA Medicare Part D Prescription Drug Cov	States of Alabama and Tennessee		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	016	0		29	10	S5755_016_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	016	0	2009	UA Medicare Part D Prescription Drug Cov	State of Michigan		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	017	0		29	10	S5755_017_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	017	0	2009	UA Medicare Part D Prescription Drug Cov	State of Ohio		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	018	0		29	10	S5755_018_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	018	0	2009	UA Medicare Part D Prescription Drug Cov	States of Indiana and Kentucky		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	019	0		29	10	S5755_019_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	019	0	2009	UA Medicare Part D Prescription Drug Cov	State of Wisconsin		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	020	0		29	10	S5755_020_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	020	0	2009	UA Medicare Part D Prescription Drug Cov	State of Illinois		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	021	0		29	10	S5755_021_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	021	0	2009	UA Medicare Part D Prescription Drug Cov	State of Missouri		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	022	0		29	10	S5755_022_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	022	0	2009	UA Medicare Part D Prescription Drug Cov	State of Arkansas		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	023	0		29	10	S5755_023_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	023	0	2009	UA Medicare Part D Prescription Drug Cov	State of Mississippi		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	024	0		29	10	S5755_024_0	2	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	024	0	2009	UA Medicare Part D Prescription Drug Cov	State of Louisiana		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	025	0		29	10	S5755_025_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	025	0	2009	UA Medicare Part D Prescription Drug Cov	State of Texas		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	026	0		29	10	S5755_026_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	026	0	2009	UA Medicare Part D Prescription Drug Cov	State of Oklahoma		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	027	0		29	10	S5755_027_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	027	0	2009	UA Medicare Part D Prescription Drug Cov	State of Kansas		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	028	0		29	10	S5755_028_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	028	0	2009	UA Medicare Part D Prescription Drug Cov	States of IA, MN, MT, NE, ND, SD and WY		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	029	0		29	10	S5755_029_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	029	0	2009	UA Medicare Part D Prescription Drug Cov	State of New Mexico		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	030	0		29	10	S5755_030_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	030	0	2009	UA Medicare Part D Prescription Drug Cov	State of Colorado		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	031	0		29	10	S5755_031_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	031	0	2009	UA Medicare Part D Prescription Drug Cov	State of Arizona		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	032	0		29	10	S5755_032_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	032	0	2009	UA Medicare Part D Prescription Drug Cov	State of Nevada		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	033	0		29	10	S5755_033_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	033	0	2009	UA Medicare Part D Prescription Drug Cov	States of Oregon and Washington		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	034	0		29	10	S5755_034_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	034	0	2009	UA Medicare Part D Prescription Drug Cov	States of Idaho and Utah		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	035	0		29	10	S5755_035_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	035	0	2009	UA Medicare Part D Prescription Drug Cov	State of California		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	038	0		29	10	S5755_038_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	038	0	2009	UA Medicare Part D Prescription Drug Cov	State of Hawaii		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	039	0		29	10	S5755_039_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	039	0	2009	UA Medicare Part D Prescription Drug Cov	State of Alaska		2	2																		(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	(866)-524-4169	(866)-524-4169	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	040	0		29	10	S5755_040_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	040	0	2009	UA Medicare Part D Rx Covg - Silver Plan	States of New Hampshire and Maine		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	041	0		29	10	S5755_041_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	041	0	2009	UA Medicare Part D Rx Covg - Silver Plan	States of CT, MA, RI and VT		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	042	0		29	10	S5755_042_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	042	0	2009	UA Medicare Part D Rx Covg - Silver Plan	State of New Jersey		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	043	0		29	10	S5755_043_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	043	0	2009	UA Medicare Part D Rx Covg - Silver Plan	States of Delaware and Maryland plus DC		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	044	0		29	10	S5755_044_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	044	0	2009	UA Medicare Part D Rx Covg - Silver Plan	States of Pennsylvania and West Virginia		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	045	0		29	10	S5755_045_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	045	0	2009	UA Medicare Part D Rx Covg - Silver Plan	State of Virginia		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	046	0		29	10	S5755_046_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	046	0	2009	UA Medicare Part D Rx Covg - Silver Plan	State of North Carolina		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	047	0		29	10	S5755_047_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	047	0	2009	UA Medicare Part D Rx Covg - Silver Plan	State of South Carolina		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	048	0		29	10	S5755_048_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	048	0	2009	UA Medicare Part D Rx Covg - Silver Plan	State of Georgia		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	049	0		29	10	S5755_049_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	049	0	2009	UA Medicare Part D Rx Covg - Silver Plan	State of Florida		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	050	0		29	10	S5755_050_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	050	0	2009	UA Medicare Part D Rx Covg - Silver Plan	States of Alabama and Tennessee		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	051	0		29	10	S5755_051_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	051	0	2009	UA Medicare Part D Rx Covg - Silver Plan	State of Michigan		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	052	0		29	10	S5755_052_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	052	0	2009	UA Medicare Part D Rx Covg - Silver Plan	State of Ohio		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	053	0		29	10	S5755_053_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	053	0	2009	UA Medicare Part D Rx Covg - Silver Plan	States of Indiana and Kentucky		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	054	0		29	10	S5755_054_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	054	0	2009	UA Medicare Part D Rx Covg - Silver Plan	State of Wisconsin		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	055	0		29	10	S5755_055_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	055	0	2009	UA Medicare Part D Rx Covg - Silver Plan	State of Illinois		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	056	0		29	10	S5755_056_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	056	0	2009	UA Medicare Part D Rx Covg - Silver Plan	State of Missouri		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	057	0		29	10	S5755_057_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	057	0	2009	UA Medicare Part D Rx Covg - Silver Plan	State of Arkansas		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	058	0		29	10	S5755_058_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	058	0	2009	UA Medicare Part D Rx Covg - Silver Plan	State of Mississippi		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	059	0		29	10	S5755_059_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	059	0	2009	UA Medicare Part D Rx Covg - Silver Plan	State of Louisiana		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	060	0		29	10	S5755_060_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	060	0	2009	UA Medicare Part D Rx Covg - Silver Plan	State of Texas		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	061	0		29	10	S5755_061_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	061	0	2009	UA Medicare Part D Rx Covg - Silver Plan	State of Oklahoma		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	062	0		29	10	S5755_062_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	062	0	2009	UA Medicare Part D Rx Covg - Silver Plan	State of Kansas		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	063	0		29	10	S5755_063_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	063	0	2009	UA Medicare Part D Rx Covg - Silver Plan	States of IA, MN, MT, NE, ND, SD and WY		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	064	0		29	10	S5755_064_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	064	0	2009	UA Medicare Part D Rx Covg - Silver Plan	State of New Mexico		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	065	0		29	10	S5755_065_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	065	0	2009	UA Medicare Part D Rx Covg - Silver Plan	State of Colorado		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	066	0		29	10	S5755_066_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	066	0	2009	UA Medicare Part D Rx Covg - Silver Plan	State of Arizona		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	067	0		29	10	S5755_067_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	067	0	2009	UA Medicare Part D Rx Covg - Silver Plan	State of Nevada		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	068	0		29	10	S5755_068_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	068	0	2009	UA Medicare Part D Rx Covg - Silver Plan	States of Oregon and Washington		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	069	0		29	10	S5755_069_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	069	0	2009	UA Medicare Part D Rx Covg - Silver Plan	States of Idaho and Utah		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	070	0		29	10	S5755_070_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	070	0	2009	UA Medicare Part D Rx Covg - Silver Plan	State of California		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	071	0		29	10	S5755_071_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	071	0	2009	UA Medicare Part D Rx Covg - Silver Plan	State of Hawaii		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	072	0		29	10	S5755_072_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	072	0	2009	UA Medicare Part D Rx Covg - Silver Plan	State of Alaska		2	2																		(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	(866)-299-3406	(866)-299-3406	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	801	0		29	10	S5755_801_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	801	0	2009	United American Employer Calendar Plan	National		1	2																		(866)-524-4199	(866)-524-4199	(866)-524-4170	(866)-524-4170	(866)-524-4199	(866)-524-4199	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5755	802	0		29	10	S5755_802_0	1	2009.01	UNITED AMERICAN INSURANCE COMPANY	United American Insurance Company	http://www.uamedicarepartd.com/	10	29				S5755	802	0	2009	United American Employer Non-Cal Drug Plan	National		1	2																		(866)-524-4199	(866)-524-4199	(866)-524-4170	(866)-524-4170	(866)-524-4199	(866)-524-4199	(866)-524-4170	(866)-524-4170	http://www.uamedicarepartd.com/	
S5766	002	0		29	10	S5766_002_0	4	2009.01	FIRST CARE, INC.	Medi-CareFirst BlueCross BlueShield	www.medi-carefirst.com	10	29				S5766	002	0	2009	Blue Rx Standard	Delaware, District of Columbia and Maryland		2	2																		(800)-693-1434	(800)-693-1434	(800)-693-0765	(800)-693-0765	(888)-784-0790	(888)-784-0790	(888)-784-0868	(888)-784-0868	http://www.medi-carefirst.com	
S5766	003	0		29	10	S5766_003_0	5	2009.01	FIRST CARE, INC.	Medi-CareFirst BlueCross BlueShield	www.medi-carefirst.com	10	29				S5766	003	0	2009	Blue Rx Enhanced	Delaware, District of Columbia and Maryland		2	2																		(800)-693-1434	(800)-693-1434	(800)-693-0765	(800)-693-0765	(888)-784-0790	(888)-784-0790	(888)-784-0868	(888)-784-0868	http://www.medi-carefirst.com	
S5768	005	0		29	10	S5768_005_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	005	0	2009	First Health Part D-Premier	First Health Part D-Premier-ME, NH		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	007	0		29	10	S5768_007_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	007	0	2009	First Health Part D-Premier	First Health Part-D-Premier-New Jersey		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	008	0		29	10	S5768_008_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	008	0	2009	First Health Part D-Premier	First Health Part D-Premier-Mid Atlantic		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	009	0		29	10	S5768_009_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	009	0	2009	First Health Part D-Premier	First Health Part D-Premier-PA, WV		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	010	0		29	10	S5768_010_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	010	0	2009	First Health Part D-Premier	First Health Part D-Premier-Virginia		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	012	0		29	10	S5768_012_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	012	0	2009	First Health Part D-Premier	First Health Part D-Premier-South Carolina		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	015	0		29	10	S5768_015_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	015	0	2009	First Health Part D-Premier	First Health Part D-Premier-AL, TN		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	016	0		29	10	S5768_016_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	016	0	2009	First Health Part D-Premier	First Health Part D-Premier-Michigan		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	017	0		29	10	S5768_017_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	017	0	2009	First Health Part D-Premier	First Health Part D-Premier-Ohio		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	018	0		29	10	S5768_018_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	018	0	2009	First Health Part D-Premier	First Health Part D-Premier-IN, KY		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	021	0		29	10	S5768_021_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	021	0	2009	First Health Part D-Premier	First Health Part D-Premier-Missouri		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	031	0		29	10	S5768_031_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	031	0	2009	First Health Part D-Premier	First Health Part D-Premier-Nevada		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	038	0		29	10	S5768_038_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	038	0	2009	First Health Part D-Premier	First Health Part D-Premier-Central New England		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	039	0		29	10	S5768_039_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	039	0	2009	First Health Part D-Premier	First Health Part D-Premier-North Carolina		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	040	0		29	10	S5768_040_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	040	0	2009	First Health Part D-Premier	First Health Part D-Premier-Georgia		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	041	0		29	10	S5768_041_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	041	0	2009	First Health Part D-Premier	First Health Part D-Premier-Florida		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	042	0		29	10	S5768_042_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	042	0	2009	First Health Part D-Premier	First Health Part D-Premier-Illinois		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	043	0		29	10	S5768_043_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	043	0	2009	First Health Part D-Premier	First Health Part D-Premier-Arkansas		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	044	0		29	10	S5768_044_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	044	0	2009	First Health Part D-Premier	First Health Part D-Premier-Louisiana		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	045	0		29	10	S5768_045_0	3	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	045	0	2009	First Health Part D-Premier	First Heatlh Part D-Premier-Texas		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	046	0		29	10	S5768_046_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	046	0	2009	First Health Part D-Premier	First Health Part D-Premier-Oklahoma		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	047	0		29	10	S5768_047_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	047	0	2009	First Health Part D-Premier	First Health Part D-Premier-Kansas		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	048	0		29	10	S5768_048_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	048	0	2009	First Health Part D-Premier	First Health Part D-Premier-New Mexico		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	082	0		29	10	S5768_082_0	1	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	082	0	2009	First Health Part D-Premier	First Health Part D-Premier-CA		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	083	0		29	10	S5768_083_0	1	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	083	0	2009	First Health Part D-Premier	First Health Part D-Premier-Wisconsin		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	084	0		29	10	S5768_084_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	084	0	2009	First Health Part D-Secure	First Health Part D-Secure-No New England		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	085	0		29	10	S5768_085_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	085	0	2009	First Health Part D-Secure	First Health Part D-Secure-Cen New England		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	086	0		29	10	S5768_086_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	086	0	2009	First Health Part D-Secure	First Health Part D-Secure-New Jersey		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	087	0		29	10	S5768_087_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	087	0	2009	First Health Part D-Secure	First Health Part D-Secure-Mid Atlantic		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	088	0		29	10	S5768_088_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	088	0	2009	First Health Part D-Secure	First Health Part D-Secure-PA, WV		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	089	0		29	10	S5768_089_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	089	0	2009	First Health Part D-Secure	First Health Part D-Secure-Virginia		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	090	0		29	10	S5768_090_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	090	0	2009	First Health Part D-Secure	First Health Part D-Secure-North Carolina		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	091	0		29	10	S5768_091_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	091	0	2009	First Health Part D-Secure	First Health Part D-Secure-South Carolina		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	092	0		29	10	S5768_092_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	092	0	2009	First Health Part D-Secure	First Health Part D-Secure-Georgia		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	093	0		29	10	S5768_093_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	093	0	2009	First Health Part D-Secure	First Health Part D-Secure-Florida		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	094	0		29	10	S5768_094_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	094	0	2009	First Health Part D-Secure	First Health Part D-Secure-AL, TN		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	095	0		29	10	S5768_095_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	095	0	2009	First Health Part D-Secure	First Health Part D-Secure-Michigan		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	096	0		29	10	S5768_096_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	096	0	2009	First Health Part D-Secure	First Health Part D-Secure-Ohio		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	097	0		29	10	S5768_097_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	097	0	2009	First Health Part D-Secure	First Health Part D-Secure-IN, KY		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	098	0		29	10	S5768_098_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	098	0	2009	First Health Part D-Secure	First Health Part D-Secure-Wisconsin		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	099	0		29	10	S5768_099_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	099	0	2009	First Health Part D-Secure	First Health Part D-Secure-Illinois		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	100	0		29	10	S5768_100_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	100	0	2009	First Health Part D-Secure	First Health Part D-Secure-Missouri		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	101	0		29	10	S5768_101_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	101	0	2009	First Health Part D-Secure	First Health Part D-Secure-Arkansas		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	102	0		29	10	S5768_102_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	102	0	2009	First Health Part D-Secure	First Health Part D-Secure-Mississippi		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	103	0		29	10	S5768_103_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	103	0	2009	First Health Part D-Secure	First health Part D-Secure-Louisiana		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	104	0		29	10	S5768_104_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	104	0	2009	First Health Part D-Secure	First Health Part D-Secure-Texas		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	105	0		29	10	S5768_105_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	105	0	2009	First Health Part D-Secure	First Health Part D-Secure-Oklahoma		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	106	0		29	10	S5768_106_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	106	0	2009	First Health Part D-Secure	First Health Part D-Secure-Kansas		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	107	0		29	10	S5768_107_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	107	0	2009	First Health Part D-Secure	First Health Part D-Secure-Upper MW and No. Plains		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	108	0		29	10	S5768_108_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	108	0	2009	First Health Part D-Secure	First Health Part D-Secure-New Mexico		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	109	0		29	10	S5768_109_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	109	0	2009	First Health Part D-Secure	First Health Part D-Secure-Colorado		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	110	0		29	10	S5768_110_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	110	0	2009	First Health Part D-Secure	First Health Part D-Secure-Arizona		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	111	0		29	10	S5768_111_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	111	0	2009	First Health Part D-Secure	First Health Part D-Secure-Nevada		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	112	0		29	10	S5768_112_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	112	0	2009	First Health Part D-Secure	First Health Part D-Secure-OR, WA		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	113	0		29	10	S5768_113_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	113	0	2009	First Health Part D-Secure	First Health Part D-Secure-ID, UT		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	114	0		29	10	S5768_114_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	114	0	2009	First Health Part D-Secure	First Health Part D-Secure-California		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	115	0		29	10	S5768_115_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	115	0	2009	First Health Part D-Secure	First Health Part D-Secure-Hawaii		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	116	0		29	10	S5768_116_0	2	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	116	0	2009	First Health Part D-Secure	First Health Part D-Secure-Alaska		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	117	0		29	10	S5768_117_0	1	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	117	0	2009	First Health Part D-Premier	First Health Part D- Premier-Alaska		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	118	0		29	10	S5768_118_0	1	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	118	0	2009	First Health Part D-Premier	First Health Part D-Premier-Idaho and Utah		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	119	0		29	10	S5768_119_0	1	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	119	0	2009	First Health Part D-Premier	First Health Part D-Premier-Colorado		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	120	0		29	10	S5768_120_0	1	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	120	0	2009	First Health Part D-Premier	First Health Part D-Premier-Mississippi		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	121	0		29	10	S5768_121_0	1	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	121	0	2009	First Health Part D-Premier	First Health Part D-Premier-Arizona		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	122	0		29	10	S5768_122_0	1	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	122	0	2009	First Health Part D-Premier	First Health Part D-Premier-Upper MW and No Plains		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	123	0		29	10	S5768_123_0	1	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	123	0	2009	First Health Part D-Premier	First Health Part D-Premier-Oregon and Washington		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5768	124	0		29	10	S5768_124_0	1	2009.01	FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY	First Health Part D	www.firsthealthpartd.com	10	29				S5768	124	0	2009	First Health Part D-Premier	First Health Part D-Premier-Hawaii		2	2																		(866)-865-0662	(866)-865-0662	(866)-236-1068	(866)-236-1068	(800)-588-3322	(800)-588-3322	(888)-788-4010	(888)-788-4010	http://www.firsthealthpremier.com/framesetdef.asp?Community=Member	
S5775	001	0		29	10	S5775_001_0	6	2009.01	PHARMACY INSURANCE CORPORATION OF AMERICA	Pharmacy Insurance Corporation of America - PICA	www.picapr.com	10	29				S5775	001	0	2009	PICA-001	Commonwealth of Puerto Rico		2	2																		(787)-625-4343	(866)-990-7422			(787)-625-4343	(866)-990-7422			www.picapr.com	
S5775	002	0		29	10	S5775_002_0	6	2009.01	PHARMACY INSURANCE CORPORATION OF AMERICA	Pharmacy Insurance Corporation of America - PICA	www.picapr.com	10	29				S5775	002	0	2009	PICA-002	Commonwealth of Puerto Rico		2	2																		(787)-625-4343	(866)-990-7422			(787)-625-4343	(866)-990-7422			www.picapr.com	
S5775	003	0		29	10	S5775_003_0	9	2009.01	PHARMACY INSURANCE CORPORATION OF AMERICA	Pharmacy Insurance Corporation of America - PICA	www.picapr.com	10	29				S5775	003	0	2009	PICA-003	Commonwealth of Puerto Rico		2	2																		(787)-625-4343	(866)-990-7422			(787)-625-4343	(866)-990-7422			www.picapr.com	
S5775	801	0		29	10	S5775_801_0	1	2009.01	PHARMACY INSURANCE CORPORATION OF AMERICA	Pharmacy Insurance Corporation of America - PICA	www.picapr.com	10	29				S5775	801	0	2009	PICA- Employer	Commonwealth of Puerto Rico		1	2																		(787)-625-4343	(866)-990-7422			(787)-625-4343	(866)-990-7422			www.picapr.com	
S5795	002	0		29	10	S5795_002_0	3	2009.01	ARKANSAS BCBS, A MUTUAL INS CO	Arkansas Blue Cross and Blue Shield	www.arkansasbluecross.com	10	29				S5795	002	0	2009	AR Blue Cross - Medi-Pak Rx Premier	State of Arkansas		2	2																		(866)-390-3369	(866)-390-3369	(888)-844-5530	(888)-844-5530	(501)-378-2937	(800)-634-6314	(800)-370-5869	(800)-370-5869	http://www.arkansasbluecross.com/health_plans/Medi-PakRx.asp	
S5795	003	0		29	10	S5795_003_0	3	2009.01	ARKANSAS BCBS, A MUTUAL INS CO	Arkansas Blue Cross and Blue Shield	www.arkansasbluecross.com	10	29				S5795	003	0	2009	AR Blue Cross - Medi-Pak Rx Basic	State of Arkansas		2	2																		(866)-390-3369	(866)-390-3369	(888)-844-5530	(888)-844-5530	(501)-378-2937	(800)-634-6314	(800)-370-5869	(800)-370-5869	http://www.arkansasbluecross.com/health_plans/Medi-PakRx.asp	
S5795	006	0		29	10	S5795_006_0	3	2009.01	ARKANSAS BCBS, A MUTUAL INS CO	Arkansas Blue Cross and Blue Shield	www.arkansasbluecross.com	10	29				S5795	006	0	2009	AR Blue Cross - Medi-Pak Rx Classic	State of Arkansas		2	2																		(866)-390-3369	(866)-390-3369	(888)-844-5530	(888)-844-5530	(501)-378-2937	(800)-634-6314	(800)-370-5869	(800)-370-5869	http://www.arkansasbluecross.com/health_plans/Medi-PakRx.asp	
S5795	802	0		29	10	S5795_802_0	3	2009.01	ARKANSAS BCBS, A MUTUAL INS CO	Arkansas Blue Cross and Blue Shield	www.arkansasbluecross.com	10	29				S5795	802	0	2009	Arkansas BCBS Std Def Employer CY 2	Employer Group Plan		1	2																		(866)-390-3369	(866)-390-3369	(888)-844-5530	(888)-844-5530	(501)-378-2937	(800)-698-8397			http://www.arkansasbluecross.com/health_plans/Medi-PakRx.asp	
S5795	804	0		29	10	S5795_804_0	3	2009.01	ARKANSAS BCBS, A MUTUAL INS CO	Arkansas Blue Cross and Blue Shield	www.arkansasbluecross.com	10	29				S5795	804	0	2009	Arkansas BCBS Std Def Employer CY 4	Employer Group Plan		1	2																		(866)-390-3369	(866)-390-3369	(888)-844-5530	(888)-844-5530	(501)-378-2937	(800)-698-8397			http://www.arkansasbluecross.com/health_plans/Medi-PakRx.asp	
S5795	805	0		29	10	S5795_805_0	3	2009.01	ARKANSAS BCBS, A MUTUAL INS CO	Arkansas Blue Cross and Blue Shield	www.arkansasbluecross.com	10	29				S5795	805	0	2009	Arkansas BCBS Std Def Employer CY 5	Employer Group Plan		1	2																		(866)-390-3369	(866)-390-3369	(888)-844-5530	(888)-844-5530	(501)-378-2937	(800)-698-8397			http://www.arkansasbluecross.com/health_plans/Medi-PakRx.asp	
S5795	807	0		29	10	S5795_807_0	3	2009.01	ARKANSAS BCBS, A MUTUAL INS CO	Arkansas Blue Cross and Blue Shield	www.arkansasbluecross.com	10	29				S5795	807	0	2009	Arkansas BCBS Std Def Employer NCY 2	Employer Group Plan		1	2																		(866)-390-3369	(866)-390-3369	(888)-844-5530	(888)-844-5530	(501)-378-2937	(800)-698-8397			http://www.arkansasbluecross.com/health_plans/Medi-PakRx.asp	
S5795	809	0		29	10	S5795_809_0	3	2009.01	ARKANSAS BCBS, A MUTUAL INS CO	Arkansas Blue Cross and Blue Shield	www.arkansasbluecross.com	10	29				S5795	809	0	2009	Arkansas BCBS Std Def Employer NCY 4	Employer Group Plan		1	2																		(866)-390-3369	(866)-390-3369	(888)-844-5530	(888)-844-5530	(501)-378-2937	(800)-698-8397			http://www.arkansasbluecross.com/health_plans/Medi-PakRx.asp	
S5795	810	0		29	10	S5795_810_0	3	2009.01	ARKANSAS BCBS, A MUTUAL INS CO	Arkansas Blue Cross and Blue Shield	www.arkansasbluecross.com	10	29				S5795	810	0	2009	Arkansas BCBS Std Def Employer NCY 5	Employer Group Plan		1	2																		(866)-390-3369	(866)-390-3369	(888)-844-5530	(888)-844-5530	(501)-378-2937	(800)-698-8397			http://www.arkansasbluecross.com/health_plans/Medi-PakRx.asp	
S5803	070	0		29	10	S5803_070_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	070	0	2009	Community CCRx Basic	State of New Hampshire and State of Maine		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	071	0		29	10	S5803_071_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	071	0	2009	Community CCRx Basic	States of CT, MA, RI, VT		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	072	0		29	10	S5803_072_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	072	0	2009	Community CCRx Basic	State of New York		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	073	0		29	10	S5803_073_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	073	0	2009	Community CCRx Basic	State of New Jersey		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	074	0		29	10	S5803_074_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	074	0	2009	Community CCRx Basic	States of Delaware, District of Columbia, Maryland		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	075	0		29	10	S5803_075_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	075	0	2009	Community CCRx Basic	States of Pennsylvania and State of West Virginia		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	076	0		29	10	S5803_076_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	076	0	2009	Community CCRx Basic	State of Virginia		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	077	0		29	10	S5803_077_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	077	0	2009	Community CCRx Basic	State of North Carolina		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	078	0		29	10	S5803_078_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	078	0	2009	Community CCRx Basic	State of South Carolina		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	079	0		29	10	S5803_079_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	079	0	2009	Community CCRx Basic	State of Georgia		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	080	0		29	10	S5803_080_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	080	0	2009	Community CCRx Basic	State of Florida		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	081	0		29	10	S5803_081_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	081	0	2009	Community CCRx Basic	State of Alabama and State of Tennessee		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	082	0		29	10	S5803_082_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	082	0	2009	Community CCRx Basic	State of Michigan		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	083	0		29	10	S5803_083_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	083	0	2009	Community CCRx Basic	State of Ohio		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	084	0		29	10	S5803_084_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	084	0	2009	Community CCRx Basic	State of Indiana and State of Kentucky		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	085	0		29	10	S5803_085_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	085	0	2009	Community CCRx Basic	State of Wisconsin		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	086	0		29	10	S5803_086_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	086	0	2009	Community CCRx Basic	State of Illinois		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	087	0		29	10	S5803_087_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	087	0	2009	Community CCRx Basic	State of Missouri		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	088	0		29	10	S5803_088_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	088	0	2009	Community CCRx Basic	State of Arkansas		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	089	0		29	10	S5803_089_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	089	0	2009	Community CCRx Basic	State of Mississippi		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	090	0		29	10	S5803_090_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	090	0	2009	Community CCRx Basic	State of Louisiana		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	091	0		29	10	S5803_091_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	091	0	2009	Community CCRx Basic	State of Texas		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	092	0		29	10	S5803_092_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	092	0	2009	Community CCRx Basic	State of Oklahoma		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	093	0		29	10	S5803_093_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	093	0	2009	Community CCRx Basic	State of Kansas		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	094	0		29	10	S5803_094_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	094	0	2009	Community CCRx Basic	States of IA, MN, MT, NE, ND, SD, WY		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	095	0		29	10	S5803_095_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	095	0	2009	Community CCRx Basic	State of New Mexico		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	096	0		29	10	S5803_096_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	096	0	2009	Community CCRx Basic	State of Colorado		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	097	0		29	10	S5803_097_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	097	0	2009	Community CCRx Basic	State of Arizona		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	098	0		29	10	S5803_098_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	098	0	2009	Community CCRx Basic	State of Nevada		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	099	0		29	10	S5803_099_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	099	0	2009	Community CCRx Basic	State of Oregon and State of Washington		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	100	0		29	10	S5803_100_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	100	0	2009	Community CCRx Basic	State of Idaho and State of Utah		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	101	0		29	10	S5803_101_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	101	0	2009	Community CCRx Basic	State of California		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	102	0		29	10	S5803_102_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	102	0	2009	Community CCRx Basic	State of Hawaii		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	103	0		29	10	S5803_103_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	103	0	2009	Community CCRx Basic	State of Alaska		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	138	0		29	10	S5803_138_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	138	0	2009	Community CCRx Choice	State of New Hampshire and State of Maine		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	139	0		29	10	S5803_139_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	139	0	2009	Community CCRx Choice	States of CT, MA, RI, VT		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	140	0		29	10	S5803_140_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	140	0	2009	Community CCRx Choice	State of New York		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	141	0		29	10	S5803_141_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	141	0	2009	Community CCRx Choice	State of New Jersey		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	142	0		29	10	S5803_142_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	142	0	2009	Community CCRx Choice	States of Delaware, District of Columbia, Maryland		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	143	0		29	10	S5803_143_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	143	0	2009	Community CCRx Choice	State of Pennsylvania and State of West Virginia		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	144	0		29	10	S5803_144_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	144	0	2009	Community CCRx Choice	State of Virginia		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	145	0		29	10	S5803_145_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	145	0	2009	Community CCRx Choice	State of North Carolina		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	146	0		29	10	S5803_146_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	146	0	2009	Community CCRx Choice	State of South Carolina		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	147	0		29	10	S5803_147_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	147	0	2009	Community CCRx Choice	State of Georgia		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	148	0		29	10	S5803_148_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	148	0	2009	Community CCRx Choice	State of Florida		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	149	0		29	10	S5803_149_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	149	0	2009	Community CCRx Choice	State of Alabama and State of Tennessee		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	150	0		29	10	S5803_150_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	150	0	2009	Community CCRx Choice	State of Michigan		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	151	0		29	10	S5803_151_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	151	0	2009	Community CCRx Choice	State of Ohio		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	152	0		29	10	S5803_152_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	152	0	2009	Community CCRx Choice	State of Indiana and State of Kentucky		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	153	0		29	10	S5803_153_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	153	0	2009	Community CCRx Choice	State of Wisconsin		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	154	0		29	10	S5803_154_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	154	0	2009	Community CCRx Choice	State of Illinois		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	155	0		29	10	S5803_155_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	155	0	2009	Community CCRx Choice	State of Missouri		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	156	0		29	10	S5803_156_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	156	0	2009	Community CCRx Choice	State of Arkansas		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	157	0		29	10	S5803_157_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	157	0	2009	Community CCRx Choice	State of Mississippi		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	158	0		29	10	S5803_158_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	158	0	2009	Community CCRx Choice	State of Louisiana		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	159	0		29	10	S5803_159_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	159	0	2009	Community CCRx Choice	State of Texas		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	160	0		29	10	S5803_160_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	160	0	2009	Community CCRx Choice	State of Oklahoma		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	161	0		29	10	S5803_161_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	161	0	2009	Community CCRx Choice	State of Kansas		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	162	0		29	10	S5803_162_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	162	0	2009	Community CCRx Choice	States of IA, MN, MT, NE, ND, SD, WY		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	163	0		29	10	S5803_163_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	163	0	2009	Community CCRx Choice	State of New Mexico		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	164	0		29	10	S5803_164_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	164	0	2009	Community CCRx Choice	State of Colorado		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	165	0		29	10	S5803_165_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	165	0	2009	Community CCRx Choice	State of Arizona		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	166	0		29	10	S5803_166_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	166	0	2009	Community CCRx Choice	State of Nevada		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	167	0		29	10	S5803_167_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	167	0	2009	Community CCRx Choice	State of Oregon and State of Washington		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	168	0		29	10	S5803_168_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	168	0	2009	Community CCRx Choice	State of Idaho and State of Utah		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	169	0		29	10	S5803_169_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	169	0	2009	Community CCRx Choice	State of California		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	170	0		29	10	S5803_170_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	170	0	2009	Community CCRx Choice	State of Hawaii		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	171	0		29	10	S5803_171_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	171	0	2009	Community CCRx Choice	State of Alaska		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	210	0		29	10	S5803_210_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	210	0	2009	Community CCRx Basic	Puerto Rico		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	211	0		29	10	S5803_211_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	211	0	2009	Community CCRx Basic	U.S. Virgin Islands		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	214	0		29	10	S5803_214_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	214	0	2009	Community CCRx Choice	Puerto Rico		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	215	0		29	10	S5803_215_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	215	0	2009	Community CCRx Choice	U.S. Virgin Islands		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	218	0		29	10	S5803_218_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	218	0	2009	Community CCRx Gold	State of New Hampshire and State of Maine		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	219	0		29	10	S5803_219_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	219	0	2009	Community CCRx Gold	States of CT, MA, RI, VT		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	220	0		29	10	S5803_220_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	220	0	2009	Community CCRx Gold	State of New York		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	221	0		29	10	S5803_221_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	221	0	2009	Community CCRx Gold	State of New Jersey		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	222	0		29	10	S5803_222_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	222	0	2009	Community CCRx Gold	States of Delaware, District of Columbia, Maryland		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	223	0		29	10	S5803_223_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	223	0	2009	Community CCRx Gold	State of Pennsylvania and State of West Virginia		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	224	0		29	10	S5803_224_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	224	0	2009	Community CCRx Gold	State of Virginia		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	225	0		29	10	S5803_225_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	225	0	2009	Community CCRx Gold	State of North Carolina		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	226	0		29	10	S5803_226_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	226	0	2009	Community CCRx Gold	State of South Carolina		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	227	0		29	10	S5803_227_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	227	0	2009	Community CCRx Gold	State of Georgia		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	228	0		29	10	S5803_228_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	228	0	2009	Community CCRx Gold	State of Florida		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	229	0		29	10	S5803_229_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	229	0	2009	Community CCRx Gold	State of Alabama and State of Tennessee		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	230	0		29	10	S5803_230_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	230	0	2009	Community CCRx Gold	State of Michigan		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	231	0		29	10	S5803_231_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	231	0	2009	Community CCRx Gold	State of Ohio		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	232	0		29	10	S5803_232_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	232	0	2009	Community CCRx Gold	State of Indiana and State of Kentucky		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	233	0		29	10	S5803_233_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	233	0	2009	Community CCRx Gold	State of Wisconsin		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	234	0		29	10	S5803_234_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	234	0	2009	Community CCRx Gold	State of Illinois		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	235	0		29	10	S5803_235_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	235	0	2009	Community CCRx Gold	State of Missouri		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	236	0		29	10	S5803_236_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	236	0	2009	Community CCRx Gold	State of Arkansas		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	237	0		29	10	S5803_237_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	237	0	2009	Community CCRx Gold	State of Mississippi		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	238	0		29	10	S5803_238_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	238	0	2009	Community CCRx Gold	State of Louisiana		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	239	0		29	10	S5803_239_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	239	0	2009	Community CCRx Gold	State of Texas		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	240	0		29	10	S5803_240_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	240	0	2009	Community CCRx Gold	State of Oklahoma		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	241	0		29	10	S5803_241_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	241	0	2009	Community CCRx Gold	State of Kansas		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	242	0		29	10	S5803_242_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	242	0	2009	Community CCRx Gold	States of IA, MN, MT, NE, ND, SD, WY		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	243	0		29	10	S5803_243_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	243	0	2009	Community CCRx Gold	State of New Mexico		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	244	0		29	10	S5803_244_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	244	0	2009	Community CCRx Gold	State of Colorado		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	245	0		29	10	S5803_245_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	245	0	2009	Community CCRx Gold	State of Arizona		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	246	0		29	10	S5803_246_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	246	0	2009	Community CCRx Gold	State of Nevada		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	247	0		29	10	S5803_247_0	2	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	247	0	2009	Community CCRx Gold	State of Oregon and State of Washington		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	248	0		29	10	S5803_248_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	248	0	2009	Community CCRx Gold	State of Idaho and State of Utah		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	249	0		29	10	S5803_249_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	249	0	2009	Community CCRx Gold	State of California		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	250	0		29	10	S5803_250_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	250	0	2009	Community CCRx Gold	State of Hawaii		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	251	0		29	10	S5803_251_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	251	0	2009	Community CCRx Gold	State of Alaska		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	252	0		29	10	S5803_252_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	252	0	2009	Community CCRx Gold	Puerto Rico		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	253	0		29	10	S5803_253_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	253	0	2009	Community CCRx Gold	U.S. Virgin Islands		2	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	801	0		29	10	S5803_801_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	801	0	2009	Community CCRx Basic	National		1	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5803	802	0		29	10	S5803_802_0	1	2009.01	PENN LIFE INS CO AND AMER PROG LIFE AND HTH INS CO	Universal American	www.communityccrx.com	10	29				S5803	802	0	2009	Community CCRx Basic	National		1	2																		(518)-447-9200	(866)-684-5353		(866)-684-5351	(518)-447-9200	(866)-423-5040		(866)-684-5351	http://www.communityccrx.com/individuals/comprehensive_formularies	
S5805	001	0		29	10	S5805_001_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5805	001	0	2009	AARP MedicareRx Preferred	New York		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5805	801	0		29	10	S5805_801_0	1	2009.01	UNITED HEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5805	801	0	2009	AARP MedicareRx for Groups	National		1	2																		(800)-545-1797	(800)-545-1797	(877)-730-4192	(877)-730-4192	(800)-545-1797	(800)-545-1797	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5805	802	0		29	10	S5805_802_0	1	2009.01	UNITED HEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5805	802	0	2009	AARP MedicareRx for Groups	National		1	2																		(800)-545-1797	(800)-545-1797	(877)-730-4192	(877)-730-4192	(800)-545-1797	(800)-545-1797	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5805	803	0		29	10	S5805_803_0	1	2009.01	UNITED HEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5805	803	0	2009	UnitedHealth Rx for Groups	National		1	2																		(888)-556-6648	(888)-556-6648	(877)-730-4203	(877)-730-4203	(888)-556-6648	(888)-556-6648	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5805	804	0		29	10	S5805_804_0	1	2009.01	UNITED HEALTHCARE INSURANCE COMPANY OF NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5805	804	0	2009	UnitedHealth Rx for Groups	National		1	2																		(888)-556-6648	(888)-556-6648	(877)-730-4203	(877)-730-4203	(888)-556-6648	(888)-556-6648	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5810	035	0		29	10	S5810_035_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	035	0	2009	Aetna Medicare Rx Essentials	Northern New England (NH, ME)		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	036	0		29	10	S5810_036_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	036	0	2009	Aetna Medicare Rx Essentials	Central New England  (CT,RI, MA,VT)		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	037	0		29	10	S5810_037_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	037	0	2009	Aetna Medicare Rx Essentials	New  York		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	038	0		29	10	S5810_038_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	038	0	2009	Aetna Medicare Rx Essentials	New Jersey		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	039	0		29	10	S5810_039_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	039	0	2009	Aetna Medicare Rx Essentials	Mid-Atlantic (DE,DC,MD)		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	040	0		29	10	S5810_040_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	040	0	2009	Aetna Medicare Rx Essentials	Pennsylvania, West Virginia		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	041	0		29	10	S5810_041_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	041	0	2009	Aetna Medicare Rx Essentials	Virginia		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	042	0		29	10	S5810_042_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	042	0	2009	Aetna Medicare Rx Essentials	North Carolina		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	043	0		29	10	S5810_043_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	043	0	2009	Aetna Medicare Rx Essentials	South Carolina		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	044	0		29	10	S5810_044_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	044	0	2009	Aetna Medicare Rx Essentials	Georgia		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	045	0		29	10	S5810_045_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	045	0	2009	Aetna Medicare Rx Essentials	Florida		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	046	0		29	10	S5810_046_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	046	0	2009	Aetna Medicare Rx Essentials	Alabama, Tennessee		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	047	0		29	10	S5810_047_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	047	0	2009	Aetna Medicare Rx Essentials	Michigan		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	048	0		29	10	S5810_048_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	048	0	2009	Aetna Medicare Rx Essentials	Ohio		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	049	0		29	10	S5810_049_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	049	0	2009	Aetna Medicare Rx Essentials	Indiana, Kentucky		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	050	0		29	10	S5810_050_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	050	0	2009	Aetna Medicare Rx Essentials	Wisconsin		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	051	0		29	10	S5810_051_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	051	0	2009	Aetna Medicare Rx Essentials	Illinois		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	052	0		29	10	S5810_052_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	052	0	2009	Aetna Medicare Rx Essentials	Missouri		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	053	0		29	10	S5810_053_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	053	0	2009	Aetna Medicare Rx Essentials	Arkansas		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	054	0		29	10	S5810_054_0	4	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	054	0	2009	Aetna Medicare Rx Essentials	Mississippi		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	055	0		29	10	S5810_055_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	055	0	2009	Aetna Medicare Rx Essentials	Louisiana		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	056	0		29	10	S5810_056_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	056	0	2009	Aetna Medicare Rx Essentials	Texas		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	057	0		29	10	S5810_057_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	057	0	2009	Aetna Medicare Rx Essentials	Oklahoma		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	058	0		29	10	S5810_058_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	058	0	2009	Aetna Medicare Rx Essentials	Kansas		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	059	0		29	10	S5810_059_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	059	0	2009	Aetna Medicare Rx Essentials	Upper MW and N Plains (IA,MN,NE,SD,ND,WY,MT)		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	060	0		29	10	S5810_060_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	060	0	2009	Aetna Medicare Rx Essentials	New Mexico		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	061	0		29	10	S5810_061_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	061	0	2009	Aetna Medicare Rx Essentials	Colorado		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	062	0		29	10	S5810_062_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	062	0	2009	Aetna Medicare Rx Essentials	Arizona		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	063	0		29	10	S5810_063_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	063	0	2009	Aetna Medicare Rx Essentials	Nevada		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	064	0		29	10	S5810_064_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	064	0	2009	Aetna Medicare Rx Essentials	Oregon, Washington		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	065	0		29	10	S5810_065_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	065	0	2009	Aetna Medicare Rx Essentials	Idaho, Utah		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	066	0		29	10	S5810_066_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	066	0	2009	Aetna Medicare Rx Essentials	California		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	067	0		29	10	S5810_067_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	067	0	2009	Aetna Medicare Rx Essentials	Hawaii		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	068	0		29	10	S5810_068_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	068	0	2009	Aetna Medicare Rx Essentials	Alaska		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	137	0		29	10	S5810_137_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	137	0	2009	Aetna Medicare Rx Plus	Northern New England (NH, ME)		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	138	0		29	10	S5810_138_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	138	0	2009	Aetna Medicare Rx Plus	Central New England  (CT,RI, MA,VT)		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	139	0		29	10	S5810_139_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	139	0	2009	Aetna Medicare Rx Plus	New York		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	140	0		29	10	S5810_140_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	140	0	2009	Aetna Medicare Rx Plus	New Jersey		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	141	0		29	10	S5810_141_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	141	0	2009	Aetna Medicare Rx Plus	Mid-Atlantic (DE,DC,MD)		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	142	0		29	10	S5810_142_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	142	0	2009	Aetna Medicare Rx Plus	Pennsylvania, West Virginia		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	143	0		29	10	S5810_143_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	143	0	2009	Aetna Medicare Rx Plus	Virginia		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	144	0		29	10	S5810_144_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	144	0	2009	Aetna Medicare Rx Plus	North Carolina		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	145	0		29	10	S5810_145_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	145	0	2009	Aetna Medicare Rx Plus	South Carolina		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	146	0		29	10	S5810_146_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	146	0	2009	Aetna Medicare Rx Plus	Georgia		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	147	0		29	10	S5810_147_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	147	0	2009	Aetna Medicare Rx Plus	Florida		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	148	0		29	10	S5810_148_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	148	0	2009	Aetna Medicare Rx Plus	Alabama, Tennessee		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	149	0		29	10	S5810_149_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	149	0	2009	Aetna Medicare Rx Plus	Michigan		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	150	0		29	10	S5810_150_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	150	0	2009	Aetna Medicare Rx Plus	Ohio		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	151	0		29	10	S5810_151_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	151	0	2009	Aetna Medicare Rx Plus	Indiana, Kentucky		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	152	0		29	10	S5810_152_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	152	0	2009	Aetna Medicare Rx Plus	Wisconsin		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	153	0		29	10	S5810_153_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	153	0	2009	Aetna Medicare Rx Plus	Illinois		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	154	0		29	10	S5810_154_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	154	0	2009	Aetna Medicare Rx Plus	Missouri		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	155	0		29	10	S5810_155_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	155	0	2009	Aetna Medicare Rx Plus	Arkansas		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	156	0		29	10	S5810_156_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	156	0	2009	Aetna Medicare Rx Plus	Mississippi		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	157	0		29	10	S5810_157_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	157	0	2009	Aetna Medicare Rx Plus	Louisiana		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	158	0		29	10	S5810_158_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	158	0	2009	Aetna Medicare Rx Plus	Texas		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	159	0		29	10	S5810_159_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	159	0	2009	Aetna Medicare Rx Plus	Oklahoma		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	160	0		29	10	S5810_160_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	160	0	2009	Aetna Medicare Rx Plus	Kansas		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	161	0		29	10	S5810_161_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	161	0	2009	Aetna Medicare Rx Plus	Upper MW and N Plains (IA,MN,NE,SD,ND,WY,MT)		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	162	0		29	10	S5810_162_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	162	0	2009	Aetna Medicare Rx Plus	New Mexico		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	163	0		29	10	S5810_163_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	163	0	2009	Aetna Medicare Rx Plus	Colorado		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	164	0		29	10	S5810_164_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	164	0	2009	Aetna Medicare Rx Plus	Arizona		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	165	0		29	10	S5810_165_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	165	0	2009	Aetna Medicare Rx Plus	Nevada		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	166	0		29	10	S5810_166_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	166	0	2009	Aetna Medicare Rx Plus	Oregon, Washington		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	167	0		29	10	S5810_167_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	167	0	2009	Aetna Medicare Rx Plus	Idaho, Utah		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	168	0		29	10	S5810_168_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	168	0	2009	Aetna Medicare Rx Plus	California		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	169	0		29	10	S5810_169_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	169	0	2009	Aetna Medicare Rx Plus	Hawaii		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	170	0		29	10	S5810_170_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	170	0	2009	Aetna Medicare Rx Plus	Alaska		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	171	0		29	10	S5810_171_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	171	0	2009	Aetna Medicare Rx Premier	Northern New England (NH, ME)		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	172	0		29	10	S5810_172_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	172	0	2009	Aetna Medicare Rx Premier	Central New England  (CT,RI, MA,VT)		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	173	0		29	10	S5810_173_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	173	0	2009	Aetna Medicare Rx Premier	New  York		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	174	0		29	10	S5810_174_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	174	0	2009	Aetna Medicare Rx Premier	New Jersey		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	175	0		29	10	S5810_175_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	175	0	2009	Aetna Medicare Rx Premier	Mid-Atlantic (DE,DC,MD)		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	176	0		29	10	S5810_176_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	176	0	2009	Aetna Medicare Rx Premier	Pennsylvania, West Virginia		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	177	0		29	10	S5810_177_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	177	0	2009	Aetna Medicare Rx Premier	Virginia		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	178	0		29	10	S5810_178_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	178	0	2009	Aetna Medicare Rx Premier	North Carolina		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	179	0		29	10	S5810_179_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	179	0	2009	Aetna Medicare Rx Premier	South Carolina		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	180	0		29	10	S5810_180_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	180	0	2009	Aetna Medicare Rx Premier	Georgia		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	181	0		29	10	S5810_181_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	181	0	2009	Aetna Medicare Rx Premier	Florida		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	182	0		29	10	S5810_182_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	182	0	2009	Aetna Medicare Rx Premier	Alabama, Tennessee		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	183	0		29	10	S5810_183_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	183	0	2009	Aetna Medicare Rx Premier	Michigan		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	184	0		29	10	S5810_184_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	184	0	2009	Aetna Medicare Rx Premier	Ohio		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	185	0		29	10	S5810_185_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	185	0	2009	Aetna Medicare Rx Premier	Indiana, Kentucky		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	186	0		29	10	S5810_186_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	186	0	2009	Aetna Medicare Rx Premier	Wisconsin		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	187	0		29	10	S5810_187_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	187	0	2009	Aetna Medicare Rx Premier	Illinois		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	188	0		29	10	S5810_188_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	188	0	2009	Aetna Medicare Rx Premier	Missouri		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	189	0		29	10	S5810_189_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	189	0	2009	Aetna Medicare Rx Premier	Arkansas		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	190	0		29	10	S5810_190_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	190	0	2009	Aetna Medicare Rx Premier	Mississippi		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	191	0		29	10	S5810_191_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	191	0	2009	Aetna Medicare Rx Premier	Louisiana		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	192	0		29	10	S5810_192_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	192	0	2009	Aetna Medicare Rx Premier	Texas		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	193	0		29	10	S5810_193_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	193	0	2009	Aetna Medicare Rx Premier	Oklahoma		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	194	0		29	10	S5810_194_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	194	0	2009	Aetna Medicare Rx Premier	Kansas		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	195	0		29	10	S5810_195_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	195	0	2009	Aetna Medicare Rx Premier	Upper MW and N Plains (IA,MN,NE,SD,ND,WY,MT)		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	196	0		29	10	S5810_196_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	196	0	2009	Aetna Medicare Rx Premier	New Mexico		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	197	0		29	10	S5810_197_0	3	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	197	0	2009	Aetna Medicare Rx Premier	Colorado		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	198	0		29	10	S5810_198_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	198	0	2009	Aetna Medicare Rx Premier	Arizona		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	199	0		29	10	S5810_199_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	199	0	2009	Aetna Medicare Rx Premier	Nevada		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	200	0		29	10	S5810_200_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	200	0	2009	Aetna Medicare Rx Premier	Oregon, Washington		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	201	0		29	10	S5810_201_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	201	0	2009	Aetna Medicare Rx Premier	Idaho, Utah		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	202	0		29	10	S5810_202_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	202	0	2009	Aetna Medicare Rx Premier	California		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	203	0		29	10	S5810_203_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	203	0	2009	Aetna Medicare Rx Premier	Hawaii		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	204	0		29	10	S5810_204_0	2	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	204	0	2009	Aetna Medicare Rx Premier	Alaska		2	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	801	0		29	10	S5810_801_0	1	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	801	0	2009	Aetna ER Medicare Prescription Part D Plan	Employer National		1	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	802	0		29	10	S5810_802_0	1	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	802	0	2009	Aetna ER Medicare Prescription Part D Plan	Employer National		1	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5810	803	0		29	10	S5810_803_0	1	2009.01	AETNA LIFE INSURANCE COMPANY	Aetna Medicare	www.aetnamedicare.com	10	29				S5810	803	0	2009	Aetna ER Medicare Prescription Part D Plan	Employer National		1	2																		(877)-238-6211	(877)-238-6211	(888)-760-4748	(888)-760-4748	(800)-213-4599	(800)-213-4599	(800)-628-3323	(800)-628-3323	http://www.aetna.com/members/individuals/medicare/medicare_resources/covered_drugs.html	
S5820	001	0		29	10	S5820_001_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	001	0	2009	AARP MedicareRx Preferred	Northern New England (NH, ME)		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	002	0		29	10	S5820_002_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	002	0	2009	AARP MedicareRx Preferred	Central New England (CT, MA, RI, VT)		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	003	0		29	10	S5820_003_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	003	0	2009	AARP MedicareRx Preferred	New Jersey		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	004	0		29	10	S5820_004_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	004	0	2009	AARP MedicareRx Preferred	Mid-Atlantic (DE, DC, MD)		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	005	0		29	10	S5820_005_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	005	0	2009	AARP MedicareRx Preferred	Pennsylvania, West Virginia		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	006	0		29	10	S5820_006_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	006	0	2009	AARP MedicareRx Preferred	Virginia		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	007	0		29	10	S5820_007_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	007	0	2009	AARP MedicareRx Preferred	North Carolina		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	008	0		29	10	S5820_008_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	008	0	2009	AARP MedicareRx Preferred	South Carolina		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	009	0		29	10	S5820_009_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	009	0	2009	AARP MedicareRx Preferred	Georgia		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	010	0		29	10	S5820_010_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	010	0	2009	AARP MedicareRx Preferred	Florida		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	011	0		29	10	S5820_011_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	011	0	2009	AARP MedicareRx Preferred	Alabama, Tennessee		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	012	0		29	10	S5820_012_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	012	0	2009	AARP MedicareRx Preferred	Michigan		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	013	0		29	10	S5820_013_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	013	0	2009	AARP MedicareRx Preferred	Ohio		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	014	0		29	10	S5820_014_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	014	0	2009	AARP MedicareRx Preferred	Indiana, Kentucky		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	015	0		29	10	S5820_015_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	015	0	2009	AARP MedicareRx Preferred	Wisconsin		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	016	0		29	10	S5820_016_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	016	0	2009	AARP MedicareRx Preferred	Illinois		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	017	0		29	10	S5820_017_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	017	0	2009	AARP MedicareRx Preferred	Missouri		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	018	0		29	10	S5820_018_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	018	0	2009	AARP MedicareRx Preferred	Arkansas		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	019	0		29	10	S5820_019_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	019	0	2009	AARP MedicareRx Preferred	Mississippi		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	020	0		29	10	S5820_020_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	020	0	2009	AARP MedicareRx Preferred	Louisiana		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	021	0		29	10	S5820_021_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	021	0	2009	AARP MedicareRx Preferred	Texas		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	022	0		29	10	S5820_022_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	022	0	2009	AARP MedicareRx Preferred	Oklahoma		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	023	0		29	10	S5820_023_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	023	0	2009	AARP MedicareRx Preferred	Kansas		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	024	0		29	10	S5820_024_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	024	0	2009	AARP MedicareRx Preferred	Upper Midwest and Northern Plains		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	025	0		29	10	S5820_025_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	025	0	2009	AARP MedicareRx Preferred	New Mexico		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	026	0		29	10	S5820_026_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	026	0	2009	AARP MedicareRx Preferred	Colorado		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	027	0		29	10	S5820_027_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	027	0	2009	AARP MedicareRx Preferred	Arizona		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	028	0		29	10	S5820_028_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	028	0	2009	AARP MedicareRx Preferred	Nevada		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	029	0		29	10	S5820_029_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	029	0	2009	AARP MedicareRx Preferred	Oregon, Washington		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	030	0		29	10	S5820_030_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	030	0	2009	AARP MedicareRx Preferred	Idaho, Utah		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	031	0		29	10	S5820_031_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	031	0	2009	AARP MedicareRx Preferred	California		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	032	0		29	10	S5820_032_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	032	0	2009	AARP MedicareRx Preferred	Hawaii		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	033	0		29	10	S5820_033_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	033	0	2009	AARP MedicareRx Preferred	Alaska		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	034	0		29	10	S5820_034_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	034	0	2009	AARP MedicareRx Preferred	American Samoa		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	035	0		29	10	S5820_035_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	035	0	2009	AARP MedicareRx Preferred	Guam		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	036	0		29	10	S5820_036_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	036	0	2009	AARP MedicareRx Preferred	Northern Mariana Islands		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	037	0		29	10	S5820_037_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	037	0	2009	AARP MedicareRx Preferred	Puerto Rico		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	038	0		29	10	S5820_038_0	4	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	038	0	2009	AARP MedicareRx Preferred	US Virgin Islands		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	142	0		29	10	S5820_142_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	142	0	2009	AARP MedicareRx Enhanced	American Samoa		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	143	0		29	10	S5820_143_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	143	0	2009	AARP MedicareRx Enhanced	Guam		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	144	0		29	10	S5820_144_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	144	0	2009	AARP MedicareRx Enhanced	Northern Mariana Islands		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	145	0		29	10	S5820_145_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	145	0	2009	AARP MedicareRx Enhanced	Puerto Rico		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	146	0		29	10	S5820_146_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	146	0	2009	AARP MedicareRx Enhanced	U.S. Virgin Islands		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	147	0		29	10	S5820_147_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	147	0	2009	AARP MedicareRx Saver	American Samoa		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	148	0		29	10	S5820_148_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	148	0	2009	AARP MedicareRx Saver	Guam		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	149	0		29	10	S5820_149_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	149	0	2009	AARP MedicareRx Saver	Northern Mariana Islands		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	150	0		29	10	S5820_150_0	2	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	150	0	2009	AARP MedicareRx Saver	Puerto Rico		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	151	0		29	10	S5820_151_0	3	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	151	0	2009	AARP MedicareRx Saver	U.S. Virgin Islands		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	801	0		29	10	S5820_801_0	1	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	801	0	2009	AARP MedicareRx for Groups	National		1	2																		(800)-545-1797	(800)-545-1797	(877)-730-4192	(877)-730-4192	(800)-545-1797	(800)-545-1797	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	802	0		29	10	S5820_802_0	1	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	802	0	2009	AARP MedicareRx for Groups	National		1	2																		(800)-545-1797	(800)-545-1797	(877)-730-4192	(877)-730-4192	(800)-545-1797	(800)-545-1797	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5820	803	0		29	10	S5820_803_0	1	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	803	0	2009	UnitedHealth Rx for Groups	National		1	2																		(888)-556-6648	(888)-556-6648	(877)-730-4203	(877)-730-4203	(888)-556-6648	(888)-556-6648	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5820	804	0		29	10	S5820_804_0	1	2009.01	UNITED HEALTHCARE INSURANCE COMPANY	UnitedHealthcare	www.partdcentral.com	10	29				S5820	804	0	2009	UnitedHealth Rx for Groups	National		1	2																		(888)-556-6648	(888)-556-6648	(877)-730-4203	(877)-730-4203	(888)-556-6648	(888)-556-6648	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5825	017	0		29	10	S5825_017_0	1	2009.01	AMERICAN PROGRESSIVE LIFE AND HEALTH INS CO NY	Universal American	www.universalamericanrx.com	10	29				S5825	017	0	2009	Universal American Rx Gold	State of New York		2	2																		(850)-436-2336	(800)-818-0007	(800)-958-2692	(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5825	045	0		29	10	S5825_045_0	1	2009.01	AMERICAN PROGRESSIVE LIFE AND HEALTH INS CO NY	Universal American	www.universalamericanrx.com	10	29				S5825	045	0	2009	Universal American Rx Bronze	State of New York		2	2																		(850)-436-2336	(800)-818-0007	(800)-958-2692	(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5825	085	0		29	10	S5825_085_0	1	2009.01	AMERICAN PROGRESSIVE LIFE AND HEALTH INS CO NY	Universal American	www.universalamericanrx.com	10	29				S5825	085	0	2009	Universal American Rx Platinum	State of New York		2	2																		(850)-436-2336	(800)-818-0007	(800)-958-2692	(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5825	802	0		29	10	S5825_802_0	1	2009.01	AMERICAN PROGRESSIVE LIFE AND HEALTH INS CO NY	Universal American	www.universalamericanrx.com	10	29				S5825	802	0	2009	Universal American Rx Employer Std Def CY2	National Plan		1	2																		(850)-436-2336	(800)-818-0007	(800)-958-2692	(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5825	804	0		29	10	S5825_804_0	1	2009.01	AMERICAN PROGRESSIVE LIFE AND HEALTH INS CO NY	Universal American	www.universalamericanrx.com	10	29				S5825	804	0	2009	Universal American Rx Employer Std Def CY4	National Plan		1	2																		(850)-436-2336	(800)-818-0007	(800)-958-2692	(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5825	805	0		29	10	S5825_805_0	1	2009.01	AMERICAN PROGRESSIVE LIFE AND HEALTH INS CO NY	Universal American	www.universalamericanrx.com	10	29				S5825	805	0	2009	Universal American Rx Employer Std Def CY5	National Plan		1	2																		(850)-436-2336	(800)-818-0007	(800)-958-2692	(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5825	807	0		29	10	S5825_807_0	1	2009.01	AMERICAN PROGRESSIVE LIFE AND HEALTH INS CO NY	Universal American	www.universalamericanrx.com	10	29				S5825	807	0	2009	Universal American Rx Employer Std Def NCY2	National Plan		1	2																		(850)-436-2336	(800)-818-0007	(800)-958-2692	(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5825	809	0		29	10	S5825_809_0	1	2009.01	AMERICAN PROGRESSIVE LIFE AND HEALTH INS CO NY	Universal American	www.universalamericanrx.com	10	29				S5825	809	0	2009	Universal American Rx Employer Std Def NCY4	National Plan		1	2																		(850)-436-2336	(800)-818-0007	(800)-958-2692	(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5825	810	0		29	10	S5825_810_0	1	2009.01	AMERICAN PROGRESSIVE LIFE AND HEALTH INS CO NY	Universal American	www.universalamericanrx.com	10	29				S5825	810	0	2009	Universal American Rx Employer Std Def NCY5	National Plan		1	2																		(850)-436-2336	(800)-818-0007	(800)-958-2692	(800)-958-2692	(850)-436-2336	(800)-807-9990		(800)-777-9083	www.universalamericanrx.com	
S5840	001	0		29	10	S5840_001_0	5	2009.01	FIRST MEDICAL HEALTH PLAN, INC	First Medical Health Plan, Inc.	www.firstpluspr.com	10	29				S5840	001	0	2009	PharmaPlus	Entire Island Puerto Rico		2	2																		(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	(787)-625-9557	(888)-767-7717	(877)-672-4242	(877)-672-4242	http://www.firstpluspr.com	
S5840	002	0		29	10	S5840_002_0	6	2009.01	FIRST MEDICAL HEALTH PLAN, INC	First Medical Health Plan, Inc.	www.firstpluspr.com	10	29				S5840	002	0	2009	PharmaPremium	Entire Island Puerto Rico		2	2																		(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	(787)-625-9557	(888)-767-7717	(877)-672-4242	(877)-672-4242	http://www.firstpluspr.com	
S5840	801	0		29	10	S5840_801_0	4	2009.01	FIRST MEDICAL HEALTH PLAN, INC	First Medical Health Plan, Inc.	www.firstpluspr.com	10	29				S5840	801	0	2009	Employer Group Prescription Drug Plan 1	Entire Island Puerto Rico		1	2																		(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	(787)-625-9557	(888)-767-7717	(877)-672-4242	(877)-672-4242	http://www.firstpluspr.com	
S5840	802	0		29	10	S5840_802_0	4	2009.01	FIRST MEDICAL HEALTH PLAN, INC	First Medical Health Plan, Inc.	www.firstpluspr.com	10	29				S5840	802	0	2009	Employer Group Prescription Drug Plan 2	Entire Island Puerto Rico		1	2																		(787)-625-9557	(866)-515-5885	(877)-672-4242	(877)-672-4242	(787)-625-9557	(888)-767-7717	(877)-672-4242	(877)-672-4242	http://www.firstpluspr.com	
S5857	001	0		29	10	S5857_001_0	3	2009.01	PRIORITY HEALTH INSURANCE COMPANY	PriorityMedicare Rx	www.priorityhealth.com/medicare	10	29				S5857	001	0	2009	PriorityMedicareRx	State of Michigan		2	2																		(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	http://www.priorityhealth.com/medicare08/druglist	
S5857	802	0		29	10	S5857_802_0	1	2009.01	PRIORITY HEALTH INSURANCE COMPANY	PriorityMedicare Rx	www.priorityhealth.com/medicare	10	29				S5857	802	0	2009	PriorityMedicareRx EG Non-Calendar Year	United States		1	2																		(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	http://www.priorityhealth.com/medicare08/druglist	
S5857	803	0		29	10	S5857_803_0	1	2009.01	PRIORITY HEALTH INSURANCE COMPANY	PriorityMedicare Rx	www.priorityhealth.com/medicare	10	29				S5857	803	0	2009	PriorityMedicareRx EG Calendar Year	United States		1	2																		(616)-464-8820	(888)-389-6648	(616)-464-8485	(888)-551-6761	(616)-464-8850	(888)-389-6676	(616)-464-8485	(888)-551-6761	http://www.priorityhealth.com/medicare08/druglist	
S5860	001	0		29	10	S5860_001_0	13	2009.01	ROCKY MOUNTAIN  HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhp.org	10	29				S5860	001	0	2009	RMHP Basic Rx	Colorado		2	2																		(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6340	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6340	http://www.rmhp.org	
S5860	003	0		29	10	S5860_003_0	13	2009.01	ROCKY MOUNTAIN  HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhp.org	10	29				S5860	003	0	2009	RMHP Essential Rx	Colorado		2	2																		(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6340	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6340	http://www.rmhp.org	
S5860	801	0		29	10	S5860_801_0	3	2009.01	ROCKY MOUNTAIN  HEALTH MAINTENANCE ORGANIZATION	Rocky Mountain Health Plans	www.rmhp.org	10	29				S5860	801	0	2009	RMHP Employer Group PDP Plan	Nation wide		1	2																		(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6340	(970)-243-7050	(800)-346-4643	(970)-248-5019	(800)-704-6340	http://www.rmhp.org	
S5877	004	0		29	10	S5877_004_0	1	2009.01	EDUCATORS MUTUAL INSURANCE ASSOCIATION	Educators Mutual Insurance Association	www.educatorsmutual.com	10	29				S5877	004	0	2009	Educators Rx Basic	State of Utah and State of Idaho		2	2																		(801)-262-7475	(800)-572-8734			(801)-262-7475	(888)-236-4823			http://www.educatorsmutual.com/medicare/emia_plans.aspx	
S5877	007	0		29	10	S5877_007_0	1	2009.01	EDUCATORS MUTUAL INSURANCE ASSOCIATION	Educators Mutual Insurance Association	www.educatorsmutual.com	10	29				S5877	007	0	2009	Educators Rx Advantage	State of Utah and State of Idaho		2	2																		(801)-262-7475	(800)-572-8734			(801)-262-7475	(888)-236-4823			http://www.educatorsmutual.com/medicare/emia_plans.aspx	
S5884	001	0		29	10	S5884_001_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	001	0	2009	Humana PDP Enhanced S5884-001	States of Alabama and Tennessee		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	002	0		29	10	S5884_002_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	002	0	2009	Humana PDP Enhanced S5884-002	States of CT, MA, RI, VT		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	003	0		29	10	S5884_003_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	003	0	2009	Humana PDP Enhanced S5884-003	State of New Jersey		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	004	0		29	10	S5884_004_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	004	0	2009	Humana PDP Enhanced S5884-004	States of DC, DE, MD		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	005	0		29	10	S5884_005_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	005	0	2009	Humana PDP Enhanced S5884-005	States of Pennsylvania and West Virginia		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	006	0		29	10	S5884_006_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	006	0	2009	Humana PDP Enhanced S5884-006	State of Virginia		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	007	0		29	10	S5884_007_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	007	0	2009	Humana PDP Enhanced S5884-007	State of North Carolina		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	008	0		29	10	S5884_008_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	008	0	2009	Humana PDP Enhanced S5884-008	State of South Carolina		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	009	0		29	10	S5884_009_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	009	0	2009	Humana PDP Enhanced S5884-009	State of Georgia		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	010	0		29	10	S5884_010_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	010	0	2009	Humana PDP Enhanced S5884-010	State of Florida		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	011	0		29	10	S5884_011_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	011	0	2009	Humana PDP Enhanced S5884-011	State of Michigan		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	012	0		29	10	S5884_012_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	012	0	2009	Humana PDP Enhanced S5884-012	State of Ohio		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	013	0		29	10	S5884_013_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	013	0	2009	Humana PDP Enhanced S5884-013	States of Indiana and Kentucky		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	014	0		29	10	S5884_014_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	014	0	2009	Humana PDP Enhanced S5884-014	State of Wisconsin		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	015	0		29	10	S5884_015_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	015	0	2009	Humana PDP Enhanced S5884-015	State of Illinois		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	016	0		29	10	S5884_016_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	016	0	2009	Humana PDP Enhanced S5884-016	State of Missouri		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	017	0		29	10	S5884_017_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	017	0	2009	Humana PDP Enhanced S5884-017	State of Arkansas		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	018	0		29	10	S5884_018_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	018	0	2009	Humana PDP Enhanced S5884-018	State of Mississippi		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	019	0		29	10	S5884_019_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	019	0	2009	Humana PDP Enhanced S5884-019	State of Louisiana		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	020	0		29	10	S5884_020_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	020	0	2009	Humana PDP Enhanced S5884-020	State of Texas		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	021	0		29	10	S5884_021_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	021	0	2009	Humana PDP Enhanced S5884-021	State of Oklahoma		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	022	0		29	10	S5884_022_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	022	0	2009	Humana PDP Enhanced S5884-022	State of Kansas		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	023	0		29	10	S5884_023_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	023	0	2009	Humana PDP Enhanced S5884-023	States of IA, MN, MT, ND, NE, SD, WY		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	024	0		29	10	S5884_024_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	024	0	2009	Humana PDP Enhanced S5884-024	State of New Mexico		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	025	0		29	10	S5884_025_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	025	0	2009	Humana PDP Enhanced S5884-025	State of Colorado		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	026	0		29	10	S5884_026_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	026	0	2009	Humana PDP Enhanced S5884-026	State of Arizona		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	027	0		29	10	S5884_027_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	027	0	2009	Humana PDP Enhanced S5884-027	State of Nevada		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	028	0		29	10	S5884_028_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	028	0	2009	Humana PDP Enhanced S5884-028	States of Oregon and Washington		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	029	0		29	10	S5884_029_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	029	0	2009	Humana PDP Enhanced S5884-029	States of Idaho and Utah		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	030	0		29	10	S5884_030_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	030	0	2009	Humana PDP Enhanced S5884-030	State of California		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	031	0		29	10	S5884_031_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	031	0	2009	Humana PDP Complete S5884-031	States of CT, MA, RI, VT		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	032	0		29	10	S5884_032_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	032	0	2009	Humana PDP Complete S5884-032	State of New Jersey		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	033	0		29	10	S5884_033_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	033	0	2009	Humana PDP Complete S5884-033	States of DC, DE, MD		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	034	0		29	10	S5884_034_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	034	0	2009	Humana PDP Complete S5884-034	States of Pennsylvania and West Virginia		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	035	0		29	10	S5884_035_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	035	0	2009	Humana PDP Complete S5884-035	State of Virginia		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	036	0		29	10	S5884_036_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	036	0	2009	Humana PDP Complete S5884-036	State of North Carolina		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	037	0		29	10	S5884_037_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	037	0	2009	Humana PDP Complete S5884-037	State of South Carolina		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	038	0		29	10	S5884_038_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	038	0	2009	Humana PDP Complete S5884-038	State of Georgia		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	039	0		29	10	S5884_039_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	039	0	2009	Humana PDP Complete S5884-039	State of Florida		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	040	0		29	10	S5884_040_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	040	0	2009	Humana PDP Complete S5884-040	States of Alabama and Tennessee		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	041	0		29	10	S5884_041_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	041	0	2009	Humana PDP Complete S5884-041	State of Michigan		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	042	0		29	10	S5884_042_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	042	0	2009	Humana PDP Complete S5884-042	State of Ohio		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	043	0		29	10	S5884_043_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	043	0	2009	Humana PDP Complete S5884-043	States of Indiana and Kentucky		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	044	0		29	10	S5884_044_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	044	0	2009	Humana PDP Complete S5884-044	State of Wisconsin		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	045	0		29	10	S5884_045_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	045	0	2009	Humana PDP Complete S5884-045	State of Illinois		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	046	0		29	10	S5884_046_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	046	0	2009	Humana PDP Complete S5884-046	State of Missouri		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	047	0		29	10	S5884_047_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	047	0	2009	Humana PDP Complete S5884-047	State of Arkansas		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	048	0		29	10	S5884_048_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	048	0	2009	Humana PDP Complete S5884-048	State of Mississippi		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	049	0		29	10	S5884_049_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	049	0	2009	Humana PDP Complete S5884-049	State of Louisiana		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	050	0		29	10	S5884_050_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	050	0	2009	Humana PDP Complete S5884-050	State of Texas		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	051	0		29	10	S5884_051_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	051	0	2009	Humana PDP Complete S5884-051	State of Oklahoma		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	052	0		29	10	S5884_052_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	052	0	2009	Humana PDP Complete S5884-052	State of Kansas		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	053	0		29	10	S5884_053_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	053	0	2009	Humana PDP Complete S5884-053	States of IA, MN, MT, ND, NE, SD, WY		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	054	0		29	10	S5884_054_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	054	0	2009	Humana PDP Complete S5884-054	State of New Mexico		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	055	0		29	10	S5884_055_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	055	0	2009	Humana PDP Complete S5884-055	State of Colorado		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	056	0		29	10	S5884_056_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	056	0	2009	Humana PDP Complete S5884-056	State of Arizona		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	057	0		29	10	S5884_057_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	057	0	2009	Humana PDP Complete S5884-057	State of Nevada		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	058	0		29	10	S5884_058_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	058	0	2009	Humana PDP Complete S5884-058	States of Oregon and Washington		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	059	0		29	10	S5884_059_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	059	0	2009	Humana PDP Complete S5884-059	States of Idaho and Utah		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	060	0		29	10	S5884_060_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	060	0	2009	Humana PDP Complete S5884-060	State of California		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	061	0		29	10	S5884_061_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	061	0	2009	Humana PDP Standard S5884-061	States of CT, MA, RI, VT		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	062	0		29	10	S5884_062_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	062	0	2009	Humana PDP Standard S5884-062	State of New Jersey		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	063	0		29	10	S5884_063_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	063	0	2009	Humana PDP Standard S5884-063	States of DC, DE, MD		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	064	0		29	10	S5884_064_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	064	0	2009	Humana PDP Standard S5884-064	States of Pennsylvania and West Virginia		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	065	0		29	10	S5884_065_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	065	0	2009	Humana PDP Standard S5884-065	State of Virginia		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	066	0		29	10	S5884_066_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	066	0	2009	Humana PDP Standard S5884-066	State of North Carolina		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	067	0		29	10	S5884_067_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	067	0	2009	Humana PDP Standard S5884-067	State of South Carolina		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	068	0		29	10	S5884_068_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	068	0	2009	Humana PDP Standard S5884-068	State of Georgia		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	069	0		29	10	S5884_069_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	069	0	2009	Humana PDP Standard S5884-069	State of Florida		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	070	0		29	10	S5884_070_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	070	0	2009	Humana PDP Standard S5884-070	States of Alabama and Tennessee		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	071	0		29	10	S5884_071_0	1	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	071	0	2009	Humana PDP Standard S5884-071	State of Michigan		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	072	0		29	10	S5884_072_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	072	0	2009	Humana PDP Standard S5884-072	State of Ohio		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	073	0		29	10	S5884_073_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	073	0	2009	Humana PDP Standard S5884-073	States of Indiana and Kentucky		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	074	0		29	10	S5884_074_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	074	0	2009	Humana PDP Standard S5884-074	State of Wisconsin		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	075	0		29	10	S5884_075_0	1	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	075	0	2009	Humana PDP Standard S5884-075	State of Illinois		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	076	0		29	10	S5884_076_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	076	0	2009	Humana PDP Standard S5884-076	State of Missouri		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	077	0		29	10	S5884_077_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	077	0	2009	Humana PDP Standard S5884-077	State of Arkansas		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	078	0		29	10	S5884_078_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	078	0	2009	Humana PDP Standard S5884-078	State of Mississippi		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	079	0		29	10	S5884_079_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	079	0	2009	Humana PDP Standard S5884-079	State of Louisiana		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	080	0		29	10	S5884_080_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	080	0	2009	Humana PDP Standard S5884-080	State of Texas		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	081	0		29	10	S5884_081_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	081	0	2009	Humana PDP Standard S5884-081	State of Oklahoma		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	082	0		29	10	S5884_082_0	1	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	082	0	2009	Humana PDP Standard S5884-082	State of Kansas		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	083	0		29	10	S5884_083_0	1	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	083	0	2009	Humana PDP Standard S5884-083	States of IA, MN, MT, ND, NE, SD, WY		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	084	0		29	10	S5884_084_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	084	0	2009	Humana PDP Standard S5884-084	State of New Mexico		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	085	0		29	10	S5884_085_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	085	0	2009	Humana PDP Standard S5884-085	State of Colorado		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	086	0		29	10	S5884_086_0	1	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	086	0	2009	Humana PDP Standard S5884-086	State of Arizona		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	087	0		29	10	S5884_087_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	087	0	2009	Humana PDP Standard S5884-087	State of Nevada		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	088	0		29	10	S5884_088_0	1	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	088	0	2009	Humana PDP Standard S5884-088	States of Oregon and Washington		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	089	0		29	10	S5884_089_0	1	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	089	0	2009	Humana PDP Standard S5884-089	States of Idaho and Utah		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	090	0		29	10	S5884_090_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	090	0	2009	Humana PDP Standard S5884-090	State of California		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	092	0		29	10	S5884_092_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	092	0	2009	Humana PDP Standard S5884-092	States of Maine and New Hampshire		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	093	0		29	10	S5884_093_0	3	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	093	0	2009	Humana PDP Standard S5884-093	State of Hawaii		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	094	0		29	10	S5884_094_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	094	0	2009	Humana PDP Standard S5884-094	State of Alaska		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	095	0		29	10	S5884_095_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	095	0	2009	Humana PDP Enhanced S5884-095	States of Maine and New Hampshire		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	096	0		29	10	S5884_096_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	096	0	2009	Humana PDP Enhanced S5884-096	State of Hawaii		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	097	0		29	10	S5884_097_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	097	0	2009	Humana PDP Enhanced S5884-097	State of Alaska		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	098	0		29	10	S5884_098_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	098	0	2009	Humana PDP Complete S5884-098	States of Maine and New Hampshire		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	099	0		29	10	S5884_099_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	099	0	2009	Humana PDP Complete S5884-099	State of Hawaii		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	100	0		29	10	S5884_100_0	2	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	100	0	2009	Humana PDP Complete S5884-100	State of Alaska		2	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	834	0		29	10	S5884_834_0	1	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	834	0	2009	Humana PDP Employer Sponsored	All Regions		1	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5884	835	0		29	10	S5884_835_0	1	2009.01	HUMANA INSURANCE COMPANY	Humana Insurance Company	www.humana-medicare.com	10	29				S5884	835	0	2009	Humana PDP Employer Sponsored Non-CY	All Regions		1	2																		(800)-281-6918	(800)-281-6918		(800)-833-3301	(800)-706-0872	(800)-706-0872		(877)-833-4486	http://www.humana.com/members/tools/prescription_tools/medicare_drug_list.asp	
S5904	001	0		29	10	S5904_001_0	4	2009.01	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.bcbsfl.com/	10	29				S5904	001	0	2009	BlueMedicare Rx-Option 1	State of Florida		2	2																		(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	www.myrxassistant.com	
S5904	002	0		29	10	S5904_002_0	4	2009.01	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.bcbsfl.com/	10	29				S5904	002	0	2009	BlueMedicare Rx-Option 2	State of Florida		2	2																		(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	www.myrxassistant.com	
S5904	003	0		29	10	S5904_003_0	5	2009.01	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.bcbsfl.com/	10	29				S5904	003	0	2009	BlueMedicare Rx-Option 3	State of Florida		2	2																		(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	www.myrxassistant.com	
S5904	801	0		29	10	S5904_801_0	2	2009.01	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.bcbsfl.com/	10	29				S5904	801	0	2009	BlueMedicare Group Rx	State of Florida with National Coverage		1	2																		(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	www.myrxassistant.com	
S5904	802	0		29	10	S5904_802_0	2	2009.01	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Blue Cross and Blue Shield of Florida, Inc.	www.bcbsfl.com/	10	29				S5904	802	0	2009	BlueMedicare Group Rx	State of Florida with National Coverage		1	2																		(800)-926-6565	(800)-926-6565	(800)-955-1339	(800)-955-1339	(904)-905-0000	(800)-876-2227	(800)-955-1339	(800)-955-1339	www.myrxassistant.com	
S5907	001	0		29	10	S5907_001_0	4	2009.01	TRIPLE-S, INC.	Triple-S, Inc.	www.ssspr.com	10	29				S5907	001	0	2009	Triple-S FarmaMed	Island of Puerto Rico		2	2																		(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	www.ssspr.com	
S5907	002	0		29	10	S5907_002_0	4	2009.01	TRIPLE-S, INC.	Triple-S, Inc.	www.ssspr.com	10	29				S5907	002	0	2009	Triple-S FarmaMed Plus	Island of Puerto Rico		2	2																		(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	www.ssspr.com	
S5907	003	0		29	10	S5907_003_0	4	2009.01	TRIPLE-S, INC.	Triple-S, Inc.	www.ssspr.com	10	29				S5907	003	0	2009	Triple-S FarmaMed Superior	Island of Puerto Rico		2	2																		(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	www.ssspr.com	
S5907	801	0		29	10	S5907_801_0	1	2009.01	TRIPLE-S, INC.	Triple-S, Inc.	www.ssspr.com	10	29				S5907	801	0	2009	Triple-S FarmaMed A	Island of Puerto Rico		1	2																		(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	www.ssspr.com	
S5907	802	0		29	10	S5907_802_0	1	2009.01	TRIPLE-S, INC.	Triple-S, Inc.	www.ssspr.com	10	29				S5907	802	0	2009	Triple-S FarmaMed B	Island of Puerto Rico		1	2																		(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	(787)-774-6083	(800)-510-0722	(787)-749-4059	(800)-383-4457	www.ssspr.com	
S5915	002	0		29	10	S5915_002_0	4	2009.01	SCOTT AND WHITE HEALTH PLAN	Scott and White Health PlanTexas Rx Plan	www.swhp.org	10	29				S5915	002	0	2009	Scott and White Health PlanTexas Rx Enhanced	Texas		2	2																		(254)-298-3141	(866)-334-3141			(254)-298-3366	(888)-333-3980			http://www.sw.org/sw/iwcontent/public/swhp/en_us/pdf/swhp_txrx_formulary.pdf	
S5915	003	0		29	10	S5915_003_0	4	2009.01	SCOTT AND WHITE HEALTH PLAN	Scott and White Health PlanTexas Rx Plan	www.swhp.org	10	29				S5915	003	0	2009	Scott and White Health Plan Texas Rx Value	Texas		2	2																		(254)-298-3141	(866)-334-3141			(254)-298-3366	(888)-333-3980			http://www.sw.org/sw/iwcontent/public/swhp/en_us/pdf/swhp_txrx_formulary.pdf	
S5915	004	0		29	10	S5915_004_0	5	2009.01	SCOTT AND WHITE HEALTH PLAN	Scott and White Health PlanTexas Rx Plan	www.swhp.org	10	29				S5915	004	0	2009	Scott and White Health Plan Texas Rx Basic	Texas		2	2																		(254)-298-3141	(866)-334-3141			(254)-298-3366	(888)-333-3980			http://www.sw.org/sw/iwcontent/public/swhp/en_us/pdf/swhp_txrx_formulary.pdf	
S5916	001	0		29	10	S5916_001_0	2	2009.01	REGENCE LIFE AND HEALTH INSURANCE COMPANY	Regence Life and Health	www.regence.com/medicareScript	10	29				S5916	001	0	2009	Regence Medicare Script	Region of Idaho and Utah		2	2																		(800)-541-8981	(800)-541-8981	(800)-382-1003	(800)-382-1003	(888)-734-3623	(888)-734-3623	(800)-382-1003	(800)-382-1003	www.regence.com/medicareScript	
S5916	002	0		29	10	S5916_002_0	2	2009.01	REGENCE LIFE AND HEALTH INSURANCE COMPANY	Regence Life and Health	www.regence.com/medicareScript	10	29				S5916	002	0	2009	Regence Medicare Script Enhanced	Region of Idaho and Utah		2	2																		(800)-541-8981	(800)-541-8981	(800)-382-1003	(800)-382-1003	(888)-734-3623	(888)-734-3623	(800)-382-1003	(800)-382-1003	www.regence.com/medicareScript	
S5916	802	0		29	10	S5916_802_0	1	2009.01	REGENCE LIFE AND HEALTH INSURANCE COMPANY	Regence Life and Health	www.regence.com/medicareScript	10	29				S5916	802	0	2009	Regence Medicare Script	Region of Idaho and Utah		1	2																		(800)-541-8981	(800)-541-8981	(800)-382-1003	(800)-382-1003	(888)-734-3623	(888)-734-3623	(800)-382-1003	(800)-382-1003	www.regence.com/medicareScript	
S5917	001	0		29	10	S5917_001_0	4	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	001	0	2009	SierraRx	Texas		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	002	0		29	10	S5917_002_0	4	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.UHRxValue.com	10	29				S5917	002	0	2009	UnitedHealth Rx Value	New Mexico		2	2																		(866)-729-6928	(866)-729-6928		(877)-730-4203	(866)-847-4338	(866)-847-4338		(877)-730-4203	www.sierrarx.com	
S5917	003	0		29	10	S5917_003_0	4	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	003	0	2009	SierraRx	Colorado		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	004	0		29	10	S5917_004_0	4	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.UHRxValue.com	10	29				S5917	004	0	2009	UnitedHealth Rx Value	Arizona		2	2																		(866)-729-6928	(866)-729-6928		(877)-730-4203	(866)-847-4338	(866)-847-4338		(877)-730-4203	www.sierrarx.com	
S5917	005	0		29	10	S5917_005_0	4	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.UHRxValue.com	10	29				S5917	005	0	2009	UnitedHealth Rx Value	Nevada		2	2																		(866)-729-6928	(866)-729-6928		(877)-730-4203	(866)-847-4338	(866)-847-4338		(877)-730-4203	www.sierrarx.com	
S5917	006	0		29	10	S5917_006_0	4	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	006	0	2009	SierraRx	Oregon and Washington		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	007	0		29	10	S5917_007_0	4	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	007	0	2009	SierraRx	Idaho and Utah		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	008	0		29	10	S5917_008_0	4	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	008	0	2009	SierraRx	California		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	009	0		29	10	S5917_009_0	2	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	009	0	2009	SierraRx Basic	New Jersey		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	010	0		29	10	S5917_010_0	2	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	010	0	2009	SierraRx Basic	Delaware, District of Columbia and Maryland		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	011	0		29	10	S5917_011_0	2	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	011	0	2009	SierraRx Basic	Pennsylvania and West Virginia		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	012	0		29	10	S5917_012_0	2	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	012	0	2009	SierraRx Basic	Virginia		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	014	0		29	10	S5917_014_0	2	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	014	0	2009	SierraRx Basic	South Carolina		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	015	0		29	10	S5917_015_0	2	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	015	0	2009	SierraRx Basic	Georgia		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	016	0		29	10	S5917_016_0	2	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	016	0	2009	SierraRx Basic	Alabama and Tennessee		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	017	0		29	10	S5917_017_0	2	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	017	0	2009	SierraRx Basic	Ohio		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	018	0		29	10	S5917_018_0	2	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	018	0	2009	SierraRx Basic	Indiana and Kentucky		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	019	0		29	10	S5917_019_0	2	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	019	0	2009	SierraRx Basic	Illinois		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	020	0		29	10	S5917_020_0	2	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	020	0	2009	SierraRx Basic	Missouri		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	021	0		29	10	S5917_021_0	2	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	021	0	2009	SierraRx Basic	Arkansas		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	022	0		29	10	S5917_022_0	2	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	022	0	2009	SierraRx Basic	Mississippi		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	023	0		29	10	S5917_023_0	2	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	023	0	2009	SierraRx Basic	Louisiana		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	024	0		29	10	S5917_024_0	2	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	024	0	2009	SierraRx Basic	Oklahoma		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	025	0		29	10	S5917_025_0	2	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	025	0	2009	SierraRx Basic	Kansas		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	026	0		29	10	S5917_026_0	2	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	026	0	2009	SierraRx Basic	Texas		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	027	0		29	10	S5917_027_0	2	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	027	0	2009	SierraRx Basic	New Mexico		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	028	0		29	10	S5917_028_0	2	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	028	0	2009	SierraRx Basic	Colorado		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	029	0		29	10	S5917_029_0	3	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	029	0	2009	SierraRx Basic	Arizona		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	030	0		29	10	S5917_030_0	2	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	030	0	2009	SierraRx Basic	Nevada		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	031	0		29	10	S5917_031_0	2	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	031	0	2009	SierraRx Basic	Oregon and Washington		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	032	0		29	10	S5917_032_0	2	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	032	0	2009	SierraRx Basic	Idaho and Utah		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5917	033	0		29	10	S5917_033_0	2	2009.01	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Sierra Health and Life Insurance Company, Inc.	www.sierrarx.com	10	29				S5917	033	0	2009	SierraRx Basic	California		2	2																		(866)-819-3450	(866)-819-3450		(877)-730-4203	(866)-819-3449	(866)-819-3449		(877)-730-4203	www.sierrarx.com	
S5921	001	0		29	10	S5921_001_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	001	0	2009	AARP MedicareRx Saver	California		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	002	0		29	10	S5921_002_0	4	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	002	0	2009	UnitedHealth Rx Basic	California		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	003	0		29	10	S5921_003_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	003	0	2009	AARP MedicareRx Enhanced	California		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	011	0		29	10	S5921_011_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	011	0	2009	AARP MedicareRx Saver	Alaska		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	012	0		29	10	S5921_012_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	012	0	2009	UnitedHealth Rx Basic	Alaska		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	013	0		29	10	S5921_013_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	013	0	2009	AARP MedicareRx Enhanced	Alaska		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	021	0		29	10	S5921_021_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	021	0	2009	AARP MedicareRx Saver	Oregon and Washington		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	022	0		29	10	S5921_022_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	022	0	2009	UnitedHealth Rx Basic	Oregon and Washington		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	023	0		29	10	S5921_023_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	023	0	2009	AARP MedicareRx Enhanced	Oregon and Washington		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	031	0		29	10	S5921_031_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	031	0	2009	AARP MedicareRx Saver	Idaho and Utah		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	032	0		29	10	S5921_032_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	032	0	2009	UnitedHealth Rx Basic	Idaho and Utah		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	033	0		29	10	S5921_033_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	033	0	2009	AARP MedicareRx Enhanced	Idaho and Utah		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	041	0		29	10	S5921_041_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	041	0	2009	AARP MedicareRx Saver	Hawaii		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	042	0		29	10	S5921_042_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	042	0	2009	UnitedHealth Rx Basic	Hawaii		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	043	0		29	10	S5921_043_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	043	0	2009	AARP MedicareRx Enhanced	Hawaii		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	051	0		29	10	S5921_051_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	051	0	2009	AARP MedicareRx Saver	Ohio		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	052	0		29	10	S5921_052_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	052	0	2009	UnitedHealth Rx Basic	Ohio		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	053	0		29	10	S5921_053_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	053	0	2009	AARP MedicareRx Enhanced	Ohio		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	061	0		29	10	S5921_061_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	061	0	2009	AARP MedicareRx Saver	Indiana and Kentucky		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	062	0		29	10	S5921_062_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	062	0	2009	UnitedHealth Rx Basic	Indiana and Kentucky		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	063	0		29	10	S5921_063_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	063	0	2009	AARP MedicareRx Enhanced	Indiana and Kentucky		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	071	0		29	10	S5921_071_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	071	0	2009	AARP MedicareRx Saver	Wisconsin		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	072	0		29	10	S5921_072_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	072	0	2009	UnitedHealth Rx Basic	Wisconsin		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	073	0		29	10	S5921_073_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	073	0	2009	AARP MedicareRx Enhanced	Wisconsin		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	081	0		29	10	S5921_081_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	081	0	2009	AARP MedicareRx Saver	Illinois		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	082	0		29	10	S5921_082_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	082	0	2009	UnitedHealth Rx Basic	Illinois		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	083	0		29	10	S5921_083_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	083	0	2009	AARP MedicareRx Enhanced	Illinois		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	091	0		29	10	S5921_091_0	3	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	091	0	2009	AARP MedicareRx Saver	Pennsylvania and West Virginia		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	092	0		29	10	S5921_092_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	092	0	2009	UnitedHealth Rx Basic	Pennsylvania and West Virginia		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	093	0		29	10	S5921_093_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	093	0	2009	AARP MedicareRx Enhanced	Pennsylvania and West Virginia		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	101	0		29	10	S5921_101_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	101	0	2009	AARP MedicareRx Saver	Virginia		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	102	0		29	10	S5921_102_0	4	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	102	0	2009	UnitedHealth Rx Basic	Virginia		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	103	0		29	10	S5921_103_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	103	0	2009	AARP MedicareRx Enhanced	Virginia		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	111	0		29	10	S5921_111_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	111	0	2009	AARP MedicareRx Saver	North Carolina		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	112	0		29	10	S5921_112_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	112	0	2009	UnitedHealth Rx Basic	North Carolina		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	113	0		29	10	S5921_113_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	113	0	2009	AARP MedicareRx Enhanced	North Carolina		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	121	0		29	10	S5921_121_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	121	0	2009	AARP MedicareRx Saver	South Carolina		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	122	0		29	10	S5921_122_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	122	0	2009	UnitedHealth Rx Basic	South Carolina		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	123	0		29	10	S5921_123_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	123	0	2009	AARP MedicareRx Enhanced	South Carolina		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	131	0		29	10	S5921_131_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	131	0	2009	AARP MedicareRx Saver	Georgia		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	132	0		29	10	S5921_132_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	132	0	2009	UnitedHealth Rx Basic	Georgia		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	133	0		29	10	S5921_133_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	133	0	2009	AARP MedicareRx Enhanced	Georgia		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	141	0		29	10	S5921_141_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	141	0	2009	AARP MedicareRx Saver	Florida		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	142	0		29	10	S5921_142_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	142	0	2009	UnitedHealth Rx Basic	Florida		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	143	0		29	10	S5921_143_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	143	0	2009	AARP MedicareRx Enhanced	Florida		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	151	0		29	10	S5921_151_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	151	0	2009	AARP MedicareRx Saver	Alabama and Tennessee		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	152	0		29	10	S5921_152_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	152	0	2009	UnitedHealth Rx Basic	Alabama and Tennessee		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	153	0		29	10	S5921_153_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	153	0	2009	AARP MedicareRx Enhanced	Alabama and Tennessee		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	161	0		29	10	S5921_161_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	161	0	2009	AARP MedicareRx Saver	Michigan		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	162	0		29	10	S5921_162_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	162	0	2009	UnitedHealth Rx Basic	Michigan		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	163	0		29	10	S5921_163_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	163	0	2009	AARP MedicareRx Enhanced	Michigan		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	171	0		29	10	S5921_171_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	171	0	2009	AARP MedicareRx Saver	New Hampshire and Maine		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	172	0		29	10	S5921_172_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	172	0	2009	UnitedHealth Rx Basic	New Hampshire and Maine		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	173	0		29	10	S5921_173_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	173	0	2009	AARP MedicareRx Enhanced	New Hampshire and Maine		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	181	0		29	10	S5921_181_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	181	0	2009	AARP MedicareRx Saver	Connecticut, Massachusetts, Rhode Island, Vermont		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	182	0		29	10	S5921_182_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	182	0	2009	UnitedHealth Rx Basic	Connecticut, Massachusetts, Rhode Island, Vermont		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	183	0		29	10	S5921_183_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	183	0	2009	AARP MedicareRx Enhanced	Connecticut, Massachusetts, Rhode Island, Vermont		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	191	0		29	10	S5921_191_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	191	0	2009	AARP MedicareRx Saver	Texas		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	192	0		29	10	S5921_192_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	192	0	2009	UnitedHealth Rx Basic	Texas		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	193	0		29	10	S5921_193_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	193	0	2009	AARP MedicareRx Enhanced	Texas		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	201	0		29	10	S5921_201_0	4	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	201	0	2009	AARP MedicareRx Saver	Oklahoma		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	202	0		29	10	S5921_202_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	202	0	2009	UnitedHealth Rx Basic	Oklahoma		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	203	0		29	10	S5921_203_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	203	0	2009	AARP MedicareRx Saver	New York		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	207	0		29	10	S5921_207_0	4	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	207	0	2009	UnitedHealth Rx Basic	New York		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	213	0		29	10	S5921_213_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	213	0	2009	AARP MedicareRx Enhanced	New York		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	221	0		29	10	S5921_221_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	221	0	2009	AARP MedicareRx Saver	Colorado		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	222	0		29	10	S5921_222_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	222	0	2009	UnitedHealth Rx Basic	Colorado		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	223	0		29	10	S5921_223_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	223	0	2009	AARP MedicareRx Enhanced	Colorado		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	231	0		29	10	S5921_231_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	231	0	2009	AARP MedicareRx Saver	Arizona		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	232	0		29	10	S5921_232_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	232	0	2009	UnitedHealth Rx Basic	Arizona		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	233	0		29	10	S5921_233_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	233	0	2009	AARP MedicareRx Enhanced	Arizona		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	235	0		29	10	S5921_235_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	235	0	2009	AARP MedicareRx Enhanced	Oklahoma		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	237	0		29	10	S5921_237_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	237	0	2009	AARP MedicareRx Saver	Delaware, Maryland and Washington D.C.		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	238	0		29	10	S5921_238_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	238	0	2009	UnitedHealth Rx Basic	Delaware, Maryland and Washington D.C.		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	239	0		29	10	S5921_239_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	239	0	2009	AARP MedicareRx Enhanced	Delaware, Maryland and Washington D.C.		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	247	0		29	10	S5921_247_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	247	0	2009	AARP MedicareRx Saver	IA, MN, MT, ND, ND, SD, WY		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	248	0		29	10	S5921_248_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	248	0	2009	UnitedHealth Rx Basic	IA, MN, MT, ND, ND, SD, WY		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	249	0		29	10	S5921_249_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	249	0	2009	AARP MedicareRx Enhanced	IA, MN, MT, ND, ND, SD,WY		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	261	0		29	10	S5921_261_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	261	0	2009	AARP MedicareRx Saver	New Mexico		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	262	0		29	10	S5921_262_0	3	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	262	0	2009	UnitedHealth Rx Basic	New Mexico		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	263	0		29	10	S5921_263_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	263	0	2009	AARP MedicareRx Enhanced	New Mexico		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	265	0		29	10	S5921_265_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	265	0	2009	AARP MedicareRx Saver	Nevada		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	266	0		29	10	S5921_266_0	3	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	266	0	2009	UnitedHealth Rx Basic	Nevada		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	273	0		29	10	S5921_273_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	273	0	2009	AARP MedicareRx Enhanced	Nevada		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	281	0		29	10	S5921_281_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	281	0	2009	AARP MedicareRx Saver	Kansas		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	282	0		29	10	S5921_282_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	282	0	2009	UnitedHealth Rx Basic	Kansas		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	283	0		29	10	S5921_283_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	283	0	2009	AARP MedicareRx Enhanced	Kansas		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	286	0		29	10	S5921_286_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	286	0	2009	AARP MedicareRx Saver	New Jersey		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	288	0		29	10	S5921_288_0	3	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	288	0	2009	UnitedHealth Rx Basic	New Jersey		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	293	0		29	10	S5921_293_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	293	0	2009	AARP MedicareRx Enhanced	New Jersey		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	301	0		29	10	S5921_301_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	301	0	2009	AARP MedicareRx Saver	Missouri		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	302	0		29	10	S5921_302_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	302	0	2009	UnitedHealth Rx Basic	Missouri		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	303	0		29	10	S5921_303_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	303	0	2009	AARP MedicareRx Enhanced	Missouri		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	311	0		29	10	S5921_311_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	311	0	2009	AARP MedicareRx Saver	Arkansas		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	312	0		29	10	S5921_312_0	3	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	312	0	2009	UnitedHealth Rx Basic	Arkansas		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	313	0		29	10	S5921_313_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	313	0	2009	AARP MedicareRx Enhanced	Arkansas		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	321	0		29	10	S5921_321_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	321	0	2009	AARP MedicareRx Saver	Mississippi		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	322	0		29	10	S5921_322_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	322	0	2009	UnitedHealth Rx Basic	Mississippi		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	323	0		29	10	S5921_323_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	323	0	2009	AARP MedicareRx Enhanced	Mississippi		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	331	0		29	10	S5921_331_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	331	0	2009	AARP MedicareRx Saver	Louisiana		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(800)-745-0922	(800)-745-0922	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	332	0		29	10	S5921_332_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	332	0	2009	UnitedHealth Rx Basic	Louisiana		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	333	0		29	10	S5921_333_0	3	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	333	0	2009	AARP MedicareRx Enhanced	Louisiana		2	2																		(888)-867-5575	(888)-867-5575	(877)-730-4192	(877)-730-4192	(888)-867-5564	(888)-867-5564	(877)-730-4192	(877)-730-4192	www.partdcentral.com	
S5921	343	0		29	10	S5921_343_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	343	0	2009	UnitedHealth Rx Basic	American Samoa		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	344	0		29	10	S5921_344_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	344	0	2009	UnitedHealth Rx Basic	Guam		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	345	0		29	10	S5921_345_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	345	0	2009	UnitedHealth Rx Basic	Northern Mariana Islands		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	346	0		29	10	S5921_346_0	4	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	346	0	2009	UnitedHealth Rx Basic	Puerto Rico		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	347	0		29	10	S5921_347_0	2	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	347	0	2009	UnitedHealth Rx Basic	U.S. Virgin Islands		2	2																		(888)-867-5562	(888)-867-5562	(877)-730-4203	(877)-730-4203	(888)-867-5561	(888)-867-5561	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	802	0		29	10	S5921_802_0	1	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	802	0	2009	UnitedHealth Rx for Groups	National		1	2																		(888)-556-6648	(888)-556-6648	(877)-730-4203	(877)-730-4203	(888)-556-6648	(888)-556-6648	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5921	837	0		29	10	S5921_837_0	1	2009.01	UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK	UnitedHealthcare	www.partdcentral.com	10	29				S5921	837	0	2009	UnitedHealth Rx for Groups	National		1	2																		(888)-556-6648	(888)-556-6648	(877)-730-4203	(877)-730-4203	(888)-556-6648	(888)-556-6648	(877)-730-4203	(877)-730-4203	www.partdcentral.com	
S5932	001	0		29	10	S5932_001_0	2	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	001	0	2009	HealthSpring Prescription Drug Plan -Reg12	Alabama, Tennessee		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	002	0		29	10	S5932_002_0	2	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	002	0	2009	HealthSpring Prescription Drug Plan -Reg 1	Northern New England		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	003	0		29	10	S5932_003_0	2	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	003	0	2009	HealthSpring Prescription Drug Plan -Reg 2	Central New England		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	004	0		29	10	S5932_004_0	2	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	004	0	2009	HealthSpring Prescription Drug Plan -Reg 3	New York		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	005	0		29	10	S5932_005_0	2	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	005	0	2009	HealthSpring Prescription Drug Plan -Reg 4	New Jersey		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	006	0		29	10	S5932_006_0	2	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	006	0	2009	HealthSpring Prescription Drug Plan -Reg 6	Pennsylvania, West Virginia		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	007	0		29	10	S5932_007_0	2	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	007	0	2009	HealthSpring Prescription Drug Plan -Reg 7	Virginia		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	008	0		29	10	S5932_008_0	3	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	008	0	2009	HealthSpring Prescription Drug Plan -Reg 8	North Carolina		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	009	0		29	10	S5932_009_0	3	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	009	0	2009	HealthSpring Prescription Drug Plan -Reg 9	South Carolina		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	010	0		29	10	S5932_010_0	4	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	010	0	2009	HealthSpring Prescription Drug Plan-Reg 10	Georgia		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	011	0		29	10	S5932_011_0	3	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	011	0	2009	HealthSpring Prescription Drug Plan-Reg 11	Florida		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	012	0		29	10	S5932_012_0	3	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	012	0	2009	HealthSpring Prescription Drug Plan-Reg 13	Michigan		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	013	0		29	10	S5932_013_0	3	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	013	0	2009	HealthSpring Prescription Drug Plan-Reg 14	Ohio		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	014	0		29	10	S5932_014_0	3	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	014	0	2009	HealthSpring Prescription Drug Plan-Reg 15	Indiana, Kentucky		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	015	0		29	10	S5932_015_0	3	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	015	0	2009	HealthSpring Prescription Drug Plan-Reg 16	Wisconsin		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	016	0		29	10	S5932_016_0	3	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	016	0	2009	HealthSpring Prescription Drug Plan-Reg 17	Illinois		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	017	0		29	10	S5932_017_0	4	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	017	0	2009	HealthSpring Prescription Drug Plan-Reg 18	Missouri		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	018	0		29	10	S5932_018_0	3	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	018	0	2009	HealthSpring Prescription Drug Plan-Reg 19	Arkansas		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	019	0		29	10	S5932_019_0	3	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	019	0	2009	HealthSpring Prescription Drug Plan-Reg 20	Mississippi		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	020	0		29	10	S5932_020_0	3	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	020	0	2009	HealthSpring Prescription Drug Plan-Reg 21	Louisiana		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	021	0		29	10	S5932_021_0	3	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	021	0	2009	HealthSpring Prescription Drug Plan-Reg 22	Texas		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	022	0		29	10	S5932_022_0	3	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	022	0	2009	HealthSpring Prescription Drug Plan-Reg 23	Oklahoma		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	023	0		29	10	S5932_023_0	3	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	023	0	2009	HealthSpring Prescription Drug Plan-Reg 24	Kansas		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	024	0		29	10	S5932_024_0	3	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	024	0	2009	HealthSpring Prescription Drug Plan-Reg 25	Upper Midwest and Northern Plains		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	025	0		29	10	S5932_025_0	3	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	025	0	2009	HealthSpring Prescription Drug Plan-Reg 26	New Mexico		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	026	0		29	10	S5932_026_0	3	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	026	0	2009	HealthSpring Prescription Drug Plan-Reg 27	Colorado		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	027	0		29	10	S5932_027_0	4	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	027	0	2009	HealthSpring Prescription Drug Plan-Reg 28	Arizona		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	028	0		29	10	S5932_028_0	4	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	028	0	2009	HealthSpring Prescription Drug Plan-Reg 29	Nevada		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	029	0		29	10	S5932_029_0	4	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	029	0	2009	HealthSpring Prescription Drug Plan-Reg 30	Oregon, Washington		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	030	0		29	10	S5932_030_0	4	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	030	0	2009	HealthSpring Prescription Drug Plan-Reg 31	Idaho, Utah		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	031	0		29	10	S5932_031_0	4	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	031	0	2009	HealthSpring Prescription Drug Plan-Reg 32	California		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	032	0		29	10	S5932_032_0	5	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	032	0	2009	HealthSpring Prescription Drug Plan-Reg 33	Hawaii		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	033	0		29	10	S5932_033_0	4	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	033	0	2009	HealthSpring Prescription Drug Plan-Reg 34	Alaska		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	034	0		29	10	S5932_034_0	4	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	034	0	2009	HealthSpring Prescription Drug Plan -Reg 5	Mid-Atlantic		2	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	802	0		29	10	S5932_802_0	4	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	802	0	2009	HealthSpring Retiree Prescription Plan	National		1	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5932	803	0		29	10	S5932_803_0	3	2009.01	HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.	HealthSpring Prescription Drug Plan	www.healthspring.com	10	29				S5932	803	0	2009	HealthSpring Retiree Drug Plan	National		1	2																		(800)-331-6293	(800)-331-6293	(866)-845-7230	(866)-845-7230	(615)-291-7024	(800)-331-6293	(866)-845-7230	(866)-845-7230	www.healthspring.com	
S5937	001	0		29	10	S5937_001_0	3	2009.01	LOUISIANA HEALTH SERVICE AND INDEMNITY COMPANY	Blue Cross and Blue Shield of Louisiana	www.bcbsla.com	10	29				S5937	001	0	2009	RxBLUE	Louisiana		2	2																		(225)-298-7788	(888)-223-2583		(800)-947-5277	(800)-593-9735	(800)-593-9735		(800)-947-5277	http://www.bcbsla.com/RxBLUEFormulary	
S5937	801	0		29	10	S5937_801_0	1	2009.01	LOUISIANA HEALTH SERVICE AND INDEMNITY COMPANY	Blue Cross and Blue Shield of Louisiana	www.bcbsla.com	10	29				S5937	801	0	2009	RxBLUE-Grp	Louisiana		1	2																		(225)-298-7788	(888)-223-2583		(800)-947-5277	(800)-593-9735	(800)-593-9735		(800)-947-5277	http://www.bcbsla.com/RxBLUEFormulary	
S5937	803	0		29	10	S5937_803_0	1	2009.01	LOUISIANA HEALTH SERVICE AND INDEMNITY COMPANY	Blue Cross and Blue Shield of Louisiana	www.bcbsla.com	10	29				S5937	803	0	2009	RxBLUE-Grp2	Louisiana		1	2																		(225)-298-7788	(888)-223-2583		(800)-947-5277	(800)-593-9735	(800)-593-9735		(800)-947-5277	http://www.bcbsla.com/RxBLUEFormulary	
S5946	001	0		29	10	S5946_001_0	2	2009.01	INSTIL HEALTH INSURANCE COMPANY	InStil Health Insurance Company	www.myinstil.com	10	29				S5946	001	0	2009	InStil Rx	South Carolina		2	2																		(877)-897-2783	(877)-897-2783	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	www.myinstil.com/internet/tric/ins/instild.nsf/0/134036AB0CAC0B7085257082006120C3?OpenDocument	
S5946	002	0		29	10	S5946_002_0	2	2009.01	INSTIL HEALTH INSURANCE COMPANY	InStil Health Insurance Company	www.myinstil.com	10	29				S5946	002	0	2009	InStil Rx	Georgia		2	2																		(877)-897-2783	(877)-897-2783	(800)-503-3118	(800)-503-3118	(877)-446-7845	(877)-446-7845	(800)-503-3118	(800)-503-3118	www.myinstil.com/internet/tric/ins/instild.nsf/0/134036AB0CAC0B7085257082006120C3?OpenDocument	
S5946	003	0		29	10	S5946_003_0	1	2009.01	INSTIL HEALTH INSURANCE COMPANY	InStil Health Insurance Company	www.myinstil.com	10	29				S5946	003	0	2009	InStil Rx Plus	South Carolina		2	2																		(803)-763-6563	(877)-897-2783	(800)-503-3118	(800)-503-3118	(803)-763-4009	(877)-446-7845	(800)-503-3118	(800)-503-3118	www.myinstil.com/internet/tric/ins/instild.nsf/0/134036AB0CAC0B7085257082006120C3?OpenDocument	
S5946	004	0		29	10	S5946_004_0	1	2009.01	INSTIL HEALTH INSURANCE COMPANY	InStil Health Insurance Company	www.myinstil.com	10	29				S5946	004	0	2009	InStil Rx Plus	Georgia		2	2																		(803)-763-6563	(877)-897-2783	(800)-503-3118	(800)-503-3118	(803)-763-4009	(877)-446-7845	(800)-503-3118	(800)-503-3118	www.myinstil.com/internet/tric/ins/instild.nsf/0/134036AB0CAC0B7085257082006120C3?OpenDocument	
S5946	801	0		29	10	S5946_801_0	1	2009.01	INSTIL HEALTH INSURANCE COMPANY	InStil Health Insurance Company	www.myinstil.com	10	29				S5946	801	0	2009	InStil Senior Group Rx	Georgia and South Carolina		1	2																		(803)-763-6563	(877)-897-2783	(800)-503-3118	(800)-503-3118	(803)-763-4009	(877)-446-7845	(800)-503-3118	(800)-503-3118	www.myinstil.com/internet/tric/ins/instild.nsf/0/134036AB0CAC0B7085257082006120C3?OpenDocument	
S5946	802	0		29	10	S5946_802_0	1	2009.01	INSTIL HEALTH INSURANCE COMPANY	InStil Health Insurance Company	www.myinstil.com	10	29				S5946	802	0	2009	InStil Senior Group Rx	Georgia and South Carolina		1	2																		(803)-763-6563	(877)-897-2783	(800)-503-3118	(800)-503-3118	(803)-763-4009	(877)-446-7845	(800)-503-3118	(800)-503-3118	www.myinstil.com/internet/tric/ins/instild.nsf/0/134036AB0CAC0B7085257082006120C3?OpenDocument	
S5953	001	0		29	10	S5953_001_0	2	2009.01	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.southcarolinablues.com/marx08	10	29				S5953	001	0	2009	MedBlue Rx	South Carolina		2	2																		(888)-645-6025	(888)-645-6025	(888)-645-6023	(888)-645-6023	(803)-264-9482	(800)-930-2836	(800)-681-3846	(800)-681-3846	www.SouthCarolinaBlues.com/Rx08	
S5953	002	0		29	10	S5953_002_0	2	2009.01	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.southcarolinablues.com/marx08	10	29				S5953	002	0	2009	MedBlue Rx Plus	South Carolina		2	2																		(888)-645-6025	(888)-645-6025	(888)-645-6023	(888)-645-6023	(803)-264-9482	(800)-930-2836	(800)-681-3846	(800)-681-3846	www.SouthCarolinaBlues.com/Rx08	
S5953	801	0		29	10	S5953_801_0	1	2009.01	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.southcarolinablues.com/marx08	10	29				S5953	801	0	2009	Group Blue Rx Plus	South Carolina		1	2																		(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-9482	(800)-930-2836	(800)-681-3846	(800)-681-3846	www.SouthCarolinaBlues.com/Rx08	
S5953	802	0		29	10	S5953_802_0	1	2009.01	BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA	Blue Cross Blue Shield of South Carolina	www.southcarolinablues.com/marx08	10	29				S5953	802	0	2009	Group Blue Rx Plus	South Carolina		1	2																		(800)-605-3256	(800)-605-3256	(888)-300-7215	(888)-300-7215	(803)-264-9482	(800)-930-2836	(800)-681-3846	(800)-681-3846	www.SouthCarolinaBlues.com/Rx08	
S5954	004	0		29	10	S5954_004_0	2	2009.01	DEAN HEALTH INSURANCE, INC.	Dean Health Insurance, Inc.	www.deancare.com/deancarerx	10	29				S5954	004	0	2009	DeanCare Rx Classic	DeanCare Rx		2	2																		(608)-827-4372	(888)-422-3326		(877)-733-6456	(608)-827-4372	(888)-422-3326		(877)-733-6456	http://www.deancare.com/deancarerx/Pharmacy/	
S5954	005	0		29	10	S5954_005_0	4	2009.01	DEAN HEALTH INSURANCE, INC.	Dean Health Insurance, Inc.	www.deancare.com/deancarerx	10	29				S5954	005	0	2009	DeanCare Rx Enhanced	DeanCare Rx		2	2																		(608)-827-4372	(888)-422-3326		(877)-733-6456	(608)-827-4372	(888)-422-3326		(877)-733-6456	http://www.deancare.com/deancarerx/Pharmacy/	
S5954	007	0		29	10	S5954_007_0	3	2009.01	DEAN HEALTH INSURANCE, INC.	Dean Health Insurance, Inc.	www.deancare.com/deancarerx	10	29				S5954	007	0	2009	DeanCare Rx Value	DeanCare Rx		2	2																		(608)-827-4372	(888)-422-3326		(877)-733-6456	(608)-827-4372	(888)-422-3326		(877)-733-6456	http://www.deancare.com/deancarerx/Pharmacy/	
S5954	801	0		29	10	S5954_801_0	1	2009.01	DEAN HEALTH INSURANCE, INC.	Dean Health Insurance, Inc.	www.deancare.com/deancarerx	10	29				S5954	801	0	2009	DeanCare Rx Employer	DeanCare Rx		1	2																		(608)-827-4372	(888)-422-3326		(877)-733-6456	(608)-827-4372	(888)-422-3326		(877)-733-6456	http://www.deancare.com/deancarerx/Pharmacy/	
S5954	803	0		29	10	S5954_803_0	1	2009.01	DEAN HEALTH INSURANCE, INC.	Dean Health Insurance, Inc.	www.deancare.com/deancarerx	10	29				S5954	803	0	2009	DeanCare Rx Employer II	DeanCare Rx		1	2																		(608)-827-4372	(888)-422-3326		(877)-733-6456	(608)-827-4372	(888)-422-3326		(877)-733-6456	http://www.deancare.com/deancarerx/Pharmacy/	
S5960	003	0		29	10	S5960_003_0	3	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	003	0	2009	MedicareRx Rewards Value	New York (NY)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	004	0		29	10	S5960_004_0	2	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	004	0	2009	MedicareRx Rewards Value	New Jersey (NJ)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	005	0		29	10	S5960_005_0	2	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	005	0	2009	MedicareRx Rewards Value	Mid-Atlantic (DC, DE, MD)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	006	0		29	10	S5960_006_0	2	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	006	0	2009	MedicareRx Rewards Value	Pennsylvania, West Virginia (PA, WV)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	008	0		29	10	S5960_008_0	2	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	008	0	2009	MedicareRx Rewards Value	North Carolina (NC)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	009	0		29	10	S5960_009_0	2	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	009	0	2009	MedicareRx Rewards Value	South Carolina (SC)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	011	0		29	10	S5960_011_0	2	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	011	0	2009	MedicareRx Rewards Value	Florida (FL)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	012	0		29	10	S5960_012_0	2	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	012	0	2009	MedicareRx Rewards Value	Alabama, Tennessee (AL, TN)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	013	0		29	10	S5960_013_0	2	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	013	0	2009	MedicareRx Rewards Value	Michigan (MI)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	017	0		29	10	S5960_017_0	2	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	017	0	2009	MedicareRx Rewards Value	Illinois (IL)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	019	0		29	10	S5960_019_0	2	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	019	0	2009	MedicareRx Rewards Value	Arkansas (AR)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	020	0		29	10	S5960_020_0	2	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	020	0	2009	MedicareRx Rewards Value	Mississippi (MS)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	021	0		29	10	S5960_021_0	2	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	021	0	2009	MedicareRx Rewards Value	Louisiana (LA)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	022	0		29	10	S5960_022_0	2	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	022	0	2009	MedicareRx Rewards Value	Texas (TX)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	023	0		29	10	S5960_023_0	2	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	023	0	2009	MedicareRx Rewards Value	Oklahoma (OK)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	025	0		29	10	S5960_025_0	2	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	025	0	2009	MedicareRx Rewards Value	Upper Midwest and Northern Plains		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	026	0		29	10	S5960_026_0	2	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	026	0	2009	MedicareRx Rewards Value	New Mexico (NM)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	028	0		29	10	S5960_028_0	2	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	028	0	2009	MedicareRx Rewards Value	Arizona (AZ)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	030	0		29	10	S5960_030_0	2	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	030	0	2009	MedicareRx Rewards Value	Oregon, Washington (OR, WA)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	031	0		29	10	S5960_031_0	2	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	031	0	2009	MedicareRx Rewards Value	Idaho, Utah (ID, UT)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	033	0		29	10	S5960_033_0	2	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	033	0	2009	MedicareRx Rewards Value	Hawaii (HI)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	034	0		29	10	S5960_034_0	2	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	034	0	2009	MedicareRx Rewards Value	Alaska (AK)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	107	0		29	10	S5960_107_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	107	0	2009	MedicareRx Rewards Standard	Northern New England (NH, ME)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	108	0		29	10	S5960_108_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	108	0	2009	MedicareRx Rewards Standard	Central New England (CT, MA, RI, VT)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	109	0		29	10	S5960_109_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	109	0	2009	MedicareRx Rewards Standard	New York (NY)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	110	0		29	10	S5960_110_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	110	0	2009	MedicareRx Rewards Standard	New Jersey (NJ)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	111	0		29	10	S5960_111_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	111	0	2009	MedicareRx Rewards Standard	Mid-Atlantic (DE, DC, MD)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	112	0		29	10	S5960_112_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	112	0	2009	MedicareRx Rewards Standard	Pennsylvania, West Virginia (PA, WV)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	113	0		29	10	S5960_113_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	113	0	2009	MedicareRx Rewards Standard	Virginia (VA)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	114	0		29	10	S5960_114_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	114	0	2009	MedicareRx Rewards Standard	North Carolina (NC)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	115	0		29	10	S5960_115_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	115	0	2009	MedicareRx Rewards Standard	South Carolina (SC)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	116	0		29	10	S5960_116_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	116	0	2009	MedicareRx Rewards Standard	Georgia (GA)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	117	0		29	10	S5960_117_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	117	0	2009	MedicareRx Rewards Standard	Florida (FL)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	118	0		29	10	S5960_118_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	118	0	2009	MedicareRx Rewards Standard	Alabama, Tennessee (AL, TN)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	119	0		29	10	S5960_119_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	119	0	2009	MedicareRx Rewards Standard	Michigan (MI)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	120	0		29	10	S5960_120_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	120	0	2009	MedicareRx Rewards Standard	Ohio (OH)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	121	0		29	10	S5960_121_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	121	0	2009	MedicareRx Rewards Standard	Indiana, Kentucky (IN, KY)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	122	0		29	10	S5960_122_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	122	0	2009	MedicareRx Rewards Standard	Wisconsin (WI)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	123	0		29	10	S5960_123_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	123	0	2009	MedicareRx Rewards Standard	Illinois (IL)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	124	0		29	10	S5960_124_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	124	0	2009	MedicareRx Rewards Standard	Missouri (MO)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	125	0		29	10	S5960_125_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	125	0	2009	MedicareRx Rewards Standard	Arkansas (AR)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	126	0		29	10	S5960_126_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	126	0	2009	MedicareRx Rewards Standard	Mississippi (MS)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	127	0		29	10	S5960_127_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	127	0	2009	MedicareRx Rewards Standard	Louisiana (LA)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	128	0		29	10	S5960_128_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	128	0	2009	MedicareRx Rewards Standard	Texas (TX)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	129	0		29	10	S5960_129_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	129	0	2009	MedicareRx Rewards Standard	Oklahoma (OK)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	130	0		29	10	S5960_130_0	5	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	130	0	2009	MedicareRx Rewards Standard	Kansas (KS)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	131	0		29	10	S5960_131_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	131	0	2009	MedicareRx Rewards Standard	Upper Midwest and Northern Plains		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	132	0		29	10	S5960_132_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	132	0	2009	MedicareRx Rewards Standard	New Mexico (NM)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	133	0		29	10	S5960_133_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	133	0	2009	MedicareRx Rewards Standard	Colorado (CO)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	134	0		29	10	S5960_134_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	134	0	2009	MedicareRx Rewards Standard	Arizona (AZ)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	135	0		29	10	S5960_135_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	135	0	2009	MedicareRx Rewards Standard	Nevada (NV)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	136	0		29	10	S5960_136_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	136	0	2009	MedicareRx Rewards Standard	Oregon, Washington (OR, WA)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	137	0		29	10	S5960_137_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	137	0	2009	MedicareRx Rewards Standard	Idaho, Utah (ID, UT)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	138	0		29	10	S5960_138_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	138	0	2009	MedicareRx Rewards Standard	California (CA)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	139	0		29	10	S5960_139_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	139	0	2009	MedicareRx Rewards Standard	Hawaii (HI)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	140	0		29	10	S5960_140_0	4	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	140	0	2009	MedicareRx Rewards Standard	Alaska (AK)		2	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	801	0		29	10	S5960_801_0	1	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	801	0	2009	MedicareRx Rewards Group Plan I	All States (Nationwide)		1	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5960	803	0		29	10	S5960_803_0	1	2009.01	UNICARE LIFE AND HEALTH INSURANCE COMPANY	UniCare	www.medicarerxrewards.com	10	29				S5960	803	0	2009	MedicareRx Rewards Group Plan II	All States (Nationwide)		1	2																		(800)-928-6201	(800)-928-6201		(877)-247-1657	(866)-892-5334	(866)-892-5334		(800)-297-1538	www.medicarerxrewards.com	
S5966	001	0		29	10	S5966_001_0	2	2009.01	GHI (GROUP HEALTH INCORPORATED)	GHI Medicare Prescription Drug Plan	www.ghi.com	10	29				S5966	001	0	2009	GHI Medicare Prescription Drug Plan	New York State		2	2																		(800)-585-5786	(800)-585-5786			(800)-325-9792	(800)-325-9792			http://www.ghi.com/Default.aspx?Page=459	
S5966	801	0		29	10	S5966_801_0	2	2009.01	GHI (GROUP HEALTH INCORPORATED)	GHI Medicare Prescription Drug Plan	www.ghi.com	10	29				S5966	801	0	2009	GHI Medicare Group Select Drug Plan	United States		1	2																		(800)-585-5786	(800)-585-5786			(800)-325-9792	(800)-325-9792			http://www.ghi.com/Default.aspx?Page=459	
S5966	803	0		29	10	S5966_803_0	2	2009.01	GHI (GROUP HEALTH INCORPORATED)	GHI Medicare Prescription Drug Plan	www.ghi.com	10	29				S5966	803	0	2009	GHI Medicare Group National Drug Plan	United States		1	2																		(800)-585-5786	(800)-585-5786			(800)-325-9792	(800)-325-9792			http://www.ghi.com/Default.aspx?Page=459	
S5967	035	0		29	10	S5967_035_0	3	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	035	0	2009	WellCare Signature	Northern New England		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	036	0		29	10	S5967_036_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	036	0	2009	WellCare Signature	Central New England		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	037	0		29	10	S5967_037_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	037	0	2009	WellCare Signature	New York		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	038	0		29	10	S5967_038_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	038	0	2009	WellCare Signature	New Jersey		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	039	0		29	10	S5967_039_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	039	0	2009	WellCare Signature	Mid-Atlantic		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	040	0		29	10	S5967_040_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	040	0	2009	WellCare Signature	Pennsylvania, West Virginia		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	041	0		29	10	S5967_041_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	041	0	2009	WellCare Signature	Virginia		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	042	0		29	10	S5967_042_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	042	0	2009	WellCare Signature	North Carolina		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	043	0		29	10	S5967_043_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	043	0	2009	WellCare Signature	South Carolina		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	044	0		29	10	S5967_044_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	044	0	2009	WellCare Signature	Georgia		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	045	0		29	10	S5967_045_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	045	0	2009	WellCare Signature	Florida		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	046	0		29	10	S5967_046_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	046	0	2009	WellCare Signature	Alabama, Tennessee		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	047	0		29	10	S5967_047_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	047	0	2009	WellCare Signature	Michigan		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	048	0		29	10	S5967_048_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	048	0	2009	WellCare Signature	Ohio		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	049	0		29	10	S5967_049_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	049	0	2009	WellCare Signature	Indiana, Kentucky		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	050	0		29	10	S5967_050_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	050	0	2009	WellCare Signature	Wisconsin		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	051	0		29	10	S5967_051_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	051	0	2009	WellCare Signature	Illinois		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	052	0		29	10	S5967_052_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	052	0	2009	WellCare Signature	Missouri		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	053	0		29	10	S5967_053_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	053	0	2009	WellCare Signature	Arkansas		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	054	0		29	10	S5967_054_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	054	0	2009	WellCare Signature	Mississippi		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	055	0		29	10	S5967_055_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	055	0	2009	WellCare Signature	Louisiana		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	056	0		29	10	S5967_056_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	056	0	2009	WellCare Signature	Texas		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	057	0		29	10	S5967_057_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	057	0	2009	WellCare Signature	Oklahoma		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	058	0		29	10	S5967_058_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	058	0	2009	WellCare Signature	Kansas		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	059	0		29	10	S5967_059_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	059	0	2009	WellCare Signature	Upper Midwest and Northern Plains		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	060	0		29	10	S5967_060_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	060	0	2009	WellCare Signature	New Mexico		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	061	0		29	10	S5967_061_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	061	0	2009	WellCare Signature	Colorado		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	062	0		29	10	S5967_062_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	062	0	2009	WellCare Signature	Arizona		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	063	0		29	10	S5967_063_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	063	0	2009	WellCare Signature	Nevada		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	064	0		29	10	S5967_064_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	064	0	2009	WellCare Signature	Oregon, Washington		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	065	0		29	10	S5967_065_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	065	0	2009	WellCare Signature	Idaho, Utah		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	066	0		29	10	S5967_066_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	066	0	2009	WellCare Signature	California		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	067	0		29	10	S5967_067_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	067	0	2009	WellCare Signature	Hawaii		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	068	0		29	10	S5967_068_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	068	0	2009	WellCare Signature	Alaska		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	138	0		29	10	S5967_138_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	138	0	2009	WellCare Classic	Northern New England		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	139	0		29	10	S5967_139_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	139	0	2009	WellCare Classic	Central New England		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	140	0		29	10	S5967_140_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	140	0	2009	WellCare Classic	New York		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	141	0		29	10	S5967_141_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	141	0	2009	WellCare Classic	New Jersey		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	142	0		29	10	S5967_142_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	142	0	2009	WellCare Classic	Mid-Atlantic		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	143	0		29	10	S5967_143_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	143	0	2009	WellCare Classic	Pennsylvania, West Virginia		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	144	0		29	10	S5967_144_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	144	0	2009	WellCare Classic	Virginia		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	145	0		29	10	S5967_145_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	145	0	2009	WellCare Classic	North Carolina		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	146	0		29	10	S5967_146_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	146	0	2009	WellCare Classic	South Carolina		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	147	0		29	10	S5967_147_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	147	0	2009	WellCare Classic	Georgia		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	148	0		29	10	S5967_148_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	148	0	2009	WellCare Classic	Florida		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	149	0		29	10	S5967_149_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	149	0	2009	WellCare Classic	Alabama, Tennessee		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	150	0		29	10	S5967_150_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	150	0	2009	WellCare Classic	Michigan		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	151	0		29	10	S5967_151_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	151	0	2009	WellCare Classic	Ohio		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	152	0		29	10	S5967_152_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	152	0	2009	WellCare Classic	Indiana, Kentucky		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	153	0		29	10	S5967_153_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	153	0	2009	WellCare Classic	Wisconsin		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	154	0		29	10	S5967_154_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	154	0	2009	WellCare Classic	Illinois		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	155	0		29	10	S5967_155_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	155	0	2009	WellCare Classic	Missouri		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	156	0		29	10	S5967_156_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	156	0	2009	WellCare Classic	Arkansas		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	157	0		29	10	S5967_157_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	157	0	2009	WellCare Classic	Mississippi		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	158	0		29	10	S5967_158_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	158	0	2009	WellCare Classic	Louisiana		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	159	0		29	10	S5967_159_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	159	0	2009	WellCare Classic	Texas		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	160	0		29	10	S5967_160_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	160	0	2009	WellCare Classic	Oklahoma		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	161	0		29	10	S5967_161_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	161	0	2009	WellCare Classic	Kansas		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	162	0		29	10	S5967_162_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	162	0	2009	WellCare Classic	Upper Midwest and Northern Plains		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	163	0		29	10	S5967_163_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	163	0	2009	WellCare Classic	New Mexico		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	164	0		29	10	S5967_164_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	164	0	2009	WellCare Classic	Colorado		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	165	0		29	10	S5967_165_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	165	0	2009	WellCare Classic	Arizona		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	166	0		29	10	S5967_166_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	166	0	2009	WellCare Classic	Nevada		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	167	0		29	10	S5967_167_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	167	0	2009	WellCare Classic	Oregon, Washington		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	168	0		29	10	S5967_168_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	168	0	2009	WellCare Classic	Idaho, Utah		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	169	0		29	10	S5967_169_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	169	0	2009	WellCare Classic	California		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	170	0		29	10	S5967_170_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	170	0	2009	WellCare Classic	Hawaii		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	171	0		29	10	S5967_171_0	2	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	171	0	2009	WellCare Classic	Alaska		2	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	801	0		29	10	S5967_801_0	1	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	801	0	2009	WellCare Smart Plan 1	Nationwide		1	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5967	802	0		29	10	S5967_802_0	1	2009.01	WELLCARE PRESCRIPTION INSURANCE, INC.	WellCare	www.wellcarepdp.com	10	29				S5967	802	0	2009	WellCare Smart Plan 2	Nationwide		1	2																		(888)-550-5252	(888)-550-5252			(888)-423-5252	(888)-423-5252			www.wellcarepdp.com	
S5975	801	0		29	10	S5975_801_0	1	2009.01	ODS HEALTH PLAN, INC.	ODS Health Plan, Inc.	www.odscompanies.com/odsadvantage	10	29				S5975	801	0	2009	ODS Advantage Rx Employer Option	National		1	2																		(503)-265-4709	(888)-786-7509	(503)-243-3958	(800)-433-6313	(503)-265-2975	(888)-217-2375	(503)-243-3958	(800)-433-6313	www.odscompanies.com/odsadvantage	
S5983	001	0		29	10	S5983_001_0	3	2009.01	MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5983	001	0	2009	Medco Medicare Prescription Plan - Choice	State of New York		2	2																		(800)-758-4570	(800)-758-4570		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5983	004	0		29	10	S5983_004_0	2	2009.01	MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5983	004	0	2009	Medco Medicare Prescription Plan - Value	State of New York		2	2																		(800)-758-4570	(800)-758-4570		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5983	005	0		29	10	S5983_005_0	3	2009.01	MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5983	005	0	2009	Medco Medicare Prescription Plan - Access	State of New York		2	2																		(800)-758-4570	(800)-758-4570		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5983	801	0		29	10	S5983_801_0	1	2009.01	MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5983	801	0	2009	Medco Medicare Prescription Plan	National Plan - Employer, Calendar Year		1	2																		(800)-758-4570	(800)-758-4570		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5983	802	0		29	10	S5983_802_0	1	2009.01	MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5983	802	0	2009	Medco Medicare Prescription Plan	National Plan - Employer, Non-Calendar Year		1	2																		(800)-758-4570	(800)-758-4570		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5983	803	0		29	10	S5983_803_0	1	2009.01	MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK	Medco Medicare Prescription Plan	www.medcomedicare.com	10	29				S5983	803	0	2009	Medco Medicare Prescription Plan	National Plan K - Calendar Year		1	2																		(800)-758-4570	(800)-758-4570		(800)-716-3231	(800)-758-3605	(800)-758-3605		(800)-716-3231	www.medcomedicare.com	
S5993	001	0		29	10	S5993_001_0	4	2009.01	HORIZON HEALTHCARE SERVICES DBA HORIZON BCBS NJ	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com	10	29				S5993	001	0	2009	Horizon Medicare Blue Rx Standard	New Jersey		2	2																		(866)-236-7376	(866)-236-7376		(866)-236-1069	(800)-224-1234	(800)-224-1234			http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	
S5993	003	0		29	10	S5993_003_0	2	2009.01	HORIZON HEALTHCARE SERVICES DBA HORIZON BCBS NJ	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com	10	29				S5993	003	0	2009	Horizon Medicare Blue Rx Plus	New Jersey		2	2																		(866)-236-7376	(866)-236-7376		(866)-236-1069	(800)-224-1234	(800)-224-1234			http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	
S5993	801	0		29	10	S5993_801_0	1	2009.01	HORIZON HEALTHCARE SERVICES DBA HORIZON BCBS NJ	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com	10	29				S5993	801	0	2009	Horizon Medicare Blue Group Rx Std	New Jersey		1	2																		(866)-236-7376	(866)-236-7376		(866)-236-1069	(800)-224-1234	(800)-224-1234			http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	
S5993	802	0		29	10	S5993_802_0	1	2009.01	HORIZON HEALTHCARE SERVICES DBA HORIZON BCBS NJ	Horizon Blue Cross Blue Shield of New Jersey, Inc.	www.horizonblue.com	10	29				S5993	802	0	2009	Horizon Medicare Blue Group Rx Std Non-CY	New Jersey		1	2																		(866)-236-7376	(866)-236-7376		(866)-236-1069	(800)-224-1234	(800)-224-1234			http://www.horizonblue.com/medicare/partd/Pharmacy_Formulary_search.aspx	
S5998	001	0		29	10	S5998_001_0	3	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	001	0	2009	BravoRx	New York BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	003	0		29	10	S5998_003_0	3	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	003	0	2009	BravoRx	New Jersey BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	005	0		29	10	S5998_005_0	3	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	005	0	2009	BravoRx	PA/WV BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	007	0		29	10	S5998_007_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	007	0	2009	BravoRx	Florida BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	009	0		29	10	S5998_009_0	3	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	009	0	2009	BravoRx	Michigan BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	011	0		29	10	S5998_011_0	3	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	011	0	2009	BravoRx	Ohio BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	013	0		29	10	S5998_013_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	013	0	2009	BravoRx	California BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	015	0		29	10	S5998_015_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	015	0	2009	BravoRx	Central New England BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	016	0		29	10	S5998_016_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	016	0	2009	BravoRx	Virginia BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	017	0		29	10	S5998_017_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	017	0	2009	BravoRx	North Carolina BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	018	0		29	10	S5998_018_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	018	0	2009	BravoRx	South Carolina BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	019	0		29	10	S5998_019_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	019	0	2009	BravoRx	Georgia BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	020	0		29	10	S5998_020_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	020	0	2009	BravoRx	Alabama and Tennessee BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	021	0		29	10	S5998_021_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	021	0	2009	BravoRx	Indiana and Kentucky BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	022	0		29	10	S5998_022_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	022	0	2009	BravoRx	Wisconsin BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	023	0		29	10	S5998_023_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	023	0	2009	BravoRx	Missouri BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	024	0		29	10	S5998_024_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	024	0	2009	BravoRx	Arkansas BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	025	0		29	10	S5998_025_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	025	0	2009	BravoRx	Mississippi BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	026	0		29	10	S5998_026_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	026	0	2009	BravoRx	Louisiana BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	027	0		29	10	S5998_027_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	027	0	2009	BravoRx	Oklahoma BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	028	0		29	10	S5998_028_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	028	0	2009	BravoRx	Kansas BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	029	0		29	10	S5998_029_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	029	0	2009	BravoRx	Upper Midwest and Northern Plains BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	030	0		29	10	S5998_030_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	030	0	2009	BravoRx	New Mexico BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	031	0		29	10	S5998_031_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	031	0	2009	BravoRx	Colorado BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	032	0		29	10	S5998_032_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	032	0	2009	BravoRx	Arizona BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	033	0		29	10	S5998_033_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	033	0	2009	BravoRx	Nevada BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	034	0		29	10	S5998_034_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	034	0	2009	BravoRx	Idaho and Utah BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	035	0		29	10	S5998_035_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	035	0	2009	BravoRx	Hawaii BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	036	0		29	10	S5998_036_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	036	0	2009	BravoRx	Alaska BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	037	0		29	10	S5998_037_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	037	0	2009	BravoRx	Mid-Atlantic Region (MD, DE and DC) BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	038	0		29	10	S5998_038_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	038	0	2009	BravoRx	Illinois Bravo Rx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S5998	039	0		29	10	S5998_039_0	2	2009.01	BRAVO HEALTH INSURANCE COMPANY, INC.	Bravo Health	www.mybravohealth.com	10	29				S5998	039	0	2009	BravoRx	Texas BravoRx		2	2																		(877)-504-7252	(877)-504-7252	(800)-964-2561	(800)-964-2561	(800)-723-9209	(800)-723-9209	(800)-964-2561	(800)-964-2561	www.mybravohealth.com/formulary	
S6875	801	0		29	10	S6875_801_0	1	2009.01	QCC INS CO D/B/A AMERIHEALTH INS CO	Select Option	http://www.site65.com	10	29				S6875	801	0	2009	Select Option Rx Group Option I CY	Pennsylvania, West Virginia area		1	2																		(888)-678-7009	(888)-678-7009	(888)-457-3002	(888)-457-3002	(877)-393-6733	(877)-393-6733	(866)-456-1683		http://www.site65.com/pgs_section_1-6_pages/03_medicare_formulary.html	
S6875	802	0		29	10	S6875_802_0	1	2009.01	QCC INS CO D/B/A AMERIHEALTH INS CO	Select Option	http://www.site65.com	10	29				S6875	802	0	2009	Select Option Rx Group Option I Non-CY	Pennsylvania, West Virginia Area		1	2																		(866)-456-1690	(866)-456-1690	(866)-456-1683	(866)-456-1683	(877)-393-6733	(877)-393-6733	(877)-219-5457		http://www.site65.com/pgs_section_1-6_pages/03_medicare_formulary.html	
S7694	001	0		29	10	S7694_001_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	001	0	2009	EnvisionRxPlus Standard	Northern New England Region 1 Envision Standard		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	002	0		29	10	S7694_002_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	002	0	2009	EnvisionRxPlus Standard	Central New England EnvisionRxPlus Std Region 02		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	003	0		29	10	S7694_003_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	003	0	2009	EnvisionRxPlus Standard	New York EnvsionRxPlus Standard  Region 03		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	004	0		29	10	S7694_004_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	004	0	2009	EnvisionRxPlus Standard	New Jersey EnvisionRxPlus Standard Region 04		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	005	0		29	10	S7694_005_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	005	0	2009	EnvisionRxPlus Standard	Mid-Atlantic EnvisionRxPlus Standard Region 05		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	006	0		29	10	S7694_006_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	006	0	2009	EnvisionRxPlus Standard	Pennsylvania, WV,EnvisionRxPlus Std Region 06		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	007	0		29	10	S7694_007_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	007	0	2009	EnvisionRxPlus Standard	Virginia EnvisionRxPlus Standard Region 07		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	008	0		29	10	S7694_008_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	008	0	2009	EnvisionRxPlus Standard	North Carolina EnvisionRxPlus Standard Region 08		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	009	0		29	10	S7694_009_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	009	0	2009	EnvisionRxPlus Standard	South Carolina EnvsionRxPlus Standard Region 09		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	010	0		29	10	S7694_010_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	010	0	2009	EnvisionRxPlus Standard	Georgia EnvisionRxPlus Standard Region 10		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	011	0		29	10	S7694_011_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	011	0	2009	EnvisionRxPlus Standard	Florida EnvisionRxPlus Standard Region 11		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	012	0		29	10	S7694_012_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	012	0	2009	EnvisionRxPlus Standard	Alabama, Tennessee EnvisionRxPlus Std Region 12		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	013	0		29	10	S7694_013_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	013	0	2009	EnvisionRxPlus Standard	Michigan EnvisionRxPlus Standard Region 13		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	014	0		29	10	S7694_014_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	014	0	2009	EnvisionRxPlus Standard	Ohio EnvisionRxPlus Standard Region 14		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	015	0		29	10	S7694_015_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	015	0	2009	EnvisionRxPlus Standard	Indiana, Kentucky EnvisionRxPlus Std Region 15		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	016	0		29	10	S7694_016_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	016	0	2009	EnvisionRxPlus Standard	Wisconsin EnvisionRxPlus Standard Region 16		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	017	0		29	10	S7694_017_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	017	0	2009	EnvisionRxPlus Standard	Illinois EnvisionRxPlus Standard Region 17		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	018	0		29	10	S7694_018_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	018	0	2009	EnvisionRxPlus Standard	Missouri EnvisionRxPlus Standard Region 18		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	019	0		29	10	S7694_019_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	019	0	2009	EnvisionRxPlus Standard	Arkansas EnvisionRxPlus Standard Region 19		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	020	0		29	10	S7694_020_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	020	0	2009	EnvisionRxPlus Standard	Mississippi EnvisionRxPlus Standard Region 20		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	021	0		29	10	S7694_021_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	021	0	2009	EnvisionRxPlus Standard	Louisiana EnvisionRxPlus Standard Region 21		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	022	0		29	10	S7694_022_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	022	0	2009	EnvisionrxPlus Standard	Texas EnvisionRxPlus Standard Region 22		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	023	0		29	10	S7694_023_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	023	0	2009	EnvisionRxPlus Standard	Oklahoma EnvisionRxPlus Standard Region 23		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	024	0		29	10	S7694_024_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	024	0	2009	EnvisionRxPlus Standard	Kansas EnvisionRxPlus Standard Region 24		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	025	0		29	10	S7694_025_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	025	0	2009	EnvisionRxPlus Standard	Upper Midwest EnvisionRxPlus Standard Region 25		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	026	0		29	10	S7694_026_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	026	0	2009	EnvisionRxPlus Standard	New Mexico EnvisionRxPlus Standard Region 26		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	027	0		29	10	S7694_027_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	027	0	2009	EnvisionRxPlus Standard	Colorado EnvisionRxPlus Standard Region 27		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	028	0		29	10	S7694_028_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	028	0	2009	EnvisionRxPlus Standard	Arizona EnvisionRxPlus Standard Region 28		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	029	0		29	10	S7694_029_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	029	0	2009	EnvisionRxPlus Standard	Nevada EnvisionRxPlus Standard Region 29		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	030	0		29	10	S7694_030_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	030	0	2009	EnvisionRxPlus Standard	Oregon, Washington EnvisionRxPlus Std Region 30		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	031	0		29	10	S7694_031_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	031	0	2009	EnvisionRxPlus Standard	Idaho, Utah EnvisionRxPlus Standard Region 31		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	032	0		29	10	S7694_032_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	032	0	2009	EnvisionRxPlus Standard	California EnvisionRxPlus Standard Region 32		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	033	0		29	10	S7694_033_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	033	0	2009	EnvisionRxPlus Standard	Hawaii EnvisionRxPlus Standard Region 33		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	034	0		29	10	S7694_034_0	4	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	034	0	2009	EnvisionRxPlus Standard	Alaska EnvisionRxPlus Standard Region 34		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	035	0		29	10	S7694_035_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	035	0	2009	EnvisionRxPlus Gold	Northern New England EnvisionRxPlus Gold Region 01		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	036	0		29	10	S7694_036_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	036	0	2009	EnvisionRxPlus Gold	Central New England EnvisionRxPlus Gold Region 02		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	037	0		29	10	S7694_037_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	037	0	2009	EnvisionRxPlus Gold	New York EnvisionRxPlus Gold Region 03		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	038	0		29	10	S7694_038_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	038	0	2009	EnvisionRxPlus Gold	New Jersey EnvisionRxPlus Gold Region 04		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	039	0		29	10	S7694_039_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	039	0	2009	EnvisionRxPlus Gold	Mid-Atlantic EnvisionRxPlus Gold Region 05		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	040	0		29	10	S7694_040_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	040	0	2009	EnvisionRxPlus Gold	Pennsylvania, WV, EnvisionRxPlus Gold Region 06		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	041	0		29	10	S7694_041_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	041	0	2009	EnvisionRxPlus Gold	Virginia EnvisionRxPlus Gold Region 07		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	042	0		29	10	S7694_042_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	042	0	2009	EnvisionRxPlus Gold	North Carolina EnvisionRxPlus Gold Region 08		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	043	0		29	10	S7694_043_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	043	0	2009	EnvisionRxPlus Gold	South Carolina EnvisionRxPlus Gold Region 09		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	044	0		29	10	S7694_044_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	044	0	2009	EnvisionRxPlus Gold	Georgia EnvisionRxPlus Gold Region 10		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	045	0		29	10	S7694_045_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	045	0	2009	EnvisionRxPlus Gold	Florida EnvisionRxPlus Gold Region 11		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	046	0		29	10	S7694_046_0	2	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	046	0	2009	EnvisionRxPlus Gold	Alabama, Tennessee EnvisionRxPlus Gold Region 12		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	047	0		29	10	S7694_047_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	047	0	2009	EnvisionRxPlus Gold	Michigan EnvisionRxPlus Gold Region 13		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	048	0		29	10	S7694_048_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	048	0	2009	EnvisionRxPlus Gold	Ohio EnvisionRxPlus Gold Region 14		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	049	0		29	10	S7694_049_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	049	0	2009	EnvisionRxPlus Gold	Indiana, Kentucky EnvisionRxPlus Gold Region 15		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	050	0		29	10	S7694_050_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	050	0	2009	EnvisionRxPlus Gold	Wisconsin EnvisionRxPlus Gold Region 16		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	051	0		29	10	S7694_051_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	051	0	2009	EnvisionRxPlus Gold	Illionis EnvisionRxPlus Gold Region 17		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	052	0		29	10	S7694_052_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	052	0	2009	EnvisionRxPlus Gold	Missouri EnvisionRxPlus Gold Region 18		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	053	0		29	10	S7694_053_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	053	0	2009	EnvisionRxPlus Gold	Arkansas EnvisionRxPlus Gold Region 19		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	054	0		29	10	S7694_054_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	054	0	2009	EnvisionRxPlus Gold	Mississippi EnvisionRxPlus Gold Region 20		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	055	0		29	10	S7694_055_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	055	0	2009	EnvisionRxPlus Gold	Louisiana EnvisionRxPlus Gold Region 21		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	056	0		29	10	S7694_056_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	056	0	2009	EnvisionRxPlus Gold	Texas EnvisionRxPlus Gold Region 22		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	057	0		29	10	S7694_057_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	057	0	2009	EnvisionRxPlus Gold	Oklahoma EnvisionRxPlus Gold Region 23		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	058	0		29	10	S7694_058_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	058	0	2009	EnvisionRxPlus Gold	Kansas EnvisionRxPlus Gold Region 24		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	059	0		29	10	S7694_059_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	059	0	2009	EnvisionRxPlus Gold	Upper Midwest EnvisionRxPlus Gold Region 25		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	060	0		29	10	S7694_060_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	060	0	2009	EnvisionRxPlus Gold	New Mexico EnvisionRxPlus Gold Region 26		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	061	0		29	10	S7694_061_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	061	0	2009	EnvisionRxPlus Gold	Colorado EnvisionRxPlus Gold Region 27		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	062	0		29	10	S7694_062_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	062	0	2009	EnvisionRxPlus Gold	Arizona EnvisionRxPlus Gold Region 28		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	063	0		29	10	S7694_063_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	063	0	2009	EnvisionRxPlus Gold	Nevada EnvisionRxPlus Gold Region 29		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	064	0		29	10	S7694_064_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	064	0	2009	EnvisionRxPlus Gold	Oregon, Washington EnvisionRxPlus Gold Region 30		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	065	0		29	10	S7694_065_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	065	0	2009	EnvisionRxPlus Gold	Idaho, Utah EnvisionRxPlus Gold Region 31		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	066	0		29	10	S7694_066_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	066	0	2009	EnvisionRxPlus Gold	California EnvisionRxPlus Gold Region 32		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	067	0		29	10	S7694_067_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	067	0	2009	EnvisionRxPlus Gold	Hawaii EnvisionRxPlus Gold Region 33		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	068	0		29	10	S7694_068_0	3	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	068	0	2009	EnvisionRxPlus Gold	Alaska EnvisionRxPlus Gold Region 34		2	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	801	0		29	10	S7694_801_0	1	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	801	0	2009	Employer Plan Calendar Year	National EGWP		1	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7694	802	0		29	10	S7694_802_0	1	2009.01	ENVISION INSURANCE COMPANY	EnvisionRx Plus	EnvisionRxPlus.com	10	29				S7694	802	0	2009	Employer Group Non-Calendar Year	National EGWP		1	2																		(330)-405-8080	(866)-250-2005		(866)-763-9630	(330)-340-5808	(866)-250-2005		(866)-763-9630	www.envisionrxplus.com	
S7950	801	0		29	10	S7950_801_0	2	2009.01	EXPRESS SCRIPTS INSURANCE CO.	SAMAscript	www.samascript.com	10	29				S7950	801	0	2009	SAMAscript	SAMAscript		1	2																		(866)-273-5788	(866)-273-5788			(866)-273-5788	(866)-273-5788			www.express-scripts.com/samascript	
S7950	802	0		29	10	S7950_802_0	2	2009.01	EXPRESS SCRIPTS INSURANCE CO.	SAMAscript	www.samascript.com	10	29				S7950	802	0	2009	SAMAscript	SAMAscript		1	2																		(866)-273-5788	(866)-273-5788			(866)-273-5788	(866)-273-5788			www.express-scripts.com/samascript	
S8067	001	0		29	10	S8067_001_0	5	2009.01	AVALON INSURANCE COMPANY	Avalon Insurance Company	www.securerx.com	10	29				S8067	001	0	2009	SecureRx - Option 3	Region 6 - Pennsylvania, West Virginia		2	2																		(877)-234-3853	(877)-234-3853	(800)-779-6961	(800)-779-6961	(888)-839-7330	(888)-839-7330	(800)-779-6961	(800)-779-6961	https://www.securerx.com/DrugFormularies/	
S8067	003	0		29	10	S8067_003_0	7	2009.01	AVALON INSURANCE COMPANY	Avalon Insurance Company	www.securerx.com	10	29				S8067	003	0	2009	SecureRx - Option 1	Region 06 - Pennsylvania and West Virginia		2	2																		(877)-234-3853	(877)-234-3853	(800)-779-6961	(800)-779-6961	(888)-839-7330	(888)-839-7330	(800)-779-6961	(800)-779-6961	https://www.securerx.com/DrugFormularies/	
S8067	004	0		29	10	S8067_004_0	5	2009.01	AVALON INSURANCE COMPANY	Avalon Insurance Company	www.securerx.com	10	29				S8067	004	0	2009	SecureRx - Option 4	Pennsylvania and West Virginia		2	2																		(877)-234-3853	(877)-234-3853	(800)-779-6961	(800)-779-6961	(888)-839-7330	(888)-839-7330	(800)-779-6961	(800)-779-6961	https://www.securerx.com/DrugFormularies/	
S8067	801	0		29	10	S8067_801_0	5	2009.01	AVALON INSURANCE COMPANY	Avalon Insurance Company	www.securerx.com	10	29				S8067	801	0	2009	SecureRx - ER	National		1	2																		(877)-234-3853	(877)-234-3853	(800)-779-6961	(800)-779-6961	(888)-839-7330	(888)-839-7330	(800)-779-6961	(800)-779-6961	https://www.securerx.com/DrugFormularies/	
S8067	802	0		29	10	S8067_802_0	5	2009.01	AVALON INSURANCE COMPANY	Avalon Insurance Company	www.securerx.com	10	29				S8067	802	0	2009	SecureRx - ER - Non-Calendar PY	National		1	2																		(877)-234-3853	(877)-234-3853	(800)-779-6961	(800)-779-6961	(888)-839-7330	(888)-839-7330	(800)-779-6961	(800)-779-6961	https://www.securerx.com/DrugFormularies/	
S8201	001	0		29	10	S8201_001_0	3	2009.01	UPMC HEALTH BENEFITS, INC	UPMC Health Plan	www.upmchealthplan.com	10	29				S8201	001	0	2009	UPMC for Life Prescription Drug Plan	State of Ohio		2	2																		(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	
S8201	802	0		29	10	S8201_802_0	1	2009.01	UPMC HEALTH BENEFITS, INC	UPMC Health Plan	www.upmchealthplan.com	10	29				S8201	802	0	2009	UPMC Employer Group PDP (CY)	State of Ohio		1	2																		(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	
S8201	803	0		29	10	S8201_803_0	1	2009.01	UPMC HEALTH BENEFITS, INC	UPMC Health Plan	www.upmchealthplan.com	10	29				S8201	803	0	2009	UPMC Employer Group PDP (FY)	State of Ohio		1	2																		(877)-539-3080	(877)-539-3080	(800)-361-2629	(800)-361-2629	(877)-381-3765	(877)-381-3765	(800)-361-2629	(800)-361-2629	http://www.upmchealthplan.com/plan/medicare/pharmacy_index.html	
S8465	001	0		29	10	S8465_001_0	2	2009.01	CITRUS HEALTH CARE	CITRUS HEALTH CARE	www.citrushc.com	10	29				S8465	001	0	2009	Citrus Part D FL.	Florida		2	2																		(402)-965-8800	(800)-546-5677	(866)-706-4757	(866)-706-4757	(813)-890-8919	(866)-769-1157	(888)-248-7875		www.citrushc.com	
S8465	002	0		29	10	S8465_002_0	4	2009.01	CITRUS HEALTH CARE	CITRUS HEALTH CARE	www.citrushc.com	10	29				S8465	002	0	2009	Citrus Part D Plus FL.	Florida		2	2																		(402)-965-8800	(800)-546-5677	(866)-706-4757	(866)-706-4757	(813)-890-8919	(866)-769-1157	(888)-248-7875		www.citrushc.com	
S8475	001	0		29	10	S8475_001_0	3	2009.01	QUALITY HEALTH PLANS, INC	QUALITY HEALTH PLANS	www.qualityhealthplans.com	10	29				S8475	001	0	2009	Quality Rx	State of Florida		2	2																		(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	www.qualityhealthplans.com	
S8475	002	0		29	10	S8475_002_0	3	2009.01	QUALITY HEALTH PLANS, INC	QUALITY HEALTH PLANS	www.qualityhealthplans.com	10	29				S8475	002	0	2009	Quality Rx Plus	State of Florida		2	2																		(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	(727)-945-8400	(866)-747-2700	(866)-455-6010	(866)-455-6010	www.qualityhealthplans.com	
S8841	803	0		29	10	S8841_803_0	1	2009.01	NMHC GROUP SOLUTION INSURANCE, INC.	NMHC Group Solutions	www.medicare.nmhc.com	10	29				S8841	803	0	2009	EGWP Calendar	National		1	2																		(866)-443-1095	(866)-443-1095	(866)-443-1094	(866)-443-1094	(866)-443-1095	(866)-443-1095	(866)-443-1094	(866)-443-1094	www.nmhc.com	
S8841	804	0		29	10	S8841_804_0	1	2009.01	NMHC GROUP SOLUTION INSURANCE, INC.	NMHC Group Solutions	www.medicare.nmhc.com	10	29				S8841	804	0	2009	EGWP Non-Calendar	National		1	2																		(866)-443-1095	(866)-443-1095	(866)-443-1094	(866)-443-1094	(866)-443-1095	(866)-443-1095	(866)-443-1094	(866)-443-1094	www.nmhc.com	
S9176	801	0		29	10	S9176_801_0	2	2009.01	CDPHP UNIVERSAL BENEFITS, INC.	CDPHP Group RxCare	www.cdphp.com	10	29				S9176	801	0	2009	CDPHP Group RxCare	State of New York		1	2																		(518)-641-3950	(800)-690-7681	(518)-641-4000	(866)-236-1069	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164	http://www.cdphp.com/images/medicare/Medicare_Formulary_2009.pdf	
S9176	802	0		29	10	S9176_802_0	2	2009.01	CDPHP UNIVERSAL BENEFITS, INC.	CDPHP Group RxCare	www.cdphp.com	10	29				S9176	802	0	2009	CDPHP Group RxCare	State of New York		1	2																		(518)-641-3950	(800)-690-7681	(518)-641-4000	(866)-236-1069	(518)-641-3400	(888)-519-4455	(518)-641-4000	(877)-261-1164	http://www.cdphp.com/images/medicare/Medicare_Formulary_2009.pdf	
