Employee Information FormWorkers’ Compensation Prescription Drug ProgramFirst Script, in conjunction with your employer, offers the finest in pharmacy benefit management programs designed specifically for workers’ compensation. Our nationwide pharmacy network and superior customer service make our pharmacy program more convenient than any other. Injured workers can fill their prescriptions at more than 67,000 retail pharmacy locations, which includes all major drug, mass retail and grocery store chains, plus 97% of local independent pharmacies—with no out-of-pocket expense.

Once your examiner determines you have a compensable claim, a First Script ID card will be mailed to you. Please note that First Script is valid only for medications prescribed to treat your work-related injury. If after using your First Script prescription card you switch to a different pharmacy for your workers’ compensation prescriptions, please call First Script Customer Service at 1.866.445.7344 with your new pharmacy name and phone number.

A&PAccredo Health GroupAccredo TherapeuticsAlbertsons PharmacyAlbertsons Sav-on

PharmacyArborAurora PharmacyB&B PharmacyBaker'sBartell DrugsBashas’ United DrugBel AirBel Air PharmacyBi-Lo FoodsBi-Lo, LLCBi-Mart PharmacyBig Y PharmacyBilo/Riverside

PharmacyBioScrip PharmacyBloom PharmacyBrooksBrookshire Brothers

PharmacyBrookshire PharmacyBruno'sBudget Chopper

PharmacyCVS PharmacyCarrs Quality CenterCash Wise Clinic

PharmacyCash Wise PharmacyCentral MarketCity MarketClinic PharmacyCoborn's Collegeville

PharmacyCoborn's Long Term

Care Pharmacy

Coborn's PharmacyCost CuttersCostcoCub PharmacyD & W Market DillonsDiscount Drug MartDoc's DrugsDominick’sDrug BarnDrug EmporiumDrug FairDrug MartDrug TownDrug WarehouseDuane ReadeEaton ApothecaryEckerd DrugsEcono Foods PharmacyFairview PharmacyFamily FareFarm Fresh PharmacyFelpausch PharmacyFood 4 LessFood City PharmacyFood City United DrugFood Lion PharmacyFood PyramidFood WorldFred MeyerFred’s Inc.Fred's PharmacyFred's XpressFruth Pharmacy, Inc.Fry’s Food & DrugGenuardi's PharmacyGerbesGiant Eagle PharmacyGiant PharmacyGlen's Markets

Grandview Medical Pharmacy

H-E-B PharmacyH-E-B PlusHaggen Food

& PharmacyHannafordHappy Harry’sHarps PharmacyHarris Teeter PharmacyHealth MartHen House PharmacyHi-School PharmacyHighpoint PharmacyHomeland PharmacyHouse Calls PharmacyHy-Vee PharmacyIke'sIngles PharmacyIsland DrugJayC PharmacyJewel-OSCO PharmacyKD Pharmacy, Inc.KLM Pharmacy, Inc.Kaiser Permanente

PharmacyKash n' Karry

PharmacyKerr DrugKessel PharmacyKing SoopersKing's PharmacyKinney DrugsKmart PharmacyKerr DrugKing SoopersKnight Drugs, Inc.Kroger PharmacyLewis DrugLivingston Medical

Pharmacy

PharmericaPick N SavePiggly Wiggly PharmacyPowell Prescription

CenterPrice Chopper PharmacyPrice Cutter PharmacyPrice Wise PharmacyProfessional Pharmacy

ServicesPublix Super Markets, Inc.QFC PharmacyQSI, Inc.Quality Markets

PharmacyRainbow PharmacyRaley’sRaley's PharmacyRalphsRameyRandallsReasor's Food &

PharmacyReasor's GroceryReasor's PharmacyReasor's SupermarketsRecept PharmacyRite AidRogers PharmacyRosauers PharmacyS-mart FoodsSack 'n Save PharmacySafeway PharmacySak 'N SaveSam’s Club PharmacySartoris Super DrugsSav-On PharmacySave Mart SupermarketsSaveRiteSchnuck’s PharmacyScolari's Pharmacy

Long’s DrugsMarc's PharmacyMarsh PharmacyMartin's PharmacyMay's DrugMed-X Drug StoresMedicap PharmacyMedicine Shoppe

PharmacyMediservMeijer PharmacyMendota HealthcareMercy East PharmacyMercy Mall PharmacyMercy Walworth

PharmacyMercy West PharmacyMercy Woodstock

PharmacyMi TiendaMilton PharmacyMinyard PharmacyMore 4 Family PharmacyMr. Z's PharmacyNavarro Discount

PharmacyNeighbor CareNob Hill PharmacyOlympic DrugOncology Rx Care

AdvantageOsco DrugOwsley Prescription

CenterP & C Food Market &

PharmacyPamida PharmacyPantryPathmarkPayLess Drug StoresPharmacy Center

Partial List of Participating First Script Pharmacies

Scot's Lo-Cost PharmacyShopKo PharmacyShopRiteSmith's Food & Drug

StoresSmitty'sSnyders Drug StoreStop & Shop PharmacyStrand PharmacyStufflebeon PharmacySun Mart PharmacySuper 1 PharmacySuper D Drug StoreSuper FreshSuper G Discount DrugSuper Rx PharmacySweetbay SupermarketsTarget StoresThrifty White PharmacyTimes PharmacyTimes SupermarketTop Food & DrugTom ThumbUS OncologyUSA DrugUnited PharmacyVillage ApothecaryVons PharmacyWaldbaum's PharmacyWalgreensWal-MartWegmansWeis PharmacyWest Broad Medical

PharmacyWestern NM Medical

GroupWhite DrugWinn-DixieWolfe Prescription CenterXpect Pharmacy

© 2012 Coventry Health Care Workers Compensation, Inc. All rights reserved.