Pharmacy Locator
The MyMatrixx pharmacy network includes all major pharmacy chains as well as most regional and independent pharmacies, including Albertson’s, Costco, CVS, H-E-B, Hy-Vee, Meijer, Publix, Raley’s, Safeway, Walgreens, Walmart, and Wegmans.
To the Pharmacist
MyMatrixx by Evernorth, administers this workers’ compensation prescription program. Please follow the steps below to submit a prescription claim. Standard first fill shall not exceed a 15-day supply or a cost of $300. This form is valid for up to 14 days from date of injury (DOI). Post-Exposure Prophylaxis medications have a higher day supply and high dollar limit. Limitations may vary.
For assistance, call Customer Service Center: 1-866-830-3886.
Pharmacy Processing Steps
- Enter BIN number: 003858
- Enter processor control: WC
- Enter the group number: 77SA
- Enter the injured worker’s nine digit ID number (SSN provided by the injured worker)
- Enter the injured worker’s first and last name
- Enter the injured worker’s date of injury (mm/dd/yyyy)