Resources / Materials
- Authorization to Disclose Health Information - English (PDF)
- Authorization to Disclose Health Information - Spanish (PDF)
- Revocation of Authorization to Disclose Health Information - English (PDF)
- Revocation of Authorization to Disclose Health Information - Spanish (PDF)
- CVS Caremark Form - English (PDF) - last updated Oct 20, 2022
- CVS Caremark Form - Spanish (PDF) - last updated Oct 20, 2022
Your current plan may have an over-the-counter (OTC) benefit that lets you buy OTC health and wellness products. This catalog includes a list of OTC items that you can order to be mailed to your home. Check the catalog for item limits.
Ordering is easy. Just follow the steps listed on your plan's catalog.
Don't want to wait? You may be able to pick up your OTC products from a CVS store near you. Please note this does not include CVS locations inside of Target stores.
Connect to the CVS OTC website to review available products and store information.
Preventive Guidelines
Preventive guidelines are based on the health needs and opportunities for improvement identified as part of the Quality Assurance Program Improvement (QAPI) program. When possible, Wellcare Prime by Absolute Total Care (Medicare-Medicaid Plan) adopts preventive guidelines that are published by nationally recognized organizations or government institutions. These guidelines may also be a statewide collaborative and/or a consensus of healthcare professionals in the applicable field.
- Recommended Adult Immunization Schedule for Adults 19 Years or Older, United States, 2022 (PDF)
- The Adult Well Male Examination
- Prevention and Control of Seasonal Influenza with Vaccines-Recommendations of the Advisory Committee on Immunization Practices - United States, 2021-22 Influenza Season
- Well-Woman Recommendations
Links
(Please note: By clicking on the links below you will be leaving the Wellcare Prime by Absolute Total Care's website.)
Procedure Code |
Procedure Description |
C9050 |
EMAPALUMAB-LZSG |
J0129 |
ABATACEPT INJECTION |
J0178 |
AFLIBERCEPT INJECTION |
J0584 |
BUROSUMAB-TWZA 1M |
J0585 |
ONABOTULINUMTOXINA |
J0604 |
CINACALCET, ESRD ON DIALYSIS |
J0717 |
CERTOLIZUMAB PEGOL INJ 1MG |
J0800 |
CORTICOTROPIN INJECTION |
J0897 |
DENOSUMAB INJECTION |
J1300 |
ECULIZUMAB INJECTION |
J1428 |
ETEPLIRSEN, 10 MG |
J1459 |
IVIG PRIVIGEN 500 MG |
J1555 |
CUVITRU, 100 MG |
J1556 |
IMM GLOB BIVIGAM, 500MG |
J1557 |
GAMMAPLEX INJECTION |
J1559 |
HIZENTRA INJECTION |
J1561 |
GAMUNEX-C/GAMMAKED |
J1566 |
IMMUNE GLOBULIN, POWDER |
J1568 |
OCTAGAM INJECTION |
J1569 |
GAMMAGARD LIQUID INJECTION |
J1572 |
FLEBOGAMMA INJECTION |
J1575 |
HYQVIA 100MG IMMUNEGLOBULIN |
J1599 |
IVIG NON-LYOPHILIZED, NOS |
J1602 |
GOLIMUMAB FOR IV USE 1MG |
J1745 |
INFLIXIMAB (REMICADE) |
J1930 |
LANREOTIDE INJECTION |
J2323 |
NATALIZUMAB INJECTION |
J2350 |
OCRELIZUMAB, 1 MG |
J2353 |
OCTREOTIDE INJECTION, DEPOT |
J2357 |
OMALIZUMAB INJECTION |
J2503 |
PEGAPTANIB SODIUM INJECTION |
J2778 |
RANIBIZUMAB INJECTION |
J3262 |
TOCILIZUMAB, 1 MG |
J3304 |
TRIAMCINOLONE ACE XR 1MG |
J3357 |
USTEKINUMAB SUB CU 1 MG |
J3380 |
VEDOLIZUMAB |
J3396 |
VERTEPORFIN INJECTION |
J7189 |
FACTOR VIIA |
J7318 |
DUROLANE 1 MG |
J7320 |
GENVISC 850, 1MG |
J7321 |
HYALGAN SUPARTZ VISCO-3 DOSE |
J7322 |
HYMOVIS INJECTION 1 MG |
J7323 |
EUFLEXXA INJ PER DOSE |
J7324 |
ORTHOVISC INJ PER DOSE |
J7325 |
SYNVISC OR SYNVISC-ONE |
J7326 |
GEL-ONE |
J7327 |
MONOVISC INJ PER DOSE |
J7328 |
GELSYN-3 INJECTION 0.1 MG |
J7329 |
TRIVISC 1 MG |
J9022 |
ATEZOLIZUMAB,10 MG |
J9145 |
INJECTION DARATUMUMAB 10 MG |
J9173 |
DURVALUMAB, 10 MG |
J9176 |
ELOTUZUMAB, 1MG |
J9308 |
RAMUCIRUMAB |
J9311 |
RITUXIMAB, HYALURONIDASE |
J9355 |
TRASTUZUMAB INJECTION |
Q2043 |
SIPULEUCEL-T AUTO CD54+ |
Q5103 |
INFLIXIMAB (INFLECTRA) |
Q5104 |
INFLIXIMAB (RENFLEXIS) |
If you have any questions, call Member Services at 1-855-735-4398 (TTY:711) (TTY: 711). Hours are from 8 a.m. to 8 p.m., Monday through Friday. After hours, on weekends and on federal holidays, you may be asked to leave a message. Your call will be returned within the next business day.