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Mail the completed Direct Member Reimbursement form along with a prescription label or pharmacy printout and a cash register receipt for your covered prescription drug to: WellCare Reimbursement Department PO Box 31577 Diltiazem is a 5- [2- (dimethylamino)ethyl]-2- (4-methoxyphenyl)-4-oxo-2,3,4,5-tetrahydro-1,5-benzothiazepin-3-yl acetate in which both stereocentres have S configuration. A calcium -channel blocker and vasodilator, it is used as the hydrochloride in the management of angina pectoris and hypertension. Find information on insurance coverage, ordering through a specialty pharmacy, and the cost of DUPIXENT® (dupilumab), a prescription medicine FDA-approved to treat five conditions.. Sanofi sells its products to wholesalers. A monthly supply of DUPIXENT (300 mg, 200 mg, or 100 mg) is defined as 2 injections per month. List price as of 1/3. Much of the time they don't. Choose a language:. 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