Crystal Reports - Report_1010_PDL_A3_Alpha_Drug_List_20041217.rpt

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Crystal Reports - Report_1010_PDL_A3_Alpha_Drug_List_20041217.rpt Powered By Docstoc
					                                                           Department of Human Services
                                                    Approved PDL for IOWA Medicaid Program
                                                                    FINAL
                                                            ALPHA DRUG LIST
                                                     PDL IMPLEMENTATION DATE 01-15-05

                                            Highlighted drugs are clinical prior authorizations

Column Header Explanations:
B, G or O:                                                                       P, N, R, or NR:
    B = Brand                                                                        P = Preferred
    G = Generic                                                                      N = Non-Preferred
    O = OTC                                                                          R = Recommended
                                                                                     NR = Non-Recommended

B    Drug                                                                                P,                   Comment
or   Name                                        Drug Category                           N,
G                                                                                       R, or
                                                                                        NR
                                                                   A
 G   *amino acid infusion 15%***              ELECTROLYTES/ NUTRITIONALS                 N
 O   *artificial tear ophth ointment***       OP. MISC                                   P
 O   *artificial tear ophth solution***       OP. MISC                                   P
 B   ACCOLATE                                 ANTIASTHMATIC - LEUKOTRIENE RECEPTOR       N
                                              ANTAGONISTS
 B   ACCUNEB                                  ANTIASTHMATIC - BETA - ADRENERGICS         P
 B   ACCUPRIL                                 ACE INHIBITORS                             N
 B   ACCURETIC                                ACE AND THIAZIDE COMBO'S                   N
 B   ACCUTANE                                 ACNE PRODUCTS: ISOTRETINOIN                P      PA Required
 B   ACCUZYME                                 TOPICAL - WOUND / DECUBITUS CARE           P
 G   acebutolol hcl                           BETA BLOCKERS - CARDIO SELECTIVE           P
 B   ACEON                                    ACE INHIBITORS                             P
 O   acetaminophen elixir 160 mg/5ml          ANALGESICS - MISC.                         P
 O   acetaminophen soln 100 mg/ml             ANALGESICS - MISC.                         P
 O   acetaminophen suppos 120 mg              ANALGESICS - MISC.                         P
 O   acetaminophen tab 325 mg                 ANALGESICS - MISC.                         P
 O   acetaminophen tab 500 mg                 ANALGESICS - MISC.                         P
 G   acetaminophen w/ codeine                 NARCOTICS - MICS.                          P
 G   acetazolamide                            DIURETICS                                  P
 G   acetic acid                              UROLOGICAL - MISC.                         P
 G   acetic acid (otic)                       EAR                                        P
 G   acetic acid vaginal gel                  VAGINAL - OTHER                            P
 G   acetic acid-aluminum acetate             EAR                                        P
 G   acetic acid-oxyquinoline vaginal gel     VAGINAL - OTHER                            N
     0.9-0.025%
 G   acetylcysteine                           ANTIASTHMATIC - MUCOLYTICS                 P
 B   ACIPHEX                                  GI - PROTON PUMP INHIBITOR                 N      PA Required from Day 1
 B   ACLOVATE                                 TOPICAL - CORTICOSTEROIDS                  N
 B   ACTIGALL                                 GI - MISC.                                 P
 B   ACTIQ                                    NARCOTICS - MICS.                          N      PA Required
 B   ACTIVELLA                                ESTROGEN COMBO'S                           N
 B   ACTONEL                                  OSTEOPOROSIS                               P
 B   ACTOS                                    DIABETIC - THIAZOL                         P
 B   ACULAR                                   OP. NSAID'S                                P
 B   ACULAR LS                                OP. NSAID'S                                P
 B   ACULAR PF                                OP. NSAID'S                                N
 G   acyclovir     cap 200mg                  HERPES AGENTS                              P


Report_1010_PDL_A3 rev A                                       12/26/2004                                                Page 1 of 63
B    Drug                                                                                  P,                   Comment
or   Name                                           Drug Category                          N,
G                                                                                         R, or
                                                                                          NR
                                                                      A                                   - Alpha Continued -
 G   acyclovir     sus 200/5ml                    HERPES AGENTS                            N
 G   acyclovir     tab 400mg                      HERPES AGENTS                            P
 G   acyclovir     tab 800mg                      HERPES AGENTS                            P
 G   acyclovir sodium                             HERPES AGENTS                            P
 B   ADALAT CC                                    CALCIUM CHANNEL BLOCKERS--NIFEDIPINES    P
 B   ADDERALL                                     STIMULANTS - AMPHETAMINES - SHORT        P
                                                  ACTING
 B   ADDERALL XR                                  STIMULANTS - AMPHETAMINES - LONG         R
                                                  ACTING
 B   ADOXA                                        TETRACYCLINES                            N
 B   ADRENALIN                                    COUGH/COLD - TOPICAL DECONGESTANTS       N
 B   ADRENALIN                                    ANTIASTHMATIC - MIXED ADRENERGICSS       N
 B   ADVAIR DISKUS                                ANTIASTHMATIC - ADRENERGIC COMBOS        P
 B   ADVICOR                                      CHOLESTEROL - HMG COA + ABSORB           P
                                                  INHIBITORS
 B   AEROBID                                      ANTIASTHMATIC - STEROID INHALANTS        P
 B   AEROBID-M                                    ANTIASTHMATIC - STEROID INHALANTS        P
 G   afeditab cr                                  CALCIUM CHANNEL BLOCKERS--NIFEDIPINES    N
 B   AGGRENOX                                     PLATELET AGGR. INHIBITORS / COMBO'S -    P
                                                  MISC.
 B   AGRYLIN                                      PLATELET AGGR. INHIBITORS / COMBO'S -    N
                                                  MISC.
 G   ah-chew                                      COUGH/COLD -                             N
                                                  DECONGESTANT-ANTIHISTAMINE-ANTICHOLI
                                                  NERGIC
 B   AKINETON                                     PARKINSONS - ANTICHOLINERGICS            P
 B   AKNE-MYCIN                                   TOPICAL - ACNE PREPARATIONS              P      PA Required
 B   ALAMAST                                      OP. ANTIALLERGICS                        P
 B   ALBENZA                                      ANTHELMINTICS                            P
 G   albumin, human inj 25%                       ELECTROLYTES/ NUTRITIONALS               N
 G   albuterol inhal aerosol 90 mcg/act           ANTIASTHMATIC - BETA - ADRENERGICS       P
 G   albuterol sulfate soln nebu 0.083%           ANTIASTHMATIC - BETA - ADRENERGICS       P
 G   albuterol sulfate soln nebu 0.5% (5 mg/ml)   ANTIASTHMATIC - BETA - ADRENERGICS       P
 G   albuterol sulfate syrup 2 mg/5ml             ANTIASTHMATIC - BETA - ADRENERGICS       P
 G   albuterol sulfate tab 2 mg                   ANTIASTHMATIC - BETA - ADRENERGICS       P
 G   albuterol sulfate tab 4 mg                   ANTIASTHMATIC - BETA - ADRENERGICS       P
 B   ALCAINE                                      OP. MISC                                 N
 B   ALDACTAZIDE TAB 25/25                        DIURETICS                                P
 B   ALDACTAZIDE TAB 50/50                        DIURETICS                                P
 B   ALDACTONE                                    DIURETICS                                N
 B   ALDARA                                       TOPICAL - GENITAL WARTS                  P
 B   ALDOMET                                      ANTIHYPERTENSIVES - CENTRAL              N
 B   ALDORIL-15                                   ANTIHYPERTENSIVE COMBOS                  N
 B   ALDORIL-25                                   ANTIHYPERTENSIVE COMBOS                  N
 B   ALESSE-28                                    CONTRACEPTIVES - MONOPHASIC              P
                                                  COMBINATION O/C'S
 B   ALINIA                                       ANTIPROTOZOAL AGENTS                     P
 B   ALLEGRA                                      ANTIHISTAMINES - NON-SEDATING            N      PA Required
 B   ALLEGRA-D                                    NON-SEDATING ANTIHISTIMINES /            N
                                                  DECONGESTANTS
 B   ALLERX DOSE PACK                             COUGH/COLD -                             N
                                                  DECONGESTANT-ANTIHISTAMINE-ANTICHOLI
                                                  NERGIC
 B   ALLERX-D                                     COUGH/COLD - DECONGESTANT &              N
                                                  ANTICHOLINERGIC
 G   allopurinol                                  GOUT                                     P
 B   ALOCRIL                                      OP. ANTIALLERGICS                        P
 B   ALOMIDE                                      OP. ANTIALLERGICS                        P
 B   ALORA                                        ESTROGENS - PATCHES                      N

Report_1010_PDL_A3 rev A                                          12/26/2004                                              Page 2 of 63
B    Drug                                                                                     P,                 Comment
or   Name                                             Drug Category                           N,
G                                                                                            R, or
                                                                                             NR
                                                                         A                                   - Alpha Continued -
 B   ALOXI                                          ANTIEMETIC - 5-HT3 RECEPTOR               N
                                                    ANTAGONISTS/ SUBSTANCE P NEUROKININ
 B   ALPHAGAN P                                     OP. SELECTIVE ALPHA ADRENERGIC            P
                                                    AGONISTS
 G   alprazolam                                     ANXIOLYTICS - BENZODIAZEPINES             P
 B   ALPRAZOLAM INTENSOL                            ANXIOLYTICS - BENZODIAZEPINES             R
 B   ALREX                                          OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    P
 B   ALTACE                                         ACE INHIBITORS                            P
 B   ALTOPREV                                       CHOLESTEROL - HMG COA + ABSORB            P
                                                    INHIBITORS
 G   aluminum chloride soln 20%                     TOPICAL - ASTRINGENTS / PROTECTANTS       P
 B   ALUPENT                                        ANTIASTHMATIC - BETA - ADRENERGICS        N
 G   amantadine hcl cap 100 mg                      ANTI-PARKINSONIAN DRUGS                   P
 G   amantadine hcl syrup 50 mg/5ml                 ANTI-PARKINSONIAN DRUGS                   P
 G   amantadine hcl tab 100 mg                      ANTI-PARKINSONIAN DRUGS                   N
 B   AMARYL                                         DIABETIC - ORAL SULFONYLUREAS             N
 B   AMBIEN                                         SEDATIVE/HYPNOTICS -                      P
                                                    NON-BENZODIAZEPINES
 B   AMBISOME                                       ANTIFUNGALS - ASSORTED                    P      PA Required > 90 days
 G   amcinonide cream 0.1%                          TOPICAL - CORTICOSTEROIDS                 P
 G   amcinonide oint 0.1%                           TOPICAL - CORTICOSTEROIDS                 N
 B   AMERGE                                         MIGRAINE - SELECTIVE SEROTONIN            P      PA Required: > 18 Units/30Days Supply
                                                    AGONISTS (5HT)--TABS
 B   AMERICAINE                                     TOPICAL - LOCAL ANESTHETICS               N
 G   amibid dm                                      COUGH/COLD - ANTITUSSIVE-EXPECTORANT      N
 B   AMICAR                                         HEMOSTATIC                                P
 G   amikacin sulfate                               AMINO GLYCOSIDES                          P
 B   AMIKIN                                         AMINO GLYCOSIDES                          P
 G   amiloride & hydrochlorothiazide                DIURETICS                                 P
 G   amiloride hcl                                  DIURETICS                                 P
 G   amino acid-urea cervical cream                 VAGINAL - OTHER                           P
 G   aminocaproic acid                              HEMOSTATIC                                P
 G   aminophylline                                  ANTIASTHMATIC - XANTHINES                 P
 B   AMINOSYN II                                    ELECTROLYTES/ NUTRITIONALS                P
 G   amiodarone hcl                                 ANTIARRHYTHMICS                           P
 G   amitriptyline hcl                              ANTIDEPRESSANTS - TRI-CYCLICS             P
 B   AMOXAPINE                                      ANTIDEPRESSANTS - TRI-CYCLICS             R
 G   amoxicillin & k clavulanate chew tab           BETA-LACTAMS / CLAVULANATE COMBO'S        N
     200-28.5 mg
 G   amoxicillin & k clavulanate chew tab           BETA-LACTAMS / CLAVULANATE COMBO'S        N
     400-57 mg
 G   amoxicillin & k clavulanate for susp           BETA-LACTAMS / CLAVULANATE COMBO'S        N
     200-28.5 mg/5ml
 G   amoxicillin & k clavulanate for susp 400-57    BETA-LACTAMS / CLAVULANATE COMBO'S        N
     mg/5ml
 G   amoxicillin & k clavulanate tab 500-125 mg     BETA-LACTAMS / CLAVULANATE COMBO'S        P
 G   amoxicillin & k clavulanate tab 875-125 mg     BETA-LACTAMS / CLAVULANATE COMBO'S        P
 G   amoxicillin (trihydrate) cap 250 mg            BETA-LACTAMS / CLAVULANATE COMBO'S        P
 G   amoxicillin (trihydrate) cap 500 mg            BETA-LACTAMS / CLAVULANATE COMBO'S        P
 G   amoxicillin (trihydrate) chew tab 125 mg       BETA-LACTAMS / CLAVULANATE COMBO'S        P
 G   amoxicillin (trihydrate) chew tab 200 mg       BETA-LACTAMS / CLAVULANATE COMBO'S        N
 G   amoxicillin (trihydrate) chew tab 250 mg       BETA-LACTAMS / CLAVULANATE COMBO'S        P
 G   amoxicillin (trihydrate) chew tab 400 mg       BETA-LACTAMS / CLAVULANATE COMBO'S        N
 G   amoxicillin (trihydrate) for susp 125 mg/5ml   BETA-LACTAMS / CLAVULANATE COMBO'S        P
 G   amoxicillin (trihydrate) for susp 200 mg/5ml   BETA-LACTAMS / CLAVULANATE COMBO'S        N
 G   amoxicillin (trihydrate) for susp 250 mg/5ml   BETA-LACTAMS / CLAVULANATE COMBO'S        P
 G   amoxicillin (trihydrate) for susp 400 mg/5ml   BETA-LACTAMS / CLAVULANATE COMBO'S        N
 G   amoxicillin (trihydrate) tab 500 mg            BETA-LACTAMS / CLAVULANATE COMBO'S        P


Report_1010_PDL_A3 rev A                                             12/26/2004                                               Page 3 of 63
B    Drug                                                                                P,                   Comment
or   Name                                          Drug Category                         N,
G                                                                                       R, or
                                                                                        NR
                                                                     A                                  - Alpha Continued -
 G   amoxicillin (trihydrate) tab 875 mg         BETA-LACTAMS / CLAVULANATE COMBO'S      N
 G   amoxil     cap 500mg                        BETA-LACTAMS / CLAVULANATE COMBO'S      P
 B   AMOXIL        CHW 200MG                     BETA-LACTAMS / CLAVULANATE COMBO'S      N
 B   AMOXIL        CHW 400MG                     BETA-LACTAMS / CLAVULANATE COMBO'S      N
 B   AMOXIL        DRO 50MG/ML                   BETA-LACTAMS / CLAVULANATE COMBO'S      P
 B   AMOXIL        SUS 200/5ML                   BETA-LACTAMS / CLAVULANATE COMBO'S      N
 G   amoxil     sus 250/5ml                      BETA-LACTAMS / CLAVULANATE COMBO'S      P
 B   AMOXIL        SUS 400/5ML                   BETA-LACTAMS / CLAVULANATE COMBO'S      N
 B   AMOXIL        TAB 500MG                     BETA-LACTAMS / CLAVULANATE COMBO'S      P
 B   AMOXIL        TAB 875MG                     BETA-LACTAMS / CLAVULANATE COMBO'S      P
 G   amphetamine-dextroamphetamine               STIMULANTS - AMPHETAMINES - SHORT       N
                                                 ACTING
 G   amphotericin b                              ANTIFUNGALS - ASSORTED                  N      PA Required > 90 days
 B   AMPHOTERICIN POW B                          MOUTH ANTI-INFECTIVES                   P
 G   ampicillin & sulbactam sodium for inj 2-1   BETA-LACTAMS / CLAVULANATE COMBO'S      N
     gm
 G   ampicillin cap 250 mg                       BETA-LACTAMS / CLAVULANATE COMBO'S      P
 G   ampicillin cap 500 mg                       BETA-LACTAMS / CLAVULANATE COMBO'S      P
 G   ampicillin for susp 125 mg/5ml              BETA-LACTAMS / CLAVULANATE COMBO'S      P
 G   ampicillin for susp 250 mg/5ml              BETA-LACTAMS / CLAVULANATE COMBO'S      P
 G   ampicillin sodium for inj 1 gm              BETA-LACTAMS / CLAVULANATE COMBO'S      P
 G   ampicillin sodium for inj 10 gm             BETA-LACTAMS / CLAVULANATE COMBO'S      P
 G   ampicillin sodium for inj 2 gm              BETA-LACTAMS / CLAVULANATE COMBO'S      P
 G   ampicillin sodium for inj 250 mg            BETA-LACTAMS / CLAVULANATE COMBO'S      P
 G   ampicillin sodium for inj 500 mg            BETA-LACTAMS / CLAVULANATE COMBO'S      P
 G   ampicillin sodium for iv soln 1 gm          BETA-LACTAMS / CLAVULANATE COMBO'S      P
 G   ampicillin sodium for iv soln 2 gm          BETA-LACTAMS / CLAVULANATE COMBO'S      P
 G   amylase-lipase-protease tab                 GI - DIGESTIVE ENZYMES                  P      PA Required
     30000-8000-30000 unit
 G   amylase-lipase-protease tab                 GI - DIGESTIVE ENZYMES                  N      PA Required
     60000-16000-60000 unit
 B   ANAFRANIL                                   ANTIDEPRESSANTS - TRI-CYCLICS           N
 B   ANALPRAM-HC                                 ANORECTAL - MISC.                       P
 B   ANAMANTLE HC                                ANORECTAL - MISC.                       N
 B   ANAPROX                                     NSAIDS                                  N      PA Required
 B   ANAPROX DS                                  NSAIDS                                  N      PA Required
 B   ANASPAZ                                     GI - ANTIDIARRHEAL / ANTACID - MISC.    P
 B   ANCEF                                       CEPHALOSPORINS                          P
 B   ANCOBON                                     ANTIFUNGALS - ASSORTED                  P      PA Required > 90 days
 G   andehist dm nr                              COUGH/COLD - NON-NARC                   P
                                                 ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                                 NE
 G   andehist nr                                 COUGH/COLD - DECONGESTANT &             P
                                                 ANTIHISTAMINE
 B   ANDRODERM                                   ANDROGENS / ANABOLICS                   P
 B   ANDROGEL                                    ANDROGENS / ANABOLICS                   P
 B   ANDROID                                     ANDROGENS / ANABOLICS                   P
 B   ANEMAGEN OB                                 VITAMINS - MISC.                        N
 B   ANEXSIA                                     NARCOTICS - MICS.                       P
 B   ANSAID                                      NSAIDS                                  N      PA Required
 B   ANTABUSE                                    ALCOHOL DETERRENTS                      P
 G   anthralin cream 1%                          ANTI-PSORIATICS                         P
 G   antibiot ear sol 1% otic                    EAR                                     P
 G   antibiot ear sus 1% otic                    EAR                                     N
 B   ANTIVERT       TAB 50MG                     ANTIEMETIC - ANTICHOLINERGIC /          P      ANTIVERT 50mg - Use two MECLIZINE
                                                 DOPAMINERGIC                                   HCL 25mg instead
 B   ANUSOL-HC                                   ANORECTAL - MISC.                       N



Report_1010_PDL_A3 rev A                                        12/26/2004                                              Page 4 of 63
B    Drug                                                                               P,                   Comment
or   Name                                         Drug Category                         N,
G                                                                                      R, or
                                                                                       NR
                                                                     A                                   - Alpha Continued -
 B   ANZEMET                                    ANTIEMETIC - 5-HT3 RECEPTOR             N
                                                ANTAGONISTS/ SUBSTANCE P NEUROKININ
 B   APRESOLINE                                 ANTIHYPERTENSIVES - CENTRAL             N
 G   aquabid-dm                                 COUGH/COLD - ANTITUSSIVE-EXPECTORANT    N
 B   AQUA-MEPHYTON                              VITAMINS                                P      RX Only
 B   AQUATAB C                                  COUGH/COLD -                            N
                                                ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                                ANT
 B   AQUATAB D                                  COUGH/COLD - DECONGESTANT W/            N
                                                EXPECTORANT
 B   AQUATAB DM                                 COUGH/COLD - ANTITUSSIVE-EXPECTORANT    N
 B   ARALAST                                    ANTIASTHMATIC - ALPHA-PROTEINASE        N      PA Required
                                                INHIBITOR
 B   ARALEN                                     ANTIMALARIAL AGENTS                     N
 B   ARANESP                                    ERYTHROPOEISIS STIMULATING AGENTS       N      PA Required
 B   ARAVA                                      RHEUMATOID ARTHRITIS -                  P
                                                NON-BIOLOGICALS
 B   AREDIA                                     OSTEOPOROSIS                            N
 B   ARICEPT                                    ALZHEIMER - CHOLINOMIMETICS             P
 B   ARISTOCORT A                               TOPICAL - CORTICOSTEROIDS               N
 B   ARIXTRA                                    ANTICOAGULANTS                          N      PA Required from Day 1
 B   ARMOUR THYROID                             THYROID HORMONES                        P
 B   ARTHROTEC 50                               NSAIDS                                  N      PA Required
 B   ARTHROTEC 75                               NSAIDS                                  N      PA Required
 O   aspirin buffered (ca carb-mg carb-mg ox)   ANALGESICS - MISC.                      P
     tab 325 mg
 O   aspirin buffered tab 325 mg                ANALGESICS - MISC.                      P
 O   aspirin chew tab 81 mg                     ANALGESICS - MISC.                      P
 O   aspirin tab 325 mg                         ANALGESICS - MISC.                      P
 O   ASPIRIN TAB 650 MG                         ANALGESICS - MISC.                      P
 O   aspirin tab 81 mg                          ANALGESICS - MISC.                      P
 O   aspirin tab delayed release 325 mg         ANALGESICS - MISC.                      P
 O   aspirin tab delayed release 650 mg         ANALGESICS - MISC.                      P
 O   aspirin tab delayed release 81 mg          ANALGESICS - MISC.                      P
 G   aspirin tab delayed release 975 mg         ANALGESICS - MISC.                      P
 G   aspirin w/ codeine                         NARCOTICS - MICS.                       P
 B   ASTELIN                                    ANTIHISTAMINES - NON-SEDATING           N      PA Required
 B   ATACAND                                    ANGIOTENSIN RECEPTOR BLOCKER            N
 B   ATACAND HCT                                ARB'S AND DIURETICS                     N
 B   ATARAX                                     ANTIHISTAMINES - OTHER                  N
 G   atenolol                                   BETA BLOCKERS - CARDIO SELECTIVE        P
 G   atenolol & chlorthalidone                  BETA BLOCKERS AND DIURETIC COMBO'S      P
 B   ATIVAN                                     ANXIOLYTICS - BENZODIAZEPINES           N
 G   atropine sulfate                           GI - ANTIDIARRHEAL / ANTACID - MISC.    P
 G   atropine sulfate (ophthalmic)              OP. CYCLOPLEGICS                        P
 B   ATROVENT                                   ANTIASTHMATIC - NASAL MISC.             P
 B   ATROVENT                                   ANTIASTHMATIC - ANTI-CHOLINERGICS       P
 G   augmented betamethasone dipropionate       TOPICAL - CORTICOSTEROIDS               P
     cream 0.05%
 G   augmented betamethasone dipropionate       TOPICAL - CORTICOSTEROIDS               N
     gel 0.05%
 G   augmented betamethasone dipropionate       TOPICAL - CORTICOSTEROIDS               N
     oint 0.05%
 B   AUGMENTIN CHW 200MG                        BETA-LACTAMS / CLAVULANATE COMBO'S      P
 B   AUGMENTIN          CHW 250MG               BETA-LACTAMS / CLAVULANATE COMBO'S      P
 B   AUGMENTIN          CHW 400MG               BETA-LACTAMS / CLAVULANATE COMBO'S      P
 B   AUGMENTIN          SUS 125/5ML             BETA-LACTAMS / CLAVULANATE COMBO'S      P
 B   AUGMENTIN          SUS 200/5ML             BETA-LACTAMS / CLAVULANATE COMBO'S      P
 B   AUGMENTIN          SUS 250/5ML             BETA-LACTAMS / CLAVULANATE COMBO'S      P

Report_1010_PDL_A3 rev A                                       12/26/2004                                               Page 5 of 63
B    Drug                                                                                 P,                   Comment
or   Name                                         Drug Category                           N,
G                                                                                        R, or
                                                                                         NR
                                                                       A                                 - Alpha Continued -
 B   AUGMENTIN       SUS 400/5ML                BETA-LACTAMS / CLAVULANATE COMBO'S        P
 B   AUGMENTIN       TAB 250MG                  BETA-LACTAMS / CLAVULANATE COMBO'S        P
 B   AUGMENTIN       TAB 500MG                  BETA-LACTAMS / CLAVULANATE COMBO'S        N
 B   AUGMENTIN       TAB 875MG                  BETA-LACTAMS / CLAVULANATE COMBO'S        N
 B   AUGMENTIN ES-600                           BETA-LACTAMS / CLAVULANATE COMBO'S        P
 B   AUGMENTIN XR                               BETA-LACTAMS / CLAVULANATE COMBO'S        P
 B   AVALIDE                                    ARB'S AND DIURETICS                       P
 B   AVANDAMET                                  DIABETIC - THIAZOL / BIGUANIDE COMBO      P
 B   AVANDIA                                    DIABETIC - THIAZOL                        P
 B   AVAPRO                                     ANGIOTENSIN RECEPTOR BLOCKER              P
 B   AVAR                                       TOPICAL - ACNE PREPARATIONS               N      PA Required
 B   AVAR GREEN                                 TOPICAL - ACNE PREPARATIONS               N      PA Required
 B   AVC                                        VAGINAL - ANTI FUNGALS                    N
 B   AVELOX                                     FLUOROQUINOLONES                          P
 B   AVELOX ABC PACK                            FLUOROQUINOLONES                          N
 B   AVENTYL                                    ANTIDEPRESSANTS - TRI-CYCLICS             N
 B   AVINZA                                     NARCOTICS-LONG ACTING                     P
 B   AVODART                                    BPH                                       P
 B   AVONEX                                     MULTIPLE SCLEROSIS AGENTS                 P
 B   AXERT                                      MIGRAINE - SELECTIVE SEROTONIN            P      PA Required: > 18 Units/30Days Supply
                                                AGONISTS (5HT)--TABS
 B   AXID                                       GI - H2-ANTAGONISTS                       N
 B   AYGESTIN                                   PROGESTINS                                P
 B   AZACTAM                                    ANTIBIOTICS - MISC.                       P
 B   AZASAN                                     PURINE ANALOG                             P
 G   azathioprine tab 50 mg                     PURINE ANALOG                             P
 B   AZELEX                                     TOPICAL - ACNE PREPARATIONS               P      PA Required
 B   AZMACORT                                   ANTIASTHMATIC - STEROID INHALANTS         P
 B   AZOPT                                      OP. CARBONIC ANHYDRASE                    P
                                                INHIBITORS/COMBO
 B   AZULFIDINE                                 GI - INFLAMMATORY BOWEL AGENTS            P
 B   AZULFIDINE EN-TABS                         GI - INFLAMMATORY BOWEL AGENTS            P

                                                                       B
 G   *b-complex w/ c & folic acid cap 1 mg***   VITAMINS - MISC.                          N
 G   *b-complex w/ c & folic acid tab 1 mg***   VITAMINS - MISC.                          P
 G   *b-complex w/ c & folic acid tab 5 mg***   VITAMINS - MISC.                          N
 G   *b-complex w/ c & folic acid tab***        VITAMINS - MISC.                          N
 G   *b-complex w/ c-min-fe & folic acid tab    VITAMINS - MISC.                          N
     106-1 mg***
 B   B & O 15-A SUPPRETTE                       GI - ANTIDIARRHEAL / ANTACID - MISC.      N
 B   B & O 16-A SUPPRETTE                       GI - ANTIDIARRHEAL / ANTACID - MISC.      N
 O   bacitracin oint 500 unit/gm                TOPICAL - ANTIBIOTIC                      P
 G   bacitracin ophth oint 500 unit/gm          OP. ANTIBIOTICS                           P
 G   bacitracin-polymyxin b ophth oint          OP. ANTIBIOTICS                           P
 G   bacitracin-polymyxin-neomycin-hc ophth     OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    N
     oint 1%
 G   baclofen                                   MUSCLE RELAXANTS                          P
 B   BACTERIOSTATIC WATER PARA                  COMPOUNDING MATERIALS                     P
 B   BACTOCILL IN DEXTROSE                      BETA-LACTAMS / CLAVULANATE COMBO'S        P
 B   BACTRIM                                    ANTI INFECTIVE COMBO'S - MISC.            N
 B   BACTROBAN        CRE 2%                    TOPICAL - ANTIBIOTIC                      P
 B   BACTROBAN        OIN 2%                    TOPICAL - ANTIBIOTIC                      P
 B   BACTROBAN NASAL                            TOPICAL - NASAL ANTIBIOTICS               P
 B   BAYHEP B                                   IMMUNE SERUMS                             N
 B   BAYTET                                     IMMUNE SERUMS                             P
 B   BECONASE AQ                                ANTIASTHMATIC - NASAL STEROIDS            N

Report_1010_PDL_A3 rev A                                          12/26/2004                                              Page 6 of 63
B    Drug                                                                              P,                   Comment
or   Name                                        Drug Category                         N,
G                                                                                     R, or
                                                                                      NR
                                                                    B                                 - Alpha Continued -
 G   belladonna alkaloids & opium suppos       GI - ANTIDIARRHEAL / ANTACID - MISC.    P
     16.2-30 mg
 G   belladonna alkaloids & opium suppos       GI - ANTIDIARRHEAL / ANTACID - MISC.    N
     16.2-60 mg
 B   BENADRYL                                  ANTIHISTAMINES - OTHER                  P
 G   benazepril & hydrochlorothiazide          ACE AND THIAZIDE COMBO'S                N
 G   benazepril hcl                            ACE INHIBITORS                          N
 B   BENICAR                                   ANGIOTENSIN RECEPTOR BLOCKER            P
 B   BENICAR HCT                               ARB'S AND DIURETICS                     N
 B   BENTYL          SYP 10MG/5ML              GI - ANTIDIARRHEAL / ANTACID - MISC.    P
 B   BENTYL          TAB 20MG                  GI - ANTIDIARRHEAL / ANTACID - MISC.    N
 B   BENZAC AC WASH                            TOPICAL - ACNE PREPARATIONS             N      PA Required
 B   BENZACLIN                                 TOPICAL - ACNE PREPARATIONS             N      PA Required
 B   BENZAMYCINPAK                             TOPICAL - ACNE PREPARATIONS             P      PA Required
 B   BENZASHAVE 5                              TOPICAL - ACNE PREPARATIONS             N      PA Required
 G   benzocaine & antipyrine                   EAR                                     P
 G   benzocaine (otic)                         EAR                                     P
 G   benzocaine-phenylephrine-antipyrine       EAR                                     P
 G   benzonatate cap 100 mg                    COUGH/COLD - ANTITUSSIVE -              P
                                               NONNARCOTIC
 G   benzonatate cap 200 mg                    COUGH/COLD - ANTITUSSIVE -              N      BENZONATATE 200mg - Use two
                                               NONNARCOTIC                                    BENZONATATE 100mg instead
 G   benzoyl peroxide cream 10%                TOPICAL - ACNE PREPARATIONS             N      PA Required
 O   benzoyl peroxide gel 10%                  TOPICAL - ACNE PREPARATIONS             P
 O   benzoyl peroxide gel 5%                   TOPICAL - ACNE PREPARATIONS             P
 O   benzoyl peroxide liq 10%                  TOPICAL - ACNE PREPARATIONS             P
 O   benzoyl peroxide liq 5%                   TOPICAL - ACNE PREPARATIONS             P
 O   benzoyl peroxide lotion 10%               TOPICAL - ACNE PREPARATIONS             P
 O   benzoyl peroxide lotion 5%                TOPICAL - ACNE PREPARATIONS             P
 G   benzoyl peroxide-erythromycin gel 5-3%    TOPICAL - ACNE PREPARATIONS             N      PA Required
 G   benztropine mesylate                      PARKINSONS - ANTICHOLINERGICS           P
 B   BETAGAN                                   OP. BETA - BLOCKERS                     N
 G   betamethasone dipropionate cream 0.05%    TOPICAL - CORTICOSTEROIDS               P
 G   betamethasone dipropionate lotion 0.05%   TOPICAL - CORTICOSTEROIDS               P
 G   betamethasone dipropionate oint 0.05%     TOPICAL - CORTICOSTEROIDS               P
 G   betamethasone valerate cream 0.1%         TOPICAL - CORTICOSTEROIDS               P
 G   betamethasone valerate lotion 0.1%        TOPICAL - CORTICOSTEROIDS               P
 G   betamethasone valerate oint 0.1%          TOPICAL - CORTICOSTEROIDS               P
 B   BETAPACE                                  BETA BLOCKERS - NON SELECTIVE           N
 B   BETAPACE AF                               BETA BLOCKERS - NON SELECTIVE           P
 B   BETASERON                                 MULTIPLE SCLEROSIS AGENTS               P
 G   betaxolol hcl                             BETA BLOCKERS - CARDIO SELECTIVE        N
 G   betaxolol hcl ophth soln 0.5%             OP. BETA - BLOCKERS                     N
 G   bethanechol chloride                      CHOLINERGIC                             P
 B   BETIMOL                                   OP. BETA - BLOCKERS                     P
 B   BETOPTIC-S                                OP. BETA - BLOCKERS                     P
 B   BEXTRA                                    COX 2 INHIBITORS - HIGHLY SELECTIVE     P      PA Required
 B   BIAXIN      SUS 125/5ML                   MACROLIDES / ERYTHROMYCIN'S /           P
                                               KETOLIDES
 B   BIAXIN      SUS 250/5ML                   MACROLIDES / ERYTHROMYCIN'S /           P
                                               KETOLIDES
 B   BIAXIN      TAB 250MG                     MACROLIDES / ERYTHROMYCIN'S /           N
                                               KETOLIDES
 B   BIAXIN      TAB 500MG                     MACROLIDES / ERYTHROMYCIN'S /           N
                                               KETOLIDES
 B   BIAXIN XL                                 MACROLIDES / ERYTHROMYCIN'S /           P
                                               KETOLIDES
 B   BIAXIN XL PAC                             MACROLIDES / ERYTHROMYCIN'S /           P
                                               KETOLIDES

Report_1010_PDL_A3 rev A                                        12/26/2004                                            Page 7 of 63
B    Drug                                                                             P,                   Comment
or   Name                                     Drug Category                           N,
G                                                                                    R, or
                                                                                     NR
                                                                  B                                  - Alpha Continued -
 B   BICILLIN C-R                           BETA-LACTAMS / CLAVULANATE COMBO'S        P
 B   BICILLIN L-A                           BETA-LACTAMS / CLAVULANATE COMBO'S        P
 B   BICITRA                                UROLOGICAL - MISC.                        P
 B   BILTRICIDE                             ANTHELMINTICS                             P
 G   bisoprolol & hydrochlorothiazide       BETA BLOCKERS AND DIURETIC COMBO'S        P
 G   bisoprolol fumarate                    BETA BLOCKERS - CARDIO SELECTIVE          N
 B   BLEPH-10                               OP. ANTIBIOTICS                           P
 B   BLEPHAMIDE                             OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    P
 B   BLEPHAMIDE S.O.P.                      OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    N
 B   BLOCADREN                              BETA BLOCKERS - NON SELECTIVE             N
 B   BOTOX                                  NEUROMUSCULAR BLOCKING AGENTS             N
 B   BRETHINE        INJ 1MG/ML             ANTIASTHMATIC - BETA - ADRENERGICS        N
 B   BRETHINE        TAB 2.5MG              ANTIASTHMATIC - BETA - ADRENERGICS        P
 B   BRETHINE        TAB 5MG                ANTIASTHMATIC - BETA - ADRENERGICS        P
 B   BREVICON-28                            CONTRACEPTIVES - MONOPHASIC               N
                                            COMBINATION O/C'S
 B   BREVOXYL                               TOPICAL - ACNE PREPARATIONS               N      PA Required
 B   BREVOXYL CLEANSING                     TOPICAL - ACNE PREPARATIONS               N      PA Required
 B   BREVOXYL-4 CREAMY WASH                 TOPICAL - ACNE PREPARATIONS               N      PA Required
 B   BREVOXYL-8 CLEANSING                   TOPICAL - ACNE PREPARATIONS               N      PA Required
 B   BREVOXYL-8 CREAMY WASH                 TOPICAL - ACNE PREPARATIONS               N      PA Required
 G   brimonidine tartrate ophth soln 0.2%   OP. SELECTIVE ALPHA ADRENERGIC            N
                                            AGONISTS
 G   bromaxefed rf                          COUGH/COLD - DECONGESTANT &               P
                                            ANTIHISTAMINE
 B   BROMFED                                COUGH/COLD - DECONGESTANT &               N
                                            ANTIHISTAMINE
 B   BROMFED-PD                             COUGH/COLD - DECONGESTANT &               N
                                            ANTIHISTAMINE
 G   bromfenex                              COUGH/COLD - DECONGESTANT &               N
                                            ANTIHISTAMINE
 G   bromfenex pd                           COUGH/COLD - DECONGESTANT &               N
                                            ANTIHISTAMINE
 G   bromocriptine mesylate                 ANTI-PARKINSONIAN DRUGS                   N
 G   brompheniramine & phenyleph            COUGH/COLD - DECONGESTANT &               N
                                            ANTIHISTAMINE
 B   BRONTEX                                COUGH/COLD - ANTITUSSIVE-EXPECTORANT      N
 B   BROVEX                                 ANTIHISTAMINES - OTHER                    N
 B   BROVEX CT                              ANTIHISTAMINES - OTHER                    N
 B   BROVEX HC                              COUGH/COLD - NARCOTIC                     N
                                            ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                            NE
 B   B-TUSS                                 COUGH/COLD - NARCOTIC                     N
                                            ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                            NE
 G   budeprion sr                           ANTIDEPRESSANTS - SELECTED SSRI'S         N
 B   BUDESONIDE                             COMPOUNDING MATERIALS                     N
 G   bumetanide                             DIURETICS                                 P
 B   BUMEX                                  DIURETICS                                 N
 B   BUPHENYL                               UREA CYCLE DISORDER - AGENTS              N
 B   BUPRENEX                               NARCOTICS - SELECTED                      N
 G   bupropion hcl                          ANTIDEPRESSANTS - SELECTED SSRI'S         N
 G   bupropion hcl                          ANTIDEPRESSANTS - SELECTED SSRI'S         R
 G   bupropion hcl er                       ANTIDEPRESSANTS - SELECTED SSRI'S         N
 G   bupropion hcl sr                       ANTIDEPRESSANTS - SELECTED SSRI'S         N
 B   BUSPAR                                 ANXIOLYTICS - MISC.                       N      BUSPIRONE 30mg - Use 2 BUSPIRONE
                                                                                             15mg tablets
 G   buspirone hcl tab 10 mg                ANXIOLYTICS - MISC.                       P
 G   buspirone hcl tab 15 mg                ANXIOLYTICS - MISC.                       P


Report_1010_PDL_A3 rev A                                      12/26/2004                                             Page 8 of 63
B    Drug                                                                                P,                 Comment
or   Name                                          Drug Category                         N,
G                                                                                       R, or
                                                                                        NR
                                                                       B                                  - Alpha Continued -
 G   buspirone hcl tab 30 mg                     ANXIOLYTICS - MISC.                     N      BUSPIRONE 30mg - Use 2 BUSPIRONE
                                                                                                15mg tablets
 G   buspirone hcl tab 5 mg                      ANXIOLYTICS - MISC.                     P
 G   buspirone hcl tab 7.5 mg                    ANXIOLYTICS - MISC.                     P
 G   butalbital-acetaminophen tab 50-325 mg      ANALGESICS - MISC.                      P
 G   butalbital-acetaminophen tab 50-650 mg      ANALGESICS - MISC.                      N
 G   butalbital-acetaminophen-caffeine cap       ANALGESICS - MISC.                      P
     50-325-40 mg
 G   butalbital-acetaminophen-caffeine cap       ANALGESICS - MISC.                      N
     50-500-40 mg
 G   butalbital-acetaminophen-caffeine tab       ANALGESICS - MISC.                      P
     50-325-40 mg
 G   butalbital-acetaminophen-caffeine tab       ANALGESICS - MISC.                      P
     50-500-40 mg
 G   butalbital-acetaminophen-caffeine w/        NARCOTICS - MICS.                       N
     codeine
 G   butalbital-aspirin-caffeine cap 50-325-40   ANALGESICS - MISC.                      N
     mg
 G   butalbital-aspirin-caffeine tab 50-325-40   ANALGESICS - MISC.                      P
     mg
 G   butalbital-aspirin-caffeine w/cod           NARCOTICS - MICS.                       N
 B   BUTISOL SODIUM                              SEDATIVE/HYPNOTICS - BARBITURATE        R
 G   butorphanol tartrate nasal soln 10 mg/ml    NARCOTICS - SELECTED                    P      PA Required for > 4 Bottles/30 Days

                                                                       C
 B   CADUET                                      CCB / LIPID                             P
 B   CAFERGOT       SUP 2/100                    MIGRAINE - MISC.                        P      PA Required: > 18 Units/30Days Supply
 B   CAFERGOT       TAB 1-100MG                  MIGRAINE - MISC.                        N      PA Required from Day 1
 B   CALAN        TAB 120MG                      CALCIUM CHANNEL                         N
                                                 BLOCKERS--VERAPAMILS
 B   CALAN        TAB 40MG                       CALCIUM CHANNEL                         N
                                                 BLOCKERS--VERAPAMILS
 B   CALAN        TAB 80MG                       CALCIUM CHANNEL                         N
                                                 BLOCKERS--VERAPAMILS
 B   CALAN SR                                    CALCIUM CHANNEL                         N
                                                 BLOCKERS--VERAPAMILS
 B   CALCIJEX                                    VITAMINS                                N      RX Only
 G   calcitriol                                  VITAMINS                                N      RX Only
 G   calcium gluconate inj 10%                   MINERALS                                N
 B   CANASA                                      GI - INFLAMMATORY BOWEL AGENTS          P
 B   CANCIDAS                                    ANTIFUNGALS - ASSORTED                  P      PA Required > 90 days
 B   CAPEX                                       TOPICAL - CORTICOSTEROIDS               P
 B   CAPITROL                                    TOPICAL - ANTISEBORRHEICS               P
 B   CAPOTEN                                     ACE INHIBITORS                          N
 G   captopril                                   ACE INHIBITORS                          P
 G   captopril & hydrochlorothiazide             ACE AND THIAZIDE COMBO'S                P
 B   CARAC                                       TOPICAL - ANTINEOPLASTICS               N
 B   CARAFATE       SUS 1GM/10ML                 GI - MISC. ANTI-ULCER                   P
 B   CARAFATE       TAB 1GM                      GI - MISC. ANTI-ULCER                   N
 G   carbamazepine chew tab 100 mg               ANTICONVULSANTS                         N      Grandfather for Seizure Disorder
 G   carbamazepine susp 100 mg/5ml               ANTICONVULSANTS                         N      Grandfather for Seizure Disorder
 G   carbamazepine tab 200 mg                    ANTICONVULSANTS                         P
 B   CARBATROL                                   ANTICONVULSANTS                         P
 G   carbaxefed dm rf                            COUGH/COLD - NON-NARC                   P
                                                 ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                                 NE
 G   carbidopa-levodopa                          ANTI-PARKINSONIAN DRUGS                 P
 G   carbinoxamine & pseudoeph                   COUGH/COLD - DECONGESTANT &             N
                                                 ANTIHISTAMINE
 G   carbinoxamine maleate liquid 4 mg/5ml       ANTIHISTAMINES - OTHER                  N
 G   carbinoxamine maleate tab sr 12hr 8 mg      ANTIHISTAMINES - OTHER                  N

Report_1010_PDL_A3 rev A                                          12/26/2004                                               Page 9 of 63
B    Drug                                                                              P,                   Comment
or   Name                                        Drug Category                         N,
G                                                                                     R, or
                                                                                      NR
                                                                  C                                   - Alpha Continued -
 G   carbinoxamine-pseudoephedrine-methsco     COUGH/COLD -                            N
     polamine                                  DECONGESTANT-ANTIHISTAMINE-ANTICHOLI
                                               NERGIC
 B   CARBOCAINE                                TOPICAL - LOCAL ANESTHETICS             N
 G   carbodex dm                               COUGH/COLD - NON-NARC                   P
                                               ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                               NE
 G   car-b-pen ta/chlor-tan                    COUGH/COLD - NON-NARC                   N
                                               ANTITUSSIVE-ANTIHISTAMINE
 G   cardec                                    COUGH/COLD - DECONGESTANT &             P
                                               ANTIHISTAMINE
 G   cardec dm                                 COUGH/COLD - NON-NARC                   P
                                               ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                               NE
 B   CARDENE                                   NICARDIPINES                            N
 B   CARDENE SR                                NICARDIPINES                            N
 B   CARDIZEM                                  CALCIUM CHANNEL BLOCKERS--DILTIAZEMS    N
 B   CARDIZEM CD                               CALCIUM CHANNEL BLOCKERS--DILTIAZEMS    N
 B   CARDIZEM LA                               CALCIUM CHANNEL BLOCKERS--DILTIAZEMS    P
 B   CARDURA                                   BPH                                     N
 G   carisoprodol                              MUSCLE RELAXANTS                        P
 G   carisoprodol w/ asa & codeine tab         MUSCLE RELAXANT -COMBINATIONS           N      PA Required
     200-325-16 mg
 G   carisoprodol w/ asa tab 200-325 mg        MUSCLE RELAXANT -COMBINATIONS           N      PA Required
 B   CARMOL 40                                 TOPICAL - EMOLLIENTS                    N
 B   CARMOL SCALP TREATMENT                    TOPICAL - ANTISEBORRHEICS               N
 B   CARMOL-HC                                 TOPICAL - STEROID COMBINATIONS          N
 G   carteolol hcl ophth soln 1%               OP. BETA - BLOCKERS                     P
 B   CARTROL                                   BETA BLOCKERS - NON SELECTIVE           N
 B   CATAFLAM                                  NSAIDS                                  N      PA Required
 B   CATAPRES                                  ANTIHYPERTENSIVES - CENTRAL             N
 B   CATAPRES-TTS-1                            ANTIHYPERTENSIVES - CENTRAL             P
 B   CATAPRES-TTS-2                            ANTIHYPERTENSIVES - CENTRAL             P
 B   CATAPRES-TTS-3                            ANTIHYPERTENSIVES - CENTRAL             P
 B   CAVERJECT                                 IMPOTENCE AGENTS                        N      PA Required
 B   CAVERJECT IMPULSE                         IMPOTENCE AGENTS                        N      PA Required
 B   CEBO #1 BLUE                              COMPOUNDING MATERIALS                   P
 B   CEBO #2 GREEN                             COMPOUNDING MATERIALS                   P
 B   CEBO #3 ORANGE                            COMPOUNDING MATERIALS                   P
 B   CEDAX                                     CEPHALOSPORINS                          N
 G   cefaclor cap 250 mg                       CEPHALOSPORINS                          P
 G   cefaclor cap 500 mg                       CEPHALOSPORINS                          N
 G   cefaclor for susp 125 mg/5ml              CEPHALOSPORINS                          N
 G   cefaclor for susp 187 mg/5ml              CEPHALOSPORINS                          N
 G   cefaclor for susp 250 mg/5ml              CEPHALOSPORINS                          P
 G   cefaclor for susp 375 mg/5ml              CEPHALOSPORINS                          N
 G   cefaclor monohydrate tab sr 12hr 500 mg   CEPHALOSPORINS                          N
 G   cefadroxil cap 500 mg                     CEPHALOSPORINS                          P
 G   cefadroxil tab 1 gm                       CEPHALOSPORINS                          N
 B   CEFAZOLIN SODIUM                          CEPHALOSPORINS                          P
 G   cefazolin sodium for inj 1 gm             CEPHALOSPORINS                          N
 G   cefazolin sodium for inj 10 gm            CEPHALOSPORINS                          P
 G   cefazolin sodium for inj 20 gm            CEPHALOSPORINS                          P
 G   cefazolin sodium for inj 500 mg           CEPHALOSPORINS                          P
 G   cefazolin sodium for iv soln 1 gm         CEPHALOSPORINS                          P
 B   CEFOL                                     VITAMINS - MISC.                        N
 G   cefpodoxime proxetil tab 100 mg           CEPHALOSPORINS                          N
 G   cefpodoxime proxetil tab 200 mg           CEPHALOSPORINS                          N

Report_1010_PDL_A3 rev A                                      12/26/2004                                              Page 10 of 63
B    Drug                                                                                  P,                   Comment
or   Name                                            Drug Category                         N,
G                                                                                         R, or
                                                                                          NR
                                                                       C                                   - Alpha Continued -
 G   ceftazidime for inj 1 gm                      CEPHALOSPORINS                          N
 G   ceftazidime for inj 2 gm                      CEPHALOSPORINS                          N
 B   CEFTIN                                        CEPHALOSPORINS                          N
 G   cefuroxime axetil tab 250 mg                  CEPHALOSPORINS                          P
 G   cefuroxime axetil tab 500 mg                  CEPHALOSPORINS                          P
 B   CEFZIL                                        CEPHALOSPORINS                          P
 B   CELEBREX                                      COX 2 INHIBITORS - HIGHLY SELECTIVE     P      PA Required
 B   CELESTONE-SOLUSPAN                            GLUCOCORTICOIDS - MINERALOCORTICOIDS    N
 B   CELEXA                                        ANTIDEPRESSANTS - SELECTED SSRI'S       R
 B   CELONTIN                                      ANTICONVULSANTS                         P
 B   CENESTIN                                      ESTROGENS - TABS                        P
 G   cephalexin cap 250 mg                         CEPHALOSPORINS                          P
 G   cephalexin cap 500 mg                         CEPHALOSPORINS                          P
 G   cephalexin for susp 125 mg/5ml                CEPHALOSPORINS                          P
 G   cephalexin for susp 250 mg/5ml                CEPHALOSPORINS                          P
 B   CEPHALEXIN MONOHYDRATE                        CEPHALOSPORINS                          P
 B   CEREBYX                                       ANTICONVULSANTS                         N      Grandfather for Seizure Disorder
 B   CHEMET                                        ANTIDOTES - CHELATING AGENTS            P
 G   cheratussin ac                                COUGH/COLD - ANTITUSSIVE-EXPECTORANT    P
 G   cheratussin dac                               COUGH/COLD -                            P
                                                   ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                                   ANT
 G   chloral hydrate                               SEDATIVE/HYPNOTICS - BARBITURATE        P
 B   CHLORAMPHENICOL                               LINCOSAMIDES / OXAZOLIDINONES /         N
                                                   LEPROSTATICS
 G   chloramphenicol sodium succinate for iv inj   LINCOSAMIDES / OXAZOLIDINONES /         N
     1 gm                                          LEPROSTATICS
 G   chlordiazepoxide hcl                          ANXIOLYTICS - BENZODIAZEPINES           P
 G   chlordiazepoxide-amitriptyline tab 10-25      PSYCHOTHERAPEUTIC COMBINATION           P
     mg
 G   chlordiazepoxide-amitriptyline tab 5-12.5     PSYCHOTHERAPEUTIC COMBINATION           P
     mg
 G   chlorhexidine gluconate soln 0.12%            MOUTH ANTISEPTICS                       P
 G   chloroquine phosphate                         ANTIMALARIAL AGENTS                     P
 G   chlorothiazide                                DIURETICS                               P
 G   chlorphen tan & pseudoeph tan                 COUGH/COLD - DECONGESTANT &             N
                                                   ANTIHISTAMINE
 G   chlorpheniramine maleate cap cr 12 mg         ANTIHISTAMINES - OTHER                  P
 G   chlorpheniramine maleate cap cr 8 mg          ANTIHISTAMINES - OTHER                  P
 O   chlorpheniramine maleate tab 4 mg             ANTIHISTAMINES - OTHER                  P
 G   chlorpheniramine-pe-methscopolamine           COUGH/COLD -                            N
     syrup 2-10-1.25 mg/5ml                        DECONGESTANT-ANTIHISTAMINE-ANTICHOLI
                                                   NERGIC
 G   chlorpheniramine-pseudoephedrine &            COUGH/COLD -                            N
     methscopolamine                               DECONGESTANT-ANTIHISTAMINE-ANTICHOLI
                                                   NERGIC
 G   chlorpheniramine-pyrilamine &                 COUGH/COLD - DECONGESTANT &             P
     phenylephrine                                 ANTIHISTAMINE
 G   chlorphen-pe-methscopolamine syrup            COUGH/COLD -                            P
     2-10-0.625 mg/5ml                             DECONGESTANT-ANTIHISTAMINE-ANTICHOLI
                                                   NERGIC
 G   chlorphen-phenyltolox-pe                      COUGH/COLD - DECONGESTANT &             N
                                                   ANTIHISTAMINE
 G   chlorpropamide                                DIABETIC - ORAL SULFONYLUREAS           P
 G   chlorthalidone                                DIURETICS                               P
 G   chlorzoxazone                                 MUSCLE RELAXANTS                        P
 G   cholestyramine light powder 4 gm/dose         CHOLESTEROL - BILE SEQUESTRANTS         P
 G   cholestyramine light powder packets 4 gm      CHOLESTEROL - BILE SEQUESTRANTS         P
 G   cholestyramine powder 4 gm/dose               CHOLESTEROL - BILE SEQUESTRANTS         P
 G   cholestyramine powder packets 4 gm            CHOLESTEROL - BILE SEQUESTRANTS         P

Report_1010_PDL_A3 rev A                                          12/26/2004                                                Page 11 of 63
B    Drug                                                                          P,                   Comment
or   Name                                         Drug Category                    N,
G                                                                                 R, or
                                                                                  NR
                                                                      C                           - Alpha Continued -
 G   choline & magnesium salicylates liq 500    ANALGESICS - MISC.                 P
     mg/5ml
 G   choline & magnesium salicylates tab 1000   ANALGESICS - MISC.                 P
     mg
 G   choline & magnesium salicylates tab 500    ANALGESICS - MISC.                 P
     mg
 G   choline & magnesium salicylates tab 750    ANALGESICS - MISC.                 P
     mg
 B   CHROMAGEN                                  VITAMINS - MISC.                   N
 B   CHROMAGEN FA                               VITAMINS - MISC.                   N
 B   CHROMAGEN FORTE                            VITAMINS - MISC.                   N
 B   CIALIS                                     IMPOTENCE AGENTS                   N      PA Required
 B   CILOXAN                                    OP. QUINOLONES                     P
 G   cimetidine                                 GI - H2-ANTAGONISTS                P
 G   cimetidine hcl                             GI - H2-ANTAGONISTS                P
 B   CIPRO                                      FLUOROQUINOLONES                   N
 B   CIPRO CYSTITIS                             FLUOROQUINOLONES                   P
 B   CIPRO HC                                   EAR                                P
 B   CIPRO I.V.                                 FLUOROQUINOLONES                   P
 B   CIPRO XR                                   FLUOROQUINOLONES                   N
 B   CIPRODEX                                   EAR                                P
 B   CIPROFLOXACIN                              FLUOROQUINOLONES                   P
 G   ciprofloxacin hcl                          FLUOROQUINOLONES                   P
 G   ciprofloxacin hcl ophth soln 0.3%          OP. QUINOLONES                     P
 B   CITRACAL PRENATAL RX                       VITAMINS - MISC.                   N
 B   CLAFORAN                                   CEPHALOSPORINS                     P
 B   CLARINEX                                   ANTIHISTAMINES - NON-SEDATING      N      PA Required
 B   CLARINEX REDITABS                          ANTIHISTAMINES - NON-SEDATING      N      PA Required
 G   clemastine fumarate syrup 0.67 mg/5ml      ANTIHISTAMINES - OTHER             N
 G   clemastine fumarate tab 2.68 mg            ANTIHISTAMINES - OTHER             N
 B   CLEOCIN          CAP 300MG                 LINCOSAMIDES / OXAZOLIDINONES /    N
                                                LEPROSTATICS
 B   CLEOCIN          INJ 300MG                 LINCOSAMIDES / OXAZOLIDINONES /    P
                                                LEPROSTATICS
 B   CLEOCIN          INJ 600MG                 LINCOSAMIDES / OXAZOLIDINONES /    P
                                                LEPROSTATICS
 B   CLEOCIN          INJ 900MG                 LINCOSAMIDES / OXAZOLIDINONES /    P
                                                LEPROSTATICS
 B   CLEOCIN          INJ 9GM                   LINCOSAMIDES / OXAZOLIDINONES /    P
                                                LEPROSTATICS
 B   CLEOCIN          SUP 100MG                 VAGINAL - ANTIBACTERIALS           P
 B   CLEOCIN PEDIATRIC GRANULE                  LINCOSAMIDES / OXAZOLIDINONES /    P
                                                LEPROSTATICS
 B   CLEOCIN VAG CRE 2%                         VAGINAL - ANTIBACTERIALS           P
 B   CLEOCIN-T                                  TOPICAL - ACNE PREPARATIONS        P      PA Required
 B   CLIMARA                                    ESTROGENS - PATCHES                N
 B   CLINAC BPO                                 TOPICAL - ACNE PREPARATIONS        N      PA Required
 B   CLINDAGEL                                  TOPICAL - ACNE PREPARATIONS        N      PA Required
 G   clindamycin hcl cap 150 mg                 LINCOSAMIDES / OXAZOLIDINONES /    P
                                                LEPROSTATICS
 G   clindamycin hcl cap 300 mg                 LINCOSAMIDES / OXAZOLIDINONES /    N      CLINDAMYCIN HCL 300MG - Use
                                                LEPROSTATICS                              Multiples of CLINDAMYCIN HCL 150mg
 G   clindamycin phosphate gel 1%               TOPICAL - ACNE PREPARATIONS        N      PA Required
 G   clindamycin phosphate inj 150 mg/ml        LINCOSAMIDES / OXAZOLIDINONES /    P
                                                LEPROSTATICS
 G   clindamycin phosphate iv soln 150 mg/ml    LINCOSAMIDES / OXAZOLIDINONES /    P
                                                LEPROSTATICS
 G   clindamycin phosphate lotion 1%            TOPICAL - ACNE PREPARATIONS        N      PA Required
 G   clindamycin phosphate soln 1%              TOPICAL - ACNE PREPARATIONS        P      PA Required
 G   clindamycin phosphate swab 1%              TOPICAL - ACNE PREPARATIONS        N      PA Required


Report_1010_PDL_A3 rev A                                       12/26/2004                                         Page 12 of 63
B    Drug                                                                           P,                   Comment
or   Name                                     Drug Category                         N,
G                                                                                  R, or
                                                                                   NR
                                                                  C                                - Alpha Continued -
 B   CLINORIL                               NSAIDS                                  N      PA Required
 B   CLIOQUINOL                             TOPICAL - ANTIFUNGALS                   N
 B   CLOBETASOL 17 PROPIONATE               TOPICAL - CORTICOSTEROIDS               N
 G   clobetasol propionate cream 0.05%      TOPICAL - CORTICOSTEROIDS               P
 G   clobetasol propionate emollient base   TOPICAL - CORTICOSTEROIDS               P
     cream 0.05%
 G   clobetasol propionate gel 0.05%        TOPICAL - CORTICOSTEROIDS               P
 G   clobetasol propionate oint 0.05%       TOPICAL - CORTICOSTEROIDS               P
 G   clobetasol propionate soln 0.05%       TOPICAL - CORTICOSTEROIDS               P
 B   CLOBEX                                 TOPICAL - CORTICOSTEROIDS               N
 B   CLODERM                                TOPICAL - CORTICOSTEROIDS               N
 G   clomipramine hcl                       ANTIDEPRESSANTS - TRI-CYCLICS           P
 G   clonazepam                             ANTICONVULSANTS                         P
 G   clonidine hcl                          ANTIHYPERTENSIVES - CENTRAL             P
 G   clorazepate dipotassium tab 15 mg      ANXIOLYTICS - BENZODIAZEPINES           P
 G   clorazepate dipotassium tab 3.75 mg    ANXIOLYTICS - BENZODIAZEPINES           R
 G   clorazepate dipotassium tab 7.5 mg     ANXIOLYTICS - BENZODIAZEPINES           P
 B   CLORPRES                               ANTIHYPERTENSIVE COMBOS                 N
 G   clotrimazole                           ANTIFUNGALS - ASSORTED                  N
 G   clotrimazole cream 1%                  TOPICAL - ANTIFUNGALS                   P
 G   clotrimazole soln 1%                   TOPICAL - ANTIFUNGALS                   P
 G   clotrimazole w/ betamethasone cream    TOPICAL - ANTIFUNGALS                   P
     1-0.05%
 G   clotrimazole w/ betamethasone lotion   TOPICAL - ANTIFUNGALS                   N
     1-0.05%
 B   COCAINE HCL                            TOPICAL - LOCAL ANESTHETICS             N
 G   codafed expectorant                    COUGH/COLD -                            N
                                            ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                            ANT
 G   codafed pediatric expecto              COUGH/COLD -                            P
                                            ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                            ANT
 B   CODEINE PHOSPHATE                      NARCOTICS - MICS.                       P
 B   CODEINE SULFATE                        NARCOTICS - MICS.                       P
 G   codeine/guaifenesin                    COUGH/COLD - ANTITUSSIVE-EXPECTORANT    N
 B   CODIMAL DH                             COUGH/COLD - NARCOTIC                   N
                                            ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                            NE
 B   CODIMAL PH                             COUGH/COLD - NARCOTIC                   N
                                            ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                            NE
 B   COENZYME Q10                           COMPOUNDING MATERIALS                   N
 B   COGENTIN                               PARKINSONS - ANTICHOLINERGICS           P
 B   COLAZAL                                GI - INFLAMMATORY BOWEL AGENTS          P
 G   colchicine                             GOUT                                    P
 G   colchicine w/ probenecid               GOUT                                    P
 B   COLDEC D                               COUGH/COLD - DECONGESTANT &             N
                                            ANTIHISTAMINE
 G   coldmist dm syp 40-15-10               COUGH/COLD -                            P
                                            ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                            ANT
 G   coldmist dm tab 12hr                   COUGH/COLD -                            N
                                            ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                            ANT
 G   coldmist s                             COUGH/COLD - DECONGESTANT W/            P
                                            EXPECTORANT
 B   COLESTID                               CHOLESTEROL - BILE SEQUESTRANTS         P
 G   colfed-a                               COUGH/COLD - DECONGESTANT &             P
                                            ANTIHISTAMINE
 G   colistimethate sodium for inj 150 mg   ANTIBIOTICS - MISC.                     P
 B   COLY-MYCIN-M                           ANTIBIOTICS - MISC.                     N

Report_1010_PDL_A3 rev A                                   12/26/2004                                              Page 13 of 63
B    Drug                                                                      P,                   Comment
or   Name                              Drug Category                           N,
G                                                                             R, or
                                                                              NR
                                                            C                                 - Alpha Continued -
 B   COLY-MYCIN-S                    EAR                                       N
 B   COLYTE        SOL               GI - ANTI - FLATULENTS / GI STIMULANTS    P
 B   COLYTE/FLAVR SOL PACKS          GI - ANTI - FLATULENTS / GI STIMULANTS    P
 B   COLYTE-FLAV SOL                 GI - ANTI - FLATULENTS / GI STIMULANTS    P
 B   COMBIPATCH                      ESTROGEN COMBO'S                          N
 B   COMBIVENT                       ANTIASTHMATIC - ADRENERGIC COMBOS         P
 B   COMTAN                          PARKINSONS - COMT INHIBITORS              P
 B   CONCERTA                        STIMULANTS - METHYLPHENIDATE - LONG       R
                                     ACTING
 B   CONDYLOX                        TOPICAL - GENITAL WARTS                   N
 B   COPAXONE                        MULTIPLE SCLEROSIS AGENTS                 N      Grandfather
 B   COPEGUS                         HEPATITIS C AGENTS                        N
 B   CORDARONE                       ANTIARRHYTHMICS                           N
 B   CORDRAN                         TOPICAL - CORTICOSTEROIDS                 N
 B   CORDRAN SP                      TOPICAL - CORTICOSTEROIDS                 N
 B   CORDRAN TAPE                    TOPICAL - CORTICOSTEROIDS                 N
 B   COREG                           BETA BLOCKERS - NON SELECTIVE             P
 B   CORGARD                         BETA BLOCKERS - NON SELECTIVE             N
 B   CORTANE-B                       EAR                                       N
 B   CORTANE-B AQUEOUS               EAR                                       N
 B   CORTANE-B-OTIC                  EAR                                       N
 B   CORTEF                          GLUCOCORTICOIDS - MINERALOCORTICOIDS      P
 B   CORTIFOAM                       ANORECTAL - MISC.                         N
 G   cortisone acetate               GLUCOCORTICOIDS - MINERALOCORTICOIDS      P
 B   CORTISPORIN CRE 0.5%            TOPICAL - ANTIBIOTIC                      N
 B   CORTISPORIN OIN 1%              TOPICAL - ANTIBIOTIC                      N
 B   CORTISPORIN OIN OP 1%           OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    P
 B   CORTISPORIN SUS OP 1%           OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    P
 B   CORTISPORIN-TC                  EAR                                       N
 G   cortomycin sol 1% otic          EAR                                       P
 G   cortomycin sus 1% otic          EAR                                       N
 B   CORZIDE                         BETA BLOCKERS AND DIURETIC COMBO'S        N
 B   COSOPT                          OP. CARBONIC ANHYDRASE                    P
                                     INHIBITORS/COMBO
 G   coughtuss                       COUGH/COLD - NARCOTIC                     N
                                     ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                     NE
 B   COUMADIN                        ANTICOAGULANTS                            P
 B   COVERA-HS                       CALCIUM CHANNEL                           N
                                     BLOCKERS--VERAPAMILS
 B   COZAAR                          ANGIOTENSIN RECEPTOR BLOCKER              P
 G   cpm/pse      cap 8-120 cr       COUGH/COLD - DECONGESTANT &               P
                                     ANTIHISTAMINE
 G   cpm/pse      cap 8-120 sr       COUGH/COLD - DECONGESTANT &               P
                                     ANTIHISTAMINE
 G   cpm/pse      syp                COUGH/COLD - DECONGESTANT &               N
                                     ANTIHISTAMINE
 G   crantex                         COUGH/COLD - DECONGESTANT W/              P
                                     EXPECTORANT
 G   crantex er                      COUGH/COLD - DECONGESTANT W/              N
                                     EXPECTORANT
 B   CREON 5                         GI - DIGESTIVE ENZYMES                    N      PA Required
 B   CREON 10                        GI - DIGESTIVE ENZYMES                    N      PA Required
 B   CREON 20                        GI - DIGESTIVE ENZYMES                    N      PA Required
 B   CRESTOR                         CHOLESTEROL - HMG COA + ABSORB            P
                                     INHIBITORS
 B   CROLOM                          OP. ANTIALLERGICS                         N
 G   cromolyn sodium ophth soln 4%   OP. ANTIALLERGICS                         P



Report_1010_PDL_A3 rev A                            12/26/2004                                                Page 14 of 63
B    Drug                                                                          P,                   Comment
or   Name                                    Drug Category                         N,
G                                                                                 R, or
                                                                                  NR
                                                                C                                   - Alpha Continued -
 G   cromolyn sodium soln nebu 20 mg/2ml   ANTIASTHMATIC - ANTIINFLAMMATORY        P
                                           AGENTS
 G   c-tanna 12                            COUGH/COLD - NON-NARC                   P
                                           ANTITUSSIVE-ANTIHISTAMINE
 B   CUBICIN                               LINCOSAMIDES / OXAZOLIDINONES /         N
                                           LEPROSTATICS
 B   CUPRIMINE                             CHELATING AGENTS                        N
 B   CUTIVATE                              TOPICAL - CORTICOSTEROIDS               P
 G   cyanocobalamin                        VITAMINS                                P      RX Only
 B   CYCLESSA                              CONTRACEPTIVES - TRI-PHASIC             P
                                           COMBINATIONS
 B   CYCLOBENZAPR POW                      MUSCLE RELAXANTS                        N      PA Required
 B   CYCLOBENZAPR POW USP                  MUSCLE RELAXANTS                        N      PA Required
 G   cyclobenzapr tab 10mg                 MUSCLE RELAXANTS                        P
 B   CYCLOCORT          CRE 0.1%           TOPICAL - CORTICOSTEROIDS               N
 B   CYCLOCORT          LOT 0.1%           TOPICAL - CORTICOSTEROIDS               P
 B   CYCLOCORT          OIN 0.1%           TOPICAL - CORTICOSTEROIDS               P
 B   CYCLOGYL                              OP. CYCLOPLEGICS                        N
 B   CYCLOMYDRIL                           OP. CYCLOPLEGICS                        N
 G   cyclopentolate hcl                    OP. CYCLOPLEGICS                        P
 B   CYLERT                                STIMULANTS - OTHER STIMULANTS / LIKE    P
                                           STIMULANTS
 B   CYMBALTA                              ANTIDEPRESSANTS - SELECTED SSRI'S       NR
 B   CYPROHEPTAD SYP 2MG/5ML               ANTIHISTAMINES - OTHER                  P
 G   cyproheptad tab 4mg                   ANTIHISTAMINES - OTHER                  P
 B   CYSTAGON                              UROLOGICAL - MISC.                      N
 B   CYSTOSPAZ                             ANTISPASMODICS                          P
 B   CYTOGAM                               IMMUNE SERUMS                           N
 B   CYTOMEL                               THYROID HORMONES                        P
 B   CYTOTEC                               GI - PROSTAGLANDINS                     P
 B   CYTOVENE           CAP 250MG          CYTO-MEGALOVIRUS AGENTS                 P
 B   CYTOVENE           CAP 500MG          CYTO-MEGALOVIRUS AGENTS                 P
 B   CYTOVENE           INJ 500MG          CYTO-MEGALOVIRUS AGENTS                 N
 G   cytra k crystals                      UROLOGICAL - MISC.                      N
 G   cytra-k                               UROLOGICAL - MISC.                      P
 G   cytuss hc                             COUGH/COLD - NARCOTIC                   P
                                           ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                           NE

                                                                D
 B   D.H.E. 45                             MIGRAINE - ERGOTAMINE DERIVATIVES       N      PA Required from Day 1
 B   DALLERGY                              COUGH/COLD -                            N
                                           DECONGESTANT-ANTIHISTAMINE-ANTICHOLI
                                           NERGIC
 B   DALLERGY JR                           COUGH/COLD - DECONGESTANT &             N
                                           ANTIHISTAMINE
 B   DALMANE                               SEDATIVE/HYPNOTICS - BENZODIAZEPINES    N
 G   d-amine-sr                            COUGH/COLD - DECONGESTANT &             P
                                           ANTIHISTAMINE
 G   danazol cap 100 mg                    ANDROGENS / ANABOLICS                   P
 G   danazol cap 200 mg                    ANDROGENS / ANABOLICS                   N
 G   danazol cap 50 mg                     ANDROGENS / ANABOLICS                   P
 B   DANOCRINE          CAP 200MG          ANDROGENS / ANABOLICS                   P
 B   DANTRIUM                              MUSCLE RELAXANTS                        N      PA Required
 B   DAPSONE                               LINCOSAMIDES / OXAZOLIDINONES /         P
                                           LEPROSTATICS
 B   DARAPRIM                              ANTIMALARIAL AGENTS                     P
 B   DARVOCET A500                         NARCOTICS - MICS.                       N
 B   DARVOCET-N 100                        NARCOTICS - MICS.                       N


Report_1010_PDL_A3 rev A                                 12/26/2004                                                Page 15 of 63
B    Drug                                                                              P,                   Comment
or   Name                                      Drug Category                           N,
G                                                                                     R, or
                                                                                      NR
                                                                 D                                     - Alpha Continued -
 B   DARVOCET-N 50                           NARCOTICS - MICS.                         N
 B   DARVON                                  NARCOTICS - MICS.                         N
 B   DARVON COMPOUND-65                      NARCOTICS - MICS.                         N
 B   DARVON-N                                NARCOTICS - MICS.                         N
 B   DAYPRO                                  NSAIDS                                    N      PA Required
 B   DDAVP       INJ 4MCG/ML                 VASOPRESSINS                              N      PA Required
 B   DDAVP       SOL 0.01%                   VASOPRESSINS                              P      PA Required
 B   DDAVP       SPR 0.01%                   VASOPRESSINS                              P      PA Required
 B   DDAVP       TAB 0.1MG                   VASOPRESSINS                              P      PA Required
 B   DDAVP       TAB 0.2MG                   VASOPRESSINS                              P      PA Required
 B   DECADRON                                GLUCOCORTICOIDS - MINERALOCORTICOIDS      N
 B   DECLOMYCIN                              TETRACYCLINES                             N
 B   DECONAMINE                              COUGH/COLD - DECONGESTANT &               N
                                             ANTIHISTAMINE
 B   DECONAMINE SR                           COUGH/COLD - DECONGESTANT &               N
                                             ANTIHISTAMINE
 G   decongestine tr                         COUGH/COLD - DECONGESTANT &               P
                                             ANTIHISTAMINE
 B   DECONSAL II                             COUGH/COLD - DECONGESTANT W/              N
                                             EXPECTORANT
 B   DELATESTRYL                             ANDROGENS / ANABOLICS                     N
 B   DELESTROGEN                             ESTROGENS - TABS                          N
 B   DEMADEX                                 DIURETICS                                 N
 G   demeclocycline hcl                      TETRACYCLINES                             N
 B   DEMEROL       INJ 100/2ML               NARCOTICS - MICS.                         N
 B   DEMEROL       INJ 100MG/ML              NARCOTICS - MICS.                         P
 B   DEMEROL       INJ 25MG/ML               NARCOTICS - MICS.                         N
 B   DEMEROL       INJ 50MG/ML               NARCOTICS - MICS.                         N
 B   DEMEROL       INJ 75MG/1.5              NARCOTICS - MICS.                         N
 B   DEMEROL       INJ 75MG/ML               NARCOTICS - MICS.                         P
 B   DEMEROL       SYP 50MG/5ML              NARCOTICS - MICS.                         P
 B   DEMEROL       TAB 100MG                 NARCOTICS - MICS.                         N
 B   DEMEROL       TAB 50MG                  NARCOTICS - MICS.                         N
 B   DEMULEN 1/35-28                         CONTRACEPTIVES - MONOPHASIC               P
                                             COMBINATION O/C'S
 B   DEMULEN 1/50-28                         CONTRACEPTIVES - MONOPHASIC               P
                                             COMBINATION O/C'S
 B   DENAVIR                                 TOPICAL - ANTIVIRALS                      N
 B   DEPAKENE                                ANTICONVULSANTS                           N      Grandfather for Seizure Disorder
 B   DEPAKOTE                                ANTICONVULSANTS                           P
 B   DEPAKOTE ER                             MIGRAINE - CARBOXYLIC ACID DERIVATIVES    P
 B   DEPAKOTE SPRINKLES                      ANTICONVULSANTS                           P
 B   DEPEN TITRATABS                         CHELATING AGENTS                          P
 B   DEPO-ESTRADIOL                          ESTROGENS - TABS                          P
 B   DEPO-MEDROL                             GLUCOCORTICOIDS - MINERALOCORTICOIDS      P
 B   DEPO-PROVERA CONTRACEPTIV               CONTRACEPTIVES - INJECTABLE               P
 B   DEPO-TESTOSTERONE                       ANDROGENS / ANABOLICS                     P
 B   DERMA-SMOOTHE/FS                        TOPICAL - CORTICOSTEROIDS                 P
 B   DERMATOP                                TOPICAL - CORTICOSTEROIDS                 N
 B   DESFERAL                                ANTIDOTES                                 P
 G   desipramine hcl                         ANTIDEPRESSANTS - TRI-CYCLICS             P
 G   desmopressin acetate inj 4 mcg/ml       VASOPRESSINS                              N      PA Required
 G   desmopressin acetate nasal soln 0.01%   VASOPRESSINS                              N      PA Required
     (refrigerated)
 G   desmopressin acetate nasal spray soln   VASOPRESSINS                              N      PA Required
     0.01% (refrigerated)
 B   DESOGEN                                 CONTRACEPTIVES - MONOPHASIC               N
                                             COMBINATION O/C'S


Report_1010_PDL_A3 rev A                                     12/26/2004                                                 Page 16 of 63
B    Drug                                                                                 P,                 Comment
or   Name                                         Drug Category                           N,
G                                                                                        R, or
                                                                                         NR
                                                                  D                                        - Alpha Continued -
 G   desogest-eth estrad & eth estrad tab       CONTRACEPTIVES - MONOPHASIC               N
     0.15-0.02/0.01 mg(21/5)                    COMBINATION O/C'S
 G   desogest-ethin est tab                     CONTRACEPTIVES - TRI-PHASIC               N
     0.1-0.025/0.125-0.025/0.15-0.025mg-mg      COMBINATIONS
 G   desogestrel & ethinyl estradiol tab 0.15   CONTRACEPTIVES - MONOPHASIC               N
     mg-30 mcg                                  COMBINATION O/C'S
 G   desonide cream 0.05%                       TOPICAL - CORTICOSTEROIDS                 P
 G   desonide lotion 0.05%                      TOPICAL - CORTICOSTEROIDS                 P
 G   desonide oint 0.05%                        TOPICAL - CORTICOSTEROIDS                 P
 B   DESOWEN        CRE 0.05%                   TOPICAL - CORTICOSTEROIDS                 P
 B   DESOWEN        LOT 0.05%                   TOPICAL - CORTICOSTEROIDS                 N
 B   DESOWEN        OIN 0.05%                   TOPICAL - CORTICOSTEROIDS                 P
 B   DESOXIMETASONE                             TOPICAL - CORTICOSTEROIDS                 P
 G   desoximetasone cream 0.25%                 TOPICAL - CORTICOSTEROIDS                 P
 G   desoximetasone gel 0.05%                   TOPICAL - CORTICOSTEROIDS                 P
 G   desoximetasone oint 0.25%                  TOPICAL - CORTICOSTEROIDS                 P
 B   DESYREL                                    ANTIDEPRESSANTS - SELECTED SSRI'S         N
 B   DETROL                                     ANTISPASMODICS                            N
 B   DETROL LA                                  ANTISPASMODICS - LONG ACTING              P
 G   dexamethasone                              GLUCOCORTICOIDS - MINERALOCORTICOIDS      P
 B   DEXAMETHASONE INTENSOL                     GLUCOCORTICOIDS - MINERALOCORTICOIDS      P
 B   DEXAMETHASONE SODIUM PHOS                  GLUCOCORTICOIDS - MINERALOCORTICOIDS      N
 G   dexamethasone sodium phosphate             GLUCOCORTICOIDS - MINERALOCORTICOIDS      P
 G   dexamethasone sodium phosphate ophth       OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    N
     soln 0.1%
 G   dexbrompheniramine & pseudoephedrine       COUGH/COLD - DECONGESTANT &               N
                                                ANTIHISTAMINE
 G   dexchlorpheniramine maleate tab cr 4 mg    ANTIHISTAMINES - OTHER                    N
 G   dexchlorpheniramine maleate tab cr 6 mg    ANTIHISTAMINES - OTHER                    N
 B   DEXEDRINE                                  STIMULANTS - AMPHETAMINES - LONG          P
                                                ACTING
 B   DEXEDRINE                                  STIMULANTS - AMPHETAMINES - SHORT         P
                                                ACTING
 G   dextroamphetamine sulfate                  STIMULANTS - AMPHETAMINES - LONG          N
                                                ACTING
 G   dextroamphetamine sulfate tab 10 mg        STIMULANTS - AMPHETAMINES - SHORT         R
                                                ACTING
 G   dextroamphetamine sulfate tab 5 mg         STIMULANTS - AMPHETAMINES - SHORT         N
                                                ACTING
 B   DEXTROMETHORPHAN HBR MONO                  COUGH/COLD - ANTITUSSIVE -                N
                                                NONNARCOTIC
 G   dextromethorphan/guaifene                  COUGH/COLD - ANTITUSSIVE-EXPECTORANT      N
 G   dextromethorphan/pseudoep                  COUGH/COLD -                              N
                                                ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                                ANT
 O   dextromethorphan-guaifenesin liquid        COUGH/COLD - ANTITUSSIVE-EXPECTORANT      P
     10-100 mg/5ml
 G   dextromethorphan-potassium                 COUGH/COLD - ANTITUSSIVE-EXPECTORANT      N
     guaiacolsulfonate
 G   dextrose 5% in lactated ringers            ELECTROLYTES/ NUTRITIONALS                P
 G   dextrose 5% w/ kcl 0.15%                   ELECTROLYTES/ NUTRITIONALS                P
 G   dextrose 5% w/ sodium chloride 0.2%        ELECTROLYTES/ NUTRITIONALS                P
 G   dextrose 5% w/ sodium chloride 0.45%       ELECTROLYTES/ NUTRITIONALS                P
 G   dextrose 5% w/ sodium chloride 0.9%        ELECTROLYTES/ NUTRITIONALS                P
 G   dextrose inj 10%                           ELECTROLYTES/ NUTRITIONALS                P
 G   dextrose inj 5%                            ELECTROLYTES/ NUTRITIONALS                P
 G   dextrose inj 50%                           ELECTROLYTES/ NUTRITIONALS                P
 G   dextrose inj 70%                           ELECTROLYTES/ NUTRITIONALS                P
 B   DEXTROSTAT                                 STIMULANTS - AMPHETAMINES - SHORT         R
                                                ACTING
 B   DHT                                        VITAMINS                                  N      RX Only

Report_1010_PDL_A3 rev A                                      12/26/2004                                                Page 17 of 63
B    Drug                                                                                 P,                   Comment
or   Name                                           Drug Category                         N,
G                                                                                        R, or
                                                                                         NR
                                                                       D                                   - Alpha Continued -
 B   DHT INTENSOL                                 VITAMINS                                N      RX Only
 B   DIABETA                                      DIABETIC - ORAL SULFONYLUREAS           N
 B   DIABETIC TUSSIN C                            COUGH/COLD - ANTITUSSIVE-EXPECTORANT    P
 B   DIAMOX                                       DIURETICS                               N
 B   DIASTAT                                      ANTICONVULSANTS                         P
 B   DIASTAT ADULT                                ANTICONVULSANTS                         P
 B   DIASTAT PEDIATRIC                            ANTICONVULSANTS                         P
 B   DIASTAT UNIVERSAL                            ANTICONVULSANTS                         P
 B   DIATX                                        VITAMINS - MISC.                        N
 G   diazepam        inj 5mg/ml                   ANXIOLYTICS - BENZODIAZEPINES           P
 B   DIAZEPAM         SOL 1MG/ML                  ANXIOLYTICS - BENZODIAZEPINES           R
 G   diazepam        tab 10mg                     ANXIOLYTICS - BENZODIAZEPINES           P
 G   diazepam        tab 2mg                      ANXIOLYTICS - BENZODIAZEPINES           P
 G   diazepam        tab 5mg                      ANXIOLYTICS - BENZODIAZEPINES           P
 B   DIAZEPAM INTENSOL                            ANXIOLYTICS - BENZODIAZEPINES           R
 G   diclofenac potassium                         NSAIDS                                  N      PA Required
 G   diclofenac sodium                            NSAIDS                                  P
 G   diclofenac sodium dr                         NSAIDS                                  P
 G   diclofenac sodium ec                         NSAIDS                                  P
 G   diclofenac sodium er                         NSAIDS                                  N      PA Required
 G   diclofenac sodium xr                         NSAIDS                                  N      PA Required
 G   dicloxacillin sodium cap 250 mg              BETA-LACTAMS / CLAVULANATE COMBO'S      P
 G   dicloxacillin sodium cap 500 mg              BETA-LACTAMS / CLAVULANATE COMBO'S      P
 G   dicyclomine hcl                              GI - ANTIDIARRHEAL / ANTACID - MISC.    P
 B   DIDRONEL                                     OSTEOPOROSIS                            N      Grandfather
 B   DIFFERIN                                     TOPICAL - ACNE PREPARATIONS             P      PA Required
 G   diflorasone diacetate cream 0.05%            TOPICAL - CORTICOSTEROIDS               N
 G   diflorasone diacetate emollient base cream   TOPICAL - CORTICOSTEROIDS               N
     0.05%
 G   diflorasone diacetate oint 0.05%             TOPICAL - CORTICOSTEROIDS               N
 B   DIFLUCAN                                     ANTIFUNGALS - ASSORTED                  P      PA Required > 90 days
 B   DIFLUCAN IN ISO-OSMOTIC D                    ANTIFUNGALS - ASSORTED                  P      PA Required > 90 days
 B   DIFLUCAN IN NACL                             ANTIFUNGALS - ASSORTED                  P      PA Required > 90 days
 G   diflunisal tab 500 mg                        ANALGESICS - MISC.                      P
 G   digoxin                                      CARDIAC GLYCOSIDES                      P
 G   dihydroergotamine mesylate inj 1 mg/ml       MIGRAINE - ERGOTAMINE DERIVATIVES       P      PA Required: > 18 Units/30Days Supply
 B   DILACOR XR                                   CALCIUM CHANNEL BLOCKERS--DILTIAZEMS    N
 B   DILANTIN                                     ANTICONVULSANTS                         P
 B   DILANTIN INFATABS                            ANTICONVULSANTS                         P
 B   DILATRATE SR                                 ANTIANGINALS--ISOSORBIDE NITRATE        N
 B   DILAUDID                                     NARCOTICS - MICS.                       N
 B   DILAUDID-5                                   NARCOTICS - MICS.                       N
 B   DILAUDID-HP                                  NARCOTICS - MICS.                       N
 G   diltia xt                                    CALCIUM CHANNEL BLOCKERS--DILTIAZEMS    P
 G   diltiazem hcl                                CALCIUM CHANNEL BLOCKERS--DILTIAZEMS    P
 G   diltiazem hcl coated beads                   CALCIUM CHANNEL BLOCKERS--DILTIAZEMS    N
 G   diltiazem hcl er                             CALCIUM CHANNEL BLOCKERS--DILTIAZEMS    P
 G   diltiazem hcl extended release beads         CALCIUM CHANNEL BLOCKERS--DILTIAZEMS    N
 G   diltiazem xr                                 CALCIUM CHANNEL BLOCKERS--DILTIAZEMS    P
 B   DIOVAN                                       ANGIOTENSIN RECEPTOR BLOCKER            P
 B   DIOVAN HCT                                   ARB'S AND DIURETICS                     P
 B   DIPENTUM                                     GI - INFLAMMATORY BOWEL AGENTS          P
 O   diphenhydramine hcl cap 25 mg                ANTIHISTAMINES - OTHER                  P
 G   diphenhydramine hcl cap 50 mg                ANTIHISTAMINES - OTHER                  P
 O   diphenhydramine hcl elixir 12.5 mg/5ml       ANTIHISTAMINES - OTHER                  P


Report_1010_PDL_A3 rev A                                         12/26/2004                                              Page 18 of 63
B    Drug                                                                             P,                   Comment
or   Name                                       Drug Category                         N,
G                                                                                    R, or
                                                                                     NR
                                                                   D                                   - Alpha Continued -
 G   diphenhydramine hcl inj 50 mg/ml         ANTIHISTAMINES - OTHER                  P
 O   diphenhydramine hcl liquid 12.5 mg/5ml   ANTIHISTAMINES - OTHER                  P
 O   diphenhydramine hcl syrup 12.5 mg/5ml    ANTIHISTAMINES - OTHER                  P
 G   diphenoxylate w/ atropine                GI - ANTIPERISTALTIC AGENTS             P
 G   dipivefrin hcl ophth soln 0.1%           OP. ADRENERGIC AGENTS                   P
 B   DIPROLENE                                TOPICAL - CORTICOSTEROIDS               P
 B   DIPROLENE AF                             TOPICAL - CORTICOSTEROIDS               N
 G   dipyridamole                             PLATELET AGGREGATION INHIBITORS         P
 G   disopyramide phosphate                   ANTIARRHYTHMICS                         N
 B   DISPERMOX                                BETA-LACTAMS / CLAVULANATE COMBO'S      N
 B   DITROPAN                                 ANTISPASMODICS                          N
 B   DITROPAN XL                              ANTISPASMODICS - LONG ACTING            P
 B   DIURIL                                   DIURETICS                               N
 B   DIURIL IV                                DIURETICS                               N
 B   DOLOBID                                  ANALGESICS - MISC.                      N
 B   DOMEBORO                                 EAR                                     N
 B   DORAL                                    SEDATIVE/HYPNOTICS - BENZODIAZEPINES    R
 B   DORYX                                    TETRACYCLINES                           N
 B   DOVONEX                                  ANTI-PSORIATICS                         P
 G   doxazosin mesylate                       BPH                                     P
 G   doxepin hcl                              ANTIDEPRESSANTS - TRI-CYCLICS           P
 G   doxepin hcl cream 5%                     TOPICAL - ANTIPRURITICS                 N
 G   doxycycline (monohydrate)                TETRACYCLINES                           N
 G   doxycycline hyclate                      TETRACYCLINES                           P
 G   drihist sr                               COUGH/COLD -                            N
                                              DECONGESTANT-ANTIHISTAMINE-ANTICHOLI
                                              NERGIC
 B   DRISDOL                                  VITAMINS                                N      RX Only
 G   drituss dm                               COUGH/COLD - ANTITUSSIVE-EXPECTORANT    N
 G   drituss hd                               COUGH/COLD -                            P
                                              ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                              ANT
 G   droperidol inj 2.5 mg/ml                 ANXIOLYTICS - MISC.                     P
 B   DRYSOL                                   TOPICAL - ASTRINGENTS / PROTECTANTS     N
 B   DUAC                                     TOPICAL - ACNE PREPARATIONS             P      PA Required
 B   DUET          CHW                        VITAMINS - MISC.                        N
 B   DUET          TAB                        VITAMINS - MISC.                        P
 B   DUONEB                                   ANTIASTHMATIC - ADRENERGIC COMBOS       P
 B   DURAGESIC                                NARCOTICS-LONG ACTING                   N      Grandfather
 B   DURICEF                                  CEPHALOSPORINS                          P
 B   DYAZIDE                                  DIURETICS                               N
 B   DYNABAC D5-PAK                           MACROLIDES / ERYTHROMYCIN'S /           N
                                              KETOLIDES
 B   DYNACIN                                  TETRACYCLINES                           N
 B   DYNACIRC                                 CALCIUM CHANNEL                         P
                                              BLOCKERS--ISRADIPINES
 B   DYNACIRC CR                              CALCIUM CHANNEL                         P
                                              BLOCKERS--ISRADIPINES
 G   dynahist er                              COUGH/COLD - DECONGESTANT &             N
                                              ANTIHISTAMINE
 G   dynatuss                                 COUGH/COLD - NON-NARC                   N
                                              ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                              NE
 B   DYNEX                                    COUGH/COLD - DECONGESTANT W/            N
                                              EXPECTORANT
 G   dyphylline                               ANTIASTHMATIC - XANTHINES               N

                                                                   E


Report_1010_PDL_A3 rev A                                      12/26/2004                                             Page 19 of 63
B    Drug                                                                                P,                   Comment
or   Name                                        Drug Category                           N,
G                                                                                       R, or
                                                                                        NR
                                                                    E                                     - Alpha Continued -
 B   E.E.S. GRANULES                           MACROLIDES / ERYTHROMYCIN'S /             P
                                               KETOLIDES
 B   EC-NAPROSYN                               NSAIDS                                    N      PA Required
 G   econazole nitrate cream 1%                TOPICAL - ANTIFUNGALS                     N
 B   ECONOPRED PLUS                            OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    N
 B   EDECRIN                                   DIURETICS                                 P
 B   EFFEXOR                                   ANTIDEPRESSANTS - SELECTED SSRI'S         NR
 B   EFFEXOR XR                                ANTIDEPRESSANTS - SELECTED SSRI'S         NR
 B   EFUDEX                                    TOPICAL - ANTINEOPLASTICS                 P
 B   ELAVIL                                    ANTIDEPRESSANTS - TRI-CYCLICS             N
 B   ELDEPRYL                                  ANTI-PARKINSONIAN DRUGS                   N
 B   ELESTAT                                   OP. ANTIALLERGICS                         P
 B   ELIDEL                                    TOPICAL - IMMUNOMODULATORS                P
 B   ELIMITE                                   TOPICAL - SCABICIDES AND PEDICULICIDES    P
 B   ELIXOPHYLLIN                              ANTIASTHMATIC - XANTHINES                 P
 B   ELMIRON                                   UROLOGICAL - MISC.                        N
 B   ELOCON                                    TOPICAL - CORTICOSTEROIDS                 P
 B   EMADINE                                   OP. ANTIALLERGICS                         P
 B   EMBREX 600                                VITAMINS - MISC.                          N
 B   EMEND                                     ANTIEMETIC - 5-HT3 RECEPTOR               N
                                               ANTAGONISTS/ SUBSTANCE P NEUROKININ
 B   EMLA                                      TOPICAL - LOCAL ANESTHETICS               P
 B   EMLA/TEGADERM                             TOPICAL - LOCAL ANESTHETICS               P
 G   enalapril maleate                         ACE INHIBITORS                            P
 G   enalapril maleate & hydrochlorothiazide   ACE AND THIAZIDE COMBO'S                  P
 B   ENBREL                                    RHEUMATOID ARTHRITIS - BIOLOGICALS        P
 B   ENDURONYL FORTE                           ANTIHYPERTENSIVE COMBOS                   N
 G   enplus-hd                                 COUGH/COLD - NARCOTIC                     P
                                               ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                               NE
 G   entab-dm                                  COUGH/COLD - ANTITUSSIVE-EXPECTORANT      N
 B   ENTEX                                     COUGH/COLD - DECONGESTANT W/              N
                                               EXPECTORANT
 B   ENTEX ER                                  COUGH/COLD - DECONGESTANT W/              N
                                               EXPECTORANT
 B   ENTEX HC                                  COUGH/COLD -                              N
                                               ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                               ANT
 B   ENTEX LA                                  COUGH/COLD - DECONGESTANT W/              N
                                               EXPECTORANT
 B   ENTEX PSE                                 COUGH/COLD - DECONGESTANT W/              N
                                               EXPECTORANT
 B   ENTOCORT EC                               GLUCOCORTICOIDS - MINERALOCORTICOIDS      P
 G   ephedrine sulfate (pressors)              PRESSORS                                  N
 B   EPIFOAM                                   TOPICAL - STEROID LOCAL ANESTHETICS       N
 G   epinephrine hcl inj 0.1 mg/ml             ANTIASTHMATIC - MIXED ADRENERGICSS        P
 G   epinephrine hcl inj 1 mg/ml               ANTIASTHMATIC - MIXED ADRENERGICSS        P
 B   EPOGEN                                    ERYTHROPOEISIS STIMULATING AGENTS         N      PA Required
 B   EQUAGESIC                                 ANALGESICS - MISC.                        N
 G   ergocalciferol                            VITAMINS                                  N      RX Only
 G   ergoloid mesylates tab 1 mg               NEUROLOGICS - MISC.                       P
 B   ERYC                                      MACROLIDES / ERYTHROMYCIN'S /             N
                                               KETOLIDES
 B   ERYPED                                    MACROLIDES / ERYTHROMYCIN'S /             P
                                               KETOLIDES
 B   ERYPED 200                                MACROLIDES / ERYTHROMYCIN'S /             P
                                               KETOLIDES
 B   ERYPED 400                                MACROLIDES / ERYTHROMYCIN'S /             P
                                               KETOLIDES


Report_1010_PDL_A3 rev A                                        12/26/2004                                              Page 20 of 63
B    Drug                                                                                     P,                   Comment
or   Name                                             Drug Category                           N,
G                                                                                            R, or
                                                                                             NR
                                                                          E                                   - Alpha Continued -
 B   ERY-TAB                                        MACROLIDES / ERYTHROMYCIN'S /             P
                                                    KETOLIDES
 B   ERYTHROMYCIN BASE                              MACROLIDES / ERYTHROMYCIN'S /             P
                                                    KETOLIDES
 B   ERYTHROMYCIN ESTOLATE                          MACROLIDES / ERYTHROMYCIN'S /             P
                                                    KETOLIDES
 G   erythromycin ethylsuccinate susp 200           MACROLIDES / ERYTHROMYCIN'S /             P
     mg/5ml                                         KETOLIDES
 G   erythromycin ethylsuccinate susp 400           MACROLIDES / ERYTHROMYCIN'S /             P
     mg/5ml                                         KETOLIDES
 G   erythromycin ethylsuccinate tab 400 mg         MACROLIDES / ERYTHROMYCIN'S /             P
                                                    KETOLIDES
 G   erythromycin gel 2%                            TOPICAL - ACNE PREPARATIONS               P      PA Required
 G   erythromycin ophth oint 5 mg/gm                OP. ANTIBIOTICS                           P
 G   erythromycin pads 2%                           TOPICAL - ACNE PREPARATIONS               P      PA Required
 G   erythromycin soln 2%                           TOPICAL - ACNE PREPARATIONS               P      PA Required
 G   erythromycin stearate tab 250 mg               MACROLIDES / ERYTHROMYCIN'S /             P
                                                    KETOLIDES
 G   erythromycin stearate tab 500 mg               MACROLIDES / ERYTHROMYCIN'S /             P
                                                    KETOLIDES
 G   erythromycin w/ delayed release particles      MACROLIDES / ERYTHROMYCIN'S /             P
     cap 250 mg                                     KETOLIDES
 G   erythromycin-sulfisoxazole for susp            ANTI INFECTIVE COMBO'S - MISC.            P
     200-600 mg/5ml
 B   ESCLIM                                         ESTROGENS - PATCHES                       N
 B   ESGIC                                          ANALGESICS - MISC.                        N
 B   ESGIC-PLUS                                     ANALGESICS - MISC.                        N
 B   ESKALITH                                       LITHIUM                                   N
 B   ESKALITH CR                                    LITHIUM                                   P
 G   estazolam                                      SEDATIVE/HYPNOTICS - BENZODIAZEPINES      P
 B   ESTRACE                                        ESTROGENS - TABS                          N
 B   ESTRACE                                        VAGINAL - ESTROGENS                       N
 B   ESTRADERM                                      ESTROGENS - PATCHES                       N
 G   estradiol                                      ESTROGENS - PATCHES                       N
 G   estradiol                                      ESTROGENS - TABS                          P
 B   ESTRING                                        VAGINAL - ESTROGENS                       N
 B   ESTRIOL                                        ESTROGENS - TABS                          N
 B   ESTRONE                                        ESTROGENS - TABS                          N
 G   estropipate                                    ESTROGENS - TABS                          P
 B   ESTROSTEP FE                                   CONTRACEPTIVES - TRI-PHASIC               N
                                                    COMBINATIONS
 G   ethambutol hcl                                 ANTIMYCOBACTERIALS /                      P
                                                    ANTITUBERCULOSIS
 B   ETHEZYME                                       TOPICAL - WOUND / DECUBITUS CARE          P
 B   ETHMOZINE                                      ANTIARRHYTHMICS                           N
 G   ethosuximide cap 250 mg                        ANTICONVULSANTS                           N      Grandfather for Seizure Disorder
 G   ethosuximide soln 250 mg/5ml                   ANTICONVULSANTS                           P
 G   ethynodiol diacetate & ethinyl estradiol tab   CONTRACEPTIVES - MONOPHASIC               N
     1 mg-35 mcg                                    COMBINATION O/C'S
 G   ethynodiol diacetate & ethinyl estradiol tab   CONTRACEPTIVES - MONOPHASIC               N
     1 mg-50 mcg                                    COMBINATION O/C'S
 G   etodolac                                       NSAIDS                                    N      PA Required
 B   EURAX                                          TOPICAL - SCABICIDES AND PEDICULICIDES    P
 B   EVISTA                                         OSTEOPOROSIS                              N
 B   EVOXAC                                         ARTIFICIAL SALIVA/STIMULANTS              P
 B   EXELDERM                                       TOPICAL - ANTIFUNGALS                     N
 B   EXELON                                         ALZHEIMER - CHOLINOMIMETICS               P
 B   EXTENDRYL                                      COUGH/COLD -                              N
                                                    DECONGESTANT-ANTIHISTAMINE-ANTICHOLI
                                                    NERGIC


Report_1010_PDL_A3 rev A                                              12/26/2004                                               Page 21 of 63
B    Drug                                                                                P,                   Comment
or   Name                                        Drug Category                           N,
G                                                                                       R, or
                                                                                        NR
                                                                     E                                  - Alpha Continued -
 B   EXTENDRYL JR                              COUGH/COLD -                              N
                                               DECONGESTANT-ANTIHISTAMINE-ANTICHOLI
                                               NERGIC
 B   EXTENDRYL SR                              COUGH/COLD -                              N
                                               DECONGESTANT-ANTIHISTAMINE-ANTICHOLI
                                               NERGIC

                                                                     F
 G   famotidine                                GI - H2-ANTAGONISTS                       P
 B   FAMVIR                                    HERPES AGENTS                             N
 G   fat emulsion iv soln 20%                  ELECTROLYTES/ NUTRITIONALS                P
 G   fe fumarate w/ b12-vit c-fa-ifc cap       VITAMINS - MISC.                          P
     110-0.015-75-0.5-240 mg
 G   fe fumarate-vit c-vit b12-fa cap          VITAMINS - MISC.                          N
     200-250-0.01-1 mg
 G   fe fumarate-vit c-vit b12-fa cap          VITAMINS - MISC.                          N
     460-60-0.01-1 mg
 B   FELBATOL                                  ANTICONVULSANTS                           P
 B   FELDENE                                   NSAIDS                                    N      PA Required
 B   FEMHRT 1/5                                ESTROGEN COMBO'S                          N
 B   FEMRING                                   VAGINAL - ESTROGENS                       N
 G   fenoprofen calcium                        NSAIDS                                    P
 G   fentanyl citrate                          NARCOTICS - MICS.                         P
 B   FERO-FOLIC-500                            VITAMINS - MISC.                          N
 O   ferrous fumarate tab 325 mg               MINERALS                                  P
 O   ferrous gluconate tab 325 mg              MINERALS                                  P
 O   ferrous sulfate elixir 220 mg/5ml         MINERALS                                  P
 O   ferrous sulfate soln 75 mg/0.6ml (15      MINERALS                                  P
     mg/0.6ml elemental fe)
 O   FERROUS SULFATE TAB 300 MG                MINERALS                                  P
 O   ferrous sulfate tab 325 mg                MINERALS                                  P
 G   ferrous sulfate-vit c-folic acid tab cr   VITAMINS - MISC.                          P
     105-500-0.8 mg
 B   FINACEA                                   TOPICAL - ACNE PREPARATIONS               N      PA Required
 B   FIORICET/CODEINE                          NARCOTICS - MICS.                         N
 B   FIORINAL                                  ANALGESICS - MISC.                        P
 B   FIORINAL/CODEINE #3                       NARCOTICS - MICS.                         P
 B   FLAGYL                                    ANTIBIOTICS - MISC.                       N
 B   FLAGYL ER                                 ANTIBIOTICS - MISC.                       N
 B   FLAREX                                    OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    P
 G   flavoxate hcl tab 100 mg                  ANTISPASMODICS                            N
 G   flecainide acetate                        ANTIARRHYTHMICS                           N
 B   FLEXERIL                                  MUSCLE RELAXANTS                          N      PA Required
 B   FLOLAN                                    PULMONARY ANTI-HYPERTENSIVES              P
 B   FLOMAX                                    BPH                                       N
 B   FLONASE                                   ANTIASTHMATIC - NASAL STEROIDS            P
 B   FLORINEF                                  GLUCOCORTICOIDS - MINERALOCORTICOIDS      P
 B   FLOVENT                                   ANTIASTHMATIC - STEROID INHALANTS         P
 B   FLOVENT ROTADISK                          ANTIASTHMATIC - STEROID INHALANTS         P
 B   FLOXIN                                    FLUOROQUINOLONES                          P
 B   FLOXIN OTIC                               EAR                                       P
 G   fluconazole                               ANTIFUNGALS - ASSORTED                    N      PA Required from Day 1
 G   fluconazole tab 100 mg                    ANTIFUNGALS - ASSORTED                    P
 G   fluconazole tab 150 mg                    ANTIFUNGALS - ASSORTED                    P
 G   fluconazole tab 200 mg                    ANTIFUNGALS - ASSORTED                    P
 G   fluconazole tab 50 mg                     ANTIFUNGALS - ASSORTED                    N      PA Required from Day 1
 G   fludrocortisone acetate                   GLUCOCORTICOIDS - MINERALOCORTICOIDS      N
 B   FLUMADINE          SYP 50MG/5ML           INFLUENZA AGENTS                          P


Report_1010_PDL_A3 rev A                                      12/26/2004                                                 Page 22 of 63
B    Drug                                                                                 P,                  Comment
or   Name                                         Drug Category                           N,
G                                                                                        R, or
                                                                                         NR
                                                                     F                                     - Alpha Continued -
 B   FLUMADINE        TAB 100MG                 INFLUENZA AGENTS                          N
 B   FLUMIST NASAL VACCINE 200                  INFLUENZA AGENTS                          P      FLUMIST NASAL VACCINE 200 -
                                                                                                 Preferred 5 - 49 yo until 3/15/2005.
 G   flunisolide nasal soln 0.025%              ANTIASTHMATIC - NASAL STEROIDS            N
 G   fluocinolone acetonide cream 0.01%         TOPICAL - CORTICOSTEROIDS                 P
 G   fluocinolone acetonide cream 0.025%        TOPICAL - CORTICOSTEROIDS                 P
 G   fluocinolone acetonide oint 0.025%         TOPICAL - CORTICOSTEROIDS                 P
 G   fluocinolone acetonide soln 0.01%          TOPICAL - CORTICOSTEROIDS                 P
 G   fluocinonide cream 0.05%                   TOPICAL - CORTICOSTEROIDS                 P
 G   fluocinonide emulsified base cream 0.05%   TOPICAL - CORTICOSTEROIDS                 P
 G   fluocinonide gel 0.05%                     TOPICAL - CORTICOSTEROIDS                 P
 G   fluocinonide oint 0.05%                    TOPICAL - CORTICOSTEROIDS                 P
 G   fluocinonide soln 0.05%                    TOPICAL - CORTICOSTEROIDS                 P
 G   fluorometholone ophth susp 0.1%            OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    N
 B   FLUOROPLEX                                 TOPICAL - ANTINEOPLASTICS                 P
 B   FLUOROURACIL                               COMPOUNDING MATERIALS                     P
 G   fluorouracil soln 2%                       TOPICAL - ANTINEOPLASTICS                 P
 G   fluorouracil soln 5%                       TOPICAL - ANTINEOPLASTICS                 P
 G   fluoxetine hcl                             ANTIDEPRESSANTS - SELECTED SSRI'S         R
 G   fluoxetine hcl cap 10 mg                   ANTIDEPRESSANTS - SELECTED SSRI'S         P
 G   fluoxetine hcl cap 20 mg                   ANTIDEPRESSANTS - SELECTED SSRI'S         P
 G   fluoxetine hcl cap 40 mg                   ANTIDEPRESSANTS - SELECTED SSRI'S         N      PROZAC,FLUOXETINE HCL 40mg CAPS
                                                                                                 - Use two FLUOXETINE HCL 20mg
                                                                                                 CAPS instead
 G   fluoxetine hcl tab 10 mg                   ANTIDEPRESSANTS - SELECTED SSRI'S         P
 G   fluoxetine hcl tab 20 mg                   ANTIDEPRESSANTS - SELECTED SSRI'S         N      FLUOXETINE HCL 20mg TABS - Use
                                                                                                 FLUOXETINE HCL 20mg CAPS instead
 B   FLUOXYMESTERONE                            ANDROGENS / ANABOLICS                     P
 G   flurazepam hcl                             SEDATIVE/HYPNOTICS - BENZODIAZEPINES      P
 G   flurbiprofen                               NSAIDS                                    P
 G   flurbiprofen sodium ophth soln 0.03%       OP. NSAID'S                               P
 G   fluticasone propionate cream 0.05%         TOPICAL - CORTICOSTEROIDS                 N
 G   fluticasone propionate oint 0.005%         TOPICAL - CORTICOSTEROIDS                 N
 G   fluvoxamine maleate                        ANTIDEPRESSANTS - SELECTED SSRI'S         P
 B   FML FORTE                                  OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    P
 B   FML LIQUIFILM                              OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    P
 B   FML S.O.P.                                 OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    P
 B   FML-S LIQUIFILM                            OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    P
 B   FOCALIN                                    STIMULANTS - METHYLPHENIDATE              R
 B   FOLGARD RX 2.2                             VITAMINS - MISC.                          P
 G   folic acid                                 VITAMINS                                  P      RX Only
 G   folic acid-vitamin b6-vitamin b12 tab      VITAMINS - MISC.                          N
     2.2-25-0.5 mg
 G   folic acid-vitamin b6-vitamin b12 tab      VITAMINS - MISC.                          N
     2.5-25-1 mg
 B   FORADIL AEROLIZER                          ANTIASTHMATIC - BETA - ADRENERGICS        P
 B   FORMALYDE-10                               TOPICAL - ANTISEPTICS / DISINFECTANTS     N
 B   FORTAMET                                   DIABETIC - ORAL BIGUANIDES                N
 B   FORTAZ                                     CEPHALOSPORINS                            P
 B   FORTAZ INFUSION PACK                       CEPHALOSPORINS                            P
 B   FORTEO                                     OSTEOPOROSIS                              N
 B   FOSAMAX                                    OSTEOPOROSIS                              P
 B   FOSCAVIR                                   CYTO-MEGALOVIRUS AGENTS                   P
 G   fosinopril sodium                          ACE INHIBITORS                            N
 B   FRAGMIN                                    ANTICOAGULANTS                            P      PA Required > Quantity Limit 30 Days
 B   FREAMINE III                               ELECTROLYTES/ NUTRITIONALS                N



Report_1010_PDL_A3 rev A                                         12/26/2004                                                 Page 23 of 63
B    Drug                                                                           P,                   Comment
or   Name                                   Drug Category                           N,
G                                                                                  R, or
                                                                                   NR
                                                                 F                                  - Alpha Continued -
 B   FROVA                                MIGRAINE - SELECTIVE SEROTONIN            N      PA Required from Day 1
                                          AGONISTS (5HT)--TABS
 B   FUNGIZONE                            ANTIFUNGALS - ASSORTED                    P      PA Required > 90 days
 B   FURACIN                              TOPICAL - BURN PRODUCTS                   N
 B   FURADANTIN                           UROLOGICAL - MISC.                        P
 G   furosemide                           DIURETICS                                 P

                                                                 G
 G   gabapentin                           ANTICONVULSANTS                           N      Grandfather for Seizure Disorder
 G   gabapentin                           COMPOUNDING MATERIALS                     N
 B   GABITRIL                             ANTICONVULSANTS                           P
 B   GAMIMUNE N                           IMMUNE SERUMS                             P
 G   ganciclovir                          CYTO-MEGALOVIRUS AGENTS                   P
 G   gani-tuss nr                         COUGH/COLD - ANTITUSSIVE-EXPECTORANT      P
 B   GANTRISIN PEDIATRIC                  ANTIBIOTICS - MISC.                       P
 B   GARAMYCIN                            AMINO GLYCOSIDES                          N
 B   GASTROCROM CON 100/5ML               GI - ANTI - FLATULENTS / GI STIMULANTS    P
 G   gauifenesin/pseudoephedri            COUGH/COLD -                              N
                                          ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                          ANT
 B   GEL-KAM ORAL CARE RINSE              DENTAL PRODUCTS                           P
 G   gemfibrozil tab 600 mg               CHOLESTEROL - FIBRIC ACID DERIVATIVES     P
 B   GENOTROPIN                           GROWTH HORMONE                            P      PA Required
 B   GENOTROPIN INTRA-MIX                 GROWTH HORMONE                            P      PA Required
 B   GENOTROPIN MINIQUICK                 GROWTH HORMONE                            P      PA Required
 B   GENTAK                               OP. ANTIBIOTICS                           P
 G   gentamicin in saline                 AMINO GLYCOSIDES                          P
 G   gentamicin sulfate                   AMINO GLYCOSIDES                          P
 G   gentamicin sulfate                   TOPICAL - ANTIBIOTIC                      P
 G   gentamicin sulfate cream 0.1%        TOPICAL - ANTIBIOTIC                      P
 G   gentamicin sulfate oint 0.1%         TOPICAL - ANTIBIOTIC                      P
 G   gentamicin sulfate ophth soln 0.3%   OP. ANTIBIOTICS                           P
 B   GEOCILLIN                            BETA-LACTAMS / CLAVULANATE COMBO'S        P
 G   gfn 1000/dm 60                       COUGH/COLD - ANTITUSSIVE-EXPECTORANT      N
 G   gfn 1200/dm 60                       COUGH/COLD - ANTITUSSIVE-EXPECTORANT      N
 G   gfn 1200/dm 60/pse 120               COUGH/COLD -                              N
                                          ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                          ANT
 G   gfn 595/pse 48/dm 32                 COUGH/COLD -                              N
                                          ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                          ANT
 G   gfn/dm/pse                           COUGH/COLD -                              N
                                          ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                          ANT
 G   gfn600/pse60/dm30 sa                 COUGH/COLD -                              N
                                          ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                          ANT
 G   gg/codeine syp 100-10/5              COUGH/COLD - ANTITUSSIVE-EXPECTORANT      P
 G   gg/codeine tab 300-10                COUGH/COLD - ANTITUSSIVE-EXPECTORANT      N
 G   gg/dm cr       tab 600-30mg          COUGH/COLD - ANTITUSSIVE-EXPECTORANT      N
 G   gg/dm la       tab                   COUGH/COLD - ANTITUSSIVE-EXPECTORANT      N
 G   gg/dm sr       tab 600-30mg          COUGH/COLD - ANTITUSSIVE-EXPECTORANT      N
 G   glipizide                            DIABETIC - ORAL SULFONYLUREAS             P
 G   glipizide er                         DIABETIC - ORAL SULFONYLUREAS             N
 B   GLUCAGEN                             DIABETIC - OTHER                          P
 B   GLUCAGON                             DIABETIC - OTHER                          P
 B   GLUCAGON EMERGENCY KIT               DIABETIC - OTHER                          P
 B   GLUCOPHAGE                           DIABETIC - ORAL BIGUANIDES                N
 B   GLUCOPHAGE XR                        DIABETIC - ORAL BIGUANIDES                N

Report_1010_PDL_A3 rev A                                    12/26/2004                                               Page 24 of 63
B    Drug                                                                                     P,                Comment
or   Name                                            Drug Category                            N,
G                                                                                            R, or
                                                                                             NR
                                                                       G                                     - Alpha Continued -
 B   GLUCOTROL                                     DIABETIC - ORAL SULFONYLUREAS              N
 B   GLUCOTROL XL                                  DIABETIC - ORAL SULFONYLUREAS              N
 B   GLUCOVANCE                                    DIABETIC - SULFONYLUREA / BIGUANIDE        P
 B   GLUTOFAC-MX                                   MINERALS                                   N
 G   glyburide                                     DIABETIC - ORAL SULFONYLUREAS              P
 G   glyburide micronized                          DIABETIC - ORAL SULFONYLUREAS              P
 G   glyburide-metformin                           DIABETIC - SULFONYLUREA / BIGUANIDE        N
 G   glycopyrrolate                                GI - ANTIDIARRHEAL / ANTACID - MISC.       N
 B   GLYNASE                                       DIABETIC - ORAL SULFONYLUREAS              N
 B   GLYSET                                        DIABETIC - ALPHAGLUCOSIDASE                P
 B   GOLYTELY         SOL                          GI - ANTI - FLATULENTS / GI STIMULANTS     P
 B   GOLYTELY         SOL PINEAPPL                 GI - ANTI - FLATULENTS / GI STIMULANTS     P
 B   GRANULEX                                      TOPICAL - ENZYMES / KERATOLYTICS / UREA    N
 B   GRIFULVIN-V                                   ANTIFUNGALS - ASSORTED                     P      PA Required > 90 days
 B   GRIS-PEG                                      ANTIFUNGALS - ASSORTED                     P      PA Required > 90 days
 G   guaiatussin ac                                COUGH/COLD - ANTITUSSIVE-EXPECTORANT       P
 G   guai-co                                       COUGH/COLD - ANTITUSSIVE-EXPECTORANT       P
 B   GUAIFED-PD                                    COUGH/COLD - DECONGESTANT W/               N
                                                   EXPECTORANT
 G   guaifenesin                                   COUGH/COLD - EXPECTORANTS                  P
 G   guaifenesin tab dm                            COUGH/COLD - ANTITUSSIVE-EXPECTORANT       N
 G   guaifenesin ac                                COUGH/COLD - ANTITUSSIVE-EXPECTORANT       P
 G   guaifenesin/phenylephrine                     COUGH/COLD - DECONGESTANT W/               P
                                                   EXPECTORANT
 G   guaifenesin/pseudoephedri                     COUGH/COLD -                               N
                                                   ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                                   ANT
 G   guaifenex dm                                  COUGH/COLD - ANTITUSSIVE-EXPECTORANT       N
 B   GUANABENZ ACETATE                             ANTIHYPERTENSIVES - CENTRAL                N
 G   guanfacine hcl                                ANTIHYPERTENSIVES - CENTRAL                P
 G   guiadrine dm                                  COUGH/COLD - ANTITUSSIVE-EXPECTORANT       N
 G   guiatuss ac                                   COUGH/COLD - ANTITUSSIVE-EXPECTORANT       P
 G   guiatuss dac                                  COUGH/COLD -                               P
                                                   ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                                   ANT
 B   GYNAZOLE-1                                    VAGINAL - ANTI FUNGALS                     N
 G   gynodiol                                      ESTROGENS - TABS                           P

                                                                       H
 B   H 9600 SR                                     COUGH/COLD - DECONGESTANT W/               N
                                                   EXPECTORANT
 B   HALCION                                       SEDATIVE/HYPNOTICS - BENZODIAZEPINES       N
 B   HALOG                                         TOPICAL - CORTICOSTEROIDS                  P
 G   halotussin-dac                                COUGH/COLD -                               P
                                                   ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                                   ANT
 G   h-c tussive                                   COUGH/COLD - NARCOTIC                      P
                                                   ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                                   NE
 B   HELIDAC                                       GI - ULCER ANTI-INFECTIVE                  P
 G   heparin sodium (porcine) 100 unit/ml in       ANTICOAGULANTS                             P
     sodium chloride 0.9%
 G   heparin sodium (porcine) inj 1000 unit/ml     ANTICOAGULANTS                             P
 G   heparin sodium (porcine) inj 10000 unit/ml    ANTICOAGULANTS                             P
 G   heparin sodium (porcine) inj 5000 unit/ml     ANTICOAGULANTS                             P
 G   heparin sodium (porcine) lock flush iv soln   ANTICOAGULANTS                             P
     10 unit/ml
 G   heparin sodium (porcine) lock flush iv soln   ANTICOAGULANTS                             P
     100 unit/ml



Report_1010_PDL_A3 rev A                                          12/26/2004                                                 Page 25 of 63
B    Drug                                                                                    P,                   Comment
or   Name                                            Drug Category                           N,
G                                                                                           R, or
                                                                                            NR
                                                                         H                                  - Alpha Continued -
 G   heparin sodium (porcine) lock flush soln 10   ANTICOAGULANTS                            P
     unit/ml
 G   heparin sodium (porcine) lock flush soln      ANTICOAGULANTS                            P
     100 unit/ml
 G   heparin sodium (porcine) w/ nacl lock flush   ANTICOAGULANTS                            N
     kit 10 unit/ml
 B   HEPARIN SODIUM DCU                            ANTICOAGULANTS                            P
 G   hepatitis b immune globulin (human) inj       IMMUNE SERUMS                             P
 B   HEPSERA                                       HEPATITIS B ONLY                          P
 B   HIPREX                                        UROLOGICAL - MISC.                        N
 G   hisdec                                        COUGH/COLD - DECONGESTANT &               N
                                                   ANTIHISTAMINE
 G   histade sr                                    COUGH/COLD - DECONGESTANT &               N
                                                   ANTIHISTAMINE
 G   hista-vent da                                 COUGH/COLD -                              N
                                                   DECONGESTANT-ANTIHISTAMINE-ANTICHOLI
                                                   NERGIC
 B   HISTEX CT                                     ANTIHISTAMINES - OTHER                    N
 B   HISTEX HC                                     COUGH/COLD - NARCOTIC                     N
                                                   ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                                   NE
 B   HISTEX IE                                     ANTIHISTAMINES - OTHER                    N
 B   HISTEX PD                                     ANTIHISTAMINES - OTHER                    N
 B   HISTEX PD 12                                  ANTIHISTAMINES - OTHER                    N
 B   HISTEX SR                                     COUGH/COLD - DECONGESTANT &               N
                                                   ANTIHISTAMINE
 G   histinex hc                                   COUGH/COLD - NARCOTIC                     P
                                                   ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                                   NE
 G   histussin hc                                  COUGH/COLD - NARCOTIC                     P
                                                   ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                                   NE
 B   HMS LIQUIFILM                                 OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    P
 G   ht-tuss dm                                    COUGH/COLD - ANTITUSSIVE-EXPECTORANT      N
 B   HUMALOG                                       DIABETIC - INSULIN                        N
 B   HUMALOG                                       DIABETIC - PENFILLS                       N      PA Required
 B   HUMALOG MIX 75/25                             DIABETIC - INSULIN                        N
 B   HUMALOG MIX 75/25 PEN                         DIABETIC - PENFILLS                       N      PA Required
 B   HUMALOG PEN                                   DIABETIC - PENFILLS                       N      PA Required
 B   HUMATIN                                       AMINO GLYCOSIDES                          P
 B   HUMATROPE                                     GROWTH HORMONE                            N      PA Required
 B   HUMATROPE COMBO PACK                          GROWTH HORMONE                            N      PA Required
 B   HUMIBID DM                                    COUGH/COLD - ANTITUSSIVE-EXPECTORANT      N
 B   HUMIBID LA                                    COUGH/COLD - EXPECTORANT MIXTURES         N
 B   HUMIRA                                        RHEUMATOID ARTHRITIS - BIOLOGICALS        N
 O   HUMULIN 50/50                                 DIABETIC - INSULIN                        N
 O   HUMULIN 70/30                                 DIABETIC - INSULIN                        N
 O   HUMULIN 70/30 PEN                             DIABETIC - PENFILLS                       N      PA Required
 O   HUMULIN L                                     DIABETIC - INSULIN                        N
 O   HUMULIN N                                     DIABETIC - INSULIN                        N
 O   HUMULIN N U-100 PEN                           DIABETIC - PENFILLS                       N      PA Required
 O   HUMULIN R                                     DIABETIC - INSULIN                        N
 O   HUMULIN U                                     DIABETIC - INSULIN                        N
 B   HYCODAN         TAB 5MG                       COUGH/COLD - ANTITUSSIVE - NARCOTIC       N
 B   HYCOTUSS EXPECTORANT                          COUGH/COLD - ANTITUSSIVE-EXPECTORANT      N
 B   HYDRAL/HCTZ CAP 25/25                         ANTIHYPERTENSIVE COMBOS                   P
 B   HYDRAL/HCTZ CAP 50/50                         ANTIHYPERTENSIVE COMBOS                   P
 G   hydralazine hcl                               ANTIHYPERTENSIVES - CENTRAL               P




Report_1010_PDL_A3 rev A                                          12/26/2004                                                Page 26 of 63
B    Drug                                                                         P,              Comment
or   Name                                   Drug Category                         N,
G                                                                                R, or
                                                                                 NR
                                                              H                                 - Alpha Continued -
 G   hydro pro dm                         COUGH/COLD -                            N
                                          ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                          ANT
 G   hydrochlorothiazide                  DIURETICS                               P
 G   hydrocod/hom syp 5-1.5/5             COUGH/COLD - ANTITUSSIVE - NARCOTIC     P
 G   hydrocodone/ tab homatrop            COUGH/COLD - ANTITUSSIVE - NARCOTIC     P
 G   hydrocodone-acetaminophen            NARCOTICS - MICS.                       P
 G   hydrocodone-guaifenesin              COUGH/COLD - ANTITUSSIVE-EXPECTORANT    P
 G   hydrocodone-ibuprofen                NARCOTICS - MICS.                       N
 G   hydrocodone-potassium guaiaco        COUGH/COLD - ANTITUSSIVE-EXPECTORANT    N
 B   HYDROCORT         POW                TOPICAL - CORTICOSTEROIDS               P
 B   HYDROCORT AC POW                     TOPICAL - CORTICOSTEROIDS               P
 B   HYDROCORT AC POW MICRONIZ            TOPICAL - CORTICOSTEROIDS               N
 G   hydrocortisone                       GLUCOCORTICOIDS - MINERALOCORTICOIDS    P
 G   hydrocortisone                       TOPICAL - CORTICOSTEROIDS               N
 G   hydrocortisone cream 1%              TOPICAL - CORTICOSTEROIDS               P
 G   hydrocortisone cream 2.5%            TOPICAL - CORTICOSTEROIDS               P
 G   hydrocortisone enema 100 mg/60ml     ANORECTAL - MISC.                       P
 G   hydrocortisone lotion 1%             TOPICAL - CORTICOSTEROIDS               P
 G   hydrocortisone lotion 2.5%           TOPICAL - CORTICOSTEROIDS               P
 G   hydrocortisone oint 1%               TOPICAL - CORTICOSTEROIDS               P
 G   hydrocortisone oint 2.5%             TOPICAL - CORTICOSTEROIDS               N
 G   hydrocortisone rectal cream 2.5%     ANORECTAL - MISC.                       P
 G   hydrocortisone valerate cream 0.2%   TOPICAL - CORTICOSTEROIDS               P
 G   hydrocortisone valerate oint 0.2%    TOPICAL - CORTICOSTEROIDS               N
 G   hydrocortisone w/acetic acid         EAR                                     N
 B   HYDROCORTONE                         GLUCOCORTICOIDS - MINERALOCORTICOIDS    P
 G   hydromet    syp 5-1.5/5              COUGH/COLD - ANTITUSSIVE - NARCOTIC     P
 G   hydromorphon sup 3mg                 NARCOTICS - MICS.                       N
 G   hydromorphon tab 2mg                 NARCOTICS - MICS.                       P
 G   hydromorphon tab 4mg                 NARCOTICS - MICS.                       P
 G   hydromorphon tab 8mg                 NARCOTICS - MICS.                       P
 G   hydro-tussin dm                      COUGH/COLD - ANTITUSSIVE-EXPECTORANT    N
 G   hydro-tussin hd                      COUGH/COLD -                            N
                                          ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                          ANT
 G   hydro-tussin xp                      COUGH/COLD -                            N
                                          ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                          ANT
 G   hydroxychloroquine sulfate           ANTIMALARIAL AGENTS                     P
 G   hydroxyzine hcl im soln 25 mg/ml     ANTIHISTAMINES - OTHER                  P
 G   hydroxyzine hcl im soln 50 mg/ml     ANTIHISTAMINES - OTHER                  P
 G   hydroxyzine hcl syrup 10 mg/5ml      ANTIHISTAMINES - OTHER                  P
 G   hydroxyzine hcl tab 10 mg            ANTIHISTAMINES - OTHER                  P
 G   hydroxyzine hcl tab 25 mg            ANTIHISTAMINES - OTHER                  N      HYDROXYZINE HCL - Use
                                                                                         HYDROXYZINE PAMOATE
 G   hydroxyzine hcl tab 50 mg            ANTIHISTAMINES - OTHER                  N      HYDROXYZINE HCL - Use
                                                                                         HYDROXYZINE PAMOATE
 G   hydroxyzine pamoate cap 100 mg       ANTIHISTAMINES - OTHER                  N      HYDROXYZINE PAMOATE 100mg - Use
                                                                                         two HYDROXYZINE PAMOATE 50mg
                                                                                         instead
 G   hydroxyzine pamoate cap 25 mg        ANTIHISTAMINES - OTHER                  P
 G   hydroxyzine pamoate cap 50 mg        ANTIHISTAMINES - OTHER                  P
 G   hyoscyamine dro 0.125/ml             GI - ANTIDIARRHEAL / ANTACID - MISC.    P
 G   hyoscyamine elx 0.125/5              GI - ANTIDIARRHEAL / ANTACID - MISC.    P
 G   hyoscyamine sub 0.125mg              GI - ANTIDIARRHEAL / ANTACID - MISC.    P
 G   hyoscyamine tab 0.125mg              GI - ANTIDIARRHEAL / ANTACID - MISC.    P
 G   hyoscyamine tab 0.375mg              GI - ANTIDIARRHEAL / ANTACID - MISC.    P

Report_1010_PDL_A3 rev A                                 12/26/2004                                          Page 27 of 63
B    Drug                                                                                  P,                   Comment
or   Name                                          Drug Category                           N,
G                                                                                         R, or
                                                                                          NR
                                                                       H                                  - Alpha Continued -
 G   hyoscyamine sulfate cr                      GI - ANTIDIARRHEAL / ANTACID - MISC.      P
 G   hyoscyamine sulfate er                      GI - ANTIDIARRHEAL / ANTACID - MISC.      P
 G   hyoscyamine sulfate sr                      GI - ANTIDIARRHEAL / ANTACID - MISC.      P
 G   hyoscyamine tab 0.15 mg                     ANTISPASMODICS                            P
 B   HYTRIN                                      BPH                                       N
 B   HYZAAR                                      ARB'S AND DIURETICS                       P

                                                                       I
 G   *iron combination cap***                    VITAMINS - MISC.                          N
 G   *iron w/ vitamin tab cr**                   VITAMINS - MISC.                          N
 G   *iron w/ vitamin tab**                      VITAMINS - MISC.                          P
 B   IBERET-FOLIC-500                            VITAMINS - MISC.                          N
 O   ibuprofen susp 100 mg/5ml                   NSAIDS                                    P
 O   ibuprofen tab 200 mg                        NSAIDS                                    P
 B   ICAR-C PLUS                                 VITAMINS - MISC.                          N
 O   ILETIN II NPH/PORK                          DIABETIC - INSULIN                        P
 O   ILETIN II REGULAR/PORK                      DIABETIC - INSULIN                        P
 B   IMDUR                                       ANTIANGINALS--ISOSORBIDE NITRATE          N
 G   imipramine hcl                              ANTIDEPRESSANTS - TRI-CYCLICS             P
 B   IMITREX      INJ 6MG/0.5                    MIGRAINE - SELECTIVE SEROTONIN            P      PA Required: > 18 Units/30Days Supply
                                                 AGONISTS (5HT)--INJECTABLES
 B   IMITREX      SPR 20MG/ACT                   MIGRAINE - SELECTIVE SEROTONIN            P      PA Required: > 18 Units/30Days Supply
                                                 AGONISTS (5HT)--INJECTABLES
 B   IMITREX      SPR 5MG/ACT                    MIGRAINE - SELECTIVE SEROTONIN            P      PA Required: > 18 Units/30Days Supply
                                                 AGONISTS (5HT)--INJECTABLES
 B   IMITREX      TAB 100MG                      MIGRAINE - SELECTIVE SEROTONIN            P      PA Required: > 18 Units/30Days Supply
                                                 AGONISTS (5HT)--TABS
 B   IMITREX      TAB 25MG                       MIGRAINE - SELECTIVE SEROTONIN            P      PA Required: > 18 Units/30Days Supply
                                                 AGONISTS (5HT)--TABS
 B   IMITREX      TAB 50MG                       MIGRAINE - SELECTIVE SEROTONIN            P      PA Required: > 18 Units/30Days Supply
                                                 AGONISTS (5HT)--TABS
 B   IMITREX STATDOSE PEN                        MIGRAINE - SELECTIVE SEROTONIN            P      PA Required: > 18 Units/30Days Supply
                                                 AGONISTS (5HT)--INJECTABLES
 B   IMITREX STATDOSE REFILL                     MIGRAINE - SELECTIVE SEROTONIN            P      PA Required: > 18 Units/30Days Supply
                                                 AGONISTS (5HT)--INJECTABLES
 G   immune globulin (human) inj                 IMMUNE SERUMS                             N
 G   immune globulin (human) iv for soln 10 gm   IMMUNE SERUMS                             P
 G   immune globulin (human) iv for soln 5 gm    IMMUNE SERUMS                             P
 G   immune globulin (human) iv for soln 6 gm    IMMUNE SERUMS                             N
 G   immune globulin (human) iv soln 10%         IMMUNE SERUMS                             N
 B   IMURAN                                      PURINE ANALOG                             N
 B   INAPSINE                                    ANXIOLYTICS - MISC.                       N
 G   indapamide                                  DIURETICS                                 P
 B   INDERAL                                     BETA BLOCKERS - NON SELECTIVE             N
 B   INDERAL LA CAP 120MG                        BETA BLOCKERS - NON SELECTIVE             N
 B   INDERAL LA CAP 160MG                        BETA BLOCKERS - NON SELECTIVE             N
 B   INDERAL LA CAP 60MG                         BETA BLOCKERS - NON SELECTIVE             P
 B   INDERAL LA CAP 80MG                         BETA BLOCKERS - NON SELECTIVE             P
 B   INDERIDE 40/25                              BETA BLOCKERS AND DIURETIC COMBO'S        N
 B   INDOCIN                                     NSAIDS                                    N      PA Required
 G   indomethacin cap 25mg                       NSAIDS                                    P
 G   indomethacin cap 50mg                       NSAIDS                                    P
 G   indomethacin cr                             NSAIDS                                    N      PA Required
 G   indomethacin er                             NSAIDS                                    N      PA Required
 B   INDOMETHACIN POW                            NSAIDS                                    N      PA Required
 B   INFERGEN                                    HEPATITIS C AGENTS                        N
 B   INFLAMASE FORTE                             OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    N
 B   INFLAMASE MILD                              OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    N


Report_1010_PDL_A3 rev A                                         12/26/2004                                               Page 28 of 63
B    Drug                                                                             P,                   Comment
or   Name                                      Drug Category                          N,
G                                                                                    R, or
                                                                                     NR
                                                                 I                                   - Alpha Continued -
 B   INNOHEP                                 ANTICOAGULANTS                           P      PA Required > Quantity Limit 30 Days
 B   INNOPRAN XL                             BETA BLOCKERS - NON SELECTIVE            P
 B   INSPRA                                  DIURETICS                                P      PA Required
 B   INTAL                                   ANTIASTHMATIC - ANTIINFLAMMATORY         N
                                             AGENTS
 B   INTAL INHALER                           ANTIASTHMATIC - ANTIINFLAMMATORY         P
                                             AGENTS
 B   INVANZ                                  CARBAPENEMS                              P
 B   IODOSORB                                TOPICAL - ANTISEPTICS / DISINFECTANTS    N
 G   iophen c-nr                             COUGH/COLD - ANTITUSSIVE-EXPECTORANT     P
 B   IOPIDINE                                OP. SELECTIVE ALPHA ADRENERGIC           N
                                             AGONISTS
 G   ipratropium bromide (nasal)             ANTIASTHMATIC - NASAL MISC.              N
 G   ipratropium bromide inhal soln 0.02%    ANTIASTHMATIC - ANTI-CHOLINERGICS        P
 G   iron dextran inj 50 mg/ml               MINERALS                                 P
 G   iron polysacch complex-vit b12-fa cap   VITAMINS - MISC.                         P
     150-0.025-1 mg
 G   isoniazid                               ANTIMYCOBACTERIALS /                     P
                                             ANTITUBERCULOSIS
 B   ISOPTIN SR                              CALCIUM CHANNEL                          N
                                             BLOCKERS--VERAPAMILS
 B   ISOPTO ATROPINE                         OP. CYCLOPLEGICS                         N
 B   ISOPTO CARBACHOL                        OP. MIOTICS - DIRECT ACTING              P
 B   ISOPTO CARPINE                          OP. MIOTICS - DIRECT ACTING              N
 B   ISOPTO HOMATROPINE                      OP. CYCLOPLEGICS                         N
 B   ISOPTO HYOSCINE                         OP. CYCLOPLEGICS                         N
 B   ISORDIL TITRADOSE                       ANTIANGINALS--ISOSORBIDE NITRATE         N
 G   isosorbide dinitrate                    ANTIANGINALS--ISOSORBIDE NITRATE         P
 G   isosorbide mononitrate                  ANTIANGINALS--ISOSORBIDE NITRATE         P
 G   isotretinoin                            ACNE PRODUCTS: ISOTRETINOIN              N      PA Required
 B   ITRACONAZOLE                            COMPOUNDING MATERIALS                    N

                                                                 K
 B   KADIAN                                  NARCOTICS-LONG ACTING                    N
 G   kanamycin sulfate                       AMINO GLYCOSIDES                         P
 B   KANTREX                                 AMINO GLYCOSIDES                         P
 B   KAON-CL                                 MINERALS                                 N
 B   KAYEXALATE                              K REMOVING RESINS                        P
 G   kcl 0.15% in d5/0.45% nacl              ELECTROLYTES/ NUTRITIONALS               P
 G   kcl 0.15% in nacl 0.9%                  ELECTROLYTES/ NUTRITIONALS               P
 G   kcl 0.224% in d5/0.45% nacl             ELECTROLYTES/ NUTRITIONALS               P
 B   K-DUR                                   MINERALS                                 P
 B   KEFLEX                                  CEPHALOSPORINS                           N
 B   KEMADRIN                                PARKINSONS - ANTICHOLINERGICS            P
 B   KENALOG                                 TOPICAL - CORTICOSTEROIDS                N
 B   KENALOG-10                              GLUCOCORTICOIDS - MINERALOCORTICOIDS     P
 B   KENALOG-40                              GLUCOCORTICOIDS - MINERALOCORTICOIDS     P
 B   KEPPRA                                  ANTICONVULSANTS                          P
 B   KERLONE                                 BETA BLOCKERS - CARDIO SELECTIVE         P
 B   KETAMINE HCL                            COMPOUNDING MATERIALS                    N
 B   KETEK                                   MACROLIDES / ERYTHROMYCIN'S /            N
                                             KETOLIDES
 G   ketoconazole                            ANTIFUNGALS - ASSORTED                   P      PA Required > 90 days
 G   ketoconazole cream 2%                   TOPICAL - ANTIFUNGALS                    N
 G   ketoconazole shampoo 2%                 TOPICAL - ANTIFUNGALS                    N
 G   ketoprofen                              NSAIDS                                   P
 G   ketorolac tromethamine                  COX 2 INHIBITORS - SELECTIVE             P      PA Required
 B   KINERET                                 RHEUMATOID ARTHRITIS - BIOLOGICALS       N

Report_1010_PDL_A3 rev A                                    12/26/2004                                                Page 29 of 63
B    Drug                                                                                  P,                   Comment
or   Name                                          Drug Category                           N,
G                                                                                         R, or
                                                                                          NR
                                                                      K                                    - Alpha Continued -
 B   KLARON                                      TOPICAL - ACNE PREPARATIONS               N      PA Required
 B   KLONOPIN                                    ANTICONVULSANTS                           N      Grandfather for Seizure Disorder
 B   KLONOPIN WAFERS                             ANTICONVULSANTS                           N      Grandfather for Seizure Disorder
 B   KLOR-CON 25                                 MINERALS                                  N
 B   KLOR-CON M15                                MINERALS                                  N
 B   K-LYTE                                      MINERALS                                  N
 B   K-LYTE DS                                   MINERALS                                  N
 B   K-LYTE/CL                                   MINERALS                                  N
 B   K-PHOS                                      MINERALS                                  P
 B   K-PHOS NEUTRAL                              MINERALS                                  N
 B   K-PHOS NO 2                                 UROLOGICAL - MISC.                        P
 B   KRISTALOSE PAK 10GM                         GI - ANTI - FLATULENTS / GI STIMULANTS    N
 B   KRISTALOSE PAK 20GM                         GI - ANTI - FLATULENTS / GI STIMULANTS    N
 G   kronofed-a                                  COUGH/COLD - DECONGESTANT &               P
                                                 ANTIHISTAMINE
 G   kronofed-a-jr                               COUGH/COLD - DECONGESTANT &               N
                                                 ANTIHISTAMINE
 B   K-TABS                                      MINERALS                                  N
 G   k-tan                                       COUGH/COLD - DECONGESTANT &               N
                                                 ANTIHISTAMINE
 G   k-tan 4                                     COUGH/COLD - DECONGESTANT &               P
                                                 ANTIHISTAMINE
 B   KUTRASE                                     GI - DIGESTIVE ENZYMES                    N      PA Required
 B   KU-ZYME                                     GI - DIGESTIVE ENZYMES                    N      PA Required
 B   KU-ZYME HP                                  GI - DIGESTIVE ENZYMES                    N      PA Required
 B   KYTRIL                                      ANTIEMETIC - 5-HT3 RECEPTOR               P
                                                 ANTAGONISTS/ SUBSTANCE P NEUROKININ

                                                                      L
 G   labetalol hcl                               BETA BLOCKERS - ALPHA / BETA              P
 B   LAC-HYDRIN                                  TOPICAL - EMOLLIENTS                      N
 G   lactated ringer's solution                  ELECTROLYTES/ NUTRITIONALS                P
 G   lactic acid (ammonium lactate) cream 12%    TOPICAL - EMOLLIENTS                      N
 O   lactic acid (ammonium lactate) lotion 12%   TOPICAL - EMOLLIENTS                      P
 G   lactic acid w/ vitamin e cream 10%-3500     TOPICAL - EMOLLIENTS                      P
     unit/30gm
 B   LACTINOL                                    TOPICAL - EMOLLIENTS                      N
 B   LACTINOL-E                                  TOPICAL - EMOLLIENTS                      N
 B   LACTOCAL-F                                  VITAMINS - MISC.                          N
 G   lactulose (encephalopathy) solution 10      GI - ANTI - FLATULENTS / GI STIMULANTS    P
     gm/15ml
 G   lactulose solution 10 gm/15ml               GI - ANTI - FLATULENTS / GI STIMULANTS    P
 B   LAMICTAL                                    ANTICONVULSANTS                           P
 B   LAMICTAL CHEWABLE DISPERS                   ANTICONVULSANTS                           P
 B   LAMISIL                                     ANTIFUNGALS - ASSORTED                    N      PA Required From Day 1
 B   LAMISIL                                     TOPICAL - ANTIFUNGALS                     N
 B   LANOXICAPS                                  CARDIAC GLYCOSIDES                        P
 B   LANOXIN                                     CARDIAC GLYCOSIDES                        P
 B   LANTUS                                      DIABETIC - INSULIN                        P
 B   LARIAM                                      ANTIMALARIAL AGENTS                       P
 B   LASIX                                       DIURETICS                                 N
 B   LAZERFORMALYDE SOLUTION                     TOPICAL - ANTISEPTICS / DISINFECTANTS     N
 B   LESCOL                                      CHOLESTEROL - HMG COA + ABSORB            P
                                                 INHIBITORS
 B   LESCOL XL                                   CHOLESTEROL - HMG COA + ABSORB            P
                                                 INHIBITORS
 B   LEUKINE                                     GRANULOCYTE CSF                           N      PA Required




Report_1010_PDL_A3 rev A                                        12/26/2004                                                  Page 30 of 63
B    Drug                                                                                  P,                   Comment
or   Name                                            Drug Category                         N,
G                                                                                         R, or
                                                                                          NR
                                                                       L                                  - Alpha Continued -
 B   LEVALL                                        COUGH/COLD -                            N
                                                   ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                                   ANT
 B   LEVALL 5.0                                    COUGH/COLD -                            N
                                                   ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                                   ANT
 B   LEVALL G                                      COUGH/COLD - DECONGESTANT W/            N
                                                   EXPECTORANT
 B   LEVAQUIN                                      FLUOROQUINOLONES                        P
 B   LEVAQUIN LEVA-PAK                             FLUOROQUINOLONES                        P
 B   LEVAQUIN PREMIX                               FLUOROQUINOLONES                        P
 B   LEVATOL                                       BETA BLOCKERS - NON SELECTIVE           P
 B   LEVBID                                        GI - ANTIDIARRHEAL / ANTACID - MISC.    N
 B   LEVITRA                                       IMPOTENCE AGENTS                        N      PA Required
 B   LEVLEN CONTRACT PACK                          CONTRACEPTIVES - MONOPHASIC             N
                                                   COMBINATION O/C'S
 B   LEVLEN-28                                     CONTRACEPTIVES - MONOPHASIC             N
                                                   COMBINATION O/C'S
 B   LEVLITE-28                                    CONTRACEPTIVES - MONOPHASIC             P
                                                   COMBINATION O/C'S
 G   levobunolol hcl ophth soln 0.25%              OP. BETA - BLOCKERS                     P
 G   levobunolol hcl ophth soln 0.5%               OP. BETA - BLOCKERS                     P
 G   levonorgestrel & ethinyl estradiol tab 0.10   CONTRACEPTIVES - MONOPHASIC             N
     mg-20 mcg                                     COMBINATION O/C'S
 G   levonorgestrel & ethinyl estradiol tab 0.15   CONTRACEPTIVES - MONOPHASIC             N
     mg-30 mcg                                     COMBINATION O/C'S
 G   levonorgestrel-eth estra tab                  CONTRACEPTIVES - TRI-PHASIC             N
     0.05-30/0.075-40/0.125-30mg-mcg               COMBINATIONS
 G   levothroid                                    THYROID HORMONES                        P
 G   levothyroxin inj 200mcg                       THYROID HORMONES                        N
 G   levothyroxin inj 500mcg                       THYROID HORMONES                        N
 G   levothyroxin tab 100mcg                       THYROID HORMONES                        P
 G   levothyroxin tab 112mcg                       THYROID HORMONES                        P
 G   levothyroxin tab 125mcg                       THYROID HORMONES                        P
 G   levothyroxin tab 137mcg                       THYROID HORMONES                        P
 G   levothyroxin tab 150mcg                       THYROID HORMONES                        P
 G   levothyroxin tab 175mcg                       THYROID HORMONES                        P
 G   levothyroxin tab 200mcg                       THYROID HORMONES                        P
 G   levothyroxin tab 25mcg                        THYROID HORMONES                        P
 G   levothyroxin tab 300mcg                       THYROID HORMONES                        P
 G   levothyroxin tab 50mcg                        THYROID HORMONES                        P
 G   levothyroxin tab 75mcg                        THYROID HORMONES                        P
 G   levothyroxin tab 88mcg                        THYROID HORMONES                        P
 G   levoxyl                                       THYROID HORMONES                        P
 B   LEVSIN                                        GI - ANTIDIARRHEAL / ANTACID - MISC.    N
 B   LEVSIN/SL                                     GI - ANTIDIARRHEAL / ANTACID - MISC.    N
 B   LEVSINEX                                      GI - ANTIDIARRHEAL / ANTACID - MISC.    N
 B   LEXAPRO                                       ANTIDEPRESSANTS - SELECTED SSRI'S       R
 B   LEXXEL                                        ACE INHIBITORS AND CA CHANNEL           N
                                                   BLOCKERS
 B   LIBRIUM                                       ANXIOLYTICS - BENZODIAZEPINES           N
 B   LIDAMANTLE                                    TOPICAL - LOCAL ANESTHETICS             N
 B   LIDAMANTLE CRE HC3-0.5%                       TOPICAL - STEROID LOCAL ANESTHETICS     P
 B   LIDAMANTLE LOT HC3-0.5%                       TOPICAL - STEROID LOCAL ANESTHETICS     N
 B   LIDEX                                         TOPICAL - CORTICOSTEROIDS               N
 B   LIDEX-E                                       TOPICAL - CORTICOSTEROIDS               N
 B   LIDOCAINE                                     TOPICAL - LOCAL ANESTHETICS             P
 G   lidocaine hcl cream 3%                        TOPICAL - LOCAL ANESTHETICS             P
 G   lidocaine hcl gel 2%                          TOPICAL - LOCAL ANESTHETICS             P

Report_1010_PDL_A3 rev A                                          12/26/2004                                              Page 31 of 63
B    Drug                                                                                 P,                   Comment
or   Name                                         Drug Category                           N,
G                                                                                        R, or
                                                                                         NR
                                                                     L                                   - Alpha Continued -
 G   lidocaine hcl local inj 1%                 TOPICAL - LOCAL ANESTHETICS               P
 G   lidocaine hcl local inj 2%                 TOPICAL - LOCAL ANESTHETICS               P
 G   lidocaine hcl local inj 4%                 TOPICAL - LOCAL ANESTHETICS               N
 G   lidocaine hcl oint 5%                      TOPICAL - LOCAL ANESTHETICS               P
 G   lidocaine hcl soln 4%                      TOPICAL - LOCAL ANESTHETICS               P
 G   lidocaine hcl viscous soln 2%              MOUTH - ANESTHETICS TOPICAL ORAL          P
 G   lidocaine inj 1% w/ epinephrine-1:100000   TOPICAL - LOCAL ANESTHETICS               P
 G   lidocaine-hydrocortisone acetate cream     TOPICAL - STEROID LOCAL ANESTHETICS       N
     3-0.5%
 G   lidocaine-prilocaine cream 2.5-2.5%        TOPICAL - LOCAL ANESTHETICS               N
 B   LIDODERM                                   TOPICAL - LOCAL ANESTHETICS               N
 B   LIMBITROL                                  PSYCHOTHERAPEUTIC COMBINATION             N
 B   LIMBITROL DS                               PSYCHOTHERAPEUTIC COMBINATION             N
 B   LINCOCIN                                   LINCOSAMIDES / OXAZOLIDINONES /           N
                                                LEPROSTATICS
 B   LINDANE                                    TOPICAL - SCABICIDES AND PEDICULICIDES    N
 G   lindane shampoo 1%                         TOPICAL - SCABICIDES AND PEDICULICIDES    N
 B   LIORESAL INTRATHECAL                       MUSCLE RELAXANTS                          P
 B   LIPITOR                                    CHOLESTEROL - HMG COA + ABSORB            P
                                                INHIBITORS
 B   LIPOSYN III                                ELECTROLYTES/ NUTRITIONALS                N
 G   lipram 4500                                GI - DIGESTIVE ENZYMES                    P      PA Required
 G   lipram-cr10                                GI - DIGESTIVE ENZYMES                    P      PA Required
 G   lipram-cr20                                GI - DIGESTIVE ENZYMES                    P      PA Required
 G   lipram-cr5                                 GI - DIGESTIVE ENZYMES                    P      PA Required
 G   lipram-pn10                                GI - DIGESTIVE ENZYMES                    P      PA Required
 G   lipram-pn16                                GI - DIGESTIVE ENZYMES                    P      PA Required
 G   lipram-pn20                                GI - DIGESTIVE ENZYMES                    P      PA Required
 G   lipram-ul12                                GI - DIGESTIVE ENZYMES                    P      PA Required
 G   lipram-ul20                                GI - DIGESTIVE ENZYMES                    P      PA Required
 G   lisinopril                                 ACE INHIBITORS                            P
 G   lisinopril & hydrochlorothiazide           ACE AND THIAZIDE COMBO'S                  P
 B   LITHIUM CARBONATE                          LITHIUM                                   P
 G   lithium carbonate cap 150 mg               LITHIUM                                   P
 G   lithium carbonate cap 300 mg               LITHIUM                                   P
 G   lithium carbonate tab cr 300 mg            LITHIUM                                   N
 G   lithium carbonate tab cr 450 mg            LITHIUM                                   N
 G   lithium citrate syrup 8 meq/5ml            LITHIUM                                   P
 B   LITHOBID                                   LITHIUM                                   P
 B   LIVOSTIN                                   OP. ANTIALLERGICS                         P
 B   LO/OVRAL 28                                CONTRACEPTIVES - MONOPHASIC               P
                                                COMBINATION O/C'S
 B   LOCOID                                     TOPICAL - CORTICOSTEROIDS                 P
 B   LOCOID LIPOCREAM                           TOPICAL - CORTICOSTEROIDS                 P
 B   LODINE                                     NSAIDS                                    N      PA Required
 B   LODOSYN                                    ANTI-PARKINSONIAN DRUGS                   P
 B   LOESTRIN 1.5/30-21                         CONTRACEPTIVES - MONOPHASIC               N
                                                COMBINATION O/C'S
 B   LOESTRIN 1/20-21                           CONTRACEPTIVES - MONOPHASIC               N
                                                COMBINATION O/C'S
 B   LOESTRIN FE                                CONTRACEPTIVES - MONOPHASIC               N
                                                COMBINATION O/C'S
 B   LOESTRIN FE 1/20                           CONTRACEPTIVES - MONOPHASIC               N
                                                COMBINATION O/C'S
 B   LOFIBRA                                    CHOLESTEROL - FIBRIC ACID DERIVATIVES     N
 G   lohist-d                                   COUGH/COLD - DECONGESTANT &               N
                                                ANTIHISTAMINE
 B   LOMOTIL                                    GI - ANTIPERISTALTIC AGENTS               N


Report_1010_PDL_A3 rev A                                         12/26/2004                                              Page 32 of 63
B    Drug                                                                                P,                   Comment
or   Name                                        Drug Category                           N,
G                                                                                       R, or
                                                                                        NR
                                                                     L                                  - Alpha Continued -
 B   LONITEN                                   ANTIHYPERTENSIVES - CENTRAL               N
 G   loperamide cap 2mg                        GI - ANTIPERISTALTIC AGENTS               P
 O   loperamide hcl liq 1 mg/5ml (0.2 mg/ml)   GI - ANTIPERISTALTIC AGENTS               P
 O   loperamide hcl tab 2 mg                   GI - ANTIPERISTALTIC AGENTS               P
 B   LOPID                                     CHOLESTEROL - FIBRIC ACID DERIVATIVES     N
 B   LOPRESSOR                                 BETA BLOCKERS - CARDIO SELECTIVE          N
 B   LOPRESSOR HCT                             BETA BLOCKERS AND DIURETIC COMBO'S        N
 B   LOPROX                                    TOPICAL - ANTIFUNGALS                     P
 B   LOPROX SHAMPOO                            TOPICAL - ANTIFUNGALS                     P
 B   LORABID                                   ANTIBIOTICS - MISC.                       N
 O   loratadine syrup 10 mg/10ml               ANTIHISTAMINES - NON-SEDATING             P
 O   loratadine tab 10 mg                      ANTIHISTAMINES - NON-SEDATING             P
 B   LORAZEPAM        CON 2MG/ML               ANXIOLYTICS - BENZODIAZEPINES             P
 G   lorazepam     inj 2mg/ml                  ANXIOLYTICS - BENZODIAZEPINES             P
 G   lorazepam     inj 4mg/ml                  ANXIOLYTICS - BENZODIAZEPINES             P
 B   LORAZEPAM        POW USP                  COMPOUNDING MATERIALS                     P
 G   lorazepam     tab 0.5mg                   ANXIOLYTICS - BENZODIAZEPINES             P
 G   lorazepam     tab 1mg                     ANXIOLYTICS - BENZODIAZEPINES             P
 G   lorazepam     tab 2mg                     ANXIOLYTICS - BENZODIAZEPINES             P
 B   LORTAB                                    NARCOTICS - MICS.                         N
 B   LORTAB 10                                 NARCOTICS - MICS.                         N
 B   LORTAB 2.5                                NARCOTICS - MICS.                         N
 B   LORTAB 5                                  NARCOTICS - MICS.                         N
 B   LORTAB 7.5                                NARCOTICS - MICS.                         N
 B   LOTEMAX                                   OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    P
 B   LOTENSIN                                  ACE INHIBITORS                            N
 B   LOTENSIN HCT                              ACE AND THIAZIDE COMBO'S                  N
 B   LOTREL                                    ACE INHIBITORS AND CA CHANNEL             P
                                               BLOCKERS
 B   LOTRISONE       CRE                       TOPICAL - ANTIFUNGALS                     P
 B   LOTRISONE       LOT                       TOPICAL - ANTIFUNGALS                     P
 B   LOTRONEX                                  GI - IRRITABLE BOWEL SYNDROME AGENTS      N
 G   lovastatin                                CHOLESTEROL - HMG COA + ABSORB            N
                                               INHIBITORS
 B   LOVENOX                                   ANTICOAGULANTS                            P      PA Required > Quantity Limit 30 Days
 B   LUMIGAN                                   OP. PROSTAGLANDINS                        P
 B   LUMINAL                                   SEDATIVE/HYPNOTICS - BARBITURATE          NR
 B   LUNELLE                                   CONTRACEPTIVES - INJECTABLE               N
 B   LURIDE                                    MINERALS                                  P
 B   LUXIQ                                     TOPICAL - CORTICOSTEROIDS                 N

                                                                     M
 G   *multiple vitamin inj**                   VITAMINS - MISC.                          N
 G   *multiple vitamins w/ minerals cap**      VITAMINS - MISC.                          P
 G   *multiple vitamins w/ minerals tab**      VITAMINS - MISC.                          P
 B   M.T.E. 7                                  MINERALS                                  N
 B   M.V.I. -12                                VITAMINS - MISC.                          P
 B   MACROBID                                  UROLOGICAL - MISC.                        N
 B   MACRODANTIN                               UROLOGICAL - MISC.                        P
 B   MAGNEBIND 400                             MINERALS                                  P
 O   magnesium oxide cap 140 mg (85 mg         GI - ANTIDIARRHEAL / ANTACID - MISC.      P      PA Required
     elemental mg)
 O   magnesium oxide tab 400 mg                GI - ANTIDIARRHEAL / ANTACID - MISC.      P      PA Required
 G   magnesium sulfate inj 50%                 MINERALS                                  P
 B   MALARONE                                  ANTIMALARIAL AGENTS                       P
 B   MANDELAMINE                               UROLOGICAL - MISC.                        N


Report_1010_PDL_A3 rev A                                        12/26/2004                                               Page 33 of 63
B    Drug                                                                               P,                   Comment
or   Name                                       Drug Category                           N,
G                                                                                      R, or
                                                                                       NR
                                                                    M                                    - Alpha Continued -
 G   maprotiline hcl                          ANTIDEPRESSANTS - SELECTED SSRI'S         R
 B   MARCAINE                                 TOPICAL - LOCAL ANESTHETICS               P
 B   MARCAINE W/O EPI                         TOPICAL - LOCAL ANESTHETICS               P
 B   MARINOL                                  ANTIEMETIC - 5-HT3 RECEPTOR               P
                                              ANTAGONISTS/ SUBSTANCE P NEUROKININ
 B   MAVIK                                    ACE INHIBITORS                            N
 B   MAXAIR AUTOHALER                         ANTIASTHMATIC - BETA - ADRENERGICS        P
 B   MAXALT                                   MIGRAINE - SELECTIVE SEROTONIN            P      PA Required: > 18 Units/30Days Supply
                                              AGONISTS (5HT)--TABS
 B   MAXALT-MLT                               MIGRAINE - SELECTIVE SEROTONIN            P      PA Required: > 18 Units/30Days Supply
                                              AGONISTS (5HT)--TABS
 B   MAXIDEX                                  OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    N
 B   MAXIDONE                                 NARCOTICS - MICS.                         N
 B   MAXIPIME                                 CEPHALOSPORINS                            P
 B   MAXITROL                                 OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    N
 B   MAXZIDE                                  DIURETICS                                 N
 B   MAXZIDE-25                               DIURETICS                                 N
 B   MEBARAL                                  SEDATIVE/HYPNOTICS - BARBITURATE          R
 G   mebendazole chew tab 100 mg              ANTHELMINTICS                             N
 O   meclizine hcl chew tab 25 mg             ANTIEMETIC - ANTICHOLINERGIC /            P
                                              DOPAMINERGIC
 O   meclizine hcl tab 12.5 mg                ANTIEMETIC - ANTICHOLINERGIC /            P
                                              DOPAMINERGIC
 O   meclizine hcl tab 25 mg                  ANTIEMETIC - ANTICHOLINERGIC /            P
                                              DOPAMINERGIC
 B   MECLOFENAMATE SODIUM                     NSAIDS                                    N      PA Required
 B   MEDROL                                   GLUCOCORTICOIDS - MINERALOCORTICOIDS      N
 G   medroxyprogesterone acetate              PROGESTINS                                P
 G   mefloquine hcl                           ANTIMALARIAL AGENTS                       N
 B   MENEST                                   ESTROGENS - TABS                          P
 B   MENTAX                                   TOPICAL - ANTIFUNGALS                     N
 G   meperidine inj 50mg/ml                   NARCOTICS - MICS.                         P
 G   meperidine syp 50mg/5ml                  NARCOTICS - MICS.                         N
 G   meperidine tab 100mg                     NARCOTICS - MICS.                         P
 G   meperidine tab 50mg                      NARCOTICS - MICS.                         P
 G   meperitab                                NARCOTICS - MICS.                         P
 B   MEPHYTON                                 VITAMINS                                  P      RX Only
 G   meprobamate tab 200 mg                   ANXIOLYTICS - MISC.                       P
 G   meprobamate tab 400 mg                   ANXIOLYTICS - MISC.                       P
 B   MEPRON                                   ANTIPROTOZOAL AGENTS                      P
 B   MERREM                                   CARBAPENEMS                               P
 B   MESCOLOR                                 COUGH/COLD -                              N
                                              DECONGESTANT-ANTIHISTAMINE-ANTICHOLI
                                              NERGIC
 B   MESTINON          SYP 60MG/5ML           NEUROLOGICS - MISC.                       P
 B   MESTINON          TAB 60MG               NEUROLOGICS - MISC.                       N
 B   MESTINON TIMESPAN                        NEUROLOGICS - MISC.                       P
 B   METADATE CD                              STIMULANTS - METHYLPHENIDATE - LONG       R
                                              ACTING
 G   metadate er                              STIMULANTS - METHYLPHENIDATE - LONG       NR
                                              ACTING
 B   METAGLIP                                 DIABETIC - SULFONYLUREA / BIGUANIDE       N
 B   METAPROTERENOL SULFATE                   ANTIASTHMATIC - BETA - ADRENERGICS        P
 G   metaproterenol sulfate syrup 10 mg/5ml   ANTIASTHMATIC - BETA - ADRENERGICS        P
 G   metformin hcl                            DIABETIC - ORAL BIGUANIDES                P
 G   metformin hcl er                         DIABETIC - ORAL BIGUANIDES                N
 G   methadone hcl                            NARCOTICS-LONG ACTING                     P
 G   methazolamide                            DIURETICS                                 P


Report_1010_PDL_A3 rev A                                      12/26/2004                                               Page 34 of 63
B    Drug                                                                                 P,                   Comment
or   Name                                         Drug Category                           N,
G                                                                                        R, or
                                                                                         NR
                                                                      M                                  - Alpha Continued -
 G   meth-bell-meth bl-phenyl sal               UROLOGICAL - MISC.                        P
 G   methenamine hippurate                      UROLOGICAL - MISC.                        N
 G   methenamine mandelate                      UROLOGICAL - MISC.                        P
 G   methenamine-methylene blue-benz            UROLOGICAL - MISC.                        N
     acd-phenyl sal-atrop-hyosc
 B   METHERGINE                                 OXYTOCICS                                 P
 G   methimazole tab 10mg                       ANTITHYROID THERAPIES                     N
 B   METHIMAZOLE TAB 20MG                       ANTITHYROID THERAPIES                     N
 G   methimazole tab 5mg                        ANTITHYROID THERAPIES                     N
 B   METHITEST                                  ANDROGENS / ANABOLICS                     N
 G   methocarbamol                              MUSCLE RELAXANTS                          P
 G   methyclothiazide                           DIURETICS                                 P
 G   methyldopa                                 ANTIHYPERTENSIVES - CENTRAL               P
 G   methyldopa & hydrochlorothiazide           ANTIHYPERTENSIVE COMBOS                   P
 G   methylin                                   STIMULANTS - METHYLPHENIDATE              P
 G   methylin er                                STIMULANTS - METHYLPHENIDATE - LONG       NR
                                                ACTING
 G   methylphenidate hcl                        STIMULANTS - METHYLPHENIDATE              P
 G   methylphenidate hcl                        STIMULANTS - METHYLPHENIDATE - LONG       NR
                                                ACTING
 G   methylphenidate hcl er                     STIMULANTS - METHYLPHENIDATE - LONG       NR
                                                ACTING
 G   methylphenidate hcl sa                     STIMULANTS - METHYLPHENIDATE - LONG       NR
                                                ACTING
 G   methylphenidate hcl sr                     STIMULANTS - METHYLPHENIDATE - LONG       NR
                                                ACTING
 G   methylprednisolone                         GLUCOCORTICOIDS - MINERALOCORTICOIDS      P
 G   metipranolol ophth soln 0.3%               OP. BETA - BLOCKERS                       P
 G   metoclopramide hcl inj 5 mg/ml             GI - ANTI - FLATULENTS / GI STIMULANTS    P
 G   metoclopramide hcl syrup 5 mg/5ml          GI - ANTI - FLATULENTS / GI STIMULANTS    P
 G   metoclopramide hcl tab 10 mg               GI - ANTI - FLATULENTS / GI STIMULANTS    P
 G   metoclopramide hcl tab 5 mg                GI - ANTI - FLATULENTS / GI STIMULANTS    P
 G   metolazone                                 DIURETICS                                 P
 G   metoprolol tartrate                        BETA BLOCKERS - CARDIO SELECTIVE          P
 B   METROCREAM                                 TOPICAL - ACNE PREPARATIONS               P      PA Required
 B   METROGEL                                   TOPICAL - ACNE PREPARATIONS               P      PA Required
 B   METROGEL VAGINAL                           VAGINAL - ANTIBACTERIALS                  P
 B   METROLOTION                                TOPICAL - ACNE PREPARATIONS               P      PA Required
 B   METRONIDAZOLE BENZOATE                     TOPICAL - ACNE PREPARATIONS               N      PA Required
 G   metronidazole cap 375 mg                   ANTIBIOTICS - MISC.                       N
 G   metronidazole cream 0.75%                  TOPICAL - ACNE PREPARATIONS               N      PA Required
 G   metronidazole in nacl 0.79% iv soln 500    ANTIBIOTICS - MISC.                       P
     mg/100ml
 G   metronidazole tab 250 mg                   ANTIBIOTICS - MISC.                       P
 G   metronidazole tab 500 mg                   ANTIBIOTICS - MISC.                       P
 G   metronidazole tab sr 24hr 750 mg           ANTIBIOTICS - MISC.                       N
 B   MEVACOR                                    CHOLESTEROL - HMG COA + ABSORB            N
                                                INHIBITORS
 G   mexiletine hcl                             ANTIARRHYTHMICS                           P
 B   MIACALCIN        INJ 200/ML                OSTEOPOROSIS                              N
 B   MIACALCIN        SPR 200/ACT               OSTEOPOROSIS                              P
 B   MICARDIS                                   ANGIOTENSIN RECEPTOR BLOCKER              P
 B   MICARDIS HCT                               ARB'S AND DIURETICS                       P
 O   miconazole nitrate cream 2%                TOPICAL - ANTIFUNGALS                     P
 O   miconazole nitrate vaginal cream 2%        VAGINAL - ANTI FUNGALS                    P
 O   miconazole nitrate vaginal suppos 100 mg   VAGINAL - ANTI FUNGALS                    P
 G   miconazole nitrate vaginal suppos 200 mg   VAGINAL - ANTI FUNGALS                    N
 B   MICRO-K                                    MINERALS                                  P

Report_1010_PDL_A3 rev A                                       12/26/2004                                                Page 35 of 63
B    Drug                                                                     P,                   Comment
or   Name                             Drug Category                           N,
G                                                                            R, or
                                                                             NR
                                                          M                                  - Alpha Continued -
 B   MICRONASE                      DIABETIC - ORAL SULFONYLUREAS             N
 B   MICROZIDE                      DIURETICS                                 N
 B   MIDAMOR                        DIURETICS                                 N
 G   midazolam     inj 1mg/ml       SEDATIVE/HYPNOTICS - BENZODIAZEPINES      P
 G   midazolam     syp 2mg/ml       SEDATIVE/HYPNOTICS - BENZODIAZEPINES      P
 G   midodrine hcl                  PRESSORS                                  N
 B   MIGRANAL                       MIGRAINE - ERGOTAMINE DERIVATIVES         P      PA Required: > 18 Units/30Days Supply
 B   MILTOWN                        ANXIOLYTICS - MISC.                       N
 B   MINIPRESS                      ANTIHYPERTENSIVES - CENTRAL               N
 B   MINIZIDE                       ANTIHYPERTENSIVE COMBOS                   N
 B   MINOCIN                        TETRACYCLINES                             N
 G   minocycline hcl                TETRACYCLINES                             P
 G   minoxidil                      ANTIHYPERTENSIVES - CENTRAL               P
 G   mintex                         COUGH/COLD - DECONGESTANT &               N
                                    ANTIHISTAMINE
 B   MINTEZOL                       ANTHELMINTICS                             P
 B   MIRALAX         PAK 3350 NF    GI - ANTI - FLATULENTS / GI STIMULANTS    N
 B   MIRALAX         POW 3350 NF    GI - ANTI - FLATULENTS / GI STIMULANTS    N
 B   MIRAPEX                        PARKINSONS - SELECTED DOPAMIN             P
                                    AGONISTS
 B   MIRCETTE                       CONTRACEPTIVES - MONOPHASIC               P
                                    COMBINATION O/C'S
 G   mirtazapine                    ANTIDEPRESSANTS - SELECTED SSRI'S         P
 G   mirtazapine                    ANTIDEPRESSANTS - SELECTED SSRI'S         R
 G   misoprostol                    GI - PROSTAGLANDINS                       N
 B   MOBIC                          COX 2 INHIBITORS - SELECTIVE              P      PA Required
 B   MODICON-28                     CONTRACEPTIVES - MONOPHASIC               P
                                    COMBINATION O/C'S
 B   MODURETIC 5-50                 DIURETICS                                 N
 G   mometasone furoate oint 0.1%   TOPICAL - CORTICOSTEROIDS                 N
 B   MONISTAT 3                     VAGINAL - ANTI FUNGALS                    N
 B   MONISTAT 7 COMBINATION PA      VAGINAL - ANTI FUNGALS                    P
 B   MONODOX                        TETRACYCLINES                             N
 B   MONOPRIL                       ACE INHIBITORS                            P
 B   MONOPRIL HCT                   ACE AND THIAZIDE COMBO'S                  P
 B   MONUROL                        UROLOGICAL - MISC.                        P
 G   morphine sul inj 10mg/ml       NARCOTICS-LONG ACTING                     P
 G   morphine sul inj 15mg/ml       NARCOTICS-LONG ACTING                     P
 G   morphine sul inj 25mg/ml       NARCOTICS-LONG ACTING                     P
 G   morphine sul inj 2mg/ml        NARCOTICS-LONG ACTING                     P
 B   MORPHINE SUL INJ 4MG/ML        NARCOTICS-LONG ACTING                     P
 G   morphine sul inj 50mg/ml       NARCOTICS-LONG ACTING                     N
 G   morphine sul inj 5mg/ml        NARCOTICS-LONG ACTING                     P
 G   morphine sul inj 8mg/ml        NARCOTICS-LONG ACTING                     P
 B   MORPHINE SUL POW               NARCOTICS - MICS.                         N
 B   MORPHINE SUL POW USP           NARCOTICS - MICS.                         N
 B   MORPHINE SUL SOL 10MG/5ML      NARCOTICS-LONG ACTING                     P
 B   MORPHINE SUL SOL 20MG/10       NARCOTICS-LONG ACTING                     P
 B   MORPHINE SUL SOL 20MG/5ML      NARCOTICS-LONG ACTING                     P
 G   morphine sul sol 20mg/ml       NARCOTICS - MICS.                         P
 G   morphine sul sup 10mg          NARCOTICS-LONG ACTING                     P
 G   morphine sul sup 20mg          NARCOTICS-LONG ACTING                     P
 G   morphine sul sup 5mg           NARCOTICS-LONG ACTING                     N
 B   MORPHINE SUL TAB 10MG          NARCOTICS - MICS.                         P
 G   morphine sul tab 15mg          NARCOTICS - MICS.                         P
 G   morphine sul tab 30mg          NARCOTICS - MICS.                         P


Report_1010_PDL_A3 rev A                             12/26/2004                                              Page 36 of 63
B    Drug                                                                             P,                   Comment
or   Name                                       Drug Category                         N,
G                                                                                    R, or
                                                                                     NR
                                                                  M                                  - Alpha Continued -
 G   morphine sulfate tab sr 12hr 100 mg      NARCOTICS-LONG ACTING                   N
 G   morphine sulfate tab sr 12hr 15 mg       NARCOTICS-LONG ACTING                   P
 G   morphine sulfate tab sr 12hr 200 mg      NARCOTICS-LONG ACTING                   N
 G   morphine sulfate tab sr 12hr 30 mg       NARCOTICS-LONG ACTING                   N
 G   morphine sulfate tab sr 12hr 60 mg       NARCOTICS-LONG ACTING                   N
 B   MOTOFEN                                  GI - ANTIPERISTALTIC AGENTS             N
 B   MOTRIN                                   NSAIDS                                  N      PA Required
 B   MS CONTIN       TAB 100MG CR             NARCOTICS-LONG ACTING                   N
 B   MS CONTIN       TAB 15MG CR              NARCOTICS-LONG ACTING                   N
 B   MS CONTIN       TAB 200MG CR             NARCOTICS-LONG ACTING                   N
 B   MS CONTIN       TAB 30MG CR              NARCOTICS-LONG ACTING                   N
 B   MS CONTIN       TAB 60MG CR              NARCOTICS-LONG ACTING                   N
 G   msir                                     NARCOTICS - MICS.                       P
 B   MUCO-FEN DM                              COUGH/COLD - ANTITUSSIVE-EXPECTORANT    N
 B   MUCOMYST                                 ANTIASTHMATIC - MUCOLYTICS              P
 B   MUCOMYST-10                              ANTIASTHMATIC - MUCOLYTICS              P
 B   MULTILYTE-20                             ELECTROLYTES/ NUTRITIONALS              N
 G   mupirocin oint 2%                        TOPICAL - ANTIBIOTIC                    N
 B   MUSE                                     IMPOTENCE AGENTS                        N      PA Required
 B   MYCELEX                                  ANTIFUNGALS - ASSORTED                  P      PA Required > 90 days
 B   MYCOBUTIN                                ANTIMYCOBACTERIALS /                    N
                                              ANTITUBERCULOSIS
 B   MYCOSTATIN                               TOPICAL - ANTIFUNGALS                   N
 B   MYOBLOC                                  NEUROMUSCULAR BLOCKING AGENTS           N
 B   MYOCHRYSINE                              ARTHRITIS - MISC.                       P
 B   MYSOLINE                                 ANTICONVULSANTS                         P
 G   mytussin ac                              COUGH/COLD - ANTITUSSIVE-EXPECTORANT    P
 G   mytussin dac                             COUGH/COLD -                            P
                                              ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                              ANT

                                                                     N
 O   *neomycin-bacitracin-polymyxin oint***   TOPICAL - ANTIBIOTIC                    P
 G   nabumetone                               COX 2 INHIBITORS - SELECTIVE            P
 G   nadolol                                  BETA BLOCKERS - NON SELECTIVE           P
 B   NAFCILLIN SODIUM                         BETA-LACTAMS / CLAVULANATE COMBO'S      P
 G   nafcillin sodium for inj 1 gm            BETA-LACTAMS / CLAVULANATE COMBO'S      P
 G   nafcillin sodium for iv soln 2 gm        BETA-LACTAMS / CLAVULANATE COMBO'S      P
 B   NAFTIN                                   TOPICAL - ANTIFUNGALS                   P
 G   nalbuphine hcl inj 10 mg/ml              NARCOTICS - SELECTED                    P
 G   nalbuphine hcl inj 20 mg/ml              NARCOTICS - SELECTED                    P
 B   NALEX DH                                 COUGH/COLD - NARCOTIC                   N
                                              ANTITUSSIVE-DECONGESTANT
 B   NALEX-A                                  COUGH/COLD - DECONGESTANT &             N
                                              ANTIHISTAMINE
 G   naloxone hcl inj 0.4 mg/ml               NARCOTIC - ANTAGONISTS                  N
 G   naltrexone hcl tab 50 mg                 NARCOTIC - ANTAGONISTS                  P
 B   NAMENDA                                  ALZHEIMER - CHOLINOMIMETICS             P
 B   NAMENDA TITRATION PAK                    ALZHEIMER - CHOLINOMIMETICS             P
 G   naphazoline hcl ophth soln 0.1%          OP. MISC                                P
 B   NAPRELAN                                 NSAIDS                                  N      PA Required
 B   NAPROSYN        SUS 125/5ML              NSAIDS                                  P
 B   NAPROSYN        TAB 500MG                NSAIDS                                  N      PA Required
 G   naproxen                                 NSAIDS                                  P
 G   naproxen sodium                          NSAIDS                                  N      PA Required
 G   naproxen sodium tab 275 mg               NSAIDS                                  N      PA Required
 G   naproxen sodium tab 550 mg               NSAIDS                                  N      PA Required

Report_1010_PDL_A3 rev A                                     12/26/2004                                              Page 37 of 63
B    Drug                                                                              P,                   Comment
or   Name                                      Drug Category                           N,
G                                                                                     R, or
                                                                                      NR
                                                                   N                                    - Alpha Continued -
 B   NARCAN                                  NARCOTIC - ANTAGONISTS                    N
 B   NARDIL                                  ANTIDEPRESSANTS - MAO INHIBITORS          R
 B   NASACORT AQ                             ANTIASTHMATIC - NASAL STEROIDS            N
 B   NASAREL                                 ANTIASTHMATIC - NASAL STEROIDS            P
 B   NASCOBAL                                VITAMINS                                  N      RX Only
 B   NASONEX                                 ANTIASTHMATIC - NASAL STEROIDS            P
 B   NATACHEW                                VITAMINS - MISC.                          N
 B   NATELLE                                 VITAMINS - MISC.                          N
 B   NATURETIN                               DIURETICS                                 N
 B   NEBUPENT                                ANTIBIOTICS - MISC.                       P
 G   nefazodone hcl                          ANTIDEPRESSANTS - SELECTED SSRI'S         P
 B   NEGGRAM                                 UROLOGICAL - MISC.                        N
 G   neomycin sulfate                        AMINO GLYCOSIDES                          P
 G   neomycin/polymyxin/hydroc               EAR                                       N
 G   neomycin-bacitrac zn-polymyx            OP. ANTIBIOTICS                           P
     3.5(5)mg-400unt-10000unt op oin
 G   neomycin-polymyxin b-gramicidin ophth   OP. ANTIBIOTICS                           P
     soln
 G   neomycin-polymyxin-dexamethasone        OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    P
     ophth oint 0.1%
 G   neomycin-polymyxin-dexamethasone        OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    P
     ophth susp 0.1%
 G   neomycin-polymyxin-hc ophth susp        OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    N
 G   neosol                                  GI - ANTIDIARRHEAL / ANTACID - MISC.      P
 B   NEOSPORIN                               OP. ANTIBIOTICS                           N
 B   NEOSPORIN GU IRRIGANT                   UROLOGICAL - MISC.                        P
 B   NEPHPLEX RX                             VITAMINS - MISC.                          P
 B   NEPHROCAPS                              VITAMINS - MISC.                          N
 B   NEPHRON FA                              VITAMINS - MISC.                          N
 B   NEPHRO-VITE RX                          VITAMINS - MISC.                          N
 B   NESTABS CBF                             VITAMINS - MISC.                          N
 B   NESTABS FA                              VITAMINS - MISC.                          N
 B   NESTABS RX                              VITAMINS - MISC.                          N
 B   NEULASTA                                GRANULOCYTE CSF                           N      PA Required
 B   NEUMEGA                                 GRANULOCYTE CSF                           N      PA Required
 B   NEUPOGEN                                GRANULOCYTE CSF                           P      PA Required
 B   NEURONTIN                               ANTICONVULSANTS                           P
 B   NEXIUM                                  GI - PROTON PUMP INHIBITOR                P      PA Required > 60 days
 B   NIACIN                                  VITAMINS                                  P      RX Only
 O   niacin tab 100 mg                       VITAMINS                                  P
 O   niacin tab 250 mg                       VITAMINS                                  P
 O   niacin tab 50 mg                        VITAMINS                                  P
 O   niacin tab 500 mg                       VITAMINS                                  P
 B   NIASPAN                                 CHOLESTEROL - FIBRIC ACID DERIVATIVES     P
 G   nicardipine hcl                         NICARDIPINES                              N
 G   nifediac cc                             CALCIUM CHANNEL BLOCKERS--NIFEDIPINES     N
 G   nifedical xl                            CALCIUM CHANNEL BLOCKERS--NIFEDIPINES     N
 G   nifedipine                              CALCIUM CHANNEL BLOCKERS--NIFEDIPINES     P
 G   nifedipine er                           CALCIUM CHANNEL BLOCKERS--NIFEDIPINES     N
 B   NIFEREX-150 FORTE                       VITAMINS - MISC.                          N
 B   NIMOTOP                                 CALCIUM CHANNEL BLOCKERS--NIFEDIPINES     N
 B   NITROBID                                NITRO - OINTMENT/CAP/CR                   P
 B   NITRO-DUR         DIS 0.1MG/HR          NITRO - PATCHES                           N
 B   NITRO-DUR         DIS 0.2MG/HR          NITRO - PATCHES                           N
 B   NITRO-DUR         DIS 0.3MG/HR          NITRO - PATCHES                           N
 B   NITRO-DUR         DIS 0.4MG/HR          NITRO - PATCHES                           N


Report_1010_PDL_A3 rev A                                       12/26/2004                                             Page 38 of 63
B    Drug                                                                              P,                   Comment
or   Name                                             Drug Category                    N,
G                                                                                     R, or
                                                                                      NR
                                                                          N                           - Alpha Continued -
 B   NITRO-DUR       DIS 0.6MG/HR                   NITRO - PATCHES                    N
 B   NITRO-DUR       DIS 0.8MG/HR                   NITRO - PATCHES                    P
 B   NITROFURANTOIN MACROCRYST                      UROLOGICAL - MISC.                 N
 G   nitrofurantoin macrocrystal                    UROLOGICAL - MISC.                 N
 G   nitrofurantoin monohyd macro                   UROLOGICAL - MISC.                 N
 G   nitroglycerin                                  NITRO - OINTMENT/CAP/CR            P
 G   nitroglycerin sl tab 0.3 mg                    NITRO - SUBLINGUAL/ SPRAY          P
 G   nitroglycerin sl tab 0.4 mg                    NITRO - SUBLINGUAL/ SPRAY          P
 G   nitroglycerin sl tab 0.6 mg                    NITRO - SUBLINGUAL/ SPRAY          P
 G   nitroglycerin td patch 24hr 0.1 mg/hr          NITRO - PATCHES                    P
 G   nitroglycerin td patch 24hr 0.2 mg/hr          NITRO - PATCHES                    P
 G   nitroglycerin td patch 24hr 0.4 mg/hr          NITRO - PATCHES                    P
 G   nitroglycerin td patch 24hr 0.6 mg/hr          NITRO - PATCHES                    P
 B   NITROLINGUAL PUMPSPRAY                         NITRO - SUBLINGUAL/ SPRAY          N
 B   NITROSTAT       SUB 0.3MG                      NITRO - SUBLINGUAL/ SPRAY          P
 B   NITROSTAT       SUB 0.4MG                      NITRO - SUBLINGUAL/ SPRAY          N
 B   NITROSTAT       SUB 0.6MG                      NITRO - SUBLINGUAL/ SPRAY          P
 G   nizatidine                                     GI - H2-ANTAGONISTS                N
 B   NIZORAL                                        ANTIFUNGALS - ASSORTED             N
 B   NIZORAL                                        TOPICAL - ANTIFUNGALS              P
 B   NORCO                                          NARCOTICS - MICS.                  N
 B   NORDETTE-21                                    CONTRACEPTIVES - MONOPHASIC        P
                                                    COMBINATION O/C'S
 B   NORDETTE-28                                    CONTRACEPTIVES - MONOPHASIC        P
                                                    COMBINATION O/C'S
 B   NORDITROPIN CARTRIDGE                          GROWTH HORMONE                     N      PA Required
 G   norethindrone & ethinyl estradiol tab 0.5      CONTRACEPTIVES - MONOPHASIC        N
     mg-35 mcg                                      COMBINATION O/C'S
 G   norethindrone & ethinyl estradiol tab 1        CONTRACEPTIVES - MONOPHASIC        N
     mg-35 mcg                                      COMBINATION O/C'S
 G   norethindrone & mestranol tab 1 mg-50          CONTRACEPTIVES - MONOPHASIC        N
     mcg                                            COMBINATION O/C'S
 G   norethindrone ace & ethinyl estradiol tab 1    CONTRACEPTIVES - MONOPHASIC        N
     mg-20 mcg                                      COMBINATION O/C'S
 G   norethindrone ace & ethinyl estradiol tab      CONTRACEPTIVES - MONOPHASIC        N
     1.5 mg-30 mcg                                  COMBINATION O/C'S
 G   norethindrone ace & ethinyl estradiol-fe tab   CONTRACEPTIVES - MONOPHASIC        N
     1 mg-20 mcg                                    COMBINATION O/C'S
 G   norethindrone ace & ethinyl estradiol-fe tab   CONTRACEPTIVES - MONOPHASIC        N
     1.5 mg-30 mcg                                  COMBINATION O/C'S
 G   norethindrone acetate                          PROGESTINS                         N
 G   norethindrone tab 0.35 mg                      CONTRACEPTIVES - PROGESTIN ONLY    N
 G   norethindrone-eth estradiol tab                CONTRACEPTIVES - TRI-PHASIC        N
     0.5-35/0.75-35/1-35 mg-mcg                     COMBINATIONS
 G   norethindrone-eth estradiol tab 0.5-35/1-35    CONTRACEPTIVES - BI-PHASIC         N
     mg-mcg (10/11)                                 COMBINATIONS
 B   NORFLEX                                        MUSCLE RELAXANTS                   N      PA Required
 B   NORGESIC FORTE                                 MUSCLE RELAXANT -COMBINATIONS      P
 G   norgestimate & ethinyl estradiol tab 0.25      CONTRACEPTIVES - MONOPHASIC        N
     mg-35 mcg                                      COMBINATION O/C'S
 G   norgestimate-eth estrad tab                    CONTRACEPTIVES - TRI-PHASIC        N
     0.18-35/0.215-35/0.25-35 mg-mcg                COMBINATIONS
 G   norgestrel & ethinyl estradiol tab 0.3 mg-30   CONTRACEPTIVES - MONOPHASIC        N
     mcg                                            COMBINATION O/C'S
 G   norgestrel & ethinyl estradiol tab 0.5 mg-50   CONTRACEPTIVES - MONOPHASIC        N
     mcg                                            COMBINATION O/C'S
 B   NORINYL 1+35                                   CONTRACEPTIVES - MONOPHASIC        N
                                                    COMBINATION O/C'S
 B   NORITATE                                       TOPICAL - ACNE PREPARATIONS        N      PA Required
 B   NOROXIN                                        FLUOROQUINOLONES                   P
 B   NORPACE                                        ANTIARRHYTHMICS                    P

Report_1010_PDL_A3 rev A                                          12/26/2004                                          Page 39 of 63
B    Drug                                                                                P,                   Comment
or   Name                                        Drug Category                           N,
G                                                                                       R, or
                                                                                        NR
                                                                     N                                  - Alpha Continued -
 B   NORPACE CR                                ANTIARRHYTHMICS                           P
 B   NORPRAMIN                                 ANTIDEPRESSANTS - TRI-CYCLICS             N
 B   NOR-QD                                    CONTRACEPTIVES - PROGESTIN ONLY           N
 G   nortriptyline hcl                         ANTIDEPRESSANTS - TRI-CYCLICS             P
 B   NORVASC                                   CALCIUM CHANNEL                           P
                                               BLOCKERS--AMLODIPINES
 B   NOVAHISTINE EXPECTORANT                   COUGH/COLD -                              N
                                               ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                               ANT
 B   NOVANATAL                                 VITAMINS - MISC.                          N
 B   NOVASTART                                 VITAMINS - MISC.                          N
 O   NOVOLIN 70/30                             DIABETIC - INSULIN                        P
 O   NOVOLIN 70/30 INNOLET                     DIABETIC - PENFILLS                       P      PA Required
 O   NOVOLIN 70/30 PENFILL                     DIABETIC - PENFILLS                       P      PA Required
 O   NOVOLIN N                                 DIABETIC - INSULIN                        P
 O   NOVOLIN N INNOLET                         DIABETIC - PENFILLS                       P      PA Required
 O   NOVOLIN N U-100 PENFILL                   DIABETIC - PENFILLS                       P      PA Required
 O   NOVOLIN R                                 DIABETIC - INSULIN                        P
 O   NOVOLIN R INNOLET                         DIABETIC - PENFILLS                       P      PA Required
 O   NOVOLIN R U-100 PENFILL                   DIABETIC - PENFILLS                       P      PA Required
 B   NOVOLOG                                   DIABETIC - INSULIN                        P
 B   NOVOLOG FLEXPEN                           DIABETIC - PENFILLS                       P      PA Required
 B   NOVOLOG MIX 70/30                         DIABETIC - INSULIN                        P
 B   NOVOLOG MIX 70/30 PENFILL                 DIABETIC - PENFILLS                       P      PA Required
 B   NOVOLOG MIX 70/30 PREFILL                 DIABETIC - PENFILLS                       P      PA Required
 B   NOVOLOG PENFILL                           DIABETIC - PENFILLS                       P      PA Required
 B   NUBAIN                                    NARCOTICS - SELECTED                      N
 B   NUCOFED                                   COUGH/COLD - NARCOTIC                     N
                                               ANTITUSSIVE-DECONGESTANT
 B   NUCOFED EXPECTORANT                       COUGH/COLD -                              N
                                               ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                               ANT
 B   NULEV                                     GI - ANTIDIARRHEAL / ANTACID - MISC.      N
 B   NULYTELY        SOL                       GI - ANTI - FLATULENTS / GI STIMULANTS    P
 B   NULYTELY        SOL CHERRY                GI - ANTI - FLATULENTS / GI STIMULANTS    P
 B   NULYTELY        SOL LMN/LIME              GI - ANTI - FLATULENTS / GI STIMULANTS    P
 B   NULYTELY        SOL ORANGE                GI - ANTI - FLATULENTS / GI STIMULANTS    P
 B   NUTROPIN                                  GROWTH HORMONE                            N      PA Required
 B   NUTROPIN AQ                               GROWTH HORMONE                            N      PA Required
 B   NUTROPIN AQ PEN                           GROWTH HORMONE                            N      PA Required
 B   NUTROPIN DEPOT                            GROWTH HORMONE                            N      PA Required
 B   NUVARING                                  CONTRACEPTIVES - PATCHES/ VAGINAL         N
                                               PRODUCTS
 G   nystatin                                  ANTIFUNGALS - ASSORTED                    P
 G   nystatin                                  VAGINAL - ANTI FUNGALS                    P
 G   nystatin cream 100000 unit/gm             TOPICAL - ANTIFUNGALS                     P
 G   nystatin oint 100000 unit/gm              TOPICAL - ANTIFUNGALS                     P
 G   nystatin susp 100000 unit/ml              MOUTH ANTI-INFECTIVES                     P
 G   nystatin topical powder                   TOPICAL - ANTIFUNGALS                     P
 G   nystatin-triamcinolone cream 100000-0.1   TOPICAL - ANTIFUNGALS                     P
     unit/gm-%
 G   nystatin-triamcinolone oint 100000-0.1    TOPICAL - ANTIFUNGALS                     P
     unit/gm-%
 B   NYSTAT-RX                                 TOPICAL - ANTIFUNGALS                     N

                                                                     O
 O   *oral electrolyte solution***             ELECTROLYTES/ NUTRITIONALS                P
 B   OCUFEN                                    OP. NSAID'S                               N


Report_1010_PDL_A3 rev A                                      12/26/2004                                                Page 40 of 63
B    Drug                                                                               P,                   Comment
or   Name                                       Drug Category                           N,
G                                                                                      R, or
                                                                                       NR
                                                                  O                                    - Alpha Continued -
 B   OCUFLOX                                  OP. QUINOLONES                            P
 G   ofloxacin                                FLUOROQUINOLONES                          N
 G   ofloxacin ophth soln 0.3%                OP. QUINOLONES                            N
 B   OGEN                                     ESTROGENS - TABS                          N
 B   OLUX                                     TOPICAL - CORTICOSTEROIDS                 N
 G   omeprazole                               GI - PROTON PUMP INHIBITOR                N      PA Required from Day 1
 G   omeprazole                               COMPOUNDING MATERIALS                     N
 O   OMEPRAZOLE MAGNESIUM DELAYED             GI - PROTON PUMP INHIBITOR                P      PA Required > 60 days
     RELEASE TAB 20 MG (BASE EQUIV)
 B   OMNICEF                                  CEPHALOSPORINS                            P
 G   omnihist l.a.                            COUGH/COLD -                              N
                                              DECONGESTANT-ANTIHISTAMINE-ANTICHOLI
                                              NERGIC
 B   OPIUM TINCTURE                           GI - ANTIPERISTALTIC AGENTS               P
 B   OPTIPRANOLOL                             OP. BETA - BLOCKERS                       N
 B   OPTIVAR                                  OP. ANTIALLERGICS                         N
 B   ORAMORPH SR                              NARCOTICS-LONG ACTING                     N
 B   ORAP                                     NEUROLOGICS - MISC.                       P
 B   ORAPRED                                  GLUCOCORTICOIDS - MINERALOCORTICOIDS      P
 B   ORGANIDIN NR                             COUGH/COLD - EXPECTORANTS                 N
 G   orphenadrine citrate                     MUSCLE RELAXANTS                          P
 G   orphenadrine w/ aspirin & caffeine tab   MUSCLE RELAXANT -COMBINATIONS             P
     25-385-30 mg
 G   orphenadrine w/ aspirin & caffeine tab   MUSCLE RELAXANT -COMBINATIONS             N      PA Required
     50-770-60 mg
 B   ORTHO EVRA                               CONTRACEPTIVES - PATCHES/ VAGINAL         P
                                              PRODUCTS
 B   ORTHO MICRONOR                           CONTRACEPTIVES - PROGESTIN ONLY           P
 B   ORTHO TRI-CYCLEN                         CONTRACEPTIVES - TRI-PHASIC               P
                                              COMBINATIONS
 B   ORTHO TRI-CYCLEN LO                      CONTRACEPTIVES - TRI-PHASIC               N
                                              COMBINATIONS
 B   ORTHO-CEPT-28                            CONTRACEPTIVES - MONOPHASIC               P
                                              COMBINATION O/C'S
 B   ORTHO-CYCLEN-28                          CONTRACEPTIVES - MONOPHASIC               P
                                              COMBINATION O/C'S
 B   ORTHO-NOVUM 1/35-28                      CONTRACEPTIVES - MONOPHASIC               P
                                              COMBINATION O/C'S
 B   ORTHO-NOVUM 1/50-28                      CONTRACEPTIVES - MONOPHASIC               P
                                              COMBINATION O/C'S
 B   ORTHO-NOVUM 10/11-28                     CONTRACEPTIVES - BI-PHASIC                P
                                              COMBINATIONS
 B   ORTHO-NOVUM 7/7/7-28                     CONTRACEPTIVES - TRI-PHASIC               P
                                              COMBINATIONS
 B   ORUVAIL                                  NSAIDS                                    N      PA Required
 B   OVACE                                    TOPICAL - ANTISEBORRHEICS                 N
 B   OVACE WASH                               TOPICAL - ANTISEBORRHEICS                 P
 B   OVCON-35/28                              CONTRACEPTIVES - MONOPHASIC               P
                                              COMBINATION O/C'S
 B   OVCON-50 28                              CONTRACEPTIVES - MONOPHASIC               P
                                              COMBINATION O/C'S
 B   OVIDE                                    TOPICAL - SCABICIDES AND PEDICULICIDES    N
 B   OVRAL 28                                 CONTRACEPTIVES - MONOPHASIC               P
                                              COMBINATION O/C'S
 B   OVRETTE 28                               CONTRACEPTIVES - PROGESTIN ONLY           N
 B   OXACILLIN SODIUM                         BETA-LACTAMS / CLAVULANATE COMBO'S        P
 B   OXANDRIN                                 ANDROGENS / ANABOLICS                     P
 G   oxaprozin                                NSAIDS                                    P
 G   oxazepam                                 ANXIOLYTICS - BENZODIAZEPINES             P
 B   OXISTAT                                  TOPICAL - ANTIFUNGALS                     N
 B   OXSORALEN ULTRA                          ANTI-PSORIATICS                           P


Report_1010_PDL_A3 rev A                                    12/26/2004                                                  Page 41 of 63
B    Drug                                                                                       P,       Comment
or   Name                                              Drug Category                            N,
G                                                                                              R, or
                                                                                               NR
                                                                         O                             - Alpha Continued -
 G   oxybutynin chloride syrup 5 mg/5ml              ANTISPASMODICS                             P
 G   oxybutynin chloride tab 5 mg                    ANTISPASMODICS                             P
 G   oxycod/apap cap 5-500mg                         NARCOTICS - MICS.                          P
 G   oxycod/apap tab 5-325mg                         NARCOTICS - MICS.                          P
 G   oxycodone hcl                                   NARCOTICS-LONG ACTING                      N
 G   oxycodone hcl                                   NARCOTICS - MICS.                          P
 G   oxycodone hcl tab 15 mg                         NARCOTICS - MICS.                          P
 G   oxycodone hcl tab 30 mg                         NARCOTICS - MICS.                          P
 G   oxycodone hcl tab 5 mg                          NARCOTICS - MICS.                          N
 G   oxycodone w/ acetaminophen tab 10-325           NARCOTICS - MICS.                          N
     mg
 G   oxycodone w/ acetaminophen tab 10-650           NARCOTICS - MICS.                          N
     mg
 G   oxycodone w/ acetaminophen tab 5-325            NARCOTICS - MICS.                          P
     mg
 G   oxycodone w/ acetaminophen tab 7.5-325          NARCOTICS - MICS.                          N
     mg
 G   oxycodone w/ acetaminophen tab 7.5-500          NARCOTICS - MICS.                          P
     mg
 G   oxycodone w/ aspirin                            NARCOTICS - MICS.                          P
 B   OXYCONTIN                                       NARCOTICS-LONG ACTING                      P
 G   oxydose                                         NARCOTICS - MICS.                          P
 G   oxyfast                                         NARCOTICS - MICS.                          P
 B   OXYIR                                           NARCOTICS - MICS.                          N
 B   OXYTROL                                         ANTISPASMODICS - LONG ACTING               N

                                                                         P
 G   *papain-urea-chlorophyllin ointment***          TOPICAL - ENZYMES / KERATOLYTICS / UREA    P
 G   *pediatric multiple vitamins w/ fl-fe chew      VITAMINS - MISC.                           P
     tab 0.5-12 mg**
 G   *pediatric multiple vitamins w/ fl-fe chew      VITAMINS - MISC.                           P
     tab 1-12 mg**
 G   *pediatric multiple vitamins w/ fl-fe drops     VITAMINS - MISC.                           P
     0.25-10 mg/ml**
 G   *pediatric multiple vitamins w/ fl-fe drops     VITAMINS - MISC.                           P
     0.5-10 mg/ml**
 G   *pediatric multiple vitamins w/ fluoride        VITAMINS - MISC.                           P
     chew tab 0.25 mg***
 G   *pediatric multiple vitamins w/ fluoride        VITAMINS - MISC.                           P
     chew tab 0.5 mg***
 G   *pediatric multiple vitamins w/ fluoride        VITAMINS - MISC.                           P
     chew tab 1 mg***
 G   *pediatric multiple vitamins w/ fluoride soln   VITAMINS - MISC.                           P
     0.25 mg/ml***
 G   *pediatric multiple vitamins w/ fluoride soln   VITAMINS - MISC.                           P
     0.5 mg/ml***
 G   *pediatric vitamins acd fluoride & fe drops     VITAMINS - MISC.                           P
     0.25-10 mg/ml***
 G   *pediatric vitamins acd w/ fluoride chew tab    VITAMINS - MISC.                           P
     1 mg***
 G   *pediatric vitamins acd w/ fluoride soln 0.25   VITAMINS - MISC.                           P
     mg/ml***
 G   *pediatric vitamins acd w/ fluoride soln 0.5    VITAMINS - MISC.                           P
     mg/ml***
 G   *prenatal mv-min w/fe-fa tab & ca chew tab      VITAMINS - MISC.                           P
     therapy pack***
 G   *prenatal vit w/ dss-fe fumarate-fa tab 29-1    VITAMINS - MISC.                           N
     mg***
 G   *prenatal vit w/ dss-fe fumarate-fa tab cr      VITAMINS - MISC.                           P
     90-1 mg***
 G   *prenatal vit w/ dss-iron carbonyl-fa tab       VITAMINS - MISC.                           P
     90-1 mg***
 G   *prenatal vit w/ fe fumarate-fa chew tab        VITAMINS - MISC.                           P
     29-1 mg***


Report_1010_PDL_A3 rev A                                            12/26/2004                                      Page 42 of 63
B    Drug                                                                                       P,                   Comment
or   Name                                              Drug Category                            N,
G                                                                                              R, or
                                                                                               NR
                                                                         P                                     - Alpha Continued -
 G   *prenatal vit w/ fe fumarate-fa tab 27-0.5      VITAMINS - MISC.                           P
     mg***
 G   *prenatal vit w/ fe fumarate-fa tab 27-1        VITAMINS - MISC.                           P
     mg***
 G   *prenatal vit w/ fe fumarate-fa tab 28-1        VITAMINS - MISC.                           N
     mg***
 G   *prenatal vit w/ fe fumarate-fa tab 29-1        VITAMINS - MISC.                           N
     mg***
 G   *prenatal vit w/ fe fumarate-fa tab 65-1        VITAMINS - MISC.                           P
     mg***
 G   *prenatal vit w/ fe polysac cmplx-fa tab        VITAMINS - MISC.                           N
     60-1 mg***
 G   *prenatal vit w/ iron carbonyl-fa tab 29-1      VITAMINS - MISC.                           N
     mg***
 G   *prenatal vit w/ iron carbonyl-fe gluc-fa tab   VITAMINS - MISC.                           P
     27-1 mg***
 G   *prenatal vit w/ iron carbonyl-fe sulf-fa tab   VITAMINS - MISC.                           N
     60-1 mg***
 G   *prenatal vit w/ sel-fe fumarate-fa tab 27-1    VITAMINS - MISC.                           P
     mg***
 G   *prenatal without a w/ fe                       VITAMINS - MISC.                           N
     carbonyl-docusate-fa tab 90-1mg***
 B   PACERONE                                        ANTIARRHYTHMICS                            N
 B   PAMELOR                                         ANTIDEPRESSANTS - TRI-CYCLICS              N
 G   pamidronate disodium                            OSTEOPOROSIS                               N
 B   PAMINE                                          GI - ANTIDIARRHEAL / ANTACID - MISC.       P
 B   PANAFIL                                         TOPICAL - ENZYMES / KERATOLYTICS / UREA    P
 B   PANCOF                                          COUGH/COLD - NARCOTIC                      N
                                                     ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                                     NE
 B   PANCOF EXP                                      COUGH/COLD -                               N
                                                     ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                                     ANT
 B   PANCOF PD                                       COUGH/COLD - NARCOTIC                      N
                                                     ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                                     NE
 B   PANCREASE                                       GI - DIGESTIVE ENZYMES                     P      PA Required
 B   PANCREASE MT 10                                 GI - DIGESTIVE ENZYMES                     N      PA Required
 B   PANCREASE MT 16                                 GI - DIGESTIVE ENZYMES                     N      PA Required
 B   PANCREASE MT 20                                 GI - DIGESTIVE ENZYMES                     N      PA Required
 B   PANCREASE MT 4                                  GI - DIGESTIVE ENZYMES                     N      PA Required
 B   PANCRECARB MS-4                                 GI - DIGESTIVE ENZYMES                     P      PA Required
 B   PANCRECARB MS-8                                 GI - DIGESTIVE ENZYMES                     N      PA Required
 G   pancrelipase                                    GI - DIGESTIVE ENZYMES                     P      PA Required
 G   pancrelipase mst-16                             GI - DIGESTIVE ENZYMES                     P      PA Required
 B   PANDEL                                          TOPICAL - CORTICOSTEROIDS                  N
 G   pangestyme cn 10                                GI - DIGESTIVE ENZYMES                     P      PA Required
 G   pangestyme cn 20                                GI - DIGESTIVE ENZYMES                     P      PA Required
 G   pangestyme ec                                   GI - DIGESTIVE ENZYMES                     P      PA Required
 G   pangestyme mt 16                                GI - DIGESTIVE ENZYMES                     P      PA Required
 G   pangestyme ul 12                                GI - DIGESTIVE ENZYMES                     P      PA Required
 G   pangestyme ul 18                                GI - DIGESTIVE ENZYMES                     P      PA Required
 G   pangestyme ul 20                                GI - DIGESTIVE ENZYMES                     P      PA Required
 B   PANLOR DC                                       NARCOTICS - MICS.                          N
 B   PANLOR SS                                       NARCOTICS - MICS.                          N
 B   PANMIST JR                                      COUGH/COLD - DECONGESTANT W/               N
                                                     EXPECTORANT
 B   PANMIST LA                                      COUGH/COLD - DECONGESTANT W/               N
                                                     EXPECTORANT
 B   PANNAZ                                          COUGH/COLD -                               N
                                                     DECONGESTANT-ANTIHISTAMINE-ANTICHOLI
                                                     NERGIC


Report_1010_PDL_A3 rev A                                            12/26/2004                                                 Page 43 of 63
B    Drug                                                                                   P,                 Comment
or   Name                                           Drug Category                           N,
G                                                                                          R, or
                                                                                           NR
                                                                        P                                   - Alpha Continued -
 B   PANNAZ S                                     COUGH/COLD -                              N
                                                  DECONGESTANT-ANTIHISTAMINE-ANTICHOLI
                                                  NERGIC
 G   papain-urea ointment 0.83 mmu-100            TOPICAL - WOUND / DECUBITUS CARE          P
     mg/gm (usp ref std f-3)
 G   papaverine hcl cap cr 150 mg                 PERIPHERAL VASODILATORS                   P
 G   papaverine hcl inj 30 mg/ml                  PERIPHERAL VASODILATORS                   P
 G   paregoric                                    GI - ANTIPERISTALTIC AGENTS               P
 B   PARLODEL                                     ANTI-PARKINSONIAN DRUGS                   P
 B   PARNATE                                      ANTIDEPRESSANTS - MAO INHIBITORS          R
 G   paromomycin sulfate                          AMINO GLYCOSIDES                          P
 G   paroxetine hcl                               ANTIDEPRESSANTS - SELECTED SSRI'S         N
 B   PATANOL                                      OP. ANTIALLERGICS                         P
 B   PAXIL       SUS 10MG/5ML                     ANTIDEPRESSANTS - SELECTED SSRI'S         R
 B   PAXIL       TAB 10MG                         ANTIDEPRESSANTS - SELECTED SSRI'S         P
 B   PAXIL       TAB 20MG                         ANTIDEPRESSANTS - SELECTED SSRI'S         P
 B   PAXIL       TAB 30MG                         ANTIDEPRESSANTS - SELECTED SSRI'S         P
 B   PAXIL       TAB 40MG                         ANTIDEPRESSANTS - SELECTED SSRI'S         P
 B   PAXIL CR                                     ANTIDEPRESSANTS - SELECTED SSRI'S         R
 B   PCE                                          MACROLIDES / ERYTHROMYCIN'S /             N
                                                  KETOLIDES
 G   pcm                                          COUGH/COLD -                              N
                                                  DECONGESTANT-ANTIHISTAMINE-ANTICHOLI
                                                  NERGIC
 G   pcm allergy                                  COUGH/COLD -                              N
                                                  DECONGESTANT-ANTIHISTAMINE-ANTICHOLI
                                                  NERGIC
 B   PEDIAFLOR                                    MINERALS                                  N
 B   PEDIAPRED                                    GLUCOCORTICOIDS - MINERALOCORTICOIDS      P
 B   PEDIAZOLE                                    ANTI INFECTIVE COMBO'S - MISC.            N
 B   PEDIOTIC                                     EAR                                       P
 B   PEDIOX                                       COUGH/COLD - DECONGESTANT &               N
                                                  ANTIHISTAMINE
 G   peg 3350-kcl-na bicarb-nacl-na sulfate for   GI - ANTI - FLATULENTS / GI STIMULANTS    P
     soln 240 gm
 G   peg 3350-kcl-sod bicarb-nacl for soln 420    GI - ANTI - FLATULENTS / GI STIMULANTS    P
     gm
 B   PEGANONE                                     ANTICONVULSANTS                           N      Grandfather for Seizure Disorder
 B   PEGASYS                                      HEPATITIS C AGENTS                        P
 B   PEG-INTRON                                   HEPATITIS C AGENTS                        P
 B   PEG-INTRON REDIPEN                           HEPATITIS C AGENTS                        P
 G   pemoline                                     STIMULANTS - OTHER STIMULANTS / LIKE      N
                                                  STIMULANTS
 B   PENICILLIN G POTASSIUM IN                    BETA-LACTAMS / CLAVULANATE COMBO'S        P
 G   penicillin v potassium for soln 125 mg/5ml   BETA-LACTAMS / CLAVULANATE COMBO'S        P
 G   penicillin v potassium for soln 250 mg/5ml   BETA-LACTAMS / CLAVULANATE COMBO'S        P
 G   penicillin v potassium tab 250 mg            BETA-LACTAMS / CLAVULANATE COMBO'S        P
 G   penicillin v potassium tab 500 mg            BETA-LACTAMS / CLAVULANATE COMBO'S        P
 B   PENLAC NAIL LACQUER                          TOPICAL - ANTIFUNGALS                     N
 B   PENTAM 300                                   ANTIBIOTICS - MISC.                       P
 B   PENTASA                                      GI - INFLAMMATORY BOWEL AGENTS            P
 G   pentazocine w/ apap                          NARCOTICS - MICS.                         N
 G   pentazocine w/ naloxone                      NARCOTICS - MICS.                         N
 G   pentoxifylline tab cr 400 mg                 PLATELET AGGR. INHIBITORS / COMBO'S -     P
                                                  MISC.
 B   PEPCID                                       GI - H2-ANTAGONISTS                       N
 B   PERCOCET                                     NARCOTICS - MICS.                         N
 B   PERCODAN                                     NARCOTICS - MICS.                         N
 G   pergolide mesylate                           PARKINSONS - SELECTED DOPAMIN             N
                                                  AGONISTS

Report_1010_PDL_A3 rev A                                         12/26/2004                                                  Page 44 of 63
B    Drug                                                                                 P,       Comment
or   Name                                         Drug Category                           N,
G                                                                                        R, or
                                                                                         NR
                                                                     P                           - Alpha Continued -
 B   PERIDEX ORAL RINSE                         MOUTH ANTISEPTICS                         N
 B   PERIOSTAT                                  TETRACYCLINES                             N
 B   PERMAX                                     PARKINSONS - SELECTED DOPAMIN             N
                                                AGONISTS
 G   permethrin cream 5%                        TOPICAL - SCABICIDES AND PEDICULICIDES    N
 O   permethrin creme rinse 1%                  TOPICAL - SCABICIDES AND PEDICULICIDES    P
 B   PERPHENAZINE/AMITRIPTYLIN                  PSYCHOTHERAPEUTIC COMBINATION             R
 G   perphenazine-amitriptyline tab 2-25 mg     PSYCHOTHERAPEUTIC COMBINATION             P
 G   perphenazine-amitriptyline tab 4-10 mg     PSYCHOTHERAPEUTIC COMBINATION             P
 G   perphenazine-amitriptyline tab 4-25 mg     PSYCHOTHERAPEUTIC COMBINATION             P
 B   PFIZERPEN-G                                BETA-LACTAMS / CLAVULANATE COMBO'S        P
 G   phenavent ped                              COUGH/COLD - DECONGESTANT W/              N
                                                EXPECTORANT
 G   phenazopyridine hcl                        UROLOGICAL - MISC.                        P
 G   phenazopyridine-butabarbital-hyoscyamine   UROLOGICAL - MISC.                        N
 G   phenclor tannate pediatri                  COUGH/COLD - DECONGESTANT &               P
                                                ANTIHISTAMINE
 B   PHENERGAN          SUP 12.5MG              ANTIEMETIC - ANTICHOLINERGIC /            P
                                                DOPAMINERGIC
 B   PHENERGAN          SUP 25MG                ANTIEMETIC - ANTICHOLINERGIC /            P
                                                DOPAMINERGIC
 B   PHENERGAN          SUP 50MG                ANTIEMETIC - ANTICHOLINERGIC /            P
                                                DOPAMINERGIC
 B   PHENERGAN          TAB 25MG                ANTIEMETIC - ANTICHOLINERGIC /            P
                                                DOPAMINERGIC
 G   phenobarbital                              SEDATIVE/HYPNOTICS - BARBITURATE          P
 B   PHENOBARBITAL SODIUM                       SEDATIVE/HYPNOTICS - BARBITURATE          NR
 G   phenyl chlor-tan                           COUGH/COLD - DECONGESTANT &               P
                                                ANTIHISTAMINE
 G   phenyleph tannate-chlorphen                COUGH/COLD - NON-NARC                     N
     tannate-carbetapentane tannate             ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                                NE
 G   phenyleph-hydrocodone                      COUGH/COLD - NARCOTIC                     N
                                                ANTITUSSIVE-DECONGESTANT
 G   phenyleph-pyril w/ hydrocod                COUGH/COLD - NARCOTIC                     P
                                                ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                                NE
 B   PHENYLEPHRINE HCL                          OP. MISC                                  N
 G   phenylephrine hcl ophth soln 10%           OP. MISC                                  P
 G   phenylephrine hcl ophth soln 2.5%          OP. MISC                                  P
 G   phenylephrine w/hydrocodone-gg             COUGH/COLD -                              N
                                                ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                                ANT
 G   phenylephrine/hydrocodone                  COUGH/COLD - NARCOTIC                     N
                                                ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                                NE
 G   phenylephrine-carbetapentane-guaifenesin   COUGH/COLD -                              P
                                                ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                                ANT
 G   phenylephrine-chlorphen-dm                 COUGH/COLD - NON-NARC                     N
                                                ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                                NE
 G   phenylephrine-chlorpheniramine-dihydroco   COUGH/COLD - NARCOTIC                     N
     deine                                      ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                                NE
 G   phenylephrine-ephedrine-chlorpheniramine   COUGH/COLD - NON-NARC                     N
     w/ carbetapentane                          ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                                NE
 G   phenylephrine-guaifenesin tab sr 12hr      COUGH/COLD - DECONGESTANT W/              P
     10-600 mg                                  EXPECTORANT
 G   phenylephrine-guaifenesin tab sr 12hr      COUGH/COLD - DECONGESTANT W/              N
     20-600 mg                                  EXPECTORANT
 G   phenylephrine-guaifenesin tab sr 12hr      COUGH/COLD - DECONGESTANT W/              N
     30-600 mg                                  EXPECTORANT


Report_1010_PDL_A3 rev A                                        12/26/2004                                    Page 45 of 63
B    Drug                                                                                     P,                   Comment
or   Name                                            Drug Category                            N,
G                                                                                            R, or
                                                                                             NR
                                                                         P                                     - Alpha Continued -
 G   phenylephrine-guaifenesin tab sr 12hr         COUGH/COLD - DECONGESTANT W/               P
     40-600 mg                                     EXPECTORANT
 G   phenylephrine-pyrilamine-dm                   COUGH/COLD - NON-NARC                      N
                                                   ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                                   NE
 G   phenylhistine expectorant                     COUGH/COLD -                               P
                                                   ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                                   ANT
 B   PHENYTEK                                      ANTICONVULSANTS                            P
 G   phenytoin sodium extended cap 100 mg          ANTICONVULSANTS                            P
 G   phenytoin sodium inj 50 mg/ml                 ANTICONVULSANTS                            P
 B   PHENYTOIN SODIUM PROMPT                       ANTICONVULSANTS                            P
 G   phenytoin susp 125 mg/5ml                     ANTICONVULSANTS                            N      Grandfather for Seizure Disorder
 B   PHISOHEX                                      TOPICAL - ANTISEPTICS / DISINFECTANTS      P
 B   PHOSLO                                        UROLOGICAL - MISC.                         P
 B   PHOSPHOLINE IODIDE                            OP. MIOTICS - DIRECT ACTING                P
 B   PHRENILIN                                     ANALGESICS - MISC.                         N
 B   PHRENILIN FORTE                               ANALGESICS - MISC.                         N
 G   phytonadione                                  VITAMINS                                   P      RX Only
 G   pilocarpine hcl                               OP. MIOTICS - DIRECT ACTING                P
 B   PILOPINE HS                                   OP. MIOTICS - DIRECT ACTING                P
 B   PIMA                                          MINERALS                                   P
 G   pindolol                                      BETA BLOCKERS - NON SELECTIVE              P
 G   piroxicam                                     NSAIDS                                     P
 B   PLAN B                                        VAGINAL - CONTRACEPTIVES                   P
 B   PLAQUENIL                                     ANTIMALARIAL AGENTS                        N
 B   PLAVIX                                        PLATELET AGGREGATION INHIBITORS            P
 B   PLENDIL                                       CALCIUM CHANNEL                            N
                                                   BLOCKERS--FELODIPINES
 B   PLETAL                                        PLATELET AGGR. INHIBITORS / COMBO'S -      P
                                                   MISC.
 B   PLEXION                                       TOPICAL - ACNE PREPARATIONS                P      PA Required
 B   PLEXION SCT                                   TOPICAL - ACNE PREPARATIONS                P      PA Required
 B   PLEXION TS                                    TOPICAL - ACNE PREPARATIONS                P      PA Required
 G   podofilox soln 0.5%                           TOPICAL - GENITAL WARTS                    N
 G   podophyllum resin soln 25%                    TOPICAL - ENZYMES / KERATOLYTICS / UREA    P
 B   POLYCITRA                                     UROLOGICAL - MISC.                         P
 B   POLYCITRA-K                                   UROLOGICAL - MISC.                         P
 B   POLYCITRA-K CRYSTALS                          UROLOGICAL - MISC.                         P
 B   POLYCITRA-LC                                  UROLOGICAL - MISC.                         P
 G   polyethylene glycol 3350 oral packet          GI - ANTI - FLATULENTS / GI STIMULANTS     P
 G   polyethylene glycol 3350 oral powder          GI - ANTI - FLATULENTS / GI STIMULANTS     P
 B   POLY-HISTINE                                  ANTIHISTAMINES - OTHER                     N
 B   POLYMYXIN B SULFATE                           ANTIBIOTICS - MISC.                        N
 G   polymyxin b-trimethoprim ophth soln 10000     OP. ANTIBIOTICS                            P
     unit/ml-0.1%
 B   POLY-PRED                                     OP. ANTIINFLAMMATORY / STEROIDS OPHTH.     N
 B   POLY-RX                                       ANTIBIOTICS - MISC.                        N
 B   POLYSPORIN                                    OP. ANTIBIOTICS                            N
 B   POLYTRIM                                      OP. ANTIBIOTICS                            P
 B   POLY-VI-FLOR CHW 0.25MG                       VITAMINS - MISC.                           N
 B   POLY-VI-FLOR CHW 0.5MG                        VITAMINS - MISC.                           P
 B   POLY-VI-FLOR CHW 1MG                          VITAMINS - MISC.                           N
 B   POLY-VI-FLOR DRO 0.25MG                       VITAMINS - MISC.                           N
 B   POLY-VI-FLOR/IRON                             VITAMINS - MISC.                           N
 B   PONSTEL                                       NSAIDS                                     N      PA Required
 G   pot & sod citrates w/citric ac                UROLOGICAL - MISC.                         P
 G   pot bicarbonate & chloride effer tab 25 meq   MINERALS                                   N

Report_1010_PDL_A3 rev A                                             12/26/2004                                                Page 46 of 63
B    Drug                                                                                  P,                Comment
or   Name                                          Drug Category                           N,
G                                                                                         R, or
                                                                                          NR
                                                                     P                                    - Alpha Continued -
 G   pot phos monobasic w/sod phos di &          MINERALS                                  P
     monobas tab 155-852-130mg
 B   POTASSIUM ACETATE                           MINERALS                                  N
 G   potassium acetate inj 2 meq/ml              MINERALS                                  P
 G   potassium bicarbonate effer tab 25 meq      MINERALS                                  P
 G   potassium chloride cap cr 10 meq            MINERALS                                  N
 G   potassium chloride inj 2 meq/ml             MINERALS                                  P
 G   potassium chloride microencapsulated crys   MINERALS                                  P
     cr tab 10 meq
 G   potassium chloride microencapsulated crys   MINERALS                                  P
     cr tab 20 meq
 G   potassium chloride oral liq 10%             MINERALS                                  P
 G   potassium chloride oral liq 20%             MINERALS                                  P
 G   potassium chloride powder packet 20 meq     MINERALS                                  P
 G   potassium chloride tab cr 10 meq            MINERALS                                  P
 G   potassium chloride tab cr 8 meq             MINERALS                                  P
 G   potassium phosphate dibasic inj 3           MINERALS                                  P
     mmole/ml
 B   PRAMOSONE                                   TOPICAL - STEROID LOCAL ANESTHETICS       P
 G   pramoxine-hc-chloroxylenol                  EAR                                       N
 G   pramoxine-hc-chloroxylenol aqueous          EAR                                       N
 B   PRANDIN                                     DIABETIC - MEGLITINIDES                   N
 B   PRAVACHOL                                   CHOLESTEROL - HMG COA + ABSORB            N
                                                 INHIBITORS
 B   PRAVIGARD PAC                               CHOLESTEROL - HMG COA + ABSORB            N
                                                 INHIBITORS
 G   prazosin hcl                                ANTIHYPERTENSIVES - CENTRAL               P
 B   PRECARE                                     VITAMINS - MISC.                          N
 B   PRECARE CONCEIVE                            VITAMINS - MISC.                          N
 B   PRECOSE                                     DIABETIC - ALPHAGLUCOSIDASE               N
 B   PRED FORTE                                  OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    P
 B   PRED MILD                                   OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    P
 B   PRED-G                                      OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    N
 B   PRED-G S.O.P.                               OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    N
 G   prednisolone                                GLUCOCORTICOIDS - MINERALOCORTICOIDS      P
 G   prednisolone acetate ophth susp 1%          OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    N
 G   prednisolone sodium phosphate               GLUCOCORTICOIDS - MINERALOCORTICOIDS      N
 G   prednisolone sodium phosphate ophth soln    OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    N
     1%
 G   prednisone                                  GLUCOCORTICOIDS - MINERALOCORTICOIDS      P
 B   PREDNISONE INTENSOL                         GLUCOCORTICOIDS - MINERALOCORTICOIDS      N
 B   PREFEST                                     ESTROGEN COMBO'S                          N
 B   PRELONE                                     GLUCOCORTICOIDS - MINERALOCORTICOIDS      N
 B   PREMARIN                                    ESTROGENS - TABS                          P
 B   PREMARIN W/APPLICATOR                       VAGINAL - ESTROGENS                       P
 B   PREMPHASE                                   ESTROGEN COMBO'S                          P
 B   PREMPRO                                     ESTROGEN COMBO'S                          P
 B   PRENATE ELITE                               VITAMINS - MISC.                          N
 B   PREVACID                                    GI - PROTON PUMP INHIBITOR                P      PA Required > 60 days
 B   PREVACID NAPRAPAC                           PPI/NSAID COMBO                           P      PA Required > 60 days
 B   PREVACID SOLUTAB                            GI - PROTON PUMP INHIBITOR                P      PA Required > 60 days
 B   PREVIDENT                                   DENTAL PRODUCTS                           P
 B   PREVIDENT 5000 BOOSTER                      DENTAL PRODUCTS                           P
 B   PREVIDENT 5000 PLUS                         DENTAL PRODUCTS                           P
 B   PREVIDENT FLUORIDE                          DENTAL PRODUCTS                           P
 B   PREVPAC                                     GI - ULCER ANTI-INFECTIVE                 P      PA Required > 60 Days
 B   PRILOSEC                                    GI - PROTON PUMP INHIBITOR                N      PA Required from Day 1


Report_1010_PDL_A3 rev A                                        12/26/2004                                                 Page 47 of 63
B    Drug                                                                          P,                   Comment
or   Name                                   Drug Category                          N,
G                                                                                 R, or
                                                                                  NR
                                                               P                                   - Alpha Continued -
 B   PRIMACOR                             PHOSPHODIESTERASE INHIBITORS             N
 B   PRIMAXIN I.M.                        CARBAPENEMS                              N
 B   PRIMAXIN IV                          CARBAPENEMS                              N
 B   PRIMAXIN IV ADD-VANTAGE              CARBAPENEMS                              N
 G   primidone tab 250 mg                 ANTICONVULSANTS                          P
 G   primidone tab 50 mg                  ANTICONVULSANTS                          N      Grandfather for Seizure Disorder
 B   PRINIVIL                             ACE INHIBITORS                           N
 B   PRINZIDE                             ACE AND THIAZIDE COMBO'S                 N
 B   PROAMATINE                           PRESSORS                                 P
 G   probenecid                           GOUT                                     P
 G   procainamide hcl                     ANTIARRHYTHMICS                          P
 B   PROCAINAMIDE HCL ER                  ANTIARRHYTHMICS                          N
 G   procainamide hcl sr                  ANTIARRHYTHMICS                          N
 B   PROCANBID                            ANTIARRHYTHMICS                          P
 B   PROCARDIA                            CALCIUM CHANNEL BLOCKERS--NIFEDIPINES    N
 B   PROCARDIA XL                         CALCIUM CHANNEL BLOCKERS--NIFEDIPINES    N
 B   PRO-CLEAR                            COUGH/COLD - ANTITUSSIVE-EXPECTORANT     P
 B   PROCRIT                              ERYTHROPOEISIS STIMULATING AGENTS        P      PA Required
 B   PROCTOCORT                           TOPICAL - CORTICOSTEROIDS                N
 B   PROCTOFOAM HC                        ANORECTAL - MISC.                        N
 B   PROFEN II DM                         COUGH/COLD -                             N
                                          ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                          ANT
 G   progesterone inj 50mg/ml             PROGESTINS                               N
 B   PROGESTERONE POW MICRONIZ            PROGESTINS                               P
 B   PROGESTERONE POW WETTABLE            PROGESTINS                               P
 B   PROGLYCEM                            DIABETIC - OTHER                         P
 B   PROLASTIN                            ANTIASTHMATIC - ALPHA-PROTEINASE         P      PA Required
                                          INHIBITOR
 B   PROLEX D                             COUGH/COLD - DECONGESTANT W/             N
                                          EXPECTORANT
 B   PROLEX DH                            COUGH/COLD - ANTITUSSIVE-EXPECTORANT     N
 B   PROLEX DM                            COUGH/COLD - ANTITUSSIVE-EXPECTORANT     N
 B   PROLEX PD                            COUGH/COLD - DECONGESTANT W/             N
                                          EXPECTORANT
 B   PROLOPRIM                            ANTIBIOTICS - MISC.                      N
 G   promethazine hcl suppos 12.5 mg      ANTIEMETIC - ANTICHOLINERGIC /           N
                                          DOPAMINERGIC
 G   promethazine hcl suppos 25 mg        ANTIEMETIC - ANTICHOLINERGIC /           N
                                          DOPAMINERGIC
 G   promethazine hcl suppos 50 mg        ANTIEMETIC - ANTICHOLINERGIC /           N
                                          DOPAMINERGIC
 G   promethazine hcl syrup 6.25 mg/5ml   ANTIEMETIC - ANTICHOLINERGIC /           P
                                          DOPAMINERGIC
 G   promethazine inj 25mg/ml             ANTIEMETIC - ANTICHOLINERGIC /           N
                                          DOPAMINERGIC
 G   promethazine inj 50mg/ml             ANTIEMETIC - ANTICHOLINERGIC /           N
                                          DOPAMINERGIC
 B   PROMETHAZINE POW                     ANTIEMETIC - ANTICHOLINERGIC /           N
                                          DOPAMINERGIC
 G   promethazine sup 12.5mg              ANTIEMETIC - ANTICHOLINERGIC /           N
                                          DOPAMINERGIC
 G   promethazine sup 25mg                ANTIEMETIC - ANTICHOLINERGIC /           N
                                          DOPAMINERGIC
 G   promethazine sup 50mg                ANTIEMETIC - ANTICHOLINERGIC /           N
                                          DOPAMINERGIC
 G   promethazine syp 6.25/5ml            ANTIEMETIC - ANTICHOLINERGIC /           P
                                          DOPAMINERGIC
 G   promethazine tab 12.5mg              ANTIEMETIC - ANTICHOLINERGIC /           N
                                          DOPAMINERGIC



Report_1010_PDL_A3 rev A                                   12/26/2004                                               Page 48 of 63
B    Drug                                                                             P,                   Comment
or   Name                                       Drug Category                         N,
G                                                                                    R, or
                                                                                     NR
                                                                   P                                 - Alpha Continued -
 G   promethazine tab 25mg                    ANTIEMETIC - ANTICHOLINERGIC /          N
                                              DOPAMINERGIC
 G   promethazine tab 50mg                    ANTIEMETIC - ANTICHOLINERGIC /          P
                                              DOPAMINERGIC
 B   PROMETHAZINE VC                          COUGH/COLD - DECONGESTANT &             N
                                              ANTIHISTAMINE
 B   PROMETHAZINE VC/CODEINE                  COUGH/COLD - NARCOTIC                   N
                                              ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                              NE
 G   promethazine w/ codeine syrup 6.25-10    COUGH/COLD - NARCOTIC                   P
     mg/5ml                                   ANTITUSSIVE-ANTIHISTAMINE
 G   promethazine-dm                          COUGH/COLD - NON-NARC                   P
                                              ANTITUSSIVE-ANTIHISTAMINE
 B   PROMETRIUM                               PROGESTINS                              N
 B   PRONESTYL                                ANTIARRHYTHMICS                         P
 G   propafenone hcl                          ANTIARRHYTHMICS                         N
 B   PROPANTHELINE BROMIDE                    GI - ANTIDIARRHEAL / ANTACID - MISC.    P
 G   proparacaine hcl ophth soln 0.5%         OP. MISC                                P
 B   PROPINE                                  OP. ADRENERGIC AGENTS                   N
 G   propoxyphene hcl                         NARCOTICS - MICS.                       P
 G   propoxyphene hcl w/ apap                 NARCOTICS - MICS.                       P
 G   propoxyphene-n w/ apap                   NARCOTICS - MICS.                       P
 G   propranolol & hydrochlorothiazide        BETA BLOCKERS AND DIURETIC COMBO'S      P
 G   propranolol hcl                          BETA BLOCKERS - NON SELECTIVE           P
 G   propylthiouracil tab 50 mg               ANTITHYROID THERAPIES                   P
 B   PRO-RED                                  COUGH/COLD - NARCOTIC                   P
                                              ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                              NE
 B   PROSCAR                                  BPH                                     P
 B   PROSED/DS                                UROLOGICAL - MISC.                      P
 B   PROSOM                                   SEDATIVE/HYPNOTICS - BENZODIAZEPINES    N
 B   PROSTIGMIN                               NEUROLOGICS - MISC.                     P
 B   PROSTIN VR PEDIATRIC                     IMPOTENCE AGENTS                        N      PA Required
 B   PROTONIX                                 GI - PROTON PUMP INHIBITOR              N      PA Required from Day 1
 B   PROTOPIC                                 TOPICAL - IMMUNOMODULATORS              N
 B   PROTROPIN                                GROWTH HORMONE                          N      PA Required
 B   PROVENTIL                                ANTIASTHMATIC - BETA - ADRENERGICS      N
 B   PROVENTIL HFA                            ANTIASTHMATIC - BETA - ADRENERGICS      N
 B   PROVERA                                  PROGESTINS                              N
 B   PROVIGIL                                 STIMULANTS - OTHER STIMULANTS / LIKE    NR
                                              STIMULANTS
 B   PROZAC        CAP 10MG                   ANTIDEPRESSANTS - SELECTED SSRI'S       N
 B   PROZAC        CAP 20MG                   ANTIDEPRESSANTS - SELECTED SSRI'S       N      PROZAC 20mg CAPS - Use
                                                                                             FLUOXETINE HCL 20mg CAPS instead
 B   PROZAC        CAP 40MG                   ANTIDEPRESSANTS - SELECTED SSRI'S       N      PROZAC,FLUOXETINE HCL 40mg CAPS
                                                                                             - Use two FLUOXETINE HCL 20mg
                                                                                             CAPS instead
 B   PROZAC        LIQ 20MG/5ML               ANTIDEPRESSANTS - SELECTED SSRI'S       R
 B   PROZAC        TAB 10MG                   ANTIDEPRESSANTS - SELECTED SSRI'S       N
 B   PROZAC WEEKLY                            ANTIDEPRESSANTS - SELECTED SSRI'S       N
 G   pseubrom                                 COUGH/COLD - DECONGESTANT &             N
                                              ANTIHISTAMINE
 G   pseubrom-pd                              COUGH/COLD - DECONGESTANT &             N
                                              ANTIHISTAMINE
 G   pseudoeph-chlorphen w/ cod               COUGH/COLD - NARCOTIC                   N
                                              ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                              NE
 G   pseudoeph-chlorphen w/ hydrocodone syr   COUGH/COLD - NARCOTIC                   N
     30-2-2.5 mg/5ml                          ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                              NE



Report_1010_PDL_A3 rev A                                     12/26/2004                                               Page 49 of 63
B    Drug                                                                              P,       Comment
or   Name                                        Drug Category                         N,
G                                                                                     R, or
                                                                                      NR
                                                                 P                            - Alpha Continued -
 G   pseudoeph-chlorphen w/ hydrocodone        COUGH/COLD - NARCOTIC                   P
     syrup 15-2-3 mg/5ml                       ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                               NE
 G   pseudoephed-bromphen-dm                   COUGH/COLD - NON-NARC                   P
                                               ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                               NE
 G   pseudoephed-bromphen-dm-gg syrup          COUGH/COLD - ANTITUSSIVE-EXPECTORANT    N
     30-2-5-50 mg/5ml                          - DECONGEST-ANTIHIST
 O   pseudoephedrine hcl syrup 30 mg/5ml       COUGH/COLD - SYSTEMIC DECONGESTANTS     P
 O   pseudoephedrine hcl tab 30 mg             COUGH/COLD - SYSTEMIC DECONGESTANTS     P
 O   pseudoephedrine hcl tab 60 mg             COUGH/COLD - SYSTEMIC DECONGESTANTS     P
 G   pseudoephedrine hcl/chlor                 COUGH/COLD - DECONGESTANT &             N
                                               ANTIHISTAMINE
 G   pseudoephedrine tan-chlorphen             COUGH/COLD - NON-NARC                   N
     tan-dextromethorphan tan                  ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                               NE
 G   pseudoephedrine w/ hydrocodone            COUGH/COLD - NARCOTIC                   N
                                               ANTITUSSIVE-DECONGESTANT
 G   pseudoephedrine/dextromet                 COUGH/COLD -                            P
                                               ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                               ANT
 G   pseudoephedrine/guaifenes                 COUGH/COLD -                            N
                                               ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                               ANT
 G   pseudoephedrine/guaifenes                 COUGH/COLD - DECONGESTANT W/            P
                                               EXPECTORANT
 G   pseudoephedrine-carbinoxamine w/          COUGH/COLD - NARCOTIC                   P
     hydrocodone                               ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                               NE
 G   pseudoephedrine-chlorpheniramine-dihydr   COUGH/COLD - NARCOTIC                   N
     ocodeine                                  ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                               NE
 G   pseudoephedrine-dihydrocodeine-guaifene   COUGH/COLD -                            N
     sin                                       ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                               ANT
 G   pseudoephedrine-guaifenesin cap cr        COUGH/COLD - DECONGESTANT W/            N
     120-250 mg                                EXPECTORANT
 G   pseudoephedrine-guaifenesin cap cr        COUGH/COLD - DECONGESTANT W/            P
     60-300 mg                                 EXPECTORANT
 G   pseudoephedrine-guaifenesin tab sr 12hr   COUGH/COLD - DECONGESTANT W/            P
     120-1200 mg                               EXPECTORANT
 G   pseudoephedrine-guaifenesin tab sr 12hr   COUGH/COLD - DECONGESTANT W/            P
     120-600 mg                                EXPECTORANT
 G   pseudoephedrine-guaifenesin tab sr 12hr   COUGH/COLD - DECONGESTANT W/            N
     45-600 mg                                 EXPECTORANT
 G   pseudoephedrine-guaifenesin tab sr 12hr   COUGH/COLD - DECONGESTANT W/            N
     45-800 mg                                 EXPECTORANT
 G   pseudoephedrine-guaifenesin tab sr 12hr   COUGH/COLD - DECONGESTANT W/            N
     48-595 mg                                 EXPECTORANT
 G   pseudoephedrine-guaifenesin tab sr 12hr   COUGH/COLD - DECONGESTANT W/            N
     60-1200 mg                                EXPECTORANT
 G   pseudoephedrine-guaifenesin tab sr 12hr   COUGH/COLD - DECONGESTANT W/            N
     60-600 mg                                 EXPECTORANT
 G   pseudoephedrine-guaifenesin tab sr 12hr   COUGH/COLD - DECONGESTANT W/            N
     75-1200 mg                                EXPECTORANT
 G   pseudoephedrine-guaifenesin tab sr 12hr   COUGH/COLD - DECONGESTANT W/            N
     80-800 mg                                 EXPECTORANT
 G   pseudoephedrine-guaifenesin tab sr 12hr   COUGH/COLD - DECONGESTANT W/            P
     85-795 mg                                 EXPECTORANT
 G   pseudoephedrine-guaifenesin tab sr 12hr   COUGH/COLD - DECONGESTANT W/            N
     90-1200 mg                                EXPECTORANT
 G   pseudoephedrine-guaifenesin tab sr 12hr   COUGH/COLD - DECONGESTANT W/            N
     90-800 mg                                 EXPECTORANT
 G   pseudoephedrine-methscopolamine           COUGH/COLD - DECONGESTANT &             N
                                               ANTICHOLINERGIC




Report_1010_PDL_A3 rev A                                    12/26/2004                                     Page 50 of 63
B    Drug                                                                             P,                   Comment
or   Name                                       Drug Category                         N,
G                                                                                    R, or
                                                                                     NR
                                                                    P                                  - Alpha Continued -
 G   pseudopehedrine-dextromet                COUGH/COLD -                            N
                                              ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                              ANT
 G   pseudovent dm                            COUGH/COLD -                            N
                                              ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                              ANT
 B   PSORCON                                  TOPICAL - CORTICOSTEROIDS               P
 B   PSORCON E                                TOPICAL - CORTICOSTEROIDS               N
 B   PSORIATEC                                ANTI-PSORIATICS                         N
 G   p-tuss dm                                COUGH/COLD -                            N
                                              ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                              ANT
 B   PULMICORT         SUS 0.25MG/2           ANTIASTHMATIC - STEROID INHALANTS       P      Preferred < 8yo
 B   PULMICORT         SUS 0.5MG/2            ANTIASTHMATIC - STEROID INHALANTS       P      Preferred < 8yo
 B   PULMICORT TURBUHALER                     ANTIASTHMATIC - STEROID INHALANTS       P      Preferred < 14yo
 B   PULMOZYME                                ANTIASTHMATIC - HYDRO-LYTIC ENZYMES     P      PA Required
 G   pyrazinamide                             ANTIMYCOBACTERIALS /                    P
                                              ANTITUBERCULOSIS
 B   PYRIDIUM                                 UROLOGICAL - MISC.                      N
 B   PYRIDIUM PLUS                            UROLOGICAL - MISC.                      P
 G   pyridostigmine bromide tab 60 mg         NEUROLOGICS - MISC.                     P
 G   pyridoxine hcl                           VITAMINS                                P      RX Only
 G   pyrilafen tannate-12                     COUGH/COLD - DECONGESTANT &             P
                                              ANTIHISTAMINE

                                                                    Q
 G   q-bid-dm                                 COUGH/COLD - ANTITUSSIVE-EXPECTORANT    N
 B   QUESTRAN                                 CHOLESTEROL - BILE SEQUESTRANTS         N
 B   QUESTRAN LIGHT                           CHOLESTEROL - BILE SEQUESTRANTS         N
 B   QUIBRON                                  ANTIASTHMATIC - XANTHINES               N
 B   QUIBRON-T/SR                             ANTIASTHMATIC - XANTHINES               N
 G   quinapril-hydrochlorothiazide            ACE AND THIAZIDE COMBO'S                N
 G   quinidine gluconate                      ANTIARRHYTHMICS                         P
 G   quinidine sulfate                        ANTIARRHYTHMICS                         P
 B   QUINIDINE SULFATE ER                     ANTIARRHYTHMICS                         N
 G   quinine sulfate                          ANTIMALARIAL AGENTS                     P
 G   quintex                                  COUGH/COLD - DECONGESTANT W/            P
                                              EXPECTORANT
 B   QUIXIN                                   OP. QUINOLONES                          P
 B   QVAR                                     ANTIASTHMATIC - STEROID INHALANTS       P

                                                                    R
 G   rabies immune globulin (human) inj 150   IMMUNE SERUMS                           P
     unit/ml
 B   RADIAPLEXRX                              TOPICAL - WOUND / DECUBITUS CARE        N
 G   ranitidine cap 150mg                     GI - H2-ANTAGONISTS                     N
 G   ranitidine cap 300mg                     GI - H2-ANTAGONISTS                     N
 B   RANITIDINE POW                           COMPOUNDING MATERIALS                   N
 B   RANITIDINE SYP 75MG/5ML                  GI - H2-ANTAGONISTS                     N
 G   ranitidine tab 150mg                     GI - H2-ANTAGONISTS                     P
 G   ranitidine tab 300mg                     GI - H2-ANTAGONISTS                     P
 B   RAPIFLUX                                 ANTIDEPRESSANTS - SELECTED SSRI'S       N
 B   RAPTIVA                                  ANTI-PSORIATICS                         N
 B   REBETOL                                  HEPATITIS C AGENTS                      P
 B   REBETRON                                 HEPATITIS C AGENTS                      P
 B   REBIF                                    MULTIPLE SCLEROSIS AGENTS               P
 B   REGENECARE WOUND                         TOPICAL - WOUND / DECUBITUS CARE        N
 B   REGRANEX                                 TOPICAL - WOUND / DECUBITUS CARE        N
 B   RELAFEN                                  COX 2 INHIBITORS - SELECTIVE            N      PA Required


Report_1010_PDL_A3 rev A                                     12/26/2004                                              Page 51 of 63
B    Drug                                                                              P,                   Comment
or   Name                                        Drug Category                         N,
G                                                                                     R, or
                                                                                      NR
                                                                    R                                   - Alpha Continued -
 B   RELAGARD                                  VAGINAL - OTHER                         N
 B   RELENZA DISKHALER                         INFLUENZA AGENTS                        P
 O   RELION 70/30                              DIABETIC - INSULIN                      P
 O   RELION N                                  DIABETIC - INSULIN                      P
 O   RELION R                                  DIABETIC - INSULIN                      P
 B   RELPAX                                    MIGRAINE - SELECTIVE SEROTONIN          P      PA Required: > 18 Units/30Days Supply
                                               AGONISTS (5HT)--TABS
 B   REMERON                                   ANTIDEPRESSANTS - SELECTED SSRI'S       R
 B   REMERON SOLTAB                            ANTIDEPRESSANTS - SELECTED SSRI'S       N
 B   REMICADE                                  GI - INFLAMMATORY BOWEL AGENTS          N
 B   REMINYL                                   ALZHEIMER - CHOLINOMIMETICS             N      Grandfather
 B   RENACIDIN                                 UROLOGICAL - MISC.                      P
 B   RENAGEL                                   UROLOGICAL - MISC.                      P
 B   RENAX                                     VITAMINS - MISC.                        N
 B   REQUIP                                    PARKINSONS - SELECTED DOPAMIN           P
                                               AGONISTS
 B   RESCULA                                   OP. PROSTAGLANDINS                      N
 B   RESERPINE                                 ANTIHYPERTENSIVES - CENTRAL             P
 B   RESPAIRE-60                               COUGH/COLD - DECONGESTANT W/            N
                                               EXPECTORANT
 B   RESPI-TANN                                COUGH/COLD - NON-NARC                   N
                                               ANTITUSSIVE-DECONGESTANT
 B   RESTASIS                                  OP. MISC                                N
 B   RESTORIL      CAP 15MG                    SEDATIVE/HYPNOTICS - BENZODIAZEPINES    N
 B   RESTORIL      CAP 30MG                    SEDATIVE/HYPNOTICS - BENZODIAZEPINES    N
 B   RESTORIL      CAP 7.5MG                   SEDATIVE/HYPNOTICS - BENZODIAZEPINES    R
 B   RETIN-A                                   TOPICAL - TRETINOIDS                    P      PA Required
 B   RETIN-A MICRO                             TOPICAL - TRETINOIDS                    N      PA Required
 B   REVIA                                     NARCOTIC - ANTAGONISTS                  N
 B   RHEUMATREX                                ARTHRITIS - MISC.                       N      RHEUMATREX - Write METHOTREXATE
                                                                                              instead
 B   RHINOCORT AQUA                            ANTIASTHMATIC - NASAL STEROIDS          N
 G   rho d immune globulin (human) im inj 50   IMMUNE SERUMS                           P
     mcg
 B   RHOGAM HUMAN                              IMMUNE SERUMS                           P
 G   ribavirin cap 200 mg                      HEPATITIS C AGENTS                      N
 B   RIDAURA                                   ARTHRITIS - MISC.                       P
 B   RIFADIN                                   ANTIMYCOBACTERIALS /                    N
                                               ANTITUBERCULOSIS
 G   rifampin                                  ANTIMYCOBACTERIALS /                    P
                                               ANTITUBERCULOSIS
 B   RILUTEK                                   ALS DRUG                                P
 G   rimantadine hydrochloride tab 100 mg      INFLUENZA AGENTS                        P
 B   RIOMET                                    DIABETIC - ORAL BIGUANIDES              N
 B   RITALIN                                   STIMULANTS - METHYLPHENIDATE            N
 B   RITALIN LA                                STIMULANTS - METHYLPHENIDATE - LONG     NR
                                               ACTING
 B   RITALIN SR                                STIMULANTS - METHYLPHENIDATE - LONG     NR
                                               ACTING
 B   RMS                                       NARCOTICS-LONG ACTING                   P
 G   robafen ac                                COUGH/COLD - ANTITUSSIVE-EXPECTORANT    P
 B   ROBAXIN-750                               MUSCLE RELAXANTS                        N      PA Required
 B   ROBINUL      INJ 0.2MG/ML                 GI - ANTIDIARRHEAL / ANTACID - MISC.    N
 B   ROBINUL      TAB 1MG                      GI - ANTIDIARRHEAL / ANTACID - MISC.    P
 B   ROBINUL FORTE                             GI - ANTIDIARRHEAL / ANTACID - MISC.    P
 B   ROCALTROL                                 VITAMINS                                P      RX Only
 B   ROCEPHIN                                  CEPHALOSPORINS                          P
 B   ROCEPHIN IN ISO-OSMOTIC D                 CEPHALOSPORINS                          P


Report_1010_PDL_A3 rev A                                      12/26/2004                                              Page 52 of 63
B    Drug                                                                         P,                   Comment
or   Name                                Drug Category                            N,
G                                                                                R, or
                                                                                 NR
                                                            R                                    - Alpha Continued -
 G   rondamine dm                      COUGH/COLD - NON-NARC                      P
                                       ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                       NE
 B   RONDEC                            COUGH/COLD - DECONGESTANT &                N
                                       ANTIHISTAMINE
 B   RONDEC DM                         COUGH/COLD - NON-NARC                      N
                                       ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                       NE
 B   RONDEC-TR                         COUGH/COLD - DECONGESTANT &                N
                                       ANTIHISTAMINE
 B   ROSAC                             TOPICAL - ACNE PREPARATIONS                P      PA Required
 B   ROSULA                            TOPICAL - ACNE PREPARATIONS                N      PA Required
 B   ROWASA                            GI - INFLAMMATORY BOWEL AGENTS             P
 B   ROXANOL                           NARCOTICS - MICS.                          P
 B   ROXANOL-T                         NARCOTICS - MICS.                          N
 B   ROXICET                           NARCOTICS - MICS.                          P
 B   ROXICODONE                        NARCOTICS - MICS.                          P
 B   ROXICODONE INTENSOL               NARCOTICS - MICS.                          N
 G   r-tanna                           COUGH/COLD - DECONGESTANT &                N
                                       ANTIHISTAMINE
 B   RUM-K                             MINERALS                                   N
 B   RYNA-12                           COUGH/COLD - DECONGESTANT &                N
                                       ANTIHISTAMINE
 B   RYNA-12 S                         COUGH/COLD - DECONGESTANT &                N
                                       ANTIHISTAMINE
 B   RYNA-12X                          COUGH/COLD -                               N
                                       DECONGESTANT-ANTIHISTAMINE W/
                                       EXPECTORANT
 B   RYNATAN                           COUGH/COLD - DECONGESTANT &                N
                                       ANTIHISTAMINE
 B   RYNATAN PEDIATRIC                 COUGH/COLD - DECONGESTANT &                N
                                       ANTIHISTAMINE
 B   RYNATUSS                          COUGH/COLD - NON-NARC                      N
                                       ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                       NE
 B   RYNATUSS PEDIATRIC                COUGH/COLD - NON-NARC                      N
                                       ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                       NE
 G   ry-t-12                           COUGH/COLD - DECONGESTANT &                P
                                       ANTIHISTAMINE
 B   RYTHMOL                           ANTIARRHYTHMICS                            P

                                                            S
 B   SAIZEN                            GROWTH HORMONE                             N      PA Required
 B   SALAGEN                           ARTIFICIAL SALIVA/STIMULANTS               N
 O   salicylic acid liquid 17%         TOPICAL - ENZYMES / KERATOLYTICS / UREA    P
 G   saline injection bacteriostatic   COMPOUNDING MATERIALS                      P
 G   salsalate tab 500 mg              ANALGESICS - MISC.                         P
 G   salsalate tab 750 mg              ANALGESICS - MISC.                         P
 B   SAL-TROPINE                       GI - ANTIDIARRHEAL / ANTACID - MISC.       P
 B   SANDOSTATIN                       SOMATOSTATIC AGENTS                        P
 B   SANDOSTATIN LAR DEPOT             SOMATOSTATIC AGENTS                        P
 B   SANTYL                            TOPICAL - ENZYMES / KERATOLYTICS / UREA    N
 B   SARAFEM                           ANTIDEPRESSANTS - SELECTED SSRI'S          N
 B   SCOPACE                           ANTIEMETIC - ANTICHOLINERGIC /             N
                                       DOPAMINERGIC
 B   SEASONALE                         CONTRACEPTIVES - MONOPHASIC                N
                                       COMBINATION O/C'S
 B   SECONAL                           SEDATIVE/HYPNOTICS - BARBITURATE           NR
 G   selegiline hcl                    ANTI-PARKINSONIAN DRUGS                    P
 G   selenious acid inj 40 mcg/ml      MINERALS                                   N
 G   selenium sulfide lotion 2.5%      TOPICAL - ANTISEBORRHEICS                  P

Report_1010_PDL_A3 rev A                              12/26/2004                                                 Page 53 of 63
B    Drug                                                                                  P,                   Comment
or   Name                                          Drug Category                           N,
G                                                                                         R, or
                                                                                          NR
                                                                      S                                   - Alpha Continued -
 B   SELSUN SHAMPOO                              TOPICAL - ANTISEBORRHEICS                 P
 B   SEMPREX-D                                   COUGH/COLD - DECONGESTANT &               N
                                                 ANTIHISTAMINE
 O   senna tab 187 mg                            GI - ANTI - FLATULENTS / GI STIMULANTS    P
 O   SENNOSIDES GRANULES 15 MG/TSP               GI - ANTI - FLATULENTS / GI STIMULANTS    P
     (15 MG/3GM)
 O   sennosides tab 8.6 mg                       GI - ANTI - FLATULENTS / GI STIMULANTS    P
 B   SEPTRA                                      ANTI INFECTIVE COMBO'S - MISC.            N
 B   SEPTRA DS                                   ANTI INFECTIVE COMBO'S - MISC.            N
 B   SERAX                                       ANXIOLYTICS - BENZODIAZEPINES             N
 B   SEREVENT                                    ANTIASTHMATIC - BETA - ADRENERGICS        P
 B   SEREVENT DISKUS                             ANTIASTHMATIC - BETA - ADRENERGICS        P
 G   sildec                                      COUGH/COLD - DECONGESTANT &               P
                                                 ANTIHISTAMINE
 G   sildec dm                                   COUGH/COLD - NON-NARC                     P
                                                 ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                                 NE
 B   SILVADENE                                   TOPICAL - BURN PRODUCTS                   N
 G   silver sulfadiazine cream 1%                TOPICAL - BURN PRODUCTS                   P
 B   SINA-12X                                    COUGH/COLD - DECONGESTANT W/              N
                                                 EXPECTORANT
 B   SINEMET                                     ANTI-PARKINSONIAN DRUGS                   N
 B   SINEMET CR                                  ANTI-PARKINSONIAN DRUGS                   N
 B   SINEQUAN                                    ANTIDEPRESSANTS - TRI-CYCLICS             N
 B   SINGULAIR                                   ANTIASTHMATIC - LEUKOTRIENE RECEPTOR      P
                                                 ANTAGONISTS
 B   SKELAXIN                                    MUSCLE RELAXANTS                          N      PA Required
 G   sodium acetate inj 2 meq/ml                 MINERALS                                  P
 G   sodium bicarbonate inj 8.4%                 MINERALS                                  P
 O   sodium bicarbonate tab 325 mg               GI - ANTIDIARRHEAL / ANTACID - MISC.      P      PA Required
 O   sodium bicarbonate tab 650 mg               GI - ANTIDIARRHEAL / ANTACID - MISC.      P      PA Required
 B   SODIUM CHLORIDE                             MINERALS                                  N
 G   sodium chloride (gu irrigant)               UROLOGICAL - MISC.                        P
 O   sodium chloride aero soln 0.9%              ANTIASTHMATIC - MISC. RESPIRATORY         P
                                                 INHALANTS
 B   SODIUM CHLORIDE BACTERIOS                   COMPOUNDING MATERIALS                     P
 O   SODIUM CHLORIDE HYPERTONIC                  OP. MISC                                  P
     OPHTH OINT 5%
 G   sodium chloride inj 0.45%                   MINERALS                                  P
 G   sodium chloride inj 0.9%                    MINERALS                                  P
 G   sodium chloride inj 2.5 meq/ml (14.6%)      MINERALS                                  N
 G   sodium chloride inj 4 meq/ml (23.4%)        MINERALS                                  N
 G   sodium chloride inj 5%                      MINERALS                                  N
 G   sodium chloride iv soln 0.9%                MINERALS                                  P
 G   sodium citrate & citric acid                UROLOGICAL - MISC.                        N
 B   SODIUM FLUORIDE                             MINERALS                                  P
 G   sodium fluoride chew tab 0.55 mg (0.25mg    MINERALS                                  P
     f)
 G   sodium fluoride chew tab 1.1 mg (0.5mg f)   MINERALS                                  P
 G   sodium fluoride chew tab 2.2 mg (1 mg f)    MINERALS                                  P
 G   sodium fluoride cream 1.1%                  DENTAL PRODUCTS                           P
 G   sodium fluoride gel 1.1% (0.5% f)           DENTAL PRODUCTS                           P
 G   sodium fluoride soln 0.275 mg/drop (0.125   MINERALS                                  P
     mg/drop f)
 G   sodium fluoride soln 0.55 mg/drop (0.25     MINERALS                                  P
     mg/drop f)
 G   sodium fluoride soln 1.1 mg/ml (0.5 mg/ml   MINERALS                                  P
     f)
 G   sodium phosphate inj 3 mmole/ml             MINERALS                                  P



Report_1010_PDL_A3 rev A                                        12/26/2004                                                Page 54 of 63
B    Drug                                                                                  P,                   Comment
or   Name                                          Drug Category                           N,
G                                                                                         R, or
                                                                                          NR
                                                                       S                                  - Alpha Continued -
 G   sodium polystyrene sulfonate oral susp 15   K REMOVING RESINS                         P
     gm/60ml
 G   sodium polystyrene sulfonate powder         K REMOVING RESINS                         P
 G   sodium polystyrene sulfonate rectal susp    K REMOVING RESINS                         P
     30 gm/120ml
 B   SOLARAZE                                    TOPICAL - ANTINEOPLASTICS                 P
 B   SOLU-CORTEF                                 GLUCOCORTICOIDS - MINERALOCORTICOIDS      P
 B   SOLU-MEDROL                                 GLUCOCORTICOIDS - MINERALOCORTICOIDS      P
 B   SOMA                                        MUSCLE RELAXANTS                          N      PA Required
 B   SOMA COMPOUND/CODEINE                       MUSCLE RELAXANT -COMBINATIONS             N      PA Required
 B   SOMNOTE                                     SEDATIVE/HYPNOTICS - BARBITURATE          NR
 B   SONATA                                      SEDATIVE/HYPNOTICS -                      N      Grandfather
                                                 NON-BENZODIAZEPINES
 B   SORIATANE                                   ANTI-PSORIATICS                           N
 G   sotalol hcl                                 BETA BLOCKERS - NON SELECTIVE             P
 G   sotalol hcl (afib/afl)                      BETA BLOCKERS - NON SELECTIVE             N
 B   SPECTAZOLE                                  TOPICAL - ANTIFUNGALS                     P
 B   SPIRIVA HANDIHALER                          ANTIASTHMATIC - ANTI-CHOLINERGICS         N
 G   spironolactone                              DIURETICS                                 P
 G   spironolactone & hydrochlorothiazide        DIURETICS                                 P
 B   SPORANOX                                    ANTIFUNGALS - ASSORTED                    N      PA Required From Day 1
 B   SPORANOX PULSEPAK                           ANTIFUNGALS - ASSORTED                    N      PA Required From Day 1
 B   SSKI                                        MINERALS                                  P
 B   STADOL NS                                   NARCOTICS - SELECTED                      N      PA Required from Day 1
 B   STALEVO 100                                 ANTI-PARKINSONIAN DRUGS                   P
 B   STALEVO 150                                 ANTI-PARKINSONIAN DRUGS                   P
 B   STALEVO 50                                  ANTI-PARKINSONIAN DRUGS                   P
 G   stannous fluoride conc 0.63%                DENTAL PRODUCTS                           P
 B   STARLIX                                     DIABETIC - MEGLITINIDES                   P
 B   STERILE DILUENT FOR FLOLA                   COMPOUNDING MATERIALS                     P
 B   STIMATE                                     VASOPRESSINS                              P      PA Required
 B   STRATTERA                                   STIMULANTS - OTHER STIMULANTS / LIKE      NR
                                                 STIMULANTS
 B   STREPTOMYCIN SULFATE                        AMINO GLYCOSIDES                          P
 B   STROMECTOL                                  ANTHELMINTICS                             P
 B   STUARTNATAL PLUS 3                          VITAMINS - MISC.                          N
 B   SUBOXONE          SUB 2-0.5MG               NARCOTICS - MICS.                         P
 B   SUBOXONE          SUB 8-2MG                 NARCOTICS - MICS.                         N
 B   SUBUTEX                                     NARCOTICS - MICS.                         P
 G   sucralfate tab 1 gm                         GI - MISC. ANTI-ULCER                     P
 B   SULAR                                       CALCIUM CHANNEL                           P
                                                 BLOCKERS--NISOLDIPINE
 B   SULFACETAMIDE SODIUM                        OP. ANTIBIOTICS                           P
 G   sulfacetamide sodium liquid 10%             TOPICAL - ANTISEBORRHEICS                 P
 G   sulfacetamide sodium ophth soln 10%         OP. ANTIBIOTICS                           P
 G   sulfacetamide sodium w/ sulfur cream        TOPICAL - ACNE PREPARATIONS               N      PA Required
     10-5%
 G   sulfacetamide sodium w/ sulfur emulsion     TOPICAL - ACNE PREPARATIONS               N      PA Required
     10-5%
 G   sulfacetamide sodium w/ sulfur lotion       TOPICAL - ACNE PREPARATIONS               N      PA Required
     10-5%
 G   sulfacetamide sodium w/ sulfur susp         TOPICAL - ACNE PREPARATIONS               N      PA Required
     10-5%
 G   sulfacetamide sodium-prednisolone ophth     OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    N
     soln 10-0.25%
 B   SULFACET-R                                  TOPICAL - ACNE PREPARATIONS               N      PA Required
 B   SULFADIAZINE                                ANTIBIOTICS - MISC.                       P
 G   sulfamethoxazole-trimethoprim susp          ANTI INFECTIVE COMBO'S - MISC.            P
     200-40 mg/5ml


Report_1010_PDL_A3 rev A                                           12/26/2004                                              Page 55 of 63
B    Drug                                                                               P,                   Comment
or   Name                                         Drug Category                         N,
G                                                                                      R, or
                                                                                       NR
                                                                      S                                 - Alpha Continued -
 G   sulfamethoxazole-trimethoprim tab 400-80   ANTI INFECTIVE COMBO'S - MISC.          P
     mg
 G   sulfamethoxazole-trimethoprim tab          ANTI INFECTIVE COMBO'S - MISC.          P
     800-160 mg
 B   SULFAMYLON                                 TOPICAL - BURN PRODUCTS                 N
 G   sulfasalazine tab 500 mg                   GI - INFLAMMATORY BOWEL AGENTS          P
 G   sulfasalazine tab delayed release 500 mg   GI - INFLAMMATORY BOWEL AGENTS          N
 B   SULFINPYRAZONE                             GOUT                                    P
 B   SULFISOXAZOLE                              ANTIBIOTICS - MISC.                     P
 B   SULFOXYL REGULAR                           TOPICAL - ACNE PREPARATIONS             N      PA Required
 B   SULFOXYL STRONG                            TOPICAL - ACNE PREPARATIONS             N      PA Required
 G   sulindac                                   NSAIDS                                  P
 B   SUMYCIN                                    TETRACYCLINES                           P
 B   SURMONTIL                                  ANTIDEPRESSANTS - TRI-CYCLICS           R
 G   su-tuss dm                                 COUGH/COLD - ANTITUSSIVE-EXPECTORANT    N
 G   su-tuss hd                                 COUGH/COLD -                            P
                                                ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                                ANT
 B   SYMBYAX                                    PSYCHOTHERAPEUTIC COMBINATION           NR
 B   SYNAGIS                                    RSV PROPHYLAXIS                         P      PA Required
 B   SYNALGOS-DC                                NARCOTICS - MICS.                       N
 B   SYNTHROID                                  THYROID HORMONES                        N      Grandfather

                                                                      T
 B   TAGAMET                                    GI - H2-ANTAGONISTS                     N
 B   TALACEN                                    NARCOTICS - MICS.                       P
 B   TALWIN NX                                  NARCOTICS - MICS.                       P
 B   TAMBOCOR                                   ANTIARRHYTHMICS                         P
 B   TAMIFLU                                    INFLUENZA AGENTS                        P
 B   TANAFED DMX                                COUGH/COLD - NON-NARC                   N
                                                ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                                NE
 B   TANAFED DP                                 COUGH/COLD - DECONGESTANT &             N
                                                ANTIHISTAMINE
 G   tannate 12 s                               COUGH/COLD - NON-NARC                   P
                                                ANTITUSSIVE-ANTIHISTAMINE
 G   tannic-12                                  COUGH/COLD - NON-NARC                   N
                                                ANTITUSSIVE-ANTIHISTAMINE
 G   tannic-12 s                                COUGH/COLD - NON-NARC                   P
                                                ANTITUSSIVE-ANTIHISTAMINE
 G   tannihist-12 rf                            COUGH/COLD - NON-NARC                   P
                                                ANTITUSSIVE-ANTIHISTAMINE
 B   TAPAZOLE                                   ANTITHYROID THERAPIES                   P
 B   TARKA                                      ACE INHIBITORS AND CA CHANNEL           P
                                                BLOCKERS
 B   TASMAR                                     PARKINSONS - COMT INHIBITORS            N
 B   TAZORAC                                    ANTI-PSORIATICS                         P
 B   TEGRETOL          CHW 100MG                ANTICONVULSANTS                         P
 B   TEGRETOL          SUS 100/5ML              ANTICONVULSANTS                         P
 B   TEGRETOL          TAB 200MG                ANTICONVULSANTS                         N      Grandfather for Seizure Disorder
 B   TEGRETOL-XR                                ANTICONVULSANTS                         P
 G   temazepam                                  SEDATIVE/HYPNOTICS - BENZODIAZEPINES    P
 B   TEMOVATE                                   TOPICAL - CORTICOSTEROIDS               N
 B   TENEX                                      ANTIHYPERTENSIVES - CENTRAL             N
 B   TENORMIN                                   BETA BLOCKERS - CARDIO SELECTIVE        N
 B   TEQUIN                                     FLUOROQUINOLONES                        P
 B   TERAZOL 3                                  VAGINAL - ANTI FUNGALS                  N
 B   TERAZOL 3 W/APPLICATOR                     VAGINAL - ANTI FUNGALS                  N
 B   TERAZOL 7                                  VAGINAL - ANTI FUNGALS                  N


Report_1010_PDL_A3 rev A                                        12/26/2004                                               Page 56 of 63
B    Drug                                                                                   P,                   Comment
or   Name                                           Drug Category                           N,
G                                                                                          R, or
                                                                                           NR
                                                                        T                                    - Alpha Continued -
 G   terazosin hcl                                BPH                                       P
 G   terbutaline sulfate tab 2.5 mg               ANTIASTHMATIC - BETA - ADRENERGICS        N
 G   terbutaline sulfate tab 5 mg                 ANTIASTHMATIC - BETA - ADRENERGICS        N
 G   terconazole vaginal cream 0.8%               VAGINAL - ANTI FUNGALS                    N
 B   TERRAMYCIN W/POLYMYXIN B                     OP. ANTIBIOTICS                           P
 B   TESSALON                                     COUGH/COLD - ANTITUSSIVE -                N
                                                  NONNARCOTIC
 B   TESTIM                                       ANDROGENS / ANABOLICS                     N
 B   TESTOSTERONE                                 ANDROGENS / ANABOLICS                     N
 G   testosterone cypionate im in oil 200 mg/ml   ANDROGENS / ANABOLICS                     P
 G   testosterone enanthate im in oil 200 mg/ml   ANDROGENS / ANABOLICS                     P
 B   TESTOSTERONE PROPIONATE                      ANDROGENS / ANABOLICS                     N
 B   TESTRED                                      ANDROGENS / ANABOLICS                     P
 B   TETRACAINE HCL                               TOPICAL - LOCAL ANESTHETICS               N
 G   tetracaine hcl ophth soln 0.5%               OP. MISC                                  P
 G   tetracycline hcl                             TETRACYCLINES                             P
 B   TEVETEN                                      ANGIOTENSIN RECEPTOR BLOCKER              P
 B   TEVETEN HCT                                  ARB'S AND DIURETICS                       P
 B   TEXACORT                                     TOPICAL - CORTICOSTEROIDS                 N
 B   THALITONE                                    DIURETICS                                 N
 B   THALOMID                                     ANTILEPROTIC                              P
 B   THEO-24                                      ANTIASTHMATIC - XANTHINES                 P
 G   theophylline                                 ANTIASTHMATIC - XANTHINES                 P
 B   THERA-FLUR-N                                 DENTAL PRODUCTS                           N
 G   thiamine hcl                                 VITAMINS                                  P      RX Only
 B   THIOLA                                       UROLOGICAL - MISC.                        N
 G   thyroid                                      THYROID HORMONES                          P
 B   THYROLAR-1                                   THYROID HORMONES                          P
 B   THYROLAR-1/2                                 THYROID HORMONES                          P
 B   THYROLAR-2                                   THYROID HORMONES                          P
 B   THYROLAR-3                                   THYROID HORMONES                          P
 B   TIAZAC                                       CALCIUM CHANNEL BLOCKERS--DILTIAZEMS      P
 G   ticlopidine hcl                              PLATELET AGGREGATION INHIBITORS           P
 B   TIGAN                                        ANTIEMETIC - ANTICHOLINERGIC /            N
                                                  DOPAMINERGIC
 B   TIKOSYN                                      ANTIARRHYTHMICS                           P
 B   TILADE                                       ANTIASTHMATIC - ANTIINFLAMMATORY          P
                                                  AGENTS
 B   TIMENTIN                                     BETA-LACTAMS / CLAVULANATE COMBO'S        P
 B   TIMOLIDE 10/25                               BETA BLOCKERS AND DIURETIC COMBO'S        N
 G   timolol maleate                              BETA BLOCKERS - NON SELECTIVE             P
 G   timolol maleate ophth gel forming soln       OP. BETA - BLOCKERS                       N
     0.25%
 G   timolol maleate ophth gel forming soln       OP. BETA - BLOCKERS                       N
     0.5%
 G   timolol maleate ophth soln 0.25%             OP. BETA - BLOCKERS                       P
 G   timolol maleate ophth soln 0.5%              OP. BETA - BLOCKERS                       P
 B   TIMOPTIC                                     OP. BETA - BLOCKERS                       N
 B   TIMOPTIC-XE                                  OP. BETA - BLOCKERS                       P
 B   TINDAMAX                                     ANTIPROTOZOAL AGENTS                      N
 G   tizanidine hcl                               MUSCLE RELAXANTS                          N      PA Required
 B   TOBI                                         AMINO GLYCOSIDES                          P
 B   TOBRADEX                                     OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    P
 G   tobramycin sulfate                           AMINO GLYCOSIDES                          P
 G   tobramycin sulfate ophth soln 0.3%           OP. ANTIBIOTICS                           P
 B   TOBREX                                       OP. ANTIBIOTICS                           N
 B   TOFRANIL                                     ANTIDEPRESSANTS - TRI-CYCLICS             N

Report_1010_PDL_A3 rev A                                            12/26/2004                                             Page 57 of 63
B    Drug                                                                               P,                   Comment
or   Name                                        Drug Category                          N,
G                                                                                      R, or
                                                                                       NR
                                                                  T                                     - Alpha Continued -
 B   TOFRANIL-PM                               ANTIDEPRESSANTS - TRI-CYCLICS            NR
 G   tolazamide                                DIABETIC - ORAL SULFONYLUREAS            P
 B   TOLBUTAMIDE                               DIABETIC - ORAL SULFONYLUREAS            P
 G   tolmetin sodium                           NSAIDS                                   N      PA Required
 O   tolnaftate cream 1%                       TOPICAL - ANTIFUNGALS                    P
 O   tolnaftate powder 1%                      TOPICAL - ANTIFUNGALS                    P
 O   tolnaftate soln 1%                        TOPICAL - ANTIFUNGALS                    P
 B   TOPAMAX                                   ANTICONVULSANTS                          N      Grandfather for Seizure Disorder
 B   TOPICORT                                  TOPICAL - CORTICOSTEROIDS                N
 B   TOPROL XL                                 BETA BLOCKERS - CARDIO SELECTIVE         P
 B   TORADOL IV/IM                             COX 2 INHIBITORS - SELECTIVE             N
 G   torsemide                                 DIURETICS                                P
 G   trace min (cr-cu-mn-se-zn) inj            MINERALS                                 P
     10-1000-500-60-5000 mcg/ml
 G   trace min (cr-cu-mn-se-zn) inj            MINERALS                                 N
     4-400-100-20-1000 mcg/ml
 B   TRACLEER                                  PULMONARY ANTI-HYPERTENSIVES             N
 G   tramadol hcl tab 50 mg                    NARCOTICS - SELECTED                     P
 B   TRANDATE                                  BETA BLOCKERS - ALPHA / BETA             N
 B   TRANSDERM-SCOP                            ANTIEMETIC - ANTICHOLINERGIC /           P
                                               DOPAMINERGIC
 B   TRANXENE T TAB 15MG                       ANXIOLYTICS - BENZODIAZEPINES            N
 B   TRANXENE T TAB 3.75MG                     ANXIOLYTICS - BENZODIAZEPINES            R
 B   TRANXENE T TAB 7.5MG                      ANXIOLYTICS - BENZODIAZEPINES            N
 B   TRANXENE-SD                               ANXIOLYTICS - BENZODIAZEPINES            NR
 B   TRAVASOL                                  ELECTROLYTES/ NUTRITIONALS               P
 B   TRAVATAN                                  OP. PROSTAGLANDINS                       P
 G   trazodone hcl tab 100 mg                  ANTIDEPRESSANTS - SELECTED SSRI'S        P
 G   trazodone hcl tab 150 mg                  ANTIDEPRESSANTS - SELECTED SSRI'S        P
 G   trazodone hcl tab 300 mg                  ANTIDEPRESSANTS - SELECTED SSRI'S        N
 G   trazodone hcl tab 50 mg                   ANTIDEPRESSANTS - SELECTED SSRI'S        P
 B   TRENTAL                                   PLATELET AGGR. INHIBITORS / COMBO'S -    N
                                               MISC.
 G   tretinoin                                 TOPICAL - TRETINOIDS                     N      PA Required
 B   TRIAMCINOLONE                             COMPOUNDING MATERIALS                    P
 B   TRIAMCINOLONE ACETONIDE                   TOPICAL - CORTICOSTEROIDS                P
 G   triamcinolone acetonide cream 0.025%      TOPICAL - CORTICOSTEROIDS                P
 G   triamcinolone acetonide cream 0.1%        TOPICAL - CORTICOSTEROIDS                P
 G   triamcinolone acetonide cream 0.5%        TOPICAL - CORTICOSTEROIDS                P
 G   triamcinolone acetonide in orabase 0.1%   MOUTH - STEROIDS                         N
 G   triamcinolone acetonide lotion 0.025%     TOPICAL - CORTICOSTEROIDS                P
 G   triamcinolone acetonide lotion 0.1%       TOPICAL - CORTICOSTEROIDS                P
 G   triamcinolone acetonide oint 0.025%       TOPICAL - CORTICOSTEROIDS                P
 G   triamcinolone acetonide oint 0.1%         TOPICAL - CORTICOSTEROIDS                P
 G   triamcinolone acetonide oint 0.5%         TOPICAL - CORTICOSTEROIDS                P
 G   triamterene & hydrochlorothiazide         DIURETICS                                P
 B   TRIAZ        GEL 3%                       TOPICAL - ACNE PREPARATIONS              N      PA Required
 B   TRIAZ        GEL 6%                       TOPICAL - ACNE PREPARATIONS              N      PA Required
 B   TRIAZ        GEL 9%                       TOPICAL - ACNE PREPARATIONS              P      PA Required
 B   TRIAZ        PAD 3%                       TOPICAL - ACNE PREPARATIONS              P      PA Required
 B   TRIAZ        PAD 6%                       TOPICAL - ACNE PREPARATIONS              P      PA Required
 B   TRIAZ        PAD 9%                       TOPICAL - ACNE PREPARATIONS              P      PA Required
 B   TRIAZ CLEANSER                            TOPICAL - ACNE PREPARATIONS              P      PA Required
 G   triazolam                                 SEDATIVE/HYPNOTICS - BENZODIAZEPINES     P
 B   TRICOR                                    CHOLESTEROL - FIBRIC ACID DERIVATIVES    P
 B   TRIDESILON                                TOPICAL - CORTICOSTEROIDS                P


Report_1010_PDL_A3 rev A                                      12/26/2004                                                 Page 58 of 63
B    Drug                                                                                 P,       Comment
or   Name                                        Drug Category                            N,
G                                                                                        R, or
                                                                                         NR
                                                                     T                           - Alpha Continued -
 G   trifluridine ophth soln 1%                OP. ANTIBIOTICS                            N
 G   trihexyphenidyl hcl                       PARKINSONS - ANTICHOLINERGICS              P
 B   TRILEPTAL                                 ANTICONVULSANTS                            P
 B   TRI-LEVLEN                                CONTRACEPTIVES - TRI-PHASIC                P
                                               COMBINATIONS
 G   trimethobenzamide hcl cap 300 mg          ANTIEMETIC - ANTICHOLINERGIC /             P
                                               DOPAMINERGIC
 G   trimethoprim tab 100 mg                   ANTIBIOTICS - MISC.                        P
 B   TRINALIN REPETABS                         COUGH/COLD - DECONGESTANT &                N
                                               ANTIHISTAMINE
 B   TRI-NORINYL 28                            CONTRACEPTIVES - TRI-PHASIC                N
                                               COMBINATIONS
 B   TRINSICON                                 VITAMINS - MISC.                           N
 G   trionate                                  COUGH/COLD - NON-NARC                      P
                                               ANTITUSSIVE-ANTIHISTAMINE
 G   trionate nf                               COUGH/COLD - NON-NARC                      N
                                               ANTITUSSIVE-ANTIHISTAMINE
 B   TRIPHASIL 28                              CONTRACEPTIVES - TRI-PHASIC                P
                                               COMBINATIONS
 G   tri-vent dm                               COUGH/COLD -                               P
                                               ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                               ANT
 B   TRI-VI-FLOR                               VITAMINS - MISC.                           N
 B   TRI-VI-FLOR/IRON                          VITAMINS - MISC.                           N
 B   TROPHAMINE                                ELECTROLYTES/ NUTRITIONALS                 N
 G   tropicamide                               OP. CYCLOPLEGICS                           P
 B   TRUSOPT                                   OP. CARBONIC ANHYDRASE                     P
                                               INHIBITORS/COMBO
 G   trypsin w/ castor oil & peruvian balsam   TOPICAL - ENZYMES / KERATOLYTICS / UREA    P
     spray
 G   tussadur-hd                               COUGH/COLD -                               N
                                               ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                               ANT
 G   tussafed-la                               COUGH/COLD -                               N
                                               ANTITUSSIVE-EXPECTORANTS-DECONGEST
                                               ANT
 B   TUSSI-12                                  COUGH/COLD - NON-NARC                      N
                                               ANTITUSSIVE-ANTIHISTAMINE
 B   TUSSI-12 S                                COUGH/COLD - NON-NARC                      N
                                               ANTITUSSIVE-ANTIHISTAMINE
 B   TUSSI-12D                                 COUGH/COLD - NON-NARC                      N
                                               ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                               NE
 B   TUSSI-12D S                               COUGH/COLD - NON-NARC                      N
                                               ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                               NE
 G   tussi-bid                                 COUGH/COLD - ANTITUSSIVE-EXPECTORANT       N
 B   TUSSIONEX PENNKINETIC EXT                 COUGH/COLD - NARCOTIC                      P
                                               ANTITUSSIVE-ANTIHISTAMINE
 B   TUSSI-ORGANIDIN NR                        COUGH/COLD - ANTITUSSIVE-EXPECTORANT       N
 B   TUSSI-ORGANIDIN-S NR                      COUGH/COLD - ANTITUSSIVE-EXPECTORANT       N
 G   tussizone-12 sus 4-30mg/5                 COUGH/COLD - NON-NARC                      P
                                               ANTITUSSIVE-ANTIHISTAMINE
 G   tussizone-12 tab 5-60mg                   COUGH/COLD - NON-NARC                      N
                                               ANTITUSSIVE-ANTIHISTAMINE
 B   TYLENOL/CODEINE #3                        NARCOTICS - MICS.                          N
 B   TYLENOL/CODEINE #4                        NARCOTICS - MICS.                          N
 B   TYMPAGESIC DROPS                          EAR                                        N
 B   TYZINE                                    COUGH/COLD - TOPICAL DECONGESTANTS         N
 B   TYZINE PEDIATRIC NASAL DR                 COUGH/COLD - TOPICAL DECONGESTANTS         N

                                                                     U
 G   ultrabrom                                 COUGH/COLD - DECONGESTANT &                N
                                               ANTIHISTAMINE

Report_1010_PDL_A3 rev A                                         12/26/2004                                   Page 59 of 63
B    Drug                                                                        P,                   Comment
or   Name                                   Drug Category                        N,
G                                                                               R, or
                                                                                NR
                                                               U                                - Alpha Continued -
 G   ultrabrom pd                        COUGH/COLD - DECONGESTANT &             N
                                         ANTIHISTAMINE
 B   ULTRACET                            NARCOTICS - SELECTED                    N      ULTRACET - Use Tramadol &
                                                                                        Acetaminophen separately
 B   ULTRAM                              NARCOTICS - SELECTED                    N
 G   ultrase                             GI - DIGESTIVE ENZYMES                  P      PA Required
 B   ULTRASE MT 12                       GI - DIGESTIVE ENZYMES                  P      PA Required
 B   ULTRASE MT 18                       GI - DIGESTIVE ENZYMES                  P      PA Required
 B   ULTRASE MT 20                       GI - DIGESTIVE ENZYMES                  P      PA Required
 B   ULTRAVATE                           TOPICAL - CORTICOSTEROIDS               P
 B   UNASYN                              BETA-LACTAMS / CLAVULANATE COMBO'S      P
 B   UNASYN ADD-VANTAGE                  BETA-LACTAMS / CLAVULANATE COMBO'S      P
 B   UNASYN BULK PACK                    BETA-LACTAMS / CLAVULANATE COMBO'S      P
 B   UNIRETIC                            ACE AND THIAZIDE COMBO'S                P
 G   unithroid                           THYROID HORMONES                        P
 G   uni-tuss hc                         COUGH/COLD - NARCOTIC                   P
                                         ANTITUSSIVE-DECONGESTANT-ANTIHISTAMI
                                         NE
 B   UNIVASC                             ACE INHIBITORS                          N
 G   urea cream 40%                      TOPICAL - EMOLLIENTS                    N
 G   urea gel 40%                        TOPICAL - EMOLLIENTS                    N
 G   urea lotion 40%                     TOPICAL - EMOLLIENTS                    P
 B   URECHOLINE                          CHOLINERGIC                             N
 B   UREX                                UROLOGICAL - MISC.                      P
 B   URIMAX                              UROLOGICAL - MISC.                      N
 B   URISED                              UROLOGICAL - MISC.                      N
 B   URISPAS                             ANTISPASMODICS                          P
 B   UROCIT-K 10                         UROLOGICAL - MISC.                      P
 B   UROCIT-K 5                          UROLOGICAL - MISC.                      P
 B   UROQID #2                           UROLOGICAL - MISC.                      P
 B   UROXATRAL                           BPH                                     N
 B   URSO                                GI - MISC.                              P
 G   ursodiol cap 300 mg                 GI - MISC.                              P

                                                               V
 B   VAGIFEM                             VAGINAL - ESTROGENS                     N
 B   VALCYTE                             CYTO-MEGALOVIRUS AGENTS                 P
 B   VALIUM                              ANXIOLYTICS - BENZODIAZEPINES           N
 G   valproate sodium inj 100 mg/ml      ANTICONVULSANTS                         P
 G   valproate sodium syrup 250 mg/5ml   ANTICONVULSANTS                         P
 G   valproic acid cap 250 mg            ANTICONVULSANTS                         P
 B   VALTREX                             HERPES AGENTS                           P
 B   VANAMIDE                            TOPICAL - EMOLLIENTS                    P
 B   VANCOCIN HCL CAP 125MG              ANTIBIOTICS - MISC.                     P
 B   VANCOCIN HCL CAP 250MG              ANTIBIOTICS - MISC.                     P
 B   VANCOCIN HCL INJ                    ANTIBIOTICS - MISC.                     N
 B   VANCOCIN HCL ISO-OSMOTIC            ANTIBIOTICS - MISC.                     P
 G   vancomycin hcl for inj 10 gm        ANTIBIOTICS - MISC.                     P
 G   vancomycin hcl for inj 1000 mg      ANTIBIOTICS - MISC.                     P
 G   vancomycin hcl for inj 500 mg       ANTIBIOTICS - MISC.                     P
 G   vancomycin hcl for inj 5000 mg      ANTIBIOTICS - MISC.                     P
 B   VANSPAR                             ANXIOLYTICS - MISC.                     N
 B   VANTIN                              CEPHALOSPORINS                          P
 B   VASERETIC                           ACE AND THIAZIDE COMBO'S                N
 G   vasopressin inj 20 unit/ml          VASOPRESSINS                            N      PA Required
 B   VASOTEC                             ACE INHIBITORS                          N
 B   VELOSEF                             CEPHALOSPORINS                          N

Report_1010_PDL_A3 rev A                                  12/26/2004                                            Page 60 of 63
B    Drug                                                                  P,                   Comment
or   Name                          Drug Category                           N,
G                                                                         R, or
                                                                          NR
                                                       V                                  - Alpha Continued -
 O   VELOSULIN BR                DIABETIC - INSULIN                        P
 B   VENOFER                     MINERALS                                  N
 B   VENTOLIN HFA                ANTIASTHMATIC - BETA - ADRENERGICS        N
 G   verapamil   inj 2.5mg/ml    CALCIUM CHANNEL                           N
                                 BLOCKERS--VERAPAMILS
 G   verapamil   tab 120mg       CALCIUM CHANNEL                           P
                                 BLOCKERS--VERAPAMILS
 G   verapamil   tab 40mg        CALCIUM CHANNEL                           P
                                 BLOCKERS--VERAPAMILS
 G   verapamil   tab 80mg        CALCIUM CHANNEL                           P
                                 BLOCKERS--VERAPAMILS
 G   verapamil hcl               CALCIUM CHANNEL                           P
                                 BLOCKERS--VERAPAMILS
 G   verapamil hcl cr            CALCIUM CHANNEL                           P
                                 BLOCKERS--VERAPAMILS
 G   verapamil hcl er            CALCIUM CHANNEL                           P
                                 BLOCKERS--VERAPAMILS
 G   verapamil hcl sr            CALCIUM CHANNEL                           P
                                 BLOCKERS--VERAPAMILS
 B   VERELAN                     CALCIUM CHANNEL                           N
                                 BLOCKERS--VERAPAMILS
 B   VERELAN PM                  CALCIUM CHANNEL                           P
                                 BLOCKERS--VERAPAMILS
 B   VERMOX                      ANTHELMINTICS                             P
 B   VERSED                      SEDATIVE/HYPNOTICS - BENZODIAZEPINES      N
 B   VEXOL                       OP. ANTIINFLAMMATORY / STEROIDS OPHTH.    N
 B   VFEND                       ANTIFUNGALS - ASSORTED                    P      PA Required > 90 days
 B   VFEND IV                    ANTIFUNGALS - ASSORTED                    P      PA Required > 90 days
 B   VIAGRA                      IMPOTENCE AGENTS                          P      PA Required
 B   VIBRAMYCIN SUS 25MG/5ML     TETRACYCLINES                             N
 B   VIBRAMYCIN SYP 50MG/5ML     TETRACYCLINES                             P
 B   VICODIN                     NARCOTICS - MICS.                         N
 B   VICOPROFEN                  NARCOTICS - MICS.                         N
 B   VIGAMOX                     OP. QUINOLONES                            P
 B   VINATE II                   VITAMINS - MISC.                          N
 B   VIOKASE                     GI - DIGESTIVE ENZYMES                    N      PA Required
 B   VIOKASE 16                  GI - DIGESTIVE ENZYMES                    N      PA Required
 B   VIOKASE 8                   GI - DIGESTIVE ENZYMES                    N      PA Required
 B   VIROPTIC                    OP. ANTIBIOTICS                           P
 B   VISICOL     TAB 1.5GM       GI - ANTI - FLATULENTS / GI STIMULANTS    N
 B   VISTARIL     CAP 25MG       ANTIHISTAMINES - OTHER                    N
 B   VISTARIL     CAP 50MG       ANTIHISTAMINES - OTHER                    P
 B   VISTARIL     SUS 25MG/5ML   ANXIOLYTICS - MISC.                       NR
 B   VISTIDE                     CYTO-MEGALOVIRUS AGENTS                   P
 B   VIVACTIL                    ANTIDEPRESSANTS - TRI-CYCLICS             R
 B   VIVELLE                     ESTROGENS - PATCHES                       P
 B   VIVELLE-DOT                 ESTROGENS - PATCHES                       P
 B   VOLTAREN                    NSAIDS                                    N      PA Required
 B   VOLTAREN                    OP. NSAID'S                               P
 B   VOLTAREN-XR                 NSAIDS                                    N      PA Required
 B   VOSPIRE ER                  ANTIASTHMATIC - BETA - ADRENERGICS        P
 B   VYTORIN                     CHOLESTEROL - HMG COA + ABSORB            P
                                 INHIBITORS

                                                       W
 G   *wound dressings - gel***   TOPICAL - WOUND / DECUBITUS CARE          N
 G   warfarin sodium tab 1 mg    ANTICOAGULANTS                            N      Grandfather
 G   warfarin sodium tab 10 mg   ANTICOAGULANTS                            N      Grandfather
 G   warfarin sodium tab 2 mg    ANTICOAGULANTS                            N      Grandfather


Report_1010_PDL_A3 rev A                           12/26/2004                                             Page 61 of 63
B    Drug                                                                                       P,                   Comment
or   Name                                              Drug Category                            N,
G                                                                                              R, or
                                                                                               NR
                                                                         W                                      - Alpha Continued -
 G   warfarin sodium tab 2.5 mg                      ANTICOAGULANTS                             N      Grandfather
 G   warfarin sodium tab 3 mg                        ANTICOAGULANTS                             P      Grandfather
 G   warfarin sodium tab 4 mg                        ANTICOAGULANTS                             P      Grandfather
 G   warfarin sodium tab 5 mg                        ANTICOAGULANTS                             N      Grandfather
 G   warfarin sodium tab 6 mg                        ANTICOAGULANTS                             N      Grandfather
 G   warfarin sodium tab 7.5 mg                      ANTICOAGULANTS                             N      Grandfather
 G   water for inject, bacteriostatic                COMPOUNDING MATERIALS                      P
 G   water for inject, bacteriostatic benzyl         COMPOUNDING MATERIALS                      P
     alcohol
 G   water for injection                             COMPOUNDING MATERIALS                      P
 G   water for irrigation, sterile irrigation soln   IRRIGATION SOLUTIONS                       P
 G   water for iv injection                          COMPOUNDING MATERIALS                      P
 B   WELCHOL                                         CHOLESTEROL - BILE SEQUESTRANTS            N
 B   WELLBUTRIN                                      ANTIDEPRESSANTS - SELECTED SSRI'S          R
 B   WELLBUTRIN TAB 100MG SR                         ANTIDEPRESSANTS - SELECTED SSRI'S          P
 B   WELLBUTRIN TAB 150MG SR                         ANTIDEPRESSANTS - SELECTED SSRI'S          P
 B   WELLBUTRIN TAB 200MG SR                         ANTIDEPRESSANTS - SELECTED SSRI'S          R
 B   WELLBUTRIN XL                                   ANTIDEPRESSANTS - SELECTED SSRI'S          R
 B   WESTCORT                                        TOPICAL - CORTICOSTEROIDS                  N
 B   WINRHO SDF                                      IMMUNE SERUMS                              P
 B   WINSTROL                                        ANDROGENS / ANABOLICS                      P

                                                                           X
 B   XALATAN                                         OP. PROSTAGLANDINS                         P
 B   XANAX                                           ANXIOLYTICS - BENZODIAZEPINES              N
 B   XANAX XR                                        ANXIOLYTICS - LONG ACTING                  NR
 B   XENADERM                                        TOPICAL - ENZYMES / KERATOLYTICS / UREA    P
 B   XENICAL                                         WEIGHT LOSS                                P      PA Required
 B   XERAC AC                                        TOPICAL - ASTRINGENTS / PROTECTANTS        P
 B   XODOL                                           NARCOTICS - MICS.                          P
 B   XOLAIR                                          ANTIASTHMATIC - ANTIINFLAMMATORY           N
                                                     AGENTS
 B   XOPENEX                                         ANTIASTHMATIC - BETA - ADRENERGICS         P
 B   XYLOCAINE        GEL 2%                         TOPICAL - LOCAL ANESTHETICS                P
 B   XYLOCAINE        INJ 1%                         TOPICAL - LOCAL ANESTHETICS                P
 B   XYLOCAINE        INJ 2%                         TOPICAL - LOCAL ANESTHETICS                P
 B   XYLOCAINE        INJ -MPF 1%                    TOPICAL - LOCAL ANESTHETICS                P
 B   XYLOCAINE        SOL 2% VISC                    MOUTH - ANESTHETICS TOPICAL ORAL           P
 B   XYLOCAINE        SOL 4%                         TOPICAL - LOCAL ANESTHETICS                P

                                                                           Y
 B   YASMIN 28                                       CONTRACEPTIVES - MONOPHASIC                N
                                                     COMBINATION O/C'S
 G   yohimbine hcl tab 5.4 mg                        IMPOTENCE AGENTS                           P      PA Required

                                                                           Z
 B   ZADITOR                                         OP. ANTIALLERGICS                          N
 B   ZANAFLEX                                        MUSCLE RELAXANTS                           N      PA Required
 B   ZANTAC         INJ 25MG/ML                      GI - H2-ANTAGONISTS                        N
 B   ZANTAC         SYP 75MG/5ML                     GI - H2-ANTAGONISTS                        P
 B   ZANTAC         TAB 150MG                        GI - H2-ANTAGONISTS                        N
 B   ZANTAC         TAB 150MG EF                     GI - H2-ANTAGONISTS                        N
 B   ZANTAC         TAB 300MG                        GI - H2-ANTAGONISTS                        N
 B   ZARONTIN        CAP 250MG                       ANTICONVULSANTS                            P
 B   ZARONTIN        SYP 250/5ML                     ANTICONVULSANTS                            N      Grandfather for Seizure Disorder
 B   ZAROXOLYN                                       DIURETICS                                  P
 B   ZEBETA                                          BETA BLOCKERS - CARDIO SELECTIVE           P


Report_1010_PDL_A3 rev A                                           12/26/2004                                                    Page 62 of 63
B    Drug                                                               P,                   Comment
or   Name                         Drug Category                         N,
G                                                                      R, or
                                                                       NR
                                                     Z                                 - Alpha Continued -
 B   ZEGERID                    GI - PROTON PUMP INHIBITOR              N      PA Required from Day 1
 B   ZELNORM                    GI - IRRITABLE BOWEL SYNDROME AGENTS    N      PA Required
 B   ZEMAIRA                    ANTIASTHMATIC - ALPHA-PROTEINASE        N      PA Required
                                INHIBITOR
 B   ZEPHREX LA                 COUGH/COLD - DECONGESTANT W/            N
                                EXPECTORANT
 B   ZESTORETIC                 ACE AND THIAZIDE COMBO'S                N
 B   ZESTRIL                    ACE INHIBITORS                          N
 B   ZETIA                      CHOLESTEROL - HMG COA + ABSORB          P
                                INHIBITORS
 B   ZIAC                       BETA BLOCKERS AND DIURETIC COMBO'S      N
 B   ZINACEF                    CEPHALOSPORINS                          P
 B   ZINC SULFATE               MINERALS                                P
 B   ZITHROMAX    INJ 500MG     MACROLIDES / ERYTHROMYCIN'S /           N
                                KETOLIDES
 B   ZITHROMAX    POW 1GM PAK   MACROLIDES / ERYTHROMYCIN'S /           N
                                KETOLIDES
 B   ZITHROMAX    SUS 100/5ML   MACROLIDES / ERYTHROMYCIN'S /           P
                                KETOLIDES
 B   ZITHROMAX    SUS 200/5ML   MACROLIDES / ERYTHROMYCIN'S /           P
                                KETOLIDES
 B   ZITHROMAX    TAB 250MG     MACROLIDES / ERYTHROMYCIN'S /           P
                                KETOLIDES
 B   ZITHROMAX    TAB 500MG     MACROLIDES / ERYTHROMYCIN'S /           P
                                KETOLIDES
 B   ZITHROMAX    TAB 600MG     MACROLIDES / ERYTHROMYCIN'S /           P
                                KETOLIDES
 B   ZITHROMAX TRI-PAK          MACROLIDES / ERYTHROMYCIN'S /           P
                                KETOLIDES
 B   ZITHROMAX Z-PAK            MACROLIDES / ERYTHROMYCIN'S /           P
                                KETOLIDES
 B   ZOCOR                      CHOLESTEROL - HMG COA + ABSORB          P
                                INHIBITORS
 B   ZODERM                     TOPICAL - ACNE PREPARATIONS             N      PA Required
 B   ZOFRAN                     ANTIEMETIC - 5-HT3 RECEPTOR             P
                                ANTAGONISTS/ SUBSTANCE P NEUROKININ
 B   ZOFRAN ODT                 ANTIEMETIC - 5-HT3 RECEPTOR             P
                                ANTAGONISTS/ SUBSTANCE P NEUROKININ
 B   ZOLOFT                     ANTIDEPRESSANTS - SELECTED SSRI'S       R
 B   ZOMIG                      MIGRAINE - SELECTIVE SEROTONIN          N      PA Required from Day 1
                                AGONISTS (5HT)--INJECTABLES
 B   ZOMIG                      MIGRAINE - SELECTIVE SEROTONIN          N      PA Required from Day 1
                                AGONISTS (5HT)--TABS
 B   ZOMIG ZMT                  MIGRAINE - SELECTIVE SEROTONIN          N      PA Required from Day 1
                                AGONISTS (5HT)--TABS
 B   ZONALON                    TOPICAL - ANTIPRURITICS                 P
 B   ZONEGRAN                   ANTICONVULSANTS                         P
 B   ZORBTIVE                   GROWTH HORMONE                          N      PA Required
 B   ZORPRIN                    ANALGESICS - MISC.                      N
 B   ZOSYN                      BETA-LACTAMS / CLAVULANATE COMBO'S      P
 B   ZOVIRAX     CAP 200MG      HERPES AGENTS                           N
 B   ZOVIRAX     CRE 5%         TOPICAL - ANTIVIRALS                    N
 B   ZOVIRAX     OIN 5%         TOPICAL - ANTIVIRALS                    P
 B   ZOVIRAX     SUS 200/5ML    HERPES AGENTS                           P
 B   ZYDONE                     NARCOTICS - MICS.                       N
 B   ZYMAR                      OP. QUINOLONES                          P
 B   ZYRTEC                     ANTIHISTAMINES - NON-SEDATING           N      PA Required
 B   ZYRTEC-D                   NON-SEDATING ANTIHISTIMINES /           N
                                DECONGESTANTS
 B   ZYVOX                      LINCOSAMIDES / OXAZOLIDINONES /         P
                                LEPROSTATICS



Report_1010_PDL_A3 rev A                         12/26/2004                                             Page 63 of 63