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Cough and Cold List Please note that generic and Medicaid Over the Counter

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Cough and Cold List Please note that generic and Medicaid  Over the Counter Powered By Docstoc
					                                ALABAMA MEDICAID AGENCY
                                               Cough and Cold List
                                                     by Brand Name



In accordance with the Omnibus Budget Reconciliation Act of 1990 (OBRA 90), agents used for the symptomatic relief of
cough and cold are an optional coverage class of drugs for the Alabama Medicaid Agency. Effective November 1, 2005,
the Alabama Medicaid Agency covers generic and OTC cough and cold products; brand name cough and cold products are
non-covered. The list below contains products which are currently covered by the Alabama Medicaid Agency. The list is
subject to change. For additional information and updates, please see the Agency website at
www.medicaid.alabama.gov.

                                                                                                         Dosage
 NDC Code      Drug Label Name                  Generic Drug Description                                 Form
 37205044652   12-HR DECONGEST 120 MG CAPLET    PSEUDOEPHEDRINE HCL ORAL 120 MG TABLET SA                Tablet
 49614043362   12-HR DECONGEST 120 MG CAPLET    PSEUDOEPHEDRINE HCL ORAL 120 MG TABLET SA                Tablet
 37205099134   ADULT MUCUS RELIEF LIQ           GUAIFENESIN ORAL 100 MG/5ML LIQUID                       Liquid
 00031867012   ADULT ROBITUSSIN COUGH SYRUP     DEXTROMETHORPHAN HBR ORAL 15 MG/5 ML SYRUP               Syrup
 50991090116   ALA-HIST AC LIQUID               PHENYLEPHRINE HCL/CODEINE PHOS ORAL 7.5-10MG/5 LIQUID    Liquid
 50991081416   ALA-HIST DM LIQUID               BROMPHENIRAMIN/PE/DEXTROMETHOR ORAL 4-7.5-15/5 LIQUID    Liquid
 13279030130   ALLANHIST PDX DROPS              D-METHORPHAN HB/P-EPD HCL/BPM ORAL 3-12.5-1/1 DROPS      Drops
 13279030716   ALLANVAN-DM SUSPENSION           DM-PE-PYRILAMINE TANNATES ORAL 25-12.5-30 ORAL SUSP      Suspension
 58605040001   ALLFEN 400 MG TABLET             GUAIFENESIN ORAL 400 MG TABLET                           Tablet
 66870042201   AMBI 10PEH-400GFN TABLET         GUAIFENESIN/PHENYLEPHRINE HCL ORAL 400MG-10MG TABLET     Tablet
 66870042301   AMBI 10PEH-400GFN-20DM TABLET    GUAIFENESIN/D-METHORPHAN HB/PE ORAL 400-20-10 TABLET     Tablet
 66870044501   AMBI 10PEH-4CPM-20DM TABLET      D-METHORPHAN HB/PE/CHLORPHENIR ORAL 20-10-4MG TABLET     Tablet
 66870044801   AMBI 20DM-4CPM TABLET            DEXTROMETHORPHAN HBR/CHLOR-MAL ORAL 20MG-4MG TABLET      Tablet
 66870040801   AMBI 40PSE-400GFN TABLET         GUAIFENESIN/P-EPHED HCL ORAL 400MG-40MG TABLET           Tablet
 66870040828   AMBI 40PSE-400GFN TABLET         GUAIFENESIN/P-EPHED HCL ORAL 400MG-40MG TABLET           Tablet
 66870040901   AMBI 40PSE-400GFN-20DM TABLET    GUAIFEN/DM HB/P-EPHEDRINE ORAL 400-20-40 TABLET          Tablet
 66870040601   AMBI 60PSE-400GFN TABLET         GUAIFENESIN/P-EPHED HCL ORAL 400MG-60MG TABLET           Tablet
 66870040701   AMBI 60PSE-400GFN-20DM TABLET    GUAIFEN/DM HB/P-EPHEDRINE ORAL 400-20-60 TABLET          Tablet
 66870044301   AMBI 60PSE-4CPM-20DM TABLET      D-METHORPHAN HB/P-EPHED HCL/CP ORAL 20-60-4MG TABLET     Tablet
 60258044416   ANDEHIST-DM NR SYRUP             D-METHORPHAN HB/P-EPD HCL/BPM ORAL 15-45-4/5 SYRUP       Syrup
 00258365401   BENZONATATE 100 MG CAPSULE       BENZONATATE ORAL 100 MG CAPSULE                          Capsule
 00258365405   BENZONATATE 100 MG CAPSULE       BENZONATATE ORAL 100 MG CAPSULE                          Capsule
 00406224701   BENZONATATE 100 MG CAPSULE       BENZONATATE ORAL 100 MG CAPSULE                          Capsule
 00406224705   BENZONATATE 100 MG CAPSULE       BENZONATATE ORAL 100 MG CAPSULE                          Capsule
 00677147201   BENZONATATE 100 MG CAPSULE       BENZONATATE ORAL 100 MG CAPSULE                          Capsule
 00904590440   BENZONATATE 100 MG CAPSULE       BENZONATATE ORAL 100 MG CAPSULE                          Capsule
 00904590460   BENZONATATE 100 MG CAPSULE       BENZONATATE ORAL 100 MG CAPSULE                          Capsule
 00904773760   BENZONATATE 100 MG CAPSULE       BENZONATATE ORAL 100 MG CAPSULE                          Capsule
 50111085101   BENZONATATE 100 MG CAPSULE       BENZONATATE ORAL 100 MG CAPSULE                          Capsule
 50111085102   BENZONATATE 100 MG CAPSULE       BENZONATATE ORAL 100 MG CAPSULE                          Capsule
 57664013388   BENZONATATE 100 MG CAPSULE       BENZONATATE ORAL 100 MG CAPSULE                          Capsule
 58177009104   BENZONATATE 100 MG CAPSULE       BENZONATATE ORAL 100 MG CAPSULE                          Capsule
 58177009108   BENZONATATE 100 MG CAPSULE       BENZONATATE ORAL 100 MG CAPSULE                          Capsule
 58177009111   BENZONATATE 100 MG CAPSULE       BENZONATATE ORAL 100 MG CAPSULE                          Capsule
 65162053610   BENZONATATE 100 MG CAPSULE       BENZONATATE ORAL 100 MG CAPSULE                          Capsule
 65162053650   BENZONATATE 100 MG CAPSULE       BENZONATATE ORAL 100 MG CAPSULE                          Capsule
 67877010501   BENZONATATE 100 MG CAPSULE       BENZONATATE ORAL 100 MG CAPSULE                          Capsule
 67877010505   BENZONATATE 100 MG CAPSULE       BENZONATATE ORAL 100 MG CAPSULE                          Capsule
 68084021401   BENZONATATE 100 MG CAPSULE       BENZONATATE ORAL 100 MG CAPSULE                          Capsule
 68084021411   BENZONATATE 100 MG CAPSULE       BENZONATATE ORAL 100 MG CAPSULE                          Capsule
 68382024701   BENZONATATE 100 MG CAPSULE       BENZONATATE ORAL 100 MG CAPSULE                          Capsule
 68382024705   BENZONATATE 100 MG CAPSULE       BENZONATATE ORAL 100 MG CAPSULE                          Capsule
 00258367801   BENZONATATE 200 MG CAPSULE       BENZONATATE ORAL 200 MG CAPSULE                          Capsule

                                                          1                                                 Effective 4/1/10
                               ALABAMA MEDICAID AGENCY
                                               Cough and Cold List
                                               by Brand Name (continued)



00406224801   BENZONATATE 200 MG CAPSULE        BENZONATATE ORAL 200 MG CAPSULE                            Capsule
00555188302   BENZONATATE 200 MG CAPSULE        BENZONATATE ORAL 200 MG CAPSULE                            Capsule
00904590560   BENZONATATE 200 MG CAPSULE        BENZONATATE ORAL 200 MG CAPSULE                            Capsule
57664013488   BENZONATATE 200 MG CAPSULE        BENZONATATE ORAL 200 MG CAPSULE                            Capsule
58177009204   BENZONATATE 200 MG CAPSULE        BENZONATATE ORAL 200 MG CAPSULE                            Capsule
65162053710   BENZONATATE 200 MG CAPSULE        BENZONATATE ORAL 200 MG CAPSULE                            Capsule
67877010601   BENZONATATE 200 MG CAPSULE        BENZONATATE ORAL 200 MG CAPSULE                            Capsule
67877010605   BENZONATATE 200 MG CAPSULE        BENZONATATE ORAL 200 MG CAPSULE                            Capsule
68382024801   BENZONATATE 200 MG CAPSULE        BENZONATATE ORAL 200 MG CAPSULE                            Capsule
42192050716   BP 8 COUGH SUSPENSION             GUAIFEN/DM HB/P-EPHEDRINE ORAL 175-15-30 ORAL SUSP         Suspension
64376073616   BPM PE DM SYRUP                   BROMPHENIRAMIN/PE/DEXTROMETHOR ORAL 2-5-10MG/5 LIQUID      Liquid
44183031316   BPM-PHENYLEPH-DM LIQUID           BROMPHENIRAMIN/PE/DEXTROMETHOR ORAL 4-10-20/5 LIQUID       Liquid
68032045916   BPM-PHENYLEPH-DM LIQUID           BROMPHENIRAMIN/PE/DEXTROMETHOR ORAL 4-10-20/5 LIQUID       Liquid
44183031116   BPM-PSE-DM LIQUID                 D-METHORPHAN HB/P-EPD HCL/BPM ORAL 20-20-4/5 LIQUID        Liquid
68032046016   BPM-PSE-DM LIQUID                 D-METHORPHAN HB/P-EPD HCL/BPM ORAL 20-20-4/5 LIQUID        Liquid
51991063716   BROMDEX D SYRUP                   D-METHORPHAN HB/P-EPD HCL/BPM ORAL 30-50-3MG LIQUID        Liquid
60258042830   BROMHIST PDX DROPS                D-METHORPHAN HB/P-EPD HCL/BPM ORAL 3-12.5-1/1 DROPS        Drops
60258044730   BROMHIST-DM DROPS                 D-METHORPHAN HB/P-EPD HCL/BPM ORAL 4-15-1MG/1 DROPS        Drops
10914044016   BROM-PE-DM 2-5-10 MG/ML SYRUP     BROMPHENIRAMIN/PE/DEXTROMETHOR ORAL 2-5-10MG/5 LIQUID      Liquid
51991014716   BROMPHENEX DM SYRUP               D-METHORPHAN HB/P-EPD HCL/BPM ORAL 30-60-4/5 SYRUP         Syrup
51991034716   BROMPHENEX DM SYRUP               D-METHORPHAN HB/P-EPD HCL/BPM ORAL 30-60-4/5 SYRUP         Syrup
68032045616   BROM-PHENYL-DEX LIQUID            BROMPHENIRAMIN/PE/DEXTROMETHOR ORAL 4-7.5-15/5 LIQUID      Liquid
66993022057   BROMPLEX DM SYRUP                 D-METHORPHAN HB/P-EPD HCL/BPM ORAL 30-60-4/5 SYRUP         Syrup
58809070701   CARBATUSS-CL LIQUID               POT GUAIACO/CAR-B-PENTANE/PE ORAL 100-20-10 LIQUID         Liquid
50383057516   CARBOFED DM SYRUP                 D-METHORPHAN HB/P-EPD HCL/BPM ORAL 15-45-4/5 SYRUP         Syrup
60258041516   CERON-DM SYRUP                    D-METHORPHAN HB/PE/CHLORPHENIR ORAL 15-12.5-4 SYRUP        Syrup
54092040006   CHERACOL D COUGH FORMULA          GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 LIQUID         Liquid
00603107558   CHERATUSSIN AC SYRUP              GUAIFENESIN/CODEINE PHOS ORAL 100-10MG/5 LIQUID            Liquid
00603107858   CHERATUSSIN DAC SYRUP             P-EPHED HCL/CODEINE/GUAIFEN ORAL 30-10-100 SYRUP           Syrup
49614047271   CHEST CONGEST-COUGH RELIEF TAB    GUAIFENESIN/D-METHORPHAN HB ORAL 400MG-20MG TABLET         Tablet
00113041926   CHILD MUCUS RELIEF COUGH LIQ      GUAIFENESIN/D-METHORPHAN HB ORAL 100-5 MG/5 LIQUID         Liquid
37205099326   CHILD MUCUS RELIEF COUGH LIQ      GUAIFENESIN/D-METHORPHAN HB ORAL 100-5 MG/5 LIQUID         Liquid
49614022426   CHILD MUCUS RELIEF LIQUID         GUAIFENESIN ORAL 100 MG/5ML LIQUID                         Liquid
00113098726   CHILDREN'S COLD & COUGH ELIXIR    BROMPHENIRAMIN/PE/DEXTROMETHOR ORAL 1-2.5-5/5 SOLUTION     Solution
63824027464   CHILDREN'S MUCINEX COUGH LIQ      GUAIFENESIN/D-METHORPHAN HB ORAL 100-5 MG/5 LIQUID         Liquid
00113028826   CHILDREN'S MUCUS RELIEF LIQ       GUAIFENESIN ORAL 100 MG/5ML LIQUID                         Liquid
54838010440   CHILDREN'S SILFEDRINE LIQ         PSEUDOEPHEDRINE HCL ORAL 15 MG/5 ML LIQUID                 Liquid
54838010470   CHILDREN'S SILFEDRINE LIQ         PSEUDOEPHEDRINE HCL ORAL 15 MG/5 ML LIQUID                 Liquid
49614037526   CHILDS COLD & COUGH DM ELIXIR     BROMPHENIRAMIN/PE/DEXTROMETHOR ORAL 1-2.5-5/5 SOLUTION     Solution
63824027364   CHILD'S MUCINEX 100 MG/5 ML LQ    GUAIFENESIN ORAL 100 MG/5ML LIQUID                         Liquid
60258022116   CHLOR-MES D LIQUID                CHLOR-MAL/PHENYLEPH/METHSCOP ORAL 2-10-0.625 LIQUID        Liquid
68032045801   CHLORPHEN-DEX-PSE DROPS           D-METHORPHAN HB/P-EPHED HCL/CP ORAL 3-9-0.8/ML DROPS       Drops
51991065716   CHLORPHENIRAMINE-CODEINE LIQ      CHLORPHENIRAMINE/CODEINE PHOS ORAL 2MG-10MG/5 LIQUID       Liquid
44183051016   CHLORPHEN-PSE-DM TANNATE SUSP     D-METHORP TAN/P-EPD TAN/CP ORAL 30-30-4/5 ORAL SUSP        Suspension
68032032316   CODEINE-GUAIFEN 10MG-200MG LIQ    GUAIFENESIN/CODEINE PHOS ORAL 200-10MG/5 LIQUID            Liquid
51991022404   COLDCOUGH PD SYRUP                PHENYLEPHRINE/DHCODEINE BT/CP ORAL 7.5-3-2/5 SYRUP         Syrup
51991022216   COLDCOUGH SYRUP                   P-EPHED HCL/DHCODEINE BT/CP ORAL 15-7.5-2/5 SYRUP          Syrup
60258023816   CORFEN-DM LIQUID                  D-METHORPHAN HB/PE/CHLORPHENIR ORAL 15-10-4/5 SOLUTION     Solution
68047027101   CORYZA-D TABLET                   P-EPHED HCL/DEXCHLORPHEN/SCOP ORAL 45-3.5-1MG TAB.SR 12H   Tablet
68047027016   CORYZA-DM SYRUP                   DM/PHENYLEPH/PYRIL/DEXCHLROPHE ORAL 5-5-5-1.25 SOLUTION    Solution
24385026226   COUGH RELIEF LIQUID               DEXTROMETHORPHAN HBR ORAL 15 MG/5 ML LIQUID                Liquid
24385026326   COUGH RELIEF LIQUID               DEXTROMETHORPHAN HBR ORAL 15 MG/5 ML LIQUID                Liquid

                                                          2                                                  Effective 4/1/10
                               ALABAMA MEDICAID AGENCY
                                               Cough and Cold List
                                               by Brand Name (continued)



49614074572   COUGHTAB 200 MG TABLET            GUAIFENESIN ORAL 200 MG TABLET                              Tablet
15127015150   COUGHTAB 400 MG TABLET            GUAIFENESIN ORAL 400 MG TABLET                              Tablet
64376072630   C-PHEN DM DROPS                   D-METHORPHAN HB/PE/CHLORPHENIR ORAL 3-3.5-1/ML DROPS        Drops
64376072716   C-PHEN DM SYRUP                   D-METHORPHAN HB/PE/CHLORPHENIR ORAL 15-12.5-4 SYRUP         Syrup
64376072740   C-PHEN DM SYRUP                   D-METHORPHAN HB/PE/CHLORPHENIR ORAL 15-12.5-4 SYRUP         Syrup
60258025001   CPM 8-PE 20-MSC 1.25 MG TAB       CHLOR-MAL/PHENYLEPH/METHSCOP ORAL 8-20-1.25 TAB.SR 12H      Tablet
13811007230   CPM-PSE DM DROPS                  D-METHORPHAN HB/P-EPHED HCL/CP ORAL 3-9-0.8/ML DROPS        Drops
51991023316   CRANTEX LIQUID                    GUAIFENESIN/PHENYLEPHRINE HCL ORAL 100-7.5/5 SYRUP          Syrup
66993055057   C-TANNA 12 SUSPENSION             CAR-B-PEN TA/CHLOR-TAN ORAL 30-4MG/5ML ORAL SUSP            Suspension
60258024316   DACEX-DM SYRUP                    GUAIFENESIN/D-METHORPHAN HB/PE ORAL 25-12.5/5 SYRUP         Syrup
60258023916   DE-CHLOR DM LIQUID                D-METHORPHAN HB/PE/CHLORPHENIR ORAL 15-10-2/5 SYRUP         Syrup
60258024016   DE-CHLOR DR LIQUID                D-METHORPHAN HB/PE/CHLORPHENIR ORAL 15-6-2MG/5 SYRUP        Syrup
60258022016   DEHISTINE SYRUP                   CHLOR-MAL/PHENYLEPH/METHSCOP ORAL 2-10-1.25 SOLUTION        Solution
53014046343   DELSYM 30 MG/5 ML LIQUID          DEXTROMETHORPHAN HBR ORAL 30 MG/5 ML LIQUID                 Liquid
53014046356   DELSYM 30 MG/5 ML LIQUID          DEXTROMETHORPHAN HBR ORAL 30 MG/5 ML LIQUID                 Liquid
53014046361   DELSYM 30 MG/5 ML LIQUID          DEXTROMETHORPHAN HBR ORAL 30 MG/5 ML LIQUID                 Liquid
63824017165   DELSYM 30 MG/5 ML SUSPENSION      DEXTROMETHORPHAN POLISTIREX ORAL 30 MG/5 ML SUS.12H SR      Suspension
63824017263   DELSYM 30 MG/5 ML SUSPENSION      DEXTROMETHORPHAN POLISTIREX ORAL 30 MG/5 ML SUS.12H SR      Suspension
63824017265   DELSYM 30 MG/5 ML SUSPENSION      DEXTROMETHORPHAN POLISTIREX ORAL 30 MG/5 ML SUS.12H SR      Suspension
63824017663   DELSYM 30 MG/5 ML SUSPENSION      DEXTROMETHORPHAN POLISTIREX ORAL 30 MG/5 ML SUS.12H SR      Suspension
63824017665   DELSYM 30 MG/5 ML SUSPENSION      DEXTROMETHORPHAN POLISTIREX ORAL 30 MG/5 ML SUS.12H SR      Suspension
63824027263   DELSYM 30 MG/5 ML SUSPENSION      DEXTROMETHORPHAN POLISTIREX ORAL 30 MG/5 ML SUS.12H SR      Suspension
63824027663   DELSYM 30 MG/5 ML SUSPENSION      DEXTROMETHORPHAN POLISTIREX ORAL 30 MG/5 ML SUS.12H SR      Suspension
63824027665   DELSYM 30 MG/5 ML SUSPENSION      DEXTROMETHORPHAN POLISTIREX ORAL 30 MG/5 ML SUS.12H SR      Suspension
64376071116   DEX PC SYRUP                      D-METHORPHAN HB/PE/CHLORPHENIR ORAL 15-6-2MG/5 SYRUP        Syrup
64376073716   DEXPHEN M SOLUTION                PHENYLEPH/DEXCHLOR/METHSCOPOL ORAL 10-1-1.25 SOLUTION       Solution
60258075016   DEX-TUSS LIQUID                   GUAIFENESIN/CODEINE PHOS ORAL 300-10MG/5 LIQUID             Liquid
68308018010   D-HIST D CAPLET                   P-EPHED HCL/DEXCHLORPHEN/SCOP ORAL 45-3.5-1MG TAB.SR 12H    Tablet
61787006204   DIABETIC TUSSIN DM LIQUID         GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 LIQUID          Liquid
61787006304   DIABETIC TUSSIN EX LIQUID         GUAIFENESIN ORAL 100 MG/5ML LIQUID                          Liquid
61787006404   DIABETIC TUSSIN MAX-STR LIQ       GUAIFENESIN/D-METHORPHAN HB ORAL 200-10MG/5 LIQUID          Liquid
68032048916   DIHYDROCODEINE-BPM-PE LIQUID      BROMPHENIRAM/PE/DIHYDROCODEINE ORAL 4-7.5-3/5 LIQUID        Liquid
60258076016   DIHYDRO-CP SYRUP                  P-EPHED HCL/DHCODEINE BT/CP ORAL 15-7.5-2/5 SYRUP           Syrup
60258076204   DIHYDRO-PE SYRUP                  PHENYLEPHRINE/DHCODEINE BT/CP ORAL 7.5-3-2/5 SYRUP          Syrup
00031223413   DIMETAPP COLD & COUGH LIQUID      BROMPHENIRAMIN/PE/DEXTROMETHOR ORAL 1-2.5-5/5 SOLUTION      Solution
00031223419   DIMETAPP COLD & COUGH LIQUID      BROMPHENIRAMIN/PE/DEXTROMETHOR ORAL 1-2.5-5/5 SOLUTION      Solution
10914080016   DM 10 MG-GUAI 300 MG LIQUID       GUAIFENESIN/D-METHORPHAN HB ORAL 300-10MG/5 LIQUID          Liquid
68032034710   DM-CHLORPHEN-METHSCOP TABLET      D-METHORPHAN HB/CHLOR-MAL/SCOP ORAL 30-8-2.5MG TAB.SR 12H   Tablet
42192050830   DM-CHLORPHEN-PHENYLEPHRIN DROP    D-METHORPHAN HB/PE/CHLORPHENIR ORAL 2.75MG/ML DROPS         Drops
10914043016   DM-PE-BROM TAN 30-25-10 MG SUS    D-METHORP TAN/PE/BR-PHENIR ORAL 30-25-10/5 ORAL SUSP        Suspension
68032030716   DM-PE-DEXCHLORPHEN TANN SUSP      DM TAN/PE TAN/DEXCHLORPHEN TAN ORAL 30-20-2/5 ORAL SUSP     Suspension
68032032716   DM-PE-PYRILAMINE TANN SUSP        DM-PE-PYRILAMINE TANNATES ORAL 25-15.5/5 ORAL SUSP          Suspension
42192050930   DM-PHENYLEPHRIN-CHLORPHEN DROP    D-METHORPHAN HB/PE/CHLORPHENIR ORAL 3-1.5-1/ML DROPS        Drops
16477013616   DONATUSS DC SYRUP                 PHENYLEPH/DIHYDROCODEINE/GUAIF ORAL 7.5-7.5-50 LIQUID       Liquid
16477013516   DONATUSS XP SUSPENSION            GUAIFEN/DM HB/P-EPHEDRINE ORAL 180-15-30 ORAL SUSP          Suspension
16477081130   DONATUSSIN DM DROPS               D-METHORPHAN HB/PE/CHLORPHENIR ORAL 3-1.5-1/ML DROPS        Drops
16477013201   DONATUSSIN DM SYRUP               GUAIFEN/DM HB/P-EPHEDRINE ORAL 150-15-30 LIQUID             Liquid
16477010630   DONATUSSIN DROPS                  GUAIFENESIN/PHENYLEPHRINE HCL ORAL 20-1.5/ML DROPS          Drops
64661009004   DRYMAX SYRUP                      PSEUDOEPHEDRINE/CPM/METHSCOPOL ORAL 30-4-1.25 LIQUID        Liquid
68308013604   D-TANN AT SUSPENSION              CARBETAPENT TAN/DIPHENHYDR TAN ORAL 30-25MG/5 ORAL SUSP     Suspension
68308014004   D-TANN CD SUSPENSION              CAR-B-PEN TA/PE/DP-HYDRAMINE ORAL 30-15-25/5 ORAL SUSP      Suspension
68308013004   D-TANN CT SUSPENSION              CAR-B-PEN TA/PE/DP-HYDRAMINE ORAL 30-7.5-25 ORAL SUSP       Suspension

                                                          3                                                   Effective 4/1/10
                              ALABAMA MEDICAID AGENCY
                                              Cough and Cold List
                                              by Brand Name (continued)



68308075560   D-TANN CT TABLET                 CAR-B-PEN TA/PE/DP-HYDRAMINE ORAL 30-10-25MG TABLET       Tablet
68308013804   D-TANN DM SUSPENSION             DM/PHENYLEPH/DIPHENHYDRAM TANN ORAL 75-7.5-25 ORAL SUSP   Suspension
00485007116   ED-A-HIST DM LIQUID              D-METHORPHAN HB/PE/CHLORPHENIR ORAL 15-10-4/5 SOLUTION    Solution
68047013804   ENDACOF AC SYRUP                 BROMPHENIRAMINE/CODEINE PHOS ORAL 2MG-10MG/5 LIQUID       Liquid
68047014516   ENDACOF-C LIQUID                 CHLORPHENIRAMINE/CODEINE PHOS ORAL 2MG-10MG/5 LIQUID      Liquid
68047014616   ENDACOF-DC LIQUID                PSEUDOEPHEDRINE HCL/CODEINE ORAL 30-10MG/5 LIQUID         Liquid
68047013916   ENDACOF-DH LIQUID                BROMPHENIRAM/PE/DIHYDROCODEINE ORAL 4-7.5-3/5 LIQUID      Liquid
68047001030   ENDACOF-PD DROPS                 D-METHORPHAN HB/P-EPD HCL/BPM ORAL 3-12.5-1/1 DROPS       Drops
68047022216   EXECLEAR-C SYRUP                 GUAIFENESIN/CODEINE PHOS ORAL 200-10MG/5 LIQUID           Liquid
68047022316   EXECLEAR-DM SYRUP                GUAIFEN/DM HB/P-EPHEDRINE ORAL 150-15-30 LIQUID           Liquid
68047015501   EXEFEN DMX TABLET                GUAIFEN/DM HB/P-EPHEDRINE ORAL 400-20-60 TABLET           Tablet
68047015401   EXEFEN-IR TABLET                 GUAIFENESIN/P-EPHED HCL ORAL 400MG-60MG TABLET            Tablet
11383016808   EXPECTORANT 100 MG/5 ML SYRUP    GUAIFENESIN ORAL 100 MG/5ML SYRUP                         Syrup
11383021930   EXPECTORANT 200 MG TABLET        GUAIFENESIN ORAL 200 MG TABLET                            Tablet
11383017808   EXPECTORANT DM COUGH SYRUP       GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP         Syrup
60258026116   GANI-TUSS NR LIQUID              GUAIFENESIN/CODEINE PHOS ORAL 100-10MG/5 LIQUID           Liquid
60258026216   GANI-TUSS-DM NR LIQUID           GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 LIQUID        Liquid
00182145916   GENAPHED 30 MG TABLET            PSEUDOEPHEDRINE HCL ORAL 30 MG TABLET                     Tablet
11383023550   G-FENESIN 400 MG CAPLET          GUAIFENESIN ORAL 400 MG TABLET                            Tablet
11383023850   G-FENESIN DM 20-400 MG CAPLET    GUAIFENESIN/D-METHORPHAN HB ORAL 400MG-20MG TABLET        Tablet
00121074404   GUAIFENESIN 100 MG/5 ML SYRUP    GUAIFENESIN ORAL 100 MG/5ML LIQUID                        Liquid
00536082585   GUAIFENESIN 100 MG/5 ML SYRUP    GUAIFENESIN ORAL 100 MG/5ML LIQUID                        Liquid
00536082597   GUAIFENESIN 100 MG/5 ML SYRUP    GUAIFENESIN ORAL 100 MG/5ML LIQUID                        Liquid
00904515460   GUAIFENESIN 200 MG TABLET        GUAIFENESIN ORAL 200 MG TABLET                            Tablet
51991060601   GUAIFENESIN 400 MG TABLET        GUAIFENESIN ORAL 400 MG TABLET                            Tablet
00121063804   GUAIFENESIN DM SYRUP             GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP         Syrup
00121063805   GUAIFENESIN DM SYRUP             GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP         Syrup
00121063810   GUAIFENESIN DM SYRUP             GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP         Syrup
00536097085   GUAIFENESIN DM SYRUP             GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP         Syrup
00536097097   GUAIFENESIN DM SYRUP             GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP         Syrup
54838012380   GUAIFENESIN NR 100 MG/5 ML       GUAIFENESIN ORAL 100 MG/5ML LIQUID                        Liquid
00121077504   GUAIFENESIN-CODEINE SYRUP        GUAIFENESIN/CODEINE PHOS ORAL 100-10MG/5 LIQUID           Liquid
00121077516   GUAIFENESIN-CODEINE SYRUP        GUAIFENESIN/CODEINE PHOS ORAL 100-10MG/5 LIQUID           Liquid
00121177505   GUAIFENESIN-CODEINE SYRUP        GUAIFENESIN/CODEINE PHOS ORAL 100-10MG/5 LIQUID           Liquid
00121177510   GUAIFENESIN-CODEINE SYRUP        GUAIFENESIN/CODEINE PHOS ORAL 100-10MG/5 LIQUID           Liquid
64376043516   GUAIFENESIN-CODEINE SYRUP        GUAIFENESIN/CODEINE PHOS ORAL 100-10MG/5 LIQUID           Liquid
64376043540   GUAIFENESIN-CODEINE SYRUP        GUAIFENESIN/CODEINE PHOS ORAL 100-10MG/5 LIQUID           Liquid
54838012480   GUAIFENESIN-DM NR LIQUID         GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 LIQUID        Liquid
68032027616   GUAIFENESIN-PHENYLEPHRINE SYR    GUAIFENESIN/PHENYLEPHRINE HCL ORAL 200-5MG/5 SYRUP        Syrup
10267013506   GUAIFENESIN-PHENYLEPHRINE TAB    GUAIFENESIN/PHENYLEPHRINE HCL ORAL 400MG-10MG TABLET      Tablet
51991008716   GUIADEX DM LIQUID                POT GUAIACO/D-METHORPHAN HB ORAL 300-15MG/5 LIQUID        Liquid
51991063316   GUIADRINE DX LIQUID              GUAIFENESIN/D-METHORPHAN HB ORAL 225-25MG/5 SOLUTION      Solution
00182025937   GUIATUSS 100 MG/5 ML SYRUP       GUAIFENESIN ORAL 100 MG/5ML LIQUID                        Liquid
00182025940   GUIATUSS 100 MG/5 ML SYRUP       GUAIFENESIN ORAL 100 MG/5ML LIQUID                        Liquid
00182606437   GUIATUSS DM SYRUP                GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP         Syrup
00182606440   GUIATUSS DM SYRUP                GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP         Syrup
00182606441   GUIATUSS DM SYRUP                GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP         Syrup
50383013516   HT-TUSS DM ELIXIR                GUAIFENESIN/D-METHORPHAN HB ORAL 200-20MG/5 ELIXIR        Elixir
00121481105   HYDROCODONE-HOMATROPINE SYRUP    HYDROCODONE BIT/HOMATROPINE ORAL 5-1.5MG/5 SYRUP          Syrup
50383004316   HYDROCODONE-HOMATROPINE SYRUP    HYDROCODONE BIT/HOMATROPINE ORAL 5-1.5MG/5 SYRUP          Syrup
60432045516   HYDROCODONE-HOMATROPINE SYRUP    HYDROCODONE BIT/HOMATROPINE ORAL 5-1.5MG/5 SYRUP          Syrup
00472103016   HYDROMET SYRUP                   HYDROCODONE BIT/HOMATROPINE ORAL 5-1.5MG/5 SYRUP          Syrup

                                                         4                                                 Effective 4/1/10
                                ALABAMA MEDICAID AGENCY
                                               Cough and Cold List
                                               by Brand Name (continued)



00603133058   IOPHEN DM LIQUID                  GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 LIQUID         Liquid
00603132858   IOPHEN NR LIQUID                  GUAIFENESIN ORAL 100 MG/5ML LIQUID                         Liquid
00603132958   IOPHEN-C NR LIQUID                GUAIFENESIN/CODEINE PHOS ORAL 100-10MG/5 LIQUID            Liquid
64661006016   J-COF DHC LIQUID                  BROMPHENRM/PSEUDOEPH/DIHYDROCD ORAL 3-15-7.5/5 LIQUID      Liquid
64661007016   J-MAX DHC LIQUID                  DIHYDROCODEINE/GUAIFENESIN ORAL 7.5-100/5 LIQUID           Liquid
00536231097   KIDCARE COUGH & COLD LIQUID       D-METHORPHAN HB/P-EPHED HCL/CP ORAL 5-15-1MG/5 LIQUID      Liquid
00536230375   KIDCARE DECONGESTANT DROPS        PSEUDOEPHEDRINE HCL ORAL 9.4MG/ML DROPS                    Drops
11383024723   L-A NASAL DECONGEST 120 MG TAB    PSEUDOEPHEDRINE HCL ORAL 120 MG TABLET SA                  Tablet
68308082404   L-ALL 12 NF SUSPENSION            CAR-B-PEN TA/PHENYLEPHRINE ORAL 30-25MG/5 ORAL SUSP        Suspension
64543035090   LIQUIBID D-R TABLET               GUAIFENESIN/PHENYLEPHRINE HCL ORAL 400MG-10MG TABLET       Tablet
68047012916   LOHIST-DM SYRUP                   BROMPHENIRAMIN/PE/DEXTROMETHOR ORAL 2-5-10MG/5 LIQUID      Liquid
66992014616   LUSONAL LIQUID                    PHENYLEPHRINE HCL ORAL 7.5MG/5ML LIQUID                    Liquid
12830071401   M-CLEAR CAPSULE                   GUAIFENESIN/CODEINE PHOS ORAL 200MG-9MG CAPSULE            Capsule
12830071716   M-CLEAR WC LIQUID                 GUAIFENESIN/CODEINE PHOS ORAL 100-6.3/5 LIQUID             Liquid
49614043252   MEDI-PHEDRINE 120 MG CAPLET       PSEUDOEPHEDRINE HCL ORAL 120 MG TABLET SA                  Tablet
49614043262   MEDI-PHEDRINE 30 MG TABLET        PSEUDOEPHEDRINE HCL ORAL 30 MG TABLET                      Tablet
49614043280   MEDI-PHEDRINE 30 MG TABLET        PSEUDOEPHEDRINE HCL ORAL 30 MG TABLET                      Tablet
49614031034   MEDI-TUSSIN 100 MG/5 ML SYRUP     GUAIFENESIN ORAL 100 MG/5ML LIQUID                         Liquid
49614036026   MEDI-TUSSIN DM DIABETIC LIQ       GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 LIQUID         Liquid
12830073516   M-END WC LIQUID                   BROMPHENIRA/PSEUDOEPHED/CODEIN ORAL 1.3-10-6.3 LIQUID      Liquid
51991028616   MINTUSS DR SYRUP                  D-METHORPHAN HB/PE/CHLORPHENIR ORAL 15-6-2MG/5 SYRUP       Syrup
63824005718   MUCINEX D ER TABLET               GUAIFENESIN/P-EPHED HCL ORAL 600MG-60MG TAB.SR 12H         Tablet
63824007235   MUCINEX DM ER 1,200-60 MG TAB     GUAIFENESIN/D-METHORPHAN HB ORAL 1200-60MG TBMP 12HR       Tablet
63824007236   MUCINEX DM ER 1,200-60 MG TAB     GUAIFENESIN/D-METHORPHAN HB ORAL 1200-60MG TBMP 12HR       Tablet
63824005620   MUCINEX DM ER 600-30 MG TABLET    GUAIFENESIN/D-METHORPHAN HB ORAL 600MG-30MG TAB.SR 12H     Tablet
63824005632   MUCINEX DM ER 600-30 MG TABLET    GUAIFENESIN/D-METHORPHAN HB ORAL 600MG-30MG TAB.SR 12H     Tablet
63824005634   MUCINEX DM ER 600-30 MG TABLET    GUAIFENESIN/D-METHORPHAN HB ORAL 600MG-30MG TAB.SR 12H     Tablet
63824005640   MUCINEX DM ER 600-30 MG TABLET    GUAIFENESIN/D-METHORPHAN HB ORAL 600MG-30MG TAB.SR 12H     Tablet
63824000820   MUCINEX ER 600 MG TABLET          GUAIFENESIN ORAL 600 MG TABLET SA                          Tablet
63824000832   MUCINEX ER 600 MG TABLET          GUAIFENESIN ORAL 600 MG TABLET SA                          Tablet
63824000834   MUCINEX ER 600 MG TABLET          GUAIFENESIN ORAL 600 MG TABLET SA                          Tablet
63824000840   MUCINEX ER 600 MG TABLET          GUAIFENESIN ORAL 600 MG TABLET SA                          Tablet
63824000850   MUCINEX ER 600 MG TABLET          GUAIFENESIN ORAL 600 MG TABLET SA                          Tablet
63824000861   MUCINEX ER 600 MG TABLET          GUAIFENESIN ORAL 600 MG TABLET SA                          Tablet
49483027206   MUCOSA 400 MG TABLET              GUAIFENESIN ORAL 400 MG TABLET                             Tablet
49483028006   MUCOSA DM TABLET                  GUAIFENESIN/D-METHORPHAN HB ORAL 400MG-20MG TABLET         Tablet
37205099226   MUCUS RELIEF 100 MG/5 ML LIQ      GUAIFENESIN ORAL 100 MG/5ML LIQUID                         Liquid
00904575840   MUCUS RELIEF 400 MG TABLET        GUAIFENESIN ORAL 400 MG TABLET                             Tablet
49614022526   MUCUS RELIEF COUGH LIQUID         GUAIFENESIN/D-METHORPHAN HB ORAL 100-5 MG/5 LIQUID         Liquid
00904577140   MUCUS RELIEF DM TABLET            GUAIFENESIN/D-METHORPHAN HB ORAL 400MG-20MG TABLET         Tablet
00904601340   MUCUS RELIEF DM TABLET            GUAIFENESIN/D-METHORPHAN HB ORAL 400MG-20MG TABLET         Tablet
00904601346   MUCUS RELIEF DM TABLET            GUAIFENESIN/D-METHORPHAN HB ORAL 400MG-20MG TABLET         Tablet
00904601352   MUCUS RELIEF DM TABLET            GUAIFENESIN/D-METHORPHAN HB ORAL 400MG-20MG TABLET         Tablet
49614022334   MUCUS RELIEF LIQUID               GUAIFENESIN ORAL 100 MG/5ML LIQUID                         Liquid
00276451004   MYCI-GC LIQUID                    GUAIFENESIN/CODEINE PHOS ORAL 100-10MG/5 LIQUID            Liquid
68047023016   MYHIST-DM LIQUID                  PYRILAMINE/PE/DEXTROMETHORPHAN ORAL 12.5-7.5/5 LIQUID      Liquid
00536439135   NASAL DECONGESTANT 30 MG TAB      PSEUDOEPHEDRINE HCL ORAL 30 MG TABLET                      Tablet
24385043280   NASAL DECONGESTANT 30 MG TAB      PSEUDOEPHEDRINE HCL ORAL 30 MG TABLET                      Tablet
16477062816   NEO AC SYRUP                      PYRIL MAL/PSEUDOEPHED/CODEINE ORAL 15-30-10/5 LIQUID       Liquid
16477056201   NEO DM SYRUP                      D-METHORPHAN HB/P-EPD HCL/BPM ORAL 30-50-3MG LIQUID        Liquid
60258039630   NEUTRAHIST PDX DROPS              D-METHORPHAN HB/P-EPHED HCL/CP ORAL 3-9-0.8/ML DROPS       Drops
68047016701   NOHIST DMX SR TABLET              D-METHORPHAN HB/PE/CHLORPHENIR ORAL 30-20-8MG TAB.SR 12H   Tablet

                                                          5                                                  Effective 4/1/10
                               ALABAMA MEDICAID AGENCY
                                               Cough and Cold List
                                               by Brand Name (continued)



68047016101   NOHIST-EXT CAPLET                 CHLOR-MAL/METHSCOPOLAMINE NIT ORAL 8MG-2.5MG TAB.SR 12H     Tablet
68047001530   NOHIST-PDX DROPS                  D-METHORPHAN HB/PE/CHLORPHENIR ORAL 2.75MG/ML DROPS         Drops
68047016916   NOHIST-PE SYRUP                   CHLOR-MAL/PHENYLEPH/METHSCOP ORAL 2-10-0.75 LIQUID          Liquid
68047016501   NOHIST-PLUS JR TABLET SA          CHLOR-MAL/PHENYLEPH/METHSCOP ORAL 4-10-1.25 TABLET SA       Tablet
68047016601   NOHIST-PLUS TABLET CHEWABLE       CHLOR-MAL/PHENYLEPH/METHSCOP ORAL 2-10-1.25 TAB CHEW        Tablet
68047016301   NOHIST-PLUS TABLET SA             CHLOR-MAL/PHENYLEPH/METHSCOP ORAL 8-20-2.5MG TAB.SR 12H     Tablet
52747042070   NOREL SR TABLET                   PHENYLEPH/ACETAMINOP/P-TLOX/CP ORAL 40-325-8MG TAB.SR 12H   Tablet
00603488621   ORGAN-I NR 200 MG TABLET          GUAIFENESIN ORAL 200 MG TABLET                              Tablet
64376073816   PBM ALLERGY SYRUP                 D-METHORPHAN HB/P-EPD HCL/BPM ORAL 15-30-3/5 LIQUID         Liquid
60258028001   PCM LA TABLET                     PSEUDOEPHEDRINE/CPM/METHSCOPOL ORAL 60-8-1.25 TAB.SR 12H    Tablet
64376071016   PDM GG SYRUP                      GUAIFENESIN/D-METHORPHAN HB/PE ORAL 200-30-10 SYRUP         Syrup
00904505020   PEDIA RELIEF COUGH-COLD LIQUID    D-METHORPHAN HB/P-EPHED HCL/CP ORAL 5-15-1MG/5 LIQUID       Liquid
64376072230   PEDIAHIST DM DROPS                D-METHORPHAN HB/P-EPD HCL/BPM ORAL 4-15-1MG/1 DROPS         Drops
64376072238   PEDIAHIST DM DROPS                D-METHORPHAN HB/P-EPD HCL/BPM ORAL 4-15-1MG/1 DROPS         Drops
54838011540   PEDIATRIC COUGH-COLD LIQUID       D-METHORPHAN HB/P-EPHED HCL/CP ORAL 5-15-1MG/5 LIQUID       Liquid
68047032016   PE-HIST DM SYRUP                  D-METHORPHAN HB/PE/CHLORPHENIR ORAL 15-5-2MG/5 SYRUP        Syrup
64376053716   PHENCARB GG SYRUP                 PHENYLEPHRINE/CARBETAPENTAN/GG ORAL 10-20-100 LIQUID        Liquid
51991066016   PHENYLEPHRINE COMPLEX LIQUID      BROMPHENIRAMIN/PE/DEXTROMETHOR ORAL 4-7.5-15/5 LIQUID       Liquid
42192051030   PHENYLEPHRINE-GUAIFENESIN DROP    GUAIFENESIN/PHENYLEPHRINE HCL ORAL 20-1.5/ML DROPS          Drops
50991071316   POLY-TUSSIN AC LIQUID             BROMPHENIRAMIN/PE/CODEINE PHOS ORAL 4-7.5-10/5 LIQUID       Liquid
50991079016   POLY-TUSSIN DHC LIQUID            BROMPHENIRAM/PE/DIHYDROCODEINE ORAL 4-7.5-3/5 LIQUID        Liquid
00682010001   PREHIST D TABLET SA               CHLOR-MAL/PHENYLEPH/METHSCOP ORAL 8-20-2.5MG TAB.SR 12H     Tablet
66594033316   PRO-CLEAR AC SYRUP                CODEINE PHOS/PYRIL MAL ORAL 9-8.33MG/5 LIQUID               Liquid
00472162908   PROMETHAZINE VC-CODEINE SYRUP     PHENYLEPHRINE HCL/COD/PROMETH ORAL 5-10-6.25 SYRUP          Syrup
00472162916   PROMETHAZINE VC-CODEINE SYRUP     PHENYLEPHRINE HCL/COD/PROMETH ORAL 5-10-6.25 SYRUP          Syrup
00603158854   PROMETHAZINE VC-CODEINE SYRUP     PHENYLEPHRINE HCL/COD/PROMETH ORAL 5-10-6.25 SYRUP          Syrup
00603158858   PROMETHAZINE VC-CODEINE SYRUP     PHENYLEPHRINE HCL/COD/PROMETH ORAL 5-10-6.25 SYRUP          Syrup
00121054705   PROMETHAZINE-CODEINE SYRUP        CODEINE/PROMETHAZINE HCL ORAL 10-6.25/5 SYRUP               Syrup
00472162704   PROMETHAZINE-CODEINE SYRUP        CODEINE/PROMETHAZINE HCL ORAL 10-6.25/5 SYRUP               Syrup
00472162708   PROMETHAZINE-CODEINE SYRUP        CODEINE/PROMETHAZINE HCL ORAL 10-6.25/5 SYRUP               Syrup
00472162716   PROMETHAZINE-CODEINE SYRUP        CODEINE/PROMETHAZINE HCL ORAL 10-6.25/5 SYRUP               Syrup
00603158554   PROMETHAZINE-CODEINE SYRUP        CODEINE/PROMETHAZINE HCL ORAL 10-6.25/5 SYRUP               Syrup
00603158558   PROMETHAZINE-CODEINE SYRUP        CODEINE/PROMETHAZINE HCL ORAL 10-6.25/5 SYRUP               Syrup
50383080416   PROMETHAZINE-CODEINE SYRUP        CODEINE/PROMETHAZINE HCL ORAL 10-6.25/5 SYRUP               Syrup
60432060616   PROMETHAZINE-CODEINE SYRUP        CODEINE/PROMETHAZINE HCL ORAL 10-6.25/5 SYRUP               Syrup
00472163004   PROMETHAZINE-DM SYRUP             D-METHORPHAN HB/PROMETH HCL ORAL 15-6.25/5 SYRUP            Syrup
00472163016   PROMETHAZINE-DM SYRUP             D-METHORPHAN HB/PROMETH HCL ORAL 15-6.25/5 SYRUP            Syrup
00603158654   PROMETHAZINE-DM SYRUP             D-METHORPHAN HB/PROMETH HCL ORAL 15-6.25/5 SYRUP            Syrup
00603158658   PROMETHAZINE-DM SYRUP             D-METHORPHAN HB/PROMETH HCL ORAL 15-6.25/5 SYRUP            Syrup
50383080316   PROMETHAZINE-DM SYRUP             D-METHORPHAN HB/PROMETH HCL ORAL 15-6.25/5 SYRUP            Syrup
60432060404   PROMETHAZINE-DM SYRUP             D-METHORPHAN HB/PROMETH HCL ORAL 15-6.25/5 SYRUP            Syrup
60432060416   PROMETHAZINE-DM SYRUP             D-METHORPHAN HB/PROMETH HCL ORAL 15-6.25/5 SYRUP            Syrup
66594044416   PRO-RED AC SYRUP                  PYRIL MA/PE/CODEINE PHOS ORAL 8.33-5-9/5 LIQUID             Liquid
64376070616   PSE BROM DM SYRUP                 D-METHORPHAN HB/P-EPD HCL/BPM ORAL 30-60-4/5 SYRUP          Syrup
64376073316   PSEUDO COUGH LIQUID               GUAIFEN/DM HB/P-EPHEDRINE ORAL 175-15-32 SOLUTION           Solution
64376073340   PSEUDO COUGH LIQUID               GUAIFEN/DM HB/P-EPHEDRINE ORAL 175-15-32 SOLUTION           Solution
64376071216   PSEUDO DM GG SYRUP                GUAIFEN/DM HB/P-EPHEDRINE ORAL 100-15-40 SYRUP              Syrup
00121042104   PSEUDOEPHED 30 MG/5 ML SYRUP      PSEUDOEPHEDRINE HCL ORAL 30 MG/5 ML SYRUP                   Syrup
00536185085   PSEUDOEPHED 30 MG/5 ML SYRUP      PSEUDOEPHEDRINE HCL ORAL 30 MG/5 ML SYRUP                   Syrup
00536185097   PSEUDOEPHED 30 MG/5 ML SYRUP      PSEUDOEPHEDRINE HCL ORAL 30 MG/5 ML SYRUP                   Syrup
00054474325   PSEUDOEPHEDRINE 30 MG TABLET      PSEUDOEPHEDRINE HCL ORAL 30 MG TABLET                       Tablet
11383009749   PSEUDOEPHEDRINE 30 MG TABLET      PSEUDOEPHEDRINE HCL ORAL 30 MG TABLET                       Tablet

                                                          6                                                    Effective 4/1/10
                               ALABAMA MEDICAID AGENCY
                                               Cough and Cold List
                                               by Brand Name (continued)



11383009796   PSEUDOEPHEDRINE 30 MG TABLET      PSEUDOEPHEDRINE HCL ORAL 30 MG TABLET                     Tablet
37205044562   PSEUDOEPHEDRINE 30 MG TABLET      PSEUDOEPHEDRINE HCL ORAL 30 MG TABLET                     Tablet
37205044580   PSEUDOEPHEDRINE 30 MG TABLET      PSEUDOEPHEDRINE HCL ORAL 30 MG TABLET                     Tablet
45802043262   PSEUDOEPHEDRINE 30 MG TABLET      PSEUDOEPHEDRINE HCL ORAL 30 MG TABLET                     Tablet
00143148510   PSEUDOEPHEDRINE 60 MG TABLET      PSEUDOEPHEDRINE HCL ORAL 60 MG TABLET                     Tablet
00054474425   PSEUDOEPHEDRINE 60 MG TABLET      PSEUDOEPHEDRINE HCL ORAL 60 MG TABLET                     Tablet
10267121504   PSEUDOEPHEDRINE 60 MG TABLET      PSEUDOEPHEDRINE HCL ORAL 60 MG TABLET                     Tablet
64376071616   PSEUDOEPHEDRINE GG SYRUP          GUAIFENESIN/P-EPHED HCL ORAL 200-40MG/5 LIQUID            Liquid
51991066516   PSEUDOEPHEDRINE-CODEINE LIQUID    PSEUDOEPHEDRINE HCL/CODEINE ORAL 30-10MG/5 LIQUID         Liquid
68016002190   PV TUSSIN CF LIQUID               GUAIFENESIN/D-METHORPHAN HB/PE ORAL 100-10-5MG LIQUID     Liquid
68016001385   PV TUSSIN DM CLEAR LIQUID         GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 LIQUID        Liquid
68016002471   PV TUSSIN DM MAX LIQUID           GUAIFENESIN/D-METHORPHAN HB ORAL 200-10MG/5 LIQUID        Liquid
68016002472   PV TUSSIN DM MAX LIQUID           GUAIFENESIN/D-METHORPHAN HB ORAL 200-10MG/5 LIQUID        Liquid
68032044016   PYRIL-PHENYLEPH-DM SUSPENSION     PYRILAMINE/PE/DEXTROMETHORPHAN ORAL 16-5-15/5 ORAL SUSP   Suspension
63868006904   QC COUGH RELIEF LIQUID            DEXTROMETHORPHAN HBR ORAL 15 MG/5 ML LIQUID               Liquid
63868007004   QC COUGH RELIEF LIQUID            DEXTROMETHORPHAN HBR ORAL 15 MG/5 ML LIQUID               Liquid
63868014310   QC SUPHEDRINE 12HR 120 MG CPLT    PSEUDOEPHEDRINE HCL ORAL 120 MG TABLET SA                 Tablet
63868014624   QC SUPHEDRINE TABLET              PSEUDOEPHEDRINE HCL ORAL 30 MG TABLET                     Tablet
63868014648   QC SUPHEDRINE TABLET              PSEUDOEPHEDRINE HCL ORAL 30 MG TABLET                     Tablet
63868024404   QC TUSSIN CF LIQUID               GUAIFENESIN/D-METHORPHAN HB/PE ORAL 100-10-5MG LIQUID     Liquid
00603085754   Q-TUSSIN 100 MG/5 ML SYRUP        GUAIFENESIN ORAL 100 MG/5ML LIQUID                        Liquid
00603085756   Q-TUSSIN 100 MG/5 ML SYRUP        GUAIFENESIN ORAL 100 MG/5ML LIQUID                        Liquid
00603085758   Q-TUSSIN 100 MG/5 ML SYRUP        GUAIFENESIN ORAL 100 MG/5ML LIQUID                        Liquid
00603085781   Q-TUSSIN 100 MG/5 ML SYRUP        GUAIFENESIN ORAL 100 MG/5ML LIQUID                        Liquid
00603085794   Q-TUSSIN 100 MG/5 ML SYRUP        GUAIFENESIN ORAL 100 MG/5ML LIQUID                        Liquid
00603085554   Q-TUSSIN DM SYRUP                 GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP         Syrup
00603085581   Q-TUSSIN DM SYRUP                 GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP         Syrup
00603085556   Q-TUSSIN-DM SYRUP                 GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP         Syrup
00603085558   Q-TUSSIN-DM SYRUP                 GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP         Syrup
00603085594   Q-TUSSIN-DM SYRUP                 GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP         Syrup
50383080916   QUAD-TUSS TANNATE PED SUSP        CAR-B-PEN TA/EPHED TAN/PE/CP ORAL 30-5-5-4/5 ORAL SUSP    Suspension
68032031733   RE DCP DROPS                      D-METHORPHAN HB/PE/CHLORPHENIR ORAL 2.75MG/ML DROPS       Drops
68032036821   RE PHENYLEPHRINE-GUAIFEN DROPS    GUAIFENESIN/PHENYLEPHRINE HCL ORAL 20-1.5/ML DROPS        Drops
68032021210   RE-DRYLEX JR TABLET               CHLOR-MAL/PHENYLEPH/METHSCOP ORAL 4-10-1.25 TABLET SA     Tablet
68032021116   RE-DRYLEX SYRUP                   PHENYLEPH/DEXCHLOR/METHSCOPOL ORAL 10-1-1.25 SOLUTION     Solution
60258034130   RELAHIST-DM PEDIATRIC DROPS       D-METHORPHAN HB/PE/CHLORPHENIR ORAL 3-2-1MG/ML DROPS      Drops
68032019216   REME HIST DM LIQUID               PYRILAMINE/PE/DEXTROMETHORPHAN ORAL 12.5-7.5/5 LIQUID     Liquid
68032019116   REME TUSSIN DM SYRUP              D-METHORPHAN HB/PE/CHLORPHENIR ORAL 15-5-2MG/5 SYRUP      Syrup
60575051319   RESPA C&C IR TABLET               DM/PE/ACETAMINOPH/DIPHENHYDRAM ORAL 20-10-575 TABLET      Tablet
60258039916   RESPERAL SYRUP                    DM/PHENYLEPH/PYRIL/DEXCHLROPHE ORAL 5-5-5-1.25 SOLUTION   Solution
00904006100   ROBAFEN 100 MG/5 ML SYRUP         GUAIFENESIN ORAL 100 MG/5ML LIQUID                        Liquid
00904006109   ROBAFEN 100 MG/5 ML SYRUP         GUAIFENESIN ORAL 100 MG/5ML LIQUID                        Liquid
00904006116   ROBAFEN 100 MG/5 ML SYRUP         GUAIFENESIN ORAL 100 MG/5ML LIQUID                        Liquid
00904006120   ROBAFEN 100 MG/5 ML SYRUP         GUAIFENESIN ORAL 100 MG/5ML LIQUID                        Liquid
00904506516   ROBAFEN AC SYRUP                  GUAIFENESIN/CODEINE PHOS ORAL 100-10MG/5 LIQUID           Liquid
00904518020   ROBAFEN-DM CLEAR SYRUP            GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP         Syrup
00904005300   ROBAFEN-DM SYRUP                  GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP         Syrup
00904005309   ROBAFEN-DM SYRUP                  GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP         Syrup
00904005316   ROBAFEN-DM SYRUP                  GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP         Syrup
00904005320   ROBAFEN-DM SYRUP                  GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP         Syrup
00904005328   ROBAFEN-DM SYRUP                  GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP         Syrup
00031862413   ROBITUSSIN CHEST CONGEST LIQ      GUAIFENESIN ORAL 100 MG/5ML LIQUID                        Liquid

                                                          7                                                 Effective 4/1/10
                               ALABAMA MEDICAID AGENCY
                                               Cough and Cold List
                                               by Brand Name (continued)



00031862421   ROBITUSSIN CHEST CONGEST LIQ      GUAIFENESIN ORAL 100 MG/5ML LIQUID                         Liquid
00031861620   ROBITUSSIN COUGH-COLD CF LIQ      GUAIFENESIN/D-METHORPHAN HB/PE ORAL 100-10-5MG LIQUID      Liquid
00031861614   ROBITUSSIN COUGH-COLD CF SYR      GUAIFENESIN/D-METHORPHAN HB/PE ORAL 100-10-5MG LIQUID      Liquid
00031861626   ROBITUSSIN COUGH-COLD CF SYR      GUAIFENESIN/D-METHORPHAN HB/PE ORAL 100-10-5MG LIQUID      Liquid
00031866813   ROBITUSSIN DM MAX LIQUID          GUAIFENESIN/D-METHORPHAN HB ORAL 200-10MG/5 LIQUID         Liquid
00031866819   ROBITUSSIN DM MAX LIQUID          GUAIFENESIN/D-METHORPHAN HB ORAL 200-10MG/5 LIQUID         Liquid
00031869412   ROBITUSSIN PEDIATRIC COUGH SYP    DEXTROMETHORPHAN HBR ORAL 7.5MG/5ML SYRUP                  Syrup
00031868613   ROBITUSSIN-COUGH-CHEST-CONG LQ    GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP          Syrup
00031868512   ROBITUSSIN-DM COUGH SYRUP         GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP          Syrup
00031868518   ROBITUSSIN-DM COUGH SYRUP         GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP          Syrup
00031868522   ROBITUSSIN-DM COUGH SYRUP         GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP          Syrup
00031868542   ROBITUSSIN-DM COUGH SYRUP         GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP          Syrup
00031868515   ROBITUSSIN-DM SYRUP               GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP          Syrup
00031868519   ROBITUSSIN-DM SYRUP               GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP          Syrup
15370000616   RU-TUSS DM LIQUID                 GUAIFEN/DM HB/P-EPHEDRINE ORAL 100-15-45 LIQUID            Liquid
15127094544   SB COUGH CONTROL DM SYRUP         GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP          Syrup
15127094548   SB COUGH CONTROL DM SYRUP         GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP          Syrup
15127094044   SB COUGH CONTROL SYRUP            GUAIFENESIN ORAL 100 MG/5ML LIQUID                         Liquid
15127094048   SB COUGH CONTROL SYRUP            GUAIFENESIN ORAL 100 MG/5ML LIQUID                         Liquid
68047029216   SCOPOHIST SYRUP                   CHLOR-MAL/PHENYLEPH/METHSCOP ORAL 2-8-0.75/5 LIQUID        Liquid
68047029001   SCOPOHIST TABLET                  PSEUDOEPHEDRINE/CPM/METHSCOPOL ORAL 60-8-1.25 TAB.SR 12H   Tablet
68047029101   SCOPOHIST-PE TABLET               CHLOR-MAL/PHENYLEPH/METHSCOP ORAL 8-20-1.25 TAB.SR 12H     Tablet
54838054480   SILDEC PE-DM SYRUP                D-METHORPHAN HB/PE/CHLORPHENIR ORAL 15-12.5-4 SYRUP        Syrup
54838053680   SILDEC-DM SYRUP                   D-METHORPHAN HB/P-EPD HCL/BPM ORAL 15-45-4/5 SYRUP         Syrup
54838013040   SILTUSSIN DAS LIQUID              GUAIFENESIN ORAL 100 MG/5ML LIQUID                         Liquid
54838020940   SILTUSSIN DM COUGH SYRUP          GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP          Syrup
54838020970   SILTUSSIN DM COUGH SYRUP          GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP          Syrup
54838020980   SILTUSSIN DM COUGH SYRUP          GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP          Syrup
54838013340   SILTUSSIN DM DAS LIQUID           GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 LIQUID         Liquid
60258042616   SIMUC-DM ELIXIR                   GUAIFENESIN/D-METHORPHAN HB ORAL 225-25MG/5 SOLUTION       Solution
49348002404   SM NASAL DECONGEST 30 MG TAB      PSEUDOEPHEDRINE HCL ORAL 30 MG TABLET                      Tablet
49348016434   SM NASAL DECONGEST 30 MG TAB      PSEUDOEPHEDRINE HCL ORAL 30 MG TABLET                      Tablet
49348029608   SM NASAL DECONGEST 30 MG TAB      PSEUDOEPHEDRINE HCL ORAL 30 MG TABLET                      Tablet
49348036101   SM SINUS 12HR 120 MG CAPLET       PSEUDOEPHEDRINE HCL ORAL 120 MG TABLET SA                  Tablet
49348036110   SM SINUS 12HR 120 MG CAPLET       PSEUDOEPHEDRINE HCL ORAL 120 MG TABLET SA                  Tablet
49348027834   SM TUSSIN 100 MG/5 ML LIQUID      GUAIFENESIN ORAL 100 MG/5ML LIQUID                         Liquid
49348027837   SM TUSSIN 100 MG/5 ML LIQUID      GUAIFENESIN ORAL 100 MG/5ML LIQUID                         Liquid
49348086134   SM TUSSIN CLEAR SYRUP             GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP          Syrup
49348001734   SM TUSSIN DM SYRUP                GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP          Syrup
49348001737   SM TUSSIN DM SYRUP                GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP          Syrup
68032032021   SONAHIST DM PEDIATRIC DROPS       D-METHORPHAN HB/PE/CHLORPHENIR ORAL 3-2-1MG/ML DROPS       Drops
68047024301   SUDATEX G TABLET                  GUAIFENESIN/P-EPHED HCL ORAL 400MG-40MG TABLET             Tablet
68047024201   SUDATEX-DM TABLET                 GUAIFEN/DM HB/P-EPHEDRINE ORAL 400-20-40 TABLET            Tablet
68047024501   SUDATRATE TABLET                  P-EPHED HCL/METHSCOPOLAMN ORAL 120-2.5MG TAB.SR 12H        Tablet
00904505324   SUDOGEST 30 MG TABLET             PSEUDOEPHEDRINE HCL ORAL 30 MG TABLET                      Tablet
00904505359   SUDOGEST 30 MG TABLET             PSEUDOEPHEDRINE HCL ORAL 30 MG TABLET                      Tablet
00904512546   SUDOGEST 60 MG TABLET             PSEUDOEPHEDRINE HCL ORAL 60 MG TABLET                      Tablet
00904512559   SUDOGEST 60 MG TABLET             PSEUDOEPHEDRINE HCL ORAL 60 MG TABLET                      Tablet
00904598720   SUDOGEST CHILD'S 30 MG/5 ML       PSEUDOEPHEDRINE HCL ORAL 30 MG/5 ML SYRUP                  Syrup
24385005452   SUPHEDRIN 12HR 120 MG CAPLET      PSEUDOEPHEDRINE HCL ORAL 120 MG TABLET SA                  Tablet
24385043262   SUPHEDRIN 30 MG TABLET            PSEUDOEPHEDRINE HCL ORAL 30 MG TABLET                      Tablet
60258024516   SU-TUSS DM ELIXIR                 GUAIFENESIN/D-METHORPHAN HB ORAL 200-20MG/5 ELIXIR         Elixir

                                                          8                                                   Effective 4/1/10
                                ALABAMA MEDICAID AGENCY
                                               Cough and Cold List
                                               by Brand Name (continued)



50383086304   TANNATE 12 S SUSPENSION           CAR-B-PEN TA/CHLOR-TAN ORAL 30-4MG/5ML ORAL SUSP         Suspension
50383086316   TANNATE 12 S SUSPENSION           CAR-B-PEN TA/CHLOR-TAN ORAL 30-4MG/5ML ORAL SUSP         Suspension
50383086604   TANNATE DMP-DEX SUSPENSION        D-METHORP TAN/P-EPD TAN/D-CP ORAL 25-75-2.5 ORAL SUSP    Suspension
50383086616   TANNATE DMP-DEX SUSPENSION        D-METHORP TAN/P-EPD TAN/D-CP ORAL 25-75-2.5 ORAL SUSP    Suspension
50383085616   TANNATE-V-DM SUSPENSION           DM-PE-PYRILAMINE TANNATES ORAL 25-12.5-30 ORAL SUSP      Suspension
13811006716   TL-DEX DM LIQUID                  GUAIFEN/DM HB/P-EPHEDRINE ORAL 200-15-32 LIQUID          Liquid
13811006916   TL-HIST CD LIQUID                 BROMPHENIRAMIN/PE/CODEINE PHOS ORAL 4-7.5-10/5 LIQUID    Liquid
13811007016   TL-HIST CM LIQUID                 CHLORPHENIRAMINE/CODEINE PHOS ORAL 2MG-10MG/5 LIQUID     Liquid
13811006816   TL-HIST DM LIQUID                 BROMPHENIRAMIN/PE/DEXTROMETHOR ORAL 4-7.5-15/5 LIQUID    Liquid
64543050004   TREXBROM LIQUID                   CARBETAPEN CIT/PE/BROMPHEN MAL ORAL 30-10-6/5 LIQUID     Liquid
64543050016   TREXBROM LIQUID                   CARBETAPEN CIT/PE/BROMPHEN MAL ORAL 30-10-6/5 LIQUID     Liquid
00067021104   TRIAMINIC COLD & COUGH LIQUID     D-METHORPHAN HB/P-EPHED HCL/CP ORAL 5-15-1MG/5 LIQUID    Liquid
00067021108   TRIAMINIC COLD & COUGH LIQUID     D-METHORPHAN HB/P-EPHED HCL/CP ORAL 5-15-1MG/5 LIQUID    Liquid
00067021118   TRIAMINIC COLD & COUGH LIQUID     D-METHORPHAN HB/P-EPHED HCL/CP ORAL 5-15-1MG/5 LIQUID    Liquid
00067021704   TRIAMINIC COUGH LIQUID            D-METHORPHAN HB/P-EPHED HCL ORAL 5-15MG/5ML SYRUP        Syrup
00067020704   TRIAMINIC COUGH-NASAL CONG LIQ    D-METHORPHAN HB/P-EPHED HCL ORAL 7.5-15MG/5 SYRUP        Syrup
51991013116   TRITAL DM LIQUID                  D-METHORPHAN HB/PE/CHLORPHENIR ORAL 15-10-4/5 SOLUTION   Solution
00642070016   TRITUSS SYRUP                     GUAIFENESIN/D-METHORPHAN HB/PE ORAL 25-12.5/5 SYRUP      Syrup
60258043116   TUSDEC-DM LIQUID                  BROMPHENIRAMIN/PE/DEXTROMETHOR ORAL 2-7.5-15/5 LIQUID    Liquid
54859050504   TUSNEL DIABETIC LIQUID            GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 LIQUID       Liquid
00642047016   TUSSALL SYRUP                     D-METHORPHAN HB/PE/D-BP ORAL 20-10-2/5 SYRUP             Syrup
00642047110   TUSSALL-ER TABLET                 D-METHORPHAN HB/PE/D-BP ORAL 30-20-6MG TAB.SR 12H        Tablet
51991060816   TUSSCOUGH DHC SYRUP               PHENYLEPHRINE/DHCODEINE BT/CP ORAL 20-3-5MG/5 SYRUP      Syrup
61570008101   TUSSIGON TABLET                   HYDROCODONE BIT/HOMATROPINE ORAL 5-1.5MG TABLET          Tablet
63868085754   TUSSIN 100 MG/5 ML LIQUID         GUAIFENESIN ORAL 100 MG/5ML LIQUID                       Liquid
63868085756   TUSSIN 100 MG/5 ML LIQUID         GUAIFENESIN ORAL 100 MG/5ML LIQUID                       Liquid
00113031026   TUSSIN 100 MG/5 ML SYRUP          GUAIFENESIN ORAL 100 MG/5ML LIQUID                       Liquid
00113031034   TUSSIN 100 MG/5 ML SYRUP          GUAIFENESIN ORAL 100 MG/5ML LIQUID                       Liquid
24385031034   TUSSIN 100 MG/5 ML SYRUP          GUAIFENESIN ORAL 100 MG/5ML LIQUID                       Liquid
37205096026   TUSSIN 100 MG/5 ML SYRUP          GUAIFENESIN ORAL 100 MG/5ML LIQUID                       Liquid
37205096034   TUSSIN 100 MG/5 ML SYRUP          GUAIFENESIN ORAL 100 MG/5ML LIQUID                       Liquid
00113051626   TUSSIN CF COUGH & COLD SYRUP      GUAIFENESIN/D-METHORPHAN HB/PE ORAL 100-10-5MG LIQUID    Liquid
00113051634   TUSSIN CF COUGH & COLD SYRUP      GUAIFENESIN/D-METHORPHAN HB/PE ORAL 100-10-5MG LIQUID    Liquid
49614032134   TUSSIN CF LIQUID                  GUAIFENESIN/D-METHORPHAN HB/PE ORAL 100-10-5MG LIQUID    Liquid
24385057826   TUSSIN DM CLEAR SYRUP             GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP        Syrup
00113035926   TUSSIN DM COUGH SYRUP             GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP        Syrup
00113035934   TUSSIN DM COUGH SYRUP             GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP        Syrup
49614031126   TUSSIN DM COUGH SYRUP             GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP        Syrup
37205071226   TUSSIN DM LIQUID                  GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 LIQUID       Liquid
24385035926   TUSSIN DM SYRUP                   GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP        Syrup
24385035934   TUSSIN DM SYRUP                   GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP        Syrup
37205097026   TUSSIN DM SYRUP                   GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP        Syrup
37205097034   TUSSIN DM SYRUP                   GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP        Syrup
63868085554   TUSSIN DM SYRUP                   GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP        Syrup
63868085556   TUSSIN DM SYRUP                   GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP        Syrup
49348030734   TUSSIN HONEY SYRUP                GUAIFENESIN ORAL 100 MG/5ML LIQUID                       Liquid
24385031026   TUSSIN SYRUP                      GUAIFENESIN ORAL 100 MG/5ML LIQUID                       Liquid
65162066386   TUSTAN 12S SUSPENSION             CAR-B-PEN TA/CHLOR-TAN ORAL 30-4MG/5ML ORAL SUSP         Suspension
65162066390   TUSTAN 12S SUSPENSION             CAR-B-PEN TA/CHLOR-TAN ORAL 30-4MG/5ML ORAL SUSP         Suspension
11383022008   ULTRA DM FREE & CLEAR LIQUID      GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 LIQUID       Liquid
49348009229   VALU-TAPP DECONGESTANT DROP       PSEUDOEPHEDRINE HCL ORAL 9.4MG/ML DROPS                  Drops
37000052004   VICKS PEDIATRIC 44E LIQUID        GUAIFENESIN/D-METHORPHAN HB ORAL 100-10MG/5 SYRUP        Syrup

                                                          9                                                Effective 4/1/10
                                 ALABAMA MEDICAID AGENCY
                                       Cough and Cold List
                                       by Brand Name (continued)



68013001420   VISRX DOSE PACK TABLET    PSEUDOEPHEDRINE/CPM/METHSCOPOL ORAL 120-2.5MG TABLET SEQ   Tablet
68013001460   VISRX DOSE PACK TABLET    PSEUDOEPHEDRINE/CPM/METHSCOPOL ORAL 120-2.5MG TABLET SEQ   Tablet
49348020029   V-R PEDIA RELIEF DROPS    PSEUDOEPHEDRINE HCL ORAL 9.4MG/ML DROPS                    Drops
68047021001   Y-COF DM TABLET           D-METHORPHAN HB/PE/D-BP ORAL 30-20-6MG TAB.SR 12H          Tablet
13811000130   Z-DEX PEDIATRIC DROPS     GUAIFENESIN/D-METHORPHAN HB/PE ORAL 35-3-2.5/1 DROPS       Drops
13811000216   Z-DEX SYRUP               GUAIFENESIN/D-METHORPHAN HB/PE ORAL 100-20-10 SYRUP        Syrup




                                                 10                                                  Effective 4/1/10

				
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