Physicians and executives are among 18 people accused of selling prescription drugs over the Internet to people without any examinations, according to an indictment unsealed Thursday that charges them with federal racketeering.

The 313-count indictment marks the first time organized-crime statutes designed to combat drug cartels and mafia rings have been used to charge anyone with selling prescription drugs over the Internet, said Lorraine Concha, an assistant special agent in charge for the Immigration and Customs Enforcement field office in San Diego.

"It's a very lucrative, fraudulent scheme at the expense of the public," said Concha. "People were in essence self-prescribing medications — they would go in as a customer online, select the dosage they were looking for, and the doctors would take all of five seconds to review the questionnaire."

AffPower, a Costa Rica-based company, took more than 1 million orders for legal pharmaceuticals including diet pills, birth control pills, Prozac and Viagra between August 2004 and June 2006, according to the indictment. It says the total value of the drugs sold exceeds $126 million.

A network of affiliated Web sites received a cut of fees in return for each order forwarded to AffPower.

The indictment names doctors and pharmacies along with AffPower executives and recruiters.

Three owners and managers of AffPower pleaded guilty last fall in federal court in San Diego to charges of money laundering and conspiring to sell prescription drugs without valid prescriptions.

Stephen Sadowsky, an attorney for one of the men, declined comment Thursday.

Doctors, who were paid $3 for each order reviewed, approved hundreds or even thousands of orders a day, the indictment says. The prescriptions were then filled through licensed online and brick-and-mortar pharmacies, who received between $5 and $13 for each order.

Only 2 percent of orders placed were rejected, Concha said.

The indictment, unsealed in federal court in San Diego, names three doctors licensed in Georgia, Kentucky, Ohio and Massachusetts and pharmacists in Colorado and Florida.

The defendants were charged with multiple counts of racketeering, money laundering, mail fraud, drug distribution and conspiracy. The charges carry up to 20 years in prison and millions in fines.

At least 11 of the defendants were arrested earlier this week in five states, according to ICE spokeswoman Lauren Mack. Two defendants are considered fugitives, and are suspected of being in Costa Rica or Canada.

Efforts to locate an AffPower Web site or phone number were unsuccessful. Two federal officials said they did not know of a company contact.