Pharmacy & Prescription Support
Performance Plus members may have access to hundreds of generic medications — many at no cost — through pharmacy support, home delivery, and retail pharmacy access.
Medication Formulary
Browse the full list of medications available through the Performance Plus pharmacy program. A valid prescription is required for all medications.
Up to 21-day supply — FREE at over 64,000 retail pharmacies nationwide. Each medication may only be filled 2 times within a 180-day period.
Showing 124 medications
| Medication Name | Strength | Max Qty |
|---|---|---|
| Diphenhydramine | 50mg | 60 |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Lidocaine Viscous HCl | 20mg/ml | 100ML |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Diclofenac Potassium | 50mg | 42 |
| Diclofenac Sodium DR | 50mg | 42 |
| Diclofenac Sodium DR | 75mg | 42 |
| Ibuprofen | 400mg | 60 |
| Ibuprofen | 600mg | 60 |
| Ibuprofen | 800mg | 60 |
| Indomethacin | 25mg | 15 |
| Ketorolac Tromethamine | 10mg | 15 |
| Meloxicam | 7.5mg | 21 |
| Naproxen | 375mg | 42 |
| Naproxen | 500mg | 42 |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Dexamethasone | 4mg | 63 |
| Fludrocortisone Acetate | 0.1mg | 21 |
| Methylprednisolone Pack | 4mg | 21 |
| Prednisone | 5mg | 30 |
| Prednisone | 10mg | 30 |
| Prednisone | 20mg | 30 |
| Prednisone | 50mg | 42 |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Betamethasone Valerate | 0.1% | 45GM |
| Clobetasol | 0.05% | 15GM |
| Clobetasol Propionate | 0.05% | 15GM |
| Hydrocortisone Cream | 2.5% | 30GM |
| Mometasone Furoate | 0.1% | 15GM |
| Triamcinolone Acetonide | 0.1% | 15GM |
| Triamcinolone Acetonide | 0.1% | 80GM |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Amoxicillin | 250mg | 63 |
| Amoxicillin | 500mg | 63 |
| Amoxicillin | 875mg | 42 |
| Amoxicillin | 250mg/5ml | 300ML |
| Amoxicillin | 400mg/5ml | 200ML |
| Amoxicillin (Trihydrate) | 500mg | 63 |
| Amoxicillin & K Clavulanate | 600mg/42.9mg/5ml | 200ML |
| Amoxicillin/Potassium Clav | 500/125mg | 63 |
| Amoxicillin/Potassium Clav | 875/125mg | 42 |
| Amoxicillin/Potassium Clav | 400/57mg/5ml | 200ML |
| Azithromycin | 250mg (#6) | 1 Card |
| Azithromycin | 500mg (#3) | 1 Card |
| Azithromycin | 200mg/5ml (30ml) | 30ML |
| Cefuroxime Axetil | 500mg | 42 |
| Cephalexin | 250mg | 84 |
| Cephalexin | 500mg | 42 |
| Cephalexin | 250mg/5ml | 400ML |
| Ciprofloxacin HCl | 250mg | 42 |
| Ciprofloxacin HCl | 500mg | 42 |
| Clindamycin HCl | 150mg | 84 |
| Doxycycline Hyclate | 20mg | 42 |
| Levofloxacin | 250mg | 20 |
| Levofloxacin | 500mg | 20 |
| Nitrofurantoin monohydrate/macrocrystals | 100mg | 42 |
| Penicillin V Potassium | 500mg | 60 |
| Penicillin V Potassium | 250mg/5ml | 400ML |
| Sulfamethoxazole/Trimethoprim | 800mg/160mg | 42 |
| Sulfamethoxazole/Trimethoprim | 200mg-40mg/5ml | 120ML |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Neomycin/Polymyxin/HC | 3.5mg-10000Unit-1%/ml | 10ML |
| Neomycin/Polymyxin/HC | 1% | 10ML |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Ciprofloxacin HCl | 0.3% | 5ML |
| Erythromycin | 5mg/gm | 3.5GM |
| Ofloxacin | 0.3% | 5ML |
| Polymyxin B Sulf/Trimethoprim | 10,000u/0.1%/ml | 10ML |
| Tobramycin | 0.3% | 5ML |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Clindamycin Phosphate | 1% | 60ML |
| Mupirocin | 2% | 22GM |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Fluconazole | 150mg | 1 |
| Metronidazole | 500mg | 60 |
| Nystatin | 100mu/ml | 60ML |
| Terbinafine | 250mg | 21 |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Clotrimazole | 1% | 45GM |
| Ketoconazole | 2% | 120ML |
| Metronidazole Vaginal Gel | 0.75% | 70GM |
| Nystatin Cream | 100,000units/gm | 30GM |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Clotrimazole/Betamethasone | 1/0.05% | 15GM |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Allopurinol | 100mg | 21 |
| Allopurinol | 300mg | 21 |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Hydroxyzine HCl | 25mg | 60 |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Neomycin/Polymyxin/Dexamethasone | 0.1% | 5ML |
| Prednisolone Acetate | 1% | 5ML |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Silver Sulfadiazine | 1% | 50GM |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Meclizine HCl | 25mg | 63 |
| Prochlorperazine Maleate | 10mg | 21 |
| Promethazine HCl | 25mg | 84 |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Acyclovir | 200mg | 50 |
| Acyclovir | 400mg | 30 |
| Acyclovir | 800mg | 30 |
| Valacyclovir HCl | 500mg | 42 |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Albuterol Sulfate & Ipratropium Bromide | 3mg/0.5mg | 90ML |
| Albuterol Sulfate Soln Nebu | 0.083% (2.5mg/3ml) | 90ML |
| Montelukast Sodium | 4mg | 21 |
| Montelukast Sodium | 5mg | 21 |
| Montelukast Sodium | 10mg | 21 |
| Prednisolone Sod Phosphate | 15mg/5mL | 120ML |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Nitroglycerin | 0.4mg | 1 of 25 |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Benzonatate | 100mg | 30 |
| Benzonatate | 200mg | 30 |
| Promethazine/DM | 6.25-15mg/5mL | 240ML |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Dicyclomine HCl | 10mg | 60 |
| Dicyclomine HCl | 20mg | 63 |
| Diphenox w/Atropine | 2.5/0.025mg | 30 |
| Famotidine | 20mg | 42 |
| Pantoprazole Sodium EC | 40mg | 21 |
| Polyethylene Glycol 3350 | 236gm | 4000ML |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Butalbital/Acetaminophen/Caffeine | 50/325/40mg | 42 |
| Naratriptan HCl | 2.5mg | 9 |
| Rizatriptan | 5mg | 6 |
| Rizatriptan | 10mg | 6 |
| Rizatriptan Benzoate ODT | 10mg | 3 |
| Sumatriptan Succinate | 50mg | 9 |
| Sumatriptan Succinate | 100mg | 9 |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Cyclobenzaprine HCl | 5mg | 30 |
| Cyclobenzaprine HCl | 10mg | 63 |
| Methocarbamol | 500mg | 60 |
| Methocarbamol | 750mg | 60 |
| Tizanidine | 2mg | 30 |
| Tizanidine | 4mg | 42 |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Chlorhexidine Gluconate | 0.12% | 473ML |
| Sodium Fluoride | 1.1% | 51GM |
| Triamcinolone | 0.1% | 5GM |
| Medication Name | Strength | Max Qty |
|---|---|---|
| Acetaminophen/Tramadol HCl | 325/37.5mg | 63 |
| Gabapentin | 300mg | 60 |
| Gabapentin | 400mg | 60 |
| Gabapentin | 600mg | 60 |
| Gabapentin | 800mg | 60 |
| Tramadol | 50mg | 63 |
Prescriptions are not guaranteed. Any prescription decision depends on clinical appropriateness, provider judgment, legal requirements, medication availability, and patient-specific factors. Some medications may require in-person evaluation, lab testing, or specialist care.
Medication availability, pricing, delivery options, retail pharmacy access, and prescription eligibility may vary. Quantity limits apply. Each acute medication may only be filled 2 times within a 180-day period. Fills after the first two will be at standard contractual pharmacy rates. Chronic medications are available via home delivery only.
Enroll in Performance Plus today and get access to pharmacy support, virtual care, and more — all for one affordable monthly membership.
Enroll Now — $69/monthPerformance Plus is not major medical insurance and does not replace emergency care, hospitalization, surgery, specialist care, or in-person medical evaluation when required. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room immediately. Membership benefits, provider availability, medication access, and service availability may vary by location, eligibility, and clinical appropriateness.