$106$39Prescription eligible
- $68$54$78$62
- $96$67Prescription eligible$96$77Prescription eligible$96$77Prescription eligible
- $96$77Prescription eligible$119$83Prescription eligible$104$83Prescription eligible
- $93$84$106$85Prescription eligible$108$86Prescription eligible
- $86Prescription eligible$114$91Prescription eligible$98Prescription eligible
- $98Prescription eligible$98Prescription eligible$128$102Prescription eligible
- $115$104$104Prescription eligible$104Prescription eligible
- $108Prescription eligible$108Prescription eligible$119Prescription eligible
- $176$123Prescription eligible$138$124Prescription eligible$173$138Prescription eligible
- $284$142$158$142$178$142Prescription eligible
- $207$144.90$215$151$176$158Prescription eligible
- $235$165$183$165$188$169Prescription eligible