- $454$217.80Prescription eligible$587$211.20$556$200.40
- $436$261.60Prescription eligible$408$244.80Prescription eligible$396$237.60Prescription eligible
- $318$190.80Prescription eligible$494$296.40Prescription eligible$674$404.40Prescription eligible
- $388$209.40Prescription eligible$398$238.80Prescription eligible$470$253.80Prescription eligible
- $590$354$438$236.40Prescription eligible$648$349.80Prescription eligible
- $348$208.80Prescription eligible$418$225.60Prescription eligible$426$229.80Prescription eligible
- $584$315.60Prescription eligible$508$304.80Prescription eligible$548$262.80Prescription eligible
- $548$262.80Prescription eligible$378$226.80Prescription eligible$422$202.80Prescription eligible
- $584$315.60Prescription eligible$548$262.80Prescription eligible$418$225.60Prescription eligible
- $578$312Prescription eligible$584$280.20Prescription eligible$538$258Prescription eligible
- $396$190.20Prescription eligible$548$295.80Prescription eligible$498$268.80Prescription eligible
- $658$315.60Prescription eligible$584$280.20Prescription eligible$508$243.60Prescription eligible








































































