- $454$245.40Prescription eligible$556$200.40$436$235.20Prescription eligible
- $428$231Prescription eligible$494$237Prescription eligible$404$218.40Prescription eligible
- $475$228Prescription eligible$441$238.20Prescription eligible$488$263.40Prescription eligible
- $648$349.80Prescription eligible$418$225.60Prescription eligible$434$234.60Prescription eligible
- $588$317.40Prescription eligible$498$268.80Prescription eligible$422$228Prescription eligible
- $581$313.80Prescription eligible$497$298.20Prescription eligible$544$261Prescription eligible
- $538$258Prescription eligible$422$228Prescription eligible$517$248.40Prescription eligible
- $517$248.40Prescription eligible$517$248.40Prescription eligible$663$318Prescription eligible
- $663$318Prescription eligible$551$264.60Prescription eligible$478$258Prescription eligible
- $592$284.40Prescription eligible$404$193.80Prescription eligible$552$298.20Prescription eligible
- $592$284.40Prescription eligible$551$264.60Prescription eligible$478$258Prescription eligible
- $404$193.80Prescription eligible$404$193.80Prescription eligible$458$247.20Prescription eligible








































































