- $454$245.40Prescription eligible$595$357$428$205.20Prescription eligible
- $556$200.40$436$235.20Prescription eligible$396$213.60Prescription eligible
- $397$214.20Prescription eligible$348$208.80Prescription eligible$420$252Prescription eligible
- $441$211.80Prescription eligible$488$263.40Prescription eligible$648$349.80Prescription eligible
- $418$225.60Prescription eligible$434$234.60Prescription eligible$588$317.40Prescription eligible
- $422$202.80Prescription eligible$497$268.20Prescription eligible$544$294Prescription eligible
- $538$258Prescription eligible$517$248.40Prescription eligible$517$279Prescription eligible
- $663$358.20Prescription eligible$663$318Prescription eligible$478$258Prescription eligible
- $551$264.60Prescription eligible$592$284.40Prescription eligible$592$284.40Prescription eligible
- $404$193.80Prescription eligible$552$265.20Prescription eligible$581$279Prescription eligible
- $517$248.40Prescription eligible$478$258Prescription eligible$404$193.80Prescription eligible
- $458$247.20Prescription eligible$472$255Prescription eligible$517$279Prescription eligible








































































