- $454$245.40Prescription eligible$595$211.20$398$238.80Prescription eligible
- $428$180Prescription eligible$556$200.40$436$235.20Prescription eligible
- $358$193.20Prescription eligible$428$231Prescription eligible$494$237Prescription eligible
- $358$193.20Prescription eligible$397$209.40Prescription eligible$404$214.80Prescription eligible
- $475$225.60Prescription eligible$348$187.80Prescription eligible$590$283.20
- $441$236.40Prescription eligible$488$263.40Prescription eligible$648$349.80Prescription eligible
- $348$187.80Prescription eligible$418$225.60Prescription eligible$434$229.80Prescription eligible
- $588$315.60Prescription eligible$517$243.60Prescription eligible$517$243.60Prescription eligible
- $517$243.60Prescription eligible$663$315.60Prescription eligible$663$315.60Prescription eligible
- $551$262.80Prescription eligible$592$280.20Prescription eligible$478$255Prescription eligible
- $548$262.80Prescription eligible$551$262.80Prescription eligible$592$280.20Prescription eligible
- $592$280.20Prescription eligible$404$190.20Prescription eligible$552$295.80Prescription eligible








































































