$86$60Prescription eligible
- $143$71.50Prescription eligible
- $86Prescription eligible$94$85Prescription eligible$68$32.40Prescription eligible
- $94$85Prescription eligible$88$47.40Prescription eligible$134$80.40Prescription eligible
- $89$37.20$88$47.40Prescription eligible
- $86Prescription eligible$73$39.60Prescription eligible
- $88$42Prescription eligible$76$45.60Prescription eligible$68$48Prescription eligible
- $86Prescription eligible$78$39Prescription eligible$104$56.40Prescription eligible
- $132$63.60Prescription eligible$83$34.80Prescription eligible$64$45Prescription eligible
- $88Prescription eligible$48$29Prescription eligible$97Prescription eligible
- $95$57Prescription eligible$86Prescription eligible$88$47.40Prescription eligible







































































