$282$169Prescription eligible
- $245$172$194$175Prescription eligible
- $318$286Prescription eligible$338$203Prescription eligible$193$154
- $254$229Prescription eligible$452$362Prescription eligible$178$125Prescription eligible
- $124$112Prescription eligible$336$302Prescription eligible$567$397Prescription eligible
- $378$340Prescription eligible$124$112Prescription eligible$154$123Prescription eligible
- $154$123Prescription eligible$138$124Prescription eligible$154$139Prescription eligible
- $348$278Prescription eligible$124$112Prescription eligible$124$112Prescription eligible
- $184$147Prescription eligible$138$124Prescription eligible$436$392Prescription eligible
- $348$278Prescription eligible$348$278Prescription eligible$462$370Prescription eligible