$378$181.20Prescription eligible
- $693$291Prescription eligible
- $246$197Prescription eligible$563$304.20Prescription eligible$248$133.80Prescription eligible
- $200Prescription eligible$79$47.40Prescription eligible$182$98.40Prescription eligible
- $220Prescription eligible$412$172.80Prescription eligible$205Prescription eligible
- $346$186.60Prescription eligible$141$59.40Prescription eligible$185$100.20
- $163$78Prescription eligible$262$141.60$266$213Prescription eligible
- $200$108Prescription eligible$363Prescription eligible$267$144Prescription eligible
- $126$67.80Prescription eligible$533$288Prescription eligible$200$96Prescription eligible
- $121$51Prescription eligible$188$101.40Prescription eligible$85Prescription eligible
- $642$308.40Prescription eligible$88Prescription eligible$324$175.20Prescription eligible
- $163$88.20Prescription eligible$478$258Prescription eligible$219$118.20Prescription eligible
- $201Prescription eligible$219$105Prescription eligible$226$108.60Prescription eligible







































































