$96$77Prescription eligible
- $78Prescription eligible$106Prescription eligible
- $96Prescription eligible$324$292Prescription eligible$106$53Prescription eligible
- $94$29Prescription eligible$106Prescription eligible$88$53
- $96$86$205Prescription eligible$328$262Prescription eligible
- $180$126$144$130$98Prescription eligible
- $98$78Prescription eligible$118$106$472$378Prescription eligible
- $124$99$118$106
- $98Prescription eligible$444$355$94$47Prescription eligible