$496$267.60
- $480$259.20$442$238.80Prescription eligible
- $486$233.40Prescription eligible$343$185.40$476$228.60
- $471$226.20$670$281.40$636$343.20
- $468$252.60Prescription eligible$347$187.20$528$285Prescription eligible
- $563$202.80$684$205.20Prescription eligible$588$317.40Prescription eligible
- $622$298.80Prescription eligible$473$255.60$444$240
- $428$256.80Prescription eligible$448$241.80Prescription eligible$438$236.40Prescription eligible
- $518$279.60Prescription eligible$582$349.20$502$271.20Prescription eligible
- $456$219Prescription eligible$472$255Prescription eligible$490$264.60Prescription eligible
- $488$263.40$578$312Prescription eligible$521$219
- $665$359.40Prescription eligible$386$208.20$357$192.60
- $456$246Prescription eligible$412$222.60Prescription eligible$482$231.60Prescription eligible








































































