$496$238.20Prescription eligible
- $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
 - $347$187.20$528$285Prescription eligible$563$202.80
 - $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$470$282
 - $578$312Prescription eligible$521$219$665$359.40Prescription eligible
 - $386$208.20$578$346.80$357$192.60
 - $456$246Prescription eligible$618$296.40Prescription eligible$412$222.60Prescription eligible
 








































































