- $480$259.20Prescription eligible$530$286.20Prescription eligible$448$268.80
- $474$199.20$680$204$351$189.60
- Prescription eligible$462$249.60$609$219$684$410.40
- Prescription eligible$588$352.80Prescription eligible$518$310.80$582$349.20
- $582$279.60Prescription eligible$533$319.80Prescription eligible$489$264
- Prescription eligible$397$214.20Prescription eligible$584$350.40Prescription eligible$545$294.60
- Prescription eligible$416$249.60Prescription eligible$545$294.60Prescription eligible$378$204
- Prescription eligible$426$229.80Prescription eligible$489$264Prescription eligible$592$284.40
- Prescription eligible$415$249Prescription eligible$394$189Prescription eligible$492$295.20
- Prescription eligible$488$292.80Prescription eligible$499$239.40



























































