$129$61.80Prescription eligible
- $142$85.20Prescription eligible$126$67.80Prescription eligible
- $309Prescription eligible$200Prescription eligible$79$47.40Prescription eligible
- $176$52.80Prescription eligible$168$90.60$324$194.40Prescription eligible
- $120$64.80$205$143.50$126$63
- $108Prescription eligible$86$51.60Prescription eligible$86$46.20Prescription eligible
- $110$59.40Prescription eligible$125$60Prescription eligible$174$157Prescription eligible
- $174$157Prescription eligible$174$157Prescription eligible$150$135Prescription eligible
- $164$88.80Prescription eligible$119$71.40Prescription eligible$316$151.80
- $120$72Prescription eligible$282Prescription eligible$132$63.60
- $122$73.20Prescription eligible
- $164$98.40Prescription eligible$188Prescription eligible
- $329$138Prescription eligible$115Prescription eligible$82Prescription eligible







































































