$94$51Prescription eligible
- $94Prescription eligible$174Prescription eligible
- $168Prescription eligible$104Prescription eligible$180Prescription eligible
- $104Prescription eligible$180Prescription eligible$131Prescription eligible
- $114Prescription eligible$180Prescription eligible$166Prescription eligible
- $96Prescription eligible$168Prescription eligible$166Prescription eligible
- $108Prescription eligible$104Prescription eligible$98Prescription eligible
- $180Prescription eligible$224Prescription eligible$118Prescription eligible
- $104Prescription eligible$84Prescription eligible$141Prescription eligible
- $84Prescription eligible$108Prescription eligible$298$160.80Prescription eligible
- $210$100.80Prescription eligible$180Prescription eligible$192Prescription eligible
- $179Prescription eligible$180Prescription eligible$180Prescription eligible
- $88Prescription eligible$128Prescription eligible$256Prescription eligible