FSA/HSA Eligible
$41.90
$14.66
$29.50
$10.32
$75.81
$26.53
$42.73
$179.74
$154.38
$54.03
$55.68
$19.49
$21.78
$7.62
$12.13
$4.25
$17.64
$6.17
$15.71
$36.66
$12.83
