Interview Notes

$$ Mary Wood, age $58,$ is single.

$$ Mary earned wages of $$51,000$ and was enrolled the entire year in a high deductible health plan $($HDHP$)$ with self$-$only coverage.

$$ During the year, Mary contributed $$2,000$ to her Health Savings Account $($HSA$)$ and her mother also contributed $$1,000$ to Mary's HSA.

$$ Mary's Form W$-2$ shows $$1,150$ in Box $12$ with code W$.$ She has Form $5498-$SA showing $$4,150$ in Box $2.$

$$ Mary has Form $1099-$SA showing her HSA distributions. She used her distributions to pay the following unreimbursed expenses:

o $$500$ for nine visits to a physical therapist after her knee surgery

o $$1,000$ unreimbursed doctor bills

o $$280$ prescription medicine

o $$1,500$ replacement of a crown

o $$300$ deep cleaning for teeth

o $$40$ over the counter medication

o $$260$ gym membership $($for her general health and fitness$)$

$$ Mary is a U$.$S$.$ citizen with a valid Social Security number.

What is the total unreimbursed qualified medical expenses reported on Form $8889,$ Part II$?$