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Prescriber Checkup

At A Glance: This Prescriber in 2011

Geriatric Medicine

Self-Reported Primary Specialty

See Other Prescribers With This Specialty in This State »

13,527Medicare Part D Prescriptions Filled, Including Refills

Rank: 21 out of 64

$718K Total Retail Price of All Prescriptions

Rank: 23 out of 64

219 Patients Receiving at Least One Drug in Part D
89%Patients 65 Years and Older
96% Subsidized Claims for Low-Income Patients

How Does This Prescriber Compare to Peers?

In the same specialty and state. Caveats »

Drugs That Present Special Risks
Costs of Prescribing
Average for
this specialty
in North Carolina

Narcotics

68% of this provider’s 219 patients filled at least one prescription for a narcotic painkiller, compared to an average of 26%.

Antipsychotics to Seniors

30% of this provider’s 196 patients 65 and older filled at least one prescription for an antipsychotic, compared to an average of 9%.

Risky Drugs to Seniors

1% of this provider’s 12,024 prescriptions for patients 65 and older were for "potentially dangerous" drugs, compared to an average of 1%.

Brand Name Drugs

17% of this provider’s prescriptions were for brand-name drugs, compared to an average of 22%.

Prescription Price

$53 was the average price of a prescription from this provider, compared to $63 among peers.

Prescriptions per Patient

62 is the average number of prescriptions (including refills) per patient, compared to an average of 32.


Another View

This chart shows a different comparison of all providers in this specialty based on their mix of drugs and volume. Providers are grouped by similarity; those least like their peers are farthest to the right. Hover over the bars to see names of other prescribers.

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This Prescriber's Drugs

The table below list this provider’s drugs, the number of prescriptions and how many went to seniors. Drugs are ranked by volume and compared with the rank for all providers in the same specialty and state.

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A

An antipsychotic drug. More » Antipsychotics are frequently given to dementia patients, though it increases their risk of death.

R

A risky drug for seniors. More » The American Geriatrics Society has said this drug is "potentially dangerous" for seniors and might be inappropriate.

N

A narcotic drug. More » Misuse and abuse of narcotics led to some 16,000 overdose deaths in 2010.

10

This provider is among the top 10 prescribers of
this drug in the country.

This provider’s prescriptions for this drug were for more days than those of peers. More » Because of this, his or her prescription count may be lower.

This provider’s prescriptions for this drug were for fewer days than those of peers. More » Because of this, his or her prescription count may be higher.

This Drug's Rank
Drug Name Total Prescriptions Filled
Including Refills
Prescriptions
to 65+
Category For this Prescriber For All Prescribers in
This Specialty in North Carolina
FUROSEMIDE

Treats fluid retention (ede... +

Treats fluid retention (edema) and high blood pressure (hypertension). More info »

739 644 1 1
CITALOPRAM HBR

Citalopram is used to treat... +

Citalopram is used to treat depression. Citalopram is in a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). It is thought to work by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance. More info »

686 626 2 11
LEVOTHYROXINE SODIUM

Levothyroxine, a thyroid ho... +

Levothyroxine, a thyroid hormone, is used to treat hypothyroidism, a condition where the thyroid gland does not produce enough thyroid hormone. Without this hormone, the body cannot function properly, resulting in: poor growth; slow speech; lack of energy; weight gain; hair loss; dry, thick skin; and increased sensitivity to cold. When taken correctly, levothyroxine reverses these symptoms. Levothyroxine is also used to treat congenital hypothyroidism (cretinism) and goiter (enlarged thyroid gland). More info »

531 451 3 4
OMEPRAZOLE

Treats heartburn, stomach u... +

Treats heartburn, stomach ulcers, gastroesophageal reflux disease (GERD), and conditions that cause your stomach to make too much acid, such as Zollinger-Ellison syndrome, endocrine tumors, and systemic mastocytosis. Also helps heal a damaged esophagus, and helps prevent stomach bleeding in patients who have a serious illness. This medicine may be used in combination with antibiotics to treat ulcers. This medicine is a proton pump inhibitor (PPI). More info »

423 376 4 3
POTASSIUM CHLORIDE

Potassium is needed to main... +

Potassium is needed to maintain good health. More info »

403 358 5 12
MIRTAZAPINE

Treats depression. +

Treats depression. More info »

357 323 6 14
DONEPEZIL HCL

Donepezil is used to treat ... +

Donepezil is used to treat dementia (a brain disorder that affects the ability to remember, think clearly, communicate, and perform daily activities and may cause changes in mood and personality) associated with Alzheimer's disease (AD; a brain disease that slowly destroys the memory and the ability to think, learn, communicate and handle daily activities). Donepezil is in a class of medications called cholinesterase inhibitors. It improves mental function (such as memory, attention, social interaction, reasoning and language abilities, and ability to perform activities of daily living) by increasing the amount of a certain naturally occurring substance in the brain. Donepezil may improve the ability to think and remember or slow the loss of these abilities in people who have AD. However, donepezil will not cure AD or prevent the loss of mental abilities at some time in the future. More info »

338 337 7 10
OXYCODONE-ACETAMINOPHEN

Used to relieve moderate to... +

Used to relieve moderate to severe pain. More info »

290 273 N 8 61
NAMENDA

Treats dementia (memory los... +

Treats dementia (memory loss and mental changes) that is a sign of Alzheimer's disease. More info »

261 247 9 13
AMLODIPINE BESYLATE

Amlodipine is used alone or... +

Amlodipine is used alone or in combination with other medications to treat high blood pressure and chest pain (angina). Amlodipine is in a class of medications called calcium channel blockers. It lowers blood pressure by relaxing the blood vessels so the heart does not have to pump as hard. It controls chest pain by increasing the supply of blood to the heart. If taken regularly, amlodipine controls chest pain, but it does not stop chest pain once it starts. Your doctor may prescribe a different medication to take when you have chest pain. More info »

216 198 10 5
OXYCODONE HCL

Oxycodone is used to reliev... +

Oxycodone is used to relieve moderate to severe pain. Oxycodone is in a class of medications called opiate (narcotic) analgesics. It works by changing the way the brain and nervous system respond to pain. More info »

213 177 N 11 65
RISPERIDONE

Treats schizophrenia and ce... +

Treats schizophrenia and certain problems caused by bipolar disorder. More info »

205 178 A 12 22
METOPROLOL TARTRATE

Metoprolol is used alone or... +

Metoprolol is used alone or in combination with other medications to treat high blood pressure. It also is used to prevent angina (chest pain) and to improve survival after a heart attack. Extended-release (long-acting) metoprolol also is used in combination with other medications to treat heart failure. Metoprolol is in a class of medications called beta blockers. It works by relaxing blood vessels and slowing heart rate to improve blood flow and decrease blood pressure More info »

204 182 13 8
WARFARIN SODIUM

Warfarin is used to prevent... +

Warfarin is used to prevent blood clots from forming or growing larger in your blood and blood vessels. It is prescribed for people with certain types of irregular heartbeat, people with prosthetic (replacement or mechanical) heart valves, and people who have suffered a heart attack. Warfarin is also used to treat or prevent venous thrombosis (swelling and blood clot in a vein) and pulmonary embolism (a blood clot in the lung). Warfarin is in a class of medications called anticoagulants ('blood thinners'). It works by decreasing the clotting ability of the blood. More info »

196 159 14 7
FAMOTIDINE

Treats ulcers, gastroesopha... +

Treats ulcers, gastroesophageal reflux disease (GERD), and conditions that cause the stomach to produce too much stomach acid. Also treats heartburn caused by acid indigestion. More info »

189 175 15 98
SIMVASTATIN

Treats high cholesterol and... +

Treats high cholesterol and triglyceride levels in the blood. Lowers risk of heart attack, stroke, and certain blood vessel problems in people with certain risk factors. This medicine is an HMG-CoA reductase inhibitor, also called a statin. More info »

185 176 16 2
IPRATROPIUM-ALBUTEROL

The combination of albutero... +

The combination of albuterol and ipratropium is used to prevent wheezing, difficulty breathing, chest tightness, and coughing in people with chronic obstructive pulmonary disease (COPD; a group of diseases that affect the lungs and airways) such as chronic bronchitis (swelling of the air passages that lead to the lungs) and emphysema (damage to the air sacs in the lungs). Albuterol and ipratropium combination is used by people whose symptoms have not been controlled by a single inhaled medication. Albuterol and ipratropium are in a class of medications called bronchodilators. Albuterol and ipratropium combination works by relaxing and opening the air passages to the lungs to make breathing easier. More info »

182 172 17 51
HYDROCODONE-ACETAMINOPHEN

Used to relieve moderate to... +

Used to relieve moderate to severe pain. More info »

176 162 N 18 9
GABAPENTIN

Treats certain types of sei... +

Treats certain types of seizures. Also treats Restless Legs Syndrome (RLS) and pain caused by shingles (postherpetic neuralgia). More info »

169 137 19 16
ZOLPIDEM TARTRATE

Zolpidem is used to treat i... +

Zolpidem is used to treat insomnia (difficulty falling asleep or staying asleep). Zolpidem belongs to a class of medications called sedative-hypnotics. It works by slowing activity in the brain to allow sleep. More info »

161 139 20 25
LAMOTRIGINE

Treats certain types of sei... +

Treats certain types of seizures and mood disorders. Often used along with other medicines. More info »

152 136 21 59
LISINOPRIL

Treats high blood pressure ... +

Treats high blood pressure and heart failure. A lower blood pressure will reduce the risk of stroke and heart attack. Also used in the first few days after a heart attack to help reduce the risk of death. This medicine is an angiotensin-converting enzyme (ACE) inhibitor. More info »

145 128 22 6
METOPROLOL SUCCINATE

Metoprolol is used alone or... +

Metoprolol is used alone or in combination with other medications to treat high blood pressure. It also is used to prevent angina (chest pain) and to improve survival after a heart attack. Extended-release (long-acting) metoprolol also is used in combination with other medications to treat heart failure. Metoprolol is in a class of medications called beta blockers. It works by relaxing blood vessels and slowing heart rate to improve blood flow and decrease blood pressure More info »

144 137 23 15
SEROQUEL

Treats schizophrenia and sy... +

Treats schizophrenia and symptoms of bipolar disorder (manic-depressive illness). Used together with other medicines to treat major depressive disorder (MDD). More info »

141 118 A 24 23
RANITIDINE HCL

Ranitidine is used to treat... +

Ranitidine is used to treat ulcers; gastroesophageal reflux disease (GERD), a condition in which backward flow of acid from the stomach causes heartburn and injury of the food pipe (esophagus); and conditions where the stomach produces too much acid, such as Zollinger-Ellison syndrome. Over-the-counter ranitidine is used to prevent and treat symptoms of heartburn associated with acid indigestion and sour stomach. Ranitidine is in a class of medications called H2 blockers. It decreases the amount of acid made in the stomach. More info »

134 121 25 44
LANTUS

Treats diabetes mellitus. I... +

Treats diabetes mellitus. Insulin is a hormone that helps get sugar from the blood to the muscles, where it is used for energy. This type of insulin usually works longer than regular insulin. More info »

133 118 26 26
POLYETHYLENE GLYCOL 3350

Treats occasional constipat... +

Treats occasional constipation. More info »

116 112 27 29
PANTOPRAZOLE SODIUM

Pantoprazole is used to tre... +

Pantoprazole is used to treat gastroesophageal reflux disease (GERD), a condition in which backward flow of acid from the stomach causes heartburn and possible injury of the esophagus (the tube between the throat and stomach). Pantoprazole is used to treat the symptoms of GERD, allow the esophagus to heal, and prevent further damage to the esophagus. It is also used to treat conditions where the stomach produces too much acid, such as Zollinger-Ellison syndrome. Pantoprazole is in a class of medications called proton-pump inhibitors. It works by decreasing the amount of acid made in the stomach. More info »

100 87 28 55
PLAVIX

Used alone or together with... +

Used alone or together with aspirin to help prevent stroke, heart attack, and other heart problems. This medicine is a blood thinner. More info »

96 95 29 19
FENTANYL

Treats severe, ongoing pain... +

Treats severe, ongoing pain (during and after surgery, cancer pain) that cannot be controlled with other medicines. This medicine is a narcotic pain reliever. More info »

95 95 N 30 68
DOXYCYCLINE HYCLATE

Doxycycline is used to trea... +

Doxycycline is used to treat bacterial infections, including pneumonia and other respiratory tract infections; Lyme disease; acne; infections of skin, genital, and urinary systems; and anthrax (after inhalational exposure). It is also used to prevent malaria. Doxycycline is in a class of medications called tetracycline antibiotics. It works by preventing the growth and spread of bacteria. Antibiotics will not work for colds, flu, or other viral infections. More info »

93 87 31 102
NYSTATIN

Treats fungus infections in... +

Treats fungus infections in the mouth, throat, and intestines. Belongs to a class of drugs called antifungals. More info »

89 89 32 103
TRAZODONE HCL

Trazodone is used to treat ... +

Trazodone is used to treat depression. Trazodone is in a class of medications called serotonin modulators. It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance. More info »

87 83 33 30
ISOSORBIDE MONONITRATE ER 86 86 34 42
RESTASIS

Treats chronic dry eye dise... +

Treats chronic dry eye disease by increasing the amount of tears in your eyes. More info »

82 79 35 165
DIVALPROEX SODIUM

Treats seizures (epilepsy).... +

Treats seizures (epilepsy). Also used to treat the manic phase of bipolar disorder (manic-depressive illness) and to prevent migraine headaches. Belongs to a class of drugs called anticonvulsants. More info »

81 80 36 38
ZYPREXA

Treats psychotic mental dis... +

Treats psychotic mental disorders, such as schizophrenia or bipolar disorder (manic-depressive illness). More info »

79 79 A 37 56
VENLAFAXINE HCL ER

Venlafaxine is used to trea... +

Venlafaxine is used to treat depression. Venlafaxine extended-release (long-acting) capsules are also used to treat generalized anxiety disorder (GAD; excessive worrying that is difficult to control), social anxiety disorder (extreme fear of interacting with others or performing in front of others that interferes with normal life), and panic disorder (sudden, unexpected attacks of extreme fear and worry about these attacks). Venlafaxine is in a class of medications called selective serotonin and norepinephrine reuptake inhibitors (SNRIs). It works by increasing the amounts of serotonin and norepinephrine, natural substances in the brain that help maintain mental balance. More info »

77 49 38 89
HYDROCHLOROTHIAZIDE

Used alone or together with... +

Used alone or together with other medicines to treat high blood pressure and fluid retention (edema). This medicine is a diuretic (water pill). More info »

75 74 39 18
PREMARIN

Estrogens are female hormon... +

Estrogens are female hormones. They are produced by the body and are necessary for the normal sexual development of the female and for the regulation?2954 More info »

74 53 R 40 154
CARBIDOPA-LEVODOPA

The combination of levodopa... +

The combination of levodopa and carbidopa is used to treat the symptoms of Parkinson's disease and Parkinson's-like symptoms that may develop after encephalitis (swelling of the brain) or injury to the nervous system caused by carbon monoxide poisoning or manganese poisoning. Parkinson's symptoms, including tremors (shaking), stiffness, and slowness of movement, are caused by a lack of dopamine, a natural substance usually found in the brain. Levodopa is in a class of medications called central nervous system agents. It works by being converted to dopamine in the brain. Carbidopa is in a class of medications called decarboxylase inhibitors. It works by preventing levodopa from being broken down before it reaches the brain. This allows for a lower dose of levodopa, which causes less nausea and vomiting. More info »

73 73 41 60
PREDNISONE

Treats inflammation (swelli... +

Treats inflammation (swelling), severe allergies, complications of chronic illnesses, and other medical problems. Also used to decrease some symptoms of cancer. This medicine is a steroid. More info »

73 64 41 40
LIDODERM

Treats nerve pain that is c... +

Treats nerve pain that is caused by herpes zoster, or "shingles." More info »

68 64 43 53
METFORMIN HCL

Metformin is used alone or ... +

Metformin is used alone or with other medications, including insulin, to treat type 2 diabetes (condition in which the body does not use insulin normally and, therefore, cannot control the amount of sugar in the blood). Metformin is in a class of drugs called biguanides. Metformin helps to control the amount of glucose (sugar) in your blood. It decreases the amount of glucose you absorb from your food and the amount of glucose made by your liver. Metformin also increases your body's response to insulin, a natural substance that controls the amount of glucose in the blood. Metformin is not used to treat type 1 diabetes (condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood). More info »

66 66 44 17
ALBUTEROL SULFATE

Albuterol is used to preven... +

Albuterol is used to prevent and treat wheezing, shortness of breath, coughing, and chest tightness caused by lung diseases such as asthma and chronic obstructive pulmonary disease (COPD; a group of diseases that affect the lungs and airways). Albuterol inhalation aerosol is also used to prevent breathing difficulties during exercise. Albuterol is in a class of medications called bronchodilators. It works by relaxing and opening air passages to the lungs to make breathing easier. More info »

66 52 44 104
CEPHALEXIN

Treats bacterial infections... +

Treats bacterial infections. Belongs to a class of drugs called cephalosporin antibiotics. More info »

65 63 46 71
DIGOXIN

Treats certain heart rhythm... +

Treats certain heart rhythm problems (atrial fibrillation). Also used to treat heart failure, usually in combination with a diuretic (water pill) and an angiotensin-converting enzyme (ACE) inhibitor. This medicine is also called digitalis. More info »

63 54 47 54
LEXAPRO

Treats severe depression an... +

Treats severe depression and generalized anxiety disorder (GAD). This medicine is a selective serotonin reuptake inhibitor (SSRI). More info »

62 35 48 28
CYMBALTA

Treats depression, anxiety,... +

Treats depression, anxiety, diabetic peripheral neuropathy (nerve pain caused by diabetes), fibromyalgia (muscle pain and stiffness), or chronic (long-lasting) pain related to muscles and bones. This medicine is a selective serotonin and norepinephrine reuptake inhibitor (SSNRI). More info »

62 61 48 39
BACLOFEN

Treats muscle spasms caused... +

Treats muscle spasms caused by multiple sclerosis and spinal cord injury or disease. This medicine is a muscle relaxer. More info »

62 30 48 79
HYDROXYZINE HCL

Hydroxyzine is used to reli... +

Hydroxyzine is used to relieve the itching caused by allergies and to control the nausea and vomiting caused by various conditions, including motion sickness. It is also used for anxiety and to treat the symptoms of alcohol withdrawal. More info »

62 59 R 48 113
GEODON

Treats schizophrenia and ce... +

Treats schizophrenia and certain problems caused by bipolar disorder. More info »

61 48 A 52 135
CEFTRIAXONE

Treats infections caused by... +

Treats infections caused by certain types of bacteria. This medicine is a cephalosporin antibiotic. More info »

60 55 53 108
MUPIROCIN

Treats skin infections and... +

Treats skin infections and bacterial infections in your nose. More info »

60 59 53 121
METOCLOPRAMIDE HCL

Metoclopramide is used to r... +

Metoclopramide is used to relieve heartburn and speed the healing of ulcers and sores in the esophagus (tube that connects the mouth to the stomach) in people who have gastroesophageal reflux disease (GERD; condition in which backward flow of acid from the stomach causes heartburn and injury of the esophagus) that did not get better with other treatments. Metoclopramide is also used to relieve symptoms caused by slow stomach emptying in people who have diabetes. These symptoms include nausea, vomiting, heartburn, loss of appetite, and feeling of fullness that lasts long after meals. Metoclopramide is in a class of medications called prokinetic agents. It works by speeding the movement of food through the stomach and intestines. More info »

59 49 55 90
ROPINIROLE HCL

Ropinirole is used alone or... +

Ropinirole is used alone or with other medications to treat the symptoms of Parkinson's disease (PD; a disorder of the nervous system that causes difficulties with movement, muscle control, and balance), including shaking of parts of the body, stiffness, slowed movements, and problems with balance. Ropinirole is also used to treat restless legs syndrome (RLS or Ekbom syndrome; a condition that causes discomfort in the legs and a strong urge to move the legs, especially at night and when sitting or lying down). Ropinirole is in a class of medications called dopamine agonists. It works by acting in place of dopamine, a natural substance in the brain that is needed to control movement. More info »

57 34 56 169
TRAMADOL HCL

Tramadol is used to relieve... +

Tramadol is used to relieve moderate to moderately severe pain. Tramadol extended-release tablets are only used by people who are expected to need medication to relieve pain around-the-clock for a long time. Tramadol is in a class of medications called opiate agonists. It works by changing the way the body senses pain. More info »

57 55 N 56 24
NOVOLOG

Treats diabetes mellitus. I... +

Treats diabetes mellitus. Insulin is a hormone that helps get sugar from the blood to the muscles, where it is used for energy. This type of insulin is similar to regular insulin, but acts in the body more quickly. More info »

56 38 58 47
NOVOLIN R

Treats diabetes mellitus. +

Treats diabetes mellitus. More info »

55 55 59 66
SPIRONOLACTONE

Treats fluid retention (ede... +

Treats fluid retention (edema) in patients with congestive heart failure, liver cirrhosis, or nephrotic syndrome. Also treats high blood pressure, heart failure, and low blood potassium (hypokalemia). This medicine is a diuretic (water pill). More info »

54 44 60 50
OXYBUTYNIN CHLORIDE ER

Oxybutynin is used to contr... +

Oxybutynin is used to control urgent, frequent, or uncontrolled urination in people who have overactive bladder (a condition in which the bladder muscles have uncontrollable spasms), spina bifida (a disability that occurs when the spinal cord does not close properly before birth), or other conditions that affect the bladder muscles. Oxybutynin is in a class of medications called anticholinergics. It works by relaxing the bladder muscles to prevent urgent, frequent, or uncontrolled urination. More info »

54 54 60 132
LIPITOR

Lowers high cholesterol and... +

Lowers high cholesterol and triglyceride levels in the blood. Lowers the risk of chest pain, stroke, heart attack, or certain heart and blood vessel problems in people who have certain risk factors. This medicine is an HMG-CoA inhibitor, also called a statin. More info »

54 31 60 21
LEVETIRACETAM

Used to help control certai... +

Used to help control certain types of seizures caused by epilepsy. This medicine is an antiepileptic. More info »

54 17 60 63
TAMSULOSIN HCL

Tamsulosin is used in men t... +

Tamsulosin is used in men to treat the symptoms of an enlarged prostate (benign prostatic hyperplasia or BPH) which include difficulty urinating (hesitation, dribbling, weak stream, and incomplete bladder emptying), painful urination, and urinary frequency and urgency. Tamsulosin is in a class of medications called alpha blockers. It works by relaxing the muscles in the prostate and bladder so that urine can flow easily. More info »

53 53 64 36
ALLOPURINOL

Treats gout and some kinds ... +

Treats gout and some kinds of kidney stones. Lowers the amount of uric acid in blood. More info »

53 53 64 43
SPIRIVA

Prevents the symptoms of br... +

Prevents the symptoms of bronchospasm caused by emphysema, chronic bronchitis, or COPD (chronic obstructive pulmonary disease). This medicine is a bronchodilator. More info »

51 40 66 64
GENTAMICIN SULFATE

Ophthalmic gentamicin is us... +

Ophthalmic gentamicin is used to treat certain eye infections. Gentamicin is in a class of medications called antibiotics. It works by killing the bacteria that cause infection. More info »

50 47 67 199
About This Data

ProPublica obtained prescribing data from Medicare’s prescription drug benefit, known as Part D, under the Freedom of Information Act. The data for 2011 includes nearly 1.2 billion prescriptions written by 1.6 million doctors, nurses and other providers. This database lists about 364,000 of those providers who wrote 50 or more prescriptions for at least one drug that year. About three-fourths went to patients 65 and older; the rest were for disabled patients. Methodology »

Caveats
  • No comparisons are shown if 10 or fewer prescribers in the state share this specialty.
  • The list of top drugs includes only those for which this provider wrote 50 or more prescriptions, but all prescriptions are counted in the summary totals at the top.
  • The calculation of “Risky Drugs to Seniors” does not include drugs for which a provider wrote 11 or fewer prescriptions because Medicare redacted the information to protect patient privacy.
  • Comparisons do not take into account the medical conditions of patients. Medications for certain conditions do not have generic alternatives, so patients would receive more expensive brand name drugs.
  • This provider's address and specialty information was last updated on Jan. 27, 2012.
  • Comparisons are based on each provider’s current address, not necessarily where he or she worked during the time period covered in this database.
Incorrect Info?

If you are a provider and you believe your address is incorrect, check the listing you created on the National Provider Identifier registry. If you change your listing, send a note to drugs@propublica.org and we will update your information. If you have other questions about this data, send a note to drugs@propublica.org.