Hospital Costs > In Missouri > Christian Hospital Northeast-Northwest, procedure costs
| Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
|---|---|---|---|---|---|---|---|---|
| Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
| Acute Myocardial Infarction, Discharged Alive W Mcc | 41 | 84 / 10 | $40.831,40 | 842 / 22 | $10.475,90 | 839 / 21 | $9.842,51 | 838 / 28 |
| Alcohol/Drug Abuse Or Dependence W/O Rehabilitation Therapy W/O Mcc | 21 | 103 / 15 | $14.554,60 | 321 / 14 | $4.507,43 | 242 / 8 | $3.641,90 | 242 / 8 |
| Amputation For Circ Sys Disorders Exc Upper Limb & Toe W Mcc | 12 | 22 / 3 | $109.305,00 | 95 / 2 | $29.843,00 | 99 / 2 | $28.635,00 | 99 / 2 |
| Bronchitis & Asthma W Cc/Mcc | 28 | 48 / 3 | $20.967,00 | 420 / 13 | $5.532,68 | 452 / 11 | $4.672,11 | 448 / 14 |
| Bronchitis & Asthma W/O Cc/Mcc | 17 | 28 / 2 | $13.439,90 | 101 / 3 | $4.269,29 | 153 / 4 | $3.348,82 | 153 / 4 |
| Cardiac Arrhythmia & Conduction Disorders W Cc | 50 | 111 / 13 | $20.467,70 | 1086 / 30 | $5.220,24 | 984 / 26 | $4.279,28 | 981 / 30 |
| Cardiac Arrhythmia & Conduction Disorders W Mcc | 64 | 59 / 5 | $29.936,00 | 952 / 21 | $7.338,89 | 458 / 16 | $6.309,48 | 455 / 16 |
| Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 27 | 123 / 23 | $11.832,80 | 564 / 14 | $3.853,78 | 696 / 27 | $2.583,26 | 692 / 25 |
| Cardiac Valve & Oth Maj Cardiothoracic Proc W Card Cath W Mcc | 18 | 51 / 5 | $212.190,00 | 90 / 4 | $55.364,90 | 67 / 3 | $54.826,30 | 67 / 3 |
| Cardiac Valve & Oth Maj Cardiothoracic Proc W/O Card Cath W Mcc | 32 | 84 / 5 | $176.913,00 | 159 / 4 | $47.336,70 | 88 / 4 | $44.299,30 | 88 / 4 |
| Cellulitis W Mcc | 13 | 45 / 13 | $30.945,70 | 401 / 14 | $8.814,00 | 289 / 16 | $7.792,46 | 288 / 15 |
| Cellulitis W/O Mcc | 65 | 124 / 11 | $19.596,70 | 1441 / 49 | $5.370,31 | 1166 / 29 | $4.403,82 | 1160 / 38 |
| Chest Pain | 38 | 113 / 10 | $17.902,80 | 760 / 20 | $4.868,58 | 621 / 31 | $3.048,47 | 617 / 23 |
| Chronic Obstructive Pulmonary Disease W Cc | 75 | 104 / 3 | $22.723,40 | 1271 / 40 | $5.916,11 | 1053 / 29 | $5.010,93 | 1049 / 31 |
| Chronic Obstructive Pulmonary Disease W Mcc | 78 | 124 / 8 | $27.280,90 | 1286 / 39 | $7.296,99 | 873 / 31 | $6.121,36 | 868 / 31 |
| Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 33 | 87 / 12 | $16.111,40 | 919 / 32 | $4.674,21 | 894 / 25 | $3.648,27 | 886 / 29 |
| Circulatory Disorders Except Ami, W Card Cath W Mcc | 17 | 76 / 13 | $53.435,40 | 376 / 12 | $12.907,50 | 401 / 14 | $12.201,60 | 396 / 14 |
| Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 40 | 148 / 19 | $34.787,70 | 748 / 26 | $6.743,88 | 753 / 22 | $5.817,67 | 751 / 30 |
| Coronary Bypass W Cardiac Cath W Mcc | 13 | 43 / 8 | $157.021,00 | 126 / 3 | $50.104,50 | 84 / 8 | $37.372,70 | 84 / 4 |
| Coronary Bypass W/O Cardiac Cath W Mcc | 34 | 25 / 2 | $136.461,00 | 90 / 5 | $34.900,70 | 83 / 5 | $32.912,40 | 83 / 6 |
| Coronary Bypass W/O Cardiac Cath W/O Mcc | 17 | 71 / 12 | $100.232,00 | 255 / 7 | $21.752,10 | 253 / 6 | $20.827,80 | 252 / 11 |
| Cranial & Peripheral Nerve Disorders W Mcc | 17 | 19 / 3 | $22.739,50 | 28 / 1 | $7.928,24 | 24 / 1 | $7.148,94 | 24 / 1 |
| Cranial & Peripheral Nerve Disorders W/O Mcc | 21 | 47 / 7 | $23.327,80 | 309 / 15 | $5.592,29 | 219 / 8 | $4.729,81 | 219 / 8 |
| Diabetes W Cc | 58 | 34 / 2 | $20.290,60 | 714 / 22 | $5.294,05 | 529 / 16 | $4.310,31 | 529 / 21 |
| Diabetes W Mcc | 25 | 32 / 4 | $36.138,60 | 401 / 8 | $8.442,48 | 230 / 3 | $7.716,72 | 230 / 3 |
| Diabetes W/O Cc/Mcc | 12 | 26 / 3 | $15.690,40 | 137 / 3 | $3.893,25 | 72 / 2 | $2.893,25 | 72 / 2 |
| Digestive Malignancy W Cc | 11 | 36 / 7 | $24.592,10 | 75 / 1 | $7.675,55 | 129 / 4 | $7.015,18 | 128 / 6 |
| Disorders Of Pancreas Except Malignancy W Cc | 21 | 40 / 6 | $19.017,90 | 269 / 9 | $5.799,00 | 387 / 10 | $4.991,38 | 386 / 13 |
| Disorders Of Pancreas Except Malignancy W/O Cc/Mcc | 11 | 27 / 10 | $15.109,50 | 135 / 7 | $4.302,09 | 213 / 6 | $3.423,55 | 213 / 9 |
| Dysequilibrium | 12 | 53 / 6 | $23.470,80 | 316 / 8 | $4.160,58 | 147 / 5 | $2.952,58 | 147 / 7 |
| Ecmo Or Trach W Mv 96+ Hrs Or Pdx Exc Face, Mouth & Neck W Maj O.R. | 17 | 64 / 7 | $418.132,00 | 198 / 10 | $116.844,00 | 238 / 13 | $115.035,00 | 237 / 14 |
| Esophagitis, Gastroent & Misc Digest Disorders W Mcc | 23 | 73 / 16 | $21.474,10 | 272 / 6 | $7.519,39 | 307 / 21 | $6.257,09 | 305 / 17 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 116 | 159 / 13 | $17.403,90 | 1048 / 30 | $4.877,85 | 1051 / 32 | $3.789,36 | 1043 / 32 |
| Extensive O.R. Procedure Unrelated To Principal Diagnosis W Cc | 11 | 33 / 11 | $63.489,10 | 141 / 10 | $17.043,50 | 162 / 11 | $16.159,10 | 161 / 11 |
| Extensive O.R. Procedure Unrelated To Principal Diagnosis W Mcc | 19 | 44 / 10 | $85.506,70 | 131 / 8 | $26.665,10 | 93 / 6 | $25.039,80 | 93 / 7 |
| G.I. Hemorrhage W Cc | 76 | 142 / 14 | $20.897,20 | 825 / 18 | $6.577,30 | 866 / 36 | $5.238,74 | 864 / 27 |
| G.I. Hemorrhage W Mcc | 41 | 80 / 7 | $35.149,50 | 512 / 13 | $10.707,80 | 585 / 20 | $9.881,27 | 586 / 24 |
| G.I. Obstruction W Cc | 37 | 55 / 9 | $19.733,10 | 631 / 22 | $5.611,76 | 560 / 21 | $4.538,46 | 559 / 22 |
| G.I. Obstruction W Mcc | 16 | 26 / 5 | $32.632,40 | 166 / 7 | $9.501,19 | 151 / 7 | $8.897,19 | 151 / 8 |
| G.I. Obstruction W/O Cc/Mcc | 13 | 58 / 17 | $13.409,60 | 399 / 10 | $4.006,31 | 760 / 16 | $3.358,92 | 757 / 23 |
| Heart Failure & Shock W Cc | 109 | 169 / 13 | $24.189,50 | 1608 / 43 | $6.220,47 | 1056 / 30 | $5.333,97 | 1054 / 29 |
| Heart Failure & Shock W Mcc | 196 | 89 / 6 | $33.070,70 | 1288 / 30 | $9.288,93 | 1177 / 33 | $8.553,48 | 1174 / 34 |
| Heart Failure & Shock W/O Cc/Mcc | 14 | 96 / 24 | $14.365,90 | 770 / 22 | $4.453,50 | 739 / 22 | $3.502,64 | 735 / 22 |
| Hip & Femur Procedures Except Major Joint W Cc | 40 | 103 / 16 | $42.960,30 | 763 / 19 | $11.651,50 | 828 / 26 | $10.656,20 | 818 / 29 |
| Hip & Femur Procedures Except Major Joint W Mcc | 12 | 50 / 17 | $61.580,20 | 322 / 12 | $17.080,80 | 228 / 14 | $16.072,80 | 227 / 13 |
| Hypertension W/O Mcc | 11 | 54 / 11 | $16.722,00 | 287 / 10 | $4.153,82 | 260 / 10 | $3.054,18 | 258 / 8 |
| Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 55 | 69 / 8 | $97.429,50 | 464 / 13 | $29.557,40 | 345 / 9 | $28.270,30 | 345 / 12 |
| Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 44 | 138 / 19 | $29.809,40 | 1143 / 30 | $6.881,82 | 553 / 30 | $5.275,75 | 552 / 21 |
| Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 37 | 131 / 19 | $41.461,10 | 738 / 24 | $10.018,10 | 442 / 16 | $9.198,19 | 441 / 17 |
| Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 21 | 81 / 18 | $26.501,70 | 968 / 30 | $4.840,62 | 702 / 20 | $3.857,76 | 698 / 22 |
| Kidney & Urinary Tract Infections W Mcc | 52 | 92 / 9 | $21.651,40 | 684 / 17 | $6.832,48 | 686 / 23 | $5.929,10 | 685 / 25 |
| Kidney & Urinary Tract Infections W/O Mcc | 73 | 160 / 13 | $15.395,00 | 996 / 27 | $4.961,14 | 1041 / 34 | $3.984,92 | 1033 / 34 |
| Laparoscopic Cholecystectomy W/O C.D.E. W Mcc | 13 | 27 / 8 | $62.875,90 | 196 / 11 | $14.778,20 | 162 / 8 | $13.857,60 | 161 / 9 |
| Lower Extrem & Humer Proc Except Hip,Foot,Femur W Cc | 11 | 44 / 14 | $38.261,70 | 121 / 4 | $10.462,30 | 37 / 2 | $9.365,55 | 37 / 4 |
| Major Chest Procedures W Cc | 15 | 59 / 7 | $52.767,90 | 136 / 5 | $15.155,70 | 178 / 7 | $14.353,50 | 178 / 9 |
| Major Gastrointestinal Disorders & Peritoneal Infections W Cc | 13 | 60 / 15 | $29.963,80 | 646 / 20 | $6.922,92 | 423 / 12 | $6.457,69 | 422 / 19 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 56 | 508 / 45 | $40.143,30 | 765 / 28 | $12.773,80 | 1090 / 27 | $11.203,60 | 1066 / 35 |
| Major Small & Large Bowel Procedures W Cc | 22 | 86 / 20 | $69.987,70 | 856 / 28 | $16.011,80 | 858 / 23 | $15.022,70 | 850 / 25 |
| Major Small & Large Bowel Procedures W Mcc | 27 | 58 / 8 | $117.533,00 | 540 / 19 | $31.965,20 | 614 / 17 | $30.926,30 | 612 / 20 |
| Medical Back Problems W/O Mcc | 15 | 106 / 22 | $25.349,00 | 840 / 23 | $5.377,47 | 656 / 13 | $4.485,73 | 654 / 20 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 47 | 79 / 9 | $19.054,30 | 358 / 9 | $6.799,72 | 533 / 18 | $6.070,87 | 530 / 20 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 46 | 120 / 17 | $15.277,50 | 992 / 29 | $4.576,98 | 1057 / 30 | $3.687,24 | 1054 / 35 |
| Other Circulatory System Diagnoses W Cc | 16 | 50 / 7 | $21.154,60 | 223 / 6 | $6.000,69 | 265 / 5 | $5.398,69 | 264 / 9 |
| Other Circulatory System Diagnoses W Mcc | 42 | 74 / 6 | $44.989,90 | 626 / 16 | $11.918,90 | 660 / 21 | $11.393,50 | 658 / 22 |
| Other Digestive System Diagnoses W Cc | 17 | 80 / 17 | $27.414,20 | 773 / 24 | $6.227,94 | 465 / 20 | $5.144,88 | 462 / 19 |
| Other Digestive System Diagnoses W Mcc | 17 | 45 / 9 | $33.404,20 | 218 / 3 | $9.890,41 | 148 / 6 | $9.091,35 | 148 / 6 |
| Other Disorders Of Nervous System W Mcc | 13 | 27 / 7 | $30.697,30 | 81 / 3 | $8.883,31 | 50 / 3 | $8.191,62 | 50 / 3 |
| Other Endocrine, Nutrit & Metab O.R. Proc W Mcc | 13 | 5 / 1 | $81.213,70 | 7 / 1 | $25.373,20 | 14 / 1 | $23.031,10 | 14 / 1 |
| Other Kidney & Urinary Tract Diagnoses W Cc | 17 | 86 / 12 | $19.152,40 | 223 / 9 | $6.155,12 | 267 / 14 | $5.377,71 | 267 / 15 |
| Other Kidney & Urinary Tract Diagnoses W Mcc | 50 | 51 / 4 | $38.943,10 | 614 / 23 | $9.898,70 | 520 / 22 | $9.176,12 | 518 / 23 |
| Other Kidney & Urinary Tract Procedures W Mcc | 13 | 25 / 4 | $85.201,70 | 118 / 4 | $19.371,20 | 76 / 1 | $18.721,30 | 76 / 1 |
| Other Resp System O.R. Procedures W Cc | 15 | 32 / 6 | $47.960,50 | 143 / 7 | $11.713,90 | 123 / 4 | $10.913,90 | 123 / 5 |
| Other Resp System O.R. Procedures W Mcc | 26 | 37 / 6 | $76.703,20 | 191 / 9 | $21.490,40 | 178 / 9 | $20.255,90 | 178 / 9 |
| Other Skin, Subcut Tiss & Breast Proc W Mcc | 11 | 11 / 2 | $37.208,50 | 3 / 1 | $13.283,50 | 4 / 1 | $12.951,80 | 4 / 1 |
| Other Vascular Procedures W Cc | 22 | 80 / 15 | $45.771,10 | 146 / 5 | $15.454,80 | 157 / 14 | $13.107,00 | 157 / 7 |
| Other Vascular Procedures W Mcc | 41 | 56 / 3 | $83.269,50 | 419 / 14 | $21.150,40 | 490 / 18 | $20.628,30 | 488 / 18 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W Mcc Or 4+ Vessels/Stents | 20 | 80 / 14 | $91.923,00 | 400 / 21 | $22.165,60 | 421 / 21 | $18.987,30 | 418 / 19 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 39 | 157 / 22 | $55.793,30 | 363 / 17 | $12.631,10 | 777 / 19 | $11.519,30 | 772 / 31 |
| Perc Cardiovasc Proc W Non-Drug-Eluting Stent W Mcc Or 4+ Ves/Stents | 20 | 25 / 2 | $71.776,20 | 73 / 3 | $18.393,70 | 98 / 6 | $17.381,70 | 98 / 6 |
| Perc Cardiovasc Proc W Non-Drug-Eluting Stent W/O Mcc | 20 | 49 / 3 | $46.797,00 | 120 / 2 | $10.824,10 | 221 / 8 | $9.860,90 | 221 / 10 |
| Perc Cardiovasc Proc W/O Coronary Artery Stent W/O Mcc | 12 | 83 / 10 | $54.032,60 | 136 / 8 | $11.831,80 | 201 / 6 | $10.922,40 | 199 / 9 |
| Peripheral Vascular Disorders W Cc | 27 | 57 / 6 | $22.379,80 | 509 / 13 | $6.042,22 | 516 / 11 | $5.370,22 | 514 / 13 |
| Peripheral Vascular Disorders W Mcc | 16 | 33 / 5 | $24.414,20 | 111 / 6 | $7.868,81 | 129 / 7 | $7.188,81 | 129 / 8 |
| Permanent Cardiac Pacemaker Implant W Cc | 13 | 64 / 14 | $60.359,50 | 352 / 12 | $16.659,50 | 109 / 15 | $13.381,20 | 109 / 3 |
| Permanent Cardiac Pacemaker Implant W Mcc | 21 | 31 / 4 | $73.882,40 | 169 / 5 | $20.187,70 | 106 / 3 | $19.555,30 | 106 / 4 |
| Poisoning & Toxic Effects Of Drugs W Mcc | 17 | 55 / 14 | $32.023,90 | 391 / 13 | $8.811,41 | 377 / 13 | $8.030,24 | 376 / 15 |
| Poisoning & Toxic Effects Of Drugs W/O Mcc | 11 | 50 / 17 | $13.540,50 | 244 / 7 | $4.384,82 | 109 / 12 | $2.923,64 | 109 / 7 |
| Psychoses | 193 | 123 / 10 | $13.165,80 | 138 / 5 | $6.275,51 | 180 / 6 | $5.417,58 | 180 / 8 |
| Pulmonary Edema & Respiratory Failure | 94 | 109 / 11 | $33.457,00 | 1225 / 33 | $7.612,63 | 808 / 24 | $6.716,20 | 808 / 26 |
| Red Blood Cell Disorders W Mcc | 24 | 47 / 4 | $22.749,00 | 230 / 4 | $7.632,96 | 387 / 8 | $7.080,96 | 385 / 11 |
| Red Blood Cell Disorders W/O Mcc | 61 | 82 / 2 | $16.354,20 | 568 / 14 | $5.457,67 | 547 / 29 | $4.031,54 | 545 / 16 |
| Renal Failure W Cc | 88 | 133 / 14 | $20.779,20 | 1058 / 33 | $6.077,84 | 890 / 28 | $5.078,01 | 882 / 27 |
| Renal Failure W Mcc | 106 | 89 / 5 | $29.885,10 | 756 / 16 | $9.212,80 | 678 / 19 | $8.336,42 | 678 / 20 |
| Renal Failure W/O Cc/Mcc | 13 | 43 / 10 | $15.875,60 | 406 / 10 | $4.167,38 | 442 / 11 | $3.426,46 | 441 / 12 |
| Respiratory Infections & Inflammations W Cc | 24 | 64 / 10 | $26.458,10 | 539 / 16 | $8.174,08 | 466 / 15 | $7.267,42 | 463 / 16 |
| Respiratory Infections & Inflammations W Mcc | 60 | 76 / 13 | $42.566,40 | 867 / 25 | $11.811,00 | 800 / 21 | $11.129,10 | 790 / 27 |
| Respiratory Neoplasms W Mcc | 12 | 40 / 11 | $36.655,10 | 203 / 7 | $10.138,70 | 238 / 9 | $9.733,33 | 238 / 13 |
| Respiratory System Diagnosis W Ventilator Support <96 Hours | 60 | 71 / 7 | $51.868,20 | 673 / 15 | $13.371,50 | 336 / 14 | $11.973,40 | 332 / 9 |
| Respiratory System Diagnosis W Ventilator Support 96+ Hours | 24 | 47 / 5 | $101.081,00 | 260 / 8 | $29.688,20 | 260 / 9 | $28.592,80 | 260 / 9 |
| Seizures W Mcc | 36 | 30 / 2 | $31.404,80 | 202 / 9 | $9.414,31 | 268 / 8 | $8.675,64 | 268 / 11 |
| Seizures W/O Mcc | 48 | 60 / 6 | $17.828,50 | 413 / 9 | $4.918,88 | 519 / 11 | $4.088,21 | 516 / 15 |
| Septicemia Or Severe Sepsis W Mv 96+ Hours | 27 | 65 / 5 | $115.124,00 | 289 / 7 | $33.941,90 | 251 / 9 | $32.390,50 | 250 / 12 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 179 | 337 / 24 | $47.402,50 | 1682 / 42 | $11.189,80 | 1151 / 29 | $10.403,10 | 1134 / 36 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 42 | 165 / 21 | $22.322,70 | 1002 / 21 | $6.718,43 | 1071 / 27 | $5.729,67 | 1068 / 33 |
| Signs & Symptoms W/O Mcc | 19 | 72 / 14 | $16.004,90 | 405 / 12 | $4.498,32 | 570 / 14 | $3.801,05 | 569 / 17 |
| Simple Pneumonia & Pleurisy W Cc | 43 | 160 / 30 | $22.643,20 | 1410 / 42 | $6.286,14 | 852 / 37 | $4.951,26 | 849 / 28 |
| Simple Pneumonia & Pleurisy W Mcc | 61 | 144 / 25 | $33.557,00 | 1256 / 36 | $8.724,48 | 1072 / 24 | $7.953,85 | 1072 / 33 |
| Simple Pneumonia & Pleurisy W/O Cc/Mcc | 12 | 81 / 28 | $13.003,40 | 510 / 12 | $4.609,92 | 680 / 24 | $3.399,25 | 677 / 21 |
| Spinal Fusion Except Cervical W/O Mcc | 20 | 174 / 22 | $99.701,70 | 730 / 17 | $23.034,40 | 512 / 8 | $21.884,00 | 509 / 18 |
| Syncope & Collapse | 44 | 125 / 12 | $23.272,80 | 1124 / 33 | $4.861,89 | 861 / 27 | $3.902,43 | 857 / 26 |
| Transient Ischemia | 44 | 81 / 6 | $25.575,00 | 990 / 27 | $4.576,34 | 796 / 18 | $3.698,52 | 792 / 24 | Total 111 procedures | 4.082 | discharges |
Source: Medicare Provider Utilization and Payment Data: Inpatient for FY2014
Average Covered Charges: The provider's average charge for services covered by Medicare for all discharges in the MS-DRG. These will vary from hospital to hospital because of differences in hospital charge structures.
Average Total Payments: The average total payments to all providers for the MS-DRG including the MSDRG amount, teaching, disproportionate share, capital, and outlier payments for all cases. Also included in average total payments are co-payment and deductible amounts that the patient is responsible for and any additional payments by third parties for coordination of benefits.
Average Medicare Payments: The average amount that Medicare pays to the provider for Medicare's share of the MS-DRG. Average Medicare payment amounts include the MS-DRG amount, teaching, disproportionate share, capital, and outlier payments for all cases. Medicare payments DO NOT include beneficiary co-payments and deductible amounts nor any additional payments from third parties for coordination of benefits. Note: In general, Medicare FFS claims with dates-of-service or dates-of-discharge on or after April 1, 2013, incurred a 2 percent reduction in Medicare payment. This is in response to mandatory across-the-board reductions in Federal spending, also known as sequestration
Hospital Rank: We have calculated the rank for each procedure within a hospital. The left number is the national ranking, the right one is the state ranking. For discharges, ranking is from highest # of discharges to lower (hospital with highest number of discharges ranks first). For charges and payments, lowest means a higher ranking.