NCPDP BLOG

By Lee Ann Stember, President & CEO of NCPDP
 
At NCPDP, we believe real transformation comes from action. Healthcare is changing quickly. New technologies and the growing need for better coordination across care teams have all created a turning point for the industry. Pharmacy is also evolving, with new responsibilities and growing potential to improve patient care.

To keep pace with these changes, we took time to reflect and listen. With input from our members, Board of Trustees, and executive team, we stepped back to take a fresh look at our strategic direction and goals.

The result is a clear and focused path forward. We have updated our vision and mission to reflect where we are going, and we have launched a new three-year strategic plan to guide our work through 2027. This plan will help NCPDP lead with purpose, support stronger data sharing across healthcare, and give pharmacy a more active role in improving health outcomes.
 
A Clear Vision for the Future
Our new vision, “Transforming healthcare through connected care,” captures the heart of what NCPDP does best. It speaks to our commitment to improving healthcare by enhancing connectivity, interoperability, and collaboration across the care continuum.

It’s a vision that builds on our legacy as a leader in standards development, while recognizing the growing role of pharmacists and other healthcare professionals in driving better patient outcomes.

Our updated vision captures where we’re headed: a healthcare system that is more efficient, better connected, safer, and fully centered around the needs of patients.
 
Defining Our Purpose
Alongside our new vision, we introduced a mission that reflects NCPDP’s continually expanding role in healthcare, “We build consensus-driven standards that enable information sharing across systems of healthcare.”

At NCPDP, we bring together a wide range of stakeholders, including pharmacists, providers, payers, and technology vendors, to collaboratively develop the standards and solutions that support the seamless exchange of clinical and administrative data.

In today’s fast-paced environment, where timely access to accurate information is critical, our mission reinforces the value interoperability provides in delivering safe, effective, and well-coordinated care.
 
Three Pillars of Strategic Growth
To bring our vision and mission to life, our Board of Trustees has restructured our strategic plan around three key pillars:

1. Improved Data Exchange
Data exchange is the cornerstone of connected care. Our goal is to eliminate silos and ensure that critical patient data, such as hospital discharges, lab results, or medication histories, flows smoothly between healthcare professionals, including pharmacists. This seamless exchange enables timely interventions, reduces medication errors, and supports better care coordination.

We are focused on helping the industry fully understand and embrace the power of NCPDP standards to support real-time, actionable information sharing.

2. Collaboration & Innovation
Innovation thrives in diverse, collaborative environments, and NCPDP has long been a trusted convener of all healthcare stakeholders. Through our consensus-driven process and initiatives like Work Group 20 focused on Coordination of Care & Innovation, we bring together healthcare leaders to co-create solutions that move the industry forward.

By fostering partnerships with other SDOs like HL7 and The Sequoia Project, we are working to align data standards and enhance pharmacy’s role in broader care delivery models. We are also piloting emerging technologies and exploring cutting-edge areas like digital therapeutics, AI, and value-based care.

3. Organizational Excellence & Sustainability
Sustaining our impact requires a solid foundation. This strategic pillar focuses on ensuring NCPDP remains agile, forward-thinking, and financially sound. We are committed to staying ahead of healthcare trends, responding to member needs, and delivering lasting value through leadership, service, and innovation.

Together with the Executive Staff, the Board is leading efforts to strengthen our organization’s infrastructure, expand member engagement, and invest in tools and technologies that support our long-term success.
 
Driving Industry-Wide Change
Our new strategic plan aligns with many of our broader efforts that are shaping the future of healthcare. Examples include the NCPDP National Facilitator Model, which is focused on expanding the role of pharmacists in care coordination; and Patient Experience Identifier, which is a vendor- and provider-neutral solution for accurately managing patient identification across the healthcare ecosystem. Concurrently, our ongoing work to improve clinical data exchange is creating new opportunities for pharmacy to play a more integrated role in patient care.

We are proud of how far we have come, but we know there is still plenty of work ahead. Our commitment to innovation and progress remains strong as we explore new ways to advance healthcare.

With our updated vision, mission, and strategic plan guiding us, NCPDP is ready to lead the next phase of healthcare transformation. Our members, including pharmacy professionals, technology experts, and healthcare leaders, are driving this effort. Together, we will build solutions that make healthcare smarter, more connected, and more effective for all.
 

By J. W. Hill, MBAHCM, Chief Operating Officer for NCPDP
 

When we talk about the impact of NCPDP standards, we are not talking in abstract terms. NCPDP staff recently completed an infographic compiling research available on NCPDP standards and how they have impacted the industry. The data clearly demonstrates, in real and measurable ways, that our standards are improving healthcare by driving efficiency, strengthening patient safety, and generating cost savings across the system.

Just last year, 1.3 million prescribers used electronic prescribing (ePrescribing), a nearly 4% increase over 2023. More than 2.6 billion ePrescriptions were processed, including 21 million specialty medications. These are not small, incremental gains. They represent a fundamental shift in how essential the NCPDP SCRIPT Standard^© is in prescribing practices in healthcare today.

Transforming Safety and Accuracy
Patient safety is at the core of everything we do. CancelRx is one patient safety aspect included within the NCPDP SCRIPT Standard^©. CancelRx ensures that pharmacists and prescribers are aligned, preventing dangerous duplications or dosing errors that can harm patients. One study found that before CancelRx was implemented, nearly 11% of canceled prescriptions were still dispensed to patients, causing a delay in the correct medication, impacting health outcomes and safety. After implementing CancelRx, researchers found that the number dropped significantly, reaching 0.0%.  

ePrescribing has also dramatically reduced the risk of adverse drug events by making drug-to-drug and allergy checks part of the process. Every avoided ER visit, hospitalization, or doctor’s office visit not only spares patients from harm but also saves the system significant costs – $9,000 per hospitalization prevented, $427 per ER visit prevented, and $111 per doctor’s visit prevented. These are more than numbers; they are better health outcomes for patients, relief for the providers who care for them, and bottom-line improvement for payers.

Driving Affordability and Adherence
Our standards are also changing the conversation around cost and medication adherence. The NCPDP Real-Time Prescription Benefit (RTPB) Standard^© allows providers to tell patients what a medication will cost at the point of prescribing instead of at the pharmacy counter. In 2023 alone, patients saved over $1.8 million by finding lower-cost alternatives through RTPB. On average, patients save $82 per prescription and more than $1,146 per specialty medication.

These savings boost medication adherence. When patients know their costs and participate in choosing lower-cost options, they are more likely to pick up their medications, which helps improve patient health and reduce overall healthcare costs. Since 2009, ePrescribing has generated between $140 and $240 billion in savings and improved health outcomes, much of that tied to improved patient adherence and fewer adverse drug events.

Reducing Burden Across the System
Efficiency is not just about saving money for patients and the healthcare system. It is also about reducing the burden for providers, including pharmacists. The NCPDP SCRIPT Electronic Prior Authorization Transaction (ePA) is a perfect example. ePA is a set of transactions within the NCPDP SCRIPT standard©, providing an electronic, real-time process for determining if a prior authorization is needed, submitting the required information, and receiving a decision for medications covered under a patient's pharmacy benefit. In 2023, fully electronic ePA transactions reduced operational costs per prescription drug prior authorization to $3.72, compared to $7.13 for web portals and $13.30 for fully manual processing. Providers can spend more time with patients, and funds can go toward better care.

The numbers speak for themselves:

• $439 million saved from reduced provider callbacks.
• $1.6 billion saved from reduced patient wait times.
• $1.6 billion in total annual savings from e-prescribing for controlled substances.

This kind of operational efficiency makes the healthcare system more sustainable.

Looking Ahead
While the numbers are impressive, they also highlight the opportunities ahead. Increased adoption of real-time benefit tools, expanded use of specialty prescribing standards, and pilots like the Pharmacy Product Availability transaction will continue to move us toward a more transparent, patient-centered, and connected healthcare system.

At NCPDP, we are committed to building on this momentum and continuing to deliver the tools and standards that make healthcare safer, more efficient, and more affordable.

For a deeper dive into the data highlighted here and the stories behind it, I encourage you to listen to the Drug Topics Over the Counter podcast: How Pharmacy Standards Drive Efficiency, Safety, and Savings with Pooja Babbrah, our EVP of Strategy and Industry Alignment. In it, she explores what these numbers mean for NCPDP and the future of pharmacy.

By Pooja Babbrah, Executive Vice President, Strategy and Industry Alignment, NCPDP

We’ve all been there. You go to the doctor, get a prescription, and head to the pharmacy, only to find out they don’t have the medication in stock. What should be a routine part of your care turns into a stressful series of phone calls or visits to multiple pharmacies, trying to find one that can fill the prescription.

This situation is more common than many realize. As of early 2025, the FDA reports that over 200 medications are on its national shortage list, including treatments for infections, cancer, and chronic conditions. For patients on multiple specialty medications, the situation can be even worse.  In these moments, delays in care can have serious consequences.

This growing access challenge is exactly what the Pharmacy Product Availability Pilot Program, a collaboration between Assistant Secretary for Technology Policy (ASTP) and NCPDP, aims to solve. The pilot is designed to make it easier for prescribers to know if a pharmacy has a specific medication in stock before sending the prescription, helping avoid treatment delays and improving the patient experience.

Why This Matters
Healthcare providers and patients alike are no strangers to the frustration of tracking down medications. Whether it's searching for hard-to-find specialty therapies or treatments in short supply, the process is often inefficient and time-consuming. A very personal example, during a recent COVID-19 spike, my sister and I had to call five different pharmacies across the town we grew up in to locate Paxlovid for our elderly parents. This scenario is all too common.

The pilot builds on a key recommendation from the Pharmacy Interoperability and Emerging Therapeutics Task Force, part of the Health Information Technology Advisory Committee (HITAC). One of the top recommendations and a priority coming out of the task force was improving transparency around medication availability, especially when it comes to specialty medications and those listed on the FDA drug shortage list.

Laying the Groundwork
NCPDP had already been exploring solutions to this issue. In early 2024, an existing task group was redirected to explore new use cases that could help address the medication access gap. The team defined five use cases, with this pilot focusing specifically on Use Case 3: enabling prescribers to find out if a selected pharmacy has the needed medication before the prescription is sent.

To support the pilot, a JSON API transaction, along with a data schema, was created and an implementation guide was created. This transaction is a stand-alone one that sits outside of the NCPDP SCRIPT ePrescribing standard.  The transaction provides a basic yes or no answer about whether the medication is available. If not, the system can also indicate when the pharmacy expects to receive all or the remaining medication needed to fill the prescription.

Pilot Goals and Participation
This six-month pilot is all about learning and refining. The goals are to:

• Gather real-world insights into how the process works for prescribers, pharmacies, and patients.
• Improve the implementation guide based on participant feedback.
• Show what’s possible when the industry collaborates on better interoperability and data exchange.

A Cross-Industry Effort
Multiple teams have been defined for the pilot, representing a wide range of healthcare stakeholders:

Prescriber Agents include:

• Digital health providers
• Long-term care providers
• Traditional healthcare providers

Pharmacy Agents include:

• National home delivery pharmacies
• Independent pharmacies
• Independent pharmacy system vendors
• Inventory management system vendors

Intermediary Agents include:

• Software vendors are committed to improving pharmacy and provider workflow

Why This Matters to Everyone
Each group involved has strong reasons for participating.
 

• Prescriber Agents want to create a better experience for their patients by helping them avoid delays or multiple attempts to access medications. Improving first fill rates can also lead to better health outcomes and reduced administrative burden for care teams.
• Pharmacy Agents see this as a way to set clearer expectations for patients and ensure that prescribers are aware of what is available at the point of care. They see this new workflow as a way to improve pharmacy operations and strengthen customer satisfaction.
• Intermediary Agents are eager to help enable smoother interoperability between systems and stakeholders. They recognize the value of removing friction in the prescription fulfillment process.

We’re proud to have participation from a diverse group of organizations, including DoseSpot, CareServices, TransferMyRx, RealTimeRx, Scriptly, PrimeRx, Amazon Pharmacy, InStockRx, D.A.W. Systems, Inc. and DrFirst.
 
Looking Ahead
As the pilot progresses, NCPDP and ASTP will continue gathering feedback and refining the approach to ensure it meets the needs of the industry. A final report is expected later this year, which will provide key findings and help inform the next steps.

While the technology may be behind the scenes, the goal is very human. It’s about making sure that patients can get the medications they need, when they need them, without unnecessary delays or stress. And it’s about showing that, together, we can build smarter, more connected healthcare solutions.
 
 

By J. W. Hill, MBAHCM, Chief Operating Officer for NCPDP

NCPDP’s 2025 Annual Technology & Business Conference brought together hundreds of healthcare stakeholders to advance the vision of Connected Care. With a focus on healthcare interoperability, innovation, and collaboration, the conference delivered a dynamic lineup of keynote presentations, panel discussions, and networking opportunities, reinforcing the importance of driving patient-centered solutions across the healthcare ecosystem.

Keynote Speakers Set the Tone for Transformation
The conference opened with an inspiring keynote from Dr. Vin Gupta, MD, former Chief Medical Officer of Amazon Pharmacy. In his session, The Future of Healthcare: How Your Organization Will Be Impacted, Dr. Gupta outlined how connected care, innovation, and patient-provider-pharmacist collaboration can transform outcomes. A key focus was on the value of NCPDP’s Patient Experience Identifier (PEI)—formerly known as the NCPDP Universal Patient Identifier—which supports safer, more effective patient matching across healthcare systems.

Other keynote highlights included:

• Scott Biggs, Director of Supplier Services at IQVIA(R), who delivered the highly anticipated IQVIA™ Market Trends Report. His session provided a data-driven review of the healthcare market and identified key trends for the year ahead.
• Allison Massari, artist and motivational speaker, whose keynote You Are the Medicine focused on resilience, compassion, and leading with purpose in times of change.

A Deep Dive into AI and Innovation
One of the most talked-about sessions of the conference was the featured panel on Artificial Intelligence (AI) in Healthcare. Panelists explored practical applications of AI in clinical decision-making, care delivery, and administrative efficiency. The conversation also tackled important considerations around responsible innovation, bias mitigation, and data governance as AI becomes increasingly embedded in healthcare workflows.

Notable Conference Events and Experiences
Beyond the keynote sessions, attendees engaged with new ideas and innovations across multiple conference features:

• Innovation & Connection Hub: An interactive networking space showcasing the latest in healthcare technology, services, and standards.
• Track Sessions: A wide range of breakout sessions broken into three tracks – AI, interoperability, and connected care - covered medication management, standards development, pharmacist-provided clinical services, and more.
• Pause with Paws: Therapy dogs brought moments of calm and comfort during the busy conference days.
• Media Attendance: Members of the Drug Topics and Total Pharmacy editorial teams were on site, conducting media interviews with attendees and speakers on the hottest issues in pharmacy and healthcare interoperability. Read more on these here: https://www.drugtopics.com/conference/ncpdp
• Podcast Launch: NCPDP also recorded the very first episodes of its new updated podcast, NCPDPunscripted, live at the conference! The show, designed to spotlight the voices, ideas, and innovations shaping healthcare, is launching soon.

Honoring Leadership and Service
Highlights from the conference included the recognition of individuals who have made a lasting impact on NCPDP and the healthcare industry.

The 2025 NCPDP Champion Award was presented to Denise McNerney of iBossWell for her unwavering commitment and service. For more than a decade, Denise has served as a strategic advisor to NCPDP, facilitating Board of Trustees planning sessions and helping shape the organization's new three-year strategic plan. Her leadership and insight have been vital to advancing NCPDP’s mission.

We also proudly recognized Kim Boyd, Principal at Leavitt Partners, with the esteemed 2025 TIME Award. Kim’s exceptional leadership, vision, and dedication have played a key role in guiding NCPDP’s strategic direction. Presented at the Annual Conference, the TIME Award celebrates her deep and lasting contributions to both NCPDP and the broader healthcare community.

Joel Walker Arp of Surescripts received the 2025 Rising Star Award, which recognizes members in their first three years of involvement who go above and beyond in contributing to NCPDP’s work. Walker’s active participation in work groups and committees has quickly made him a standout leader among our newest members.

Adam Souza of CVS Health was honored with the Benjamin D. Ward Distinguished Member Award, which recognizes exemplary leadership and service on behalf of NCPDP. Adam’s dedication and accomplishments have left a meaningful mark on the organization and reflect the spirit of collaboration that drives our mission forward.

The conference also welcomed new leadership on the Board of Trustees:

• Mindy Smith, R.Ph., MHA, Senior Vice President of Professional Affairs at AnewHealth, was appointed Chair
• Chris Mendez, Vice President of Data Strategy and Operations at Mercalis, was named Vice Chair
• Tim Fensky, Principal Consultant at Pharmacy Insights, was named Secretary/Treasurer
• Lawrence King, PharmD (Surescripts) was elected as a new member, while Mara Mitchel (Oscar Health) and Christian Tadrus, PharmD, R.Ph., FASCP, NSC (Tadrus Advisory Group) were re-elected
• Continuing members include leaders from Humana, Leavitt Partners, and InfoWerks

Launching NCPDP’s New Strategic Plan
This year’s conference served as the official launch of NCPDP’s new three-year strategic plan, which focuses on:

• Improving the quality and accessibility of healthcare data exchange
• Encouraging collaboration and innovation across sectors
• Ensuring the sustainability and operational excellence of NCPDP

The strategic plan reinforces NCPDP’s role as a trusted standards development organization, championing solutions that empower pharmacists, reduce administrative burden, and improve patient outcomes.

A Milestone for the NCPDP Foundation
During the President & CEO Leadership and Appreciation Dinner, NCPDP President & CEO Lee Ann Stember and the Board of Trustees announced a $1 million donation to the NCPDP Foundation to establish an endowment in honor of Executive Director John W. Hill, MBAHCM. The gift recognizes John’s leadership and supports the Foundation’s mission to advance healthcare through standards-based innovation, research, and pharmacist empowerment.

It was a great year, thanks to our attendees, speakers, sponsors, and exhibitors who made this year’s conference such a resounding success. Your energy, expertise, and commitment to advancing connected care continue to drive meaningful change in our industry. We look forward to another impactful and inspiring gathering at NCPDP's 2026 Annual Technology & Business Conference will be held May 4 -6, 2026, at the Westin Kierland Resort & Spa in Scottsdale, Arizona.
 

By Lee Ann Stember, President and CEO 

Our executive team recently returned from attending ViVE 2025 in Nashville.  The conference sparked important conversations about the future of healthcare, reinforcing the need for pharmacists to play a bigger role in innovation. Our executive team walked away with key insights on where the industry is headed and the opportunities that lie ahead.  Below are observations from our team and what stood out during the three-day event. 

Absence of Pharmacy Discussion 

Pharmacy's role in healthcare is growing, but it's often left out of important industry discussions. At ViVE 2025, AI, interoperability, and new care models were hot topics, but pharmacy’s presence was noticeably limited. Aside from one major announcement from DoseSpot and a panel on Retail Health, there was little representation from the sector. Given its impact on chronic disease management, medication adherence, and patient outcomes, it’s clear that pharmacy needs a bigger seat at the table to help shape a more connected, patient-focused future 

AI and Emerging Technologies Reshaping Healthcare 

Artificial intelligence (AI) is no longer just a buzzword in healthcare, it’s actively transforming the way we live and operate. AI-driven solutions are being used to enhance efficiency, streamline workflows, and improve care delivery. However, responsible AI governance is critical to ensuring ethical implementation and equitable outcomes. AI should enhance, not replace, the human elements of healthcare. 

One of the most promising applications of AI is ambient listening technology, which is improving workflow efficiency by reducing administrative tasks and enhancing real-time data exchange. By automating documentation, this technology allows clinicians to give more time back to patient care. Pharmacists can also utilize these advancements to improve collaboration with care teams and optimize medication management. 

Remote patient monitoring (RPM) is another area that we will see benefiting from AI’s ability to analyze vast amounts of patient data. With new ICD codes enabling reimbursement for RPM services, providers and pharmacists now have an opportunity to play a larger role in these initiatives such as driving better medication adherence and patient engagement while reducing provider burden. 

Pharmacy’s Expanding Role in Chronic Care and Physician Support 

As physician shortages continue to strain the healthcare system, the need for alternative care models are becoming more critical. This gives pharmacists the opportunity to step in as essential care providers, particularly in chronic disease management and medication therapy. Expanding their role alleviates physician burden while ensuring patients receive timely, comprehensive care. 

At the same time, the decline of community pharmacies is driving health systems to strengthen their own pharmacy services. Many are integrating pharmacies within primary care clinics, improving medication management, adherence, and overall clinical outcomes. With the rise of virtual care and RPM, pharmacy teams are becoming integral to care coordination, working directly with patients to optimize medication use and alleviate pressure on physicians. 

Policy Shifts and the Importance of Self-Governance 

Federal regulatory changes and the potential for deregulation remain key topics of discussion for healthcare industry leaders. While policy shifts can introduce a feeling of uncertainty, one thing remains the same, the importance of maintaining ethical, patient-first care. Regardless of the direction of policy changes, the focus is on ensuring that patient care remains a priority. 

In light of these developments, organizations are encouraged to uphold self-governance and ensure that care practices remain aligned with patient needs. This approach supports a healthcare system that is both adaptable to changing regulations and committed to delivering quality outcomes for patients, regardless of external influences. 

The Path Forward: Elevating Pharmacy in Healthcare Innovation 

While ViVE 2025 showcased groundbreaking advancements, it also brought to light the need for greater pharmacy representation during industry discussions. Pharmacy professionals play a crucial role in chronic disease management, medication adherence, and overall quality improvement. Making sure they are heard in future healthcare discussions is key to creating better, more connected care. 

As AI, interoperability, and new care models continue to reshape healthcare, pharmacy must be included at the forefront of innovation. With collaboration, embracing technology, and advocating for a stronger role in patient care, pharmacists can help lead the charge toward a more connected and patient-focused healthcare system. 

By Lee Ann Stember, President and CEO 

Pharmacy interoperability has become a cornerstone of advancing healthcare, giving pharmacists the opportunity to play a more active role in care coordination and patient outcomes. However, achieving full interoperability is no small task. Pharmacies face a variety of challenges, from outdated systems to complex technologies, requiring teamwork and innovation to overcome.

One of the most significant challenges is the use of outdated systems that are incompatible with modern electronic health records (EHRs). These outdated systems limit the seamless exchange of data, hindering efforts to provide connected care. Additionally, concerns about data privacy, security, and the high cost of technology upgrades make it difficult for pharmacies to invest in interoperability. Tight profit margins and a complex business model add to these difficulties.

Despite these hurdles, pharmacy interoperability holds immense potential to transform patient-centered care. When pharmacists have access to real-time clinical data, they can play a pivotal role in improving medication adherence, reducing errors, and supporting chronic disease management. By integrating pharmacists early and more effectively into the healthcare ecosystem, interoperability empowers them to deliver comprehensive, personalized care that improves health outcomes. By integrating pharmacists early and more effectively into the healthcare ecosystem, interoperability empowers them to deliver comprehensive, personalized care that improves health outcomes.

NCPDP has taken a proactive approach to ensure its standards evolve with the rapid pace of healthcare innovation. Through collaboration with stakeholders and initiatives like the Sequoia Project Pharmacy Interoperability Workgroup, NCPDP ensures pharmacy standards remain aligned with technological advancements and emerging needs. In partnership with the HL7® Pharmacy Workgroup, joint-balloted HL7® FHIR® implementation guides are created to support care coordination across the team. By fostering collaboration with industry stakeholders, NCPDP ensures its standards stay dynamic and forward-looking through pilot programs of innovative solutions.

NCPDP recognizes that emerging technologies like AI, including machine learning and Natural Language Processing (NLP) are poised to revolutionize pharmacy interoperability. AI-driven tools can enhance data analytics, enabling pharmacists to predict medication adherence and optimize therapy plans. The Patient Experience Identifier Solution (PEI) leverages AI to improve patient matching, ensuring accurate identification across disparate systems. Similarly, blockchain and machine learning promise to enhance data security and real-time exchange, making connected care a reality.

Looking ahead, the future of pharmacy technology is evolving fast! Value-based care is making clinical data-sharing more important than ever, and predictive analytics is helping pharmacists stay ahead of medication issues. Telepharmacy and mobile health tools will make it easier for patients—especially those in remote areas—to get the care they need. AI-driven medication management and real-time monitoring apps will improve pharmacist-driven precision medicine. As digital tools grow, they will also empower patients to take charge of their health, strengthening the pharmacist-patient connection and leading to better overall care.
 
At its core, the push for pharmacy interoperability is not just about technology—it's about enhancing lives. For nearly five decades, NCPDP has been at the forefront of this mission, working to bring stakeholders together and develop solutions that prioritize patient well-being. By enabling pharmacists to serve as key connectors, interoperability ensures that patients receive the right care at the right time. Every step forward brings us closer to a healthcare system that values collaboration, efficiency, and above all, the health of the people it serves.