PPRNet Reports

PPRNet Report Payment Form

Practice Information

Practice ID*

Practice Name*

Contact Name*

Contact Email*

List name and address as it appears on the credit card.

Cardholder First Name*

Cardholder Last Name*

Address*

Address 2

City*

State*

Zip*

Fees:

Monthly Reports - Select number of providers indicated on invoice

Number of providers

Custom Reports

Exclude Providers Report - $500

Custom Report (enter amount on invoice) $_____.00

Credit card payments will be directed to the SC.gov website for secure payment processing.
You will receive a receipt from SC.gov.

For questions contact us at pprnet@musc.edu or call 843-876-1212.