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GLOBAL SURGERY CALCULATOR Global Surgery Calculator. Method 2: You can look up your 2021 procedure code global days requirement by using this tool. Enter your procedure code. Alternatively, you can go straight to our Medicare Physicians Fee Schedule Tool and lookup your code there. Warning!Please enter a
NSC - PALMETTO GBASEE MORE ON PALMETTOGBA.COMIVR TRANSLATOR
This IVR conversion tool was created to assist providers in entering the PTAN, beneficiary's Medicare number or name into the IVR. In the fields below, simply type in the PTAN, Medicare number or the first six letters of the beneficiary’s last name exactly as theyPALMETTO GBA
PTAN_STATUS
Your Railroad Medicare PTAN is not active. This tool cannot create a new PTAN if: You are enrolled under your Social Security Number (SSN) instead of a Tax Identification Number (TIN) Your local Part B MAC PTAN is linked to multiple NPIs. In these cases, please call our Provider Contact Center at 888-355-9165 and select Option 3.APPEALS CALCULATOR
Appeals Calculator Self Service Tool. Providers may appeal claims that are partially or fully denied, as long as the claim has ‘appeal rights’. Different levels of appeals have different timelines in which the appeal rights are valid. Note: If the deadline date falls on a Saturday, Sunday, legal holiday, or any other non-work day, thePALMETTO GBA
JURISDICTION M PART APALMETTO GBA
The Redetermination Status tool is available in the Self Service Tools section of the Part B home page. Use this tool to find out if Palmetto GBA has received your Redetermination Request and whether your request is pending or completed. To access, all you need is the Internal Control Number (ICN) from your Medicare Remittance Notice for the PALMETTO GBA-JURISDICTION J PART A MACJURISDICTION J PART B MACJURISDICTION M PART A MAC Palmetto GBA, LLC 17 Technology Circle Columbia, South Carolina 29203TEL (803) 735-1034
GLOBAL SURGERY CALCULATOR Global Surgery Calculator. Method 2: You can look up your 2021 procedure code global days requirement by using this tool. Enter your procedure code. Alternatively, you can go straight to our Medicare Physicians Fee Schedule Tool and lookup your code there. Warning!Please enter a
NSC - PALMETTO GBASEE MORE ON PALMETTOGBA.COMIVR TRANSLATOR
This IVR conversion tool was created to assist providers in entering the PTAN, beneficiary's Medicare number or name into the IVR. In the fields below, simply type in the PTAN, Medicare number or the first six letters of the beneficiary’s last name exactly as theyPALMETTO GBA
PTAN_STATUS
Your Railroad Medicare PTAN is not active. This tool cannot create a new PTAN if: You are enrolled under your Social Security Number (SSN) instead of a Tax Identification Number (TIN) Your local Part B MAC PTAN is linked to multiple NPIs. In these cases, please call our Provider Contact Center at 888-355-9165 and select Option 3.APPEALS CALCULATOR
Appeals Calculator Self Service Tool. Providers may appeal claims that are partially or fully denied, as long as the claim has ‘appeal rights’. Different levels of appeals have different timelines in which the appeal rights are valid. Note: If the deadline date falls on a Saturday, Sunday, legal holiday, or any other non-work day, thePALMETTO GBA
JURISDICTION M PART APALMETTO GBA
The Redetermination Status tool is available in the Self Service Tools section of the Part B home page. Use this tool to find out if Palmetto GBA has received your Redetermination Request and whether your request is pending or completed. To access, all you need is the Internal Control Number (ICN) from your Medicare Remittance Notice for theRAILROAD PROVIDERS
Palmetto GBA Interactive CMS-1500 Claim Form Instructions. Send paper claims to: Palmetto GBA Railroad Medicare. P.O. Box 10066. Augusta, GA 30999-0001. File an eClaim: eServices users also have the ability to submit paperless eClaims through the portal. See section 4.6 of the eServices User Manual (PDF, 8.59 MB) for more information.PALMETTO GBA
Railroad Medicare COVID-19 Hotline: Effective immediately, the Palmetto GBA Railroad Medicare COVID-19 hotline can be reached at 888-882-7931 between the hours of 8:30 a.m. to 7 p.m. ET. Customer Service Representatives can assist with provisional enrollment, as well as providing information about accelerated payment requests.PALMETTO GBA
Some denials can be adjusted via telephone reopening. You may submit your appeal request in writing or through our website using eServices. Railroad Medicare also accepts redetermination requests via fax at (803) 462-2218. First level of appeal: redetermination. Timeframe: 120 days from the receipt of the initial determination.PALMETTO GBA
Provider Enrollment. Palmetto GBA is the Railroad Retirement Board Specialty Medicare Administrative Contactor (RRB SMAC). We process Part B fee-for-service claims for Railroad Medicare beneficiaries nationwide. If you are a Part B Medicare provider, you are eligible to provide care to Railroad Medicare patients, but you will need torequest
PALMETTO GBA
Palmetto GBA Medicare Electronic Data Interchange (EDI) is pleased to offer an online Direct Data Entry (DDE) enrollment form for Jurisdiction M North Carolina Part A, South Carolina Part A and HHH; as well as Jurisdiction J Alabama Part A, Georgia Part APALMETTO GBA
© 2021, Palmetto GBA, LLC INTERACTIVE CMS-1500 The CMS-1500 orm is the standard paper claim orm used by providers or suppliers to bill Medicare Fee-For-Service (FFS) contractors. This interactive guide provides instruction on how to complete the orm. To ensure timely processing o the claim orm, you must ollow the orm instructions and complete all required inormation. Select each eld below or more inormation!PALMETTO GBA
Palmetto GBA is providing a Redetermination: First Level Appeal form for providers to use. While not required, this form may make submitting your redeterminations easier. The form includes all of the required elements for making a valid request, and it will ensure that your request is directed to the proper area once received in ouroffice.
HOME HEALTH PROSPECTIVE PAYMENT SYSTEM Home HealthProspective Payment System. 1: Periods Ending on or After 1/1/21 Episodes Beginning on or After 1/1/20 (PDGM) Episodes Beginning in CY 2019 and Ending CY 2020 Episodes Ending on or After 1/1/19 Episodes Ending on or After 1/1/18 Episodes Ending on or After 1/1/17 Episodes Ending on or After 1/1/16 Episodes Ending on or After 1/1/15 DDE STATUS LOCATIONS DDE Status Locations . Page 2 # Prior Status Prior Location New Status New Location 87. S B0100 S M15MS 88. S B0100 S M1639 89. S B0100 SM1743
GLOBAL SURGERY CALCULATOR Global Surgery Calculator. Method 2: You can look up your 2021 procedure code global days requirement by using this tool. Enter your procedure code. Alternatively, you can go straight to our Medicare Physicians Fee Schedule Tool and lookup your code there. Warning!Please enter a
PALMETTO GBA
PALMETTO GBA
IVR TRANSLATOR
This IVR conversion tool was created to assist providers in entering the PTAN, beneficiary's Medicare number or name into the IVR. In the fields below, simply type in the PTAN, Medicare number or the first six letters of the beneficiary’s last name exactly as theyAPPEALS CALCULATOR
Appeals Calculator Self Service Tool. Providers may appeal claims that are partially or fully denied, as long as the claim has ‘appeal rights’. Different levels of appeals have different timelines in which the appeal rights are valid. Note: If the deadline date falls on a Saturday, Sunday, legal holiday, or any other non-work day, thePTAN_STATUS
Your Railroad Medicare PTAN is not active. This tool cannot create a new PTAN if: You are enrolled under your Social Security Number (SSN) instead of a Tax Identification Number (TIN) Your local Part B MAC PTAN is linked to multiple NPIs. In these cases, please call our Provider Contact Center at 888-355-9165 and select Option 3. JURISDICTION M PART APALMETTO GBA
Palmetto GBA Medicare Electronic Data Interchange (EDI) is pleased to offer an online Direct Data Entry (DDE) enrollment form for Jurisdiction M North Carolina Part A, South Carolina Part A and HHH; as well as Jurisdiction J Alabama Part A, Georgia Part APALMETTO GBA
AMNIOTIC PRODUCT INJECTIONS FOR MUSCULOSKELETAL Amniotic Product Injections for Musculoskeletal Indications-Non-Wound Contractor Advisory Committee (CAC) Meeting Agenda Teleconference OnlyMay 12, 2021
GLOBAL SURGERY CALCULATOR Global Surgery Calculator. Method 2: You can look up your 2021 procedure code global days requirement by using this tool. Enter your procedure code. Alternatively, you can go straight to our Medicare Physicians Fee Schedule Tool and lookup your code there. Warning!Please enter a
PALMETTO GBA
PALMETTO GBA
IVR TRANSLATOR
This IVR conversion tool was created to assist providers in entering the PTAN, beneficiary's Medicare number or name into the IVR. In the fields below, simply type in the PTAN, Medicare number or the first six letters of the beneficiary’s last name exactly as theyAPPEALS CALCULATOR
Appeals Calculator Self Service Tool. Providers may appeal claims that are partially or fully denied, as long as the claim has ‘appeal rights’. Different levels of appeals have different timelines in which the appeal rights are valid. Note: If the deadline date falls on a Saturday, Sunday, legal holiday, or any other non-work day, thePTAN_STATUS
Your Railroad Medicare PTAN is not active. This tool cannot create a new PTAN if: You are enrolled under your Social Security Number (SSN) instead of a Tax Identification Number (TIN) Your local Part B MAC PTAN is linked to multiple NPIs. In these cases, please call our Provider Contact Center at 888-355-9165 and select Option 3. JURISDICTION M PART APALMETTO GBA
Palmetto GBA Medicare Electronic Data Interchange (EDI) is pleased to offer an online Direct Data Entry (DDE) enrollment form for Jurisdiction M North Carolina Part A, South Carolina Part A and HHH; as well as Jurisdiction J Alabama Part A, Georgia Part APALMETTO GBA
AMNIOTIC PRODUCT INJECTIONS FOR MUSCULOSKELETAL Amniotic Product Injections for Musculoskeletal Indications-Non-Wound Contractor Advisory Committee (CAC) Meeting Agenda Teleconference OnlyMay 12, 2021
PALMETTO GBA
This is the Jurisdiction 11 Part A home page. The Centers for Medicare & Medicaid Services (CMS) is implementing prior authorization to test whether prior authorization helps reduce expenditures, while maintaining or improving access to and quality of care.PALMETTO GBA
Railroad Medicare COVID-19 Hotline: Effective immediately, the Palmetto GBA Railroad Medicare COVID-19 hotline can be reached at 888-882-7931 between the hours of 8:30 a.m. to 7 p.m. ET. Customer Service Representatives can assist with provisional enrollment, as well as providing information about accelerated payment requests.RAILROAD PROVIDERS
Palmetto GBA Interactive CMS-1500 Claim Form Instructions. Send paper claims to: Palmetto GBA Railroad Medicare. P.O. Box 10066. Augusta, GA 30999-0001. File an eClaim: eServices users also have the ability to submit paperless eClaims through the portal. See section 4.6 of the eServices User Manual (PDF, 8.59 MB) for more information.PALMETTO GBA
Providers Enrolled in Medicare in Approved or Opt-Out Status Website. Provider Enrollment Resources. PECOS - Click here to enroll, change your Medicare information, and add or delete group members or locations. Then print, sign and date the two-page Certification Statement, and mail the Certification Statement and all supporting paper documentation to Palmetto GBA within seven days ofPALMETTO GBA
Some denials can be adjusted via telephone reopening. You may submit your appeal request in writing or through our website using eServices. Railroad Medicare also accepts redetermination requests via fax at (803) 462-2218. First level of appeal: redetermination. Timeframe: 120 days from the receipt of the initial determination.PALMETTO GBA
Direct Data Entry (DDE) IDs DDE User ID numbers are assigned to individuals at each facility who utilize the DDE system. Each user must have an individual DDE User ID. One ID can access multiple provider numbers. For security reasons, you must not share your DDEUser ID.
JURISDICTION M HHH
Claims Payment Issues Log. Here is a list of system-related claims payment and processing issues. These issues have been reported to the Centers for Medicare & Medicaid Services (CMS) and/or the Fiscal Intermediary Standard System (FISS). Please check often for updates before contacting the provider contact center.RAILROAD PROVIDERS
Answer Railroad Medicare does not require or process forms to set up electronic funds transfer (EFT), or to make changes to EFT bank account information. Railroad Medicare EFT is set up using the bank account information that is on file for the provider with your local Part B Medicare Administrative Contractor (MAC).PALMETTO GBA
The Redetermination Status tool is available in the Self Service Tools section of the Part B home page. Use this tool to find out if Palmetto GBA has received your Redetermination Request and whether your request is pending or completed. To access, all you need is the Internal Control Number (ICN) from your Medicare Remittance Notice for thePALMETTO GBA
The table of risk lists drug therapy requiring intensive monitoring for toxicity as a high risk management option. For drugs with a well-defined clinical response and a high therapeutic index (i.e., low toxicity), intensive therapeutic drug monitoring is not necessary. GLOBAL SURGERY CALCULATOR Global Surgery Calculator. Method 2: You can look up your 2021 procedure code global days requirement by using this tool. Enter your procedure code. Alternatively, you can go straight to our Medicare Physicians Fee Schedule Tool and lookup your code there. Warning!Please enter a
NSC - PALMETTO GBASEE MORE ON PALMETTOGBA.COMPALMETTO GBA
IVR TRANSLATOR
This IVR conversion tool was created to assist providers in entering the PTAN, beneficiary's Medicare number or name into the IVR. In the fields below, simply type in the PTAN, Medicare number or the first six letters of the beneficiary’s last name exactly as theyPALMETTO GBA
PALMETTO GBA
© 2021, Palmetto GBA, LLCPTAN_STATUS
Your Railroad Medicare PTAN is not active. This tool cannot create a new PTAN if: You are enrolled under your Social Security Number (SSN) instead of a Tax Identification Number (TIN) Your local Part B MAC PTAN is linked to multiple NPIs. In these cases, please call our Provider Contact Center at 888-355-9165 and select Option 3.PALMETTO GBA
PALMETTO GBA
The Redetermination Status tool is available in the Self Service Tools section of the Part B home page. Use this tool to find out if Palmetto GBA has received your Redetermination Request and whether your request is pending or completed. To access, all you need is the Internal Control Number (ICN) from your Medicare Remittance Notice for the AMNIOTIC PRODUCT INJECTIONS FOR MUSCULOSKELETAL Amniotic Product Injections for Musculoskeletal Indications-Non-Wound Contractor Advisory Committee (CAC) Meeting Agenda Teleconference OnlyMay 12, 2021
GLOBAL SURGERY CALCULATOR Global Surgery Calculator. Method 2: You can look up your 2021 procedure code global days requirement by using this tool. Enter your procedure code. Alternatively, you can go straight to our Medicare Physicians Fee Schedule Tool and lookup your code there. Warning!Please enter a
NSC - PALMETTO GBASEE MORE ON PALMETTOGBA.COMPALMETTO GBA
IVR TRANSLATOR
This IVR conversion tool was created to assist providers in entering the PTAN, beneficiary's Medicare number or name into the IVR. In the fields below, simply type in the PTAN, Medicare number or the first six letters of the beneficiary’s last name exactly as theyPALMETTO GBA
PALMETTO GBA
© 2021, Palmetto GBA, LLCPTAN_STATUS
Your Railroad Medicare PTAN is not active. This tool cannot create a new PTAN if: You are enrolled under your Social Security Number (SSN) instead of a Tax Identification Number (TIN) Your local Part B MAC PTAN is linked to multiple NPIs. In these cases, please call our Provider Contact Center at 888-355-9165 and select Option 3.PALMETTO GBA
PALMETTO GBA
The Redetermination Status tool is available in the Self Service Tools section of the Part B home page. Use this tool to find out if Palmetto GBA has received your Redetermination Request and whether your request is pending or completed. To access, all you need is the Internal Control Number (ICN) from your Medicare Remittance Notice for the AMNIOTIC PRODUCT INJECTIONS FOR MUSCULOSKELETAL Amniotic Product Injections for Musculoskeletal Indications-Non-Wound Contractor Advisory Committee (CAC) Meeting Agenda Teleconference OnlyMay 12, 2021
PALMETTO GBA
Railroad Medicare COVID-19 Hotline: Effective immediately, the Palmetto GBA Railroad Medicare COVID-19 hotline can be reached at 888-882-7931 between the hours of 8:30 a.m. to 7 p.m. ET. Customer Service Representatives can assist with provisional enrollment, as well as providing information about accelerated payment requests.PALMETTO GBA
Some denials can be adjusted via telephone reopening. You may submit your appeal request in writing or through our website using eServices. Railroad Medicare also accepts redetermination requests via fax at (803) 462-2218. First level of appeal: redetermination. Timeframe: 120 days from the receipt of the initial determination.PALMETTO GBA
Form Finder. Please select an answer for each of the questions that will be shown below. You will be directed to the correct form based upon your answer to each of the questions. These forms should only be submitted to regarding beneficiaries or claims using the instructions at the bottom of the form. To change your answer to a previous question, click on the question text.PALMETTO GBA
Provider Enrollment. Palmetto GBA is the Railroad Retirement Board Specialty Medicare Administrative Contactor (RRB SMAC). We process Part B fee-for-service claims for Railroad Medicare beneficiaries nationwide. If you are a Part B Medicare provider, you are eligible to provide care to Railroad Medicare patients, but you will need torequest
277CA EDIT LOOKUP TOOL 277CA Edit Lookup Tool. The 277CA Edit Lookup Tool will assist you with Medicare Fee-For-Service (FFS) Part A and Part B edits produced via the ASC X12 Version 5010PALMETTO GBA
Palmetto GBA is providing a Redetermination: First Level Appeal form for providers to use. While not required, this form may make submitting your redeterminations easier. The form includes all of the required elements for making a valid request, and it will ensure that your request is directed to the proper area once received in ouroffice.
JURISDICTION M PART A Attn: Cost Report Acceptance (AG-390) Post Office Box 100307. Columbia, SC 29202–3307. Amended cost reports. Amended cost reports follow the same process and can be filed through MCRef (for cost reporting periods ending on or after 12/31/2017) or through the HOME HEALTH PROSPECTIVE PAYMENT SYSTEM Home HealthProspective Payment System. 1: Periods Ending on or After 1/1/21 Episodes Beginning on or After 1/1/20 (PDGM) Episodes Beginning in CY 2019 and Ending CY 2020 Episodes Ending on or After 1/1/19 Episodes Ending on or After 1/1/18 Episodes Ending on or After 1/1/17 Episodes Ending on or After 1/1/16 Episodes Ending on or After 1/1/15 EMERGENCY AMBULANCE SERVICES: REGULATIONS AND REQUIRED As a result of CR 9761, ‘Ambulance Staffing Requirements’, effective January 1, 2017, revisions were made to ambulance vehicle/ staffing requirements. DDE STATUS LOCATIONS DDE Status Locations . Page 2 # Prior Status Prior Location New Status New Location 87. S B0100 S M15MS 88. S B0100 S M1639 89. S B0100 SM1743
GLOBAL SURGERY CALCULATOR Global Surgery Calculator. Method 2: You can look up your 2021 procedure code global days requirement by using this tool. Enter your procedure code. Alternatively, you can go straight to our Medicare Physicians Fee Schedule Tool and lookup your code there. Warning!Please enter a
NSC - PALMETTO GBASEE MORE ON PALMETTOGBA.COMIVR TRANSLATOR
This IVR conversion tool was created to assist providers in entering the PTAN, beneficiary's Medicare number or name into the IVR. In the fields below, simply type in the PTAN, Medicare number or the first six letters of the beneficiary’s last name exactly as theyPALMETTO GBA
PALMETTO GBA
PALMETTO GBA
PALMETTO GBA
PALMETTO GBA
PTAN_STATUS
Your Railroad Medicare PTAN is not active. This tool cannot create a new PTAN if: You are enrolled under your Social Security Number (SSN) instead of a Tax Identification Number (TIN) Your local Part B MAC PTAN is linked to multiple NPIs. In these cases, please call our Provider Contact Center at 888-355-9165 and select Option 3.PALMETTO GBA
The Redetermination Status tool is available in the Self Service Tools section of the Part B home page. Use this tool to find out if Palmetto GBA has received your Redetermination Request and whether your request is pending or completed. To access, all you need is the Internal Control Number (ICN) from your Medicare Remittance Notice for the GLOBAL SURGERY CALCULATOR Global Surgery Calculator. Method 2: You can look up your 2021 procedure code global days requirement by using this tool. Enter your procedure code. Alternatively, you can go straight to our Medicare Physicians Fee Schedule Tool and lookup your code there. Warning!Please enter a
NSC - PALMETTO GBASEE MORE ON PALMETTOGBA.COMIVR TRANSLATOR
This IVR conversion tool was created to assist providers in entering the PTAN, beneficiary's Medicare number or name into the IVR. In the fields below, simply type in the PTAN, Medicare number or the first six letters of the beneficiary’s last name exactly as theyPALMETTO GBA
PALMETTO GBA
PALMETTO GBA
PALMETTO GBA
PALMETTO GBA
PTAN_STATUS
Your Railroad Medicare PTAN is not active. This tool cannot create a new PTAN if: You are enrolled under your Social Security Number (SSN) instead of a Tax Identification Number (TIN) Your local Part B MAC PTAN is linked to multiple NPIs. In these cases, please call our Provider Contact Center at 888-355-9165 and select Option 3.PALMETTO GBA
The Redetermination Status tool is available in the Self Service Tools section of the Part B home page. Use this tool to find out if Palmetto GBA has received your Redetermination Request and whether your request is pending or completed. To access, all you need is the Internal Control Number (ICN) from your Medicare Remittance Notice for theNSC - PALMETTO GBA
The National Supplier Clearinghouse is the single organizational entity responsible for issuing or revoking Medicare supplier billing privileges for suppliers of Durable Medical Equipment, Orthotics and Supplies (DMEPOS). NSC Application Status Tool New Supplier Enrollment Register for NSC Webinars. Appeals Process Licensure DatabaseNewsletters.
PALMETTO GBA
This is the Jurisdiction 11 Part A home page. The Centers for Medicare & Medicaid Services (CMS) is implementing prior authorization to test whether prior authorization helps reduce expenditures, while maintaining or improving access to and quality of care.PALMETTO GBA
Some denials can be adjusted via telephone reopening. You may submit your appeal request in writing or through our website using eServices. Railroad Medicare also accepts redetermination requests via fax at (803) 462-2218. First level of appeal: redetermination. Timeframe: 120 days from the receipt of the initial determination.PALMETTO GBA
The telephone hotline 1-833-820-6138 has been created for providers and suppliers to initiate provisional temporary Medicare billing privileges and address questions regarding provider enrollment flexibilities afforded by the COVID-19 waiver. The hotline is available Monday through Friday, from 8:30 a.m. to MEDICARE PHYSICIAN FEE SCHEDULE PART B Medicare Physician Fee Schedule Part B. April - 2021. This fee was accessed on 5/10/2021 at 9:35:22 p.m. using the Palmetto GBA Medicare Fee Schedule Part B Lookup Tool. CMS updates and corrects fees often, which may mean the information below is out of date. You should always used the most up-to-date fee schedules, which are available onlinePALMETTO GBA
© 2021, Palmetto GBA, LLCPALMETTO GBA
Learn how to enroll as a Railroad Medicare provider. We frequently update our articles to reflect the latest changes and updates to Medicare, and strongly recommend you visit this article at link below to confirm you have the latest version.PALMETTO GBA
Direct Data Entry (DDE) IDs DDE User ID numbers are assigned to individuals at each facility who utilize the DDE system. Each user must have an individual DDE User ID. One ID can access multiple provider numbers. For security reasons, you must not share your DDEUser ID.
277CA EDIT LOOKUP TOOL 277CA Edit Lookup Tool. The 277CA Edit Lookup Tool will assist you with Medicare Fee-For-Service (FFS) Part A and Part B edits produced via the ASC X12 Version 5010PALMETTO GBA
Palmetto GBA is providing a Redetermination: First Level Appeal form for providers to use. While not required, this form may make submitting your redeterminations easier. The form includes all of the required elements for making a valid request, and it will ensure that your request is directed to the proper area once received in ouroffice.
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Jurisdiction J Part A MAC Jurisdiction J Part B MAC Jurisdiction M Part A MAC Jurisdiction M Part B MAC Jurisdiction M Home Health and Hospice MAC MolDX® National SupplierClearingÂhouse MAC
Pricing, Data Analysis, and Coding (PDAC) RRB Specialty MAC Beneficiaries RRB Specialty MAC Providers DMEPOS Competitive Bidding ProgramFront
End System Coverage Gap Discount Program Third Party AdministratorPALMETTO GBA, LLC
17 Technology Circle Columbia, South Carolina 29203TEL (803) 735-1034
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