Pay My Bill

Loudoun Medical Group has made it easy for you to pay your medical bill online!
Disclaimer: Our payment portal is supported by IE 10 and IE 11, Firefox, Safari and Chrome.

Patient Information

Patient Name:Name as it appears on your bill

Patient Account Number:Patient account number located on your bill

Practice/Doctor Name:As it appears on your bill

Date of Service:
Not Required. If not filled out, please note that this will be applied to your oldest balance.Format: MM/DD/YY

Payment Amount:

Pay an Additional Bill +

Patient Name:Name as it appears on your bill

Patient Account Number:Patient account number located on your bill

Practice/Doctor Name:As it appears on your bill

Date of Service:
Not Required. If not filled out, please note that this will be applied to your oldest balance.Format: MM/DD/YY

Payment Amount:

Pay an Additional Bill +

Patient Name:Name as it appears on your bill

Patient Account Number:Patient account number located on your bill

Practice/Doctor Name:As it appears on your bill

Date of Service:
Not Required. If not filled out, please note that this will be applied to your oldest balance.Format: MM/DD/YY

Payment Amount:

Pay an Additional Bill +

Patient Name:Name as it appears on your bill

Patient Account Number:Patient account number located on your bill

Practice/Doctor Name:As it appears on your bill

Date of Service:
Not Required. If not filled out, please note that this will be applied to your oldest balance.Format: MM/DD/YY

Payment Amount:

Credit Card Information

Card Holder Name:Name as it appears on your credit card

Card Number:No spaces or dashes

Expiration Date:Format: MMYY

CVV2/CVC:

Street Address:

City:

State:

Zip:

Contact Phone:In the event we need to contact you

Email Address:Where you want your receipt delivered

Grand Total of Payments

By clicking the 'Process Payment' button you are agreeing to allow Loudoun Medical Group to charge the credit card above in the amount below.

Please only press the button once and then wait for further instructions.

Questions?

If you need assistance, please contact our billing department.

703.443.6717 Billing
lmgbilling@lmgdoctors.com

We Proudly Accept

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We take our customer's privacy and security seriously. Learn how we keep your information secure.

Patient Information

Credit Card Information

Grand Total of Payments

Questions?

We Proudly Accept

You're Protected

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