Pay My Bill

Loudoun Medical Group has made it easy for you to pay your medical bill online!

Show me where these items
are on my bill

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:Format: MM/DD/YY

Payment Amount:

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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:Format: MM/DD/YY

Payment Amount:

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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: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: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:

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Street Address:

City:

State: VA AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT WA WV WI WY

Zip:

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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

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