Patient Notebook

Inland Imaging LLC

PO Box 371863

Pittsburgh, PA 15250

Phone: (888) 737 - 4455

Make a Payment

Need to make a payment? Please fill out the information below and hit continue.

Error Summary

Please, correctly fill out all required fields.

1. Patient Information

First Name *

M.I.

Last Name *

Account Number

Medicalis MRN (with dashes)

00-00-00-00

Email Address *

A receipt will be sent to this email address.

2. Payment Amount

Amount

$25.00 minimum monthly payment is required

3. Payment Method

Credit/Debit Card

Name on Card *

Card Number *

Expiration Date *

Security Code *

Zip Code *

Cancel