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Medical Bill Payment

Thank you for your payment, and thank you for choosing MIT Health.
Please allow three business days for your payment to be processed.

Statement Number

Patient Name

Responsible Party

Total Amount

First Name

Last Name

Street Address 1

Street Address 2

City

State/Province

Please enter State/Province code (e.g. MA)

Postal Code

Country

Phone Number

Email Address

Upon submission you will be directed to a secure form to enter your payment details.