Pay Your Bill

To pay your bill, complete the fields below and press "submit payment." For all billing or payment inquiries, please contact Scopo Services, Inc. at 844-217-7204 or nbinetti@scoposervices.com

Payment Detail

PAYMENT AMOUNT *

BILL STATEMENT NUMBER *

Patient Information

PATIENT NAME (if different from cardholder)

PATIENT EMAIL (if different from cardholder)

PHONE (if different from cardholder)

DATE OF BIRTH

Card Information

NAME ON CARD *

CREDIT CARD NUMBER *

EXPIRATION DATE *

CVV *

Billing Address

EMAIL *

ADDRESS *

CITY *

COUNTRY *

STATE *

ZIP / POSTAL CODE *

PHONE *

Payment Amount

$0.00

By clicking “Submit Payment”, you agree to pay the above amount and provide your information to help us process your payment and detect fraud. Please see our Privacy Policy for more information on our data practices.

SUBMIT PAYMENT

Hirahara MD Homepage

For Patients

Pay Your Bill