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www2.patientpay.net Open in urlscan Pro
18.172.112.89  Public Scan

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Submitted URL: https://ppay.onl/mRJofg
Effective URL: https://www2.patientpay.net/security/login/token/CE278448DEB229CEEC8ADB3F5EF61C6DDB3DE95A19D34BCC4C5A89CFC5BFC460635D52CE119...
Submission: On May 21 via manual from US — Scanned from NL

Form analysis 1 forms found in the DOM

<form _ngcontent-qlp-c192="" novalidate="" class="login2-form ng-tns-c192-0 ng-untouched ng-pristine ng-invalid ng-star-inserted" style=""><mat-form-field _ngcontent-qlp-c192="" appearance="outline"
    class="mat-form-field form-element ng-tns-c192-0 ng-tns-c112-1 mat-primary mat-form-field-type-mat-input mat-form-field-appearance-outline mat-form-field-can-float mat-form-field-has-label mat-form-field-hide-placeholder ng-untouched ng-pristine ng-invalid ng-star-inserted">
    <div class="mat-form-field-wrapper ng-tns-c112-1">
      <div class="mat-form-field-flex ng-tns-c112-1">
        <div class="mat-form-field-outline ng-tns-c112-1 ng-star-inserted">
          <div class="mat-form-field-outline-start ng-tns-c112-1" style="width: 7px;"></div>
          <div class="mat-form-field-outline-gap ng-tns-c112-1" style="width: 125.5px;"></div>
          <div class="mat-form-field-outline-end ng-tns-c112-1"></div>
        </div>
        <div class="mat-form-field-outline mat-form-field-outline-thick ng-tns-c112-1 ng-star-inserted">
          <div class="mat-form-field-outline-start ng-tns-c112-1" style="width: 7px;"></div>
          <div class="mat-form-field-outline-gap ng-tns-c112-1" style="width: 125.5px;"></div>
          <div class="mat-form-field-outline-end ng-tns-c112-1"></div>
        </div><!----><!----><!---->
        <div class="mat-form-field-infix ng-tns-c112-1"><input _ngcontent-qlp-c192="" type="tel" matinput="" formcontrolname="dob" appmaskdate=""
            class="mat-input-element mat-form-field-autofill-control mat-datepicker-input fs-exclude ng-tns-c112-1 ng-untouched ng-pristine ng-invalid cdk-text-field-autofill-monitored" aria-describedby="mat-hint-0" required="" id="mat-input-0"
            data-placeholder="MM/DD/YYYY" aria-required="true" min="1900-01-01T00:00:00+00:00" max="2024-05-22T00:27:12+02:00"><span class="mat-form-field-label-wrapper ng-tns-c112-1"><label
              class="mat-form-field-label ng-tns-c112-1 mat-empty mat-form-field-empty ng-star-inserted" id="mat-form-field-label-1" for="mat-input-0" aria-owns="mat-input-0"><!----><mat-label _ngcontent-qlp-c192=""
                class="ng-tns-c112-1 ng-star-inserted">Your Date of Birth</mat-label><!----><span aria-hidden="true" class="mat-placeholder-required mat-form-field-required-marker ng-tns-c112-1 ng-star-inserted"> *</span><!----></label><!----></span>
        </div><!---->
      </div><!---->
      <div class="mat-form-field-subscript-wrapper ng-tns-c112-1"><!---->
        <div class="mat-form-field-hint-wrapper ng-tns-c112-1 ng-trigger ng-trigger-transitionMessages ng-star-inserted" style="opacity: 1; transform: translateY(0%);"><!----><mat-hint _ngcontent-qlp-c192=""
            class="mat-hint ng-tns-c112-1 ng-star-inserted" id="mat-hint-0" style="">Use MM/DD/YYYY format</mat-hint><!---->
          <div class="mat-form-field-hint-spacer ng-tns-c112-1"></div>
        </div><!---->
      </div>
    </div>
  </mat-form-field><button _ngcontent-qlp-c192="" mat-flat-button="" color="primary" class="mat-focus-indicator login-btn ng-tns-c192-0 mat-flat-button mat-button-base mat-primary"><span class="mat-button-wrapper"><span _ngcontent-qlp-c192=""
        class="ng-tns-c192-0 ng-star-inserted">View Bill</span><!----><!----></span><span matripple="" class="mat-ripple mat-button-ripple"></span><span class="mat-button-focus-overlay"></span></button></form>

Text Content

To securely view your bill, enter your date of birth.

Your Date of Birth *
Use MM/DD/YYYY format

View Bill
Billing Provided by
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