@juggernautsei, I went back to chrome and noticed some small diffs between your formdata and mine:
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I have a ‘state’ field for the patient info between ‘city’ and ‘postal’ but you don’t
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Your provider has two IDs, repeated twice, once in the ‘qualifier’ field and again in ‘wenoClinicId’. I have one number, also repeated in the same two fields, but it has a colon on the end, like this: “C36275:” This number comes from our globals->connectors->weno erx clinic id, but it does not have a trailing colon there.