65"]},{"conversions":{"T":"Yes"},"field":"accepting_new_patients","ignore":["F"],"input_type":"radio"},{"field":"lgbtq_friendly","ignore":[null,"No"]},{"field":"languages.language","order_by":"frequency"},{"field":"gender","ignore":["Unknown"],"input_type":"radio"},{"field":"provider_type","input_type":"typeahead","order_by":"frequency"},{"conversions":{},"field":"specialties.specialty.untouched","ignore":[],"input_type":"typeahead","max_visible":5,"name":"Specialties","order_by":"alphanumeric","order_by_custom":[],"show_count":true,"titlecase":false,"typeahead":{"all_filters_label":"","placeholder":"","top_filters":[],"top_filters_label":""}}],"facets_v9":[{"conversions":{"T":"Book Online"},"field":"provider.direct_book_capable","ignore":["false"],"input_type":"checkbox","name":"Book Online"},{"field":"provider.insurance_accepted","input_type":"typeahead","order_by":"alphanumeric"},{"field":"provider.age_groups_seen","order_by_custom":["Infant 0-2","Child 2-12","Adolescent 12-17","Adult 18-65","Older Adult >65"]},{"conversions":{"T":"Yes"},"field":"provider.accepting_new_patients","ignore":["false"],"input_type":"radio"},{"field":"provider.lgbtq_friendly","ignore":[null,"No"]},{"field":"provider.languages","order_by":"frequency"},{"field":"provider.gender","ignore":["Unknown"],"input_type":"radio"},{"field":"provider.provider_type","input_type":"typeahead","order_by":"frequency"},{"field":"provider.specialties.name","input_type":"typeahead","order_by":"alphanumeric","titlecase":false}],"gxv2_enabled":true,"index":"2201aydz_pmc","insurance_disclaimer":{"enabled":true},"location_facet":{"miles":"25","options":["Any","5","10","25","50","100"]},"logos":[{"field":"provider_is_employed","logo_map":[{"img_url":"https://cdn.kyruus.com/pmc-customer-static-assets/2201aydz/images/1.3/KyruusOverlakeProviderImage_330x150.png","value":"True"}],"show_in_profile":true,"show_in_search_results":true}],"logos_v9":[{"field":"provider_is_employed","logo_map":[{"img_url":"https://cdn.kyruus.com/pmc-customer-static-assets/2201aydz/images/1.3/KyruusOverlakeProviderImage_330x150.png","value":true}],"show_in_profile":true,"show_in_search_results":true}],"modal_display":{"book_online_url":true,"hide_cta":true,"phone":false,"request_form_url":false,"show_book_online_only_with_availability":true,"skip_modal":false,"virtual_care":true},"provider":{"badge_data":[{"field":"accepting_new_patients"},{"field":"lgbtq_friendly","ignore":[null,"No"]}],"summary_data":[{"field":"specialties","secondary_subfield":"subspecialty","subfield":"specialty"},{"field":"about_the_provider","field_type":"rich_text"},{"field":"awards","field_type":"rich_text"},{"field":"gender","ignore":["Unknown"]},{"field":"languages","subfield":"language"},{"field":"age_groups_seen","subfield":"name"},{"field":"provider_organizations"},{"field":"network_affiliations.name"}],"tabs":[{"content":"provider/tab/summary","data":{"role":"profile"},"href":"profile"},{"content":"provider/tab/locations","data":{"role":"locations"},"href":"locations"},{"content":"provider/tab/experience","data":{"role":"experience"},"href":"experience"},{"content":"provider/tab/insurance","data":{"role":"insurance"},"href":"insurance"}]},"provider_v9":{"badge_data":[{"field":"accepting_new_patients"},{"field":"lgbtq_friendly","ignore":[null,"No"]}],"summary_data":[{"field":"specialties","secondary_subfield":"subspecialty","subfield":"specialty"},{"field":"about_the_provider","field_type":"rich_text"},{"field":"gender","ignore":["Unknown"]},{"field":"languages","subfield":"language"},{"field":"age_groups_seen","subfield":"name"},{"field":"provider_organizations"},{"field":"network_affiliations.name"}],"tabs":[{"content":"provider/tab/summary","data":{"role":"profile"},"href":"profile"},{"content":"provider/tab/locations","data":{"role":"locations"},"href":"locations"},{"content":"provider/tab/experience","data":{"role":"experience"},"href":"experience"},{"content":"provider/tab/insurance","data":{"role":"insurance"},"href":"insurance"}]},"search_results_page":{"summary_data":[{"field":"specialties","secondary_subfield":"subspecialty","subfield":"specialty"},{"field":"pronouns"}]},"search_results_page_v9":{"search_facet_chips":true,"summary_data":[{"field":"specialties","secondary_subarray":"subspecialties","secondary_subfield":"name","subfield":"name"},{"field":"pronouns"}]},"search_widget":{"allow_empty_search":true,"persist_query":true,"show_location":false,"sort_order":"networks,relevance","typeahead_categories":[{"category":"clinical_experience"},{"category":"specialty_synonym"},{"category":"name"},{"category":"practice_group"},{"category":"network_affiliation"},{"category":"practice_location"},{"category":"primary_care"}],"use_primary_care_condition":false},"social_share":{"email":true,"facebook":true,"twitter":true},"sort_options":["best_match","distance","alphabetical","reverse_alphabetical"],"theme":{"color_background_badge":"#0077C8","color_button":"#1b365d","color_button_hover":"#1b365d","color_button_quaternary":"color_providermatch_quaternary","color_button_quaternary_disabled":"color_providermatch_quaternary","color_button_quaternary_hover":"color_providermatch_quaternary","color_button_tertiary":"color_providermatch_tertiary","color_button_tertiary_disabled":"color_providermatch_tertiary","color_button_tertiary_hover":"color_providermatch_tertiary","color_link":"#02466b","color_link_hover":"#02466b","color_providermatch":"#C9D7EE","color_providermatch_quaternary":"#25C159","color_providermatch_tertiary":"#0077C8","provider_profile_border_radius":"5px","provider_profile_border_style":"solid","provider_profile_border_width":"1px","provider_profile_box_shadow":"0px -2px 4px -1px rgba(0, 0, 0, 0.06)","provider_profile_color_background":"#FFFFFF","provider_profile_color_border":"#E5E5E5","provider_profile_provider_image_border_radius":"50%","sw_color_bg_container":"#0077c8","sw_color_button":"#1b365d","sw_color_label":"#FFFFFF"},"third_party":{"mychart":{"db_login":{"common_url_params":{"client_id":"cb56c88f-ad05-4ac2-bd26-0a33e3afff88","redirect_uri":"https://pmc-2201aydz.provider-match.com/redirect"},"enabled":true,"login_url_base":"https://sfd.overlakehospital.org/FHIRproxy/oauth2/authorize","login_url_params":{"aud":"urn:ohmc:ce-prd"},"show_proxy_booking_controls":false},"issuer_to_source_system":{"urn:ohmc:ce-prd":"epic"}}},"display_availability_in_search":false,"enable_read_only_availability":false,"darkship_display_providers_on_locations_page":false,"darkship_KENG_31725":false,"emergency_disclaimer_md":{"enabled":false},"hide_availability_density":false,"insurance_information_link_href":null,"KENG_38276_show_search_suggestions_v9":false,"locale":"en-US","logging_metadata":{"init_metadata":{"product_name":"Providermatch Client","deployment":"prd","customer_code":"2201aydz","user_id":"a65c0422-7a21-4732-9d95-e983f100cea5","tracking_token":"0b2b7186-87bc-4bf9-981f-91e4a667bcb0"},"event_metadata":{"user_type":"Anonymous","customer_id":"2201aydz","actor":"2201aydz","distinct_id":"c172cba9-d056-5285-a751-26592eacd3da","search_token":"e4fdf3c3-0303-4756-9edb-7656d72f451c","user_token":"a65c0422-7a21-4732-9d95-e983f100cea5"}},"minimum_appointment_purposes_for_filter":null,"persona":"consumer","show_powered_by_kyruus_logo":true,"search_home":"/","show_dbw_appt_time_alt_providers":false,"show_provider_profile_alt_providers":false,"skip_db_enablement_check":false,"host":"//www.drc-me.com/providers","direct_book":{"allow_cancellation":false,"darkship__KENG_6874":true,"direct_book_enabled":true,"editable_demographic_fields":[{"isRequired":true,"label":"Phone Number","subFields":{"phone":{"countryFormat":"US","invalidMsg":"Phone format (999) 999-9999","isRequired":true,"isRequiredMsg":"Phone is required","path":"patient.phone.number","placeholder":"(___) ___-____"}},"type":"phone","width":"l"},{"confirm":{"invalidMsg":"Email addresses do not match","isRequired":true,"isRequiredMsg":"Email is required","label":"Confirm Email","path":"patient.confirmEmail","placeholder":"username@email.com"},"invalidMsg":"Email format address@example.com","isReadOnly":false,"isRequired":true,"isRequiredMsg":"Email is required","label":"Email","path":"patient.email","placeholder":"username@email.com","type":"email"},{"group":"Insurance 1","isRequired":true,"isRequiredMsg":"Insurance name is required","label":"Primary Insurance","options":[{"label":"Aetna","value":"Aetna"},{"label":"Aetna Premier Care Network","value":"Aetna Premier Care Network"},{"label":"Aetna Premier Care Network PLUS","value":"Aetna Premier Care Network PLUS"},{"label":"Aetna Whole Health","value":"Aetna Whole Health"},{"label":"PacMed, PolyClinic, Providence/Swedish, Rainier Health Network","value":"PacMed, PolyClinic, Providence/Swedish, Rainier Health Network"},{"label":"Altius Health Plans (Coventry - First Health - Aetna)","value":"Altius Health Plans (Coventry - First Health - Aetna)"},{"label":"America's Health Plan","value":"America's Health Plan"},{"label":"Assurant Health (First Choice)","value":"Assurant Health (First Choice)"},{"label":"Asuris Health Plan (Regence)","value":"Asuris Health Plan (Regence)"},{"label":"Avizent","value":"Avizent"},{"label":"Beechstreet (First Choice)","value":"Beechstreet (First Choice)"},{"label":"Berkley Risk Administrators","value":"Berkley Risk Administrators"},{"label":"Boeing - BCBS of IL Standard PPO","value":"Boeing - BCBS of IL Standard PPO"},{"label":"Boeing - BCBS - Select Network EPO","value":"Boeing - BCBS - Select Network EPO"},{"label":"Boeing - BCBS - Traditional Medical","value":"Boeing - BCBS - Traditional Medical"},{"label":"Boeing - BCBS - Advantage+","value":"Boeing - BCBS - Advantage+"},{"label":"BlueCross/Blue Shield Out-of-State (BlueCard)","value":"BlueCross/Blue Shield Out-of-State (BlueCard)"},{"label":"Christian Brothers (Aetna)","value":"Christian Brothers (Aetna)"},{"label":"CIGNA","value":"CIGNA"},{"label":"CIGNA Local/Local Plus","value":"CIGNA Local/Local Plus"},{"label":"Coordinated Care/Centene Ambetter","value":"Coordinated Care/Centene Ambetter"},{"label":"Coventry/CCN (Aetna)","value":"Coventry/CCN (Aetna)"},{"label":"Crawford & Co.","value":"Crawford & Co."},{"label":"Definity Health (United Healthcare)","value":"Definity Health (United Healthcare)"},{"label":"Eberle Vivian","value":"Eberle Vivian"},{"label":"Employee Benefit Mgmt. Services (First Choice)","value":"Employee Benefit Mgmt. Services (First Choice)"},{"label":"Evergreen Health (First Choice)","value":"Evergreen Health (First Choice)"},{"label":"Fidelity (First Choice)","value":"Fidelity (First Choice)"},{"label":"First Choice Health Network","value":"First Choice Health Network"},{"label":"First Choice Health Preferred Network ","value":"First Choice Health Preferred Network "},{"label":"First Health (Coventry - Aetna)","value":"First Health (Coventry - Aetna)"},{"label":"Gallagher Basset Services","value":"Gallagher Basset Services"},{"label":"Greatwest (CIGNA)","value":"Greatwest (CIGNA)"},{"label":"Health Payor Organization (HPO)","value":"Health Payor Organization (HPO)"},{"label":"Healthcare Management Administrators (HMA) (Regence)","value":"Healthcare Management Administrators (HMA) (Regence)"},{"label":"Healthnet (First Choice)","value":"Healthnet (First Choice)"},{"label":"Healthsmart","value":"Healthsmart"},{"label":"Humana Choice Care","value":"Humana Choice Care"},{"label":"INBA (First Choice)","value":"INBA (First Choice)"},{"label":"Kaiser Foundation Health Plan of Washington - HMO plans - Core, Alliant Select, Options Select*","value":"Kaiser Foundation Health Plan of Washington - HMO plans - Core, Alliant Select, Options Select*"},{"label":"Kaiser Foundation Health Plan of Washington - POS plans - Options, Alliant Plus/Connect*","value":"Kaiser Foundation Health Plan of Washington - POS plans - Options, Alliant Plus/Connect*"},{"label":"Kaiser Foundation Health Plan of Washington Options, Inc. - PPO plans - Access PPO, Options PPO*","value":"Kaiser Foundation Health Plan of Washington Options, Inc. - PPO plans - Access PPO, Options PPO*"},{"label":"Kaiser Foundation Health Plan of Washington - Cascade, Virtual Pulse, Flex, Core, HAS, 21 (Health Exchange)*","value":"Kaiser Foundation Health Plan of Washington - Cascade, Virtual Pulse, Flex, Core, HAS, 21 (Health Exchange)*"},{"label":"King County Safety & Claims","value":"King County Safety & Claims"},{"label":"Kitsap Health Plans (First Choice)","value":"Kitsap Health Plans (First Choice)"},{"label":"Lifewise Health Plan of WA - Preferred","value":"Lifewise Health Plan of WA - Preferred"},{"label":"Lifewise Assurance Co","value":"Lifewise Assurance Co"},{"label":"Lifewise of OR","value":"Lifewise of OR"},{"label":"Moda Health Plans (First Choice)","value":"Moda Health Plans (First Choice)"},{"label":"Molina Marketplace (Cascade, Core, Constant, Choice) (Health Exchange)","value":"Molina Marketplace (Cascade, Core, Constant, Choice) (Health Exchange)"},{"label":"MultiPlan","value":"MultiPlan"},{"label":"National Preferred Provider Network (NPPN)","value":"National Preferred Provider Network (NPPN)"},{"label":"Pacificsource","value":"Pacificsource"},{"label":"Preferred Health Network (PHN)","value":"Preferred Health Network (PHN)"},{"label":"Premera Blue Cross PPO*","value":"Premera Blue Cross PPO*"},{"label":"Private Health Care Systems (PHCS)","value":"Private Health Care Systems (PHCS)"},{"label":"Regence Group Adminstrators","value":"Regence Group Adminstrators"},{"label":"Regence Blue Shield PPO","value":"Regence Blue Shield PPO"},{"label":"Regence Uniform Medical Plan (UMP) Classic","value":"Regence Uniform Medical Plan (UMP) Classic"},{"label":"Regence Uniform Medical Plan (UMP) Achieve 1 & 2","value":"Regence Uniform Medical Plan (UMP) Achieve 1 & 2"},{"label":"Regence Uniform Medical Plan (UMP) High Deductible or CDHP","value":"Regence Uniform Medical Plan (UMP) High Deductible or CDHP"},{"label":"Regence UMP Plus - Puget Sound High Value Network","value":"Regence UMP Plus - Puget Sound High Value Network"},{"label":"Safeway Risk Management","value":"Safeway Risk Management"},{"label":"Seattle Area Plumbing & Pipefitting (Aetna)","value":"Seattle Area Plumbing & Pipefitting (Aetna)"},{"label":"Sedgwick CMS","value":"Sedgwick CMS"},{"label":"Sound Health & Wellness Trust (Aetna)","value":"Sound Health & Wellness Trust (Aetna)"},{"label":"Three Rivers Provider Network (TRPN)","value":"Three Rivers Provider Network (TRPN)"},{"label":"UMR (United Healthcare)","value":"UMR (United Healthcare)"},{"label":"United Healthcare PPO, POS, HMO","value":"United Healthcare PPO, POS, HMO"},{"label":"United Healthcare Choice & Choice Plus","value":"United Healthcare Choice & Choice Plus"},{"label":"United Healthcare Core & Core Plus","value":"United Healthcare Core & Core Plus"},{"label":"United Healthcare - Charter","value":"United Healthcare - Charter"},{"label":"United Healthcare - Cascade Select","value":"United Healthcare - Cascade Select"},{"label":"United Healthcare Doctors Plan and Doctors Plus Plan","value":"United Healthcare Doctors Plan and Doctors Plus Plan"},{"label":"United Healthcare - Navigate","value":"United Healthcare - Navigate"},{"label":"United Healthcare NexusACO (R, RB, RP, OA, OAP)","value":"United Healthcare NexusACO (R, RB, RP, OA, OAP)"},{"label":"United Healthcare Options & Options Plus","value":"United Healthcare Options & Options Plus"},{"label":"United Healthcare - Signature Value & Value Plus (Health Exchange)","value":"United Healthcare - Signature Value & Value Plus (Health Exchange)"},{"label":"United Payors PPO","value":"United Payors PPO"},{"label":"USA Managed Care","value":"USA Managed Care"}],"path":"appointment.plan_Name1","type":"simpleSelect"},{"group":"Insurance 1","label":"Guarantor Full Name","path":"appointment.guarantor","type":"string"},{"group":"Insurance 2","isRequired":true,"label":"Insurance Group ID Number","path":"appointment.group_id1","type":"string"},{"group":"Insurance 2","isRequired":true,"label":"Insurance Member ID Number","path":"appointment.member_id1","type":"string"},{"group":"Interpreter","isRequired":false,"label":"Interpreter Needed?","options":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}],"path":"appointment.interpreter_req","placeholder":"Interpreter Needed?","type":"simpleSelect"},{"group":"Interpreter","isRequired":false,"label":"Interpreter Language (If Needed)","path":"appointment.interpreter_language","type":"string"},{"defaultValue":"No","group":"ADA","isRequired":false,"label":"Hard of Hearing?","options":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}],"path":"appointment.hard_of_hearing","placeholder":"","type":"simpleSelect"},{"defaultValue":"No","group":"ADA","isRequired":false,"label":"Deaf?","options":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}],"path":"appointment.deaf","placeholder":"","type":"simpleSelect"},{"defaultValue":"No","group":"ADA","isRequired":false,"label":"Speech Impaired?","options":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}],"path":"appointment.speech_impaired","placeholder":"","type":"simpleSelect"},{"group":"ADA","isRequired":false,"label":"Needs for Hearing or Speech Disability","path":"appointment.ada_needs","type":"string"},{"defaultValue":"No","group":"Vision","isRequired":false,"label":"Low Vision?","options":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}],"path":"appointment.low_vision","placeholder":"","type":"simpleSelect"},{"defaultValue":"No","group":"Vision","isRequired":false,"label":"Blind?","options":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}],"path":"appointment.blind","placeholder":"","type":"simpleSelect"},{"displayCharacterCount":true,"isRequired":true,"isRequiredMsg":"Reason for visit is required","label":"What is the reason for your visit?","maxLength":"350","path":"appointment.notes","placeholder":"Appointment reason must be less than 350 characters","rows":5,"type":"textarea"}],"google_tag_manager_id":"GTM-P8QWW8F","keng8312_use_sched_v2":true,"patient_reg_form":{"addOns":{"consent-add-on":[{"sentence":"Confirmation and reminder emails may contain personal and protected health information."},{"hasModal":true,"modalContent":{"body":["The Health Insurance Portability and Accountability Act of 1996 (HIPAA) recommends that e-mail containing protected health information be encrypted. We cannot guarantee that appointment confirmation e-mails will be encrypted and therefore it is possible that the confidentiality of such communications may be breached by a third party.","E-mails can easily be circulated and forwarded to unintended recipients.","Backup copies of e-mails may exist even after the recipient has deleted his or her copy.","Employers and on-line services have a right to inspect e-mails transmitted through their systems.","E-mails may be able to be intercepted, altered, forwarded, or used without authorization or detection."],"title":"Risks of Emailing Health Information"},"sentence":"Learn more about the risks of e-mailing this information."}]},"disclaimer":["We respect your right to privacy. By submitting this form, you agree to receive periodic health related information and updates from us. Please refer to the website privacy policy and terms of service for more information about how your information is used. We cannot guarantee that all communications will be encrypted.","Information included in email, voice, and text messages may include your first name, date/time of appointments, name of physician, physician phone number and other pertinent demographic or health information. There is some risk that individually identifiable health information or other sensitive or confidential information contained in such email, voice, or text messages may be misdirected, disclosed to, or intercepted by unauthorized third parties."],"fields":[{"subFields":{"first":{"isRequired":true,"isRequiredMsg":"First name is required","label":"First Name","path":"patient.name.first","placeholder":"Legal First Name"},"last":{"isRequired":true,"isRequiredMsg":"Last name is required","label":"Last Name","path":"patient.name.last","placeholder":"Legal Last Name"}},"type":"name"},{"day":{"ariaDescription":"This is a numeric input that accepts a two-digit day and will automatically focus into the next input for you.","autoComplete":"bday-day","invalidMsg":"Please enter a valid day.","isRequiredMsg":"Day is required.","label":"Day","name":"dob-day","placeholder":"DD"},"group":"DOB, Gender, Phone","invalidMsg":"Please enter a valid date of birth","isRequired":true,"isRequiredMsg":"Date of birth is required","label":"Date of Birth","month":{"ariaDescription":"This is a numeric input that accepts a two-digit month and will automatically focus into the next input for you.","autoComplete":"bday-month","invalidMsg":"Please enter a valid month.","isRequiredMsg":"Month is required.","label":"Month","name":"dob-month","placeholder":"MM"},"path":"patient.dob","type":"dob","year":{"ariaDescription":"This is a numeric input that accepts a four-digit year.","autoComplete":"bday-year","invalidMsg":"Please enter a valid year.","isRequiredMsg":"Year is required.","label":"Year","name":"dob-year","placeholder":"YYYY"}},{"group":"DOB, Gender, Phone","isRequired":true,"isRequiredMsg":"Gender is required","label":"Gender","options":[{"label":"Female","value":"female"},{"label":"Male","value":"male"},{"label":"Unknown","value":"unknown"},{"label":"X","value":"non-disclosure"}],"path":"patient.gender","placeholder":"Gender","type":"simpleSelect"},{"group":"DOB, Gender, Phone","isRequired":true,"label":"Phone Number","subFields":{"phone":{"countryFormat":"US","invalidMsg":"Phone format (999) 999-9999","isRequired":true,"isRequiredMsg":"Phone is required","path":"patient.phone.number","placeholder":"(___) ___-____"}},"type":"phone","width":"l"},{"label":"Address","subFields":{"city":{"isRequired":true,"isRequiredMsg":"City is required","path":"patient.address.city","placeholder":"City"},"state":{"isRequired":true,"isRequiredMsg":"State is required","options":[{"label":"AL","value":"AL"},{"label":"AK","value":"AK"},{"label":"AZ","value":"AZ"},{"label":"AR","value":"AR"},{"label":"CA","value":"CA"},{"label":"CO","value":"CO"},{"label":"CT","value":"CT"},{"label":"DE","value":"DE"},{"label":"FL","value":"FL"},{"label":"GA","value":"GA"},{"label":"HI","value":"HI"},{"label":"ID","value":"ID"},{"label":"IL","value":"IL"},{"label":"IN","value":"IN"},{"label":"IA","value":"IA"},{"label":"KS","value":"KS"},{"label":"KY","value":"KY"},{"label":"LA","value":"LA"},{"label":"ME","value":"ME"},{"label":"MD","value":"MD"},{"label":"MA","value":"MA"},{"label":"MI","value":"MI"},{"label":"MN","value":"MN"},{"label":"MS","value":"MS"},{"label":"MO","value":"MO"},{"label":"MT","value":"MT"},{"label":"NE","value":"NE"},{"label":"NV","value":"NV"},{"label":"NH","value":"NH"},{"label":"NJ","value":"NJ"},{"label":"NM","value":"NM"},{"label":"NY","value":"NY"},{"label":"NC","value":"NC"},{"label":"ND","value":"ND"},{"label":"OH","value":"OH"},{"label":"OK","value":"OK"},{"label":"OR","value":"OR"},{"label":"PA","value":"PA"},{"label":"RI","value":"RI"},{"label":"SC","value":"SC"},{"label":"SD","value":"SD"},{"label":"TN","value":"TN"},{"label":"TX","value":"TX"},{"label":"UT","value":"UT"},{"label":"VT","value":"VT"},{"label":"VA","value":"VA"},{"label":"WA","value":"WA"},{"label":"WV","value":"WV"},{"label":"WI","value":"WI"},{"label":"WY","value":"WY"}],"path":"patient.address.state","placeholder":"State"},"street1":{"isRequired":true,"isRequiredMsg":"Address is required","path":"patient.address.street1","placeholder":"Address 1"},"street2":{"path":"patient.address.street2","placeholder":"Address 2 (Apt, Suite, PO Box, etc.)"},"zip":{"isRequired":true,"isRequiredMsg":"Zip is required","path":"patient.address.zip","placeholder":"Zip"}},"type":"address"},{"confirm":{"invalidMsg":"Email addresses do not match","isRequired":true,"isRequiredMsg":"Email is required","label":"Confirm Email","path":"patient.confirmEmail","placeholder":"username@email.com"},"invalidMsg":"Email format address@example.com","isReadOnly":false,"isRequired":true,"isRequiredMsg":"Email is required","label":"Email","path":"patient.email","placeholder":"username@email.com","type":"email"},{"addOn":"consent-add-on","isRequired":true,"isRequiredMsg":"Consent is required","label":"Consent to Email","path":"patient.email_consent","placeholder":"Does the patient consent to receive emails from us?","type":"checkbox"},{"group":"Insurance 1","isRequired":true,"isRequiredMsg":"Insurance name is required","label":"Primary Insurance","options":[{"label":"Aetna","value":"Aetna"},{"label":"Aetna Premier Care Network","value":"Aetna Premier Care Network"},{"label":"Aetna Premier Care Network PLUS","value":"Aetna Premier Care Network PLUS"},{"label":"Aetna Whole Health","value":"Aetna Whole Health"},{"label":"PacMed, PolyClinic, Providence/Swedish, Rainier Health Network","value":"PacMed, PolyClinic, Providence/Swedish, Rainier Health Network"},{"label":"Altius Health Plans (Coventry - First Health - Aetna)","value":"Altius Health Plans (Coventry - First Health - Aetna)"},{"label":"America's Health Plan","value":"America's Health Plan"},{"label":"Assurant Health (First Choice)","value":"Assurant Health (First Choice)"},{"label":"Asuris Health Plan (Regence)","value":"Asuris Health Plan (Regence)"},{"label":"Avizent","value":"Avizent"},{"label":"Beechstreet (First Choice)","value":"Beechstreet (First Choice)"},{"label":"Berkley Risk Administrators","value":"Berkley Risk Administrators"},{"label":"Boeing - BCBS of IL Standard PPO","value":"Boeing - BCBS of IL Standard PPO"},{"label":"Boeing - BCBS - Select Network EPO","value":"Boeing - BCBS - Select Network EPO"},{"label":"Boeing - BCBS - Traditional Medical","value":"Boeing - BCBS - Traditional Medical"},{"label":"Boeing - BCBS - Advantage+","value":"Boeing - BCBS - Advantage+"},{"label":"BlueCross/Blue Shield Out-of-State (BlueCard)","value":"BlueCross/Blue Shield Out-of-State (BlueCard)"},{"label":"Christian Brothers (Aetna)","value":"Christian Brothers (Aetna)"},{"label":"CIGNA","value":"CIGNA"},{"label":"CIGNA Local/Local Plus","value":"CIGNA Local/Local Plus"},{"label":"Coordinated Care/Centene Ambetter","value":"Coordinated Care/Centene Ambetter"},{"label":"Coventry/CCN (Aetna)","value":"Coventry/CCN (Aetna)"},{"label":"Crawford & Co.","value":"Crawford & Co."},{"label":"Definity Health (United Healthcare)","value":"Definity Health (United Healthcare)"},{"label":"Eberle Vivian","value":"Eberle Vivian"},{"label":"Employee Benefit Mgmt. Services (First Choice)","value":"Employee Benefit Mgmt. Services (First Choice)"},{"label":"Evergreen Health (First Choice)","value":"Evergreen Health (First Choice)"},{"label":"Fidelity (First Choice)","value":"Fidelity (First Choice)"},{"label":"First Choice Health Network","value":"First Choice Health Network"},{"label":"First Choice Health Preferred Network ","value":"First Choice Health Preferred Network "},{"label":"First Health (Coventry - Aetna)","value":"First Health (Coventry - Aetna)"},{"label":"Gallagher Basset Services","value":"Gallagher Basset Services"},{"label":"Greatwest (CIGNA)","value":"Greatwest (CIGNA)"},{"label":"Health Payor Organization (HPO)","value":"Health Payor Organization (HPO)"},{"label":"Healthcare Management Administrators (HMA) (Regence)","value":"Healthcare Management Administrators (HMA) (Regence)"},{"label":"Healthnet (First Choice)","value":"Healthnet (First Choice)"},{"label":"Healthsmart","value":"Healthsmart"},{"label":"Humana Choice Care","value":"Humana Choice Care"},{"label":"INBA (First Choice)","value":"INBA (First Choice)"},{"label":"Kaiser Foundation Health Plan of Washington - HMO plans - Core, Alliant Select, Options Select*","value":"Kaiser Foundation Health Plan of Washington - HMO plans - Core, Alliant Select, Options Select*"},{"label":"Kaiser Foundation Health Plan of Washington - POS plans - Options, Alliant Plus/Connect*","value":"Kaiser Foundation Health Plan of Washington - POS plans - Options, Alliant Plus/Connect*"},{"label":"Kaiser Foundation Health Plan of Washington Options, Inc. - PPO plans - Access PPO, Options PPO*","value":"Kaiser Foundation Health Plan of Washington Options, Inc. - PPO plans - Access PPO, Options PPO*"},{"label":"Kaiser Foundation Health Plan of Washington - Cascade, Virtual Pulse, Flex, Core, HAS, 21 (Health Exchange)*","value":"Kaiser Foundation Health Plan of Washington - Cascade, Virtual Pulse, Flex, Core, HAS, 21 (Health Exchange)*"},{"label":"King County Safety & Claims","value":"King County Safety & Claims"},{"label":"Kitsap Health Plans (First Choice)","value":"Kitsap Health Plans (First Choice)"},{"label":"Lifewise Health Plan of WA - Preferred","value":"Lifewise Health Plan of WA - Preferred"},{"label":"Lifewise Assurance Co","value":"Lifewise Assurance Co"},{"label":"Lifewise of OR","value":"Lifewise of OR"},{"label":"Moda Health Plans (First Choice)","value":"Moda Health Plans (First Choice)"},{"label":"Molina Marketplace (Cascade, Core, Constant, Choice) (Health Exchange)","value":"Molina Marketplace (Cascade, Core, Constant, Choice) (Health Exchange)"},{"label":"MultiPlan","value":"MultiPlan"},{"label":"National Preferred Provider Network (NPPN)","value":"National Preferred Provider Network (NPPN)"},{"label":"Pacificsource","value":"Pacificsource"},{"label":"Preferred Health Network (PHN)","value":"Preferred Health Network (PHN)"},{"label":"Premera Blue Cross PPO*","value":"Premera Blue Cross PPO*"},{"label":"Private Health Care Systems (PHCS)","value":"Private Health Care Systems (PHCS)"},{"label":"Regence Group Adminstrators","value":"Regence Group Adminstrators"},{"label":"Regence Blue Shield PPO","value":"Regence Blue Shield PPO"},{"label":"Regence Uniform Medical Plan (UMP) Classic","value":"Regence Uniform Medical Plan (UMP) Classic"},{"label":"Regence Uniform Medical Plan (UMP) Achieve 1 & 2","value":"Regence Uniform Medical Plan (UMP) Achieve 1 & 2"},{"label":"Regence Uniform Medical Plan (UMP) High Deductible or CDHP","value":"Regence Uniform Medical Plan (UMP) High Deductible or CDHP"},{"label":"Regence UMP Plus - Puget Sound High Value Network","value":"Regence UMP Plus - Puget Sound High Value Network"},{"label":"Safeway Risk Management","value":"Safeway Risk Management"},{"label":"Seattle Area Plumbing & Pipefitting (Aetna)","value":"Seattle Area Plumbing & Pipefitting (Aetna)"},{"label":"Sedgwick CMS","value":"Sedgwick CMS"},{"label":"Sound Health & Wellness Trust (Aetna)","value":"Sound Health & Wellness Trust (Aetna)"},{"label":"Three Rivers Provider Network (TRPN)","value":"Three Rivers Provider Network (TRPN)"},{"label":"UMR (United Healthcare)","value":"UMR (United Healthcare)"},{"label":"United Healthcare PPO, POS, HMO","value":"United Healthcare PPO, POS, HMO"},{"label":"United Healthcare Choice & Choice Plus","value":"United Healthcare Choice & Choice Plus"},{"label":"United Healthcare Core & Core Plus","value":"United Healthcare Core & Core Plus"},{"label":"United Healthcare - Charter","value":"United Healthcare - Charter"},{"label":"United Healthcare - Cascade Select","value":"United Healthcare - Cascade Select"},{"label":"United Healthcare Doctors Plan and Doctors Plus Plan","value":"United Healthcare Doctors Plan and Doctors Plus Plan"},{"label":"United Healthcare - Navigate","value":"United Healthcare - Navigate"},{"label":"United Healthcare NexusACO (R, RB, RP, OA, OAP)","value":"United Healthcare NexusACO (R, RB, RP, OA, OAP)"},{"label":"United Healthcare Options & Options Plus","value":"United Healthcare Options & Options Plus"},{"label":"United Healthcare - Signature Value & Value Plus (Health Exchange)","value":"United Healthcare - Signature Value & Value Plus (Health Exchange)"},{"label":"United Payors PPO","value":"United Payors PPO"},{"label":"USA Managed Care","value":"USA Managed Care"}],"path":"appointment.plan_Name1","type":"simpleSelect"},{"group":"Insurance 1","label":"Guarantor Full Name","path":"appointment.guarantor","type":"string"},{"group":"Insurance 2","isRequired":true,"label":"Insurance Group ID Number","path":"appointment.group_id1","type":"string"},{"group":"Insurance 2","isRequired":true,"label":"Insurance Member ID Number","path":"appointment.member_id1","type":"string"},{"group":"Interpreter","isRequired":false,"isRequiredMsg":"Interpreter Needed is required","label":"Interpreter Needed?","options":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}],"path":"appointment.interpreter_req","placeholder":"Interpreter Needed?","type":"simpleSelect"},{"group":"Interpreter","isRequired":false,"label":"Interpreter Language (If Needed)","path":"appointment.interpreter_language","type":"string"},{"defaultValue":"No","group":"ADA","isRequired":false,"label":"Hard of Hearing?","options":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}],"path":"appointment.hard_of_hearing","placeholder":"","type":"simpleSelect"},{"defaultValue":"No","group":"ADA","isRequired":false,"label":"Deaf?","options":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}],"path":"appointment.deaf","placeholder":"","type":"simpleSelect"},{"defaultValue":"No","group":"ADA","isRequired":false,"label":"Speech Impaired?","options":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}],"path":"appointment.speech_impaired","placeholder":"","type":"simpleSelect"},{"group":"ADA/Vision","isRequired":false,"label":"Needs for Hearing or Speech Disability","path":"appointment.ada_needs","type":"string"},{"defaultValue":"No","group":"ADA/Vision","isRequired":false,"label":"Low Vision?","options":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}],"path":"appointment.low_vision","placeholder":"","type":"simpleSelect"},{"defaultValue":"No","group":"ADA/Vision","isRequired":false,"label":"Blind?","options":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}],"path":"appointment.blind","placeholder":"","type":"simpleSelect"},{"displayCharacterCount":true,"isRequired":true,"isRequiredMsg":"Reason for visit is required","label":"What is the reason for your visit?","maxLength":"350","path":"appointment.notes","placeholder":"Appointment reason must be less than 350 characters","rows":5,"type":"textarea"}]},"patient_type":{"buttons":[{"button_text":"Yes","patient_type":"existing"},{"button_text":"No","patient_type":"new"}]},"timezone":"America/Los_Angeles","use_appointment_reasons":false,"use_availability_service":true,"recaptchaSiteKey":"6Lc8lOkUAAAAAER417YBcfrvsZQEvtvpHZa2t0hV"}},"authenticatedUserInfo":null,"settings":{"PMA_URL":"https://pma.kyruus.com/providers/?mine","PROVIDERS_PER_PAGE":10,"SEARCH_V9_URL":"https://prd-searchservice-v8.kyruus.com/v9"},"searchWidgetConfig":null,"availability":{"patientRel":"","purpose":null,"loading":false,"purposeOptions":{"new":[],"established":[]},"error":"","slotsByProviderId":{},"slotsStatusByProviderId":{},"hasFetchingSlotCountsFailed":false},"slotsCountLoading":false,"csrfToken":"","locations":{},"searchMap":{"locations":{"state":"pending"},"providers":{"state":"pending"},"providersByLocation":{}},"searchMapV9":{"locations":{"state":"pending"},"providers":{"state":"pending"},"providersByLocation":{}},"customerCode":"2201aydz","tokens":{"consumerTrackingToken":"0b2b7186-87bc-4bf9-981f-91e4a667bcb0","searchToken":"e4fdf3c3-0303-4756-9edb-7656d72f451c","searchShuffleToken":"52a6c62f-3ab9-4a3c-a55e-5166bf3106fe","anonymousUserId":"c172cba9-d056-5285-a751-26592eacd3da","userToken":"a65c0422-7a21-4732-9d95-e983f100cea5"},"device":{"isWebview":false,"isBot":false}}">