<?xml version="1.0" encoding="UTF-8"?>
					<ASSESSMENT>
						<ASMT_SYS_CD>OASIS</ASMT_SYS_CD>
                        <TRANS_TYPE_CD>3</TRANS_TYPE_CD>
                        <ITM_SBST_CD>XX</ITM_SBST_CD>
                        <ITM_SET_VRSN_CD>E1-012025</ITM_SET_VRSN_CD>
						<SPEC_VRSN_CD>3.01</SPEC_VRSN_CD>
                        <CORRECTION_NUM>01</CORRECTION_NUM>
						<STATE_CD>VA</STATE_CD>
						<HHA_AGENCY_ID>368102</HHA_AGENCY_ID>
						<NATL_PRVDR_ID>1234567891</NATL_PRVDR_ID>
						<SFW_ID>830423655</SFW_ID>
						<SFW_NAME>Home Care Business Services</SFW_NAME>
						<SFW_EMAIL_ADR>info@myhomecarebiz.com</SFW_EMAIL_ADR>
						<SFW_PROD_NAME>PowerPath</SFW_PROD_NAME>
						<SFW_PROD_VRSN_CD>1.0001</SFW_PROD_VRSN_CD>
						<ACY_DOC_CD>^</ACY_DOC_CD>
						<M0010_CCN>242353</M0010_CCN>
						<M0014_BRANCH_STATE>^</M0014_BRANCH_STATE>
						<M0016_BRANCH_ID>N</M0016_BRANCH_ID>
						<M0018_PHYSICIAN_ID>1801093968</M0018_PHYSICIAN_ID>
						<M0018_PHYSICIAN_UK>0</M0018_PHYSICIAN_UK>
						<M0020_PAT_ID>7670</M0020_PAT_ID>
						<M0030_START_CARE_DT>20251006</M0030_START_CARE_DT>
						<M0032_ROC_DT>^</M0032_ROC_DT>
						<M0032_ROC_DT_NA>1</M0032_ROC_DT_NA>
						<M0040_PAT_FNAME>Marquis</M0040_PAT_FNAME>
						<M0040_PAT_MI>^</M0040_PAT_MI>
						<M0040_PAT_LNAME>Black</M0040_PAT_LNAME>
						<M0040_PAT_SUFFIX>^</M0040_PAT_SUFFIX>
						<M0050_PAT_ST>AZ</M0050_PAT_ST>
						<M0060_PAT_ZIP>85712</M0060_PAT_ZIP>
						<M0063_MEDICARE_NUM>5W46E57XN09</M0063_MEDICARE_NUM>
						<M0063_MEDICARE_NA>0</M0063_MEDICARE_NA>
						<M0064_SSN>^</M0064_SSN>
						<M0064_SSN_UK>1</M0064_SSN_UK>
						<M0065_MEDICAID_NUM>^</M0065_MEDICAID_NUM>
						<M0065_MEDICAID_NA>1</M0065_MEDICAID_NA>
						<M0066_PAT_BIRTH_DT>19630601</M0066_PAT_BIRTH_DT>
						<M0069_PAT_GENDER>1</M0069_PAT_GENDER>
						
					    <M0080_ASSESSOR_DISCIPLINE>01</M0080_ASSESSOR_DISCIPLINE>
						<M0090_INFO_COMPLETED_DT>20251006</M0090_INFO_COMPLETED_DT>
						<M0100_ASSMT_REASON>01</M0100_ASSMT_REASON>
                        <M0906_DC_TRAN_DTH_DT>^</M0906_DC_TRAN_DTH_DT>
				  </ASSESSMENT>
			
