2026 Consolidated CDA

ALLERGIES AND ADVERSE REACTIONSNo Known Drug AllergiesNo Known Drug Allergies

MEDICATIONSNo known MedicationsPROBLEMSNo known health problemsENCOUNTERSEncounter Performer Location Date

NO CHARGE
Robin Blackwell
Auburn Montgomery Warhawk Health Services
Jun 22, 20237461 East Dr STE 102MontgomeryAL361178092USAuburn Montgomery Warhawk Health ServicesPROCEDURESProcedure Date

VARICELLA-ZOSTER VIRUS AB (IgG) (QUEST), [CPT-4: 4439]
06/22/2023
HEP B Surface Antibody, QUANTITATIVE (QUEST), [CPT-4: 8475]
06/22/2023
TDap, [CPT-4: 90715]
06/22/2023
HEPATITIS B SURFACE ANTIGEN, [LOINC: 5195-3]
01/08/2021
MMR TITER, [CPT-4: 5259]
06/22/2023
Hepatitis B vaccine (HepB), adult dosage, 3 dose schedule, for intramuscula, [CPT-4: 90746]
11/30/2020
Tetanus, diphtheria toxoids and acellular pertussi, [CPT-4: 90715]
11/30/2020
Immunization Injection Administration, [CPT-4: 90471]
12/01/2020
Influenza virus vaccine, [CPT-4: 90686]
11/30/20207461 East Dr STE 102MontgomeryAL361178092USAuburn Montgomery Warhawk Health Services7461 East Dr STE 102MontgomeryAL361178092US7461 East Dr STE 102MontgomeryAL361178092USAuburn Montgomery Warhawk Health Services7461 East Dr STE 102MontgomeryAL361178092US7461 East Dr STE 102MontgomeryAL361178092USAuburn Montgomery Warhawk Health Services7461 East Dr STE 102MontgomeryAL361178092US7461 East Dr STE 102MontgomeryAL361178092USAuburn Montgomery Warhawk Health Services7461 East Dr STE 102MontgomeryAL361178092US7461 East Dr STE 102MontgomeryAL361178092USAuburn Montgomery Warhawk Health Services7461 East Dr STE 102MontgomeryAL361178092US7461 East Dr STE 102MontgomeryAL361178092USAuburn Montgomery Warhawk Health Services7461 East Dr STE 102MontgomeryAL361178092US7461 East Dr STE 102MontgomeryAL361178092USAuburn Montgomery Warhawk Health Services7461 East Dr STE 102MontgomeryAL361178092US7461 East Dr STE 102MontgomeryAL361178092USAuburn Montgomery Warhawk Health Services7461 East Dr STE 102MontgomeryAL361178092US7461 East Dr STE 102MontgomeryAL361178092USAuburn Montgomery Warhawk Health Services7461 East Dr STE 102MontgomeryAL361178092US

            MEDICAL EQUIPMENTPatient has no history of implantable devicesIMMUNIZATIONSName Date Status

Hepatitis B vaccine (HepB), adult dosage, 3 dose schedule, for intramuscula
11/30/2020
Completed
Tetanus, diphtheria toxoids and acellular pertussi
11/30/2020
Completed
Influenza virus vaccine
11/30/2020
Completed
TDap
06/22/2023
CompletedHepatitis B vaccine (HepB), adult dosage, 3 dose schedule, for intramuscula4eA77GlaxoSmithKline7461 East DrMontgomeryALUSRobinBlackwellCRNPAuburn Montgomery Student Health Services7461 East DrMontgomeryAL36117USTetanus, diphtheria toxoids and acellular pertussi4f99gGlaxoSmithKline7461 East DrMontgomeryALUSRobinBlackwellCRNPAuburn Montgomery Student Health Services7461 East DrMontgomeryAL36117USInfluenza virus vaccine9A235GlaxoSmithKline7461 East DrMontgomeryALUSRobinBlackwellCRNPAuburn Montgomery Student Health Services7461 East DrMontgomeryAL36117USTDapDH3A2GlaxoSmithKline7461 East DrMontgomeryALUSRobinBlackwellCRNPAuburn Montgomery Student Health Services7461 East DrMontgomeryAL36117USVITAL SIGNSNo Vitals Signs Selected to be DisplayedRESULTSResult Type Result Value Date

MEASLES AB (IGG), IMMUNE STATUS
>300.00
06/23/2023
MUMPS VIRUS AB (IGG), IMMUNE STATUS
>300.00
06/23/2023
RUBELLA AB (IGG), IMMUNE STATUS
4.59
06/23/2023
HEPATITIS B SURFACE AB IMMUNITY, QN
>1000
06/23/2023
VARICELLA ZOSTER VIRUS ANTIBODY (IGG)
>4000.00
06/23/2023>300.00>300.00>1000>4000.00PLAN OF TREATMENTNo Treatment Plan Defined Goals SectionNo goal informationHealth Concerns SectionNo Known Health Concerns on INSTRUCTIONSNo Known Instructions/Patient EducationSOCIAL HISTORYNo Social History Selected to be DisplayedFUNCTIONAL STATUSNo informationMENTAL STATUSNo information

Procedure	Date
VARICELLA-ZOSTER VIRUS AB (IgG) (QUEST), [CPT-4: 4439]	06/22/2023
HEP B Surface Antibody, QUANTITATIVE (QUEST), [CPT-4: 8475]	06/22/2023
TDap, [CPT-4: 90715]	06/22/2023
HEPATITIS B SURFACE ANTIGEN, [LOINC: 5195-3]	01/08/2021
MMR TITER, [CPT-4: 5259]	06/22/2023
Hepatitis B vaccine (HepB), adult dosage, 3 dose schedule, for intramuscula, [CPT-4: 90746]	11/30/2020
Tetanus, diphtheria toxoids and acellular pertussi, [CPT-4: 90715]	11/30/2020
Immunization Injection Administration, [CPT-4: 90471]	12/01/2020
Influenza virus vaccine, [CPT-4: 90686]	11/30/2020

Name	Date	Status
Hepatitis B vaccine (HepB), adult dosage, 3 dose schedule, for intramuscula	11/30/2020	Completed
Tetanus, diphtheria toxoids and acellular pertussi	11/30/2020	Completed
Influenza virus vaccine	11/30/2020	Completed
TDap	06/22/2023	Completed

Result Type	Result Value	Date
MEASLES AB (IGG), IMMUNE STATUS	>300.00	06/23/2023
MUMPS VIRUS AB (IGG), IMMUNE STATUS	>300.00	06/23/2023
RUBELLA AB (IGG), IMMUNE STATUS	4.59	06/23/2023
HEPATITIS B SURFACE AB IMMUNITY, QN	>1000	06/23/2023
VARICELLA ZOSTER VIRUS ANTIBODY (IGG)	>4000.00	06/23/2023