2026 Consolidated CDA

ALLERGIES AND ADVERSE REACTIONSNo Known Drug AllergiesNo Known Drug Allergies

MEDICATIONSMedication Start Date Directions Status

omeprazole 20 mg capsule,delayed release, [RxNorm: 104099]
10/21/2021
TAKE 1 CAPSULE (20 MG) BY ORAL ROUTE ONCE DAILY 30 MINUTES TO 1 HOUR BEFORE A MEAL
ActivePROBLEMSNo known health problemsENCOUNTERSEncounter Performer Location Date

NO CHARGE
Maranda Fain
Auburn Montgomery Warhawk Health Services
Oct 19, 2021
NO CHARGE
Maranda Fain
Auburn Montgomery Warhawk Health Services
Oct 21, 20217461 East Dr STE 102MontgomeryAL361178092USAuburn Montgomery Warhawk Health Services7461 East Dr STE 102MontgomeryAL361178092USAuburn Montgomery Warhawk Health ServicesPROCEDURESProcedure Date

UA, [CPT-4: 81003]
10/21/2021
TB test - IPPD, [CPT-4: SP86580]
10/19/20217461 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

TDap
08/15/2020
Completed
MMR
08/15/2020
Completed
MMR
08/05/2021
CompletedTDap7461 East DrMontgomeryALUSMarandaFainCRNPAuburn Montgomery Student Health Services7461 East DrMontgomeryAL36117USMMR7461 East DrMontgomeryALUSMarandaFainCRNPAuburn Montgomery Student Health Services7461 East DrMontgomeryAL36117USMMR7461 East DrMontgomeryALUSMarandaFainCRNPAuburn Montgomery Student Health Services7461 East DrMontgomeryAL36117USVITAL SIGNSDate Height Weight BMI Blood Pressure Temperature Pulse Pulse Oximetry Respiratory Rate Inhaled Oxygen Concentration Head Circumference Percentage BMI Percentage Weight to Length Percentage

10/21/2021 173 cm 63 kg 20.98 119/82 mm[Hg] 36 Cel 72 bpm 99 pct 19 bpmRESULTSResult Type Result Value Date

Leukocytes-Urine
Negative
10/21/2021
Urobilinogen-Urine
Negative
10/21/2021
Protein [Mass/Volume] in Urine by Test strip
Negative mg/dL
10/21/2021
pH of Urine by Test strip
5 [pH]
10/21/2021
Blood-Urine
Negative
10/21/2021
Ketones [Mass/Volume] in Urine by Test strip
Negative mg/dL
10/21/2021
Glucose [Mass/Volume] in Urine by Test strip
Negative mg/dL
10/21/2021
Specific Gravity of Urine by Test strip
1.010
10/21/2021
Bilirubin-Urine
Negative
10/21/2021
Nitrites-Urine
Negative
10/21/2021
Appearance of Urine
clear
10/21/2021
Color of Urine
yellow
10/21/2021
TB Read Only
Negative
10/21/2021NegativeNegativeNegativeNegativeNegativeNegativeNegativeNegativeclearyellowNegativeTREATMENT PLANName Type Date

REFERRAL
 East Montgomery Imaging Center-US of abdomen and Left rib XR
November 12, 2021
REFERRAL
 East Montgomery Imaging Center-US of abdomen and Left rib XR
November 12, 2021
REFERRAL
 East Montgomery Imaging Center
October 21, 2021
REFERRAL
 East Montgomery Imaging Center
October 21, 2021 East Montgomery Imaging Center-US of abdomen and Left rib XR East Montgomery Imaging Center-US of abdomen and Left rib XR East Montgomery Imaging Center East Montgomery Imaging CenterGoals 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

Encounter	Performer	Location	Date
NO CHARGE	Maranda Fain	Auburn Montgomery Warhawk Health Services	Oct 19, 2021
NO CHARGE	Maranda Fain	Auburn Montgomery Warhawk Health Services	Oct 21, 2021

Procedure	Date
UA, [CPT-4: 81003]	10/21/2021
TB test - IPPD, [CPT-4: SP86580]	10/19/2021

Name	Date	Status
TDap	08/15/2020	Completed
MMR	08/15/2020	Completed
MMR	08/05/2021	Completed

Result Type	Result Value	Date
Leukocytes-Urine	Negative	10/21/2021
Urobilinogen-Urine	Negative	10/21/2021
Protein [Mass/Volume] in Urine by Test strip	Negative mg/dL	10/21/2021
pH of Urine by Test strip	5 [pH]	10/21/2021
Blood-Urine	Negative	10/21/2021
Ketones [Mass/Volume] in Urine by Test strip	Negative mg/dL	10/21/2021
Glucose [Mass/Volume] in Urine by Test strip	Negative mg/dL	10/21/2021
Specific Gravity of Urine by Test strip	1.010	10/21/2021
Bilirubin-Urine	Negative	10/21/2021
Nitrites-Urine	Negative	10/21/2021
Appearance of Urine	clear	10/21/2021
Color of Urine	yellow	10/21/2021
TB Read Only	Negative	10/21/2021

Name	Type	Date
REFERRAL	East Montgomery Imaging Center-US of abdomen and Left rib XR	November 12, 2021
REFERRAL	East Montgomery Imaging Center-US of abdomen and Left rib XR	November 12, 2021
REFERRAL	East Montgomery Imaging Center	October 21, 2021
REFERRAL	East Montgomery Imaging Center	October 21, 2021