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
Nov 03, 2022
NO CHARGE
Robin Blackwell
Auburn Montgomery Warhawk Health Services
Nov 07, 2022
NO CHARGE
Robin Blackwell
Auburn Montgomery Warhawk Health Services
Dec 07, 2022
NO CHARGE
Robin Blackwell
Auburn Montgomery Warhawk Health Services
Dec 09, 20227461 East Dr STE 102MontgomeryAL361178092USAuburn Montgomery Warhawk Health Services7461 East Dr STE 102MontgomeryAL361178092USAuburn Montgomery Warhawk Health Services7461 East Dr STE 102MontgomeryAL361178092USAuburn Montgomery Warhawk Health Services7461 East Dr STE 102MontgomeryAL361178092USAuburn Montgomery Warhawk Health ServicesPROCEDURESProcedure Date

HEP B Surface Antibody, QUANTITATIVE (QUEST), [CPT-4: 8475]
11/03/2022
TB test - IPPD, [CPT-4: SP86580]
12/07/2022
MMR, [CPT-4: 90707]
11/07/2022
MMR TITER, [CPT-4: 5259]
11/03/2022
MMR TITER, [CPT-4: 5259]
12/07/2022
Immunization Injection Administration, [CPT-4: 90471]
11/07/2022
Immunization Injection Administration, [CPT-4: 90471]
11/03/20227461 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

MMR
11/07/2022
CompletedMMRW009106Merck Co., Inc.7461 East DrMontgomeryALUSRobinBlackwellCRNPAuburn Montgomery Student Health Services7461 East DrMontgomeryAL36117USVITAL SIGNSNo Vitals Signs Selected to be DisplayedRESULTSResult Type Result Value Date

TB Read Only
Negative
12/09/2022
MEASLES AB (IGG), IMMUNE STATUS
62.90
12/08/2022
MUMPS VIRUS AB (IGG), IMMUNE STATUS
55.40
12/08/2022
RUBELLA AB (IGG), IMMUNE STATUS
20.00
12/08/2022
MEASLES AB (IGG), IMMUNE STATUS
58.60
11/04/2022
MUMPS VIRUS AB (IGG), IMMUNE STATUS
37.20
11/04/2022
RUBELLA AB (IGG), IMMUNE STATUS
0.94
11/04/2022
HEPATITIS B SURFACE AB IMMUNITY, QN
24
11/04/2022NegativePLAN 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

Encounter	Performer	Location	Date
NO CHARGE	Robin Blackwell	Auburn Montgomery Warhawk Health Services	Nov 03, 2022
NO CHARGE	Robin Blackwell	Auburn Montgomery Warhawk Health Services	Nov 07, 2022
NO CHARGE	Robin Blackwell	Auburn Montgomery Warhawk Health Services	Dec 07, 2022
NO CHARGE	Robin Blackwell	Auburn Montgomery Warhawk Health Services	Dec 09, 2022

Procedure	Date
HEP B Surface Antibody, QUANTITATIVE (QUEST), [CPT-4: 8475]	11/03/2022
TB test - IPPD, [CPT-4: SP86580]	12/07/2022
MMR, [CPT-4: 90707]	11/07/2022
MMR TITER, [CPT-4: 5259]	11/03/2022
MMR TITER, [CPT-4: 5259]	12/07/2022
Immunization Injection Administration, [CPT-4: 90471]	11/07/2022
Immunization Injection Administration, [CPT-4: 90471]	11/03/2022

Result Type	Result Value	Date
TB Read Only	Negative	12/09/2022
MEASLES AB (IGG), IMMUNE STATUS	62.90	12/08/2022
MUMPS VIRUS AB (IGG), IMMUNE STATUS	55.40	12/08/2022
RUBELLA AB (IGG), IMMUNE STATUS	20.00	12/08/2022
MEASLES AB (IGG), IMMUNE STATUS	58.60	11/04/2022
MUMPS VIRUS AB (IGG), IMMUNE STATUS	37.20	11/04/2022
RUBELLA AB (IGG), IMMUNE STATUS	0.94	11/04/2022
HEPATITIS B SURFACE AB IMMUNITY, QN	24	11/04/2022