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
Dec 07, 2022
NO CHARGE
Lindsey Barton
Auburn Montgomery Warhawk Health Services
Dec 12, 2022
NO CHARGE
Lindsey Barton
Auburn Montgomery Warhawk Health Services
Dec 14, 2022
NO CHARGE
Robin Blackwell
Auburn Montgomery Warhawk Health Services
Jan 13, 2023
NO CHARGE
Robin Blackwell
Auburn Montgomery Warhawk Health Services
Jul 13, 20237461 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 Services7461 East Dr STE 102MontgomeryAL361178092USAuburn Montgomery Warhawk Health ServicesPROCEDURESProcedure Date

CBC W/ DIFF (QUEST), [CPT-4: 6399]
12/05/2022
VARICELLA-ZOSTER VIRUS AB (IgG) (QUEST), [CPT-4: 4439]
12/05/2022
HEP B Surface Antibody, QUANTITATIVE (QUEST), [CPT-4: 8475]
12/05/2022
HEP B Surface Antibody, QUANTITATIVE (QUEST), [CPT-4: 8475]
07/13/2023
Hepatitis B, [CPT-4: 90746]
07/13/2023
Hepatitis B, [CPT-4: 90746]
12/12/2022
Hepatitis B, [CPT-4: 90746]
01/13/2023
TB test - IPPD, [CPT-4: SP86580]
12/12/2022
TB test - IPPD, [CPT-4: SP86580]
12/05/2022
Varicella, [CPT-4: 90716]
12/12/2022
MMR TITER, [CPT-4: 5259]
12/05/2022
Immunization Injection Administration, [CPT-4: 90471]
07/13/2023
Immunization Injection Administration, [CPT-4: 90471]
01/13/2023
Immunization Injection Administration, [CPT-4: 90471]
12/12/2022
Influenza virus vaccine, [CPT-4: 90686]
12/05/2022
addtl immunization administration, [CPT-4: 90472]
12/12/20227461 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 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 102MontgomeryAL361178092US7461 East Dr STE 102MontgomeryAL361178092USAuburn Montgomery Warhawk Health Services7461 East Dr STE 102MontgomeryAL361178092US

            MEDICAL EQUIPMENTPatient has no history of implantable devicesIMMUNIZATIONSName Date Status

Influenza virus vaccine
12/05/2022
Completed
Hepatitis B
12/12/2022
Completed
Varicella
12/12/2022
Completed
Hepatitis B
01/13/2023
Completed
Hepatitis B
07/13/2023
CompletedInfluenza virus vaccineM3R5BGlaxoSmithKline7461 East DrMontgomeryALUSRobinBlackwellCRNPAuburn Montgomery Student Health Services7461 East DrMontgomeryAL36117USHepatitis B25K3MGlaxoSmithKline7461 East DrMontgomeryALUSRobinBlackwellCRNPAuburn Montgomery Student Health Services7461 East DrMontgomeryAL36117USVaricellaW018829Merck Co., Inc.7461 East DrMontgomeryALUSRobinBlackwellCRNPAuburn Montgomery Student Health Services7461 East DrMontgomeryAL36117USHepatitis BNT9X3GlaxoSmithKline7461 East DrMontgomeryALUSRobinBlackwellCRNPAuburn Montgomery Student Health Services7461 East DrMontgomeryAL36117USHepatitis BD23D3GlaxoSmithKline7461 East DrMontgomeryALUSRobinBlackwellCRNPAuburn 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

12/05/2022 160 cm 126 kg 49.1 141/89 mm[Hg] 37 Cel 67 bpm 100 pct 16 bpmRESULTSResult Type Result Value Date

TB Read Only
Negative
12/07/2022
TB Read Only
Negative
12/14/2022
MEASLES AB (IGG), IMMUNE STATUS
125.00
12/06/2022
MUMPS VIRUS AB (IGG), IMMUNE STATUS
64.80
12/06/2022
RUBELLA AB (IGG), IMMUNE STATUS
1.40
12/06/2022
HEPATITIS B SURFACE AB IMMUNITY, QN
<5
12/06/2022
VARICELLA ZOSTER VIRUS ANTIBODY (IGG)
<135.00
12/06/2022
WHITE BLOOD CELL COUNT
8.7
12/06/2022
RED BLOOD CELL COUNT
3.93
12/06/2022
HEMOGLOBIN
12.5
12/06/2022
HEMATOCRIT
36.9
12/06/2022
MCV
93.9
12/06/2022
MCH
31.8
12/06/2022
MCHC
33.9
12/06/2022
RDW
11.4
12/06/2022
PLATELET COUNT
396
12/06/2022
MPV
9.8
12/06/2022
ABSOLUTE NEUTROPHILS
4420
12/06/2022
ABSOLUTE LYMPHOCYTES
3506
12/06/2022
ABSOLUTE MONOCYTES
600
12/06/2022
ABSOLUTE EOSINOPHILS
131
12/06/2022
ABSOLUTE BASOPHILS
44
12/06/2022
NEUTROPHILS
50.8
12/06/2022
LYMPHOCYTES
40.3
12/06/2022
MONOCYTES
6.9
12/06/2022
EOSINOPHILS
1.5
12/06/2022
BASOPHILS
0.5
12/06/2022NegativeNegative<5<135.00PLAN 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

Encounter	Performer	Location	Date
NO CHARGE	Robin Blackwell	Auburn Montgomery Warhawk Health Services	Dec 07, 2022
NO CHARGE	Lindsey Barton	Auburn Montgomery Warhawk Health Services	Dec 12, 2022
NO CHARGE	Lindsey Barton	Auburn Montgomery Warhawk Health Services	Dec 14, 2022
NO CHARGE	Robin Blackwell	Auburn Montgomery Warhawk Health Services	Jan 13, 2023
NO CHARGE	Robin Blackwell	Auburn Montgomery Warhawk Health Services	Jul 13, 2023

Procedure	Date
CBC W/ DIFF (QUEST), [CPT-4: 6399]	12/05/2022
VARICELLA-ZOSTER VIRUS AB (IgG) (QUEST), [CPT-4: 4439]	12/05/2022
HEP B Surface Antibody, QUANTITATIVE (QUEST), [CPT-4: 8475]	12/05/2022
HEP B Surface Antibody, QUANTITATIVE (QUEST), [CPT-4: 8475]	07/13/2023
Hepatitis B, [CPT-4: 90746]	07/13/2023
Hepatitis B, [CPT-4: 90746]	12/12/2022
Hepatitis B, [CPT-4: 90746]	01/13/2023
TB test - IPPD, [CPT-4: SP86580]	12/12/2022
TB test - IPPD, [CPT-4: SP86580]	12/05/2022
Varicella, [CPT-4: 90716]	12/12/2022
MMR TITER, [CPT-4: 5259]	12/05/2022
Immunization Injection Administration, [CPT-4: 90471]	07/13/2023
Immunization Injection Administration, [CPT-4: 90471]	01/13/2023
Immunization Injection Administration, [CPT-4: 90471]	12/12/2022
Influenza virus vaccine, [CPT-4: 90686]	12/05/2022
addtl immunization administration, [CPT-4: 90472]	12/12/2022

Name	Date	Status
Influenza virus vaccine	12/05/2022	Completed
Hepatitis B	12/12/2022	Completed
Varicella	12/12/2022	Completed
Hepatitis B	01/13/2023	Completed
Hepatitis B	07/13/2023	Completed

Result Type	Result Value	Date
TB Read Only	Negative	12/07/2022
TB Read Only	Negative	12/14/2022
MEASLES AB (IGG), IMMUNE STATUS	125.00	12/06/2022
MUMPS VIRUS AB (IGG), IMMUNE STATUS	64.80	12/06/2022
RUBELLA AB (IGG), IMMUNE STATUS	1.40	12/06/2022
HEPATITIS B SURFACE AB IMMUNITY, QN	<5	12/06/2022
VARICELLA ZOSTER VIRUS ANTIBODY (IGG)	<135.00	12/06/2022
WHITE BLOOD CELL COUNT	8.7	12/06/2022
RED BLOOD CELL COUNT	3.93	12/06/2022
HEMOGLOBIN	12.5	12/06/2022
HEMATOCRIT	36.9	12/06/2022
MCV	93.9	12/06/2022
MCH	31.8	12/06/2022
MCHC	33.9	12/06/2022
RDW	11.4	12/06/2022
PLATELET COUNT	396	12/06/2022
MPV	9.8	12/06/2022
ABSOLUTE NEUTROPHILS	4420	12/06/2022
ABSOLUTE LYMPHOCYTES	3506	12/06/2022
ABSOLUTE MONOCYTES	600	12/06/2022
ABSOLUTE EOSINOPHILS	131	12/06/2022
ABSOLUTE BASOPHILS	44	12/06/2022
NEUTROPHILS	50.8	12/06/2022
LYMPHOCYTES	40.3	12/06/2022
MONOCYTES	6.9	12/06/2022
EOSINOPHILS	1.5	12/06/2022
BASOPHILS	0.5	12/06/2022