Patient presents with complaint of dysmenorrhea, characterized as painful menstruation.  The patient reports experiencing cramping lower abdominal pain,  with onset typically coinciding with menses onset or shortly before.  Pain severity is described as [mild, moderate, or severe], impacting daily activities [minimally, moderately, or significantly].  Associated symptoms may include back pain, pelvic pain, nausea, vomiting, headache, and fatigue.  The patient denies fever, chills, abnormal vaginal discharge, or urinary symptoms.  Pain is managed with [medication, heat therapy, rest, or other].  Menstrual history includes menarche at age [age], cycle length of [number] days, and flow described as [light, normal, or heavy].  Gynecological history includes [gravida, para, abortions], and last pelvic exam was [date].  Differential diagnosis includes primary dysmenorrhea, secondary dysmenorrhea, endometriosis, pelvic inflammatory disease, and uterine fibroids.  Assessment suggests [primary or secondary] dysmenorrhea based on [clinical findings].  Plan includes [pain management strategies, lifestyle modifications, diagnostic testing such as pelvic ultrasound or laparoscopy if indicated, referral to gynecology if needed, and patient education regarding menstrual cramps, period pain, and dysmenorrhea management].  Follow-up recommended in [timeframe] to assess symptom control and discuss further management options.  ICD-10 code N94.6 (primary dysmenorrhea) or N94.89 (other specified abnormal uterine bleeding) may be considered depending on the specific diagnosis.  CPT codes for evaluation and management services will be based on the complexity of the visit.