Patient presents with symptoms consistent with a diagnosis of Paranoid Schizophrenia.  The patient exhibits prominent positive symptoms including auditory hallucinations, persecutory delusions, and disorganized thought processes as evidenced by tangential and circumstantial speech.  Negative symptoms such as flat affect, avolition, and alogia are also observed, though less prominent than the positive symptoms.  The patient meets DSM-5 criteria for Schizophrenia, specifically the paranoid subtype, with significant functional impairment noted in social and occupational domains.  Onset of symptoms was reported approximately two years prior, with a gradual decline in functioning.  Current presentation is marked by increased anxiety, suspicion, and social withdrawal.  Differential diagnosis includes delusional disorder, schizoaffective disorder, and substance-induced psychotic disorder; however, these were ruled out based on clinical interview, collateral information, and laboratory testing.  Treatment plan includes initiation of antipsychotic medication, specifically Risperidone, starting at a low dose and titrating upwards as tolerated.  Referral to individual therapy focusing on cognitive behavioral therapy for psychosis (CBTp) is also recommended to address delusional thinking and improve coping skills.  Patient education regarding medication adherence, symptom management, and community resources will be provided.  Prognosis is guarded, with ongoing monitoring and adjustment of the treatment plan as needed.  ICD-10 code F20.0 is assigned.  Medical billing will reflect evaluation and management services with a focus on psychiatric diagnostic evaluation and treatment planning.  Follow-up appointment scheduled in two weeks to assess medication response and treatment progress.