Patient presents with abdominal pain, epigastric pain, or stomach ache, the chief complaint.  Onset, duration, character, location, radiation, associated symptoms, and relieving or exacerbating factors were explored.  Differential diagnoses considered include gastritis, gastroenteritis, peptic ulcer disease, gastroesophageal reflux disease GERD, irritable bowel syndrome IBS, food poisoning, appendicitis, cholecystitis, pancreatitis, and small bowel obstruction.  The patient's pain description is documented, noting whether it is sharp, dull, cramping, burning, gnawing, or aching.  Associated symptoms such as nausea, vomiting, diarrhea, constipation, bloating, belching, indigestion, heartburn, fever, chills, loss of appetite, and weight loss were investigated.  A review of systems including gastrointestinal, genitourinary, cardiovascular, and respiratory systems was performed.  Physical examination findings including abdominal tenderness, guarding, rigidity, rebound tenderness, bowel sounds, and vital signs are recorded.  Diagnostic tests considered or performed may include a complete blood count CBC, comprehensive metabolic panel CMP, urinalysis, stool studies, abdominal ultrasound, upper endoscopy EGD, or CT scan of the abdomen and pelvis.  Severity of stomach ache was assessed and documented as mild, moderate, or severe.  The assessment includes a preliminary diagnosis and clinical impression based on the patient's presentation, history, and examination findings.  The treatment plan may include dietary modifications, over-the-counter medications such as antacids or H2 blockers, prescription medications such as proton pump inhibitors PPIs or antibiotics, or referral to a gastroenterologist for further evaluation and management.  Patient education was provided on symptom management, follow-up care, and when to seek immediate medical attention.  Return to clinic or emergency room instructions were reviewed with the patient.  Medical coding utilizing ICD-10 codes for abdominal pain R10.x and related diagnoses will be performed for billing and insurance purposes.  CPT codes for evaluation and management EandM services and any procedures performed will be documented accordingly.