Student InformationSemester:SpringCourse:MSN6050C Advanced Practice Women HealthPreceptor:TREJO, RODOLFOClinical Site:NEIGHBORHOOD FAMILY PRACTICESetting Type:Rural visit -Patient DemographicsAge:21 yearsRace:HispanicGender:FemaleInsurance:MedicareReferral:No referralClinical InformationTime with Patient:28 minutesConsult with Preceptor:15 minutesType of Decision-Making:Moderate complexityReason for Visit:EpisodicChief Complaint:I have a lesion on my genitaliaType of HP:Expanded Problem FocusedSocial Problems Addressed:Sanitation/HygieneSafetySexualityPrevention Procedures/Skills (Observed/Assisted/Performed)Physical Assessment – Physical Assessment (Perf)General Skills – Vaginal Exam (Perf)General Skills – Vital Signs (Perf)ICD-10 Diagnosis Codes#1 - A60.04 - HERPESVIRAL VULVOVAGINITISCPT Billing Codes#1 - 99204 - OFFICE/OP VISIT, NEW PT, MEDICALLY APPROPRIATE HX/EXAM; MODERATE LEVEL MED DECISION; 45-59 MINBirth & DeliveryMedications# OTC Drugs taken regularly:0# Prescriptions currently prescribed:0# New/Refilled Prescriptions This Visit:2Types of New/Refilled Prescriptions This Visit:Analgesic/Antipyretic – NSAIDSInfectious Diseases – Antiviral agents Adherence Issues with Medications: Other Questions About This CasePatient's Primary Language:SpanishSmoking Assessment:NeverAdvanced Directive:NoPacks per day: