Patient presents with hypertension and chronic kidney disease.  Blood pressure consistently elevated above target goal of less than 13080 mmHg despite adherence to prescribed antihypertensive therapy including a thiazide diuretic and an ACE inhibitor.  Laboratory results demonstrate elevated serum creatinine and decreased estimated glomerular filtration rate (eGFR), consistent with stage 3 chronic kidney disease.  Patient reports no specific complaints of edema, shortness of breath, or chest pain.  Review of systems otherwise unremarkable.  Physical examination reveals no peripheral edema, carotid bruits, or other significant findings.  Assessment:  Hypertension, uncontrolled;  Chronic Kidney Disease, stage 3.  Plan:  Optimize antihypertensive regimen by adding a calcium channel blocker.  Emphasize importance of lifestyle modifications including dietary sodium restriction, weight management, and regular exercise.  Monitor kidney function with regular serum creatinine and eGFR measurements.  Educate patient on the importance of medication adherence and potential complications of hypertension and chronic kidney disease including cardiovascular disease and end-stage renal disease.  Referral to nephrology for co-management is recommended.  Follow-up scheduled in 4 weeks to reassess blood pressure control and kidney function.  ICD-10 codes: I12.9, N39.0.  Medical billing codes will be determined based on services provided.