Designed for the complexities of specialty documentation.
Parkinson's disease, tremor progression on carbidopa-levodopa.
MRI brain — no acute intracranial abnormality.
CMP within range · TSH 2.1 · B12 402.
Fall-risk screening due (MIPS 318).
Chronic illness with progression requiring medication adjustment and prescription management.
Chronological summary from prior notes, labs, imaging, medications, and other records in the EHR.
Chronological summary from prior notes, labs, imaging, medications, and other records in the EHR.
Pre-charting dictations and documents with attribution.
Bring your existing shortcuts into Marvix without rebuilding your workflow.
Captures the consult, including patient quotes.
Disease, visit type, templates and clinical scores.
Your tone, structure, and phrasing.
Answers from the transcript, notes, and patient history.
Orders, referrals, and instructions by voice.
Clinical possibilities informed by the patient's history and findings.
Consult + relevant history in one note.
E/M, CPT, ICD-10, HCCs & modifiers.
Coverage language, LCD criteria, and clinical scores.
AVS, referral letters, PCP summaries, and more, in your format.
Speech to text across your EHR and applications.
Completed notes pushed back section-by-section.
MIPS and HEDIS gaps, surfaced before or during the visit.
Results that need attention, surfaced during the visit.
Coding and documentation gaps.
See how Marvix AI has changed documentation time, after-hours work, coding, and provider experience.
Impact estimates vary by practice, workflow, and utilization.
Over three months, MOHC tracked documentation time, after-hours workload and note quality as Marvix AI moved into daily use — generating 3,853 clinical notes from more than 1,100 hours of recorded consultations.
Real AI. Real Impact.
See how Marvix AI has changed documentation time, after-hours work, coding, and provider experience.
CAPACITY
2 hrs/day
Less documentation time
CODING
$43K
From coding accuracy
CAPACITY
15% more
Patient capacity recovered
CODING
$54K
From complete HCC capture
CAPACITY
$80K
Per provider, per year
CODING
$31K
Modifier & add-on billing
Impact estimates vary by practice, workflow, and utilization.
7.8×
ROI at MOHC, The US Oncology Network
Tap for the full case study
Every Marvix AI note ties documentation to the codes it supports — so the level you bill is the level you can defend. If a claim is questioned, the proof is already in the note.
E/M level justified
MDM complexity, total time, and counseling are captured in the note — not bolted on after the fact.
ICD-10 to the right specificity
Seizure type, localization, and intractability are coded so claims aren't downcoded or denied.
CPT & procedure codes captured
EEG, EMG/NCS, and injection procedures are pulled from the encounter — nothing missed in the chair.
Audit-ready trail
Every code links back to the exact line in the note that supports it. If a claim is questioned, the proof is already there.
HCC recapture & modifiers
Chronic conditions are recaptured for accurate HCC risk scores, with modifiers applied so nothing gets underbilled.
Coding
Audit-ready
E/M 99214
Established patient · moderate complexity
SUPPORTED BY
Detailed interval history (HPI, ROS, PMH)
Focused neurological examination
Moderate-complexity medical decision-making
ICD-10
G40.209
· Focal epilepsy, not intractable
G93.81
· Mesial temporal sclerosis
CPT
95816
· Routine EEG, awake & drowsy
95711
· Ambulatory EEG monitoring
HCC
HCC 51
· Epilepsy, recaptured
MODIFIERS
-25
· Separate E/M on procedure day
$262B
in claims denied annually falls into the gap between what's written and what payers require.
(CAQH)
TRUST & COMPLIANCE
HIPAA compliant
SOC 2 certified
BAA available
No model training on your data
US data residency
Configurable data retention
PHI retention you control
Auto-deletes after 30 days. Configurable down to 1.
No fine-tuning on customer data
Never used to train Marvix models. Enterprise plan.
Encryption end to end
TLS in transit, AES-256 at rest.
Role-based access & SSO
Permissions, authentication, and single sign-on.
Audit logging
Every view, edit, and change logged and exportable.
Clinician review before filing
Stays a draft until you review and accept it.
Your data stays yours.
HIPAA · SOC 2 · BAA · US data residency
PHI retention you control.
Auto-deletes after 30 days, configurable to 1.
No training on your data.
Never used to fine-tune Marvix AI models.
Encrypted end to end.
TLS in transit, AES-256 at rest.
Role-based access & SSO.
Permissions, authentication, single sign-on.
Audit logging.
Every view, edit and change, exportable.
Clinician review first.
Stays a draft until you accept it.
When we looked for AI scribe vendors we went through a tedious process to find the right fit and we've found that in Marvix AI. Their software is customizable, integratable with EMR, specialist-friendly and is incredibly user friendly. They're responsive and willing to meet you where you are in today's ever changing AI landscape.
AM
Amanda McFayden
Director of Clinical Operations, DENT Neurologic Institute
Absolutely transformative! Marvix AI has literally changed my life by giving me back my most precious resource—time. I no longer spend weekends and evenings painstakingly finishing notes or writing long letters. With Marvix AI, I have my own personal scribe that seems to know me better than I know myself.
MC
Dr. Madeline Chadehumbe
CMO, Neurabilities
Marvix AI is amazing. It cuts the physician's cognitive effort by 50%. It captures details necessary for billing and documentation. I highly recommend it to all providers.
MQ
Dr. Mohammad Qasaymeh
Director of Pediatrics, DENT Neurologic Institute
Marvix AI has changed my work-life balance significantly! It's the single best advancement in charting — EVER!
TP
Tammy Pesaresi, AGPCNP-C
DENT Neurologic Institute
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Don't see your EHR? We can build a custom integration for your practice. Talk to us.
Our AI Models Specialize Across
135 Specialties
Built for your specialty, customised for your practice.
Built for complex, longitudinal neurology.
Capture complex neurological visits, review years of patient history in seconds, and generate technical notes with medical necessity language across 14 neurology subspecialties.
Neurology Follow-up Note
Neurology
PATIENT: John Doe · 52 yrs · Epilepsy follow-up
HISTORY & INTERVAL CHANGE
Returns for routine epilepsy follow-up on levetiracetam 1000 mg BID. Reports two focal impaired-awareness seizures in the past three months, down from six.
EXAM & FINDINGS
Alert and fully oriented. Cranial nerves II–XII intact. Motor 5/5 throughout. Gait narrow-based and steady, no tremor at rest.
ASSESSMENT & FOLLOW-UP
Increase levetiracetam to 1500 mg BID. Repeat routine EEG within six weeks. Return in three months.
Built for complex, longitudinal oncology.
Capture nuanced oncology encounters, bring prior treatment history into view, and document assessments, decisions, and follow-up clearly.
Oncology Follow-up Note
Oncology
PATIENT: Sample Patient · Treatment follow-up
HISTORY & INTERVAL CHANGE
Returns to review interval symptoms, treatment tolerance, and recent imaging. Fatigue is stable, with no new concerning symptoms reported.
EXAM & FINDINGS
Performance status, treatment effects, laboratory results, and imaging findings were reviewed with the patient.
ASSESSMENT & FOLLOW-UP
Continue the documented treatment plan, monitor for adverse effects, and arrange follow-up after the next assessment.
Built for complex, longitudinal orthopedics.
Capture complex orthopedic visits, review years of patient history in seconds, and generate technical notes with medical necessity language across orthopedic subspecialties.
Orthopedic Follow-up Note
Orthopedics
PATIENT: Sample Patient · Knee pain follow-up
HISTORY & INTERVAL CHANGE
Returns to review persistent knee discomfort, activity limits, and response to the current rehabilitation plan.
EXAM & FINDINGS
Gait, range of motion, strength, and focal tenderness were assessed. Prior imaging was reviewed in the context of today's exam.
ASSESSMENT & FOLLOW-UP
Findings and functional goals were discussed. The plan records rehabilitation steps, symptom monitoring, and follow-up.
Built for complex, longitudinal nephrology.
Capture complex nephrology visits, review years of patient history in seconds, and generate technical notes with medical necessity language across every nephrology subspecialty.
Nephrology Follow-up Note
Nephrology
PATIENT: Sample Patient · Kidney care follow-up
HISTORY & INTERVAL CHANGE
Returns for longitudinal kidney care. Interval symptoms, medications, home measurements, and recent laboratory trends were reviewed.
EXAM & FINDINGS
Volume status, blood pressure, and relevant laboratory results were documented and compared with prior visits.
ASSESSMENT & FOLLOW-UP
The assessment summarizes kidney function trends and the monitoring plan, with follow-up and care coordination documented.
Built for complex, longitudinal epilepsy care.
Capture complex epilepsy visits, review years of patient history in seconds, and generate technical notes with medical necessity language across every epilepsy subspecialty.
Epilepsy Follow-up Note
Epilepsy
PATIENT: Sample Patient · Seizure follow-up
HISTORY & INTERVAL CHANGE
Seizure diary, event frequency, triggers, and treatment tolerance were reviewed since the previous visit.
EXAM & FINDINGS
Focused neurologic findings and available diagnostic results were documented for longitudinal comparison.
ASSESSMENT & FOLLOW-UP
The plan captures seizure monitoring, safety counseling, and timing of the next neurology review.
Built for complex, longitudinal psychiatry.
Capture complex psychiatry visits, review years of patient history in seconds, and generate technical notes with medical necessity language across every psychiatry subspecialty.
Psychiatry Progress Note
Psychiatry
PATIENT: Sample Patient · Behavioral health follow-up
HISTORY & INTERVAL CHANGE
Mood, sleep, daily function, and treatment response were reviewed in the patient's own words.
EXAM & FINDINGS
Mental status observations and relevant screening results were documented alongside the interval history.
ASSESSMENT & FOLLOW-UP
The assessment records current goals, follow-up support, and the shared care plan.
Built for complex, longitudinal pediatrics.
Capture complex pediatric visits, review years of patient history in seconds, and generate technical notes with medical necessity language across every pediatric subspecialty.
Pediatric Follow-up Note
Pediatrics
PATIENT: Sample Patient · Pediatric follow-up
HISTORY & INTERVAL CHANGE
The caregiver described interval symptoms, growth, school or home function, and response to prior guidance.
EXAM & FINDINGS
Age-appropriate exam findings and growth measurements were reviewed and documented.
ASSESSMENT & FOLLOW-UP
The plan summarizes caregiver guidance, monitoring needs, and the next pediatric visit.
Built for complex, longitudinal ketamine therapy.
Capture complex ketamine therapy visits, review years of patient history in seconds, and generate technical notes with medical necessity language across every protocol.
Ketamine Therapy Progress Note
Ketamine Therapy
PATIENT: Sample Patient · Therapy follow-up
HISTORY & INTERVAL CHANGE
The patient described symptom changes and functional response since the last monitored session.
EXAM & FINDINGS
The visit record includes interval screening, observed status, and treatment-tolerance notes.
ASSESSMENT & FOLLOW-UP
The team documented response, safety review, and the next follow-up discussion.
Built for complex, longitudinal integrative care.
Capture complex integrative care visits, review years of patient history in seconds, and generate technical notes with medical necessity language across every integrative subspecialty.
Integrative Care Follow-up Note
Integrative Care
PATIENT: Sample Patient · Integrative care follow-up
HISTORY & INTERVAL CHANGE
The patient reviewed symptoms, daily routines, and progress toward agreed wellness goals.
EXAM & FINDINGS
Relevant findings and patient-reported measures were documented for comparison with earlier visits.
ASSESSMENT & FOLLOW-UP
The plan coordinates conventional care, self-management goals, and follow-up.
Built for complex, longitudinal cardiology.
Capture complex cardiology visits, review years of patient history in seconds, and generate technical notes with medical necessity language across every cardiology subspecialty.
Cardiology Follow-up Note
Cardiology
PATIENT: Sample Patient · Cardiac follow-up
HISTORY & INTERVAL CHANGE
Reports interval exercise tolerance, symptoms, and home measurements since the prior visit.
EXAM & FINDINGS
Cardiac exam findings and available testing were reviewed against the patient's baseline.
ASSESSMENT & FOLLOW-UP
The assessment captures symptom trends, monitoring, and the next cardiology review.
Built for complex, longitudinal ENT care.
Capture complex ENT & otolaryngology visits, review years of patient history in seconds, and generate technical notes with medical necessity language across every subspecialty.
ENT Follow-up Note
ENT / Otolaryngology
PATIENT: Sample Patient · ENT follow-up
HISTORY & INTERVAL CHANGE
Returns to review upper-airway symptoms, treatment response, and effects on daily activities.
EXAM & FINDINGS
Focused ear, nose, and throat findings were documented with relevant prior test results.
ASSESSMENT & FOLLOW-UP
The plan records symptom tracking, supportive care, and timing of follow-up.
Built for complex, longitudinal primary care.
Capture complex primary care visits, review years of patient history in seconds, and generate technical notes with medical necessity language across every primary care need.
Primary Care Follow-up Note
Primary Care
PATIENT: Sample Patient · Primary care follow-up
HISTORY & INTERVAL CHANGE
The patient reviewed interval concerns, current medications, preventive care, and chronic-condition goals.
EXAM & FINDINGS
Vital signs and focused findings were documented with the relevant history and results.
ASSESSMENT & FOLLOW-UP
The shared plan covers monitoring, referrals where needed, and the next primary-care visit.
Built for complex, longitudinal podiatry.
Capture complex podiatry visits, review years of patient history in seconds, and generate technical notes with medical necessity language across every podiatric subspecialty.
Podiatry Follow-up Note
Podiatry
PATIENT: Sample Patient · Foot pain follow-up
HISTORY & INTERVAL CHANGE
Returns to review foot discomfort, footwear, activity limits, and response to prior care.
EXAM & FINDINGS
Skin, circulation, sensation, gait, and focal foot findings were documented as relevant.
ASSESSMENT & FOLLOW-UP
The plan records symptom management, self-care guidance, and follow-up.
Built for complex, longitudinal rheumatology.
Capture complex rheumatology visits, review years of patient history in seconds, and generate technical notes with medical necessity language across every rheumatology subspecialty.
Rheumatology Follow-up Note
Rheumatology
PATIENT: Sample Patient · Joint care follow-up
HISTORY & INTERVAL CHANGE
Reports interval joint symptoms, morning function, and treatment tolerance since the last visit.
EXAM & FINDINGS
Joint findings and available inflammatory markers were reviewed alongside prior assessments.
ASSESSMENT & FOLLOW-UP
The assessment summarizes symptom trends, monitoring, and the agreed follow-up plan.
Built for complex, longitudinal pulmonology.
Capture complex pulmonology visits, review years of patient history in seconds, and generate technical notes with medical necessity language across every pulmonology subspecialty.
Pulmonology Follow-up Note
Pulmonology
PATIENT: Sample Patient · Respiratory follow-up
HISTORY & INTERVAL CHANGE
Returns to discuss breathing symptoms, activity tolerance, and response to the current care plan.
EXAM & FINDINGS
Focused respiratory findings and relevant testing were documented for comparison over time.
ASSESSMENT & FOLLOW-UP
The plan captures symptom monitoring, patient guidance, and the next pulmonary review.
Our AI Models Specialize Across 135 Specialties
Built for your specialty, customised for your practice.
Selected Specialty · Neurology
Built for complex, longitudinal neurology.
Capture complex neurological visits, review years of patient history in seconds, and generate technical notes with medical necessity language across 14 neurology subspecialties.
SPECIALTY CAPABILITIES
Captures seizure semiology and cranial nerve exams
Builds Patient Recaps from prior charts
Captures PHQ-9, PDQ-39 and ASRS scores
Codes ICD-10 with MDM rationale
Supports 90 to 120 minute consults
RECOGNIZED PARTNER
Marvix AI is a partner in the AAN Practice Success Network.
Explore specialty templates
→
NEUROLOGY FOLLOW-UP NOTE
Synced to EHR
PATIENT: Martin Summit · 74 yrs · Cognitive evaluation
Chief Complaint (CC)
Progressive memory loss over the past three years with increasing forgetfulness, difficulty managing daily tasks, word-finding difficulty, and concern for dementia.
History of Present Illness
Martin Summit is a 74-year-old right-handed male presenting for evaluation of progressive cognitive decline over approximately three years. His wife reports forgetfulness, repetitive questioning, and misplaced items that have gradually worsened. Over the past year he has had greater difficulty managing finances and medications, following multistep tasks, and keeping track of dates, though he remains familiar with close family and his home.
He reports occasional word-finding difficulty and slower processing speed. His wife notes mild apathy but no personality change, aggression, or visual hallucinations. Sleep is fragmented with occasional daytime naps, and he removes his CPAP mask partway through most nights. There is no history of stroke, seizure, head trauma, loss of consciousness, or rapidly progressive neurological decline.
Past Medical History
Current Medications
Amlodipine 5 mg daily
Metformin 1000 mg twice daily
Atorvastatin 20 mg nightly
Aspirin 81 mg daily
Vitamin D3 1000 IU daily
Past Surgical History
Family History
Social History
Martin Summit is a retired accountant who lives with his wife. He has never smoked and drinks alcohol occasionally. He denies illicit drug use. He remains physically active with daily walks but has reduced participation in community activities because of memory concerns.
Functional Status
Activities of Daily Living (ADLs):
Independent with dressing, bathing, toileting, and feeding
Occasionally requires reminders for personal hygiene
Instrumental Activities of Daily Living (IADLs):
Requires assistance with finances
Wife manages medications
Has difficulty organizing appointments
Continues to drive locally but avoids unfamiliar routes
Reduced confidence with shopping independently
Functional Activities Questionnaire (FAQ) score 11/30 based on his wife's report
Review of Systems (ROS)
General: Mild fatigue. No fever or unintentional weight loss.
Respiratory: No cough or dyspnea.
Cardiovascular: No chest pain or palpitations.
GI: No nausea, vomiting, abdominal pain, or change in bowel habits.
Psychiatric: Mild apathy and decreased motivation. No depression, hallucinations, or suicidal ideation. PHQ-9 score 4, consistent with minimal depressive symptoms.
Musculoskeletal: Mild chronic bilateral knee discomfort.
Neurological: Progressive short-term memory impairment, word-finding difficulty, slowed processing speed, and occasional disorientation in unfamiliar environments. No focal weakness, numbness, tremor, seizures, gait instability, or loss of consciousness.
Vitals
BP: 132/76 mmHg
Pulse: 68 bpm
Temp: 98.1°F
Height: 175 cm
Weight: 80 kg
BMI: 26.1 kg/m²
Examination
General:
Pleasant elderly male in no acute distress.
Mental Status Exam:
Appearance: Well groomed
Behavior: Cooperative and attentive
Mood: Euthymic
Affect: Appropriate with full range
Thought Process: Logical but slowed
Interactions: Appropriate with preserved social awareness
Neurological:
Mental Status: Alert and oriented to person and place but incorrectly identified the date. Speech fluent with occasional word-finding pauses. Immediate registration intact. Delayed recall impaired with recall of 1 out of 3 objects after five minutes, improving to 2 out of 3 with category cues. Mild impairment in attention during serial sevens. Clock drawing demonstrated mild visuospatial disorganization. Estimated MoCA score 22/30, declined from 25/30 in March 2024.
Cranial Nerves: Cranial nerves II-XII intact. Pupils equal and reactive to light. Extraocular movements full. Facial strength and sensation symmetric. Hearing mildly reduced bilaterally to conversational voice.
Motor: Normal bulk and tone. Strength 5/5 throughout. No rigidity, bradykinesia, tremor, or pronator drift.
Reflexes: 2+ and symmetric throughout.
Coordination: Finger-to-nose and rapid alternating movements intact bilaterally.
Sensory: Intact to light touch, vibration, and proprioception.
Gait and Station: Mildly slowed gait with preserved arm swing. Able to perform tandem gait with minimal difficulty. Negative Romberg.
Labs and Imaging
Laboratory Tests (June 2026):
CBC and comprehensive metabolic panel within normal limits. Sodium 138 mmol/L, Creatinine 0.96 mg/dL (eGFR 82 mL/min/1.73 m²), HbA1c 7.0%, Vitamin B12 462 pg/mL, Folate 12.4 ng/mL, TSH 2.18 uIU/mL. No reversible metabolic cause for cognitive impairment identified.
MRI Brain (July 2026):
Mild bilateral hippocampal volume loss with mild generalized cerebral atrophy, slightly greater than expected for age. Mild chronic microvascular white matter changes (Fazekas Grade 1). No acute infarction, hemorrhage, hydrocephalus, or intracranial mass. Interval development of hippocampal volume loss compared with March 2024.
MRI Brain (March 2024):
Age-appropriate cerebral volume without hippocampal atrophy. Scattered punctate white matter hyperintensities. No acute intracranial abnormality.
Assessment
Progressive cognitive impairment concerning for early Alzheimer's disease
Mild cognitive impairment affecting instrumental activities of daily living
Mild chronic cerebral small vessel ischemic disease
Obstructive sleep apnea with suboptimal CPAP adherence, possible contributor to cognitive symptoms
Hypertension and type 2 diabetes mellitus, stable
Plan
Ordered
Medications:
No medication changes pending diagnostic evaluation
Labs:
Plasma p-tau217
Procedures:
Comprehensive neuropsychological testing
CPAP compliance download
Follow Up
Follow-up is scheduled in six weeks after completion of neuropsychological testing to review results, establish a definitive diagnosis, discuss treatment options, and determine the need for pharmacologic therapy and additional safety planning. His wife was advised to call sooner for any sudden change in cognition, new focal weakness or speech difficulty, falls, or new behavioral symptoms such as hallucinations or agitation.
10. Outputs Chips
OUTPUTS FROM ONE ENCOUNTER
Clinical Note
ICD-10 & E/M Coding
Patient Instructions
Referral Letter
Selected Specialty · Oncology
Built for multidisciplinary oncology.
Summarize every line of therapy in seconds and generate notes with biomarker detail and NCCN-aligned recommendations.
SPECIALTY CAPABILITIES
Records TNM staging and biomarker status
Builds Patient Recaps from prior charts
Summarizes every line of therapy
Trends tumor markers across visits
Captures ECOG and Karnofsky scores
Generates NCCN-based recommendations
Codes ICD-10 with MDM rationale
RECOGNIZED PARTNER
Marvix AI is a partner in the AAN Practice Success Network.
Explore specialty templates
→
Oncology Follow-Up Note
Synced to EHR
PATIENT: Sabrina Wentz · 56 yrs · Metastatic breast cancer restaging
Chief Complaint
Follow-up for metastatic hormone receptor-positive breast cancer with review of six-month restaging on second-line elacestrant.
History of Present Illness
Sabrina Wentz is a 56-year-old postmenopausal female with metastatic hormone receptor-positive, HER2-low breast cancer involving bone and liver, diagnosed in 2019 and treated with multiple lines of therapy. She presents to review restaging imaging after six months of second-line elacestrant, started in March 2026 after progression on fulvestrant and palbociclib.
She reports mild intermittent afternoon fatigue and occasional mid-back stiffness that does not limit activity. She continues to work full time. She states, "I feel like myself again, and I want to keep working as long as I can."
Past Medical History
Initial diagnosis (April 2019): invasive ductal carcinoma of the right breast, Nottingham grade 2, ER 95%, PR 80%, HER2 1+ by IHC, Ki-67 22%, pT2 pN1a M0, anatomic stage IIB
Adjuvant therapy (2019 to 2022): dose-dense doxorubicin and cyclophosphamide for four cycles followed by weekly paclitaxel for twelve weeks (June to October 2019), whole breast and regional nodal radiation to 50 Gy in 25 fractions with a 10 Gy tumor bed boost (November and December 2019), and leuprolide with exemestane starting January 2020 (leuprolide stopped in 2022 after biochemical confirmation of menopause)
First-line metastatic therapy (September 2023): fulvestrant with palbociclib and denosumab, plus palliative radiation to L2 at 20 Gy in 5 fractions, with disease stable for 29 months
Past Surgical History
Past Imaging
CT Chest, Abdomen, and Pelvis with Contrast and Whole-Body Bone Scan (September 21, 2026):
Past Labs
Circulating Tumor DNA, Guardant360 (February 2026):
Family History
Social History
Sabrina Wentz is married and lives with her husband. She has two adult children who live nearby. She works full time as a paralegal. She has never smoked, drinks one glass of wine on weekends, and denies illicit drug use. She walks 30 minutes daily. Her husband is her designated health care proxy, and she completed an advance directive in April 2026.
Current Medications
Allergies
No known drug allergies
Review of Systems
General: Mild afternoon fatigue. Weight stable at 66 kg over six months. No fevers or night sweats.
Skin: No rash. Mild chronic hyperpigmentation of the right breast from prior radiation.
Eyes: No vision changes.
HENT: No jaw pain, dental pain, or oral lesions.
Respiratory: No cough or shortness of breath.
Cardiovascular: No chest pain, palpitations, or edema.
GI: Grade 1 nausea during the first month of elacestrant, now resolved. No abdominal pain, right upper quadrant discomfort, or change in bowel habits.
Neurological: Stable numbness in both feet since 2019. No new weakness, gait change, headache, or bowel or bladder dysfunction.
Musculoskeletal: Occasional mild mid-back stiffness without focal pain.
Psychiatric: Mild anxiety before restaging scans. No depressed mood.
Physical Exam
General: Well-appearing female in no acute distress.
Vital signs: BP 128/78 mmHg, HR 76 bpm, Temperature 98.2°F, SpO2 98% on room air, Height 163 cm, Weight 66 kg.
Skin: Mild post-radiation hyperpigmentation of the right breast. No rash.
Eyes: Sclerae anicteric.
HENT: Oral mucosa intact without exposed bone or gingival inflammation.
Breast: Well-healed right lumpectomy and axillary incisions. No palpable masses in either breast. No skin thickening or nipple changes.
Lymph Nodes: No cervical, supraclavicular, or axillary lymphadenopathy.
Respiratory: Lungs clear to auscultation bilaterally.
Cardiovascular: Regular rate and rhythm without murmurs. No peripheral edema.
GI: Soft, non-tender, non-distended. No hepatomegaly.
Neurological: Decreased vibration sensation at both great toes, unchanged from prior exams. Strength 5/5 throughout. Reflexes 2+ and symmetric. Gait normal.
Musculoskeletal: No point tenderness over the thoracic or lumbar spine, pelvis, or ribs. Full range of motion of the right shoulder without lymphedema.
Psychiatric: Alert and oriented with appropriate mood and affect.
Assessment and Plan
Metastatic HR-Positive, HER2-Low Breast Cancer to Bone and Liver, on Second-Line Elacestrant:
The patient has completed six months of elacestrant for ESR1-mutated disease following progression on fulvestrant and palbociclib after 29 months of disease control. Restaging CT demonstrates partial response, with the dominant segment VI hepatic lesion decreasing from 2.4 cm to 1.5 cm and two smaller lesions nearly resolving. Bone lesions are stable and sclerotic without new sites. CA 27.29 has declined from 112 to 64 U/mL. ECOG performance status is 0 and she continues to work full time. Findings support continuation of current therapy.
Ordered
Medications: Elacestrant 345 mg daily, 30-day supply with 2 refills
Labs: CBC with differential, CMP, and CA 27.29 in 4 weeks. Fasting lipid panel in December 2026
Imaging: CT chest, abdomen, and pelvis with contrast and whole-body bone scan in December 2026
Procedures: Dental evaluation January 2027
Procedures Today: Denosumab 120 mg subcutaneous injection
ECOG Performance Status (Beta)
ECOG Score 0: The patient is fully active and able to carry on all pre-disease activities without restriction. She works full time as a paralegal and walks 30 minutes daily, with only mild afternoon fatigue that does not limit her activities.
Karnofsky Performance Status (Beta)
Karnofsky Score 90: The patient is able to carry on normal activity and work with minor signs or symptoms of disease, including mild fatigue and occasional back stiffness. She requires no assistance with personal care or daily activities.
Recommendations as per NCCN Guidelines
For Recurrent or Stage IV HR-Positive, HER2-Negative Breast Cancer:
9. Outputs Chips
OUTPUTS FROM ONE ENCOUNTER
Clinical Note
ICD-10 & E/M Coding
Patient Instructions
Referral Letter
Selected Specialty · Orthopedics
Built for imaging-driven Orthopedics.
Structure joint-specific exams with laterality carried through every section and turn imaging into technical summaries that support surgical necessity.
SPECIALTY CAPABILITIES
Carries laterality through every section
Structures joint-specific exams and special tests
Summarizes X-ray and MRI in radiologic language
Builds Patient Recaps of prior treatments
Captures KOOS JR and PROMIS scores
Inserts procedure and consent macros
Codes ICD-10 and CPT with MDM rationale
RECOGNIZED PARTNER
Marvix AI is a partner in the AAN Practice Success Network.
Explore specialty templates
→
Orthopedic Surgical Consultation Note
Synced to EHR
PATIENT: Andy Harris · 61 yrs · Right knee osteoarthritis
Chief Complaint (CC)
Worsening right knee pain, stiffness, and progressive functional decline despite more than six years of conservative treatment, presenting for surgical consultation.
History of Present Illness
Andy Harris is a 61-year-old right-hand-dominant male presenting for surgical consultation for end-stage osteoarthritis of the right knee, with symptoms since a skiing injury in 2015 and a partial medial meniscectomy in 2016. Pain is 8/10 with activity and 5/10 at rest despite more than six years of conservative care.
Pain is medial and worse with stairs, rising from a chair, and standing over 20 minutes, with night pain three to four nights weekly. He uses a cane for longer distances. He denies locking, giving way, trauma, fevers, or radiating pain. KOOS JR declined from 68.3 to 47.5. He states, "I've done every shot and brace there is, and now I just want my life back."
Other Histories
Past Medical History:
Conservative treatment of the right knee: meloxicam and a home exercise program; corticosteroid injections in April 2022 (about four months of relief), September 2023 (three months), February 2025 and August 2025 (about six weeks each); hyaluronic acid series in March 2023 with minimal benefit; 12 weeks of formal physical therapy from February through May 2024; medial unloader brace since June 2024
Past Surgical History:
Family History:
Social History:
Works full time as a commercial electrician, a role that involves frequent kneeling, ladder climbing, and prolonged standing
Married and lives with his wife in a two-story home with 14 interior stairs and the primary bedroom on the second floor
Wife is retired and available to assist during postoperative recovery
Former smoker with a 15 pack-year history, quit in 2010
Drinks two beers per week. Denies illicit drug use
Goals are to return to work, walk his dog two miles daily, and resume golf
Labs and Imaging
Allergies
No known drug allergies
Current Medications
Review of Systems (ROS)
General: No fevers, chills, or unintentional weight loss. Intentional 6 kg weight loss since March 2026.
Skin: No rashes, wounds, or skin breakdown around either knee.
Eyes: No vision changes.
HENT: No dental pain or active dental infection.
Respiratory: No cough or shortness of breath.
Cardiovascular: No chest pain, palpitations, or exertional dyspnea.
GI: No abdominal pain or GI bleeding with NSAID use.
Neurological: No numbness, tingling, or weakness in either lower extremity.
Psychiatric: Reports frustration with activity limitations. No depressed mood.
Musculoskeletal: Right knee pain rated 8/10 with activity and 5/10 at rest, 30 minutes of morning stiffness, intermittent swelling, and night pain. Mild intermittent left knee aching after prolonged activity. No hip or low back pain.
Vitals
BP: 134/82 mmHg
Pulse: 72 bpm
Temp: 98.3°F
Height: 1.78 m
Weight: 99 kg
BMI: 31.2
Physical Exam (PE)
General Appearance: Well-appearing male in no acute distress. Ambulates with an antalgic gait favoring the right lower extremity without an assistive device in clinic.
Skin: Intact skin over both knees. Well-healed right knee arthroscopic portal scars. No erythema or open wounds.
Eyes: Extraocular movements intact.
HENT: Normocephalic, atraumatic.
Respiratory: Lungs clear to auscultation bilaterally.
Cardiovascular: Regular rate and rhythm. Dorsalis pedis and posterior tibial pulses 2+ bilaterally with capillary refill under 2 seconds.
GI: Soft, non-tender.
Neurological: Sensation intact to light touch in the L3 through S1 dermatomes bilaterally. EHL, tibialis anterior, and gastrocnemius strength 5/5 bilaterally.
Psychiatric: Alert and oriented with appropriate mood and affect.
Musculoskeletal:
Right Knee: Varus alignment of approximately 7 degrees, partially correctable with valgus stress. Mild effusion without warmth or erythema. Tenderness along the medial joint line with no lateral joint line tenderness. Range of motion 3 to 105 degrees with a 3-degree flexion contracture and pain at terminal flexion. Palpable crepitus throughout range of motion. Lachman and anterior drawer negative. Posterior drawer negative. Stable to varus and valgus stress at 0 and 30 degrees. McMurray test reproduces medial joint line pain without a palpable click. Patellar grind test mildly positive. Quadriceps strength 4+/5 limited by pain.
Left Knee: Neutral alignment. No effusion. Mild medial joint line tenderness. Range of motion 0 to 130 degrees with mild crepitus. Ligamentously stable. Quadriceps strength 5/5.
Right Hip: Full, painless range of motion. Negative log roll and FADIR testing, excluding referred hip pain.
Assessment and Plan
Recommendations
Discussion Notes
Andy Harris has a seven-year history of right knee symptoms dating to a skiing injury in 2015 and arthroscopic partial medial meniscectomy in 2016. We reviewed his radiographs from March 2021, January 2024, and today side by side, demonstrating progression from early medial narrowing to complete loss of the medial joint space with varus deformity.
We reviewed each conservative treatment he has completed, including medications, formal physical therapy, an unloader brace, a hyaluronic acid series, and four corticosteroid injections, with relief decreasing from four months after the first injection to six weeks after the most recent. I explained that additional injections are unlikely to provide durable benefit and that an injection within three months of surgery would increase his risk of periprosthetic infection.
We discussed total knee arthroplasty in detail, including the procedure, implant type, anesthesia plan, and expected hospital course with same-day or next-day discharge. We reviewed the risks of surgery, including infection, blood clots, stiffness, persistent pain, injury to nerves or blood vessels, periprosthetic fracture, implant loosening, and the potential need for revision surgery. We discussed that most patients experience substantial pain relief and functional improvement, with recovery continuing for up to one year.
We discussed the demands of his work as an electrician. I explained that kneeling may remain uncomfortable after arthroplasty and that we would plan a graded return to duty with his employer. Given the 14 stairs to his bedroom, we discussed arranging a first-floor recovery space for the first two weeks.
The patient's questions were answered and he expressed understanding of the risks, benefits, and alternatives. He elected to proceed with right total knee arthroplasty, and informed consent was obtained and documented.
Ordered
Medications: Continue meloxicam 15 mg daily until 7 days before surgery
Labs: CBC, BMP, PT/INR, type and screen, urinalysis, nasal MRSA screen
Imaging: No additional imaging required. Current standing and long-leg alignment radiographs to be used for surgical templating
Procedures: Right total knee arthroplasty on November 18, 2026. Referrals to primary care for preoperative clearance and to physical therapy for prehabilitation
Procedures Today: Informed consent obtained for right total knee arthroplasty
9. Outputs Chips
OUTPUTS FROM ONE ENCOUNTER
Clinical Note
ICD-10 & E/M Coding
Patient Instructions
Referral Letter
Selected Specialty · Nephrology
Built for long-term kidney care.
Track CKD progression across years of labs and generate problem-based notes ready for dialysis and transplant planning.
SPECIALTY CAPABILITIES
Stages CKD from eGFR and UACR trends
Auto-tags CKD etiology across visits
Builds Patient Recaps from prior labs
Tracks anemia and CKD-MBD markers
Captures dialysis access and session details
Structures plans by nephrologic problem
Codes ICD-10 with MDM rationale
RECOGNIZED PARTNER
Marvix AI is a partner in the AAN Practice Success Network.
Explore specialty templates
→
Nephrology Follow-Up Note
Synced to EHR
PATIENT: Joe Hurley · 64 yrs · CKD stage 4 follow-up
Chief Complaint (CC)
Follow-up for progressive chronic kidney disease stage G4 A3 due to diabetic kidney disease, with review of kidney replacement therapy planning and transplant evaluation.
History of Present Illness
Joe Hurley is a 64-year-old male with type 2 diabetes since 2004 and hypertension since 2006 who returns for follow-up of chronic kidney disease, now stage G4 A3 and approaching kidney failure. He chose preemptive kidney transplantation after kidney replacement therapy education, with hemodialysis as a bridge if needed.
He reports decreased appetite with early satiety, mild afternoon fatigue, intermittent itching of the forearms and back, mild ankle swelling, and a 2 kg weight gain. Home blood pressure averages 138/82 mmHg. He denies nausea, vomiting, confusion, chest pain, dyspnea, or decreased urine output. He is adherent but struggles to limit potassium-rich foods. He states, "I want to get the transplant before I ever need dialysis."
Past Medical History
Hyperkalemia to 5.6 mmol/L and metabolic acidosis with serum bicarbonate of 19 mmol/L (2024), managed with patiromer and sodium bicarbonate
Iron deficiency with anemia of CKD (first noted 2023), treated with intravenous ferric carboxymaltose; darbepoetin started August 2025
Medication changes: empagliflozin added in 2021, finerenone added in 2022 for persistent albuminuria of 960 mg/g with UACR decreasing to 610 mg/g within six months, semaglutide started in 2023, and metformin discontinued in 2024 when eGFR fell below 30 mL/min/1.73 m²
Current Medications
Lisinopril 40 mg daily
Amlodipine 10 mg daily
Furosemide 40 mg twice daily
Empagliflozin 10 mg daily
Finerenone 10 mg daily
Semaglutide 1 mg subcutaneous weekly
Insulin glargine 18 units nightly
Patiromer 8.4 g daily
Sodium bicarbonate 650 mg three times daily
Darbepoetin alfa 40 mcg subcutaneous every 2 weeks
Ergocalciferol 50,000 IU weekly
Atorvastatin 40 mg nightly
Aspirin 81 mg daily
Past Surgical History
Family History
Social History
Joe Hurley is married and lives with his wife. He retired in 2025 after 30 years as a postal carrier. He quit smoking in 2008 after a 20 pack-year history. He does not drink alcohol and denies illicit drug use. He walks 20 minutes most days. His wife is undergoing evaluation as a potential living kidney donor.
Functional Status
Activities of Daily Living (ADLs):
Independent with all basic self-care activities
Instrumental Activities of Daily Living (IADLs):
Independent with finances, driving, and medication management
Uses a weekly pill organizer and tracks home blood pressure and blood glucose readings
Reduced stamina for yard work over the past six months
Review of Systems (ROS)
General: Mild afternoon fatigue. Decreased appetite with early satiety. Weight up 2 kg over three months.
Skin: Intermittent pruritus of the forearms and back.
Eyes: Stable vision since panretinal photocoagulation.
Respiratory: No shortness of breath, cough, or orthopnea.
Cardiovascular: Mild bilateral ankle swelling by end of day. No chest pain or palpitations.
GI: No nausea, vomiting, dysgeusia, or change in bowel habits.
GU: No decrease in urine output, hematuria, or foamy urine beyond baseline.
Musculoskeletal: No bone pain or muscle cramps.
Neurological: Stable numbness in both feet. No confusion, tremor, or restless legs.
Psychiatric: Mild anxiety regarding transplant timing. No depressed mood.
Vitals
BP: 142/84 mmHg
Pulse: 74 bpm
Temp: 98.0°F
Height: 180 cm
Weight: 94 kg (92 kg three months ago)
BMI: 29.0 kg/m²
Examination
General:
Well-appearing male in no acute distress.
HEENT:
Conjunctivae mildly pale. Oral mucosa moist.
Neck:
Jugular venous pressure approximately 7 cm H2O.
Cardiovascular:
Regular rate and rhythm. No murmurs, rubs, or gallops. No pericardial friction rub.
Respiratory:
Lungs clear to auscultation bilaterally without crackles.
Abdomen:
Soft, non-tender, non-distended. No bruits.
Extremities:
1+ bilateral pitting edema to the mid-shin.
Vascular Access:
Left radiocephalic arteriovenous fistula with strong palpable thrill and continuous bruit along the forearm. Vein palpable and straight for approximately 10 cm with no aneurysmal segments, erythema, or tenderness. Hand warm with intact radial pulse distal to the anastomosis.
Skin:
Mild excoriations on the dorsal forearms. No rash or calciphylaxis lesions.
Neurological:
Alert and oriented. No asterixis. Decreased monofilament sensation at both feet, unchanged.
Labs and Imaging
eGFR and Albuminuria Trend (CKD-EPI 2021):
2017: Creatinine 1.48 mg/dL, eGFR 54 mL/min/1.73 m², UACR 180 mg/g (G3a A2)
2019: Creatinine 1.70 mg/dL, eGFR 46 mL/min/1.73 m², UACR 420 mg/g (G3a A3)
2021: Creatinine 2.00 mg/dL, eGFR 38 mL/min/1.73 m², UACR 880 mg/g (G3b A3)
2022: Creatinine 2.18 mg/dL, eGFR 34 mL/min/1.73 m², UACR 960 mg/g (G3b A3)
2023: Creatinine 2.36 mg/dL, eGFR 31 mL/min/1.73 m², UACR 610 mg/g (G3b A3)
2024: Creatinine 2.62 mg/dL, eGFR 27 mL/min/1.73 m², UACR 540 mg/g (G4 A3)
2025: Creatinine 2.98 mg/dL, eGFR 23 mL/min/1.73 m², UACR 590 mg/g (G4 A3)
March 2026: Creatinine 3.22 mg/dL, eGFR 21 mL/min/1.73 m², UACR 650 mg/g (G4 A3)
September 2026: Creatinine 3.52 mg/dL, eGFR 19 mL/min/1.73 m², UACR 710 mg/g (G4 A3)
Average eGFR decline of approximately 4 mL/min/1.73 m² per year. Kidney Failure Risk Equation estimates 2-year risk of kidney failure at 34% and 5-year risk at 74%.
Laboratory Tests (September 2026):
Sodium 138 mmol/L, potassium 5.2 mmol/L, chloride 106 mmol/L, bicarbonate 21 mmol/L, BUN 58 mg/dL, glucose 128 mg/dL, calcium 8.9 mg/dL, phosphorus 5.1 mg/dL, magnesium 2.1 mg/dL, albumin 3.8 g/dL, uric acid 8.1 mg/dL.
CKD-MBD (September 2026): Intact PTH 212 pg/mL (148 pg/mL in 2024), 25-hydroxyvitamin D 28 ng/mL.
Anemia Panel (September 2026): Hemoglobin 10.6 g/dL (9.6 g/dL in August 2025 before darbepoetin), ferritin 312 ng/mL, transferrin saturation 24%.
Diabetes and Lipids (September 2026): HbA1c 6.9%, interpreted with caution given ESA therapy and reduced kidney function. LDL 68 mg/dL.
Hepatitis B Immunity (2025): Anti-HBs 42 mIU/mL following completed vaccination series.
Serologic Evaluation (2019): ANA, ANCA, complement levels, hepatitis B and C serologies, SPEP, and serum free light chains unremarkable. Kidney biopsy was not pursued given longstanding diabetes with proliferative diabetic retinopathy and progressive albuminuria
Arteriovenous Fistula Duplex Ultrasound (July 2026):
Left radiocephalic fistula with flow volume of 620 mL/min, outflow vein diameter of 5.8 mm, and depth of 4 mm from skin. No stenosis or thrombus. Findings consistent with a maturing fistula approaching readiness for cannulation.
Renal Ultrasound (February 2026):
Right kidney 9.4 cm and left kidney 9.2 cm with increased cortical echogenicity and mild cortical thinning, decreased from 10.2 cm and 10.0 cm in 2019. No hydronephrosis, stones, or masses.
Transthoracic Echocardiogram (November 2025):
LVEF 55% with mild concentric left ventricular hypertrophy. No significant valvular disease.
Assessment
Chronic kidney disease stage G4 A3 due to diabetic kidney disease, progressive, approaching kidney failure
Hyperkalemia, controlled on potassium binder
Metabolic acidosis of CKD
Anemia of chronic kidney disease
CKD-mineral and bone disorder with secondary hyperparathyroidism and hyperphosphatemia
Volume overload, mild
Hypertension, above goal
Kidney replacement therapy planning with preemptive transplant evaluation
Type 2 diabetes mellitus, controlled
Plan
Ordered
Medications:
Sevelamer carbonate 800 mg three times daily with meals
Furosemide increased to 80 mg every morning and 40 mg every afternoon
Labs:
BMP, CBC, and phosphorus monthly
Iron studies, calcium, phosphorus, and intact PTH in 3 months
Imaging:
Arteriovenous fistula duplex ultrasound
Referrals:
Renal dietitian
Transplant center update for waitlist activation
Procedures Today:
Arteriovenous fistula assessment
Follow Up
Follow-up is scheduled in 6 weeks to reassess volume status, potassium, and uremic symptoms after the diuretic adjustment, with labs drawn one week prior. The patient was advised to seek immediate care for shortness of breath, chest pain, confusion, persistent nausea or vomiting, marked decrease in urine output, or loss of thrill in his fistula.
9. Outputs Chips
OUTPUTS FROM ONE ENCOUNTER
Clinical Note
ICD-10 & E/M Coding
Patient Instructions
Referral Letter
Selected Specialty · Neurology
Built for complex, longitudinal neurology.
Capture complex neurological visits, review years of patient history in seconds, and generate technical notes with medical necessity language across 14 neurology subspecialties.
SPECIALTY CAPABILITIES
Captures seizure semiology and cranial nerve exams
Builds Patient Recaps from prior charts
Captures PHQ-9, PDQ-39 and ASRS scores
Codes ICD-10 with MDM rationale
Supports 90 to 120 minute consults
RECOGNIZED PARTNER
Marvix AI is a partner in the AAN Practice Success Network.
Explore specialty templates
→
NEUROLOGY FOLLOW-UP NOTE
Synced to EHR
PATIENT: Martin Summit · 74 yrs · Cognitive evaluation
Chief Complaint (CC)
Progressive memory loss over the past three years with increasing forgetfulness, difficulty managing daily tasks, word-finding difficulty, and concern for dementia.
History of Present Illness
Martin Summit is a 74-year-old right-handed male presenting for evaluation of progressive cognitive decline over approximately three years. His wife reports forgetfulness, repetitive questioning, and misplaced items that have gradually worsened. Over the past year he has had greater difficulty managing finances and medications, following multistep tasks, and keeping track of dates, though he remains familiar with close family and his home.
He reports occasional word-finding difficulty and slower processing speed. His wife notes mild apathy but no personality change, aggression, or visual hallucinations. Sleep is fragmented with occasional daytime naps, and he removes his CPAP mask partway through most nights. There is no history of stroke, seizure, head trauma, loss of consciousness, or rapidly progressive neurological decline.
Past Medical History
Current Medications
Amlodipine 5 mg daily
Metformin 1000 mg twice daily
Atorvastatin 20 mg nightly
Aspirin 81 mg daily
Vitamin D3 1000 IU daily
Past Surgical History
Family History
Social History
Martin Summit is a retired accountant who lives with his wife. He has never smoked and drinks alcohol occasionally. He denies illicit drug use. He remains physically active with daily walks but has reduced participation in community activities because of memory concerns.
Functional Status
Activities of Daily Living (ADLs):
Independent with dressing, bathing, toileting, and feeding
Occasionally requires reminders for personal hygiene
Instrumental Activities of Daily Living (IADLs):
Requires assistance with finances
Wife manages medications
Has difficulty organizing appointments
Continues to drive locally but avoids unfamiliar routes
Reduced confidence with shopping independently
Functional Activities Questionnaire (FAQ) score 11/30 based on his wife's report
Review of Systems (ROS)
General: Mild fatigue. No fever or unintentional weight loss.
Respiratory: No cough or dyspnea.
Cardiovascular: No chest pain or palpitations.
GI: No nausea, vomiting, abdominal pain, or change in bowel habits.
Psychiatric: Mild apathy and decreased motivation. No depression, hallucinations, or suicidal ideation. PHQ-9 score 4, consistent with minimal depressive symptoms.
Musculoskeletal: Mild chronic bilateral knee discomfort.
Neurological: Progressive short-term memory impairment, word-finding difficulty, slowed processing speed, and occasional disorientation in unfamiliar environments. No focal weakness, numbness, tremor, seizures, gait instability, or loss of consciousness.
Vitals
BP: 132/76 mmHg
Pulse: 68 bpm
Temp: 98.1°F
Height: 175 cm
Weight: 80 kg
BMI: 26.1 kg/m²
Examination
General:
Pleasant elderly male in no acute distress.
Mental Status Exam:
Appearance: Well groomed
Behavior: Cooperative and attentive
Mood: Euthymic
Affect: Appropriate with full range
Thought Process: Logical but slowed
Interactions: Appropriate with preserved social awareness
Neurological:
Mental Status: Alert and oriented to person and place but incorrectly identified the date. Speech fluent with occasional word-finding pauses. Immediate registration intact. Delayed recall impaired with recall of 1 out of 3 objects after five minutes, improving to 2 out of 3 with category cues. Mild impairment in attention during serial sevens. Clock drawing demonstrated mild visuospatial disorganization. Estimated MoCA score 22/30, declined from 25/30 in March 2024.
Cranial Nerves: Cranial nerves II-XII intact. Pupils equal and reactive to light. Extraocular movements full. Facial strength and sensation symmetric. Hearing mildly reduced bilaterally to conversational voice.
Motor: Normal bulk and tone. Strength 5/5 throughout. No rigidity, bradykinesia, tremor, or pronator drift.
Reflexes: 2+ and symmetric throughout.
Coordination: Finger-to-nose and rapid alternating movements intact bilaterally.
Sensory: Intact to light touch, vibration, and proprioception.
Gait and Station: Mildly slowed gait with preserved arm swing. Able to perform tandem gait with minimal difficulty. Negative Romberg.
Labs and Imaging
Laboratory Tests (June 2026):
CBC and comprehensive metabolic panel within normal limits. Sodium 138 mmol/L, Creatinine 0.96 mg/dL (eGFR 82 mL/min/1.73 m²), HbA1c 7.0%, Vitamin B12 462 pg/mL, Folate 12.4 ng/mL, TSH 2.18 uIU/mL. No reversible metabolic cause for cognitive impairment identified.
MRI Brain (July 2026):
Mild bilateral hippocampal volume loss with mild generalized cerebral atrophy, slightly greater than expected for age. Mild chronic microvascular white matter changes (Fazekas Grade 1). No acute infarction, hemorrhage, hydrocephalus, or intracranial mass. Interval development of hippocampal volume loss compared with March 2024.
MRI Brain (March 2024):
Age-appropriate cerebral volume without hippocampal atrophy. Scattered punctate white matter hyperintensities. No acute intracranial abnormality.
Assessment
Progressive cognitive impairment concerning for early Alzheimer's disease
Mild cognitive impairment affecting instrumental activities of daily living
Mild chronic cerebral small vessel ischemic disease
Obstructive sleep apnea with suboptimal CPAP adherence, possible contributor to cognitive symptoms
Hypertension and type 2 diabetes mellitus, stable
Plan
Ordered
Medications:
No medication changes pending diagnostic evaluation
Labs:
Plasma p-tau217
Procedures:
Comprehensive neuropsychological testing
CPAP compliance download
Follow Up
Follow-up is scheduled in six weeks after completion of neuropsychological testing to review results, establish a definitive diagnosis, discuss treatment options, and determine the need for pharmacologic therapy and additional safety planning. His wife was advised to call sooner for any sudden change in cognition, new focal weakness or speech difficulty, falls, or new behavioral symptoms such as hallucinations or agitation.
10. Outputs Chips
OUTPUTS FROM ONE ENCOUNTER
Clinical Note
ICD-10 & E/M Coding
Patient Instructions
Referral Letter
Selected Specialty · Neurology
Built for complex, longitudinal neurology.
Capture complex neurological visits, review years of patient history in seconds, and generate technical notes with medical necessity language across 14 neurology subspecialties.
SPECIALTY CAPABILITIES
Captures seizure semiology and cranial nerve exams
Builds Patient Recaps from prior charts
Captures PHQ-9, PDQ-39 and ASRS scores
Codes ICD-10 with MDM rationale
Supports 90 to 120 minute consults
RECOGNIZED PARTNER
Marvix AI is a partner in the AAN Practice Success Network.
Explore specialty templates
→
NEUROLOGY FOLLOW-UP NOTE
Synced to EHR
PATIENT: Martin Summit · 74 yrs · Cognitive evaluation
Chief Complaint (CC)
Progressive memory loss over the past three years with increasing forgetfulness, difficulty managing daily tasks, word-finding difficulty, and concern for dementia.
History of Present Illness
Martin Summit is a 74-year-old right-handed male presenting for evaluation of progressive cognitive decline over approximately three years. His wife reports forgetfulness, repetitive questioning, and misplaced items that have gradually worsened. Over the past year he has had greater difficulty managing finances and medications, following multistep tasks, and keeping track of dates, though he remains familiar with close family and his home.
He reports occasional word-finding difficulty and slower processing speed. His wife notes mild apathy but no personality change, aggression, or visual hallucinations. Sleep is fragmented with occasional daytime naps, and he removes his CPAP mask partway through most nights. There is no history of stroke, seizure, head trauma, loss of consciousness, or rapidly progressive neurological decline.
Past Medical History
Current Medications
Amlodipine 5 mg daily
Metformin 1000 mg twice daily
Atorvastatin 20 mg nightly
Aspirin 81 mg daily
Vitamin D3 1000 IU daily
Past Surgical History
Family History
Social History
Martin Summit is a retired accountant who lives with his wife. He has never smoked and drinks alcohol occasionally. He denies illicit drug use. He remains physically active with daily walks but has reduced participation in community activities because of memory concerns.
Functional Status
Activities of Daily Living (ADLs):
Independent with dressing, bathing, toileting, and feeding
Occasionally requires reminders for personal hygiene
Instrumental Activities of Daily Living (IADLs):
Requires assistance with finances
Wife manages medications
Has difficulty organizing appointments
Continues to drive locally but avoids unfamiliar routes
Reduced confidence with shopping independently
Functional Activities Questionnaire (FAQ) score 11/30 based on his wife's report
Review of Systems (ROS)
General: Mild fatigue. No fever or unintentional weight loss.
Respiratory: No cough or dyspnea.
Cardiovascular: No chest pain or palpitations.
GI: No nausea, vomiting, abdominal pain, or change in bowel habits.
Psychiatric: Mild apathy and decreased motivation. No depression, hallucinations, or suicidal ideation. PHQ-9 score 4, consistent with minimal depressive symptoms.
Musculoskeletal: Mild chronic bilateral knee discomfort.
Neurological: Progressive short-term memory impairment, word-finding difficulty, slowed processing speed, and occasional disorientation in unfamiliar environments. No focal weakness, numbness, tremor, seizures, gait instability, or loss of consciousness.
Vitals
BP: 132/76 mmHg
Pulse: 68 bpm
Temp: 98.1°F
Height: 175 cm
Weight: 80 kg
BMI: 26.1 kg/m²
Examination
General:
Pleasant elderly male in no acute distress.
Mental Status Exam:
Appearance: Well groomed
Behavior: Cooperative and attentive
Mood: Euthymic
Affect: Appropriate with full range
Thought Process: Logical but slowed
Interactions: Appropriate with preserved social awareness
Neurological:
Mental Status: Alert and oriented to person and place but incorrectly identified the date. Speech fluent with occasional word-finding pauses. Immediate registration intact. Delayed recall impaired with recall of 1 out of 3 objects after five minutes, improving to 2 out of 3 with category cues. Mild impairment in attention during serial sevens. Clock drawing demonstrated mild visuospatial disorganization. Estimated MoCA score 22/30, declined from 25/30 in March 2024.
Cranial Nerves: Cranial nerves II-XII intact. Pupils equal and reactive to light. Extraocular movements full. Facial strength and sensation symmetric. Hearing mildly reduced bilaterally to conversational voice.
Motor: Normal bulk and tone. Strength 5/5 throughout. No rigidity, bradykinesia, tremor, or pronator drift.
Reflexes: 2+ and symmetric throughout.
Coordination: Finger-to-nose and rapid alternating movements intact bilaterally.
Sensory: Intact to light touch, vibration, and proprioception.
Gait and Station: Mildly slowed gait with preserved arm swing. Able to perform tandem gait with minimal difficulty. Negative Romberg.
Labs and Imaging
Laboratory Tests (June 2026):
CBC and comprehensive metabolic panel within normal limits. Sodium 138 mmol/L, Creatinine 0.96 mg/dL (eGFR 82 mL/min/1.73 m²), HbA1c 7.0%, Vitamin B12 462 pg/mL, Folate 12.4 ng/mL, TSH 2.18 uIU/mL. No reversible metabolic cause for cognitive impairment identified.
MRI Brain (July 2026):
Mild bilateral hippocampal volume loss with mild generalized cerebral atrophy, slightly greater than expected for age. Mild chronic microvascular white matter changes (Fazekas Grade 1). No acute infarction, hemorrhage, hydrocephalus, or intracranial mass. Interval development of hippocampal volume loss compared with March 2024.
MRI Brain (March 2024):
Age-appropriate cerebral volume without hippocampal atrophy. Scattered punctate white matter hyperintensities. No acute intracranial abnormality.
Assessment
Progressive cognitive impairment concerning for early Alzheimer's disease
Mild cognitive impairment affecting instrumental activities of daily living
Mild chronic cerebral small vessel ischemic disease
Obstructive sleep apnea with suboptimal CPAP adherence, possible contributor to cognitive symptoms
Hypertension and type 2 diabetes mellitus, stable
Plan
Ordered
Medications:
No medication changes pending diagnostic evaluation
Labs:
Plasma p-tau217
Procedures:
Comprehensive neuropsychological testing
CPAP compliance download
Follow Up
Follow-up is scheduled in six weeks after completion of neuropsychological testing to review results, establish a definitive diagnosis, discuss treatment options, and determine the need for pharmacologic therapy and additional safety planning. His wife was advised to call sooner for any sudden change in cognition, new focal weakness or speech difficulty, falls, or new behavioral symptoms such as hallucinations or agitation.
10. Outputs Chips
OUTPUTS FROM ONE ENCOUNTER
Clinical Note
ICD-10 & E/M Coding
Patient Instructions
Referral Letter
Selected Specialty · Neurology
Built for complex, longitudinal neurology.
Capture complex neurological visits, review years of patient history in seconds, and generate technical notes with medical necessity language across 14 neurology subspecialties.
SPECIALTY CAPABILITIES
Captures seizure semiology and cranial nerve exams
Builds Patient Recaps from prior charts
Captures PHQ-9, PDQ-39 and ASRS scores
Codes ICD-10 with MDM rationale
Supports 90 to 120 minute consults
RECOGNIZED PARTNER
Marvix AI is a partner in the AAN Practice Success Network.
Explore specialty templates
→
NEUROLOGY FOLLOW-UP NOTE
Synced to EHR
PATIENT: Martin Summit · 74 yrs · Cognitive evaluation
Chief Complaint (CC)
Progressive memory loss over the past three years with increasing forgetfulness, difficulty managing daily tasks, word-finding difficulty, and concern for dementia.
History of Present Illness
Martin Summit is a 74-year-old right-handed male presenting for evaluation of progressive cognitive decline over approximately three years. His wife reports forgetfulness, repetitive questioning, and misplaced items that have gradually worsened. Over the past year he has had greater difficulty managing finances and medications, following multistep tasks, and keeping track of dates, though he remains familiar with close family and his home.
He reports occasional word-finding difficulty and slower processing speed. His wife notes mild apathy but no personality change, aggression, or visual hallucinations. Sleep is fragmented with occasional daytime naps, and he removes his CPAP mask partway through most nights. There is no history of stroke, seizure, head trauma, loss of consciousness, or rapidly progressive neurological decline.
Past Medical History
Current Medications
Amlodipine 5 mg daily
Metformin 1000 mg twice daily
Atorvastatin 20 mg nightly
Aspirin 81 mg daily
Vitamin D3 1000 IU daily
Past Surgical History
Family History
Social History
Martin Summit is a retired accountant who lives with his wife. He has never smoked and drinks alcohol occasionally. He denies illicit drug use. He remains physically active with daily walks but has reduced participation in community activities because of memory concerns.
Functional Status
Activities of Daily Living (ADLs):
Independent with dressing, bathing, toileting, and feeding
Occasionally requires reminders for personal hygiene
Instrumental Activities of Daily Living (IADLs):
Requires assistance with finances
Wife manages medications
Has difficulty organizing appointments
Continues to drive locally but avoids unfamiliar routes
Reduced confidence with shopping independently
Functional Activities Questionnaire (FAQ) score 11/30 based on his wife's report
Review of Systems (ROS)
General: Mild fatigue. No fever or unintentional weight loss.
Respiratory: No cough or dyspnea.
Cardiovascular: No chest pain or palpitations.
GI: No nausea, vomiting, abdominal pain, or change in bowel habits.
Psychiatric: Mild apathy and decreased motivation. No depression, hallucinations, or suicidal ideation. PHQ-9 score 4, consistent with minimal depressive symptoms.
Musculoskeletal: Mild chronic bilateral knee discomfort.
Neurological: Progressive short-term memory impairment, word-finding difficulty, slowed processing speed, and occasional disorientation in unfamiliar environments. No focal weakness, numbness, tremor, seizures, gait instability, or loss of consciousness.
Vitals
BP: 132/76 mmHg
Pulse: 68 bpm
Temp: 98.1°F
Height: 175 cm
Weight: 80 kg
BMI: 26.1 kg/m²
Examination
General:
Pleasant elderly male in no acute distress.
Mental Status Exam:
Appearance: Well groomed
Behavior: Cooperative and attentive
Mood: Euthymic
Affect: Appropriate with full range
Thought Process: Logical but slowed
Interactions: Appropriate with preserved social awareness
Neurological:
Mental Status: Alert and oriented to person and place but incorrectly identified the date. Speech fluent with occasional word-finding pauses. Immediate registration intact. Delayed recall impaired with recall of 1 out of 3 objects after five minutes, improving to 2 out of 3 with category cues. Mild impairment in attention during serial sevens. Clock drawing demonstrated mild visuospatial disorganization. Estimated MoCA score 22/30, declined from 25/30 in March 2024.
Cranial Nerves: Cranial nerves II-XII intact. Pupils equal and reactive to light. Extraocular movements full. Facial strength and sensation symmetric. Hearing mildly reduced bilaterally to conversational voice.
Motor: Normal bulk and tone. Strength 5/5 throughout. No rigidity, bradykinesia, tremor, or pronator drift.
Reflexes: 2+ and symmetric throughout.
Coordination: Finger-to-nose and rapid alternating movements intact bilaterally.
Sensory: Intact to light touch, vibration, and proprioception.
Gait and Station: Mildly slowed gait with preserved arm swing. Able to perform tandem gait with minimal difficulty. Negative Romberg.
Labs and Imaging
Laboratory Tests (June 2026):
CBC and comprehensive metabolic panel within normal limits. Sodium 138 mmol/L, Creatinine 0.96 mg/dL (eGFR 82 mL/min/1.73 m²), HbA1c 7.0%, Vitamin B12 462 pg/mL, Folate 12.4 ng/mL, TSH 2.18 uIU/mL. No reversible metabolic cause for cognitive impairment identified.
MRI Brain (July 2026):
Mild bilateral hippocampal volume loss with mild generalized cerebral atrophy, slightly greater than expected for age. Mild chronic microvascular white matter changes (Fazekas Grade 1). No acute infarction, hemorrhage, hydrocephalus, or intracranial mass. Interval development of hippocampal volume loss compared with March 2024.
MRI Brain (March 2024):
Age-appropriate cerebral volume without hippocampal atrophy. Scattered punctate white matter hyperintensities. No acute intracranial abnormality.
Assessment
Progressive cognitive impairment concerning for early Alzheimer's disease
Mild cognitive impairment affecting instrumental activities of daily living
Mild chronic cerebral small vessel ischemic disease
Obstructive sleep apnea with suboptimal CPAP adherence, possible contributor to cognitive symptoms
Hypertension and type 2 diabetes mellitus, stable
Plan
Ordered
Medications:
No medication changes pending diagnostic evaluation
Labs:
Plasma p-tau217
Procedures:
Comprehensive neuropsychological testing
CPAP compliance download
Follow Up
Follow-up is scheduled in six weeks after completion of neuropsychological testing to review results, establish a definitive diagnosis, discuss treatment options, and determine the need for pharmacologic therapy and additional safety planning. His wife was advised to call sooner for any sudden change in cognition, new focal weakness or speech difficulty, falls, or new behavioral symptoms such as hallucinations or agitation.
10. Outputs Chips
OUTPUTS FROM ONE ENCOUNTER
Clinical Note
ICD-10 & E/M Coding
Patient Instructions
Referral Letter
Selected Specialty · Neurology
Built for complex, longitudinal neurology.
Capture complex neurological visits, review years of patient history in seconds, and generate technical notes with medical necessity language across 14 neurology subspecialties.
SPECIALTY CAPABILITIES
Captures seizure semiology and cranial nerve exams
Builds Patient Recaps from prior charts
Captures PHQ-9, PDQ-39 and ASRS scores
Codes ICD-10 with MDM rationale
Supports 90 to 120 minute consults
RECOGNIZED PARTNER
Marvix AI is a partner in the AAN Practice Success Network.
Explore specialty templates
→
NEUROLOGY FOLLOW-UP NOTE
Synced to EHR
PATIENT: Martin Summit · 74 yrs · Cognitive evaluation
Chief Complaint (CC)
Progressive memory loss over the past three years with increasing forgetfulness, difficulty managing daily tasks, word-finding difficulty, and concern for dementia.
History of Present Illness
Martin Summit is a 74-year-old right-handed male presenting for evaluation of progressive cognitive decline over approximately three years. His wife reports forgetfulness, repetitive questioning, and misplaced items that have gradually worsened. Over the past year he has had greater difficulty managing finances and medications, following multistep tasks, and keeping track of dates, though he remains familiar with close family and his home.
He reports occasional word-finding difficulty and slower processing speed. His wife notes mild apathy but no personality change, aggression, or visual hallucinations. Sleep is fragmented with occasional daytime naps, and he removes his CPAP mask partway through most nights. There is no history of stroke, seizure, head trauma, loss of consciousness, or rapidly progressive neurological decline.
Past Medical History
Current Medications
Amlodipine 5 mg daily
Metformin 1000 mg twice daily
Atorvastatin 20 mg nightly
Aspirin 81 mg daily
Vitamin D3 1000 IU daily
Past Surgical History
Family History
Social History
Martin Summit is a retired accountant who lives with his wife. He has never smoked and drinks alcohol occasionally. He denies illicit drug use. He remains physically active with daily walks but has reduced participation in community activities because of memory concerns.
Functional Status
Activities of Daily Living (ADLs):
Independent with dressing, bathing, toileting, and feeding
Occasionally requires reminders for personal hygiene
Instrumental Activities of Daily Living (IADLs):
Requires assistance with finances
Wife manages medications
Has difficulty organizing appointments
Continues to drive locally but avoids unfamiliar routes
Reduced confidence with shopping independently
Functional Activities Questionnaire (FAQ) score 11/30 based on his wife's report
Review of Systems (ROS)
General: Mild fatigue. No fever or unintentional weight loss.
Respiratory: No cough or dyspnea.
Cardiovascular: No chest pain or palpitations.
GI: No nausea, vomiting, abdominal pain, or change in bowel habits.
Psychiatric: Mild apathy and decreased motivation. No depression, hallucinations, or suicidal ideation. PHQ-9 score 4, consistent with minimal depressive symptoms.
Musculoskeletal: Mild chronic bilateral knee discomfort.
Neurological: Progressive short-term memory impairment, word-finding difficulty, slowed processing speed, and occasional disorientation in unfamiliar environments. No focal weakness, numbness, tremor, seizures, gait instability, or loss of consciousness.
Vitals
BP: 132/76 mmHg
Pulse: 68 bpm
Temp: 98.1°F
Height: 175 cm
Weight: 80 kg
BMI: 26.1 kg/m²
Examination
General:
Pleasant elderly male in no acute distress.
Mental Status Exam:
Appearance: Well groomed
Behavior: Cooperative and attentive
Mood: Euthymic
Affect: Appropriate with full range
Thought Process: Logical but slowed
Interactions: Appropriate with preserved social awareness
Neurological:
Mental Status: Alert and oriented to person and place but incorrectly identified the date. Speech fluent with occasional word-finding pauses. Immediate registration intact. Delayed recall impaired with recall of 1 out of 3 objects after five minutes, improving to 2 out of 3 with category cues. Mild impairment in attention during serial sevens. Clock drawing demonstrated mild visuospatial disorganization. Estimated MoCA score 22/30, declined from 25/30 in March 2024.
Cranial Nerves: Cranial nerves II-XII intact. Pupils equal and reactive to light. Extraocular movements full. Facial strength and sensation symmetric. Hearing mildly reduced bilaterally to conversational voice.
Motor: Normal bulk and tone. Strength 5/5 throughout. No rigidity, bradykinesia, tremor, or pronator drift.
Reflexes: 2+ and symmetric throughout.
Coordination: Finger-to-nose and rapid alternating movements intact bilaterally.
Sensory: Intact to light touch, vibration, and proprioception.
Gait and Station: Mildly slowed gait with preserved arm swing. Able to perform tandem gait with minimal difficulty. Negative Romberg.
Labs and Imaging
Laboratory Tests (June 2026):
CBC and comprehensive metabolic panel within normal limits. Sodium 138 mmol/L, Creatinine 0.96 mg/dL (eGFR 82 mL/min/1.73 m²), HbA1c 7.0%, Vitamin B12 462 pg/mL, Folate 12.4 ng/mL, TSH 2.18 uIU/mL. No reversible metabolic cause for cognitive impairment identified.
MRI Brain (July 2026):
Mild bilateral hippocampal volume loss with mild generalized cerebral atrophy, slightly greater than expected for age. Mild chronic microvascular white matter changes (Fazekas Grade 1). No acute infarction, hemorrhage, hydrocephalus, or intracranial mass. Interval development of hippocampal volume loss compared with March 2024.
MRI Brain (March 2024):
Age-appropriate cerebral volume without hippocampal atrophy. Scattered punctate white matter hyperintensities. No acute intracranial abnormality.
Assessment
Progressive cognitive impairment concerning for early Alzheimer's disease
Mild cognitive impairment affecting instrumental activities of daily living
Mild chronic cerebral small vessel ischemic disease
Obstructive sleep apnea with suboptimal CPAP adherence, possible contributor to cognitive symptoms
Hypertension and type 2 diabetes mellitus, stable
Plan
Ordered
Medications:
No medication changes pending diagnostic evaluation
Labs:
Plasma p-tau217
Procedures:
Comprehensive neuropsychological testing
CPAP compliance download
Follow Up
Follow-up is scheduled in six weeks after completion of neuropsychological testing to review results, establish a definitive diagnosis, discuss treatment options, and determine the need for pharmacologic therapy and additional safety planning. His wife was advised to call sooner for any sudden change in cognition, new focal weakness or speech difficulty, falls, or new behavioral symptoms such as hallucinations or agitation.
10. Outputs Chips
OUTPUTS FROM ONE ENCOUNTER
Clinical Note
ICD-10 & E/M Coding
Patient Instructions
Referral Letter
Selected Specialty · Neurology
Built for complex, longitudinal neurology.
Capture complex neurological visits, review years of patient history in seconds, and generate technical notes with medical necessity language across 14 neurology subspecialties.
SPECIALTY CAPABILITIES
Captures seizure semiology and cranial nerve exams
Builds Patient Recaps from prior charts
Captures PHQ-9, PDQ-39 and ASRS scores
Codes ICD-10 with MDM rationale
Supports 90 to 120 minute consults
RECOGNIZED PARTNER
Marvix AI is a partner in the AAN Practice Success Network.
Explore specialty templates
→
NEUROLOGY FOLLOW-UP NOTE
Synced to EHR
PATIENT: Martin Summit · 74 yrs · Cognitive evaluation
Chief Complaint (CC)
Progressive memory loss over the past three years with increasing forgetfulness, difficulty managing daily tasks, word-finding difficulty, and concern for dementia.
History of Present Illness
Martin Summit is a 74-year-old right-handed male presenting for evaluation of progressive cognitive decline over approximately three years. His wife reports forgetfulness, repetitive questioning, and misplaced items that have gradually worsened. Over the past year he has had greater difficulty managing finances and medications, following multistep tasks, and keeping track of dates, though he remains familiar with close family and his home.
He reports occasional word-finding difficulty and slower processing speed. His wife notes mild apathy but no personality change, aggression, or visual hallucinations. Sleep is fragmented with occasional daytime naps, and he removes his CPAP mask partway through most nights. There is no history of stroke, seizure, head trauma, loss of consciousness, or rapidly progressive neurological decline.
Past Medical History
Current Medications
Amlodipine 5 mg daily
Metformin 1000 mg twice daily
Atorvastatin 20 mg nightly
Aspirin 81 mg daily
Vitamin D3 1000 IU daily
Past Surgical History
Family History
Social History
Martin Summit is a retired accountant who lives with his wife. He has never smoked and drinks alcohol occasionally. He denies illicit drug use. He remains physically active with daily walks but has reduced participation in community activities because of memory concerns.
Functional Status
Activities of Daily Living (ADLs):
Independent with dressing, bathing, toileting, and feeding
Occasionally requires reminders for personal hygiene
Instrumental Activities of Daily Living (IADLs):
Requires assistance with finances
Wife manages medications
Has difficulty organizing appointments
Continues to drive locally but avoids unfamiliar routes
Reduced confidence with shopping independently
Functional Activities Questionnaire (FAQ) score 11/30 based on his wife's report
Review of Systems (ROS)
General: Mild fatigue. No fever or unintentional weight loss.
Respiratory: No cough or dyspnea.
Cardiovascular: No chest pain or palpitations.
GI: No nausea, vomiting, abdominal pain, or change in bowel habits.
Psychiatric: Mild apathy and decreased motivation. No depression, hallucinations, or suicidal ideation. PHQ-9 score 4, consistent with minimal depressive symptoms.
Musculoskeletal: Mild chronic bilateral knee discomfort.
Neurological: Progressive short-term memory impairment, word-finding difficulty, slowed processing speed, and occasional disorientation in unfamiliar environments. No focal weakness, numbness, tremor, seizures, gait instability, or loss of consciousness.
Vitals
BP: 132/76 mmHg
Pulse: 68 bpm
Temp: 98.1°F
Height: 175 cm
Weight: 80 kg
BMI: 26.1 kg/m²
Examination
General:
Pleasant elderly male in no acute distress.
Mental Status Exam:
Appearance: Well groomed
Behavior: Cooperative and attentive
Mood: Euthymic
Affect: Appropriate with full range
Thought Process: Logical but slowed
Interactions: Appropriate with preserved social awareness
Neurological:
Mental Status: Alert and oriented to person and place but incorrectly identified the date. Speech fluent with occasional word-finding pauses. Immediate registration intact. Delayed recall impaired with recall of 1 out of 3 objects after five minutes, improving to 2 out of 3 with category cues. Mild impairment in attention during serial sevens. Clock drawing demonstrated mild visuospatial disorganization. Estimated MoCA score 22/30, declined from 25/30 in March 2024.
Cranial Nerves: Cranial nerves II-XII intact. Pupils equal and reactive to light. Extraocular movements full. Facial strength and sensation symmetric. Hearing mildly reduced bilaterally to conversational voice.
Motor: Normal bulk and tone. Strength 5/5 throughout. No rigidity, bradykinesia, tremor, or pronator drift.
Reflexes: 2+ and symmetric throughout.
Coordination: Finger-to-nose and rapid alternating movements intact bilaterally.
Sensory: Intact to light touch, vibration, and proprioception.
Gait and Station: Mildly slowed gait with preserved arm swing. Able to perform tandem gait with minimal difficulty. Negative Romberg.
Labs and Imaging
Laboratory Tests (June 2026):
CBC and comprehensive metabolic panel within normal limits. Sodium 138 mmol/L, Creatinine 0.96 mg/dL (eGFR 82 mL/min/1.73 m²), HbA1c 7.0%, Vitamin B12 462 pg/mL, Folate 12.4 ng/mL, TSH 2.18 uIU/mL. No reversible metabolic cause for cognitive impairment identified.
MRI Brain (July 2026):
Mild bilateral hippocampal volume loss with mild generalized cerebral atrophy, slightly greater than expected for age. Mild chronic microvascular white matter changes (Fazekas Grade 1). No acute infarction, hemorrhage, hydrocephalus, or intracranial mass. Interval development of hippocampal volume loss compared with March 2024.
MRI Brain (March 2024):
Age-appropriate cerebral volume without hippocampal atrophy. Scattered punctate white matter hyperintensities. No acute intracranial abnormality.
Assessment
Progressive cognitive impairment concerning for early Alzheimer's disease
Mild cognitive impairment affecting instrumental activities of daily living
Mild chronic cerebral small vessel ischemic disease
Obstructive sleep apnea with suboptimal CPAP adherence, possible contributor to cognitive symptoms
Hypertension and type 2 diabetes mellitus, stable
Plan
Ordered
Medications:
No medication changes pending diagnostic evaluation
Labs:
Plasma p-tau217
Procedures:
Comprehensive neuropsychological testing
CPAP compliance download
Follow Up
Follow-up is scheduled in six weeks after completion of neuropsychological testing to review results, establish a definitive diagnosis, discuss treatment options, and determine the need for pharmacologic therapy and additional safety planning. His wife was advised to call sooner for any sudden change in cognition, new focal weakness or speech difficulty, falls, or new behavioral symptoms such as hallucinations or agitation.
10. Outputs Chips
OUTPUTS FROM ONE ENCOUNTER
Clinical Note
ICD-10 & E/M Coding
Patient Instructions
Referral Letter
Selected Specialty · Neurology
Built for complex, longitudinal neurology.
Capture complex neurological visits, review years of patient history in seconds, and generate technical notes with medical necessity language across 14 neurology subspecialties.
SPECIALTY CAPABILITIES
Captures seizure semiology and cranial nerve exams
Builds Patient Recaps from prior charts
Captures PHQ-9, PDQ-39 and ASRS scores
Codes ICD-10 with MDM rationale
Supports 90 to 120 minute consults
RECOGNIZED PARTNER
Marvix AI is a partner in the AAN Practice Success Network.
Explore specialty templates
→
NEUROLOGY FOLLOW-UP NOTE
Synced to EHR
PATIENT: Martin Summit · 74 yrs · Cognitive evaluation
Chief Complaint (CC)
Progressive memory loss over the past three years with increasing forgetfulness, difficulty managing daily tasks, word-finding difficulty, and concern for dementia.
History of Present Illness
Martin Summit is a 74-year-old right-handed male presenting for evaluation of progressive cognitive decline over approximately three years. His wife reports forgetfulness, repetitive questioning, and misplaced items that have gradually worsened. Over the past year he has had greater difficulty managing finances and medications, following multistep tasks, and keeping track of dates, though he remains familiar with close family and his home.
He reports occasional word-finding difficulty and slower processing speed. His wife notes mild apathy but no personality change, aggression, or visual hallucinations. Sleep is fragmented with occasional daytime naps, and he removes his CPAP mask partway through most nights. There is no history of stroke, seizure, head trauma, loss of consciousness, or rapidly progressive neurological decline.
Past Medical History
Current Medications
Amlodipine 5 mg daily
Metformin 1000 mg twice daily
Atorvastatin 20 mg nightly
Aspirin 81 mg daily
Vitamin D3 1000 IU daily
Past Surgical History
Family History
Social History
Martin Summit is a retired accountant who lives with his wife. He has never smoked and drinks alcohol occasionally. He denies illicit drug use. He remains physically active with daily walks but has reduced participation in community activities because of memory concerns.
Functional Status
Activities of Daily Living (ADLs):
Independent with dressing, bathing, toileting, and feeding
Occasionally requires reminders for personal hygiene
Instrumental Activities of Daily Living (IADLs):
Requires assistance with finances
Wife manages medications
Has difficulty organizing appointments
Continues to drive locally but avoids unfamiliar routes
Reduced confidence with shopping independently
Functional Activities Questionnaire (FAQ) score 11/30 based on his wife's report
Review of Systems (ROS)
General: Mild fatigue. No fever or unintentional weight loss.
Respiratory: No cough or dyspnea.
Cardiovascular: No chest pain or palpitations.
GI: No nausea, vomiting, abdominal pain, or change in bowel habits.
Psychiatric: Mild apathy and decreased motivation. No depression, hallucinations, or suicidal ideation. PHQ-9 score 4, consistent with minimal depressive symptoms.
Musculoskeletal: Mild chronic bilateral knee discomfort.
Neurological: Progressive short-term memory impairment, word-finding difficulty, slowed processing speed, and occasional disorientation in unfamiliar environments. No focal weakness, numbness, tremor, seizures, gait instability, or loss of consciousness.
Vitals
BP: 132/76 mmHg
Pulse: 68 bpm
Temp: 98.1°F
Height: 175 cm
Weight: 80 kg
BMI: 26.1 kg/m²
Examination
General:
Pleasant elderly male in no acute distress.
Mental Status Exam:
Appearance: Well groomed
Behavior: Cooperative and attentive
Mood: Euthymic
Affect: Appropriate with full range
Thought Process: Logical but slowed
Interactions: Appropriate with preserved social awareness
Neurological:
Mental Status: Alert and oriented to person and place but incorrectly identified the date. Speech fluent with occasional word-finding pauses. Immediate registration intact. Delayed recall impaired with recall of 1 out of 3 objects after five minutes, improving to 2 out of 3 with category cues. Mild impairment in attention during serial sevens. Clock drawing demonstrated mild visuospatial disorganization. Estimated MoCA score 22/30, declined from 25/30 in March 2024.
Cranial Nerves: Cranial nerves II-XII intact. Pupils equal and reactive to light. Extraocular movements full. Facial strength and sensation symmetric. Hearing mildly reduced bilaterally to conversational voice.
Motor: Normal bulk and tone. Strength 5/5 throughout. No rigidity, bradykinesia, tremor, or pronator drift.
Reflexes: 2+ and symmetric throughout.
Coordination: Finger-to-nose and rapid alternating movements intact bilaterally.
Sensory: Intact to light touch, vibration, and proprioception.
Gait and Station: Mildly slowed gait with preserved arm swing. Able to perform tandem gait with minimal difficulty. Negative Romberg.
Labs and Imaging
Laboratory Tests (June 2026):
CBC and comprehensive metabolic panel within normal limits. Sodium 138 mmol/L, Creatinine 0.96 mg/dL (eGFR 82 mL/min/1.73 m²), HbA1c 7.0%, Vitamin B12 462 pg/mL, Folate 12.4 ng/mL, TSH 2.18 uIU/mL. No reversible metabolic cause for cognitive impairment identified.
MRI Brain (July 2026):
Mild bilateral hippocampal volume loss with mild generalized cerebral atrophy, slightly greater than expected for age. Mild chronic microvascular white matter changes (Fazekas Grade 1). No acute infarction, hemorrhage, hydrocephalus, or intracranial mass. Interval development of hippocampal volume loss compared with March 2024.
MRI Brain (March 2024):
Age-appropriate cerebral volume without hippocampal atrophy. Scattered punctate white matter hyperintensities. No acute intracranial abnormality.
Assessment
Progressive cognitive impairment concerning for early Alzheimer's disease
Mild cognitive impairment affecting instrumental activities of daily living
Mild chronic cerebral small vessel ischemic disease
Obstructive sleep apnea with suboptimal CPAP adherence, possible contributor to cognitive symptoms
Hypertension and type 2 diabetes mellitus, stable
Plan
Ordered
Medications:
No medication changes pending diagnostic evaluation
Labs:
Plasma p-tau217
Procedures:
Comprehensive neuropsychological testing
CPAP compliance download
Follow Up
Follow-up is scheduled in six weeks after completion of neuropsychological testing to review results, establish a definitive diagnosis, discuss treatment options, and determine the need for pharmacologic therapy and additional safety planning. His wife was advised to call sooner for any sudden change in cognition, new focal weakness or speech difficulty, falls, or new behavioral symptoms such as hallucinations or agitation.
10. Outputs Chips
OUTPUTS FROM ONE ENCOUNTER
Clinical Note
ICD-10 & E/M Coding
Patient Instructions
Referral Letter
Selected Specialty · Neurology
Built for complex, longitudinal neurology.
Capture complex neurological visits, review years of patient history in seconds, and generate technical notes with medical necessity language across 14 neurology subspecialties.
SPECIALTY CAPABILITIES
Captures seizure semiology and cranial nerve exams
Builds Patient Recaps from prior charts
Captures PHQ-9, PDQ-39 and ASRS scores
Codes ICD-10 with MDM rationale
Supports 90 to 120 minute consults
RECOGNIZED PARTNER
Marvix AI is a partner in the AAN Practice Success Network.
Explore specialty templates
→
NEUROLOGY FOLLOW-UP NOTE
Synced to EHR
PATIENT: Martin Summit · 74 yrs · Cognitive evaluation
Chief Complaint (CC)
Progressive memory loss over the past three years with increasing forgetfulness, difficulty managing daily tasks, word-finding difficulty, and concern for dementia.
History of Present Illness
Martin Summit is a 74-year-old right-handed male presenting for evaluation of progressive cognitive decline over approximately three years. His wife reports forgetfulness, repetitive questioning, and misplaced items that have gradually worsened. Over the past year he has had greater difficulty managing finances and medications, following multistep tasks, and keeping track of dates, though he remains familiar with close family and his home.
He reports occasional word-finding difficulty and slower processing speed. His wife notes mild apathy but no personality change, aggression, or visual hallucinations. Sleep is fragmented with occasional daytime naps, and he removes his CPAP mask partway through most nights. There is no history of stroke, seizure, head trauma, loss of consciousness, or rapidly progressive neurological decline.
Past Medical History
Current Medications
Amlodipine 5 mg daily
Metformin 1000 mg twice daily
Atorvastatin 20 mg nightly
Aspirin 81 mg daily
Vitamin D3 1000 IU daily
Past Surgical History
Family History
Social History
Martin Summit is a retired accountant who lives with his wife. He has never smoked and drinks alcohol occasionally. He denies illicit drug use. He remains physically active with daily walks but has reduced participation in community activities because of memory concerns.
Functional Status
Activities of Daily Living (ADLs):
Independent with dressing, bathing, toileting, and feeding
Occasionally requires reminders for personal hygiene
Instrumental Activities of Daily Living (IADLs):
Requires assistance with finances
Wife manages medications
Has difficulty organizing appointments
Continues to drive locally but avoids unfamiliar routes
Reduced confidence with shopping independently
Functional Activities Questionnaire (FAQ) score 11/30 based on his wife's report
Review of Systems (ROS)
General: Mild fatigue. No fever or unintentional weight loss.
Respiratory: No cough or dyspnea.
Cardiovascular: No chest pain or palpitations.
GI: No nausea, vomiting, abdominal pain, or change in bowel habits.
Psychiatric: Mild apathy and decreased motivation. No depression, hallucinations, or suicidal ideation. PHQ-9 score 4, consistent with minimal depressive symptoms.
Musculoskeletal: Mild chronic bilateral knee discomfort.
Neurological: Progressive short-term memory impairment, word-finding difficulty, slowed processing speed, and occasional disorientation in unfamiliar environments. No focal weakness, numbness, tremor, seizures, gait instability, or loss of consciousness.
Vitals
BP: 132/76 mmHg
Pulse: 68 bpm
Temp: 98.1°F
Height: 175 cm
Weight: 80 kg
BMI: 26.1 kg/m²
Examination
General:
Pleasant elderly male in no acute distress.
Mental Status Exam:
Appearance: Well groomed
Behavior: Cooperative and attentive
Mood: Euthymic
Affect: Appropriate with full range
Thought Process: Logical but slowed
Interactions: Appropriate with preserved social awareness
Neurological:
Mental Status: Alert and oriented to person and place but incorrectly identified the date. Speech fluent with occasional word-finding pauses. Immediate registration intact. Delayed recall impaired with recall of 1 out of 3 objects after five minutes, improving to 2 out of 3 with category cues. Mild impairment in attention during serial sevens. Clock drawing demonstrated mild visuospatial disorganization. Estimated MoCA score 22/30, declined from 25/30 in March 2024.
Cranial Nerves: Cranial nerves II-XII intact. Pupils equal and reactive to light. Extraocular movements full. Facial strength and sensation symmetric. Hearing mildly reduced bilaterally to conversational voice.
Motor: Normal bulk and tone. Strength 5/5 throughout. No rigidity, bradykinesia, tremor, or pronator drift.
Reflexes: 2+ and symmetric throughout.
Coordination: Finger-to-nose and rapid alternating movements intact bilaterally.
Sensory: Intact to light touch, vibration, and proprioception.
Gait and Station: Mildly slowed gait with preserved arm swing. Able to perform tandem gait with minimal difficulty. Negative Romberg.
Labs and Imaging
Laboratory Tests (June 2026):
CBC and comprehensive metabolic panel within normal limits. Sodium 138 mmol/L, Creatinine 0.96 mg/dL (eGFR 82 mL/min/1.73 m²), HbA1c 7.0%, Vitamin B12 462 pg/mL, Folate 12.4 ng/mL, TSH 2.18 uIU/mL. No reversible metabolic cause for cognitive impairment identified.
MRI Brain (July 2026):
Mild bilateral hippocampal volume loss with mild generalized cerebral atrophy, slightly greater than expected for age. Mild chronic microvascular white matter changes (Fazekas Grade 1). No acute infarction, hemorrhage, hydrocephalus, or intracranial mass. Interval development of hippocampal volume loss compared with March 2024.
MRI Brain (March 2024):
Age-appropriate cerebral volume without hippocampal atrophy. Scattered punctate white matter hyperintensities. No acute intracranial abnormality.
Assessment
Progressive cognitive impairment concerning for early Alzheimer's disease
Mild cognitive impairment affecting instrumental activities of daily living
Mild chronic cerebral small vessel ischemic disease
Obstructive sleep apnea with suboptimal CPAP adherence, possible contributor to cognitive symptoms
Hypertension and type 2 diabetes mellitus, stable
Plan
Ordered
Medications:
No medication changes pending diagnostic evaluation
Labs:
Plasma p-tau217
Procedures:
Comprehensive neuropsychological testing
CPAP compliance download
Follow Up
Follow-up is scheduled in six weeks after completion of neuropsychological testing to review results, establish a definitive diagnosis, discuss treatment options, and determine the need for pharmacologic therapy and additional safety planning. His wife was advised to call sooner for any sudden change in cognition, new focal weakness or speech difficulty, falls, or new behavioral symptoms such as hallucinations or agitation.
10. Outputs Chips
OUTPUTS FROM ONE ENCOUNTER
Clinical Note
ICD-10 & E/M Coding
Patient Instructions
Referral Letter
Selected Specialty · Neurology
Built for complex, longitudinal neurology.
Capture complex neurological visits, review years of patient history in seconds, and generate technical notes with medical necessity language across 14 neurology subspecialties.
SPECIALTY CAPABILITIES
Captures seizure semiology and cranial nerve exams
Builds Patient Recaps from prior charts
Captures PHQ-9, PDQ-39 and ASRS scores
Codes ICD-10 with MDM rationale
Supports 90 to 120 minute consults
RECOGNIZED PARTNER
Marvix AI is a partner in the AAN Practice Success Network.
Explore specialty templates
→
NEUROLOGY FOLLOW-UP NOTE
Synced to EHR
PATIENT: Martin Summit · 74 yrs · Cognitive evaluation
Chief Complaint (CC)
Progressive memory loss over the past three years with increasing forgetfulness, difficulty managing daily tasks, word-finding difficulty, and concern for dementia.
History of Present Illness
Martin Summit is a 74-year-old right-handed male presenting for evaluation of progressive cognitive decline over approximately three years. His wife reports forgetfulness, repetitive questioning, and misplaced items that have gradually worsened. Over the past year he has had greater difficulty managing finances and medications, following multistep tasks, and keeping track of dates, though he remains familiar with close family and his home.
He reports occasional word-finding difficulty and slower processing speed. His wife notes mild apathy but no personality change, aggression, or visual hallucinations. Sleep is fragmented with occasional daytime naps, and he removes his CPAP mask partway through most nights. There is no history of stroke, seizure, head trauma, loss of consciousness, or rapidly progressive neurological decline.
Past Medical History
Current Medications
Amlodipine 5 mg daily
Metformin 1000 mg twice daily
Atorvastatin 20 mg nightly
Aspirin 81 mg daily
Vitamin D3 1000 IU daily
Past Surgical History
Family History
Social History
Martin Summit is a retired accountant who lives with his wife. He has never smoked and drinks alcohol occasionally. He denies illicit drug use. He remains physically active with daily walks but has reduced participation in community activities because of memory concerns.
Functional Status
Activities of Daily Living (ADLs):
Independent with dressing, bathing, toileting, and feeding
Occasionally requires reminders for personal hygiene
Instrumental Activities of Daily Living (IADLs):
Requires assistance with finances
Wife manages medications
Has difficulty organizing appointments
Continues to drive locally but avoids unfamiliar routes
Reduced confidence with shopping independently
Functional Activities Questionnaire (FAQ) score 11/30 based on his wife's report
Review of Systems (ROS)
General: Mild fatigue. No fever or unintentional weight loss.
Respiratory: No cough or dyspnea.
Cardiovascular: No chest pain or palpitations.
GI: No nausea, vomiting, abdominal pain, or change in bowel habits.
Psychiatric: Mild apathy and decreased motivation. No depression, hallucinations, or suicidal ideation. PHQ-9 score 4, consistent with minimal depressive symptoms.
Musculoskeletal: Mild chronic bilateral knee discomfort.
Neurological: Progressive short-term memory impairment, word-finding difficulty, slowed processing speed, and occasional disorientation in unfamiliar environments. No focal weakness, numbness, tremor, seizures, gait instability, or loss of consciousness.
Vitals
BP: 132/76 mmHg
Pulse: 68 bpm
Temp: 98.1°F
Height: 175 cm
Weight: 80 kg
BMI: 26.1 kg/m²
Examination
General:
Pleasant elderly male in no acute distress.
Mental Status Exam:
Appearance: Well groomed
Behavior: Cooperative and attentive
Mood: Euthymic
Affect: Appropriate with full range
Thought Process: Logical but slowed
Interactions: Appropriate with preserved social awareness
Neurological:
Mental Status: Alert and oriented to person and place but incorrectly identified the date. Speech fluent with occasional word-finding pauses. Immediate registration intact. Delayed recall impaired with recall of 1 out of 3 objects after five minutes, improving to 2 out of 3 with category cues. Mild impairment in attention during serial sevens. Clock drawing demonstrated mild visuospatial disorganization. Estimated MoCA score 22/30, declined from 25/30 in March 2024.
Cranial Nerves: Cranial nerves II-XII intact. Pupils equal and reactive to light. Extraocular movements full. Facial strength and sensation symmetric. Hearing mildly reduced bilaterally to conversational voice.
Motor: Normal bulk and tone. Strength 5/5 throughout. No rigidity, bradykinesia, tremor, or pronator drift.
Reflexes: 2+ and symmetric throughout.
Coordination: Finger-to-nose and rapid alternating movements intact bilaterally.
Sensory: Intact to light touch, vibration, and proprioception.
Gait and Station: Mildly slowed gait with preserved arm swing. Able to perform tandem gait with minimal difficulty. Negative Romberg.
Labs and Imaging
Laboratory Tests (June 2026):
CBC and comprehensive metabolic panel within normal limits. Sodium 138 mmol/L, Creatinine 0.96 mg/dL (eGFR 82 mL/min/1.73 m²), HbA1c 7.0%, Vitamin B12 462 pg/mL, Folate 12.4 ng/mL, TSH 2.18 uIU/mL. No reversible metabolic cause for cognitive impairment identified.
MRI Brain (July 2026):
Mild bilateral hippocampal volume loss with mild generalized cerebral atrophy, slightly greater than expected for age. Mild chronic microvascular white matter changes (Fazekas Grade 1). No acute infarction, hemorrhage, hydrocephalus, or intracranial mass. Interval development of hippocampal volume loss compared with March 2024.
MRI Brain (March 2024):
Age-appropriate cerebral volume without hippocampal atrophy. Scattered punctate white matter hyperintensities. No acute intracranial abnormality.
Assessment
Progressive cognitive impairment concerning for early Alzheimer's disease
Mild cognitive impairment affecting instrumental activities of daily living
Mild chronic cerebral small vessel ischemic disease
Obstructive sleep apnea with suboptimal CPAP adherence, possible contributor to cognitive symptoms
Hypertension and type 2 diabetes mellitus, stable
Plan
Ordered
Medications:
No medication changes pending diagnostic evaluation
Labs:
Plasma p-tau217
Procedures:
Comprehensive neuropsychological testing
CPAP compliance download
Follow Up
Follow-up is scheduled in six weeks after completion of neuropsychological testing to review results, establish a definitive diagnosis, discuss treatment options, and determine the need for pharmacologic therapy and additional safety planning. His wife was advised to call sooner for any sudden change in cognition, new focal weakness or speech difficulty, falls, or new behavioral symptoms such as hallucinations or agitation.
10. Outputs Chips
OUTPUTS FROM ONE ENCOUNTER
Clinical Note
ICD-10 & E/M Coding
Patient Instructions
Referral Letter
Selected Specialty · Neurology
Built for complex, longitudinal neurology.
Capture complex neurological visits, review years of patient history in seconds, and generate technical notes with medical necessity language across 14 neurology subspecialties.
SPECIALTY CAPABILITIES
Captures seizure semiology and cranial nerve exams
Builds Patient Recaps from prior charts
Captures PHQ-9, PDQ-39 and ASRS scores
Codes ICD-10 with MDM rationale
Supports 90 to 120 minute consults
RECOGNIZED PARTNER
Marvix AI is a partner in the AAN Practice Success Network.
Explore specialty templates
→
NEUROLOGY FOLLOW-UP NOTE
Synced to EHR
PATIENT: Martin Summit · 74 yrs · Cognitive evaluation
Chief Complaint (CC)
Progressive memory loss over the past three years with increasing forgetfulness, difficulty managing daily tasks, word-finding difficulty, and concern for dementia.
History of Present Illness
Martin Summit is a 74-year-old right-handed male presenting for evaluation of progressive cognitive decline over approximately three years. His wife reports forgetfulness, repetitive questioning, and misplaced items that have gradually worsened. Over the past year he has had greater difficulty managing finances and medications, following multistep tasks, and keeping track of dates, though he remains familiar with close family and his home.
He reports occasional word-finding difficulty and slower processing speed. His wife notes mild apathy but no personality change, aggression, or visual hallucinations. Sleep is fragmented with occasional daytime naps, and he removes his CPAP mask partway through most nights. There is no history of stroke, seizure, head trauma, loss of consciousness, or rapidly progressive neurological decline.
Past Medical History
Current Medications
Amlodipine 5 mg daily
Metformin 1000 mg twice daily
Atorvastatin 20 mg nightly
Aspirin 81 mg daily
Vitamin D3 1000 IU daily
Past Surgical History
Family History
Social History
Martin Summit is a retired accountant who lives with his wife. He has never smoked and drinks alcohol occasionally. He denies illicit drug use. He remains physically active with daily walks but has reduced participation in community activities because of memory concerns.
Functional Status
Activities of Daily Living (ADLs):
Independent with dressing, bathing, toileting, and feeding
Occasionally requires reminders for personal hygiene
Instrumental Activities of Daily Living (IADLs):
Requires assistance with finances
Wife manages medications
Has difficulty organizing appointments
Continues to drive locally but avoids unfamiliar routes
Reduced confidence with shopping independently
Functional Activities Questionnaire (FAQ) score 11/30 based on his wife's report
Review of Systems (ROS)
General: Mild fatigue. No fever or unintentional weight loss.
Respiratory: No cough or dyspnea.
Cardiovascular: No chest pain or palpitations.
GI: No nausea, vomiting, abdominal pain, or change in bowel habits.
Psychiatric: Mild apathy and decreased motivation. No depression, hallucinations, or suicidal ideation. PHQ-9 score 4, consistent with minimal depressive symptoms.
Musculoskeletal: Mild chronic bilateral knee discomfort.
Neurological: Progressive short-term memory impairment, word-finding difficulty, slowed processing speed, and occasional disorientation in unfamiliar environments. No focal weakness, numbness, tremor, seizures, gait instability, or loss of consciousness.
Vitals
BP: 132/76 mmHg
Pulse: 68 bpm
Temp: 98.1°F
Height: 175 cm
Weight: 80 kg
BMI: 26.1 kg/m²
Examination
General:
Pleasant elderly male in no acute distress.
Mental Status Exam:
Appearance: Well groomed
Behavior: Cooperative and attentive
Mood: Euthymic
Affect: Appropriate with full range
Thought Process: Logical but slowed
Interactions: Appropriate with preserved social awareness
Neurological:
Mental Status: Alert and oriented to person and place but incorrectly identified the date. Speech fluent with occasional word-finding pauses. Immediate registration intact. Delayed recall impaired with recall of 1 out of 3 objects after five minutes, improving to 2 out of 3 with category cues. Mild impairment in attention during serial sevens. Clock drawing demonstrated mild visuospatial disorganization. Estimated MoCA score 22/30, declined from 25/30 in March 2024.
Cranial Nerves: Cranial nerves II-XII intact. Pupils equal and reactive to light. Extraocular movements full. Facial strength and sensation symmetric. Hearing mildly reduced bilaterally to conversational voice.
Motor: Normal bulk and tone. Strength 5/5 throughout. No rigidity, bradykinesia, tremor, or pronator drift.
Reflexes: 2+ and symmetric throughout.
Coordination: Finger-to-nose and rapid alternating movements intact bilaterally.
Sensory: Intact to light touch, vibration, and proprioception.
Gait and Station: Mildly slowed gait with preserved arm swing. Able to perform tandem gait with minimal difficulty. Negative Romberg.
Labs and Imaging
Laboratory Tests (June 2026):
CBC and comprehensive metabolic panel within normal limits. Sodium 138 mmol/L, Creatinine 0.96 mg/dL (eGFR 82 mL/min/1.73 m²), HbA1c 7.0%, Vitamin B12 462 pg/mL, Folate 12.4 ng/mL, TSH 2.18 uIU/mL. No reversible metabolic cause for cognitive impairment identified.
MRI Brain (July 2026):
Mild bilateral hippocampal volume loss with mild generalized cerebral atrophy, slightly greater than expected for age. Mild chronic microvascular white matter changes (Fazekas Grade 1). No acute infarction, hemorrhage, hydrocephalus, or intracranial mass. Interval development of hippocampal volume loss compared with March 2024.
MRI Brain (March 2024):
Age-appropriate cerebral volume without hippocampal atrophy. Scattered punctate white matter hyperintensities. No acute intracranial abnormality.
Assessment
Progressive cognitive impairment concerning for early Alzheimer's disease
Mild cognitive impairment affecting instrumental activities of daily living
Mild chronic cerebral small vessel ischemic disease
Obstructive sleep apnea with suboptimal CPAP adherence, possible contributor to cognitive symptoms
Hypertension and type 2 diabetes mellitus, stable
Plan
Ordered
Medications:
No medication changes pending diagnostic evaluation
Labs:
Plasma p-tau217
Procedures:
Comprehensive neuropsychological testing
CPAP compliance download
Follow Up
Follow-up is scheduled in six weeks after completion of neuropsychological testing to review results, establish a definitive diagnosis, discuss treatment options, and determine the need for pharmacologic therapy and additional safety planning. His wife was advised to call sooner for any sudden change in cognition, new focal weakness or speech difficulty, falls, or new behavioral symptoms such as hallucinations or agitation.
10. Outputs Chips
OUTPUTS FROM ONE ENCOUNTER
Clinical Note
ICD-10 & E/M Coding
Patient Instructions
Referral Letter
Selected Specialty · Neurology
Built for complex, longitudinal neurology.
Capture complex neurological visits, review years of patient history in seconds, and generate technical notes with medical necessity language across 14 neurology subspecialties.
SPECIALTY CAPABILITIES
Captures seizure semiology and cranial nerve exams
Builds Patient Recaps from prior charts
Captures PHQ-9, PDQ-39 and ASRS scores
Codes ICD-10 with MDM rationale
Supports 90 to 120 minute consults
RECOGNIZED PARTNER
Marvix AI is a partner in the AAN Practice Success Network.
Explore specialty templates
→
NEUROLOGY FOLLOW-UP NOTE
Synced to EHR
PATIENT: Martin Summit · 74 yrs · Cognitive evaluation
Chief Complaint (CC)
Progressive memory loss over the past three years with increasing forgetfulness, difficulty managing daily tasks, word-finding difficulty, and concern for dementia.
History of Present Illness
Martin Summit is a 74-year-old right-handed male presenting for evaluation of progressive cognitive decline over approximately three years. His wife reports forgetfulness, repetitive questioning, and misplaced items that have gradually worsened. Over the past year he has had greater difficulty managing finances and medications, following multistep tasks, and keeping track of dates, though he remains familiar with close family and his home.
He reports occasional word-finding difficulty and slower processing speed. His wife notes mild apathy but no personality change, aggression, or visual hallucinations. Sleep is fragmented with occasional daytime naps, and he removes his CPAP mask partway through most nights. There is no history of stroke, seizure, head trauma, loss of consciousness, or rapidly progressive neurological decline.
Past Medical History
Current Medications
Amlodipine 5 mg daily
Metformin 1000 mg twice daily
Atorvastatin 20 mg nightly
Aspirin 81 mg daily
Vitamin D3 1000 IU daily
Past Surgical History
Family History
Social History
Martin Summit is a retired accountant who lives with his wife. He has never smoked and drinks alcohol occasionally. He denies illicit drug use. He remains physically active with daily walks but has reduced participation in community activities because of memory concerns.
Functional Status
Activities of Daily Living (ADLs):
Independent with dressing, bathing, toileting, and feeding
Occasionally requires reminders for personal hygiene
Instrumental Activities of Daily Living (IADLs):
Requires assistance with finances
Wife manages medications
Has difficulty organizing appointments
Continues to drive locally but avoids unfamiliar routes
Reduced confidence with shopping independently
Functional Activities Questionnaire (FAQ) score 11/30 based on his wife's report
Review of Systems (ROS)
General: Mild fatigue. No fever or unintentional weight loss.
Respiratory: No cough or dyspnea.
Cardiovascular: No chest pain or palpitations.
GI: No nausea, vomiting, abdominal pain, or change in bowel habits.
Psychiatric: Mild apathy and decreased motivation. No depression, hallucinations, or suicidal ideation. PHQ-9 score 4, consistent with minimal depressive symptoms.
Musculoskeletal: Mild chronic bilateral knee discomfort.
Neurological: Progressive short-term memory impairment, word-finding difficulty, slowed processing speed, and occasional disorientation in unfamiliar environments. No focal weakness, numbness, tremor, seizures, gait instability, or loss of consciousness.
Vitals
BP: 132/76 mmHg
Pulse: 68 bpm
Temp: 98.1°F
Height: 175 cm
Weight: 80 kg
BMI: 26.1 kg/m²
Examination
General:
Pleasant elderly male in no acute distress.
Mental Status Exam:
Appearance: Well groomed
Behavior: Cooperative and attentive
Mood: Euthymic
Affect: Appropriate with full range
Thought Process: Logical but slowed
Interactions: Appropriate with preserved social awareness
Neurological:
Mental Status: Alert and oriented to person and place but incorrectly identified the date. Speech fluent with occasional word-finding pauses. Immediate registration intact. Delayed recall impaired with recall of 1 out of 3 objects after five minutes, improving to 2 out of 3 with category cues. Mild impairment in attention during serial sevens. Clock drawing demonstrated mild visuospatial disorganization. Estimated MoCA score 22/30, declined from 25/30 in March 2024.
Cranial Nerves: Cranial nerves II-XII intact. Pupils equal and reactive to light. Extraocular movements full. Facial strength and sensation symmetric. Hearing mildly reduced bilaterally to conversational voice.
Motor: Normal bulk and tone. Strength 5/5 throughout. No rigidity, bradykinesia, tremor, or pronator drift.
Reflexes: 2+ and symmetric throughout.
Coordination: Finger-to-nose and rapid alternating movements intact bilaterally.
Sensory: Intact to light touch, vibration, and proprioception.
Gait and Station: Mildly slowed gait with preserved arm swing. Able to perform tandem gait with minimal difficulty. Negative Romberg.
Labs and Imaging
Laboratory Tests (June 2026):
CBC and comprehensive metabolic panel within normal limits. Sodium 138 mmol/L, Creatinine 0.96 mg/dL (eGFR 82 mL/min/1.73 m²), HbA1c 7.0%, Vitamin B12 462 pg/mL, Folate 12.4 ng/mL, TSH 2.18 uIU/mL. No reversible metabolic cause for cognitive impairment identified.
MRI Brain (July 2026):
Mild bilateral hippocampal volume loss with mild generalized cerebral atrophy, slightly greater than expected for age. Mild chronic microvascular white matter changes (Fazekas Grade 1). No acute infarction, hemorrhage, hydrocephalus, or intracranial mass. Interval development of hippocampal volume loss compared with March 2024.
MRI Brain (March 2024):
Age-appropriate cerebral volume without hippocampal atrophy. Scattered punctate white matter hyperintensities. No acute intracranial abnormality.
Assessment
Progressive cognitive impairment concerning for early Alzheimer's disease
Mild cognitive impairment affecting instrumental activities of daily living
Mild chronic cerebral small vessel ischemic disease
Obstructive sleep apnea with suboptimal CPAP adherence, possible contributor to cognitive symptoms
Hypertension and type 2 diabetes mellitus, stable
Plan
Ordered
Medications:
No medication changes pending diagnostic evaluation
Labs:
Plasma p-tau217
Procedures:
Comprehensive neuropsychological testing
CPAP compliance download
Follow Up
Follow-up is scheduled in six weeks after completion of neuropsychological testing to review results, establish a definitive diagnosis, discuss treatment options, and determine the need for pharmacologic therapy and additional safety planning. His wife was advised to call sooner for any sudden change in cognition, new focal weakness or speech difficulty, falls, or new behavioral symptoms such as hallucinations or agitation.
10. Outputs Chips
OUTPUTS FROM ONE ENCOUNTER
Clinical Note
ICD-10 & E/M Coding
Patient Instructions
Referral Letter
Selected Specialty · Neurology
Built for complex, longitudinal neurology.
Capture complex neurological visits, review years of patient history in seconds, and generate technical notes with medical necessity language across 14 neurology subspecialties.
SPECIALTY CAPABILITIES
Captures seizure semiology and cranial nerve exams
Builds Patient Recaps from prior charts
Captures PHQ-9, PDQ-39 and ASRS scores
Codes ICD-10 with MDM rationale
Supports 90 to 120 minute consults
RECOGNIZED PARTNER
Marvix AI is a partner in the AAN Practice Success Network.
Explore specialty templates
→
NEUROLOGY FOLLOW-UP NOTE
Synced to EHR
PATIENT: Martin Summit · 74 yrs · Cognitive evaluation
Chief Complaint (CC)
Progressive memory loss over the past three years with increasing forgetfulness, difficulty managing daily tasks, word-finding difficulty, and concern for dementia.
History of Present Illness
Martin Summit is a 74-year-old right-handed male presenting for evaluation of progressive cognitive decline over approximately three years. His wife reports forgetfulness, repetitive questioning, and misplaced items that have gradually worsened. Over the past year he has had greater difficulty managing finances and medications, following multistep tasks, and keeping track of dates, though he remains familiar with close family and his home.
He reports occasional word-finding difficulty and slower processing speed. His wife notes mild apathy but no personality change, aggression, or visual hallucinations. Sleep is fragmented with occasional daytime naps, and he removes his CPAP mask partway through most nights. There is no history of stroke, seizure, head trauma, loss of consciousness, or rapidly progressive neurological decline.
Past Medical History
Current Medications
Amlodipine 5 mg daily
Metformin 1000 mg twice daily
Atorvastatin 20 mg nightly
Aspirin 81 mg daily
Vitamin D3 1000 IU daily
Past Surgical History
Family History
Social History
Martin Summit is a retired accountant who lives with his wife. He has never smoked and drinks alcohol occasionally. He denies illicit drug use. He remains physically active with daily walks but has reduced participation in community activities because of memory concerns.
Functional Status
Activities of Daily Living (ADLs):
Independent with dressing, bathing, toileting, and feeding
Occasionally requires reminders for personal hygiene
Instrumental Activities of Daily Living (IADLs):
Requires assistance with finances
Wife manages medications
Has difficulty organizing appointments
Continues to drive locally but avoids unfamiliar routes
Reduced confidence with shopping independently
Functional Activities Questionnaire (FAQ) score 11/30 based on his wife's report
Review of Systems (ROS)
General: Mild fatigue. No fever or unintentional weight loss.
Respiratory: No cough or dyspnea.
Cardiovascular: No chest pain or palpitations.
GI: No nausea, vomiting, abdominal pain, or change in bowel habits.
Psychiatric: Mild apathy and decreased motivation. No depression, hallucinations, or suicidal ideation. PHQ-9 score 4, consistent with minimal depressive symptoms.
Musculoskeletal: Mild chronic bilateral knee discomfort.
Neurological: Progressive short-term memory impairment, word-finding difficulty, slowed processing speed, and occasional disorientation in unfamiliar environments. No focal weakness, numbness, tremor, seizures, gait instability, or loss of consciousness.
Vitals
BP: 132/76 mmHg
Pulse: 68 bpm
Temp: 98.1°F
Height: 175 cm
Weight: 80 kg
BMI: 26.1 kg/m²
Examination
General:
Pleasant elderly male in no acute distress.
Mental Status Exam:
Appearance: Well groomed
Behavior: Cooperative and attentive
Mood: Euthymic
Affect: Appropriate with full range
Thought Process: Logical but slowed
Interactions: Appropriate with preserved social awareness
Neurological:
Mental Status: Alert and oriented to person and place but incorrectly identified the date. Speech fluent with occasional word-finding pauses. Immediate registration intact. Delayed recall impaired with recall of 1 out of 3 objects after five minutes, improving to 2 out of 3 with category cues. Mild impairment in attention during serial sevens. Clock drawing demonstrated mild visuospatial disorganization. Estimated MoCA score 22/30, declined from 25/30 in March 2024.
Cranial Nerves: Cranial nerves II-XII intact. Pupils equal and reactive to light. Extraocular movements full. Facial strength and sensation symmetric. Hearing mildly reduced bilaterally to conversational voice.
Motor: Normal bulk and tone. Strength 5/5 throughout. No rigidity, bradykinesia, tremor, or pronator drift.
Reflexes: 2+ and symmetric throughout.
Coordination: Finger-to-nose and rapid alternating movements intact bilaterally.
Sensory: Intact to light touch, vibration, and proprioception.
Gait and Station: Mildly slowed gait with preserved arm swing. Able to perform tandem gait with minimal difficulty. Negative Romberg.
Labs and Imaging
Laboratory Tests (June 2026):
CBC and comprehensive metabolic panel within normal limits. Sodium 138 mmol/L, Creatinine 0.96 mg/dL (eGFR 82 mL/min/1.73 m²), HbA1c 7.0%, Vitamin B12 462 pg/mL, Folate 12.4 ng/mL, TSH 2.18 uIU/mL. No reversible metabolic cause for cognitive impairment identified.
MRI Brain (July 2026):
Mild bilateral hippocampal volume loss with mild generalized cerebral atrophy, slightly greater than expected for age. Mild chronic microvascular white matter changes (Fazekas Grade 1). No acute infarction, hemorrhage, hydrocephalus, or intracranial mass. Interval development of hippocampal volume loss compared with March 2024.
MRI Brain (March 2024):
Age-appropriate cerebral volume without hippocampal atrophy. Scattered punctate white matter hyperintensities. No acute intracranial abnormality.
Assessment
Progressive cognitive impairment concerning for early Alzheimer's disease
Mild cognitive impairment affecting instrumental activities of daily living
Mild chronic cerebral small vessel ischemic disease
Obstructive sleep apnea with suboptimal CPAP adherence, possible contributor to cognitive symptoms
Hypertension and type 2 diabetes mellitus, stable
Plan
Ordered
Medications:
No medication changes pending diagnostic evaluation
Labs:
Plasma p-tau217
Procedures:
Comprehensive neuropsychological testing
CPAP compliance download
Follow Up
Follow-up is scheduled in six weeks after completion of neuropsychological testing to review results, establish a definitive diagnosis, discuss treatment options, and determine the need for pharmacologic therapy and additional safety planning. His wife was advised to call sooner for any sudden change in cognition, new focal weakness or speech difficulty, falls, or new behavioral symptoms such as hallucinations or agitation.
10. Outputs Chips
OUTPUTS FROM ONE ENCOUNTER
Clinical Note
ICD-10 & E/M Coding
Patient Instructions
Referral Letter
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