6350373	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351678	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0"}	RxNorm:6918	{n/a}	1
6350374	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350375	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Please consult a clinical pharmacist for more information."}	1
6350376	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350377	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350378	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350379	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350380	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2C19 ultarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350381	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2C19 ultarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2D6 genotype does not appear to have been ordered for this patient. CYP2D6 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6350382	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350383	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments.Please consult a clinical pharmacist for more information."}	1
6350567	general	Pre-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "1.5"}	{"HLA-B": "No *15:02 result"}	{"HLA-B": "No *15:02 result", "CYP2C9": "1.5"}	RxNorm:72236	{"HLA-B*15:02 genotype may be important for fosphenytoin adverse events. An HLA-B*15:02 genotype does not appear to have been ordered for this patient. Use of an alternative antiepileptic may be recommended. Please consult a clinical pharmacist for more information."}	1
6350384	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350385	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350386	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Please consult a clinical pharmacist for more information."}	1
6350387	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Please consult a clinical pharmacist for more information."}	1
6350388	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Please consult a clinical pharmacist for more information."}	1
6350389	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Please consult a clinical pharmacist for more information."}	1
6350390	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 poor metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350391	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350392	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350393	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350394	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350568	general	No CDS	{CYP2C9,HLA-B}	{}	{"CYP2C9": "1.5"}	{"HLA-B": "*15:02 negative"}	{"HLA-B": "*15:02 negative", "CYP2C9": "1.5"}	RxNorm:72236	{n/a}	1
6351679	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0"}	RxNorm:6918	{n/a}	1
6350395	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350396	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350397	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350398	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350399	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350400	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350401	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350402	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Indeterminate"}	RxNorm:3638	{n/a}	1
6350403	general	Pre-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. CYP2D6 genotype does not appear to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350404	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 intermediate metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350405	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 intermediate metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350593	general	No CDS	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:5095	{n/a}	1
6351680	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75"}	RxNorm:6918	{n/a}	1
6350406	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350407	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 intermediate metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350408	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 intermediate metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350409	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{n/a}	1
6350410	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{n/a}	1
6350411	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{n/a}	1
6350412	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{n/a}	1
6350413	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{n/a}	1
6350414	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 poor metabolizer and a likely CYP2C19 intermediate metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350415	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350416	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350417	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350418	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350594	general	Pre-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2C19 genotype may be important for imipramine dosing and use. A CYP2C19 genotype does not appear to have been ordered for this patient. Use of an alternative agent or dose may be recommended. Please consult a clinical pharmacist for more information."}	1
6350419	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350420	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350421	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350422	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350423	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350424	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350425	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350426	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{n/a}	1
6350427	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a likely CYP2C19 intermediate metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2C19 result. Because a CYP2D6 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350428	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 poor metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350429	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 poor metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351681	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5"}	RxNorm:6918	{n/a}	1
6350430	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 poor metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350431	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 poor metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350432	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a likely CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If doxepin is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350433	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a likely CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If doxepin is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350434	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a likely CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If doxepin is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350435	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a likely CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If doxepin is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350436	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a likely CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If doxepin is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350437	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 poor metabolizer and a likely CYP2C19 poor metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350438	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350439	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350440	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350441	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350442	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350443	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350444	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350445	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350446	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350447	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350448	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a likely CYP2C19 poor metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If doxepin is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350449	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a likely CYP2C19 poor metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If doxepin is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Because a CYP2D6 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350595	general	Pre-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. Neither a CYP2D6 nor CYP2C19 genotype appears to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350450	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350451	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350452	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350453	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350454	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Because a CYP2C19 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350455	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Because a CYP2C19 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350456	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Because a CYP2C19 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350457	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Because a CYP2C19 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350458	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Because a CYP2C19 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350459	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 poor metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6351682	general	No CDS	{CYP2D6}	{"CYP2D6": "Normal Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	RxNorm:6918	{n/a}	1
6350460	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6350461	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6350462	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6350463	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6350464	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6350465	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6350466	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6350467	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6350468	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6351683	general	No CDS	{CYP2D6}	{"CYP2D6": "Normal Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	RxNorm:6918	{n/a}	1
6350469	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6350470	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6350471	general	Pre-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2C19 genotype may be important for doxepin dosing and use. A CYP2C19 genotype does not appear to have been ordered for this patient. Use of an alternative agent or dose may be recommended. Please consult a clinical pharmacist for more information."}	1
6350472	general	Pre-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. Neither a CYP2D6 nor CYP2C19 genotype appears to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350473	general	No CDS	{CYP2B6}	{"CYP2B6": "Indeterminate"}	{}	{}	{"CYP2B6": "Indeterminate"}	RxNorm:195085	{n/a}	1
6350474	general	Pre-test	{CYP2B6}	{"CYP2B6": "No Result"}	{}	{}	{"CYP2B6": "No Result"}	RxNorm:195085	{"CYP2B6 genetic status may be predictive of adverse events with efavirenz. A CYP2B6 genotype does not appear to have been ordered for this patient. A decreased dose may be recommended. Please consult a clinical pharmacist for more information."}	1
6350475	general	No CDS	{CYP2B6}	{"CYP2B6": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2B6": "Ultrarapid Metabolizer"}	RxNorm:195085	{n/a}	1
6350476	general	No CDS	{CYP2B6}	{"CYP2B6": "Rapid Metabolizer"}	{}	{}	{"CYP2B6": "Rapid Metabolizer"}	RxNorm:195085	{n/a}	1
6350477	general	No CDS	{CYP2B6}	{"CYP2B6": "Normal Metabolizer"}	{}	{}	{"CYP2B6": "Normal Metabolizer"}	RxNorm:195085	{n/a}	1
6350478	general	Post-test	{CYP2B6}	{"CYP2B6": "Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Intermediate Metabolizer"}	RxNorm:195085	{"This patient is predicted to be a CYP2B6 intermediate metabolizer and may be at an increased risk of adverse events due to higher plasma concentrations of efavirenz. Consider initiating efavirenz with a decreased dose of 400 mg/day. Please consult a clinical pharmacist for more information."}	1
6350479	general	Post-test	{CYP2B6}	{"CYP2B6": "Poor Metabolizer"}	{}	{}	{"CYP2B6": "Poor Metabolizer"}	RxNorm:195085	{"This patient is predicted to be a CYP2B6 poor metabolizer and may be at an increased risk of adverse events due to higher plasma concentrations of efavirenz. Consider initiating efavirenz with a decreased dose of 200 or 400 mg/day. Please consult a clinical pharmacist for more information."}	1
6350480	general	Post-test	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	RxNorm:3920	{"Based on genotype, this patient is predicted to be malignant hyperthermia susceptible. Halogenated volatile anesthetics or depolarizing muscle relaxants are relatively contraindicated in persons with MHS. They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available, effective, and safe in patients with MHS. Please consult an anesthesiologist or clinical pharmacist for more information."}	1
6350481	general	Post-test	{RYR1,CACNA1S}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:3920	{"Based on genotype, this patient is predicted to be malignant hyperthermia susceptible. Halogenated volatile anesthetics or depolarizing muscle relaxants are relatively contraindicated in persons with MHS. They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available, effective, and safe in patients with MHS. Please consult an anesthesiologist or clinical pharmacist for more information."}	1
6350482	general	Pre-test	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	RxNorm:3920	{"Malignant Hyperthermia Susceptibility is an inherited trait linked to changes within the RYR1 and CACNA1S genes. Genetic testing can help to guide anesthetic agent use."}	1
6350483	general	Pre-test	{RYR1,CACNA1S}	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:3920	{"Malignant Hyperthermia Susceptibility is an inherited trait linked to changes within the RYR1 and CACNA1S genes. Genetic testing can help to guide anesthetic agent use."}	1
6350484	general	Pre-test	{RYR1,CACNA1S}	{"RYR1": "No Result", "CACNA1S": "No Result"}	{}	{}	{"RYR1": "No Result", "CACNA1S": "No Result"}	RxNorm:3920	{"Malignant Hyperthermia Susceptibility is an inherited trait linked to changes within the RYR1 and CACNA1S genes. Genetic testing can help to guide anesthetic agent use."}	1
6350487	general	Post-test	{CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:321988	{"Based on the genotype result, this patient is predicted to be a CYP2C19 ultrarapid metabolizer and is at risk for lower plasma concentrations and increased probability of therapeutic failure with standard dosing. Consider a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2C19. If escitalopram is clinically appropriate, and adequate efficacy is not achieved at standard maintenance dosing, consider titrating to a higher maintenance dose. Please consult a clinical pharmacist for more information."}	1
6350488	general	Post-test	{CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2C19": "Rapid Metabolizer"}	RxNorm:321988	{"Based on the genotype result, this patient is predicted to be a CYP2C19 rapid metabolizer and may be at risk for lower plasma concentrations and increased probability of therapeutic failure with standard dosing. Initiate therapy with recommended starting dose. If patient does not adequately respond, consider titrating to a higher maintenance dose or switching to a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2C19. Please consult a clinical pharmacist for more information."}	1
6350489	general	No CDS	{CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2C19": "Normal Metabolizer"}	RxNorm:321988	{n/a}	1
6350490	general	Post-test	{CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:321988	{"Based on the genotype result, this patient is predicted to be a likely CYP2C19 intermediate metabolizer and is at risk for higher plasma concentrations and increased probability of side effects with standard dosing. Initiate therapy with recommended starting dose, but consider a slower titration schedule and lower maintenance dose. Please consult a clinical pharmacist for more information."}	1
6350491	general	Post-test	{CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Intermediate Metabolizer"}	RxNorm:321988	{"Based on the genotype result, this patient is predicted to be a CYP2C19 intermediate metabolizer and is at risk for higher plasma concentrations and increased probability of side effects with standard dosing. Initiate therapy with recommended starting dose, but consider a slower titration schedule and lower maintenance dose. Please consult a clinical pharmacist for more information."}	1
6350492	general	Post-test	{CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{}	{}	{"CYP2C19": "Likely Poor Metabolizer"}	RxNorm:321988	{"Based on the genotype result, this patient is predicted to be a likely CYP2C19 poor metabolizer and is at risk for higher plasma concentrations and increased probability of side effects with standard dosing. Consider a clinically appropriate antidepressant not predominantly metabolized by CYP2C19. If escitalopram is clinically appropriate, consider a lower starting dose, slower titration schedule and 50% reduction of the standard maintenance dose. Please consult a clinical pharmacist for more information."}	1
6350493	general	Post-test	{CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{}	{}	{"CYP2C19": "Poor Metabolizer"}	RxNorm:321988	{"Based on the genotype result, this patient is predicted to be a CYP2C19 poor metabolizer and is at risk for higher plasma concentrations and increased probability of side effects with standard dosing. Consider a clinically appropriate antidepressant not predominantly metabolized by CYP2C19. If escitalopram is clinically appropriate, consider a lower starting dose, slower titration schedule and 50% reduction of the standard maintenance dose. Please consult a clinical pharmacist for more information."}	1
6350494	general	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:321988	{n/a}	1
6350495	general	Pre-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "No Result"}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0", "SLCO1B1": "No Result"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 normal metabolizer. Based on CYP2C9 phenotype there is no reason to adjust the dose of fluvastatin. Because an SLCO1B1 genotype does not appear to have been ordered for this patient, it is not known if SLCO1B1 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6350496	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Possible Decreased Function"}	{"CYP2C9": "0.5"}	{}	{"CYP2C9": "0.5", "SLCO1B1": "Possible Decreased Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 poor metabolizer and to have SLCO1B1 possible decreased function. The patient is at an increased risk of a fluvastatin-induced myopathy. Prescribe an alternative statin depending on the desired potency. Please consult a clinical pharmacist for more information."}	1
6350497	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Possible Decreased Function"}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a", "SLCO1B1": "Possible Decreased Function"}	RxNorm:41127	{n/a}	1
6350498	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Indeterminate"}	{"CYP2C9": "1.0"}	{}	{"CYP2C9": "1.0", "SLCO1B1": "Indeterminate"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 intermediate metabolizer and may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤40mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >40mg is needed for desired efficacy, consider an alternative statin or combination therapy. Because SLCO1B1 phenotype could not be assigned based on genotyping performed, it is not known if SLCO1B1 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6350499	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Indeterminate"}	{"CYP2C9": "1.5"}	{}	{"CYP2C9": "1.5", "SLCO1B1": "Indeterminate"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 intermediate metabolizer and may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤40mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >40mg is needed for desired efficacy, consider an alternative statin or combination therapy. Because SLCO1B1 phenotype could not be assigned based on genotyping performed, it is not known if SLCO1B1 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6350500	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Indeterminate"}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0", "SLCO1B1": "Indeterminate"}	RxNorm:41127	{n/a}	1
6350501	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Indeterminate"}	{"CYP2C9": "0.0"}	{}	{"CYP2C9": "0.0", "SLCO1B1": "Indeterminate"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 poor metabolizer and may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >20mg is needed for desired efficacy, consider an alternative statin or combination therapy. Because SLCO1B1 phenotype could not be assigned based on genotyping performed, it is not known if SLCO1B1 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6350502	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Indeterminate"}	{"CYP2C9": "0.5"}	{}	{"CYP2C9": "0.5", "SLCO1B1": "Indeterminate"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 poor metabolizer and may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >20mg is needed for desired efficacy, consider an alternative statin or combination therapy. Because SLCO1B1 phenotype could not be assigned based on genotyping performed, it is not known if SLCO1B1 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6350503	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Indeterminate"}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a", "SLCO1B1": "Indeterminate"}	RxNorm:41127	{n/a}	1
6350504	general	Pre-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Indeterminate"}	{"CYP2C9": "No Result"}	{}	{"CYP2C9": "No Result", "SLCO1B1": "Indeterminate"}	RxNorm:41127	{"CYP2C9 and SLCO1B1 genetic status may be predictive of the risk of fluvastatin-induced myopathydue to altered drug exposure. Because a CYP2C9 genotype does not appear to have been ordered for this patient and SLCO1B1 phenotype could not be assigned based on genotyping performed, it is not known if these results would influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6350505	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "No Result"}	{"CYP2C9": "1.0"}	{}	{"CYP2C9": "1.0", "SLCO1B1": "No Result"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 intermediate metabolizer and may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤40mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >40mg is needed for desired efficacy, consider an alternative statin or combination therapy. Because an SLCO1B1 genotype does not appear to have been ordered for this patient, it is not known if SLCO1B1 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6350506	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "No Result"}	{"CYP2C9": "1.5"}	{}	{"CYP2C9": "1.5", "SLCO1B1": "No Result"}	RxNorm:41127	{"CYP2C9 and SLCO1B1 genetic status may be predictive of the risk of myopathy to this medication due to altered drug metabolism. This patient is predicted to be a CYP2C9 intermediate metabolizer and may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤40mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If dose >40mg needed for desired efficacy, consider an alternative statin or combination therapy (i.e. fluvastatin plus non-statin guideline directed medical therapy). Because a SLCO1B1 genotype does not appear to have been ordered for this patient, it is not known if SLCO1B1 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6350507	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "No Result"}	{"CYP2C9": "0.0"}	{}	{"CYP2C9": "0.0", "SLCO1B1": "No Result"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 poor metabolizer and may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >20mg is needed for desired efficacy, consider an alternative statin or combination therapy. Because an SLCO1B1 genotype does not appear to have been ordered for this patient, it is not known if SLCO1B1 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6350508	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "No Result"}	{"CYP2C9": "0.5"}	{}	{"CYP2C9": "0.5", "SLCO1B1": "No Result"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 poor metabolizer and may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >20mg is needed for desired efficacy, consider an alternative statin or combination therapy. Because a SLCO1B1 genotype does not appear to have been ordered for this patient, it is not known if SLCO1B1 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6350509	general	Pre-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "No Result"}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a", "SLCO1B1": "No Result"}	RxNorm:41127	{"CYP2C9 and SLCO1B1 genetic status may be predictive of the risk of fluvastatin-induced myopathy due to altered drug exposure. Because an SLCO1B1 genotype does not appear to have been ordered for this patient and CYP2C9 phenotype could not be assigned based on genotyping performed, it is not known if these results would influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6350510	general	Pre-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "No Result"}	{"CYP2C9": "No Result"}	{}	{"CYP2C9": "No Result", "SLCO1B1": "No Result"}	RxNorm:41127	{"CYP2C9 and SLCO1B1 genetic status may be predictive of the risk of fluvastatin-induced myopathy due to altered drug exposure. Neither a CYP2C9 nor SLCO1B1 genotype appears to have been ordered for this patient. Use of an alternative dose or drug may be recommended. Please consult a clinical pharmacist for more information."}	1
6350511	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Decreased Function"}	{"CYP2C9": "1.0"}	{}	{"CYP2C9": "1.0", "SLCO1B1": "Decreased Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 intermediate metabolizer and to have SLCO1B1 decreased function. The patient may be at an increased risk of a fluvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If dose >20mg needed for desired efficacy, consider an alternative statin or combination therapy (i.e. fluvastatin plus non-statin guideline directed medical therapy). Please consult a clinical pharmacist for more information."}	1
6350512	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Decreased Function"}	{"CYP2C9": "1.5"}	{}	{"CYP2C9": "1.5", "SLCO1B1": "Decreased Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 intermediate metabolizer and to have SLCO1B1 decreased function. Thise patient may be at an increased risk of a fluvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >20mg is needed for desired efficacy, consider an alternative statin or combination therapy. Please consult a clinical pharmacist for more information."}	1
6350513	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Decreased Function"}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0", "SLCO1B1": "Decreased Function"}	RxNorm:41127	{n/a}	1
6350514	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Decreased Function"}	{"CYP2C9": "0.0"}	{}	{"CYP2C9": "0.0", "SLCO1B1": "Decreased Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 poor metabolizer and to have SLCO1B1 decreased function. This patient is at an increased risk of a fluvastatin-induced myopathy. Prescribe an alternative statin depending on the desired potency. Please consult a clinical pharmacist for more information."}	1
6350515	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Decreased Function"}	{"CYP2C9": "0.5"}	{}	{"CYP2C9": "0.5", "SLCO1B1": "Decreased Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 poor metabolizer and to have SLCO1B1 decreased function. The patient is at an increased risk of a fluvastatin-induced myopathy. Prescribe an alternative statin depending on the desired potency. Please consult a clinical pharmacist for more information."}	1
6350516	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Decreased Function"}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a", "SLCO1B1": "Decreased Function"}	RxNorm:41127	{n/a}	1
6350517	general	Pre-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Decreased Function"}	{"CYP2C9": "No Result"}	{}	{"CYP2C9": "No Result", "SLCO1B1": "Decreased Function"}	RxNorm:41127	{"CYP2C9 genetic status may be predictive of the risk of fluvastatin-induced myopathy due to altered drug exposure. Because a CYP2C9 genotype does not appear to have been ordered for this patient, it is not known if these results would influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6350518	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Normal Function"}	{"CYP2C9": "1.0"}	{}	{"CYP2C9": "1.0", "SLCO1B1": "Normal Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 intermediate metabolizer and to have SLCO1B1 normal function. This patient may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤40mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >40mg is needed for desired efficacy, consider an alternative statin or combination therapy. Please consult a clinical pharmacist for more information."}	1
6350519	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Normal Function"}	{"CYP2C9": "1.5"}	{}	{"CYP2C9": "1.5", "SLCO1B1": "Normal Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 intermediate metabolizer and to have SLCO1B1 normal function. This patient may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤40mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >40mg is needed for desired efficacy, consider an alternative statin or combination therapy. Please consult a clinical pharmacist for more information."}	1
6350520	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Normal Function"}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0", "SLCO1B1": "Normal Function"}	RxNorm:41127	{n/a}	1
6350521	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Normal Function"}	{"CYP2C9": "0.0"}	{}	{"CYP2C9": "0.0", "SLCO1B1": "Normal Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 poor metabolizer and to have SLCO1B1 normal function. This patient may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >20mg is needed for desired efficacy, consider an alternative statin or combination therapy. Please consult a clinical pharmacist for more information."}	1
6350522	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Normal Function"}	{"CYP2C9": "0.5"}	{}	{"CYP2C9": "0.5", "SLCO1B1": "Normal Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 poor metabolizer and to have SLCO1B1 normal function. This patient may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If dose >20mg needed for desired efficacy, consider an alternative statin or combination therapy (i.e. fluvastatin plus non-statin guideline directed medical therapy). Please consult a clinical pharmacist for more information."}	1
6350523	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Normal Function"}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a", "SLCO1B1": "Normal Function"}	RxNorm:41127	{n/a}	1
6350524	general	Pre-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Normal Function"}	{"CYP2C9": "No Result"}	{}	{"CYP2C9": "No Result", "SLCO1B1": "Normal Function"}	RxNorm:41127	{"CYP2C9 genetic status may be predictive of the risk of fluvastatin-induced myopathy due to altered drug exposure. Because a CYP2C9 genotype does not appear to have been ordered for this patient, it is not known if these results would influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6350525	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Poor Function"}	{"CYP2C9": "1.0"}	{}	{"CYP2C9": "1.0", "SLCO1B1": "Poor Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 intermediate metabolizer and to have SLCO1B1 poor function. Thise patient is at an increased risk of a fluvastatin-induced myopathy. Prescribe an alternative statin depending on the desired potency. Please consult a clinical pharmacist for more information."}	1
6350526	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Poor Function"}	{"CYP2C9": "1.5"}	{}	{"CYP2C9": "1.5", "SLCO1B1": "Poor Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 intermediate metabolizer and to have SLCO1B1 poor function. This patient is at an increased risk of a fluvastatin-induced myopathy. Prescribe an alternative statin depending on the desired potency. Please consult a clinical pharmacist for more information."}	1
6350527	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Poor Function"}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0", "SLCO1B1": "Poor Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 normal metabolizer and to have SLCO1B1 poor function. The patient may be at an increased risk of a fluvastatin-induced myopathy. Prescribe ≤40mg as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose > 40mg is needed for desired efficacy, consider a higher dose (>40mg) if patient is tolerating 40mg per day or an alternative statin or combination therapy. Please consult a clinical pharmacist for more information."}	1
6350528	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Poor Function"}	{"CYP2C9": "0.0"}	{}	{"CYP2C9": "0.0", "SLCO1B1": "Poor Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 poor metabolizer and to have SLCO1B1 poor function. The patient is at an increased risk of a fluvastatin-induced myopathy. Prescribe an alternative statin depending on the desired potency. Please consult a clinical pharmacist for more information."}	1
6350529	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Poor Function"}	{"CYP2C9": "0.5"}	{}	{"CYP2C9": "0.5", "SLCO1B1": "Poor Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 poor metabolizer and to have SLCO1B1 poor function. The patient is at an increased risk of a fluvastatin-induced myopathy. Prescribe an alternative statin depending on the desired potency. Please consult a clinical pharmacist for more information."}	1
6350530	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Poor Function"}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a", "SLCO1B1": "Poor Function"}	RxNorm:41127	{"This patient is predicted to have SLCO1B1 poor function and may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤40mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >40mg is needed, consider a higher dose (>40mg) if patient is tolerating 40mg per day or an alternative statin or combination therapy. Because CYP2C9 phenotype could not be assigned based on genotyping performed, it is not known if CYP2C9 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6350531	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Poor Function"}	{"CYP2C9": "No Result"}	{}	{"CYP2C9": "No Result", "SLCO1B1": "Poor Function"}	RxNorm:41127	{"This patient is predicted to have SLCO1B1 poor function and may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤40mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >40mg is needed, consider a higher dose (>40mg) if patient s tolerating 40mg per day or an alternative statin or combination therapy. Because a CYP2C9 genotype does not appear to have been ordered for this patient, it is not known if CYP2C9 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6350532	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Increased Function"}	{"CYP2C9": "1.0"}	{}	{"CYP2C9": "1.0", "SLCO1B1": "Increased Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 intermediate metabolizer and to have SLCO1B1 increased. This patient may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤40mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >40mg is needed for desired efficacy, consider an alternative statin or combination therapy. Please consult a clinical pharmacist for more information."}	1
6350533	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Increased Function"}	{"CYP2C9": "1.5"}	{}	{"CYP2C9": "1.5", "SLCO1B1": "Increased Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 intermediate metabolizer and to have SLCO1B1 increased. This patient may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤40mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >40mg is needed for desired efficacy, consider an alternative statin or combination therapy. Please consult a clinical pharmacist for more information."}	1
6350534	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Increased Function"}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0", "SLCO1B1": "Increased Function"}	RxNorm:41127	{n/a}	1
6350535	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Increased Function"}	{"CYP2C9": "0.0"}	{}	{"CYP2C9": "0.0", "SLCO1B1": "Increased Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 poor metabolizer and to have SLCO1B1 increased. This patient may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >20mg is needed for desired efficacy, consider an alternative statin or combination therapy. Please consult a clinical pharmacist for more information."}	1
6350536	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Increased Function"}	{"CYP2C9": "0.5"}	{}	{"CYP2C9": "0.5", "SLCO1B1": "Increased Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 poor metabolizer and to have SLCO1B1 increased. This patient may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If dose >20mg needed for desired efficacy, consider an alternative statin or combination therapy (i.e. fluvastatin plus non-statin guideline directed medical therapy). Please consult a clinical pharmacist for more information."}	1
6350537	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Increased Function"}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a", "SLCO1B1": "Increased Function"}	RxNorm:41127	{n/a}	1
6350538	general	Pre-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Increased Function"}	{"CYP2C9": "No Result"}	{}	{"CYP2C9": "No Result", "SLCO1B1": "Increased Function"}	RxNorm:41127	{"CYP2C9 genetic status may be predictive of the risk of fluvastatin-induced myopathy due to altered drug exposure. Because a CYP2C9 genotype does not appear to have been ordered for this patient, it is not known if these results would influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6350894	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0"}	RxNorm:26225	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a poor response due to low plasma concentrations of ondansetron. Consider selecting an alternative medication not extensively metabolized by CYP2D6 (i.e., granisetron). Please consult a clinical pharmacist for more information."}	1
6350539	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Possible Decreased Function"}	{"CYP2C9": "1.0"}	{}	{"CYP2C9": "1.0", "SLCO1B1": "Possible Decreased Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 intermediate metabolizer and to have SLCO1B1 possible decreased function. The patient may be at an increased risk of a fluvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If dose >20mg needed for desired efficacy, consider an alternative statin or combination therapy (i.e. fluvastatin plus non-statin guideline directed medical therapy). Please consult a clinical pharmacist for more information."}	1
6350540	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Possible Decreased Function"}	{"CYP2C9": "1.5"}	{}	{"CYP2C9": "1.5", "SLCO1B1": "Possible Decreased Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 intermediate metabolizer and to have SLCO1B1 possible decreased function. Thise patient may be at an increased risk of a fluvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >20mg is needed for desired efficacy, consider an alternative statin or combination therapy. Please consult a clinical pharmacist for more information."}	1
6350541	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Possible Decreased Function"}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0", "SLCO1B1": "Possible Decreased Function"}	RxNorm:41127	{n/a}	1
6350542	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Possible Decreased Function"}	{"CYP2C9": "0.0"}	{}	{"CYP2C9": "0.0", "SLCO1B1": "Possible Decreased Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 poor metabolizer and to have SLCO1B1 poor function. This patient is at an increased risk of a fluvastatin-induced myopathy. Prescribe an alternative statin depending on the desired potency. Please consult a clinical pharmacist for more information."}	1
6350543	general	Pre-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Possible Decreased Function"}	{"CYP2C9": "No Result"}	{}	{"CYP2C9": "No Result", "SLCO1B1": "Possible Decreased Function"}	RxNorm:41127	{"CYP2C9 genetic status may be predictive of the risk of fluvastatin-induced myopathy due to altered drug exposure. Because a CYP2C9 genotype does not appear to have been ordered for this patient, it is not known if these results would influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6350544	general	Pre-test	{CYP2D6}	{}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result"}	RxNorm:42355	{"CYP2D6 genotype may be important for fluvoxamine dosing and use. A CYP2D6 genotype does not appear to have been ordered for this patient. Please consult a clinical pharmacist for more information."}	1
6350545	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0"}	RxNorm:42355	{n/a}	1
6350546	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0"}	RxNorm:42355	{n/a}	1
6350547	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0"}	RxNorm:42355	{n/a}	1
6350548	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75"}	RxNorm:42355	{n/a}	1
6350549	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5"}	RxNorm:42355	{n/a}	1
6350550	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25"}	RxNorm:42355	{n/a}	1
6350551	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0"}	RxNorm:42355	{n/a}	1
6350552	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0"}	RxNorm:42355	{n/a}	1
6350553	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0"}	RxNorm:42355	{n/a}	1
6350554	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75"}	RxNorm:42355	{n/a}	1
6350555	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5"}	RxNorm:42355	{n/a}	1
6350556	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	RxNorm:42355	{n/a}	1
6350557	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	RxNorm:42355	{n/a}	1
6350558	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	RxNorm:42355	{n/a}	1
6350559	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	RxNorm:42355	{n/a}	1
6350560	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	RxNorm:42355	{n/a}	1
6350561	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0"}	RxNorm:42355	{n/a}	1
6350562	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75"}	RxNorm:42355	{n/a}	1
6350563	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5"}	RxNorm:42355	{n/a}	1
6350564	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25"}	RxNorm:42355	{n/a}	1
6350565	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0"}	RxNorm:42355	{"Based on the genotype result, this patient is predicted to be a CYP2D6 poor metabolizer and is at risk for higer plasma concentrations and increased probability of side effects with standard dosing. Consider a 25-50% reduction in recommended starting dose and slower titration schedule or consider a clinicaly appropriate alternative not predominantly metabolized by CYP2D6. Please consult a clinical pharmacist for more information."}	1
6350566	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a"}	RxNorm:42355	{n/a}	1
6351684	general	No CDS	{CYP2D6}	{"CYP2D6": "Normal Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	RxNorm:6918	{n/a}	1
6350569	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "1.0"}	{"HLA-B": "*15:02 negative"}	{"HLA-B": "*15:02 negative", "CYP2C9": "1.0"}	RxNorm:72236	{"Based on the genotype result, this patient is predicted to be a CYP2C9 Intermediate Metabolizer and is at increased risk for developing fosphenytoin-induced toxicities. For first dose, use typical initial or loading dose. For subsequent doses, use approximately 25% less than typical maintenance dose. Subsequent doses should be adjusted according to therapeutic drug monitoring, response and side effects. Please consult a clinical pharmacist for more information"}	1
6350570	general	No CDS	{CYP2C9,HLA-B}	{}	{"CYP2C9": "2.0"}	{"HLA-B": "*15:02 negative"}	{"HLA-B": "*15:02 negative", "CYP2C9": "2.0"}	RxNorm:72236	{n/a}	1
6350571	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "0.5"}	{"HLA-B": "*15:02 negative"}	{"HLA-B": "*15:02 negative", "CYP2C9": "0.5"}	RxNorm:72236	{"Based on the genotype result, this patient is predicted to be a CYP2C9 Poor Metabolizer and is at increased risk for developing fosphenytoin-induced toxicities. For first dose, use typical initial or loading dose. For subsequent doses use approximately 50% less than typical maintenance dose. Subsequent doses should be adjusted according to therapeutic drug monitoring, response, and side effects. Please consult a clinical pharmacist for more information."}	1
6350572	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "0.0"}	{"HLA-B": "*15:02 negative"}	{"HLA-B": "*15:02 negative", "CYP2C9": "0.0"}	RxNorm:72236	{"Based on the genotype result, this patient is predicted to be a CYP2C9 Poor Metabolizer and is at increased risk for developing fosphenytoin-induced toxicities. For first dose, use typical initial or loading dose. For subsequent doses use approximately 50% less than typical maintenance dose. Subsequent doses should be adjusted according to therapeutic drug monitoring, response, and side effects. Please consult a clinical pharmacist for more information."}	1
6350573	general	No CDS	{CYP2C9,HLA-B}	{}	{"CYP2C9": "n/a"}	{"HLA-B": "*15:02 negative"}	{"HLA-B": "*15:02 negative", "CYP2C9": "n/a"}	RxNorm:72236	{n/a}	1
6350574	general	Pre-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "No Result"}	{"HLA-B": "*15:02 negative"}	{"HLA-B": "*15:02 negative", "CYP2C9": "No Result"}	RxNorm:72236	{"CYP2C9 diplotype may be important for fosphenytoin dosing. A CYP2C9 genotype does not appear to have been ordered for this patient. Use of an alternative dose may be recommended. Please consult a clinical pharmacist for more information."}	1
6350575	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "1.5"}	{"HLA-B": "*15:02 positive"}	{"HLA-B": "*15:02 positive", "CYP2C9": "1.5"}	RxNorm:72236	{"The HLA-B*15:02 allele has been detected in this patient. This allele is associated with high risk of cutaneous adverse drug reaction to fosphenytoin. DO NOT prescribe fosphenytoin, fosfosphenytoin, carbamazepine, or oxcarbazepine. Choose an alternate antiepileptic drug. If the patient has previously used fosphenytoin consistently for longer than three months without incidence of cutaneous adverse reactions, cautiously consider use of fosphenytoin in the future. For more information, please consult a clinical pharmacist."}	1
6350576	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "1.0"}	{"HLA-B": "*15:02 positive"}	{"HLA-B": "*15:02 positive", "CYP2C9": "1.0"}	RxNorm:72236	{"The HLA-B*15:02 allele has been detected in this patient. This allele is associated with high risk of cutaneous adverse drug reaction to fosphenytoin. DO NOT prescribe fosphenytoin, fosfosphenytoin, carbamazepine, or oxcarbazepine. Choose an alternate antiepileptic drug. If the patient has previously used fosphenytoin consistently for longer than three months without incidence of cutaneous adverse reactions, cautiously consider use of fosphenytoin in the future. For more information, please consult a clinical pharmacist."}	1
6350577	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "2.0"}	{"HLA-B": "*15:02 positive"}	{"HLA-B": "*15:02 positive", "CYP2C9": "2.0"}	RxNorm:72236	{"The HLA-B*15:02 allele has been detected in this patient. This allele is associated with high risk of cutaneous adverse drug reaction to fosphenytoin. DO NOT prescribe fosphenytoin, fosfosphenytoin, carbamazepine, or oxcarbazepine. Choose an alternate antiepileptic drug. If the patient has previously used fosphenytoin consistently for longer than three months without incidence of cutaneous adverse reactions, cautiously consider use of fosphenytoin in the future. For more information, please consult a clinical pharmacist."}	1
6350578	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "0.5"}	{"HLA-B": "*15:02 positive"}	{"HLA-B": "*15:02 positive", "CYP2C9": "0.5"}	RxNorm:72236	{"The HLA-B*15:02 allele has been detected in this patient. This allele is associated with high risk of cutaneous adverse drug reaction to fosphenytoin. DO NOT prescribe fosphenytoin, fosfosphenytoin, carbamazepine, or oxcarbazepine. Choose an alternate antiepileptic drug. If the patient has previously used fosphenytoin consistently for longer than three months without incidence of cutaneous adverse reactions, cautiously consider use of fosphenytoin in the future. For more information, please consult a clinical pharmacist."}	1
6350579	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "0.0"}	{"HLA-B": "*15:02 positive"}	{"HLA-B": "*15:02 positive", "CYP2C9": "0.0"}	RxNorm:72236	{"The HLA-B*15:02 allele has been detected in this patient. This allele is associated with high risk of cutaneous adverse drug reaction to fosphenytoin. DO NOT prescribe fosphenytoin, fosfosphenytoin, carbamazepine, or oxcarbazepine. Choose an alternate antiepileptic drug. If the patient has previously used fosphenytoin consistently for longer than three months without incidence of cutaneous adverse reactions, cautiously consider use of fosphenytoin in the future. For more information, please consult a clinical pharmacist."}	1
6350580	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "n/a"}	{"HLA-B": "*15:02 positive"}	{"HLA-B": "*15:02 positive", "CYP2C9": "n/a"}	RxNorm:72236	{"The HLA-B*15:02 allele has been detected in this patient. This allele is associated with high risk of cutaneous adverse drug reaction to fosphenytoin. DO NOT prescribe fosphenytoin, fosfosphenytoin, carbamazepine, or oxcarbazepine. Choose an alternate antiepileptic drug. If the patient has previously used fosphenytoin consistently for longer than three months without incidence of cutaneous adverse reactions, cautiously consider use of fosphenytoin in the future. For more information, please consult a clinical pharmacist."}	1
6351685	general	No CDS	{CYP2D6}	{"CYP2D6": "Normal Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	RxNorm:6918	{n/a}	1
6350581	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "No Result"}	{"HLA-B": "*15:02 positive"}	{"HLA-B": "*15:02 positive", "CYP2C9": "No Result"}	RxNorm:72236	{"The HLA-B*15:02 allele has been detected in this patient. This allele is associated with high risk of cutaneous adverse drug reaction to fosphenytoin. DO NOT prescribe fosphenytoin, fosfosphenytoin, carbamazepine, or oxcarbazepine. Choose an alternate antiepileptic drug. If the patient has previously used fosphenytoin consistently for longer than three months without incidence of cutaneous adverse reactions, cautiously consider use of fosphenytoin in the future. For more information, please consult a clinical pharmacist."}	1
6350582	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "1.0"}	{"HLA-B": "No *15:02 result"}	{"HLA-B": "No *15:02 result", "CYP2C9": "1.0"}	RxNorm:72236	{"CYP2C9 and HLA-B*15:02 genotype can affect a patient's response to fosphenytoin. Based on the genotype result, this patient is predicted to be a CYP2C9 Intermediate Metabolizer and is at increased risk for developing fosphenytoin-induced toxicities. For first dose, use typical initial or loading dose. For subsequent doses, use approximately 25% less than typical maintenance dose. Subsequent doses should be adjusted according to therapeutic drug monitoring, response and side effects. An HLA-B*15:02 genotype does not appear to have been ordered for this patient. Use of an alternative antiepileptic may be recommended. Please consult a clinical pharmacist for more information"}	1
6350583	general	Pre-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "2.0"}	{"HLA-B": "No *15:02 result"}	{"HLA-B": "No *15:02 result", "CYP2C9": "2.0"}	RxNorm:72236	{"HLA-B*15:02 genotype may be important for fosphenytoin adverse events. An HLA-B*15:02 genotype does not appear to have been ordered for this patient. Use of an alternative antiepileptic may be recommended. Please consult a clinical pharmacist for more information."}	1
6350584	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "0.5"}	{"HLA-B": "No *15:02 result"}	{"HLA-B": "No *15:02 result", "CYP2C9": "0.5"}	RxNorm:72236	{"CYP2C9 and HLA-B*15:02 genotype can affect a patient's response to fosphenytoin. Based on the genotype result, this patient is predicted to be a CYP2C9 Poor Metabolizer and is at increased risk for developing fosphenytoin-induced toxicities. For first dose, use typical initial or loading dose. For subsequent doses use approximately 50% less than typical maintenance dose. Subsequent doses should be adjusted according to therapeutic drug monitoring, response, and side effects. An HLA-B*15:02 genotype does not appear to have been ordered for this patient. Use of an alternative antiepileptic may be recommended. Please consult a clinical pharmacist for more information."}	1
6350585	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "0.0"}	{"HLA-B": "No *15:02 result"}	{"HLA-B": "No *15:02 result", "CYP2C9": "0.0"}	RxNorm:72236	{"CYP2C9 and HLA-B*15:02 genotype can affect a patient's response to fosphenytoin. Based on the genotype result, this patient is predicted to be a CYP2C9 Poor Metabolizer and is at increased risk for developing fosphenytoin-induced toxicities. For first dose, use typical initial or loading dose. For subsequent doses use approximately 50% less than typical maintenance dose. Subsequent doses should be adjusted according to therapeutic drug monitoring, response, and side effects. An HLA-B*15:02 genotype does not appear to have been ordered for this patient. Use of an alternative antiepileptic may be recommended. Please consult a clinical pharmacist for more information."}	1
6350586	general	Pre-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "n/a"}	{"HLA-B": "No *15:02 result"}	{"HLA-B": "No *15:02 result", "CYP2C9": "n/a"}	RxNorm:72236	{"HLA-B*15:02 genotype may be important for fosphenytoin adverse events. An HLA-B*15:02 genotype does not appear to have been ordered for this patient. Use of an alternative antiepileptic may be recommended. Please consult a clinical pharmacist for more information."}	1
6350587	general	Pre-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "No Result"}	{"HLA-B": "No *15:02 result"}	{"HLA-B": "No *15:02 result", "CYP2C9": "No Result"}	RxNorm:72236	{"A CYP2C9 and HLA-B*15:02 genotype does not appear to have been ordered for this patient. HLA-B and CYP2C9 genotype may be important for fosphenytoin dosing and use.Use of an alternative dose may be recommended. Please consult a clinical pharmacist for more information."}	1
6350588	general	Post-test	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	RxNorm:5095	{"Based on genotype, this patient is predicted to be malignant hyperthermia susceptible. Halogenated volatile anesthetics or depolarizing muscle relaxants are relatively contraindicated in persons with MHS. They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available, effective, and safe in patients with MHS. Please consult an anesthesiologist or clinical pharmacist for more information."}	1
6350589	general	Post-test	{RYR1,CACNA1S}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:5095	{"Based on genotype, this patient is predicted to be malignant hyperthermia susceptible. Halogenated volatile anesthetics or depolarizing muscle relaxants are relatively contraindicated in persons with MHS. They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available, effective, and safe in patients with MHS. Please consult an anesthesiologist or clinical pharmacist for more information."}	1
6350590	general	Pre-test	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	RxNorm:5095	{"Malignant Hyperthermia Susceptibility is an inherited trait linked to changes within the RYR1 and CACNA1S genes. Genetic testing can help to guide anesthetic agent use."}	1
6350591	general	Pre-test	{RYR1,CACNA1S}	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:5095	{"Malignant Hyperthermia Susceptibility is an inherited trait linked to changes within the RYR1 and CACNA1S genes. Genetic testing can help to guide anesthetic agent use."}	1
6350592	general	Pre-test	{RYR1,CACNA1S}	{"RYR1": "No Result", "CACNA1S": "No Result"}	{}	{}	{"RYR1": "No Result", "CACNA1S": "No Result"}	RxNorm:5095	{"Malignant Hyperthermia Susceptibility is an inherited trait linked to changes within the RYR1 and CACNA1S genes. Genetic testing can help to guide anesthetic agent use."}	1
6350596	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6350597	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6350598	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6350599	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6350600	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6350601	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6350602	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6350603	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6350604	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6351686	general	No CDS	{CYP2D6}	{"CYP2D6": "Normal Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	RxNorm:6918	{n/a}	1
6350605	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6350606	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6350607	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Because a CYP2C19 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350608	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Because a CYP2C19 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350609	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Because a CYP2C19 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350610	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Because a CYP2C19 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350611	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Because a CYP2C19 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350612	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350613	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350614	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6351687	general	No CDS	{CYP2D6}	{"CYP2D6": "Intermediate Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0"}	RxNorm:6918	{n/a}	1
6350615	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350616	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 poor metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6350617	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a likely CYP2C19 poor metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350618	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a likely CYP2C19 poor metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Because a CYP2D6 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350619	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350620	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350621	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350622	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350623	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350624	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351688	general	No CDS	{CYP2D6}	{"CYP2D6": "Intermediate Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75"}	RxNorm:6918	{n/a}	1
6350625	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350626	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350627	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350628	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350629	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350630	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a likely CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350631	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a likely CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350632	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a likely CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350633	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a likely CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350634	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a likely CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351783	general	No CDS	{G6PD}	{"G6PD": "No Result"}	{}	{}	{"G6PD": "No Result"}	RxNorm:10831	{n/a}	1
6350635	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 poor metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350636	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 poor metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350637	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 poor metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350638	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 poor metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350639	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 poor metabolizer and a likely CYP2C19 poor metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350640	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a likely CYP2C19 intermediate metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2C19 result. Because a CYP2D6 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350641	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
6350642	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350643	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350644	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350645	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351689	general	No CDS	{CYP2D6}	{"CYP2D6": "Intermediate Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5"}	RxNorm:6918	{n/a}	1
6350646	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350647	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350648	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350649	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350650	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350651	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350652	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350653	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
6350654	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
6350655	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
6350656	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
6350657	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
6350658	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 intermediate metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350670	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Indeterminate"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350659	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 intermediate metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350660	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 intermediate metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350661	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 intermediate metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350662	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 poor metabolizer and a likely CYP2C19 intermediate metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350663	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Indeterminate"}	RxNorm:5691	{n/a}	1
6350664	general	Pre-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Indeterminate"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. CYP2D6 genotype does not appear to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350665	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Indeterminate"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350666	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Indeterminate"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350667	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Indeterminate"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350668	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Indeterminate"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350669	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Indeterminate"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351690	general	No CDS	{CYP2D6}	{"CYP2D6": "Intermediate Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25"}	RxNorm:6918	{n/a}	1
6351784	general	No CDS	{G6PD}	{"G6PD": "Normal"}	{}	{}	{"G6PD": "Normal"}	RxNorm:10831	{n/a}	1
6350671	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Indeterminate"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350672	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Indeterminate"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350673	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Indeterminate"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350674	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Indeterminate"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350675	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Indeterminate"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350676	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Indeterminate"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Please consult a clinical pharmacist for more information."}	1
6350677	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Indeterminate"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Please consult a clinical pharmacist for more information."}	1
6350678	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Indeterminate"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Please consult a clinical pharmacist for more information."}	1
6350679	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Indeterminate"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Please consult a clinical pharmacist for more information."}	1
6350680	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Indeterminate"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Please consult a clinical pharmacist for more information."}	1
6350681	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Indeterminate"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350682	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Indeterminate"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments.Please consult a clinical pharmacist for more information."}	1
6350683	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Indeterminate"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350684	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Indeterminate"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350685	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Indeterminate"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 poor metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350686	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2C19 ultarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350687	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2C19 ultarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2D6 genotype does not appear to have been ordered for this patient. CYP2D6 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6350688	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350689	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350690	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350691	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350692	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351785	general	No CDS	{G6PD}	{"G6PD": "Deficient"}	{}	{}	{"G6PD": "Deficient"}	RxNorm:10831	{n/a}	1
6351917	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0"}	RxNorm:39786	{n/a}	1
6350693	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350694	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350695	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350696	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350697	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350698	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350699	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and CYP2C19 ultrarapid metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350700	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and CYP2C19 ultrarapid metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350701	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and CYP2C19 ultrarapid metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350702	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and CYP2C19 ultrarapid metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351918	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0"}	RxNorm:39786	{n/a}	1
6350703	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and CYP2C19 ultrarapid metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350704	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a CYP2C19 ultrarapid metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350705	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a CYP2C19 ultrarapid metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350706	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a CYP2C19 ultrarapid metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350707	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a CYP2C19 ultrarapid metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350708	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 poor metabolizer and a CYP2C19 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350709	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Rapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2C19 rapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350710	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Rapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2C19 rapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2D6 genotype does not appear to have been ordered for this patient. CYP2D6 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6350711	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Rapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 rapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350712	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Rapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 rapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351919	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75"}	RxNorm:39786	{n/a}	1
6350713	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Rapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 rapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350714	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Rapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 rapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350715	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Rapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 rapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350716	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Rapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 rapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350717	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Rapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 rapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350718	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Rapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 rapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350719	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Rapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 rapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350720	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Rapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 rapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350721	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Rapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 rapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350722	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Rapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 poor metabolizer and a CYP2C19 rapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350895	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5"}	RxNorm:26225	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a poor response due to low plasma concentrations of ondansetron. Consider selecting an alternative medication not extensively metabolized by CYP2D6 (i.e., granisetron). Please consult a clinical pharmacist for more information."}	1
6350723	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Rapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and CYP2C19 rapid metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350724	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Rapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and CYP2C19 rapid metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350725	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Rapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and CYP2C19 rapid metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350726	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Rapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and CYP2C19 rapid metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350727	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Rapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and CYP2C19 rapid metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350728	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Rapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a CYP2C19 rapid metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350729	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Rapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a CYP2C19 rapid metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350730	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Rapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a CYP2C19 rapid metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350731	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Rapid Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a CYP2C19 rapid metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350732	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2C19 poor metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351920	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5"}	RxNorm:39786	{n/a}	1
6350733	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2C19 poor metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Because a CYP2D6 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350734	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 poor metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350735	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 poor metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350736	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 poor metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350737	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 poor metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350738	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 poor metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350739	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 poor metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350740	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 poor metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350741	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 poor metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350742	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 poor metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350743	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 poor metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351921	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25"}	RxNorm:39786	{n/a}	1
6350744	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 poor metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350745	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350746	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350747	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350748	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350749	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If imipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350750	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a CYP2C19 poor metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350751	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a CYP2C19 poor metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350752	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a CYP2C19 poor metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350753	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a CYP2C19 poor metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350754	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Poor Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 poor metabolizer and a CYP2C19 poor metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350755	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2C19 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2C19 result. Because a CYP2D6 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350756	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{n/a}	1
6350757	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and CYP2C19 normal metabolizer. Based on the CYP2D6 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350758	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and CYP2C19 normal metabolizer. Based on the CYP2D6 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350759	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and CYP2C19 normal metabolizer. Based on the CYP2D6 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350760	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and CYP2C19 normal metabolizer. Based on the CYP2D6 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350761	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and CYP2C19 normal metabolizer. Based on the CYP2D6 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350762	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and CYP2C19 normal metabolizer. Based on the CYP2D6 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350763	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and CYP2C19 normal metabolizer. Based on the CYP2D6 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350815	H.pylori_erosive eso	Post-test	{CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:17128	{"Based on the genotype result, this patient is predicted to be a CYP2C19 ultrarapid metabolizer and is at risk for decreased plasma concentrations and therapeutic failure with standard dosing. Increase starting daily dose by 100%. Daily dose may be given in divided doses. Monitor for efficacy. Please consult a clinical pharmacist for more information."}	1
6350764	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and CYP2C19 normal metabolizer. Based on the CYP2D6 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350765	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and CYP2C19 normal metabolizer. Based on the CYP2D6 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350766	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and CYP2C19 normal metabolizer. Based on the CYP2D6 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350767	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and CYP2C19 normal metabolizer. Based on the CYP2D6 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350768	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{n/a}	1
6350769	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{n/a}	1
6350770	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{n/a}	1
6350771	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{n/a}	1
6350772	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{n/a}	1
6350773	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a CYP2C19 normal metabolizer. Based on the CYP2D6 result, the patient may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments."}	1
6350774	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a CYP2C19 normal metabolizer. Based on the CYP2D6 result, the patient may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments."}	1
6350775	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a CYP2C19 normal metabolizer. Based on the CYP2D6 result, the patient may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments."}	1
6350776	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a CYP2C19 normal metabolizer. Based on the CYP2D6 result, the patient may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments."}	1
6350816	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2C19": "Normal Metabolizer"}	RxNorm:17128	{n/a}	1
6351025	general	Pre-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "No Result"}	{}	{}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "No Result"}	RxNorm:36437	{"CYP2C19 genotype may be important for the use of sertraline. A CYP2C19 genotype does not appear to have been ordered for this patient. Please consult a clinical pharmacist for more information."}	1
6350777	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 poor metabolizer and a CYP2C19 normal metabolizer. Based on the CYP2D6 result, this patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If imipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350778	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2C19 intermediate metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2C19 result. Because a CYP2D6 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350779	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
6350780	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350781	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350782	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350783	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350784	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350785	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350786	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350787	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350897	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0"}	RxNorm:26225	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a poor response due to low plasma concentrations of ondansetron. Consider selecting an alternative medication not extensively metabolized by CYP2D6 (i.e., granisetron). Please consult a clinical pharmacist for more information."}	1
6350788	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350789	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350790	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350791	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
6350792	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
6350793	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
6350794	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
6350795	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
6350796	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a CYP2C19 intermediate metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350797	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a CYP2C19 intermediate metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350798	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a CYP2C19 intermediate metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350799	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a CYP2C19 intermediate metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350800	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 poor metabolizer and a CYP2C19 intermediate metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If imipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350817	non-H.pylori_erosive	Post-test	{CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:17128	{"Based on the genotype result, this patient is predicted to be a CYP2C19 ultrarapid metabolizer and is at risk for decreased plasma concentrations and therapeutic failure with standard dosing. Increase starting daily dose by 100%. Daily dose may be given in divided doses. Monitor for efficacy. Please consult a clinical pharmacist for more information."}	1
6350801	general	Post-test	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	RxNorm:6026	{"Based on genotype, this patient is predicted to be malignant hyperthermia susceptible. Halogenated volatile anesthetics or depolarizing muscle relaxants are relatively contraindicated in persons with MHS. They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available, effective, and safe in patients with MHS. Please consult an anesthesiologist or clinical pharmacist for more information."}	1
6350802	general	Post-test	{RYR1,CACNA1S}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:6026	{"Based on genotype, this patient is predicted to be malignant hyperthermia susceptible. Halogenated volatile anesthetics or depolarizing muscle relaxants are relatively contraindicated in persons with MHS. They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available, effective, and safe in patients with MHS. Please consult an anesthesiologist or clinical pharmacist for more information."}	1
6350803	general	Pre-test	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	RxNorm:6026	{"Malignant Hyperthermia Susceptibility is an inherited trait linked to changes within the RYR1 and CACNA1S genes. Genetic testing can help to guide anesthetic agent use."}	1
6350804	general	Pre-test	{RYR1,CACNA1S}	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:6026	{"Malignant Hyperthermia Susceptibility is an inherited trait linked to changes within the RYR1 and CACNA1S genes. Genetic testing can help to guide anesthetic agent use."}	1
6350805	general	Pre-test	{RYR1,CACNA1S}	{"RYR1": "No Result", "CACNA1S": "No Result"}	{}	{}	{"RYR1": "No Result", "CACNA1S": "No Result"}	RxNorm:6026	{"Malignant Hyperthermia Susceptibility is an inherited trait linked to changes within the RYR1 and CACNA1S genes. Genetic testing can help to guide anesthetic agent use."}	1
6350806	general	No CDS	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:6026	{n/a}	1
6350807	H.pylori_erosive eso	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:17128	{n/a}	1
6350808	H.pylori_erosive eso	Post-test	{CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Intermediate Metabolizer"}	RxNorm:17128	{"Based on the genotype result, this patient is predicted to be a CYP2C19 intermediate metabolizer. Initiate standard starting daily dose. If this proton pump inhibitor has been given for chronic therapy (>12 weeks) and after efficacy has been achieved, consider 50% reduction in daily dose to minimize the incidence of adverse events and monitor for continued efficacy. Please consult a clinical pharmacist for more information."}	1
6350809	H.pylori_erosive eso	Post-test	{CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:17128	{"Based on the genotype result, this patient is predicted to be a CYP2C19 likely intermediate metabolizer. Initiate standard starting daily dose. If this proton pump inhibitor has been given for chronic therapy (>12 weeks) and after efficacy has been achieved, consider 50% reduction in daily dose to minimize the incidence of adverse events and monitor for continued efficacy. Please consult a clinical pharmacist for more information."}	1
6350810	H.pylori_erosive eso	Post-test	{CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{}	{}	{"CYP2C19": "Likely Poor Metabolizer"}	RxNorm:17128	{"Based on the genotype result, this patient is predicted to be a CYP2C19 likely poor metabolizer. Initiate standard starting daily dose. If this proton pump inhibitor has been given for chronic therapy (>12 weeks) and after efficacy has been achieved, consider 50% reduction in daily dose to minimize the incidence of adverse events and monitor for continued efficacy. Please consult a clinical pharmacist for more information."}	1
6350811	H.pylori_erosive eso	Pre-test	{CYP2C19}	{"CYP2C19": "No Result"}	{}	{}	{"CYP2C19": "No Result"}	RxNorm:17128	{"CYP2C19 genotype may be important for this proton pump inhibitor's dosing. A CYP2C19 genotype does not appear to have been ordered for this patient. Please consult a clinical pharmacist for more information."}	1
6350812	H.pylori_erosive eso	Post-test	{CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2C19": "Normal Metabolizer"}	RxNorm:17128	{"Based on the genotype result, this patient is predicted to be a CYP2C19 normal metabolizer. The patient may be at risk for therapeutic failure at standard doses. Consider increasing the dose by 50-100%. Daily dose may be given in divided doses. Monitor for efficacy. Please consult a clinical pharmacist for more information."}	1
6350813	H.pylori_erosive eso	Post-test	{CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{}	{}	{"CYP2C19": "Poor Metabolizer"}	RxNorm:17128	{"Based on the genotype result, this patient is predicted to be a CYP2C19 poor metabolizer. Initiate standard starting daily dose. If this proton pump inhibitor has been given for chronic therapy (>12 weeks) and after efficacy has been achieved, consider 50% reduction in daily dose to minimize the incidence of adverse events and monitor for continued efficacy. Please consult a clinical pharmacist for more information."}	1
6350814	H.pylori_erosive eso	Post-test	{CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2C19": "Rapid Metabolizer"}	RxNorm:17128	{"Based on the genotype result, this patient is predicted to be a CYP2C19 rapid metabolizer. The patient may be at risk for therapeutic failure at standard doses. Consider increasing the dose by 50-100%. Daily dose may be given in divided doses. Monitor for efficacy. Please consult a clinical pharmacist for more information."}	1
6350818	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2C19": "Rapid Metabolizer"}	RxNorm:17128	{n/a}	1
6351922	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0"}	RxNorm:39786	{n/a}	1
6350820	non-H.pylori_erosive	Post-test	{CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:17128	{"Based on the genotype result, this patient is predicted to be a CYP2C19 likely intermediate metabolizer. Initiate standard starting daily dose. If this proton pump inhibitor has been given for chronic therapy (>12 weeks) and after efficacy has been achieved, consider 50% reduction in daily dose to minimize the incidence of adverse events and monitor for continued efficacy. Please consult a clinical pharmacist for more information."}	1
6350821	non-H.pylori_erosive	Post-test	{CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Intermediate Metabolizer"}	RxNorm:17128	{"Based on the genotype result, this patient is predicted to be a CYP2C19 intermediate metabolizer. Initiate standard starting daily dose. If this proton pump inhibitor has been given for chronic therapy (>12 weeks) and after efficacy has been achieved, consider 50% reduction in daily dose to minimize the incidence of adverse events and monitor for continued efficacy. Please consult a clinical pharmacist for more information."}	1
6350822	non-H.pylori_erosive	Post-test	{CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{}	{}	{"CYP2C19": "Likely Poor Metabolizer"}	RxNorm:17128	{"Based on the genotype result, this patient is predicted to be a CYP2C19 likely poor metabolizer. Initiate standard starting daily dose. If this proton pump inhibitor has been given for chronic therapy (>12 weeks) and after efficacy has been achieved, consider 50% reduction in daily dose to minimize the incidence of adverse events and monitor for continued efficacy. Please consult a clinical pharmacist for more information."}	1
6350823	non-H.pylori_erosive	Post-test	{CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{}	{}	{"CYP2C19": "Poor Metabolizer"}	RxNorm:17128	{"Based on the genotype result, this patient is predicted to be a CYP2C19 poor metabolizer. Initiate standard starting daily dose. If this proton pump inhibitor has been given for chronic therapy (>12 weeks) and after efficacy has been achieved, consider 50% reduction in daily dose to minimize the incidence of adverse events and monitor for continued efficacy. Please consult a clinical pharmacist for more information."}	1
6350824	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:17128	{n/a}	1
6350825	general	Pre-test	{SLCO1B1}	{"SLCO1B1": "No Result"}	{}	{}	{"SLCO1B1": "No Result"}	RxNorm:6472	{"SLCO1B1 genetic status may be predictive of the risk of lovastatin-induced myopathy due to altered drug exposure. An SLCO1B1 genotype does not appear to have been ordered for this patient. Use of an alternative drug or dose may be recommended. Please consult a clinical pharmacist for more information."}	1
6350826	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Increased Function"}	{}	{}	{"SLCO1B1": "Increased Function"}	RxNorm:6472	{n/a}	1
6350827	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Normal Function"}	{}	{}	{"SLCO1B1": "Normal Function"}	RxNorm:6472	{n/a}	1
6350828	general	Post-test	{SLCO1B1}	{"SLCO1B1": "Decreased Function"}	{}	{}	{"SLCO1B1": "Decreased Function"}	RxNorm:6472	{"This patient is predicted to have SLCO1B1 decreased function and is at increased risk for developing lovastatin-induced myopathy. Prescribe an alternative statin depending on the desired potency. If lovastatin therapy is warranted, limit dose to ≤20mg per day. Please consult a clinical pharmacist for more information."}	1
6350829	general	Post-test	{SLCO1B1}	{"SLCO1B1": "Possible Decreased Function"}	{}	{}	{"SLCO1B1": "Possible Decreased Function"}	RxNorm:6472	{"This patient is predicted to have SLCO1B1 possible decreased function and is at increased risk for developing lovastatin-induced myopathy. Prescribe an alternative statin depending on the desired potency. If lovastatin therapy is warranted, limit dose to ≤20mg per day. Please consult a clinical pharmacist for more information."}	1
6350830	general	Post-test	{SLCO1B1}	{"SLCO1B1": "Poor Function"}	{}	{}	{"SLCO1B1": "Poor Function"}	RxNorm:6472	{"This patient is predicted to have SLCO1B1 poor function and is at increased risk for developing lovastatin-induced myopathy. Prescribe an alternative statin depending on the desired potency. Please consult a clinical pharmacist for more information."}	1
6350831	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Indeterminate"}	{}	{}	{"SLCO1B1": "Indeterminate"}	RxNorm:6472	{n/a}	1
6350832	general	Post-test	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	RxNorm:6857	{"Based on genotype, this patient is predicted to be malignant hyperthermia susceptible. Halogenated volatile anesthetics or depolarizing muscle relaxants are relatively contraindicated in persons with MHS. They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available, effective, and safe in patients with MHS. Please consult an anesthesiologist or clinical pharmacist for more information."}	1
6350833	general	Post-test	{RYR1,CACNA1S}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:6857	{"Based on genotype, this patient is predicted to be malignant hyperthermia susceptible. Halogenated volatile anesthetics or depolarizing muscle relaxants are relatively contraindicated in persons with MHS. They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available, effective, and safe in patients with MHS. Please consult an anesthesiologist or clinical pharmacist for more information."}	1
6350834	general	Pre-test	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	RxNorm:6857	{"Malignant Hyperthermia Susceptibility is an inherited trait linked to changes within the RYR1 and CACNA1S genes. Genetic testing can help to guide anesthetic agent use."}	1
6350835	general	Pre-test	{RYR1,CACNA1S}	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:6857	{"Malignant Hyperthermia Susceptibility is an inherited trait linked to changes within the RYR1 and CACNA1S genes. Genetic testing can help to guide anesthetic agent use."}	1
6350840	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0"}	RxNorm:7531	{"Based on the genotype result, this patient is predicted to be a CYP2D6 ultrarapid metabolizer and may have lower than expected plasma concentrations resulting in an increased probability of pharmacotherapy failure. Consider alternative drug not metabolized by CYP2D6. If nortriptyline is warranted, utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350841	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75"}	RxNorm:7531	{"Based on the genotype result, this patient is predicted to be a CYP2D6 ultrarapid metabolizer and may have lower than expected plasma concentrations resulting in an increased probability of pharmacotherapy failure. Consider alternative drug not metabolized by CYP2D6. If nortriptyline is warranted, utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350842	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0"}	RxNorm:7531	{"Based on the genotype result, this patient is predicted to be a CYP2D6 ultrarapid metabolizer and may have lower than expected plasma concentrations resulting in an increased probability of pharmacotherapy failure. Consider alternative drug not metabolized by CYP2D6. If nortriptyline is warranted, utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350843	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5"}	RxNorm:7531	{"Based on the genotype result, this patient is predicted to be a CYP2D6 ultrarapid metabolizer and may have lower than expected plasma concentrations resulting in an increased probability of pharmacotherapy failure. Consider alternative drug not metabolized by CYP2D6. If nortriptyline is warranted, utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350844	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25"}	RxNorm:7531	{"Based on the genotype result, this patient is predicted to be a CYP2D6 ultrarapid metabolizer and may have lower than expected plasma concentrations resulting in an increased probability of pharmacotherapy failure. Consider alternative drug not metabolized by CYP2D6. If nortriptyline is warranted, utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350845	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0"}	RxNorm:7531	{"Based on the genotype result, this patient is predicted to be a CYP2D6 ultrarapid metabolizer and may have lower than expected plasma concentrations resulting in an increased probability of pharmacotherapy failure. Consider alternative drug not metabolized by CYP2D6. If nortriptyline is warranted, utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350846	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0"}	RxNorm:7531	{"Based on the genotype result, this patient is predicted to be a CYP2D6 ultrarapid metabolizer and may have lower than expected plasma concentrations resulting in an increased probability of pharmacotherapy failure. Consider alternative drug not metabolized by CYP2D6. If nortriptyline is warranted, utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350847	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75"}	RxNorm:7531	{"Based on the genotype result, this patient is predicted to be a CYP2D6 ultrarapid metabolizer and may have lower than expected plasma concentrations resulting in an increased probability of pharmacotherapy failure. Consider alternative drug not metabolized by CYP2D6. If nortriptyline is warranted, utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350848	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0"}	RxNorm:7531	{"Based on the genotype result, this patient is predicted to be a CYP2D6 ultrarapid metabolizer and may have lower than expected plasma concentrations resulting in an increased probability of pharmacotherapy failure. Consider alternative drug not metabolized by CYP2D6. If nortriptyline is warranted, utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350849	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5"}	RxNorm:7531	{"Based on the genotype result, this patient is predicted to be a CYP2D6 ultrarapid metabolizer and may have lower than expected plasma concentrations resulting in an increased probability of pharmacotherapy failure. Consider alternative drug not metabolized by CYP2D6. If nortriptyline is warranted, utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350850	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	RxNorm:7531	{n/a}	1
6350851	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	RxNorm:7531	{n/a}	1
6350852	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	RxNorm:7531	{n/a}	1
6350853	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	RxNorm:7531	{n/a}	1
6350854	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	RxNorm:7531	{n/a}	1
6350855	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0"}	RxNorm:7531	{"Based on the genotype result, this patient is predicted to be a CYP2D6 intermediate metabolizer and may experience higher than expected plasma concentrations of nortriptyline resulting in an increased the probability of adverse reactions. Consider a 25% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350896	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25"}	RxNorm:26225	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a poor response due to low plasma concentrations of ondansetron. Consider selecting an alternative medication not extensively metabolized by CYP2D6 (i.e., granisetron). Please consult a clinical pharmacist for more information."}	1
6350856	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75"}	RxNorm:7531	{"Based on the genotype result, this patient is predicted to be a CYP2D6 intermediate metabolizer and may experience higher than expected plasma concentrations of nortriptyline resulting in an increased the probability of adverse reactions. Consider a 25% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350857	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5"}	RxNorm:7531	{"Based on the genotype result, this patient is predicted to be a CYP2D6 intermediate metabolizer and may experience higher than expected plasma concentrations of nortriptyline resulting in an increased the probability of adverse reactions. Consider a 25% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350858	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25"}	RxNorm:7531	{"Based on the genotype result, this patient is predicted to be a CYP2D6 intermediate metabolizer and may experience higher than expected plasma concentrations of nortriptyline resulting in an increased the probability of adverse reactions. Consider a 25% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350859	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0"}	RxNorm:7531	{"Based on the genotype result, this patient is predicted to be a CYP2D6 poor metabolizer and may experience higher than expected plasma concentrations of nortriptyline resulting in an increased the probability of adverse reactions. Consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6350860	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a"}	RxNorm:7531	{n/a}	1
6350861	H.pylori_erosive eso	Pre-test	{CYP2C19}	{"CYP2C19": "No Result"}	{}	{}	{"CYP2C19": "No Result"}	RxNorm:7646	{"CYP2C19 genotype may be important for this proton pump inhibitor's dosing. A CYP2C19 genotype does not appear to have been ordered for this patient. Please consult a clinical pharmacist for more information."}	1
6350862	H.pylori_erosive eso	Post-test	{CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:7646	{"Based on the genotype result, this patient is predicted to be a CYP2C19 ultrarapid metabolizer and is at risk for decreased plasma concentrations and therapeutic failure with standard dosing. Increase starting daily dose by 100%. Daily dose may be given in divided doses. Monitor for efficacy. Please consult a clinical pharmacist for more information."}	1
6350863	H.pylori_erosive eso	Post-test	{CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2C19": "Rapid Metabolizer"}	RxNorm:7646	{"Based on the genotype result, this patient is predicted to be a CYP2C19 rapid metabolizer. The patient may be at risk for therapeutic failure at standard doses. Consider increasing the dose by 50-100%. Daily dose may be given in divided doses. Monitor for efficacy. Please consult a clinical pharmacist for more information."}	1
6350864	H.pylori_erosive eso	Post-test	{CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2C19": "Normal Metabolizer"}	RxNorm:7646	{"Based on the genotype result, this patient is predicted to be a CYP2C19 normal metabolizer. The patient may be at risk for therapeutic failure at standard doses. Consider increasing the dose by 50-100%. Daily dose may be given in divided doses. Monitor for efficacy. Please consult a clinical pharmacist for more information."}	1
6350865	H.pylori_erosive eso	Post-test	{CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:7646	{"Based on the genotype result, this patient is predicted to be a CYP2C19 likely intermediate metabolizer. Initiate standard starting daily dose. If this proton pump inhibitor has been given for chronic therapy (>12 weeks) and after efficacy has been achieved, consider 50% reduction in daily dose to minimize the incidence of adverse events and monitor for continued efficacy. Please consult a clinical pharmacist for more information."}	1
6350866	H.pylori_erosive eso	Post-test	{CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Intermediate Metabolizer"}	RxNorm:7646	{"Based on the genotype result, this patient is predicted to be a CYP2C19 intermediate metabolizer. Initiate standard starting daily dose. If this proton pump inhibitor has been given for chronic therapy (>12 weeks) and after efficacy has been achieved, consider 50% reduction in daily dose to minimize the incidence of adverse events and monitor for continued efficacy. Please consult a clinical pharmacist for more information."}	1
6350867	H.pylori_erosive eso	Post-test	{CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{}	{}	{"CYP2C19": "Likely Poor Metabolizer"}	RxNorm:7646	{"Based on the genotype result, this patient is predicted to be a CYP2C19 likely poor metabolizer. Initiate standard starting daily dose. If this proton pump inhibitor has been given for chronic therapy (>12 weeks) and after efficacy has been achieved, consider 50% reduction in daily dose to minimize the incidence of adverse events and monitor for continued efficacy. Please consult a clinical pharmacist for more information."}	1
6350868	H.pylori_erosive eso	Post-test	{CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{}	{}	{"CYP2C19": "Poor Metabolizer"}	RxNorm:7646	{"Based on the genotype result, this patient is predicted to be a CYP2C19 poor metabolizer. Initiate standard starting daily dose. If this proton pump inhibitor has been given for chronic therapy (>12 weeks) and after efficacy has been achieved, consider 50% reduction in daily dose to minimize the incidence of adverse events and monitor for continued efficacy. Please consult a clinical pharmacist for more information."}	1
6350869	H.pylori_erosive eso	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:7646	{n/a}	1
6350870	non-H.pylori_erosive	Pre-test	{CYP2C19}	{"CYP2C19": "No Result"}	{}	{}	{"CYP2C19": "No Result"}	RxNorm:7646	{"CYP2C19 genotype may be important for this proton pump inhibitor's dosing. A CYP2C19 genotype does not appear to have been ordered for this patient. Please consult a clinical pharmacist for more information."}	1
6350871	non-H.pylori_erosive	Post-test	{CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:7646	{"Based on the genotype result, this patient is predicted to be a CYP2C19 ultrarapid metabolizer and is at risk for decreased plasma concentrations and therapeutic failure with standard dosing. Increase starting daily dose by 100%. Daily dose may be given in divided doses. Monitor for efficacy. Please consult a clinical pharmacist for more information."}	1
6350872	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2C19": "Rapid Metabolizer"}	RxNorm:7646	{n/a}	1
6350873	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2C19": "Normal Metabolizer"}	RxNorm:7646	{n/a}	1
6350874	non-H.pylori_erosive	Post-test	{CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:7646	{"Based on the genotype result, this patient is predicted to be a CYP2C19 likely intermediate metabolizer. Initiate standard starting daily dose. If this proton pump inhibitor has been given for chronic therapy (>12 weeks) and after efficacy has been achieved, consider 50% reduction in daily dose to minimize the incidence of adverse events and monitor for continued efficacy. Please consult a clinical pharmacist for more information."}	1
6350875	non-H.pylori_erosive	Post-test	{CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Intermediate Metabolizer"}	RxNorm:7646	{"Based on the genotype result, this patient is predicted to be a CYP2C19 intermediate metabolizer. Initiate standard starting daily dose. If this proton pump inhibitor has been given for chronic therapy (>12 weeks) and after efficacy has been achieved, consider 50% reduction in daily dose to minimize the incidence of adverse events and monitor for continued efficacy. Please consult a clinical pharmacist for more information."}	1
6350876	non-H.pylori_erosive	Post-test	{CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{}	{}	{"CYP2C19": "Likely Poor Metabolizer"}	RxNorm:7646	{"Based on the genotype result, this patient is predicted to be a CYP2C19 likely poor metabolizer. Initiate standard starting daily dose. If this proton pump inhibitor has been given for chronic therapy (>12 weeks) and after efficacy has been achieved, consider 50% reduction in daily dose to minimize the incidence of adverse events and monitor for continued efficacy. Please consult a clinical pharmacist for more information."}	1
6350877	non-H.pylori_erosive	Post-test	{CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{}	{}	{"CYP2C19": "Poor Metabolizer"}	RxNorm:7646	{"Based on the genotype result, this patient is predicted to be a CYP2C19 poor metabolizer. Initiate standard starting daily dose. If this proton pump inhibitor has been given for chronic therapy (>12 weeks) and after efficacy has been achieved, consider 50% reduction in daily dose to minimize the incidence of adverse events and monitor for continued efficacy. Please consult a clinical pharmacist for more information."}	1
6350878	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:7646	{n/a}	1
6350879	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25"}	RxNorm:26225	{n/a}	1
6350880	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0"}	RxNorm:26225	{n/a}	1
6350881	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a"}	RxNorm:26225	{n/a}	1
6350882	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	RxNorm:26225	{n/a}	1
6350883	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	RxNorm:26225	{n/a}	1
6350884	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	RxNorm:26225	{n/a}	1
6350885	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	RxNorm:26225	{n/a}	1
6350886	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	RxNorm:26225	{n/a}	1
6350887	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0"}	RxNorm:26225	{n/a}	1
6350888	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75"}	RxNorm:26225	{n/a}	1
6350889	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5"}	RxNorm:26225	{n/a}	1
6350890	general	Pre-test	{CYP2D6}	{}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result"}	RxNorm:26225	{"CYP2D6 genetic status may be predictive of poor response to this medication. A CYP2D6 genotype does not appear to have been ordered for this patient. Use of an alternative drug may be recommended. Please consult a clinical pharmacist for more information."}	1
6350891	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0"}	RxNorm:26225	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a poor response due to low plasma concentrations of ondansetron. Consider selecting an alternative medication not extensively metabolized by CYP2D6 (i.e., granisetron). Please consult a clinical pharmacist for more information."}	1
6350892	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0"}	RxNorm:26225	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a poor response due to low plasma concentrations of ondansetron. Consider selecting an alternative medication not extensively metabolized by CYP2D6 (i.e., granisetron). Please consult a clinical pharmacist for more information."}	1
6350893	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75"}	RxNorm:26225	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a poor response due to low plasma concentrations of ondansetron. Consider selecting an alternative medication not extensively metabolized by CYP2D6 (i.e., granisetron). Please consult a clinical pharmacist for more information."}	1
6351923	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0"}	RxNorm:39786	{n/a}	1
6350898	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0"}	RxNorm:26225	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a poor response due to low plasma concentrations of ondansetron. Consider selecting an alternative medication not extensively metabolized by CYP2D6 (i.e., granisetron). Please consult a clinical pharmacist for more information."}	1
6350899	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75"}	RxNorm:26225	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a poor response due to low plasma concentrations of ondansetron. Consider selecting an alternative medication not extensively metabolized by CYP2D6 (i.e., granisetron). Please consult a clinical pharmacist for more information."}	1
6350900	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0"}	RxNorm:26225	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a poor response due to low plasma concentrations of ondansetron. Consider selecting an alternative medication not extensively metabolized by CYP2D6 (i.e., granisetron). Please consult a clinical pharmacist for more information."}	1
6350901	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5"}	RxNorm:26225	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a poor response due to low plasma concentrations of ondansetron. Consider selecting an alternative medication not extensively metabolized by CYP2D6 (i.e., granisetron). Please consult a clinical pharmacist for more information."}	1
6350902	general	Pre-test	{HLA-B}	{}	{}	{"HLA-B": "No *15:02 result on file"}	{"HLA-B": "No *15:02 result on file"}	RxNorm:32624	{"HLA-B*15:02 genetic status may be predictive of a severe cutaneous adverse reaction to oxcarbazepine, including Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). A HLA-B*15:02 genotype does not appear to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6350903	general	Post-test	{HLA-B}	{}	{}	{"HLA-B": "*15:02 positive"}	{"HLA-B": "*15:02 positive"}	RxNorm:32624	{"HLA-B*15:02 genetic status may be predictive of a severe cutaneous adverse reaction to oxcarbazepine. This patient is HLA-B*15:02 positive and may be at an increased risk of oxcarbazepine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). If the patient is oxcarbazepine-naive and alternative agents are available, do not use oxcarbazepine. The latency period for SJS/TEN is short (< 8 weeks); therefore, if the patient has previously used oxcarbazepine for longer than 3 months without incidence of cutaneous adverse reactions, cautiously consider use of oxcarbazepine. Please consult a clinical pharmacist for more information."}	1
6350904	general	No CDS	{HLA-B}	{}	{}	{"HLA-B": "*15:02 negative"}	{"HLA-B": "*15:02 negative"}	RxNorm:32624	{n/a}	1
6350905	H.pylori_erosive eso	Post-test	{CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2C19": "Normal Metabolizer"}	RxNorm:40790	{"Based on the genotype result, this patient is predicted to be a CYP2C19 normal metabolizer. The patient may be at risk for therapeutic failure at standard doses. Consider increasing the dose by 50-100%. Daily dose may be given in divided doses. Monitor for efficacy. Please consult a clinical pharmacist for more information."}	1
6350906	H.pylori_erosive eso	Pre-test	{CYP2C19}	{"CYP2C19": "No Result"}	{}	{}	{"CYP2C19": "No Result"}	RxNorm:40790	{"CYP2C19 genotype may be important for this proton pump inhibitor's dosing. A CYP2C19 genotype does not appear to have been ordered for this patient. Please consult a clinical pharmacist for more information."}	1
6350907	H.pylori_erosive eso	Post-test	{CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:40790	{"Based on the genotype result, this patient is predicted to be a CYP2C19 ultrarapid metabolizer and is at risk for decreased plasma concentrations and therapeutic failure with standard dosing. Increase starting daily dose by 100%. Daily dose may be given in divided doses. Monitor for efficacy. Please consult a clinical pharmacist for more information."}	1
6350908	H.pylori_erosive eso	Post-test	{CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2C19": "Rapid Metabolizer"}	RxNorm:40790	{"Based on the genotype result, this patient is predicted to be a CYP2C19 rapid metabolizer. The patient may be at risk for therapeutic failure at standard doses. Consider increasing the dose by 50-100%. Daily dose may be given in divided doses. Monitor for efficacy. Please consult a clinical pharmacist for more information."}	1
6350909	H.pylori_erosive eso	Post-test	{CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:40790	{"Based on the genotype result, this patient is predicted to be a CYP2C19 likely intermediate metabolizer. Initiate standard starting daily dose. If this proton pump inhibitor has been given for chronic therapy (>12 weeks) and after efficacy has been achieved, consider 50% reduction in daily dose to minimize the incidence of adverse events and monitor for continued efficacy. Please consult a clinical pharmacist for more information."}	1
6350910	H.pylori_erosive eso	Post-test	{CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Intermediate Metabolizer"}	RxNorm:40790	{"Based on the genotype result, this patient is predicted to be a CYP2C19 intermediate metabolizer. Initiate standard starting daily dose. If this proton pump inhibitor has been given for chronic therapy (>12 weeks) and after efficacy has been achieved, consider 50% reduction in daily dose to minimize the incidence of adverse events and monitor for continued efficacy. Please consult a clinical pharmacist for more information."}	1
6350911	H.pylori_erosive eso	Post-test	{CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{}	{}	{"CYP2C19": "Likely Poor Metabolizer"}	RxNorm:40790	{"Based on the genotype result, this patient is predicted to be a CYP2C19 likely poor metabolizer. Initiate standard starting daily dose. If this proton pump inhibitor has been given for chronic therapy (>12 weeks) and after efficacy has been achieved, consider 50% reduction in daily dose to minimize the incidence of adverse events and monitor for continued efficacy. Please consult a clinical pharmacist for more information."}	1
6351924	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0"}	RxNorm:39786	{n/a}	1
6350912	H.pylori_erosive eso	Post-test	{CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{}	{}	{"CYP2C19": "Poor Metabolizer"}	RxNorm:40790	{"Based on the genotype result, this patient is predicted to be a CYP2C19 poor metabolizer. Initiate standard starting daily dose. If this proton pump inhibitor has been given for chronic therapy (>12 weeks) and after efficacy has been achieved, consider 50% reduction in daily dose to minimize the incidence of adverse events and monitor for continued efficacy. Please consult a clinical pharmacist for more information."}	1
6350913	H.pylori_erosive eso	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:40790	{n/a}	1
6350914	non-H.pylori_erosive	Pre-test	{CYP2C19}	{"CYP2C19": "No Result"}	{}	{}	{"CYP2C19": "No Result"}	RxNorm:40790	{"CYP2C19 genotype may be important for this proton pump inhibitor's dosing. A CYP2C19 genotype does not appear to have been ordered for this patient. Please consult a clinical pharmacist for more information."}	1
6350915	non-H.pylori_erosive	Post-test	{CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:40790	{"Based on the genotype result, this patient is predicted to be a CYP2C19 ultrarapid metabolizer and is at risk for decreased plasma concentrations and therapeutic failure with standard dosing. Increase starting daily dose by 100%. Daily dose may be given in divided doses. Monitor for efficacy. Please consult a clinical pharmacist for more information."}	1
6350916	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2C19": "Rapid Metabolizer"}	RxNorm:40790	{n/a}	1
6350917	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2C19": "Normal Metabolizer"}	RxNorm:40790	{n/a}	1
6350918	non-H.pylori_erosive	Post-test	{CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:40790	{"Based on the genotype result, this patient is predicted to be a CYP2C19 likely intermediate metabolizer. Initiate standard starting daily dose. If this proton pump inhibitor has been given for chronic therapy (>12 weeks) and after efficacy has been achieved, consider 50% reduction in daily dose to minimize the incidence of adverse events and monitor for continued efficacy. Please consult a clinical pharmacist for more information."}	1
6350919	non-H.pylori_erosive	Post-test	{CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Intermediate Metabolizer"}	RxNorm:40790	{"Based on the genotype result, this patient is predicted to be a CYP2C19 intermediate metabolizer. Initiate standard starting daily dose. If this proton pump inhibitor has been given for chronic therapy (>12 weeks) and after efficacy has been achieved, consider 50% reduction in daily dose to minimize the incidence of adverse events and monitor for continued efficacy. Please consult a clinical pharmacist for more information."}	1
6350920	non-H.pylori_erosive	Post-test	{CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{}	{}	{"CYP2C19": "Likely Poor Metabolizer"}	RxNorm:40790	{"Based on the genotype result, this patient is predicted to be a CYP2C19 likely poor metabolizer. Initiate standard starting daily dose. If this proton pump inhibitor has been given for chronic therapy (>12 weeks) and after efficacy has been achieved, consider 50% reduction in daily dose to minimize the incidence of adverse events and monitor for continued efficacy. Please consult a clinical pharmacist for more information."}	1
6350921	non-H.pylori_erosive	Post-test	{CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{}	{}	{"CYP2C19": "Poor Metabolizer"}	RxNorm:40790	{"Based on the genotype result, this patient is predicted to be a CYP2C19 poor metabolizer. Initiate standard starting daily dose. If this proton pump inhibitor has been given for chronic therapy (>12 weeks) and after efficacy has been achieved, consider 50% reduction in daily dose to minimize the incidence of adverse events and monitor for continued efficacy. Please consult a clinical pharmacist for more information."}	1
6350922	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:40790	{n/a}	1
6350923	general	Pre-test	{CYP2D6}	{}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result"}	RxNorm:32937	{"CYP2D6 genotype may be important for paroxetine dosing and use. A CYP2D6 genotype does not appear to have been ordered for this patient. Please consult a clinical pharmacist for more information."}	1
6350924	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0"}	RxNorm:32937	{"Based on the genotype result, this patient is predicted to be a CYP2D6 ultrarapid metabolizer and is at risk for lower plasma concentrations and increased probability of therapeutic failure with standard dosing. Select alternative drug not predominantly metabolized by CYP2D6. Please consult a clinical pharmacist for more information."}	1
6350925	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0"}	RxNorm:32937	{"Based on the genotype result, this patient is predicted to be a CYP2D6 ultrarapid metabolizer and is at risk for lower plasma concentrations and increased probability of therapeutic failure with standard dosing. Select alternative drug not predominantly metabolized by CYP2D6. Please consult a clinical pharmacist for more information."}	1
6350926	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0"}	RxNorm:32937	{"Based on the genotype result, this patient is predicted to be a CYP2D6 ultrarapid metabolizer and is at risk for lower plasma concentrations and increased probability of therapeutic failure with standard dosing. Select alternative drug not predominantly metabolized by CYP2D6. Please consult a clinical pharmacist for more information."}	1
6350927	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75"}	RxNorm:32937	{"Based on the genotype result, this patient is predicted to be a CYP2D6 ultrarapid metabolizer and is at risk for lower plasma concentrations and increased probability of therapeutic failure with standard dosing. Select alternative drug not predominantly metabolized by CYP2D6. Please consult a clinical pharmacist for more information."}	1
6351020	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Rapid Metabolizer"}	RxNorm:36437	{n/a}	1
6350928	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5"}	RxNorm:32937	{"Based on the genotype result, this patient is predicted to be a CYP2D6 ultrarapid metabolizer and is at risk for lower plasma concentrations and increased probability of therapeutic failure with standard dosing. Select alternative drug not predominantly metabolized by CYP2D6. Please consult a clinical pharmacist for more information."}	1
6350929	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25"}	RxNorm:32937	{"Based on the genotype result, this patient is predicted to be a CYP2D6 ultrarapid metabolizer and is at risk for lower plasma concentrations and increased probability of therapeutic failure with standard dosing. Select alternative drug not predominantly metabolized by CYP2D6. Please consult a clinical pharmacist for more information."}	1
6350930	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0"}	RxNorm:32937	{"Based on the genotype result, this patient is predicted to be a CYP2D6 ultrarapid metabolizer and is at risk for lower plasma concentrations and increased probability of therapeutic failure with standard dosing. Select alternative drug not predominantly metabolized by CYP2D6. Please consult a clinical pharmacist for more information."}	1
6350931	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0"}	RxNorm:32937	{"Based on the genotype result, this patient is predicted to be a CYP2D6 ultrarapid metabolizer and is at risk for lower plasma concentrations and increased probability of therapeutic failure with standard dosing. Select alternative drug not predominantly metabolized by CYP2D6. Please consult a clinical pharmacist for more information."}	1
6350932	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0"}	RxNorm:32937	{"Based on the genotype result, this patient is predicted to be a CYP2D6 ultrarapid metabolizer and is at risk for lower plasma concentrations and increased probability of therapeutic failure with standard dosing. Select alternative drug not predominantly metabolized by CYP2D6. Please consult a clinical pharmacist for more information."}	1
6350933	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75"}	RxNorm:32937	{"Based on the genotype result, this patient is predicted to be a CYP2D6 ultrarapid metabolizer and is at risk for lower plasma concentrations and increased probability of therapeutic failure with standard dosing. Select alternative drug not predominantly metabolized by CYP2D6. Please consult a clinical pharmacist for more information."}	1
6350934	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5"}	RxNorm:32937	{"Based on the genotype result, this patient is predicted to be a CYP2D6 ultrarapid metabolizer and is at risk for lower plasma concentrations and increased probability of therapeutic failure with standard dosing. Select alternative drug not predominantly metabolized by CYP2D6. Please consult a clinical pharmacist for more information."}	1
6350935	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	RxNorm:32937	{n/a}	1
6350936	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	RxNorm:32937	{n/a}	1
6350937	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	RxNorm:32937	{n/a}	1
6350938	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	RxNorm:32937	{n/a}	1
6350939	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	RxNorm:32937	{n/a}	1
6350940	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0"}	RxNorm:32937	{"Based on the genotype result, this patient is predicted to be a CYP2D6 intermediate metabolizer and is at risk for higer plasma concentrations and increased probability of side effects with standard dosing. Consider a lower starting dose and slower titration schedule. Please consult a clinical pharmacist for more information."}	1
6350941	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75"}	RxNorm:32937	{"Based on the genotype result, this patient is predicted to be a CYP2D6 intermediate metabolizer and is at risk for higer plasma concentrations and increased probability of side effects with standard dosing. Consider a lower starting dose and slower titration schedule. Please consult a clinical pharmacist for more information."}	1
6350942	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5"}	RxNorm:32937	{"Based on the genotype result, this patient is predicted to be a CYP2D6 intermediate metabolizer and is at risk for higer plasma concentrations and increased probability of side effects with standard dosing. Consider a lower starting dose and slower titration schedule. Please consult a clinical pharmacist for more information."}	1
6350943	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25"}	RxNorm:32937	{"Based on the genotype result, this patient is predicted to be a CYP2D6 intermediate metabolizer and is at risk for higer plasma concentrations and increased probability of side effects with standard dosing. Consider a lower starting dose and slower titration schedule. Please consult a clinical pharmacist for more information."}	1
6350944	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0"}	RxNorm:32937	{"Based on the genotype result, this patient is predicted to be a CYP2D6 poor metabolizer and is at risk for higer plasma concentrations and increased probability of side effects with standard dosing. Consider a 50% reduction in recommended starting dose, slower titration schedule, and a 50% lower maintenance dose. Please consult a clinical pharmacist for more information."}	1
6350945	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a"}	RxNorm:32937	{n/a}	1
6350946	general	No CDS	{CYP2C9,HLA-B}	{}	{"CYP2C9": "1.5"}	{"HLA-B": "*15:02 negative"}	{"HLA-B": "*15:02 negative", "CYP2C9": "1.5"}	RxNorm:8183	{n/a}	1
6351021	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Rapid Metabolizer"}	RxNorm:36437	{n/a}	1
6351925	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75"}	RxNorm:39786	{n/a}	1
6350947	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "1.0"}	{"HLA-B": "*15:02 negative"}	{"HLA-B": "*15:02 negative", "CYP2C9": "1.0"}	RxNorm:8183	{"Based on the genotype result, this patient is predicted to be a CYP2C9 Intermediate Metabolizer and is at increased risk for developing phenytoin-induced toxicities. For first dose, use typical initial or loading dose. For subsequent doses, use approximately 25% less than typical maintenance dose. Subsequent doses should be adjusted according to therapeutic drug monitoring, response and side effects. Please consult a clinical pharmacist for more information"}	1
6350948	general	No CDS	{CYP2C9,HLA-B}	{}	{"CYP2C9": "2.0"}	{"HLA-B": "*15:02 negative"}	{"HLA-B": "*15:02 negative", "CYP2C9": "2.0"}	RxNorm:8183	{n/a}	1
6350949	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "0.5"}	{"HLA-B": "*15:02 negative"}	{"HLA-B": "*15:02 negative", "CYP2C9": "0.5"}	RxNorm:8183	{"Based on the genotype result, this patient is predicted to be a CYP2C9 Poor Metabolizer and is at increased risk for developing phenytoin-induced toxicities. For first dose, use typical initial or loading dose. For subsequent doses use approximately 50% less than typical maintenance dose. Subsequent doses should be adjusted according to therapeutic drug monitoring, response, and side effects. Please consult a clinical pharmacist for more information."}	1
6350950	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "0.0"}	{"HLA-B": "*15:02 negative"}	{"HLA-B": "*15:02 negative", "CYP2C9": "0.0"}	RxNorm:8183	{"Based on the genotype result, this patient is predicted to be a CYP2C9 Poor Metabolizer and is at increased risk for developing phenytoin-induced toxicities. For first dose, use typical initial or loading dose. For subsequent doses use approximately 50% less than typical maintenance dose. Subsequent doses should be adjusted according to therapeutic drug monitoring, response, and side effects. Please consult a clinical pharmacist for more information."}	1
6350951	general	No CDS	{CYP2C9,HLA-B}	{}	{"CYP2C9": "n/a"}	{"HLA-B": "*15:02 negative"}	{"HLA-B": "*15:02 negative", "CYP2C9": "n/a"}	RxNorm:8183	{n/a}	1
6350952	general	Pre-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "No Result"}	{"HLA-B": "*15:02 negative"}	{"HLA-B": "*15:02 negative", "CYP2C9": "No Result"}	RxNorm:8183	{"CYP2C9 diplotype may be important for phenytoin dosing. A CYP2C9 genotype does not appear to have been ordered for this patient. Use of an alternative dose may be recommended. Please consult a clinical pharmacist for more information."}	1
6350953	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "1.5"}	{"HLA-B": "*15:02 positive"}	{"HLA-B": "*15:02 positive", "CYP2C9": "1.5"}	RxNorm:8183	{"The HLA-B*15:02 allele has been detected in this patient. This allele is associated with high risk of cutaneous adverse drug reaction to phenytoin. DO NOT prescribe phenytoin, fosphenytoin, carbamazepine, or oxcarbazepine. Choose an alternate antiepileptic drug. If the patient has previously used phenytoin consistently for longer than three months without incidence of cutaneous adverse reactions, cautiously consider use of phenytoin in the future. For more information, please consult a clinical pharmacist."}	1
6350954	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "1.0"}	{"HLA-B": "*15:02 positive"}	{"HLA-B": "*15:02 positive", "CYP2C9": "1.0"}	RxNorm:8183	{"The HLA-B*15:02 allele has been detected in this patient. This allele is associated with high risk of cutaneous adverse drug reaction to phenytoin. DO NOT prescribe phenytoin, fosphenytoin, carbamazepine, or oxcarbazepine. Choose an alternate antiepileptic drug. If the patient has previously used phenytoin consistently for longer than three months without incidence of cutaneous adverse reactions, cautiously consider use of phenytoin in the future. For more information, please consult a clinical pharmacist."}	1
6350955	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "2.0"}	{"HLA-B": "*15:02 positive"}	{"HLA-B": "*15:02 positive", "CYP2C9": "2.0"}	RxNorm:8183	{"The HLA-B*15:02 allele has been detected in this patient. This allele is associated with high risk of cutaneous adverse drug reaction to phenytoin. DO NOT prescribe phenytoin, fosphenytoin, carbamazepine, or oxcarbazepine. Choose an alternate antiepileptic drug. If the patient has previously used phenytoin consistently for longer than three months without incidence of cutaneous adverse reactions, cautiously consider use of phenytoin in the future. For more information, please consult a clinical pharmacist."}	1
6350956	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "0.5"}	{"HLA-B": "*15:02 positive"}	{"HLA-B": "*15:02 positive", "CYP2C9": "0.5"}	RxNorm:8183	{"The HLA-B*15:02 allele has been detected in this patient. This allele is associated with high risk of cutaneous adverse drug reaction to phenytoin. DO NOT prescribe phenytoin, fosphenytoin, carbamazepine, or oxcarbazepine. Choose an alternate antiepileptic drug. If the patient has previously used phenytoin consistently for longer than three months without incidence of cutaneous adverse reactions, cautiously consider use of phenytoin in the future. For more information, please consult a clinical pharmacist."}	1
6350957	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "0.0"}	{"HLA-B": "*15:02 positive"}	{"HLA-B": "*15:02 positive", "CYP2C9": "0.0"}	RxNorm:8183	{"The HLA-B*15:02 allele has been detected in this patient. This allele is associated with high risk of cutaneous adverse drug reaction to phenytoin. DO NOT prescribe phenytoin, fosphenytoin, carbamazepine, or oxcarbazepine. Choose an alternate antiepileptic drug. If the patient has previously used phenytoin consistently for longer than three months without incidence of cutaneous adverse reactions, cautiously consider use of phenytoin in the future. For more information, please consult a clinical pharmacist."}	1
6350958	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "n/a"}	{"HLA-B": "*15:02 positive"}	{"HLA-B": "*15:02 positive", "CYP2C9": "n/a"}	RxNorm:8183	{"The HLA-B*15:02 allele has been detected in this patient. This allele is associated with high risk of cutaneous adverse drug reaction to phenytoin. DO NOT prescribe phenytoin, fosphenytoin, carbamazepine, or oxcarbazepine. Choose an alternate antiepileptic drug. If the patient has previously used phenytoin consistently for longer than three months without incidence of cutaneous adverse reactions, cautiously consider use of phenytoin in the future. For more information, please consult a clinical pharmacist."}	1
6351022	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Indeterminate", "CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2B6": "Indeterminate", "CYP2C19": "Rapid Metabolizer"}	RxNorm:36437	{n/a}	1
6350959	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "No Result"}	{"HLA-B": "*15:02 positive"}	{"HLA-B": "*15:02 positive", "CYP2C9": "No Result"}	RxNorm:8183	{"The HLA-B*15:02 allele has been detected in this patient. This allele is associated with high risk of cutaneous adverse drug reaction to phenytoin. DO NOT prescribe phenytoin, fosphenytoin, carbamazepine, or oxcarbazepine. Choose an alternate antiepileptic drug. If the patient has previously used phenytoin consistently for longer than three months without incidence of cutaneous adverse reactions, cautiously consider use of phenytoin in the future. For more information, please consult a clinical pharmacist."}	1
6350960	general	Pre-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "1.5"}	{"HLA-B": "No *15:02 result"}	{"HLA-B": "No *15:02 result", "CYP2C9": "1.5"}	RxNorm:8183	{"HLA-B*15:02 genotype may be important for phenytoin adverse events. An HLA-B*15:02 genotype does not appear to have been ordered for this patient. Use of an alternative antiepileptic may be recommended. Please consult a clinical pharmacist for more information."}	1
6350961	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "1.0"}	{"HLA-B": "No *15:02 result"}	{"HLA-B": "No *15:02 result", "CYP2C9": "1.0"}	RxNorm:8183	{"CYP2C9 and HLA-B*15:02 genotype can affect a patient's response to phenytoin. Based on the genotype result, this patient is predicted to be a CYP2C9 Intermediate Metabolizer and is at increased risk for developing phenytoin-induced toxicities. For first dose, use typical initial or loading dose. For subsequent doses, use approximately 25% less than typical maintenance dose. Subsequent doses should be adjusted according to therapeutic drug monitoring, response and side effects. An HLA-B*15:02 genotype does not appear to have been ordered for this patient. Use of an alternative antiepileptic may be recommended. Please consult a clinical pharmacist for more information"}	1
6350962	general	Pre-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "2.0"}	{"HLA-B": "No *15:02 result"}	{"HLA-B": "No *15:02 result", "CYP2C9": "2.0"}	RxNorm:8183	{"HLA-B*15:02 genotype may be important for phenytoin adverse events. An HLA-B*15:02 genotype does not appear to have been ordered for this patient. Use of an alternative antiepileptic may be recommended. Please consult a clinical pharmacist for more information."}	1
6350963	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "0.5"}	{"HLA-B": "No *15:02 result"}	{"HLA-B": "No *15:02 result", "CYP2C9": "0.5"}	RxNorm:8183	{"CYP2C9 and HLA-B*15:02 genotype can affect a patient's response to phenytoin. Based on the genotype result, this patient is predicted to be a CYP2C9 Poor Metabolizer and is at increased risk for developing phenytoin-induced toxicities. For first dose, use typical initial or loading dose. For subsequent doses use approximately 50% less than typical maintenance dose. Subsequent doses should be adjusted according to therapeutic drug monitoring, response, and side effects. An HLA-B*15:02 genotype does not appear to have been ordered for this patient. Use of an alternative antiepileptic may be recommended. Please consult a clinical pharmacist for more information."}	1
6350964	general	Post-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "0.0"}	{"HLA-B": "No *15:02 result"}	{"HLA-B": "No *15:02 result", "CYP2C9": "0.0"}	RxNorm:8183	{"CYP2C9 and HLA-B*15:02 genotype can affect a patient's response to phenytoin. Based on the genotype result, this patient is predicted to be a CYP2C9 Poor Metabolizer and is at increased risk for developing phenytoin-induced toxicities. For first dose, use typical initial or loading dose. For subsequent doses use approximately 50% less than typical maintenance dose. Subsequent doses should be adjusted according to therapeutic drug monitoring, response, and side effects. An HLA-B*15:02 genotype does not appear to have been ordered for this patient. Use of an alternative antiepileptic may be recommended. Please consult a clinical pharmacist for more information."}	1
6350965	general	Pre-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "n/a"}	{"HLA-B": "No *15:02 result"}	{"HLA-B": "No *15:02 result", "CYP2C9": "n/a"}	RxNorm:8183	{"HLA-B*15:02 genotype may be important for phenytoin adverse events. An HLA-B*15:02 genotype does not appear to have been ordered for this patient. Use of an alternative antiepileptic may be recommended. Please consult a clinical pharmacist for more information."}	1
6350966	general	Pre-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "No Result"}	{"HLA-B": "No *15:02 result"}	{"HLA-B": "No *15:02 result", "CYP2C9": "No Result"}	RxNorm:8183	{"A CYP2C9 and HLA-B*15:02 genotype does not appear to have been ordered for this patient. HLA-B and CYP2C9 genotype may be important for phenytoin dosing and use.Use of an alternative dose may be recommended. Please consult a clinical pharmacist for more information."}	1
6350967	general	Pre-test	{CYP2C9}	{}	{"CYP2C9": "No Result"}	{}	{"CYP2C9": "No Result"}	RxNorm:8356	{"CYP2C9 genotype may be important for piroxicam dosing and use. A CYP2C9 genotype does not appear to have been ordered for this patient. Use of an alternative agent or dose may be recommended. Please consult a clinical pharmacist for more information."}	1
6350968	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0"}	RxNorm:8356	{n/a}	1
6350969	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "1.5"}	{}	{"CYP2C9": "1.5"}	RxNorm:8356	{n/a}	1
6350970	general	Post-test	{CYP2C9}	{}	{"CYP2C9": "1.0"}	{}	{"CYP2C9": "1.0"}	RxNorm:8356	{"Based on the genotype result, this patient is predicted to be a CYP2C9 Intermediate Metabolizer with an activity score of 1 and is expected to have higher plasma concentrations of piroxicam which may increase the risk of toxicities. Choose an alternative therapy not metabolized by CYP2C9 or not significantly impacted by CYP2C9 genetic variants in vivo or choose an NSAID metabolized by CYP2C9 but with a shorter half-life (such as celecoxib, flurbiprofen, lornoxicam, or ibuprofen). Please consult a clinical pharmacist for more information."}	1
6350971	general	Post-test	{CYP2C9}	{}	{"CYP2C9": "0.5"}	{}	{"CYP2C9": "0.5"}	RxNorm:8356	{"Based on the genotype result, this patient is predicted to be a CYP2C9 Poor Metabolizer with an activity score of 0.5 and is expected to have higher plasma concentrations of piroxicam which may increase the risk of toxicities. Choose an alternative therapy not metabolized by CYP2C9 or not significantly impacted by CYP2C9 genetic variants in vivo or choose an NSAID metabolized by CYP2C9 but with a shorter half-life (such as celecoxib, flurbiprofen, lornoxicam, or ibuprofen). Please consult a clinical pharmacist for more information."}	1
6351926	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5"}	RxNorm:39786	{n/a}	1
6350972	general	Post-test	{CYP2C9}	{}	{"CYP2C9": "0.0"}	{}	{"CYP2C9": "0.0"}	RxNorm:8356	{"Based on the genotype result, this patient is predicted to be a CYP2C9 Poor Metabolizer with an activity score of 0 and is expected to have higher plasma concentrations of piroxicam which may increase the risk of toxicities. Choose an alternative therapy not metabolized by CYP2C9 or not significantly impacted by CYP2C9 genetic variants in vivo or choose an NSAID metabolized by CYP2C9 but with a shorter half-life (such as celecoxib, flurbiprofen, lornoxicam, or ibuprofen). Please consult a clinical pharmacist for more information."}	1
6350973	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a"}	RxNorm:8356	{n/a}	1
6350974	general	Pre-test	{SLCO1B1}	{"SLCO1B1": "No Result"}	{}	{}	{"SLCO1B1": "No Result"}	RxNorm:861634	{"SLCO1B1 genetic status may be predictive of the risk of pitavastatin-induced myopathy due to altered drug exposure. An SLCO1B1 genotype does not appear to have been ordered for this patient. Use of an alternative statin or dose may be recommended. Please consult a clinical pharmacist for more information."}	1
6350975	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Increased Function"}	{}	{}	{"SLCO1B1": "Increased Function"}	RxNorm:861634	{n/a}	1
6350976	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Normal Function"}	{}	{}	{"SLCO1B1": "Normal Function"}	RxNorm:861634	{n/a}	1
6350977	general	Post-test	{SLCO1B1}	{"SLCO1B1": "Decreased Function"}	{}	{}	{"SLCO1B1": "Decreased Function"}	RxNorm:861634	{"This patient is predicted to have SLCO1B1 decreased function and may be at increased risk for developing pitavastatin-induced myopathy. Prescribe ≤2mg as a starting dose and adjust doses of pitavastatin based on disease-spesific guidelines. If a dose >2mg is needed for desired efficacy, consider an alternative statin or combination therapy. Please consult a clinical pharmacist for more information."}	1
6350978	general	Post-test	{SLCO1B1}	{"SLCO1B1": "Possible Decreased Function"}	{}	{}	{"SLCO1B1": "Possible Decreased Function"}	RxNorm:861634	{"This patient is predicted to have SLCO1B1 possible decreased function and may be at increased risk for developing pitavastatin-induced myopathy. Prescribe ≤2mg as a starting dose and adjust doses of pitavastatin based on disease-spesific guidelines. If a dose >2mg is needed for desired efficacy, consider an alternative statin or combination therapy. Please consult a clinical pharmacist for more information."}	1
6350979	general	Post-test	{SLCO1B1}	{"SLCO1B1": "Poor Function"}	{}	{}	{"SLCO1B1": "Poor Function"}	RxNorm:861634	{"This patient is predicted to have SLCO1B1 poor function and may be at increased risk for developing pitavastatin-induced myopathy. Prescribe ≤1mg as a starting dose and adjust doses of pitavastatin based on disease-specific guidelines. If a dose >1mg is needed for desired efficacy, consider an alternative statin or combination therapy. Please consult a clinical pharmacist for more information."}	1
6350980	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Indeterminate"}	{}	{}	{"SLCO1B1": "Indeterminate"}	RxNorm:861634	{n/a}	1
6350981	general	Pre-test	{SLCO1B1}	{"SLCO1B1": "No Result"}	{}	{}	{"SLCO1B1": "No Result"}	RxNorm:42463	{"SLCO1B1 genetic status may be predictive of the risk of pravastatin-induced myopathy due to altered drug exposure. An SLCO1B1 genotype does not appear to have been ordered for this patient. Use of an alternative statin or dose may be recommended. Please consult a clinical pharmacist for more information."}	1
6350982	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Increased Function"}	{}	{}	{"SLCO1B1": "Increased Function"}	RxNorm:42463	{n/a}	1
6350983	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Normal Function"}	{}	{}	{"SLCO1B1": "Normal Function"}	RxNorm:42463	{n/a}	1
6350984	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Decreased Function"}	{}	{}	{"SLCO1B1": "Decreased Function"}	RxNorm:42463	{n/a}	1
6350985	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Possible Decreased Function"}	{}	{}	{"SLCO1B1": "Possible Decreased Function"}	RxNorm:42463	{n/a}	1
6350986	general	Post-test	{SLCO1B1}	{"SLCO1B1": "Poor Function"}	{}	{}	{"SLCO1B1": "Poor Function"}	RxNorm:42463	{"This patient is predicted to have SLCO1B1 poor function and may be at increased risk for developing pravastatin-induced myopathy. Prescribe ≤40mg per day as a starting dose and adjust doses of pravastatin based on disease-specific guidelines. If a dose >40mg is needed, consider a higher dose (>40mg) if patient is tolerating 40mg or an alternative statin or combination therapy. Please consult a clinical pharmacist for more information."}	1
6350987	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Indeterminate"}	{}	{}	{"SLCO1B1": "Indeterminate"}	RxNorm:42463	{n/a}	1
6350988	general	Post-test	{SLCO1B1,ABCG2}	{"ABCG2": "Decreased Function", "SLCO1B1": "Indeterminate"}	{}	{}	{"ABCG2": "Decreased Function", "SLCO1B1": "Indeterminate"}	RxNorm:301542	{"This patient is predicted to have ABCG2 decreased function. Based on ABCG2 phenotype there is no reason to adjust the dose of rosuvastatin. Because SLCO1B1 phenotype could not be assigned based on genotyping performed, it is not known if SLCO1B1 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6350989	general	Post-test	{SLCO1B1,ABCG2}	{"ABCG2": "Normal Function", "SLCO1B1": "Indeterminate"}	{}	{}	{"ABCG2": "Normal Function", "SLCO1B1": "Indeterminate"}	RxNorm:301542	{"This patient is predicted to have ABCG2 normal function. Based on ABCG2 phenotype there is no reason to adjust the dose of rosuvastatin. Because SLCO1B1 phenotype could not be assigned based on genotyping performed, it is not known if SLCO1B1 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6351023	general	Pre-test	{CYP2B6,CYP2C19}	{"CYP2B6": "No Result", "CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2B6": "No Result", "CYP2C19": "Rapid Metabolizer"}	RxNorm:36437	{"CYP2B6 genotype may be important for the use of sertraline and does not appear to have been ordered for this patient. Please consult a clinical pharmacist for more information."}	1
6351927	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	RxNorm:39786	{n/a}	1
6350990	general	Post-test	{SLCO1B1,ABCG2}	{"ABCG2": "Poor Function", "SLCO1B1": "Indeterminate"}	{}	{}	{"ABCG2": "Poor Function", "SLCO1B1": "Indeterminate"}	RxNorm:301542	{"This patient is predicted to have ABCG2 poor function and may be at an increased risk of rosuvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of rosuvastatin based on disease-specific and specific population guidelines. If a dose >20mg is needed for desired efficacy, consider an alternative statin or combination therapy. Because SLCO1B1 phenotype could not be assigned based on genotyping performed, it is not known if SLCO1B1 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6350991	general	Pre-test	{SLCO1B1,ABCG2}	{"ABCG2": "No Result", "SLCO1B1": "Indeterminate"}	{}	{}	{"ABCG2": "No Result", "SLCO1B1": "Indeterminate"}	RxNorm:301542	{"ABCG2 and SLCO1B1 genetic status may be predictive of the risk of rosuvastatin-induced myopathy due to altered drug exposure. Because an ABCG2 genotype does not appear to have been ordered for this patient and SLCO1B1 phenotype could not be assigned based on genotyping performed, it is not known if these results would influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6350992	general	Post-test	{SLCO1B1,ABCG2}	{"ABCG2": "Decreased Function", "SLCO1B1": "No Result"}	{}	{}	{"ABCG2": "Decreased Function", "SLCO1B1": "No Result"}	RxNorm:301542	{"This patient is predicted to have ABCG2 decreased function. Based on ABCG2 phenotype there is no reason to adjust the dose of rosuvastatin. Because an SLCO1B1 genotype does not appear to have been ordered for this patient, it is not known if SLCO1B1 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6350993	general	Post-test	{SLCO1B1,ABCG2}	{"ABCG2": "Poor Function", "SLCO1B1": "No Result"}	{}	{}	{"ABCG2": "Poor Function", "SLCO1B1": "No Result"}	RxNorm:301542	{"This patient is predicted to have ABCG2 poor function and may be at an increased risk of rosuvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of rosuvastatin based on disease-specific and specific population guidelines. If a dose > 20mg is needed for desired efficacy, consider combination therapy. Because an SLCO1B1 genotype does not appear to have been ordered for this patient, it is not known if SLCO1B1 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6350994	general	Pre-test	{SLCO1B1,ABCG2}	{"ABCG2": "Normal Function", "SLCO1B1": "No Result"}	{}	{}	{"ABCG2": "Normal Function", "SLCO1B1": "No Result"}	RxNorm:301542	{"This patient is predicted to have ABCG2 normal function. Based on ABCG2 phenotype there is no reason to adjust the dose of rosuvastatin. Because an SLCO1B1 genotype does not appear to have been ordered for this patient, it is not known if SLCO1B1 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6350995	general	Pre-test	{SLCO1B1,ABCG2}	{"ABCG2": "No Result", "SLCO1B1": "No Result"}	{}	{}	{"ABCG2": "No Result", "SLCO1B1": "No Result"}	RxNorm:301542	{"ABCG2 and SLCO1B1 genetic status may be predictive of the risk of rosuvastatin-induced myopathy due to altered drug exposure. Neither a ABCG2 nor SLCO1B1 genotype appears to have been ordered for this patient. Use of an alternative dose or drug may be recommended. Please consult a clinical pharmacist for more information."}	1
6350996	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Decreased Function", "SLCO1B1": "Decreased Function"}	{}	{}	{"ABCG2": "Decreased Function", "SLCO1B1": "Decreased Function"}	RxNorm:301542	{n/a}	1
6350997	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Normal Function", "SLCO1B1": "Decreased Function"}	{}	{}	{"ABCG2": "Normal Function", "SLCO1B1": "Decreased Function"}	RxNorm:301542	{n/a}	1
6350998	general	Post-test	{SLCO1B1,ABCG2}	{"ABCG2": "Poor Function", "SLCO1B1": "Decreased Function"}	{}	{}	{"ABCG2": "Poor Function", "SLCO1B1": "Decreased Function"}	RxNorm:301542	{"This patient is predicted to have ABCG2 poor function and SLCO1B1 decreased function. This patient may be at an increased risk of a rosuvastatin-induced myopathy. Prescribe ≤10mg as a starting dose and adjust doses of rosuvastatin based on disease-specific and specific population guidelines. If a dose >10mg is needed for desired efficacy, consider an alternative statin or combination therapy. Please consult a clinical pharmacist for more information."}	1
6350999	general	Pre-test	{SLCO1B1,ABCG2}	{"ABCG2": "No Result", "SLCO1B1": "Decreased Function"}	{}	{}	{"ABCG2": "No Result", "SLCO1B1": "Decreased Function"}	RxNorm:301542	{"This patient is predicted to have SLCO1B1 decreased function. Based on SLCO1B1 phenotype there is no reason to adjust the dose of rosuvastatin. Because a ABCG2 genotype does not appear to have been ordered for this patient, it is not known if ABCG2 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6351000	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Decreased Function", "SLCO1B1": "Normal Function"}	{}	{}	{"ABCG2": "Decreased Function", "SLCO1B1": "Normal Function"}	RxNorm:301542	{n/a}	1
6351001	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Normal Function", "SLCO1B1": "Normal Function"}	{}	{}	{"ABCG2": "Normal Function", "SLCO1B1": "Normal Function"}	RxNorm:301542	{n/a}	1
6351002	general	Post-test	{SLCO1B1,ABCG2}	{"ABCG2": "Poor Function", "SLCO1B1": "Normal Function"}	{}	{}	{"ABCG2": "Poor Function", "SLCO1B1": "Normal Function"}	RxNorm:301542	{"This patient is predicted to have ABCG2 poor function and SLCO1B1 normal function. This patient may be at an increased risk of rosuvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of rosuvastatin based on disease-specific guidelines. If a dose >20mg is needed for desired efficacy, consider an alternative statin or combination therapy. Please consult a clinical pharmacist for more information."}	1
6351003	general	Post-test	{SLCO1B1,ABCG2}	{"ABCG2": "No Result", "SLCO1B1": "Normal Function"}	{}	{}	{"ABCG2": "No Result", "SLCO1B1": "Normal Function"}	RxNorm:301542	{"This patient is predicted to have SLCO1B1 normal function. Based on SLCO1B1 phenotype there is no reason to adjust the dose of rosuvastatin. Because a ABCG2 genotype does not appear to have been ordered for this patient, it is not known if ABCG2 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6351004	general	Post-test	{SLCO1B1,ABCG2}	{"ABCG2": "Decreased Function", "SLCO1B1": "Poor Function"}	{}	{}	{"ABCG2": "Decreased Function", "SLCO1B1": "Poor Function"}	RxNorm:301542	{"This patient is predicted to have ABCG2 decreased function and SLCO1B1 poor function. This patient may be at an increased risk of a rosuvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of rosuvastatin based on disease-specific and specific population guidelines. If a dose >20mg is needed for desired efficacy, consider combination therapy. Please consult a clinical pharmacist for more information."}	1
6351005	general	Post-test	{SLCO1B1,ABCG2}	{"ABCG2": "Normal Function", "SLCO1B1": "Poor Function"}	{}	{}	{"ABCG2": "Normal Function", "SLCO1B1": "Poor Function"}	RxNorm:301542	{"This patient is predicted to have ABCG2 normal function and SLCO1B1 poor function. This patient may be at an increased risk of a rosuvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of rosuvastatin based on disease-specific and specific population guidelines. If a dose >20mg is needed for desired efficacy, consider combination therapy. Please consult a clinical pharmacist for more information."}	1
6351006	general	Post-test	{SLCO1B1,ABCG2}	{"ABCG2": "Poor Function", "SLCO1B1": "Poor Function"}	{}	{}	{"ABCG2": "Poor Function", "SLCO1B1": "Poor Function"}	RxNorm:301542	{"This patient is predicted to have ABCG2 poor function and SLCO1B1 poor function. This patient may be at an increased risk of a rosuvastatin-induced myopathy. Prescribe ≤10mg per day as a starting dose and adjust doses of rosuvastatin based on disease-specific and specific population guidelines. If a dose >10mg is needed for desired efficacy, consider combination therapy. Please consult a clinical pharmacist for more information."}	1
6351007	general	Post-test	{SLCO1B1,ABCG2}	{"ABCG2": "No Result", "SLCO1B1": "Poor Function"}	{}	{}	{"ABCG2": "No Result", "SLCO1B1": "Poor Function"}	RxNorm:301542	{"This patient is predicted to have SLCO1B1 poor function and may be at an increased risk of rosuvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of rosuvastatin based on disease-specific and specific population guidelines. If a dose > 20mg is needed for desired efficacy, consider combination therapy. Because an ABCG2 genotype does not appear to have been ordered for this patient, it is not known if ABCG2 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6351008	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Decreased Function", "SLCO1B1": "Possible Decreased Function"}	{}	{}	{"ABCG2": "Decreased Function", "SLCO1B1": "Possible Decreased Function"}	RxNorm:301542	{n/a}	1
6351009	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Normal Function", "SLCO1B1": "Possible Decreased Function"}	{}	{}	{"ABCG2": "Normal Function", "SLCO1B1": "Possible Decreased Function"}	RxNorm:301542	{n/a}	1
6351010	general	Post-test	{SLCO1B1,ABCG2}	{"ABCG2": "Poor Function", "SLCO1B1": "Possible Decreased Function"}	{}	{}	{"ABCG2": "Poor Function", "SLCO1B1": "Possible Decreased Function"}	RxNorm:301542	{"This patient is predicted to have ABCG2 poor function and SLCO1B1 possible decreased function. This patient may be at an increased risk of a rosuvastatin-induced myopathy. Prescribe ≤10mg as a starting dose and adjust doses of rosuvastatin based on disease-specific and specific population guidelines. If a dose >10mg is needed for desired efficacy, consider an alternative statin or combination therapy. Please consult a clinical pharmacist for more information."}	1
6351011	general	Pre-test	{SLCO1B1,ABCG2}	{"ABCG2": "No Result", "SLCO1B1": "Possible Decreased Function"}	{}	{}	{"ABCG2": "No Result", "SLCO1B1": "Possible Decreased Function"}	RxNorm:301542	{"This patient is predicted to have SLCO1B1 possible decreased function. Based on SLCO1B1 phenotype there is no reason to adjust the dose of rosuvastatin. Because a ABCG2 genotype does not appear to have been ordered for this patient, it is not known if ABCG2 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6351012	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Decreased Function", "SLCO1B1": "Increased Function"}	{}	{}	{"ABCG2": "Decreased Function", "SLCO1B1": "Increased Function"}	RxNorm:301542	{n/a}	1
6351013	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Normal Function", "SLCO1B1": "Increased Function"}	{}	{}	{"ABCG2": "Normal Function", "SLCO1B1": "Increased Function"}	RxNorm:301542	{n/a}	1
6351014	general	Post-test	{SLCO1B1,ABCG2}	{"ABCG2": "Poor Function", "SLCO1B1": "Increased Function"}	{}	{}	{"ABCG2": "Poor Function", "SLCO1B1": "Increased Function"}	RxNorm:301542	{"This patient is predicted to have ABCG2 poor function and SLCO1B1 increased function. This patient may be at an increased risk of rosuvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of rosuvastatin based on disease-specific guidelines. If a dose >20mg is needed for desired efficacy, consider an alternative statin or combination therapy. Please consult a clinical pharmacist for more information."}	1
6351015	general	Post-test	{SLCO1B1,ABCG2}	{"ABCG2": "No Result", "SLCO1B1": "Increased Function"}	{}	{}	{"ABCG2": "No Result", "SLCO1B1": "Increased Function"}	RxNorm:301542	{"This patient is predicted to have SLCO1B1 increased function. Based on SLCO1B1 phenotype there is no reason to adjust the dose of rosuvastatin. Because a ABCG2 genotype does not appear to have been ordered for this patient, it is not known if ABCG2 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6351016	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	RxNorm:36437	{n/a}	1
6351017	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Normal Metabolizer"}	RxNorm:36437	{n/a}	1
6351018	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Normal Metabolizer"}	RxNorm:36437	{n/a}	1
6351019	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Rapid Metabolizer"}	RxNorm:36437	{n/a}	1
6351026	general	Pre-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "No Result"}	{}	{}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "No Result"}	RxNorm:36437	{"CYP2C19 genotype may be important for the use of sertraline. A CYP2C19 genotype does not appear to have been ordered for this patient. Please consult a clinical pharmacist for more information."}	1
6351027	general	Pre-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "No Result"}	{}	{}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "No Result"}	RxNorm:36437	{"CYP2C19 genotype may be important for the use of sertraline. A CYP2C19 genotype does not appear to have been ordered for this patient. Please consult a clinical pharmacist for more information."}	1
6351028	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "No Result"}	{}	{}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "No Result"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2B6 intermediate metabolizer and may be at risk for higher plasma concentrations with standard dosing. Initiate therapy with recommended starting dose. Consider a slower titration schedule and lower maintenance dose. Because a CYP2C19 genotype does not appear to have been ordered for this patient, it is not known if CYP2C19 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6351029	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "No Result"}	{}	{}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "No Result"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2B6 poor metabolizer and may be at risk for higher plasma concentrations with standard dosing. Consider a lower starting dose, slower titration schedule and 25% reduction of standard maintenance dose or select a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2B6. Because a CYP2C19 genotype does not appear to have been ordered for this patient, it is not known if CYP2C19 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6351030	general	Pre-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Indeterminate", "CYP2C19": "No Result"}	{}	{}	{"CYP2B6": "Indeterminate", "CYP2C19": "No Result"}	RxNorm:36437	{"CYP2C19 genotype may be important for the use of sertraline. A CYP2C19 genotype does not appear to have been ordered for this patient. Please consult a clinical pharmacist for more information."}	1
6351031	general	Pre-test	{CYP2B6,CYP2C19}	{"CYP2B6": "No Result", "CYP2C19": "No Result"}	{}	{}	{"CYP2B6": "No Result", "CYP2C19": "No Result"}	RxNorm:36437	{"CYP2C19 and CYP2B6 genotypes may be important for the use of sertraline and do not appear to have been ordered for this patient. Please consult a clinical pharmacist for more information."}	1
6351032	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 ultrarapid metabolizer and a CYP2B6 ultrarapid metabolizer and may be at risk for lower plasma concentrations with standard dosing. Initiate therapy with recommended starting dose. If patient does not adequately respond to recommended maintenance dosing, consider titrating to a higher maintenance dose or switching to a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2C19 or CYP2B6. Please consult a clinical pharmacist for more information."}	1
6351033	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 ultrarapid metabolizer and a CYP2B6 rapid metabolizer and may be at risk for lower plasma concentrations with standard dosing. Initiate therapy with recommended starting dose. If patient does not adequately respond to recommended maintenance dosing, consider titrating to a higher maintenance dose or switching to a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2C19 or CYP2B6. Please consult a clinical pharmacist for more information."}	1
6351034	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:36437	{n/a}	1
6351035	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:36437	{n/a}	1
6351036	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:36437	{n/a}	1
6351037	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Indeterminate", "CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2B6": "Indeterminate", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:36437	{n/a}	1
6351038	general	Pre-test	{CYP2B6,CYP2C19}	{"CYP2B6": "No Result", "CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2B6": "No Result", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:36437	{"CYP2B6 genotype may be important for the use of sertraline and does not appear to have been ordered for this patient. Please consult a clinical pharmacist for more information."}	1
6351039	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 rapid metabolizer and a CYP2B6 ultrarapid metabolizer and may be at risk for lower plasma concentrations with standard dosing. Initiate therapy with recommended starting dose. If patient does not adequately respond to recommended maintenance dosing, consider titrating to a higher maintenance dose or switching to a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2C19. Please consult a clinical pharmacist for more information."}	1
6351078	general	Pre-test	{CYP2B6,CYP2C19}	{"CYP2B6": "No Result", "CYP2C19": "Indeterminate"}	{}	{}	{"CYP2B6": "No Result", "CYP2C19": "Indeterminate"}	RxNorm:36437	{"CYP2B6 genotype may be important for the use of sertraline and does not appear to have been ordered for this patient. Please consult a clinical pharmacist for more information."}	1
6351040	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Rapid Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 rapid metabolizer and a CYP2B6 rapid metabolizer and may be at risk for lower plasma concentrations with standard dosing. Initiate therapy with recommended starting dose. If patient does not adequately respond to recommended maintenance dosing, consider titrating to a higher maintenance dose or switching to a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2C19. Please consult a clinical pharmacist for more information."}	1
6351041	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Normal Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 normal metabolizer and a CYP2B6 poor metabolizer and may be at risk for higher plasma concentrations with standard dosing. Consider a lower starting dose, slower titration schedule and 25% reduction of standard maintenance dose or select a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2B6. Please consult a clinical pharmacist for more information."}	1
6351042	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Indeterminate", "CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2B6": "Indeterminate", "CYP2C19": "Normal Metabolizer"}	RxNorm:36437	{n/a}	1
6351043	general	Pre-test	{CYP2B6,CYP2C19}	{"CYP2B6": "No Result", "CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2B6": "No Result", "CYP2C19": "Normal Metabolizer"}	RxNorm:36437	{"CYP2B6 genotype may be important for the use of sertraline and does not appear to have been ordered for this patient. Please consult a clinical pharmacist for more information."}	1
6351044	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:36437	{n/a}	1
6351045	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:36437	{n/a}	1
6351046	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 likely intermediate metabolizer and a CYP2B6 normal metabolizer and may be at risk for higher plasma concentrations with standard dosing. Initiate therapy with recommended starting dose. Consider a slower titration schedule and lower maintenance dose. Please consult a clinical pharmacist for more information."}	1
6351047	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 likely intermediate metabolizer and a CYP2B6 intermediate metabolizer and may be at risk for higher plasma concentrations with standard dosing. Initiate therapy with recommended starting dose. Consider a slower titration schedule and lower maintenance dose. Please consult a clinical pharmacist for more information."}	1
6351048	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 likely intermediate metabolizer and a CYP2B6 poor metabolizer and may be at risk for higher plasma concentrations with standard dosing. Consider a lower starting dose, slower titration schedule and 50% reduction of standard maintenance dose. Please consult a clinical pharmacist for more information."}	1
6351049	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Indeterminate", "CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Indeterminate", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 likely intermediate metabolizer may be at risk for higher plasma concentrations with standard dosing. Initiate therapy with recommended starting dose. Consider a slower titration schedule and lower maintenance dose. Please consult a clinical pharmacist for more information."}	1
6351050	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "No Result", "CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "No Result", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a likely CYP2C19 intermediate metabolizer and may be at risk for higer plasma concentrations with standard dosing. Initiate therapy with recommended starting dose. Consider a slower titration schedule and lower maintenance dose. Because a CYP2B6 genotype does not appear to have been ordered for this patient, it is not known if CYP2B6 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information.Please consult a clinical pharmacist for more information."}	1
6351051	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:36437	{n/a}	1
6351052	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:36437	{n/a}	1
6351053	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 intermediate metabolizer and a CYP2B6 normal metabolizer and may be at risk for higher plasma concentrations with standard dosing. Initiate therapy with recommended starting dose. Consider a slower titration schedule and lower maintenance dose. Please consult a clinical pharmacist for more information."}	1
6351928	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	RxNorm:39786	{n/a}	1
6351054	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 intermediate metabolizer and a CYP2B6 intermediate metabolizer and may be at risk for higher plasma concentrations with standard dosing. Initiate therapy with recommended starting dose. Consider a slower titration schedule and lower maintenance dose. Please consult a clinical pharmacist for more information."}	1
6351055	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 intermediate metabolizer and a CYP2B6 poor metabolizer and may be at risk for higher plasma concentrations with standard dosing. Consider a lower starting dose, slower titration schedule and 50% reduction of standard maintenance dose. Please consult a clinical pharmacist for more information."}	1
6351056	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Indeterminate", "CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Indeterminate", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 intermediate metabolizer may be at risk for higher plasma concentrations with standard dosing. Initiate therapy with recommended starting dose. Consider a slower titration schedule and lower maintenance dose. Please consult a clinical pharmacist for more information."}	1
6351057	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "No Result", "CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "No Result", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 intermediate metabolizer and may be at risk for higer plasma concentrations with standard dosing. Initiate therapy with recommended starting dose. Consider a slower titration schedule and lower maintenance dose. Because a CYP2B6 genotype does not appear to have been ordered for this patient, it is not known if CYP2B6 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information.Please consult a clinical pharmacist for more information."}	1
6351058	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{}	{}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 likely poor metabolizer and a CYP2B6 ultrarapid metabolizer and may be at risk for higher plasma concentrations with standard dosing. Consider a lower starting dose, slower titration schedule and 50% reduction of standard maintenance dose or select a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2C19. Please consult a clinical pharmacist for more information."}	1
6351059	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{}	{}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 likely poor metabolizer and a CYP2B6 rapid metabolizer and may be at risk for higher plasma concentrations with standard dosing. Consider a lower starting dose, slower titration schedule and 50% reduction of standard maintenance dose or select a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2C19. Please consult a clinical pharmacist for more information."}	1
6351060	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{}	{}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 likely poor metabolizer and a CYP2B6 normal metabolizer and may be at risk for higher plasma concentrations with standard dosing. Consider a lower starting dose, slower titration schedule and 50% reduction of standard maintenance dose or select a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2C19. Please consult a clinical pharmacist for more information."}	1
6351061	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{}	{}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 likely poor metabolizer and a CYP2B6 intermediate metabolizer and may be at risk for higher plasma concentrations with standard dosing. Consider a lower starting dose, slower titration schedule and 50% reduction of standard maintenance dose or select a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2C19. Please consult a clinical pharmacist for more information."}	1
6351062	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	{}	{}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 likely poor metabolizer and a CYP2B6 poor metabolizer and may be at risk for higher plasma concentrations with standard dosing. Select an alternative antidepressant not primarily metabolized by CYP2C19 or CYP2B6. Please consult a clinical pharmacist for more information."}	1
6351063	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Indeterminate", "CYP2C19": "Likely Poor Metabolizer"}	{}	{}	{"CYP2B6": "Indeterminate", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 poor metabolizer may be at risk for higher plasma concentrations with standard dosing. Consider a lower starting dose, slower titration schedule and 50% reduction of standard maintenance dose as compared to CYP2C19 normal metabolizers or select a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2C19. Please consult a clinical pharmacist for more information."}	1
6351064	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "No Result", "CYP2C19": "Likely Poor Metabolizer"}	{}	{}	{"CYP2B6": "No Result", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 likely poor metabolizer may be at risk for higher plasma concentrations with standard dosing. Consider a lower starting dose, slower titration schedule and 50% reduction of standard maintenance dose as compared to CYP2C19 normal metabolizers or select a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2C19. Please consult a clinical pharmacist for more information."}	1
6351065	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	{}	{}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 poor metabolizer and a CYP2B6 ultrarapid metabolizer and may be at risk for higher plasma concentrations with standard dosing. Consider a lower starting dose, slower titration schedule and 50% reduction of standard maintenance dose or select a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2C19. Please consult a clinical pharmacist for more information."}	1
6351066	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	{}	{}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Poor Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 likely poor metabolizer and a CYP2B6 rapid metabolizer and may be at risk for higher plasma concentrations with standard dosing. Consider a lower starting dose, slower titration schedule and 50% reduction of standard maintenance dose or select a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2C19. Please consult a clinical pharmacist for more information."}	1
6351067	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Poor Metabolizer"}	{}	{}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Poor Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 poor metabolizer and a CYP2B6 normal metabolizer and may be at risk for higher plasma concentrations with standard dosing. Consider a lower starting dose, slower titration schedule and 50% reduction of standard maintenance dose or select a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2C19. Please consult a clinical pharmacist for more information."}	1
6351068	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Poor Metabolizer"}	{}	{}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Poor Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 poor metabolizer and a CYP2B6 intermediate metabolizer and may be at risk for higher plasma concentrations with standard dosing. Consider a lower starting dose, slower titration schedule and 50% reduction of standard maintenance dose or select a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2C19. Please consult a clinical pharmacist for more information."}	1
6351069	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Poor Metabolizer"}	{}	{}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Poor Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 poor metabolizer and a CYP2B6 poor metabolizer and may be at risk for higher plasma concentrations with standard dosing. Select an alternative antidepressant not primarily metabolized by CYP2C19 or CYP2B6. Please consult a clinical pharmacist for more information."}	1
6351070	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Indeterminate", "CYP2C19": "Poor Metabolizer"}	{}	{}	{"CYP2B6": "Indeterminate", "CYP2C19": "Poor Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 poor metabolizer may be at risk for higher plasma concentrations with standard dosing. Consider a lower starting dose, slower titration schedule and 50% reduction of standard maintenance dose as compared to CYP2C19 normal metabolizers or select a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2C19. Please consult a clinical pharmacist for more information."}	1
6351071	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "No Result", "CYP2C19": "Poor Metabolizer"}	{}	{}	{"CYP2B6": "No Result", "CYP2C19": "Poor Metabolizer"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 poor metabolizer and may be at risk for higer plasma concentrations with standard dosing. Consider a lower starting dose, slower titration schedule and 50% reduction of standard maintenance dose or select a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2C19. Because a CYP2B6 genotype does not appear to have been ordered for this patient, it is not known if CYP2B6 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
6351072	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Indeterminate"}	{}	{}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Indeterminate"}	RxNorm:36437	{n/a}	1
6351073	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Indeterminate"}	{}	{}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Indeterminate"}	RxNorm:36437	{n/a}	1
6351074	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Indeterminate"}	{}	{}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Indeterminate"}	RxNorm:36437	{n/a}	1
6351075	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Indeterminate"}	{}	{}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Indeterminate"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2B6 intermediate metabolizer and may be at risk for higher plasma concentrations with standard dosing. Initiate therapy with recommended starting dose. Consider a slower titration schedule and lower maintenance dose. Please consult a clinical pharmacist for more information."}	1
6351076	general	Post-test	{CYP2B6,CYP2C19}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Indeterminate"}	{}	{}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Indeterminate"}	RxNorm:36437	{"Based on the genotype result, this patient is predicted to be a CYP2C19 poor metabolizer may be at risk for higher plasma concentrations with standard dosing. Consider a lower starting dose, slower titration schedule and 25% reduction of standard maintenance dose as compared to CYP2B6 normal metabolizers or select a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2B6. Please consult a clinical pharmacist for more information."}	1
6351077	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Indeterminate", "CYP2C19": "Indeterminate"}	{}	{}	{"CYP2B6": "Indeterminate", "CYP2C19": "Indeterminate"}	RxNorm:36437	{n/a}	1
6351929	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	RxNorm:39786	{n/a}	1
6351930	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	RxNorm:39786	{n/a}	1
6351079	general	Post-test	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	RxNorm:36453	{"Based on genotype, this patient is predicted to be malignant hyperthermia susceptible. Halogenated volatile anesthetics or depolarizing muscle relaxants are relatively contraindicated in persons with MHS. They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available, effective, and safe in patients with MHS. Please consult an anesthesiologist or clinical pharmacist for more information."}	1
6351080	general	Post-test	{RYR1,CACNA1S}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:36453	{"Based on genotype, this patient is predicted to be malignant hyperthermia susceptible. Halogenated volatile anesthetics or depolarizing muscle relaxants are relatively contraindicated in persons with MHS. They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available, effective, and safe in patients with MHS. Please consult an anesthesiologist or clinical pharmacist for more information."}	1
6351081	general	Pre-test	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	RxNorm:36453	{"Malignant Hyperthermia Susceptibility is an inherited trait linked to changes within the RYR1 and CACNA1S genes. Genetic testing can help to guide anesthetic agent use."}	1
6351082	general	Pre-test	{RYR1,CACNA1S}	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:36453	{"Malignant Hyperthermia Susceptibility is an inherited trait linked to changes within the RYR1 and CACNA1S genes. Genetic testing can help to guide anesthetic agent use."}	1
6351083	general	Pre-test	{RYR1,CACNA1S}	{"RYR1": "No Result", "CACNA1S": "No Result"}	{}	{}	{"RYR1": "No Result", "CACNA1S": "No Result"}	RxNorm:36453	{"Malignant Hyperthermia Susceptibility is an inherited trait linked to changes within the RYR1 and CACNA1S genes. Genetic testing can help to guide anesthetic agent use."}	1
6351084	general	No CDS	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:36453	{n/a}	1
6351085	general	Pre-test	{SLCO1B1}	{"SLCO1B1": "No Result"}	{}	{}	{"SLCO1B1": "No Result"}	RxNorm:36567	{"SLCO1B1 genetic status may be predictive of the risk of simvastatin-induced myopathy due to altered drug exposure. An SLCO1B1 genotype does not appear to have been ordered for this patient. Use of an alternative dose or drug may be recommended. Please consult a clinical pharmacist for more information."}	1
6351086	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Increased Function"}	{}	{}	{"SLCO1B1": "Increased Function"}	RxNorm:36567	{n/a}	1
6351087	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Normal Function"}	{}	{}	{"SLCO1B1": "Normal Function"}	RxNorm:36567	{n/a}	1
6351088	general	Post-test	{SLCO1B1}	{"SLCO1B1": "Decreased Function"}	{}	{}	{"SLCO1B1": "Decreased Function"}	RxNorm:36567	{"This patient is predicted to have SLCO1B1 decreased function and is at increased risk for developing simvastatin-induced myopathy. Prescribe an alternative statin depending on the desired potency. If simvastatin therapy is warranted, limit dose to <20mg per day. Please consult a clinical pharmacist for more information."}	1
6351089	general	Post-test	{SLCO1B1}	{"SLCO1B1": "Possible Decreased Function"}	{}	{}	{"SLCO1B1": "Possible Decreased Function"}	RxNorm:36567	{"This patient is predicted to have SLCO1B1 possible decreased function and is at increased risk for developing simvastatin-induced myopathy. Prescribe an alternative statin depending on the desired potency. If simvastatin therapy is warranted, limit dose to <20mg per day. Please consult a clinical pharmacist for more information."}	1
6351090	general	Post-test	{SLCO1B1}	{"SLCO1B1": "Poor Function"}	{}	{}	{"SLCO1B1": "Poor Function"}	RxNorm:36567	{"This patient is predicted to have SLCO1B1 poor function and is at increased risk for developing simvastatin-inducedmyopathy. Prescribe an alternative statin depending on the desired potency. Please consult a clinical pharmacist for more information."}	1
6351091	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Indeterminate"}	{}	{}	{"SLCO1B1": "Indeterminate"}	RxNorm:36567	{n/a}	1
6351092	general	Post-test	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	RxNorm:10154	{"Based on genotype, this patient is predicted to be malignant hyperthermia susceptible. Halogenated volatile anesthetics or depolarizing muscle relaxants are relatively contraindicated in persons with MHS. They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available, effective, and safe in patients with MHS. Please consult an anesthesiologist or clinical pharmacist for more information."}	1
6351093	general	Post-test	{RYR1,CACNA1S}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:10154	{"Based on genotype, this patient is predicted to be malignant hyperthermia susceptible. Halogenated volatile anesthetics or depolarizing muscle relaxants are relatively contraindicated in persons with MHS. They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available, effective, and safe in patients with MHS. Please consult an anesthesiologist or clinical pharmacist for more information."}	1
6351094	general	Pre-test	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	RxNorm:10154	{"Malignant Hyperthermia Susceptibility is an inherited trait linked to changes within the RYR1 and CACNA1S genes. Genetic testing can help to guide anesthetic agent use."}	1
6351095	general	Pre-test	{RYR1,CACNA1S}	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:10154	{"Malignant Hyperthermia Susceptibility is an inherited trait linked to changes within the RYR1 and CACNA1S genes. Genetic testing can help to guide anesthetic agent use."}	1
6351096	general	Pre-test	{RYR1,CACNA1S}	{"RYR1": "No Result", "CACNA1S": "No Result"}	{}	{}	{"RYR1": "No Result", "CACNA1S": "No Result"}	RxNorm:10154	{"Malignant Hyperthermia Susceptibility is an inherited trait linked to changes within the RYR1 and CACNA1S genes. Genetic testing can help to guide anesthetic agent use."}	1
6351097	general	No CDS	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:10154	{n/a}	1
6351098	general	Pre-test	{CYP3A5}	{"CYP3A5": "No Result"}	{}	{}	{"CYP3A5": "No Result"}	RxNorm:42316	{"CYP3A5 results may be important for tacrolimus dosing. A CYP3A5 genotype does not appear to have been ordered for this patient. Use of an alternative dose may be recommended. Please consult a clinical pharmacist for more information."}	1
6351099	general	Post-test	{CYP3A5}	{"CYP3A5": "Normal Metabolizer"}	{}	{}	{"CYP3A5": "Normal Metabolizer"}	RxNorm:42316	{"Based on the genotype result, this patient is predicted to have lower tacrolimus serum drug levels if initiated on a standard tacrolimus starting dose. Consider increasing the starting dose to 1.5 times to 2 times the standard dose. Total starting dose should not exceed 0.3mg/kg/day. Further dose adjustments or selection of alternative therapy may be necessary due to other clinical factors (e.g., medication interactions, or hepatic function). Use therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351100	general	Post-test	{CYP3A5}	{"CYP3A5": "Intermediate Metabolizer"}	{}	{}	{"CYP3A5": "Intermediate Metabolizer"}	RxNorm:42316	{"Based on the genotype result, this patient is predicted to have lower tacrolimus serum drug levels if initiated on a standard tacrolimus starting dose. Consider increasing the starting dose to 1.5 times to 2 times the standard dose. Total starting dose should not exceed 0.3mg/kg/day. Further dose adjustments or selection of alternative therapy may be necessary due to other clinical factors (e.g., medication interactions, or hepatic function). Use therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351101	general	Post-test	{CYP3A5}	{"CYP3A5": "Possible Intermediate Metabolizer"}	{}	{}	{"CYP3A5": "Possible Intermediate Metabolizer"}	RxNorm:42316	{"Based on the genotype result, this patient is predicted to have lower tacrolimus serum drug levels if initiated on a standard tacrolimus starting dose. Consider increasing the starting dose to 1.5 times to 2 times the standard dose. Total starting dose should not exceed 0.3mg/kg/day. Further dose adjustments or selection of alternative therapy may be necessary due to other clinical factors (e.g., medication interactions, or hepatic function). Use therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351102	general	No CDS	{CYP3A5}	{"CYP3A5": "Poor Metabolizer"}	{}	{}	{"CYP3A5": "Poor Metabolizer"}	RxNorm:42316	{n/a}	1
6351103	general	No CDS	{CYP3A5}	{"CYP3A5": "Indeterminate"}	{}	{}	{"CYP3A5": "Indeterminate"}	RxNorm:42316	{n/a}	1
6351104	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0"}	RxNorm:10324	{n/a}	1
6351105	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5"}	RxNorm:10324	{n/a}	1
6351106	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25"}	RxNorm:10324	{n/a}	1
6351107	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0"}	RxNorm:10324	{n/a}	1
6351108	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0"}	RxNorm:10324	{n/a}	1
6351109	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75"}	RxNorm:10324	{n/a}	1
6351110	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0"}	RxNorm:10324	{n/a}	1
6351111	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5"}	RxNorm:10324	{n/a}	1
6351112	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	RxNorm:10324	{n/a}	1
6351113	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	RxNorm:10324	{n/a}	1
6351114	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	RxNorm:10324	{n/a}	1
6351115	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	RxNorm:10324	{n/a}	1
6351116	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	RxNorm:10324	{n/a}	1
6351117	general	Pre-test	{CYP2D6}	{}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result"}	RxNorm:10324	{"CYP2D6 genetic status may be predictive of poor response to this medication. A CYP2D6 genotype does not appear to have been ordered for this patient. Use of an alternative dose or drug may be recommended. Please consult a clinical pharmacist for more information."}	1
6351118	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0"}	RxNorm:10324	{n/a}	1
6351119	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0"}	RxNorm:10324	{n/a}	1
6351120	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75"}	RxNorm:10324	{n/a}	1
6351931	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	RxNorm:39786	{n/a}	1
6351121	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0"}	RxNorm:10324	{"This patient is predicted to have lower than normal CYP2D6 activity and may be at an increased risk of a poor tamoxifen response due to low endoxifen (active component of tamoxifen) concentrations. Consider hormonal therapy such as an aromatase inhibitor for postmenopausal women or aromatase inhibitor along with ovarian function suppression in premenopausal women. If aromatase inhibitor use is contraindicated, consideration should be given to use a higher but FDA approved tamoxifen dose (40 mg/day). Avoid CYP2D6 inhibitors. Please consult a clinical pharmacist for more information."}	1
6351122	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75"}	RxNorm:10324	{"This patient is predicted to have lower than normal CYP2D6 activity and may be at an increased risk of a poor tamoxifen response due to low endoxifen (active component of tamoxifen) concentrations. Consider hormonal therapy such as an aromatase inhibitor for postmenopausal women or aromatase inhibitor along with ovarian function suppression in premenopausal women. If aromatase inhibitor use is contraindicated, consideration should be given to use a higher but FDA approved tamoxifen dose (40 mg/day). Avoid CYP2D6 inhibitors. Please consult a clinical pharmacist for more information."}	1
6351123	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5"}	RxNorm:10324	{"This patient is predicted to have lower than normal CYP2D6 activity and may be at an increased risk of a poor tamoxifen response due to low endoxifen (active component of tamoxifen) concentrations. Consider hormonal therapy such as an aromatase inhibitor for postmenopausal women or aromatase inhibitor along with ovarian function suppression in premenopausal women. If aromatase inhibitor use is contraindicated, consideration should be given to use a higher but FDA approved tamoxifen dose (40 mg/day). Avoid CYP2D6 inhibitors. Please consult a clinical pharmacist for more information."}	1
6351124	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25"}	RxNorm:10324	{"This patient is predicted to have lower than normal CYP2D6 activity and may be at an increased risk of a poor tamoxifen response due to low endoxifen (active component of tamoxifen) concentrations. Consider hormonal therapy such as an aromatase inhibitor for postmenopausal women or aromatase inhibitor along with ovarian function suppression in premenopausal women. If aromatase inhibitor use is contraindicated, consideration should be given to use a higher but FDA approved tamoxifen dose (40 mg/day). Avoid CYP2D6 inhibitors. Please consult a clinical pharmacist for more information."}	1
6351125	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0"}	RxNorm:10324	{"This patient is predicted to be a CYP2D6 poor metabolizer and may be at an increased risk of a poor tamoxifen response due to low endoxifen (active component of tamoxifen) concentrations. Recommend alternative hormonal therapy such as an aromatase inhibitor for postmenopausal women or aromatase inhibitor along with ovarian function suppression in premenopausal women. Note, higher dose tamoxifen (40 mg/day) increases but does not normalize endoxifen concentrations in CYP2D6 poor metabolizers. Please consult a clinical pharmacist for more information."}	1
6351126	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a"}	RxNorm:10324	{n/a}	1
6351127	general	Pre-test	{CYP2C9}	{}	{"CYP2C9": "No Result"}	{}	{"CYP2C9": "No Result"}	RxNorm:37790	{"CYP2C9 genotype may be important for Tenoxicam dosing and use. A CYP2C9 genotype does not appear to have been ordered for this patient. Use of an alternative agent or dose may be recommended. Please consult a clinical pharmacist for more information."}	1
6351128	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0"}	RxNorm:37790	{n/a}	1
6351129	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "1.5"}	{}	{"CYP2C9": "1.5"}	RxNorm:37790	{n/a}	1
6351130	general	Post-test	{CYP2C9}	{}	{"CYP2C9": "1.0"}	{}	{"CYP2C9": "1.0"}	RxNorm:37790	{"Based on the genotype result, this patient is predicted to be a CYP2C9 Intermediate Metabolizer with an activity score of 1 and is expected to have higher plasma concentrations of Tenoxicam which may increase the risk of toxicities. Choose an alternative therapy not metabolized by CYP2C9 or not significantly impacted by CYP2C9 genetic variants in vivo or choose an NSAID metabolized by CYP2C9 but with a shorter half-life (such as celecoxib, flurbiprofen, lornoxicam, or ibuprofen). Please consult a clinical pharmacist for more information."}	1
6351131	general	Post-test	{CYP2C9}	{}	{"CYP2C9": "0.5"}	{}	{"CYP2C9": "0.5"}	RxNorm:37790	{"Based on the genotype result, this patient is predicted to be a CYP2C9 Poor Metabolizer with an activity score of 0.5 and is expected to have higher plasma concentrations of Tenoxicam which may increase the risk of toxicities. Choose an alternative therapy not metabolized by CYP2C9 or not significantly impacted by CYP2C9 genetic variants in vivo or choose an NSAID metabolized by CYP2C9 but with a shorter half-life (such as celecoxib, flurbiprofen, lornoxicam, or ibuprofen). Please consult a clinical pharmacist for more information."}	1
6351132	general	Post-test	{CYP2C9}	{}	{"CYP2C9": "0.0"}	{}	{"CYP2C9": "0.0"}	RxNorm:37790	{"Based on the genotype result, this patient is predicted to be a CYP2C9 Poor Metabolizer with an activity score of 0 and is expected to have higher plasma concentrations of Tenoxicam which may increase the risk of toxicities. Choose an alternative therapy not metabolized by CYP2C9 or not significantly impacted by CYP2C9 genetic variants in vivo or choose an NSAID metabolized by CYP2C9 but with a shorter half-life (such as celecoxib, flurbiprofen, lornoxicam, or ibuprofen). Please consult a clinical pharmacist for more information."}	1
6351133	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a"}	RxNorm:37790	{n/a}	1
6351134	general	Pre-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "No Result"}	RxNorm:10834	{"CYP2C19 genotype may be important for trimipramine dosing and use. A CYP2C19 genotype does not appear to have been ordered for this patient. Use of an alternative agent or dose may be recommended. Please consult a clinical pharmacist for more information."}	1
6351620	general	Pre-test	{CYP2C9}	{}	{"CYP2C9": "No Result"}	{}	{"CYP2C9": "No Result"}	RxNorm:41493	{"CYP2C9 genotype may be important for meloxicam dosing and use. A CYP2C9 genotype does not appear to have been ordered for this patient. Use of an alternative agent or dose may be recommended. Please consult a clinical pharmacist for more information."}	1
6351135	general	Pre-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "No Result"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. Neither a CYP2D6 nor CYP2C19 genotype appears to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6351136	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "No Result"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6351137	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "No Result"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6351138	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "No Result"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6351139	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "No Result"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6351140	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "No Result"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6351141	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "No Result"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6351142	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "No Result"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6351143	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "No Result"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6351501	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0"}	RxNorm:2670	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at increased risk of developing toxicities to codeine and tramadol. Consider selecting an alternative analgesic agent. If opioid use is warranted, avoid codeine and tramadol. Please consult a clinical pharmacist for more information."}	1
6351144	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "No Result"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6351145	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "No Result"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6351146	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "No Result"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6351147	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "No Result"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Because a CYP2C19 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6351148	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "No Result"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Because a CYP2C19 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6351149	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "No Result"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Because a CYP2C19 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6351150	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "No Result"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Because a CYP2C19 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6351151	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "No Result"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Because a CYP2C19 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6351152	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "No Result"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6351153	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "No Result"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6351621	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0"}	RxNorm:41493	{n/a}	1
6351154	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "No Result"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6351155	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "No Result"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6351156	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "No Result"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 poor metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If trimipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6351157	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a likely CYP2C19 poor metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If trimipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351158	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a likely CYP2C19 poor metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If trimipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Because a CYP2D6 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6351159	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351160	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351161	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351162	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351163	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351622	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "1.5"}	{}	{"CYP2C9": "1.5"}	RxNorm:41493	{n/a}	1
6351164	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351165	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351166	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351167	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351168	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351169	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351170	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a likely CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If trimipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351171	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a likely CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If trimipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351172	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a likely CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If trimipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351173	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a likely CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If trimipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351174	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a likely CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If trimipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351175	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 poor metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351176	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 poor metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351177	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 poor metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351178	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 poor metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351179	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 poor metabolizer and a likely CYP2C19 poor metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351180	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a likely CYP2C19 intermediate metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2C19 result. Because a CYP2D6 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6351181	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
6351182	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351183	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351184	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351185	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351186	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351187	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351188	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351189	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351190	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351191	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351192	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351193	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
6351194	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
6351195	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
6351196	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
6351197	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
6351198	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 intermediate metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351199	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 intermediate metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351200	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 intermediate metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351201	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 intermediate metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351202	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 poor metabolizer and a likely CYP2C19 intermediate metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351203	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Indeterminate"}	RxNorm:10834	{n/a}	1
6351204	general	Pre-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Indeterminate"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. CYP2D6 genotype does not appear to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6351205	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Indeterminate"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351206	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Indeterminate"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351207	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Indeterminate"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351208	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Indeterminate"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351209	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Indeterminate"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351210	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Indeterminate"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351211	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Indeterminate"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351212	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Indeterminate"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351213	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Indeterminate"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351214	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Indeterminate"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351215	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Indeterminate"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351216	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Indeterminate"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Please consult a clinical pharmacist for more information."}	1
6351217	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Indeterminate"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Please consult a clinical pharmacist for more information."}	1
6351218	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Indeterminate"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Please consult a clinical pharmacist for more information."}	1
6351219	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Indeterminate"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Please consult a clinical pharmacist for more information."}	1
6351220	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Indeterminate"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Please consult a clinical pharmacist for more information."}	1
6351502	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0"}	RxNorm:2670	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at increased risk of developing toxicities to codeine and tramadol. Consider selecting an alternative analgesic agent. If opioid use is warranted, avoid codeine and tramadol. Please consult a clinical pharmacist for more information."}	1
6351221	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Indeterminate"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351222	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Indeterminate"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments.Please consult a clinical pharmacist for more information."}	1
6351223	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Indeterminate"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351224	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Indeterminate"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351225	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Indeterminate"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 poor metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If trimipramine is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351226	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2C19 ultarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351227	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2C19 ultarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2D6 genotype does not appear to have been ordered for this patient. CYP2D6 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6351228	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351229	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351230	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351503	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75"}	RxNorm:2670	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at increased risk of developing toxicities to codeine and tramadol. Consider selecting an alternative analgesic agent. If opioid use is warranted, avoid codeine and tramadol. Please consult a clinical pharmacist for more information."}	1
6351231	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351232	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351233	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351234	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351235	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351236	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351237	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351238	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351239	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and CYP2C19 ultrarapid metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351240	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and CYP2C19 ultrarapid metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351546	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "1.5"}	{}	{"CYP2C9": "1.5"}	RxNorm:4502	{n/a}	1
6351241	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and CYP2C19 ultrarapid metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351242	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and CYP2C19 ultrarapid metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351243	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and CYP2C19 ultrarapid metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351244	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a CYP2C19 ultrarapid metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351245	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a CYP2C19 ultrarapid metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351246	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a CYP2C19 ultrarapid metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351247	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a CYP2C19 ultrarapid metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351248	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 poor metabolizer and a CYP2C19 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351249	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Rapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2C19 rapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351250	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Rapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2C19 rapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2D6 genotype does not appear to have been ordered for this patient. CYP2D6 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
6351568	Hydrocodone	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	RxNorm:5489	{n/a}	1
6351251	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Rapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 rapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351252	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Rapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 rapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351253	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Rapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 rapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6351254	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Rapid Metabolizer"}	RxNorm:10834	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 rapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
