6728242	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Normal Function"}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0", "SLCO1B1": "Normal Function"}	RxNorm:41127	{n/a}	1
6728243	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
6728244	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
6728245	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Normal Function"}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a", "SLCO1B1": "Normal Function"}	RxNorm:41127	{n/a}	1
6728246	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
6728247	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
6728248	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
6728249	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
6728250	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
6728251	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
6728252	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
6728253	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
6728254	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
6728255	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
6728256	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Increased Function"}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0", "SLCO1B1": "Increased Function"}	RxNorm:41127	{n/a}	1
6728257	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
6728258	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
6728259	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Increased Function"}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a", "SLCO1B1": "Increased Function"}	RxNorm:41127	{n/a}	1
6728260	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
6728616	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
6728261	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
6728262	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
6728263	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Possible Decreased Function"}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0", "SLCO1B1": "Possible Decreased Function"}	RxNorm:41127	{n/a}	1
6728264	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
6728265	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
6728266	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
6728267	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0"}	RxNorm:42355	{n/a}	1
6728268	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0"}	RxNorm:42355	{n/a}	1
6728269	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0"}	RxNorm:42355	{n/a}	1
6728270	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75"}	RxNorm:42355	{n/a}	1
6728271	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5"}	RxNorm:42355	{n/a}	1
6728272	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25"}	RxNorm:42355	{n/a}	1
6728273	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0"}	RxNorm:42355	{n/a}	1
6728274	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0"}	RxNorm:42355	{n/a}	1
6728275	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0"}	RxNorm:42355	{n/a}	1
6728276	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75"}	RxNorm:42355	{n/a}	1
6728277	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5"}	RxNorm:42355	{n/a}	1
6728278	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	RxNorm:42355	{n/a}	1
6728279	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	RxNorm:42355	{n/a}	1
6728280	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	RxNorm:42355	{n/a}	1
6728281	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	RxNorm:42355	{n/a}	1
6728282	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	RxNorm:42355	{n/a}	1
6728283	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0"}	RxNorm:42355	{n/a}	1
6728284	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75"}	RxNorm:42355	{n/a}	1
6728285	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5"}	RxNorm:42355	{n/a}	1
6728286	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25"}	RxNorm:42355	{n/a}	1
6728287	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
6728288	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a"}	RxNorm:42355	{n/a}	1
6729418	general	No CDS	{CYP2D6}	{"CYP2D6": "Normal Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	RxNorm:6918	{n/a}	1
6728291	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
6728292	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
6728293	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
6728294	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
6728295	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
6728296	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
6728297	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
6728298	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
6728299	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
6728300	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
6728301	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
6728302	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
6729419	general	No CDS	{CYP2D6}	{"CYP2D6": "Intermediate Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0"}	RxNorm:6918	{n/a}	1
6728303	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
6728304	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
6728305	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
6728306	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
6728307	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
6728308	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
6728309	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
6728310	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
6728311	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
6728312	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
6728313	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
6728314	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
6728318	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
6728319	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
6728320	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
6728321	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
6728322	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
6728323	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
6728324	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
6728325	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
6728326	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
6729420	general	No CDS	{CYP2D6}	{"CYP2D6": "Intermediate Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75"}	RxNorm:6918	{n/a}	1
6728327	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
6728328	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
6728329	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
6728330	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
6728331	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
6728332	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
6728333	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
6728334	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
6728335	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
6728336	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
6729421	general	No CDS	{CYP2D6}	{"CYP2D6": "Intermediate Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5"}	RxNorm:6918	{n/a}	1
6728337	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
6728338	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
6728339	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
6728340	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
6728341	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
6728342	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
6728343	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
6728344	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
6728345	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
6728346	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
6729422	general	No CDS	{CYP2D6}	{"CYP2D6": "Intermediate Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25"}	RxNorm:6918	{n/a}	1
6728347	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
6728348	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
6728349	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
6728350	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
6728351	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
6728352	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
6728353	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
6728354	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
6728355	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
6728356	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
6729654	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0"}	RxNorm:39786	{n/a}	1
6728357	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
6728358	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
6728359	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
6728360	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
6728361	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
6728362	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
6728363	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
6728364	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
6728365	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
6728366	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
6728367	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
6729655	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0"}	RxNorm:39786	{n/a}	1
6728368	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
6728369	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
6728370	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
6728371	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
6728372	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
6728373	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
6728374	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
6728375	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
6728376	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
6728377	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
6728378	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
6728379	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
6728380	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
6728392	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
6728381	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
6728382	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
6728383	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
6728384	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
6728385	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Indeterminate"}	RxNorm:5691	{n/a}	1
6728386	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
6728387	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
6728388	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
6728389	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
6728390	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
6728391	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
6729656	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0"}	RxNorm:39786	{n/a}	1
6729657	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75"}	RxNorm:39786	{n/a}	1
6728393	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
6728394	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
6728395	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
6728396	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
6728397	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
6728398	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
6728399	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
6728400	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
6728401	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
6728402	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
6728403	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
6728404	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
6728405	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
6728406	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
6728407	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
6728408	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
6728409	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
6728410	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
6728411	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
6728412	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
6728413	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
6728414	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
6729658	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5"}	RxNorm:39786	{n/a}	1
6729659	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	RxNorm:39786	{n/a}	1
6728415	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
6728416	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
6728417	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
6728418	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
6728419	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
6728420	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
6728421	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
6728422	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
6728423	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
6728424	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
6729660	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	RxNorm:39786	{n/a}	1
6728425	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
6728426	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
6728427	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
6728428	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
6728429	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
6728430	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
6728431	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
6728432	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
6728433	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
6728434	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
6729661	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	RxNorm:39786	{n/a}	1
6728435	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
6728436	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
6728437	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
6728438	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
6728439	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
6728440	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
6728441	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
6728442	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
6728443	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
6728444	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
6728617	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
6728445	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
6728446	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
6728447	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
6728448	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
6728449	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
6728450	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
6728451	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
6728452	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
6728453	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
6728454	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
6729662	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	RxNorm:39786	{n/a}	1
6728455	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
6728456	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
6728457	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
6728458	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
6728459	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
6728460	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
6728461	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
6728462	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
6728463	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
6728464	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
6728465	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
6729663	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	RxNorm:39786	{n/a}	1
6728466	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
6728467	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
6728468	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
6728469	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
6728470	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
6728471	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
6728472	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
6728473	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
6728474	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
6728475	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
6728476	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
6728477	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
6728478	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{n/a}	1
6728479	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
6728480	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
6728481	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
6728482	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
6728483	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
6728484	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
6728485	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
6728537	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
6728486	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
6728487	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
6728488	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
6728489	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
6728490	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{n/a}	1
6728491	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{n/a}	1
6728492	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{n/a}	1
6728493	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{n/a}	1
6728494	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{n/a}	1
6728495	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
6728496	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
6728497	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
6728498	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
6728538	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2C19": "Normal Metabolizer"}	RxNorm:17128	{n/a}	1
6728747	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
6728499	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
6728500	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
6728501	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
6728502	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
6728503	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
6728504	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
6728505	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
6728506	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
6728507	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
6728508	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
6728509	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
6728619	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
6728510	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
6728511	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
6728512	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
6728513	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
6728514	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
6728515	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
6728516	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
6728517	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
6728518	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
6728519	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
6728520	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
6728521	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
6728522	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
6728539	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
6728523	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
6728524	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
6728525	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
6728526	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
6728527	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
6728528	general	No CDS	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:6026	{n/a}	1
6728529	H.pylori_erosive eso	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:17128	{n/a}	1
6728530	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
6728531	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
6728532	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
6728533	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
6728534	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
6728535	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
6728536	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
6728540	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2C19": "Rapid Metabolizer"}	RxNorm:17128	{n/a}	1
6728542	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
6728543	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
6728544	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
6728545	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
6728546	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:17128	{n/a}	1
6728547	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
6728548	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Increased Function"}	{}	{}	{"SLCO1B1": "Increased Function"}	RxNorm:6472	{n/a}	1
6728549	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Normal Function"}	{}	{}	{"SLCO1B1": "Normal Function"}	RxNorm:6472	{n/a}	1
6728550	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
6728551	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
6728552	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
6728553	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Indeterminate"}	{}	{}	{"SLCO1B1": "Indeterminate"}	RxNorm:6472	{n/a}	1
6728554	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
6728555	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
6728556	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
6728557	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
6728562	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
6728563	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
6728564	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
6728565	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
6728566	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
6728567	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
6728568	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
6728569	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
6728570	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
6728571	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
6728572	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	RxNorm:7531	{n/a}	1
6728573	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	RxNorm:7531	{n/a}	1
6728574	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	RxNorm:7531	{n/a}	1
6728575	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	RxNorm:7531	{n/a}	1
6728576	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	RxNorm:7531	{n/a}	1
6728577	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
6728618	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
6728578	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
6728579	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
6728580	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
6728581	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
6728582	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a"}	RxNorm:7531	{n/a}	1
6728583	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
6728584	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
6728585	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
6728586	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
6728587	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
6728588	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
6728589	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
6728590	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
6728591	H.pylori_erosive eso	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:7646	{n/a}	1
6728592	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
6728593	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
6728594	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2C19": "Rapid Metabolizer"}	RxNorm:7646	{n/a}	1
6728595	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2C19": "Normal Metabolizer"}	RxNorm:7646	{n/a}	1
6728596	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
6728597	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
6728598	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
6728599	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
6728600	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:7646	{n/a}	1
6728601	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25"}	RxNorm:26225	{n/a}	1
6728602	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0"}	RxNorm:26225	{n/a}	1
6728603	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a"}	RxNorm:26225	{n/a}	1
6728604	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	RxNorm:26225	{n/a}	1
6728605	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	RxNorm:26225	{n/a}	1
6728606	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	RxNorm:26225	{n/a}	1
6728607	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	RxNorm:26225	{n/a}	1
6728608	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	RxNorm:26225	{n/a}	1
6728609	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0"}	RxNorm:26225	{n/a}	1
6728610	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75"}	RxNorm:26225	{n/a}	1
6728611	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5"}	RxNorm:26225	{n/a}	1
6728612	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
6728613	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
6728614	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
6728615	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
6728620	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
6728621	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
6728622	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
6728623	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
6728624	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
6728625	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
6728626	general	No CDS	{HLA-B}	{}	{}	{"HLA-B": "*15:02 negative"}	{"HLA-B": "*15:02 negative"}	RxNorm:32624	{n/a}	1
6728627	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
6728628	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
6728629	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
6728630	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
6728631	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
6728632	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
6728633	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
6728634	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
6728635	H.pylori_erosive eso	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:40790	{n/a}	1
6728636	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
6728637	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
6728638	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2C19": "Rapid Metabolizer"}	RxNorm:40790	{n/a}	1
6728639	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2C19": "Normal Metabolizer"}	RxNorm:40790	{n/a}	1
6728640	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
6728641	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
6728642	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
6728643	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
6728644	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:40790	{n/a}	1
6728645	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
6728646	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
6728647	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
6728648	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
6728649	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
6728742	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Rapid Metabolizer"}	RxNorm:36437	{n/a}	1
6728650	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
6728651	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
6728652	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
6728653	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
6728654	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
6728655	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
6728656	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
6728657	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	RxNorm:32937	{n/a}	1
6728658	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	RxNorm:32937	{n/a}	1
6728659	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	RxNorm:32937	{n/a}	1
6728660	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	RxNorm:32937	{n/a}	1
6728661	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	RxNorm:32937	{n/a}	1
6728662	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
6728663	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
6728664	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
6728665	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
6728666	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
6728667	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a"}	RxNorm:32937	{n/a}	1
6728668	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
6728743	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Rapid Metabolizer"}	RxNorm:36437	{n/a}	1
6728669	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
6728670	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
6728671	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
6728672	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
6728673	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
6728674	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
6728675	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
6728676	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
6728677	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
6728678	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
6728679	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
6728680	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
6728744	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Indeterminate", "CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2B6": "Indeterminate", "CYP2C19": "Rapid Metabolizer"}	RxNorm:36437	{n/a}	1
6728681	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
6728682	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
6728683	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
6728684	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
6728685	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
6728686	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
6728687	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
6728688	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
6728689	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
6728690	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0"}	RxNorm:8356	{n/a}	1
6728691	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "1.5"}	{}	{"CYP2C9": "1.5"}	RxNorm:8356	{n/a}	1
6728692	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
6728693	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
6728694	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
6728695	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a"}	RxNorm:8356	{n/a}	1
6728696	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
6728697	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Increased Function"}	{}	{}	{"SLCO1B1": "Increased Function"}	RxNorm:861634	{n/a}	1
6728698	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Normal Function"}	{}	{}	{"SLCO1B1": "Normal Function"}	RxNorm:861634	{n/a}	1
6728699	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
6728700	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
6728701	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
6728702	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Indeterminate"}	{}	{}	{"SLCO1B1": "Indeterminate"}	RxNorm:861634	{n/a}	1
6728703	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
6728704	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Increased Function"}	{}	{}	{"SLCO1B1": "Increased Function"}	RxNorm:42463	{n/a}	1
6728705	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Normal Function"}	{}	{}	{"SLCO1B1": "Normal Function"}	RxNorm:42463	{n/a}	1
6728706	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Decreased Function"}	{}	{}	{"SLCO1B1": "Decreased Function"}	RxNorm:42463	{n/a}	1
6728707	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Possible Decreased Function"}	{}	{}	{"SLCO1B1": "Possible Decreased Function"}	RxNorm:42463	{n/a}	1
6728708	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
6728709	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Indeterminate"}	{}	{}	{"SLCO1B1": "Indeterminate"}	RxNorm:42463	{n/a}	1
6728710	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
6728711	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
6728745	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
6728712	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
6728713	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
6728714	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
6728715	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
6728716	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
6728717	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
6728718	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Decreased Function", "SLCO1B1": "Decreased Function"}	{}	{}	{"ABCG2": "Decreased Function", "SLCO1B1": "Decreased Function"}	RxNorm:301542	{n/a}	1
6728719	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Normal Function", "SLCO1B1": "Decreased Function"}	{}	{}	{"ABCG2": "Normal Function", "SLCO1B1": "Decreased Function"}	RxNorm:301542	{n/a}	1
6728720	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
6728721	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
6728722	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Decreased Function", "SLCO1B1": "Normal Function"}	{}	{}	{"ABCG2": "Decreased Function", "SLCO1B1": "Normal Function"}	RxNorm:301542	{n/a}	1
6728723	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Normal Function", "SLCO1B1": "Normal Function"}	{}	{}	{"ABCG2": "Normal Function", "SLCO1B1": "Normal Function"}	RxNorm:301542	{n/a}	1
6728724	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
6728725	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
6728726	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
6728727	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
6728728	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
6728729	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
6728730	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Decreased Function", "SLCO1B1": "Possible Decreased Function"}	{}	{}	{"ABCG2": "Decreased Function", "SLCO1B1": "Possible Decreased Function"}	RxNorm:301542	{n/a}	1
6728731	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Normal Function", "SLCO1B1": "Possible Decreased Function"}	{}	{}	{"ABCG2": "Normal Function", "SLCO1B1": "Possible Decreased Function"}	RxNorm:301542	{n/a}	1
6728732	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
6728733	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
6728734	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Decreased Function", "SLCO1B1": "Increased Function"}	{}	{}	{"ABCG2": "Decreased Function", "SLCO1B1": "Increased Function"}	RxNorm:301542	{n/a}	1
6728735	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Normal Function", "SLCO1B1": "Increased Function"}	{}	{}	{"ABCG2": "Normal Function", "SLCO1B1": "Increased Function"}	RxNorm:301542	{n/a}	1
6728736	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
6728737	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
6728738	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	RxNorm:36437	{n/a}	1
6728739	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Normal Metabolizer"}	RxNorm:36437	{n/a}	1
6728740	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Normal Metabolizer"}	RxNorm:36437	{n/a}	1
6728741	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Rapid Metabolizer"}	RxNorm:36437	{n/a}	1
6728748	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
6728749	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
6728750	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
6728751	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
6728752	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
6728753	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
6728754	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
6728755	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
6728756	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:36437	{n/a}	1
6728757	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:36437	{n/a}	1
6728758	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:36437	{n/a}	1
6728759	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Indeterminate", "CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2B6": "Indeterminate", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:36437	{n/a}	1
6728760	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
6728761	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
6728800	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
6728762	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
6728763	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
6728764	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Indeterminate", "CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2B6": "Indeterminate", "CYP2C19": "Normal Metabolizer"}	RxNorm:36437	{n/a}	1
6728765	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
6728766	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:36437	{n/a}	1
6728767	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:36437	{n/a}	1
6728768	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
6728769	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
6728770	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
6728771	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
6728772	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
6728773	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:36437	{n/a}	1
6728774	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:36437	{n/a}	1
6728775	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
6728776	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
6728777	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
6728778	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
6728779	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
6728780	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
6728781	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
6728782	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
6728783	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
6728784	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
6728785	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
6728786	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
6728787	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
6728788	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
6728789	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
6728790	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
6728791	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
6728792	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
6728793	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
6728794	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Indeterminate"}	{}	{}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Indeterminate"}	RxNorm:36437	{n/a}	1
6728795	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Indeterminate"}	{}	{}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Indeterminate"}	RxNorm:36437	{n/a}	1
6728796	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Indeterminate"}	{}	{}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Indeterminate"}	RxNorm:36437	{n/a}	1
6728797	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
6728798	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
6728799	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Indeterminate", "CYP2C19": "Indeterminate"}	{}	{}	{"CYP2B6": "Indeterminate", "CYP2C19": "Indeterminate"}	RxNorm:36437	{n/a}	1
6728801	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
6728802	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
6728803	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
6728804	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
6728805	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
6728806	general	No CDS	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:36453	{n/a}	1
6728807	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
6728808	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Increased Function"}	{}	{}	{"SLCO1B1": "Increased Function"}	RxNorm:36567	{n/a}	1
6728809	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Normal Function"}	{}	{}	{"SLCO1B1": "Normal Function"}	RxNorm:36567	{n/a}	1
6728810	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
6728811	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
6728812	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
6728813	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Indeterminate"}	{}	{}	{"SLCO1B1": "Indeterminate"}	RxNorm:36567	{n/a}	1
6728814	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
6728815	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
6728816	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
6728817	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
6728818	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
6728819	general	No CDS	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:10154	{n/a}	1
6728820	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
6728821	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
6728822	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
6728823	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
6728824	general	No CDS	{CYP3A5}	{"CYP3A5": "Poor Metabolizer"}	{}	{}	{"CYP3A5": "Poor Metabolizer"}	RxNorm:42316	{n/a}	1
6728825	general	No CDS	{CYP3A5}	{"CYP3A5": "Indeterminate"}	{}	{}	{"CYP3A5": "Indeterminate"}	RxNorm:42316	{n/a}	1
6728826	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0"}	RxNorm:10324	{n/a}	1
6728827	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5"}	RxNorm:10324	{n/a}	1
6728828	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25"}	RxNorm:10324	{n/a}	1
6728829	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0"}	RxNorm:10324	{n/a}	1
6728830	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0"}	RxNorm:10324	{n/a}	1
6728831	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75"}	RxNorm:10324	{n/a}	1
6728832	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0"}	RxNorm:10324	{n/a}	1
6728833	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5"}	RxNorm:10324	{n/a}	1
6728834	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	RxNorm:10324	{n/a}	1
6728835	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	RxNorm:10324	{n/a}	1
6728836	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	RxNorm:10324	{n/a}	1
6728837	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	RxNorm:10324	{n/a}	1
6728838	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	RxNorm:10324	{n/a}	1
6728839	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
6728840	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0"}	RxNorm:10324	{n/a}	1
6728841	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0"}	RxNorm:10324	{n/a}	1
6728842	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75"}	RxNorm:10324	{n/a}	1
6728843	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
6728844	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
6728845	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
6728846	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
6728847	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
6728848	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a"}	RxNorm:10324	{n/a}	1
6728849	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
6728850	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0"}	RxNorm:37790	{n/a}	1
6728851	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "1.5"}	{}	{"CYP2C9": "1.5"}	RxNorm:37790	{n/a}	1
6728852	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
6728853	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
6728854	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
6728855	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a"}	RxNorm:37790	{n/a}	1
6728856	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
6729473	general	Pre-test	{MT-RNR1}	{"MT-RNR1": "No Result"}	{}	{}	{"MT-RNR1": "No Result"}	RxNorm:2049549	{"A MT-RNR1 genotype does not appear to have been ordered for this patient. MT-RNR1 genotype may be an important risk factor for aminoglycoside-induced hearing loss. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6728857	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
6728858	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
6728859	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
6728860	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
6728861	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
6728862	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
6728863	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
6728864	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
6728865	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
6729223	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
6728866	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
6728867	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
6728868	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
6728869	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
6728870	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
6728871	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
6728872	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
6728873	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
6728874	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
6728875	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
6728876	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
6728877	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
6728878	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
6728879	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
6728880	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
6728881	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
6728882	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
6728883	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
6728884	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
6728885	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
6728886	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
6728887	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
6728888	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
6728889	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
6728890	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
6728891	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
6728892	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
6728893	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
6728894	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
6728895	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
6728896	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
6728897	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
6728898	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
6728899	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
6728900	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
6728901	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
6728902	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
6728903	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
6728904	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
6728905	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
6728906	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
6728907	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
6728908	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
6728909	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
6728910	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
6728911	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
6728912	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
6728913	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
6728914	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
6728915	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
6728916	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
6728917	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
6728918	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
6728919	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
6728920	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
6728921	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
6728922	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
6728923	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
6728924	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
6728925	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Indeterminate"}	RxNorm:10834	{n/a}	1
6728926	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
6728927	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
6728928	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
6728929	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
6728930	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
6728931	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
6728932	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
6728933	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
6728934	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
6728935	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
6728936	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
6728937	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
6728938	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
6728939	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
6728940	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
6728941	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
6728942	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
6729224	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
6728943	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
6728944	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
6728945	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
6728946	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
6728947	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
6728948	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
6728949	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
6728950	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
6728951	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
6728952	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
6729225	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
6728953	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
6728954	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
6728955	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
6728956	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
6728957	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
6728958	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
6728959	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
6728960	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
6728961	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
6728962	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
6729268	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "1.5"}	{}	{"CYP2C9": "1.5"}	RxNorm:4502	{n/a}	1
6728963	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
6728964	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
6728965	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
6728966	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
6728967	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
6728968	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
6728969	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
6728970	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
6728971	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
6728972	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
6728973	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
6728974	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
6728975	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
6728976	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
6728977	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "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
6728978	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "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
6728979	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "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
6728980	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
6728981	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "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
6728982	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "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
6729289	<50mg TDD HTN	Pre-test	{NAT2}	{"NAT2": "No Result"}	{}	{}	{"NAT2": "No Result"}	RxNorm:5470	{"The patient's NAT2 genotype may be important for hydralazine dosing in the setting of resistant hypertension. A NAT2 genotype does not appear to have been ordered for this patient. Please consult a clinical pharmacist for more information."}	1
6728983	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "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
6728984	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "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 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 trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6728985	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "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 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 trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6728986	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "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 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 trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6728987	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "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 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 trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6728988	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "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 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 trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6728989	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "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 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 trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6728990	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "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 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 trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6728991	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "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 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 trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6728992	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "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 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 trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6728993	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "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 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 trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6728994	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "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 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
6728995	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "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 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
6728996	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "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 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
6728997	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "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 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
6728998	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "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 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
6728999	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "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 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
6729000	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "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 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
6729001	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "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 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
6729002	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "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 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
6729003	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "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 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
6729004	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "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 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
6729005	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "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 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
6729006	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "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 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
6729007	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "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 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
6729008	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "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 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
6729009	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "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 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
6729010	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "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 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
6729011	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "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 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
6729012	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "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 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
6729013	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "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 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
6729014	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "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 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
6729015	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "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 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
6729016	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "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 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
6729017	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Normal 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 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
6729018	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Normal Metabolizer"}	RxNorm:10834	{n/a}	1
6729019	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Normal 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 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 trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6729020	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Normal 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 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 trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6729021	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Normal 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 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 trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6729022	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Normal 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 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 trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6729023	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Normal 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 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 trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6729037	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Normal 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 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
6729024	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Normal 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 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 trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6729025	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Normal 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 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 trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6729026	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Normal 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 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 trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6729027	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Normal 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 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 trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6729028	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Normal 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 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 trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6729029	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Normal 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 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 trimipramine is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
6729030	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Normal Metabolizer"}	RxNorm:10834	{n/a}	1
6729031	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Normal Metabolizer"}	RxNorm:10834	{n/a}	1
6729032	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Normal Metabolizer"}	RxNorm:10834	{n/a}	1
6729033	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Normal Metabolizer"}	RxNorm:10834	{n/a}	1
6729034	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Normal Metabolizer"}	RxNorm:10834	{n/a}	1
6729035	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Normal 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 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
6729036	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Normal 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 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
6729063	adults	Pre-test	{CYP2C19}	{"CYP2C19": "No Result"}	{}	{}	{"CYP2C19": "No Result"}	RxNorm:121243	{"CYP2C19 genotype may be important for voriconazole dosing and use. 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
6729038	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Normal 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 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
6729039	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Normal 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 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 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
6729040	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "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 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
6729041	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
6729042	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "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 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
6729043	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "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 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
6729044	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "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 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
6729045	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "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 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
6729046	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "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 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
6729047	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "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 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
6729048	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "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 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
6729097	aspirin <1g	No CDS	{G6PD}	{"G6PD": "No Result"}	{}	{}	{"G6PD": "No Result"}	RxNorm:1191	{n/a}	1
6729098	aspirin <1g	No CDS	{G6PD}	{"G6PD": "Normal"}	{}	{}	{"G6PD": "Normal"}	RxNorm:1191	{n/a}	1
6729049	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "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 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
6729050	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "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 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
6729051	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "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 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
6729052	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "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 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
6729053	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
6729054	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
6729055	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
6729056	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
6729057	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
6729058	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "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 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
6729059	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "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 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
6729060	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "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 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
6729061	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "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 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
6729062	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "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 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
6729064	adults	Post-test	{CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:121243	{"Based on the genotype result, this patient is predicted to be a CYP2C19 ultrarapid metabolizer, and the probability of attainment of therapeutic concentrations is small. Choose an alternative agent that is not dependent on CYP2C19 metabolism as primary therapy instead of voriconazole such as isavuconazole, liposomal amphotericin B or posaconazole. Selection of an alternative agent should be based upon other clinical factors such as drug interactions, hepatic and/or renal function, suspected or documented fungal species, site of infection, and comorbidities. Please consult a clinical pharmacist for more information."}	1
6729065	adults	Post-test	{CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2C19": "Rapid Metabolizer"}	RxNorm:121243	{"Based on the genotype result, this patient is predicted to be a CYP2C19 rapid metabolizer, and the probability of attainment of therapeutic concentrations is modest. Choose an alternative agent that is not dependent on CYP2C19 metabolism as primary therapy instead of voriconazole such as isavuconazole, liposomal amphotericin B or posaconazole. Selection of an alternative agent should be based upon other clinical factors such as drug interactions, hepatic and/or renal function, suspected or documented fungal species, site of infection, and comorbidities. Please consult a clinical pharmacist for more information."}	1
6729066	adults	No CDS	{CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2C19": "Normal Metabolizer"}	RxNorm:121243	{n/a}	1
6729067	adults	No CDS	{CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:121243	{n/a}	1
6729068	adults	No CDS	{CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Intermediate Metabolizer"}	RxNorm:121243	{n/a}	1
6729069	adults	Post-test	{CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{}	{}	{"CYP2C19": "Likely Poor Metabolizer"}	RxNorm:121243	{"Based on the genotype result, this patient is predicted to be a likely CYP2C19 poor metabolizer, and higher than normal trough concentrations of voriconazole are likely and may increase the probability of adverse reactions. Choose an alternative agent that is not dependent on CYP2C19 metabolism as primary therapy instead of voriconazole such as isavuconazole, liposomal amphotericin B or posaconazole. Selection of an alternative agent should be based upon other clinical factors such as drug interactions, hepatic and/or renal function, suspected or documented fungal species, site of infection, and comorbidities. Where voriconazole is strongly indicated for treatment of an invasive mycosis, administration of a lower dosage with meticulous therapeutic drug monitoring may be feasible. Please consult a clinical pharmacist for more information."}	1
6729070	adults	Post-test	{CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{}	{}	{"CYP2C19": "Poor Metabolizer"}	RxNorm:121243	{"Based on the genotype result, this patient is predicted to be a CYP2C19 poor metabolizer, and higher than normal trough concentrations of voriconazole are likely and may increase the probability of adverse reactions. Choose an alternative agent that is not dependent on CYP2C19 metabolism as primary therapy instead of voriconazole such as isavuconazole, liposomal amphotericin B or posaconazole. Selection of an alternative agent should be based upon other clinical factors such as drug interactions, hepatic and/or renal function, suspected or documented fungal species, site of infection, and comorbidities. Where voriconazole is strongly indicated for treatment of an invasive mycosis, administration of a lower dosage with meticulous therapeutic drug monitoring may be feasible. Please consult a clinical pharmacist for more information."}	1
6729071	adults	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:121243	{n/a}	1
6729072	pediatrics	Pre-test	{CYP2C19}	{"CYP2C19": "No Result"}	{}	{}	{"CYP2C19": "No Result"}	RxNorm:121243	{"CYP2C19 genotype may be important for voriconazole dosing and use. 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
6729073	pediatrics	Post-test	{CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:121243	{"Based on the genotype result, this patient is predicted to be a CYP2C19 ultrarapid metabolizer, and the probability of attainment of therapeutic concentrations is small. Choose an alternative agent that is not dependent on CYP2C19 metabolism as primary therapy instead of voriconazole such as liposomal amphotericin B or posaconazole. Selection of an alternative agent should be based upon other clinical factors such as drug interactions, hepatic and/or renal function, suspected or documented fungal species, site of infection, and comorbidities. Please consult a clinical pharmacist for more information."}	1
6729074	pediatrics	Post-test	{CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2C19": "Rapid Metabolizer"}	RxNorm:121243	{"Based on the genotype result, this patient is predicted to be a CYP2C19 rapid metabolizer, and the probability of attainment of therapeutic concentrations is variable. Initiate therapy with recommended standard of care dosing. Meticulous therapeutic drug monitoring to titrate dose to therapeutic trough concentrations is critical due to large variability in trough concentrations in rapid metabolizers. Please consult a clinical pharmacist for more information."}	1
6729075	pediatrics	No CDS	{CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2C19": "Normal Metabolizer"}	RxNorm:121243	{n/a}	1
6729076	pediatrics	No CDS	{CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:121243	{n/a}	1
6729077	pediatrics	No CDS	{CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Intermediate Metabolizer"}	RxNorm:121243	{n/a}	1
6729099	aspirin <1g	No CDS	{G6PD}	{"G6PD": "Deficient"}	{}	{}	{"G6PD": "Deficient"}	RxNorm:1191	{n/a}	1
6729100	aspirin <1g	Post-test	{G6PD}	{"G6PD": "Deficient with CNSHA"}	{}	{}	{"G6PD": "Deficient with CNSHA"}	RxNorm:1191	{"This patient has a result consistent with G6PD deficiency with chronic nonspherocytic hemolytic anemia (CNSHA). Increased monitoring for worsening of hemolytic anemia may be indicated for patients with G6PD deficiency with CNSHA who receive medications. Please consult a clinical pharmacist for more information."}	1
6729078	pediatrics	Post-test	{CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{}	{}	{"CYP2C19": "Likely Poor Metabolizer"}	RxNorm:121243	{"Based on the genotype result, this patient is predicted to be a likely CYP2C19 poor metabolizer, and higher than normal trough concentrations of voriconazole are likely with normal starting dosages and may increase the probability of adverse reactions. Choose an alternative agent that is not dependent on CYP2C19 metabolism as primary therapy instead of voriconazole such as liposomal amphotericin B or posaconazole. Selection of an alternative agent should be based upon other clinical factors such as drug interactions, hepatic and/or renal function, suspected or documented fungal species, site of infection, and comorbidities. Where voriconazole is strongly indicated for treatment of an invasive mycosis, administration of a lower dosage with meticulous therapeutic drug monitoring may be feasible. Please consult a clinical pharmacist for more information."}	1
6729079	pediatrics	Post-test	{CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{}	{}	{"CYP2C19": "Poor Metabolizer"}	RxNorm:121243	{"Based on the genotype result, this patient is predicted to be a CYP2C19 poor metabolizer, and higher than normal trough concentrations of voriconazole are likely with normal starting dosages and may increase the probability of adverse reactions. Choose an alternative agent that is not dependent on CYP2C19 metabolism as primary therapy instead of voriconazole such as liposomal amphotericin B or posaconazole. Selection of an alternative agent should be based upon other clinical factors such as drug interactions, hepatic and/or renal function, suspected or documented fungal species, site of infection, and comorbidities. Where voriconazole is strongly indicated for treatment of an invasive mycosis, administration of a lower dosage with meticulous therapeutic drug monitoring may be feasible. Please consult a clinical pharmacist for more information."}	1
6729080	pediatrics	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:121243	{n/a}	1
6729081	general	Pre-test	{HLA-B}	{}	{}	{"HLA-B": "No *57:01 result on file"}	{"HLA-B": "No *57:01 result on file"}	RxNorm:190521	{"A HLA-B*57:01 genotype test is recommended before prescribing abacavir per the FDA's black box warning regarding the risk of serious hypersensitivity reactions in patients that carry this allele. A HLA-B*57:01 genotype test does not appear to have been ordered for this patient. Please do the following to order the HLA-B*57:01 genotype test (insert dialogue boxes here to order clinical HLA-B test)."}	1
6729082	general	No CDS	{HLA-B}	{}	{}	{"HLA-B": "*57:01 negative"}	{"HLA-B": "*57:01 negative"}	RxNorm:190521	{n/a}	1
6729083	general	Post-test	{HLA-B}	{}	{}	{"HLA-B": "*57:01 positive"}	{"HLA-B": "*57:01 positive"}	RxNorm:190521	{"The HLA-B*57:01 allele has been detected in this patient. This allele is associated with high risk of severe hypersensitivity to abacavir. DO NOT prescribe abacavir per the FDA's black box warning. Please choose an alternate antiretroviral. For more information, please consult a clinical pharmacist."}	1
6729084	general	Pre-test	{HLA-B}	{}	{}	{"HLA-B": "No *58:01 result on file"}	{"HLA-B": "No *58:01 result on file"}	RxNorm:519	{"An HLA-B*58:01 genotype test does not appear to have been ordered for this patient. Patients who carry this allele are at increased risk of serious dermatologic reactions with the use of allopurinol, including Toxic Epidermal Necrolysis and Stevens-Johnson Syndrome. Please consult a clinical pharmacist for more information."}	1
6729085	general	No CDS	{HLA-B}	{}	{}	{"HLA-B": "*58:01 negative"}	{"HLA-B": "*58:01 negative"}	RxNorm:519	{n/a}	1
6729086	general	Post-test	{HLA-B}	{}	{}	{"HLA-B": "*58:01 positive"}	{"HLA-B": "*58:01 positive"}	RxNorm:519	{"The patient carries the HLA-B*58:01 allele, which indicates that the patient is at risk of developing a serious dermatologic reaction, including Toxic Epidermal Necrolysis or Stevens-Johnson Syndrome. Allopurinol is contraindicated. Please consult a clinical pharmacist for more information."}	1
6729087	general	Post-test	{MT-RNR1}	{"MT-RNR1": "increased risk of aminoglycoside-induced hearing loss"}	{}	{}	{"MT-RNR1": "increased risk of aminoglycoside-induced hearing loss"}	RxNorm:641	{"Based on the MT-RNR1 genotype result, this patient is predicted to be at increased risk of aminoglycoside-induced hearing loss. Aminoglycosides are likely to cause IRREVERSIBLE hearing loss in this patient. For help with selecting an alternative agent, please consult a clinical pharmacist or Infectious Diseases Service."}	1
6729088	general	No CDS	{MT-RNR1}	{"MT-RNR1": "normal risk of aminoglycoside-induced hearing loss"}	{}	{}	{"MT-RNR1": "normal risk of aminoglycoside-induced hearing loss"}	RxNorm:641	{n/a}	1
6729089	general	No CDS	{MT-RNR1}	{"MT-RNR1": "uncertain risk of aminoglycoside-induced hearing loss"}	{}	{}	{"MT-RNR1": "uncertain risk of aminoglycoside-induced hearing loss"}	RxNorm:641	{n/a}	1
6729090	general	Pre-test	{MT-RNR1}	{"MT-RNR1": "No Result"}	{}	{}	{"MT-RNR1": "No Result"}	RxNorm:641	{"A MT-RNR1 genotype does not appear to have been ordered for this patient. MT-RNR1 genotype may be an important risk factor for aminoglycoside-induced hearing loss. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
6729091	general	No CDS	{G6PD}	{"G6PD": "Normal"}	{}	{}	{"G6PD": "Normal"}	RxNorm:7833	{n/a}	1
6729092	general	No CDS	{G6PD}	{"G6PD": "Deficient"}	{}	{}	{"G6PD": "Deficient"}	RxNorm:7833	{n/a}	1
6729093	general	Post-test	{G6PD}	{"G6PD": "Deficient with CNSHA"}	{}	{}	{"G6PD": "Deficient with CNSHA"}	RxNorm:7833	{"This patient has a result consistent with G6PD deficiency with chronic nonspherocytic hemolytic anemia (CNSHA). Increased monitoring for worsening of hemolytic anemia may be indicated for patients with G6PD deficiency with CNSHA who receive medications. Please consult a clinical pharmacist for more information."}	1
6729094	general	No CDS	{G6PD}	{"G6PD": "Variable"}	{}	{}	{"G6PD": "Variable"}	RxNorm:7833	{n/a}	1
6729095	general	No CDS	{G6PD}	{"G6PD": "Indeterminate"}	{}	{}	{"G6PD": "Indeterminate"}	RxNorm:7833	{n/a}	1
6729096	general	No CDS	{G6PD}	{"G6PD": "No Result"}	{}	{}	{"G6PD": "No Result"}	RxNorm:7833	{n/a}	1
6729103	adults	Post-test	{CYP2D6}	{}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0"}	RxNorm:38400	{"This patient is predicted to be a CYP2D6 poor metabolizer and may be at an increased risk of atomoxetine-related adverse events. Initiate with a dose of 40 mg/day and if no clinical response and in the absence of adverse events after 2 weeks increase dose to 80 mg/day. If response is inadequate after 2 weeks consider obtaining a plasma concentration 2-4 h after dosing. If concentration is <200 ng/ml, consider a proportional dose increase to achieve a concentration to approach 400 ng/ml. If unacceptable side effects are present at any time, consider a reduction in dose. Please consult a clinical pharmacist for more information."}	1
6729104	adults	Post-test	{CYP2D6}	{}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25"}	RxNorm:38400	{"This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of atomoxetine-related adverse events. Initiate with a dose of 40 mg/day and if no clinical response and in the absence of adverse events after 2 weeks increase dose to 80 mg/day. If response is inadequate after 2 weeks consider obtaining a plasma concentration 2-4 h after dosing. If concentration is <200 ng/ml, consider a proportional dose increase to achieve a concentration to approach 400 ng/ml. If unacceptable side effects are present at any time, consider a reduction in dose. Please consult a clinical pharmacist for more information."}	1
6729105	adults	Post-test	{CYP2D6}	{}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5"}	RxNorm:38400	{"This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of atomoxetine-related adverse events. Initiate with a dose of 40 mg/day and if no clinical response and in the absence of adverse events after 2 weeks increase dose to 80 mg/day. If response is inadequate after 2 weeks consider obtaining a plasma concentration 2-4 h after dosing. If concentration is <200 ng/ml, consider a proportional dose increase to achieve a concentration to approach 400 ng/ml. If unacceptable side effects are present at any time, consider a reduction in dose. Please consult a clinical pharmacist for more information."}	1
6729106	adults	Post-test	{CYP2D6}	{}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75"}	RxNorm:38400	{"This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of atomoxetine-related adverse events. Initiate with a dose of 40 mg/day and if no clinical response and in the absence of adverse events after 2 weeks increase dose to 80 mg/day. If response is inadequate after 2 weeks consider obtaining a plasma concentration 2-4 h after dosing. If concentration is <200 ng/ml, consider a proportional dose increase to achieve a concentration to approach 400 ng/ml. If unacceptable side effects are present at any time, consider a reduction in dose. Please consult a clinical pharmacist for more information."}	1
6729107	adults	Post-test	{CYP2D6}	{}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0"}	RxNorm:38400	{"This patient is predicted to be a CYP2D6 Intermediate metabolizer and may not achieve adequate serum concentrations for the intended effect at standard dosing. Initiate with a dose of 40 mg/day and increase to 80 mg/day after 3 days. If no clinical response and in the absence of adverse events after 2 weeks, consider increasing dose to 100 mg/day. If no clinical response observed after 2 weeks, consider obtaining a peak plasma concentration (1 to 2 hours after dose administered). If <200 ng/ml, consider a proportional increase in dose to approach 400 ng/ml. Dosages greater than 100 mg/day may be needed to achieve target concentrations. Please consult a clinical pharmacist for more information."}	1
6729108	adults	Post-test	{CYP2D6}	{}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	RxNorm:38400	{"Although this patient is predicted to be a CYP2D6 normal metabolizer, this patient may not achieve adequate serum concentrations for the intended effect at standard dosing. Initiate with a dose of 40 mg/day and increase to 80 mg/day after 3 days. If no clinical response and in the absence of adverse events after 2 weeks, consider increasing dose to 100 mg/day. If no clinical response observed after 2 weeks, consider obtaining a peak plasma concentration (1 to 2 hours after dose administered). If <200 ng/ml, consider a proportional increase in dose to approach 400 ng/ml. Dosages greater than 100 mg/day may be needed to achieve target concentrations. Please consult a clinical pharmacist for more information."}	1
6729109	adults	Post-test	{CYP2D6}	{}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	RxNorm:38400	{"Although this patient is predicted to be a CYP2D6 normal metabolizer, this patient may not achieve adequate serum concentrations for the intended effect at standard dosing. Initiate with a dose of 40 mg/day and increase to 80 mg/day after 3 days. If no clinical response and in the absence of adverse events after 2 weeks, consider increasing dose to 100 mg/day. If no clinical response observed after 2 weeks, consider obtaining a peak plasma concentration (1 to 2 hours after dose administered). If <200 ng/ml, consider a proportional increase in dose to approach 400 ng/ml. Dosages greater than 100 mg/day may be needed to achieve target concentrations. Please consult a clinical pharmacist for more information."}	1
6729110	adults	Post-test	{CYP2D6}	{}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	RxNorm:38400	{"Although this patient is predicted to be a CYP2D6 normal metabolizer, this patient may not achieve adequate serum concentrations for the intended effect at standard dosing. Initiate with a dose of 40 mg/day and increase to 80 mg/day after 3 days. If no clinical response and in the absence of adverse events after 2 weeks, consider increasing dose to 100 mg/day. If no clinical response observed after 2 weeks, consider obtaining a peak plasma concentration (1 to 2 hours after dose administered). If <200 ng/ml, consider a proportional increase in dose to approach 400 ng/ml. Dosages greater than 100 mg/day may be needed to achieve target concentrations. Please consult a clinical pharmacist for more information."}	1
6729111	adults	Post-test	{CYP2D6}	{}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	RxNorm:38400	{"Although this patient is predicted to be a CYP2D6 normal metabolizer, this patient may not achieve adequate serum concentrations for the intended effect at standard dosing. Initiate with a dose of 40 mg/day and increase to 80 mg/day after 3 days. If no clinical response and in the absence of adverse events after 2 weeks, consider increasing dose to 100 mg/day. If no clinical response observed after 2 weeks, consider obtaining a peak plasma concentration (1 to 2 hours after dose administered). If <200 ng/ml, consider a proportional increase in dose to approach 400 ng/ml. Dosages greater than 100 mg/day may be needed to achieve target concentrations. Please consult a clinical pharmacist for more information."}	1
6729112	adults	Post-test	{CYP2D6}	{}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5"}	RxNorm:38400	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and it is unlikely this patient would achieve adequate serum concentrations for the intended effect at standard dosing. Initiate with a dose of 40 mg/day and increase to 80 mg/day after 3 days. If no clinical response and in the absence of adverse events after 2 weeks, consider increasing dose to 100 mg/day. If no clinical response observed after 2 weeks, consider obtaining a peak plasma concentration (1 to 2 hours after dose administered). If <200 ng/ml, consider a proportional increase in dose to approach 400 ng/ml. Dosages greater than 100 mg/day may be needed to achieve target concentrations. Please consult a clinical pharmacist for more information."}	1
6729113	adults	Post-test	{CYP2D6}	{}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75"}	RxNorm:38400	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and it is unlikely this patient would achieve adequate serum concentrations for the intended effect at standard dosing. Initiate with a dose of 40 mg/day and increase to 80 mg/day after 3 days. If no clinical response and in the absence of adverse events after 2 weeks, consider increasing dose to 100 mg/day. If no clinical response observed after 2 weeks, consider obtaining a peak plasma concentration (1 to 2 hours after dose administered). If <200 ng/ml, consider a proportional increase in dose to approach 400 ng/ml. Dosages greater than 100 mg/day may be needed to achieve target concentrations. Please consult a clinical pharmacist for more information."}	1
6729114	adults	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0"}	RxNorm:38400	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and it is unlikely this patient would achieve adequate serum concentrations for the intended effect at standard dosing. Initiate with a dose of 40 mg/day and increase to 80 mg/day after 3 days. If no clinical response and in the absence of adverse events after 2 weeks, consider increasing dose to 100 mg/day. If no clinical response observed after 2 weeks, consider obtaining a peak plasma concentration (1 to 2 hours after dose administered). If <200 ng/ml, consider a proportional increase in dose to approach 400 ng/ml. Dosages greater than 100 mg/day may be needed to achieve target concentrations. Please consult a clinical pharmacist for more information."}	1
6729115	adults	Post-test	{CYP2D6}	{}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0"}	RxNorm:38400	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and it is unlikely this patient would achieve adequate serum concentrations for the intended effect at standard dosing. Initiate with a dose of 40 mg/day and increase to 80 mg/day after 3 days. If no clinical response and in the absence of adverse events after 2 weeks, consider increasing dose to 100 mg/day. If no clinical response observed after 2 weeks, consider obtaining a peak plasma concentration (1 to 2 hours after dose administered). If <200 ng/ml, consider a proportional increase in dose to approach 400 ng/ml. Dosages greater than 100 mg/day may be needed to achieve target concentrations. Please consult a clinical pharmacist for more information."}	1
6729116	adults	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25"}	RxNorm:38400	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and it is unlikely this patient would achieve adequate serum concentrations for the intended effect at standard dosing. Initiate with a dose of 40 mg/day and increase to 80 mg/day after 3 days. If no clinical response and in the absence of adverse events after 2 weeks, consider increasing dose to 100 mg/day. If no clinical response observed after 2 weeks, consider obtaining a peak plasma concentration (1 to 2 hours after dose administered). If <200 ng/ml, consider a proportional increase in dose to approach 400 ng/ml. Dosages greater than 100 mg/day may be needed to achieve target concentrations. Please consult a clinical pharmacist for more information."}	1
6729117	adults	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5"}	RxNorm:38400	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and it is unlikely this patient would achieve adequate serum concentrations for the intended effect at standard dosing. Initiate with a dose of 40 mg/day and increase to 80 mg/day after 3 days. If no clinical response and in the absence of adverse events after 2 weeks, consider increasing dose to 100 mg/day. If no clinical response observed after 2 weeks, consider obtaining a peak plasma concentration (1 to 2 hours after dose administered). If <200 ng/ml, consider a proportional increase in dose to approach 400 ng/ml. Dosages greater than 100 mg/day may be needed to achieve target concentrations. Please consult a clinical pharmacist for more information."}	1
6729118	adults	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75"}	RxNorm:38400	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and it is unlikely this patient would achieve adequate serum concentrations for the intended effect at standard dosing. Initiate with a dose of 40 mg/day and increase to 80 mg/day after 3 days. If no clinical response and in the absence of adverse events after 2 weeks, consider increasing dose to 100 mg/day. If no clinical response observed after 2 weeks, consider obtaining a peak plasma concentration (1 to 2 hours after dose administered). If <200 ng/ml, consider a proportional increase in dose to approach 400 ng/ml. Dosages greater than 100 mg/day may be needed to achieve target concentrations. Please consult a clinical pharmacist for more information."}	1
6729119	adults	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0"}	RxNorm:38400	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and it is unlikely this patient would achieve adequate serum concentrations for the intended effect at standard dosing. Initiate with a dose of 40 mg/day and increase to 80 mg/day after 3 days. If no clinical response and in the absence of adverse events after 2 weeks, consider increasing dose to 100 mg/day. If no clinical response observed after 2 weeks, consider obtaining a peak plasma concentration (1 to 2 hours after dose administered). If <200 ng/ml, consider a proportional increase in dose to approach 400 ng/ml. Dosages greater than 100 mg/day may be needed to achieve target concentrations. Please consult a clinical pharmacist for more information."}	1
6729131	pediatrics	Post-test	{CYP2D6}	{}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	RxNorm:38400	{"Although this patient is predicted to be a CYP2D6 normal metabolizer, this patient may not achieve adequate serum concentrations for the intended effect at standard dosing. Initiate with a dose of 0.5 mg/kg/day and increase to 1.2 mg/kg/day after 3 days. If no clinical response and in the absence of adverse events after 2 weeks, consider obtaining a peak plasma concentration (1 to 2 hours after dose administered). If <200 ng/ml, consider a proportional increase in dose to approach 400 ng/ml. Please consult a clinical pharmacist for more information."}	1
6729120	adults	Post-test	{CYP2D6}	{}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0"}	RxNorm:38400	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and it is unlikely this patient would achieve adequate serum concentrations for the intended effect at standard dosing. Initiate with a dose of 40 mg/day and increase to 80 mg/day after 3 days. If no clinical response and in the absence of adverse events after 2 weeks, consider increasing dose to 100 mg/day. If no clinical response observed after 2 weeks, consider obtaining a peak plasma concentration (1 to 2 hours after dose administered). If <200 ng/ml, consider a proportional increase in dose to approach 400 ng/ml. Dosages greater than 100 mg/day may be needed to achieve target concentrations. Please consult a clinical pharmacist for more information."}	1
6729121	adults	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0"}	RxNorm:38400	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and it is unlikely this patient would achieve adequate serum concentrations for the intended effect at standard dosing. Initiate with a dose of 40 mg/day and increase to 80 mg/day after 3 days. If no clinical response and in the absence of adverse events after 2 weeks, consider increasing dose to 100 mg/day. If no clinical response observed after 2 weeks, consider obtaining a peak plasma concentration (1 to 2 hours after dose administered). If <200 ng/ml, consider a proportional increase in dose to approach 400 ng/ml. Dosages greater than 100 mg/day may be needed to achieve target concentrations. Please consult a clinical pharmacist for more information."}	1
6729122	adults	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0"}	RxNorm:38400	{"This patient is predicted to be a CYP2D6 ultrarapid metabolizer and it is unlikely this patient would achieve adequate serum concentrations for the intended effect at standard dosing. Initiate with a dose of 40 mg/day and increase to 80 mg/day after 3 days. If no clinical response and in the absence of adverse events after 2 weeks, consider increasing dose to 100 mg/day. If no clinical response observed after 2 weeks, consider obtaining a peak plasma concentration (1 to 2 hours after dose administered). If <200 ng/ml, consider a proportional increase in dose to approach 400 ng/ml. Dosages greater than 100 mg/day may be needed to achieve target concentrations. Please consult a clinical pharmacist for more information."}	1
6729123	adults	No CDS	{CYP2D6}	{}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a"}	RxNorm:38400	{n/a}	1
6729124	adults	Pre-test	{CYP2D6}	{}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result"}	RxNorm:38400	{"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 may be recommended. Please consult a clinical pharmacist for more information."}	1
6729125	pediatrics	Post-test	{CYP2D6}	{}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0"}	RxNorm:38400	{"This patient is predicted to be a CYP2D6 poor metabolizer and may be at an increased risk of a atomoxetine-related adverse events. Initiate with a dose of 0.5 mg/kg/day and if no clinical response and in the absence of adverse events after 2 weeks, consider obtaining a plasma concentration 4 h after dosing. If response is inadequate and concentration is <200 ng/ml, consider a proportional dose increase to achieve a concentration to approach 400 ng/ml. If unacceptable side effects are present at any time, consider a reduction in dose. Please consult a clinical pharmacist for more information."}	1
6729126	pediatrics	Post-test	{CYP2D6}	{}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25"}	RxNorm:38400	{"This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a atomoxetine-related adverse events. Initiate with a dose of 0.5 mg/kg/day and if no clinical response and in the absence of adverse events after 2 weeks, consider obtaining a plasma concentration 2-4 h after dosing. If response is inadequate and concentration is <200 ng/ml, consider a proportional dose increase to achieve a concentration to approach 400 ng/ml. If unacceptable side effects are present at any time, consider a reduction in dose. Please consult a clinical pharmacist for more information."}	1
6729127	pediatrics	Post-test	{CYP2D6}	{}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5"}	RxNorm:38400	{"This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a atomoxetine-related adverse events. Initiate with a dose of 0.5 mg/kg/day and if no clinical response and in the absence of adverse events after 2 weeks, consider obtaining a plasma concentration 2-4 h after dosing. If response is inadequate and concentration is <200 ng/ml, consider a proportional dose increase to achieve a concentration to approach 400 ng/ml. If unacceptable side effects are present at any time, consider a reduction in dose. Please consult a clinical pharmacist for more information."}	1
6729128	pediatrics	Post-test	{CYP2D6}	{}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75"}	RxNorm:38400	{"This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a atomoxetine-related adverse events. Initiate with a dose of 0.5 mg/kg/day and if no clinical response and in the absence of adverse events after 2 weeks, consider obtaining a plasma concentration 2-4 h after dosing. If response is inadequate and concentration is <200 ng/ml, consider a proportional dose increase to achieve a concentration to approach 400 ng/ml. If unacceptable side effects are present at any time, consider a reduction in dose. Please consult a clinical pharmacist for more information."}	1
6729129	pediatrics	Post-test	{CYP2D6}	{}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0"}	RxNorm:38400	{"This patient is predicted to be a CYP2D6 intermediate metabolizer and may not achieve adequate serum concentrations for the intended effect at standard dosing. Initiate with a dose of 0.5 mg/kg/day and increase to 1.2 mg/kg/day after 3 days. If no clinical response and in the absence of adverse events after 2 weeks, consider obtaining a peak plasma concentration (1 to 2 hours after dose administered). If <200 ng/ml, consider a proportional increase in dose to approach 400 ng/ml. Please consult a clinical pharmacist for more information."}	1
6729130	pediatrics	Post-test	{CYP2D6}	{}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	RxNorm:38400	{"Although this patient is predicted to be a CYP2D6 normal metabolizer, this patient may not achieve adequate serum concentrations for the intended effect at standard dosing. Initiate with a dose of 0.5 mg/kg/day and increase to 1.2 mg/kg/day after 3 days. If no clinical response and in the absence of adverse events after 2 weeks, consider obtaining a peak plasma concentration (1 to 2 hours after dose administered). If <200 ng/ml, consider a proportional increase in dose to approach 400 ng/ml. Please consult a clinical pharmacist for more information."}	1
6729132	pediatrics	Post-test	{CYP2D6}	{}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	RxNorm:38400	{"Although this patient is predicted to be a CYP2D6 normal metabolizer, this patient may not achieve adequate serum concentrations for the intended effect at standard dosing. Initiate with a dose of 0.5 mg/kg/day and increase to 1.2 mg/kg/day after 3 days. If no clinical response and in the absence of adverse events after 2 weeks, consider obtaining a peak plasma concentration (1 to 2 hours after dose administered). If <200 ng/ml, consider a proportional increase in dose to approach 400 ng/ml. Please consult a clinical pharmacist for more information."}	1
6729133	pediatrics	Post-test	{CYP2D6}	{}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	RxNorm:38400	{"Although this patient is predicted to be a CYP2D6 normal metabolizer, this patient may not achieve adequate serum concentrations for the intended effect at standard dosing. Initiate with a dose of 0.5 mg/kg/day and increase to 1.2 mg/kg/day after 3 days. If no clinical response and in the absence of adverse events after 2 weeks, consider obtaining a peak plasma concentration (1 to 2 hours after dose administered). If <200 ng/ml, consider a proportional increase in dose to approach 400 ng/ml. Please consult a clinical pharmacist for more information."}	1
