7591128	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 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 doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591129	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 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 doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591130	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 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 doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591131	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 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 doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7592696	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0"}	RxNorm:39786	{n/a}	1
7591132	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 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 doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591133	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 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 doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591134	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 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 doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591135	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 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 doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591136	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591137	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591138	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591139	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591140	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591141	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7592697	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75"}	RxNorm:39786	{n/a}	1
7591142	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591143	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Please consult a clinical pharmacist for more information."}	1
7591144	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591145	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591146	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591147	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a CYP2C19 ultrarapid metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591148	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2C19 ultarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591149	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2C19 ultarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2D6 genotype does not appear to have been ordered for this patient. CYP2D6 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
7591150	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591151	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments.Please consult a clinical pharmacist for more information."}	1
7591335	general	Pre-test	{CYP2C9,HLA-B}	{}	{"CYP2C9": "1.5"}	{"HLA-B": "No *15:02 result"}	{"HLA-B": "No *15:02 result", "CYP2C9": "1.5"}	RxNorm:72236	{"HLA-B*15:02 genotype may be important for fosphenytoin adverse events. An HLA-B*15:02 genotype does not appear to have been ordered for this patient. Use of an alternative antiepileptic may be recommended. Please consult a clinical pharmacist for more information."}	1
7591152	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591153	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591154	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Please consult a clinical pharmacist for more information."}	1
7591155	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Please consult a clinical pharmacist for more information."}	1
7591156	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Please consult a clinical pharmacist for more information."}	1
7591157	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Please consult a clinical pharmacist for more information."}	1
7591158	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 poor metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591159	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591160	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591161	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591162	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591336	general	No CDS	{CYP2C9,HLA-B}	{}	{"CYP2C9": "1.5"}	{"HLA-B": "*15:02 negative"}	{"HLA-B": "*15:02 negative", "CYP2C9": "1.5"}	RxNorm:72236	{n/a}	1
7592698	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5"}	RxNorm:39786	{n/a}	1
7591163	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591164	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591165	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591166	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591167	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591168	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591169	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591170	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Indeterminate"}	RxNorm:3638	{n/a}	1
7591171	general	Pre-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Indeterminate"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. CYP2D6 genotype does not appear to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
7591172	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 intermediate metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591173	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 intermediate metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591361	general	No CDS	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:5095	{n/a}	1
7592699	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25"}	RxNorm:39786	{n/a}	1
7591174	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591175	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 intermediate metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591176	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 intermediate metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591177	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{n/a}	1
7591178	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{n/a}	1
7591179	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{n/a}	1
7591180	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{n/a}	1
7591181	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{n/a}	1
7591182	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 poor metabolizer and a likely CYP2C19 intermediate metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591183	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591184	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591185	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591186	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591362	general	Pre-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2C19 genotype may be important for imipramine dosing and use. A CYP2C19 genotype does not appear to have been ordered for this patient. Use of an alternative agent or dose may be recommended. Please consult a clinical pharmacist for more information."}	1
7591187	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591188	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591189	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591190	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591191	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591192	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591193	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 intermediate metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591194	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{n/a}	1
7591195	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a likely CYP2C19 intermediate metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2C19 result. Because a CYP2D6 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
7591196	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 poor metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591197	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 poor metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7592700	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0"}	RxNorm:39786	{n/a}	1
7592701	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0"}	RxNorm:39786	{n/a}	1
7591198	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 poor metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591199	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and a likely CYP2C19 poor metabolizer. The patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591200	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a likely CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If doxepin is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591201	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a likely CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If doxepin is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591202	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a likely CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If doxepin is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591203	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a likely CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If doxepin is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591204	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer and a likely CYP2C19 poor metabolizer. Based on the CYP2C19 result, the patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If doxepin is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591205	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 poor metabolizer and a likely CYP2C19 poor metabolizer. This patient may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591206	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591207	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591208	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591209	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591210	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591211	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591212	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591213	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591214	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591215	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and a likely CYP2C19 poor metabolizer. Consider selecting an alternative drug. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591216	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a likely CYP2C19 poor metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If doxepin is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7591217	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Likely Poor Metabolizer"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a likely CYP2C19 poor metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2C19. If doxepin is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. Because a CYP2D6 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
7591363	general	Pre-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "No Result"}	RxNorm:5691	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. Neither a CYP2D6 nor CYP2C19 genotype appears to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
7591218	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
7591219	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
7591220	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
7591221	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 intermediate metabolizer and may be at an increased risk of a sub-optimal response. Consider a 25% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
7591222	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Because a CYP2C19 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
7591223	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Because a CYP2C19 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
7591224	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Because a CYP2C19 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
7591225	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Because a CYP2C19 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
7591226	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 normal metabolizer. There is no reason to selectively adjust the dose of this medication based on the CYP2D6 result. Because a CYP2C19 genotype does not appear to have been ordered for this patient, use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
7591227	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 poor metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted, consider a 50% reduction of recommended starting dose and utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
7592702	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0"}	RxNorm:39786	{n/a}	1
7591228	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
7591229	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
7591230	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
7591231	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
7591232	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
7591233	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
7591234	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
7591235	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
7591236	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
7592703	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75"}	RxNorm:39786	{n/a}	1
7592704	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5"}	RxNorm:39786	{n/a}	1
7591237	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
7591238	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. This patient is predicted to be a CYP2D6 ultrarapid metabolizer and may be at an increased risk of a sub-optimal response. Consider selecting an alternative drug not metabolized by CYP2D6. If doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. A CYP2C19 genotype does not appear to have been ordered for this patient. CYP2C19 genetic status may be important for alternative drugs. Please consult a clinical pharmacist for more information."}	1
7591239	general	Pre-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2C19 genotype may be important for doxepin dosing and use. A CYP2C19 genotype does not appear to have been ordered for this patient. Use of an alternative agent or dose may be recommended. Please consult a clinical pharmacist for more information."}	1
7591240	general	Pre-test	{CYP2D6,CYP2C19}	{"CYP2C19": "No Result"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "No Result"}	RxNorm:3638	{"CYP2D6 and CYP2C19 genetic status may be predictive of an adverse reaction or poor response to this medication due to altered drug metabolism. Neither a CYP2D6 nor CYP2C19 genotype appears to have been ordered for this patient. Use of an alternative agent may be recommended. Please consult a clinical pharmacist for more information."}	1
7591241	general	No CDS	{CYP2B6}	{"CYP2B6": "Indeterminate"}	{}	{}	{"CYP2B6": "Indeterminate"}	RxNorm:195085	{n/a}	1
7591242	general	Pre-test	{CYP2B6}	{"CYP2B6": "No Result"}	{}	{}	{"CYP2B6": "No Result"}	RxNorm:195085	{"CYP2B6 genetic status may be predictive of adverse events with efavirenz. A CYP2B6 genotype does not appear to have been ordered for this patient. A decreased dose may be recommended. Please consult a clinical pharmacist for more information."}	1
7591243	general	No CDS	{CYP2B6}	{"CYP2B6": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2B6": "Ultrarapid Metabolizer"}	RxNorm:195085	{n/a}	1
7591244	general	No CDS	{CYP2B6}	{"CYP2B6": "Rapid Metabolizer"}	{}	{}	{"CYP2B6": "Rapid Metabolizer"}	RxNorm:195085	{n/a}	1
7591245	general	No CDS	{CYP2B6}	{"CYP2B6": "Normal Metabolizer"}	{}	{}	{"CYP2B6": "Normal Metabolizer"}	RxNorm:195085	{n/a}	1
7591246	general	Post-test	{CYP2B6}	{"CYP2B6": "Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Intermediate Metabolizer"}	RxNorm:195085	{"This patient is predicted to be a CYP2B6 intermediate metabolizer and may be at an increased risk of adverse events due to higher plasma concentrations of efavirenz. Consider initiating efavirenz with a decreased dose of 400 mg/day. Please consult a clinical pharmacist for more information."}	1
7591247	general	Post-test	{CYP2B6}	{"CYP2B6": "Poor Metabolizer"}	{}	{}	{"CYP2B6": "Poor Metabolizer"}	RxNorm:195085	{"This patient is predicted to be a CYP2B6 poor metabolizer and may be at an increased risk of adverse events due to higher plasma concentrations of efavirenz. Consider initiating efavirenz with a decreased dose of 200 or 400 mg/day. Please consult a clinical pharmacist for more information."}	1
7591248	general	Post-test	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Malignant Hyperthermia Susceptibility"}	RxNorm:3920	{"Based on genotype, this patient is predicted to be malignant hyperthermia susceptible. Halogenated volatile anesthetics or depolarizing muscle relaxants are relatively contraindicated in persons with MHS. They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available, effective, and safe in patients with MHS. Please consult an anesthesiologist or clinical pharmacist for more information."}	1
7591249	general	Post-test	{RYR1,CACNA1S}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "Malignant Hyperthermia Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:3920	{"Based on genotype, this patient is predicted to be malignant hyperthermia susceptible. Halogenated volatile anesthetics or depolarizing muscle relaxants are relatively contraindicated in persons with MHS. They should not be used, except in extraordinary circumstances where the benefits outweigh the risks. In general, alternative anesthetics are widely available, effective, and safe in patients with MHS. Please consult an anesthesiologist or clinical pharmacist for more information."}	1
7591250	general	Pre-test	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "No Result"}	RxNorm:3920	{"Malignant Hyperthermia Susceptibility is an inherited trait linked to changes within the RYR1 and CACNA1S genes. Genetic testing can help to guide anesthetic agent use."}	1
7591251	general	Pre-test	{RYR1,CACNA1S}	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "No Result", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:3920	{"Malignant Hyperthermia Susceptibility is an inherited trait linked to changes within the RYR1 and CACNA1S genes. Genetic testing can help to guide anesthetic agent use."}	1
7591252	general	Pre-test	{RYR1,CACNA1S}	{"RYR1": "No Result", "CACNA1S": "No Result"}	{}	{}	{"RYR1": "No Result", "CACNA1S": "No Result"}	RxNorm:3920	{"Malignant Hyperthermia Susceptibility is an inherited trait linked to changes within the RYR1 and CACNA1S genes. Genetic testing can help to guide anesthetic agent use."}	1
7591255	general	Post-test	{CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:321988	{"Based on the genotype result, this patient is predicted to be a CYP2C19 ultrarapid metabolizer and is at risk for lower plasma concentrations and increased probability of therapeutic failure with standard dosing. Consider a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2C19. If escitalopram is clinically appropriate, and adequate efficacy is not achieved at standard maintenance dosing, consider titrating to a higher maintenance dose. Please consult a clinical pharmacist for more information."}	1
7591256	general	Post-test	{CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2C19": "Rapid Metabolizer"}	RxNorm:321988	{"Based on the genotype result, this patient is predicted to be a CYP2C19 rapid metabolizer and may be at risk for lower plasma concentrations and increased probability of therapeutic failure with standard dosing. Initiate therapy with recommended starting dose. If patient does not adequately respond, consider titrating to a higher maintenance dose or switching to a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2C19. Please consult a clinical pharmacist for more information."}	1
7591257	general	No CDS	{CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2C19": "Normal Metabolizer"}	RxNorm:321988	{n/a}	1
7591258	general	Post-test	{CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:321988	{"Based on the genotype result, this patient is predicted to be a likely CYP2C19 intermediate metabolizer and is at risk for higher plasma concentrations and increased probability of side effects with standard dosing. Initiate therapy with recommended starting dose, but consider a slower titration schedule and lower maintenance dose. Please consult a clinical pharmacist for more information."}	1
7591259	general	Post-test	{CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2C19": "Intermediate Metabolizer"}	RxNorm:321988	{"Based on the genotype result, this patient is predicted to be a CYP2C19 intermediate metabolizer and is at risk for higher plasma concentrations and increased probability of side effects with standard dosing. Initiate therapy with recommended starting dose, but consider a slower titration schedule and lower maintenance dose. Please consult a clinical pharmacist for more information."}	1
7591260	general	Post-test	{CYP2C19}	{"CYP2C19": "Likely Poor Metabolizer"}	{}	{}	{"CYP2C19": "Likely Poor Metabolizer"}	RxNorm:321988	{"Based on the genotype result, this patient is predicted to be a likely CYP2C19 poor metabolizer and is at risk for higher plasma concentrations and increased probability of side effects with standard dosing. Consider a clinically appropriate antidepressant not predominantly metabolized by CYP2C19. If escitalopram is clinically appropriate, consider a lower starting dose, slower titration schedule and 50% reduction of the standard maintenance dose. Please consult a clinical pharmacist for more information."}	1
7591261	general	Post-test	{CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{}	{}	{"CYP2C19": "Poor Metabolizer"}	RxNorm:321988	{"Based on the genotype result, this patient is predicted to be a CYP2C19 poor metabolizer and is at risk for higher plasma concentrations and increased probability of side effects with standard dosing. Consider a clinically appropriate antidepressant not predominantly metabolized by CYP2C19. If escitalopram is clinically appropriate, consider a lower starting dose, slower titration schedule and 50% reduction of the standard maintenance dose. Please consult a clinical pharmacist for more information."}	1
7591262	general	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:321988	{n/a}	1
7591263	general	Pre-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "No Result"}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0", "SLCO1B1": "No Result"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 normal metabolizer. Based on CYP2C9 phenotype there is no reason to adjust the dose of fluvastatin. Because an SLCO1B1 genotype does not appear to have been ordered for this patient, it is not known if SLCO1B1 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
7591264	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Possible Decreased Function"}	{"CYP2C9": "0.5"}	{}	{"CYP2C9": "0.5", "SLCO1B1": "Possible Decreased Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 poor metabolizer and to have SLCO1B1 possible decreased function. The patient is at an increased risk of a fluvastatin-induced myopathy. Prescribe an alternative statin depending on the desired potency. Please consult a clinical pharmacist for more information."}	1
7591265	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Possible Decreased Function"}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a", "SLCO1B1": "Possible Decreased Function"}	RxNorm:41127	{n/a}	1
7591266	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Indeterminate"}	{"CYP2C9": "1.0"}	{}	{"CYP2C9": "1.0", "SLCO1B1": "Indeterminate"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 intermediate metabolizer and may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤40mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >40mg is needed for desired efficacy, consider an alternative statin or combination therapy. Because SLCO1B1 phenotype could not be assigned based on genotyping performed, it is not known if SLCO1B1 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
7591267	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Indeterminate"}	{"CYP2C9": "1.5"}	{}	{"CYP2C9": "1.5", "SLCO1B1": "Indeterminate"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 intermediate metabolizer and may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤40mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >40mg is needed for desired efficacy, consider an alternative statin or combination therapy. Because SLCO1B1 phenotype could not be assigned based on genotyping performed, it is not known if SLCO1B1 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
7591268	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Indeterminate"}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0", "SLCO1B1": "Indeterminate"}	RxNorm:41127	{n/a}	1
7591269	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Indeterminate"}	{"CYP2C9": "0.0"}	{}	{"CYP2C9": "0.0", "SLCO1B1": "Indeterminate"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 poor metabolizer and may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >20mg is needed for desired efficacy, consider an alternative statin or combination therapy. Because SLCO1B1 phenotype could not be assigned based on genotyping performed, it is not known if SLCO1B1 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
7591270	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Indeterminate"}	{"CYP2C9": "0.5"}	{}	{"CYP2C9": "0.5", "SLCO1B1": "Indeterminate"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 poor metabolizer and may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >20mg is needed for desired efficacy, consider an alternative statin or combination therapy. Because SLCO1B1 phenotype could not be assigned based on genotyping performed, it is not known if SLCO1B1 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
7591271	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Indeterminate"}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a", "SLCO1B1": "Indeterminate"}	RxNorm:41127	{n/a}	1
7591272	general	Pre-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Indeterminate"}	{"CYP2C9": "No Result"}	{}	{"CYP2C9": "No Result", "SLCO1B1": "Indeterminate"}	RxNorm:41127	{"CYP2C9 and SLCO1B1 genetic status may be predictive of the risk of fluvastatin-induced myopathydue to altered drug exposure. Because a CYP2C9 genotype does not appear to have been ordered for this patient and SLCO1B1 phenotype could not be assigned based on genotyping performed, it is not known if these results would influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
7591273	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "No Result"}	{"CYP2C9": "1.0"}	{}	{"CYP2C9": "1.0", "SLCO1B1": "No Result"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 intermediate metabolizer and may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤40mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >40mg is needed for desired efficacy, consider an alternative statin or combination therapy. Because an SLCO1B1 genotype does not appear to have been ordered for this patient, it is not known if SLCO1B1 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
7591274	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "No Result"}	{"CYP2C9": "1.5"}	{}	{"CYP2C9": "1.5", "SLCO1B1": "No Result"}	RxNorm:41127	{"CYP2C9 and SLCO1B1 genetic status may be predictive of the risk of myopathy to this medication due to altered drug metabolism. This patient is predicted to be a CYP2C9 intermediate metabolizer and may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤40mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If dose >40mg needed for desired efficacy, consider an alternative statin or combination therapy (i.e. fluvastatin plus non-statin guideline directed medical therapy). Because a SLCO1B1 genotype does not appear to have been ordered for this patient, it is not known if SLCO1B1 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
7591275	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "No Result"}	{"CYP2C9": "0.0"}	{}	{"CYP2C9": "0.0", "SLCO1B1": "No Result"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 poor metabolizer and may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >20mg is needed for desired efficacy, consider an alternative statin or combination therapy. Because an SLCO1B1 genotype does not appear to have been ordered for this patient, it is not known if SLCO1B1 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
7591276	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "No Result"}	{"CYP2C9": "0.5"}	{}	{"CYP2C9": "0.5", "SLCO1B1": "No Result"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 poor metabolizer and may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >20mg is needed for desired efficacy, consider an alternative statin or combination therapy. Because a SLCO1B1 genotype does not appear to have been ordered for this patient, it is not known if SLCO1B1 results would further influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
7591277	general	Pre-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "No Result"}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a", "SLCO1B1": "No Result"}	RxNorm:41127	{"CYP2C9 and SLCO1B1 genetic status may be predictive of the risk of fluvastatin-induced myopathy due to altered drug exposure. Because an SLCO1B1 genotype does not appear to have been ordered for this patient and CYP2C9 phenotype could not be assigned based on genotyping performed, it is not known if these results would influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
7591278	general	Pre-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "No Result"}	{"CYP2C9": "No Result"}	{}	{"CYP2C9": "No Result", "SLCO1B1": "No Result"}	RxNorm:41127	{"CYP2C9 and SLCO1B1 genetic status may be predictive of the risk of fluvastatin-induced myopathy due to altered drug exposure. Neither a CYP2C9 nor SLCO1B1 genotype appears to have been ordered for this patient. Use of an alternative dose or drug may be recommended. Please consult a clinical pharmacist for more information."}	1
7591279	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Decreased Function"}	{"CYP2C9": "1.0"}	{}	{"CYP2C9": "1.0", "SLCO1B1": "Decreased Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 intermediate metabolizer and to have SLCO1B1 decreased function. The patient may be at an increased risk of a fluvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If dose >20mg needed for desired efficacy, consider an alternative statin or combination therapy (i.e. fluvastatin plus non-statin guideline directed medical therapy). Please consult a clinical pharmacist for more information."}	1
7591280	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Decreased Function"}	{"CYP2C9": "1.5"}	{}	{"CYP2C9": "1.5", "SLCO1B1": "Decreased Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 intermediate metabolizer and to have SLCO1B1 decreased function. Thise patient may be at an increased risk of a fluvastatin-induced myopathy. Prescribe ≤20mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >20mg is needed for desired efficacy, consider an alternative statin or combination therapy. Please consult a clinical pharmacist for more information."}	1
7591281	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Decreased Function"}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0", "SLCO1B1": "Decreased Function"}	RxNorm:41127	{n/a}	1
7591282	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Decreased Function"}	{"CYP2C9": "0.0"}	{}	{"CYP2C9": "0.0", "SLCO1B1": "Decreased Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 poor metabolizer and to have SLCO1B1 decreased function. This patient is at an increased risk of a fluvastatin-induced myopathy. Prescribe an alternative statin depending on the desired potency. Please consult a clinical pharmacist for more information."}	1
7591283	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Decreased Function"}	{"CYP2C9": "0.5"}	{}	{"CYP2C9": "0.5", "SLCO1B1": "Decreased Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 poor metabolizer and to have SLCO1B1 decreased function. The patient is at an increased risk of a fluvastatin-induced myopathy. Prescribe an alternative statin depending on the desired potency. Please consult a clinical pharmacist for more information."}	1
7591284	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Decreased Function"}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a", "SLCO1B1": "Decreased Function"}	RxNorm:41127	{n/a}	1
7591285	general	Pre-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Decreased Function"}	{"CYP2C9": "No Result"}	{}	{"CYP2C9": "No Result", "SLCO1B1": "Decreased Function"}	RxNorm:41127	{"CYP2C9 genetic status may be predictive of the risk of fluvastatin-induced myopathy due to altered drug exposure. Because a CYP2C9 genotype does not appear to have been ordered for this patient, it is not known if these results would influence the recommended dose or drug. Please consult a clinical pharmacist for more information."}	1
7591286	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Normal Function"}	{"CYP2C9": "1.0"}	{}	{"CYP2C9": "1.0", "SLCO1B1": "Normal Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 intermediate metabolizer and to have SLCO1B1 normal function. This patient may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤40mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >40mg is needed for desired efficacy, consider an alternative statin or combination therapy. Please consult a clinical pharmacist for more information."}	1
7591287	general	Post-test	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Normal Function"}	{"CYP2C9": "1.5"}	{}	{"CYP2C9": "1.5", "SLCO1B1": "Normal Function"}	RxNorm:41127	{"This patient is predicted to be a CYP2C9 intermediate metabolizer and to have SLCO1B1 normal function. This patient may be at an increased risk of fluvastatin-induced myopathy. Prescribe ≤40mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If a dose >40mg is needed for desired efficacy, consider an alternative statin or combination therapy. Please consult a clinical pharmacist for more information."}	1
7591288	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Normal Function"}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0", "SLCO1B1": "Normal Function"}	RxNorm:41127	{n/a}	1
7591289	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
7591290	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
7591291	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Normal Function"}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a", "SLCO1B1": "Normal Function"}	RxNorm:41127	{n/a}	1
7591292	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
7591293	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
7591294	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
7591295	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
7591296	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
7591297	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
7591298	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
7591299	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
7591300	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
7591301	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
7591302	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Increased Function"}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0", "SLCO1B1": "Increased Function"}	RxNorm:41127	{n/a}	1
7591303	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
7591304	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
7591305	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Increased Function"}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a", "SLCO1B1": "Increased Function"}	RxNorm:41127	{n/a}	1
7591306	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
7591662	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
7591307	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
7591308	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
7591309	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Possible Decreased Function"}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0", "SLCO1B1": "Possible Decreased Function"}	RxNorm:41127	{n/a}	1
7591310	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
7591311	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
7591312	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
7591313	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0"}	RxNorm:42355	{n/a}	1
7591314	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0"}	RxNorm:42355	{n/a}	1
7591315	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0"}	RxNorm:42355	{n/a}	1
7591316	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75"}	RxNorm:42355	{n/a}	1
7591317	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5"}	RxNorm:42355	{n/a}	1
7591318	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25"}	RxNorm:42355	{n/a}	1
7591319	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0"}	RxNorm:42355	{n/a}	1
7591320	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0"}	RxNorm:42355	{n/a}	1
7591321	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0"}	RxNorm:42355	{n/a}	1
7591322	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75"}	RxNorm:42355	{n/a}	1
7591323	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5"}	RxNorm:42355	{n/a}	1
7591324	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	RxNorm:42355	{n/a}	1
7591325	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	RxNorm:42355	{n/a}	1
7591326	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	RxNorm:42355	{n/a}	1
7591327	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	RxNorm:42355	{n/a}	1
7591328	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	RxNorm:42355	{n/a}	1
7591329	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0"}	RxNorm:42355	{n/a}	1
7591330	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75"}	RxNorm:42355	{n/a}	1
7591331	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5"}	RxNorm:42355	{n/a}	1
7591332	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25"}	RxNorm:42355	{n/a}	1
7591333	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
7591334	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a"}	RxNorm:42355	{n/a}	1
7592705	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	RxNorm:39786	{n/a}	1
7591337	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
7591338	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
7591339	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
7591340	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
7591341	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
7591342	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
7591343	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
7591344	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
7591345	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
7591346	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
7591347	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
7591348	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
7592706	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	RxNorm:39786	{n/a}	1
7591349	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
7591350	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
7591351	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
7591352	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
7591353	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
7591354	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
7591355	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
7591356	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
7591357	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
7591358	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
7591359	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
7591360	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
7591364	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
7591365	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
7591366	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
7591367	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
7591368	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
7591369	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
7591370	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
7591371	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
7591372	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
7592707	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	RxNorm:39786	{n/a}	1
7591373	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
7591374	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
7591375	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
7591376	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
7591377	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
7591378	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
7591379	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
7591380	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
7591381	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
7591382	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
7592708	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	RxNorm:39786	{n/a}	1
7591383	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
7591384	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
7591385	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
7591386	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
7591387	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
7591388	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
7591389	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
7591390	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
7591391	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
7591392	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
7592709	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	RxNorm:39786	{n/a}	1
7591393	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
7591394	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
7591395	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
7591396	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
7591397	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
7591398	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
7591399	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
7591400	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
7591401	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
7591402	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
7591403	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
7591404	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
7591405	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
7591406	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
7591407	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
7591408	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
7591409	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
7591410	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
7591411	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
7591412	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
7591413	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
7591414	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
7591415	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
7591416	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
7591417	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
7591418	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
7591419	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
7591420	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
7591421	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
7591422	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
7591423	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
7591424	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
7591425	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
7591426	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
7591438	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
7591427	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
7591428	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
7591429	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
7591430	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
7591431	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Indeterminate"}	RxNorm:5691	{n/a}	1
7591432	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
7591433	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
7591434	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
7591435	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
7591436	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
7591437	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
7592447	general	Pre-test	{CYP2D6}	{"CYP2D6": "No Result"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result"}	RxNorm:6918	{"CYP2D6 genotype may be important for metoprolol 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
7591439	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
7591440	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
7591441	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
7591442	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
7591443	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
7591444	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
7591445	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
7591446	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
7591447	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
7591448	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
7591449	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
7591450	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
7591451	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
7591452	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
7591453	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
7591454	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
7591455	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
7591456	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
7591457	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
7591458	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
7591459	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
7591460	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
7592448	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": ">2.25"}	{}	{"CYP2D6": ">2.25"}	RxNorm:6918	{n/a}	1
7591461	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
7591462	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
7591463	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
7591464	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
7591465	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
7591466	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
7591467	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
7591468	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
7591469	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
7591470	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
7591471	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
7591472	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
7591473	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
7591474	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
7591475	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
7591476	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
7591477	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
7591478	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
7591479	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
7591480	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
7592449	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0"}	RxNorm:6918	{n/a}	1
7591481	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
7591482	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
7591483	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
7591484	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
7591485	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
7591486	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
7591487	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
7591488	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
7591489	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
7591490	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
7591663	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
7591491	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
7591492	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
7591493	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
7591494	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
7591495	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
7591496	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
7591497	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
7591498	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
7591499	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
7591500	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
7592450	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0"}	RxNorm:6918	{n/a}	1
7591501	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
7591502	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
7591503	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
7591504	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
7591505	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
7591506	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
7591507	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
7591508	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
7591509	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
7591510	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
7591511	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
7592451	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0"}	RxNorm:6918	{n/a}	1
7591512	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
7591513	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
7591514	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
7591515	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
7591516	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
7591517	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
7591518	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
7591519	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
7591520	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
7591521	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
7591522	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
7591523	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
7591524	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{n/a}	1
7591525	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
7591526	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
7591527	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
7591528	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
7591529	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
7591530	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
7591531	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
7591583	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
7591532	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
7591533	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
7591534	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
7591535	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
7591536	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{n/a}	1
7591537	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{n/a}	1
7591538	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{n/a}	1
7591539	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{n/a}	1
7591540	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{n/a}	1
7591541	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
7591542	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
7591543	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
7591544	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
7591584	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2C19": "Normal Metabolizer"}	RxNorm:17128	{n/a}	1
7591793	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
7591545	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
7591546	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
7591547	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
7591548	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
7591549	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
7591550	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
7591551	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
7591552	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
7591553	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
7591554	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
7591555	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
7591665	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
7591556	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
7591557	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
7591558	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
7591559	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
7591560	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
7591561	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
7591562	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
7591563	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
7591564	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
7591565	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
7591566	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
7591567	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
7591568	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
7591585	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
7591569	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
7591570	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
7591571	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
7591572	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
7591573	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
7591574	general	No CDS	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:6026	{n/a}	1
7591575	H.pylori_erosive eso	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:17128	{n/a}	1
7591576	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
7591577	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
7591578	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
7591579	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
7591580	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
7591581	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
7591582	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
7591586	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2C19": "Rapid Metabolizer"}	RxNorm:17128	{n/a}	1
7592452	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75"}	RxNorm:6918	{n/a}	1
7591588	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
7591589	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
7591590	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
7591591	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
7591592	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:17128	{n/a}	1
7591593	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
7591594	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Increased Function"}	{}	{}	{"SLCO1B1": "Increased Function"}	RxNorm:6472	{n/a}	1
7591595	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Normal Function"}	{}	{}	{"SLCO1B1": "Normal Function"}	RxNorm:6472	{n/a}	1
7591596	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
7591597	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
7591598	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
7591599	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Indeterminate"}	{}	{}	{"SLCO1B1": "Indeterminate"}	RxNorm:6472	{n/a}	1
7591600	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
7591601	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
7591602	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
7591603	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
7591608	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
7591609	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
7591610	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
7591611	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
7591612	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
7591613	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
7591614	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
7591615	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
7591616	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
7591617	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
7591618	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	RxNorm:7531	{n/a}	1
7591619	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	RxNorm:7531	{n/a}	1
7591620	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	RxNorm:7531	{n/a}	1
7591621	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	RxNorm:7531	{n/a}	1
7591622	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	RxNorm:7531	{n/a}	1
7591623	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
7591664	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
7591624	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
7591625	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
7591626	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
7591627	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
7591628	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a"}	RxNorm:7531	{n/a}	1
7591629	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
7591630	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
7591631	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
7591632	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
7591633	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
7591634	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
7591635	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
7591636	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
7591637	H.pylori_erosive eso	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:7646	{n/a}	1
7591638	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
7591639	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
7591640	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2C19": "Rapid Metabolizer"}	RxNorm:7646	{n/a}	1
7591641	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2C19": "Normal Metabolizer"}	RxNorm:7646	{n/a}	1
7591642	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
7591643	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
7591644	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
7591645	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
7591646	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:7646	{n/a}	1
7591647	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25"}	RxNorm:26225	{n/a}	1
7591648	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0"}	RxNorm:26225	{n/a}	1
7591649	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a"}	RxNorm:26225	{n/a}	1
7591650	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	RxNorm:26225	{n/a}	1
7591651	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	RxNorm:26225	{n/a}	1
7591652	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	RxNorm:26225	{n/a}	1
7591653	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	RxNorm:26225	{n/a}	1
7591654	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	RxNorm:26225	{n/a}	1
7591655	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0"}	RxNorm:26225	{n/a}	1
7591656	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75"}	RxNorm:26225	{n/a}	1
7591657	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5"}	RxNorm:26225	{n/a}	1
7591658	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
7591659	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
7591660	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
7591661	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
7591666	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
7591667	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
7591668	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
7591669	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
7591670	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
7591671	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
7591672	general	No CDS	{HLA-B}	{}	{}	{"HLA-B": "*15:02 negative"}	{"HLA-B": "*15:02 negative"}	RxNorm:32624	{n/a}	1
7591673	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
7591674	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
7591675	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
7591676	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
7591677	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
7591678	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
7591679	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
7592453	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5"}	RxNorm:6918	{n/a}	1
7591680	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
7591681	H.pylori_erosive eso	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:40790	{n/a}	1
7591682	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
7591683	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
7591684	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2C19": "Rapid Metabolizer"}	RxNorm:40790	{n/a}	1
7591685	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2C19": "Normal Metabolizer"}	RxNorm:40790	{n/a}	1
7591686	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
7591687	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
7591688	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
7591689	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
7591690	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:40790	{n/a}	1
7591691	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
7591692	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
7591693	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
7591694	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
7591695	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
7591788	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Rapid Metabolizer"}	RxNorm:36437	{n/a}	1
7591696	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
7591697	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
7591698	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
7591699	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
7591700	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
7591701	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
7591702	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
7591703	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	RxNorm:32937	{n/a}	1
7591704	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	RxNorm:32937	{n/a}	1
7591705	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	RxNorm:32937	{n/a}	1
7591706	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	RxNorm:32937	{n/a}	1
7591707	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	RxNorm:32937	{n/a}	1
7591708	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
7591709	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
7591710	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
7591711	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
7591712	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
7591713	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a"}	RxNorm:32937	{n/a}	1
7591714	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
7591789	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Rapid Metabolizer"}	RxNorm:36437	{n/a}	1
7591715	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
7591716	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
7591717	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
7591718	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
7591719	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
7591720	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
7591721	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
7591722	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
7591723	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
7591724	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
7591725	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
7591726	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
7591790	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Indeterminate", "CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2B6": "Indeterminate", "CYP2C19": "Rapid Metabolizer"}	RxNorm:36437	{n/a}	1
7591727	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
7591728	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
7591729	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
7591730	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
7591731	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
7591732	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
7591733	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
7591734	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
7591735	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
7591736	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0"}	RxNorm:8356	{n/a}	1
7591737	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "1.5"}	{}	{"CYP2C9": "1.5"}	RxNorm:8356	{n/a}	1
7591738	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
7591739	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
7592454	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25"}	RxNorm:6918	{n/a}	1
7591740	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
7591741	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a"}	RxNorm:8356	{n/a}	1
7591742	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
7591743	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Increased Function"}	{}	{}	{"SLCO1B1": "Increased Function"}	RxNorm:861634	{n/a}	1
7591744	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Normal Function"}	{}	{}	{"SLCO1B1": "Normal Function"}	RxNorm:861634	{n/a}	1
7591745	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
7591746	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
7591747	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
7591748	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Indeterminate"}	{}	{}	{"SLCO1B1": "Indeterminate"}	RxNorm:861634	{n/a}	1
7591749	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
7591750	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Increased Function"}	{}	{}	{"SLCO1B1": "Increased Function"}	RxNorm:42463	{n/a}	1
7591751	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Normal Function"}	{}	{}	{"SLCO1B1": "Normal Function"}	RxNorm:42463	{n/a}	1
7591752	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Decreased Function"}	{}	{}	{"SLCO1B1": "Decreased Function"}	RxNorm:42463	{n/a}	1
7591753	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Possible Decreased Function"}	{}	{}	{"SLCO1B1": "Possible Decreased Function"}	RxNorm:42463	{n/a}	1
7591754	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
7591755	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Indeterminate"}	{}	{}	{"SLCO1B1": "Indeterminate"}	RxNorm:42463	{n/a}	1
7591756	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
7591757	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
7591791	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
7592455	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0"}	RxNorm:6918	{n/a}	1
7591758	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
7591759	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
7591760	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
7591761	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
7591762	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
7591763	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
7591764	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Decreased Function", "SLCO1B1": "Decreased Function"}	{}	{}	{"ABCG2": "Decreased Function", "SLCO1B1": "Decreased Function"}	RxNorm:301542	{n/a}	1
7591765	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Normal Function", "SLCO1B1": "Decreased Function"}	{}	{}	{"ABCG2": "Normal Function", "SLCO1B1": "Decreased Function"}	RxNorm:301542	{n/a}	1
7591766	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
7591767	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
7591768	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Decreased Function", "SLCO1B1": "Normal Function"}	{}	{}	{"ABCG2": "Decreased Function", "SLCO1B1": "Normal Function"}	RxNorm:301542	{n/a}	1
7591769	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Normal Function", "SLCO1B1": "Normal Function"}	{}	{}	{"ABCG2": "Normal Function", "SLCO1B1": "Normal Function"}	RxNorm:301542	{n/a}	1
7591770	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
7591771	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
7591772	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
7591773	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
7591774	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
7591775	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
7591776	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Decreased Function", "SLCO1B1": "Possible Decreased Function"}	{}	{}	{"ABCG2": "Decreased Function", "SLCO1B1": "Possible Decreased Function"}	RxNorm:301542	{n/a}	1
7591777	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Normal Function", "SLCO1B1": "Possible Decreased Function"}	{}	{}	{"ABCG2": "Normal Function", "SLCO1B1": "Possible Decreased Function"}	RxNorm:301542	{n/a}	1
7591778	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
7591779	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
7591780	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Decreased Function", "SLCO1B1": "Increased Function"}	{}	{}	{"ABCG2": "Decreased Function", "SLCO1B1": "Increased Function"}	RxNorm:301542	{n/a}	1
7591781	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Normal Function", "SLCO1B1": "Increased Function"}	{}	{}	{"ABCG2": "Normal Function", "SLCO1B1": "Increased Function"}	RxNorm:301542	{n/a}	1
7591782	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
7591783	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
7591784	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	RxNorm:36437	{n/a}	1
7591785	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Normal Metabolizer"}	RxNorm:36437	{n/a}	1
7591786	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Normal Metabolizer"}	RxNorm:36437	{n/a}	1
7591787	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Rapid Metabolizer"}	RxNorm:36437	{n/a}	1
7591794	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
7591795	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
7591796	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
7591797	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
7591798	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
7591799	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
7591800	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
7591801	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
7591802	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:36437	{n/a}	1
7591803	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:36437	{n/a}	1
7591804	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:36437	{n/a}	1
7591805	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Indeterminate", "CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2B6": "Indeterminate", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:36437	{n/a}	1
7591806	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
7591807	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
7591846	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
7591808	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
7591809	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
7591810	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Indeterminate", "CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2B6": "Indeterminate", "CYP2C19": "Normal Metabolizer"}	RxNorm:36437	{n/a}	1
7591811	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
7591812	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:36437	{n/a}	1
7591813	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:36437	{n/a}	1
7591814	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
7591815	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
7591816	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
7591817	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
7591818	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
7591819	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:36437	{n/a}	1
7591820	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:36437	{n/a}	1
7591821	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
7592456	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0"}	RxNorm:6918	{n/a}	1
7591822	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
7591823	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
7591824	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
7591825	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
7591826	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
7591827	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
7591828	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
7591829	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
7591830	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
7591831	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
7591832	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
7591833	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
7591834	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
7591835	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
7591836	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
7591837	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
7591838	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
7591839	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
7591840	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Indeterminate"}	{}	{}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Indeterminate"}	RxNorm:36437	{n/a}	1
7591841	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Indeterminate"}	{}	{}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Indeterminate"}	RxNorm:36437	{n/a}	1
7591842	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Indeterminate"}	{}	{}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Indeterminate"}	RxNorm:36437	{n/a}	1
7591843	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
7591844	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
7591845	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Indeterminate", "CYP2C19": "Indeterminate"}	{}	{}	{"CYP2B6": "Indeterminate", "CYP2C19": "Indeterminate"}	RxNorm:36437	{n/a}	1
7592457	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0"}	RxNorm:6918	{n/a}	1
7591847	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
7591848	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
7591849	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
7591850	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
7591851	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
7591852	general	No CDS	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:36453	{n/a}	1
7591853	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
7591854	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Increased Function"}	{}	{}	{"SLCO1B1": "Increased Function"}	RxNorm:36567	{n/a}	1
7591855	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Normal Function"}	{}	{}	{"SLCO1B1": "Normal Function"}	RxNorm:36567	{n/a}	1
7591856	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
7591857	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
7591858	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
7591859	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Indeterminate"}	{}	{}	{"SLCO1B1": "Indeterminate"}	RxNorm:36567	{n/a}	1
7591860	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
7591861	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
7591862	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
7591863	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
7591864	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
7591865	general	No CDS	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:10154	{n/a}	1
7591866	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
7591867	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
7591868	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
7591869	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
7591870	general	No CDS	{CYP3A5}	{"CYP3A5": "Poor Metabolizer"}	{}	{}	{"CYP3A5": "Poor Metabolizer"}	RxNorm:42316	{n/a}	1
7591871	general	No CDS	{CYP3A5}	{"CYP3A5": "Indeterminate"}	{}	{}	{"CYP3A5": "Indeterminate"}	RxNorm:42316	{n/a}	1
7591872	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0"}	RxNorm:10324	{n/a}	1
7591873	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5"}	RxNorm:10324	{n/a}	1
7591874	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25"}	RxNorm:10324	{n/a}	1
7591875	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0"}	RxNorm:10324	{n/a}	1
7591876	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0"}	RxNorm:10324	{n/a}	1
7591877	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75"}	RxNorm:10324	{n/a}	1
7591878	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0"}	RxNorm:10324	{n/a}	1
7591879	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5"}	RxNorm:10324	{n/a}	1
7591880	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	RxNorm:10324	{n/a}	1
7591881	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	RxNorm:10324	{n/a}	1
7591882	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	RxNorm:10324	{n/a}	1
7591883	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	RxNorm:10324	{n/a}	1
7591884	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	RxNorm:10324	{n/a}	1
7591885	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
7591886	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0"}	RxNorm:10324	{n/a}	1
7591887	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0"}	RxNorm:10324	{n/a}	1
7591888	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75"}	RxNorm:10324	{n/a}	1
7592458	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75"}	RxNorm:6918	{n/a}	1
7591889	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
7591890	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
7591891	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
7591892	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
7591893	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
7591894	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a"}	RxNorm:10324	{n/a}	1
7591895	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
7591896	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0"}	RxNorm:37790	{n/a}	1
7591897	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "1.5"}	{}	{"CYP2C9": "1.5"}	RxNorm:37790	{n/a}	1
7591898	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
7591899	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
7591900	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
7591901	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a"}	RxNorm:37790	{n/a}	1
7591902	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
7592262	general	Pre-test	{CYP2D6}	{}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result"}	RxNorm:2670	{"CYP2D6 genotype is important for codeine and tramadol dosing and use. A CYP2D6 genotype does not appear to have been ordered for this patient. Use of an alternative analgesic agent (other than tramadol) may be recommended. Please consult a clinical pharmacist for more information."}	1
7591903	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
7591904	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
7591905	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
7591906	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
7591907	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
7591908	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
7591909	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
7591910	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
7591911	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
7592246	general	Post-test	{G6PD}	{"G6PD": "Deficient with CNSHA"}	{}	{}	{"G6PD": "Deficient with CNSHA"}	RxNorm:2348	{"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
7591912	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
7591913	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
7591914	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
7591915	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
7591916	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
7591917	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
7591918	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
7591919	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
7591920	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
7591921	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
7592247	general	No CDS	{G6PD}	{"G6PD": "Variable"}	{}	{}	{"G6PD": "Variable"}	RxNorm:2348	{n/a}	1
7591922	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
7591923	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
7591924	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
7591925	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
7591926	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
7591927	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
7591928	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
7591929	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
7591930	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
7591931	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
7592248	general	No CDS	{G6PD}	{"G6PD": "Indeterminate"}	{}	{}	{"G6PD": "Indeterminate"}	RxNorm:2348	{n/a}	1
7591932	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
7591933	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
7591934	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
7591935	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
7591936	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
7591937	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
7591938	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
7591939	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
7591940	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
7591941	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
7592251	general	No CDS	{G6PD}	{"G6PD": "Deficient"}	{}	{}	{"G6PD": "Deficient"}	RxNorm:2393	{n/a}	1
7591942	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
7591943	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
7591944	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
7591945	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
7591946	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
7591947	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
7591948	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
7591949	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
7591950	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
7591951	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
7591952	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
7591953	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
7591954	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
7591955	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
7591956	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
7591957	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
7591958	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
7591959	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
7591960	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
7591961	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
7591962	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
7591963	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
7591964	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
7591965	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
7591966	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
7591967	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
7591968	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
7591969	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
7591970	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
7591971	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Indeterminate"}	RxNorm:10834	{n/a}	1
7591972	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
7591973	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
7591974	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
7591975	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
7591976	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
7591977	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
7592459	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5"}	RxNorm:6918	{n/a}	1
7591978	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
7591979	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
7591980	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
7591981	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
7591982	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
7591983	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
7591984	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
7591985	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
7591986	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
7591987	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
7591988	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
7592252	general	Post-test	{G6PD}	{"G6PD": "Deficient with CNSHA"}	{}	{}	{"G6PD": "Deficient with CNSHA"}	RxNorm:2393	{"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
7591989	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
7591990	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
7591991	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
7591992	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
7591993	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
7591994	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
7591995	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
7591996	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
7591997	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
7591998	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
7592253	general	No CDS	{G6PD}	{"G6PD": "Variable"}	{}	{}	{"G6PD": "Variable"}	RxNorm:2393	{n/a}	1
7592254	general	No CDS	{G6PD}	{"G6PD": "Indeterminate"}	{}	{}	{"G6PD": "Indeterminate"}	RxNorm:2393	{n/a}	1
7591999	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
7592000	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
7592001	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
7592002	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
7592003	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
7592004	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
7592005	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
7592006	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
7592007	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
7592008	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
7592255	general	No CDS	{G6PD}	{"G6PD": "No Result"}	{}	{}	{"G6PD": "No Result"}	RxNorm:2551	{n/a}	1
7592009	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
