7843786	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Normal 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 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
7843787	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "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 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
7843861	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
7843788	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "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 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
7843789	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "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 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
7843790	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "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 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
7843791	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "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 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
7843792	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "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 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
7843793	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "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 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
7843794	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "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 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
7843795	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "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 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
7843796	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "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 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
7843797	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "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 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
7843798	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "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 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
7843799	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "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 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
7843800	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "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 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
7843801	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "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 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
7843802	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "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 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
7843803	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "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 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
7843804	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "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 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
7843805	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "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 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
7843806	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "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 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
7843807	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "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 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
7843808	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Poor Metabolizer"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "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 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
7845154	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": ">2.25"}	{}	{"CYP2D6": ">2.25"}	RxNorm:6918	{n/a}	1
7843809	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "CYP2C19": "Rapid 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 rapid 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
7843810	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "CYP2C19": "Rapid 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 rapid 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
7843811	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "0.5"}	{}	{"CYP2D6": "0.5", "CYP2C19": "Rapid 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 rapid 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
7843812	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25", "CYP2C19": "Rapid 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 rapid 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
7843813	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Rapid 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 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 doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7843814	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Rapid 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 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 doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7843815	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Rapid 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 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 doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7843816	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Rapid 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 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 doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7843817	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Rapid 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 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 doxepin is warranted utilize therapeutic drug monitoring to guide dose adjustments. Please consult a clinical pharmacist for more information."}	1
7843818	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0", "CYP2C19": "Rapid 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 rapid 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
7843887	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{n/a}	1
7843819	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0", "CYP2C19": "Rapid 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 rapid 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
7843820	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0", "CYP2C19": "Rapid 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 rapid 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
7843821	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75", "CYP2C19": "Rapid 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 rapid 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
7843822	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0", "CYP2C19": "Rapid 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 rapid 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
7843823	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5", "CYP2C19": "Rapid 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 rapid 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
7843824	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25", "CYP2C19": "Rapid 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 rapid 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
7843825	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0", "CYP2C19": "Rapid 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 rapid 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
7843826	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0", "CYP2C19": "Rapid 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 rapid 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
7843827	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75", "CYP2C19": "Rapid 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 rapid 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
7843828	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0", "CYP2C19": "Rapid 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 rapid 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
7843947	general	No CDS	{CYP2B6}	{"CYP2B6": "Indeterminate"}	{}	{}	{"CYP2B6": "Indeterminate"}	RxNorm:195085	{n/a}	1
7844127	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
7843829	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5", "CYP2C19": "Rapid 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 rapid 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
7843830	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Rapid 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 rapid 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
7843831	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result", "CYP2C19": "Rapid 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 rapid 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
7843832	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "1.0"}	{}	{"CYP2D6": "1.0", "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 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
7843833	general	Post-test	{CYP2D6,CYP2C19}	{"CYP2C19": "Ultrarapid Metabolizer"}	{"CYP2D6": "0.75"}	{}	{"CYP2D6": "0.75", "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 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
7843834	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
7843835	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
7843836	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
7843837	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
7843838	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
7845155	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0"}	RxNorm:6918	{n/a}	1
7843839	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
7843840	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
7843841	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
7843842	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
7843843	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
7843844	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
7843845	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
7843846	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
7843847	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
7843848	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
7844128	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
7843850	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
7843851	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
7843852	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
7843853	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
7843854	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
7843855	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
7843856	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
7843857	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
7843858	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
7843859	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
7843860	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
7843862	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
7843863	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
7843864	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
7843865	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
7843866	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
7843867	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
7843868	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
7843869	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
7843870	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
7843871	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
7843872	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
7845156	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0"}	RxNorm:6918	{n/a}	1
7843873	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
7843874	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
7843875	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
7843876	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Indeterminate"}	RxNorm:3638	{n/a}	1
7843877	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
7843878	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
7843879	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
7843880	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
7843881	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
7843882	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
7843883	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{n/a}	1
7843884	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{n/a}	1
7843885	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{n/a}	1
7843886	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{n/a}	1
7843888	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
7843889	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
7843890	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
7843891	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
7843892	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
7843893	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
7843894	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
7843895	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
7843896	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
7843897	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
7843898	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
7843899	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
7843900	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:3638	{n/a}	1
7843901	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
7843902	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
7843903	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
7843904	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
7843905	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
7843906	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
7843907	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
7843908	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
7843948	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
7843909	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
7843910	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
7843911	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
7843912	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
7843913	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
7843914	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
7843915	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
7843916	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
7843917	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
7843918	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
7843949	general	No CDS	{CYP2B6}	{"CYP2B6": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2B6": "Ultrarapid Metabolizer"}	RxNorm:195085	{n/a}	1
7843950	general	No CDS	{CYP2B6}	{"CYP2B6": "Rapid Metabolizer"}	{}	{}	{"CYP2B6": "Rapid Metabolizer"}	RxNorm:195085	{n/a}	1
7843951	general	No CDS	{CYP2B6}	{"CYP2B6": "Normal Metabolizer"}	{}	{}	{"CYP2B6": "Normal Metabolizer"}	RxNorm:195085	{n/a}	1
7843919	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
7843920	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
7843921	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
7843922	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
7843923	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
7843924	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
7843925	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
7843926	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
7843927	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
7843928	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
7845157	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0"}	RxNorm:6918	{n/a}	1
7843929	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
7843930	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
7843931	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
7843932	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
7843933	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
7843934	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
7843935	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
7843936	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
7843937	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
7843952	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
7844129	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
7843938	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
7843939	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
7843940	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
7843941	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
7843942	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
7843943	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
7843944	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
7843945	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
7843946	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
7843954	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
7845256	general	No CDS	{G6PD}	{"G6PD": "Normal"}	{}	{}	{"G6PD": "Normal"}	RxNorm:10171	{n/a}	1
7843955	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
7843956	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
7843957	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
7843958	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
7843959	general	No CDS	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:3920	{n/a}	1
7843960	general	Pre-test	{CYP2C19}	{"CYP2C19": "No Result"}	{}	{}	{"CYP2C19": "No Result"}	RxNorm:321988	{"CYP2C19 genotype may be important for the use of escitalopram. A CYP2C19 genotype does not appear to have been ordered for this patient. Please consult a clinical pharmacist for more information."}	1
7843961	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
7843962	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
7843963	general	No CDS	{CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2C19": "Normal Metabolizer"}	RxNorm:321988	{n/a}	1
7843964	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
7843965	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
7843966	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
7843967	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
7843968	general	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:321988	{n/a}	1
7843969	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
7843970	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
7843971	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Possible Decreased Function"}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a", "SLCO1B1": "Possible Decreased Function"}	RxNorm:41127	{n/a}	1
7843972	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
7843973	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
7843974	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Indeterminate"}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0", "SLCO1B1": "Indeterminate"}	RxNorm:41127	{n/a}	1
7843975	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
7843976	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
7843977	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Indeterminate"}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a", "SLCO1B1": "Indeterminate"}	RxNorm:41127	{n/a}	1
7843978	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
7843979	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
7843980	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
7843981	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
7843982	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
7843983	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
7843984	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
7843985	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
7843986	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
7843987	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Decreased Function"}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0", "SLCO1B1": "Decreased Function"}	RxNorm:41127	{n/a}	1
7843988	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
7843989	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
7843990	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Decreased Function"}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a", "SLCO1B1": "Decreased Function"}	RxNorm:41127	{n/a}	1
7843991	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
7843992	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
7843993	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
7843994	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Normal Function"}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0", "SLCO1B1": "Normal Function"}	RxNorm:41127	{n/a}	1
7844039	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
7843995	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
7843996	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
7843997	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Normal Function"}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a", "SLCO1B1": "Normal Function"}	RxNorm:41127	{n/a}	1
7843998	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
7843999	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
7844000	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
7844001	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
7844002	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
7844003	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
7844004	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
7844005	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
7844006	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
7844040	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a"}	RxNorm:42355	{n/a}	1
7845158	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75"}	RxNorm:6918	{n/a}	1
7844007	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
7844008	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Increased Function"}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0", "SLCO1B1": "Increased Function"}	RxNorm:41127	{n/a}	1
7844009	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
7844010	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
7844011	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Increased Function"}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a", "SLCO1B1": "Increased Function"}	RxNorm:41127	{n/a}	1
7844012	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
7844013	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
7844014	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
7844015	general	No CDS	{SLCO1B1,CYP2C9}	{"SLCO1B1": "Possible Decreased Function"}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0", "SLCO1B1": "Possible Decreased Function"}	RxNorm:41127	{n/a}	1
7844016	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
7844017	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
7844018	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
7844019	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0"}	RxNorm:42355	{n/a}	1
7844020	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥5.0"}	{}	{"CYP2D6": "≥5.0"}	RxNorm:42355	{n/a}	1
7844021	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0"}	RxNorm:42355	{n/a}	1
7844022	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.75"}	{}	{"CYP2D6": "≥3.75"}	RxNorm:42355	{n/a}	1
7844023	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5"}	RxNorm:42355	{n/a}	1
7844024	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25"}	RxNorm:42355	{n/a}	1
7844025	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0"}	RxNorm:42355	{n/a}	1
7844041	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
7844042	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
7844043	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
7844044	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
7844045	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
7844046	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
7844047	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
7844048	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
7844049	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
7844050	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
7844051	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
7844052	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
7844053	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
7844130	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
7844054	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
7844055	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
7844056	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
7844057	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
7844058	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
7844059	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
7844060	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
7844061	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
7844062	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
7844063	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
7844064	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
7844065	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
7844066	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
7844067	general	No CDS	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:5095	{n/a}	1
7844068	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
7844069	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
7844070	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
7844071	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
7844072	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
7844073	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
7844074	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
7844075	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
7844131	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
7845159	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5"}	RxNorm:6918	{n/a}	1
7844076	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
7844077	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
7844078	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
7844079	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
7844080	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
7844081	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
7844082	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
7844083	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
7844084	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
7844085	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
7844086	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
7844087	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
7844088	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
7844089	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
7844090	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
7844091	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
7844092	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
7844093	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
7844094	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
7844095	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
7844096	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
7844097	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
7844098	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
7844099	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
7844100	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
7844101	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
7844102	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
7844103	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
7844104	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
7844105	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
7844154	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
7844106	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
7844107	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
7844108	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
7844109	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
7844110	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
7844111	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
7844112	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
7844113	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
7844114	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
7844115	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
7844497	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
7844116	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
7844117	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
7844118	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
7844119	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
7844120	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
7844121	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
7844122	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
7844123	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
7844124	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
7844125	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
7844126	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
7844132	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
7844133	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
7844134	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
7844135	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
7844136	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
7844137	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Indeterminate"}	RxNorm:5691	{n/a}	1
7844138	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
7844139	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
7844140	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
7844141	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
7844142	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
7844498	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	RxNorm:36437	{n/a}	1
7844143	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
7844144	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
7844145	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
7844146	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
7844147	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
7844148	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
7844149	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
7844150	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
7844151	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
7844152	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
7844153	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
7844399	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
7844155	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
7844156	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
7844157	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
7844158	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
7844159	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
7844160	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
7844161	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
7844162	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
7844163	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
7844164	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
7844400	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
7844165	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
7844166	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
7844167	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
7844168	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
7844169	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
7844170	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
7844171	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
7844172	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
7844173	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
7844174	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
7845160	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.25"}	{}	{"CYP2D6": "≥3.25"}	RxNorm:6918	{n/a}	1
7844175	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
7844176	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
7844177	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
7844178	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
7844179	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
7844180	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
7844181	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
7844182	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
7844183	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
7844184	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
7845257	general	No CDS	{G6PD}	{"G6PD": "Deficient"}	{}	{}	{"G6PD": "Deficient"}	RxNorm:10171	{n/a}	1
7844185	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
7844186	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
7844187	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
7844188	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
7844189	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
7844190	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
7844191	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
7844192	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
7844193	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
7844194	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
7844401	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
7844195	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
7844196	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
7844197	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
7844198	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
7844199	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
7844200	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
7844201	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
7844202	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
7844203	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
7844204	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
7844420	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
7844205	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
7844206	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
7844207	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
7844208	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
7844209	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
7844210	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
7844211	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
7844212	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
7844213	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
7844214	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
7844215	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
7844216	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
7844217	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
7844218	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
7844219	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
7844220	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
7844221	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
7844222	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
7844223	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
7844224	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
7844225	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
7845161	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "≥3.0"}	{}	{"CYP2D6": "≥3.0"}	RxNorm:6918	{n/a}	1
7844226	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
7844227	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
7844228	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
7844229	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
7844230	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{n/a}	1
7844231	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
7844232	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
7844233	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
7844234	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
7844235	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
7844249	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
7844236	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
7844237	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
7844238	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
7844239	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
7844240	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
7844241	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
7844242	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{n/a}	1
7844243	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{n/a}	1
7844244	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{n/a}	1
7844245	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{n/a}	1
7844246	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Normal Metabolizer"}	RxNorm:5691	{n/a}	1
7844247	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
7844248	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
7844281	H.pylori_erosive eso	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:17128	{n/a}	1
7844490	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Normal Metabolizer"}	RxNorm:36437	{n/a}	1
7844250	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
7844251	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
7844252	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
7844253	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
7844254	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
7844255	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
7844256	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
7844257	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
7844258	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
7844259	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
7844260	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
7844343	H.pylori_erosive eso	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:7646	{n/a}	1
7845162	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "4.0"}	{}	{"CYP2D6": "4.0"}	RxNorm:6918	{n/a}	1
7844261	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
7844262	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
7844263	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
7844264	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
7844265	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
7844266	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
7844267	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
7844268	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
7844269	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Intermediate Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:5691	{n/a}	1
7844270	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
7844271	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
7844272	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
7844273	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
7844274	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
7844275	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
7844276	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
7844277	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
7844278	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
7844279	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
7844280	general	No CDS	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:6026	{n/a}	1
7844282	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
7844283	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
7844284	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
7844285	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
7844286	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
7844287	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
7844288	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
7844289	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
7844290	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2C19": "Normal Metabolizer"}	RxNorm:17128	{n/a}	1
7844291	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
7844292	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2C19": "Rapid Metabolizer"}	RxNorm:17128	{n/a}	1
7844293	non-H.pylori_erosive	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
7844294	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
7844295	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
7844344	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
7844296	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
7844297	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
7844298	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:17128	{n/a}	1
7844299	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
7844300	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Increased Function"}	{}	{}	{"SLCO1B1": "Increased Function"}	RxNorm:6472	{n/a}	1
7844301	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Normal Function"}	{}	{}	{"SLCO1B1": "Normal Function"}	RxNorm:6472	{n/a}	1
7844302	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
7844303	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
7844304	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
7844305	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Indeterminate"}	{}	{}	{"SLCO1B1": "Indeterminate"}	RxNorm:6472	{n/a}	1
7844306	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
7844307	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
7844308	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
7844309	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
7844310	general	Pre-test	{RYR1,CACNA1S}	{"RYR1": "No Result", "CACNA1S": "No Result"}	{}	{}	{"RYR1": "No Result", "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
7844311	general	No CDS	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:6857	{n/a}	1
7844312	general	Pre-test	{CYP2D6}	{}	{"CYP2D6": "No Result"}	{}	{"CYP2D6": "No Result"}	RxNorm:7531	{"CYP2D6 genetic status may be important for nortriptyline dosing and use. 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
7844353	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "0.25"}	{}	{"CYP2D6": "0.25"}	RxNorm:26225	{n/a}	1
7844313	general	Post-test	{CYP2D6}	{}	{"CYP2D6": "≥6.0"}	{}	{"CYP2D6": "≥6.0"}	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
7844314	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
7844315	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
7844316	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
7844317	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
7844318	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
7844319	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
7844320	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
7844321	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
7844322	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
7844323	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
7844324	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	RxNorm:7531	{n/a}	1
7844325	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	RxNorm:7531	{n/a}	1
7844326	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	RxNorm:7531	{n/a}	1
7844327	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	RxNorm:7531	{n/a}	1
7844328	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	RxNorm:7531	{n/a}	1
7844354	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "0.0"}	{}	{"CYP2D6": "0.0"}	RxNorm:26225	{n/a}	1
7844355	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a"}	RxNorm:26225	{n/a}	1
7844329	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
7844330	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
7844331	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
7844332	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
7844333	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
7844334	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a"}	RxNorm:7531	{n/a}	1
7844335	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
7844336	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
7844337	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
7844338	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
7844339	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
7844340	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
7844341	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
7844342	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
7844345	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
7844346	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2C19": "Rapid Metabolizer"}	RxNorm:7646	{n/a}	1
7844347	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2C19": "Normal Metabolizer"}	RxNorm:7646	{n/a}	1
7844348	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
7844349	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
7844350	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
7844351	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
7844352	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:7646	{n/a}	1
7844376	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
7844377	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
7844378	general	No CDS	{HLA-B}	{}	{}	{"HLA-B": "*15:02 negative"}	{"HLA-B": "*15:02 negative"}	RxNorm:32624	{n/a}	1
7844379	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
7844380	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
7844381	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
7844382	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
7844491	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Normal Metabolizer"}	RxNorm:36437	{n/a}	1
7844383	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
7844384	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
7844385	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
7844386	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
7844387	H.pylori_erosive eso	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:40790	{n/a}	1
7844388	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
7844389	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
7844390	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2C19": "Rapid Metabolizer"}	RxNorm:40790	{n/a}	1
7844391	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2C19": "Normal Metabolizer"}	RxNorm:40790	{n/a}	1
7844392	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
7844393	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
7844394	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
7844395	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
7844396	non-H.pylori_erosive	No CDS	{CYP2C19}	{"CYP2C19": "Indeterminate"}	{}	{}	{"CYP2C19": "Indeterminate"}	RxNorm:40790	{n/a}	1
7844397	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
7844398	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
7844402	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
7844403	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
7844404	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
7844405	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
7844406	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
7844407	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
7844408	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
7844409	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	RxNorm:32937	{n/a}	1
7844410	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0"}	RxNorm:32937	{n/a}	1
7844411	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75"}	RxNorm:32937	{n/a}	1
7844412	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5"}	RxNorm:32937	{n/a}	1
7844413	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25"}	RxNorm:32937	{n/a}	1
7844414	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
7844415	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
7844416	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
7844417	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
7844418	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
7844419	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a"}	RxNorm:32937	{n/a}	1
7844421	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
7844422	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
7844423	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
7844424	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
7844425	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
7844426	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
7844427	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
7844428	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
7844429	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
7844430	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
7844431	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
7844432	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
7844492	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Normal Metabolizer"}	RxNorm:36437	{n/a}	1
7844433	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
7844434	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
7844435	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
7844436	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
7844437	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
7844438	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
7844439	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
7844440	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
7844441	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
7844442	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0"}	RxNorm:8356	{n/a}	1
7844443	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "1.5"}	{}	{"CYP2C9": "1.5"}	RxNorm:8356	{n/a}	1
7844444	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
7844445	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
7845163	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "3.0"}	{}	{"CYP2D6": "3.0"}	RxNorm:6918	{n/a}	1
7844446	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
7844447	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a"}	RxNorm:8356	{n/a}	1
7844448	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
7844449	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Increased Function"}	{}	{}	{"SLCO1B1": "Increased Function"}	RxNorm:861634	{n/a}	1
7844450	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Normal Function"}	{}	{}	{"SLCO1B1": "Normal Function"}	RxNorm:861634	{n/a}	1
7844451	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
7844452	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
7844453	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
7844454	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Indeterminate"}	{}	{}	{"SLCO1B1": "Indeterminate"}	RxNorm:861634	{n/a}	1
7844455	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
7844456	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Increased Function"}	{}	{}	{"SLCO1B1": "Increased Function"}	RxNorm:42463	{n/a}	1
7844457	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Normal Function"}	{}	{}	{"SLCO1B1": "Normal Function"}	RxNorm:42463	{n/a}	1
7844458	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Decreased Function"}	{}	{}	{"SLCO1B1": "Decreased Function"}	RxNorm:42463	{n/a}	1
7844459	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Possible Decreased Function"}	{}	{}	{"SLCO1B1": "Possible Decreased Function"}	RxNorm:42463	{n/a}	1
7844460	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
7844461	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Indeterminate"}	{}	{}	{"SLCO1B1": "Indeterminate"}	RxNorm:42463	{n/a}	1
7844462	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
7844463	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
7844493	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Rapid Metabolizer"}	RxNorm:36437	{n/a}	1
7844494	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Rapid Metabolizer"}	{}	{}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Rapid Metabolizer"}	RxNorm:36437	{n/a}	1
7844464	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
7844465	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
7844466	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
7844467	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
7844468	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
7844469	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
7844470	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Decreased Function", "SLCO1B1": "Decreased Function"}	{}	{}	{"ABCG2": "Decreased Function", "SLCO1B1": "Decreased Function"}	RxNorm:301542	{n/a}	1
7844471	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Normal Function", "SLCO1B1": "Decreased Function"}	{}	{}	{"ABCG2": "Normal Function", "SLCO1B1": "Decreased Function"}	RxNorm:301542	{n/a}	1
7844472	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
7844473	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
7844474	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Decreased Function", "SLCO1B1": "Normal Function"}	{}	{}	{"ABCG2": "Decreased Function", "SLCO1B1": "Normal Function"}	RxNorm:301542	{n/a}	1
7844475	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Normal Function", "SLCO1B1": "Normal Function"}	{}	{}	{"ABCG2": "Normal Function", "SLCO1B1": "Normal Function"}	RxNorm:301542	{n/a}	1
7844476	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
7844477	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
7844478	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
7844479	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
7844480	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
7844481	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
7844482	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Decreased Function", "SLCO1B1": "Possible Decreased Function"}	{}	{}	{"ABCG2": "Decreased Function", "SLCO1B1": "Possible Decreased Function"}	RxNorm:301542	{n/a}	1
7844483	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Normal Function", "SLCO1B1": "Possible Decreased Function"}	{}	{}	{"ABCG2": "Normal Function", "SLCO1B1": "Possible Decreased Function"}	RxNorm:301542	{n/a}	1
7844484	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
7844485	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
7844486	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Decreased Function", "SLCO1B1": "Increased Function"}	{}	{}	{"ABCG2": "Decreased Function", "SLCO1B1": "Increased Function"}	RxNorm:301542	{n/a}	1
7844487	general	No CDS	{SLCO1B1,ABCG2}	{"ABCG2": "Normal Function", "SLCO1B1": "Increased Function"}	{}	{}	{"ABCG2": "Normal Function", "SLCO1B1": "Increased Function"}	RxNorm:301542	{n/a}	1
7844488	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
7844489	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
7844499	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
7844500	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
7844501	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
7844502	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
7844503	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
7844504	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
7844505	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
7844506	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
7844507	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
7844508	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:36437	{n/a}	1
7844509	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2B6": "Intermediate Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:36437	{n/a}	1
7844510	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2B6": "Poor Metabolizer", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:36437	{n/a}	1
7844511	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Indeterminate", "CYP2C19": "Ultrarapid Metabolizer"}	{}	{}	{"CYP2B6": "Indeterminate", "CYP2C19": "Ultrarapid Metabolizer"}	RxNorm:36437	{n/a}	1
7844512	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
7844527	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
7844513	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
7844514	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
7844515	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
7844516	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Indeterminate", "CYP2C19": "Normal Metabolizer"}	{}	{}	{"CYP2B6": "Indeterminate", "CYP2C19": "Normal Metabolizer"}	RxNorm:36437	{n/a}	1
7844517	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
7844518	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:36437	{n/a}	1
7844519	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:36437	{n/a}	1
7844520	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
7844521	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
7844522	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
7844523	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
7844524	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
7844525	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:36437	{n/a}	1
7844526	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	{}	{}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Intermediate Metabolizer"}	RxNorm:36437	{n/a}	1
7844528	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
7844529	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
7844530	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
7844531	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
7844532	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
7844533	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
7844534	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
7844535	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
7844536	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
7844537	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
7844538	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
7844539	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
7844540	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
7844541	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
7844542	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
7844543	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
7844544	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
7844545	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
7844546	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Indeterminate"}	{}	{}	{"CYP2B6": "Ultrarapid Metabolizer", "CYP2C19": "Indeterminate"}	RxNorm:36437	{n/a}	1
7844547	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Indeterminate"}	{}	{}	{"CYP2B6": "Rapid Metabolizer", "CYP2C19": "Indeterminate"}	RxNorm:36437	{n/a}	1
7844548	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Indeterminate"}	{}	{}	{"CYP2B6": "Normal Metabolizer", "CYP2C19": "Indeterminate"}	RxNorm:36437	{n/a}	1
7844549	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
7844550	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
7844551	general	No CDS	{CYP2B6,CYP2C19}	{"CYP2B6": "Indeterminate", "CYP2C19": "Indeterminate"}	{}	{}	{"CYP2B6": "Indeterminate", "CYP2C19": "Indeterminate"}	RxNorm:36437	{n/a}	1
7844578	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥4.0"}	{}	{"CYP2D6": "≥4.0"}	RxNorm:10324	{n/a}	1
7844579	general	No CDS	{CYP2D6}	{}	{"CYP2D6": "≥3.5"}	{}	{"CYP2D6": "≥3.5"}	RxNorm:10324	{n/a}	1
7844552	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
7844553	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
7844554	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
7844555	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
7844556	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
7844557	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
7844558	general	No CDS	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:36453	{n/a}	1
7844559	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
7844560	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Increased Function"}	{}	{}	{"SLCO1B1": "Increased Function"}	RxNorm:36567	{n/a}	1
7844561	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Normal Function"}	{}	{}	{"SLCO1B1": "Normal Function"}	RxNorm:36567	{n/a}	1
7844562	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
7844563	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
7844564	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
7844565	general	No CDS	{SLCO1B1}	{"SLCO1B1": "Indeterminate"}	{}	{}	{"SLCO1B1": "Indeterminate"}	RxNorm:36567	{n/a}	1
7844566	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
7844567	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
7844568	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
7844569	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
7844570	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
7844571	general	No CDS	{RYR1,CACNA1S}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	{}	{}	{"RYR1": "Uncertain Susceptibility", "CACNA1S": "Uncertain Susceptibility"}	RxNorm:10154	{n/a}	1
7844572	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
7844573	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
7844574	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
7844575	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
7844576	general	No CDS	{CYP3A5}	{"CYP3A5": "Poor Metabolizer"}	{}	{}	{"CYP3A5": "Poor Metabolizer"}	RxNorm:42316	{n/a}	1
7844577	general	No CDS	{CYP3A5}	{"CYP3A5": "Indeterminate"}	{}	{}	{"CYP3A5": "Indeterminate"}	RxNorm:42316	{n/a}	1
7844601	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
7844602	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "2.0"}	{}	{"CYP2C9": "2.0"}	RxNorm:37790	{n/a}	1
7844603	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "1.5"}	{}	{"CYP2C9": "1.5"}	RxNorm:37790	{n/a}	1
7844604	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
7844605	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
7844606	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
7844607	general	No CDS	{CYP2C9}	{}	{"CYP2C9": "n/a"}	{}	{"CYP2C9": "n/a"}	RxNorm:37790	{n/a}	1
7844608	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
7844609	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
7844610	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
7844611	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
7844612	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
7844613	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
7844614	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
7844615	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
7844616	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
7844617	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
7844618	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
7844619	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
7844620	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
7844621	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
7844622	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
7844623	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
7844624	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
7844625	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
7844626	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
7844627	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
7845261	general	No CDS	{G6PD}	{"G6PD": "No Result"}	{}	{}	{"G6PD": "No Result"}	RxNorm:10178	{n/a}	1
7844628	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
7844629	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
7844630	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
7844631	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
7844632	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
7844633	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
7844634	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
7844635	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
7844636	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
7844637	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
7845164	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.75"}	{}	{"CYP2D6": "2.75"}	RxNorm:6918	{n/a}	1
7844638	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
7844639	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
7844640	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
7844641	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
7844642	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
7844643	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
7844644	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
7844645	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
7844646	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
7844647	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
7845165	general	No CDS	{CYP2D6}	{"CYP2D6": "Ultrarapid Metabolizer"}	{"CYP2D6": "2.5"}	{}	{"CYP2D6": "2.5"}	RxNorm:6918	{n/a}	1
7844648	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
7844649	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
7844650	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
7844651	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
7844652	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
7844653	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
7844654	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
7844655	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
7844656	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
7844657	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
7844658	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
7844659	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
7844660	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
7844661	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
7844662	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
7844663	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
7844664	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
7844665	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
7844666	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
7844667	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
7844668	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "2.0"}	{}	{"CYP2D6": "2.0", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
7844669	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.75"}	{}	{"CYP2D6": "1.75", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
7844670	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.5"}	{}	{"CYP2D6": "1.5", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
7844671	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Likely Intermediate Metabolizer"}	{"CYP2D6": "1.25"}	{}	{"CYP2D6": "1.25", "CYP2C19": "Likely Intermediate Metabolizer"}	RxNorm:10834	{n/a}	1
7844672	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
7844673	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
7844674	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
7844675	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
7844676	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
7844677	general	No CDS	{CYP2D6,CYP2C19}	{"CYP2C19": "Indeterminate"}	{"CYP2D6": "n/a"}	{}	{"CYP2D6": "n/a", "CYP2C19": "Indeterminate"}	RxNorm:10834	{n/a}	1
7844678	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
7844679	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
7844680	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
7844681	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
7844682	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
7844683	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
7845166	general	No CDS	{CYP2D6}	{"CYP2D6": "Normal Metabolizer"}	{"CYP2D6": "2.25"}	{}	{"CYP2D6": "2.25"}	RxNorm:6918	{n/a}	1
7844684	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
7844685	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
7844686	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
7844687	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
