OBJECTIVES: To describe the application and perceived utility of pharmacogenomic recommendations among physicians managing a cohort of Medicare patients’ chronic medical conditions.  METHODS: From January 1 through April 30, 2013, genetic results were reviewed from Medicare patients. Demographic data included patients’ date of birth, age, ethnicity, gender, medication count, ICD-9-CM diagnosis codes, insurance information, and current medications. Patients’ physicians were provided with a standardized report, including CYP3A4, CYP3A5, CYP2D6, CYP2C19, CYP2C9, VKORC1, MTHFR1298, MTHFR677, Factor V, and Factor II genotypes, phenotypes, and individualized clinical recommendations. Physicians’ responses to a survey regarding the use of the recommendations were then summarized. RESULTS: One hundred and ninety-five patients, with a mean age of 66 years (59% female) and an average of 8.7 medications were reviewed. Seventy-seven percent (144/187) of physicians’ responses indicated that the reports were received in a timely manner and 99% (192/194) indicated that they were actionable and easy to understand. Forty-one percent (77/186) made a dosing change, 52% (99/192) a medication change, and 10% (14/137) a medication therapy duration change. Twenty-five percent (46/183) indicated that without the report, no changes would have been made, while 38% reflected that their clinical assessment alone would have led to therapy modification. CONCLUSIONS: Despite timely receipt and ease of understanding, physicians appear reluctant to utilize pharmacogenomic recommendations from an outside source to make changes to medication dosing, regimen, or duration for their patients.