| 02520435 | Apo-Pomalidomide(Off-Formulary Interchangeable) | 425.0000 | 425.0000 |
| 02538075 | Jamp Pomalidomide(Off-Formulary Interchangeable) | 425.0000 | 425.0000 |
| 02506408 | Nat-Pomalidomide(Off-Formulary Interchangeable) | 425.0000 | 425.0000 |
| 02419599 | Pomalyst(Off-Formulary Interchangeable) | 500.0000 | 425.0000 |
| 02504081 | Reddy-Pomalidomide(Off-Formulary Interchangeable) | 425.0000 | 425.0000 |
| 02523981 | Sandoz Pomalidomide(Off-Formulary Interchangeable) | 425.0000 | 425.0000 |