| Reason | |||
|---|---|---|---|
| 0667262364604000 | Rp 1,925,000,000 | - | |
| 0030710925606000 | Rp 1,936,000,000 | - | |
| 0316096593604000 | Rp 1,958,000,000 | - | |
PT Multi Graha Medika | 0020491528606000 | Rp 1,969,000,000 | tidak dilakukan pembuktian kualifikasi |
| 0314638164606000 | - | - | |
PT Sumber Mulya Alkesindo | 0030017313618000 | - | - |
PT Mutiara Husada Sejahtera | 00*1**7****43**0 | - | - |
PT Spero Abadi Medika | 06*2**9****06**0 | - | - |
PT Delta Sarana Medika | 0315605972606000 | - | - |
PT Surya Asia Husada | 03*3**1****18**0 | - | - |
CV Santiadji Langgeng | 0315980896609000 | - | - |
| 0029096070606000 | - | - | |
| 0031778665606000 | - | - | |
| 0313349250618000 | - | - | |
| 0210216735511000 | - | - |