| Administrative Score (SA) | Reason | ||||
|---|---|---|---|---|---|
Surya Chandra Nata | 00*5**5****05**0 | Rp 11,904,420,000 | 92.52 | 97.76 | - |
UD Azka Graha Mandiri | 00*3**5****01**0 | Rp 11,909,975,000 | 91.54 | 97.43 | - |
PT Surya Candra Dwipa | 00*1**1****04**0 | Rp 11,916,850,000 | 92.49 | - | Tidak lulus kualifikasi karena masa berlaku Ijin Sub PAK tanggal 22 Maret 2013 |
PT Anugerah Bali Medika | 00*7**4****01**0 | - | - | - | - |
PT Mahesar Chandra | 00*2**9****19**0 | - | 86.25 | - | Tidak masuk passing grade |
| 0031791072609000 | - | 86.32 | - | tidak masuk passing grade | |
| 0010612281051000 | - | 80.55 | - | tidak masuk passing grade | |
PT Calista Matra Medica | 0022321319911000 | - | 85.69 | - | tidak masuk passing grade |
Nona Rulitasary | 00*2**9****07**0 | - | - | - | - |
PT Prasasti Dwimitra | 0314817396604000 | - | - | - | - |
CV Senada Pratama Mandiri | 00*0**5****22**0 | - | - | - | - |
PT Ayu Dimas Abadi | 00*3**6****03**0 | - | - | - | - |
| 0313854457906000 | - | - | - | - | |
PT Utun Nusantara | 0017283813901000 | - | - | - | - |
| 0011265097904000 | - | - | - | - | |
PT Graha Karya Abadi | 0027488972009000 | - | - | - | - |
PT Mapan Medika Indonesia | 03*3**0****03**0 | - | - | - | - |
| 0312615669906000 | - | - | - | - | |
| 0025631342517000 | - | - | - | - | |
CV Ina Shinta | 00*7**9****22**0 | - | - | - | - |
| 0013157086007000 | - | - | - | - | |
PT Tri Delta Jaya | 0210216735503000 | - | - | - | - |
PT Mega Andalan Kalasan | 00*8**3****42**0 | - | - | - | - |
| 0014129050904000 | - | - | - | - | |
| 0020178463901000 | - | - | - | - | |
PT Gama Balidwipa | 00*6**3****04**0 | - | - | - | - |
| 0023144728017000 | - | - | - | - | |
| 0010611846051000 | - | - | - | - | |
CV Millenium | 00*5**8****14**0 | - | - | - | - |