| Nama Penyedia | Harga Penawaran |
| PT. MITRA RAJAWALI MEDIKA | Rp 1.050.170.000,00 |
| PT. ELFISK BORAM FARMA JAYA | Rp 1.050.995.000,00 |
| PT.MITRA JAYA ABADI MANDIRI | |
| CV. ANGELO MULIA PRATAMA | |
| CV AGUNG WICAKSANA | |
| PT Citra Tunas Medika | |
| PT. ILHAM AKBAR BERSAMA | |
| PT. GRAHA MEDISTRA UTAMA | |
| CV AGUNG WICAKSANA |