Berkas Pencairan Apbn Alkes ( Prosedure )

7/24/2019 Berkas Pencairan Apbn Alkes ( Prosedure )

1/88

Lampiran : Berita Acara Pemeriksaan PPHP Pekerjaaan Pengadaan Alat Kesehatan, Kedokteran dan KB RSUD Provinsi Kepri anj!ngpinang

"omor : #$%&'BAPP(PHP'APB"'RSUD

anggal : ) Desem*er +%-

Lokasi : anj!ngpinang

S!m*er Dana : APB" ah!n Anggaran +%-

No Nama Barang Type/Merk Harga Satuan Quantita

. Scan $ slice / UPS %%kva Ale0ion $ / 1P 2--+. Series ' oshi*a '3apan Rp $,2#%,2%2,%%%

+ 4pmi L!mera 5 ' carl6eiss' 1erman7

Rp ,)+&,+&+,%%%

- SL5 LA8P/Assesories/5nstr!ment ta*le SL()%% ' SH5" "5PP4"' 3apan Rp +-&,%%%,%%%

# Snellen chart projector .P )%% ' SH5" "5PP4"' 3apan Rp -9,%%%,%%%

) rial lens ith ;rame S ' D5A84"D'USA Rp +%-,$-$,%%%

# Hematolog7 Anal76er ) Di== Anal76er Bo!le ' ?!int!s'Sedia Rp &2),#)#,%%%

) Kimia Klinik Anal76er A+) ' Bios7stem'spain Rp 2%%,%%%,%%%

$ 407gen ;lometer ith H!midi=ier/ Adapter ;H() ' medima0'koreaRp -,9%#,%%%

)%

& all S!ction Unit /Adapter/.onector .(A#%% ' medima0'korea Rp $,-%%,%%% -%

9 S!ction P!mp Porta*le ;S> ( &%% ' 1a*ler 8edical 'UK Rp #-,9,%%% %

2 Patient 8onitor Arg!s L.8 Pl!s ' Schiler ' Siss Rp &&,+&+,%%%

+% 4perating Lamp ' Simeon 8edical ( 1erman7Rp &&&,+&+,%%%

+ Anastesi 8achine ith lectros!rgical Unit H; #%%L ' Deimed' 1erman7 Rp -#%,2%2,%%% +

4phtalmic 4perating 8iscroscope =or anterior dan

posterior

;!nd!scop7 5ndirect ireless/carr7ingcase'4phtalmoskop

US1 AB Scan / Biometer Pro*e, Bscan pro*e,Printer,Local rolle7

SimL>D &%%% ( SimL>D )%%% /Sim.A8 SD


2/88

+# Aerosol Anios ' Aerosept A;';rance Rp -$,-$-,%%% + !ni

+) Set *or t!lang elektrik .oli*ri ' s7ntes' german7 Rp $+%,%%%,%%% !ni

+$ Set Bor t!lang elektrik mikro >lectric Pen Drive ' s7ntes'german7 Rp #-#,+-9,%%% !ni

+& A!tomatic iss!e Processor =or Histolog7 Application P%+% ' Leica' .hina Under license germanRp )+$,2%%,%%%

!ni

+9 >m*edding S7stems >1)%H/. ' Leica' .hina Under license germanRp -%),+)%,%%% !ni

+2 8an!al Rotar7 8icrotome ;or 4!tstanding R8++-) ' Leica' .hina Under license germanRp +99,+%%,%%% !ni

-% ater*ath H5+% ' Leica' .hina Under license germanRp +-,$)%,%%% !ni

- Hot Plate H5+% ' Leica' .hina Under license germanRp +-,%%,%%% !ni

-+ Linear Stainer S#%+% ' Leica' .hina Under license german Rp $,%%+,%%% !ni

-- 8ikroskop / .amera D8&)% / 5..)%HD ' Leica' .hina Under license germanRp 9,99,%%% !ni

-# .r7ostat =or Advanced Applications .82)% ' Leica' .hina Under license germanRp $$%,%%%,%%% !ni

-) .7tocentri=!ge Aerospra7 ' Leica' .hina Under license germanRp +-$,)%%,%%% !ni-$ Res!sitation set =or ad!lt 8ark 5< Ad!lt ' Am*!' Denmark Rp $,-$-,%%% ) !ni

-& Res!sitation set =or child 8ark 5< *a*7 ' Am*!' Denmark Rp $,-$-,%%% - !ni

-9 8atras Dec!*it!s P> &%%+ ' Paramo!nt' 5ndonesia Rp $,$-%,%%% % !ni

-2 5nstr!ment role7 -)% ' 8AK' 5"D4">S5A Rp ),9--,%%% +% !ni

#%


3/88

$ B!k! 5shcihara +9 plate +9 Plate ' 5shcihara'3apan Rp +-2,%%% !ni

$+ 1!nting ver*an g!nting *engkokE Steinless steel ' ajimaco'Pakistan Rp -%,%%% ) !ni

$- Hand l!p Steinless steel ' >0 .hina Rp +&,%%% + !ni

$# Handle 8iror Steinless steel ' He*! 8edical 1m*h'1erman7 Rp -%%,%%% !ni

$) Head *o0 *a7i c!k!p *!lan ;oldadome ' "at!s 8edical 5nc'USA Rp ,%%%,%%% - !ni

$$ Head *o0 *a7i premat!r ;oldadome ' "at!s 8edical 5nc'USA Rp ,%%%,%%% ) !ni

$& Head *o0 in=ant ;oldadome ' "at!s 8edical 5nc'USA Rp ,)%%,%%% ) !ni

$9 Head lamp


4/88

22 askom *esar stainless #% cm ' Health'5ndia Rp )%,%%% % !ni

%% askom kecil stainless + cm ' Health'5ndia Rp -%,%%% % !ni

% askom sedang stainless -$ cm ' Health'5ndia Rp #%,%%% % !ni

%+ ermometer Standar ' Sa=et7'3apan Rp -%,%%% % !ni

%-ensimeter

' AB"'5ndonesiaRp ,#-%,%%% +

!ni

%# 8inor set 0(.hina Rp 9,%&%,%%% + !ni

% Rak ta*!ng reaksi stainless )% ta*!ngE


5/88

ealisasi (isik 51D Ke*idanan Bedah .entral Radiologi Raat 3alan La*or

Quantitas Total

!nit Rp $,2#%,2%2,%%%

!nit Rp ,)+&,+&+,%%%

!nit Rp +-&,%%%,%%%

!nit Rp -9,%%%,%%%

!nit Rp -2,%%,%%%

!nit Rp ,9-%,%%%

- !nit Rp 9%,%%%,%%% -

- !nit Rp #%,##%,%%% -

!nit Rp +%,)%%,%%%

!nit Rp &,%%%,%%%

!nit Rp #$,9%%,%%%

!nit Rp -)&,)%%,%%%

!nit Rp +%-,$-$,%%%

!nit Rp &2),#)#,%%%

!nit Rp 2%%,%%%,%%%

)% !nit Rp 2%,+%%,%%%$ # + &

-% !nit Rp 92,%%%,%%% - + 9 #

% !nit Rp #-,9%,%%% +

!nit Rp ,2#2,22+,%%% + +

!nit Rp &&&,+&+,%%%

!nit Rp 9$-,2)$,%%%

+ !nit Rp )#-,#%%,%%% +

+ !nit Rp $9,99,%%% +

Raat 5napDeasa

Raat 5napAnak

RaBe

)atatanHasil


6/88

+ !nit Rp +&+,&+$,%%% +

!nit Rp $+%,%%%,%%%

!nit Rp #-#,+-9,%%%

!nit Rp )+$,2%%,%%%

!nit Rp -%),+)%,%%%

!nit Rp +99,+%%,%%%

!nit Rp +-,$)%,%%%

!nit Rp +-,%%,%%%

!nit Rp $,%%+,%%%

!nit Rp 9,99,%%%

!nit Rp $$%,%%%,%%%

!nit Rp +-$,)%%,%%% ) !nit Rp -,9),%%%

- !nit Rp 2,%92,%%%

% !nit Rp $$,-%%,%%% -

+% !nit Rp $,$$%,%%% - # -

+ !nit Rp ,$$%,%%%,%%%

+ !nit Rp ,)%%,%%%,%%%

) !nit Rp ),%%%,%%%

!nit Rp +,%&-,)$%,%%%

!nit Rp 2%2,%2%,%%%

+ !nit Rp -)%,%%%,%%% +

!nit Rp +,#2,%2%,%%%

) !nit Rp )#,%%%,%%%

) !nit Rp 29,%%%,%%%

!nit Rp +)$,-++,%%%

# !nit Rp +,%$2,%99,%%%

!nit Rp -,%$%,%%%

!nit Rp 22%,%%%

) !nit Rp #,#%%,%%% + +

- !nit Rp 2,&+%,%%%

) !nit Rp &,$)%,%%% - +

+ !nit Rp &,2+%,%%%

% !nit Rp $-,2%%,%%% +

) !nit Rp 2,%%%,%%%

) !nit Rp #,)%%,%%%

) !nit Rp &,)%%,%%%


7/88

!nit Rp +-2,%%%

) !nit Rp #)%,%%%

+ !nit Rp )#,%%% +

!nit Rp -%%,%%%

- !nit Rp -,%%%,%%%

) !nit Rp ),%%%,%%%

) !nit Rp &,)%%,%%%

% !nit Rp ),)%%,%%% + +

+% !nit Rp $,%%%,%%% ) )

+% !nit Rp #,%%%,%%%

) !nit Rp +)%,%%%

% !nit Rp #,)#%,%%%

+ +) !nit Rp ),%%%,%%% +

% !nit Rp ),%%%,%%%

% !nit Rp -%%,%%%

!nit Rp 99%,%%%

!nit Rp -,%%%

!nit Rp )%,%%%

9 !nit Rp ,$%%,%%%

9 !nit Rp ,$%%,%%%

# !nit Rp +%%,%%%

% !nit Rp +,+%%,%%% + -

% !nit Rp +,+%%,%%% + + +

& !nit Rp +9%,%%% +

) !nit Rp &)%,%%% + %

) !nit Rp +%,%%% - )

9 !nit Rp 2,$%%,%%% + + +

) !nit Rp $,)%%,%%%

- !nit Rp -,2%%,%%%

+) !nit Rp ,%%%,%%%

% !nit Rp %,%%%

-% !nit Rp ,)%%,%%%

) !nit Rp +,+)%,%%%

+) !nit Rp -,&)%,%%% +

% !nit Rp )%%,%%%

% !nit Rp -+%,%%% #

) !nit Rp )%%,%%%

) !nit Rp )%%,%%%


8/88

% !nit Rp )%%,%%%

% !nit Rp -%%,%%%

% !nit Rp #%%,%%%

% !nit Rp -%%,%%%

+!nit Rp &,$%,%%%

- +

% !nit Rp $,)%%,%%%

) !nit Rp $,$%%,%%% +

!nit Rp -,&+&,%%%

- !nit Rp #,)%%,%%% -

# !nit Rp 2,#)+,%%% #

+ !nit Rp $,#%,%%% +

- !nit Rp ,+2%,%%% -+% !nit Rp -#,)#%,%%%

!nit Rp $2,+%%,%%%

!nit Rp -2,+%%,%%%

Rp --,++$,#%%,%%%

Rp -,-++,$#%,%%%

p "#$&'$0&0$000


9/88

Perina Reha* 8edik .SSD ;armasi Keperaatan otal K!rang

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10/88

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11/88

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12/88

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13/88

Lampiran : Berita Acara Penerimaan Barang Pekerjaaan Pengadaan Alat Kesehatan, Kedokteran dan KB RSUD Provinsi Kepri anj!ngpinang

"omor : #$+ 'BA(P"B'APB"'RSUD

anggal : ) Desem*er +%-

Lokasi : anj!ngpinang

S!m*er Dana : APB" ah!n Anggaran +%-

No Nama Barang Type/Merk Harga Satuan Quantitas

. Scan $ slice / UPS %%kva Ale0ion $ / 1P 2--+. Series ' oshi*a '3apan Rp $,2#%,2%2,%%% !nit

+ 4pmi L!mera 5 ' carl6eiss' 1erman7 Rp ,)+&,+&+,%%% !nit

- SL5 LA8P/Assesories/5nstr!ment ta*le SL()%% ' SH5" "5PP4"' 3apan Rp +-&,%%%,%%% !nit

# Snellen chart projector .P )%% ' SH5" "5PP4"' 3apan Rp -9,%%%,%%% !nit

) rial lens ith ;rame S ' D5A84"D'USA Rp +%-,$-$,%%% !nit

# Hematolog7 Anal76er ) Di== Anal76er Bo!le ' ?!int!s'Sedia Rp &2),#)#,%%% !nit

) Kimia Klinik Anal76er A+) ' Bios7stem'spain Rp 2%%,%%%,%%% !nit

$ 407gen ;lometer ith H!midi=ier/ Adapter ;H() ' medima0'koreaRp -,9%#,%%%

)% !nit

& all S!ction Unit /Adapter/.onector .(A#%% ' medima0'korea Rp $,-%%,%%% -% !nit

9 S!ction P!mp Porta*le ;S> ( &%% ' 1a*ler 8edical 'UK Rp #-,9,%%% % !nit

2 Patient 8onitor Arg!s L.8 Pl!s ' Schiler ' 1erman7 Rp &&,+&+,%%% !nit

+% 4perating Lamp ' Simeon 8edical ( 1erman7Rp &&&,+&+,%%%

!nit

+ Anastesi 8achine ith


14/88

++ 4perating a*le man!al SPL-- ' 8i6!ho ' japan Rp +&,&%%,%%% + !nit R

+- >lectros!rgical Unit H; #%%L ' Deimed' 1erman7 Rp -#%,2%2,%%% + !nit R

+# Aerosol Anios ' Aerosept A;';rance Rp -$,-$-,%%% + !nit R

+) Set *or t!lang elektrik .oli*ri ' s7ntes' german7 Rp $+%,%%%,%%% !nit R

+$ Set Bor t!lang elektrik mikro >lectric Pen Drive ' s7ntes'german7 Rp #-#,+-9,%%% !nit R

+& A!tomatic iss!e Processor =or Histolog7 Application P%+% ' Leica' .hina Under license germRp )+$,2%%,%%%

!nit R

+9 >m*edding S7stems >1)%H/. ' Leica' .hina Under license germ Rp -%),+)%,%%% !nit R

+2 8an!al Rotar7 8icrotome ;or 4!tstanding R8++-) ' Leica' .hina Under license germ Rp +99,+%%,%%% !nit R

-% ater*ath H5+% ' Leica' .hina Under license germ Rp +-,$)%,%%% !nit R

- Hot Plate H5+% ' Leica' .hina Under license germ Rp +-,%%,%%% !nit R

-+ Linear Stainer S#%+% ' Leica' .hina Under license germ Rp $,%%+,%%% !nit R-- 8ikroskop / .amera D8&)% / 5..)%HD ' Leica' .hina Under license germ Rp 9,99,%%% !nit R

-# .r7ostat =or Advanced Applications .82)% ' Leica' .hina Under license germ Rp $$%,%%%,%%% !nit R

-) .7tocentri=!ge Aerospra7 ' Leica' .hina Under license germ Rp +-$,)%%,%%% !nit R

-$ Res!sitation set =or ad!lt 8ark 5< Ad!lt ' Am*!' Denmark Rp $,-$-,%%% ) !nit R

-& Res!sitation set =or child 8ark 5< *a*7 ' Am*!' Denmark Rp $,-$-,%%% - !nit R

-9 8atras Dec!*it!s P> &%%+ ' Paramo!nt' 5ndonesia Rp $,$-%,%%% % !nit R

-2 5nstr!ment role7 -)% ' 8AK' 5"D4">S5A Rp ),9--,%%% +% !nit R

#%


15/88

)& 5nstr!ment ca*inet -+2% ' 8AK' 5"D4">S5A Rp $,-2%,%%% % !nit R

)9 Bak 5nstr!ment *esar #)0-%0) cm ' Health'5ndia Rp $%%,%%% ) !nit R

)2 Bak 5nstr!ment kecil +)0-)0$& cm ' Health'5ndia Rp -%%,%%% ) !nit R

$% Bak 5nstr!ment sedang -02)0$- cm ' Health'5ndia Rp )%%,%%% ) !nit R

$ B!k! 5shcihara +9 plate +9 Plate ' 5shcihara'3apan Rp +-2,%%% !nit R

$+ 1!nting ver*an g!nting *engkokE Steinless steel ' ajimaco'Pakistan Rp -%,%%% ) !nit R

$- Hand l!p Steinless steel ' >0 .hina Rp +&,%%% + !nit R

$# Handle 8iror Steinless steel ' He*! 8edical 1m*h'1erman7 Rp -%%,%%% !nit R

$) Head *o0 *a7i c!k!p *!lan ;oldadome ' "at!s 8edical 5nc'USA Rp ,%%%,%%% - !nit R

$$ Head *o0 *a7i premat!r ;oldadome ' "at!s 8edical 5nc'USA Rp ,%%%,%%% ) !nit R

$& Head *o0 in=ant ;oldadome ' "at!s 8edical 5nc'USA Rp ,)%%,%%% ) !nit R

$9 Head lamp


16/88

2- im*angan *a7i @B && ' @amamoto 1iken'.hina Rp #)%,%%% ) !nit R

2# im*angan *erat *adan


17/88

(+A.S

Direkt!r


18/88

ealisasi (isik

Quantitas Total

!nit Rp $,2#%,2%2,%%%

!nit Rp ,)+&,+&+,%%%

!nit Rp +-&,%%%,%%%

!nit Rp -9,%%%,%%%

!nit Rp -2,%%,%%%

!nit Rp ,9-%,%%%

- !nit Rp 9%,%%%,%%%

- !nit Rp #%,##%,%%%

!nit Rp +%,)%%,%%%

!nit Rp &,%%%,%%%

!nit Rp #$,9%%,%%%

!nit Rp -)&,)%%,%%%

!nit Rp +%-,$-$,%%%

!nit Rp &2),#)#,%%%

!nit Rp 2%%,%%%,%%%

)% !nit Rp 2%,+%%,%%%

-% !nit Rp 92,%%%,%%%

% !nit Rp #-,9%,%%%

!nit Rp ,2#2,22+,%%%

!nit Rp &&&,+&+,%%%

!nit Rp 9$-,2)$,%%%

)atatanHasil


19/88

+ !nit Rp )#-,#%%,%%%

+ !nit Rp $9,99,%%%

+ !nit Rp +&+,&+$,%%%

!nit Rp $+%,%%%,%%%

!nit Rp #-#,+-9,%%%

!nit Rp )+$,2%%,%%%

!nit Rp -%),+)%,%%%

!nit Rp +99,+%%,%%%

!nit Rp +-,$)%,%%%

!nit Rp +-,%%,%%%

!nit Rp $,%%+,%%% !nit Rp 9,99,%%%

!nit Rp $$%,%%%,%%%

!nit Rp +-$,)%%,%%%

) !nit Rp -,9),%%%

- !nit Rp 2,%92,%%%

% !nit Rp $$,-%%,%%%

+% !nit Rp $,$$%,%%%

+ !nit Rp ,$$%,%%%,%%%

+ !nit Rp ,)%%,%%%,%%%

) !nit Rp ),%%%,%%%

!nit Rp +,%&-,)$%,%%%

!nit Rp 2%2,%2%,%%%

+ !nit Rp -)%,%%%,%%% !nit Rp +,#2,%2%,%%%

) !nit Rp )#,%%%,%%%

) !nit Rp 29,%%%,%%%

!nit Rp +)$,-++,%%%

# !nit Rp +,%$2,%99,%%%

!nit Rp -,%$%,%%%

!nit Rp 22%,%%%

) !nit Rp #,#%%,%%%

- !nit Rp 2,&+%,%%%

) !nit Rp &,$)%,%%%

+ !nit Rp &,2+%,%%%


20/88

% !nit Rp $-,2%%,%%%

) !nit Rp 2,%%%,%%%

) !nit Rp #,)%%,%%%

) !nit Rp &,)%%,%%%

!nit Rp +-2,%%%

) !nit Rp #)%,%%%

+ !nit Rp )#,%%%

!nit Rp -%%,%%%

- !nit Rp -,%%%,%%%

) !nit Rp ),%%%,%%%

) !nit Rp &,)%%,%%%

% !nit Rp ),)%%,%%%+% !nit Rp $,%%%,%%%

+% !nit Rp #,%%%,%%%

) !nit Rp +)%,%%%

% !nit Rp #,)#%,%%%

) !nit Rp ),%%%,%%%

% !nit Rp ),%%%,%%%

% !nit Rp -%%,%%%

!nit Rp 99%,%%%

!nit Rp -,%%%

!nit Rp )%,%%%

9 !nit Rp ,$%%,%%%

9 !nit Rp ,$%%,%%%

# !nit Rp +%%,%%%% !nit Rp +,+%%,%%%

% !nit Rp +,+%%,%%%

& !nit Rp +9%,%%%

) !nit Rp &)%,%%%

) !nit Rp +%,%%%

9 !nit Rp 2,$%%,%%%

) !nit Rp $,)%%,%%%

- !nit Rp -,2%%,%%%

+) !nit Rp ,%%%,%%%

% !nit Rp %,%%%

-% !nit Rp ,)%%,%%%


21/88

) !nit Rp +,+)%,%%%

+) !nit Rp -,&)%,%%%

% !nit Rp )%%,%%%

% !nit Rp -+%,%%%

) !nit Rp )%%,%%%

) !nit Rp )%%,%%%

% !nit Rp )%%,%%%

% !nit Rp -%%,%%%

% !nit Rp #%%,%%%

% !nit Rp -%%,%%%

+

!nit Rp &,$%,%%%

% !nit Rp $,)%%,%%%

) !nit Rp $,$%%,%%%

!nit Rp -,&+&,%%%

- !nit Rp #,)%%,%%%

# !nit Rp 2,#)+,%%%

+ !nit Rp $,#%,%%%

- !nit Rp ,+2%,%%%

+% !nit Rp -#,)#%,%%%

!nit Rp $2,+%%,%%%

!nit Rp -2,+%%,%%%

Rp --,++$,#%%,%%%

Rp -,-++,$#%,%%%

p "#$&'$0&0$000

nerimaI

AH SA,+T .M.M AAH

LA.AN +A.

!AAN 201"


22/88

A PANA

+%%% %-


23/88

5nvoice

"omor :

anggal :) Desem*er +%-

No Nama Barang Type/Merk ,emasan Satuan Harga Satuan olume

Alat pelind!ng diri apron plastik &) 0 -) cmE 8aesindo pcs pcs Rp ,#- %% pcs Rp

+ Alat S!ntik Sekali Pakai ml ins!lin er!mo %% set' kotak pcs Rp -,#%% % Pcs Rp

- Alat S!ntik Sekali Pakai ml t!*erk!lin er!mo %% set' kotak pcs Rp -,%- 9%%% Pcs Rp# Alat S!ntik Sekali Pakai - ml er!mo %% set' kotak pcs Rp +,+)- 9%%% Pcs Rp

) Alat S!ntik Sekali Pakai ) ml er!mo %% set' kotak pcs Rp +,&+% +)%% Pcs Rp

$ Alat S!ntik Sekali Pakai % ml er!mo %% set' kotak pcs Rp -,)+9 +%%% Pcs Rp

& Alat S!ntik Sekali Pakai +% ml er!mo )% set' kotak pcs Rp $,$- +%%% Pcs Rp

9 Alat S!ntik Sekali Pakai )% ml . er!mo +% set' kotak pcs Rp +),)%% )%% Pcs Rp

2 Alat S!ntik Sekali Pakai )% ml > er!mo +% set' kotak pcs Rp +,&)% +%% Pcs Rp

% Alkohol Sa* > .are %% pcs'*o0 kotak Rp --,%%% )% kotak Rp

artic!lating paper S"SKA *!ngk!s *!ngk!s Rp %$,%%% *!ngk!s Rp

+ A!toclave ape Steam -'# -8 rol rol Rp +$,%%% ) rol Rp

- Ag "4- !tk H Lokal *otol *otol Rp +)%,%%% *otol Rp

# Bacterial(


24/88

+$ Benang catg!t chromic % Biod7namic rol rol Rp ,%&$,#%% - rol Rp

+& Benang catg!t chromic +'% Biod7namic rol rol Rp ,)%,9%% + rol Rp

+9 Benang catg!t chromic -'% Biod7namic rol rol Rp ,9,#%% rol Rp

+2 Benang catg!t chromic #'% Biod7namic rol rol Rp ,%,$%% rol Rp

-% Benang catg!t cromic Biod7namic rol rol Rp ,)%,9%% $ rol Rp

- Benang catg!t plain % Biod7namic rol rol Rp ,%&$,#%% - rol Rp

-+ *enang catg!t plain Biod7namic rol rol Rp ,)%,9%% - rol Rp

-- Benang catg!t plain +'% Biod7namic rol rol Rp ,)%,9%% rol Rp

-# Benang catg!t plain -'% Biod7namic rol rol Rp ,9,#%% rol Rp

-) Benang catg!t plain #'% Biod7namic rol rol Rp ,%,$%% rol Rp

-$ S85 + pcs'*o0 *o0 Rp )#%,%%% +) *o0 Rp

-& S85 + pcs'*o0 *o0 Rp )#%,%%% +) *o0 Rp

-9 S85 + pcs'*o0 *o0 Rp )%,%%% -) *o0 Rp

-2 S85 + pcs'*o0 *o0 Rp #9%,%%% % *o0 Rp

#% Benang chromic no% jar!m *!lat, #) mm,'+ circle S85 + pcs'*o0 *o0 Rp )#%,%%% # *o0 Rp

# Benang chromic no jar!m *!lat, #9 mm, '+ circle S85 + pcs'*o0 *o0 Rp )#%,%%% +$ *o0 Rp

#+ S85 + pcs'*o0 *o0 Rp )#%,%%% #% *o0 Rp

#- Benang chromic no-'% c!tting,+# mm,-'9circle S85 + pcs'*o0 *o0 Rp $%%,%%% - *o0 Rp

## Benang chromic no#'% c!tting, +# mm,-'9 circle S85 + pcs'*o0 *o0 Rp $%%,%%% - *o0 Rp

#) S85 + pcs'*o0 *o0 Rp $%%,%%% % *o0 Rp

#$ S85 + pcs'*o0 *o0 Rp $%%,%%% % *o0 Rp

#& S85 + pcs'*o0 *o0 Rp )#%,%%% % *o0 Rp

#9 S85 + pcs'*o0 *o0 Rp )#%,%%% % *o0 Rp

#2 *enang n7lon %'% jar!m segitiga $# mm S85 +pcs'*o0 pcs Rp +,+)$,%%% kit Rp

)% Benang n7lon +'% jar!m segitiga, -% mm, -'9 circle S85 + pcs'*o0 *o0 Rp )#%,%%% % *o0 Rp

) Benang n7lon -'% jar!m segitiga, +# mm,-'9 circle S85 + pcs'*o0 *o0 Rp )#%,%%% 9 *o0 Rp

)+ Benang n7lon #'% jar!m segitiga, 2mm,-'9 circle S85 + pcs'*o0 *o0 Rp )-#,%%% - *o0 Rp

)- S85 + pcs'*o0 *o0 Rp 2%$,%%% % *o0 Rp

Benang catg!t plain no % jar!m *!lat, -& mm,'+

circleBenang catg!t plain no +'% jar!m *!lat, -& mm,'+circle

Benang catg!t plain no -'% jar!m segitiga, +#mm,-'# circle

Benang catg!t plain #'% jar!m segitiga, $mm,-'9circle

Benang chromic no+'% jar!m *!lat,#% mm,'+circle

*enang chromic ith needle -'% jar!m segitiga,+#mm,-'9 circle

*enang chromic ith needle #'% jar!m segitiga,+#mm,-'9 circle

*enang cromic ith needle % jar!m *!lat,#) mm,'+circle

*enang cromic ith needle no jar!m *!lat,#9mm,'+ circle

Benang poliglactine2% no% jar!m *!lat,#9mm,'+circle


25/88

)# S85 + pcs'*o0 *o0 Rp 22%,%%% 9 *o0 Rp

)) S85 + pcs'*o0 *o0 Rp &2+,%%% + *o0 Rp

)$ S85 + pcs'*o0 *o0 Rp 9$,%%% % *o0 Rp

)& S85 + pcs'*o0 *o0 Rp 9$,%%% % *o0 Rp

)9 S85 + pcs'*o0 *o0 Rp 9+9,%%% % *o0 Rp

)2 *enang poliprolene % jar!m *!lat,#%mm,'+ circle S85 + pcs'*o0 *o0 Rp &%+,%%% + *o0 Rp

$% Benang polipropilen c!tting no %, +#mm S85 + pcs'*o0 *o0 Rp &)%,%%% & *o0 Rp

$ Benang polipropilen c!tting no +'%, +#mm S85 + pcs'*o0 *o0 Rp &)%,%%% ) *o0 Rp

$+ Benang polipropilen c!tting no -'%, 2mm S85 + pcs'*o0 *o0 Rp &+%,%%% ) *o0 Rp

$- Benang polipropilen c!tting no #'%, 2mm S85 + pcs'*o0 *o0 Rp &+%,%%% & *o0 Rp

$# Benang polipropilen c!tting no )'% $mm S85 + pcs'*o0 *o0 Rp &+%,%%% % *o0 Rp

$) S85 + pcs'*o0 *o0 Rp &+%,%%% % *o0 Rp

$$ S85 + pcs'*o0 *o0 Rp &+%,%%% ) *o0 Rp

$& Benang silk % Biod7namic rol rol Rp )$%,%%% rol Rp

$9 *enang silk Biod7namic rol rol Rp )$%,%%% + rol Rp

$2 *enang silk + Biod7namic rol rol Rp #2%,%%% rol Rp

&% *enang silk +'% Biod7namic rol rol Rp )$%,%%% ) rol Rp

& *enang silk -'% Biod7namic rol rol Rp #2%,%%% - rol Rp&+ *enang silk #'% Biod7namic rol rol Rp #2%,%%% rol Rp

&- *enang silk *lack % jar!m *!lat,-& mm, '+ circle S85 + pcs'*o0 *o0 Rp #%+,%%% % *o0 Rp

*enang silk *lack +'% jar!m *!lat, +$ mm,'+ circle S85 + pcs'*o0 *o0 Rp #%+,%%% +% *o0 Rp

&) *enang silk *lack jar!m *!lat,-& mm,'+ circle S85 + pcs'*o0 *o0 Rp #%+,%%% % *o0 Rp

&$ *enang silk *lack -'% jar!m *!lat,+$ mm, '+ circle S85 + pcs'*o0 *o0 Rp #%+,%%% 2 *o0 Rp

&& *enang silk *lack #'% jar!m *!lat,+%mm,'+ circle S85 + pcs'*o0 *o0 Rp #%+,%%% $ *o0 Rp

&9 S85 + pcs'*o0 *o0 Rp #+%,%%% *o0 Rp

&2 S85 + pcs'*o0 *o0 Rp #+%,%%% +% *o0 Rp

9% S85 + pcs'*o0 *o0 Rp #+%,%%% ) *o0 Rp

9 S85 + pcs'*o0 *o0 Rp #%+,%%% % *o0 Rp

Benang poliglactine2% no jar!m *!lat, #9mm,'+circle

Benang poliglactine2% no+'% jar!m *!lat,-$mm,'+ circle

Benang poliglicolid acid no % jar!m *!lat,#%mm,'+ circle

Benang poliglicolid acid no jar!m*!lat,#9mm,'+ circle

Benang poliglicolid acid no +'% jar!m *!lat,#% mm'+ circle

Benang polipropilen c!tting no )'%, 2 mm,-'9circle

Benang polipropilen c!tting no $'%, $ mm, -'9circle

*enang silk *lack #'% jar!m segitiga,2mm,-'9circle

*enang silk *lack no % jar!m segitiga, +#mm,-'9circle

*enang silk *lack no jar!m segitiga, -&mm,-'9circle

*enang silk *lack no +'% jar!m *!lat, +$mm,'+circle


26/88

9+ S85 + pcs'*o0 *o0 Rp #+%,%%% & *o0 Rp

9- S85 + pcs'*o0 *o0 Rp #+%,%%% ) *o0 Rp

9# S85 + pcs'*o0 *o0 Rp 2%$,%%% % *o0 Rp

9) S85 + pcs'*o0 *o0 Rp 22%,%%% % *o0 Rp

9$ S85 + pcs'*o0 *o0 Rp &2+,%%% % *o0 Rp

9& Blade no % RK %%*h'ktk kotak Rp +)%,%%% % kotak Rp

99 Blade no RK %%*h'ktk kotak Rp +)%,%%% 9 kotak Rp

92 Blade no ) RK %%*h'ktk kotak Rp +)%,%%% & kotak Rp

2% Blade no +% RK %%*h'ktk kotak Rp +)%,%%% % kotak Rp

2 Blade no++ RK %%*h'ktk kotak Rp +)%,%%% & kotak Rp

2+ Boie Dick est Pack -% pack -8 pack pack Rp +,%&%,%%% # pak Rp

2- Bone Plate "arro 9 1lid Holes L-)mm B Bra!n *h *h Rp &&),%%% ) *h Rp

2# Bone Plate "arro 2 1lid Holes L)mm B Bra!n *h *h Rp 9-),2%% ) *h Rp

2) Bone Plate "arro % 1lid Holes L$&mm B Bra!n *h *hRp 2),-%%

) *h Rp

2$ Bone Plate "arro 1lid Holes L9-mm B Bra!n *h *hRp 2&2,2%%

) *h Rp

2& Bone Plate "arro + 1lid Holes L22mm B Bra!n *h *hRp ,%##,)%%

) *h Rp

29 Bone Plate "arro # 1lid Holes L+-mm B Bra!n *h *h

Rp ,+-&,-%%

% *h Rp

22 Bone Plate "arro $ 1lid Holes L+$-mm B Bra!n *h *hRp ,#--,%%%

% *h Rp

%% Bone Plate Board $ 1lid Holes L%-mm B Bra!n *h *h Rp ,%+9,9%% % *h Rp

% Bone Plate Board 9 1lid Holes L-)mm B Bra!n *h *h Rp ,+%),%%% # *h Rp

%+ Bone Plate Board 2 1lid Holes L)mm B Bra!n *h *h Rp ,+$2,$%% # *h Rp

%- Bone Plate Board % 1lid Holes L$&mm B Bra!n *h *h Rp ,--#,+%% # *h Rp

%# Bone Plate Board 1lid Holes L9-mm B Bra!n *h *h Rp ,-2&,2%% # *h Rp

%) Bone Plate Board + 1lid Holes L22mm B Bra!n *h *h Rp ,#$+,)%% # *h Rp

%$ Bone Plate Board # 1lid Holes L+-mm B Bra!n *h *h Rp ,$)),-%% % *h Rp

%& Bone Plate Board $ 1lid Holes L+$-mm B Bra!n *h *h Rp ,&22,-%% % *h Rp

%9 Bone Plate Board 9 1lid Holes L+2)mm B Bra!n *h *h Rp ,2+&,)%% % *h Rp

%2 Breathing Bag non(Late0 "eoprene E %) L Altera *h *h Rp 9%,%%% ++ *h Rp

% Breathing Bag non(Late0 "eoprene E L Altera *h *h Rp 9%,%%% & *h Rp

Breathing Bag non(Late0 "eoprene E + L Altera *h *h Rp 9%,%%% +- *h Rp

+ Breathing Bag non(Late0 "eoprene E - L Altera *h *h Rp 9%,%%% # *h Rp

- Altera *h *h Rp --,%%% ) *h Rp

*enang silk *lack no +'% jar!m segitiga,2mm, -'9circle

*enang silk *lack no -'% jar!m segitiga, 2mm,-'9circle

Benang s!rg7cr7l 2% no % jar!m *!lat, #9mm, '+circle

Benang s!rg7cr7l 2% no jar!m *!lat,#9mm,'+circle

Benang s!rg7cr7l 2% no +'% jar!m *!lat,-$mm,'+ circle

.atheter 8o!nts, >0tendi*le !*ing, sivel

.onnector,Bronhoscope ports, aspiration ports,)mm= end


27/88

# Altera *h *h Rp --,%%% *h Rp

) B Bra!n *h *h Rp &&),%%% +9 *h Rp

$ B Bra!n *h *h Rp 2),%%% # *h Rp

& .entral 0tendi*le !*ing, sivel

.onnector,Bronhoscope ports, aspiration ports,++mm= end

.entral


28/88

)# .ortical Scre #) 0 -9mm =!ll thread B Bra!n pcs *h Rp )),%%% % *h Rp

)) .ortical Scre #) 0 #%mm =!ll thread B Bra!n pcs *h Rp )),%%% % *h Rp

)$ .ortical Scre #) 0 #+mm =!ll thread B Bra!n pcs *h Rp )),%%% % *h Rp

)& .ortical Scre #) 0 ##mm =!ll thread B Bra!n pcs *h Rp )),%%% % *h Rp

)9 .ortical Scre #) 0 #$mm =!ll thread B Bra!n pcs *h Rp )),%%% % *h Rp

)2 .ortical Scre #) 0 #9mm =!ll thread B Bra!n pcs *h Rp )),%%% % *h Rp

$% .ond7l *!ttress pl & holes sha=tE Le=t B Bra!n *h *h Rp +,&-,-%% + *h Rp

$ .ond7l *!ttress pl & holes sha=tE Right B Bra!n *h *h Rp +,&-,-%% + *h Rp

$+ .ond7l *!ttress pl 2 holes sha=tE Le=t B Bra!n *h *h Rp +,9#-,9%% *h Rp

$- .ond7l *!ttress pl 2 holes sha=tE Right B Bra!n *h *h Rp +,9#-,9%% *h Rp

$# .loverlea= Plate - holes Sha=tE L99mm B Bra!n *h *h Rp ,#2#,9%% % *h Rp

$) .loverlea= Plate # holes Sha=tE L%#mm B Bra!n *h *h Rp ,))2,#%% % *h Rp$$ cotton *!d Lokal )%'pack pack Rp +,%%% + pack Rp

$& .otton roll BS" rol'kg kg Rp 9,&+% ) kg Rp

$9 BS" %'Bo0 *h Rp $9,%% )% *h Rp

$2 BS" )'*o0 *h Rp +%,2&) %% *h Rp

&% BS" %'*o0 *h Rp #,)#% %% *h Rp

& BS" 9'*o0 *h Rp +,#9) %% *h Rp

&+ BS" $'*o0 *h Rp 2,+2) +% *h Rp

&- BS" 9'*o0 *h Rp 9,$$% +% *h Rp

BS" %'*o0 *h Rp 9,% %% *h Rp

&) BS" %'*o0 *h Rp $,)$% %% *h Rp

&$ BS" %'*o0 *h Rp -,2)% 22 *h Rp

&& BS" +%'*o0 *h Rp +#,%#& %% *h Rp

&9 BS" %'*o0 kotak Rp -,)%% +% *o0 Rp

&2 BS" 9'*o0 *h Rp -,2)% %% *h Rp

Dressing antimikro*a 7ang diimpregnasi de*ganh7drogel, !nt!k mel!nakan jaringan nekrotik ata!slo!gh7 !k &) cm C &) cm

Dressing =iksasi !nt!k melind!ngi l!ka / *antalanl!ka dengan da7a serap tinggi dan anti lengket % C-% cm

Dressing =iksasi !nt!k melind!ngi l!ka / *antalanl!ka dengan da7a serap tinggi dan anti lengket &,+C ) cm

Dressing =iksasi !nt!k melind!ngi l!ka / *antalanl!ka dengan da7a serap tinggi dan anti lengket 9 C

) cm

Dressing =iksasi !nt!k melind!ngi l!ka / *antalanl!ka dengan da7a serap tinggi dan anti lengket% C+) cm

Dressing =iksasi !nt!k melind!ngi l!ka / *antalanl!ka dengan da7a serap tinggi dan anti lengket9 0% cm

Dressing =iksasi !nt!k melind!ngi l!ka dari =limpol7!rethane !k 0 # cm

Dressing =iksasi !nt!k melind!ngi l!ka dari =limpol7!rethane !k 9 C % cm

Dressing =iksasi !nt!k melind!ngi l!ka, dari =limpol7!rethane !k ) C &+ cm

Dressing H7drocoloid steril 7ang memp!n7ailapisan perekat !tk men7erap l!ka eks!dat sedikit(sedang !k% cm C % cm

Dressing "on oven dengan *antalan l!ka 7angmen7erap eks!dat !k ) 0 &,+ cm

Dressing "on oven dengan *antalan l!ka 7angmen7erap eks!dat !k 9 0 % cm


29/88

9% BS" 9'*o0 pcs Rp &,9+% %% *h Rp

9 BS" #%'*o0 *h Rp +2,)% %% *h Rp

9+ D!k steril disposi*le -+ 0 -$ cm 0 &% g 8aesindo )% pcs ' *o0 *h Rp -,2%% %%% *h Rp

9- >lastic Bandage - inchi BS" rol rol Rp #),)2 -% rol Rp

9# >lastic Bandage # inchi BS" rol rol Rp )#,&2- %% rol Rp

9) >lastic Bandage $ inchi BS" rol rol Rp &2,$+ #% rol Rp

9$ >lektroda anak SAR48>D(" )% pcs'ktk kotak Rp +)%,%%% kotak Rp

9& >lektroda *a7i SAR48>D(" )% pcs'ktk kotak Rp -+,)%% kotak Rp

99 >lektroda deasa SAR48>D(" )% pcs'ktk kotak Rp 2%,%%% -% kotak Rp

92 >ndoracheal !*e Unc!==ed 8!rph7 "o+% mmS!mi

*h *h Rp +$,&-% #% *h Rp

2% >ndoracheal !*e Unc!==ed 8!rph7 "o+) mmS!mi

*h *h Rp +$,&-% -% *h Rp

2 >ndoracheal !*e Unc!==ed 8!rph7 "o- mmS!mi

*h *h Rp +$,&-% -% *h Rp

2+ >ndoracheal !*e Unc!==ed 8!rph7 "o-) mmS!mi

*h *h Rp +$,&-% -) *h Rp

2- >ndoracheal !*e Unc!==ed 8!rph7 "o#% mmS!mi

*h *h Rp +$,&-% +% *h Rp

2#S!mi

*h *h Rp )$,#%% -% *h Rp

2)S!mi

*h *h Rp #%,%%% -% *h Rp

2$Bicakcilar

*h *h Rp -),%%% -% *h Rp

2&Bicakcilar

*h *h Rp -),%%% -% *h Rp

29Bicakcilar

*h *h Rp -),%%% # *h Rp

22Bicakcilar

*h *h Rp -),%%% # *h Rp

+%%Bicakcilar

*h *h Rp -),%%% # *h Rp

+%Bicakcilar

*h *h Rp -),%%% ) *h Rp

+%+Bicakcilar

*h *h Rp -),%%% +% *h Rp

+%-Bicakcilar

*h *h Rp -),%%% % *h Rp

+%#Bicakcilar

*h *h Rp -),%%% % *h Rp

Dressing "on oven dengan *antalan l!ka 7angmen7erap eks!dat !k% C +% cm

Dressing Sa* !tk tampon'l!ka dalam'*erongga !k# cm0$ cm

>ndoracheal !*e ith .!==ed 8!rph7 "o+,%mm

>ndoracheal !*e ith .!==ed 8!rph7 "o+,)mm

>ndoracheal !*e ith .!==ed 8!rph7 "o-,%mm

>ndoracheal !*e ith .!==ed 8!rph7 "o-,)mm

>ndoracheal !*e ith .!==ed 8!rph7 "o#,%mm

>ndoracheal !*e ith .!==ed 8!rph7 "o#,)mm

>ndoracheal !*e ith .!==ed 8!rph7 "o),%mm

>ndoracheal !*e ith .!==ed 8!rph7 "o),)mm

>ndoracheal !*e ith .!==ed 8!rph7 "o$,%mm

>ndoracheal !*e ith .!==ed 8!rph7 "o$,)mm

>ndoracheal !*e ith .!==ed 8!rph7 "o&,%mm


30/88

+%)Bicakcilar

*h *h Rp -),%%% % *h Rp

+%$Bicakcilar

*h *h Rp -),%%% % *h Rp

+%&Bicakcilar

*h *h Rp -),%%% % *h Rp

+%9Bicakcilar

*h *h Rp -),%%% % *h Rp

+%2B Bra!n

% set'*o0 *o0 Rp 9%),%%% # *o0 Rp

+% BS" %*h'*o0 *h Rp 2&,%%% % *h Rp

+ .el!losa ith haemostatic e==ect !k ) 0&,) cm Lokal +% pcs'*o0 *o0 Rp -,#)%,%%% *o0 Rp

++ >tanol &% Lokal *otol L Rp +%,%%% #%% *otol Rp

+- HUR>< *h *h Rp )%,%%% + *h Rp

+# HUR>< *h *h Rp )%,%%% -% *h Rp

+) HUR>< *h *h Rp )%,%%% +% *h Rp

+$ 1elang identitas *a7i *ir! Lokal *o0'%% pccs kotak Rp ++%,%%% 9 kotak Rp

+& 1elang identitas *a7i pink Lokal *o0'%% pccs kotak Rp ++%,%%% 9 kotak Rp

+9 1elang identitas i*! *ir! Lokal *o0'%% pccs kotak Rp +)%,%%% - kotak Rp

+2 1elang 5dentitas i*! pink Lokal *o0' %% pcs kotak Rp +)%,%%% - kotak Rp

++% 1ips =i*erglass !k % cm 0-,$ m BS" roll rol Rp $-,-)% -% rol Rp

++ 1ips =i*erglass !k &) cm0-,$ m BS" roll rol Rp #),+% #% rol Rp

+++ 1ips =i*erglass !k+,) cm 0-,$m BS" roll rol Rp 9&,))% -% rol Rp

++- 1!edel Aira7 %%%'%-% mm, sterille Bicakcilar *h *h Rp ),%%% ++ *h Rp

++# 1!edel Aira7 %%%'%#% mm, sterille Bicakcilar *h *h Rp ),%%% ++ *h Rp

++) 1!edel Aira7 %%%'%)% mm, sterille Bicakcilar *h *h Rp ),%%% ++ *h Rp

++$ 1!edel Aira7 '%$% mm, sterille Bicakcilar *h *h Rp ),%%% ++ *h Rp

++& 1!edel Aira7 +'%&% mm, sterille Bicakcilar *h *h Rp ),%%% ++ *h Rp

++9 1!edel Aira7 -'%9% mm, sterille Bicakcilar *h *h Rp ),%%% $+ *h Rp

++2 1!edel Aira7 #'%2% mm, sterille Bicakcilar *h *h Rp ),%%% 29 *h Rp

+-% 1!edel Aira7 )'%% mm, sterille Bicakcilar *h *h Rp ),%%% )9 *h Rp

+- 1!edel Aira7 $'% mm, sterille Bicakcilar *h *h Rp ),%%% #+ *h Rp

+-+ 1!edel Aira7, si6e %%%, Length %% mm S!mi *h *h Rp +$,%%% + *h Rp

+-- 1!edel Aira7, si6e %%%, Length % mm S!mi *h *h Rp +$,%%% + *h Rp

+-# 1!edel Aira7, si6e %%%, Length +% mm S!mi *h *h Rp +$,%%% + *h Rp

+-) 1!edel Aira7, si6e %%%, Length -% mm S!mi *h *h Rp +$,%%% 2 *h Rp

+-$ 1!edel Aira7, si6e %%%, Length #% mm S!mi *h *h Rp +$,%%% % *h Rp

+-& 1!edel Aira7, si6e %%%, Length )% mm S!mi *h *h Rp +$,%%% % *h Rp

+-9 1!edel Aira7, si6e %%%, Length $% mm S!mi *h *h Rp +$,%%% 2 *h Rp

>ndoracheal !*e ith .!==ed 8!rph7 "o&,)mm

>ndoracheal !*e ith .!==ed 8!rph7 "o9,%mm

>ndoracheal !*e ith .!==ed 8!rph7 "o9,)mm

>ndoracheal !*e ith .!==ed 8!rph7 "o2,%mm

>pid!ral Anastesia .ateter / "eedle set 19 0 - '#ith =ilter

>pithel Dressing 7ang mem*ant! proses epitelisasi

!nt!k l!ka *akar dan skin gra=t !k %cm 0) cm

;inger Sensor Sp4+ =or Ad!lt -% kg Re!sa*le;inger Pro*e

;inger Sensor Sp4+ =or Ad!lt M -% kg, "eonate -kg Si6e ) 0 +) mm >lastic ape

;inger Sensor Sp4+ =or 5n=ant -(+% kg Si6e ) 0 9)mm >lastic ape


31/88

+-2 1!edel Aira7, si6e %%%, Length &% mm S!mi *h *h Rp +$,%%% % *h Rp

+#% 1!edel Aira7, si6e %%%, Length 9% mm S!mi *h *h Rp +$,%%% +# *h Rp

+# 1!edel Aira7, si6e %%%, Length 2% mm S!mi *h *h Rp +$,%%% +# *h Rp

+#+ g7ps sintetis ,late0 =ree !k ) cm0-,$ m BS" roll rol Rp #&,))% +% rol Rp

+#- g7ps sintetis ,late0 =ree !k &,) cm0-,$ m BS" roll rol Rp &+,2 % rol Rp

+## H+4+ Lokal *otol 9%%ml *otol Rp +),%%% +# *otol Rp

+#) Handscoon non steril SE Stardec )% psg'ktk kotak Rp )),%%% +2% kotak Rp

+#$ Handscoon non steril LE Stardec )% psg'ktk kotak Rp )),%%% +%% kotak Rp

+#& Handscoon non steril 8E Stardec )% psg'ktk kotak Rp )),%%% #)% kotak Rp

+#9 Handscoon panjang Lokal pasang psg Rp ),%%% -% psg Rp

+#2 Ansell )% psg'*o0 psg Rp ++,%%% )% psg Rp

+)% Handscoon steril !tk *edah "o $ SUR15PR4 )% psg*o0 psg Rp ),%%% % psg Rp

+) Handscoon steril !tk *edah "o $,) SUR15PR4 )%psg'*o0 psg Rp ),%%% +%% psg Rp

+)+ Handscoon steril !tk *edah "o & SUR15PR4 )%psg'*o0 psg Rp ),%%% -%%% psg Rp

+)- Handscoon steril !tk *edah "o&,) SUR15PR4 )% psg'*o0 psg Rp ),%%% +%%% psg Rp

+)# Handscoon steril !tk *edah "o 9 SUR15PR4 )% psg'*o0 psg Rp ),%%% %%% psg Rp

+)) hemostasis t!lang Bone a0E +,) gr B Bra!n pcs *h Rp )#,%%% + *h Rp

+)$ 5n=!s Accessories, Per=!sor t!*ing )% cm ' hite B Bra!n +)pcs'*o0 *o0 Rp 2)%,%%% % *o0 Rp

+)& 5n=!sion set anak mikroE er!mo )% set'pack set Rp ),#%% 9%% set Rp

+)9 5n=!sion set deasa makroE er!mo )% set'pack set Rp ,%%% +%%% set Rp

+)2 int!*ation st7let mandrinE ++mm Phasco pcs *h Rp ##,%%% )% *h Rp

+$% int!*ation st7let mandrinE --mm Phasco pcs *h Rp ##,%%% -% *h Rp

+$ int!*ation st7let mandrinE #-mm Phasco pcs *h Rp ##,%%% % *h Rp

+$+ 5ternal .hemical 5ndikator steam +#% strip'*o0 -8 +#% strip'*o0 *o0 Rp -2,%%% 9 *o0 Rp

+$- 5< .ateter no # 1 itho!t port er!mo )%pcs'*o0 *h Rp ++,+%% % *h Rp

+$# 5< .ateter no $ 1 itho!t port er!mo )%pcs'*o0 *h Rp ++,+%% #%% *h Rp

+$) 5< .ateter no 9 1 ith port B Bra!n %%pcs'*o0 *h Rp +-,$%% %%% *h Rp

+$$ 5< .ateter no 9 1 itho!t port er!mo )%pcs'*o0 *h Rp ++,+%% %%% *h Rp

+$& 5< .ateter no +% 1 ith port B Bra!n %%pcs'*o0 *h Rp +-,$%% +%% *h Rp

+$9 5< .ateter no +% 1 itho!t port er!mo )%pcs'*o0 *h Rp ++,+%% %%% *h Rp

+$2 5< .ateter no ++ 1 ith port B Bra!n %% *!ah'kotak *h Rp +-,$%% )%% *h Rp

+&% 5< .ateter no ++ 1 itho!t port er!mo )%pcs'*o0 *h Rp ++,+%% %%% *h Rp

+& 5< .ateter no +# 1 ith port B Bra!n %% *!ah'kotak *h Rp +#,&%% 9%% *h Rp

+&+ 5< .ateter no +# 1 itho!t port er!mo )%pcs'*o0 *h Rp ++,+%% $%% *h Rp

+&- 5< .ateter no+$ 1 port er!mo )%pcs'*o0 *h Rp -#,+%% )%% *h Rp

+ 3ackson Reeves Ad!lt Bicakcilar *h *h Rp +&),%%% + *h Rp+&) 3ackson Reeves Pediatric Bicakcilar *h *h Rp +&),%%% # *h Rp

+&$ jar!m hecting k!lit si6e # 8ani +*h'*ngks *!ngk!s Rp 9$,%%% % *!ngk!s Rp

+&& jar!m hecting k!lit si6e $ 8ani +*h'*ngks *!ngk!s Rp 9$,%%% % *!ngk!s Rp

+&9 jar!m hecting k!lit si6e +% 8ani +*h'*ngks *!ngk!s Rp 9$,%%% % *!ngk!s Rp

+&2 jar!m hecting k!lit si6e +# 8ani +*h'*ngks *!ngk!s Rp 9$,%%% +% *!ngk!s Rp

+9% jar!m hecting k!lit si6e +$ 8ani +*h'*ngks *!ngk!s Rp 9$,%%% % *!ngk!s Rp

Handscoon steril encore orthopaedic "o 9 ,poder

=ree


32/88

+9 jar!m hecting k!lit si6e -% 8ani +*h'*ngks *!ngk!s Rp 9$,%%% ) *!ngk!s Rp

+9+ jar!m hecting k!lit si6e -& 8ani +*h'*ngks *!ngk!s Rp 9$,%%% ) *!ngk!s Rp

+9- jar!m hecting k!lit si6e #% 8ani +*h'*ngks *!ngk!s Rp 9$,%%% % *!ngk!s Rp

+9# jar!m hecting otot si6e # 8ani +*h'*ngks *!ngk!s Rp 9$,%%% % *!ngk!s Rp

+9) jar!m hecting otot si6e $ 8ani +*h'*ngks *!ngk!s Rp 9$,%%% ) *!ngk!s Rp

+9$ jar!m hecting otot si6e +% 8ani +*h'*ngks *!ngk!s Rp 9$,%%% ) *!ngk!s Rp

+9& jar!m hecting otot si6e +# 8ani +*h'*ngks *!ngk!s Rp 9$,%%% ) *!ngk!s Rp

+99 jar!m hecting otot si6e +$ 8ani +*h'*ngks *!ngk!s Rp 9$,%%% % *!ngk!s Rp

+92 jar!m hecting otot si6e -% 8ani +*h'*ngks *!ngk!s Rp 9$,%%% - *!ngk!s Rp

+2% jar!m hecting otot si6e -& 8ani +*h'*ngks *!ngk!s Rp 9$,%%% ) *!ngk!s Rp

+2 jar!m hecting otot si6e #% 8ani +*h'*ngks *!ngk!s Rp 9$,%%% + *!ngk!s Rp

+2+ 3ar!m Spinal Anastesi !k +) 1 0 - '+N clear h!* B Bra!n +) pcs'*o0 kotak Rp &&),%%% % kotak Rp

+2- 3ar!m Spinal Anastesi !k +& 1 0 - '+N clear h!* B Bra!n +) pcs'*o0 kotak Rp 2%%,%%% # kotak Rp

+2# 3ar!m s!ntik no +& 1 er!mo %%*h'kotak *h Rp ,%%% %%% *h Rp

+2) 3ar!m s!ntik no+) 1 er!mo %%*h'kotak *h Rp ,%%% ++% *h Rp

+2$ jell7 US1 1allon ;arker )L galon Rp -+#,)%% -% galon Rp

+2& kasa hidro=il steril *o0 !k $0$ cm 5nnova *o0 *o0 Rp &,+$% 2%% *o0 Rp

+29 kasa pem*al!t hidro=il #m 0 % cm 5nnova )% 'rol rol Rp --,-9) +2 rol Rp

+22 kasa pem*al!t hidro=il #m 0 ) cm 5nnova %% 'rol rol Rp --,-9) +% rol Rp

-%% kassa *eranti*iotik Dar7at!le *o0'% lm*r lem*ar Rp -,2%% #)% lem*ar Rp

-% BS" )rol'*o0 rol Rp #&$,&%% -% rol Rp

-%+ kassa hidro=il g!l!ng #% 0 9% cm 5nnova rol *esar rol Rp +%,%%% #% rol Rp

-%- kertas ctg Ultrarec rol rol Rp #%,%%% 2 rol Rp

-%# kertas >K1, le*ar )- mm ekg channelE ;!k!da rol rol Rp +%,%%% %% rol Rp

-%) kertas spirometeri !nt!k alat Spirometri 85R 85R rol rol Rp -%%,%%% + rol Rp

-%$ B Bra!n *h *hRp #&,2%%

) *h Rp

-%& B Bra!n *h *hRp )%,&%%

) *h Rp

-%9 B Bra!n *h *hRp )-,)%%

% *h Rp

-%2 B Bra!n *h *hRp $$,#%%

% *h Rp

-% B Bra!n *h *hRp -2,$%%

) *h Rp

- B Bra!n *h *hRp -2,$%%

) *h Rp

-+ B Bra!n *h *hRp -2,$%%

) *h Rp

-- B Bra!n *h *hRp #-&,-%%

+ *h Rp

kassa *ir! -9,# m0% cm,%% kat!n !tkorthopedi

Kirschner Boring ire 90-% mmroc'Ro!nd'Pack'%

Kirschner Boring ire +%0-% mmroc'Ro!nd'Pack'%

Kirschner Boring ire ++0-% mmroc'Ro!nd'Pack'%

Kirschner Boring ire +)0-% mmroc'Ro!nd'Pack'%

Kirschner Boring ire #0)%mmroc'Ro!nd'Pack'%

Kirschner Boring ire $0)%mmroc'Ro!nd'Pack'%

Kirschner Boring ire 90)%mmroc'Ro!nd'Pack'%

Kirschner Boring ire $0%+mmDBLroc'Pack'%


33/88

-# B Bra!n *h *hRp #-&,-%%

*h Rp

-) B Bra!n *h *hRp #-&,-%%

% *h Rp

-$ B Bra!n *h *hRp #&+,#%%

% *h Rp

-& B Bra!n *h *hRp #&+,#%%

% *h Rp

-9 B Bra!n *h *hRp $$#,-%%

*h Rp

-2 K44 Disposa*le 8an!al Res!sitator Ad!lt K44 *h *h Rp +&9,%%% + *h Rp

-+% K44 Disposa*le 8an!al Res!sitator 5n=ant K44 *h *h Rp +&9,%%% + *h Rp

-+ K44 Disposa*le 8an!al Res!sitator Paediatric K44 *h *h Rp +&9,%%% + *h Rp

-++ 3ell7 Pel!mas ortopedi Lokal *h *h Rp )%,%%% % *h Rp

-+- laminaria 8 8edg7n *h *h Rp 9,+%% ) *h Rp

-+# Laringeal 8ask Aira7 L8AE ;le0i*le "o+ S!mi *h *h Rp $&&,$%% *h Rp

-+) Laringeal 8ask Aira7 L8AE ;le0i*le "o+) S!mi *h *h Rp $&&,$%% *h Rp

-+$ Laringeal 8ask Aira7 L8AE ;le0i*le "o- S!mi *h *h Rp $&&,$%% *h Rp

-+& Lar7ngeal 8ask Aira7 ' L8A "o ,) S!mi *h *h Rp +#%,%%% - *h Rp

-+9 Lar7ngeal 8ask Aira7 ' L8A "o + S!mi *h *h Rp +#%,%%% - *h Rp

-+2 Lar7ngeal 8ask Aira7 ' L8A "o - S!mi *h *h Rp +#%,%%% +% *h Rp

--% Lar7ngeal 8ask Aira7 ' L8A "o # S!mi *h *h Rp +#%,%%% +% *h Rp

-- Lar7ngeal 8ask Aira7 ' L8A "o S!mi *h *h Rp +#%,%%% ) *h Rp

--+ Lar7ngeal 8ask Aira7 ' L8A "o +,) S!mi *h *h Rp +#%,%%% +% *h Rp

--- S!mi *h *h Rp -,%%%,%%% % *h Rp

--# S!mi *h *h Rp -,%%%,%%% % *h Rp

--) 8alleolar Scre #)0+%mm Part hread B Bra!n *h *h Rp $$,%%% ) *h Rp

--$ 8alleolar Scre #)0+)mm Part hread B Bra!n *h *h Rp $$,%%% ) *h Rp

--& 8alleolar Scre #)0-%mm Part hread B Bra!n *h *h Rp $$,%%% ) *h Rp

--9 8alleolar Scre #)0-)mm Part hread B Bra!n *h *h Rp ,-%% ) *h Rp

--2 8alleolar Scre #)0#%mm Part hread B Bra!n *h *h Rp ,-%% % *h Rp

-#% 8alleolar Scre #)0#)mm Part hread B Bra!n *h *h Rp 9$,-%% % *h Rp-# 8alleolar Scre #)0)%mm Part hread B Bra!n *h *h Rp 9$,-%% % *h Rp

-#+ 8alleolar Scre #)0))mm Part hread B Bra!n *h *h Rp 2$,)%% % *h Rp

-#- 8alleolar Scre #)0$%mm Part hread B Bra!n *h *h Rp 2$,)%% % *h Rp

-## 8ini .ortical Scre )0$mm B Bra!n *h *h Rp +#,)%% % *h Rp

-#) 8ini .ortical Scre )0&mm B Bra!n *h *h Rp +#,)%% % *h Rp

-#$ 8ini .ortical Scre )09mm B Bra!n *h *h Rp +#,)%% % *h Rp

Kirschner Boring ire $0+&mmDBLroc'Pack'%

Kirschner Boring ire $0)+mmDBLroc'Pack'%

Kirschner Boring ire $0++2mmDBLroc'Pack'%

Kirschner Boring ire $0-%)mmDBLroc'Pack'%

Kirschner Boring ire +%0+-%mmDBLroc'Pack'%

Lar7ngeal 8ask Aira7L8AE ;ashtrach >re!sa*leE"o &,)mm

Lar7ngeal 8ask Aira7L8AE ;ashtrach >re!sa*leE"o &mm


34/88

-#& 8ini .ortical Scre )02mm B Bra!n *h *h Rp -+,9%% % *h Rp

-#9 8ini .ortical Scre )0%mm B Bra!n *h *h Rp -+,9%% % *h Rp

-#2 8ini .ortical Scre )0mm B Bra!n *h *h Rp #+,%% % *h Rp

-)% 8ini .ortical Scre )0+mm B Bra!n *h *h Rp #+,%% % *h Rp

-) 8ini .ortical Scre )0#mm B Bra!n *h *h Rp )%,#%% % *h Rp

-)+ 8ini .ortical Scre )0$mm B Bra!n *h *h Rp )%,#%% % *h Rp

-)- 8ini .ortical Scre +%0%mm B Bra!n *h *h Rp +-,$%% % *h Rp

-)# 8ini .ortical Scre +%0+mm B Bra!n *h *h Rp +-,$%% % *h Rp

-)) 8ini .ortical Scre +%0#mm B Bra!n *h *h Rp +&,-%% % *h Rp

-)$ 8ini .ortical Scre +%0$mm B Bra!n *h *h Rp +&,-%% % *h Rp

-)& 8ini .ortical Scre +%09mm B Bra!n *h *h Rp -),$%% % *h Rp

-)9 8ini .ortical Scre +%0+%mm B Bra!n *h *h Rp -),$%% % *h Rp-)2 8ini .ortical Scre +%0++mm B Bra!n *h *h Rp &$,+%% % *h Rp

-$% 8ini .ortical Scre +%0+#mm B Bra!n *h *h Rp &$,+%% % *h Rp

-$ 8ini Bone Plate # 1lid Holes L+-mm B Bra!n *h *h Rp +&$,9%% % *h Rp

-$+ 8ini Bone Plate ) 1lid Holes L+2mm B Bra!n *h *h Rp -9,-%% % *h Rp

-$- 8ini Bone Plate $ 1lid Holes L-)mm B Bra!n *h *h Rp -#-,+%% % *h Rp

-$# 8ini Plate # 1lid Holes L 9mm B Bra!n *h *h Rp +,2%% % *h Rp

-$) 8ini Bone Plate # 1lid Holes L++mm B Bra!n *h *h Rp &+&,%% % *h Rp

-$$ 8ini Bone Plate ) 1lid Holes L+&mm B Bra!n *h *h Rp 9+%,-%% % *h Rp

-$& 8ini Bone Plate $ 1lid Holes L-+mm B Bra!n *h *h Rp 99-,2%% % *h Rp

-$9 8ini Bone Plate & 1lid Holes L-&mm B Bra!n *h *h Rp 2&2,2%% % *h Rp

-$2 8asker "2) 4nemade +%'*o0 *o0 Rp $-,-)% +% *o0 Rp

-&% 8asker ne*!li6er anak SAL>R set set Rp )&,+%% +% set Rp

-& masker ne*!li6er deasa SAL>R set set Rp --,+%% $- set Rp-&+ 8asker ali hija! 8aesindo )%pcs'inner inner Rp +-,)%% )%) inner Rp

-&- 8ess hernia )C) pol7prop7lene pcs *h Rp &9%,%%% % *h Rp

- nasal kan!l anak Serenit7 set set Rp +,&9% %% set Rp

-&) nasal kan!l *a7i Serenit7 set set Rp -),&)% +) set Rp

-&$ nasal kan!l deasa Serenit7 set set Rp -,-% )% set Rp

-&& S!mi *h *h Rp $%,%%% 9 *h Rp

-&9 S!mi *h *h Rp $%,%%% 9 *h Rp

-&2 S!mi *h *h Rp $%,%%% 9 *h Rp

-9% S!mi *h *h Rp $%,%%% 9 *h Rp

-9 S!mi *h *h Rp $%,%%% 9 *h Rp

-9+ S!mi *h *h Rp $%,%%% 9 *h Rp

-9- S!mi *h *h Rp $%,%%% 9 *h Rp

"asophar7ngeal Aira7, Standard P


35/88

-9# S!mi *h *h Rp $%,%%% 9 *h Rp

-9) S!mi *h *h Rp $%,%%% 9 *h Rp

-9$ S!mi *h *h Rp $%,%%% 2 *h Rp

-9& S!mi *h *h Rp $%,%%% 2 *h Rp

-99 "eonatal H8> Altera *h *h Rp #%,%%% +% *h Rp

-92 Altera *h *h Rp #),%%% %% *h Rp

-2% "on Re*reating 8ask !k anak SAL>R set *h Rp #),&)% %% *h Rp

-2 "on Re*reating 8ask !k deasa SAL>R set *h Rp +2,+)% )%% *h Rp

-2+ Altera *h *h Rp )%,%%% +) *h Rp

-2- Lokal +'*o0 *h Rp 2,%% % *h Rp

-2# Altera *h *h Rp +&),%%% % *h Rp

-2) BS" rol rol Rp +#,&$+ 9 rol Rp

-2$ BS" rol rol Rp --,%& - rol Rp

-2& BS" rol rol Rp #-,+2$ - rol Rp

-29 BS" rol rol Rp ,-&),9#& + rol Rp

-22 BS" rol rol Rp ,#29,+%% + rol Rp

#%% BS" rol rol Rp ,$#9,%+% + rol Rp

#% BS" rol rol Rp ,)29,%9% + rol Rp

#%+ BS" rol rol Rp ,&,2%% + rol Rp

#%- BS" rol rol Rp ,#9),&) + rol Rp

#%# BS" $*h'*o0 *h Rp &,)+) %% *h Rp

#%) BS" +*h'*o0 *h Rp -,)-% %% *h Rp

#%$ BS" roll rol Rp $+),%%% rol Rp

#%& BS" roll rol Rp -&),%%% rol Rp

#%9 BS" roll rol Rp #)%,%%% rol Rp

#%2 Pengikat tali p!sat Lokal kotak'+% pcs *h Rp +,)%% % *h Rp

"asophar7ngeal Aira7, Standard P


36/88

#% BS" +#%rol'*o0 rol Rp -#,%)% $% rol Rp

# BS" +#%rol'*o0 rol Rp +9,-&) )% rol Rp

#+ BS" +#%rol'*o0 rol Rp -2,&+) $% rol Rp

#- Plastik 4*at !k % 0 ) cm Kilp Plastik pak'%%pcs pak Rp +9,&)% 9% pak Rp

## Plastik 4*at !k % 0 & cm Kilp Plastik pak'%%pcs pak Rp ),%%% 9% pak Rp

#) Plastik 4*at !k - 0 9,& cm Kilp Plastik pak'%%pcs pak Rp +%,%%% )% pak Rp

#$ Plastik 4*at !k 9,) 0 - cm Kilp Plastik pak'%%pcs pak Rp +-,%%% #% pak Rp

#& Pelar!t 8ikro=ilm !nt!k l!ka B Bra!n Botol *otol Rp &),%%% *otol Rp

#9 BS" rol rol Rp +,%% )% rol Rp

#2 BS" rol rol Rp ),9%% )% rol Rp

#+% BS" rol rol Rp ++,&%% +%% rol Rp

#+ BS" %% pcs *h Rp #,)#% $%% *h Rp

#++ BS" rol rol Rp $#,)&) +% rol Rp

#+- Plester ransparant, tahan Air % cm0%m BS" rol rol Rp -%%,%%% ) rol Rp

#+# Plester ransparant, tahan Air) cm0%m BS" rol rol Rp )9,%%% ) rol Rp

#+) BS" %'Bo0 *h Rp -2,&+) )% *h Rp

#+$ S!mi *h *h Rp +),%%% # *h Rp

#+& S!mi *h *h Rp +),%%% 2 *h Rp

#+9 S!mi *h *h Rp +),%%% % *h Rp

#+2 ?!arter !*!lar Plate ) Holes L-2mm B Bra!n *h *h Rp ),+)% % *h Rp

#-% ?!arter !*!lar Plate $ Holes L#&mm B Bra!n *h *h Rp -%%,##% % *h Rp

#- Re*rething 8ask !k anak Lokal set set Rp $%,%%% % set Rp

#-+ Re*rething 8ask !k deasa Lokal set set Rp )),%%% % set Rp

#-- R!sch *h *h Rp +$-,%%% ) *h Rp

#-# R!sch *h *h Rp +$-,%%% ) *h Rp

#-) R!sch *h *h Rp +$-,%%% ) *h Rp

Per*an retensi !tk =iksasi pd *agian t!*!h 7gmemiliki mo*ilitas tinggi dan kohesi= %cm 0 #m

Per*an retensi !tk =iksasi pd *agian t!*!h 7gmemiliki mo*ilitas tinggi dan kohesi= !k 9cm 0 #m

Per*an retensi !tk =iksasi pd *agian t!*!h 7gmemiliki mo*ilitas tinggi dan kohesi= !k+cm 0 # m

plester *ahan kertas dengan perekat hipo alergen!nt!k k!lit sensiti=, +,)cm 02,+m dengan pemotong

plester coklat, da7a rekat k!at,m!dah diso*ek ,+)cm 0 #,) m

plester coklat, da7a rekat k!at,m!dah diso*ek ) cm0 #,) m

Plester Dressing ;iksasi iv cateter, transparan, tahanair dan *akhteri !k ),9 0 9 cm

Plester P!tih ransparan !nt!k =iksasi l!ka le*ar+%0) m

Pol7!rethan =oam dressing dengan lapisan silikon )cm C ) cm

Pre=ormed racheal !*e, oral ith lo Press!re.!== t7pe 8!rph7 "o $) mm

Pre=ormed racheal !*e, 4ral ith lo Press!re.!== t7pe 8!rph7 "o &% mm

Pre=ormed racheal !*e, 4ral ith lo Press!re.!== t7pe 8!rph7 "o &) mm

Rein=orced >ndotracheal !*e ith .!==ed >"on Kinking E "o -% mm *hE

Rein=orced >ndotracheal !*e ith .!==ed >"on Kinking E "o -) mm *hE

Rein=orced >ndotracheal !*e ith .!==ed >"on Kinking E "o #% mm *hE


37/88

#-$ R!sch *h *h Rp +$-,%%% ) *h R

#-& R!sch *h *h Rp +$-,%%% ) *h R

#-9 R!sch *h *h Rp +$-,%%% ) *h R

#-2 R!sch *h *h Rp +$-,%%% ) *h R

##% R!sch *h *h Rp +$-,%%% ) *h R

## R!sch *h *h Rp +$-,%%% ) *h R

##+ R!sch *h *h Rp +$-,%%% ) *h R

##- Respirator7, Anaesthesia ;ace 8ask, Ad!lt Large Koo *h *h Rp -2,)%% + *h Rp

### Respirator7, Anaesthesia ;ace 8ask, Ad!lt 8edi!m Koo *h *h Rp -2,)%% - *h R

##) Respirator7, Anaesthesia ;ace 8ask, Ad!lt Small Koo *h *h Rp -2,)%% + *h Rp

##$ Respirator7, Anaesthesia ;ace 8ask, .hild Koo *h *h Rp -2,)%% *h Rp

##& Respirator7, Anaesthesia ;ace 8ask, 5n=ant Koo *h *h Rp -2,)%% *h Rp

##9 Respirator7, Anaesthesia ;ace 8ask, "eonate Koo *h *h Rp -2,)%% *h Rp

##2 Respirator7, Anaesthesia ;ace 8ask, Pre("eonate Koo *h *h Rp -2,)%% - *h R

#)% Reconstr!ction Plate str ) holes D-) L)9mm B Bra!n *h *h Rp ,+-&,+9) % *h Rp

#) Reconstr!ction Plate str $ holes D-) L&%mm B Bra!n *h *h Rp ,-#-,9$% - *h R

#)+ Reconstr!ction Plate str &holes D-) L9+mm B Bra!n *h *h Rp ,#9#,2#) - *h R

#)- Reconstr!ction Plate str 9holes D-) L2#mm B Bra!n *h *h Rp ,$&2,9+) - *h R

#)# Reconstr!ction Plate str 9 holes D+& L$#mm B Bra!n *h *h Rp ,-%9,--) % *h Rp

#)) Reconstr!ction Plate str % holes D+& L9%mm B Bra!n *h *h Rp ,#9#,2#) % *h Rp

#)$ Reconstr!ction Plate str + holes D+& L2$mm B Bra!n *h *h Rp ,$&2,9+) % *h Rp

#)& Sa*!n cair desin=ektan sta*imedE B Bra!n liter liter Rp 9%%,%%% -% liter R

#)9 Sa*!n cair desin=ektan endoscop7 Hel76imeE B Bra!n liter liter Rp #)%,%%% +) liter R

#)2 Sa*!n cair desin=ektan perm!kaan *ra!nodermE B Bra!n liter liter Rp -%,%%% % liter R

Rein=orced >ndotracheal !*e ith .!==ed >"on Kinking E "o #) mm *hE

Rein=orced >ndotracheal !*e ith .!==ed >"on Kinking E "o )% mm *hE

Rein=orced >ndotracheal !*e ith .!==ed >"on Kinking E "o )) mm *hE

Rein=orced >ndotracheal !*e ith .!==ed >"on Kinking E "o $% mm *hE

Rein=orced >ndotracheal !*e ith .!==ed >"on Kinking E "o $) mm *hE

Rein=orced >ndotracheal !*e ith .!==ed >"on Kinking E "o &% mm *hE

Rein=orced >ndotracheal !*e ith .!==ed >"on Kinking E "o &) mm *hE


38/88

#$% Sa*!n .!ci angan !tk kmr operasi H7dre0 *otol ) L *otol Rp 2+%,%%% -% *otol Rp

#$ Sa*!n 8andi Ba7i Lokal *otol *otol Rp %,%%% % *otol Rp

#$+ Sediplast Sediplast +%%pcs'kotak kotak Rp -,&)%,%%% % kotak Rp

#$- Selang "1 no % =eeding t!*eE Bicakcilar pcs *h Rp $,%%% )% *h Rp

#$# Selang "1 no + stomach t!*eE er!mo pcs *h Rp 9,%%% ) *h Rp

#$) Selang "1 no # stomach t!*eE er!mo pcs *h Rp 9,%%% ) *h Rp

#$$ Selang "1 no $ stomach t!*eE er!mo pcs *h Rp 9,%%% % *h Rp

#$& Selang "1 no 9 stomach t!*eE er!mo pcs *h Rp 9,%%% +%% *h Rp

#$9 Selang "1 no +% stomach t!*eE Bicakcilar pcs *h Rp ,)%% ) *h Rp

#$2 Selang "1 no ++ stomach t!*eE Bicakcilar pcs *h Rp ,)%% ) *h Rp

#&% Selang "1 no +# stomach t!*eE Bicakcilar pcs *h Rp ,)%% % *h Rp

#& Selang "1 no -,) =eeding t!*eE er!mo pcs *h Rp ),-%% )+ *h Rp#&+ Selang "1 no ) =eeding t!*eE er!mo pcs *h Rp ),-%% %% *h Rp

#&- Selang "1 no ) panjang =eeding t!*eE er!mo pcs *h Rp ),-%% +%% *h Rp

# Selang "1 no $ =eeding t!*eE er!mo pcs *h Rp ),-%% )% *h Rp

#&) Selang "1 no 9 =eeding t!*eE er!mo pcs *h Rp ),-%% )% *h Rp

#&$ Simple 8ask 4+ !k anak SAL>R set set Rp -$,$%% ) set Rp

#&& Simple 8ask 4+ !k *a7i Lokal set set Rp -+,92% +- set Rp

#&9 Simple 8ask !k deasa SAL>R set set Rp +,&%% ) set Rp

#&2 Skin raction Kit Anak +N *erperekatE BS" kit kit Rp $),-+ ) kit Rp

#9% Skin raction Kit anak +N tidak *erperekatE BS" kit kit Rp $),%9& +% kit Rp

#9 Skin raction Kit Deasa -N *erperekatE BS" kit kit Rp 92,##% ) kit Rp

#9+ Schan6 Scre $%0%mm hread -%mm B Bra!n *h *h Rp 2-,)%% % *h Rp

#9- Schan6 Scre $%0&%mm hread #%mm B Bra!n *h *h Rp ,%9&,%$) % *h Rp#9# Schan6 Scre 90#%mm hread +mm B Bra!n *h *h Rp %,2)% *h Rp

#9) Schan6 Scre 90#%mm hread $mm B Bra!n *h *h Rp %,2)% % *h Rp

#9$ Schan6 Scre 90)%mm hread +mm B Bra!n *h *h Rp &$9,-)) % *h Rp

#9& Schan6 Scre 90)%mm hread $mm B Bra!n *h *h Rp &$9,-)) % *h Rp

#99 Schan6 Scre -%0-)mm B Bra!n *h *h Rp &2-,&-% % *h Rp

#92 Schan6 Scre -%0)%mm B Bra!n *h *h Rp &2-,&-% % *h Rp

#2% Schan6 Scre -%0$%mm B Bra!n *h *h Rp &2-,&-% 9 *h Rp

#2 Schan6 Scre -%0&%mm B Bra!n *h *h Rp &2-,&-% % *h Rp

#2+ Steinmann Pin $0))mm 'hread riang B Bra!n *h *h Rp $2#,+$% % *h Rp

#2- Steinmann Pin $0$)mm 'hread riang B Bra!n *h *h Rp $2#,+$% % *h Rp

#2# Small ;ragment Plate # Holes +&mm L--mm B Bra!n *h *h Rp -$#,-9) % *h Rp

#2) Small ;ragment Plate $ Holes +&mm L#2mm B Bra!n *h *h Rp -$#,-9) % *h Rp

#2$ Small ;ragment Plate 9 Holes +&mm L$)mm B Bra!n *h *h Rp #+9,--% % *h Rp

#2& Small ;ragment Plate ) Holes +&mm L-+mm B Bra!n *h *h Rp -,$%) % *h Rp

#29 Small ;ragmentPlate +&mm & 1lHoles L$%mm B Bra!n *h *h Rp 2%+,--) % *h Rp


39/88

#22 Small ;ragmentPlate +&mm 9 1lHoles L$9mm B Bra!n *h *h Rp 22%,$#% % *h Rp

)%% Small ;ragmentPlate +&mm % 1lHoles L9#mm B Bra!n *h *h Rp ,$&,+)% % *h Rp

)% Small ;ragmentPlate +&mm + 1lHoles L%%mm B Bra!n *h *h Rp ,+2%,%$) % *h Rp

)%+ Small ;ragment Plate +&mm # 1l Holes L-$mm B Bra!n *h *h Rp $9-,%2) % *h Rp

)%- Small ;ragment Plate +&mm ) 1l Holes L##mm B Bra!n *h *h Rp &)$,&) ) *h Rp

)%# Small ;ragment Plate +&mm $ 1l Holes L)+mm B Bra!n *h *h Rp 9-,%) ) *h Rp

)%) Small ;ragment Plate -)mm # 1l Holes L)%mm B Bra!n *h *h Rp $)&,&+% % *h Rp

)%$ Small ;ragment Plate -)mm ) 1l Holes L$+mm B Bra!n *h *h Rp $2-,+#) % *h Rp

)%& Small ;ragment Plate -)mm $ 1l Holes Lmm B Bra!n *h *h Rp ,)$% % *h Rp

)%9 Small ;ragment Plate -)mm & 1l Holes L9$mm B Bra!n *h *h Rp &)#,#) % *h Rp

)%2 Small ;ragment Plate -)mm 9 1l Holes L29mm B Bra!n *h *h Rp &2+,&) ) *h Rp

)% Small ;ragment Plate -)mm % 1l Holes L++mm B Bra!n *h *h Rp 2&+,-&% ) *h Rp

) Small ;ragment Plate -)mm + 1l Holes L#$mm B Bra!n *h *h Rp ,-,#)) + *h Rp

)+ Spare Blade 4rthopedi !nt!k alat BA&%$R B Bra!n *h *h Rp #,2%% ) *h Rp

)- Spare Blade 4rthopedi !nt!k alat BA&)R B Bra!n *h *h Rp ##,%%% % *h Rp

)# Splinting cepat Leg !k S hiteE BS" pcs *h Rp -,)%% *h R

)) Splinting cepat Loer Leg !k L hiteE BS" pcs *h Rp #,9&) *h Rp

)$ Splinting cepat rist !kL hiteE BS" pcs *h Rp 2%,9%% *h Rp

)& Splinting cepat Loer Leg !k mhiteE BS" pcs *h Rp +#,9)% *h Rp

)9 Splinting cepat !tk el*o !k L hiteE BS" pcs *h Rp %&,9+) *h Rp

)2 Splinting cepat !tk el*o !k m hiteE BS" pcs *h Rp %,%) *h Rp

)+% Splinting cepat !tk HandOrist !kL hiteE BS" pcs *h Rp 2$,#&) *h Rp

)+ Splinting cepat !tk HandOrist !km hiteE BS" pcs *h Rp 2$,#&) *h Rp

)++ Splinting cepat rist !k8 hiteE BS" pcs *h Rp 2%,9%% *h Rp

)+- Splinting cepat!tk el*o !k S hiteE BS" pcs *h Rp &2,#)% *h Rp)+# Splinting dari S7ntetic .ast %cm0-%cm BS" rol rol Rp )$,--# + rol Rp

)+) Splinting dari S7ntetic .ast %cm0#%cm BS" rol rol Rp +%9,##) + rol Rp

)+$ Splinting dari S7ntetic .ast +,)cm0$)cm BS" rol rol Rp -&%,#&2 + rol Rp

)+& Splinting dari S7ntetic .ast +,)cm0&$cm BS" rol rol Rp #--,&) + rol Rp

)+9 Splinting dari S7ntetic .ast &,)cm0-%cm BS" rol rol Rp #),-#+ -% rol Rp

)+2 Steri D!al >co Roll Plat %cm 0 +%% -8 roll rol Rp )2,$$& # rol Rp


40/88

)-% Steri D!al >co Roll Plat )cm 0 +%% -8 roll rol Rp 22&,)%% # rol Rp

)- Steri D!al >co Roll Plat +%cm 0 +%% -8 roll rol Rp ,&),%%% # rol Rp

)-+ Steri D!al >co Roll Plat +)cm 0 +%% -8 roll rol Rp ,)+),%%% # rol Rp

)-- Steri D!al >co Roll Plat #%cm 0 +%% -8 roll rol Rp +,)%%,%%% + rol Rp

)-# Steri D!al >co Roll Plat &,) cm 0 +%% -8 roll rol Rp ##-,&)% # rol Rp

)-) Steri D!al >co Roll Plat 1!sse )cm 0 %% -8 roll rol Rp &+,)%% # rol Rp

)-$ Steri D!al >co Roll Plat 1!sse +%cm 0 %% -8 roll rol Rp 2+,)%% # rol Rp

)-& Steri D!al >co Roll Plat 1!sse +)cm 0 %% -8 roll rol Rp ,%%,%%% # rol Rp

)-9 Pel!mas 5nstr!ment orthopedi spra7 -%%ml B Bra!n *h *h Rp ,$&+,%%% + *h Rp

)-2 S!ction .atheter ith Kapkon .onnector % .h Bicakcilar *h *h Rp #,9%% )% *h Rp

)#% S!ction .atheter ith Kapkon .onnector + .h Bicakcilar *h *h Rp #,9%% %% *h Rp

)# S!ction .atheter ith Kapkon .onnector # .h Bicakcilar *h *h Rp #,9%% )% *h Rp

)#+ S!ction .atheter ith Kapkon .onnector $ .h Bicakcilar *h *h Rp #,9%% %% *h Rp

)#- S!ction .atheter ith Kapkon .onnector 9 .h Bicakcilar *h *h Rp #,9%% % *h Rp

)## S!ction .onnecting t!*e -%% cm Bicakcilar pcs *h Rp -&,%%% +% *h Rp

)#) Spoon Plate ) Holes sha=tE L%%mm B Bra!n *h *h Rp ,))2,#%% % *h Rp

)#$ Spoon Plate $ Holes sha=tE L+%mm B Bra!n *h *h Rp ,&2#,%%% % *h Rp

)#& Semi(t!*!lar Plate $ holes +mm L%-mm B Bra!n *h *h Rp #&,%%% % *h Rp

)#9 Semi(t!*!lar Plate $9 holes +mm L-)mm B Bra!n *h *hRp #++,$%%

% *h Rp

)#2 Schan6 Scre )%09%mm B Bra!n *h *h Rp #9,$%% % *h Rp

))% Schan6 Scre )%0+%mm B Bra!n *h *h Rp )%,%%% % *h Rp

)) Schan6 Scre )%0)%mm B Bra!n *h *h Rp )2,)%% % *h Rp

))+ Schan6 Scre )%0&%mm B Bra!n *h *h Rp ))2,%% % *h Rp

))- Schan6 Scre )%0+%%mm B Bra!n *h *h Rp )9,-%% $ *h Rp

))# Schan6 Scre #%02%mm B Bra!n *h *h Rp #%&,9%% 2 *h Rp

))) Schan6 Scre #%0-%mm B Bra!n *h *h Rp #+&,+%% % *h Rp

))$ Stain Steel ireso=t %mm coils%mm B Bra!n *h *h Rp #%&,9%% *h Rp

))& Stain Steel ireso=t %mm coils+mm B Bra!n *h *h Rp #$9,&%% % *h Rp

))9 Stain Steel ireso=t %mm coils)mm B Bra!n *h *h Rp $&9,+%% % *h Rp

))2 Spalk Ka7! !tk immo*ilisasi Lokal pak pak Rp ),%%%,%%% pak Rp

)$% Scre ap D)mm L)%'+-mm Dental Shank B Bra!n *h *hRp ,%9+,-%%

% *h Rp

)$ Scre ap D+%mm L)#'+9mm Dental Shank B Bra!n *h *hRp ,-#,2%%

% *h Rp

)$+ Scre ap D+&mm L-%'-&mm s!are Shank B Bra!n *h *hRp 9#$,%%

) *h Rp

)$- Scre ap D-)mm L-%'&%mm s!are Shank B Bra!n *h *hRp 9#$,%%

% *h Rp


41/88

)$# Scre ap D-)mm L-%'))mm s!are Shank B Bra!n *h *hRp 9#$,%%

% *h Rp

)$) ist drill D#)mm L +%'&%mm riangshk B Bra!n *h *hRp ,)+9,#%%

% *h Rp

)$$ ist drill D-+mm L $%'+%mm s!areshk B Bra!n *h *hRp ,%$),&%%

) *h Rp

)$& ist drill D+&mm L )'&)mm s!areshk B Bra!n *h *hRp 2%9,9%%

% *h Rp

)$9 ist drill D+)mm L )'&)mm s!areshk B Bra!n *h *hRp &)),&%%

% *h Rp

)$2 (Plate # Holes Sha=tE L9#mm B Bra!n *h *h Rp ,+9$,+%% % *h Rp

)&% (Plate ) Holes Sha=tE L%%mm B Bra!n *h *h Rp ,))2,#%% % *h Rp

)& (Plate $ Holes Sha=tE L$mm B Bra!n *h *h Rp ,$9$,&%% % *h Rp

)&+ Plate -)mm Head # Holes'Sha=t # Holes L)$mm B Bra!n *h *hRp &)+,%%%

+ *h Rp

)&- Plate -)mm Head # Holes'Sha=t $ Holes L&9mm B Bra!n *h *hRp 9$9,+%%

+ *h Rp

) B!ttress Plate # Holes Sha=tE L9%mm B Bra!n *h *h Rp ,)#+,9%% % *h Rp

)&) B!ttress Plate ) Holes Sha=tE L2$mm B Bra!n *h *h Rp ,&%-,9%% % *h Rp

)&$ B!ttress Plate $ Holes Sha=tE L+mm B Bra!n *h *h Rp ,92$,+%% % *h Rp

)&& hreea7 B Bra!n )% pcs'ktk *h Rp ++,%%% -%% *h Rp

)&9 hree(a7 stopcock ith t!*ing %cm er!mo +)pcs'*o0 *h Rp 2,$%% %% *h Rp

)&2 to!nge spatel disposi*le anak Lokal )% set'pack pack Rp &,$%% % pack Rp

)9% o!nge spatel disposi*le deasa ka7! Lokal )%pcs'*o0 pack Rp &,$%% % pack Rp

)9 hora0 t!*e no ) Lokal *h *h Rp )),%%% % *h Rp

)9+ horacic .ateter no+9 Lokal *h *h Rp 9%,%%% % *h Rp

)9- tracheal t!*e ith c!== )%mm racheoso=tE Bicakcilar *h *h Rp +),%%% + *h Rp

)9# tracheal t!*e ith c!== $%mm racheoso=tE Bicakcilar *h *h Rp +),%%% + *h Rp

)9) tracheal t!*e ith c!== &%mm racheoso=tE Bicakcilar *h *h Rp +),%%% + *h Rp

)9$ tracheal t!*e ith c!== &)mm racheoso=tE Bicakcilar *h *h Rp +),%%% + *h Rp

)9& tracheal t!*e ith c!== 9%mm racheoso=tE Bicakcilar *h *h Rp +),%%% *h Rp

)99 ran=!sion set 9% cm, =ilter s!r=ace area ++ cm+ B Bra!n +) set'pack *h Rp +-,%%% 9-% *h Rp

)92 ranso=i0 Set rans=er !tk cairan sterilE B Bra!n pcs *h Rp -,%%% +# *h Rp

)2% Under Ped $%02% cm Lokal %%'pak *h Rp -)%,%%% *h Rp)2 Urine *ag Serenit7 pcs *h Rp 9,%%% %%% *h Rp

)2+ Urine .ateter + a7 no +, silicon elastomar RP %pcs'*o0 *h Rp $,)%% % *h Rp

)2- Urine cateter + a7 no #, silicon elastomar BS" %pcs'*o0 *h Rp -,)% +% *h Rp


42/88

)2# Urine cateter + a7 no $, silicon elastomar BS" )pcs'*o0 *h Rp -,)% $%% *h Rp

)2) Urine cateter + a7 no 9, silicon elastomar BS" %pcs'*o0 *h Rp -,)% -%% *h Rp

)2$ Urin cateter + a7 no +%, silicon elastomar BS" %pcs'*o0 *h Rp -,)% )%% *h Rp

)2& Urine cateter - a7 no 9, silicon elastomar RP )pcs'*o0 *o0 Rp 9),%%% )% *o0 Rp

)29 Urine cateter - a7 no+%, silicon elastomar RP )pcs'*o0 *o0 Rp 9),%%% -% *o0 Rp

)22 RP %pcs'*o0 *o0 Rp )#,%%% +% *o0 Rp

$%% RP %pcs'*o0 *o0 Rp )#,%%% +% *o0 Rp

$% US1 ;ilm cm !tk alat !sg son7 Sonn7 rol rol Rp +-%,%%% $ rol Rp

$%+ ing "eedle "o +- 1 er!mo )% pcs' kotak *h Rp 2,%%% % *h Rp

$%- ing "eedle "o +) 1 er!mo )% pcs' kotak *h Rp 2,%%% % *h Rp

$%# ing "eedle "o +& 1 er!mo )% pcs' kotak *h Rp 2,%%% ) *h Rp

$%) asher ;'-)0#mm canc scre &mm "arang *h *h Rp 29,#)) % *h Rp

$%$ asher D%mm "arang *h *h Rp %2,$+% % *h Rp

$%& asher D-%mm "arang *h *h Rp 22,#&% % *h Rp

$%9 Lidocaine jell7 + % gr Lidocaine %*h'*o0 *o0 Rp #$9,)22 - *o0 Rp

$%2 Adhesive .ond!ctive Pasta !nt!k >>1 ensive -pcs'pak pak Rp ,$)%,%%% pack Rp

$% Skin Prep 1el !nt!k aplikasi elektroda >>1 "!prep -pcs'pak pak Rp ,$)%,%%% pack Rp

$ .omposit, Solare .omplete Kit *ahan tam*al gigiE 1. kit kit Rp ,$2#,%%% kit Rp

$+ >tching s7ringe gel Dentamerica +s7r'*ag *ag Rp +)%,%%% *ag Rp

$- 1liserin 1liserin liter liter Rp #),%%% liter Rp

$# Saliva >jector 8eddese7 +% pcs'sak sak Rp )%,%%% ) sak Rp

$) Hemospon echne +#'*o0 *o0 Rp )%,%%% *o0 Rp

$$ 8C1 =ilm !k!ran 9 0 +# cm green Kodak kotak kotak Rp &$%,%%% ) kotak Rp

$& 8C1 =ilm !k!ran +# 0 -% cm green Kodak kotak kotak Rp ,+9+,)%% ) kotak Rp

$9 8C1 =ilm !k!ran -% 0#% cm green Kodak kotak kotak Rp +,%2%,%%% ) kotak Rp

$2 8C1 =ilm !k!ran -) 0 -) cm green Kodak kotak kotak Rp +,9),%%% # kotak Rp

$+% 8C1 =ilm !k!ran -) 0 #- cm green Kodak kotak kotak Rp +,&)),%%% - kotak Rp

$+ Bari!m S!l=at 2+ !tk Bari!m 8eal >SKA@ -,) kg'kit kit Rp 2)%,%%% # kit Rp

$++ disposi*le kit !tk enema Lokal 0#%%gr pack Rp 9%,%%% % pack Rp

$+- air in=lator !tk enema Lokal *h *h Rp )),%%% % *h Rp

$+# one shot in=lator !tk enema Lokal *h *h Rp )),%%% % *h Rp

$+) Kontras Radiologi omnipa!e -%%mg5'+% ml 4mnipa!e $ vial'D!s vial Rp 2+,%%% $ vial Rp

$+$ Kontras Radiologi omnipa!e -%%mg5')% ml 4mnipa!e % vial'D!s vial Rp ++9,9%% ) vial Rp

$+& Hatella +) pcs ' ktk kotak Rp -)%,%%% kotak Rp

Urine cateter padiatric no %, silicon elastomarith s7let'mandrin

Urine cateter padiatric no 9, silicon elastomar ithmandrin

;ilm dental periapikal, set dengan *ahan penc!ci=ilm


43/88

$+9 Developer li!id,!tk a!tomatic Kodak set set Rp 2$9,%%% +% set Rp

$+2 ;i0er li!id, !tk a!tomatic Kodak set set Rp $$%,%%% # set Rp

$-% Alat periksa 1DS cepat Benecheck set set Rp &)%,%%% + set Rp

$- .ol!ter Scatter Pak !tk alat hematologi H8C ) di== ,2 L / +,) L'*o0 *o0 Rp 2,)++,&%% # *o0 Rp

$-+ - ml' *otol *otol Rp -,2-+,)%% ) *otol Rp

$-- .o!lter .len6 !tk alat hematologi H8C ) di== ) L'*o0 *o0 Rp #,22&,-%% # *o0 Rp

$-# +% L'*o0 *o0 Rp +,#&),$$% # *o0 Rp

$-) .o!lter L7se !tk alat hematologi H8C ) di== L'*o0 *o0 Rp $,#9),$%% # *o0 Rp

$-$ Deck 1lass +% kotak kecil Sail Brand %%%pcs' *o0 *o0 Rp -+),%%% ) *o0 Rp

$-& 1olongan Darah anti A Reiged %ml'*otol *otol Rp &),%%% + *otol Rp

$-9 1olongan Darah anti B Reiged %ml'*otol *otol Rp &),%%% + *otol Rp

$-2 1olongan Darah Rhes!s Reiged %ml'*otol *otol Rp %%,%%% + *otol Rp

$#% 5mmersion 4il Reiged -% ml'*otol *otol Rp +%+,9%% - *otol Rp

$# heparin injection Heparin % vial'*o0 vial Rp )),%%% 9 vial Rp

$#+ Lancet Blood "esco %% pcs'*o0 *o0 Rp -+,)%% #9 *o0 Rp

$#- lar!tan cat Bromo .ress7l Bl!e Lokal )%% ml'*otol *otol Rp $)%,%%% *otol Rp

$## Lar!tan cat 1iemsa Reiged %% ml'*otol *otol Rp +&-,%%% ) *otol Rp

$#) Lar!tan !rk Reiged %%% ml'*otol *otol Rp +#2,$%% *otol Rp

$#$ 8ethanol Reiged L'*otol *otol Rp #%+,%%% + *otol Rp

$#& mini collect !ng! K- >DA %,)ml


44/88

$$- c=as .K8B !tk Alat Kimia Klinik .o*as Roche -0 ml'*o0 *o0Rp $)$,-&%

+ *o0 R

$$# c=as U !tk Alat Kimia Klinik .o*as Roche +0- ml'*o0 *o0 Rp 99),%) % *o0 Rp

$$) c=as Lipid !tk Alat Kimia Klinik .o*as Roche -0 ml'*o0 *o0Rp $%+,))%

*o0 R

$$$ c=as H*A. !tk Alat Kimia Klinik .o*as Roche -0+ ml'*o0 *o0Rp ,%,-

- *o0 R

$$& .K !tk Alat Kimia Klinik .o*as Roche +0%% test'*o0 *o0 Rp )%%,9)9 - *o0 R

$$9 .K8B !tk Alat Kimia Klinik .o*as Roche +0)% test'*o0 *o0 Rp ###,+% # *o0 R

$$2 .leaner .o*as !tk Alat Kimia Klinik .o*as Roche %%% ml'*otol *otolRp ,%9,9&)

) *otol R

$&% Roche pak pack Rp ,9%-,$) % pack Rp

$& Roche pak pack Rp -&,-$-

% pack Rp

$&+ 1amma 1 !tk Alat Kimia Klinik .o*as Roche #0)% test'*o0 *o0Rp -%9,%%

*o0 R

$&- 1l!kosa !tk Alat Kimia Klinik .o*as Roche #0%% test'*o0 *o0 Rp -),%%% & *o0 R

$ H*A. !tk Alat Kimia Klinik .o*as Roche +0%% test' *o0 *o0 Rp ,2&-,29) # *o0 R

$&) Roche 9%% test' *o0 *o0Rp $&+,&)%

+ *o0 R

$&$ 5S> deproteini6er !tk Alat Kimia Klinik .o*as Roche $0+ ml'*o0 *o0Rp $#-,)%%

% *o0 Rp

$&& Kolesterol HDL !tk Alat Kimia Klinik .o*as Roche +0%% test'*o0 *o0Rp ,%$,#-%

$ *o0 R

$&9 kolesterol otal !tk Alat Kimia Klinik .o*as Roche #0%% test'*o0 *o0 Rp #2&,+)% *o0 R

$&2 Kreatinin !tk Alat Kimia Klinik .o*as Roche +0%% test'*o0 *o0 Rp #$9,9&9 & *o0 R

$9% Roche +#%% pcs'*o0 *o0Rp +,29,$+)

& *o0 R

$9 mini collect merah K- non >DA %,)ml


45/88

$2% rigliserida !nt!k alat kimia klinik co*as Roche +0%% test'*o0 *o0Rp --$,-&)

& *o0 R

$2 Ure!m !tk Alat Kimia Klinik .o*as Roche #0%% test'*o0 *o0 Rp )92,9&) ) *o0 R

$2+ @ello ip "esco %%% pcs'pk pack Rp +#%,%%% % pack R

$2- .ali*rator .atridge !tk alat A1D pH40 "ova Biomedical pcs' *o0 *o0 Rp -,9-&,2%% $ *o0 R

$2# 8em*rane .!p kit p.4+ !tk alat A1D pH40 "ova Biomedical - pcs'*o0 *o0 Rp ,)92,%%% *o0 R

$2) 8em*rane .!p kit p4+ !tk alat A1D pH40 "ova Biomedical $ pcs'*o0 *o0 Rp ,#$+,%%% *o0 R

$2$ "ova Biomedical %% ml'*otol *otol Rp 2)$,%%% + *otol R

$2& Pre heater Deproteini6ing !tk alat A1D pH40 "ova Biomedical -%0,# ml'*o0 *o0 Rp $-),%%% + *o0 R

$29 .ontrol pH40 - level !tk alat A1D pH40 "ova Biomedical -% amp!l' *o0 *o0 Rp ,#)-,#%& - *o0 R

$22 .ali*rator S4+ + level !tk alat A1D pH40 "ova Biomedical +% amp!l' *o0 *o0 Rp ,%),$%% + *o0 R

&%% re=erence sensor !tk alat A1D pH40 "ova Biomedical pcs'*o0 *o0 Rp ),)#),%%% + *o0 R

&% sensor p.4+ !tk alat A1D pH40 "ova Biomedical pcs'*o0 *o0 Rp 2,+$),%%% *o0 R

&%+ sensor pH !tk alat A1D pH40 "ova Biomedical pcs'*o0 *o0 Rp 9,-)-,%%% + *o0 R

&%- sensor S4+ !tk alat A1D pH40 "ova Biomedical pcs'*o0 *o0 Rp 2,+$),%%% + *o0 R

&%# 'R p!mp !tk alat A1D pH40 "ova Biomedical pcs'*o0 *o0 Rp +,+,%%% + *o0 R

&%) sensor "a !tk alat A1D pH40 "ova Biomedical pcs'*o0 *o0 Rp ,$%%,%%% - *o0 R

&%$ .reatinine !nt!k alat kimia klinik Bios7stem A) Bios7stem % 0 )% mL' *o0 *o0Rp ),$+$,%%%

+ *o0 R

&%& .holesterol !nt!k alat kimia klinik Bios7stem A) Bios7stem % 0 )% mL' *o0 *o0Rp #,9-%,$%%

*o0 R

&%9 Bios7stem ) 0 )% mL' *o0 *o0Rp -,-2),%%%

*o0 R

&%2 Bios7stem ) 0 )% mL' *o0 *o0Rp -,-2),%%%

+ *o0 R

&% Bios7stem ) 0 )% mL' *o0 *o0Rp -,$++,2)%

+ *o0 R

& ALP(A8P !nt!k alat kimia klinik Bios7stem A) Bios7stem ) 0 )% mL' *o0 *o0Rp -,%&+,2$%

*o0 R

&+ Bios7stem ) 0 )% mL' *o0 *o0Rp &,+#),2%%

+ *o0 R

&- Uric Acid !nt!k alat kimia klinik Bios7stem A) Bios7stem % 0 )% mL' *o0 *o0Rp $,#%+,%%%

+ *o0 R

pH electroda conditioning sol!tion !tk alat A1DpH40

Billr!*in otal !nt!k alat kimia klinik Bios7stemA)

Billir!*in Direct !nt!k alat kimia klinik Bios7stemA)

Urea ' B!n U< !nt!k alat kimia klinik Bios7stemA)

Q(1l!tam7lrans=erase Q(1E !nt!k alat kimiaklinik Bios7stem A)


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Bios7stem - 0 ) mL' *o0 *o0Rp -,2+9,)%%

*o0 Rp

&) rigl7cerides !nt!k alat kimia klinik Bios7stem A) Bios7stem % 0 )% mL' *o0 *o0Rp 2,$$,+%%

*o0 Rp

&$ AS ' 14!nt!k alat kimia klinik Bios7stem A) Bios7stem ) 0 )% mL' *o0 *o0Rp -,$++,2)%

+ *o0 Rp

&& AL ' 1P !nt!k alat kimia klinik Bios7stem A) Bios7stem ) 0 )% mL' *o0 *o0Rp -,$++,2)%

+ *o0 Rp

&9 Al*!min !nt!k alat kimia klinik Bios7stem A) Bios7stem ) 0 )% mL' *o0 *o0Rp -,%)2,-9%

*o0 Rp

&2 Bios7stem ) 0 +% mL' *o0 *o0Rp ,+%-,)%%

*o0 R

&+% Bios7stem # 0 +% mL' *o0 *o0Rp 9,9+&,%%%

*o0 Rp

&+ Bios7stem - 0 ) mL' *o0 *o0Rp ),#)$,+)%

*o0 Rp

&++ Bios7stem ) 0 ) mL' *o0 *o0Rp -,$++,2)%

*o0 Rp

&+- Bios7stem ) 0 ) mL' *o0 *o0Rp -,++%,#%%

+ *o0 Rp

&+# Bios7stem 0 %,) mL' *o0 *o0Rp ,&+$,$%%

*o0 Rp

&+) Sampel .!p !nt!k alat kimia klinik Bios7stem A) Bios7stem %%%pcs ' pk pack Rp +,-#,%%%

+ pack Rp

&+$ Bios7stem % Rotor ' pk pack Rp +,#+),%%%

+ pack Rp

&+& Bios7stem 0 %%% mL' *otol *otolRp ,$#,%%%

*otol Rp

&+9 Bios7stem 0 %%% mL' *otol *otolRp +,#+),%%%

*otol Rp

&+2 AS4 Reiged )% tes' pack pack Rp #-,#%% pack Rp

&-% .RP Reiged )% tes' pack pack Rp #-,#%% % pack Rp

&- Rhe!matoid ;actor Reiged %% tes' pack pack Rp -%),)%% pack Rp

&-+ St7phi anti 4 Reiged ) ml' *otol *otol Rp 2%,%%% + *otol Rp

&-- St7phi anti H Reiged ) ml' *otol *otol Rp 2%,%%% + *otol Rp

&-# Sparat7phi A anti 4 Reiged ) ml' *otol *otol Rp 2%,%%% + *otol Rp

&-) Sparat7phi A anti H Reiged ) ml' *otol *otol Rp 2%,%%% + *otol Rp

&-$ Sparat7phi B anti 4 Reiged ) ml' *otol *otol Rp 2%,%%% + *otol Rp

&-& Sparat7phi B anti H Reiged ) ml' *otol *otol Rp 2%,%%% + *otol Rp

&-9 Sparat7phi . anti 4 Reiged ) ml' *otol *otol Rp 2%,%%% + *otol Rp&-2 Sparat7phi . anti H Reiged ) ml' *otol *otol Rp 2%,%%% + *otol Rp

% !*e0 ; Lokal )ml '*o0 *o0 Rp -,)&),%%% + *o0 Rp

tes anti deng!e 84"4 +$ device'*o0 *o0 Rp ,$#%,$+) # *o0 Rp

+ HBsAg 5"S A"S>R #% device'*o0 *o0 Rp )+),%%% 2 *o0 Rp

- Anti HBs 5. 5"S A"S>R #% device'*o0 *o0 Rp &9&,)%% - *o0 Rp

# Anti H.< 5. 5"S A"S>R #% device'*o0 *o0 Rp &9&,)%% # *o0 Rp

.reatin Kinase .KE !nt!k alat kimia klinikBios7stem A)

(Am7lase Direct !nt!k alat kimia klinik Bios7stemA)

.holesterol HDL Direct !nt!k alat kimia klinikBios7stem A)

.reatin Kinase 8B .K(8BE !nt!k alat kimiaklinik Bios7stem A)

Bio.hemistr7 .ontrol Ser!m level !nt!k alatkimia klinik Bios7stem A)

8!ltiple .ali*ration !nt!k alat kimia klinikBios7stem A)

.K(8B .ontrol Ser!m !nt!k alat kimia klinikBios7stem A)

Reaction Rotor !nt!k alat kimia klinik Bios7stemA)

.oncentrated S7stem Li!id !nt!k alat kimia klinikBios7stem A)

ashing Sol!tion concentrated +% L !nt!k alatkimia klinik Bios7stem A)


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) 8alaria 5. 5"S A"S>R -% device'*o0 *o0 Rp ,-+,)%% & *o0 Rp

$ Anti S7philis 5. 84"4 +) device' *o0 *o0 Rp -#-,&)% - *o0 Rp

& 5g8 anti HA< Lokal +) device '*o0 *o0 Rp +,&2#,%%% + *o0 Rp

H.1 Plano test !rin Acon )% device '*o0 *o0 Rp %%,%%% % *o0 Rp

"S deng!e earl7 rapid "ova Brand +) device'*o0 *o0 Rp -,&)%,%%% ) *o0 R

&)% est "arko*a $ indikator 5"S A"S>R +) pack'*o0 *o0 Rp ,$9%,%%% - *o0 R

&) B 5. Lokal #% device'*o0 *o0 Rp +,%#,9&) - *o0 Rp

&)+ sprit!s Lokal liter *otol Rp +%,%%% % *otol Rp

&)- cat 1ram stein A B,.,D Reiged # C%% ml'*o0 *o0 Rp +%,)%% % *o0 Rp

&)# ;ree # !tk alat imm!nologi centa!r advia Siemens )% test'*o0 *o0 Rp +,)$&,)$) # *o0 R

&)) Siemens %% test'*o0 *o0

Rp ),)2,#)%+ *o0 R

&)$ .>A !tk alat imm!nologi centa!r advia Siemens %% test'*o0 *o0 Rp +,9+%,))% *o0 Rp

&)& Siemens %% test'*o0 *o0Rp $,2+%,&)%

% *o0 Rp

&)9 HBsAg !tk alat imm!nologi centa!r advia Siemens +%% test'*o0 *o0 Rp 2,$##,#%% % *o0 Rp

&)2 PSA !tk alat imm!nologi centa!r advia Siemens %% test' *o0 *o0 Rp +,$#-,-&) % *o0 Rp

&$% .A(+) !tk alat imm!nologi centa!r advia Siemens %% test' *o0 *o0 Rp ,-$%,%)% % *o0 Rp

&$ .A(2(2 !tk alat imm!nologi centa!r advia Siemens )% test' *o0 *o0 Rp +,$#-,-&) % *o0 Rp

&$+ A;P !tk alat imm!nologi centa!r advia Siemens %% test' *o0 *o0 Rp +,$$,2$) % *o0 Rp

&$- .A )(- !tk alat imm!nologi centa!r advia Siemens %% test' *o0 *o0 Rp ),2$,+)% % *o0 Rp

&$# HBS Ag ?. Kit !tk alat imm!nologi centa!r advia Siemens + 0 % mL'*o0 *o0Rp #,)9),$)%

*o0 Rp

&$) .AL A !tk alat imm!nologi centa!r advia Siemens + 0 ) mL '*o0 *o0 Rp +,##$,+)% *o0 Rp

&$$ .AL D !tk alat imm!nologi centa!r advia Siemens + 0 ) mL'*o0 *o0 Rp +,22&,+)% *o0 Rp

&$& .>A Dil!ent !tk alat imm!nologi centa!r advia Siemens + 0 ) mL'*o0 *o0Rp ,$#-,)%%

*o0 Rp

&$9 8UL5D5L !tk alat imm!nologi centa!r advia Siemens + 0 +) mL'*o0 *o0Rp ,2,#%%

*o0 R

&$2 Siemens + 0 +) mL'*o0 *o0Rp ,&)9,#)%

% *o0 Rp

&&% Siemens + 0 )%% mL'*o0 *o0Rp $99,&)%

- *o0 Rp

&& .!vettes !tk alat imm!nologi centa!r advia Siemens -%%% pcs'*o0 *o0 Rp #,9%,2)% % *o0 Rp

&&+ Sample ip !tk alat imm!nologi centa!r advia Siemens $#9% pcs'*o0 *o0Rp $,-)),)%%

% *o0 Rp

&&- Sample .!p !tk alat imm!nologi centa!r advia Siemens )%% pcs'*o0 *o0Rp %,)2+,)%%

% *o0 Rp

& ash Reagent !tk alat imm!nologi centa!r advia Siemens +0)%% mL *o0 Rp ,))$,%% ) *o0 Rp

&&) Siemens + vials'*o0 *o0Rp -,+%,%)%

*o0 Rp

&&$ Pot !rin Lokal pcs pcs Rp +,)%% % pcs Rp

&&& Roche %% strip'*o0 *otol Rp -)%,%%% *otol Rp

SH Ultra -rd gen !tk alat imm!nologi centa!r

advia

High Sensitive rop 5 !tk alat imm!nologi centa!radvia

Ancilar7 Pro*e ash !tk alat imm!nologi centa!radvia

.P Reagent O+ acid *aseE !tk alat imm!nologicenta!r advia

.leaning Sol!tion !tk alat imm!nologi centa!radvia

!rine reagent .om*!r % tes 8 !tk alat !rinalisamiditron


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&&9 Urine control tes 8 !tk alat !rinalisa miditron Roche )% tes'*o0 *otol Rp +2$,%%% ) *otol R

&&2 Biorad !rinal7sis control !tk alat !rinalisa miditron Roche +ml'*otol *otol Rp #%%,%%% % *otol Rp

&9% reagen "one Apelt Lokal %% ml'*otol *otol Rp -92,%%% *otol R

&9 reagen Pand7 Reiged %% ml'*otol *otol Rp %#,%%% *otol R

&9+ reagen Rivalta Lokal )%% ml'*otol *otol Rp $+),%%% *otol R

&9- kertas thermal paper pH40 ) roll'*o0 *o0 Rp $-),%%% *o0 R

&9# Lar!tan cat Steinheimer 8al*in Lokal +)% ml'*otol *otol Rp $+),%%% *otol R

&9) >osin Reiged %%ml Rp +#,9%% *otol R

&9$ ;4B one step H>84SUR> Lokal )%%ml'*otol *otol Rp )%%,%%% *otol R

&9& ;R>S>"5US paket paket Rp )%,%%% % paket Rp

&99 ;R>S>"5US paket paket Rp -),%%% % paket Rp

&92 ;R>S>"5US +'paket paket Rp +-,%%% % paket Rp

TOTAL RPPN 10% R

TOTAL HA!A

PT. BINTANG

I

D

Paket Single Use dengan HD Pack Pol7s!l=one.apillar7 Dial7ser'Lo ;l!0 Hemo=lo HPS,BloodLine !*ing Sistem,.airan Acid .onsentra'Part A,Bi*ag Sodi!m Bicar*onante,Hemoldialisis PackE!nt!k alat Hemodialisa ;reseni!s

Paket Re(Use dengan HD Pack Pol7s!l=one.apillar7 Dial7ser'Lo ;l!0 Hemo=lo HPS,BloodLine !*ing Sistem,.airan Acid .onsentra'Part A,Bi*ag Sodi!m Bicar*onante,Hemoldialisis PackE!nt!k alat Hemodialisa ;reseni!s

Dial7sis ;ist!la "eedleA< ;ist!lla 1A dan 1


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asi (isik

Total

Rp #,-%%

Rp (

Rp (Rp +,#%-,)%%

Rp +,+#%,%%%

Rp &,%)$,%%%

Rp +,-+$,%%%

Rp +,&)%,%%%

Rp +,))%,%%%

Rp (

Rp %$,%%%

Rp (

Rp +)%,%%%

Rp $$,%%%

Rp (

Rp #+-,)%%

Rp #,+%%,%%%

Rp +,#%%,%%%

Rp &$2,)%%

Rp (

Rp (

Rp (

Rp (

Rp ,%92,$%%

Rp +,9$%,+%%


50/88

Rp (

Rp (

Rp (

Rp (

Rp (

Rp (

Rp (

Rp (

Rp (

Rp (

Rp -,)%%,%%%

Rp -,)%%,%%%

Rp &,9)%,%%%

Rp #,9%%,%%%

Rp +,$%,%%%

Rp #,%#%,%%%

Rp +,#+%,%%%

Rp +,$%%,%%%

Rp &,9%%,%%%

Rp (

Rp (

Rp (

Rp (

Rp +,+)$,%%%

Rp ),#%%,%%%

Rp #,-+%,%%%

Rp ,$%+,%%%

Rp (


51/88

Rp &,9+%,%%%

Rp 2,)%#,%%%

Rp (

Rp (

Rp (

Rp ,#%#,%%%

Rp ),+)%,%%%

Rp -,&)%,%%%

Rp %,9%%,%%%

Rp ),%#%,%%%

Rp &,+%%,%%%

Rp &,+%%,%%%

Rp -,$%%,%%%

Rp (

Rp (

Rp (

Rp ,+%,%%%

Rp (Rp (

Rp #,%+%,%%%

Rp 9,%#%,%%%

Rp #,%+%,%%%

Rp -,$9,%%%

Rp +,#+,%%%

Rp #+%,%%%

Rp 9,#%%,%%%

Rp +,%%,%%%

Rp (


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Rp +,2#%,%%%

Rp $,-%%,%%%

Rp (

Rp (

Rp (

Rp (

Rp +,%%%,%%%

Rp ,&)%,%%%

Rp (

Rp ,&)%,%%%

Rp (

Rp -,9&),%%%

Rp #,&2,)%%

Rp #,)&$,)%%

Rp #,922,)%%

Rp ),+++,)%%

Rp (

Rp (

Rp (

Rp #,9+%,%%%

Rp ),%&9,#%%

Rp ),--$,9%%

Rp ),)2,$%%

Rp ),9)%,%%%

Rp (

Rp (

Rp (

Rp (

Rp (

Rp 99%,%%%

Rp 9%,%%%

Rp --,%%%


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Rp --,%%%

Rp ,$+),%%%

Rp ,--%,%%%

Rp (

Rp #,#%%,%%%

Rp (

Rp (

Rp (

Rp (

Rp (

Rp (

Rp (

Rp ,+%9,%%%

Rp (

Rp ,+%9,%%%

Rp (

Rp (

Rp (

Rp (

Rp (

Rp (

Rp (

Rp (

Rp (

Rp ,9%

Berkas Pencairan Apbn Alkes ( Prosedure )

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