Pengumuman Alkes 2015

RUMAH SAKIT ANAK DAN BUNDA HARAPAN KITA
Jl. Let. Jen. S. Parman Kav. 87, Jakarta Barat

UNIT LAYANAN PENGADAAN BARANG/JASA
KELOMPOK KERJA PENGADAAN BARANG
Nomor : ULP.00.03.11.003.9 Jakarta, 24 Februari 2015

Lampiran : --
Perihal : Pengumuman Pemenang Lelang
Pengadaan ALKES Habis Pakai Semester
I Tahun 2015 RSAB Harapan Kita
Kepada Yth :
Seluruh peserta lelang
di -
tempat
Dengan hormat,
Sehubungan dengan Pengadaan ALKES Habis Pakai Semester I Tahun 2015 RSAB Harapan Kita
,dengan ini diberitahukan bahwa setelah diadakan Evaluasi Dokumen penawaran dan Evaluasi
Kualifikasi, maka berdasarkan Surat Penetapan Pemenang Lelang Nomor : ULP.00.03.11.003.8
tanggal 24 Februari 2015 telah ditetapkan pemenang (terlampir).
Demikian untuk diketahui.
Ttd.
Kelompok Kerja Pengadaan Barang
ULP pengumumanRSAB Harapan Kita
LAMPIRAN PENGUMUMAN PEMENANG LELANG
PT. BUMI INDAH MEDIKA

Harga satuan
No Nama Barang Spesifikasi Qty Satuan + PPN 10% Jumlah (Rp)
(Rp)
3 Slang Suction Full Silicon Non Steril , 200,00 Meter 110.000,00 22.000.000,00
7 Sarung Tangan Kerja RRT 140,00 Pasang 33.000,00 4.620.000,00
32 Kertas CTG M 1913 A Philips 50,00 Pak 163.900,00 8.195.000,00
58 Kondom 25 - 3.100,00 Buah 1.540,00 4.774.000,00
77 Oro Pharingeal Anak 12,00 Pieces 60.500,00 726.000,00
78 Oro Pharingeal Bayi 12,00 Pieces 66.000,00 792.000,00
84 Thermometer Digital Microlife 100,00 Pieces 154.000,00 15.400.000,00
91 Karet Gelang Berwarna ((warna) 1 bal isi 9 warna 1,00 bag 880.000,00 880.000,00
94 Dental X- Ray Film Intra Oral Self rectificat ,Sim 14,00 Unit
W Chair 231.000,00 3.234.000,00
96 Strip Crown ( Arterior Crown ) TDV 1,00 Box 594.000,00 594.000,00
97 Mouth Mirror # 4 Hahnenkratt 10137/ASA 70,00 Pieces
Dental 129.800,00 9.086.000,00
98 Discs Hyperflex Komet 911 HV.104.180 Komet 911 HV.104.180 1,00 Pieces 341.000,00 341.000,00
99 Spreader # 40 Mani 0199 1,00 Pak 173.800,00 173.800,00
100 Diamond Inst Bur Mani EX-21 EF Mani EX-21 EF 5,00 Pieces 99.000,00 495.000,00
101 Diamond Inst Bur Mani TF-12 EF Mani TF-12 EF 5,00 Pieces 99.000,00 495.000,00
102 Molar Band + buccal tube 13 LR OO 2,00 Pieces 181.500,00 363.000,00
103 Self - Locking Separating Springe TP Orthodontics 853 - 018 2,00 Pak 473.000,00 946.000,00
104 Open Coil Spring Ni-Ti Orthoorganizer 2,00 Roll 1.155.000,00 2.310.000,00
105 Mouth mirror # 3 Krouskoft 35,00 Pieces 129.800,00 4.543.000,00
106 Gates Drills No.2 Mani 2,00 Pak 104.500,00 209.000,00
107 Mini Endo Box Acto Star/Densplay Densplay 2,00 Buah 699.600,00 1.399.200,00
108 Paper Points # 20 Inline/Reokoe/Swedent Inline 10,00 Pieces 93.500,00 935.000,00
109 Paper Points # 25 Inline/Reokoe/Swedent Inline 10,00 Pieces 93.500,00 935.000,00
110 Molar Band + Buccal Tube 20 LL OO 8,00 Pieces 181.500,00 1.452.000,00
111 Ceramic Abrasives K 671 - 104 - 230 K 671 - 104 - 230/ D+Z 2,00 Pieces 88.000,00 176.000,00
112 Ceramic Abrasives K 671 - 104 - 220 K 671 - 104 - 220/D+Z 2,00 Pieces 88.000,00 176.000,00
113 Power O 3M Unitek / Ormco / OO 3M Unitek 12,00 Pak 704.000,00 8.448.000,00
114 Sterilization Bags Runyes 5 cm Runyes 5 cm 6,00 Roll 715.000,00 4.290.000,00
115 Sterilization Bags/ Medipack Runyes 7 cm Runyes 7 cm x 200 6,00 Roll 731.500,00 4.389.000,00
116 Sterilization Bags Runyes 10 cm Runyes 10 cm 6,00 Roll 814.000,00 4.884.000,00
118 Stainles Steel Archwire 016 Low 3M Unitex 301 6,00 Pieces 473.000,00 2.838.000,00
119 Stainles Steel Archwire 016x002 Up 210 - 0701 3M Unitex 300 017 6,00 Pak
473.000,00 2.838.000,00
120 Single Separators 00 400 - 355 / 3 M Unitex 3 M Unitex 4,00 Pak 352.000,00 1.408.000,00
121 Molar Band + Buccal Tube 17 LL Ormco 8,00 Pieces 181.500,00 1.452.000,00
122 Molar Band + Buccal Tube 19 LL Ormco 8,00 Pieces 181.500,00 1.452.000,00
123 Molar Band + buccal Tube 27 LR Ormco 8,00 Pieces 181.500,00 1.452.000,00
124 Molar Band + Buccal Tube 20 LR Ormco 8,00 Pieces 181.500,00 1.452.000,00
125 Molar Band + Buccal Tube 19 UL Ormco 8,00 Pieces 181.500,00 1.452.000,00
126 Molar Band + Buccal Tube 29 UL Ormco 5,00 Pieces 181.500,00 907.500,00
127 Molar Band + buccal Tube 27 UL Ormco 8,00 Pieces 181.500,00 1.452.000,00
128 Molar Band + buccal Tube 27 UR Ormco 5,00 Pieces 181.500,00 907.500,00
129 Molar Band + Buccal Tube 29 UR Ormco 4,00 Pieces 181.500,00 726.000,00
130 Molar Band + Buccal Tube 19 LR Ormco 8,00 Pieces 181.500,00 1.452.000,00
131 Paper Points # 30 Inline 8,00 Pieces 93.500,00 748.000,00
132 Bracket 0,22 RB 5 5 Forestendent - 20,00 Set 561.000,00 11.220.000,00
133 Power Chain Shorty 400-386 OO 400-386 2,00 Roll 385.000,00 770.000,00
134 Kotak Model Plastik Lion Star 100,00 Pieces 17.600,00 1.760.000,00
135 O-Ring Asorted 3M 3,00 Pak 462.000,00 1.386.000,00
136 Bracket Intique Silk Ceramic OT-18-1340 3,00 Case 3.905.000,00 11.715.000,00
137 Silver Solder 759-0025 025 wire 3,00 Roll 583.000,00 1.749.000,00
138 Power chain 3M, UNITEX 2,00 Set 440.000,00 880.000,00
139 Bone Cutters K H 254 E 314 012 K H 254 E 314 012 1,00 Pieces 412.500,00 412.500,00
140 Clear chin Elastic Ormco 10 16 inchi Ormco 1D 16 INCHI . 3-1/2 2,00 Pak
OZ 462.000,00 924.000,00
141 Arch Bar 1 m Dentaurum 2,00 Roll 968.000,00 1.936.000,00
142 Bone cutters KH 162.314.016 KH 162.314.016 2,00 Pieces 825.000,00 1.650.000,00
143 Bone Cutters (F) D+Z CB 162.205.016 D+Z CB 162.205.016 / KH 2,00 Pieces
1620016 / SS White 550.000,00 1.100.000,00
144 Bone Cutters (F) D+Z 152 A 205 016 D+Z 152 A 205 016 / KH 162 2,00 Pieces
A / SS White 418.000,00 836.000,00
145 Bone Cutters (F) D+Z 162 A 314 016 SS White D+Z 162 A 314 016 / KH 161 2,00 Pieces
061 / SS White 412.500,00 825.000,00
146 Bone Cutters D+Z CB 167.104.023 SS White D+Z CB 167.104.023 / 2,00 Pieces
Meisinger / SS White 748.000,00 1.496.000,00
147 Bone Cutters D+Z CB 162.314.016 SS White D+Z CB 162.314.016 2,00 Pieces
412.500,00 825.000,00
148 Bone Cutters D+Z CB 255 A 316 012SS White D+Z CB 255 A 316 012 2,00 Pieces
412.500,00 825.000,00
149 Bone Cutters D+Z CB 166 A 104 021 D+Z CB 166 A 104 021 2,00 Pieces 440.000,00 880.000,00
150 Com Indikator Hansin Hansin 2,00 Pak 1.182.500,00 2.365.000,00
151 Carbide Burs KH 166 204 021 KH 166 204 021 2,00 Pieces 671.000,00 1.342.000,00
Page 1 of 18
Harga satuan
(Rp)
155 Carbide Burs KH 141 A 104 027 KH 141 A 104 027 2,00 Pieces 231.000,00 462.000,00
157 Carbide Burs K 6830 RL 314 016 K 6830 RL 314 016 2,00 Pieces 275.000,00 550.000,00
158 Direct Band Buccal Tube 022 LR Ormco 2,00 Doos 2.090.000,00 4.180.000,00
159 Exelent Disp Bibs / slaberce Runies 60,00 Pak 132.000,00 7.920.000,00
167 Molar Band + Buccal Tube 10 LR Ormco 2,00 Pieces 181.500,00 363.000,00
168 Bone Cutters D+Z CB 255.A.314.012Maisinger D+Z CB 255.A.314.012 2,00 Pieces
412.500,00 825.000,00
169 Remanium Soft Dentaurum 500-025-00 2,00 Pieces 489.500,00 979.000,00
170 Diamond Inst Bur@ BR-40/D+Z 801.314.016 Mani BR-40 5,00 Pieces
99.000,00 495.000,00
171 Diamond Inst Bur@ BR-49/D+Z CB 1.314.012 Mani BR-41 5,00 Pieces
99.000,00 495.000,00
172 Diamond Inst Bur@ Mani BR-45/D+Z Mani BR-42 5,00 Pieces 99.000,00 495.000,00
173 Diamond Inst Bur@ Mani BR-46/D+Z CB Mani BR-43 5,00 Pieces 99.000,00 495.000,00
99.000,00 495.000,00
99.000,00 495.000,00
176 Diamond Inst Bur@ Mani BR-42/D+Z CB Mani BR-46 5,00 Pieces 99.000,00 495.000,00
177 Diamond Inst Bur (EF)Mani TR-11EF/D+Z Mani TR-11EF 5,00 Pieces 99.000,00 495.000,00
178 Diamond Inst Bur (EF)Mani TC-11EF/D+Z Mani TC-11EF 5,00 Pieces 99.000,00 495.000,00
179 Diamond Inst Bur (Fine) Mani TR-11F/D+Z Mani TR-11F 5,00 Pieces 99.000,00 495.000,00
180 Diamond Inst Bur Mani TC-11C/D+Z(Coarse) Mani TC-11C 5,00 Pieces 99.000,00 495.000,00
181 Diamond Inst Bur (I) SI-46/D+Z 805.314.012 Mani SI-46 5,00 Pieces
99.000,00 495.000,00
182 Diamond Inst Bur (I) Mani SI-47/D+Z 805.314 Mani SI-47 5,00 Pieces
99.000,00 495.000,00
183 Diamond Inst Bur (I) SI-48/D+Z 805.314.016 Mani SI-48 5,00 Pieces
99.000,00 495.000,00
184 Diamond Inst Bur (I) SI-S46/D+Z 807.314.012 Mani SI-S46 5,00 Pieces
99.000,00 495.000,00
185 Diamond Inst Bur (I) SI-47C/D+Z 805.314.018 Mani SI-47C 1,00 Pieces
99.000,00 99.000,00
186 Diamond Inst Bur Mani SF-41/D+Z (FO) Mani SF-41 5,00 Pieces 99.000,00 495.000,00
187 DiamondInst Bur(F) Mani SF-11 837 Mani SF-11 5,00 Pieces
KR.314.010 99.000,00 495.000,00
188 DiamondInst Bur(F)Mani -SF 12 837 KR.314.012 Mani SF-12 5,00 Pieces
99.000,00 495.000,00
189 Diamond Inst Bur (F)SF-31/D+Z 836.314.012 Mani SF-31 5,00 Pieces
99.000,00 495.000,00
190 Diamond Inst Bur (F) SO-21/D+Z 863.314.012 Mani SO-21 3,00 Pieces
99.000,00 297.000,00
191 Diamond Inst Bur (F) RS-21/D+Z 847 KR.314 Mani RS-21 4,00 Pieces
99.000,00 396.000,00
192 Diamond Inst Bur (F)TF-S23/D+Z 845.314.016 Mani TF-S23 5,00 Pieces
99.000,00 495.000,00
193 Tungsten Carbide Bur K.H.254.314.012 K.H.254.314.012 2,00 Pieces 132.000,00 264.000,00
194 Diamond Inst Bur (F) TF-11/D+Z 850.314.014 Mani TF-11 5,00 Pieces
99.000,00 495.000,00
195 Diamond Inst Bur (F) Mani TF-12F/D+Z 886,314 Mani TF-12F 3,00 Pieces
99.000,00 297.000,00
196 Diamond Inst Bur (F) Mani TC-S21 D+Z 884 Mani TC-S21 2,00 Pieces 99.000,00 198.000,00
197 Diamond Inst Bur (F)D+Z 882.314.014 Mani/ D+Z 882.314.014 2,00 Pieces 121.000,00 242.000,00
198 Diamond Inst Bur (F)Mani/D+Z 879.314.014 Mani/D+Z 879.314.014 2,00 Pieces 121.000,00 242.000,00
199 Diamond Inst Bur (F)Mani/ D+Z 878.314.016 Mani/ D+Z 878.314.016 2,00 Pieces
121.000,00 242.000,00
200 Medipac uk. 10 x 200 - 2,00 Roll 594.000,00 1.188.000,00
203 Dental Floss Oral B Oral B 4,00 Roll 33.000,00 132.000,00
204 Amplas Kain Tipis P.100 Thee Star - 5,00 Lembar 26.400,00 132.000,00
205 Arch Wire SS 016 X 016 upper 016 X 016 upper,ormco,210- 3,00 Box
0706 627.000,00 1.881.000,00
206 Arch Wire SS 016 X 016 lower 016 X 016 lower,ormco,211- 2,00 Box
0706 627.000,00 1.254.000,00
207 Paper Points # 45-80 Inline 2,00 Pak 93.500,00 187.000,00
210 Hedstroem File # 15, 21 mm AO16D 021 015 Dentsply AO16D 021 015 8,00 Pak
104.500,00 836.000,00
212 Lentulo Densply 5,00 Buah 803.000,00 4.015.000,00
213 Matrix Band 7 mm Kohler 6,00 Roll 583.000,00 3.498.000,00
214 Brush Nillor/Brushes Jiffy 25,00 Pieces 11.550,00 288.750,00
Page 2 of 18
Harga satuan
(Rp)
218 Steell Separating Strips R Art. # 570004 R Art. # 570004 2,00 Pak 495.000,00 990.000,00
219 TMA -CNA 016 x 022 Upper OO 100-944 (5) 4,00 Pak 797.500,00 3.190.000,00
220 Hedstroem File #35, 21 mm AO16D 021 035 DentsplyAO16D 021 035 4,00 Pak
104.500,00 418.000,00
221 Separator 3M Unitex 2,00 Pak 1.705.000,00 3.410.000,00
222 Triple Flex Archwires 3M Unitex 260-032 2,00 Pak 1.072.500,00 2.145.000,00
223 Spreaders # 30 Mani 0197 2,00 Pak 170.500,00 341.000,00
224 Spreaders 35 Mani 0198 2,00 Pak 170.500,00 341.000,00
225 Band Premolar Cleat Bawah No. 9 - 5,00 Buah 181.500,00 907.500,00
233 Ormesh Flat Lingua Button GAC 2,00 Set 935.000,00 1.870.000,00
234 Ormesh Curve Lingua Button GAC 2,00 Set 935.000,00 1.870.000,00
235 Ni-Ti Broad Arch 0,16 Lower 0,16 Lower;super elastic / 3 M 2,00 Box
946.000,00 1.892.000,00
236 Ni-Ti Broad Arch 0,14 lower super elastic 0,14 lower ;Ormco,3m unitex 2,00 Box
946.000,00 1.892.000,00
237 Ni-Ti Broad Arch 0,18 upper 0,18 upper;Ormco 205-0003 3,00 Box
946.000,00 2.838.000,00
238 Ni-Ti Broad Arch 0,18 lower 0,18 lower ;Ormco ,205-007 2,00 Box 946.000,00 1.892.000,00
239 Refil bracket, Forestadent Slot 022 2 atas kanan Insisive 2 atas kanan 20,00 Buah
275.000,00 5.500.000,00
240 Hedstroem File #10, 21 mm AO16D 021 010 Dentsply AO16D 021 010 5,00 Pak
93.500,00 467.500,00
93.500,00 748.000,00
93.500,00 374.000,00
93.500,00 374.000,00
244 TMA-CNA 016 x 022 Lower OO 100-954 (5) 8,00 Pak 825.000,00 6.600.000,00
245 Cephalometric Tracing Paper 630-020 OO 630-020 2,00 Pieces 1.072.500,00 2.145.000,00
247 Band Premolar Cleat Bawah No. 13 ORMCO 5,00 Buah 181.500,00 907.500,00
251 Hedstroem File #8, 21 mm AO16D 021 008 Dentsply AO16D 021 008 5,00 Pak 93.500,00 467.500,00
93.500,00 374.000,00
93.500,00 374.000,00
254 Hedstroem File #8, 25 mm AO16D 025 008 Dentsply AO16D 025 008 4,00 Pak 93.500,00 374.000,00
255 Hedstroem File #10, 25 mm AO16D 025 010 Densply AO16D 025 010 4,00 Pak
93.500,00 374.000,00
93.500,00 374.000,00
93.500,00 374.000,00
93.500,00 374.000,00
259 Hedstroem File #45-80, 25 mm AO16D 025 901 Dentsply AO16D 025 901 4,00 Pak
165.000,00 660.000,00
260 Box For 68 Hole (TJ ) TJ 4,00 Pieces 128.700,00 514.800,00
261 Shade Guide Vita 2,00 Set 2.024.000,00 4.048.000,00
262 Karet ortho seal 1/4, 3.OZ 1/4, 3.OZ l, Ormco 11,00 KOTAK 2.178.000,00 23.958.000,00
263 Niti Open Coil Spring Ormco Medium 221-5512 2,00 Pak 1.001.000,00 2.002.000,00
264 Silkam / Silk Black 3-0 B.Braun F 1134043 2,00 Box 1.826.000,00 3.652.000,00
265 Chirurge - Sec I / Section Surgi Tip Micro Hager Werken / Roeko 100,00 Pak 704.000,00 70.400.000,00
266 Hartmetall Frazer 104.040/H139.104.023 Komet H79UM 104.040 2,00 Pieces 247.500,00 495.000,00
267 Matrix Band Ivory Asa Dental 2,00 Pieces 77.000,00 154.000,00
268 Hedstroem File #45-80, 21 mm AO16D 021 901 Dentsply AO16D 021 901 4,00 Pak
165.000,00 660.000,00
269 Spray Nozzle EX-6 NSK H 019711 2,00 Pieces 286.000,00 572.000,00
270 Ultrafak # 00 Ultradent 2,00 Botol 429.000,00 858.000,00
271 Napkin Dispotech/Runies 10,00 Roll 126.500,00 1.265.000,00
274 Nitinol Super Elastic 016 x 022 lower 4297-954 3M Unitek Ref 4297-954 6,00 Pak
632.500,00 3.795.000,00
275 Nitinol Super Elastic 016 x 022 upper 3M Unitek Ref 4297-953 6,00 Pak 632.500,00 3.795.000,00
276 Exterpatie/Spiro Colorinox #20 Dentsply A0004B 021.020.01 3,00 Pak
132.000,00 396.000,00
277 Exterpatie/Spiro Colorinox #25 Dentsply A0004B 021.025.01 2,00 Pak
132.000,00 264.000,00
93.500,00 374.000,00
279 Surgical Inst Bur (RC) D+Z CB 141A.104.027 D+Z CB 141A.104.027 2,00 Pak
368.500,00 737.000,00
280 Molar Band + buccal tube 25 UR Ormco 8,00 Pieces 181.500,00 1.452.000,00
Page 3 of 18
Harga satuan
(Rp)
281 Molar Band + buccal tube 25 UL Ormco 8,00 Pieces 181.500,00 1.452.000,00
282 Molar Band + buccal tube 30 UL Ormco 5,00 Pieces 181.500,00 907.500,00
283 Molar Band + buccal tube 11 UR Ormco 2,00 Pieces 181.500,00 363.000,00
288 Molar Band + buccal tube 14 UL Ormco 4,00 Buah 181.500,00 726.000,00
298 Molar Band + buccal tube 15 LL Ormco 8,00 Pieces 181.500,00 1.452.000,00
299 Molar Band + buccal tube 15 LR Ormco 8,00 Pieces 181.500,00 1.452.000,00
300 Molar Band + buccal tube 16 LL Ormco 4,00 Pieces 181.500,00 726.000,00
301 Molar Band + buccal tube 16 LR Ormco 4,00 Pieces 181.500,00 726.000,00
320 Tracing paper ORTHO ORGANIZER 2,00 Pak 1.760.000,00 3.520.000,00
321 Amalgam remover D+Z CB 21RMX.314.012 4,00 Pieces 187.000,00 748.000,00
322 Bonding Brush Tips 3/4 FN Plash 1048 Ortho Tecnology FN Plash 20,00 Pak
1048 302.500,00 6.050.000,00
323 SR Facebow short outer bow Ormco Size 4,00 Pak 302.500,00 1.210.000,00
324 Brite-gear cervical neck pads blue Ormco 6,00 Pak 797.500,00 4.785.000,00
325 Break-away Release Modules Medium (white) Ormco 2,00 Pieces
220.000,00 440.000,00
326 1 St Molar Band Combination 018 UR Ormco 2,00 Buah 286.000,00 572.000,00
327 1 St Molar Band Combination 018 UL Ormco 4,00 Buah 286.000,00 1.144.000,00
329 Dental Cotton roll Wellnes Wellnes S/ M 20,00 Pak 99.000,00 1.980.000,00
330 Brush Tips(50 Tips) Dentaurum 163-417-00 Dentaurum 163-417-00 10,00 Pak 209.000,00 2.090.000,00
331 Flexi Napkin Clips 00 650-013 10,00 Pieces 38.500,00 385.000,00
332 Shorty Ligature Twist 010 OO 100-412 4,00 Tabung 594.000,00 2.376.000,00
333 Tungsten Carbide Bur D+Z CB 33L 500.104.012 D+Z CB 33L 500.104.012 4,00 Pak
522.500,00 2.090.000,00
334 Tungsten Carbide Cutter Burs D+Z CC 251 AX 104.060/K 4,00 Pak 522.500,00 2.090.000,00
335 Tungstens Carbide Bone Cutter Burs D+Z CB 255A 500.314.012 / K 4,00 Pieces
550.000,00 2.200.000,00
336 Intra Oral Elastics Ormco 2,00 Pak 275.000,00 550.000,00
337 Impression Partial Trays Asco 6,00 Set 412.500,00 2.475.000,00
338 Impression Trays D Hayasi D 6,00 Set 165.000,00 990.000,00
339 Impression Trays C Hayasi C 6,00 Set 165.000,00 990.000,00
340 Impression Trays B Hayasi 6,00 Set 165.000,00 990.000,00
341 Mixing Pad 2,5" x 2,5" OT 600-600/Kuraray 945-WD 2,00 Pieces
126.500,00 253.000,00
Page 4 of 18
Harga satuan
(Rp)
362 Power Chain Shorty 400-337 OO 400-337 2,00 Pak 181.500,00 363.000,00
363 Medipac Uk. 15 x 200 - 2,00 Roll 572.000,00 1.144.000,00
364 Rubber besar komet 8,00 Buah 23.100,00 184.800,00
365 Rubber sedang - 9,00 Buah 23.100,00 207.900,00
366 Rubber kecil AF - 6,00 Buah 23.100,00 138.600,00
367 Karet ortho moose 5/16 3 & 6.OZ 5/16 3 & 6.OZ 2,00 KOTAK 1.892.000,00 3.784.000,00
368 Power Chain Shorty 400-382 OT/OO 400-382/3M Unitex 2,00 Roll
406-307 412.500,00 825.000,00
369 Band Premolar Cleat Bawah No.14 Ormco 5,00 Buah 181.500,00 907.500,00
378 Super-Snap Polysttrips Shopu - L 525 2,00 Pak 412.500,00 825.000,00
379 Super-Snap Polystrips Shopu - L 526 2,00 Pak 412.500,00 825.000,00
380 Dental Cotton Balls Mini Wellnes,500 gr Wellnes,500 gr 6,00 Pak 181.500,00 1.089.000,00
381 Molar Band + buccal Tube 10 LL Ormco 2,00 Pieces 181.500,00 363.000,00
388 Molar Band + buccal Tube 10 UL Ormco 2,00 Pieces 181.500,00 363.000,00
401 Niti Spring Extension F.00325 (12 mm) Ormco 222-5612 2,00 Pak 1.485.000,00 2.970.000,00
404 Crown /Instrument Set/ Preparation Shopu Shopu / D+Z 2,00 Set 1.100.000,00 2.200.000,00
405 High Puff Headgear W Strong Chincap Dentaurum 744-709-00 2,00 Set 715.000,00 1.430.000,00
406 Intra Oral Elastic / Chipmunk (1/8") Ormco 1D(1/8")OO 2,00 Pak 286.000,00 572.000,00
407 Intra Oral Elastic / Rabbit (3/16") Ormco 1D(3/16")OO 2,00 Pak 286.000,00 572.000,00
408 Kunci Tips Scaller NSK 4,00 Pieces 291.500,00 1.166.000,00
409 Molar Band Combination (1 set) Ormco 6,00 Pieces 181.500,00 1.089.000,00
410 Mini Endo Bloc Dentsply A0327.000.000 Dentsply A0327.000.000 2,00 Pieces 275.000,00 550.000,00
411 Niti Dictllzing Spring 10 x 45 Ormco 2,00 Roll 880.000,00 1.760.000,00
412 Niti Spring Extention F 00325 (9 mm) Ormco 222-5612 2,00 Pak 1.529.000,00 3.058.000,00
413 Power Chain Shorty 400-318LF OO 400-318LF 2,00 Pak 390.500,00 781.000,00
414 Power Chain Shorty 400-342 OO 400-342 2,00 Pak 390.500,00 781.000,00
416 Plastic Pins Sjoding Sweeden 6,00 Pak 231.000,00 1.386.000,00
417 Remanium 016 x 016 Dentaurum 537-340-00 2,00 Pieces 825.000,00 1.650.000,00
418 Remanium Splint with Hooks Dentaurum 2,00 Pak 495.000,00 990.000,00
419 SK Facebow Short Ormco Size 3 3,00 Pak 393.800,00 1.181.400,00
420 Sponges for Clean-Stand 268P.2 dENTSPLY A2685.000.002 2,00 Pieces 418.000,00 836.000,00
421 Surgical Needles Cutting F 11340543 Bbraun F 11340543 6,00 Pak 280.500,00 1.683.000,00
422 1 St Molar Band Combination 022 UR Ormco 2,00 Pieces 275.000,00 550.000,00
423 Surgical Instrument 141A 104 035 D+Z CB 141A 104 035 2,00 Pieces 413.600,00 827.200,00
424 Surgical Instrument 141 104 035 D+Z CB 141 104 035 2,00 Pieces 413.600,00 827.200,00
427 Surgical Instrument 141A 205 035 D+Z CB 141A 205 035 2,00 Pieces 440.000,00 880.000,00
428 Surgical Instrument@ 141A 206 031 D+Z CB 141A 206 031 2,00 Pieces 511.500,00 1.023.000,00
430 Cotton Roll coden Coden / ASA Dental 4,00 Doos 104.500,00 418.000,00
431 Elastic Thread / Power tread grey grey / ORMCO 4,00 Roll 462.000,00 1.848.000,00
432 NI-TI Broad Arch 0,14 upper super elastic 0,14 upper super elastic, 3 M 6,00 Box
539.000,00 3.234.000,00
433 Carbide Burs KH 166RF 204 021 KH 166RF 204 021 2,00 Pieces 660.000,00 1.320.000,00
Page 5 of 18
Harga satuan
(Rp)
434 Diamond Instrument Burs (EF)Mani TR - 13 EF Mani TR - 13 EF 5,00 Pieces
99.000,00 495.000,00
435 Diamond Instrument Burs ( EF )Mani TR - 26 EF Mani TR - 26 EF 5,00 Pieces
99.000,00 495.000,00
436 Diamond Instrument Burs (FINE )Mani TF - 13 C Mani TF - 13 C 5,00 Pieces
99.000,00 495.000,00
437 Diamond Instrument Bur ( F ) Mani TF-12 Mani TF- 5,00 Pieces
12/D+Z868.314016/Maisinger
/SS White /K 99.000,00 495.000,00
438 Disp Gelas Kumur TJ / Lokal , isi 50 pcs 200,00 Pak 16.500,00 3.300.000,00
439 Enchance Finishing System 624055 X Densply # 624055 X 2,00 Doos 704.000,00 1.408.000,00
440 Enchance Finishing System # 624065 Densply # 624065 2,00 Doos 704.000,00 1.408.000,00
441 Enchance Finshing System 624045 X Densply # 624045 X 2,00 Pak 704.000,00 1.408.000,00
442 Extra Oral Cheack Retractor Ormco / OT /USA 2,00 Pieces 616.000,00 1.232.000,00
444 Gips Spatula Plastik Prudental 6,00 Pieces 176.000,00 1.056.000,00
445 Impression Trays Hayasi A Hayasi A 6,00 Set 165.000,00 990.000,00
446 Exterpatie / Spiro Colorinox # 35 Dentsply AOOO4B.021.035.01 4,00 Pak
132.000,00 528.000,00
447 Exterpatie / Spiro Coloronix # 40 Dentsply AOOO4B.021.040.01 4,00 Pak
132.000,00 528.000,00
448 Bracket Mini 2000 Ortho Classic 022 Ormco Ortho Classic 022 Ormco 50,00 Case 704.000,00 35.200.000,00
449 Polybib/Disp Bibs Dentamerica 878A 24,00 Pak 104.500,00 2.508.000,00
450 Wedge M/L Triodent UK.M( 2064 ) 2,00 Pak 847.000,00 1.694.000,00
451 Matrix Band / Tab Matrix 5,5mm/4,5mm/7mm Triodent M 2,00 Box
1.210.000,00 2.420.000,00
452 Stainlees Steel Archwire 016 Up 3M Unitex 301-161 6,00 Pak 473.000,00 2.838.000,00
454 Titan Mini Screw 1014 - 1608 Forestadent 1014 - 1608 2,00 Pak 3.069.000,00 6.138.000,00
455 Titan Mini Screw 1014-1606 Forestadent 1014-1606 2,00 Pak 3.069.000,00 6.138.000,00
456 Sterilization Bags 15cm Runyes 5,00 Roll 770.000,00 3.850.000,00
457 Tungsten Carbide ( F ) H 162 204 /205 016 H 162 204 /205 016 3,00 Pieces 313.500,00 940.500,00
458 Tungsten Carbide ( F )H 162A 204/205 016 H 162A 204/205 016 3,00 Pieces 313.500,00 940.500,00
459 Tungsten Carbide ( F )H 254E 314.012 H 254E 314.012 4,00 Pieces 313.500,00 1.254.000,00
460 Tungsten Carbide ( F ) H 162. 104. 016 4,00 Pieces 143.000,00 572.000,00
461 Tungsten Carbide ( F ) H 33L 316. 010 H 33L 316. 010 4,00 Pieces 143.000,00 572.000,00
462 Diamond Instrument Burs ( R )6801 314 014 6801 314 014 3,00 Pieces
99.000,00 297.000,00
463 Diamond instrument Burs ( R )6801 314 012 6801 314 012 3,00 Pieces
143.000,00 429.000,00
464 Diamond Instrument Burs ( R )S 6801 314 014 S 6801 314 014 3,00 Pieces
99.000,00 297.000,00
465 Diamond Instrument Burs ( R )S 6801 314 012 S 6801 314 012 3,00 Pieces
143.000,00 429.000,00
466 Diamond Instrument Burs ( F )6835 KR 314 010 6835 KR 314 010 3,00 Pieces
143.000,00 429.000,00
467 Diamond Instrument Burs ( F )6835 314 012 6835 314 012 3,00 Pieces
143.000,00 429.000,00
99.000,00 297.000,00
469 Diamond Instrument Burs ( F )807 314 012 807 314 012 3,00 Pieces 143.000,00 429.000,00
470 Diamond Instrument Burs ( F )6836 KR 314 014 6836 KR 314 014 3,00 Pieces
99.000,00 297.000,00
471 Diamond Instrument Bur (Coarse)Mani TR - 13 Mani TR - 13 C 5,00 Pieces
C 99.000,00 495.000,00
472 K - Flexofile # 15.21 mm Dentsply AO12C 021.015 2,00 Pak 121.000,00 242.000,00
473 K - Flexofile # 20.21 mm Dentsply AO12C 021. 020 2,00 Pak 154.000,00 308.000,00
477 K - Flexofile # 15.25 mm Dentsply AO12C 025 . 015 2,00 Pak 154.000,00 308.000,00
482 K - Flexofile # 35.25 mm Dentsply AO12C 025 .035 2,00 Pak 154.000,00 308.000,00
99.000,00 297.000,00
143.000,00 429.000,00
485 Diamond Instrument Burs ( EF ) 859 EF 314 014 859 EF 314 014 3,00 Pieces
143.000,00 429.000,00
143.000,00 286.000,00
487 Diamond Instrument Burs ( Ef )858 EF 314 014 858 EF 314 014 3,00 Pieces
143.000,00 429.000,00
488 Diamond Instrument Burs(F)8878 K 314 012 8878 K 314 012 + C 47 2,00 Pieces
C47 143.000,00 286.000,00
143.000,00 429.000,00
99.000,00 297.000,00
99.000,00 297.000,00
143.000,00 429.000,00
99.000,00 495.000,00
Page 6 of 18
Harga satuan
(Rp)
494 Diamond Instrument Burs2858 314 014 2858 314 014 5,00 Pieces 99.000,00 495.000,00
495 Diamond Instrument Burs2879 K 314 018 2879 K 314 018 5,00 Pieces 99.000,00 495.000,00
496 Metal Crowns Stainles steel Primary Molar 1,00 Box
Crown 4.950.000,00 4.950.000,00
498 Crown Cutter for metal & ceramic / swivel Cord H 4 MC XXL 314 . 014 1,00 Pieces
297.000,00 297.000,00
499 Bone Cutters ( F ) D+Z CB komet H 267 016 komet H 267 016 4,00 Pieces
412.500,00 1.650.000,00
500 Crown Cutterfor metal & ceramcs 314 012 Komet H4 MC 314 012 8,00 Pieces 297.000,00 2.376.000,00
501 K - Flexofile # 15 - 40,21mm Dentsply AO12C 021 900 4,00 Pak 143.000,00 572.000,00
502 K - Flexofile # 15 -40,25mm Dentsply AO12C 025 900 4,00 Pak 143.000,00 572.000,00
503 Brush Holder / Bonding Brush tip Holder Dentaurum 163-149 6,00 Pieces
00/OT/FN/ Ultradent 60.500,00 363.000,00
504 Carvule 0,3 x 12mm Heraus Kulzer 5,00 Doos 198.000,00 990.000,00
505 Diamond Instr.Burs (FINE) Mani EX-21F / D+Z Mani EX-21F / D+Z 5,00 Pieces
99.000,00 495.000,00
506 Molar Band + Buccal Tube 22 UR Ormco 8,00 Pieces 181.500,00 1.452.000,00
509 NIti Super Elastic 014 Up . 3M UNitex 296-912 3M UNitex 296-912 6,00 Roll
473.000,00 2.838.000,00
510 Niti Super Elastic 014 Low. 3M Unitex 296-912 3M Unitex 296-912 6,00 Pak
473.000,00 2.838.000,00
511 Niti Super Elastic 016 Up. 3M Unitex 4296-913 3M Unitex 4296-913 6,00 Pak
539.000,00 3.234.000,00
512 Coform Crown Plastic .( SDI ) SDI 2,00 Set 1.210.000,00 2.420.000,00
513 Bracket Slot 0.22 Upp 5-5W/CSBCHK-KIT310551 CSBCHK-KIT31 055 10B 2,00 Set
660.000,00 1.320.000,00
514 Oclusal Foto kodak isi 25 kodak isi 25 4,00 Box 682.000,00 2.728.000,00
515 Refil Bracket slot 022/ Insisive 1 atas kanan Densply KIT 31-055-10B 10,00 Buah 52.250,00 522.500,00
516 refil Bracket Slot 022/ Insisive 1 atas kiri Densply / Kit 31- 055-10B 10,00 Buah 52.250,00 522.500,00
517 bump -R sleeve Tubing TP 100-240/238 TP. Orthodontic ,grey 2,00 Roll 412.500,00 825.000,00
518 Carvule 0,3 x 16mm Heraus Kulzer 5,00 Doos 203.500,00 1.017.500,00
519 Bur Wrench NSK T 102-702 NSK 2,00 Pieces 247.500,00 495.000,00
520 Jiffy Polisher Variety ( Ultradent # 848 ) ( Ultradent # 848 ) 2,00 Pak 1.265.000,00 2.530.000,00
521 Micro Aplicator Ultradent #1106 4,00 Pak 319.000,00 1.276.000,00
524 Stainles Steel Archwire 016 x 022 Low 3M Unitex 300-018 6,00 Pak 462.000,00 2.772.000,00
525 Tungsten Carbide Bur D + Z CC 79.104.040/K D + Z CC 79.104.040/K 4,00 Pak
478.500,00 1.914.000,00
526 Utility Glove HU-Friedy 40-060 HU - Friedy 40 - 060 1,00 Pak 825.000,00 825.000,00
527 Applyfix 4 Dispensing Gun System Kettenbach - Germany # 1,00 Pieces
17203 1.760.000,00 1.760.000,00
528 Push Button Ormco 1,00 Pak 990.000,00 990.000,00
529 Karet Ortho Dolpin Ormco 5/16 6.OZ 2,00 KOTAK 1.892.000,00 3.784.000,00
530 Disposible Saliva Sweden/ASA Dental 30,00 Pak 110.000,00 3.300.000,00
531 Karet Ortho Otter Ormco 3/16 3.OZ 2,00 KOTAK 1.892.000,00 3.784.000,00
532 Alumunium Tray 28 X 18 cm nichrominox 181450-3 5,00 Pieces 176.000,00 880.000,00
533 Alumunium Tray 20 x 15 cm nichrominox 181480-2/3/4/5 5,00 Pieces
176.000,00 880.000,00
534 NI-TI 012 UPPER ormco 6,00 Box 1.072.500,00 6.435.000,00
535 NI-TI 012 Lower ormco 4,00 Box 1.072.500,00 4.290.000,00
536 NI-TI 014 Upper ormco 205-009 6,00 Box 1.072.500,00 6.435.000,00
537 NI-TI 014 Lower ormco 205-0011 4,00 Box 1.072.500,00 4.290.000,00
538 NI-TI 016 x 022 Upper Ormco 210-0502 6,00 Box 1.402.500,00 8.415.000,00
539 NI-TI 016 X 022 Lower Ormco 211-0502 2,00 Box 1.402.500,00 2.805.000,00
540 CNA Broad Arch /TMA 016 x 022 Upper ormco 210-0402/GAC 3,00 Box 1.402.500,00 4.207.500,00
541 CNA Broad Arch /TMA 016 x 022 Lower Ormco 211-0402 /GAC 2,00 Box 1.402.500,00 2.805.000,00
542 CNA Broad Arch / TMA 0.18 Upper Ormco 210-0302/GAC 3,00 Box 1.402.500,00 4.207.500,00
543 CNA Broad Arch / TMA 0.18 Lower Ormco/GAC 4,00 Box 1.402.500,00 5.610.000,00
544 CNA Broad Arch / TMA 016 x 016 Upper Ortho Organizer 100-960 3,00 Box 1.402.500,00 4.207.500,00
545 CNA Broad Arch / TMA 016 x 016 Lower Ortho Organizer 100-961 4,00 Box 1.402.500,00 5.610.000,00
546 Arch Wire SS 018 Upper Ormco 210-0028 3,00 Box 1.100.000,00 3.300.000,00
547 Arch wire SS 018 Lower Ormco 211-0028 4,00 Box 1.100.000,00 4.400.000,00
548 Arch Wire SS 016 x 022 Upper Ormco 210-0701 3,00 Box 880.000,00 2.640.000,00
549 Arch Wire SS 016 x 022 Lower Ormco 211-0701 4,00 Box 880.000,00 3.520.000,00
550 Crimpabley hook GAC 47-601-21 , isi 500 2,00 Pak 1.892.000,00 3.784.000,00
551 Arch Wire SS 016 Upper Ormco 210-0026 3,00 Box 1.100.000,00 3.300.000,00
552 Arch Wire SS 016 Lower Ormco 210-0026 4,00 Box 1.100.000,00 4.400.000,00
553 Tube Molar Band Slot 0.022 Rectg atas kanan Dentsply Ref 68-162-43 , isi 10 2,00 Pak
1.760.000,00 3.520.000,00
554 Tube Molar Band slot 0.022 Rectg Atas Kiri Dentsply Ref 68-262-43 , isi 10 2,00 Pak
1.760.000,00 3.520.000,00
555 Stainless Steel Round Arch 0120 0.36-266-1336 PK 0120 (0.36-266-1336) 2,00 Tube
2.970.000,00 5.940.000,00
556 Stainless Steel Round Arch 0130 0.30-266-1330 pk 0130 (0.30-266-1330) 2,00 Tube
2.970.000,00 5.940.000,00
557 Ni-Ti Broad Arch 0,16 upper ormco 205-0001 3,00 Box 1.072.500,00 3.217.500,00
558 Medipac uk. 20 x 200 2,00 Roll 715.000,00 1.430.000,00
559 Crown & Bridge Preparation shopu 2,00 Set 1.001.000,00 2.002.000,00
560 Ligature wire dentarium 537-340-00 2,00 Roll 495.000,00 990.000,00
Page 7 of 18
Harga satuan
(Rp)
561 Bring Sectional Matrix System/Matrix Ring triodent Uk S,M,L 2,00 Box 1.540.000,00 3.080.000,00
562 Tungsten Carbide Bur ( R ) H 141 104 023 2,00 Pieces 638.000,00 1.276.000,00
563 Mixing Pads Exaflex 6,00 Pieces 68.200,00 409.200,00
564 Niti Super Elastic 016 Low 3M / unitex 4296-914/ ORMCO 6,00 Pak
550.000,00 3.300.000,00
565 Crimpable Split OT # 020 - 100 2,00 Pak 368.500,00 737.000,00
566 Diamond Instrument Bur (F) Mani TR-20 5,00 Pieces 99.000,00 495.000,00
567 Agate Spatula Prudenta 6,00 Pieces 104.500,00 627.000,00
568 Diamond Instrument Burs (FINE)TC-11F Mani TC-11F 6,00 Pieces 99.000,00 594.000,00
569 Disc Hyperflex K. 911 HV 104 080 2,00 Pieces 330.000,00 660.000,00
570 Brite Gear Cervical Neck Pads ORMCO 2,00 Pieces 214.500,00 429.000,00
571 Mandalaris K 2,00 Pieces 126.500,00 253.000,00
572 Marquis Roth 022 OT # M.18-1340 10,00 Pak 660.000,00 6.600.000,00
573 Direct Band Buccal Tube 022 UL ORMCO 2,00 Pak 2.090.000,00 4.180.000,00
574 Intra oral Elastic / Fox ORMCO 1D (3/16")OO/3M 2,00 Pak
Unitex 286.000,00 572.000,00
575 Power Chain Shorty 406 696 OO 400-384/3M Unitex 406- 2,00 Pak
696 368.500,00 737.000,00
576 Tab - Matrix 6,5mm Triodent 2,00 Pak 880.000,00 1.760.000,00
577 Remanium Dentaurum 580-040-00 2,00 Roll 489.500,00 979.000,00
578 V 3 Ring Neuro Triodent # 3301 2,00 Pak 4.290.000,00 8.580.000,00
579 V 3 Ring Universal Triodent # 3302 2,00 Pak 4.290.000,00 8.580.000,00
580 Study Model Pertumbuhan Gigi YGKI 2,00 Set 440.000,00 880.000,00
581 Study Model Gigi Implaksi YGKI 2,00 Pieces 440.000,00 880.000,00
582 Surgical Instrument 141A 206 031/ H 141 023 Komet H 141 023 2,00 Pieces
572.000,00 1.144.000,00
583 Ultrasonic Scaler Tips NSK / EMS 4,00 Pieces 1.925.000,00 7.700.000,00
584 1 St Molar Band Combination 018 UR # 25 Ormco / OO 3,00 Pieces 203.500,00 610.500,00
585 1 St Molar Band Combination 018 UL # 24 Ormco / OO 3,00 Pieces 203.500,00 610.500,00
586 SR Facebow Short outer Bow size 4 Ormco 4,00 Pak 294.800,00 1.179.200,00
587 Protaper sequence Dentsply / Mailefer 2,00 Pak 1.100.000,00 2.200.000,00
588 Diamond Instrument Bur (C) 6805 314 014 8,00 Pieces 143.000,00 1.144.000,00
589 Diamond Instrument Burs (F) 6836 314 014 3,00 Pieces 99.000,00 297.000,00
592 diamond Instrument Burs 2862 314 014 5,00 Pieces 99.000,00 495.000,00
593 Molar Lip Bumper 0,18/022 Ormco 5,00 Pieces 143.000,00 715.000,00
594 Tungsten carbide Bu ( F)H 269 314 016 H 269 314 016 6,00 Pieces 330.000,00 1.980.000,00
595 Koas Kecil TJ 2,00 Buah 19.250,00 38.500,00
596 Self Cure Acrylic Repair Material Hillon S Court Limited 2,00 Set 308.000,00 616.000,00
597 Hart Metall Fraser Edenta 5210-060 2,00 Buah 220.000,00 440.000,00
600 Hart Metall Fraser Edenta 0220-023 HP Edenta 0220-023 HP 2,00 Buah 220.000,00 440.000,00
601 Polisher For Acrylic Edenta 0665 HP 10,00 Buah 27.500,00 275.000,00
602 Polisher For Acrylic Edenta 0666HP 10,00 Buah 27.500,00 275.000,00
603 Ni-Ti 016 Upper Super Elastic 3M Unitex 3,00 Box 1.100.000,00 3.300.000,00
604 Ni-Ti 016 Lower Super Elastic 3M Unitex 2,00 Box 1.100.000,00 2.200.000,00
605 Refil Bracket Slot 0.022 Canninus atas kanan Densply 31-132-00 20,00 Buah 52.250,00 1.045.000,00
606 Refil Bracket Slot 0.022 Canninus Atas Kiri Dentsply 31-232-00 20,00 Buah 52.250,00 1.045.000,00
607 Refil Bracket Slot 0.022 Insisive 2 Atas Kiri Dentsply 31-222-00 20,00 Buah 52.250,00 1.045.000,00
608 Badge Holder - 5,00 Pieces 107.250,00 536.250,00
609 TLD / Film Badge - 1,00 Pieces 357.500,00 357.500,00
610 Wix Lip Bumper Ormco Size 3,00 Pieces 264.000,00 792.000,00
611 Kapas Cressa 2,00 KG 66.000,00 132.000,00
612 Ni-Ti 016 x 016 Uppwer Super Elastic 3M , UNITEX 3,00 Box 1.072.500,00 3.217.500,00
613 Scaler Tip Satelec 10 x beltmont Satelec 10 x - 2,00 Buah
F00359 2.090.000,00 4.180.000,00
615 Ni-Ti 016 x 016 Lower Super Elastic 3M , UNITEX 2,00 Box 1.072.500,00 2.145.000,00
616 Ni-Ti 016 x 022 Upper Super Elastic 3M , UNITEX 3,00 Box 1.072.500,00 3.217.500,00
617 Ni-Ti 016 x 022 Lower Super Elastic 3M , UNITEX 2,00 Box 1.072.500,00 2.145.000,00
618 Refil Bracket Slot 0.022 Premolar 2 atas kanan Densply 10,00 Buah
52.250,00 522.500,00
619 Refil Bracket Slot 0.022 Premolar 1 atas kanan Densply 10,00 Buah
52.250,00 522.500,00
620 Refil Bracket Slot 0.022 Premolar 2 Atas Kiri Densply 10,00 Buah 52.250,00 522.500,00
621 Refil Bracket Slot 0.022 Premolar 1 atas kiri Densply 10,00 Buah 52.250,00 522.500,00
622 Band Molar 0.022 Single tube Cleat Atas Kanan No 9 Ormco 10,00 Buah
181.500,00 1.815.000,00
181.500,00 1.815.000,00
181.500,00 1.815.000,00
625 Band Molar 0.022 Single tube Cleat Atas Kanan no 12 Ormco 10,00 Buah
181.500,00 1.815.000,00
181.500,00 1.815.000,00
181.500,00 1.815.000,00
181.500,00 1.815.000,00
Page 8 of 18
Harga satuan
(Rp)
629 Band Molar 0.022 Single tube Cleat Atas Kanan NO 16 Ormco 10,00 Buah
181.500,00 1.815.000,00
181.500,00 1.815.000,00
181.500,00 1.815.000,00
632 Band Molar 0.022 Single tube Cleat Atas Kanan no 19 Ormco 10,00 Buah
181.500,00 1.815.000,00
181.500,00 1.815.000,00
181.500,00 1.815.000,00
181.500,00 1.815.000,00
181.500,00 1.815.000,00
181.500,00 1.815.000,00
181.500,00 1.815.000,00
181.500,00 1.815.000,00
181.500,00 1.815.000,00
181.500,00 1.815.000,00
181.500,00 1.815.000,00
181.500,00 1.815.000,00
181.500,00 1.815.000,00
645 Band Molar 0.022 Single tube Cleat Atas kiri No 9 Ormco 10,00 Buah 181.500,00 1.815.000,00
649 Band Molar 0.022 Single tube Cleat Atas kiri No 13 ormc o 10,00 Buah 181.500,00 1.815.000,00
653 Band Molar 0.022 Single tube Cleat Atas kiri No 17 Ormcoi 10,00 Buah 181.500,00 1.815.000,00
666 Band Molar 0.022 Single tube Cleat Atas kiri No 30 ormco 10,00 Buah 181.500,00 1.815.000,00
669 Band Molar 0.022 Singletube Rect Cleat bwh ka No 09 Ormco R.Slot Bawah 10,00 Buah
kanan 181.500,00 1.815.000,00
670 Band Molar 0.022 Singletube Rect Cleat Bwh Ka No 10 Ormco R.Slot bawah 10,00 Buah
Kanan 181.500,00 1.815.000,00
671 Band Molar 0.022 Singletube Rect Cleat Bwh Ka No 12 ormco R.Slot Bawah 10,00 Buah
Kanan 181.500,00 1.815.000,00
672 Band Molar 0.022 Singletube Rect Cleat Bwh Ka No 13 Ormco R.Slot Bawah 10,00 Buah
Kanan 181.500,00 1.815.000,00
kanan 181.500,00 1.815.000,00
674 Band Molar 0.022 Singletube Rect Cleat Bwh Ka no 16 Ormco R.Slot Bawah 10,00 Buah
kanan 181.500,00 1.815.000,00
kanan 181.500,00 1.815.000,00
Kanan 181.500,00 1.815.000,00
677 Band Molar 0.022 Singletube Rect Cleat Bwh Ka No 19 Ormco 10,00 Buah
181.500,00 1.815.000,00
Kanan 181.500,00 1.815.000,00
Kanan 181.500,00 1.815.000,00
680 Band Molar 0.022 Singletube Rect Cleat Bwh Ka No 22 Ormco R. Slot bawah 10,00 Buah
Kanan 181.500,00 1.815.000,00
Kanan 181.500,00 1.815.000,00
Kanan 181.500,00 1.815.000,00
Page 9 of 18
Harga satuan
(Rp)
683 Band Molar 0.022 Singletube Rect Cleat Bwh Ka No 25 Ormco R. Slot Bawah 10,00 Buah
kanan 181.500,00 1.815.000,00
kanan 181.500,00 1.815.000,00
kanan 181.500,00 1.815.000,00
kanan 181.500,00 1.815.000,00
Kanan 181.500,00 1.815.000,00
kanan 181.500,00 1.815.000,00
Kanan 181.500,00 1.815.000,00
Kanan 181.500,00 1.815.000,00
691 Band Molar 0.022 Singletube Rect Cleat Bwh Ki No 9 Ormco 10,00 Buah
181.500,00 1.815.000,00
692 Band Molar 0.022 Singletube Rect Cleat Bwh Ki No 10 Ormco R. Slot bawah 10,00 Buah
Kiri 181.500,00 1.815.000,00
693 Band Molar 0.022 Singletube Rect Cleat Bwh Ki No 11 Ormco R. Slot Bawah 10,00 Buah
Kiri 181.500,00 1.815.000,00
694 Band Molar 0.022 Singletube Rect Cleat Bwh Ki No 12 Ormco R.Slot Bawah 10,00 Buah
Kiri 181.500,00 1.815.000,00
Kiri 181.500,00 1.815.000,00
Kiri 181.500,00 1.815.000,00
697 Band Molar 0.022 Singletube Rect Cleat Bwh Ki No 15 Ormco R.Slot bawah 10,00 Buah
kiri 181.500,00 1.815.000,00
Kiri 181.500,00 1.815.000,00
699 Band Molar 0.022 Singletube Rect Cle Bwh Ki 17 No 17 Ormco R. Slot Bawah 10,00 Buah
Kiri 181.500,00 1.815.000,00
700 Band Molar 0.022 Singletube Rect Cleat Bwh Ki No 18 Ormco R. Slot bawah 10,00 Buah
Kiri 181.500,00 1.815.000,00
701 Band Molar 0.022 Singletube Rect Cleat Bwh Ki No 19 Ormco R. slot Bawah 10,00 Buah
Kiri 181.500,00 1.815.000,00
702 Band Molar 0.022 Singletube Rect Cleat Bwh Ki No 20 Ormco r. Slot Bawah 10,00 Buah
Kiri 181.500,00 1.815.000,00
Kiri 181.500,00 1.815.000,00
704 Band Molar 0.022 Singletube Rect Cleat Bwh Ki No 22 Ormco R. slot Bawah 10,00 Buah
Kiri 181.500,00 1.815.000,00
Kiri 181.500,00 1.815.000,00
Kiri 181.500,00 1.815.000,00
Kiri 181.500,00 1.815.000,00
kiri 181.500,00 1.815.000,00
kiri 181.500,00 1.815.000,00
710 Carbide Burs KH 254 E K H 254 E 314.012 2,00 Pieces 341.000,00 682.000,00
711 Niti Super Elastic 017 x 025 Up 3M , UNITEX 4,00 Pak 550.000,00 2.200.000,00
712 Bone Cutters H 162 SL 314 014 H 162 SL 314 014 4,00 Pieces 522.500,00 2.090.000,00
713 Bone Cutters H 33L 505 320 016 H 33L 505 320 016 4,00 Pieces 522.500,00 2.090.000,00
714 Bone Cutters H 267 104 016 H 267 104 016 4,00 Pieces 522.500,00 2.090.000,00
715 Abutment Cutter H 847 KRG 314 016 4,00 Pieces 522.500,00 2.090.000,00
716 Carbide Burs KH 163 RF 104 014 KH 163 RF 104 014 4,00 Pieces 253.000,00 1.012.000,00
718 Diamond Instrument Burs (FINE) Mani EX21 10,00 Pieces 99.000,00 990.000,00
719 Diamond Instrument Burs K. 310.204.012 10,00 Pieces 99.000,00 990.000,00
720 Diamond Instrument Burs K.310.204.014 10,00 Pieces 99.000,00 990.000,00
721 Steel Finishing Instrument Bur K.310.204.012 K.310.204.012 5,00 Pieces
99.000,00 495.000,00
722 Steel Finishing Instrument Bur K.310.204.014 K.310.204.014 10,00 Pieces
99.000,00 990.000,00
723 Diamond Instrument Burs (FO) Mani FO - 32 10,00 Pieces 99.000,00 990.000,00
724 Diamond Instrument Burs (Metal Crown) K8851 314 012 4,00 Pieces 121.000,00 484.000,00
725 Hedstroem File # 15-45.21 mm Dentsply AO16D. 021 900 4,00 Pak 170.500,00 682.000,00
726 Hedstroem File # 15-45.25 mm Dentsply AO 16D. 025 900 4,00 Pak 170.500,00 682.000,00
727 K - Flexofile # 15 - 40,31 mm Dentsply AO 12C 031. 900 4,00 Pak 121.000,00 484.000,00
728 K - Flexofile # 40.21 mm Dentsply AO 12 C 021.040 4,00 Pak 121.000,00 484.000,00
729 Niti Super Elastics 017 x 025 Low 3M , Unitex 4,00 Pak 550.000,00 2.200.000,00
730 Diamond Instrument Bur (F) Mani Sf - 41 6,00 Pieces 99.000,00 594.000,00
731 Adhesive Remover komet H22AGK(314) 6,00 Pieces 165.000,00 990.000,00
732 Adhesive Remover Komet H22ALGK(314) 6,00 Pieces 165.000,00 990.000,00
733 Molar Band + Buccal Tube 17 LR ormco 2,00 Pieces 181.500,00 363.000,00
735 Kapas Gulung/Sublimat - 200,00 Pak Isi 50 35.750,00 7.150.000,00
737 Grafik BU 80 PT.SUN 7,00 Pak 2.530.000,00 17.710.000,00
738 Kapiler Hematokrit 10 tube/pak Asisten 21,00 Pak 489.500,00 10.279.500,00
Page 10 of 18
Harga satuan
(Rp)
740 Micro Filter 02 UL,50 Gelman 6,00 Pak 2.750.000,00 16.500.000,00
743 Tabung Durham Lokal 6,00 Pak 440.000,00 2.640.000,00
744 Tabung Reaksi 18X180 Mm Gelas Pyrex 5,00 Pak 2.475.000,00 12.375.000,00
745 Proses Caver Stainles,25 bh Shandon 6,00 Pak 1.485.000,00 8.910.000,00
746 Kartu Golongan Darah AIM / 100 pc 90,00 Pak 82.500,00 7.425.000,00
747 Sodium Citrat 3,2% (2ml 100bh) Greieener 18,00 Pak 286.000,00 5.148.000,00
751 Citrat 3 NA 1ml 1501306 Cloth Factor 100pcs Aquasel 18,00 Box
368.500,00 6.633.000,00
756 Cryos 1,8 ml , 50 bh 7946 NUNC 3,00 Pak 660.000,00 1.980.000,00
757 ESR Pipet + Citrate 0,32 ml 1501226 Vectube 3,00 Pak 1.155.000,00 3.465.000,00
759 Sarung Tangan Nitrilie , S H Seal 210,00 Pak 53.900,00 11.319.000,00
760 Sarung Tangan Nitrile , L H Seal 18,00 Box Isi 100 53.900,00 970.200,00
765 Microtome Blade / 819 ( 50 BH ) Leica 15,00 Pak 1.980.000,00 29.700.000,00
768 Seamless Ribbon (ERC-09) seamles 18,00 Buah 104.500,00 1.881.000,00
771 Vol Pipet 10 ml Resisten 9,00 Buah 110.000,00 990.000,00
772 Vol Pipet 5 ml Resisten 9,00 Buah 110.000,00 990.000,00
773 Pisau AA 225 R Aesculap 2,00 Buah 4.565.000,00 9.130.000,00
774 Sample Cup Conical 4 ml 42412510 (100/pak) Sysmex 6,00 Pak
1.078.000,00 6.468.000,00
775 Cassette Embeding B. 1003500/500 bh Shandon 11,00 Box 1.320.000,00 14.520.000,00
776 Reaction Tube SU 40 90407219 (1000/pak) Sysmex 6,00 Pak
5.060.000,00 30.360.000,00
777 Cryos 1,8 ml NUNC 15,00 Pak 660.000,00 9.900.000,00
778 Tip Yellow ,1000 bh Italiana 45,00 Pak 121.000,00 5.445.000,00
779 Karet seal Astrup / 100 Lokal 6,00 Pak 192.500,00 1.155.000,00
781 Cell Culture Dish , 100 x 20 mm 430167 Corning 12,00 Pak 181.500,00 2.178.000,00
785 Sarung tangan Nitrile M Handseal 30,00 Pak 53.900,00 1.617.000,00
788 Kertas Saring Cat . 1001 185 diameter 18,5 Wathman 6,00 Pak
742.500,00 4.455.000,00
789 Cuvette & Steel Ball TECO GmbH 1,00 Kit 8.250.000,00 8.250.000,00
795 Cotton Swab Steril, 231110 microgen 18,00 Pak 165.000,00 2.970.000,00
796 Petri Dish 90 mm Steril, S90001 microgen 15,00 Pak 1.815.000,00 27.225.000,00
797 Inoculation Loops 10 ul, 33210010D microgen 6,00 Pak 1.265.000,00 7.590.000,00
798 K3 EDTA 0,5ML / 50 PCS Aquisel 240,00 Pak 181.500,00 43.560.000,00
799 Lithium Heparin 1 ml Tube / 100 bh Aquisel 18,00 Pak 302.500,00 5.445.000,00
801 Syringe Clot Catcher Phox NOVA 3,00 Pak 1.210.000,00 3.630.000,00
815 Holding Pipette Z Shapped ( TPC ) 25,00 Box Isi 10 3.300.000,00 82.500.000,00
818 Yellow Tip Greiner Box isi 1000, Greiner 4,00 Box 302.500,00 1.210.000,00
819 Alumunium Foil - 2,00 Box 77.000,00 154.000,00
820 Injection LHCR 35 Dipa 2,00 Box Isi 10 4.290.000,00 8.580.000,00
821 Catether Female (Urine Catether) - 20,00 Buah 15.400,00 308.000,00
824 Pipet PasteurJP (Volac) 230 MM Box/1000 2,00 Box 1.045.000,00 2.090.000,00
825 IVF Non Toxic Syringe - 70,00 Buah 253.000,00 17.710.000,00
826 Falcon 7521 Box isi 100 6,00 Box 3.850.000,00 23.100.000,00
829 Gynetics 4220 IUI LOT 20070405 - 150,00 Buah 115.500,00 17.325.000,00
830 Holding pipette LHCR 35 Dipa 5,00 Box Isi 10 3.685.000,00 18.425.000,00
831 Coda Inline Filter 2,00 Buah 2.629.000,00 5.258.000,00
832 Coda Aero Filter - 2,00 Buah 4.719.000,00 9.438.000,00
835 Injection Z Shaped (TPC) - 7,00 Box 4.675.000,00 32.725.000,00
836 SURE-TEZ HCG Pregnacy Test - 2,00 Box 275.000,00 550.000,00
843 Shepard Intrauterine Insem.set,J-IUIE-542009 - 15,00 Buah
143.000,00 2.145.000,00
844 Spezial Indikator (PH. 6.5 -10.0) - 1,00 Pak 308.000,00 308.000,00
845 Spezial Indikator (PH 6.4-8.4) - 1,00 Pak 352.000,00 352.000,00
852 ANSELL STERIL NO. 6.0 PF / SARUNG TANGAN gammex Powder Free, box isi 320,00 Pasang
40 11.550,00 3.696.000,00
853 ANSELL STERIL NO. 6.5 PF / SARUNG TANGAN gammex powder free, box isi 9.000,00 Pasang
40 11.550,00 103.950.000,00
854 ANSELL STERIL NO. 7.0 PF / SARUNG TANGAN gammex powder free, box isi 6.500,00 Pasang
40 11.550,00 75.075.000,00
855 ANSELL STERIL NO. 7.5 PF/ SARUNG TANGAN gammex powder free, box isi 3.850,00 Pasang
40 11.550,00 44.467.500,00
856 ANSELL STERIL NO. 8.0 PF/ SARUNG TANGAN gammex powder free, box isi 1.100,00 Pasang
40 11.550,00 12.705.000,00
871 DISP BLADE 10 AESCULAP aesculap, box 100 3,00 Box Isi 100 209.000,00 627.000,00
872 DISP BLADE 11 AESCULAP aesculap, box isi 100 6,00 Box Isi 100 209.000,00 1.254.000,00
Total 1.922.820.900,00
PT. CIPTA SUKSES MEDIKA

Harga satuan
(Rp)
924 INFUSION SET PUMP TERUMO terumo, box isi 20 600,00 Pieces 33.000,00 19.800.000,00
939 MICRODRIP/BURET TSPM 270L terumo, box isi 10 350,00 Pieces 73.000,00 25.550.000,00
941 MICROPORE 1/2"X 10 YD DISPENSER 15350 3M, type 1535-0, box isi 24 72,00 Pieces
8.575,00 617.400,00
24 Nebulizer Mask Child - 500,00 Buah 38.500,00 19.250.000,00
33 Kertas ECG Multi Channel Fukuda ME 90,00 Pak 88.000,00 7.920.000,00
Page 11 of 18
Harga satuan
(Rp)
35 Kertas USG UPP-110 HG Sony 150,00 Roll 165.000,00 24.750.000,00
429 Wooden tongue depressor general care / TJ 30,00 Box 20.570,00 617.100,00
753 K3 EDTA 0,5 ml / 50 pcs Intherma 90,00 Pak 145.200,00 13.068.000,00
849 ALCOHOL SWAB (BD) BD 1.250,00 Box Isi 100 29.040,00 36.300.000,00
879 DRAINAGE BAG ADULT JMS jms, box isi 10 1.250,00 Pieces 58.905,00 73.631.250,00
890 EXTENSION TUBE 1 jms, 100cm, 0.79ml ,box isi 7.500,00 Pieces
50 27.500,00 206.250.000,00
891 EXTENSION TUBE 2 jms, 100 cm, 4.90ml, box isi 100,00 Pieces
25 27.500,00 2.750.000,00
892 FEEDING TUBE 3/40 CM JMS jms, box isi 50 150,00 Pieces 11.825,00 1.773.750,00
893 FEEDING TUBE 5/120CM JMS jms, box isi 50 200,00 Pieces 11.825,00 2.365.000,00
894 FEEDING TUBE 5/40 CM JMS jms, box isi 50 100,00 Pieces 11.825,00 1.182.500,00
895 FEEDING TUBE 6/40 CM JMS jms, box isi 50 30,00 Pieces 11.825,00 354.750,00
896 FEEDING TUBE 8/120CM JMS jms, box isi 50 1.400,00 Pieces 11.825,00 16.555.000,00
897 FEEDING TUBE 8/40 CM JMS jms, box isi 50 1.600,00 Pieces 11.825,00 18.920.000,00
903 FOLLEY CATH FR 6 NORTA 2way,norta ,bsn, box 10 100,00 Pieces 66.000,00 6.600.000,00
904 FOLLEY CATH FR 8 NORTA 2way,norta ,bsn, box isi 10 180,00 Pieces 66.000,00 11.880.000,00
905 FOLLEY CATH FR 10 NORTA 2way,norta, bsn, box isi 10 130,00 Pieces 66.000,00 8.580.000,00
926 INJECTION PLUG / IN-STOPPER LUER LOCK zontic/bbraun, box isi 100 750,00 Pieces 3.327,50 2.495.625,00
938 MERSILENE TAPR RS 22 ethicon, box isi 6 1,00 Box Isi 6 2.823.480,00 2.823.480,00
947 PISAU CUKUR ( RAZOR ) dahlhausen, box isi 100 600,00 Pieces 3.025,00 1.815.000,00
988 SPUIT 1 CC TB TERUMO terumo, box isi 100 5.000,00 Pieces 1.650,00 8.250.000,00
989 SPUIT 2.5 CC TERUMO terumo, box isi 100 25,00 Box Isi 100 132.000,00 3.300.000,00
990 SPUIT 3 CC BD BD, box isi 100 800,00 Pieces 990,00 792.000,00
994 SPUIT 10 CC TERUMO terumo, box isi 100 5.000,00 Pieces 1.540,00 7.700.000,00
999 SPUIT 50CC CATH TIP TRM terumo 450,00 Pieces 19.250,00 8.662.500,00
1013 TEGADERM 1627 3M,box isi 20 750,00 Pieces 24.200,00 18.150.000,00
1021 UNDERPADS UP-150 23"X36" NS/ SC 849 Prevail,802493, carton isi 150 10.000,00 Pieces
4.675,00 46.750.000,00
1022 URINE COLECTOR PEDIATRIC (UDPS) JMS jms, box isi 25 550,00 Pieces 25.795,00 14.187.250,00
1025 VENFLON 18 G /Venflon Pro BD 1.000,00 Pieces 17.700,00 17.700.000,00
1026 VENFLON 20 G /Venflon Pro BD 500,00 Pieces 17.700,00 8.850.000,00
1027 VENFLON 22 G /Venflon pro BD 750,00 Pieces 17.700,00 13.275.000,00
1042 WING NEEDLE 25 G JMS jms, box isi 100 1.000,00 Pieces 6.435,00 6.435.000,00
1050 LARYNGEAL MASK AMBU NO.3.0 - 5,00 Pieces 357.500,00 1.787.500,00
1057 ANSELL NON STERILE SIZE L microtouch dermaclean pwd 10,00 Box Isi 100
free 112.200,00 1.122.000,00
1059 PDS II VIO 5-0 70CM C-1 Z 1013 H ethicon, box isi 36 1,00 Box isi 36
3.901.920,00 3.901.920,00
1065 FOLLEY CATH FR 12 WRP 2WAY, wrp 100,00 Pieces 10.642,50 1.064.250,00
1066 NASSAL CANNULA ADULT (hospitech) hospitech 350,00 Pieces 11.000,00 3.850.000,00
1067 NASSAL CANNULA CHILD (hospitech) hospitech 120,00 Pieces 11.000,00 1.320.000,00
1082 UMBILICAL CORD CLAMP (JMS) 1.000,00 Pieces 18.920,00 18.920.000,00
1084 MEDIGRIP PLUS 6.0 ansell 50,00 Pasang 8.057,50 402.875,00
1085 MEDIGRIP PLUS 6.5 ansell 250,00 Pasang 8.057,50 2.014.375,00
1088 MEDIGRIP PLUS 8.0 ansell 50,00 Pasang 8.057,50 402.875,00
1097 CONNECTING TUBE 2-TUNEL (hospitech) 1.400,00 Pieces 42.350,00 59.290.000,00
1099 FOLLEY CATH FR 16 WRP 110,00 Pieces 10.642,50 1.170.675,00
1101 IVENA 22 G jms ,box isi 50 200,00 Pieces 12.815,00 2.563.000,00
1102 IVENA 24 G jms, box isi 50 150,00 Pieces 12.815,00 1.922.250,00
1108 SURGIGUT CHROM 2-0 CG-923 90CM 72,00 Pieces 55.000,00 3.960.000,00
1109 SUCTION CATH. FR 8 hospitech hospitech 2.000,00 Pieces 4.950,00 9.900.000,00
1115 SUCTION CATH. FR 10 hospitech 450,00 Pieces 4.950,00 2.227.500,00
1130 ANSELL NON STERILE SIZE XS microtouch dermaclean pwd 15,00 Box Isi 100
free 111.155,00 1.667.325,00
1136 SUCTION CATH .FR 6 hospitech 400,00 Pieces 4.950,00 1.980.000,00
1170 THERMOMETER SAFETY safety, box isi 12 120,00 Pieces 12.100,00 1.452.000,00
1177 TEGADERM 1623 3M,box isi 100 9.000,00 Lembar 4.400,00 39.600.000,00
1182 ANSELL NON STERILE SIZE S microtouch dermaclean pwd 2.500,00 Box Isi 100
free 111.155,00 277.887.500,00
1184 ANSELL NON STERILE SIZE M microtouch dermaclean pwd 120,00 Box Isi 100
free 111.155,00 13.338.600,00
1195 FEEDING DRIP TYPE 100 ML/ FEED BURET SET jms, box isi 50 600,00 Pieces
161.150,00 96.690.000,00
1197 LARYNGEAL MASK AMBU NO.2 - 15,00 Pieces 357.500,00 5.362.500,00
1200 FOLLEY CATH FR 26 WRP 2way,wrp, box isi 10 10,00 Pieces 10.642,50 106.425,00
920 INF SET WITH BURET JMS jms, box isi 10 300,00 Pieces 66.220,00 19.866.000,00
925 INFUSION SET TYPE 500 jms, box isi 25 5.000,00 Pieces 19.910,00 99.550.000,00
943 MUCUS EXTRACTOR FR.10 JMS jms, box isi 25 750,00 Pieces 28.380,00 21.285.000,00
1019 THREE WAY STOP COCK (TRM) terumo, box isi 50 3.750,00 Pieces 17.050,00 63.937.500,00
Total 1.441.619.675,00
Page 12 of 18
Harga satuan
(Rp)
PT. Citra Vita Buana
Harga satuan
(Rp)
1106 DISP.SUCTION BAG 2.5 LTR medela 750,00 Pieces 79.200,00 59.400.000,00
Total 59.400.000,00
PT. Dos Ni Roha

Harga satuan
(Rp)
862 CERTOFIX MONO PAED + ACCES bbraun 60,00 Pieces 495.247,50 29.714.850,00
864 CHROMIC 1 HR 43 box isi 24, bbraun 80,00 Pieces 64.295,00 5.143.600,00
865 CHROMIC 2 HR 48 box isi 24, bbraun 200,00 Pieces 57.090,00 11.418.000,00
866 CHROMIC 2/0 HR 37 S bbraun 1.050,00 Pieces 58.520,00 61.446.000,00
867 CHROMIC 3/0 TAP HR 26 bbraun 18,00 Pieces 53.515,00 963.270,00
942 MONOSYN 3-0 DS 24 bbraun, isi 36 300,00 Pieces 90.516,80 27.155.040,00
948 PLAIN 0 HR 43 TAPER bbraun 50,00 Pieces 51.975,00 2.598.750,00
949 PLAIN 3/0 CUTT DS 24 bbraun 180,00 Pieces 49.665,00 8.939.700,00
950 PLAIN 3/0 TAP HR 26 bbraun 24,00 Pieces 53.130,00 1.275.120,00
951 PLAIN 4/0 TAPER HR 17 bbraun 120,00 Pieces 58.135,00 6.976.200,00
953 PREMILENE 3/0 DS 24 bbraun 36,00 Pieces 70.840,00 2.550.240,00
970 SAFIL 1 HR 40 S bbraun, box isi 36 500,00 Pieces 75.075,00 37.537.500,00
971 SILK 0 HR 30 TAP bbraun 100,00 Pieces 45.870,00 4.587.000,00
972 SILK 1 HR 48 TAP bbraun 24,00 Pieces 56.485,00 1.355.640,00
973 SILK 2/0 CUTT DS 30 bbraun 12,00 Pieces 56.430,00 677.160,00
974 SILK 2/0 TAP HR 26 bbraun 180,00 Pieces 43.120,00 7.761.600,00
975 SILK 2/0 W.O NEEDLE 13X60 bbraun 72,00 Pieces 43.230,00 3.112.560,00
976 SILK 3/0 CUTT DS 24 bbraun 360,00 Pieces 40.040,00 14.414.400,00
979 SILK 3/0 W.O NEEDLE 13X60 bbraun 12,00 Pieces 41.250,00 495.000,00
980 SILK 4/0 CUTT DS 19 bbraun 12,00 Pieces 41.470,00 497.640,00
1054 SILK 1 TAP HR 35 bbraun 24,00 Pieces 53.130,00 1.275.120,00
1083 SPINOCAN G 29 NEEDLE bbraun ,box isi 25 25,00 Pieces 45.606,00 1.140.150,00
1117 CERTOFIX MONO V 220 Bbraun 110,00 Pieces 345.411,00 37.995.210,00
1144 MEDIFIX MANOMETER SCALA bbraun 5,00 Pieces 219.351,00 1.096.755,00
1166 LYOSTYPT 5 x 8cm box isi 6pc, bbraun 120,00 Pieces 88.550,00 10.626.000,00
1198 SAFIL 4/0 HR 17 bbraun, box isi 36 100,00 Pieces 75.364,30 7.536.430,00
1223 CHROMIC 2 HR 43 box isi 24, bbraun 12,00 Pieces 57.200,00 686.400,00
1228 HYSTOACRYL 0.5 ML box isi 5, bbraun 75,00 SACHET 192.500,00 14.437.500,00
Total 329.463.035,00
PT. IDS Medical Systems

Harga satuan
(Rp)
880 E T T CUFF 5.0 PORTEX portex 25,00 Pieces 74.404,00 1.860.100,00
881 E T T CUFF 5.5 PORTEX portex 20,00 Pieces 86.631,71 1.732.634,20
882 E T T CUFF 6.5 PORTEX portex 10,00 Pieces 86.631,71 866.317,10
885 E T T NO 2.5 PORTEX portex 30,00 Pieces 67.858,56 2.035.756,80
911 GUIDEL AIRWAY NO. 1 portex 30,00 Pieces 24.057,00 721.710,00
914 GUIDEL AIRWAY NO.00 portex 30,00 Pieces 24.057,00 721.710,00
1005 SUCTION CATH.FR 8 PORTEX portex 2.200,00 Pieces 42.659,76 93.851.472,00
1062 REDAX DRENTECH COMPACT PX 10105PX 5,00 Pieces 692.736,00 3.463.680,00
1076 BIONECTOR 2 896.03 vygon 400,00 Pieces 27.225,00 10.890.000,00
1093 CVC SINGLE LUMEN FR:7 (CV-50014) ARROW arrow 3,00 Pieces
237.600,00 712.800,00
1118 CVC SET 2 LUMEN FR : 7 ARROW arrow,cv-17702-E 5,00 Pieces 647.020,00 3.235.100,00
1135 EPIDURAL MINIPACK SYST 1 18G Smith medical ,uk 5,00 Pieces 170.084,20 850.421,00
1137 CVC SET 2 LUMEN FR: 5 ARROW arrow 2,00 Pieces 835.659,00 1.671.318,00
1149 TRACHEOSTOMY TUBE 7.5 portex 5,00 Pieces 688.050,00 3.440.250,00
1161 E T T SOUTH ORAL 6.0 PX portex 15,00 Pieces 275.775,50 4.136.632,50
1176 LARYNGEAL MASK 2.5 PX portex 5,00 Pieces 248.930,00 1.244.650,00
Page 13 of 18
Harga satuan
(Rp)
1180 E T T NO 5.5 PORTEX portex 10,00 Pieces 67.858,56 678.585,60
1207 NASSAL CPAP (DOUBLE CUP) 2596.20 FR.10 vygon, fr.10 100,00 Pieces
246.675,00 24.667.500,00
1210 CVC SET 2 LUMEN FR : 4 ARROW arrow,cs-14402 3,00 Unit 667.013,00 2.001.039,00
1212 UMBILICAL CATHETER 3.5 FR L 38CM 270.03 vygon 90,00 Pieces
37.125,22 3.341.269,80
1213 UMBILICAL CATHETER 5.0 FR L 38 CM 270.05 vygon 50,00 Pieces
42.898,68 2.144.934,00
1217 NASSAL CPAP (DOUBLE CUP) 2596.15 FR.08 vygon 50,00 Pieces
246.675,00 12.333.750,00
1218 LARYNGEAL MASK 2.0 PX portex 10,00 Pieces 248.930,00 2.489.300,00
1221 E T T SOUTH ORAL 3.0 PX portex 5,00 Pieces 151.613,00 758.065,00
1004 SUCTION CATH.FR 6 PORTEX portex 900,00 Pieces 42.659,76 38.393.784,00
Total 265.361.704,15
PT. Kimia Farma T&D

Harga satuan
(Rp)
40 Chemical Indicator Strip, EO 125 3M 12,00 Pak 605.000,00 7.260.000,00
62 Biological Indicator 1264 / Attes EO box/25 vial 3M ( box/ 25 vial ) 2,00 Box
1.210.000,00 2.420.000,00
952 PLESTER NA/ TRANSPORE 1/2 X 10 YARD 3M, box isi 24 360,00 Pieces 12.000,00 4.320.000,00
6 Attest EO 1264 3M 3,00 Box 2.960.100,00 8.880.300,00
26 Plester Putih (0.5 X 10) BSN medical leukofix 2136 12,00 Roll 15.840,00 190.080,00
38 Attest Steam ( 50 ampul )TM1292 TM 10,00 Box 1.973.400,00 19.734.000,00
42 Wipak Sterilizer R 44 Steryking,Intergastra 30,00 Roll 2.405.370,00 72.161.100,00
53 Thermometer Dewasa Nipro 12,00 Buah 16.390,00 196.680,00
61 Paper Roll EO / TM 1217 Steri - Vac 3,00 Box 437.030,00 1.311.090,00
64 Tinta Mesin PAC 3000 Gettinge,Intergastra 1,00 Set 2.886.400,00 2.886.400,00
75 Deeper Kacang Sedang 2 cm x 1,5cm (1815SM) 10.000,00 Pieces
550,00 5.500.000,00
79 Sterigage Chemical Steam TM 1243A 3M 4,00 Pak 2.192.740,00 8.770.960,00
749 Needle Flashback 22 x 1 BD 90,00 Box 94.380,00 8.494.200,00
750 Tube PLN 13 X 75 4,0 BD 60,00 Box 185.460,00 11.127.600,00
754 Culture Swab Plus Amies 220116 BD 12,00 Box 980.100,00 11.761.200,00
758 Wingset 25x75 , 367294 BD 5,00 Box 423.500,00 2.117.500,00
787 Tube Micro 365974 BD 16,00 Box 209.660,00 3.354.560,00
869 CYSTOFIX 8 CM bbraun 3,00 Pieces 324.500,00 973.500,00
875 DISP NEEDLE 18 G NIPRO nipro, box isi 100 160,00 Box Isi 100 31.460,00 5.033.600,00
876 DISP NEEDLE 24 G NIPRO nipro, box isi 100 125,00 Box Isi 100 31.460,00 3.932.500,00
907 FOLLEY CATH FR 14 BARD 2way,bardia, box isi 10 10,00 Pieces 15.620,00 156.200,00
908 FOLLEY CATH FR 14 WRP 2way,wrp, box isi 10 20,00 Pieces 9.790,00 195.800,00
915 GYPSONA 3 INCH BSN 5,00 Pieces 27.280,00 136.400,00
916 GYPSONA 4 INCH BSN 5,00 Roll 38.170,00 190.850,00
918 HYPAFIX 10CM X 5 M 1pcs/20, BSN 300,00 Pieces 102.410,00 30.723.000,00
919 HYPAFIX 5CM X 5 M BSN 300,00 Pieces 53.790,00 16.137.000,00
923 INFUSION SET PUMP NIPRO nipro, box isi 50 50,00 Pieces 7.370,00 368.500,00
927 KAPAS 50 Gr (husada) husada 10,00 Pieces 3.740,00 37.400,00
928 KAPAS 100 Gr (husada) husada 300,00 Pieces 7.150,00 2.145.000,00
931 KASA HYDROFIL 5CM X 4 YD (husada) husada ,pack isi 10 200,00 Roll 1.430,00 286.000,00
932 KASA HYDROFIL 10CM X 4 YD (husada) husada, pack isi 10 1.200,00 Roll 3.080,00 3.696.000,00
933 KASA STERIL 1/16 (husada) husada 16x16 1.600,00 Pieces 5.940,00 9.504.000,00
982 SOFBAN BIRU 3 INCH BSN 5,00 Roll 15.510,00 77.550,00
983 SOFBAN BIRU 4 INCH BSN 5,00 Roll 19.580,00 97.900,00
987 SPUIT 1 CC TB NIPRO nipro, box isi 100 30.000,00 Pieces 1.320,00 39.600.000,00
992 SPUIT 5 CC NIPRO nipro, box isi 100 38.000,00 Pieces 1.100,00 41.800.000,00
993 SPUIT 5 CC TERUMO terumo, box isi 100 25,00 Box Isi 100 1.320,00 33.000,00
998 SPUIT 50CC CATH TIP NIPRO nipro, box isi 25 700,00 Pieces 16.280,00 11.396.000,00
1014 TENSOCREPE 3 INCH BSN 15,00 Roll 56.210,00 843.150,00
1015 TENSOCREPE 4 INCH BSN 15,00 Roll 67.650,00 1.014.750,00
1016 TENSOCREPE 6 INCH BSN 15,00 Roll 88.880,00 1.333.200,00
1017 THERMOMETER NIPRO nipro, box isi 12 12,00 Pieces 16.390,00 196.680,00
1018 THREE WAY STOP COCK (NPR) nipro, box isi 50 500,00 Pieces 7.920,00 3.960.000,00
1023 UROGARD ADULT/URINE BAG 500,00 Pieces 44.000,00 22.000.000,00
1040 WING NEEDLE 23 G NIPRO nipro, box isi 50 150,00 Pieces 4.950,00 742.500,00
1041 WING NEEDLE 25 G NIPRO nipro, box isi 50 100,00 Pieces 4.950,00 495.000,00
1049 CUTISORB SORBACT RIBBON GAUZE 2X50CM BSN 3,00 Pieces
80.630,00 241.890,00
1078 CERTOFIX DUO V 720 bbraun 10,00 Pieces 66.000,00 660.000,00
1111 HYPAFIX 15 X 5 CM bsn 100,00 Roll 141.460,00 14.146.000,00
1112 KAPAS SARI LURIK 1 KG bsn 80,00 Roll 94.490,00 7.559.200,00
1121 CUTIMED ALGINATE 10 X 10 CM bsn 10,00 Pieces 39.600,00 396.000,00
Page 14 of 18
Harga satuan
(Rp)
1122 CUTIMED HYDRO-B 10 X 10 CM bsn 5,00 Pieces 38.940,00 194.700,00
1123 CUTIMED SORBACT ROUND SWAB 3 CM bsn 3,00 Pak 114.180,00 342.540,00
1124 CUTIMED SORBACT 10 X 10 CM bsn 10,00 Pak 84.590,00 845.900,00
1131 CUTISEL CLASSIC 10 X 10CM bsn 3,00 Lembar 9.350,00 28.050,00
1169 ELASTOMULL HAFT 10 CM X 4 M bsn 5,00 Roll 39.380,00 196.900,00
1209 SPINAL NEEDLE 27 G (BD) BD,quincky,box isi 25 125,00 Pieces 34.870,00 4.358.750,00
Total 430.345.380,00
PT. Medquest Jaya Global

Harga satuan
(Rp)
1152 CLAVE CONNECTOR CS 10 - 100,00 Pieces 37.285,05 3.728.505,00
1153 CLAVE CONNECTOR CS 50 - 100,00 Pieces 42.000,00 4.200.000,00
1183 MICROCLAVE-T ICU medical 3.000,00 Pieces 49.161,75 147.485.250,00
Total 155.413.755,00
PT. Parazelsus Indonesia

Harga satuan
(Rp)
1 Benang Ethilon 8-0 W 1765,Ethicon isi 12 pcs 8,00 Box isi 12 129.476,60 1.035.812,80
201 Benang PDS II Z 432 H,Ethicon isi 36 pcs Z 432 H,Ethicon isi 36 pcs 4,00 Box 121.933,90 487.735,60
860 BONE WAX 2.5 GM W 810 ethicon, 1,00 Box isi 12 131.054,00 131.054,00
945 PDS II 0 USP 0 150CM CTX 1/2C W 9261 T ethicon, isi 24 1,00 Box isi 24
134.856,70 134.856,70
946 PDS II 6-0 45CM 13MM 2ARM W 9096 H ethicon, isi 36 1,00 Box isi 36 175.519,30 175.519,30
954 PROLENE BLU 2-0 45CM 3/8 8685 H ethicon, box isi 36 1,00 Box isi 36 84.565,80 84.565,80
955 PROLENE 3-0 16 MM 1/2R D/A W 8558 ethicon, box isi 12 2,00 Box isi 12 144.400,30 288.800,60
956 PROLENE 3-0 26MM REV CUT W 8684 ethicon, box isi 12 2,00 Box isi 12 84.621,90 169.243,80
957 PROLENE 4-0 8604 G CLEAR ethicon, box isi 12 1,00 Box isi 12 126.000,60 126.000,60
958 PROLENE BLU 4-0 45CM 3/8 8619 G ethicon,box isi 12 2,00 Box isi 12 123.337,50 246.675,00
959 PROLENE 4-0 17MM 1/2 D/A W 8935 ethicon, box isi 12 1,00 Box isi 12 124.304,40 124.304,40
960 PROLENE BLU 5-0 60CM 1/2 13 8205 H ethicon, box isi 36 2,00 Box isi 36 219.186,00 438.372,00
961 PROLENE BLU 5-0 45CM 3/8 13 8605 G ethicon, box isi 12 6,00 Box isi 12 126.000,60 756.003,60
963 PROLENE UND 45 CM MO.7 8606 G ethicon, box isi 12 8,00 Box isi 12 126.000,60 1.008.004,80
1011 SURGICEL GAUZE 5 X 7.5 CM W 1913T box isi 24, J&J 1,00 Box isi 24 89.370,60 89.370,60
1028 VICRYL CTD 1 40 1/2C RB W 9431 ethicon, box isi 12/ vcp359H 1,00 Box isi 12
94.033,50 94.033,50
1029 VICRYL CTD 2/0 25MM 0.5C O W 9121 ethicon ,box isi 12 /vcp317H 2,00 Box isi 12
83.944,30 167.888,60
1030 VICRYL VIO 2/0 90MM M3V-34 W 9463 ethicon, box isi 12/ 5,00 Box isi 12
vcp517H/isi 36 92.761,90 463.809,50
1032 VICRYL CTD 3/0 26MM RE CT W 9890 ethicon, box isi 12 3,00 Box isi 12 78.686,30 236.058,90
1033 VICRYL CTD 3/0 20MM 0.5C O W 9114 ethicon, box isi 12 3,00 Box isi 12 93.522,00 280.566,00
1034 VICRYL CTD 4/0 19MM RE CUT W 9386 ethicon, box isi 36 /vcp392H 2,00 Box isi 12
74.446,90 148.893,80
1035 VICRYL CTD 4/0 16MM 0.5C O W 9106 ethicon, box isi 12 /vcp304H 45,00 Box isi 12
83.265,60 3.746.952,00
1036 VICRYL CTD 5/0 12MM CUR REV W 9501 T ethicon, box isi 24 1,00 Box isi 24 120.192,60 120.192,60
1037 VICRYL CTD 5/0 16MM 0.5C O W 9105 ethicon ,box isi 12 /vcp303H 11,00 Box isi 12
box isi 36 82.248,10 904.729,10
1038 VICRYL CTD UND 6/0 11MM P-1 W 9500 T ethicon, box isi 24 1,00 Box isi 24
120.234,40 120.234,40
1068 DERMABOND 2 SKIN ADHESIVE HV PRECISION ethicon AHV6 box isi 6 3,00 Box Isi 6
252.678,80 758.036,40
1160 PROLENE BLU 4-0 90CM RB-1 W8557 ethicon, box isi 36, box isi 12 3,00 Box isi 12
144.400,30 433.200,90
Total 13.019.948,70
PT. Restu Ibu Sejati

Harga satuan
(Rp)
2 Disp.Barium Enema Kit + Asesoris E-Z-EM 18,00 Set 676.500,00 12.177.000,00
5 Jarum Disp. No. 30 Nipro 200,00 Buah 495,00 99.000,00
8 Kapsul kosong no.3 Brataco 3.000,00 Buah 66,00 198.000,00
9 Cotton Buds 100's (Baby) Casson J & J 65,00 Pak 9.350,00 607.750,00
10 Botol 30 ml + Tutup beling 500,00 Buah 1.782,00 891.000,00
13 Pot Obat 100 ml + tutup - 300,00 Buah 1.210,00 363.000,00
14 Pot Obat 50 ml + tutup - 400,00 Buah 528,00 211.200,00
17 Kapsul kosong no.1 Brataco 10.000,00 Pieces 66,00 660.000,00
19 Kantong Plastik uk. 1 kg Tmpt Obat/Alkes Lokal 100,00 KG 39.600,00 3.960.000,00
Page 15 of 18
Harga satuan
(Rp)
20 Kantong Plastik uk. 0,5 kg Tmpt Obat/Alkes Lokal 10,00 KG 39.600,00 396.000,00
37 Autoclave Tape 50,00 Roll 107.800,00 5.390.000,00
44 Label steam Art No.240-871 Green Intergastra 6,00 Box 7.150.000,00 42.900.000,00
45 Label steam Art No.240-874 Yellow gke-GmbH,Germany 6,00 Box 7.150.000,00 42.900.000,00
46 Kapas lidi 500 7.500,00 Pieces 385,00 2.887.500,00
47 Kasa Lipat besar 10 x 10 cm Gauze Pad , 10x10cm 16 Ply X- 5.000,00 Pieces
ray detectable 2.145,00 10.725.000,00
50 Tutup Kepala Disp. Pria (Doos Isi 100) Hospilab. 10,00 Doos 99.000,00 990.000,00
51 Tutup Kepala Disp.Wanita (Doos Isi 100) Hospilab 30,00 Doos 85.800,00 2.574.000,00
56 Cervix Brush 200,00 Buah 1.870,00 374.000,00
60 Kantong Plastik Uk. 0,25 Kg Tmpt Obat/alkes Lokal 30,00 Kilogram
39.600,00 1.188.000,00
68 Botol 50 ml + Tutup beling 150,00 Buah 1.870,00 280.500,00
69 Kasa Kecil Uk 6 cm x 6 cm Solamed, JRS 50.000,00 Lembar 781,00 39.050.000,00
70 Kasa sedang/ Uk 7,5cm x 7,5cm Solamed, JRS 50.000,00 Lembar 968,00 48.400.000,00
72 Gaas Perut 8 Play Uk 35 x 35 cm (35358SM) Solamed, 240,00 Pieces
15.180,00 3.643.200,00
73 Roll Gaas 8 Play 90 x 12 cm ( J90128SM) Solamed 240,00 Roll 13.860,00 3.326.400,00
80 Pampers XL dewasa 6,00 Pak 52.800,00 316.800,00
83 Kasa Besar UK 12 x 12 cm X-Ray 2.500,00 Lembar 2.090,00 5.225.000,00
85 NAP / Pen Grafik Hijau - 2,00 Botol 1.078.000,00 2.156.000,00
86 NAP / Pen Grafik Merah - 2,00 Botol 1.078.000,00 2.156.000,00
88 Kertas Printer Autocl Udono BU 80(isi 2 Set) kokusai 2,00 Box
1.083.500,00 2.167.000,00
89 Teplon Mesin Press Wifak - 2,00 Buah 214.500,00 429.000,00
90 Karet Panbel Mesin Press Wifak - 2,00 Buah 231.000,00 462.000,00
92 Bowiedick DC02 Intergastra 1,00 Box Isi 20 2.255.000,00 2.255.000,00
93 TST AC Double Streps Intergastra 5,00 box isi 260 638.000,00 3.190.000,00
95 Cotton Tripped Applicator,Surgilab Applicator,Surgilab 2,00 Box 275.000,00 550.000,00
443 Bouffant Nurse 's Cap Hospilab Hospilab 4,00 Pak 176.000,00 704.000,00
453 Surgeon Cap / Hod cap Hospilab 2,00 Doos 209.000,00 418.000,00
734 Tampon Vagina (1053SM) 700,00 Pieces 5.390,00 3.773.000,00
736 Grafik PAC 50 intergastra 100,00 Pak 3.146.000,00 314.600.000,00
791 Tip Blue /500 bh ITALIANA 60,00 Pak 132.000,00 7.920.000,00
811 Falcon 1008 - 1,00 Box 3.520.000,00 3.520.000,00
812 Nuncleon TC Dish - 5,00 Pak 4.972.000,00 24.860.000,00
813 Denuding MLX 275 / 14319 Dipa,pak / 20 5,00 Pak 2.695.000,00 13.475.000,00
814 Wipak No. 7 Steriking - 3,00 Box 2.640.000,00 7.920.000,00
822 Denuding MLX 150 / 14305 Dipa,pak / 20 12,00 Pak 4.015.000,00 48.180.000,00
823 Embryo Transfer K-JETS 6019-SIVF COOK - 50,00 Buah 1.452.000,00 72.600.000,00
827 Stripper Tips # MXL 3 - CC (1000UM) 20/Pack 9,00 Pak 3.795.000,00 34.155.000,00
828 Ovum Asp Single Lumen UHO Nedle K-OSN-1730-A-60/Nedle 50,00 Buah
K-OSN-1730-17-60
1.034.000,00 51.700.000,00
833 Urine Container cat. 102548-tutup merah box isi 200 2,00 Box 1.815.000,00 3.630.000,00
837 Denuding 14301 - 7,00 Pak Isi 20 2.695.000,00 18.865.000,00
839 Pre Treatment Filter Cartridge - 1,00 Set 5.830.000,00 5.830.000,00
840 Progard T3 Pack / PROG 000 T3 Progard T3 Pack For Ro Cart. 1,00 Pak
Optimum protect 6.875.000,00 6.875.000,00
841 Q PAK TEX / Q PAK 00T EX Q PAK TEX ( Organix Resin ) 1,00 Pak
Cartridge Filter 7.260.000,00 7.260.000,00
842 TANK MPK 01 / Vent Filter for PE Vent Filter for PE Reservoir 60 1,00 Pak
ltr 3.410.000,00 3.410.000,00
847 TDT ( REF: 1308000 Set TDT, Lot 1161/R260) - 15,00 Buah
836.000,00 12.540.000,00
857 BARAKSCORT DISP.(APRON) box isi 100 10.000,00 Lembar 3.080,00 30.800.000,00
858 BASIC BREATH SYSTEM 4508 intersurgical 190,00 Pieces 429.000,00 81.510.000,00
861 BREATH SYSTEM T-KIT 2506 intersurgical 150,00 Pieces 52.800,00 7.920.000,00
863 CHAMBER MR290 fisher & paykel 300,00 Pieces 291.500,00 87.450.000,00
991 SPUIT 3 CC NIPRO nipro, box isi 100 75.000,00 Pieces 979,00 73.425.000,00
1012 SURGILAB FACE MASK/LEMBAR (OK) box isi 50 5.000,00 Lembar 1.980,00 9.900.000,00
1063 JACKSON REES/ADULT T-PIECE 2 L 2108 intersurgical 5,00 Pieces
264.000,00 1.320.000,00
1064 JACKSON REES/INFANT T-PIECE 0.5 L 2122 intersurgical 5,00 Pieces 462.000,00 2.310.000,00
1080 PAMPERS BABY SWEETY S 800,00 Pak 20.350,00 16.280.000,00
1092 TISSUE LIVI EVO HAND TOWEL box isi 24 6.000,00 Roll 7.920,00 47.520.000,00
1138 OXICENCOR LCS 30,00 Pieces 348.700,00 10.461.000,00
1159 OXICENSOR II SP02 COM N masimo 120,00 Pieces 319.000,00 38.280.000,00
1162 MASKER PAED 1122 intersurgical 5,00 Pieces 145.200,00 726.000,00
Page 16 of 18
Harga satuan
(Rp)
1185 BASIC BREATH PAED 2142 intersurgical 40,00 Pieces 132.000,00 5.280.000,00
1193 FILTER 1644 intersurgical 100,00 Pieces 60.500,00 6.050.000,00
30 Disp Stik Pengukur Kdr Gula Dlm Darah Tube Isi 30,Gluko DR,Terumo 6.500,00 Pieces
7.370,00 47.905.000,00
63 Cartridge 8-170 EO steri Gas 3M ( box/12 klg ) 120,00 Kaleng 319.000,00 38.280.000,00
71 Kasa Heacting Up Uk. 5cm x 8 cm ( 3215SM) Solamed , JRS 24,00 Box Isi 100
129.800,00 3.115.200,00
74 Tampon Roll/ Gauze Roll 150 x 5 cm (20160SM) Solamed / JRS 400,00 Roll
8.470,00 3.388.000,00
834 Denuding 14313 Internal Diameter 0,146- 17,00 Pieces
0,155mm 2.695.000,00 45.815.000,00
Total 1.681.694.850,00
PT. Sentra Asia Gemilang

Harga satuan
(Rp)
868 COLOSTOMY CONVATEC (22771) 38MM convatec, actife life 1pc 75,00 Pieces 51.905,70 3.892.927,50
906 FOLLEY CATH FR 12 BARD 2way,bardia, box isi 10 10,00 Pieces 15.785,00 157.850,00
1055 DUODERM CGF DRESSING 4 X 4 lembar 4 x 4 convatec 30,00 Pieces 87.964,80 2.638.944,00
1056 CLAMP SURFIT TAIL CLOSURE 175635 -CONVATEC 3,00 Pieces 46.407,90 139.223,70
1070 NEBULIZER MASK CHILD 1063 uroplast 25,00 Pieces 46.970,00 1.174.250,00
1071 NEBULIZER MASK ADULT 1061 uroplast 25,00 Pieces 46.970,00 1.174.250,00
1125 E T T NO 3.0 EUROMEDICAL euromedical 5,00 Pieces 45.870,00 229.350,00
1126 E T T NO.3.5 EUROMEDICAL euromedical 5,00 Pieces 45.870,00 229.350,00
1155 UNDERPAD NICE CARE 60 X 90 - 50,00 Pak 5.313,00 265.650,00
1156 GLOVE NON STERIL SIZE S FREE POWDER win 125,00 Box 48.895,00 6.111.875,00
1157 GLOVE NON STERIL SIZE M FREE POWDER WIN 75,00 Box 48.895,00 3.667.125,00
1158 GLOVE NON STERIL SIZE XS FREE POWDER win 50.000,00 Lembar 489,50 24.475.000,00
1163 STOMAHESIVE PASTA convatec 60,00 Tube 255.486,00 15.329.160,00
1164 DUODERM EXTRATHIN pak isi 10 lbr 4x4 convatec 275,00 Pieces 39.454,80 10.850.070,00
1199 AQUACEL 10 x 10 pak isi 10 180,00 Pieces 104.781,60 18.860.688,00
1201 STOMAHESIVE POWDER convatec 25,00 Tube 194.040,00 4.851.000,00
1222 COLOSTOMY CONVATEC 20922 convatec, actife live 1pc 200,00 Pieces 88.473,00 17.694.600,00
1224 DUODERM HYDROACTI GEL tube,hydroactive gel convatec 15,00 Tube
80.311,00 1.204.665,00
1226 KALTOSTAT ROPE 2 GR - 10,00 Pieces 102.194,40 1.021.944,00
1227 KALTOSTAT DRESSING 7.5 X 12 CM CONVATEC 60,00 Lembar 81.658,50 4.899.510,00
Total 119.555.482,20
PT. Tirta Raditya Indonesia

Harga satuan
(Rp)
4 Jarum Disp. No. 27 Terumo 200,00 Buah 482,90 96.580
11 Kantong Plastik Uk. 1 Ons Tmpt Obat/Alkes - 20,00 KG 33.550,00 671.000
12 Pot Obat 200 ml + tutup - 400,00 Buah 1.342,00 536.800
25 Botol 100 ml +Tutup beling 500,00 Buah 1.342,00 671.000
27 CR Film Uk. 20 x 25 Kodak, Box/125 pcs 24,00 box isi 125 23.413,50 561.924
31 Kertas ECG 1 Chaenel Fukuda ME 40,00 Roll 33.550,00 1.342.000
36 Kertas USG Echo UPC- 21 L Sony / Color printing ,4 4,00 Pak
dimensi 402.600,00 1.610.400
59 Spalk Kayu Spalk 50,00 Buah 69.300,00 3.465.000
67 Botol 200 ml +Tutup beling 150,00 Botol 2.684,00 402.600
76 Kapas Gigi 7.500,00 Buah 134,20 1.006.500
117 Kassa Hydrophile / Kas Gulung SN / Gulung 2,00 Roll 134.200,00 268.400
246 Fixomull Trasparent 72216-00 10 m x 5 cm 10,00 Roll 100.650,00 1.006.500
614 Blades No 12 B. Braun 3,00 Box 93.940,00 281.820
761 Deck Glass 18 X 18 mm, /20 pc Superior 18,00 Pak 40.260,00 724.680
762 Deck Glass 24 X 24 mm,/20pc Superior 15,00 Pak 40.260,00 603.900
763 Deck Glass 24 X 60 mm,20 pcs Superior 15,00 Pak 40.260,00 603.900
764 Objeck Glass Preclean Biozatic Essco 80,00 Pak 20.130,00 1.610.400
769 Lancet blood ,200 Pcs Misawa. 15,00 Box 114.070,00 1.711.050
782 Kertas Pembersih Lensa - 6,00 Pak 33.550,00 201.300
870 CYSTOFIX 12 CM bbraun 10,00 Pieces 425.950,80 4.259.508
917 HEPAFIX L LOCK 17G/1.4MM bbraun 5,00 Pieces 281.820,00 1.409.100
934 LAMINARIA STICK L box isi 12 24,00 Pieces 100.650,00 2.415.600
935 LAMINARIA STICK M box isi 12 12,00 Pieces 100.650,00 1.207.800
937 MEDIFIX LUER LUCK bbraun 10,00 Pieces 100.972,30 1.009.723
969 SAFIL 0 HR 40 S bbraun, box isi 36 200,00 Pieces 83.740,80 16.748.160
984 SPINOCAN G 25 NEEDLE bbraun 100,00 Pieces 24.156,00 2.415.600
Page 17 of 18
Harga satuan
(Rp)
1079 KACA MATA GOOGLE 200,00 Pieces 22.814,00 4.562.800
1103 PEN NEEDLE 31GX5 NORDIC/BD MICROFINE box 100 200,00 Pieces 3.335,20 667.040
1119 ANDALAN I.U.D TCU 380A Safe Load 15,00 Pieces 33.550,00 503.250
1120 ANDALAN I.U.D SILVERLINE 380 60,00 Pieces 33.550,00 2.013.000
1229 LEUKOMED I.V 6 CM X 8 CM 50,00 Pieces 3.300,00 165.000
1231 NASAL CANNULA PREMATURE /Salter Labs 1610 10,00 Pieces
8.030,00 80.300
1031 VICRYL 3/0 CUTT W 9511 H ethicon, box isi 24 24,00 Pieces 93.940,00 2.254.560
1173 TEGADERM 1626 3M,box isi 50 100,00 Pieces 16.104,00 1.610.400
850 ALCOHOL SWAB PASTIK pastik 750,00 Box Isi 100 53.680,00 40.260.000
922 INFUSION SET PAED 500 jms, box isi 25 600,00 Pieces 21.472,00 12.883.200
1000 STOMACH TUBE FR 12 (120cm) JMS jms, box isi 20 10,00 Pieces 17.446,00 174.460
Total 130.494.595,00
PT. Triputra Aman Makmur

Harga satuan
(Rp)
28 CR Film Uk. 28 x 35 Kodak, Box/125 pcs 18,00 box isi 125 3.261.500,00 58.707.000,00
29 CR Film Uk. 35 x 43 Kodak, Box/125 pcs 3,00 box isi 125 4.766.300,00 14.298.900,00
741 Sample Cup 1,5ml 1000 cup Siemens 20,00 Box 959.420,00 19.188.400,00
755 Cuvette Cartrige D 828 Siemens 18,00 Box 3.489.090,00 62.803.620,00
1020 TROCAR ENDO 355 SD 5 MM bladeless trocar,endpath 3,00 Pieces
5mm,100ml,xcel 1.100.000,00 3.300.000,00
1181 MULTIFIRE GIA 60 - 6038 S /DST auto suture ,DST 5,00 Pieces 3.475.200,00 17.376.000,00
1189 MULTIFIRE DST GIA 60-6038 L auto suture, DST 15,00 Pieces 726.000,00 10.890.000,00
1196 MULTIFIRE DST GIA 80 - 8048 S auto suture 3,00 Pieces 3.475.200,00 10.425.600,00
1205 TROCART VERSAPORT 5-11 MM covidien 5,00 Pieces 1.100.000,00 5.500.000,00
1214 MULTIFIRE GIA80-4.8 8048L auto suture 8,00 Pieces 726.000,00 5.808.000,00
1215 MULTIFIRE GIA80-3.8 8038L /DST auto suture, DST 3,00 Pieces 660.000,00 1.980.000,00
39 Bowie Dick Test gdm 280,00 Pak 116.600,00 32.648.000,00
Total 242.925.520,00
PT. Unolab Mitra Persada

Harga satuan
(Rp)
23 Spatula lidah kayu Lokal 5.000,00 Buah 374,00 1.870.000,00
34 Kertas Tiup Paru-Paru (Doos Isi 100) Minato 3,00 Doos 880.000,00 2.640.000,00
48 Masker tie on 50 OneMed,Sensi,Win,Remedi 180,00 Doos 19.800,00 3.564.000,00
49 Masker ear loop 50 OneMed.Sensi,Win.Remedi 30,00 Doos 20.900,00 627.000,00
52 Masker Disp. N95 German OneMed 10,00 Buah 15.400,00 154.000,00
57 Objeck Glass ,72 pc/pak (slides) Sail Brand 60,00 Pak 13.200,00 792.000,00
739 Centrifuge Tube Steril 15 ml /25 bh 430791 Corning 18,00 Pak
153.500,00 2.763.000,00
742 Sample Cup 1,5 ml ,1000 pc lokal 15,00 Pak 220.000,00 3.300.000,00
748 Transfer Pipet 3 ml , 500 buah NAZ 10,00 Pak 220.000,00 2.200.000,00
752 Feses Container + sendok Lokal 1.800,00 Buah 1.760,00 3.168.000,00
766 Printer Paper 110 X 30 ml. Thermalindo 120,00 Roll 18.700,00 2.244.000,00
767 Printer Paper 57 X 30 ml. Thermalindo 120,00 Roll 11.000,00 1.320.000,00
770 K3 EDTA ,2 ml .IDO 30-E2P / 100 bh Indolab 60,00 Pak 198.000,00 11.880.000,00
780 TC Flask , 25cm Plug seal Cap 430168 Corning 9,00 Pak 385.000,00 3.465.000,00
783 Tabung Kaca 13 x 100mm Pyrex 10,00 Pak 550.000,00 5.500.000,00
784 Urine Container Non steril 60ml OM 6.000,00 Buah 1.100,00 6.600.000,00
786 Tabung kaca 12 x 75 mm Pyrex 10,00 Pak 495.000,00 4.950.000,00
790 Tabung Plastik 12 x 75 mm / 1000pc Lokal 10,00 Pak 385.000,00 3.850.000,00
792 Urine Container Steril 60ml OM 1.800,00 Buah 1.870,00 3.366.000,00
793 Transfer Pipet 3 ml Steril, 31027003A microgen 5,00 Pak 1.100.000,00 5.500.000,00
794 Transfer Pipet 1 ml Steril, 31027001A microgen 5,00 Pak 1.100.000,00 5.500.000,00
800 Parafilm 4 x 1,25 - 15,00 Buah 423.500,00 6.352.500,00
817 Pipet Pasteur Brand 230 mm (1000) - 2,00 Box 687.500,00 1.375.000,00
838 Blue Tip Effendrof 5,00 Box Isi 1000 165.000,00 825.000,00
Total 98.040.500,00
TTD.
KELOMPOK KERJA PENGADAAN BARANG
ULP RSAB HARAPAN KITA
Page 18 of 18

Pengumuman Alkes 2015

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RUMAH SAKIT ANAK DAN BUNDA HARAPAN KITA

Jl. Let. Jen. S. Parman Kav. 87, Jakarta Barat

Nomor : ULP.00.03.11.003.9 Jakarta, 24 Februari 2015

Demikian untuk diketahui.

PT. BUMI INDAH MEDIKA

PT. CIPTA SUKSES MEDIKA

PT. Dos Ni Roha

PT. IDS Medical Systems

PT. Kimia Farma T&D

PT. Medquest Jaya Global

PT. Parazelsus Indonesia

PT. Restu Ibu Sejati

PT. Sentra Asia Gemilang

PT. Tirta Raditya Indonesia

PT. Triputra Aman Makmur

PT. Unolab Mitra Persada

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