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DAFTAR INFORMASI HARGA PERALATAN KESEHATAN & LABORATORIUM

EFEKTIF 1 JANUARI 2005 S/D 31 DESEMBER 2005

No. Nama Peralatan Negara Asal/ No. Registrasi HJSA


Model/Tipe Merk Satuan Sole Agent
Urut Kesehatan Pabrikan DepKes RI (Rp)
1 Test Gula Darah Ascensia Elite Bayer Diagnostics Amerika Serikat AKL 10101303502 1 Unit 1,100,000 PT Barito Budi Pharmindo
2 Urine Analyzer Clinitek Status Bayer Diagnostics Inggris AKL 10102403806 1 Unit 18,000,000 PT Barito Budi Pharmindo
3 Urine Analyzer Clinitek 500 Bayer Diagnostics Amerika Serikat AKL 10102400463 1 Unit 75,000,000 PT Barito Budi Pharmindo
4 Hematology Analyzer Advia 60 Bayer Diagnostics Perancis AKL 20205300367 1 Unit 130,000,000 PT Barito Budi Pharmindo
5 Hematology Analyzer Advia 120 Bayer Diagnostics Inggris AKL 20205300365 1 Unit 950,000,000 PT Barito Budi Pharmindo
6 Photometer RA 50 Bayer Diagnostics Irlandia AKL 10101303503 1 Unit 90,000,000 PT Barito Budi Pharmindo
7 Clinical Chemistry Analyzer Express Plus Bayer Diagnostics Amerika Serikat AKL 10102301423 1 Unit 450,000,000 PT Barito Budi Pharmindo
8 Blood Gas Analyzer Rapidlab 248 Bayer Diagnostics Inggris AKL 20102303725 1 Unit 250,000,000 PT Barito Budi Pharmindo
9 Electrolyte Analyzer Rapidchem 744 Bayer Diagnostics Amerika Serikat AKL 10101400528 1 Unit 90,000,000 PT Barito Budi Pharmindo
DAFTAR INFORMASI HARGA PERALATAN KESEHATAN & LABORATORIUM
EFFECTIVE : SEPTEMBER 2005 S/D DESEMBER 2006

No Nama Barang/Produk MODEL/TYPE NEGARA ASAL/PABRIKAN Satuan No.Registrasi HJSA SOLE AGENT
(1) (2) (3) (4) (5) (6) (7) (8)
1 COMPUTERIZED DENTAL X-RAY IRIX WALL MOUNTED STD ARM Trovi Rajawali Indonesia / Perancis unit KD 1501590001 93,750,000 PT.Rajawali Nusindo
2 COMPUTERIZED DENTAL X-RAY IRIX WALL MOUNTED SCC ARM Trovi Rajawali Indonesia / Perancis unit KD 1501590001 121,250,000 PT.Rajawali Nusindo
3 COMPUTERIZED DENTAL X-RAY IRIX MOBILE STD ARM Trovi Rajawali Indonesia / Perancis unit KD 1501590001 108,750,000 PT.Rajawali Nusindo
4 COMPUTERIZED DENTAL X-RAY IRIX MOBILE SCC ARM Trovi Rajawali Indonesia / Perancis unit KD 1501590001 127,750,000 PT.Rajawali Nusindo
5 COMPUTERIZED DENTAL X-RAY SPACIX CCX TIMER Trovi Rajawali Indonesia / Perancis unit KD 1501590010 113,750,000 PT.Rajawali Nusindo
6 RADIOVISIOGRAPHY ULTIMATE IMAGING RVG UI ZISE 1 ( 20 X 30 ) Trovi Rajawali Indonesia / Perancis unit KD 1501590009 402,062,500 PT.Rajawali Nusindo
7 RADIOVISIOGRAPHY ULTIMATE IMAGING RVG UI USB ZISE 1 ( 20 X 30 ) Trovi Rajawali Indonesia / Perancis unit KD 1501590009 410,750,000 PT.Rajawali Nusindo
8 Intra Oral Camera STOMAVISION - STV KIT Trovi Rajawali Indonesia / Perancis set KD 1501590009 256,750,000 PT.Rajawali Nusindo
9 PANORAMIC X-RAY UNIT w/o Cephalometri Ortho Slice - OS 500 Trovi Rajawali Indonesia / Perancis unit KD 1501590005 1,109,937,500 PT.Rajawali Nusindo
10 PANORAMIC X-RAY UNIT w/o Cephalometri Ortho Slice - OS 500 C Trovi Rajawali Indonesia / Perancis unit KD 1501590005 1,349,500,000 PT.Rajawali Nusindo
11 PANORAMIC X-RAY UNIT w/o Cephalometri Ortho Slice - OS 1000 E Trovi Rajawali Indonesia / Perancis unit KD 1501590005 1,274,000,000 PT.Rajawali Nusindo
12 PANORAMIC X-RAY UNIT w/o Cephalometri Ortho Slice - OS 1000 Trovi Rajawali Indonesia / Perancis unit KD 1501590005 1,354,750,000 PT.Rajawali Nusindo
13 PANORAMIC X-RAY UNIT w/o Cephalometri Ortho Slice - OS 1000 EP Trovi Rajawali Indonesia / Perancis unit KD 1501590005 1,437,187,500 PT.Rajawali Nusindo
14 PANORAMIC X-RAY UNIT w/o Cephalometri Ortho Slice - OS 1000 P Trovi Rajawali Indonesia / Perancis unit KD 1501590005 1,517,000,000 PT.Rajawali Nusindo
15 PANORAMIC X-RAY UNIT w/o Cephalometri Ortho Slice - OS 1000 CE Trovi Rajawali Indonesia / Perancis unit KD 1501590005 1,549,500,000 PT.Rajawali Nusindo
16 PANORAMIC X-RAY UNIT w/o Cephalometri Ortho Slice - OS 1000 C Trovi Rajawali Indonesia / Perancis unit KD 1501590005 1,626,625,000 PT.Rajawali Nusindo
17 Accessories Digipan - DIGIPOS 500 Trovi Rajawali Indonesia / Perancis unit KD 1501590005 795,812,500 PT.Rajawali Nusindo
18 Accessories Digipan - DIGIPOS 1000 Trovi Rajawali Indonesia / Perancis unit KD 1501590005 795,812,500 PT.Rajawali Nusindo
19 Accessories Tomography KIT - OS 1000 KT Trovi Rajawali Indonesia / Perancis unit KD 1501590005 123,812,500 PT.Rajawali Nusindo
20 Accessories Cephalometri - OC 1000 CK Trovi Rajawali Indonesia / Perancis unit KD 1501590005 288,662,500 PT.Rajawali Nusindo
21 Manual Panoramic Dentorama Plus Floor Mount, 220 V Trovi Rajawali Indonesia / Italy unit AKD 20601500119 848,726,750 PT.Rajawali Nusindo
22 Manual Panoramic with Cephalometri Dentorama Plus CEPH Floor Mount, 220 V Trovi Rajawali Indonesia / Italy unit AKD 20601500119 971,391,250 PT.Rajawali Nusindo
23 Digital Panoramic Dentorama Digital Trovi Rajawali Indonesia / Italy unit AKD 20601500119 2,087,638,000 PT.Rajawali Nusindo
24 Digital Panoramic with Cephalometri Dentorama Digital, analog ceph ready 18x24cm Trovi Rajawali Indonesia / Italy unit AKD 20601500119 2,130,570,500 PT.Rajawali Nusindo
25 Mobile X-Ray Unit 60 mA OMNIX N 60 Trovi Rajawali Indonesia / Perancis unit AKD 21501500210 272,500,000 PT.Rajawali Nusindo
26 Mobile X-Ray Unit 100 mA OMNIX N 100 HF Trovi Rajawali Indonesia / Perancis unit AKD 21501500210 737,879,250 PT.Rajawali Nusindo
27 Mobile X-Ray Unit 250 mA Motorized MOVIX 16 PRO Trovi Rajawali Indonesia / Perancis unit AKL 21501501824 1,694,605,500 PT.Rajawali Nusindo
28 Mobile X-Ray Unit 320 mA Motorized MOVIX 20 PRO Trovi Rajawali Indonesia / Perancis unit AKL 21501501824 1,931,379,250 PT.Rajawali Nusindo
29 General purpose x-ray 100 mA OMNIX N 100 ST + TFS 3 Trovi Rajawali Indonesia / Perancis set KD 1501590006 651,250,000 PT.Rajawali Nusindo
30 General purpose x-ray 200 mA OMNIX N 200 ST + TPF 1 Trovi Rajawali Indonesia / Perancis set KD 1501590006 980,250,000 PT.Rajawali Nusindo
31 General purpose x-ray 300 mA OMNIX N 300 ST + TPF 1 Trovi Rajawali Indonesia / Perancis set KD 1501590006 1,087,500,000 PT.Rajawali Nusindo
32 General purpose x-ray 400 mA HF N 400 HF /RAD ROOM SET Trovi Rajawali Indonesia / Perancis set AKD 21501500213 1,548,637,500 PT.Rajawali Nusindo
DAFTAR INFORMASI HARGA PERALATAN KESEHATAN & LABORATORIUM
EFFECTIVE : SEPTEMBER 2005 S/D DESEMBER 2006

No Nama Barang/Produk MODEL/TYPE NEGARA ASAL/PABRIKAN Satuan No.Registrasi HJSA SOLE AGENT
(1) (2) (3) (4) (5) (6) (7) (8)
33 General purpose x-ray 500 mA+Tilting Table TRII + TBM Trovi Rajawali Indonesia / Korea set dlm proses 1,625,000,000 PT.Rajawali Nusindo
34 General purpose x-ray 500 mA+Floating Table N500HF + TPF1S+PM 1 Trovi Rajawali Indonesia / Perancis set KD 1501590006 2,250,000,000 PT.Rajawali Nusindo
35 General purpose x-ray 500 mA+Tilting Table N500HF + TBM 1 Trovi Rajawali Indonesia / Perancis set KD 1501590006 1,875,000,000 PT.Rajawali Nusindo
36 General purpose x-ray 500 mA+RF Table N500HF + TBM 5 V2 Trovi Rajawali Indonesia / Perancis set KD 1501590006 3,750,000,000 PT.Rajawali Nusindo
37 General purpose x-ray 500 mA + RC Table N500HF + EVOLUTION E+ Trovi Rajawali Indonesia / Perancis set KD 1501590006 6,912,500,000 PT.Rajawali Nusindo
38 General purpose x-ray 500 mA + RC Table+I N500HF + EVOLUTION E+I Trovi Rajawali Indonesia / Perancis set KD 1501590006 7,800,000,000 PT.Rajawali Nusindo
39 C-Arm Unit C-Arm SB Trovi Rajawali Indonesia / Italy unit Dlm proses 3,750,000,000 PT.Rajawali Nusindo
40 C-Arm Unit C-Arm RB Trovi Rajawali Indonesia / Italy unit Dlm proses 4,250,000,000 PT.Rajawali Nusindo
41 Mammography Mammograph Trovi Rajawali Indonesia / Italy unit AKD 21501500117 2,250,000,000 PT.Rajawali Nusindo
42 CT-Scan CT SCAN ANATOM - ASR 800 Analogic Scientific / USA unit Dlm proses 8,437,500,000 PT.Rajawali Nusindo
43 MRI MRI Analogic Scientific / USA unit Dlm proses 16,250,000,000 PT.Rajawali Nusindo
44 CT-Scan Injector ASA-200E CT injector Analogic Scientific / USA unit Dlm proses 425,000,000 PT.Rajawali Nusindo
45 TERAPHY UNIT Cobalt - 60 Teletheraphy Unit / Type: GWGP80 A Analogic Scientific / USA unit Dlm proses 10,000,000,000 PT.Rajawali Nusindo
46 TERAPHY UNIT Cobalt - 60 Teletheraphy Unit / Type: GWXJ80 Analogic Scientific / USA unit Dlm proses 11,250,000,000 PT.Rajawali Nusindo
47 TERAPHY UNIT Medical LINAC Analogic Scientific / USA unit Dlm proses 11,875,000,000 PT.Rajawali Nusindo
48 RF Table + II 9" + TV Monitor TBM 5 Trovi Rajawali Indonesia unit KD 1501590006 2,302,750,000 PT.Rajawali Nusindo
49 RC/RF Table + II 9" + TV Monitor EVOLUTION Trovi Rajawali Indonesia unit KD 1501590006 6,116,500,000 PT.Rajawali Nusindo
50 X-ray Imager NRS CCD Trovi Rajawali Indonesia unit KD 1501590006 5,263,750,000 PT.Rajawali Nusindo
51 Standard Bucky Table TFS 3 Trovi Rajawali Indonesia unit KD 1501590006 68,000,000 PT.Rajawali Nusindo
52 Floating Bucky Table TPF 1 Trovi Rajawali Indonesia unit KD 1501590006 107,375,000 PT.Rajawali Nusindo
53 Cassette Holder PM 3 Trovi Rajawali Indonesia unit KD 1501590006 12,375,000 PT.Rajawali Nusindo
54 Stand Bucky PM 1 Trovi Rajawali Indonesia unit KD 1501590006 70,750,000 PT.Rajawali Nusindo
55 Automatic Processing Machine MICROMAC 3300 Trovi Rajawali Indonesia unit KD 1501690074 236,500,000 PT.Rajawali Nusindo
56 Automatic Processing Machine MICROMAC 3800 Trovi Rajawali Indonesia unit KD 1501690074 345,500,000 PT.Rajawali Nusindo
57 Automatic Processing Machine MICROMAC 5000 Trovi Rajawali Indonesia unit KD 1501690074 444,250,000 PT.Rajawali Nusindo
58 FILM GREEN SENSITIVE TRIMAX - G / 18 x 24 cm (100) Trovi Rajawali Indonesia box KD 1501690089 1,187,500 PT.Rajawali Nusindo
59 FILM GREEN SENSITIVE TRIMAX - G / 24 x 30 cm (100) Trovi Rajawali Indonesia box KD 1501690089 1,962,500 PT.Rajawali Nusindo
60 FILM GREEN SENSITIVE TRIMAX - G / 30 x 40 cm (100) Trovi Rajawali Indonesia box KD 1501690089 3,207,500 PT.Rajawali Nusindo
61 FILM GREEN SENSITIVE TRIMAX - G / 35 x 35 cm (100) Trovi Rajawali Indonesia box KD 1501690089 3,385,000 PT.Rajawali Nusindo
62 FILM GREEN SENSITIVE TRIMAX - G / 35 x 43 cm (100) Trovi Rajawali Indonesia box KD 1501690089 4,082,500 PT.Rajawali Nusindo
63 Developer liquid DEVELOPER, 20 Liter (LIQUID) Trovi Rajawali Indonesia btl KD 1501690089 1,487,500 PT.Rajawali Nusindo
64 Fixer Liquid FIXER, 20 Liter (LIQUID) Trovi Rajawali Indonesia btl KD 1501690089 917,500 PT.Rajawali Nusindo
DAFTAR INFORMASI HARGA PERALATAN KESEHATAN & LABORATORIUM
EFFECTIVE : SEPTEMBER 2005 S/D DESEMBER 2006

No Nama Barang/Produk MODEL/TYPE NEGARA ASAL/PABRIKAN Satuan No.Registrasi HJSA SOLE AGENT
(1) (2) (3) (4) (5) (6) (7) (8)
65 FILM BLUE SENSITIVE TRIMAX - B / 18 x 24 cm (100) Trovi Rajawali Indonesia box KD 1501690089 1,187,500 PT.Rajawali Nusindo
66 FILM BLUE SENSITIVE TRIMAX - B / 24 x 30 cm (100) Trovi Rajawali Indonesia box KD 1501690089 1,962,500 PT.Rajawali Nusindo
67 FILM BLUE SENSITIVE TRIMAX - B / 30 x 40 cm (100) Trovi Rajawali Indonesia box KD 1501690089 3,207,500 PT.Rajawali Nusindo
68 FILM BLUE SENSITIVE TRIMAX - B / 35 x 35 cm (100) Trovi Rajawali Indonesia box KD 1501690089 3,385,000 PT.Rajawali Nusindo
69 FILM BLUE SENSITIVE TRIMAX - B / 35 x 43 cm (100) Trovi Rajawali Indonesia box KD 1501690089 4,082,500 PT.Rajawali Nusindo
70 Developer serbuk DEVELOPER, (POWDER) Trovi Rajawali Indonesia dos KD 1501690089 560,000 PT.Rajawali Nusindo
71 Fixer serbuk FIXER, (POWDER) Trovi Rajawali Indonesia dos KD 1501690089 615,000 PT.Rajawali Nusindo
72 Cassette with Screen GREEN SENSITIVE Ukuran 18 x 24 cm Trovi Rajawali Indonesia set 4,812,500 PT.Rajawali Nusindo
73 Cassette with Screen GREEN SENSITIVE Ukuran 24 x 30 cm (100) Trovi Rajawali Indonesia set 6,462,500 PT.Rajawali Nusindo
74 Cassette with Screen GREEN SENSITIVE Ukuran 30 x 40 cm (100) Trovi Rajawali Indonesia set 9,350,000 PT.Rajawali Nusindo
75 Cassette with Screen GREEN SENSITIVE Ukuran 35 x 35 cm (100) Trovi Rajawali Indonesia set 9,625,000 PT.Rajawali Nusindo
76 Film Dryer - FD 1 Film Dryer - FD 1 Trovi Rajawali Indonesia pc 18,500,000 PT.Rajawali Nusindo
77 Viewer Single Viewer Single Trovi Rajawali Indonesia pc 3,500,000 PT.Rajawali Nusindo
78 Viewer Double Viewer Double Trovi Rajawali Indonesia pc 5,250,000 PT.Rajawali Nusindo
79 Viewer Triple Viewer Triple Trovi Rajawali Indonesia pc 5,500,000 PT.Rajawali Nusindo
80 Appron 0,5 mm Pb Appron 0,5 mm Pb Trovi Rajawali Indonesia pc 8,125,000 PT.Rajawali Nusindo
81 Lead Marker Lead Marker Trovi Rajawali Indonesia pc 5,250,000 PT.Rajawali Nusindo
82 Safety light Safety light Trovi Rajawali Indonesia pc 2,375,000 PT.Rajawali Nusindo
83 Cerobong Cerobong Trovi Rajawali Indonesia pc 2,925,000 PT.Rajawali Nusindo
84 Film Transfer Box Film Transfer Box Trovi Rajawali Indonesia pc 10,250,000 PT.Rajawali Nusindo
85 Manual Tank Developer 10 ltr Manual Tank Developer 10 ltr Trovi Rajawali Indonesia pc 7,500,000 PT.Rajawali Nusindo
86 Manual Tank Developer 20 ltr Manual Tank Developer 20 ltr Trovi Rajawali Indonesia pc 8,750,000 PT.Rajawali Nusindo
87 X-Ray Barrier X-Ray Barrier Trovi Rajawali Indonesia pc 87,750,000 PT.Rajawali Nusindo
88 Film Hanger (all size) Film Hanger (all size) Trovi Rajawali Indonesia set 3,687,500 PT.Rajawali Nusindo
Lysholm Grid Ratio 8:1 Lysholm Grid Ratio 8:1 PT.Rajawali Nusindo
89 Ukuran : 18x24 cm Ukuran : 18x24 cm Trovi Rajawali Indonesia pc 24,562,500 PT.Rajawali Nusindo
100 Ukuran : 24x30 cm Ukuran : 24x30 cm Trovi Rajawali Indonesia pc 28,075,000 PT.Rajawali Nusindo
111 Ukuran : 30x40 cm Ukuran : 30x40 cm Trovi Rajawali Indonesia pc 31,587,500 PT.Rajawali Nusindo
122 Ukuran : 35x35 cm Ukuran : 35x35 cm Trovi Rajawali Indonesia pc 35,125,000 PT.Rajawali Nusindo
133 Gloves, Merk E-Zem USA Gloves, Merk E-Zem USA Trovi Rajawali Indonesia pc 32,250,000 PT.Rajawali Nusindo
144 Pocket Dosimeter Pocket Dosimeter Trovi Rajawali Indonesia pc 58,500,000 PT.Rajawali Nusindo
155 Lead Glass 30x30 cm Lead Glass 30x30 cm Trovi Rajawali Indonesia pc 47,525,000 PT.Rajawali Nusindo
DAFTAR INFORMASI HARGA PERALATAN KESEHATAN & LABORATORIUM
EFFECTIVE : SEPTEMBER 2005 S/D DESEMBER 2006

No Nama Barang/Produk MODEL/TYPE NEGARA ASAL/PABRIKAN Satuan No.Registrasi HJSA SOLE AGENT
(1) (2) (3) (4) (5) (6) (7) (8)
Lysholm Grid Ratio 6:1 Lysholm Grid Ratio 6:1 PT.Rajawali Nusindo
156 Ukuran : 18x24 cm Ukuran : 18x24 cm Trovi Rajawali Indonesia pc 14,050,000 PT.Rajawali Nusindo
157 Ukuran : 24x30 cm Ukuran : 24x30 cm Trovi Rajawali Indonesia pc 17,550,000 PT.Rajawali Nusindo
158 Ukuran : 30x40 cm Ukuran : 30x40 cm Trovi Rajawali Indonesia pc 21,075,000 PT.Rajawali Nusindo
159 Ukuran : 35x35 cm Ukuran : 35x35 cm Trovi Rajawali Indonesia pc 24,575,000 PT.Rajawali Nusindo
160 Portable B/W USG SONEO Kontron Medical / France unit AKL 21501501354 570,000,000 PT.Rajawali Nusindo
161 B/W USG KUI 110 Light (V5) Kontron Ultrasound Indonesia unit KD 1501690087 650,000,000 PT.Rajawali Nusindo
162 B/W USG KUI 110 Master (V5) Kontron Ultrasound Indonesia unit KD 1501690087 700,000,000 PT.Rajawali Nusindo
163 USG COLLOR KUI 330 Master (V5) Kontron Ultrasound Indonesia unit AKD 215001500165 1,180,000,000 PT.Rajawali Nusindo
164 USG COLLOR - CD KUI 330 Expert (V5) Kontron Ultrasound Indonesia unit AKD 215001500165 1,540,000,000
165 USG COLLOR - 3D KUI 330 Excellence Kontron Ultrasound Indonesia unit AKD 215001500165 2,750,000,000
166 USG COLLOR IMAGIG 5000 Kontron Medical / France unit AKL 21501501355 2,375,000,000
167 Transducer 3.5 MHz CV convex transducer Kontron Ultrasound Indonesia pc AKD 215001500165 187,125,000
168 Transducer 3.5 MHz MC microconvex transducer Kontron Ultrasound Indonesia pc AKD 215001500165 292,125,000
169 Transducer 5 MHz LV linear transducer Kontron Ultrasound Indonesia pc AKD 215001500165 365,000,000
170 Transducer 6.5 MHz MC microconvex transducer Kontron Ultrasound Indonesia pc AKD 215001500165 354,375,000
171 Transducer 7.5 MHz LV linear transducer (50 mm) Kontron Ultrasound Indonesia pc AKD 215001500165 187,125,000
172 Transducer 7.5 MHz LVS linear transducer (38 mm) Kontron Ultrasound Indonesia pc AKD 215001500165 280,000,000
173 Transducer 3.5 MHz GP sector annular transducer Kontron Ultrasound Indonesia pc AKD 215001500165 280,000,000
174 Transducer 5 MHz GP sector annular transducer Kontron Ultrasound Indonesia pc AKD 215001500165 280,000,000
175 Transducer 7.5 MHz GP sector annular transducer Kontron Ultrasound Indonesia pc AKD 215001500165 280,000,000
176 Transducer 14 MHz PV (musculo-skeleton) Kontron Ultrasound Indonesia pc AKD 215001500165 305,250,000
177 Transducer 6.5 MHz MR endorectal multiplan transducer Kontron Ultrasound Indonesia pc AKD 215001500165 377,375,000
178 Transducer 6.5 MHz EV endovaginal/endorectal endfire Kontron Ultrasound Indonesia pc AKD 215001500165 272,375,000
179 Transducer 6.5 MHz VMC endovaginal/endorectal endfire Kontron Ultrasound Indonesia pc AKD 215001500165 272,375,000
180 Transducer 2 MHz PEN Doppler pencil transducer Kontron Ultrasound Indonesia pc AKD 215001500165 52,000,000
181 Transducer 4 MHz PEN Doppler pencil transducer Kontron Ultrasound Indonesia pc AKD 215001500165 52,000,000
182 Transducer 8 MHz PEN Doppler pencil transducer Kontron Ultrasound Indonesia pc AKD 215001500165 52,000,000
183 Transducer 2 MHz TCD transcranial Doppler pencil transducer Kontron Ultrasound Indonesia pc AKD 215001500165 60,750,000
184 PATIENT MONITOR BM TRI Kontron Medical / France unit AKD 20501400226 137,500,000
185 ANAESTHESY MACHINE ORSA 3 Kontron Medical / France unit AKL 20403400732 975,000,000
DAFTAR INFORMASI HARGA PERALATAN & LABORATORIUM
EFFECTIVE : OKTOBER 2005 S/D MARET 2006
PT. GRAHA ISMAYA, LTD

NO
NAMA PERALATAN KESEHATAN TIPE PRODUK MERK NEGARA ASAL NO. REGISTRASI SATUAN HJSA (RP) SOLE AGENT
URUT

1 PATIENT BED FULL ELECTRIC HCB-8332H ACARE TAIWAN DEPKES RI AKL 10902304272 UNIT Rp 45,182,000 PT. GRAHA ISMAYA

2 PATIENT BED FULL MANUAL 4 ENGKOL HCB-M0033 ACARE TAIWAN DEPKES RI AKL 10902304358 UNIT Rp 39,864,000 PT. GRAHA ISMAYA

3 PATIENT BED FULL MANUAL 3 ENGKOL HCB-M0032 ACARE TAIWAN DEPKES RI AKL 10902304357 UNIT Rp 37,273,000 PT. GRAHA ISMAYA

4 PATIENT BED FULL ELECTRIC AMP-240 A ACARE TAIWAN DEPKES RI AKL 10902500089 UNIT Rp 85,273,000 PT. GRAHA ISMAYA

5 PATIENT BED FULL ELECTRIC AMP-240 C ACARE TAIWAN DEPKES RI AKL 10902500090 UNIT Rp 122,364,000 PT. GRAHA ISMAYA

6 TRANSPORTATION STRECHER T 10 ACARE TAIWAN SEDANG DALAM PROSES UNIT Rp 54,410,000 PT. GRAHA ISMAYA

7 TRANSPORTATION STRECHER T 20A ACARE TAIWAN SEDANG DALAM PROSES UNIT Rp 76,637,000 PT. GRAHA ISMAYA

8 TRANSPORTATION STRECHER T 20B ACARE TAIWAN SEDANG DALAM PROSES UNIT Rp 126,091,000 PT. GRAHA ISMAYA

9 OVERBED TABLE 300 CS ACARE TAIWAN SEDANG DALAM PROSES UNIT Rp 7,682,000 PT. GRAHA ISMAYA

10 BED SIDE CABINET CB-204 ACARE TAIWAN SEDANG DALAM PROSES UNIT Rp 7,410,000 PT. GRAHA ISMAYA

11 NURSING CART NC5010 ACARE TAIWAN SEDANG DALAM PROSES UNIT Rp 51,910,000 PT. GRAHA ISMAYA

12 NURSING CART NC5010R ACARE TAIWAN SEDANG DALAM PROSES UNIT Rp 61,819,000 PT. GRAHA ISMAYA

13 EEG WITH BRAIN MAPPING Neurotrace-BM AKONIC SA ARGENTINA DEPKES RI AKL 21001302215 UNIT Rp 311,000,000 PT. GRAHA ISMAYA

14 EEG WITH POLYSOMNOGRAPHY Neurotrace-PSG AKONIC SA ARGENTINA DEPKES RI AKL 21001302216 UNIT Rp 410,455,000 PT. GRAHA ISMAYA

15 EEG (ELECTROENCHEPALOGRAPH) BIO PC-EEG AKONIC SA ARGENTINA DEPKES RI AKL 22001302217 UNIT Rp 325,091,000 PT. GRAHA ISMAYA

16 EEG (ELECTROENCHEPALOGRAPH) Neurotrace-EEG AKONIC SA ARGENTINA DEPKES RI AKL 21001302214 UNIT Rp 258,773,000 PT. GRAHA ISMAYA

17 EEG WITH BRAIN MAPPING BIO PC-BM AKONIC SA ARGENTINA DEPKES RI AKL 21001302219 UNIT Rp 465,728,000 PT. GRAHA ISMAYA

18 AUDIOMETER Model 160 AMPLIVOX LTD ENGLAND DEPKES RI AKL 20701402754 UNIT Rp 56,637,000 PT. GRAHA ISMAYA

19 AUDIOMETER PC 850 AMPLIVOX LTD ENGLAND DEPKES RI AKL 20701402755 UNIT Rp 215,728,000 PT. GRAHA ISMAYA

20 AUDIOMETER Model 240 AMPLIVOX LTD ENGLAND DEPKES RI AKL 20701402756 UNIT Rp 76,955,000 PT. GRAHA ISMAYA

21 AUDIOMETER Model 260 AMPLIVOX LTD ENGLAND DEPKES RI AKL 20701402757 UNIT Rp 83,410,000 PT. GRAHA ISMAYA

22 AUDIOMETER Model 270 AMPLIVOX LTD ENGLAND DEPKES RI AKL 20701402758 UNIT Rp 89,182,000 PT. GRAHA ISMAYA

23 AUDIOMETER CA 850 Series 3 AMPLIVOX LTD ENGLAND DEPKES RI AKL 20701402759 UNIT Rp 150,182,000 PT. GRAHA ISMAYA

24 AUDIOMETER Model 116 AMPLIVOX LTD ENGLAND DEPKES RI AKL 20701402760 UNIT Rp 49,228,000 PT. GRAHA ISMAYA

25 AUDIOMETER Model 160 AMPLIVOX LTD ENGLAND SEDANG DALAM PROSES UNIT Rp 56,637,000 PT. GRAHA ISMAYA

26 ELECTRO ACOUSTIC EAR SIMULATOR Amplivox ER70 AMPLIVOX LTD ENGLAND SEDANG DALAM PROSES UNIT Rp 17,091,000 PT. GRAHA ISMAYA

27 INFUSION PUMP DIGINFUSA 5010 ARCOMED SWITZERLAND DEPKES RI AKL 20902200448 UNIT Rp 61,864,000 PT. GRAHA ISMAYA

28 SYRINGE PUMP SYRAMED µSP 6000 ARCOMED SWITZERLAND DEPKES RI AKL 20902200446 UNIT Rp 36,682,000 PT. GRAHA ISMAYA

29 INFUSION PUMP VOLUMED µVP 5000 ARCOMED SWITZERLAND DEPKES RI AKL 20902200447 UNIT Rp 41,773,000 PT. GRAHA ISMAYA

30 INFUSION PUMP VOLUMED µVP 5005 ARCOMED SWITZERLAND DEPKES RI AKL 20902200447 UNIT Rp 41,728,000 PT. GRAHA ISMAYA

31 PCA PUMP SYRAMED 6000 ARCOMED SWITZERLAND SEDANG DALAM PROSES UNIT Rp 63,364,000 PT. GRAHA ISMAYA

32 POCKET DOPPLER WAKI 2-TC ATYS MEDICAL FRANCE DEPKES RI AKL 20502304269 UNIT Rp 783,273,000 PT. GRAHA ISMAYA

33 TRANSCRANIAL DAN VASCULAR DOPPLER BASIC TCD ATYS MEDICAL FRANCE DEPKES RI AKL 20502304270 UNIT Rp 373,500,000 PT. GRAHA ISMAYA

34 TRANSCRANIAL DAN VASCULAR DOPPLER WAKI 1-TC ATYS MEDICAL FRANCE DEPKES RI AKL 20502304271 UNIT Rp 454,728,000 PT. GRAHA ISMAYA

35 POCKET TCD MICROFLOW ATYS MEDICAL FRANCE SEDANG DALAM PROSES UNIT Rp 14,364,000 PT. GRAHA ISMAYA

36 TRANSCRANIAL DAN VASCULAR DOPPLER BASIC S ATYS MEDICAL FRANCE SEDANG DALAM PROSES UNIT Rp 205,046,000 PT. GRAHA ISMAYA

37 TRANSCRANIAL DAN VASCULAR DOPPLER WAKI 1- TO ATYS MEDICAL FRANCE SEDANG DALAM PROSES UNIT Rp 444,046,000 PT. GRAHA ISMAYA

38 TRANSCRANIAL DAN VASCULAR DOPPLER WAKI 1-TC-TO ATYS MEDICAL FRANCE SEDANG DALAM PROSES UNIT Rp 577,728,000 PT. GRAHA ISMAYA

39 TRANSCRANIAL DAN VASCULAR DOPPLER 1 Ch. WAKI 2-TC-TO ATYS MEDICAL FRANCE SEDANG DALAM PROSES UNIT Rp 583,500,000 PT. GRAHA ISMAYA

40 TRANSCRANIAL DAN VASCULAR DOPPLER 2 Ch. WAKI 2-TC-TO ATYS MEDICAL FRANCE SEDANG DALAM PROSES UNIT Rp 843,637,000 PT. GRAHA ISMAYA

41 CLINICAL CHEMISTRY ANALYZER/DRUG MONITORING EXPRESS PLUS BAYER GERMANY DEPKES RI AKL 10102301423 UNIT Rp 823,137,000 PT. GRAHA ISMAYA

42 BLOOD GAS ANALYZER & ELECTROLIT ANALYZER RAPIDLAB 348 BAYER GERMANY DEPKES RI AKL 20102303724 UNIT Rp 726,546,000 PT. GRAHA ISMAYA

43 BLOOD GAS ANALYZER RAPIDLAB 248 BAYER GERMANY DEPKES RI AKL 20102303725 UNIT Rp 414,319,000 PT. GRAHA ISMAYA

44 ELECTTROLIT ANALYZER RAPIDCHEM 744 BAYER GERMANY DEPKES RI AKL 10101400528 UNIT Rp 329,364,000 PT. GRAHA ISMAYA

45 HEMATOLOGY ANALYZER ADVIA 60 BAYER GERMANY DEPKES RI AKL 20205300367 UNIT Rp 309,182,000 PT. GRAHA ISMAYA

46 URINE ANALYZER CLINITEX-500 BAYER GERMANY DEPKES RI AKL 10102400463 UNIT Rp 185,046,000 PT. GRAHA ISMAYA

47 HEMATOLOGY ANALYZER ADVIA 120 BAYER GERMANY SEDANG DALAM PROSES UNIT Rp 2,728,864,000 PT. GRAHA ISMAYA
48 ANAESTHESY MACHINE Sirius 2000 BLEASE ENGLAND DEPKES RI AKL 20403402425 UNIT Rp 751,591,000 PT. GRAHA ISMAYA
49 ANAESTHESY MACHINE Sirius 3000 BLEASE ENGLAND DEPKES RI AKL 20403402424 UNIT Rp 814,546,000 PT. GRAHA ISMAYA

50 ANAESTHESY MACHINE Frontline Focus BLEASE ENGLAND DEPKES RI AKL 20403303178 UNIT Rp 420,864,000 PT. GRAHA ISMAYA

51 VENTILATOR ANAESTHSY 8500 Ventilator BLEASE ENGLAND DEPKES RI AKL 20403303176 UNIT Rp 385,455,000 PT. GRAHA ISMAYA

52 VENTILATOR ANAESTHSY 6500 Ventilator BLEASE ENGLAND DEPKES RI AKL 20403303177 UNIT Rp 287,500,000 PT. GRAHA ISMAYA

53 TILTING TABLE DM-RFT-5 DONGMUN KOREA DEPKES RI AKL 21501301948 UNIT Rp 429,682,000 PT. GRAHA ISMAYA

54 BUCKY TABLE DMBT-1 DONGMUN KOREA DEPKES RI AKL 21501301949 UNIT Rp 32,455,000 PT. GRAHA ISMAYA

55 BUCKY TABLE DMFT-1 DONGMUN KOREA DEPKES RI AKL 21501301951 UNIT Rp 23,819,000 PT. GRAHA ISMAYA

56 WALL BUCKY STAND DM-VB-1 DONGMUN KOREA DEPKES RI AKL 21501301951 UNIT Rp 47,591,000 PT. GRAHA ISMAYA
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NAMA PERALATAN KESEHATAN TIPE PRODUK MERK NEGARA ASAL NO. REGISTRASI SATUAN HJSA (RP) SOLE AGENT
URUT

57 AUTOMATIC FILM PROCESSOR DSP-33SQ DONGMUN KOREA DEPKES RI AKL 21501301971 UNIT Rp 110,773,000 PT. GRAHA ISMAYA

58 AUTOMATIC FILM PROCESSOR DSP-5000 DONGMUN KOREA DEPKES RI AKL 21501301972 UNIT Rp 214,637,000 PT. GRAHA ISMAYA

59 AUTOMATIC FILM PROCESSOR DSP-3800 DONGMUN KOREA DEPKES RI AKL 21501301973 UNIT Rp 188,682,000 PT. GRAHA ISMAYA

60 AUTOMATIC FILM PROCESSOR DSP-3300 DONGMUN KOREA SEDANG DALAM PROSES UNIT Rp 110,773,000 PT. GRAHA ISMAYA

61 X-RAY SYSTEM, 100 mA X-RAY SYSTEM 100 mA DONGMUN KOREA 008800.3.226.00001110805 UNIT Rp 446,091,000 PT. GRAHA ISMAYA

62 X-RAY SYSTEM, 300 mA X-RAY SYSTEM 300 mA DONGMUN KOREA 008800.3.226.00001110805 UNIT Rp 597,910,000 PT. GRAHA ISMAYA

63 X-RAY SYSTEM, 500 mA X-RAY SYSTEM 500 mA DONGMUN KOREA 008800.3.226.00001110805 UNIT Rp 684,000,000 PT. GRAHA ISMAYA

64 X-RAY UNIT, 100 mA DM-300mA DONGMUN KOREA DEPKES RI AKL 21501502527 UNIT Rp 597,910,000 PT. GRAHA ISMAYA

65 MOBILE X-RAY, 100 mA DM-100MR DONGMUN KOREA DEPKES RI AKL 215012526 UNIT Rp 365,182,000 PT. GRAHA ISMAYA

66 FLUORISCOPY & X-RAY UNIT, 500 mA DMRFTV 500 DONGMUN KOREA DEPKES RI AKL 21501502525 UNIT Rp 1,618,273,000 PT. GRAHA ISMAYA

67 X-RAY UNIT, 100 mA DM-500mA DONGMUN KOREA DEPKES RI AKL 21501502524 UNIT Rp 684,000,000 PT. GRAHA ISMAYA

68 MOBILE X-RAY, 300 mA DM-3125MR DONGMUN KOREA DEPKES RI AKL 21501502522 UNIT Rp 386,091,000 PT. GRAHA ISMAYA

69 X-RAY UNIT, 100 mA DM-100ST DONGMUN KOREA DEPKES RI AKL 21501502523 UNIT Rp 446,091,000 PT. GRAHA ISMAYA

70 PORTABLE X-RAY DIG-310 DONGMUN KOREA DEPKES RI AKL 21501502519 UNIT Rp 210,728,000 PT. GRAHA ISMAYA

71 ETHYL CHLORIDE ETHYL CHLORIDE DR HENNING GERMANY DKI 9458700139A1.- 1 BTL Rp 97,500,000 PT. GRAHA ISMAYA

72 ELECTROSURGEY UNIT, 300 W ERBOTOM ICC 300 E and H ERBE GERMANY DEPKES RI AKL 21603200527 UNIT Rp 250,728,000 PT. GRAHA ISMAYA

73 ELECTROSURGEY UNIT, 200 W ERBOTOM ICC 200 ERBE GERMANY DEPKES RI AKL 21603200531 UNIT Rp 204,364,000 PT. GRAHA ISMAYA

74 ELECTROSURGEY UNIT, 80 W ERBOTOM ICC 80 ERBE GERMANY DEPKES RI AKL 21603200533 UNIT Rp 95,455,000 PT. GRAHA ISMAYA

75 ELECTROSURGEY UNIT, 50 W ERBOTOM ICC 50 ERBE GERMANY DEPKES RI AKL 21603200532 UNIT Rp 92,046,000 PT. GRAHA ISMAYA

76 ELECTROSURGEY UNIT, 350 W ERBOTOM ICC 350 ERBE GERMANY DEPKES RI AKL 21603200528 UNIT Rp 393,319,000 PT. GRAHA ISMAYA

77 ARGON PLASMA COAGULATION APC 300 ERBE GERMANY DEPKES RI AKL 21603200529 UNIT Rp 399,046,000 PT. GRAHA ISMAYA

77 ERBOKRYO ERBOKRYO 12 CRYOGUN ERBE GERMANY DEPKES RI AKL 21603200530 UNIT Rp 164,455,000 PT. GRAHA ISMAYA

78 WATER JET SURGERY HELIX HYDRO JET ERBE GERMANY DEPKES RI AKL 21603401162 UNIT Rp 2,233,773,000 PT. GRAHA ISMAYA

79 ELECTROSURGICAL UNIT WITH LARGE SCREEN VIO 300D WITH APC ERBE GERMANY DEPKES RI AKL 21603401161 UNIT Rp 1,392,046,000 PT. GRAHA ISMAYA

80 ELECTROSURGICAL UNIT WITH LARGE SCREEN VIO 300S WITH APC ERBE GERMANY DEPKES RI AKL 21603401161 UNIT Rp 1,197,228,000 PT. GRAHA ISMAYA

81 ELECTROSURGICAL UNIT WITH LARGE SCREEN VIO 200D WITH APC ERBE GERMANY SEDANG DALAM PROSES UNIT Rp 780,864,000 PT. GRAHA ISMAYA

82 SPIROMETER PORTABLE DISCOVERY FUTUREMED USA DEPKES RI AKL 20401402443 UNIT Rp 68,319,000 PT. GRAHA ISMAYA

83 SPIROMETER COMPUTERIZE SPIROVISION 3+ FUTUREMED USA DEPKES RI AKL 20401402444 UNIT Rp 129,591,000 PT. GRAHA ISMAYA

84 ELECTROCARDIOGRAPH 3 CHANNEL EZ-3 FUTUREMED USA DEPKES RI AKL 20502402439 UNIT Rp 59,455,000 PT. GRAHA ISMAYA

85 ELECTROCARDIOGRAPH 3 CHANNEL EZ-3 FUTUREMED USA DEPKES RI AKL 20502402439 UNIT Rp 61,864,000 PT. GRAHA ISMAYA

86 ELECTROCARDIOGRAPH MULTI CHANNEL P80 POWER FUTUREMED USA DEPKES RI AKL 20502402442 UNIT Rp 95,637,000 PT. GRAHA ISMAYA

87 ELECTROCARDIOGRAPH MULTI CHANNEL P80 POWER FUTUREMED USA DEPKES RI AKL 20502402442 UNIT Rp 128,591,000 PT. GRAHA ISMAYA

88 ELECTROCARDIOGRAPH MULTI CHANNEL P80 SIX FUTUREMED USA DEPKES RI AKL 20502402440 UNIT Rp 89,591,000 PT. GRAHA ISMAYA

89 ELECTROCARDIOGRAPH MULTI CHANNEL P80 SIX FUTUREMED USA DEPKES RI AKL 20502402440 UNIT Rp 97,637,000 PT. GRAHA ISMAYA

90 ELECTROCARDIOGRAPH 1 CHANNEL 108 FUTUREMED USA SEDANG DALAM PROSES UNIT Rp 38,864,000 PT. GRAHA ISMAYA

91 ELECTROCARDIOGRAPH 1 CHANNEL 110 FUTUREMED USA SEDANG DALAM PROSES UNIT Rp 45,410,000 PT. GRAHA ISMAYA

92 WASHER DISINFECTOR DEKO 190 FRANKE FINLAND DEPKES RI AKL 20903500698 UNIT Rp 345,500,000 PT. GRAHA ISMAYA

93 WASHER DISINFECTOR DEKO 25 FRANKE FINLAND DEPKES RI AKL 20903500700 UNIT Rp 169,364,000 PT. GRAHA ISMAYA

94 WASHER DISINFECTOR DEKO 260 FRANKE FINLAND DEPKES RI AKL 20903500697 UNIT Rp 420,273,000 PT. GRAHA ISMAYA

95 WASHER DISINFECTOR DEKO 260 FRANKE FINLAND DEPKES RI AKL 20903500697 UNIT Rp 428,955,000 PT. GRAHA ISMAYA

96 WASHER DISINFECTOR DEKO 2000 FRANKE FINLAND DEPKES RI AKL 20903500699 UNIT Rp 684,455,000 PT. GRAHA ISMAYA

97 WASHER DISINFECTOR DEKO 2000 FRANKE FINLAND DEPKES RI AKL 20903500699 UNIT Rp 685,137,000 PT. GRAHA ISMAYA

98 WASHER DISINFECTOR DEKO 2000 FRANKE FINLAND DEPKES RI AKL 20903500699 UNIT Rp 718,137,000 PT. GRAHA ISMAYA

99 WASHER DISINFECTOR DEKO 2000 FRANKE FINLAND DEPKES RI AKL 20903500699 UNIT Rp 752,591,000 PT. GRAHA ISMAYA

100 DRYING CABINET FOR WASHER DISINFECTOR DC 2200 FRANKE FINLAND DEPKES RI AKL 20903500696 UNIT Rp 265,364,000 PT. GRAHA ISMAYA

101 DRYING CABINET FOR WASHER DISINFECTOR DC 2200 FRANKE FINLAND DEPKES RI AKL 20903500696 UNIT Rp 285,000,000 PT. GRAHA ISMAYA

102 Ambulance Stretcher 923523 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 27,137,000 PT. GRAHA ISMAYA

103 Baby Box (Incl. Matras) 922109 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 3,046,000 PT. GRAHA ISMAYA

104 Baby Resuscitation Table 922521 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 3,273,000 PT. GRAHA ISMAYA

105 Baby Resuscitation Table 922522 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 3,319,000 PT. GRAHA ISMAYA

106 Bed Screen 921418 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 1,819,000 PT. GRAHA ISMAYA

107 Bed Screen 921419 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 1,910,000 PT. GRAHA ISMAYA

108 Bedside locker 921300 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 2,864,000 PT. GRAHA ISMAYA

109 Bedside locker 921303 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 2,910,000 PT. GRAHA ISMAYA
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NAMA PERALATAN KESEHATAN TIPE PRODUK MERK NEGARA ASAL NO. REGISTRASI SATUAN HJSA (RP) SOLE AGENT
URUT

110 Bowl Stand single 922621 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 2,637,000 PT. GRAHA ISMAYA

111 Bowl Stand Ganda 922622 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 3,046,000 PT. GRAHA ISMAYA

112 Children bed (incl.matras) 922101 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 8,364,000 PT. GRAHA ISMAYA

113 Dressing Trolley 922218 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 4,273,000 PT. GRAHA ISMAYA

114 Dressing Trolley 922219 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 4,046,000 PT. GRAHA ISMAYA

115 Emergency Stretcher 921333 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 8,455,000 PT. GRAHA ISMAYA

116 Emergency Trolley Meja Lipat Baja 921335 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 5,046,000 PT. GRAHA ISMAYA

117 Emergency Trolley Meja Lipat ST.Steel 922335 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 8,546,000 PT. GRAHA ISMAYA

118 Emergency Trolley Biasa Baja 921345 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 4,591,000 PT. GRAHA ISMAYA

119 Emergency Trolley Biasa St.Steel 922345 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 8,137,000 PT. GRAHA ISMAYA

120 Examination Lamp 922693 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 3,046,000 PT. GRAHA ISMAYA

121 Examination Table 921542 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 4,182,000 PT. GRAHA ISMAYA

122 Examination Table (Incl.Tangga Pasien) 921543 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 3,228,000 PT. GRAHA ISMAYA

123 Folding Stretcher 921174 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 6,728,000 PT. GRAHA ISMAYA

124 Food Trolley Non Electric 922235 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 12,091,000 PT. GRAHA ISMAYA

125 Food Trolley Electric 922236 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 30,591,000 PT. GRAHA ISMAYA

126 Food Trolley Electric 922237 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 30,273,000 PT. GRAHA ISMAYA

127 Gynaecolog Bed 921777 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 6,137,000 PT. GRAHA ISMAYA

128 Gynaecolog Bed Baja 921561 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 6,137,000 PT. GRAHA ISMAYA

129 Gynaecolog Bed St.Steel 922561 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 9,182,000 PT. GRAHA ISMAYA

130 Hospital Bed gigi balang 921120 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 6,137,000 PT. GRAHA ISMAYA

131 Hospital Bed 1 crank 921288 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 6,273,000 PT. GRAHA ISMAYA

132 - Tanpa tiang infus 921287 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 6,091,000 PT. GRAHA ISMAYA

133 - Tanpa tiang infus dan alingan 921286 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 5,819,000 PT. GRAHA ISMAYA

134 - Tanpa tiang infus, alingan dan roda 921285 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 4,864,000 PT. GRAHA ISMAYA

135 Hospital Bed 1 crank 921109 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 8,637,000 PT. GRAHA ISMAYA

136 - Tanpa tiang infus 921108 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 7,682,000 PT. GRAHA ISMAYA

137 - Tanpa tiang infus dan alingan 921107 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 6,864,000 PT. GRAHA ISMAYA

138 - Tanpa tiang infus, alingan dan roda 921106 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 5,637,000 PT. GRAHA ISMAYA

139 Hospital Bed 2 Crank 921105 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 10,546,000 PT. GRAHA ISMAYA

140 - Tanpa tiang infus 921104 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 9,591,000 PT. GRAHA ISMAYA

141 - Tanpa tiang infus dan alingan 921103 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 8,819,000 PT. GRAHA ISMAYA

142 - Tanpa tiang infus, alingan dan roda 921102 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 7,591,000 PT. GRAHA ISMAYA

143 Hospital Bed 3 Crank 921101 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 12,182,000 PT. GRAHA ISMAYA

144 - Tanpa tiang infus 921100 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 11,182,000 PT. GRAHA ISMAYA

145 - Tanpa tiang infus dan alingan 921099 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 10,364,000 PT. GRAHA ISMAYA

146 - Tanpa tiang infus, alingan dan roda 921098 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 9,137,000 PT. GRAHA ISMAYA

147 Exercise Stairs GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 6,364,000 PT. GRAHA ISMAYA

148 Incubator (Digital ) 920193 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 37,091,000 PT. GRAHA ISMAYA

149 Incubator (manual ) 920193 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 32,137,000 PT. GRAHA ISMAYA

150 Incubator Transport+Trolley 920194 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 48,546,000 PT. GRAHA ISMAYA

151 Infant Warmer + Resusitasi (Manual) 920191 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 118,182,000 PT. GRAHA ISMAYA

152 Infant Warmer + Resusitasi (Servo) 920191 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 149,591,000 PT. GRAHA ISMAYA

153 Infrared Lamp 922677 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 5,728,000 PT. GRAHA ISMAYA

154 Infusion Stand 4 kaki 922624 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 1,228,000 PT. GRAHA ISMAYA

155 Infusion Stand 5 kaki 922625 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 1,455,000 PT. GRAHA ISMAYA

156 Instrument Cupboard 1 pintu baja 921305 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 4,591,000 PT. GRAHA ISMAYA

157 Instrument Cupboard 1 pintu baja 921306 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 5,000,000 PT. GRAHA ISMAYA

158 Instrument Cupboard 1 pintu St.Steel 922305 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 10,319,000 PT. GRAHA ISMAYA

159 Instrument Cupboard 1 pintu St.Steel 922306 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 10,319,000 PT. GRAHA ISMAYA

160 Instrument Cupboard 2 pintu baja 921307 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 5,773,000 PT. GRAHA ISMAYA

161 Instrument Cupboard 2 pintu baja 921308 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 5,773,000 PT. GRAHA ISMAYA

162 Instrument Cupboard 2 pintu St.Steel 922307 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 12,182,000 PT. GRAHA ISMAYA

163 Instrument Cupboard 2 pintu St.Steel 922308 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 12,182,000 PT. GRAHA ISMAYA
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NAMA PERALATAN KESEHATAN TIPE PRODUK MERK NEGARA ASAL NO. REGISTRASI SATUAN HJSA (RP) SOLE AGENT
URUT

164 Instrument Table 1/2 laci 1 rak 922217 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 3,500,000 PT. GRAHA ISMAYA

165 Instrument Table 1/2 laci 2 rak 922220 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 3,682,000 PT. GRAHA ISMAYA

166 Instrument Table Laci Full 1 Rak 922222 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 3,500,000 PT. GRAHA ISMAYA

167 Instrument Table Laci Full 2 Rak 922221 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 3,682,000 PT. GRAHA ISMAYA

168 Instrument Trolley 1 Rak 922216 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 3,046,000 PT. GRAHA ISMAYA

169 Instrument Trolley 2 Rak 922214 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 3,228,000 PT. GRAHA ISMAYA

170 Instrument Trolley 2 Rak 922215 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 3,410,000 PT. GRAHA ISMAYA

171 Instrument Trolley 3 Rak baja 921240 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 5,455,000 PT. GRAHA ISMAYA

172 Instrument Trolley 3 Rak St.Steel 922240 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 5,637,000 PT. GRAHA ISMAYA

173 Keranda 921473 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 4,955,000 PT. GRAHA ISMAYA

174 Laundry Trolley 920271 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 3,455,000 PT. GRAHA ISMAYA

175 Laundry Trolley 920272 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 2,637,000 PT. GRAHA ISMAYA

176 Laundry Trolley Carrier 921201 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 5,637,000 PT. GRAHA ISMAYA

177 Laundry Trolley Kanvas 921271 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 5,046,000 PT. GRAHA ISMAYA

178 Lockers 8 pintu 990721 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 16,046,000 PT. GRAHA ISMAYA

179 Mattras Biasa 10cm GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 773,000 PT. GRAHA ISMAYA

180 Mattras Biasa 15cm GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 910,000 PT. GRAHA ISMAYA

181 Mattras Dunlopillo 10cm GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 4,000,000 PT. GRAHA ISMAYA

182 Mattras Dunlopillo 15cm GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 5,410,000 PT. GRAHA ISMAYA

183 Medicine Trolley 16 laci 922337 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 15,546,000 PT. GRAHA ISMAYA

184 Medicine Trolley 24 laci 922238 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 15,864,000 PT. GRAHA ISMAYA

185 Medicine Trolley 32 laci 922239 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 16,137,000 PT. GRAHA ISMAYA

186 Medicine Trolley 8 laci 922336 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 14,773,000 PT. GRAHA ISMAYA

187 Meja Distribusi 922241 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 6,319,000 PT. GRAHA ISMAYA

188 Meja periksa Bayi 920521 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 3,319,000 PT. GRAHA ISMAYA

189 Mobile Stretcher (brancard) 921334 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 6,046,000 PT. GRAHA ISMAYA

190 Mobile Stretcher (brancard) 922334 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 7,682,000 PT. GRAHA ISMAYA

191 Overbed Table/Mayo 923451 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 2,682,000 PT. GRAHA ISMAYA

192 Overbed Table/Mayo 923453 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 1,319,000 PT. GRAHA ISMAYA

193 Paralel Bar 922501 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 3,773,000 PT. GRAHA ISMAYA

194 Patient Stretcher 921332 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 5,591,000 PT. GRAHA ISMAYA

195 Phototherapy 921634 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 8,000,000 PT. GRAHA ISMAYA

196 Rak Pakaian Bersih 922399 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 10,819,000 PT. GRAHA ISMAYA

197 Rak Susun dengan roda 924224 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 5,091,000 PT. GRAHA ISMAYA

198 Rak Susun tanpa roda 924223 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 10,000,000 PT. GRAHA ISMAYA

199 Standard Cassette 923222 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 5,137,000 PT. GRAHA ISMAYA

200 Stretcher Jenazah 921471 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 4,955,000 PT. GRAHA ISMAYA

201 Tangga Pasien Baja GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 410,000 PT. GRAHA ISMAYA

202 Trolley Anaesthesi GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 4,000,000 PT. GRAHA ISMAYA

203 Trolley ECG GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 2,864,000 PT. GRAHA ISMAYA

204 Trolley NVS GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 6,364,000 PT. GRAHA ISMAYA

205 Trolley Oksigen 1,5m3 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 591,000 PT. GRAHA ISMAYA

206 Trolley Oksigen 6m3 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 1,728,000 PT. GRAHA ISMAYA

207 UV Sterilizer 922634 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 8,182,000 PT. GRAHA ISMAYA

208 Wheel Chair 921251 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 2,455,000 PT. GRAHA ISMAYA

209 Work Table 922740 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 5,273,000 PT. GRAHA ISMAYA

210 Work Table 922741 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 5,637,000 PT. GRAHA ISMAYA

211 X-ray film dryer 15 film GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 9,364,000 PT. GRAHA ISMAYA

212 X-Ray Film Viewer 1 film 921631 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 1,000,000 PT. GRAHA ISMAYA

213 X-Ray Film Viewer 2 film 921632 GRIS INDONESIA YF.05.02.V.A.SK.549 UNIT Rp 1,410,000 PT. GRAHA ISMAYA

214 X-Ray Film Viewer 3 film 921633 GRIS INDONESIA SERTIFIKASI IJIN PRODUKSI UNIT Rp 2,091,000 PT. GRAHA ISMAYA

215 INFUSION PUMP G 3000 GRASEBY ENGLAND SEDANG DALAM PROSES UNIT Rp 55,773,000 PT. GRAHA ISMAYA

216 SYRINGE PUMP G3100 GRASEBY ENGLAND SEDANG DALAM PROSES UNIT Rp 44,591,000 PT. GRAHA ISMAYA

217 SYRINGE PUMP G3150 GRASEBY ENGLAND SEDANG DALAM PROSES UNIT Rp 55,773,000 PT. GRAHA ISMAYA
DAFTAR INFORMASI HARGA PERALATAN & LABORATORIUM
EFFECTIVE : OKTOBER 2005 S/D MARET 2006
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NAMA PERALATAN KESEHATAN TIPE PRODUK MERK NEGARA ASAL NO. REGISTRASI SATUAN HJSA (RP) SOLE AGENT
URUT

218 SYRINGE PUMP G3200 GRASEBY ENGLAND SEDANG DALAM PROSES UNIT Rp 59,455,000 PT. GRAHA ISMAYA

219 SYRINGE PUMP OMNIFUSE 4100 GRASEBY ENGLAND SEDANG DALAM PROSES UNIT Rp 52,046,000 PT. GRAHA ISMAYA

220 PCA PUMP G3300 GRASEBY ENGLAND SEDANG DALAM PROSES UNIT Rp 92,910,000 PT. GRAHA ISMAYA

221 ANAESTHESY PUMP G3400 GRASEBY ENGLAND SEDANG DALAM PROSES UNIT Rp 52,046,000 PT. GRAHA ISMAYA

222 ANAESTHESY PUMP G3500 GRASEBY ENGLAND SEDANG DALAM PROSES UNIT Rp 81,773,000 PT. GRAHA ISMAYA

223 SYRINGE MOBILE PUMP G9000 GRASEBY ENGLAND SEDANG DALAM PROSES UNIT Rp 70,637,000 PT. GRAHA ISMAYA

224 APNOEA/RESPIRATION MONITOR MR10 GRASEBY ENGLAND SEDANG DALAM PROSES UNIT Rp 26,000,000 PT. GRAHA ISMAYA

225 APNOEA/RESPIRATION MONITOR MR10S GRASEBY ENGLAND SEDANG DALAM PROSES UNIT Rp 59,455,000 PT. GRAHA ISMAYA

226 SYRINGE DRIVER MS16 GRASEBY ENGLAND SEDANG DALAM PROSES UNIT Rp 26,000,000 PT. GRAHA ISMAYA

227 SYRINGE DRIVER MS18 GRASEBY ENGLAND SEDANG DALAM PROSES UNIT Rp 26,000,000 PT. GRAHA ISMAYA

228 SYRINGE DRIVER MS26 GRASEBY ENGLAND SEDANG DALAM PROSES UNIT Rp 26,000,000 PT. GRAHA ISMAYA

229 MICRO HEMATOCRIT CENTRIFUGE MHC HAWKSLEY ENGLAND DEPKES RI AKL 10209402373 UNIT Rp 56,546,000 PT. GRAHA ISMAYA

230 MICRO HEMATOCRIT CENTRIFUGE MARK IV HAWKSLEY ENGLAND DEPKES RI AKL 10209402374 UNIT Rp 78,819,000 PT. GRAHA ISMAYA

231 HYPO-HYPERTHERMIA SYSTEM RIPPLE COOL HAWKSLEY ENGLAND DEPKES RI AKL 11403402371 UNIT Rp 531,137,000 PT. GRAHA ISMAYA

232 HYPERTHERMIA SYSTEM RIPPLE HEAT Mark C HAWKSLEY ENGLAND DEPKES RI AKL 11403402372 UNIT Rp 211,500,000 PT. GRAHA ISMAYA

233 AIR BED 19000-00 HAWKSLEY ENGLAND SEDANG DALAM PROSES UNIT Rp 8,910,000 PT. GRAHA ISMAYA

234 AIR BED 39000-00 HAWKSLEY ENGLAND SEDANG DALAM PROSES UNIT Rp 14,864,000 PT. GRAHA ISMAYA

235 HEMOGLOBINOMETER SAHLI HEMOGLOBINE HAWKSLEY ENGLAND SEDANG DALAM PROSES UNIT Rp 3,000,000 PT. GRAHA ISMAYA

236 SUCTION PUMP MOBILE HicoVac 700 CH / A HIRTZ/GERMANY GERMANY DEPKES RI AKL 20903402472 UNIT Rp 85,500,000 PT. GRAHA ISMAYA

237 SUCTION PUMP MOBILE HicoVac 700 CH / B HIRTZ/GERMANY GERMANY DEPKES RI AKL 20903402473 UNIT Rp 74,273,000 PT. GRAHA ISMAYA

238 SUCTION PUMP PORTABLE Hico-Rapidovac 791-16 HIRTZ/GERMANY GERMANY DEPKES RI AKL 20903402885 UNIT Rp 18,000,000 PT. GRAHA ISMAYA

239 SUCTION PUMP FOR DRAINAGE Hico-Permavac 785 HIRTZ/GERMANY GERMANY DEPKES RI AKL 20903402886 UNIT Rp 20,273,000 PT. GRAHA ISMAYA

240 NEBULIZER Hico Ultrasonat 810 HIRTZ/GERMANY GERMANY DEPKES RI AKL 20403402890 UNIT Rp 49,000,000 PT. GRAHA ISMAYA

241 HYCO/HYPERTERMIA SYSTEM Hico Aquatherm 660 HIRTZ/GERMANY GERMANY DEPKES RI AKL 20505402892 UNIT Rp 51,637,000 PT. GRAHA ISMAYA

242 HYCO/HYPERTERMIA SYSTEM Hico Variotherm 550 HIRTZ/GERMANY GERMANY DEPKES RI AKL 20505402893 UNIT Rp 213,773,000 PT. GRAHA ISMAYA

243 ANTI DECUBITUS BED Hico Decubimat 370 HIRTZ/GERMANY GERMANY DEPKES RI AKL 10903402895 UNIT Rp 36,046,000 PT. GRAHA ISMAYA

244 HYCO/HYPERTERMIA SYSTEM Hico Hypotherm 680 HIRTZ/GERMANY GERMANY DEPKES RI AKL 20505402894 UNIT Rp 168,773,000 PT. GRAHA ISMAYA

245 ANTI DECUBITUS BED Hico Decubimat 380 HIRTZ/GERMANY GERMANY DEPKES RI AKL 10903402897 UNIT Rp 74,319,000 PT. GRAHA ISMAYA

246 ANTI DECUBITUS BED Hico Decubimat 390 HIRTZ/GERMANY GERMANY DEPKES RI AKL 10903402898 UNIT Rp 105,773,000 PT. GRAHA ISMAYA

247 ANTI DECUBITUS BED Hico Decubimat 375 HIRTZ/GERMANY GERMANY DEPKES RI AKL 10903402899 UNIT Rp 59,455,000 PT. GRAHA ISMAYA

248 ANTI DECUBITUS BED Hico Decubimat 367 HIRTZ/GERMANY GERMANY SEDANG DALAM PROSES UNIT Rp 7,637,000 PT. GRAHA ISMAYA

249 ANTI DECUBITUS BED Hico Decubimat 369 HIRTZ/GERMANY GERMANY SEDANG DALAM PROSES UNIT Rp 8,546,000 PT. GRAHA ISMAYA

250 WATER MATRASS HICO-DECPLOT HIRTZ/GERMANY GERMANY SEDANG DALAM PROSES UNIT Rp 5,864,000 PT. GRAHA ISMAYA

251 WATER MATRASS HICO-SENSIPLOT HIRTZ/GERMANY GERMANY SEDANG DALAM PROSES UNIT Rp 9,000,000 PT. GRAHA ISMAYA

252 WATER MATRASS HICO-SENSIPLOT HIRTZ/GERMANY GERMANY SEDANG DALAM PROSES UNIT Rp 11,273,000 PT. GRAHA ISMAYA

253 WATER MATRASS HICO-AQUALIT HIRTZ/GERMANY GERMANY SEDANG DALAM PROSES UNIT Rp 4,500,000 PT. GRAHA ISMAYA

254 PULSE OXYMETER LP-5 HME Limited UK DEPKES RI AKL 20502303179 UNIT Rp 27,591,000 PT. GRAHA ISMAYA

255 PATIENT MONITOR LP-400 HME Limited UK DEPKES RI AKL 20502303180 UNIT Rp 492,137,000 PT. GRAHA ISMAYA

256 DEFIBRILLATOR LP-200 HME Limited UK DEPKES RI AKL 20502303186 UNIT Rp 202,819,000 PT. GRAHA ISMAYA

257 ECG MONITOR LP-10 HME Limited UK DEPKES RI AKL 20502303130 UNIT Rp 71,910,000 PT. GRAHA ISMAYA

258 PATIENT MONITOR LP-300 HME Limited UK SEDANG DALAM PROSES UNIT Rp 212,819,000 PT. GRAHA ISMAYA

259 CENTRAL MONITOR LP-850 HME Limited UK SEDANG DALAM PROSES UNIT Rp 483,182,000 PT. GRAHA ISMAYA

260 VENTILATOR ICU INTER NEO INTERMED BRAZIL DEPKES RI AKL 20403402162 UNIT Rp 371,000,000 PT. GRAHA ISMAYA

261 VENTILATOR ICU INTER 5 PLUS INTERMED BRAZIL DEPKES RI AKL 20403402161 UNIT Rp 406,273,000 PT. GRAHA ISMAYA

262 VENTILATOR ICU INTER 3 PLUS INTERMED BRAZIL DEPKES RI AKL 20403402422 UNIT Rp 333,955,000 PT. GRAHA ISMAYA

263 VENTILATOR ICU INTER PLUS VAPS INTERMED BRAZIL DEPKES RI AKL 20403402423 UNIT Rp 459,046,000 PT. GRAHA ISMAYA

264 PATIENT MONITOR M12 INVIVO-MDE USA DEPKES RI AKL 20502302100 UNIT Rp 232,864,000 PT. GRAHA ISMAYA

265 PATIENT MONITOR M12 INVIVO-MDE USA DEPKES RI AKL 20502302100 UNIT Rp 242,410,000 PT. GRAHA ISMAYA

266 PATIENT MONITOR M12 INVIVO-MDE USA DEPKES RI AKL 20502302100 UNIT Rp 306,682,000 PT. GRAHA ISMAYA

267 PATIENT MONITOR M12 INVIVO-MDE USA DEPKES RI AKL 20502302100 UNIT Rp 297,137,000 PT. GRAHA ISMAYA

268 PATIENT MONITOR Escort M8 INVIVO-MDE USA DEPKES RI AKL 20502403219 UNIT Rp 149,319,000 PT. GRAHA ISMAYA

269 PATIENT MONITOR (BASIC) Escort M10 INVIVO-MDE USA DEPKES RI AKL 20501403451 UNIT Rp 272,955,000 PT. GRAHA ISMAYA

270 PATIENT MONITOR (UPGRADABLE) Escort PRISM SE INVIVO-MDE USA DEPKES RI AKL 20501403450 UNIT Rp 280,500,000 PT. GRAHA ISMAYA

271 CENTRAL MONITOR Escort Vision INVIVO-MDE USA DEPKES RI AKL 20502500088 UNIT Rp 1,196,546,000 PT. GRAHA ISMAYA
DAFTAR INFORMASI HARGA PERALATAN & LABORATORIUM
EFFECTIVE : OKTOBER 2005 S/D MARET 2006
PT. GRAHA ISMAYA, LTD

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NAMA PERALATAN KESEHATAN TIPE PRODUK MERK NEGARA ASAL NO. REGISTRASI SATUAN HJSA (RP) SOLE AGENT
URUT

272 CENTRAL MONITOR, 2 BED CENTURION INVIVO-MDE USA SEDANG DALAM PROSES UNIT Rp 244,910,000 PT. GRAHA ISMAYA

273 CENTRAL MONITOR, 4 BED CENTURION INVIVO-MDE USA SEDANG DALAM PROSES UNIT Rp 285,091,000 PT. GRAHA ISMAYA

274 CENTRAL MONITOR, 8 BED CENTURION INVIVO-MDE USA SEDANG DALAM PROSES UNIT Rp 317,228,000 PT. GRAHA ISMAYA

275 OPERATING LAMP System One DUO ORBITAL MEDICAL ILLUMINATION USA DEPKES RI AKL 21603500695 UNIT Rp 203,000,000 PT. GRAHA ISMAYA

276 OPERATING LAMP CENTURION 041543B MEDICAL ILLUMINATION USA DEPKES RI AKL 21603500694 UNIT Rp 75,500,000 PT. GRAHA ISMAYA

277 OPERATING LAMP System One Solo Ceiling CS2230 MEDICAL ILLUMINATION USA DEPKES RI AKL 21603502827 UNIT Rp 99,319,000 PT. GRAHA ISMAYA

278 OPERATING LAMP System One Solo Orbital SS2230 MEDICAL ILLUMINATION USA DEPKES RI AKL 21603502811 UNIT Rp 106,319,000 PT. GRAHA ISMAYA

279 EXAMINATION LAMP Centry Tradisional 021343 MEDICAL ILLUMINATION USA DEPKES RI AKL 21603502876 UNIT Rp 35,091,000 PT. GRAHA ISMAYA

280 OPERATING LAMP System ONE TRIO ORBITAL MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 299,682,000 PT. GRAHA ISMAYA

281 OPERATING LAMP System One DUO TRADITIONAL MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 189,000,000 PT. GRAHA ISMAYA

282 EXAMINATION LAMP CENTRY 021342 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 33,000,000 PT. GRAHA ISMAYA

283 EXAMINATION LAMP CENTRY 021343 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 35,091,000 PT. GRAHA ISMAYA

284 EXAMINATION LAMP CENTRY 021344 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 32,773,000 PT. GRAHA ISMAYA

285 EXAMINATION LAMP CENTRY 021345 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 63,137,000 PT. GRAHA ISMAYA

286 SURGERY LIGHTS CENTURION 021542 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 43,591,000 PT. GRAHA ISMAYA

287 SURGERY LIGHTS CENTURION 021543 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 49,000,000 PT. GRAHA ISMAYA

288 SURGERY LIGHTS CENTURION 021544 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 43,819,000 PT. GRAHA ISMAYA

289 SURGERY LIGHTS CENTURION 021545 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 85,182,000 PT. GRAHA ISMAYA

290 SURGERY LIGHTS CENTURION 021542B MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 70,046,000 PT. GRAHA ISMAYA

291 SURGERY LIGHTS CENTURION 021543B MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 70,682,000 PT. GRAHA ISMAYA

292 SURGERY LIGHTS CENTURION 021544B MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 70,182,000 PT. GRAHA ISMAYA

293 SPOT LIGHTS CENTURA 022842 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 51,273,000 PT. GRAHA ISMAYA

294 SPOT LIGHTS CENTURA 022843 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 57,091,000 PT. GRAHA ISMAYA

295 SPOT LIGHTS CENTURA 022844 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 51,455,000 PT. GRAHA ISMAYA

296 SPOT LIGHTS CENTURA 022845 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 28,182,000 PT. GRAHA ISMAYA

297 SPOT LIGHTS CENTURA 022942 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 58,773,000 PT. GRAHA ISMAYA

298 SPOT LIGHTS CENTURA 022943 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 63,228,000 PT. GRAHA ISMAYA

299 SPOT LIGHTS CENTURA 022944 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 58,819,000 PT. GRAHA ISMAYA

300 SPOT LIGHTS CENTURA 022945 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 115,228,000 PT. GRAHA ISMAYA

301 COMBINATION CEILLING LIGHTS CENTRY & CENTURION MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 76,455,000 PT. GRAHA ISMAYA

302 COMBINATION CEILLING LIGHTS DUAL CENTURA MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 107,864,000 PT. GRAHA ISMAYA

303 COMBINATION CEILLING LIGHTS CENTRY & CENTURA MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 81,910,000 PT. GRAHA ISMAYA

304 COMBINATION CEILLING LIGHTS CENTURION & CENTURA MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 92,864,000 PT. GRAHA ISMAYA

305 COMBINATION CEILLING LIGHTS CENTRY & CENTURA MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 89,319,000 PT. GRAHA ISMAYA

306 COMBINATION CEILLING LIGHTS CENTURION & CENTURA MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 100,228,000 PT. GRAHA ISMAYA

307 CEILING TRACKS CHUTTLE TRAC CEILING MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 35,910,000 PT. GRAHA ISMAYA

308 CEILING TRACKS CHUTTLE TRAC CEILING MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 46,319,000 PT. GRAHA ISMAYA

309 DIAGNOSTIC UV "WOODS" LIGHT CENTURY DIAGNOSTIC MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 8,728,000 PT. GRAHA ISMAYA

310 DIAGNOSTIC UV "WOODS" LIGHT CENTURY DIAGNOSTIC MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 12,637,000 PT. GRAHA ISMAYA

311 DIAGNOSTIC UV "WOODS" LIGHT CENTURY DIAGNOSTIC MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 13,273,000 PT. GRAHA ISMAYA

312 DIAGNOSTIC UV "WOODS" LIGHT CENTURY DIAGNOSTIC MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 13,728,000 PT. GRAHA ISMAYA

313 DIAGNOSTIC UV "WOODS" LIGHT CENTURY DIAGNOSTIC MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 14,364,000 PT. GRAHA ISMAYA

314 DIAGNOSTIC UV "WOODS" LIGHT CENTURY DIAGNOSTIC MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 8,728,000 PT. GRAHA ISMAYA

315 DIAGNOSTIC UV "WOODS" LIGHT CENTURY DIAGNOSTIC MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 12,637,000 PT. GRAHA ISMAYA

316 DIAGNOSTIC UV "WOODS" LIGHT CENTURY DIAGNOSTIC MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 13,273,000 PT. GRAHA ISMAYA

317 DIAGNOSTIC UV "WOODS" LIGHT CENTURY DIAGNOSTIC MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 13,728,000 PT. GRAHA ISMAYA

318 EXAM/ DIAGNOSTIC LIGHTS CENTRY 041342 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 34,591,000 PT. GRAHA ISMAYA

319 EXAM/ DIAGNOSTIC LIGHTS CENTRY 041344 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 34,955,000 PT. GRAHA ISMAYA

320 EXAM/ DIAGNOSTIC LIGHTS CENTRY 041345 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 67,500,000 PT. GRAHA ISMAYA

321 SURGERY LIGHTS CENTURION 041542 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 47,637,000 PT. GRAHA ISMAYA

322 SURGERY LIGHTS CENTURION 041543 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 53,819,000 PT. GRAHA ISMAYA

323 SURGERY LIGHTS CENTURION 041544 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 48,046,000 PT. GRAHA ISMAYA

324 SURGERY LIGHTS CENTURION 041545 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 93,637,000 PT. GRAHA ISMAYA

325 SURGERY LIGHTS CENTURION 041542B MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 74,046,000 PT. GRAHA ISMAYA
DAFTAR INFORMASI HARGA PERALATAN & LABORATORIUM
EFFECTIVE : OKTOBER 2005 S/D MARET 2006
PT. GRAHA ISMAYA, LTD

NO
NAMA PERALATAN KESEHATAN TIPE PRODUK MERK NEGARA ASAL NO. REGISTRASI SATUAN HJSA (RP) SOLE AGENT
URUT

326 SURGERY LIGHTS CENTURION 041543B MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 75,500,000 PT. GRAHA ISMAYA

327 SURGERY LIGHTS CENTURION 041544B MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 74,410,000 PT. GRAHA ISMAYA

328 SURGERY LIGHTS CENTURA 042842 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 52,682,000 PT. GRAHA ISMAYA

329 SURGERY LIGHTS CENTURA 042843 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 58,637,000 PT. GRAHA ISMAYA

330 SURGERY LIGHTS CENTURA 042844 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 53,091,000 PT. GRAHA ISMAYA

331 SURGERY LIGHTS CENTURA 042845 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 103,773,000 PT. GRAHA ISMAYA

332 SURGERY LIGHTS CENTURA 042942 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 66,728,000 PT. GRAHA ISMAYA

333 SURGERY LIGHTS CENTURA 042942 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 72,046,000 PT. GRAHA ISMAYA

334 SPOT LIGHTS CENTURA 042942 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 66,864,000 PT. GRAHA ISMAYA

335 SPOT LIGHTS CENTURA 042942 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 131,319,000 PT. GRAHA ISMAYA

336 COMBINATION CEILLING LIGHTS CENTRY & CENTURION MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 80,682,000 PT. GRAHA ISMAYA

337 COMBINATION CEILLING LIGHTS DUAL CENTURY MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 117,546,000 PT. GRAHA ISMAYA

338 COMBINATION CEILLING LIGHTS CENTRY & CENTURA MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 85,773,000 PT. GRAHA ISMAYA

339 COMBINATION CEILLING LIGHTS CENTURION & CENTURA MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 98,682,000 PT. GRAHA ISMAYA

340 COMBINATION CEILLING LIGHTS CENTRY & CENTURA MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 99,500,000 PT. GRAHA ISMAYA

341 COMBINATION CEILLING LIGHTS CENTURION & CENTURA MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 112,455,000 PT. GRAHA ISMAYA

342 EXAMINATION LAMP VERSALITE MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 4,455,000 PT. GRAHA ISMAYA

343 EXAMINATION LAMP MED/VED 011641 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 11,455,000 PT. GRAHA ISMAYA

344 EXAMINATION LAMP MED/VED 011642 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 11,410,000 PT. GRAHA ISMAYA

345 EXAMINATION LAMP MED/VED 011646 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 11,273,000 PT. GRAHA ISMAYA

346 EXAMINATION LAMP MED/VED 011647 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 7,137,000 PT. GRAHA ISMAYA

347 EXAMINATION LAMP MED/VED 012641 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 13,046,000 PT. GRAHA ISMAYA

348 EXAMINATION LAMP MED/VED 012642 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 13,410,000 PT. GRAHA ISMAYA

349 EXAMINATION LAMP MED/VED 012646 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 13,182,000 PT. GRAHA ISMAYA

350 EXAMINATION LAMP MED/VED 012647 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 13,819,000 PT. GRAHA ISMAYA

351 EXAMINATION LAMP MEDI.EXAM 011141 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 13,682,000 PT. GRAHA ISMAYA

352 EXAMINATION LAMP MEDI.EXAM 011142 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 13,546,000 PT. GRAHA ISMAYA

353 EXAMINATION LAMP MEDI.EXAM 011146 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 14,091,000 PT. GRAHA ISMAYA

354 EXAMINATION LAMP MEDI.EXAM 011147 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 14,955,000 PT. GRAHA ISMAYA

355 EXAMINATION LAMP MEDI-LITE 011342 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 23,228,000 PT. GRAHA ISMAYA

356 EXAMINATION LAMP MEDI-LITE 011343 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 26,819,000 PT. GRAHA ISMAYA

357 EXAMINATION LAMP MEDI-LITE 011344 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 25,273,000 PT. GRAHA ISMAYA

358 EXAMINATION LAMP MEDI-LITE 011345 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 48,137,000 PT. GRAHA ISMAYA

359 MINI SPOT LIGHTS MINI-SPOT 012041 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 13,773,000 PT. GRAHA ISMAYA

360 MINI SPOT LIGHTS MINI-SPOT 012042 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 14,137,000 PT. GRAHA ISMAYA

361 MINI SPOT LIGHTS MINI-SPOT 012046 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 14,637,000 PT. GRAHA ISMAYA

362 MINI SPOT LIGHTS MINI-SPOT 012047 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 15,364,000 PT. GRAHA ISMAYA

363 MAGNIFYING LIGHT MEDI-VUE 045041 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 14,637,000 PT. GRAHA ISMAYA

364 MAGNIFYING LIGHT MEDI-VUE 045042 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 14,364,000 PT. GRAHA ISMAYA

365 MAGNIFYING LIGHT MEDI-VUE 045047 MEDICAL ILLUMINATION USA SEDANG DALAM PROSES UNIT Rp 16,819,000 PT. GRAHA ISMAYA

366 VENTILATOR EMERGENCY transPAC 200D PNEUPAC ENGLAND DEPKES RI AKL 20403301997 UNIT Rp 191,728,000 PT. GRAHA ISMAYA

367 VENTILATOR EMERGENCY ventiPAC 200D PNEUPAC ENGLAND DEPKES RI AKL 20403302001 UNIT Rp 197,910,000 PT. GRAHA ISMAYA

368 VENTILATOR EMERGENCY FOR BABY babyPAC 100 PNEUPAC ENGLAND DEPKES RI AKL 20403301999 UNIT Rp 314,182,000 PT. GRAHA ISMAYA

369 VENTILATOR EMERGENCY transPAC 2D PNEUPAC ENGLAND DEPKES RI AKL 20403301998 UNIT Rp 179,319,000 PT. GRAHA ISMAYA

370 VENTILATOR EMERGENCY paraPAC 2D PNEUPAC ENGLAND DEPKES RI AKL 20403302205 UNIT Rp 179,319,000 PT. GRAHA ISMAYA

371 VENTILATOR EMERGENCY paraPAC 200 PNEUPAC ENGLAND DEPKES RI AKL 20403302207 UNIT Rp 191,728,000 PT. GRAHA ISMAYA

372 VENTILATOR EMERGENCY paraPAC 200D PNEUPAC ENGLAND DEPKES RI AKL 20403302202 UNIT Rp 191,728,000 PT. GRAHA ISMAYA

373 VENTILATOR EMERGENCY compPAC 200 PNEUPAC ENGLAND DEPKES RI AKL 20403302206 UNIT Rp 357,910,000 PT. GRAHA ISMAYA

374 SPLINT SET SAGER Traction Splint PNEUPAC ENGLAND DEPKES RI AKL 11303303082 UNIT Rp 16,955,000 PT. GRAHA ISMAYA

375 LARYNGOSCOPE LSFM 3 PNEUPAC ENGLAND SEDANG DALAM PROSES UNIT Rp 11,500,000 PT. GRAHA ISMAYA

376 LARYNGOSCOPE LSCM 3 PNEUPAC ENGLAND SEDANG DALAM PROSES UNIT Rp 6,591,000 PT. GRAHA ISMAYA

377 LARYNGOSCOPE LSCML 4 PNEUPAC ENGLAND SEDANG DALAM PROSES UNIT Rp 6,637,000 PT. GRAHA ISMAYA

378 RESPONDER RESPONDER 2 R PNEUPAC ENGLAND SEDANG DALAM PROSES UNIT Rp 67,182,000 PT. GRAHA ISMAYA

379 EMERGENCY VENTILATOR FOR TOXIC AREA COMPACT (COM 200) PNEUPAC ENGLAND SEDANG DALAM PROSES UNIT Rp 357,910,000 PT. GRAHA ISMAYA
DAFTAR INFORMASI HARGA PERALATAN & LABORATORIUM
EFFECTIVE : OKTOBER 2005 S/D MARET 2006
PT. GRAHA ISMAYA, LTD

NO
NAMA PERALATAN KESEHATAN TIPE PRODUK MERK NEGARA ASAL NO. REGISTRASI SATUAN HJSA (RP) SOLE AGENT
URUT

380 PULSE OXYMETER PULSE PAC PNEUPAC ENGLAND SEDANG DALAM PROSES UNIT Rp 40,819,000 PT. GRAHA ISMAYA

381 OPERATING TABLE OPX MOBILIS 200 G SCHMITZ GERMANY DEPKES RI AKL 11603300005 UNIT Rp 597,364,000 PT. GRAHA ISMAYA

382 OPERATING TABLE OPX MOBILIS 300 C SCHMITZ GERMANY DEPKES RI AKL 11603300006 UNIT Rp 615,546,000 PT. GRAHA ISMAYA

383 OPERATING TABLE OPX MOBILIS 300 C/G SCHMITZ GERMANY DEPKES RI AKL 11603300007 UNIT Rp 704,637,000 PT. GRAHA ISMAYA

384 OPERATING TABLE OPX MOBILIS 300 CL SCHMITZ GERMANY DEPKES RI AKL 11603300008 UNIT Rp 705,546,000 PT. GRAHA ISMAYA

385 OPERATING TABLE OPX MOBILIS 300 CLE SCHMITZ GERMANY DEPKES RI AKL 11603300009 UNIT Rp 822,000,000 PT. GRAHA ISMAYA

386 OPERATING TABLE OPX MOBILIS 300 CL/G SCHMITZ GERMANY DEPKES RI AKL 11603300010 UNIT Rp 794,637,000 PT. GRAHA ISMAYA

387 OPERATING TABLE OPX MOBILIS 300 CLE/G SCHMITZ GERMANY DEPKES RI AKL 11603300011 UNIT Rp 911,091,000 PT. GRAHA ISMAYA

388 OPERATING TABLE OPX MOBILIS 300 CE SCHMITZ GERMANY DEPKES RI AKL 11603300012 UNIT Rp 732,000,000 PT. GRAHA ISMAYA

389 OPERATING TABLE OPX MOBILIS 300 CE/G SCHMITZ GERMANY DEPKES RI AKL 11603300013 UNIT Rp 821,137,000 PT. GRAHA ISMAYA

390 INSTRUMENT SERVING TABLE 232.417 SCHMITZ GERMANY DEPKES RI AKL 10903300435 UNIT Rp 60,591,000 PT. GRAHA ISMAYA

391 DRESSING & TREATMENT TROLLEY 265.205 SCHMITZ GERMANY DEPKES RI AKL 10903300434 UNIT Rp 54,046,000 PT. GRAHA ISMAYA

392 OPERATING TABLE OPX MOBILIS 200 SCHMITZ GERMANY DEPKES RI AKL 11603300014 UNIT Rp 508,273,000 PT. GRAHA ISMAYA

393 OPERATING TABLE OPX 125.110 SCHMITZ GERMANY SEDANG DALAM PROSES UNIT Rp 388,410,000 PT. GRAHA ISMAYA

394 OPERATING TABLE OPX 125.111 SCHMITZ GERMANY SEDANG DALAM PROSES UNIT Rp 438,682,000 PT. GRAHA ISMAYA

395 OPERATING TABLE OPX 125.211 SCHMITZ GERMANY SEDANG DALAM PROSES UNIT Rp 506,319,000 PT. GRAHA ISMAYA

396 OPERATING TABLE Mobilis RC 40/G SCHMITZ GERMANY SEDANG DALAM PROSES UNIT Rp 1,051,000,000 PT. GRAHA ISMAYA

397 OPERATING TABLE OPX MOBILIS RC 30 SCHMITZ GERMANY SEDANG DALAM PROSES UNIT Rp 868,819,000 PT. GRAHA ISMAYA

398 OPERATING TABLE OPX MOBILIS RC 30/G SCHMITZ GERMANY SEDANG DALAM PROSES UNIT Rp 961,728,000 PT. GRAHA ISMAYA

399 OPERATING TABLE OPX MOBILIS RC 30/L SCHMITZ GERMANY SEDANG DALAM PROSES UNIT Rp 955,319,000 PT. GRAHA ISMAYA

400 OPERATING TABLE OPX MOBILIS RC 30L/G SCHMITZ GERMANY SEDANG DALAM PROSES UNIT Rp 1,049,046,000 PT. GRAHA ISMAYA

401 GYNECOLOGY TABLE MEDIMATIC 115.705 SCHMITZ GERMANY SEDANG DALAM PROSES UNIT Rp 130,046,000 PT. GRAHA ISMAYA

402 GYNECOLOGY TABLE MEDIMATIC 115.715 SCHMITZ GERMANY SEDANG DALAM PROSES UNIT Rp 263,319,000 PT. GRAHA ISMAYA

403 GYNECOLOGY TABLE MEDIMATIC 115.725 SCHMITZ GERMANY SEDANG DALAM PROSES UNIT Rp 307,728,000 PT. GRAHA ISMAYA

404 GYNECOLOGY TABLE MEDIMATIC 115.755 SCHMITZ GERMANY SEDANG DALAM PROSES UNIT Rp 379,591,000 PT. GRAHA ISMAYA

405 PATIENT TRANSPORT STX 280.202 SCHMITZ GERMANY SEDANG DALAM PROSES UNIT Rp 307,364,000 PT. GRAHA ISMAYA

406 PATIENT TRANSPORT STX 280.203 SCHMITZ GERMANY SEDANG DALAM PROSES UNIT Rp 345,728,000 PT. GRAHA ISMAYA

407 PATIENT TRANSPORT STX 280.204 SCHMITZ GERMANY SEDANG DALAM PROSES UNIT Rp 347,046,000 PT. GRAHA ISMAYA

408 PATIENT TRANSPORT STX 280.206 SCHMITZ GERMANY SEDANG DALAM PROSES UNIT Rp 436,955,000 PT. GRAHA ISMAYA

409 PATIENT TRANSPORT STX 280.220 SCHMITZ GERMANY SEDANG DALAM PROSES UNIT Rp 433,864,000 PT. GRAHA ISMAYA

410 PATIENT STRETCHER STS 282.100 SCHMITZ GERMANY SEDANG DALAM PROSES UNIT Rp 251,273,000 PT. GRAHA ISMAYA

411 PATIENT STRETCHER STS 282.200 SCHMITZ GERMANY SEDANG DALAM PROSES UNIT Rp 336,046,000 PT. GRAHA ISMAYA

412 USG PORTABLE CTS-200 SIUI CHINA DEPKES RI AKL 21501402507 UNIT Rp 128,591,000 PT. GRAHA ISMAYA

413 USG PORTABLE CTS-285 SIUI CHINA DEPKES RI AKL 21501402508 UNIT Rp 168,773,000 PT. GRAHA ISMAYA

414 USG PORTABLE CTS-385 PLUS SIUI CHINA DEPKES RI AKL 21501402509 UNIT Rp 180,819,000 PT. GRAHA ISMAYA

415 USG PORTABLE CTS-485 SIUI CHINA DEPKES RI AKL 21501402503 UNIT Rp 289,319,000 PT. GRAHA ISMAYA

416 USG MOBILE CTS-310B SIUI CHINA DEPKES RI AKL 21501402505 UNIT Rp 281,273,000 PT. GRAHA ISMAYA

417 USG MOBILE CTS-415 SIUI CHINA DEPKES RI AKL 21501402504 UNIT Rp 369,682,000 PT. GRAHA ISMAYA

418 USG COLLOR DOPPLER APOGEE 800+ SIUI CHINA DEPKES RI AKL 21501402506 UNIT Rp 1,647,455,000 PT. GRAHA ISMAYA

419 USG MOBILE CTS 5000 SIUI CHINA SEDANG DALAM PROSES UNIT Rp 562,546,000 PT. GRAHA ISMAYA

420 USG MOBILE CTS 6000 SIUI CHINA SEDANG DALAM PROSES UNIT Rp 1,044,728,000 PT. GRAHA ISMAYA

421 USG COLLOR DOPPLER APOGEE 3500 SIUI CHINA SEDANG DALAM PROSES UNIT Rp 1,084,910,000 PT. GRAHA ISMAYA

422 CRYOSTAT MEV SLEE GERMANY DEPKES RI AKL 10203402644 UNIT Rp 542,364,000 PT. GRAHA ISMAYA

423 CRYOSTAT MNT SLEE GERMANY DEPKES RI AKL 10203402646 UNIT Rp 876,000,000 PT. GRAHA ISMAYA

424 ROTARY MICROTOME CUT 4055 SLEE GERMANY DEPKES RI AKL 10203402650 UNIT Rp 166,910,000 PT. GRAHA ISMAYA

425 ROTARY MICROTOME CUT 4060 SLEE GERMANY DEPKES RI AKL 10203402651 UNIT Rp 203,046,000 PT. GRAHA ISMAYA

426 ROTARY MICROTOME CUT 5062 SLEE GERMANY DEPKES RI AKL 10203402647 UNIT Rp 282,319,000 PT. GRAHA ISMAYA

427 ROTARY MICROTOME CUT 6062 SLEE GERMANY DEPKES RI AKL 10203402648 UNIT Rp 423,273,000 PT. GRAHA ISMAYA

428 MICROTOME SHARPENER MMS SLEE GERMANY DEPKES RI AKL 10203402643 UNIT Rp 266,819,000 PT. GRAHA ISMAYA

429 TISSUE PROCESSOR S 2052 SLEE GERMANY DEPKES RI AKL 10203402642 UNIT Rp 504,819,000 PT. GRAHA ISMAYA

430 ELECTRIC DRILL (ORTHOPEDY) High Speed System SODEM SWITZERLAND DEPKES RI AKL 11603303690 UNIT Rp 405,773,000 PT. GRAHA ISMAYA

431 ELECTRIC DRILL (ORTHOPEDY) Power System Plus SODEM SWITZERLAND DEPKES RI AKL 11603303267 UNIT Rp 268,864,000 PT. GRAHA ISMAYA

432 NEBULIZER Turboneb CLEMENT CLARKE UK DEPKES RI AKL 20403500693 UNIT Rp 15,637,000 PT. GRAHA ISMAYA

433 NEBULIZER Econoneb CLEMENT CLARKE UK DEPKES RI AKL 20403500695 UNIT Rp 13,410,000 PT. GRAHA ISMAYA
DAFTAR INFORMASI HARGA PERALATAN & LABORATORIUM
EFFECTIVE : OKTOBER 2005 S/D MARET 2006
PT. GRAHA ISMAYA, LTD

NO
NAMA PERALATAN KESEHATAN TIPE PRODUK MERK NEGARA ASAL NO. REGISTRASI SATUAN HJSA (RP) SOLE AGENT
URUT

434 NEBULIZER World Traveler CLEMENT CLARKE UK DEPKES RI AKL 20403500688 UNIT Rp 24,046,000 PT. GRAHA ISMAYA

435 NEBULIZER AC 4000 CLEMENT CLARKE UK DEPKES RI AKL 20403500691 UNIT Rp 11,955,000 PT. GRAHA ISMAYA

436 NEBULIZER AC 2000 CLEMENT CLARKE UK DEPKES RI AKL 20403500694 UNIT Rp 15,637,000 PT. GRAHA ISMAYA

437 DENTAL UNIT Evolution MARC BELE BRAZIL DEPKES RI AKL 10605501508 UNIT Rp 113,910,000 PT. GRAHA ISMAYA

438 DENTAL UNIT Advanced I MARC BELE BRAZIL DEPKES RI AKL 10605501509 UNIT Rp 215,910,000 PT. GRAHA ISMAYA

439 DENTAL UNIT Excellent I MARC BELE BRAZIL DEPKES RI AKL 10605501510 UNIT Rp 152,410,000 PT. GRAHA ISMAYA

440 DENTAL UNIT Excellent II MARC BELE BRAZIL DEPKES RI AKL 10605501511 UNIT Rp 175,591,000 PT. GRAHA ISMAYA

441 DENTAL UNIT Titanium MARC BELE BRAZIL DEPKES RI AKL 10605501512 UNIT Rp 285,000,000 PT. GRAHA ISMAYA

442 OPERATING LAMP MOBILE ET 19 S DAI - ICHI SHOMEI JAPAN DEPKES RI AKL 10903501516 UNIT Rp 123,728,000 PT. GRAHA ISMAYA

443 OPERATING LAMP MOBILE ET 9 S DAI - ICHI SHOMEI JAPAN DEPKES RI AKL 10903501519 UNIT Rp 49,773,000 PT. GRAHA ISMAYA

444 OPERATING LAMP MOBILE ET 23 S DAI - ICHI SHOMEI JAPAN DEPKES RI AKL 10903501520 UNIT Rp 188,319,000 PT. GRAHA ISMAYA

445 OPERATING LAMP WITH CAMERA SYSTEMS ET 2323 TV DAI - ICHI SHOMEI JAPAN DEPKES RI AKL 10903501523 UNIT Rp 594,864,000 PT. GRAHA ISMAYA

446 OPERATING LAMP CEILING ET 29 DAI - ICHI SHOMEI JAPAN DEPKES RI AKL 21603501657 UNIT Rp 297,500,000 PT. GRAHA ISMAYA

447 OPERATING LAMP CEILING ET 23 DAI - ICHI SHOMEI JAPAN DEPKES RI AKL 21603501656 UNIT Rp 194,864,000 PT. GRAHA ISMAYA

448 OPERATING LAMP CEILING ET 29 23 DAI - ICHI SHOMEI JAPAN DEPKES RI AKL 21603501655 UNIT Rp 443,591,000 PT. GRAHA ISMAYA

449 OPERATING LAMP WITH CAMERA SYSTEMS ET 29TV 23 DAI - ICHI SHOMEI JAPAN DEPKES RI AKL 21603501654 UNIT Rp 710,137,000 PT. GRAHA ISMAYA

450 OPERATING LAMP MOBILE ET 2323 DAI - ICHI SHOMEI JAPAN DEPKES RI AKL 10903501521 UNIT Rp 337,000,000 PT. GRAHA ISMAYA

451 OPERATING LAMP WITH CAMERA SYSTEMS ET 2923 TV DAI - ICHI SHOMEI JAPAN DEPKES RI AKL 10903501518 UNIT Rp 692,637,000 PT. GRAHA ISMAYA

452 OPERATING LAMP WITH CAMERA SYSTEMS ET 29 TV DAI - ICHI SHOMEI JAPAN DEPKES RI AKL 21603501653 UNIT Rp 570,546,000 PT. GRAHA ISMAYA

453 OPERATING LAMP WITH CAMERA SYSTEMS ET 23 TV DAI - ICHI SHOMEI JAPAN SEDANG DALAM PROSES UNIT Rp 457,000,000 PT. GRAHA ISMAYA

454 OPERATING LAMP CEILING ET19 DAI - ICHI SHOMEI JAPAN SEDANG DALAM PROSES UNIT Rp 143,955,000 PT. GRAHA ISMAYA

455 OPERATING LAMP CEILING ET1919 DAI - ICHI SHOMEI JAPAN SEDANG DALAM PROSES UNIT Rp 253,773,000 PT. GRAHA ISMAYA

456 OPERATING LAMP CEILING ET9 DAI - ICHI SHOMEI JAPAN SEDANG DALAM PROSES UNIT Rp 70,637,000 PT. GRAHA ISMAYA

457 OPERATING LAMP CEILING ET9W DAI - ICHI SHOMEI JAPAN SEDANG DALAM PROSES UNIT Rp 56,410,000 PT. GRAHA ISMAYA

458 LAPAROTOMY PEDIATRIC INST.SET VARIOUS RUDOLF GERMANY DEPKES RI AKL 11603502636 SET Rp 189,364,000 PT. GRAHA ISMAYA

459 LARGE INSTRUMENT SET VARIOUS RUDOLF GERMANY DEPKES RI AKL 11603502635 SET Rp 19,182,000 PT. GRAHA ISMAYA

460 LARGE BONE INSTRUMENT SET VARIOUS RUDOLF GERMANY DEPKES RI AKL 11303502634 SET Rp 131,955,000 PT. GRAHA ISMAYA

461 Laryngectomy Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 10703502633 SET Rp 113,000,000 PT. GRAHA ISMAYA

462 Lumbal Function Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 10803502632 SET Rp 10,682,000 PT. GRAHA ISMAYA

463 Labioplasty Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 10703502631 SET Rp 53,410,000 PT. GRAHA ISMAYA

464 Incision and Drainage Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11603502630 SET Rp 25,682,000 PT. GRAHA ISMAYA

465 Hordeolum Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11203502629 SET Rp 8,682,000 PT. GRAHA ISMAYA

466 Hernia Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 10803502628 SET Rp 73,591,000 PT. GRAHA ISMAYA

467 Hecting Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11603502627 SET Rp 10,000,000 PT. GRAHA ISMAYA

468 Basic Eye Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11203502626 SET Rp 52,319,000 PT. GRAHA ISMAYA

469 Adult Basic Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11603502502 SET Rp 87,182,000 PT. GRAHA ISMAYA

470 Abdominal Urology Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 10803502503 SET Rp 128,773,000 PT. GRAHA ISMAYA

471 Amputasi Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11603502504 SET Rp 79,864,000 PT. GRAHA ISMAYA

472 Appendectomy Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11603502505 SET Rp 63,637,000 PT. GRAHA ISMAYA

473 Bandage Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11603502506 SET Rp 17,410,000 PT. GRAHA ISMAYA

474 Basic Neurosurgery Craniotomy Inst. Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11002502507 SET Rp 116,364,000 PT. GRAHA ISMAYA

475 Basic Obgyn Operating Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11104502508 SET Rp 290,091,000 PT. GRAHA ISMAYA

476 Basic Orthopedy Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 1130352509 SET Rp 268,591,000 PT. GRAHA ISMAYA

477 Bladder Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 10804502510 SET Rp 60,773,000 PT. GRAHA ISMAYA

478 Catarac Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11203502512 SET Rp 124,046,000 PT. GRAHA ISMAYA

479 Chalazion Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11203502513 SET Rp 24,410,000 PT. GRAHA ISMAYA

480 Child Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11603502514 SET Rp 59,955,000 PT. GRAHA ISMAYA

481 Circumsision Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11104502515 SET Rp 6,910,000 PT. GRAHA ISMAYA

482 Tracheotomy Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 10703502585 SET Rp 25,910,000 PT. GRAHA ISMAYA

483 Sectio Caeserean/Hysterectomy Inst. Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11603502584 SET Rp 149,000,000 PT. GRAHA ISMAYA

484 Partus Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11104502583 SET Rp 25,046,000 PT. GRAHA ISMAYA

485 Minor Basic Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11603502582 SET Rp 60,637,000 PT. GRAHA ISMAYA

486 Mayor Basic Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11603502581 SET Rp 109,819,000 PT. GRAHA ISMAYA

487 Laparotomy Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11603502580 SET Rp 231,091,000 PT. GRAHA ISMAYA
DAFTAR INFORMASI HARGA PERALATAN & LABORATORIUM
EFFECTIVE : OKTOBER 2005 S/D MARET 2006
PT. GRAHA ISMAYA, LTD

NO
NAMA PERALATAN KESEHATAN TIPE PRODUK MERK NEGARA ASAL NO. REGISTRASI SATUAN HJSA (RP) SOLE AGENT
URUT

488 Vena Sectio Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11603502548 SET Rp 25,364,000 PT. GRAHA ISMAYA

489 Forceps Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11104502547 SET Rp 130,591,000 PT. GRAHA ISMAYA

490 Excision of Skin Growths Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11603502546 SET Rp 40,182,000 PT. GRAHA ISMAYA

491 Ear Microsurgery Thympanoplasty & Stapedec Inst. Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 10703502544 SET Rp 227,182,000 PT. GRAHA ISMAYA

492 Ear Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 10703502543 SET Rp 144,455,000 PT. GRAHA ISMAYA

493 Dilatation & Curret Diagnostic Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 21104502543 SET Rp 41,819,000 PT. GRAHA ISMAYA

494 Dilatation & Curret Abortus Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 21104502541 SET Rp 44,091,000 PT. GRAHA ISMAYA

495 Basic Cardiovascular Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 10504502539 SET Rp 286,864,000 PT. GRAHA ISMAYA

496 Gastrointestinal Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 10803502800 SET Rp 303,091,000 PT. GRAHA ISMAYA

497 Hand Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11603502802 SET Rp 198,228,000 PT. GRAHA ISMAYA

498 Maxillo Facial Surgery Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 10703502803 SET Rp 710,637,000 PT. GRAHA ISMAYA

499 Mastoidectomy Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11603502804 SET Rp 81,500,000 PT. GRAHA ISMAYA

500 Mastectomy Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11603502805 SET Rp 38,773,000 PT. GRAHA ISMAYA

501 Mandible Bone Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11303502806 SET Rp 48,819,000 PT. GRAHA ISMAYA

502 Laminectomy Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11603502807 SET Rp 218,728,000 PT. GRAHA ISMAYA

503 Haemorrhoid / Para Anal Fistule Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11603502796 SET Rp 59,819,000 PT. GRAHA ISMAYA

504 Gynecology Minor Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11104502797 SET Rp 102,819,000 PT. GRAHA ISMAYA

505 Gynekology Examination Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11104502798 SET Rp 38,637,000 PT. GRAHA ISMAYA

506 Glaucoma Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11203502799 SET Rp 142,410,000 PT. GRAHA ISMAYA

507 Vaginal Basic Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 10804502879 SET Rp 113,819,000 PT. GRAHA ISMAYA

508 Urology Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 10804502880 SET Rp 241,182,000 PT. GRAHA ISMAYA

509 Tubectomy Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 10804502881 SET Rp 11,000,000 PT. GRAHA ISMAYA

510 Thyroidectomy Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 10703502883 SET Rp 158,546,000 PT. GRAHA ISMAYA

511 Thympanoplasty Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 10703502884 SET Rp 439,182,000 PT. GRAHA ISMAYA

512 Vascular Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11603502885 SET Rp 241,228,000 PT. GRAHA ISMAYA

513 Trepanasi Instrument Set VARIOUS RUDOLF GERMANY DEPKES RI AKL 11002502882 SET Rp 64,364,000 PT. GRAHA ISMAYA

514 Anuscopes VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 14,773,000 PT. GRAHA ISMAYA

515 Arthroscopy Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 543,819,000 PT. GRAHA ISMAYA

516 Basic (ENT) THT Instrument Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 176,728,000 PT. GRAHA ISMAYA

517 Basic Obgyn Operating Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 290,091,000 PT. GRAHA ISMAYA

518 Basic Orthopedic Instrument Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 268,591,000 PT. GRAHA ISMAYA

519 Embriotomy Instrument Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 66,273,000 PT. GRAHA ISMAYA

520 Functional Ensdoscopy Sinus Surgery (FESS) VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 868,864,000 PT. GRAHA ISMAYA

521 Laparoscope Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 1,397,455,000 PT. GRAHA ISMAYA

522 Mayor Oncology Surgery Inst. Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 209,591,000 PT. GRAHA ISMAYA

523 Micro Surgery Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 90,273,000 PT. GRAHA ISMAYA

524 Micro Gynaecology Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 96,319,000 PT. GRAHA ISMAYA

525 Minor Plastic Surgery Instrument Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 62,410,000 PT. GRAHA ISMAYA

526 Myringotomy Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 24,637,000 PT. GRAHA ISMAYA

527 Nasal Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 149,546,000 PT. GRAHA ISMAYA

528 Neuro Surgery Basic Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 138,910,000 PT. GRAHA ISMAYA

529 Opthalmology Operating Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 290,273,000 PT. GRAHA ISMAYA

530 Oral Surgery set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 180,228,000 PT. GRAHA ISMAYA

531 Otopsy Instrument Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 682,000,000 PT. GRAHA ISMAYA

532 Pediatric Instrument Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 447,591,000 PT. GRAHA ISMAYA

533 Plastic Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 98,546,000 PT. GRAHA ISMAYA

534 Plaster of Paris Cast Remove VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 54,773,000 PT. GRAHA ISMAYA

535 Plaster of Paris Instrument Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 53,182,000 PT. GRAHA ISMAYA

536 Policlinic ENT Instrument Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 89,410,000 PT. GRAHA ISMAYA

537 Polypectomy Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 18,591,000 PT. GRAHA ISMAYA

538 Prostatectomy Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 74,364,000 PT. GRAHA ISMAYA

539 Pterigium Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 23,500,000 PT. GRAHA ISMAYA

540 Rectal Instrument Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 64,046,000 PT. GRAHA ISMAYA

541 Skin Graft Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 58,410,000 PT. GRAHA ISMAYA
DAFTAR INFORMASI HARGA PERALATAN & LABORATORIUM
EFFECTIVE : OKTOBER 2005 S/D MARET 2006
PT. GRAHA ISMAYA, LTD

NO
NAMA PERALATAN KESEHATAN TIPE PRODUK MERK NEGARA ASAL NO. REGISTRASI SATUAN HJSA (RP) SOLE AGENT
URUT

542 Strippening Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 7,591,000 PT. GRAHA ISMAYA

543 Thoracotomy Instrument Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 216,410,000 PT. GRAHA ISMAYA

544 Tonsilectomy/Adenodectomy Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 89,591,000 PT. GRAHA ISMAYA

545 Trepanasi Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 64,364,000 PT. GRAHA ISMAYA

546 Pediatric Thoracotomy Instrument Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 234,500,000 PT. GRAHA ISMAYA

547 Tonometers Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 143,091,000 PT. GRAHA ISMAYA

548 Vitreorethinal Surgery Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 389,591,000 PT. GRAHA ISMAYA

549 Nasal-Polyprctomy Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 203,728,000 PT. GRAHA ISMAYA

550 Cytoscope Instrument Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 79,455,000 PT. GRAHA ISMAYA

551 Resectoscopy Basic VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 306,637,000 PT. GRAHA ISMAYA

552 Laparoscopy Basic VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 124,137,000 PT. GRAHA ISMAYA

553 ThoracoscopyBasic VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 1,586,410,000 PT. GRAHA ISMAYA

554 Thoracentesis a paracentesis VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 9,728,000 PT. GRAHA ISMAYA

555 Chest aspiration Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 27,637,000 PT. GRAHA ISMAYA

556 Trans Urethal Resection (TUR) set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 154,364,000 PT. GRAHA ISMAYA

557 Obstetrical Instrument Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 111,182,000 PT. GRAHA ISMAYA

558 Pleural Biopsy Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 8,410,000 PT. GRAHA ISMAYA

559 Labioplasty Instr. Set VARIOUS RUDOLF GERMANY SEDANG DALAM PROSES SET Rp 53,410,000 PT. GRAHA ISMAYA

560 STRESS TEST ECG SYSTEM PCE-200 W/TREADMILL WELCH ALLYN USA SEDANG DALAM PROSES UNIT Rp 585,500,000 PT. GRAHA ISMAYA

561 STRESS TEST ECG SYSTEM PCE-210 WELCH ALLYN USA SEDANG DALAM PROSES UNIT Rp 607,137,000 PT. GRAHA ISMAYA

562 REST ECG (ECG BASED PC) PCR 100 PC WELCH ALLYN USA SEDANG DALAM PROSES UNIT Rp 155,546,000 PT. GRAHA ISMAYA

563 REST ECG (ECG BASED PC) PCR 100i PC WELCH ALLYN USA SEDANG DALAM PROSES UNIT Rp 177,182,000 PT. GRAHA ISMAYA

564 REST ECG (ECG BASED PC) CER-100 WELCH ALLYN USA SEDANG DALAM PROSES UNIT Rp 129,591,000 PT. GRAHA ISMAYA

565 ECG 1 CHANNEL K130B CAMINA ITALY SEDANG DALAM PROSES UNIT Rp 45,637,000 PT. GRAHA ISMAYA

566 ECG 1 CHANNEL K130D W/HR DISPLAY CAMINA ITALY SEDANG DALAM PROSES UNIT Rp 53,455,000 PT. GRAHA ISMAYA

567 ECG 1 CHANNEL K130D W/HR DISPLAY & INTP CAMINA ITALY SEDANG DALAM PROSES UNIT Rp 58,182,000 PT. GRAHA ISMAYA

568 ECG 3 CHANNEL K360 B CAMINA ITALY SEDANG DALAM PROSES UNIT Rp 64,455,000 PT. GRAHA ISMAYA

569 ECG 3 CHANNEL K360D W/HR DISPLAY CAMINA ITALY SEDANG DALAM PROSES UNIT Rp 71,546,000 PT. GRAHA ISMAYA

570 ECG 3 CHANNEL K 360D W/HR DISPLAY & INTP CAMINA ITALY SEDANG DALAM PROSES UNIT Rp 72,910,000 PT. GRAHA ISMAYA

MICROSCOPE OPERASI (SURGICAL


571 MC-M1912 DVF BRAZIL SEDANG DALAM PROSES UNIT Rp 136,819,000 PT. GRAHA ISMAYA
MICROSCOPE) FOR ENT

MICROSCOPE OPERASI (SURGICAL


572 MC-M900 DVF BRAZIL SEDANG DALAM PROSES UNIT Rp 178,546,000 PT. GRAHA ISMAYA
MICROSCOPE) FOR ENT

MICROSCOPE OPERASI (SURGICAL


573 MC-M900MF DVF BRAZIL SEDANG DALAM PROSES UNIT Rp 295,137,000 PT. GRAHA ISMAYA
MICROSCOPE) FOR ENT
MICROSCOPE OPERASI (SURGICAL
574 MICROSCOPE) FOR ENT WITH MC-M900MF DVF BRAZIL SEDANG DALAM PROSES UNIT Rp 380,910,000 PT. GRAHA ISMAYA
ASSISTANT SCOPE
MICROSCOPE OPERASI (SURGICAL
575 MICROSCOPE) FOR ENT WITH VIDEO MC-M900MF DVF BRAZIL SEDANG DALAM PROSES UNIT Rp 424,137,000 PT. GRAHA ISMAYA
CAMERA
MICROSCOPE OPERASI (SURGICAL
576 MC-M3101XY DVF BRAZIL SEDANG DALAM PROSES UNIT Rp 574,228,000 PT. GRAHA ISMAYA
MICROSCOPE) FOR OPTHALMOLOGY

MICROSCOPE OPERASI (SURGICAL


577 MC-M902 DVF BRAZIL SEDANG DALAM PROSES UNIT Rp 178,546,000 PT. GRAHA ISMAYA
MICROSCOPE) FOR OPTHALMOLOGY

MICROSCOPE OPERASI (SURGICAL


578 MC_M902MF DVF BRAZIL SEDANG DALAM PROSES UNIT Rp 295,137,000 PT. GRAHA ISMAYA
MICROSCOPE) FOR OPTHALMOLOGY

MICROSCOPE OPERASI (SURGICAL


579 MICROSCOPE) FOR OPTHALMOLOGY MC-M3101XY DVF BRAZIL SEDANG DALAM PROSES UNIT Rp 660,000,000 PT. GRAHA ISMAYA
WITH ASSISTANT SCOPE

MICROSCOPE OPERASI (SURGICAL


580 MICROSCOPE) FOR OPTHALMOLOGY MC-M3101XY DVF BRAZIL SEDANG DALAM PROSES UNIT Rp 703,228,000 PT. GRAHA ISMAYA
WITH VIDEO CAMERA

581 SLIT LAMP LF-M4 DVF BRAZIL SEDANG DALAM PROSES UNIT Rp 124,819,000 PT. GRAHA ISMAYA

582 KERATOMETER OF-M2 DVF BRAZIL SEDANG DALAM PROSES UNIT Rp 80,137,000 PT. GRAHA ISMAYA

583 HIGH SPIN WASHING MACHINE LM6 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 128,591,000 PT. GRAHA ISMAYA

584 HIGH SPIN WASHING MACHINE LM8 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 178,864,000 PT. GRAHA ISMAYA

585 HIGH SPIN WASHING MACHINE LM11 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 219,000,000 PT. GRAHA ISMAYA
DAFTAR INFORMASI HARGA PERALATAN & LABORATORIUM
EFFECTIVE : OKTOBER 2005 S/D MARET 2006
PT. GRAHA ISMAYA, LTD

NO
NAMA PERALATAN KESEHATAN TIPE PRODUK MERK NEGARA ASAL NO. REGISTRASI SATUAN HJSA (RP) SOLE AGENT
URUT

586 HIGH SPIN WASHING MACHINE LM18 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 334,000,000 PT. GRAHA ISMAYA

587 HIGH SPIN WASHING MACHINE LM23 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 403,091,000 PT. GRAHA ISMAYA

588 HIGH SPIN WASHING MACHINE LM30 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 735,773,000 PT. GRAHA ISMAYA

589 HIGH SPIN WASHING MACHINE LM40 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 863,455,000 PT. GRAHA ISMAYA

590 HIGH SPIN WASHING MACHINE LM55 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 1,077,910,000 PT. GRAHA ISMAYA

591 HIGH SPIN WASHING MACHINE LM70 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 1,437,728,000 PT. GRAHA ISMAYA

592 HIGH SPIN WASHING MACHINE LM 85 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 1,769,000,000 PT. GRAHA ISMAYA

593 LOW SPIN WASHING MACHINE RC 8 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 126,773,000 PT. GRAHA ISMAYA

594 LOW SPIN WASHING MACHINE RC 11 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 140,182,000 PT. GRAHA ISMAYA

595 LOW SPIN WASHING MACHINE RC 14 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 199,819,000 PT. GRAHA ISMAYA

596 LOW SPIN WASHING MACHINE RC 18 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 224,410,000 PT. GRAHA ISMAYA

597 LOW SPIN WASHING MACHINE RC 23 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 272,910,000 PT. GRAHA ISMAYA

598 LOW SPIN WASHING MACHINE RC 30 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 411,046,000 PT. GRAHA ISMAYA

599 LOW SPIN WASHING MACHINE RC 40 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 507,591,000 PT. GRAHA ISMAYA

600 LOW SPIN WASHING MACHINE RC 55 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 629,455,000 PT. GRAHA ISMAYA

601 HYDRO EXTRACTOR ZP 400 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 149,364,000 PT. GRAHA ISMAYA

602 HYDRO EXTRACTOR ZP 450 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 188,046,000 PT. GRAHA ISMAYA

603 HYDRO EXTRACTOR ZP 635 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 307,410,000 PT. GRAHA ISMAYA

604 HYDRO EXTRACTOR ZP 730 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 491,819,000 PT. GRAHA ISMAYA

605 HYDRO EXTRACTOR ZP 900SEL IMESA ITALY SEDANG DALAM PROSES UNIT Rp 1,193,410,000 PT. GRAHA ISMAYA

606 TUMBLE DRYER ES 10 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 104,864,000 PT. GRAHA ISMAYA

607 TUMBLE DRYER ES 14 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 124,410,000 PT. GRAHA ISMAYA

608 TUMBLE DRYER ES 18 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 134,182,000 PT. GRAHA ISMAYA

609 TUMBLE DRYER ES 23 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 155,500,000 PT. GRAHA ISMAYA

610 TUMBLE DRYER ES 34 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 172,864,000 PT. GRAHA ISMAYA

611 TUMBLE DRYER ES 55 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 421,319,000 PT. GRAHA ISMAYA

612 TUMBLE DRYER ES 55 1Tilting IMESA ITALY SEDANG DALAM PROSES UNIT Rp 477,364,000 PT. GRAHA ISMAYA

613 TUMBLE DRYER ES 55 2Tilting IMESA ITALY SEDANG DALAM PROSES UNIT Rp 534,137,000 PT. GRAHA ISMAYA

614 FLATWORK IRONER M 1000/25 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 84,637,000 PT. GRAHA ISMAYA

615 FLATWORK IRONER M 1250/25 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 91,137,000 PT. GRAHA ISMAYA

616 FLATWORK IRONER M 1500/25 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 94,728,000 PT. GRAHA ISMAYA

617 FLATWORK IRONER M 1500/33 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 166,364,000 PT. GRAHA ISMAYA

618 FLATWORK IRONER M 1750/33 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 178,637,000 PT. GRAHA ISMAYA

619 FLATWORK IRONER M 2000/33 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 209,728,000 PT. GRAHA ISMAYA

620 FLATWORK IRONER PF 1700 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 555,455,000 PT. GRAHA ISMAYA

621 FLATWORK IRONER PF 2160 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 592,728,000 PT. GRAHA ISMAYA

622 FLATWORK IRONER PF 2540 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 611,182,000 PT. GRAHA ISMAYA

623 FLATWORK IRONER PF 2800 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 633,955,000 PT. GRAHA ISMAYA

624 WET CLEAN WASHER ICM 78 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 406,864,000 PT. GRAHA ISMAYA

625 WET CLEAN WASHER ICM 90 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 463,273,000 PT. GRAHA ISMAYA

626 WET CLEAN WASHER ICM 120 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 564,137,000 PT. GRAHA ISMAYA

627 WET CLEAN WASHER ICM 170 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 823,819,000 PT. GRAHA ISMAYA

628 WET CLEAN WASHER ICM 230 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 1,196,273,000 PT. GRAHA ISMAYA

629 WET CLEAN WASHER ICM 300 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 1,406,410,000 PT. GRAHA ISMAYA

630 WET CLEAN WASHER ICD 14 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 187,682,000 PT. GRAHA ISMAYA

631 WET CLEAN WASHER ICD 18 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 198,910,000 PT. GRAHA ISMAYA

632 WET CLEAN WASHER ICD 23 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 260,728,000 PT. GRAHA ISMAYA

633 WET CLEAN WASHER ICD 34 IMESA ITALY SEDANG DALAM PROSES UNIT Rp 279,910,000 PT. GRAHA ISMAYA

634 POCKET DOPPLER PD 1 ULTRASOUND ENGLAND SEDANG DALAM PROSES UNIT Rp 9,273,000 PT. GRAHA ISMAYA

635 POCKET DOPPLER PD 1+ ULTRASOUND ENGLAND SEDANG DALAM PROSES UNIT Rp 13,182,000 PT. GRAHA ISMAYA

636 POCKET DOPPLER PD 1 dwr ULTRASOUND ENGLAND SEDANG DALAM PROSES UNIT Rp 15,046,000 PT. GRAHA ISMAYA

637 POCKET DOPPLER BIDI 1 ULTRASOUND ENGLAND SEDANG DALAM PROSES UNIT Rp 45,273,000 PT. GRAHA ISMAYA

638 POCKET DOPPLER PD 1 V ULTRASOUND ENGLAND SEDANG DALAM PROSES UNIT Rp 12,637,000 PT. GRAHA ISMAYA

639 POCKET DOPPLER PD 1 combi ULTRASOUND ENGLAND SEDANG DALAM PROSES UNIT Rp 12,364,000 PT. GRAHA ISMAYA
DAFTAR INFORMASI HARGA PERALATAN & LABORATORIUM
EFFECTIVE : OKTOBER 2005 S/D MARET 2006
PT. GRAHA ISMAYA, LTD

NO
NAMA PERALATAN KESEHATAN TIPE PRODUK MERK NEGARA ASAL NO. REGISTRASI SATUAN HJSA (RP) SOLE AGENT
URUT

640 CARDIOTOCOGRAPH (CTG) / FETAL MONITOR PFM 1 ULTRASOUND ENGLAND SEDANG DALAM PROSES UNIT Rp 131,500,000 PT. GRAHA ISMAYA

641 ELECTROTHERAPY UNIT EDiT® 100 NEMECTRON GERMANY SEDANG DALAM PROSES UNIT Rp 76,100,000 PT. GRAHA ISMAYA

642 ELECTROTHERAPY UNIT EDiT® 400 NEMECTRON GERMANY SEDANG DALAM PROSES UNIT Rp 77,300,000 PT. GRAHA ISMAYA

643 ULTRASOUND THERAPY UNIT NEMECTROSON 110 NEMECTRON GERMANY SEDANG DALAM PROSES UNIT Rp 83,950,000 PT. GRAHA ISMAYA

644 ULTRASOUND THERAPY UNIT NEMECTROSON 400 NEMECTRON GERMANY SEDANG DALAM PROSES UNIT Rp 90,000,000 PT. GRAHA ISMAYA

645 MICROWAVE DIATHERMY NT 250 NEMECTRON GERMANY SEDANG DALAM PROSES UNIT Rp 179,650,000 PT. GRAHA ISMAYA

646 SHORTWAVE DIATHERMY NT 200 NEMECTRON GERMANY SEDANG DALAM PROSES UNIT Rp 333,900,000 PT. GRAHA ISMAYA

647 SPECIAL THERAPY NEM TENS NEMECTRON GERMANY SEDANG DALAM PROSES UNIT Rp 9,350,000 PT. GRAHA ISMAYA

648 SPECIAL THERAPY NePTUN SL NEMECTRON GERMANY SEDANG DALAM PROSES UNIT Rp 58,650,000 PT. GRAHA ISMAYA

649 BALNEO THERAPY Ionozon® Bath NEMECTRON GERMANY SEDANG DALAM PROSES UNIT Rp 677,150,000 PT. GRAHA ISMAYA

650 OXYGEN CONCENTRATOR INTEGRA 10 SEQUAL USA SEDANG DALAM PROSES UNIT Rp 35,750,000 PT. GRAHA ISMAYA

651 OXYGEN CONCENTRATOR WITH OMS INTEGRA 10 SEQUAL USA SEDANG DALAM PROSES UNIT Rp 39,000,000 PT. GRAHA ISMAYA

652 ELECTROTHERAPY UNIT NEUROVECTOR N48 IBRAMED BRAZIL SEDANG DALAM PROSES UNIT Rp 21,400,000 PT. GRAHA ISMAYA

653 ELECTROTHERAPY UNIT NEURODYN 10 CHANNELS N49 IBRAMED BRAZIL SEDANG DALAM PROSES UNIT Rp 38,550,000 PT. GRAHA ISMAYA

654 ELECTROTHERAPY UNIT NEURODYN HIGH VOLT N50 IBRAMED BRAZIL SEDANG DALAM PROSES UNIT Rp 25,500,000 PT. GRAHA ISMAYA

655 ELECTROTHERAPY UNIT NEURODYN ESTHETIC N52 IBRAMED BRAZIL SEDANG DALAM PROSES UNIT Rp 25,250,000 PT. GRAHA ISMAYA

656 ELECTROTHERAPY UNIT NEURODYN N43 IBRAMED BRAZIL SEDANG DALAM PROSES UNIT Rp 19,950,000 PT. GRAHA ISMAYA

657 ELECTROTHERAPY UNIT NEURODYN II 4 CHANNELS N53 IBRAMED BRAZIL SEDANG DALAM PROSES UNIT Rp 9,850,000 PT. GRAHA ISMAYA

658 ELECTROTHERAPY UNIT NEURODYN COMPACT N51 IBRAMED BRAZIL SEDANG DALAM PROSES UNIT Rp 7,150,000 PT. GRAHA ISMAYA

659 ELECTROTHERAPY UNIT NEORODYN III N45 IBRAMED BRAZIL SEDANG DALAM PROSES UNIT Rp 5,700,000 PT. GRAHA ISMAYA

660 ELECTROTHERAPY UNIT NEURODYN TENS/FES PORTABLE N46 IBRAMED BRAZIL SEDANG DALAM PROSES UNIT Rp 4,950,000 PT. GRAHA ISMAYA

661 ELECTROTHERAPY UNIT NEURODYN TENS PORTABLE N47 IBRAMED BRAZIL SEDANG DALAM PROSES UNIT Rp 8,950,000 PT. GRAHA ISMAYA

662 ELECTROTHERAPY UNIT STRIAT S19 IBRAMED BRAZIL SEDANG DALAM PROSES UNIT Rp 4,700,000 PT. GRAHA ISMAYA

663 ULTRASOUND THERAPY SONOPULSE 1 E 3 MHZ S33 IBRAMED BRAZIL SEDANG DALAM PROSES UNIT Rp 21,400,000 PT. GRAHA ISMAYA

664 ULTRASOUND THERAPY SONOPULSE II 1,0 MHZ S28 IBRAMED BRAZIL SEDANG DALAM PROSES UNIT Rp 38,542,800 PT. GRAHA ISMAYA

665 ULTRASOUND THERAPY SONOPULSE II 3,0 MHZ S30 IBRAMED BRAZIL SEDANG DALAM PROSES UNIT Rp 25,500,000 PT. GRAHA ISMAYA

666 ULTRASOUND THERAPY SONOPULSE III 1,0 e 3,0 MHZ S34 IBRAMED BRAZIL SEDANG DALAM PROSES UNIT Rp 25,250,000 PT. GRAHA ISMAYA

667 ULTRASOUND THERAPY SONOPULSE COMPACT 1,0 MHZ S35 IBRAMED BRAZIL SEDANG DALAM PROSES UNIT Rp 19,950,000 PT. GRAHA ISMAYA

668 ULTRASOUND THERAPY SONOPULSE COMPACT 3,0 MHZ S36 IBRAMED BRAZIL SEDANG DALAM PROSES UNIT Rp 9,850,000 PT. GRAHA ISMAYA

669 LASER THERAPY LASERPULSE L42 IBRAMED BRAZIL SEDANG DALAM PROSES UNIT Rp 12,150,000 PT. GRAHA ISMAYA

670 LASER THERAPY CANETA 660 nm C660 IBRAMED BRAZIL SEDANG DALAM PROSES UNIT Rp 19,250,000 PT. GRAHA ISMAYA

671 LASER THERAPY CANETA 830 nm C830 IBRAMED BRAZIL SEDANG DALAM PROSES UNIT Rp 22,050,000 PT. GRAHA ISMAYA

672 LASER THERAPY CANETA 904 nm C904 IBRAMED BRAZIL SEDANG DALAM PROSES UNIT Rp 19,250,000 PT. GRAHA ISMAYA

673 DERMOTHERAPY VACUUM THERAPY DERMOTONUS D 90 IBRAMED BRAZIL SEDANG DALAM PROSES UNIT Rp 71,350,000 PT. GRAHA ISMAYA

674 DERMOTHERAPY VACUUM THERAPY DERMOTONUS SLIM D91 IBRAMED BRAZIL SEDANG DALAM PROSES UNIT Rp 38,550,000 PT. GRAHA ISMAYA

675 STEAM THERAPY DERMOSTEAM D90 IBRAMED BRAZIL SEDANG DALAM PROSES UNIT Rp 14,100,000 PT. GRAHA ISMAYA

676 BLOOD & INFUSION WARMER ASTOTHERM® plus 220 STIHLER ELECTRONIC GERMANY SEDANG DALAM PROSES UNIT Rp 58,550,000 PT. GRAHA ISMAYA

677 BLOOD & INFUSION WARMER ASTOTHERM® plus 220S STIHLER ELECTRONIC GERMANY SEDANG DALAM PROSES UNIT Rp 65,450,000 PT. GRAHA ISMAYA

678 BLOOD & INFUSION WARMER ASTOTHERM® plus 260 STIHLER ELECTRONIC GERMANY SEDANG DALAM PROSES UNIT Rp 54,550,000 PT. GRAHA ISMAYA

679 BLOOD & INFUSION WARMER ASTOTHERM® plus 260S STIHLER ELECTRONIC GERMANY SEDANG DALAM PROSES UNIT Rp 70,450,000 PT. GRAHA ISMAYA

680 HEATED BLANKET ASTOPAS SYSTEM 150 STIHLER ELECTRONIC GERMANY SEDANG DALAM PROSES UNIT Rp 77,000,000 PT. GRAHA ISMAYA

681 HEATED BLANKET ASTOPAD plus STIHLER ELECTRONIC GERMANY SEDANG DALAM PROSES UNIT Rp 39,250,000 PT. GRAHA ISMAYA

682 HEATED BLANKET ASTOPAS SYSTEM 180 STIHLER ELECTRONIC GERMANY SEDANG DALAM PROSES UNIT Rp 87,250,000 PT. GRAHA ISMAYA

683 ELECTRIC BED SERIES MEB 703 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 36,950,000 PT. GRAHA ISMAYA

684 ELECTRIC BED SERIES MEB 803 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 42,100,000 PT. GRAHA ISMAYA

685 ELECTRIC BED SERIES MEB 203 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 38,000,000 PT. GRAHA ISMAYA

686 ELECTRIC BED SERIES MEB 213 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 39,650,000 PT. GRAHA ISMAYA

687 ELECTRIC BED SERIES MEB 223 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 44,800,000 PT. GRAHA ISMAYA

688 ELECTRIC BED SERIES MEB 243 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 39,650,000 PT. GRAHA ISMAYA

689 ICU BED SERIES MEB 704 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 36,950,000 PT. GRAHA ISMAYA

690 ICU BED SERIES MEB 804 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 42,100,000 PT. GRAHA ISMAYA

691 ICU BED SERIES MEB 223R MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 38,000,000 PT. GRAHA ISMAYA

692 MANUAL BED SERIES MMB 302 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 20,600,000 PT. GRAHA ISMAYA

693 MANUAL BED SERIES MEB 312 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 25,500,000 PT. GRAHA ISMAYA
DAFTAR INFORMASI HARGA PERALATAN & LABORATORIUM
EFFECTIVE : OKTOBER 2005 S/D MARET 2006
PT. GRAHA ISMAYA, LTD

NO
NAMA PERALATAN KESEHATAN TIPE PRODUK MERK NEGARA ASAL NO. REGISTRASI SATUAN HJSA (RP) SOLE AGENT
URUT

694 MANUAL BED SERIES MEB 303 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 25,800,000 PT. GRAHA ISMAYA

695 MANUAL BED SERIES MEB 313 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 30,650,000 PT. GRAHA ISMAYA

696 MANUAL BED SERIES MEB 202 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 24,150,000 PT. GRAHA ISMAYA

697 MANUAL BED SERIES MEB 212 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 24,700,000 PT. GRAHA ISMAYA

698 MANUAL BED SERIES MEB 203 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 27,400,000 PT. GRAHA ISMAYA

699 MANUAL BED SERIES MEB 213 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 27,950,000 PT. GRAHA ISMAYA

700 MANUAL BED SERIES MEB 223 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 32,850,000 PT. GRAHA ISMAYA

701 MANUAL BED SERIES MEB 243 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 28,500,000 PT. GRAHA ISMAYA

702 BEDSIDE CABINET MBC 101 ABS CABINET MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 3,050,000 PT. GRAHA ISMAYA

703 BEDSIDE CABINET MBC 102 (COMB CABINET) MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 3,550,000 PT. GRAHA ISMAYA

704 BEDSIDE CABINET MBC 102 (COMB CABINET) MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 3,900,000 PT. GRAHA ISMAYA

705 BEDSIDE CABINET MBC 102 (COMB CABINET) MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 3,800,000 PT. GRAHA ISMAYA

706 BEDSIDE CABINET MBC 102 (COMB CABINET) MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 4,100,000 PT. GRAHA ISMAYA

707 EMERGENCY TROLLEY MET-6600 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 106,100,000 PT. GRAHA ISMAYA

708 EMERGENCY TROLLEY MET 3100 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 23,950,000 PT. GRAHA ISMAYA

709 EMERGENCY TROLLEY MET 3200 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 28,300,000 PT. GRAHA ISMAYA

710 EMERGENCY TROLLEY MET 3300 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 31,550,000 PT. GRAHA ISMAYA

711 SCRUB SINK MS 7100 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 195,850,000 PT. GRAHA ISMAYA

712 SCRUB SINK MS 7200 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 274,700,000 PT. GRAHA ISMAYA

713 SCRUB SINK MS 7300 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 315,500,000 PT. GRAHA ISMAYA

714 SCRUB SINK MS 7400 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 168,650,000 PT. GRAHA ISMAYA

715 SCRUB SINK MS 7500 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 247,500,000 PT. GRAHA ISMAYA

716 SCRUB SINK MS 7600 MEDICAL MASTER TAIWAN SEDANG DALAM PROSES UNIT Rp 273,100,000 PT. GRAHA ISMAYA
DAFTAR INFORMASI HARGA PERALATAN KESEHATAN & LABORATORIUM
EFFECTIVE: 1 Oktober 2005

No. Urut Nama Peralatan Kesehatan Model/Type Merk Negara Asal/Pabrikan No. Registrasi Satuan HJSA Sole Agent
DepKes RI

1 Audiology Diagnostic Systems AuDx (Perform OAE Biologic USA AKL 20701401986 USD 17,160 PT. Tiara Kencana
test without computer)

2 Audiology Diagnostic Systems Scout Sport Biologic USA Dalam proses USD 22,405 PT. Tiara Kencana
3 Audiology Diagnostic Systems ABAER / Scout with Biologic USA Dalam proses USD 41,771 PT. Tiara Kencana
DP & TE
4 Audiology Diagnostic Systems Navigator Pro Biologic USA AKL 20701401984 USD 37,156 PT. Tiara Kencana
5 Audiology Diagnostic Systems Navigator Pro/Scout Biologic USA Dalam proses USD 48,011 PT. Tiara Kencana
with DP & TE
6 Audiology Diagnostic Systems Navigator Pro / Biologic USA Dalam proses USD 68,291 PT. Tiara Kencana
MASTER
7 Audiology Diagnostic Systems Navigator Pro / Biologic USA Dalam proses USD 58,931 PT. Tiara Kencana
ABAER / Scout with
DP & TE
8 Bone Densitometer UBIS 5000 DMS France AKL 21501401987 USD 53,876 PT. Tiara Kencana
9 Capnometer Weinmann - Weinmann Germany Dalam proses EUR 7,784.40 PT. Tiara Kencana
Capnocount mini
10 Cardiotogograph Antepartum - Ultrasound England Dalam proses GBP 10,483 PT. Tiara Kencana
Fetatrack 310-A Technologies
single fetal monitor
11 Cardiotogograph Antepartum - Ultrasound England Dalam proses GBP 12,043 PT. Tiara Kencana
Fetatrack 310-A twin Technologies
fetal monitor
12 Cardiotogograph Cardiotocograph - Ultrasound England Dalam proses GBP 28,482 PT. Tiara Kencana
Intrapartum - Technologies
Fetatrack 360-I
13 Cardiotogograph Antepartum - Ultrasound England Dalam proses GBP 20,589 PT. Tiara Kencana
Fetatrack 360-A Technologies
14 Dental Unit WD6131-C Medix China Dalam proses USD 14,197 PT. Tiara Kencana
Option:
1. Curing light USD 2,455 PT. Tiara Kencana
2. Aircompressor USD 1,720 PT. Tiara Kencana
15 Dental Unit WD6323 Medix China Dalam proses USD 36,909 PT. Tiara Kencana
Option:
1. Curing light USD 2,455 PT. Tiara Kencana
2. Aircompressor USD 1,720 PT. Tiara Kencana
16 Dental Unit WD6131-C+ Medix China Dalam proses USD 16,573 PT. Tiara Kencana
Option:
1. Curing light USD 2,455 PT. Tiara Kencana
2. Aircompressor USD 1,720 PT. Tiara Kencana
No. Urut Nama Peralatan Kesehatan Model/Type Merk Negara Asal/Pabrikan No. Registrasi Satuan HJSA Sole Agent
DepKes RI
17 Dental Unit WD6631-F Medix China Dalam proses USD 18,929 PT. Tiara Kencana
Option:
1. Digital image USD 72,655 PT. Tiara Kencana
system for dental
2. Fiber high USD 2,945 PT. Tiara Kencana
speed handpiece
3. Ultrasonic USD 2,455 PT. Tiara Kencana
scalar
4. Curing light USD 2,455 PT. Tiara Kencana
5. Aircompressor USD 1,720 PT. Tiara Kencana
18 Dental Unit WD6423 Medix China Dalam proses USD 21,769 PT. Tiara Kencana
Option:
1. Digital image USD 72,655 PT. Tiara Kencana
system for dental
2. Fiber high USD 2,945 PT. Tiara Kencana
speed handpiece
3. Ultrasonic USD 2,455 PT. Tiara Kencana
scalar
4. Curing light USD 2,455 PT. Tiara Kencana
5. Aircompressor USD 1,720 PT. Tiara Kencana
19 Diagnostic Ultrasound Systems CONCEPT / MC Dynamic England AKL 21501401957 GBP 11,700 PT. Tiara Kencana
tanpa probe & printer Imaging

20 Diagnostic Ultrasound Systems Ultrasound scanner Dynamic England Dalam proses USD 36,524 PT. Tiara Kencana
LCM2100a + 3,5 MHz Imaging
tranducer & 6,5 MHz
endovaginal tranducer

21 Diagnostic Ultrasound Systems CONCEPT / G tanpa Dynamic England AKL 21501401959 GBP 15,444 PT. Tiara Kencana
probe & printer Imaging
22 Diagnostic Ultrasound Systems Ultrasound scanner Dynamic England Dalam proses USD 31,025 PT. Tiara Kencana
PU400 + 3,5 MHz Imaging
tranducer & 6,5 MHz
endovaginal tranducer

23 Digital ECG System 12 Channels ECG Power ECG USA Dalam proses USD 15,339 PT. Tiara Kencana
with Digital archiving
capability PC ECG
1200 S
24 Digital ECG System Power ECG + Power ECG USA Dalam proses USD 30,881 PT. Tiara Kencana
Treadmill
25 Treadmill Trackmaster standard Power ECG USA Dalam proses USD 12,960 PT. Tiara Kencana
No. Urut Nama Peralatan Kesehatan Model/Type Merk Negara Asal/Pabrikan No. Registrasi Satuan HJSA Sole Agent
DepKes RI
26 Treadmill Trackmaster standard Power ECG USA Dalam proses USD 14,138 PT. Tiara Kencana
+ panel
27 Digital EEG Ceegraph Netlink Biologic USA AKL 20701401985 USD 47,263 PT. Tiara Kencana
28 Digital EEG Ceegraph Traveller Biologic USA Dalam proses PT. Tiara Kencana
29 Digital EEG Ceegraph Netlink (40 Biologic USA Dalam proses USD 47,263 PT. Tiara Kencana
channel)
30 Digital EEG + Brain mapping Ceegraph Netlink + Biologic USA Dalam proses USD 58,183 PT. Tiara Kencana
Brain Atlas
31 Digital Epilepsy Monitoring Digital EEG - Epilepsy Biologic USA Dalam proses USD 65,592 PT. Tiara Kencana
Monitoring
32 Electroconvulsive Therapy (ECT)Stubi Convul-2 Kamine Indonesia Dalam proses Rp 109,090,909 PT. Tiara Kencana
33 Emergency case Weinmann Weinmann Germany Dalam proses EUR 1,207 PT. Tiara Kencana
Emergency case -
ULM I
34 Emergency case Weinmann Weinmann Germany Dalam proses EUR 1,304 PT. Tiara Kencana
Emergency case -
ULM II
35 Emergency case Weinmann Weinmann Germany Dalam proses EUR 1,551 PT. Tiara Kencana
Emergency case -
ULM III
36 Emergency case Weinmann Rescue Weinmann Germany Dalam proses EUR 3,987 PT. Tiara Kencana
Pack - Rescue pack
standard
37 Emergency case Weinmann Rescue Weinmann Germany Dalam proses EUR 792 PT. Tiara Kencana
Pack - Rescue pack I
mini (kosong)
38 Emergency case Weinmann Rescue Weinmann Germany Dalam proses EUR 13,831 PT. Tiara Kencana
Pack - Rescue pack
respiration
39 Emergency case Weinmann Rescue Weinmann Germany Dalam proses EUR 12,028 PT. Tiara Kencana
Pack - Rescue pack I
mini respiratory
40 Incinerator Incinerator 0.3 m3 Kamine Indonesia Dalam proses Rp 139,636,364 PT. Tiara Kencana
PWR - INC-KMN 03
41 Incinerator Incinerator 0.5 m3 Kamine Indonesia Dalam proses Rp 174,545,455 PT. Tiara Kencana
PWR - INC-KMN 05
42 Incinerator Incinerator 1 m3 Kamine Indonesia Dalam proses Rp 245,142,545 PT. Tiara Kencana
PWR - INC-KMN 10
43 Incinerator Incinerator 2 m3 Kamine Indonesia Dalam proses Rp 418,909,091 PT. Tiara Kencana
PWR - INC-KMN 20
44 Sleep apnea diagnostic SOMNOcheck effort Weinmann Germany AKL 20403501247 EUR 16,829 PT. Tiara Kencana
45 Oxygen Concentrator OC 6 Rimer Alco England KL 0403790444 GBP 153,439 PT. Tiara Kencana
46 Oxygen Concentrator OC 11 Rimer Alco England Dalam proses GBP 156,384 PT. Tiara Kencana
47 Oxygen Concentrator OC 20 Rimer Alco England Dalam proses GBP 206,292 PT. Tiara Kencana
No. Urut Nama Peralatan Kesehatan Model/Type Merk Negara Asal/Pabrikan No. Registrasi Satuan HJSA Sole Agent
DepKes RI
48 Oxygen Concentrator OC 35 Rimer Alco England Dalam proses GBP 261,807 PT. Tiara Kencana
49 Oxygen Therapy Unit Weinmann Mobile Weinmann Germany Dalam proses EUR 4,337 PT. Tiara Kencana
Oxygen Therapy Unit -
OXYFLOW Revy WM
33500
50 Oxygen Therapy Unit Weinmann Mobile Weinmann Germany Dalam proses EUR 2,031 PT. Tiara Kencana
Oxygen Therapy Unit -
OXYFLOW Basic WM
33200
51 Oxygen Therapy Unit Weinmann Mobile Weinmann Germany Dalam proses EUR 2,193 PT. Tiara Kencana
Oxygen Therapy Unit -
OXYFLOW Standard
WM 33300
52 Oxygen Therapy Unit Weinmann Mobile Weinmann Germany Dalam proses EUR 3,547 PT. Tiara Kencana
Oxygen Therapy Unit -
OXYFLOW Care WM
33400
53 Oxygen Therapy Unit Weinmann Transport Weinmann Germany Dalam proses EUR 1,070.16 PT. Tiara Kencana
Oxygen - OXYBAG
Hit WM 33100
54 Oxygen Therapy Unit Weinmann - Weinmann Germany Dalam proses EUR 3,088.80 PT. Tiara Kencana
Oxycount mini
55 Pocket Doppler Fetatrack 120+ Ultrasound England Dalam proses GBP 1,154 PT. Tiara Kencana
Technologies
56 Polysomnography Sleepscan Netlink Biologic USA AKL 21001401969 USD 131,459 PT. Tiara Kencana
57 Pressure reducer Weinmann Pressure Weinmann Germany Dalam proses EUR 567.84 PT. Tiara Kencana
Reducer - OXYWAY
fast WM 30800
58 Pressure reducer Weinmann Pressure Weinmann Germany Dalam proses EUR 461.76 PT. Tiara Kencana
Reducer - OXYWAY
fix WM 30050
59 Pressure reducer Weinmann Pressure Weinmann Germany Dalam proses EUR 474.24 PT. Tiara Kencana
Reducer - OXYWAY
fine WM 30500
60 Pulsoximeter Weinmann - Weinmann Germany Dalam proses EUR 5,272.80 PT. Tiara Kencana
Oxycount mini with
Multi base 2
61 Resuscitator Weinmann Combibag Weinmann Germany Dalam proses EUR 459 PT. Tiara Kencana
- Combibag Standard
WM 11000
No. Urut Nama Peralatan Kesehatan Model/Type Merk Negara Asal/Pabrikan No. Registrasi Satuan HJSA Sole Agent
DepKes RI
62 Resuscitator Weinmann Combibag Weinmann Germany Dalam proses EUR 540 PT. Tiara Kencana
- Combibag with
reservoir WM 11052

63 Suction pump Weinmann Manuvac Weinmann Germany Dalam proses EUR 2,805 PT. Tiara Kencana
WM 10800
64 Suction pump Weinmann Accuvac Weinmann Germany Dalam proses EUR 2,122 PT. Tiara Kencana
Basic WM 10700
65 Suction pump Weinmann Accuvac Weinmann Germany Dalam proses EUR 2,805 PT. Tiara Kencana
Rescue WM 10620
66 Traction Unit Electronic Traction Kamine Indonesia Dalam proses Rp 27,272,727 PT. Tiara Kencana
System for Cervical &
Lumbar traction
67 Transcranial Doppler TCD 2 Ch (Desktop) - Rimed USA Dalam proses USD 51,985 PT. Tiara Kencana
Intraview
68 Transcranial Doppler TCD 4 Ch (Desktop) - Rimed USA Dalam proses USD 67,383 PT. Tiara Kencana
Fourview
69 Transcranial Doppler TCD 2 Ch (Portable) - Rimed USA Dalam proses USD 54,659 PT. Tiara Kencana
Smartlite
70 Transcranial Doppler TCD 4 Ch (Portable) - Rimed USA Dalam proses USD 65,891 PT. Tiara Kencana
Smartlite
71 Transcranial Doppler TCD - Neurovision Multigon USA Dalam proses USD 39,655 PT. Tiara Kencana
500 P (Palm)
72 Ventilator Weinmann Ventilator - Weinmann Germany Dalam proses EUR 7,956 PT. Tiara Kencana
Medumat Basic-p WM
22650

73 Ventilator Weinmann Ventilator - Weinmann Germany Dalam proses EUR 9,354 PT. Tiara Kencana
Medumat Standard
WM 22500

74 Ventilator Weinmann Ventilator - Weinmann Germany Dalam proses EUR 11,585 PT. Tiara Kencana
Medumat Stabdard-a
WM 22800

75 Ventilator Weinmann Ventilator - Weinmann Germany Dalam proses EUR 1,335 PT. Tiara Kencana
Modul Oxygen WM
22200
76 Ventilator Weinmann Ventilator - Weinmann Germany Dalam proses EUR 1,420 PT. Tiara Kencana
Modul Suction WM
22220
77 Ventilator Weinmann Ventilator - Weinmann Germany Dalam proses EUR 2,118 PT. Tiara Kencana
Modul Combi WM
22210
No. Urut Nama Peralatan Kesehatan Model/Type Merk Negara Asal/Pabrikan No. Registrasi Satuan HJSA Sole Agent
DepKes RI
78 Ventilator Weinmann Ventilator - Weinmann Germany Dalam proses EUR 1,058 PT. Tiara Kencana
Modul interface WM
22230
79 Ventilator Weinmann Ventilator - Weinmann Germany Dalam proses EUR 63.02 PT. Tiara Kencana
Lifeway with tube

80 Ventilator Weinmann Ventilator - Weinmann Germany Dalam proses EUR 49.61 PT. Tiara Kencana
Lifeway with mask

81 Ventilator Weinmann Life base Weinmann Germany Dalam proses EUR 12,782.64 PT. Tiara Kencana
mini II dengan
carrying platform &
modul (WM 8120)
82 Ventilator Weinmann Life base Weinmann Germany Dalam proses EUR 14,161.68 PT. Tiara Kencana
II dengan carrying
platform & modul
(WM 8100)
83 Ventilator Weinmann Life base Weinmann Germany Dalam proses EUR 15,366.00 PT. Tiara Kencana
III dengan carrying
platform & modul
(WM 8215)
84 X - Ray Unit MEDIX - X-Ray unit - Medix China Dalam proses USD 24,447 PT. Tiara Kencana
F30-IIF 200mA
medical diagnostic
unit, one-tube one-
table
85 X - Ray Unit MEDIX - X-Ray unit - Medix China Dalam proses USD 35,228 PT. Tiara Kencana
F30-IIG 200mA
medical diagnostic
unit, two-tube two-
table
86 X - Ray Unit MEDIX - X-Ray unit - Medix China Dalam proses USD 53,607 PT. Tiara Kencana
F78-IIC 300mA
medical diagnostic
unit, two-tube two-
table, micro-processor
controlled generator

87 X - Ray Unit MEDIX - X-Ray unit - Medix China Dalam proses USD 49,778 PT. Tiara Kencana
F78-IIIB 300mA
medical diagnostic
unit, two-tube two-
table
No. Urut Nama Peralatan Kesehatan Model/Type Merk Negara Asal/Pabrikan No. Registrasi Satuan HJSA Sole Agent
DepKes RI
88 X - Ray Unit MEDIX - X-Ray unit - Medix China Dalam proses USD 60,087 PT. Tiara Kencana
F78-IIIC 300mA
medical diagnostic
unit, two-tube two-
table, micro-processor
controlled generator

89 X - Ray Unit MEDIX - X-Ray unit - Medix China Dalam proses USD 60,676 PT. Tiara Kencana
F99-IBT 500mA
medical diagnostic
unit, two-tube two-
table
90 X - Ray Unit MEDIX - X-Ray unit - Medix China Dalam proses USD 73,636 PT. Tiara Kencana
F99-ICT 500mA
medical diagnostic
unit, two-tube two-
table, micro-processor
controlled generator

91 Spirometer Datospir 120 C Sibelmed Spain Dalam proses EUR 6,744 PT. Tiara Kencana
92 Spirometer Datospir 120 D Sibelmed Spain Dalam proses EUR 8,731 PT. Tiara Kencana
93 Audimometri AC-50 Sibelmed Spain Dalam proses EUR 6,562 PT. Tiara Kencana

Catatan:
Harga sewaktu-waktu dapat berubah tanpa pemberitahuan sebelumnya
Harga netto, tidak termasuk pajak
Harga franko Jakarta
PT. PANCARAYA KRISNAMANDIRI
DAFTAR INFORMASI HARGA PERALATAN KESEHATAN & LABORATORIUM
EFFECTIVE : 2 JANUARI 2006

No. Negara Asal No. Registrasi HJSA


Nama Peralatan Kesehatan Model/Type Merk Satuan Sole Agent
Urut / Pabrikan DepKes RI (Rp)

THT

1. ENT Treatment Unit New Model MEDICINDO Indonesia Dalam Proses Unit 35,000,000 PT. Pancaraya Krisnamandiri
(Include Film Viewer)
Optional :
- ENT Chair Static Model MEDICINDO Indonesia Dalam Proses Unit 11,250,000 PT. Pancaraya Krisnamandiri
- Doctor's Stool MEDICINDO Indonesia Dalam Proses Buah 1,600,000 PT. Pancaraya Krisnamandiri
- Trolly for Observasi Sinuscopy 101 MEDICINDO Indonesia Dalam Proses Buah 3,750,000 PT. Pancaraya Krisnamandiri
- Light Source MEDICINDO Indonesia Dalam Proses Unit 6,250,000 PT. Pancaraya Krisnamandiri
- Trolly for Observasi Sinuscopy + Light 101 MEDICINDO Indonesia Dalam Proses Unit 10,625,000 PT. Pancaraya Krisnamandiri
Source

2. ENT Chair Electric Model MEDICINDO Indoesia Dalam Proses Unit 30,750,000 PT. Pancaraya Krisnamandiri

3 ENT Treatment Unit HSE-3000M HAESUNG Korea Dalam Proses Unit 59,000,000 PT. Pancaraya Krisnamandiri
ENT Chair OC-3000 HAESUNG Korea Dalam Proses Unit 43,500,000 PT. Pancaraya Krisnamandiri

4. ENT Treatment Unit FEU-100 FUKUGAWA Japan Dalam Proses Unit 151,500,000 PT. Pancaraya Krisnamandiri
ENT Chair FEC-101 FUKUGAWA Japan Dalam Proses Unit 148,500,000 PT. Pancaraya Krisnamandiri

5. Doctor's Stool MEDICINDO Indonesia Dalam Proses Buah 1,600,000 PT. Pancaraya Krisnamandiri
Doctor's Stool SHIN-NIPPON Japan Dalam Proses Buah 3,500,000 PT. Pancaraya Krisnamandiri

6. Instrument Kecil Poli THT, terdiri dari : PRECISEMED Germany Dalam Proses Set 16,225,000 PT. Pancaraya Krisnamandiri
- Hartman Ear Specula set of 3 pcs EA 01 - 41
- Nasal Specula
- Vienna Nasal Specula Infant NA 04 - 41
- Vienna Nasal Specula Children NA 04 - 42
- Vienna Nasal Specula Adult NA 04 - 43
- Tieck - Halle Specula NA 03 - 10
- Troltch Nasal Foceps NB 13 - 15
- Lucae Ear Dressing Forceps EU 04 - 14
- Ear Syringe 100cc, Metal Currete EB 10 - 10
- Buck Curette blunt size 0. EF 04 - 00
- Buck Curette blunt size 1. EF 04 - 01
- Buck Curette blunt size 2. EF 04 - 02
- Hartman Ear Polyppus Forceps 8.5cm EH 85 - 01
- Bruening Tongue Depressor NN 14 - 19
- Paracintesis Needle ONDEKO Japan Dalam Proses Buah PT. Pancaraya Krisnamandiri
- Handle Laryng Mirror ONDEKO Japan Dalam Proses Buah PT. Pancaraya Krisnamandiri
- Laryng Mirror (No. 1-6) ONDEKO Japan Dalam Proses Buah PT. Pancaraya Krisnamandiri
- Pocket Otoscope 22840 WELCH ALLYN USA Dalam Proses Buah PT. Pancaraya Krisnamandiri

7. Instrument Kecil Poli THT HILBRO Pakistan Dalam Proses Set 8,500,000 PT. Pancaraya Krisnamandiri
Terdiri dari
- Ear Specula : H 44 - 020
H 44 - 021
H 44 - 022
- Nasal Specula : H 46 - 041
H 46 - 042
H 46 - 043
- Curettes : H 44 - 230
H 44 - 231
H 44 - 232
- Tieck Halle H 46 - 041
- Ear Dressing Lucae H 44 -370
- Nasal Dressing H 46 -170
- Nasal Dressing H 46 - 180
- Suction Canula 1,5mm; 2mm; 3mm
- Bruening Tongue Depressor (5pcs) H 48 - 230
- Ear Syring H 44 104
- Ear Micro Forceps Straight H 44 - 450
- Ear Micro Forceps Curved H 44 - 460
- Nasal Dressing Forceps H 46 - 230
- Handle Laryng Mirror H 50 - 590
- Paracintesis Needle ONDEKO Japan Dalam Proses Buah PT. Pancaraya Krisnamandiri
- Larryng Mirror (6pcs) ONDEKO Japan Dalam Proses Buah PT. Pancaraya Krisnamandiri
- Pocket Otoscope 22840 WELCH ALLYN USA Dalam Proses Buah PT. Pancaraya Krisnamandiri

8. SET TES PENDENGARAN :


- Diagnostic Audiometer AD 226 INTERACOUSTIC Denmark Dalam Proses Unit 40,000,000 PT. Pancaraya Krisnamandiri
- Sound Proof Chamber MEDICINDO Indonesia Dalam Proses Unit 28,875,000 PT. Pancaraya Krisnamandiri
- Kursi Stainless Steel MEDICINDO Indonesia Dalam Proses Unit 3,200,000 PT. Pancaraya Krisnamandiri

9. INSTRUMENT SET THT : HILBRO Pakistan Dalam Proses Set 8,213,000 PT. Pancaraya Krisnamandiri
- TONSILO ADENOIDECTOMY SET
Terdiri dari :
- Yankauer 23cm / 9" H 06 - 300
- Metzembeaum-Nelson 18cm / 7" H 10 - 121
- Negus Tonsil 19cm / 7 1/2" H 14 - 771
- Adenoid Curettes H 46 -851
- Adenoid Curettes H 46 -852
- Adenoid Curettes H 46 -853
- Mouth Gags Davis Boyle H 48 - 100
- Mouth Gags Jenning 13cm / 5" H 48 - 164
- Mouth Gags Jenning 15cm / 6" H 48 - 166
- Tobold Tongue Depressor 14cm / 5 1/2" H 48 - 280
- Abraham Tonsil Knivew 21cm / 8 1/2" H 50 - 080
- Hurd Tonsil 22,5cm / 9" H 50 - 130
- Schnidt Tonsil Haemostatic 19cm / 7" H 50 -191
- Schnidt Tonsil Haemostatic 19cm / 7" H 50 - 201
- Schnidt Tonsil Haemostatic H 50 - 203
- Blohmke 20cm / 8" H 50 - 1211
- Eves Tonsil Snare 28cm / 11" H 50 - 260

10. TONSILECTOMY SET PRECISEMED Germany Dalam Proses Set 49,225,000 PT. Pancaraya Krisnamandiri
Terdiri dari :
- Davis Boyle Mouth Gags
Davis Boyle Tongue Depressor NM 01 - 10
Davis Boyle Tongue Depressor NM 01 - 20
Davis Boyle Tongue Depressor NM 01 - 30
Davis Boyle Tongue Depressor NM 01 - 40
Davis Boyle Tongue Depressor NM 01 - 50
Davis Boyle Tongue Depressor NM 01 - 90
- Sluder Balanger NU 10 - 99
- Schnidt Tonsil Haemostatic Forceps NR 56 - 19
- Negus Haemustatic Forceps NR 27 - 01
- Hurd Cleft Palate Needle NP 02 - 02
- Henke Tonsil Elevator NQ 01 - 23
- Abraham Tonsil Forceps NP 34 - 21
- Metzembaum Scissors, Cvd 5473 - 03
- White Tonsil Forceps NR 20 - 18
- Blohmke NR 55 - 20
- Eves Tonsil Snare NU 02 - 30
- Steel Wire 0,3mm Bundle NU 05 - 03
- Tobold Tongue Depressor NN 20 - 00
- Yankeur Tonsil Tube NK 05 - 23
- Hurd Tonsil NQ 01 - 09
- Jenning Mouth Gag, 13mm NM 55 - 13
- Jenning Mouth Gags, 15mm NM 55 - 15
- Roeder Tonsil Snare 20 - 00
Pilar Retractor for Davis Boyle Mouth Gags MEDICINDO Indonesia Dalam Proses Set PT. Pancaraya Krisnamandiri

Alternatif : PRECISEMED Germany Dalam Proses Set 4,750,000 PT. Pancaraya Krisnamandiri
- Mclvor Mouth Gag :
Tongue Depressor, S NM 02 - 10
Tongue Depressor, M NM 02 - 20
Tongue Depressor, L NM 02 - 30
Handle NM 02 - 90
- Roder Bender MEDICINDO Indonesia Dalam Proses Buah 1,155,000 PT. Pancaraya Krisnamandiri

11. POLYPECTOMY HILBRO Pakistan Dalam Proses Set 3,250,000 PT. Pancaraya Krisnamandiri
Terdiri dari :
- Heyman Nasal Scissors 18cm / 7" H 10 - 190
- Frazier Cannula 6 Fg H 30 - 230
- Frazier Cannula 8 Fg H 30 - 232
- Killian Nasal Speculum 35mm H 46 - 031
- Killian Nasal Speculum 50mm H 46 - 032
- Killian Nasal Speculum 75mm H 46 - 033
- Krause Nasal Snare H 46 - 120
- Wire Snare 0,4mm H 46 - 152
- Troeltsh Dressing Tampon Fcp 18cm / 7" H 46 - 152
- Gruenwald (Jansen) 20cm / 8" H 46 -180

12. POLYPECTOMY PRECISEMED Germany Dalam Proses Set 11,825,000 PT. Pancaraya Krisnamandiri
Terdiri dari :
- Killian Specula 50mm NA 02 - 50
- Killian Specula 75mm NA 02 - 75
- Gruenwald Dressing Forcep 20cm NB 12 - 20
- Krause Nasal Snare NU 04 - 26
- Bundle Wire 10m x 0,4mm NU 06 - 40
- Frazier Suction Canula Charr 6,17cm NK 06 - 06
- Frazier Suction Canula Charr 8,17cm NK 06 - 08
- Heyman Nasal Scissors 5306 - 03

13. MASTOIDECTOMY HILBRO Pakistan Dalam Proses Set 4,550,000 PT. Pancaraya Krisnamandiri
Terdiri dari :
- Scalpel Handle NO. 7 H 08 - 067
- Weitlaner Blunt 13cm H 18 - 941
- Bone Chisel 6mm H 28 - 230
- Bone Chisel 13mm H 28 - 250
- Collin 30mm - 220mg H 28 - 280
- Volkman Bone Curette H 28 - 388
- Troeltsch Ear Dressing 13cm / 5" H 44 - 364
- Hartman Ear Polypus Frcp 14cm / 5 1/2" H 44 - 402
- Hartman Ear Polypus Frcp 8,5cm / 3 1/2" H 44 - 450
- Freer Chesels 4mm H 46 - 670
- Freer Chesels 4mm H 46 - 671
14. MASTOIDECTOMY PRECISEMED Germany Dalam Proses Set 12,850,000 PT. Pancaraya Krisnamandiri
Terdiri dari :
- Scalpel Handle NO. 7 3525 - 7K
- Hartman Ear Polypus Forceps 8,5cm EH 85 - 01
- Lucae Ear Dressing Forceps EU 04 - 14
- Freer Chisel Straight 4mm NH 01 - 04
- Freer Chisel Curved 4mm NH 02 - 04
- Schede Bone Currette size 000 BS 38 - 30
- Weitland Retractor Blunt GE 94 -13
- Collin 30mm - 20mmg COLLIN
15. SINUS SURGERY HILBRO Pakistan Dalam Proses Set 5,375,000 PT. Pancaraya Krisnamandiri
Terdiri dari :
- Coakley Trocar H 06 - 180
- Piere Trocar H 06 - 200
- Collin 30mm - 220mg H 28 - 280
- Killian Nasal Speculum 50mm H 46 - 032
- Killian Speculum 75mm H 46 - 033
- Gruenwald 20cm / 8" H 46 -180
- Hartman Dressing Forceps H 46 - 210
- Takahasi 19cm / 7 1/2" Etmoid & Nasal H 46 - 332
Cutting
- Nasal Cutting Forceps Well Blakeley H 46 - 351
19cm / 7 1/2"
- Freer Septum Elevator & Respatoris H 46 - 594
- Ballenger Septum Knives H 46 - 632
- Freer 16cm / 6 1/2" H 46 - 671
- Coakley Trocar H 46 - 821
- Eicken - Killian 3mm H 46 - 930

16. SINUS SURGERY PRECISEMED Germany Dalam Proses Set 23,500,000 PT. Pancaraya Krisnamandiri
Terdiri dari :
- Killian Nasal Speculla 5mm NA 02 - 50
- Killian Nasal Speculla 75mm NA 02 - 75
- Weil-Bakesley Cutting Forceps NC 36 - 01
- Takahasi Nasal Forceps NC 33 - 02
- Freer Elevator Double Ended 1926 - 00
- Balanger Septum Knife and Gouge NG 20 - 00
- Gruenwald Dressing Forceps NB 12 - 20
- Hartman Polypus Forceps 20mm NB 50 - 20
- Collin 20mmg - 220mg COLLIN
- Piere Trocar VT 93 - 30
- Eiken Killian Wash Canulla NI 93 30
- Coakley Curette NI 07 -01

17. TRACHEOTOMY HILBRO Pakistan Dalam Proses Set 2,750,000 PT. Pancaraya Krisnamandiri
Terdiri dari :
- Trocar 25 G Fig 1 H 06 - 060
- Trocar H 06 - 200
- Yankeur Suction Tubes H 06 - 300
- Scalpel Handle No. 7 H 08 - 067
- Laborde 14cm H 32 - 030
- Trachea Retractor H 32 - 060
- Trachea Tubes 8mm H 32 - 144
- Trachea Tubes 9mm H 32 - 145
- Trachea Tubes 10mm H 32 - 146

18. TRACHEOTOMY PRECISEMED Germany Dalam Proses Set 16,500,000 PT. Pancaraya Krisnamandiri
Terdiri dari :
- Piere Trocar 3mm VT 32 - 30
- Piere Trocar 4mm VT 32 - 40
- Trocar Standart VT 05 - 55
- Yankauer Suction Tube NK 05 - 23
- Scalpel Handle No. 7 3525 - 7K
- Trachea Retractor Blunt 2 prong TR 12 - 02
- Chevalier-J Trachea tube Tube, 8mm TR 50 - 08
- Chevalier-J Trachea tube Tube, 9mm TR 50 - 09
- Chevalier-J Trachea tube Tube, 10mm TR 50 - 10
- Laborde Tracheal Dilator TR 06 - 14
- Trousseau Dilator Forceps TR 04 - 14
- Gruenwald Dressing Forceps NB 12 - 20

19. TRACHEOTOMY SET HILBRO Pakistan Dalam Proses Set 3,575,000 PT. Pancaraya Krisnamandiri
Terdiri dari :
- Tracheotomy Set, Complete in stainless H 32 - 240
steel case compressing
- Scalpel Stainless, 3cm H 08 - 003
- Bowlby Tracheal Dilating Forceps H 32 - 020
- Tracheal Hook, Sharp H 32 - 050
- Tracheal Hook, Blunt H 32 - 060
- Fuller Tracheotomy Tiube, 18 H 32 - 212
- Fuller Tracheotomy Tiube, 22 H 32 - 213
- Fuller Tracheotomy Tiube, 26 H 32 - 214

20. C.W.L.. HILBRO Pakistan Dalam Proses Set 19,250,000 PT. Pancaraya Krisnamandiri
Terdiri dari :
- Heyman Nasal Scissors H 10 - 190
- Retractor Blunt H 18 - 172
- Bone Chisel and Gouge H 28 - 124
- Collin Hammer 30mm - 220mg H 28 - 280
- Frazier Canulla 6Fg H 30 - 230
- Killian Nasal Specula 50mm H 46 - 032
- Killian Nasal Specula 75mm H 46 - 033
- Dressing and Tampon Forceps H 46 - 180
- Hartman Nasal Polypus and Septum Fcp H 46 - 230
- Ethmoid Nasal Cutting Forceps H 46 - 291
- Nasal Cutting Forceps H 46 - 396
- Hajek Kopler H 46 - 462
- Ballanger Septum Knives H 46 - 632
- Ballanger H 46 - 640
- Feer Chesels 4mm H 46 - 670
- Freer 16cm / 6 1/2" H 46 - 671
- Cottle Nasal Rasps H 46 - 700
- Nasal Rasps H 46 - 722
- Nasal Rasps H 46 - 730
- Cottle Walsam Septum Straightening Fcp H 46- 830
- Asch Septum Forceps H 46 - 840
- Eicken Killian Antrum Cannula H 46 - 930
- Antrum Spoon 19cm 4,300,307 FIEGERT Germany Dalam Proses Buah PT. Pancaraya Krisnamandiri
- Blakesley-Wilde Nasal Fcp Str size 0=3.0mm 420.0441.0 FIEGERT Germany Dalam Proses Buah PT. Pancaraya Krisnamandiri
- Blakesley-Wilde Nasal Fcp up curved 45º 420.0442.0 FIEGERT Germany Dalam Proses Buah PT. Pancaraya Krisnamandiri
size 0=3.5mm, 110mm working length.
- Sinuscope Trocar Beak shaped with 4,100,502 FIEGERT Germany Dalam Proses Buah PT. Pancaraya Krisnamandiri
obturator 5,5mm Ø fitting to 70º scope
with 4mm Ø
- Freer Double Elevator 20cm 4,300,311 FIEGERT Germany Dalam Proses Buah PT. Pancaraya Krisnamandiri
- Syringe

21. C.W.L. PRECISEMED Germany Dalam Proses Set 55,000,000 PT. Pancaraya Krisnamandiri
Terdiri dari :
- Heyman Nasal Scissor 5306 - 03
- Tracheal Retractor 2 prong Blunt TR 12 - 02
- Lacrymal sac chisel west 1946 - 50
- Collin Hammer 30mg - 220mg COLLIN
- Frazier Suction Cannulla Charr 6,17cm NK 06 - 06
- Frazier Suction Cannulla Charr 8,17cm NK 06 - 08
- Killian Speculla 50mm NA 02 - 50
- Killian Speculla 75mm NA 02 - 75
- Killian Speculla 90mm NA 02 - 90
- Gruenwald Nasal Forceps 20cm Bayo NB 12 - 20
- Hajek Nasal Cutting Forceps NC 39 - 34
- Freer Moscous Knife NG 01 - 15
- Freer Moscous Chesel Straight Knife 4mm NH 01 - 04
- Freer Moscous Chesel Straight Knife 5mm NH 02 - 04
- Cottle Nasal Rasp NH 70 - 00
- Wiener Nasal Rasp NH 72 - 00
- Aufright Nasal Rasp NH 73 - 01
- Cottle Walsam Septum Forceps NI 21 - 00
- Ash Septum Forceps NI 24 - 00
- Eiken-Killian Wash Canulla NI 93 - 30
- Luc Etmoid Forceps NC 05 - 01
- Takahashi Nasal Forceps NC 33 - 02
- Weil-Blakesley cutting Forceps 3,4mm NC 36 - 01
- Coakley Curette NI 07 - 01

22. SET OBSERVASI SINUSCOPY MEGA MEDICAL Korea Dalam Proses Set 93,750,000 PT. Pancaraya Krisnamandiri
Terdiri dari :
- Visual System Light Source
(250W Halogen Lamp) with freezing
- CCD Camera (1/3 "410.000 Pixel, Hand Gun
- Adaptor C-Mount
- Monitor 14" (480 line)
- Light Cable (11,5 Ø, 2M) Glass Fiber
- Sinuscope (0º / 4,0 Ø 175mm)
- Sinuscope (30º / 4,0 Ø 175mm)
- Sinuscope (70º / 4,0 Ø 175mm)

Optional :
- Trolly MEDICINDO Indonesia Dalam Proses Unit 4,375,000 PT. Pancaraya Krisnamandiri
- Trolly Original MEGA MEDICAL Korea Dalam Proses Unit 9,350,000 PT. Pancaraya Krisnamandiri
- Computer System Pentium IV complete 12,500,000
for CCD Camera

23. SET OBSERVASI SINUSCOPY FIEGERT Germany Dalam Proses Set 177,500,000 PT. Pancaraya Krisnamandiri
ALTERNATIF I
Terdiri dari :
- Fiber Optic light cable 180c 4,8mm 1100148
Resistant to crushing and bending, with
pull relief sterilizable at 134ºC adapters
light-source and instrument
- Antroscope/Sinuscope, autoclavable 500.0400A
4mm Ø Direction view 0º, ring-shapped
array of light guide for excelent
illumination with protection sheath.
- Antroscope/Sinuscope, autoclavable 500.0430A
4mm Ø Direction view 30º, ring-shapped
array of light guide for excelent
illumination with protection sheath.
- Antroscope/Sinuscope, autoclavable 500.0470A
4mm Ø Direction view 70º, ring-shapped
array of light guide for excelent
illumination with protection sheath.
- C-Mount TV Adapter Length 40mm for 1800028
standartd eye piece without TV Monitor.
- CCD Color Camera WAT-202D
- Halogen Cold Light Proyector 24V MEDICINDO Indonesia Dalam Proses PT. Pancaraya Krisnamandiri
- Troly MEDICINDO Indonesia Dalam Proses PT. Pancaraya Krisnamandiri
- TV Monitor 14" SONY

Optional :
- Computer System Pentium IV complete 12,500,000 PT. Pancaraya Krisnamandiri
for CCD Camera

24. SET OBSERVASI SINUSCOPY FIEGERT Germany Dalam Proses Set 233,750,000 PT. Pancaraya Krisnamandiri
ALTERNATIVE II
Terdiri dari :
- Halogen Cold Light Proyektor 24V 250W 100.0250-2
2 light outlet storz continous light
adjusment
- Fiber optic light cable 180cm 4,78mm 110.0148
Resistant to crushing and bending, with
pull relief sterilizable at 134ºC / 73ºF
without endoscope with adapters
light-source and Instruments Storz
- Antroscope/Sinuscope, autoclavable 500.0400A
4mm Ø Direction view 0º, ring-shapped
array of light guide for excelent
illumination with protection sheath.
- Antroscope/Sinuscope, autoclavable 500.0430A
4mm Ø Direction view 30º, ring-shapped
array of light guide for excelent
- Antroscope/Sinuscope, autoclavable 500.0470A
4mm Ø Direction view 70º, ring-shapped
array of light guide for excelent
illumination with protection sheath.
- Tele-Laryngopharingoscope 401.1100
- C-Mount TV Adapter Length 40mm for 180.0028
standard Eye Piece without TV Monitor.
- CCD Camera ECOCAM V-F (PAL) 840191 ILO Germany Dalam Proses Buah PT. Pancaraya Krisnamandiri
Freez Function single-CCD / C-mount
Camera Head
- TV Monitor 14" SONY
- Trolly
Optional :
- Computer system Pentium IV Complete 12,500,000
for CCD Camera

25. SINUSCOPE SURGERY FIEGERT Germany Dalam Proses Set 33,000,000 PT. Pancaraya Krisnamandiri
- Freer Double Elevator 20cm 430.0311
- Irrigation tube long curved acc to Eicken 440.0325
Killian 2,5mm Ø
- Hajek-Koppler Punch,cutting up ward 90º 420.0431
- Sinuscope Trocar beak shaped with 410.0502
obturator 5,5mm Ø fitting to 70º scope
with 4mm Ø
- Nasal Scissors 13cm straight 420.0461
- Antrum Punch Backward cutting upward 420.0422
3.0mm Ø rigid
- Antrum currette small 19cm 430.0325
- Blakesley-Wilde Nasal Forceps straight 420.0441.0
size 0=3.0mm
- Blakesley-Wilde Nasal Forceps forceps 420.04420
up curved 45º, size 0=3,5mm 110mm
working length.
- Antrum spoon 19cm 430.0307
- Sickle knife 19cm 430.0301
- Suction tube Fergusson frazier 9 charr 440.0301-09
120mm
- Nasal Specull Killian 55mm 470.1012
- Nasal Specula Killian 70mm 470.1013
- Heymann Nasal Scissors 5304-03 PRECISEMED Germany PT. Pancaraya Krisnamandiri
26. FLEXIBEL NASOPHARYNGOSCOPE
A. FIEGERT Germany Dalam Proses Set 143,000,000 PT. Pancaraya Krisnamandiri
- Rhino-Pharyngo-Laryngo-Fiberskop 800.3800
Flexible.
Diameter : 3,4mm Ø
Model : Silver
Angulation : up 120º / down 100º
Direct of view : 0º
Field of view : 95º
Depth of field : 1 - 50mm
Working length : 300mm
- Halogen Cold Light Proyektor 24V 250W 100.0250-2
2 light outlet storz continous light
adjusment.
- Fiber Optic light cable 180cm 4,8mm 110.0148
Resistant to crushing and bending, with
pull relief sterilizable at 134º C / 273º F
without endoscope with adapters light -
source and Instruments Storz.

B. FIEGERT Germany Dalam Proses Set 198,000,000 PT. Pancaraya Krisnamandiri


Terdiri dari :
- Flexible Bronchofiberscope, fully 801.3700
immersible, with 2-way angulation,
one-hand operation
Field of view : 95º
Depth of field : 5mm - 50mm
Working Length : 600mm
Diameter : 3,9mm
Angulation : up 160º / down 100º
Working channel : 1,4mm Ø
Accessories include :
- Flexible biopsy forceps
- Flexible claening brush
- Leakage tester
- ETO valve
- Cleaning tube
- Leakage cap
- Silicon Oil
- Instruction Manual
- Transport suitcase
- Halogen Cold Light Proyector 24V 250W 100.0250-2
2 light outlet storz continous light
adjusment
- Fiber Optic light cable 180cm 4,8mm 110.0148
Resistance to crushing and bending,
with pull relief sterilazable at 134º C /
273º F without endoscope with adapters
light-source and Instrument Storz

27. SET TYMPANOPLASTY (THT) : ONDEKO Japan Dalam Proses Set 80,850,000 PT. Pancaraya Krisnamandiri
Ear Micro Surgery Set
Terdiri dari :
- Rosen Knife 5001 - 1
- Rosen Knife 5001 - 2
- Rosen Exploreing Needle 5001 - 5
- Exploring Needle Curved 5001 - 6
- Rosen Suction Tube 2 pcs 5001 - 14
- Vynil Tube w/conector 5001 - 16
- Rosen ear Speculum S.M.L. 5001 - 17
- Shea Knife Small 5002 - 1
- Shea Knife lncision 5002 - 2
- Shea Pick Sharp Pointed 5002 - 3
- Shea Hook Penestra 45º 5002 - 5
- Shea Currette 5002 - 9
- Shea Elevator Left 5002 - 10
- Shea Elevator Right 5002 - 11
- Circular Punch straight Micro Model 5007 - 2
- Grasping Forceps Extra small curved 5007 - 6
- Kazama up cupper 5007 - 10
- Scissors, up turned 5007 - 11
- Gouge 5005 - 4mm
- Aspiration Tubes for ear, with thumb 5006
plate and cut of (set of 5 pcs)
- Medium Chesels 5010
- Medium Gouges 5010
- Weitlaner Blunt Retractor 13cm GE 94 - 13
- Collin 30m - 220mg H 28 - 280 HILBRO Pakistan Dalam Proses Buah PT. Pancaraya Krisnamandiri

Operating Microscoe for ENT F=250mm OP-2 SHIN-NIPPON Japan AKL 21201502593 Unit 108,750,000 PT. Pancaraya Krisnamandiri

Hand Drill New Hand Engine (2 curved & ROYAL FX-30 ONDEKO Japan Dalam Proses Unit 92,500,000 PT. Pancaraya Krisnamandiri
1 straight hand piece)

Mata Burr : ONDEKO Japan Dalam Proses Buah PT. Pancaraya Krisnamandiri
- Cutting Burr, 1.0 mm Ø 70 - 103 330,000
- Cutting Burr, 1.8 mm Ø 71 - 105 330,000
- Cutting Burr, 2.7 mm Ø 72 - 107 385,000
- Cutting Burr, 4.0 mm Ø 73 - 110 687,500
- Cutting Burr, 5.0 mm Ø 74 - 112 1,075,000
- Polishing Burr, 1.0 mm Ø 75 - 123 330,000
- Polishing Burr, 1.8 mm Ø 76 - 125 330,000
- Polishing Burr, 2.7 mm Ø 77 - 127 550,000
- Polishing Burr, 4.0 mm Ø 78 - 130 750,000
- Polishing Burr, 5.0 mm Ø 79 - 132 1,100,000
- Diamond Burr, 1.0 mm Ø 80 - 143 1,750,000
- Diamond Burr, 1.8 mm Ø 81 - 145 2,175,000
- Diamond Burr, 2.7 mm Ø 82 - 147 2,175,000
- Diamond Burr, 4.0 mm Ø 83 - 150 2,500,000
- Diamond Burr, 5.0 mm Ø 84 - 152 2,900,000

28. ENDOSCOPE SET ONDEKO Japan Dalam Proses Set 189,750,000 PT. Pancaraya Krisnamandiri
Terdiri dari :
- Jackson's Bronchoscope, 0.8 x 40 cm
(with fiber light guide)
- Jackson's Bronchoscope, 0.5 x 40 cm
(with fiber light guide)
- Ono's Esophageal speculum for adult
- Ono's Esophageal speculum for child
(with fiber light guide)
- Protect mask
- Jackson's Esophagoscope, 0.8 x 45 cm
(with fiber light guide)
- Jackson's Esophagoscope, 0.5 x 35 cm
(with fiber light guide)
- Robert Endoscope forceps, 28 cm long
- Robert Endoscope forceps, 48 cm long
- Robert Forceps, tip only, Alligator Jaws
- Jackson Endoscope Forcep, handle only
- Jackson Tip only (12 kinds) No. A - L
- Jackson tube only (30, 35, 40, 45, 50cm)
(5 kinds)
- Loupe only
- Suction Tubes (Metal characters)
(wide, narrow, long, short) (4 kinds)
- Sponge carrier long & short (2kinds0
- Bite Block (metal made) (2 pcs / 1 set)
- Bite Block (hard rubber made)
(2 pcs / 1 set)
- Fiber cable for Bronchoscope,
esophagoscope, laryngoscope and
esophageal, speculum.
- Fiber light source, Model : TL-90 with
above scope connector.
- AC : 220V 50 / 60 HZ

28. Screening Audiometer with RS232C and AS 216 INTERACOUSTIC Denmark Dalam Proses Unit 35,475,000 PT. Pancaraya Krisnamandiri
printer interface and with UPS400 Medical
CE approved external power cable.
Included Part :
- Audiometric Headset with 0250 Peltor TDH39PA
noise Exclosure
- Bone Conductor B71
- Medical CE Approved Switch UPS400
Mode Power Cable
- Power Cable
- Patient Response Switch APS2
- Audiogram Chart Pen Set 2X100 AF12
- Dust Cover PCR-AS216
- Carrying Case ACC26

30. Diagnostic Audiometer, AC, BC masking AD 226 INTERACOUSTIC Denmark Dalam Proses Unit 40,000,000 PT. Pancaraya Krisnamandiri
and RS232C and Printer Interface
Included Parts :
- Audiometric Headset TDH39
- Bone Conductor B71
- Patien Response Switch APS2
- Medical CE Approved Switch UPS400
Mode Power Cable
- Power Cable
- Audiogram Charts 2X100 AF12
- Pen Set
- Dust Cover PCR-AD226
- Printing Adapter IPA-26
- Carrying Case ACC26

31. Diagnostic Audiometer with AC BC with AD 229e INTERACOUSTIC Denmark Dalam Proses Unit 60,775,000 PT. Pancaraya Krisnamandiri
masking two speech Input FF, ABLB,
stenger, Bekesy, SISI, MHA and with
RS232C Interface and printer interface.
Included Parts :
- Audiometric Headset TDH39
- Bone Conductor B71
- Patien Response Switch APS2
- Medical CE Approved Switch UPS400
Mode Power Cable
- Power Cable
- Audiogram Charts 2X100 AF12
- Pen Set
- Dust Cover PCR-AD229
- Printing Adapter IPA-26
- Carrying Case ACC25

32. Diagnostic Audiometer with AC BC with AD 229e INTERACOUSTIC Denmark Dalam Proses Unit 61,000,000 PT. Pancaraya Krisnamandiri
masking two speech Input FF, ABLB,
stenger, Bekesy, SISI, MHA and with
RS232C Interface and printer interface.
- 2X12watt External Power Amplifier AP-12
- Free Field Loud Speaker ALS 7
- Carrying case ACC25
- Wall Talk Back Microphone EM-400

33. Clinical Audiometer with two Independent AC 40 INTERACOUSTIC Denmark Dalam Proses Unit 124,875,000 PT. Pancaraya Krisnamandiri
Channels Bekesy, MLD, ABLB,
Loudness Scaling and high frequency
Include Parts :
- Audiometric Headset TDH39
- Bone Conductor B71
- High Frequency Heeadset R-80
- 2 units of APS2
- Power Cable
- Audiogram Charts 2X100 AF12
- Pen Set
- Dust Cover PCR-AC40
- Built in Thermal printer incl 5 roll of paper AC40-PRT

Optional Accessories :
- Electret Microphone for Talk Back EM400 1,100,000
- Monitor Headset MTH400 1,100,000
- Monitor Headset with boom microphone MTH400M 3,850,000

34. Audiometri and Impedance AA 222/AA220 INTERACOUSTIC Denmark Dalam Proses Unit 106,700,000 PT. Pancaraya Krisnamandiri
Include :
Bone Conductor B71
Audiometric Headset TDH39
Patien Signal APS2
35. Clinical Impedance Audiometer AZ 26 INTERACOUSTIC Denmark Dalam Proses Unit 98,750,000 PT. Pancaraya Krisnamandiri
Include Parts :
- Universal Probe system with shoulder ATP-AZ26
strap, wrist strap
- Single Earphone HBZ35 w/headband for TDH39z
contralateral stimulus.
- 3 rolls of recording paper TPR26
- Power Cable
- Box of 65 Assorted Eartips BET 50
- Dust Cover PCR-AZ26
- Patient Respone switch APS2
- Calibration unit 0.2-0.5-1-2-3-4 and 5ml CAT40

36. Automatic Middle Ear Analyzer AT 235 INTERACOUSTIC Denmark Dalam Proses Unit 92,000,000 PT. Pancaraya Krisnamandiri
Include Parts :
- Universal Probe system with shoulder ATP-AT235u
strap, wrist strap
- Single Earphone HBZ35 w/headband for TDH39z
contralateral stimulus.
- External Switch Mode Power Cable UPS400
- Power Cable
- Box of 65 Assorted Eartips BET 50
- 3 Rolls of Recording Paper TPR26
- Dust Cover PCR-AT235
- Patient Respone switch APS2
- Calibration unit 0.2-0.5-1-2-3-4 and 5ml CAT 227
- Carrying Case ACC25
Optional Parts
Audiometric Head set TDH39z 5,500,000
Bone Conductor B71 4,250,000

37. OAE Screening Precision OTO READ INTERACOUSTIC Denmark Dalam Proses Unit 118,250,000 PT. Pancaraya Krisnamandiri
Clinical Included parts Otoread
- Handle unit ( Otoread ) including probe
cord ceadle
- Printer including power supply and power
cable
- Printer cable
- Probe Cord Foe Extensions ( 100 cm / 39
inches )
- 2 Thermal Printer paper roll
- Box Ear Tips 146 Ear tips ( 12 Size )
- 4 Probe Tips
- 4 AA / UW 3 / R6 Alkaline Batteries
- Operation / service / CE Manual

38. ABR BERA Eclipse with EP 25 INTERACOUSTIC Denmark Dalam Proses Unit 325,000,000 PT. Pancaraya Krisnamandiri
EP 25 Black box version wit USB Cable
Excl. PC included parts :
- Ia Base Software
- Installation Software EP25
- Pre amplifer EPA25
- ABR Insert Earphones EAR-Tone
- Electrode Cable Standard with buttons ETB15
- Electrode Cable Universal ETU15
- Electrode Cable with Re-usable electrodes ETR15
- Tip Trode Electrode Cable Set with TEB25
buttons
- Tip Trode Electrode Cable Set Universal TU25
- Pre-gelled Electrode Pads ( 25 pieces ) PEG15
- Skin Preperation Gel SPG15
- 10 pcs of Tip Trodes electrodes for TTE25
ECOCHG
- Power Cable
- Operation / Service / Multilingual CE
Manuals
- Bone Conductor B71
- Audiometric Headset ( Shielded ) TDH 39

39. Head Lamp MEDICINDO Indonesia Dalam Proses Set 1,650,000 PT. Pancaraya Krisnamandiri

40. Portable Head Light w/ headhand w/charger 46072 WELCH ALLYN U.S.A Dalam Proses Set 4,500,000 PT. Pancaraya Krisnamandiri

41. Procedure Head light w/battery pack 49022 WELCH ALLYN U.S.A Dalam Proses Set 14,500,000 PT. Pancaraya Krisnamandiri
42. Head Lamp system Binner 3.5mm x 820029 ILO Germany Dalam Proses Set 17,000,000 PT. Pancaraya Krisnamandiri
2200mm. Fiber Focus Adjustable

43. Laryngoscope with 4 balde MEDICAL DEVICES Pakistan Dalam Proses Buah 1,950,000 PT. Pancaraya Krisnamandiri

44. Pocket Otoscope with 4 reusable specule 22840 WELCH ALLYN U.S.A Dalam Proses Buah 770,000 PT. Pancaraya Krisnamandiri
w/o spare lamp

45. 3.5V Diagnostic Otoscope with throat 20000 WELCH ALLYN U.S.A Dalam Proses Buah 3,300,000 PT. Pancaraya Krisnamandiri
illuminator and specule, with regular battrey
handle.

46. 3.5V Macro View Otoscope with Lithium 23810 WELCH ALLYN U.S.A Dalam Proses Buah 5,650,000 PT. Pancaraya Krisnamandiri
handle.

47. COMPACT Video Otoscope with Lithium- 23105-SM-P WELCH ALLYN U.S.A Dalam Proses Buah 17,350,000 PT. Pancaraya Krisnamandiri
Ion handle
PAL System w/spare Lamp

Diagnostic Basic Set


48. Pocket Junior Otoscope Ophthalmoscope & 95001 WELCH ALLYN U.S.A Dalam Proses Buah 1,950,000 PT. Pancaraya Krisnamandiri
Soft case

49. Diagnostic Set, consist of : 97150BI WELCH ALLYN U.S.A Dalam Proses Buah 3,990,000 PT. Pancaraya Krisnamandiri
- Ophthalmoscope Head 11710
- Otoscope Head 25020
- Convertible Handle 71020B
- Hard Case 05251
- 3.5V Hologen Lamp for 11710 03000
- 3.5V Hologen Lamp for 25020 03100

50. Diagnostic Set : 18320 WELCH ALLYN U.S.A Dalam Proses Buah 9,650,000 PT. Pancaraya Krisnamandiri
- Coaxial Ophthalmoscope Head 11720
- Streak Retinoscope Head 18200
- Ni-Cad Rechargeable Heandle & Charger 71062
Hard Case
- 3.5V Hologen Lamp 04900
- Hologen HPX Lamp 08200

51. Tycos Elite Stetoscope,25" ( Balack ) 5079-125 WELCH ALLYN U.S.A Dalam Proses Buah 2,200,000 PT. Pancaraya Krisnamandiri

52. Profesional Adu;t Double Head Stetoscope 5079-135 WELCH ALLYN U.S.A Dalam Proses Buah 850,000 PT. Pancaraya Krisnamandiri
28" ( Balck )

53. Profesional Pediatric Double Head stetos 5079-145 WELCH ALLYN U.S.A Dalam Proses Buah 850,000 PT. Pancaraya Krisnamandiri
cope 28" ( Balck )

54. LS-150 w/ floor stand 44505 WELCH ALLYN U.S.A Dalam Proses Buah 6,250,000 PT. Pancaraya Krisnamandiri

55. Lumiview Portable Binocular Head Mount 205124 WELCH ALLYN U.S.A Dalam Proses Buah 10,000,000 PT. Pancaraya Krisnamandiri
10/ Direct power Source

56. Tycos 767-Series wall Aneroid 7670-01 WELCH ALLYN U.S.A Dalam Proses Buah 2,200,000 PT. Pancaraya Krisnamandiri

57. TR-1 DS 66 Integrated Aneroid Sphyg with 5098-27 WELCH ALLYN U.S.A Dalam Proses Buah 2,300,000 PT. Pancaraya Krisnamandiri
adult cuff.

58. Integrate Aneriod Sphynomanomater Adult D545-11C WELCH ALLYN U.S.A Dalam Proses Buah 1,100,000 PT. Pancaraya Krisnamandiri
w/case

59. Braun themo Scan 04000-200 WELCH ALLYN U.S.A Dalam Proses Buah 2,100,000 PT. Pancaraya Krisnamandiri

60. Suretemp plus Thermometer 01690-410 WELCH ALLYN U.S.A Dalam Proses Buah 4,400,000 PT. Pancaraya Krisnamandiri

61. Ear wash system-english-PAL 29350EI WELCH ALLYN U.S.A Dalam Proses Buah 5,775,000 PT. Pancaraya Krisnamandiri

62. Machintosh Fiber Optic Laryngoscope ( 5 69696 WELCH ALLYN U.S.A Dalam Proses Buah 9,800,000 PT. Pancaraya Krisnamandiri
blades, 2 handles ) in case

63. Miller Fiber Optic Laryngoscope ( 5 blades, 68696 WELCH ALLYN U.S.A Dalam Proses Buah 11,350,000 PT. Pancaraya Krisnamandiri
2 handles ) in case

64. ENT Microscope OP-C12 Floor Stand EP 5 OP-C12-220V OPTOMIC Spanyol Dalam Proses Unit 78,750,000 PT. Pancaraya Krisnamandiri
Optional
PAL Complete Op- TV6 consist of beam OP-TV-5-220 OPTOMIC Spanyol Dalam Proses Buah 38,000,000 PT. Pancaraya Krisnamandiri
splitter and camera system

65. ENT Treatment Unit TG-910 EVELIGHT Taiwan Dalam Proses Unit 36,750,000 PT. Pancaraya Krisnamandiri

66. Autoclave Horizontal TA-610 EVELIGHT Taiwan Dalam Proses Unit 83,600,000 PT. Pancaraya Krisnamandiri

67. Autoclave Table Top TA-640 EVELIGHT Taiwan Dalam Proses Unit 10,000,000 PT. Pancaraya Krisnamandiri

68. Autoclave Table Top EA-652 EVELIGHT Taiwan Dalam Proses Unit 21,000,000 PT. Pancaraya Krisnamandiri

69. Autoclave Vertical Type TA-630 EVELIGHT Taiwan Dalam Proses Unit 60,500,000 PT. Pancaraya Krisnamandiri

70. Operating Lamp 5 Lamp Ceilling Mounted TLD-500H EVELIGHT Taiwan Dalam Proses Unit 45,650,000 PT. Pancaraya Krisnamandiri
Type

71. Operating Lamp 8 Lamp Ceilling Mounted TLD-800H EVELIGHT Taiwan Dalam Proses Unit 54,450,000 PT. Pancaraya Krisnamandiri
Type

72. ENT Treatment Unit New Model MEDICINDO Indonesia Dalam Proses Unit 35,000,000 PT. Pancaraya Krisnamandiri

73. ENT Chair MEDICINDO Indonesia Dalam Proses Unit 30,750,000 PT. Pancaraya Krisnamandiri

74. Operating table for Ophthalmology MEDICINDO Indonesia Dalam Proses Unit 30,650,000 PT. Pancaraya Krisnamandiri

75. Multi purpose Operating table MEDICINDO Indonesia Dalam Proses Unit 41,250,000 PT. Pancaraya Krisnamandiri

76. Sound Proof Chamber MEDICINDO Indonesia Dalam Proses Unit 28,875,000 PT. Pancaraya Krisnamandiri

77. Gynecologycal Examination Table MEDICINDO Indonesia Dalam Proses Unit 36,850,000 PT. Pancaraya Krisnamandiri

78. Treatment Obgyn MEDICINDO Indonesia Dalam Proses Unit 34,000,000 PT. Pancaraya Krisnamandiri

79. Doctor's Stool tanpa sandaran MEDICINDO Indonesia Dalam Proses Buah 1,600,000 PT. Pancaraya Krisnamandiri

80. Doctor's Stool pakai sandaran MEDICINDO Indonesia Dalam Proses Buah 2,200,000 PT. Pancaraya Krisnamandiri
81. Lampu Sorot MEDICINDO Indonesia Dalam Proses Buah 2,475,000 PT. Pancaraya Krisnamandiri

82. Trolly Sinuscope MEDICINDO Indonesia Dalam Proses Unit 4,375,000 PT. Pancaraya Krisnamandiri

83. UV-Room Sterilizer MEDICINDO Indonesia Dalam Proses Unit 9,500,000 PT. Pancaraya Krisnamandiri

84. Optotype Snellen Electric MEDICINDO Indonesia Dalam Proses Unit 2,250,000 PT. Pancaraya Krisnamandiri

85. Light Source MEDICINDO Indonesia Dalam Proses Buah 8,000,000 PT. Pancaraya Krisnamandiri

86. Suction Pump MEDICINDO Indonesia Dalam Proses Unit 17,000,000 PT. Pancaraya Krisnamandiri

87. Dermatology/ Ophthalmological and MEDICINDO Indonesia Dalam Proses Unit 30,750,000 PT. Pancaraya Krisnamandiri
Operating table

88. Dermatology Examination Table, static MEDICINDO Indonesia Dalam Proses Unit 4,950,000 PT. Pancaraya Krisnamandiri

89. Head Lamp MEDICINDO Indonesia Dalam Proses Buah 1,600,000 PT. Pancaraya Krisnamandiri

90. Doctor's Stool for surgery MEDICINDO Indonesia Dalam Proses Unit 22,500,000 PT. Pancaraya Krisnamandiri

91. Wood Lamp MEDICINDO Indonesia Dalam Proses Unit 775,000 PT. Pancaraya Krisnamandiri

92. Magnifyng Lamp with stand MEDICINDO Indonesia Dalam Proses Unit 2,400,000 PT. Pancaraya Krisnamandiri

No. Negara Asal No. Registrasi HJSA


Nama Peralatan Kesehatan Model/Type Merk Satuan Sole Agent
Urut / Pabrikan DepKes RI (Rp)

KULIT

1 Tray Unit, with Lamp 120V 50 Watt MD-10 MEDICINDO Indonesia Dalam Proses Unit 4,500,000 PT. Pancaraya Krisnamandiri

2 Tray Unit MD-11 MEDICINDO Indonesia Dalam Proses Unit 3,500,000 PT. Pancaraya Krisnamandiri
3 Doctor's Stool MD-12 MEDICINDO Indonesia Dalam Proses Buah 1,600,000 PT. Pancaraya Krisnamandiri

4 Model ceiling 30 W TL UV MEDICINDO Indonesia Dalam Proses Buah 550,000 PT. Pancaraya Krisnamandiri

5 Dermatology / Opthalmological and MEDICINDO Indonesia Dalam Proses Unit 30,750,000 PT. Pancaraya Krisnamandiri
Operating Table

6 Dermatology Examination Table, Static MEDICINDO Indonesia Dalam Proses Unit 4,950,000 PT. Pancaraya Krisnamandiri

7 Light w/arm Luminaire and transformer w/ LS 200 WELCH ALLYN U.S.A Dalam Proses Unit 17,875,000 PT. Pancaraya Krisnamandiri
mobile stand

8 Electro Surgical Coutery Monopolar HFS 45 LIARRE Italy Dalam Proses Unit 10,900,000 PT. Pancaraya Krisnamandiri

9 Electro Surgical Coutery Monopolar HFS 100 LIARRE Italy Dalam Proses Unit 28,600,000 PT. Pancaraya Krisnamandiri
& Bipolar

10 Premier 200 I e electro Surgery unit ( 220V ) 9006601 PRIMIER U.S.A Dalam Proses Unit 55,600,000 PT. Pancaraya Krisnamandiri
Included :
5 1/2" straight bipolar coagulating fcp 9006308 PRIMIER U.S.A Dalam Proses Buah
Standard Bipolar Adapter Cord, reusable 9006313 PRIMIER U.S.A Dalam Proses Buah
( Not Shown )
Hand Control Pencil, reusable, one each 9006515 PRIMIER U.S.A Dalam Proses Buah
Dual-Foot Controller 9006525 PRIMIER U.S.A Dalam Proses Buah
Reausable Poly Plate tm, Single cell 9006545 PRIMIER U.S.A Dalam Proses Buah

11 Electro Surgical Unit 200 W SM2000F SM MEDICAL Korea Dalam Proses Unit 23,950,000 PT. Pancaraya Krisnamandiri
( included Bipolar forceps 18cm blunt and
cable )

12 Evacuator / Air Filtration System, USA PREMIER U.S.A Dalam Proses Unit 23,950,000 PT. Pancaraya Krisnamandiri

13 Doctor's Stool Stainless Steel ( pakai MEDICINDO Indonesia Dalam Proses Unit 2,250,000 PT. Pancaraya Krisnamandiri
sandaran )

14 Loupe Optivisor DA.3 DONEGAN U.S.A Dalam Proses Buah 650,000 PT. Pancaraya Krisnamandiri
15 Sterile Glass 160 Watt LIARREY italy Dalam Proses Buah 2,700,000 PT. Pancaraya Krisnamandiri

16 Instrument Dermatology Dalam Proses Set 88,000,000 PT. Pancaraya Krisnamandiri


Terdiri dari :
- Dermatology/ Ophthalmological and MEDICINDO Indonesia Unit
Operating Table
- Table Top Autoclave TA-640 EVERLIGHT Taiwan Unit
- Electro Surgery Coutery Monopolar & HFS 95 LIARRE Italy Unit
Bipolar
- Tray Unit with lamp 12V 50Watt MD-10 MEDICINDO Indonesia Buah
- Instrument Tray 10 Inst PST U.S.A Buah
- Eye Scissors, cvd.Blunt.9cm 4705-03 PRECISEMED German Buah
- Strabismus Scissors 10.5cm, str 4628-03 PRECISEMED German Buah
- Eye Scissors, str.Pointed.9cm 4704-01 PRECISEMED German Buah
- Eye Scissors, cvd.Pointed.9cm 4705-01 PRECISEMED German Buah
- Hartman Mosquito forceps, str 2272-10 PRECISEMED German Buah
- Hartman Mosquito forceps, cvd 2273-10 PRECISEMED German Buah
- Backhaus Towel Clamp 2265-95 PRECISEMED German Buah
- Chiruugische Pinset 2400-07 PRECISEMED German Buah
- Anaomische pinset 2410-07 PRECISEMED German Buah
- Adson Chirurgies 2420-10 PRECISEMED German Buah
- Adson Anatomische 2422-10 PRECISEMED German Buah
- Comedo Extractor 1033100 PREMIER U.S.A Buah
- Meyhoefer Chalazion Curette size 4 AA 1879 APPASAMY India Buah
- Schamberg Comedo Extractor H 40-090 HILBRO Pakistan Buah
- Skin Hook H 40-052 HILBRO Pakistan Buah
- Schede Bone Curette H 28-388 HILBRO Pakistan Buah
- Schede Bone Curette H 28-389 HILBRO Pakistan Buah
- Comedo Extractor H 40-062 HILBRO Pakistan Buah

17 Set Dermatology Dalam Proses Set 49,500,000 PT. Pancaraya Krisnamandiri


Terdiri dari :
- Meja Periksa Static ( Dermatology ) MEDICINDO Indonesia Unit
- Examination Lamp 12V 50 W MEDICINDO Indonesia Unit
- Electro Surgery Coutery Monopolar HFS 45 LIARRE Taiwan Unit
- Table Top Autoclave TA-640 EVERLIGHT Italy Unit
- Tray unit MD-11 MEDICINDO Indonesia Buah
- Magnifying lamp MEDICINDO Indonesia Buah
- Wood Lamp besar MEDICINDO Indonesia Buah
- Instrument Tray for 10 inst PST U.S.A Buah
- Eye Scissors.cvd.Blunt, 9cm 4705-03 PRECISEMED German Buah
- Strabismus Scissors 10.5cm,str 4628-03 PRECISEMED German Buah
- Eye Scissors.str.Pointed, 9cm 4704-01 PRECISEMED German Buah
- Eye Scissors.cvd.Pointed, 9cm 4705-01 PRECISEMED German Buah
- Hartman Mosquito forceps, str 2272-10 PRECISEMED German Buah
- Hartman Mosquito forceps, cvd 2273-10 PRECISEMED German Buah
- Backhaus Towel camp 2265-95 PRECISEMED German Buah
- Chirurgische Pinset 2400-07 PRECISEMED German Buah
- Anatomische Pinset 2410-07 PRECISEMED German Buah
- Adson Chiruigies 2420-10 PRECISEMED German Buah
- Adson Anatomische 2422-10 PRECISEMED German Buah
- Comedo Extractor 1033100 PREMIER U.S.A Buah
- Meyhoefer Chalazion Curette size 4 AA 1879 APPSAMY India Buah
- schamberg Comedo extractor H 40-090 HILBRO Pakistan Buah
- Skin Hook H 40-052 HILBRO Pakistan Buah
- Schede Bone Curette H 28-388 HILBRO Pakistan Buah
- Schede Bone Curette H 28-389 HILBRO Pakistan Buah
- Comedo Extractor H 40-062 HILBRO Pakistan Buah

18 Captain 25 Laser Digital CO2/25W SM MEDICAL Korea Dalam Proses Unit 118,250,000 PT. Pancaraya Krisnamandiri

19 Captain 25 Laser Digital CO2/ W SM MEDICAL Korea Dalam Proses unit 144,000,000 PT. Pancaraya Krisnamandiri

20 Cryogenic system, terdiri dari : BRYMILL U.S.A Dalam proses Buah 42,350,000 PT. Pancaraya Krisnamandiri
- Liquid Nitrogen storage 10 lt B 501-10 Buah
- With drawal Tube B-503 Buah
- Cryo AC-3 B-800 Buah
Cryotote model # 601 Buah
1.5 in x 16g Straight spray needle B 107-16 Buah
1.5 in x 20g Straight spray B 107-20 Buah
1cm flat Probe 205-1 Buah
2cm flat Probe 205-2 Buah
3cm Flat Probe 205-3 Buah

21 Dermabrasi Dalam Proses Set 14,600,000 PT. Pancaraya Krisnamandiri


Terdiri dari :
- Micromotor 220V - 32000 RPM HNSY Japan Buah
- Regular dermabrader Pear 2026159 PREMIER U.S.A Buah
- Regular Dermabrader cone 2026150 PREMIER U.S.A Buah
- Regular Dermabrader Dome 2026180 PREMIER U.S.A Buah
- Regular 17 x 6 2026121 PREMIER U.S.A Buah

22 Minor Kulit Dalam Proses Set 6,000,000 PT. Pancaraya Krisnamandiri


- Scalpel Handle H 08-067 HILBRO Pakistan Buah
- Adson Dressing Forceps H 12-090 HILBRO Pakistan Buah
- Adson Tissue Forceps H 12-320 HILBRO Pakistan Buah
- Backhaus Towel Camp H 14-940 HILBRO Pakistan Buah
- Needle holder without serrated H 22-030 HILBRO Pakistan Buah
- Bandage Scissors Buah
- Sonde kuku Buah
- Hartman Mosquito Forceps str 2272-10 PRECISEMED German Buah
- Hartman Mosquito Forceps cvd 2273-10 PRECISEMED German Buah
- Strabismus scissors str 4628-03 PRECISEMED German Buah
- Eye Scissors, str, pointed 4704-01 PRECISEMED German Buah
- Eye Scissors, cvd, pointed 4705-01 PRECISEMED German Buah
- Instrument Tray for 10 inst PST U.S.A Buah

23 Lippo Suction Set WELL'S JOHNSON U.S.A Dalam Proses Set 54,750,000 PT. Pancaraya Krisnamandiri
Terdiri dari :
- Syringes Toomey Bell 60cc Buah
- Horseshoe lock 60cc 20-1709-02 Buah
- BACKER Round Dissecting Cannula 3mmx 20-1228-00 Buah
23cm on a 60 cc Toomey Bell Base
- BACKER Round Dissecting Cnnula 20-1228-00 Buah
4mm x 23cm
- COBRA Aggressive Cannula 3mm x 23cm 20-1209-00 Buah
- COBRA Aggressive Cannula 4mm x 23cm 20-1209-00 Buah
on a 60cc Toomey Bell
- Two Hole Standard 4mm x 23cm on a 60cc 20-1201-00 Buah
Toomey bell
- Three Hole Standard 3mm x 17cm 20-1202-00 Buah
- Cannula Dual Port 3mm x 23cm spatula 20-1216-00 Buah
- Cannula Multi Infusion 3mm x 23 cm 20-1218-00 Buah
- Cannula Two Port Radial 2mm x 17 cm 20-1204-00 Buah
- Cannula Multi Plate Infusion 2mm x 17 cm 20-1218-00 Buah
- Three hole Standard 2mm x 17 cm 20-1202-00 Buah
- Cannula Dual Port spatula 2mm x 17 cm 20-1202-00 Buah
DAFTAR INFORMASI HARGA PERALATAN KESEHATAN & LABORATORIUM
EFFECTIVE : …………….. S/D …………………….

No. Urut Nama Peralatan Kesehatan Model/Type Negara Asal/Pabrikan No. Registrasi Satuan HJSA Sole Agent
Depkes RI (Rp)
1 Operative Laparoscopy Various Wisap GmbH-Germany Depkes RI AKL 1 Set 1,342,104,000 BETA MEDICAL
20802402933
2 Laparoscopy Sederhana Various Wisap GmbH-Germany Depkes RI AKL 1 Set 1,085,232,000 BETA MEDICAL
20802402933
3 Diagnostic Laparoscopy Various Wisap GmbH-Germany Depkes RI AKL 1 Set 599,448,000 BETA MEDICAL
20802402933
4 Hysteroscopy System Various Wisap GmbH-Germany Depkes RI AKL 1 Set 583,008,000 BETA MEDICAL
20802403270
5 Fetal Doppler SonicaidOne Oxford-England Depkes RI AKL 1 Unit 14,000,000 BETA MEDICAL
21101403280
6 Fetal Doppler 421 Oxford-England Depkes RI AKL 1 Unit 40,000,000 BETA MEDICAL
21101403279
7 Fetal Monitor Team Standard Oxford-England Depkes RI AKL 1 Unit 161,280,000 BETA MEDICAL
21102403283
8 Fetal Monitor Team Duo Oxford-England Depkes RI AKL 1 Unit 191,520,000 BETA MEDICAL
21102403283
9 Fetal Monitor Team IP Oxford-England Depkes RI AKL 1 Unit 200,000,000 BETA MEDICAL
21102403283
10 Gynecology Chair 400330 Medifa-Germany Depkes RI AKL 1 Unit 216,000,000 BETA MEDICAL
11603403276
11 Gynecology Chair 400308 Medifa-Germany Depkes RI AKL 1 Unit 144,000,000 BETA MEDICAL
11603403276
12 Operating Table 500020 Medifa-Germany Depkes RI AKL 1 Unit 378,000,000 BETA MEDICAL
1160403275
13 Operating Table 500120 Medifa-Germany Depkes RI AKL 1 Unit 438,000,000 BETA MEDICAL
1160403275
14 Operating Table 503020 Medifa-Germany Depkes RI AKL 1 Unit 439,200,000 BETA MEDICAL
1160403275
15 Operating Table 503120 Medifa-Germany Depkes RI AKL 1 Unit 486,000,000 BETA MEDICAL
1160403275
16 Operating Table 504020 Medifa-Germany Depkes RI AKL 1 Unit 572,400,000 BETA MEDICAL
1160403275
17 Operating Table 504120 Medifa-Germany Depkes RI AKL 1 Unit 586,800,000 BETA MEDICAL
1160403275
18 Operating Table 600200 Medifa-Germany Depkes RI AKL 1 Unit 917,760,000 BETA MEDICAL
11603403274
19 Operating Table 600500 Medifa-Germany Depkes RI AKL 1 Unit 1,165,920,000 BETA MEDICAL
11603403274
20 Operating Table 600510 Medifa-Germany Depkes RI AKL 1 Unit 1,265,520,000 BETA MEDICAL
11603403274
21 Operating Table 600700 Medifa-Germany Depkes RI AKL 1 Unit 1,472,400,000 BETA MEDICAL
11603403274
22 Operating Table 600710 Medifa-Germany Depkes RI AKL 1 Unit 1,572,000,000 BETA MEDICAL
11603403274
23 Tracheotomy Set Various SHM-Germany Depkes RI AKL 1 Set 9,772,000 BETA MEDICAL
11603403485
24 Bandage Instrument Set Various SHM-Germany Depkes RI AKL 1 Set 4,566,500 BETA MEDICAL
11603403478
25 Orthopedic Set Various SHM-Germany Depkes RI AKL 1 Set 181,146,000 BETA MEDICAL
11303403476
26 Appendectomy Set Various SHM-Germany Depkes RI AKL 1 Set 51,195,000 BETA MEDICAL
11603403482
27 Basic Instrument Set Various SHM-Germany Depkes RI AKL 1 Set 5,314,500 BETA MEDICAL
11603403483
28 Mayor Surgical Set Various SHM-Germany Depkes RI AKL 1 Set 87,377,000 BETA MEDICAL
11603403475
29 Minor Surgical Set Various SHM-Germany Depkes RI AKL 1 Set 11,353,000 BETA MEDICAL
11603403475
30 Partus Instrument Set Various SHM-Germany Depkes RI AKL 1 Set 8,560,000 BETA MEDICAL
11104403480
31 Embriotomy Set Various SHM-Germany Depkes RI AKL 1 Set 17,604,500 BETA MEDICAL
11104403479
32 Vena Sectio Set Various SHM-Germany Depkes RI AKL 1 Set 11,930,000 BETA MEDICAL
11603403486
33 Sectio Caicerian Set Various SHM-Germany Depkes RI AKL 1 Set 108,199,000 BETA MEDICAL
11104403481
34 Kat Bedah Dasar Various SHM-Germany Depkes RI AKL 1 Set 77,761,000 BETA MEDICAL
11603403488
35 Heacting Set Various SHM-Germany Depkes RI AKL 1 Set 4,242,500 BETA MEDICAL
11603403477
36 Surgical & Diagnostic Microscope SOM12 Karl Kaps-Germany Depkes RI AKL 1 Unit 1,677,600,000 BETA MEDICAL
11603403282
37 Surgical & Diagnostic Microscope SOM62/Manual-3Fold Karl Kaps-Germany Depkes RI AKL 1 Unit 352,344,000 BETA MEDICAL
11603403282
38 Surgical & Diagnostic Microscope SOM62/Manual-8Fold Karl Kaps-Germany Depkes RI AKL 1 Unit 407,208,000 BETA MEDICAL
11603403282
39 Surgical & Diagnostic Microscope SOM62/Motorized-3Fold Karl Kaps-Germany Depkes RI AKL 1 Unit 580,896,000 BETA MEDICAL
11603403282
40 Surgical & Diagnostic Microscope SOM62/Motorized-8Fold Karl Kaps-Germany Depkes RI AKL 1 Unit 631,440,000 BETA MEDICAL
11603403282
41 Colposcope SOM52 Karl Kaps-Germany Depkes RI AKL 1 Unit 384,000,000 BETA MEDICAL
21101403281
42 Mini Colposcope KP3000 Karl Kaps-Germany Depkes RI AKL 1 Unit 264,000,000 BETA MEDICAL
21101403281
43 Diagnostic Scanner HS-2000 Honda-Japan Depkes RI AKL 1 Unit 250,000,000 BETA MEDICAL
21102402931
44 Diagnostic Scanner HS-4000 Honda-Japan Depkes RI AKL 1 Unit 420,000,000 BETA MEDICAL
21102402932
DAFTAR INFORMASI HARGA PERALATAN KESEHATAN
EFECTIVE : TAHUN 2005

NEGARA ASAL NO.


NO. MODEL/ HJSA
NAMA PERALATAN KESEHATAN MERK / REGISTRASI SATUAN SOLE AGENT
URUT TYPE ( Rp. )
PABRIKAN DEPKES RI

I. PERALATAN BEDAH

1 OPERATIVE LAPARASCOPY FOR SURGERY KARL STORZ JERMAN TERDAFTAR 1 SET Rp 859,280,000.00 PT. MASTER DUTA
2 ELECTRONIC CO2 ENDOFLATOR KARL STORZ JERMAN TERDAFTAR 1 SET Rp 189,760,000.00 PT. MASTER DUTA
HIGH FLOW INSUFFLATION 20 L/MIN.
3 LAPAROMAT KARL STORZ JERMAN TERDAFTAR 1 SET Rp 182,753,000.00 PT. MASTER DUTA
SUCTION & IRRIGATION UNIT FOR LAPARASCOPY
4 AUTOCON KARL STORZ JERMAN TERDAFTAR 1 SET Rp 412,800,000.00 PT. MASTER DUTA

II. PERALATAN KEBIDANAN

1 OPERATIVE LAPARASCOPY FOR SURGERY KARL STORZ JERMAN TERDAFTAR 1 SET Rp 880,900,000.00 PT. MASTER DUTA
& GYNAECOLOGY
2 THERMOFLATOR KARL STORZ JERMAN TERDAFTAR 1 SET Rp 241,161,000.00 PT. MASTER DUTA
WITH HIGH FLOW INSUFFLATION 30 L/MIN
GAS PREHEATED 37°C
3 HAMOU ENDOMAT KARL STORZ JERMAN TERDAFTAR 1 SET Rp 258,000,000.00 PT. MASTER DUTA
SUCTION & IRRIGATION UNIT FOR
LAPARASCOPY & HYSTEROSCOPY
4 ELECTROMECHANIC MORCELATOR & KARL STORZ JERMAN TERDAFTAR 1 SET Rp 201,680,000.00 PT. MASTER DUTA
UNIDRIVE MOTOR SYSTEM FOR MYOMA
5 HYSTEROSCOPY SET KARL STORZ JERMAN TERDAFTAR 1 SET Rp 384,440,000.00 PT. MASTER DUTA
FOR DIAGNOSTIC & OPERATIVE WITH
INTRA UTERINE RESECTION
6 AUTOCON KARL STORZ JERMAN TERDAFTAR 1 SET Rp 412,800,000.00 PT. MASTER DUTA

III. PERALATAN UROLOGY

1 UROLOGY SET KARL STORZ JERMAN TERDAFTAR 1 SET Rp 620,940,000.00 PT. MASTER DUTA
2 CYSTOSCOPY SET KARL STORZ JERMAN TERDAFTAR 1 SET Rp 221,260,000.00 PT. MASTER DUTA
3 TUR KARL STORZ JERMAN TERDAFTAR 1 SET Rp 190,410,000.00 PT. MASTER DUTA
4 U R S WITH LIHTOTRIPSY KARL STORZ JERMAN TERDAFTAR 1 SET Rp 492,360,000.00 PT. MASTER DUTA
5 PERCUTANEOUS NEPROSTOMY KARL STORZ JERMAN TERDAFTAR 1 SET Rp 518,170,000.00 PT. MASTER DUTA
WITH ULTRASONIC GENERATOR
6 PEDIATRIC UROLOGY KARL STORZ JERMAN TERDAFTAR 1 SET Rp 335,330,000.00 PT. MASTER DUTA
7 AUTOCON KARL STORZ JERMAN TERDAFTAR 1 SET Rp 412,800,000.00 PT. MASTER DUTA

IV. PERALATAN THT

1 FUNCTIONAL ENDOSCOPIC SINUS SURGERY KARL STORZ JERMAN TERDAFTAR 1 SET Rp 427,000,000.00 PT. MASTER DUTA
2 BRONCHOSCOPE FOR ADULT & PEDIATRIC KARL STORZ JERMAN TERDAFTAR 1 SET Rp 472,280,000.00 PT. MASTER DUTA
3 ESOPHAGOSCOPE FOR ADULT & PEDIATRIC KARL STORZ JERMAN TERDAFTAR 1 SET Rp 455,170,000.00 PT. MASTER DUTA
4 MICROSURGERY - KLEINSASER LARYNGOSCOPE KARL STORZ JERMAN TERDAFTAR 1 SET Rp 338,650,000.00 PT. MASTER DUTA
FOR ADULT & PEDIATRIC
5 ENT ENDOSCOPY FOR POLICLINIC WITH DX CAM KARL STORZ JERMAN TERDAFTAR 1 SET Rp 480,070,000.00 PT. MASTER DUTA
( NOSE, EAR & LARYNGOSCOPE )
6 ENT ENDOSCOPY FOR POLICLINIC WITH MEDIPACK KARL STORZ JERMAN TERDAFTAR 1 SET Rp 636,780,000.00 PT. MASTER DUTA

7 FLEXIBLE NASO LARYNGO-PHARYNGOSCOPE KARL STORZ JERMAN TERDAFTAR 1 SET Rp 665,800,000.00 PT. MASTER DUTA

IV. PERALATAN NEUROLOGY

1 ENDOSCOPY FOR NEUROLOGY KARL STORZ JERMAN TERDAFTAR 1 SET Rp 769,040,000.00 PT. MASTER DUTA
2 ENDOSPINE SET FOR THE ENDOSCOPICALLY KARL STORZ JERMAN TERDAFTAR 1 SET Rp 743,400,000.00 PT. MASTER DUTA
ASSISTED TREATMENT OF LUMBAR DISK

V. PERALATAN ORTHOPAEDIC

1 ARTHROSCOPY SET KARL STORZ JERMAN TERDAFTAR 1 SET Rp 1,485,550,000.00 PT. MASTER DUTA
2 SHOULDER ARTHROSCOPY KARL STORZ JERMAN TERDAFTAR 1 SET Rp 353,241,000.00 PT. MASTER DUTA
3 ANTERIOR CRUCIATE LIGAMENT (ACL) KARL STORZ JERMAN TERDAFTAR 1 SET Rp 382,980,000.00 PT. MASTER DUTA

Jakarta, 26 September 2005

PT. MASTER DUTA

Dra. Surjany Kurniawan


Direktris
Daftar Keagenan PT Andiarta Matra Utama

No Nama Alat Merk / Negara Asal Type No. Registrasi Harga


Sole Agent

1 Biphasic Defibrillator Reanibex-Spain Reanibex-1 Dalam Proses 51,144,000


2 DC Shock Monitor + printer Reanibex-Spain Reanibex 5 Dalam Proses 106,575,000
3 DC Shock (Monitor + printer + Reanibex-Spain Reanibex 5 Dalam Proses 199,247,000
ECG + SPO2 + Pacemaker)
4 DC Shock (Manual + Biphasic) Reanibex-Spain Reanibex 700 Dalam Proses 205,402,000
(monitor + Recorder + SPO 2 + ECG+
Pacemaker)

5 ECT Monitor + printer (4 variabel) MECTA - USA Model 5000Q Dalam Proses 294,000,000
6 ECT Monitor + printer (1 variabel) MECTA - USA Model 5000M Dalam Proses 245,000,000
7 ECT (4 variabel) MECTA - USA Model 4000Q Dalam Proses 159,250,000

8 Dental unit + Chair Mediprogress-Slovakia Chiradent Dalam Proses 152,268,000


9 Laparoscope ILO Elektronik -GMBH Various Dalam Proses 444,063,000

10 Patient monitor (ECG, SPO2, NIBP, Digicare - USA LW 6000 Dalam Proses 134,750,000
11 Temp, HR, Printer)
12 Pulse Oximetry Digicare - USA PO 930 Dalam Proses 33,075,000
13 Central Monitor Digicare - USA DS 820 Dalam Proses 242,550,000

14 USG Portable + Probe connector + Danatech - USA DMS 100 Dalam Proses 137,690,000
Printer
15 Electro Counter 300 Watt Danatech - USA SE 501E Dalam Proses 68,600,000

16 Anaesthesia Machine Hersill - Spain Regina Dalam Proses 338,713,000


2 Vaporizer+ Ventilator
17 Anaesthesia Machine Hersill - Spain Regina Dalam Proses 491,838,000
2 Vaporizer+ Ventilator Electronic
18 Suction Pump 2 Bottle Hersill - Spain Eurovac H 40 Dalam Proses 27,563,000
19 Thorax Pump Hersill - Spain Eurovac L 10i Dalam Proses 19,110,000
20 Emergency Kit Hersill - Spain Oxyvac R 3000 Dalam Proses 41,206,000

21 Infusion Pump Nikisso-Japan PFA 06 Dalam Proses 42,875,000


22 Syringe Pump Nikisso-Japan PSK 01 Dalam Proses 38,710,000

23 ICU Ventilator for Pediatric Accutronic-Swiss Fabian Dalam Proses 441,459,000

24 Appendictomy Set Sklar/USA Various Dalam Proses 20,419,000


25 Bandage Set Sklar/USA Various Dalam Proses 9,398,000
26 Basic Eye Set Sklar/USA Various Dalam Proses 50,860,000
27 Basic Obgyn Set Sklar/USA Various Dalam Proses 62,777,000
28 Cataract Set Sklar/USA Various Dalam Proses 78,409,000
29 Circumsisi Set Sklar/USA Various Dalam Proses 39,681,000
30 Dillatation & Curretage Set Sklar/USA Various Dalam Proses 35,288,000
31 Sectio Caesarean Sklar/USA Various Dalam Proses 11,364,000
32 Hysterectomy Set Sklar/USA Various Dalam Proses 27,242,000
33 Embryotomy Set Sklar/USA Various Dalam Proses 42,581,000

Page 1
No Nama Alat Merk / Negara Asal Type No. Registrasi Harga
Sole Agent

34 Mayor Basic Instrument Set Sklar/USA Various Dalam Proses 70,209,000


35 Minor Basic Instrument Set Sklar/USA Various Dalam Proses 31,941,000
36 Nasal Set Sklar/USA Various Dalam Proses 95,012,000
37 Partus Set Sklar/USA Various Dalam Proses 2,879,000
38 Tonsilectomy Set Sklar/USA Various Dalam Proses 32,698,000
39 Tracheotomy Set Sklar/USA Various Dalam Proses 16,053,000
40 Vena Sectio Set Sklar/USA Various Dalam Proses 3,559,000
41 Basic Orthopedic Set Sklar/USA Various Dalam Proses 63,700,000
42 Laparotomy Set Sklar/USA Various Dalam Proses 29,400,000
43 Nephrectomy Set Sklar/USA Various Dalam Proses 58,800,000
44 Herniotomy Set Sklar/USA Various Dalam Proses 24,500,000
45 Infant laparotomy Set Sklar/USA Various Dalam Proses 30,625,000
46 Gynecology Surgery Set Sklar/USA Various Dalam Proses 51,450,000
47 Mastectomy Set Sklar/USA Various Dalam Proses 56,350,000

Page 2
DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

1 USG FOR GENERAL ABDOMINAL & OBSGYN, PORTABLE BK MEDICAL - DENMARK MERLIN 1101-1 UNIT AKL 21501303138 Rp. 579,425,000.00
2 USG FOR GENERAL ABDOMINAL & OBSGYN W/ STAND, PORTABLE BK MEDICAL - DENMARK MERLIN 1101-1 UNIT AKL 21501303138 Rp. 596,209,000.00
3 USG FOR UROLOGY (PROSTATE) WITH STAND, PORTABLE BK MEDICAL - DENMARK MERLIN 1101-1 UNIT AKL 21501303138 Rp. 662,862,000.00
4 Transd 5.5/7.0/8.0 Mhz for Pediatric, Small Part, Intraoperative BK MEDICAL - DENMARK 8560 UNIT AKL 21501303138 Rp. 289,802,000.00
5 Transd Endovaginal 5.0/6.5/7.5 MHz for Transvaginal BK MEDICAL - DENMARK 8561 UNIT AKL 21501303138 Rp. 212,895,000.00
6 TRANDUSCER 6.0 / 8.0 / 10.0 MHz FOR ENDO RECTAL BK MEDICAL - DENMARK 8567 UNIT AKL 21501303137 Rp. 289,802,000.00
7 USG CONSOLE ONLY ( WITHOUT TRANSDUCER ) BK MEDICAL - DENMARK FALCON 2101-1 EXL UNIT AKL 21501303137 Rp. 743,480,000.00
8 USG CONSOLE FOR GENERAL ABDOMINAL & OBSGYN BK MEDICAL - DENMARK FALCON 2101-1 EXL UNIT AKL 21501303137 Rp. 956,375,000.00
9 USG CONSOLE FOR UROLOGY ( PROSTATE ) BK MEDICAL - DENMARK FALCON 2101-1 EXL UNIT AKL 21501303137 Rp. 1,033,282,000.00
10 USG CONSOLE FOR CARDIAC BK MEDICAL - DENMARK FALCON 2101-1 EXL UNIT AKL 21501303137 Rp. 1,033,282,000.00
11 USG CONSOLE FOR INTRAOPERATIVE BK MEDICAL - DENMARK FALCON 2101-1 EXL UNIT AKL 21501303137 Rp. 1,033,282,000.00
12 USG CONSOLE ONLY (WITHOUT TRANSDUCER), COLOR BK MEDICAL - DENMARK HAWK 2102 - 6 EXL UNIT AKL 21501303136 Rp. 1,771,727,000.00
13 USG CONSOLE FOR GENERAL ABDOMINAL & OBSGYN, COLOR BK MEDICAL - DENMARK HAWK 2102 - 6 EXL UNIT AKL 21501303136 Rp. 1,984,622,000.00
14 USG CONSOLE FOR UROLOGY (PROSTATE), COLOR BK MEDICAL - DENMARK HAWK 2102 - 6 EXL UNIT AKL 21501303136 Rp. 2,061,530,000.00
15 USG CONSOLE FOR CARDIAC, COLOR BK MEDICAL - DENMARK HAWK 2102 - 6 EXL UNIT AKL 21501303136 Rp. 2,061,530,000.00
16 USG CONSOLE FOR INTRAOPERATIVE, COLOR BK MEDICAL - DENMARK HAWK 2102 - 6 EXL UNIT AKL 21501303136 Rp. 2,061,530,000.00
17 USG CONSOLE ONLY (WITHOUT TRANSDUCER), COLOR BK MEDICAL - DENMARK HAWK 2102-7 EXL UNIT AKL 21501200621 Rp. 2,069,239,000.00
18 USG CONSOLE FOR GENERAL ABDOMINAL & OBSGYN, COLOR BK MEDICAL - DENMARK HAWK 2102-7 EXL UNIT AKL 21501200621 Rp. 2,282,134,000.00
19 USG CONSOLE FOR UROLOGY ( PROSTATE ) COLOR BK MEDICAL - DENMARK HAWK 2102-7 EXL UNIT AKL 21501200621 Rp. 2,359,041,000.00
20 USG CONSOLE FOR CARDIAC, COLOR BK MEDICAL - DENMARK HAWK 2102-7 EXL UNIT AKL 21501200621 Rp. 2,359,041,000.00
21 USG CONSOLE FOR INTRAOPERATIVE, COLOR BK MEDICAL - DENMARK HAWK 2102-7 EXL UNIT AKL 21501200621 Rp. 2,359,041,000.00
22 Transd. Endo, MFI 6/7.5/10MHz, BK MEDICAL - DENMARK 8538 UNIT AKL 21501303136 Rp. 212,885,000.00
23 Transd Transrectal Multiplane, MFI 6/7.5/10 MHz BK MEDICAL - DENMARK 8551 UNIT AKL 21501303136 Rp. 212,885,000.00
24 Transd. Laparoscopic , MFI 5/6.5/7.5 MHz BK MEDICAL - DENMARK 8655 UNIT AKL 21501303136 Rp. 630,858,000.00
25 Transd. Transrectal Biplane , MFI 5/6.5/7.5 MHz BK MEDICAL - DENMARK 8658 UNIT AKL 21501303136 Rp. 630,858,000.00
26 TRAND. INTRAOPERATIVE T-PROBE, MFI 5/6.5/7.5 MHz BK MEDICAL - DENMARK 8659 UNIT AKL 21501303136 Rp. 289,788,000.00
27 TRAND END-FIRE VAGINAL, MFI 5/6.5/7.5 MHz BK MEDICAL - DENMARK 8661 UNIT AKL 21501303136 Rp. 212,885,000.00
28 TRAND NEURO SURGICAL, MFI 5/6.5/8 MHz BK MEDICAL - DENMARK 8662 UNIT AKL 21501303136 Rp. 289,788,000.00
29 TRAND. BURR HOLE, MFI 5/6.5/7.5 MHz BK MEDICAL - DENMARK 8663 UNIT AKL 21501303136 Rp. 289,788,000.00
30 TRANDUSCER CONVEX, MFI 2.7 / 3.5 / 5 MHz BK MEDICAL - DENMARK 8665 UNIT AKL 21501303136 Rp. 212,885,000.00
31 TRAND OBSTETRIC 3RD TRIMESTER CONVEX, MFI 2.5/3.5/5 MHz BK MEDICAL - DENMARK 8801 UNIT AKL 21501303136 Rp. 289,788,000.00
32 TRAND FETAL CONVEX, MFI 4.3/5/6 MHz BK MEDICAL - DENMARK 8802 UNIT AKL 21501303136 Rp. 289,788,000.00
33 TRAND INTERCOSTAL CONVEX, MFI 3.5/4.3/5.0 MHz BK MEDICAL - DENMARK 8803 UNIT AKL 21501303136 Rp. 289,788,000.00
34 TRAND LINEAR SMALL PART, BREAST & VASCULAR, MFI 5/6.5/8 MHz BK MEDICAL - DENMARK 8804 UNIT AKL 21501303136 Rp. 289,788,000.00
35 SMALL PART, BREAST & VASCULAR LINEAR TRANSD., MFI 8/10/12 MHZ BK MEDICAL - DENMARK 8805 UNIT AKL 21501303136 Rp. 325,284,000.00
36 CONVEX CARDIAC TRANSD., MFI BK MEDICAL - DENMARK 8807 UNIT AKL 21501303136 Rp. 289,788,000.00
37 L3DI-2100 COLOR WITH MOVER CONTROL BK MEDICAL - DENMARK 6502-C2 UNIT AKL 21501303136 Rp. 1,512,118,000.00
38 CYTOLOGICAL NEEDLE KIT FOR 8566/8666 TRANDUSCER BK MEDICAL - DENMARK UA0033 UNIT AKL 21501303136 Rp. 28,191,000.00

DOC/PT. PPH/200905 Page 1 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

39 HISTOLOGICAL BIOPSY NEEDLE KIT, 19 GAUGE BK MEDICAL - DENMARK UA0034 UNIT AKL 21501303136 Rp. 59,143,000.00
40 HISTOLOGICAL BIOPSY NEEDLE KIT 20 GAUGE BK MEDICAL - DENMARK UA0035 UNIT AKL 21501303136 Rp. 59,143,000.00
41 ENDO CAVITY ROTATIONAL MOVER (ECRM) BK MEDICAL - DENMARK UA0550 UNIT AKL 21501303136 Rp. 111,493,000.00
42 PUNCTURE ATTACHMENT FOR 8537/8538 BK MEDICAL - DENMARK UA0875 UNIT AKL 21501303136 Rp. 24,887,000.00
43 PUNCTURE ATTACHMENT BK MEDICAL - DENMARK UA0935 UNIT AKL 21501303136 Rp. 29,690,000.00
44 PUNCTURE ATTACHMENT, DIAM. 0.6 - 2.0 MM. BK MEDICAL - DENMARK UA0940 UNIT AKL 21501303136 Rp. 39,626,000.00
45 LIGHTPEN KIT FOR SYSTEM SERIES 2100 BK MEDICAL - DENMARK UA1209 UNIT AKL 21501303136 Rp. 29,867,000.00
46 PUNCTURE ATTACHMENT DIAM 1.2 - 3.6 MM. BK MEDICAL - DENMARK UA1217 UNIT AKL 21501303136 Rp. 40,217,000.00
47 PUNCTURE ATTACHMENT FOR 8557/8657 TRANDUSCER BK MEDICAL - DENMARK UA1231 UNIT AKL 21501303136 Rp. 64,372,000.00
48 PUNCTURE GUIDE FOR 8560/8660 TRANDUSCER BK MEDICAL - DENMARK UA1239 UNIT AKL 21501303136 Rp. 59,144,000.00
49 PUNCTURE ATTACHMENT FOR 8561/8661 TRANDUSCER BK MEDICAL - DENMARK UA1242 UNIT AKL 21501303136 Rp. 70,381,000.00
50 PUNCTURE ATTACHMENT FOR 8562/8662 TRANDUSCER BK MEDICAL - DENMARK UA1243 UNIT AKL 21501303136 Rp. 70,381,000.00
51 PUNCTURE ATTACHMENTFOR 8563/8663 TRANDUSCER BK MEDICAL - DENMARK UA1244 UNIT AKL 21501303136 Rp. 70,381,000.00
52 PUNCTURE ATTACHMENT FOR 8802/8803 TRANDUSCER BK MEDICAL - DENMARK UA1250 UNIT AKL 21501303136 Rp. 65,058,000.00
53 PUNCTURE ATTACHMENT FOR 8804/8805 TRANDUSCER BK MEDICAL - DENMARK UA1251 UNIT AKL 21501303136 Rp. 82,802,000.00
54 PUNCTURE ATTACHMENTFOR. 8567/8667 TRANDUSCER BK MEDICAL - DENMARK UA1256 UNIT AKL 21501303136 Rp. 34,304,000.00
55 PUNCTURE ATTACHMENT 22,0 mm. FOR 85/8808 TRANDUSCER BK MEDICAL - DENMARK UA1257 UNIT AKL 21501303136 Rp. 8,753,000.00
56 NEEDLE GUIDE ATTACHMENT BK MEDICAL - DENMARK UC5299 UNIT AKL 21501303136 Rp. 2,153,000.00
57 EEG 32 CHANNELS LAPTOP MODEL CADWELL - USA EASY II LT UNIT AKL 21001300222 Rp. 899,678,000.00
58 EEG 32 CHANNELS CONSOLE MODEL CADWELL - USA EASY II CONSOLE UNIT AKL 21001300222 Rp. 835,938,000.00
59 EEG 32 CHANNELS WITH SLEEP ANALYSIS CADWELL - USA EASY II SLEEP UNIT AKL 21001300222 Rp. 1,057,383,000.00
60 BRAINMAPPING CADWELL - USA EASY II + SPIKE + MAPPING UNIT AKL 21001300222 Rp. 1,120,225,000.00
61 AMBULATORY EEG CADWELL - USA EASY AMBULATORY UNIT DALAM PROSES Rp. 763,387,000.00
62 EMG W/ EVOKED POTENTIAL (EP) 2 CH., CONSOLE MODEL CADWELL - USA SIERRA II CONSOLE UNIT AKL 21401300152 Rp. 1,232,504,000.00
63 EMG W/ EVOKED POTENTIAL (EP) 2 CH., LAPTOP MODEL CADWELL - USA SIERRA II WEDGE UNIT AKL 21401300152 Rp. 1,149,013,000.00
64 EMG W/ EVOKED POTENTIAL (EP) 4 CH., CONSOLE MODEL CADWELL - USA SIERRA II CONSOLE UNIT AKL 21401300152 Rp. 1,391,106,000.00
65 EMG W/ EVOKED POTENTIAL (EP) 4 CH., LAPTOP MODEL CADWELL - USA SIERRA II WEDGE UNIT AKL 21401300152 Rp. 1,269,611,000.00
66 ECG SINGLE CHANNEL W/ INTERPRETIVE CARDIOLINE - ITALY DELTA 1 PLUS I UNIT AKL 20502300577 Rp. 77,360,000.00
67 ECG SINGLE CHANNEL W/ INTERPRETIVE FOR PEDIATRIC CARDIOLINE - ITALY DELTA 1 PLUS I UNIT AKL 20502300577 Rp. 77,360,000.00
68 ECG 3/6 CHANNELS STD. MODEL CARDIOLINE - ITALY DELTA 3/6 PLUS UNIT AKL 20502300578 Rp. 80,096,000.00
69 ECG 3/6 CHANNELS STD. MODEL FOR PEDIATRIC CARDIOLINE - ITALY DELTA 3/6 PLUS UNIT AKL 20502300578 Rp. 80,096,000.00
70 ECG 3/6 CHANNELS W/ INTERPRETIVE CARDIOLINE - ITALY DELTA 3/6 PLUS I UNIT AKL 20502300578 Rp. 93,776,000.00
71 ECG 3/6 CHANNELS W/ INTERPRETIVE FOR PEDIATRIC CARDIOLINE - ITALY DELTA 3/6 PLUS I UNIT AKL 20502300578 Rp. 93,776,000.00
72 ECG 6 CH. FULL ALPHANUMERIC KEYBOARD CARDIOLINE - ITALY DELTA 60 PLUS UNIT AKL 20502300579 Rp. 131,260,000.00
73 ECG 6 CH. FULL ALPHANUMERIC KEYBOARD FOR PEDIATRIC CARDIOLINE - ITALY DELTA 60 PLUS UNIT AKL 20502300579 Rp. 131,260,000.00
74 ECG 6 CH. FULL ALPHANUMERIC KEYBOARD W/ INTERPRETIVE CARDIOLINE - ITALY DELTA 60 PLUS I UNIT AKL 20502300579 Rp. 144,940,000.00
75 ECG 6 CH. FULL ALPHANUMERIC KEYBOARD W/ INTERPRETIVE FOR PEDIATRIC CARDIOLINE - ITALY DELTA 60 PLUS I UNIT AKL 20502300579 Rp. 144,940,000.00
76 AgCl LIMB ELECTRODE WITHOUT STRAP (MIN. ORDER 4 PCS) CARDIOLINE - ITALY 873 - 3405 PC DALAM PROSES Rp. 205,000.00

DOC/PT. PPH/200905 Page 2 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

77 AgCl SUCTION ELECTRODE ( MINIMUM ORDER 6 PCS ) CARDIOLINE - ITALY 873 - 3406 PC DALAM PROSES Rp. 356,000.00
78 ROLL OF THERMAL BLACK PAPER 60 x 30 CARDIOLINE - ITALY 874 - 3560 PACKAGE DALAM PROSES Rp. 96,000.00
79 ROLL OF THERMAL BLACK PAPER 210 x 30 CARDIOLINE - ITALY 874 - 3556 PACKAGE DALAM PROSES Rp. 342,000.00
80 Z-FOLD PACK OF THERMAL BLACK PAPER 60 X 300 / 1 CARDIOLINE - ITALY 874 - 5558 PACKAGE DALAM PROSES Rp. 123,000.00
81 Z-FOLD PACK OF THERMAL BLACK PAPER110 x 300 / 1 CARDIOLINE - ITALY 874 - 5554 PACKAGE DALAM PROSES Rp. 233,000.00
82 Z-FOLD PACK OF THERMAL BLACK PAPER 210 x 200 / 1 CARDIOLINE - ITALY 874 - 5556 PACKAGE DALAM PROSES Rp. 739,000.00
83 DELTAVIS-THREE CHANNELS ECG LCD MONITOR CARDIOLINE - ITALY 888 - 0409 UNIT DALAM PROSES Rp. 23,256,000.00
84 INTERFACE BOARD A/D CARDIOLINE - ITALY 888 - 9304 UNIT DALAM PROSES Rp. 4,104,000.00
85 ECT STRESS TEST SYSTEM WITH TREADMILL CARDIOLINE - ITALY PRIMA STRESS TEST UNIT DALAM PROSES Rp. 895,000,000.00
86 ELECTROCARDIOGRAPH 12 CHANNELS WITH 6 CHS LCD DISPLAY CARDIOLINE - ITALY ELAN UNIT DALAM PROSES Rp. 189,550,000.00
87 ECG 12 CH W/ INTERPRETIVE & 6 CHS LCD DISPLAY CARDIOLINE - ITALY ELAN CP/I UNIT DALAM PROSES Rp. 206,650,000.00
88 HOLTER SYSTEM W/ ARRYTHMIA, ST HRV IN TIME CARDIOLINE - ITALY PRIMA HOLTER UNIT DALAM PROSES Rp. 697,680,000.00
89 HOLTER SYSTEM W/ ARRYTHMIA, ST HRV IN TIME AND FREQ. CARDIOLINE - ITALY PRIMA HOLTER TOP UNIT AKL 20502300556 Rp. 875,520,000.00
90 TREADMILL CARDIOTREAD CARDIOLINE - ITALY CARDIOTREAD UNIT DALAM PROSES Rp. 349,866,000.00
91 COMBINED HOLTER AND STRESS TESTING SYSTEM CARDIOLINE - ITALY COMBINE SYSTEM UNIT DALAM PROSES Rp. 684,000,000.00
92 STEAM STERILIZER, DUAL TEMPERATURE 12 L CERTOCLAV - AUSTRIA CV-EL 12L GS UNIT AKL 20903300581 Rp. 49,445,000.00
93 STEAM STERILIZER, DUAL TEMPERATURE 18 L CERTOCLAV - AUSTRIA CV-EL 18L GS UNIT AKL 20903300581 Rp. 68,816,000.00
94 STEAM STERILIZER, MULTICONTROL 12 L CERTOCLAV - AUSTRIA MULTICONTROL 12 L UNIT AKL 20903300582 Rp. 100,006,000.00
95 STEAM STERILIZER, MULTICONTROL 18 L CERTOCLAV - AUSTRIA MULTICONTROL 18 L UNIT AKL 20903300582 Rp. 113,221,000.00
96 COMPUTERIZED SPIROMETER COSMED - ITALY QUARK PFT 1 INT UNIT AKL 20401200618 Rp. 357,718,000.00
97 COMPUTERIZED SPIROMETRTY WITH RESIDUAL CAPACITY TESTING COSMED - ITALY QUARK PFT 2 UNIT DALAM PROSES Rp. 893,000,000.00
WITH O2 PARAMAGNETIC
98 COMPUTERIZED SPIROMETRY WITH LUNG DIFUSSING CAPACITY TESTING COSMED - ITALY QUARK PFT 3 UNIT DALAM PROSES Rp. 819,634,000.00
99 COMPUTERIZED SPIROMETRY WITH RESIDUAL CAPACITY AND COSMED - ITALY QUARK PFT 4 UNIT DALAM PROSES Rp. 1,235,971,000.00
DIFUSSING CAPACITY WITH O2 PARAMAGNETIC
100 CARDIOPULMONARY STRESS TEST WITH ERGOMETER COSMED - ITALY QUARK C 12 UNIT DALAM PROSES Rp. 1,341,057,000.00
101 CARDIOPULMONARY STRESS TEST W/ O2 PARAMAGNETIC & ERGOMETER COSMED - ITALY QUARK C 12 UNIT DALAM PROSES Rp. 1,494,957,000.00
102 CARDIOPULMONARY STRESS TEST W/ TREADMILL & TELEMETRI ECG COSMED - ITALY QUARK b2 INT UNIT AKL 20502304339 Rp. 2,309,789,000.00
103 CARDIOPULMONARY STRESS TEST WITH TREADMILL COSMED - ITALY QUARK b2 INT UNIT AKL 20502304339 Rp. 1,806,502,000.00
104 PORTABLE SPIROMETER COSMED - ITALY PONY FX UNIT DALAM PROSES Rp. 166,554,000.00
105 MOBILE EXAMINATION LAMP, FIXFOCUS, RA=96 DR. MACH - GERMANY MACH 115WSF UNIT AKL 10903300160 Rp. 28,536,000.00
106 MOBILE EXAMINATION LAMP, FOCUSABLE, RA=93 DR. MACH - GERMANY MACH 120 F UNIT AKL 10903300160 Rp. 49,316,000.00
107 MOBILE OPERATING LAMP 3 LAMP FOCUSABLE, BATTERY & CHARGER DR. MACH - GERMANY M3F UNIT AKL 21603300157 Rp. 337,027,000.00
108 MOBILE OPERATING LAMP 3 LAMP DUA FOCUS, BATTERY & CHARGER DR. MACH - GERMANY M3DF UNIT AKL 21603300157 Rp. 358,047,000.00
109 OPERATING LAMP 3 FOCUSABLE DR. MACH - GERMANY MACH M3F UNIT AKL 21603300157 Rp. 250,258,000.00
110 OPERATING LAMP 3 LAMP DUO FOCUS SYSTEM DR. MACH - GERMANY MACH M3DF UNIT AKL 21603300157 Rp. 271,325,000.00
111 OPERATING LAMP 4 LAMP FOCUSABLE DR. MACH - GERMANY MACH 400F UNIT AKL 21603300153 Rp. 332,085,000.00
112 OPERATING LAMP 4 LAMP DUO FOCUS SYSTEM DR. MACH - GERMANY MACH 400DF UNIT AKL 21603300153 Rp. 363,015,000.00

DOC/PT. PPH/200905 Page 3 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

113 OPERATING LAMP 4 LAMP AUTO FOCUS SYSTEM DR. MACH - GERMANY MACH 400AF UNIT AKL 21603300153 Rp. 438,139,000.00
114 OPERATING LAMP 5 LAMP FOCUSABLE DR. MACH - GERMANY MACH 500F UNIT AKL 21603300153 Rp. 367,995,000.00
115 OPERATING LAMP 5 LAMP DUO FOCUS SYSTEM DR. MACH - GERMANY MACH 500DF UNIT AKL 21603300153 Rp. 410,847,000.00
116 OPERATING LAMP 5 LAMP AUTO FOCUS SYSTEM DR. MACH - GERMANY MACH 500AF UNIT AKL 21603300153 Rp. 485,971,000.00
117 OPERATING LAMP 7 LAMP FOCUSABLE DR. MACH - GERMANY MACH 700F UNIT AKL 21603300153 Rp. 604,570,000.00
118 OPERATING LAMP 7 LAMP DUO FOCUS SYSTEM DR. MACH - GERMANY MACH 700DF UNIT AKL 21603300153 Rp. 656,855,000.00
119 OPERATING LAMP 7 LAMP AUTO FOCUS SYSTEM DR. MACH - GERMANY MACH 700AF UNIT AKL 21603300153 Rp. 728,675,000.00
120 OPERATING LAMP 7 DUO FOCUS LAMP - 5 FOCUS LAMP DR. MACH - GERMANY MACH-700 DF + MACH 500F UNIT AKL 21603300153 Rp. 1,080,294,000.00
121 OPERATING LAMP 7 DUO FOCUS LAMP - 4 FOCUS LAMP DR. MACH - GERMANY MACH-700 DF + MACH 400F UNIT AKL 21603300153 Rp. 1,039,357,000.00
122 OPERATING LAMP 7 DUO FOCUS LAMP - 3 FOCUS LAMP DR. MACH - GERMANY MACH-700 DF + MACH 380F UNIT AKL 21603300153 Rp. 996,552,000.00
123 OPERATING LAMP 5 DUO FOCUS LAMP - 5 FOCUS LAMP DR. MACH - GERMANY MACH-500 DF + MACH 500F UNIT AKL 21603300153 Rp. 856,742,000.00
124 OPERATING LAMP 5 DUO FOCUS LAMP - 4 FOCUS LAMP DR. MACH - GERMANY MACH-500 DF + MACH 400 F UNIT AKL 21603300153 Rp. 815,805,000.00
125 OPERATING LAMP 5 DUO FOCUS LAMP - 3 FOCUS LAMP DR. MACH - GERMANY MACH-500 DF + MACH 380 F UNIT AKL 21603300153 Rp. 773,000,000.00
126 OPERATING LAMP 4 DUO FOCUS LAMP - 4 FOCUS LAMP DR. MACH - GERMANY MACH 400 DF + MACH 400 F UNIT AKL 21603300153 Rp. 767,686,000.00
127 OPERATING LAMP 4 DUO FOCUS LAMP - 3 FOCUS LAMP DR. MACH - GERMANY MACH 400 DF + MACH 380 F UNIT AKL 21603300153 Rp. 724,881,000.00
128 OPERATING LAMP 3 DUO FOCUS LAMP -3 FOCUS LAMP DR. MACH - GERMANY MACH 380 DF + MACH 380 F UNIT AKL 21603300153 Rp. 674,894,000.00
129 OPERATING LAMP 3 DUO FOCUS LAMP - 1 FOCUS LAMP DR. MACH - GERMANY MACH 380 DF + MACH 130 F UNIT AKL 21603300153 Rp. 529,626,000.00
130 ABDOMINAL GYNECOLOGICAL SURGERY SET ELCON - GERMANY 598-5030 SET AKL 21603300363 Rp. 32,969,000.00
131 ABDOMINAL HYSTERECTOMY INSTRUMENT SET ELCON - GERMANY 592-302 SET AKL 21603300363 Rp. 51,344,000.00
132 ABDOMINAL SURGERY INSTURMENT SET ELCON - GERMANY 590-740 SET AKL 21603300363 Rp. 92,496,000.00
133 ABDOMINOPERINEAL RESECTION SET ELCON - GERMANY 598-1130 SET AKL 21603300363 Rp. 29,549,000.00
134 ADENOIDECTOMY INSTRUMENT SET ELCON - GERMANY 593-702 SET AKL 21603300363 Rp. 89,558,000.00
135 AMPUTATION SET ELCON - GERMANY 598-4070 SET AKL 21603300363 Rp. 9,952,000.00
136 AMPUTATION SET, DIGITAL ELCON - GERMANY 598-4120 SET AKL 21603300363 Rp. 26,266,000.00
137 ANALPLASTY SET ELCON - GERMANY 598-2070 SET AKL 21603300363 Rp. 34,097,000.00
138 ANESTOPHON STETHOSCOPE ELCON - GERMANY 511-4173 SET AKL 21603300363 Rp. 854,000.00
139 ANTERIOR & POSTERIOR COLPORRHAPHY SET ELCON - GERMANY 598-5260 SET AKL 21603300363 Rp. 59,782,000.00
140 APPENDECTOMY INSTRUMENT SET ELCON - GERMANY 590-780 SET AKL 21603300363 Rp. 37,639,000.00
141 ARCH BAR APPLICATION SET ELCON - GERMANY 598-6540 SET AKL 21603300363 Rp. 8,140,000.00
142 ARTHROSCOPIE-INSTRUM. SET ELCON - GERMANY 598-4042 SET AKL 21603300363 Rp. 80,746,000.00
143 ARTHROTOMY - MENISCOTOMY SET ELCON - GERMANY 598-4040 SET AKL 21603300363 Rp. 38,270,000.00
144 AURAL POLYPECTOMY SET ELCON - GERMANY 593-150 SET AKL 21603300363 Rp. 6,858,000.00
145 BABY DUPLEX STETHOSCOPE ELCON - GERMANY 511-4126 SET AKL 21603300363 Rp. 1,339,000.00
146 BABY LAMINECTOMY INSTRUMENT SET ELCON - GERMANY 598-3512 SET AKL 21603300363 Rp. 42,305,000.00
147 BANDAGE INSTRUMENT SET ELCON - GERMANY 155-170 SET AKL 21603300363 Rp. 3,721,000.00
148 BARTHOLIN CYST EXCISION SET ELCON - GERMANY 598-5180 SET AKL 21603300363 Rp. 19,186,000.00
149 BLEPHAROPLASTY SET, BASIC ELCON - GERMANY 598-7010 SET AKL 21603300363 Rp. 18,536,000.00
150 BLOOD EXCHANGE TRAY ELCON - GERMANY 598-1190 SET AKL 21603300363 Rp. 4,446,000.00

DOC/PT. PPH/200905 Page 4 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

151 BONE MARROW INSTRUMENT SET ELCON - GERMANY 598-234 SET AKL 21603300363 Rp. 20,075,000.00
152 CALDWELL CLINIC INSTRUMENT SET ELCON - GERMANY 593-310 SET AKL 21603300363 Rp. 43,918,000.00
153 CARDIOVASCULAR BABY SET ELCON - GERMANY 598-3010 SET AKL 21603300363 Rp. 78,831,000.00
154 CARDIOVASCULAR INSTRUMENT SET BASIC ELCON - GERMANY 590-450 SET AKL 21603300363 Rp. 287,357,000.00
155 CATARACT INSTRUMENT SET ELCON - GERMANY 596-240 SET AKL 21603300363 Rp. 76,068,000.00
156 CERVICAL BIOPSY SET ELCON - GERMANY 598-5160 SET AKL 21603300363 Rp. 11,183,000.00
157 CERVIX CAUTERIZATION SET ELCON - GERMANY 598-5170 SET AKL 21603300363 Rp. 8,242,000.00
158 CHALAZION INSTRUMENT SET ELCON - GERMANY 596-140 SET AKL 21603300363 Rp. 93,339,000.00
159 CIRCUMCISSION SET - NEWBORN ELCON - GERMANY 598-2580 SET AKL 21603300363 Rp. 21,614,000.00
160 CIRCUMCISSION, INFANT ELCON - GERMANY 590-992 SET AKL 21603300363 Rp. 7,445,000.00
161 CIRCUMCISSION-ADULTS INSTRUMENT SET ELCON - GERMANY 590-996 SET AKL 21603300363 Rp. 11,399,000.00
162 CLEFT PALATE REPAIR SET ELCON - GERMANY 593-380 SET AKL 21603300363 Rp. 36,183,000.00
163 COLPOTOMY SET ELCON - GERMANY 598-5280 SET AKL 21603300363 Rp. 16,177,000.00
164 COMEDO EXTRACTOR SET ELCON - GERMANY 592-920 SET AKL 21603300363 Rp. 4,529,000.00
165 CORNEAL TRANSPLANT SET ELCON - GERMANY 598-7070 SET AKL 21603300363 Rp. 86,902,000.00
166 CRANIOTOMY INSTRUMENT SET ELCON - GERMANY 598-3520 SET AKL 21603300363 Rp. 162,484,000.00
167 CUT DOWN SET ELCON - GERMANY 598-100 SET AKL 21603300363 Rp. 6,700,000.00
168 CYSTECTOMY SET ELCON - GERMANY 598-2350 SET AKL 21603300363 Rp. 66,998,000.00
169 CYSTOLITHOTOMY SET ELCON - GERMANY 598-2370 SET AKL 21603300363 Rp. 8,755,000.00
170 CYSTOTOMY AND CYSTOSTOMY SET ELCON - GERMANY 598-2360 SET AKL 21603300363 Rp. 27,941,000.00
171 DCR (DACRYOCYSTORHINOSTOMY) SET ELCON - GERMANY 598-7150 SET AKL 21603300363 Rp. 81,430,000.00
172 DILATATION AND CURETTAGE INSTRUMENT SET ELCON - GERMANY 592-210 SET AKL 21603300363 Rp. 21,033,000.00
173 DRESSING INSTRUMENT SET ELCON - GERMANY 590-290 SET AKL 21603300363 Rp. 4,898,000.00
174 DUPLEX STETHOSCOPE ELCON - GERMANY 511-4106 SET AKL 21603300363 Rp. 1,482,000.00
175 EAR FOREIGN BODY REMOVAL SET ELCON - GERMANY 598-6040 SET AKL 21603300363 Rp. 3,796,000.00
176 EAR SURGERY INSTRUMENT SET ELCON - GERMANY 593-102 SET AKL 21603300363 Rp. 176,257,000.00
177 ELECTRIC HAND MOTOR 220 V W QUICK COUPL ELCON - GERMANY 593-102 SET AKL 21603300363 Rp. 170,998,000.00
178 EMBRIOTOMY INSTRUMENT SET ELCON - GERMANY 592-070 SET AKL 21603300363 Rp. 15,368,000.00
179 EMERGENCY SURGERY INSTRUMENT SET ELCON - GERMANY 598-1030 SET AKL 21603300363 Rp. 17,408,000.00
180 EMERGENCY TRACHEOSTOMY INSTRUMENT SET ELCON - GERMANY 593-802 SET AKL 21603300363 Rp. 34,357,000.00
181 ENT BASIC INSTRUMENT SET ELCON - GERMANY 593-002 SET AKL 21603300363 Rp. 77,824,000.00
182 ENT DIAGNOSTIC FIRST TREATMENT SET ELCON - GERMANY 593-010 SET AKL 21603300363 Rp. 42,172,000.00
183 ENT EXAMINATION SET ELCON - GERMANY 598-6010 SET AKL 21603300363 Rp. 11,662,000.00
184 ENT SURGICAL INSTRUMENT SET ELCON - GERMANY 598-6000 SET AKL 21603300363 Rp. 176,540,000.00
185 ENUCLEATION (EVISCERATION) SET ELCON - GERMANY 598-7120 SET AKL 21603300363 Rp. 28,283,000.00
186 EPISIOTOMY & LACERATION REPAIR SET ELCON - GERMANY 598-5420 SET AKL 21603300363 Rp. 15,835,000.00
187 EPISPADIAS REPAIR SET ELCON - GERMANY 598-2590 SET AKL 21603300363 Rp. 25,650,000.00
188 EXCISION OF SKIN GROWTH SET ELCON - GERMANY 598-1070 SET AKL 21603300363 Rp. 19,904,000.00

DOC/PT. PPH/200905 Page 5 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

189 EXCISION SET ELCON - GERMANY 598-140 SET AKL 21603300363 Rp. 4,036,000.00
190 EXPLORATION SET ELCON - GERMANY 598-400E SET AKL 21603300363 Rp. 4,754,000.00
191 EYE SURGERY SET, BASIC ELCON - GERMANY 598-7000 SET AKL 21603300363 Rp. 32,524,000.00
192 EYELIDS & CONJUNCTIVA SET ELCON - GERMANY 598-7020 SET AKL 21603300363 Rp. 79,139,000.00
193 EYE-MUSCLE SET ELCON - GERMANY 598-7110 SET AKL 21603300363 Rp. 33,619,000.00
194 FINE NEEDLES BIOPSY SET ELCON - GERMANY VARIOUS SET AKL 21603300363 Rp. 7,562,000.00
195 FISTULECTOMY SET ELCON - GERMANY 598-2050 SET AKL 21603300363 Rp. 6,703,000.00
196 FORCEPS DELIVERY SET ELCON - GERMANY VARIOUS SET AKL 21603300363 Rp. 57,100,000.00
197 FOREIGN BODY REMOVAL SET ELCON - GERMANY 598-1080 SET AKL 21603300363 Rp. 35,739,000.00
198 FUNCTIONAL ENDOSCOPY SINUS SURGERY ELCON - GERMANY 441-650 SET AKL 21603300363 Rp. 363,029,000.00
199 GALL BLADDER & BILE DUCT SET ELCON - GERMANY 598-1140 SET AKL 21603300363 Rp. 36,799,000.00
200 GALL BLADDER INSTRUMENT SET ELCON - GERMANY 590-802 SET AKL 21603300363 Rp. 47,243,000.00
201 GASTRO-INTESTINAL INSTRUMENT SET ELCON - GERMANY 590-700 SET AKL 21603300363 Rp. 250,680,000.00
202 GLAUCOMA INSTRUMENT SET ELCON - GERMANY 596-250 SET AKL 21603300363 Rp. 40,840,000.00
203 GROIN LYMPHADENECTOMY SET ELCON - GERMANY 598-5150 SET AKL 21603300363 Rp. 29,515,000.00
204 GYNAECOLOGICAL WARD TREATMENT SET ELCON - GERMANY 598-5020 SET AKL 21603300363 Rp. 18,468,000.00
205 GYNAECOLOGY EXAMINATION SET ELCON - GERMANY 592-602 SET AKL 21603300363 Rp. 6,230,000.00
206 GYNECOLOGY / OBSTETRICS SET ELCON - GERMANY 598-5050 SET AKL 21603300363 Rp. 90,117,000.00
207 HAEMORROID INSTRUMENT SET ELCON - GERMANY 591-030 SET AKL 21603300363 Rp. 43,395,000.00
208 HAND SURGERY INSTRUMENT SET ELCON - GERMANY 595-102 SET AKL 21603300363 Rp. 106,062,000.00
209 HAND TENDON REPAIR SET ELCON - GERMANY 598-4130 SET AKL 21603300363 Rp. 63,680,000.00
210 HEAD LAMP ELCON - GERMANY 100-420 SET AKL 21603300363 Rp. 12,415,000.00
211 HEMORRHOIDECTOMY SET ELCON - GERMANY 598-2040 SET AKL 21603300363 Rp. 26,231,000.00
212 HERNIA SET, CHILD ELCON - GERMANY 590-792 SET AKL 21603300363 Rp. 35,574,000.00
213 HERNIA SET, INFANT ELCON - GERMANY 590-794 SET AKL 21603300363 Rp. 39,298,000.00
214 HERNIOTOMY INSTRUMENT SET ELCON - GERMANY 590-790 SET AKL 21603300363 Rp. 43,417,000.00
215 HUDSON HAND DRILL 25.5 CM WITH SCREW ELCON - GERMANY 340-505 SET AKL 21603300363 Rp. 6,019,000.00
216 HYDROCEPHALUS SHUNT OPERATIONS SET ELCON - GERMANY 598-3570 SET AKL 21603300363 Rp. 68,126,000.00
217 HYMENECTOMY SET ELCON - GERMANY 598-5080 SET AKL 21603300363 Rp. 10,363,000.00
218 HYSTERECTOMY INSTRUMENT SET ELCON - GERMANY 592-302 SET AKL 21603300363 Rp. 45,851,000.00
219 INCISION & DRAINAGE SET ELCON - GERMANY 598-1180 SET AKL 21603300363 Rp. 16,690,000.00
220 INCISION AND DRAINAGE OF ABSCESS SET ELCON - GERMANY 598-1060 SET AKL 21603300363 Rp. 8,447,000.00
221 INSTRUMENT SET IN CASE BASIC ELCON - GERMANY 155-100 SET AKL 21603300363 Rp. 6,704,000.00
222 INSTRUMENT SET, PEDIATRIC BASIC ELCON - GERMANY 590-300 SET AKL 21603300363 Rp. 184,895,000.00
223 GENERAL PAEDIATRIC SURGERY INSTRUMENT SET ELCON - GERMANY 590-302 SET AKL 21603300363 Rp. 41,585,000.00
224 INSTRUMENT SPLINTER SET ELCON - GERMANY 598-400B SET AKL 21603300363 Rp. 787,000.00
225 INTESTINAL INSTRUMENT SET ELCON - GERMANY 590-730 SET AKL 21603300363 Rp. 74,698,000.00
226 INTRA-CAPSULAR SET, BASIC ELCON - GERMANY 598-7060 SET AKL 21603300363 Rp. 60,876,000.00

DOC/PT. PPH/200905 Page 6 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

227 IRIDECTOMY INSTRUMENT SET ELCON - GERMANY 596-100 SET AKL 21603300363 Rp. 79,295,000.00
228 IRIDECTOMY SET, BASIC ELCON - GERMANY 598-7050 SET AKL 21603300363 Rp. 60,739,000.00
229 ISCHIORECTAL ABCESS SET ELCON - GERMANY 598-2060 SET AKL 21603300363 Rp. 7,114,000.00
230 KERATOPLASTY INSTRUMENT SET ELCON - GERMANY 596-300 SET AKL 21603300363 Rp. 82,365,000.00
231 KIDNEY INSTRUMENT SET BASIC ELCON - GERMANY 590-904 SET AKL 21603300363 Rp. 53,198,000.00
232 KIDNEY TRANSPLANT SET FOR THE DONOR PROCEDURE ELCON - GERMANY 598-2320 SET AKL 21603300363 Rp. 39,467,000.00
233 KIDNEY TRANSPLANT SET FOR THE RECIPIENT PROCEDURE ELCON - GERMANY 598-2330 SET AKL 21603300363 Rp. 93,845,000.00
234 KUENTSCHER NAIL SET ELCON - GERMANY 598-4160 SET AKL 21603300363 Rp. 169,666,000.00
235 LACERATION SET ELCON - GERMANY 598-6560 SET AKL 21603300363 Rp. 3,181,000.00
236 LACRIMAL SET ELCON - GERMANY 598-7040 SET AKL 21603300363 Rp. 28,420,000.00
237 LAMINECTOMY INSTRUMENT SET ELCON - GERMANY 597-000 SET AKL 21603300363 Rp. 272,139,000.00
238 LAPARATOMY INSTRUMENT SET FOR ADULT ELCON - GERMANY VARIOUS SET AKL 21603300363 Rp. 66,855,000.00
239 LAPARATOMY INSTRUMENT SET FOR CHILD ELCON - GERMANY VARIOUS SET AKL 21603300363 Rp. 52,111,000.00
240 LAPARATOMY INSTRUMENT SET FOR INFANT ELCON - GERMANY 590-754 SET AKL 21603300363 Rp. 40,844,000.00
241 LAPARATOMY OBS/GYN INSTRUMENT SET ELCON - GERMANY 590-766 SET AKL 21603300363 Rp. 63,378,000.00
242 LARGE BONE SET ELCON - GERMANY 598-4010 SET AKL 21603300363 Rp. 107,422,000.00
243 LARGE SUTURE INSTRUMENT SET ELCON - GERMANY 155-134 SET AKL 21603300363 Rp. 8,363,000.00
244 LARYNGECTOMY SET ELCON - GERMANY 598-6120 SET AKL 21603300363 Rp. 68,605,000.00
245 LARYNGOFISSURE SET ELCON - GERMANY 598-6130 SET AKL 21603300363 Rp. 7,627,000.00
246 LIVER PUNCTURE SET ELCON - GERMANY VARIOUS SET AKL 21603300363 Rp. 48,308,000.00
247 LIVER/PLEURAL BIOPSY SET ELCON - GERMANY VARIOUS SET AKL 21603300363 Rp. 37,496,000.00
248 LUMBAL PUNCTION INSTRUMENT SET ELCON - GERMANY 597-092 SET AKL 21603300363 Rp. 2,483,000.00
249 MAJOR BASIC SURGICAL INSTRUMENT SET ELCON - GERMANY 590-110 SET AKL 21603300363 Rp. 55,900,000.00
250 MAJOR RECTAL INSTRUMENT SET ELCON - GERMANY 598-2000 SET AKL 21603300363 Rp. 37,586,000.00
251 MAJOR VAGINAL REPAIR SET ELCON - GERMANY 598-5190 SET AKL 21603300363 Rp. 20,144,000.00
252 MANDIBLE OSTECTOMY SET ELCON - GERMANY 598-6530 SET AKL 21603300363 Rp. 18,913,000.00
253 MASTOIDECTOMY INSTRUMENT SET ELCON - GERMANY 593-122 SET AKL 21603300363 Rp. 79,171,000.00
254 MEATOTOMY SET ELCON - GERMANY 598-2540 SET AKL 21603300363 Rp. 19,528,000.00
255 MICRO CURETTAGE ELCON - GERMANY VARIOUS SET AKL 21603300363 Rp. 8,186,000.00
256 MICROSURGERY INSTRUMENT SET ELCON - GERMANY 590-496 SET AKL 21603300363 Rp. 86,361,000.00
257 MINOR BASIC INSTRUMENT SET ELCON - GERMANY 590-210A SET AKL 21603300363 Rp. 18,261,000.00
258 MINOR EAR SET ELCON - GERMANY 593-104 SET AKL 21603300363 Rp. 24,290,000.00
259 MISCELLANEOUS ORTHOPAEDIC SET ELCON - GERMANY 598-4080 SET AKL 21603300363 Rp. 27,428,000.00
260 MYRINGOTOMY FOREIGN BODIES SET ELCON - GERMANY 598-6020 SET AKL 21603300363 Rp. 6,156,000.00
261 NASAL SEPTUM (NASAL MAXILARY) INSTRUMENT SET ELCON - GERMANY 598-6052 SET AKL 21603300363 Rp. 95,280,000.00
262 NEONATAL CHEST TUBE SET ELCON - GERMANY 598-3030 SET AKL 21603300363 Rp. 3,249,000.00
263 NEPHRECTOMY/UROLOGY INSTRUMENT SET ELCON - GERMANY 590-900 SET AKL 21603300363 Rp. 152,677,000.00
264 NEPHRO, NEPHROS, NEPHROLITHO PYELO & PYELOS TOMY SET ELCON - GERMANY 598-2310 SET AKL 21603300363 Rp. 12,107,000.00

DOC/PT. PPH/200905 Page 7 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

265 NEUROSURGICAL INSTRUMENT SET BASIC ELCON - GERMANY 597-004 SET AKL 21603300363 Rp. 302,864,000.00
266 NEUROSURGICAL INSTRUMENT SET BASIC, BABY ELCON - GERMANY 598-3502 SET AKL 21603300363 Rp. 183,483,000.00
267 NEW BORN WARD INSTRUMENT SET ELCON - GERMANY 592-092 SET AKL 21603300363 Rp. 9,623,000.00
268 NORMAL DELIVERY SET ELCON - GERMANY 598-5410 SET AKL 21603300363 Rp. 35,636,000.00
269 OBSTETRIC DIAGNOSTIC KIT ELCON - GERMANY 591-020 SET AKL 21603300363 Rp. 2,276,000.00
270 OBSTETRICAL INSTRUMENT SET ELCON - GERMANY 598-5400 SET AKL 21603300363 Rp. 40,424,000.00
271 OOPHORECTOMY & OOPHOROCYSTECTOMY SET ELCON - GERMANY 598-5040 SET AKL 21603300363 Rp. 10,363,000.00
272 OPTHALMIC INSTRUMENT SET BASIC ELCON - GERMANY 596-020 SET AKL 21603300363 Rp. 41,243,000.00
273 ORCHIECTOMY SET ELCON - GERMANY 598-2550 SET AKL 21603300363 Rp. 4,720,000.00
274 ORTHOPAEDIC INSTRUMENT SET BASIC ELCON - GERMANY 594-100 SET AKL 21603300363 Rp. 124,214,000.00
275 OSCILLATING ELECTRIC SAW 220 V ELCON - GERMANY 400-450 SET AKL 21603300363 Rp. 31,526,000.00
276 OVARIAN CYSTOTECTOMY INSTRUMENT SET ELCON - GERMANY 592-660 SET AKL 21603300363 Rp. 38,030,000.00
277 PALATOPLASTY (CLEFT PALATE) SET ELCON - GERMANY 592-660 SET AKL 21603300363 Rp. 33,824,000.00
278 PANCREATECTOMY & SPLENECTOMY SET ELCON - GERMANY 598-1150 SET AKL 21603300363 Rp. 51,745,000.00
279 PANCREATODUODENECTOMY SET ELCON - GERMANY 598-1160 SET AKL 21603300363 Rp. 81,738,000.00
280 PARAMETRIAL FIXATION SET ELCON - GERMANY 598-5270 SET AKL 21603300363 Rp. 23,701,000.00
281 PARTUS INSTRUMENT SET ELCON - GERMANY 592-042 SET AKL 21603300363 Rp. 7,325,000.00
282 PELVIC SET ELCON - GERMANY 598-5250 SET AKL 21603300363 Rp. 46,273,000.00
283 PERINEAL PLASTIC SET ELCON - GERMANY 598-5090 SET AKL 21603300363 Rp. 22,504,000.00
284 PERINEAL PROSTATECTOMY SET ELCON - GERMANY 598-2530 SET AKL 21603300363 Rp. 47,196,000.00
285 PILONIDAL CYST EXCISION SET ELCON - GERMANY 598-2020 SET AKL 21603300363 Rp. 4,138,000.00
286 PINARD STETHOSCOPE (MADE OF ALUMINIUM), 15 cm ELCON - GERMANY 100-200 SET AKL 21603300363 Rp. 245,000.00
287 PINARD-WINTER STETHOSCOPE (MADE OF WOOD), 18 cm ELCON - GERMANY 100-206 SET AKL 21603300363 Rp. 297,000.00
288 PLASTER CAST REMOVAL SET ELCON - GERMANY 594-000 SET AKL 21603300363 Rp. 33,802,000.00
289 PLASTIC RECONSTRUCTION SET ELCON - GERMANY 598-6510 SET AKL 21603300363 Rp. 31,361,000.00
290 PLASTIC REPAIR INSTRUMENT SET ELCON - GERMANY 598-1040 SET AKL 21603300363 Rp. 32,866,000.00
291 PLASTIC SURGERY INSTRUMENT SET ELCON - GERMANY VARIOUS SET AKL 21603300363 Rp. 72,514,000.00
292 PLEURAL PUNCTURE SET ELCON - GERMANY 591-910 SET AKL 21603300363 Rp. 24,453,000.00
293 POLYCLINIC INSTRUMENT SET ELCON - GERMANY 155-180 SET AKL 21603300363 Rp. 4,341,000.00
294 POLYPECTOMY SET ELCON - GERMANY 593-312 SET AKL 21603300363 Rp. 14,010,000.00
295 POSTERIOR PROCTOTOMY INSTRUMENT SET ELCON - GERMANY 598-2074 SET AKL 21603300363 Rp. 20,965,000.00
296 PTERIGIUM INSTRUMENT SET ELCON - GERMANY 596-390 SET AKL 21603300363 Rp. 30,047,000.00
297 PYELOPLASTY, URETEROPLASTY SET ELCON - GERMANY 598-2340 SET AKL 21603300363 Rp. 19,426,000.00
298 RADICAL MASTECTOMY SET ELCON - GERMANY 598-1210 SET AKL 21603300363 Rp. 49,522,000.00
299 RADICAL VULVECTOMY SET ELCON - GERMANY 598-5140 SET AKL 21603300363 Rp. 26,710,000.00
300 RANEY CLIP APPLYING FORCEPS 16 CM ELCON - GERMANY 341-300 SET AKL 21603300363 Rp. 2,257,000.00
301 RECTAL INSTRUMENT SET BASIC ELCON - GERMANY 591-010 SET AKL 21603300363 Rp. 38,916,000.00
302 RECTAL SPECULA SET ELCON - GERMANY 598-2080 SET AKL 21603300363 Rp. 28,010,000.00

DOC/PT. PPH/200905 Page 8 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

303 RETINAL DETACHMENT SET ELCON - GERMANY 598-7090 SET AKL 21603300363 Rp. 44,631,000.00
304 RHINOPLASTY INSTRUMENT SET ELCON - GERMANY 593-340 SET AKL 21603300363 Rp. 69,849,000.00
305 SALPINGOSTOMY SET (FOR VAGINAL & ABDOMINAL PROCEDURES) ELCON - GERMANY 598-5060 SET AKL 21603300363 Rp. 13,030,000.00
306 SECTIO ALTA ELCON - GERMANY VARIOUS SET AKL 21603300363 Rp. 50,132,000.00
307 SECTIO CAESAREAN INSTRUMENT SET ELCON - GERMANY 592-100 SET AKL 21603300363 Rp. 31,183,000.00
308 SELF RETAINING RETRACTOR ELCON - GERMANY VARIOUS SET AKL 21603300363 Rp. 31,349,000.00
309 SIMPLE MASTECTOMY SET ELCON - GERMANY 598-1200 SET AKL 21603300363 Rp. 41,895,000.00
310 SIMPLE VULVECTOMY SET ELCON - GERMANY 598-5130 SET AKL 21603300363 Rp. 47,606,000.00
311 SKIN GRAFT SET ELCON - GERMANY 598-6550 SET AKL 21603300363 Rp. 43,879,000.00
312 SKULL TRACTION SET ELCON - GERMANY 598-3550 SET AKL 21603300363 Rp. 17,989,000.00
313 SMALL BONE SET ELCON - GERMANY 598-4020 SET AKL 21603300363 Rp. 96,649,000.00
314 SMALL DRESSING SET ELCON - GERMANY 598-400F SET AKL 21603300363 Rp. 10,226,000.00
315 SMALL INSTRUMENT INCISION SET ELCON - GERMANY 598-400D SET AKL 21603300363 Rp. 3,078,000.00
316 SOFT TISSUE DISSECTING SET BASIC ELCON - GERMANY 594-130 SET AKL 21603300363 Rp. 23,603,000.00
317 SOFT TISSUE INSTRUMENT SET FOR ORTHOPAEDIC SURGERY ELCON - GERMANY 598-4050 SET AKL 21603300363 Rp. 54,139,000.00
318 STANDARD BONE FORCEPS SET ELCON - GERMANY 421-9840 SET AKL 21603300363 Rp. 29,246,000.00
319 STEINMANN & KIRSCHNER PIN SET ELCON - GERMANY 598-4140 SET AKL 21603300363 Rp. 44,768,000.00
320 STEINMANN PINS & INTRAMEDULLARY PINS ELCON - GERMANY 598-4150 SET AKL 21603300363 Rp. 98,120,000.00
321 STOMACH OPERATION SET ELCON - GERMANY 598-1090 SET AKL 21603300363 Rp. 42,818,000.00
322 STRABISMUS INSTRUMENT SET ELCON - GERMANY 596-160 SET AKL 21603300363 Rp. 39,554,000.00
323 SUBMUCOUS RESECTION SET ELCON - GERMANY 598-6060 SET AKL 21603300363 Rp. 38,099,000.00
324 SUPPLEMENTAL ORTHOPAEDIC INSTRUMENT SET ELCON - GERMANY 598-4030 SET AKL 21603300363 Rp. 52,565,000.00
325 SUPRA + RETROPUBIC PROSTATECTOMY INSTRUMET SET ELCON - GERMANY 590-920 SET AKL 21603300363 Rp. 61,618,000.00
326 SUTURE REMOVAL SET ELCON - GERMANY 598-400A SET AKL 21603300363 Rp. 9,815,000.00
327 SUTURING SET ELCON - GERMANY 598-120 SET AKL 21603300363 Rp. 3,112,000.00
328 SYMPATHECTOMY SET ELCON - GERMANY 598-3540 SET AKL 21603300363 Rp. 41,382,000.00
329 TAYLOR REFLEX HAMMER, 20 cm ELCON - GERMANY 100-111 SET AKL 21603300363 Rp. 271,000.00
330 TETRALOGY OF FALLOT SET ELCON - GERMANY 598-3020 SET AKL 21603300363 Rp. 65,014,000.00
331 THORACOTOMY INSTRUMENT SET ELCON - GERMANY 590-412 SET AKL 21603300363 Rp. 153,670,000.00
332 THORACOTOMY SET - ADULT ELCON - GERMANY 598-3040 SET AKL 21603300363 Rp. 86,116,000.00
333 THORACOTOMY SET - PEDIATRIC ELCON - GERMANY 598-3000 SET AKL 21603300363 Rp. 121,478,000.00
334 THYROIDECTOMY MINOR DISSECTING SET ELCON - GERMANY 598-1300 SET AKL 21603300363 Rp. 201,506,000.00
335 TONSILECTOMY INSTRUMENT SET ELCON - GERMANY 593-704 SET AKL 21603300363 Rp. 136,068,000.00
336 TRACHEOSTOMY SET FOR ADULTS ELCON - GERMANY 598-6141 SET AKL 21603300363 Rp. 27,497,000.00
337 TRACHEOSTOMY SET FOR CHILDREN ELCON - GERMANY 598-6140 SET AKL 21603300363 Rp. 27,292,000.00
338 TREPANATION INSTRUMENT SET ELCON - GERMANY 598-3530 SET AKL 21603300363 Rp. 80,458,000.00
339 TUBAL PLASTY SET ELCON - GERMANY 598-5200 SET AKL 21603300363 Rp. 16,484,000.00
340 TUNING FORK SET ELCON - GERMANY 430-121 SET AKL 21603300363 Rp. 12,889,000.00

DOC/PT. PPH/200905 Page 9 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

341 TYMPANOPLASTY INSTRUMENT SET ELCON - GERMANY 593-140 SET AKL 21603300363 Rp. 87,433,000.00
342 URETEROLITHOTOMY SET ELCON - GERMANY 598-2390 SET AKL 21603300363 Rp. 18,263,000.00
343 URETEROTOMY AND URETEROSTOMY SET ELCON - GERMANY 598-2380 SET AKL 21603300363 Rp. 10,055,000.00
344 URETHRAL DILATION AND INTERNAL URETHROTOMY SET ELCON - GERMANY 598-2560 SET AKL 21603300363 Rp. 15,253,000.00
345 UROLOGY ADDITIONAL SET - STONES ELCON - GERMANY 598-2500 SET AKL 21603300363 Rp. 47,093,000.00
346 UTERINE EVACUATION SET ELCON - GERMANY 598-5440 SET AKL 21603300363 Rp. 12,654,000.00
347 VAGINAL CLOSURE SET ELCON - GERMANY 598-5120 SET AKL 21603300363 Rp. 22,298,000.00
348 VAGINAL CONSTRUCTION SET #1 (FOR SKIN GRAFT) ELCON - GERMANY 598-5230 SET AKL 21603300363 Rp. 15,595,000.00
349 VAGINAL CONSTRUCTION SET #II (FOR VAGINAL CONSTRUCTION) ELCON - GERMANY 598-5240 SET AKL 21603300363 Rp. 20,041,000.00
350 VAGINAL HYSTERECTOMY INSTRUMENT SET ELCON - GERMANY 592-402 SET AKL 21603300363 Rp. 39,670,000.00
351 VAGINAL INSTRUMENT SET, BASIC ELCON - GERMANY 598-5010 SET AKL 21603300363 Rp. 27,121,000.00
352 VAGINAL SPECULA SET ELCON - GERMANY 598-5300 SET AKL 21603300363 Rp. 10,773,000.00
353 VAGINAL TOILET ( GYNAECOLOGICAL EXAMINATION ) SET ELCON - GERMANY 598-5000 SET AKL 21603300363 Rp. 26,357,000.00
354 VAGOTOMY SET ELCON - GERMANY 598-2030 SET AKL 21603300363 Rp. 14,090,000.00
355 VARICES OPERATING SET ELCON - GERMANY 598-4060 SET AKL 21603300363 Rp. 25,684,000.00
356 VASCULAR FORCEPS SET ELCON - GERMANY 598-3120 SET AKL 21603300363 Rp. 135,056,000.00
357 VASECTOMY SET ELCON - GERMANY 598-2510 SET AKL 21603300363 Rp. 7,079,000.00
358 VENA SECTIO SET IN METAL CASE ELCON - GERMANY 155-140 SET AKL 21603300363 Rp. 12,603,000.00
359 VENTRICULOGRAPHY SET ELCON - GERMANY 598-3560 SET AKL 21603300363 Rp. 80,986,000.00
360 VESICOVAGINAL FISTULA REPAIR SET ELCON - GERMANY 598-5210 SET AKL 21603300363 Rp. 7,729,000.00
361 VITRECTOMY SET ELCON - GERMANY 598-7140 SET AKL 21603300363 Rp. 134,611,000.00
362 WIRE EXTENSION SET ELCON - GERMANY 598-400G SET AKL 21603300363 Rp. 68,674,000.00
363 WIRE INSTRUMENT SET ELCON - GERMANY 421-9810 SET AKL 21603300363 Rp. 78,125,000.00
364 LABIOPLASTY INSTRUMENT SET ELCON - GERMANY VARIOUS SET AKL 21603300363 Rp. 101,383,000.00
365 ELECTRO THERAPY SYSTEM ULTRASOUND EMS - ENGLAND THERASONIC 350-EMS-3501 UNIT AKL 21403300221 Rp. 36,708,000.00
366 MEDI-LINK DUAL FREQUENCY ULTRASOUND EMS - ENGLAND ML 9110 UNIT AKL 21403300221 Rp. 102,830,000.00
367 MEDI-LINK DUAL FREQUENCY ULTRASOUND (MODULE ONLY) EMS - ENGLAND ML 9110 (M) UNIT AKL 21403300221 Rp. 61,334,000.00
368 ULTRASOUND SOLO 1 MHZ., AC EMS - ENGLAND SOLO THERASONIC 3551 UNIT DALAM PROSES Rp. 39,648,000.00
369 ULTRASOUND SOLO 1 MHZ., AC & BATTERY EMS - ENGLAND SOLO THERASONIC 3551 B UNIT DALAM PROSES Rp. 43,008,000.00
370 ULTRASOUND SOLO 3 MHZ., AC EMS - ENGLAND SOLO THERASONIC 3553 UNIT DALAM PROSES Rp. 39,648,000.00
371 ULTRASOUND SOLO 3 MHZ., AC & BATTERY EMS - ENGLAND SOLO THERASONIC 3553 B UNIT DALAM PROSES Rp. 43,008,000.00
372 ULTRASOUND SOLO 1 & 3 MHZ., AC EMS - ENGLAND SOLO THERASONIC 455 UNIT DALAM PROSES Rp. 60,144,000.00
373 ULTRASOUND SOLO 1 & 3 MHZ., AC & BATTERY EMS - ENGLAND SOLO THERASONIC 455 B UNIT DALAM PROSES Rp. 63,504,000.00
374 INTERFERENTIAL THERAPY UNIT EMS - ENGLAND EMS 950 UNIT AKL 21403300221 Rp. 71,820,000.00
375 MEDILINK INTERFERENTIAL THERAPY EMS - ENGLAND ML-9410 UNIT AKL 21403300221 Rp. 105,017,000.00
376 MEDILINK INTERFERENTIAL THERAPY (MODULE ONLY) EMS - ENGLAND ML-9410 (M) UNIT AKL 21403300221 Rp. 63,521,000.00
377 INTERFERENTIAL THERAPY UNIT SOLO EMS - ENGLAND EMS 965 UNIT DALAM PROSES Rp. 77,280,000.00
378 INTERFERENTIAL THERAPY UNIT SOLO EMS - ENGLAND EMS 955 UNIT DALAM PROSES Rp. 57,120,000.00

DOC/PT. PPH/200905 Page 10 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

379 SUCTION UNIT EMS - ENGLAND ML-9500 UNIT AKL 21403300221 Rp. 77,933,000.00
380 LASER UNIT EMS - ENGLAND EMS 750 UNIT AKL 21403300221 Rp. 134,383,000.00
381 MEDI-LINK LASER UNIT EMS - ENGLAND ML9810 UNIT AKL 21403300221 Rp. 165,346,000.00
382 MEDI-LINK LASER UNIT (MODULE ONLY) EMS - ENGLAND ML9810 (M) UNIT AKL 21403300221 Rp. 123,850,000.00
383 MEDI-LINK STIMULATION THERAPY EMS - ENGLAND ML 9310 UNIT AKL 21403300221 Rp. 111,369,000.00
384 MEDI-LINK STIMULATION THERAPY (MODULE ONLY) EMS - ENGLAND ML 9310 (M) UNIT AKL 21403300221 Rp. 69,873,000.00
385 MEDI-LINK MEDIWAVE STIMULATION EMS - ENGLAND MEDIWAVE-ML 9320 UNIT AKL 21403300221 Rp. 96,625,000.00
386 MEDI-LINK MEDIWAVE STIMULATION (MODULE ONLY) EMS - ENGLAND ML 9320 (M) UNIT AKL 21403300221 Rp. 55,129,000.00
387 STIMULATOR SINGLE CHANNEL EMS - ENGLAND BIOSTIM EMS 5200 UNIT AKL 21403300221 Rp. 29,686,000.00
388 STIMULATOR SINGLE CHANNEL WITH VAGINAL PROBE EMS - ENGLAND BIOSTIM EMS 5100 UNIT AKL 21403300221 Rp. 30,324,000.00
389 TENS UNIT DUAL-CHANNEL EMS - ENGLAND TENS 2000 UNIT AKL 21403300221 Rp. 9,462,000.00
390 MEDI-LINK PULSED SHORTWAVE THERAPY EMS - ENGLAND ML 9610 UNIT AKL 21403300221 Rp. 182,953,000.00
391 MEDI-LINK PULSED SHORTWAVE THERAPY (MODULE ONLY) EMS - ENGLAND ML 9610 (M) UNIT AKL 21403300221 Rp. 120,338,000.00
392 SHORTWAVE THERAPY CONTINUOUS AND PULSED EMS - ENGLAND EMS 205 UNIT AKL 21403300221 Rp. 308,986,000.00
393 SHORTWAVE THERAPY PULSED EMS - ENGLAND EMS 702 UNIT AKL 21403300221 Rp. 210,353,000.00
394 BIOFEEDBACK SYSTEM 1 CHANNEL EMG EMS - ENGLAND BIOTRAC-EMS 5000 UNIT AKL 21403300221 Rp. 23,940,000.00
395 BIOFEEDBACK SYSTEM 1 CHANNEL EMG EMS - ENGLAND BIOTRAC 2 -EMS 5300 UNIT AKL 21403300221 Rp. 22,982,000.00
396 EMG BIOFEEDBACK DUAL-CHANNEL EMS - ENGLAND ML 9710 UNIT AKL 21403300221 Rp. 102,709,000.00
397 EMG BIOFEEDBACK DUAL-CHANNEL (MODULE ONLY) EMS - ENGLAND ML 9710 (M) UNIT AKL 21403300221 Rp. 61,213,000.00
398 MEDI-LINK COMMUNICATION (MODULE ONLY) EMS - ENGLAND ML 9030 UNIT AKL 21403300221 Rp. 139,417,000.00
399 VARITHERM WAX BATH MARK III W/ALUMINIUM DUSTCOVER EMS - ENGLAND LNC 884 UNIT AKL 21403300221 Rp. 75,970,000.00
400 WAX PURIFICATION UNIT 200/240 VAC EMS - ENGLAND LNC 886 UNIT AKL 21403300221 Rp. 34,793,000.00
401 INFRARED LAMP SUPER 2 EMS - ENGLAND NC 616 UNIT AKL 21403300221 Rp. 37,825,000.00
402 EMS HYDROPAK HEATER EMS - ENGLAND LNC 400 UNIT AKL 21403300221 Rp. 40,191,000.00
403 REUSABLE HOT / COLD PACK EMS - ENGLAND VARIOUS UNIT AKL 21403300221 Rp. 6,189,000.00
404 EASY ICE CUBER EMS - ENGLAND ACM 25AE UNIT AKL 21403300221 Rp. 61,864,000.00
405 ICE MACHINE EMS - ENGLAND AF 10-AS UNIT AKL 21403300221 Rp. 218,880,000.00
406 AUTOMATIC CUBE MARKER EMS - ENGLAND IM 20-AS UNIT AKL 21403300221 Rp. 60,648,000.00
407 ICE MAGIC FLAKED ICE MACHINE EMS - ENGLAND AF 85 UNIT AKL 21403300221 Rp. 155,040,000.00
408 TREATMENT TABLE 2SECTION HYDRAULIC MODEL, EMS - ENGLAND RH 075A UNIT AKL 21403500724 Rp. 49,248,000.00
409 TREATMENT TABLE 2SECTION ELECTRIC W/ BREATHING SLOT EMS - ENGLAND RH 076B UNIT AKL 21403500724 Rp. 55,632,000.00
410 TREATMENT TABLE 3SECTION ELECTRIC W/ BREATHING SLOT EMS - ENGLAND RH 079B UNIT AKL 21403500724 Rp. 54,720,000.00
411 NEUROLOGY FROM TREATMENT TABLE EMS - ENGLAND RH 081 UNIT AKL 21403500818 Rp. 69,255,000.00
412 VARIABLE HEIGHT TILT TABLE EMS - ENGLAND RH 083 UNIT AKL 21403500818 Rp. 90,288,000.00
413 TRACTION TABLE - ELECTRIC AND TRACTION MACHINE EMS - ENGLAND RH 085 + RH 087 UNIT 03500500 + AKL 2140Rp. 239,999,000.00
414 TRACTION TABLE - HYDRAULIC AND TRACTION MACHINE EMS - ENGLAND RH 084 + RH 087 UNIT DALAM PROSES Rp. 236,208,000.00
415 AEROBIC EXERCISE EMS - ENGLAND RH 108 TUNTURI C500 UNIT DALAM PROSES Rp. 22,800,000.00
416 POWER STEPPER EMS - ENGLAND RH 301 UNIT DALAM PROSES Rp. 27,269,000.00

DOC/PT. PPH/200905 Page 11 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

417 ERGOMETER EMS - ENGLAND RH 325 AX1 UNIT AKL 11402304336 Rp. 39,125,000.00
418 MARATHON POWER DRIVEN TREADMILL W/ COMPUTER CONTROL EMS - ENGLAND MARATHON - RH 213 UNIT AKL 11402304338 Rp. 186,048,000.00
419 TELETRIMETER EMS - ENGLAND RH - 300 UNIT DALAM PROSES Rp. 2,280,000.00
420 VIBRATOR COMPLETE WITH SPONGE RUBBER APPLICATOR EMS - ENGLAND M9 UNIT DALAM PROSES Rp. 12,130,000.00
421 WALL BARS - SINGLE SECTION EMS - ENGLAND RH - 012 UNIT DALAM PROSES Rp. 17,237,000.00
422 WALL BARS - DOUBLE SECTION EMS - ENGLAND RH - 013 UNIT DALAM PROSES Rp. 26,904,000.00
423 WALL BARS - TRIPLE SECTION EMS - ENGLAND RH - 014 UNIT DALAM PROSES Rp. 41,861,000.00
424 METAL PARALLEL BAR EMS - ENGLAND RH - 063 UNIT DALAM PROSES Rp. 20,520,000.00
425 BALANCE BENCH ( 267 CM ) EMS - ENGLAND RH - 016 UNIT DALAM PROSES Rp. 16,781,000.00
426 BALANCE BENCH ( 335 CM ) EMS - ENGLAND RH - 015 UNIT DALAM PROSES Rp. 23,803,000.00
427 MOBILE POSTURE MIRROR EMS - ENGLAND RH - 066 UNIT DALAM PROSES Rp. 15,504,000.00
428 CONVENTIONAL WOODEN STEP WITH FIXED HEIGHT HAND RAIL EMS - ENGLAND RH - 017 UNIT DALAM PROSES Rp. 66,120,000.00
429 CORNER STEP, ADJUSTABLE HAND RAIL EMS - ENGLAND RH - 020 UNIT DALAM PROSES Rp. 58,186,000.00
430 CORNER STEP, FIXED HEIGHT HAND RAIL EMS - ENGLAND RH - 019 UNIT DALAM PROSES Rp. 45,509,000.00
431 WOBBLE BOARD EMS - ENGLAND RH - 030 UNIT DALAM PROSES Rp. 4,332,000.00
432 ROCKER BOARD EMS - ENGLAND RH - 031 UNIT DALAM PROSES Rp. 4,332,000.00
433 BODY BALL 650 MM DIAMETER BLUE EMS - ENGLAND RH 288 UNIT DALAM PROSES Rp. 1,309,000.00
434 BODY BALL 750 MM DIAMETER YELLOW EMS - ENGLAND RH 289 UNIT DALAM PROSES Rp. 1,573,000.00
435 BODY BALL 850 MM DIAMETER RED EMS - ENGLAND RH 290 UNIT DALAM PROSES Rp. 2,216,000.00
436 BODY BALL 950 MM DIAMETER BLUE EMS - ENGLAND RH 291 UNIT DALAM PROSES Rp. 2,658,000.00
437 ICU & OPERATING ROOM SYRINGE PUMP FRESENIUS VIAL - FRANCE PILOT C UNIT AKL 20902300224 Rp. 50,616,000.00
438 ICU & ICCU SYRINGE PUMP FRESENIUS VIAL - FRANCE PILOT DELTA UNIT AKL 20902300224 Rp. 57,456,000.00
439 ICU & ICCU SYRINGE PUMP WITH STAND FRESENIUS VIAL - FRANCE PILOT DELTA UNIT AKL 20902300224 Rp. 69,426,000.00
440 ANAESTHESIA SYRINGE PUMP FRESENIUS VIAL - FRANCE PILOT ANAESTHESIA UNIT AKL 20902300224 Rp. 58,140,000.00
441 DOUBLE CHANNEL SYRINGE PUMP FRESENIUS VIAL - FRANCE PROGRAM 2 UNIT DALAM PROSES Rp. 95,760,000.00
442 SYRINGE & INFUSION DATA MANAGEMENT FRESENIUS VIAL - FRANCE BASE A UNIT AKL 20902300574 Rp. 23,940,000.00
443 SYRINGE PUMP WITH MANAGEMENT FRESENIUS VIAL - FRANCE BASE INTENSIVE UNIT AKL 20902300575 Rp. 173,736,000.00
444 SYRINGE PUMP MODULE FRESENIUS VIAL - FRANCE MODULE DPS UNIT AKL 20902300223 Rp. 57,456,000.00
445 INFUSION PUMP MODULE FRESENIUS VIAL - FRANCE MODULE MVP+ MS UNIT AKL 20902300161 Rp. 71,820,000.00
446 INFUSION PUMP MODULE FRESENIUS VIAL - FRANCE MODULE MVP+ PT UNIT AKL 20902300161 Rp. 71,820,000.00
447 VOLUMETRIC INFUSION PUMP FRESENIUS VIAL - FRANCE OPTIMA ST UNIT AKL 20902300161 Rp. 71,136,000.00
448 VOLUMETRIC INFUSION PUMP WITH STAND FRESENIUS VIAL - FRANCE OPTIMA ST UNIT AKL 20902300161 Rp. 83,106,000.00
449 TARGET CONTROLLED INFUSION PUMP ( TCI ) FOR ANAESTHESI FRESENIUS VIAL - FRANCE TCI PACK UNIT AKL 20902300226 Rp. 120,042,000.00
450 PATIENT CONTROLLED ANALGESIA SYSTEM FRESENIUS VIAL - FRANCE MASTER PCA PACK UNIT AKL 20902300225 Rp. 97,812,000.00
451 INFUSION & SYRINGE PUMP INTEGRATED SYSTEM FRESENIUS VIAL - FRANCE MIX UNIT AKL 20902300575 Rp. 370,044,000.00
452 FULLY INFUSION & SYRINGE PUMP INTEGRATED SYSTEM FRESENIUS VIAL - FRANCE MIX UNIT AKL 20902300575 Rp. 700,211,000.00
453 EXTRACTING FORCEPS FOR ADULT INSTRUMENT SET KARL REICHLE - GERMANY VARIOUS UNIT DALAM PROSES Rp. 47,917,000.00
454 EXTRACTING FORCEPS FOR CHILD INSTRUMENT SET KARL REICHLE - GERMANY VARIOUS UNIT DALAM PROSES Rp. 20,015,000.00

DOC/PT. PPH/200905 Page 12 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

455 DENTAL SET KARL REICHLE - GERMANY VARIOUS UNIT DALAM PROSES Rp. 37,819,000.00
456 SMALL OPERATION INSTRUMENT SET KARL REICHLE - GERMANY VARIOUS UNIT DALAM PROSES Rp. 48,383,000.00
457 MOUTH MIRROR KARL REICHLE - GERMANY VARIOUS UNIT DALAM PROSES Rp. 698,000.00
458 COLPOSCOPE W/ 15X MAGNIFICATION , TILT-O-MATIC STAND LEISEGANG - GERMANY 1-TI UNIT AKL 21101300563 Rp. 164,160,000.00
459 COLPOSCOPE W/ 15X MAGNIFICATION , SWING-O-MATIC MOUNT LEISEGANG - GERMANY 1-SW UNIT AKL 21101300563 Rp. 203,832,000.00
460 COLPOSCOPE W/ 7.5/15/30X MAG., , TILT-O-MATIC STAND LEISEGANG - GERMANY 1D - TI UNIT AKL 21101300563 Rp. 228,456,000.00
461 COLPOSCOPE W/ 7.5/15/30X MAG., BALANCE-O-MATIC MOUNT LEISEGANG - GERMANY 1D - BA UNIT AKL 21101300563 Rp. 324,490,000.00
462 COLPOSCOPE W/ 3.75/7.5/15X MAG., TILT-O-MATIC STAND LEISEGANG - GERMANY 1DS - TI UNIT AKL 21101300563 Rp. 228,456,000.00
463 COLPOSCOPE W/ 3.75/7.5/15X MAG., BALANCE-O-MATIC MOUNT LEISEGANG - GERMANY 1DS-BA UNIT AKL 21101300563 Rp. 324,490,000.00
464 COLPOSCOPE MINI W/ 10X FIXED MAG., UPRIGHT STAND LEISEGANG - GERMANY 4 - UP UNIT AKL 21101300563 Rp. 79,344,000.00
465 VIDEO COLPOSCOPE LEISEGANG - GERMANY 3 MLF-BA UNIT DALAM PROSES Rp. 959,655,000.00
466 LASIK SET MORIA - FRANCE #346 UNIT AKL 11203400101 Rp. 39,074,000.00
467 CATARACT, EXTRACAPSULAR, LENS IMPLATATION, PHACO SET MORIA - FRANCE #400 UNIT AKL 11203400092 Rp. 210,913,000.00
468 CHALAZION SET MORIA - FRANCE #401 UNIT AKL 11203400102 Rp. 36,977,000.00
469 CORNEAL FOREIGN BODY EXTRACTION SET MORIA - FRANCE #402 UNIT AKL 11203400093 Rp. 10,314,000.00
470 RETINAL DETACHEMENT SET MORIA - FRANCE #403 UNIT AKL 11203400094 Rp. 118,311,000.00
471 STITCHS REMOVAL SET MORIA - FRANCE #404 UNIT AKL 11203400095 Rp. 28,127,000.00
472 ENUCLEATION, EVISCERATION SET MORIA - FRANCE #405 UNIT AKL 11203400096 Rp. 73,848,000.00
473 GLAUCOMA TRABECULECTOMY SET MORIA - FRANCE #406 UNIT AKL 11203400097 Rp. 133,879,000.00
474 KERAPTOPLASTY SET MORIA - FRANCE #407 UNIT AKL 11203400098 Rp. 139,821,000.00
475 PTERYGION SET MORIA - FRANCE #408 UNIT AKL 11203400099 Rp. 54,064,000.00
476 LIDS, TRICHIASIS AND PTOSIS SET MORIA - FRANCE #409 UNIT AKL 11203400100 Rp. 52,680,000.00
477 STRABISMUS SET MORIA - FRANCE #410 UNIT AKL 11203400104 Rp. 119,542,000.00
478 LACHRYMAL DUCTS INTUBATION SET MORIA - FRANCE #411 UNIT AKL 11203400103 Rp. 33,775,000.00
479 ANTEPARTUM TWIN FETAL MONITOR (CTG) NICOLET VASCULAR - USA VERSALAB APM2 UNIT AKL 21501302174 Rp. 204,545,000.00
480 FETAL DOPPLER W/ ALKALINE BATTERY, 2 MHZ NICOLET VASCULAR - USA ELITE 100 UNIT DALAM PROSES Rp. 16,929,000.00
481 FETAL DOPPLER W/ ALKALINE BATTERY, 3 MHZ NICOLET VASCULAR - USA ELITE 100 UNIT DALAM PROSES Rp. 16,929,000.00
482 FETAL DOPPLER W/ ALKALINE BATTERY, 2&3 MHZ NICOLET VASCULAR - USA ELITE 100 UNIT DALAM PROSES Rp. 23,769,000.00
483 DIGITAL FETAL DOPPLER W/ ALKALINE BATTERY, 2&3 MHZ NICOLET VASCULAR - USA ELITE 200 UNIT DALAM PROSES Rp. 31,635,000.00
484 DIGITAL FETAL DOPPLER W/ RECHARGEABLE BATTERY, 2&3 MHZ NICOLET VASCULAR - USA ELITE 200 R UNIT DALAM PROSES Rp. 34,029,000.00
485 FETAL DOPPLER W/ RECHARGEABLE BATTERY, 2&3 MHZ NICOLET VASCULAR - USA IMEXDOP CT+ UNIT AKL 21501302171 Rp. 45,999,000.00
486 FETAL DOPPLER W/ RECHARGEABLE BATTERY, 2&3 MHZ NICOLET VASCULAR - USA FREEDOP UNIT AKL 21501302173 Rp. 68,229,000.00
487 VASCULAR DOPPLER W/ ALKALINE BATTERY, 5&8 MHZ NICOLET VASCULAR - USA ELITE 100 UNIT DALAM PROSES Rp. 23,769,000.00
488 VASCULAR DOPPLER W/ RECHARGEABLE BATTERY, 5&8 MHZ NICOLET VASCULAR - USA ELITE 100 R UNIT DALAM PROSES Rp. 27,873,000.00
489 DIGITAL VASCULAR DOPPLER W/ ALKALINE BATTERY, 5&8 MHZ NICOLET VASCULAR - USA ELITE 200 UNIT DALAM PROSES Rp. 31,635,000.00
490 DIGITAL VASCULAR DOPPLER W/ RECHARGEABLE BATTERY, 5&8 MHZ NICOLET VASCULAR - USA ELITE 200 R UNIT DALAM PROSES Rp. 34,029,000.00
491 VASCULAR DOPPLER W/ RECHARGEABLE BATTERY, 5&8 MHZ NICOLET VASCULAR - USA POCKET-DOP II UNIT DALAM PROSES Rp. 31,977,000.00
492 VASCULAR DOPPLER W/ RECHARGEABLE BATTERY, 5&8 MHZ NICOLET VASCULAR - USA IMEXDOP CT+ UNIT AKL 21501302171 Rp. 45,999,000.00

DOC/PT. PPH/200905 Page 13 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

493 VASCULAR DOPPLER W/ RECHARGEABLE BATTERY, 5&8 MHZ NICOLET VASCULAR - USA CAREDOP UNIT AKL 21501302172 Rp. 32,490,000.00
494 VASCULAR DOPPLER W/ RECHARGEABLE BATTERY, 5&8 MHZ NICOLET VASCULAR - USA FREEDOP UNIT AKL 21501302173 Rp. 68,229,000.00
495 STETHOSCOPE DOPPLER NICOLET VASCULAR - USA STETHODOP SD50 UNIT AKL 2051500816 Rp. 13,509,000.00
496 STETHOSCOPE DOPPLER WITH CARDIOLOGY STYLE NICOLET VASCULAR - USA STETHODOP SD52 UNIT AKL 2051500816 Rp. 15,219,000.00
497 ULTRASONIC NEBULIZER NOUVAG - SWISS PICO UNIT AKL 20403300328 Rp. 28,970,000.00
498 ULTRASONIC NEBULIZER MOBILE STANDARD NOUVAG - SWISS ULTRASONIC 2000-3204 UNIT AKL 20403301775 Rp. 59,928,000.00
499 SUCTION PUMP WITH 1.5 LT. BOTTLE NOUVAG - SWISS VACUSON 18/1.5 (4041) UNIT AKL 21603304173 Rp. 23,669,000.00
500 SUCTION UNIVERSAL PUMP NOUVAG - SWISS VACUSON 40U UNIT AKL 21603304160 Rp. 77,607,000.00
501 SUCTION DRAINAGE PUMP FOR CONTINUOUS & THORAX DRAINAGE NOUVAG - SWISS VACUSON 40 D UNIT DALAM PROSES Rp. 95,604,000.00
502 SUCTION VACUM EXTRACTOR PUMP NOUVAG - SWISS VACUSON 40E UNIT DALAM PROSES Rp. 87,228,000.00
503 SUCTION CURETTAGE PUMP NOUVAG - SWISS VACUSON 40CU UNIT DALAM PROSES Rp. 87,228,000.00
504 SUCTION LIPOSUCTION PUMP NOUVAG - SWISS VACUSON 60L UNIT AKL 21603400928 Rp. 85,638,000.00
505 LIPO VIBRATION SYSTEM SUCTION PUMP NOUVAG - SWISS VACUSON 60LP UNIT DALAM PROSES Rp. 379,684,000.00
506 SUCTION SURGERY PUMP NOUVAG - SWISS VACUSON 60C UNIT AKL 21603301980 Rp. 92,237,000.00
507 PANORAMIC DENTAL X-RAY UNIT PANORAMIC - USA PC - 1000 UNIT DALAM PROSES Rp. 448,875,000.00
508 PANORAMIC / CEPHALOMETRIC DENTAL X-RAY UNIT PANORAMIC - USA PC - 1000 / LASER 1000 UNIT DALAM PROSES Rp. 628,425,000.00
509 ANAESTHESIA MACHINE ONE VAPORIZER, BASIC PENLON - ENGLAND PRIMA SP 101 UNIT AKL 20403300219 Rp. 494,254,000.00
510 ANAESTHESIA MACHINE ONE VAPORIZER WITH MAHD, BASIC PENLON - ENGLAND PRIMA SP 102 + MAHD UNIT AKL 20403300219 Rp. 623,767,000.00
511 ANAESTHESIA MACHINE TWO VAPORIZER W/ MAHD, ADDITIONAL SHELF PENLON - ENGLAND PRIMA SP 102 + MAHD UNIT AKL 20403300219 Rp. 763,412,000.00
512 ANAESTHESIA MACH. W/ MAHD, BASIC, TOUCHSCREEN VENTILATOR PENLON - ENGLAND PRIMA SP 101 + MAHD + AV-900 UNIT AKL 20403300219 Rp. 915,096,000.00
513 ANAESTHESIA MACH W/ MAHD, TOUCHSCREEN VENT. O2 MON, SPIROMETRY PENLON - ENGLAND PRIMA SP 102 + MAHD+AV-900 UNIT AKL 20403300219 Rp. 981,157,000.00
514 ANAESTHESIA MACH 2 VAP. W/ MAHD, ADD SHELF, TOUCHSCREEN VENT, PENLON - ENGLAND PRIMA SP 102 + MAHD+AV-900 UNIT AKL 20403300219 Rp. 1,120,802,000.00
515 ANAESTHESIA DRAW OVER SYSTEM HOSPITAL UNIT PENLON - ENGLAND EMO 51024 UNIT AKL 20403302118 Rp. 225,857,000.00
516 ANAESTHESIA TRI SERVICE APARATUS PENLON - ENGLAND TRI SERVICE UNIT DALAM PROSES Rp. 218,654,000.00
517 ANAESTHETIC GAS SCAVENGING SYSTEM ( AGSS ) PENLON - ENGLAND AGSS UNIT DALAM PROSES Rp. 139,348,000.00
518 ANAESTHESIA VENT. W/ TOUCHSCREEN TECH. BASIC MODEL PENLON - ENGLAND AV 900 ( AV9ZZ ESU ) UNIT AKL 20403300154 Rp. 315,757,000.00
519 ANAESTHESIA VENT. W/ TOUCHSCREEN , SPIROMETRY & O2 MONITOR PENLON - ENGLAND AV 900 ( AV9SM ESU ) UNIT AKL 20403300154 Rp. 357,390,000.00
520 ANAESTHESIA VENTILATOR PENLON - ENGLAND NUFFIELD 200 UNIT AKL 20403300155 Rp. 163,276,000.00
521 ANAESTHESIA VENTILATOR CIRCLE SYSTEM MODE PENLON - ENGLAND NUFFIELD 200 CSM UNIT AKL 20403300155 Rp. 215,342,000.00
522 ANAESTHESIA VENT. MULTIVENT ETHER COMP. E E MODEL PENLON - ENGLAND MANLEY MULTIVENT UNIT DALAM PROSES Rp. 288,931,000.00
523 ANAESTHESIA VENT. MULTIVENT NON-ETHER COMP. E MODEL PENLON - ENGLAND MANLEY MULTIVENT UNIT DALAM PROSES Rp. 288,931,000.00
524 JACKSON REESE PENLON - ENGLAND 51543 UNIT DALAM PROSES Rp. 12,212,000.00
525 CARDIFF INFANT RESUSCITATION W/ METAL LARYNGOSCOPE PENLON - ENGLAND 50442 UNIT DALAM PROSES Rp. 32,011,000.00
526 INFANT MC COY FIBERLIGHT LARYNGOSCOPE PENLON - ENGLAND MC COY (50465) UNIT DALAM PROSES Rp. 27,862,000.00
527 PEDIATRIC MC COY FIBRELIGHT LARYNGOSCOPE PENLON - ENGLAND MC COY (50467) UNIT DALAM PROSES Rp. 27,862,000.00
528 ADULT MC COY FIBRELIGHT LARYNGOSCOPE PENLON - ENGLAND MC COY (50469) UNIT DALAM PROSES Rp. 27,862,000.00
529 ADULT FIBERLIGHT LARYNGOSCOPE MACINTOSH PENLON - ENGLAND MACINTOSH UNIT DALAM PROSES Rp. 26,557,000.00
530 PEDIATRIC FIBERLIGHT LARYNGOSCOPE MACINTOSH PENLON - ENGLAND MACINTOSH UNIT DALAM PROSES Rp. 19,918,000.00

DOC/PT. PPH/200905 Page 14 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

531 INFANT FIBRELIGHT LARYNGOSCOPE MILLER PENLON - ENGLAND MILLER UNIT DALAM PROSES Rp. 19,918,000.00
532 THORACOSCOPE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 988,318,000.00
533 THORACOSCOPE WITH VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,455,764,000.00
534 ARTHROSCOPE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,468,555,000.00
535 ARTHROSCOPE WITH VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,936,000,000.00
536 VIDEO SYSTEM FOR GENERAL ENDOSCOPE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 467,446,000.00
537 LAPAROSCOPIC OPERATION & SURGERY INST. SET, BASIC RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 2,135,633,000.00
538 LAPAROSCOPIC OPERATION & SURGERY INST. SET W/ VIDEO, BASIC RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 2,603,078,000.00
539 LAPAROSCOPIC SURGERY INST. SET BASIC W/ FLEXIBLE FIBRE CHOLED. RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 2,399,178,000.00
540 LAPAROSCOPIC SURG INST SET BASIC, FLEX FIBRE CHOLED &VIDEO CAM RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 2,866,623,000.00
541 LAPAROSCOPIC SURG INST SET BASIC 2 FLEX FIBRE CHOLED. RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 2,728,866,000.00
542 LAPAROSCOPIC SURG INST SET 2 FLEX FIBRE CHOLED & VIDEO CAM RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 3,196,311,000.00
543 EXTENSION OF INST. SET FOR PEDIATRIC LAPAROSCOPIC SURGERY RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,044,653,000.00
544 EXTENSION OF INST. SET FOR GYNAEC. LAPAROSCOPIC SURGERY RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 3,935,832,000.00
545 URETHROTOME RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 286,596,000.00
546 URETHROTOME WITH VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 754,042,000.00
547 RESECTOSCOPE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 299,312,000.00
548 RESECTOSCOPE WITH VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 766,757,000.00
549 TUR RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 370,926,000.00
550 T U R WITH VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 838,372,000.00
551 CYSTOSCOPE / CYSTO-URETHROSCOPE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 869,022,000.00
552 CYSTOSCOPE / CYSTO-URETHROSCOPE WITH VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,336,468,000.00
553 FLEXIBLE FIBERSCOPE FOR CYSTO-URETHROSCOPY RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 429,484,000.00
554 FLEXIBLE FIBERSCOPE F. CYSTO-URETHROSCOPY W/ VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 896,929,000.00
555 VIDEO SYSTEM FOR UROLOGY ENDOSCOPE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 467,446,000.00
556 DIAGNOSTICAL CYSTO-URETHROSCOPE, ADULT RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 214,024,000.00
557 DIAGNOSTICAL CYSTO-URETHROSCOPE, ADULT W/ VIDEO SYSTEM RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 681,469,000.00
558 CYSTO-URETHROSCOPE, ADULT, OPERATION RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,017,929,000.00
559 CYSTO-URETHROSCOPE, ADULT WITH VIDEO SYSTEM, OPERATION RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,532,570,000.00
560 CYSTO-URETHROSCOPE W/ TRANSURETHRAL INCONTINENCE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,212,390,000.00
561 CYSTO-URETHROSCOPE W/ TRANSURETHRAL INCONTINENCE VIDEO RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,727,032,000.00
562 DIAGNOSTICAL CYSTO-URETHROSCOPE, PEDIATRIC RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 257,800,000.00
563 CYSTO-URETHROSCOPE, PED. W/ VIDEO SYSTEM, DIAGNOSTIC RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 725,245,000.00
564 CYSTO-URETHROSCOPE, PEDIATRIC, OPERATION RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 704,978,000.00
565 CYSTO-URETHROSCOPE, PED. W/ VIDEO SYSTEM, OPERATION RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,172,424,000.00
566 CYSTO-URETHROSCOPE, PED, INF. & NEONATE, OPERATION RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 841,915,000.00
567 CYSTO-URETHROSCOPE, PED. INF. & NEONATE W/ VIDEO, OPERATION RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,309,361,000.00
568 CYSTO-URETHROSCOPE, PEDIATRIC, INFANT & NEONATE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,024,201,000.00

DOC/PT. PPH/200905 Page 15 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

569 CYSTO-URETHROSCOPE, PEDIATRIC, INFANT & NEONATE W/ VIDEO RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,491,647,000.00
570 VIDEO CAMERA SYSTEM RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 467,446,000.00
571 FLEXIBLE FIBRE-CYSTOSCOPE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 429,484,000.00
572 FLEXIBLE FIBRE-CYSTOSCOPE WITH VIDEO SYSTEM RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 896,929,000.00
573 FLEXIBLE MINIATURE FIBRE-CYSTO-URETHROSCOPE FOR PEDIATRIC RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 359,032,000.00
574 FLEXIBLE MINIATURE FIBRE-CYSTO-URETHROSCOPE F. PED. W/ VIDEO RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 826,477,000.00
575 VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 467,446,000.00
576 RESECTOSCOPE SET RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 859,986,000.00
577 RESECTOSCOPE SET WITH VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,327,432,000.00
578 RESECTOSCOPE SET WITH SUPRAPUBIC ASPIRATION SET RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 897,470,000.00
579 RESECTOSCOPE SET W/ SUPRAPUBIC ASPIRATION SET & VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,364,915,000.00
580 RESECTOSCOPE PEDIATRIC SET WITH 9 FR. SHEATH RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 260,529,000.00
581 RESECTOSCOPE PEDIATRIC SET WITH 11.5 FR. SHEATH RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 240,016,000.00
582 RESECTOSCOPE PEDIATRIC SET W/ 9 FR. SHEATH & CAMERA VIDEO RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 727,974,000.00
583 RESECTOSCOPE PEDIATRIC SET W/ 11.5 FR. SHEATH & CAMERA VIDEO RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 707,461,000.00
584 URETHROTOME SET RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 286,596,000.00
585 URETHROTOME SET WITH ADD. HOLLOW STRICTURE SCALPEL RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 305,064,000.00
586 URETHROTOME SET WITH VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 754,042,000.00
587 URETHROTOME SET W/ ADD. HOLLOW STRICTURE SCALPEL W/ VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 772,510,000.00
588 URETHROTOME FOR NEONATE, INFANT, CHILD RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 267,786,000.00
589 URETHROTOME FOR NEONATE, INFANT, CHILD W/ VIDEO RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 735,232,000.00
590 PERCUTANEOUS UNIVERSAL NEPHROSCOPE SET 1 RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 312,998,000.00
591 PERCUTANEOUS UNIVERSAL NEPHROSCOPE SET 2 RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 329,620,000.00
592 PERCUTANEOUS UNIVERSAL NEPHROSCOPE SET 2 W/ VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 797,065,000.00
593 PERCUTANEOUS UNIVERSAL NEPHROSCOPE SET RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 512,932,000.00
594 PERCUTANEOUS UNIVERSAL NEPHROSCOPE SET W/ VIDEO RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 980,377,000.00
595 URETERO - RENOSCOPE SET 1 RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 449,593,000.00
596 URETERO - RENOSCOPE SET 2 RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 348,498,000.00
597 URETERO - RENOSCOPE SET 1 W/ VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 917,039,000.00
598 URETERO - RENOSCOPE SET 2 W/ VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 815,944,000.00
599 COMPACT NEEDLE FIBRE URETERO-RENOSCOPE FOR CHILD RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 236,322,000.00
600 COMPACT NEEDLE FIBRE URETERO-RENOSCOPE FOR CHILD W/ VIDEO RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 703,768,000.00
601 LITHOCLAST BASIC UNIT WITH STANDARD HANDLE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,381,680,000.00
602 LITHOCLAST BASIC UNIT WITH MASTER HANDLE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,409,998,000.00
603 LITHOCLAST BASIC UNIT WITH STANDARD HANDLE & OPTION 1 RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,413,281,000.00
604 LITHOCLAST BASIC UNIT WITH STANDARD HANDLE, OPTION 1 & 2 RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,605,006,000.00
605 LITHOCLAST BASIC UNIT WITH STANDARD HANDLE, COMPLETE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,680,236,000.00
606 LAPAROSCOPE / PELVISCOPE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 2,362,173,000.00

DOC/PT. PPH/200905 Page 16 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

607 LAPAROSCOPE / PELVISCOPE WITH VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 2,829,619,000.00
608 LAPAROSCOPE/PELVISCOPE W/ OPERATING TELESCOPE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 2,510,943,000.00
609 LAPAROSCOPE/PELVISCOPE W/ OP. TELESCOPE W/ VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 2,978,389,000.00
610 VIDEO SYSTEM FOR GYNAECOLOGY ENDOSCOPE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 467,446,000.00
611 HYSTEROSCOPE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,099,263,000.00
612 HYSTEROSCOPE WITH VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,566,709,000.00
613 GASTROSCOPE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,255,208,000.00
614 GASTROSCOPE WITH VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,722,654,000.00
615 LAPAROSCOPE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 2,173,595,000.00
616 LAPAROSCOPE WITH VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,722,654,000.00
617 COLONOSCOPE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 781,060,000.00
618 COLONOSCOPE WITH VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,248,505,000.00
619 RECTOSCOPE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 483,540,000.00
620 RECTOSCOPE WITH VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 950,986,000.00
621 VIDEO SYSTEM FOR GASTROENTEROLOGY ENDOSCOPE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 467,446,000.00
622 EAR ENDOSCOPE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 159,242,000.00
623 EAR ENDOSCOPE WITH VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 626,688,000.00
624 SINUSCOPE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 359,681,000.00
625 SINUSCOPE WITH VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 827,127,000.00
626 FLEXIBLE NASO-PHARYNGO-LARYNGOSCOPE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 461,358,000.00
627 FLEXIBLE NASO-PHARYNGO-LARYNGOSCOPE WITH VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 928,804,000.00
628 FUNCTIONAL ENDOSCOPY SINUS SURGERY ( FESS ) RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 784,828,000.00
629 FUNCTIONAL ENDOSCOPY SINUS SURGERY (FESS) W/ VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,252,274,000.00
630 VIDEO SYSTEM FOR O.R.L (THT) ENDOSCOPE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 467,446,000.00
631 BRONCHOSCOPE RIGID RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 388,580,000.00
632 BRONCHOSCOPE RIGID WITH VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 856,026,000.00
633 BRONCHOSCOPE FLEXIBLE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 608,281,000.00
634 BRONCHOSCOPE FLEXIBLE WITH VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 1,075,727,000.00
635 LARYNGOSCOPE, RIGID RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 221,247,000.00
636 LARYNGOSCOPE, RIGID W/ VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 688,692,000.00
637 LARYNGOSCOPE, FLEXIBLE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 519,977,000.00
638 LARYNGOSCOPE, FLEXIBLE W/ VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 987,422,000.00
639 OESOPHAGOSCOPE RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 431,467,000.00
640 OESOPHAGOSCOPE W/ VIDEO CAMERA RICHARD WOLF - GERMANY VARIOUS SET AKL 11603300213 Rp. 898,913,000.00
641 ESWL SET, COMPLETE SET RICHARD WOLF - GERMANY VARIOUS SET DALAM PROSES Rp. 12,386,385,000.00
642 ESWL SET, COMPLETE SET RICHARD WOLF - GERMANY VARIOUS SET DALAM PROSES Rp. 13,315,770,000.00
643 ESWL SET, COMPLETE SET RICHARD WOLF - GERMANY VARIOUS SET DALAM PROSES Rp. 13,898,595,000.00
644 LITHOTRIPTOR SET RICHARD WOLF - GERMANY VARIOUS SET DALAM PROSES Rp. 6,609,150,000.00

DOC/PT. PPH/200905 Page 17 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

645 COLOR MONITOR ECG / RESP / NIBP / SPO2 / 2TEMP WELCH ALLYN - USA PROPAQ-CS 242 UNIT AKL 20502200619 Rp. 359,707,000.00
646 COLOR MONITOR ECG / RESP / NIBP / SPO2 / 2TEMP WITH PRINTER WELCH ALLYN - USA PROPAQ-CS 242 UNIT AKL 20502200619 Rp. 420,457,000.00
647 COLOR MONITOR ECG / RESP / NIBP / SPO2 / 2TEMP WITH PRINTER FOR PEDIATRIC WELCH ALLYN - USA PROPAQ-CS 242 UNIT AKL 20502200619 Rp. 422,493,000.00
648 COLOR MONITOR ECG / RESP / NIBP / SPO2 FOR NEONATE WITH 2TEMP & PRINTER WELCH ALLYN - USA PROPAQ-CS 242 UNIT AKL 20502200619 Rp. 429,174,000.00
649 COLOR MONITOR ECG / RESP / NIBP / SPO2 / 2TEMP WITH ETCO2 ANDPRINTER WELCH ALLYN - USA PROPAQ-CS 242 UNIT AKL 20502200619 Rp. 567,355,000.00
650 COLOR MONITOR ECG / RESP / NIBP / 1 IBP / SPO2 / 2TEMP WELCH ALLYN - USA PROPAQ-CS 244 UNIT AKL 20502200619 Rp. 429,838,000.00
651 COLOR MONITOR ECG / RESP / NIBP / 1 IBP / SPO2 / 2TEMP WITH PRINTER WELCH ALLYN - USA PROPAQ-CS 244 UNIT AKL 20502200619 Rp. 490,588,000.00
652 COLOR MONITOR ECG / RESP / NIBP / 1 IBP / SPO2 / 2TEMP WITH PRINTER FOR PEDIATRIC WELCH ALLYN - USA PROPAQ-CS 244 UNIT AKL 20502200619 Rp. 495,057,000.00
653 COLOR MONITOR ECG / RESP / NIBP / 1 IBP / SPO2 FOR NEONATE WITH 2TEMP AND PRINTER WELCH ALLYN - USA PROPAQ-CS 244 UNIT AKL 20502200619 Rp. 501,738,000.00
654 COLOR MONITOR ECG / RESP / NIBP / 1 IBP / SPO2 / 2TEMP WITH ETCO2 AND PRINTER WELCH ALLYN - USA PROPAQ-CS 244 UNIT AKL 20502200619 Rp. 636,645,000.00
655 COLOR MONITOR ECG / RESP / NIBP / 2 IBP / SPO2 / 2TEMP WELCH ALLYN - USA PROPAQ-CS 246 UNIT AKL 20502200619 Rp. 470,476,000.00
656 COLOR MONITOR ECG / RESP / NIBP / 2 IBP / SPO2 / 2TEMP WITH PRINTER WELCH ALLYN - USA PROPAQ-CS 246 UNIT AKL 20502200619 Rp. 529,171,000.00
657 COLOR MONITOR FOR ICU/ICCU ECG / RESP / NIBP / 2 IBP / SPO2 / 2TEMP WITH ETCO2 AND PRINTE WELCH ALLYN - USA PROPAQ-CS 246 UNIT AKL 20502200619 Rp. 673,453,000.00
658 MONITOR ECG / RESP / NIBP / SPO2 / 2TEMP WELCH ALLYN - USA PROPAQ ENCORE 202-EL UNIT AKL 20501300220 Rp. 322,280,000.00
659 MONITOR ECG / RESP / NIBP / SPO2 / 2TEMP WITH PRINTER WELCH ALLYN - USA PROPAQ ENCORE 202-EL UNIT AKL 20501300220 Rp. 383,030,000.00
660 MONITOR ECG / RESP / NIBP / SPO2 / 2TEMP WITH ETCO2 AND PRINTER WELCH ALLYN - USA PROPAQ ENCORE 202-EL UNIT AKL 20501300220 Rp. 532,361,000.00
661 MONITOR ECG / RESP / NIBP / 1 IBP / SPO2 / 2TEMP WELCH ALLYN - USA PROPAQ ENCORE 204-EL UNIT AKL 20501300220 Rp. 394,844,000.00
662 MONITOR ECG / RESP / NIBP / 1 IBP / SPO2 / 2TEMP WITH PRINTER WELCH ALLYN - USA PROPAQ ENCORE 204-EL UNIT AKL 20501300220 Rp. 455,594,000.00
663 MONITOR ECG / RESP / NIBP / 1 IBP / SPO2 / 2TEMP WITH ETCO2 AND PRINTER WELCH ALLYN - USA PROPAQ ENCORE 204-EL UNIT AKL 20501300220 Rp. 604,925,000.00
664 MONITOR ECG / RESP / NIBP / 2 IBP / SPO2 / 2TEMP WELCH ALLYN - USA PROPAQ ENCORE 206-EL UNIT AKL 20501300220 Rp. 451,700,000.00
665 MONITOR ECG / RESP / NIBP / 2 IBP / SPO2 / 2TEMP WITH PRINTER WELCH ALLYN - USA PROPAQ ENCORE 206-EL UNIT AKL 20501300220 Rp. 512,450,000.00
666 MONITOR ECG / RESP / NIBP / 2 IBP / SPO2 / 2TEMP WITH ETCO2 AND PRINTER WELCH ALLYN - USA PROPAQ ENCORE 206-EL UNIT AKL 20501300220 Rp. 638,552,000.00
667 CENTRAL STATION FOR PROPAQ WELCH ALLYN - USA ACUITY LT UNIT DALAM PROSES Rp. ##############
668 AMBULATORY ECG MONITORING WELCH ALLYN - USA MICROPAQ 402 UNIT DALAM PROSES Rp. 130,526,000.00
669 AMBULATORY ECG AND SPO2 MONITORING WELCH ALLYN - USA MICROPAC 404 UNIT DALAM PROSES Rp. 203,090,000.00
670 SPOT VITAL SIGN (NIBP / SPO2) WITH MOBILE STAND WELCH ALLYN - USA 42N0B-E2-M UNIT AKL 20501300218 Rp. 74,924,000.00
671 SPOT VITAL SIGN (NIBP / SPO2 / TEMP) WITH MOBILE STAND WELCH ALLYN - USA 42NTB-E2-M UNIT AKL 20501300218 Rp. 91,671,000.00
672 VITAL SIGN (NIBP) WITH MOBILE STAND WELCH ALLYN - USA 5200O-E2 UNIT AKL 20501300217 Rp. 64,081,000.00
673 VITAL SIGN (NIBP) WITH PRINTER AND MOBILE STAND WELCH ALLYN - USA 5200P-E2 UNIT AKL 20501300217 Rp. 83,219,000.00
674 VITAL SIGN (NIBP & TEMP) WITH MOBILE STAND WELCH ALLYN - USA 520T0-E2 UNIT AKL 20501300217 Rp. 81,962,000.00
675 VITAL SIGN (NIBP & TEMP) WITH PRINTER AND MOBILE STAND WELCH ALLYN - USA 520TP-E2 UNIT AKL 20501300217 Rp. 101,098,000.00
676 VITAL SIGN (NIBP & SPO2) WITH MOBILE STAND WELCH ALLYN - USA 52N0O-E2 UNIT AKL 20501300217 Rp. 128,038,000.00
677 VITAL SIGN (NIBP & SPO2) WITH PRINTER AND MOBILE STAND WELCH ALLYN - USA 52N0P-E2 UNIT AKL 20501300217 Rp. 147,176,000.00
678 VITAL SIGN (NIBP, SPO2, TEMP) WITH MOBILE STAND WELCH ALLYN - USA 52NTO-E2 UNIT AKL 20501300217 Rp. 145,919,000.00
679 VITAL SIGN (NIBP, SPO2, TEMP) WITH PRINTER AND MOBILE STAND WELCH ALLYN - USA 52NTP-E2 UNIT AKL 20501300217 Rp. 165,054,000.00
680 BEDSIDE MONITOR ECG / SPO2 / NIBP WITH MOBILE STAND WELCH ALLYN - USA ATLAS 621S0 UNIT AKL 20501300216 Rp. 199,143,000.00
681 BEDSIDE MONITOR ECG / SPO2 / NIBP WITH PRINTER & MOBILE STAND WELCH ALLYN - USA ATLAS 621SP UNIT AKL 20501300216 Rp. 223,480,000.00
682 BEDSIDE MONITOR ECG / SPO2 / NIBP / TEMP / RESP / BATTERY / RS232 WITH MOBILE STAND WELCH ALLYN - USA ATLAS 622N0 UNIT AKL 20501300216 Rp. 240,092,000.00

DOC/PT. PPH/200905 Page 18 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

683 BEDSIDE MONITOR ECG / SPO2 / NIBP / TEMP / RESP / BATTERY / RS232 WELCH ALLYN - USA ATLAS 622NP UNIT AKL 20501300216 Rp. 264,428,000.00
WITH PRINTER & MOBILE STAND
684 INTEGRATED DIAGNOSTIC SYSTEM W/ ELECTRONIC THERMOMETERAND WELCH ALLYN - USA 76791-2 SET DALAM PROSES Rp. 42,486,000.00
SPHYGMOMANOMETER
685 INTEGRATED DIAGNOSTIC SYSTEM W/ ELECTRONIC THERMOMETERAND WELCH ALLYN - USA 76791-2 + 5082-204-2 SET DALAM PROSES Rp. 43,197,000.00
SPHYGMOMANOMETER, PEDIATRIC
686 INTEGRATED DIAGNOSTIC SYSTEM W/ ELECTRONIC THERMOMETERAND WELCH ALLYN - USA 76791-2 + 5082-202-2 SET DALAM PROSES Rp. 43,141,000.00
SPHYGMOMANOMETER, INFANT
687 INTEGRATED DIAGNOSTIC SYSTEM WELCH ALLYN - USA 76792-2 SET DALAM PROSES Rp. 32,864,000.00
688 INTEGRATED DIAGNOSTIC SYSTEM, PEDIATRIC WELCH ALLYN - USA 76792-2 + 5082-204-2 SET DALAM PROSES Rp. 33,574,000.00
689 INTEGRATED DIAGNOSTIC SYSTEM, INFANT WELCH ALLYN - USA 76792-2 + 5082-202-2 SET DALAM PROSES Rp. 33,519,000.00
690 DIAGNOSTIC SET (RECHARGEABLE BATTERY) WELCH ALLYN - USA 97201 SET AKL 10703303617 Rp. 17,925,000.00
691 DIAGNOSTIC SET ( AA BATTERY) WELCH ALLYN - USA 98502 SET DALAM PROSES Rp. 13,169,000.00
692 HALOGEN PENLITE WELCH ALLYN - USA 76600 UNIT DALAM PROSES Rp. 1,429,000.00
693 MOBILE ANEROID SPHYGMOMANOMETER WELCH ALLYN - USA 7670-04* UNIT AKL 20501400178 Rp. 8,738,000.00
694 MOBILE ANEROID SPHYGMOMANOMETER, PEDIATRIC WELCH ALLYN - USA 7670-04* + 5082-204-2 UNIT AKL 20501400178 Rp. 9,449,000.00
695 MOBILE ANEROID SPHYGMOMANOMETER, INFANT WELCH ALLYN - USA 7670-04* + 5082-202-2 UNIT AKL 20501400178 Rp. 9,393,000.00
696 MOBILE ANEROID SPHYGMOMANOMETER WITH ELECTRONICTHERMOMETER WELCH ALLYN - USA 7670-04T9 UNIT AKL 20501400178 Rp. 15,218,000.00
697 WALL ANEROID SPHYGMOMANOMETER WELCH ALLYN - USA 7670-01 UNIT AKL 20501400178 Rp. 4,871,000.00
698 WALL ANEROID SPHYGMOMANOMETER, PEDIATRIC WELCH ALLYN - USA 7670-01 + 5082-204-2 UNIT AKL 20501400178 Rp. 5,581,000.00
699 WALL ANEROID SPHYGMOMANOMETER, INFANT WELCH ALLYN - USA 7670-01 + 5082-202-2 UNIT AKL 20501400178 Rp. 5,526,000.00
700 DIGITAL BLOOD PRESSURE SYSTEM, MANUAL INFLATION WELCH ALLYN - USA ARDEN 7052-33 + 37 UNIT DALAM PROSES Rp. 2,209,000.00
701 DIGITAL BLOOD PRESSURE SYSTEM, AUTO INFLATION WELCH ALLYN - USA ARDEN 7052-34 + 37 UNIT DALAM PROSES Rp. 3,858,000.00
702 ANEROID SPHYGMOMANOMETER PEDIATRIC WELCH ALLYN - USA 5098-72 UNIT DALAM PROSES Rp. 2,390,000.00
703 ANEROID SPHYGMOMANOMETER INFANT, NEWBORN WELCH ALLYN - USA 5098-72+5082-07 UNIT DALAM PROSES Rp. 3,015,000.00
704 ANEROID SPHYGMOMANOMETER, ADULT WELCH ALLYN - USA 5098-70 UNIT DALAM PROSES Rp. 2,390,000.00
705 CARDIOLOGY TRIPLE HEAD STETHOSCOPE WELCH ALLYN - USA HARVEY DLX 5079-324 UNIT DALAM PROSES Rp. 5,771,000.00
706 ELECTRONIC STETHOSCOPE WELCH ALLYN - USA MEDITRON 5079-400 UNIT DALAM PROSES Rp. 18,300,000.00
707 PEDIATRIC STETHOSCOPE WELCH ALLYN - USA PROFESIONAL 5079-287 UNIT DALAM PROSES Rp. 2,012,000.00
708 INFANT STETHOSCOPE WELCH ALLYN - USA PROFESIONAL 5079-227 UNIT DALAM PROSES Rp. 2,308,000.00
709 ANESTHESIOLOGY STETHOSCOPE SINGLE HEAD WELCH ALLYN - USA PROFESIONAL 5079-230 UNIT DALAM PROSES Rp. 2,071,000.00
710 PEDIATRIC ANESTHESIOLOGY STETHOSCOPE SINGLE HEAD WELCH ALLYN - USA 5079-231 UNIT DALAM PROSES Rp. 2,106,000.00
711 STETHOSCOPE DOUBLE HEAD WELCH ALLYN - USA 5079-76 UNIT DALAM PROSES Rp. 774,000.00
712 ELECTRONIC THERMOMETER RECTAL WELCH ALLYN - USA SURE TEMP (01986-500) UNIT AKL 20901304161 Rp. 5,656,000.00
713 ELECTRONIC THERMOMETER ORAL PROBE WELCH ALLYN - USA SURE TEMP (01679-500) UNIT AKL 20901304161 Rp. 11,096,000.00
714 ELECTRONIC THERMOMETER WALL HOLDER, ORAL PROBE WELCH ALLYN - USA SURE TEMP (01679-410) UNIT AKL 20901304161 Rp. 11,921,000.00
715 RECTAL PROBE 1.2 M (FOR MODEL 679) WELCH ALLYN - USA 02679-000 PC AKL 20901304161 Rp. 2,638,000.00
716 MODEL 600, 675, 678, 679 & 986 DISPOSABLE PROBE COVER - BOX OF 1,000 WELCH ALLYN - USA 05031-101 PC AKL 20901304161 Rp. 1,204,000.00

DOC/PT. PPH/200905 Page 19 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

717 MODEL 986 DISPOSABLE PROBE COVERS - BOX OF 250 WELCH ALLYN - USA 20500-250 PC AKL 20901304161 Rp. 535,000.00
718 PANOPTIC OPTHALMOSCOPE, BLUE FILTER AND LENS WELCH ALLYN - USA 11820 UNIT AKL 212021304163 Rp. 26,015,000.00
719 OPHTHALMOSCOPE COAXIAL WELCH ALLYN - USA 11720 UNIT AKL 21201403354 Rp. 15,280,000.00
720 OPHTHALMOSCOPE WELCH ALLYN - USA 11710 UNIT DALAM PROSES Rp. 14,689,000.00
721 OPHTHALMOSCOPE BINOCULAR INDIRECT WELCH ALLYN - USA 12500-DY UNIT DALAM PROSES Rp. 45,997,000.00
722 OPHTHALMOSCOPE POCKET WELCH ALLYN - USA 12821 UNIT DALAM PROSES Rp. 6,188,000.00
723 OPHTHALMIC POCKETSCOPE SET WELCH ALLYN - USA 94820 SET DALAM PROSES Rp. 17,289,000.00
724 STRABISMOSCOPE SET WELCH ALLYN - USA 12452-C UNIT DALAM PROSES Rp. 9,490,000.00
725 AUTOREFRACTOR WITH PRINTER WELCH ALLYN - USA 14012 UNIT AKL 11201304164 Rp. 228,729,000.00
726 POCKET TRANSILLUMINATOR WELCH ALLYN - USA 14220 UNIT DALAM PROSES Rp. 3,909,000.00
727 POCKET RETINOSCOPE WELCH ALLYN - USA 16221 UNIT DALAM PROSES Rp. 9,462,000.00
728 OPHTALMIC DIAGNOSTIC SET WELCH ALLYN - USA 18375 SM SET DALAM PROSES Rp. 30,942,000.00
729 3.5V STRABISMOSCOPE SET W/ LITHIUM ION RECHARGEABLE HANDLE WELCH ALLYN - USA 12452 UNIT DALAM PROSES Rp. 16,658,000.00
730 3.5V STREAK RETINOSCOPE W/ LITHIUM ION RECHARGEABLE HANDLE WELCH ALLYN - USA 18200 UNIT DALAM PROSES Rp. 17,455,000.00
731 2.5V STREAK RETINOSCOPE WELCH ALLYN - USA 17341 UNIT DALAM PROSES Rp. 12,047,000.00
732 3.5V DIAGNOSTIC OTOSCOPE /THROAT ILLUMINATOR WITH INSUFFLATOR BULB WELCH ALLYN - USA 20001 UNIT AKL 10703403353 Rp. 12,429,000.00
AND LITHIUM ION RECHARGEABLE HANDLE
733 3.5V HALOGEN DIAGNOSTIC OTOSCOPE WITH SPECULAWITH INSUFFLATOR WELCH ALLYN - USA 25021 UNIT DALAM PROSES Rp. 12,095,000.00
AND LITHIUM ION RECHARGEABLE HANDLE
734 PORTABLE BINOCULAR MICROSCOPE LUMIVIEW HEADMOUNT WITH PORTABLE POWER SOURCE WELCH ALLYN - USA 20502H UNIT DALAM PROSES Rp. 25,389,000.00
735 3.5V OPERATING OTOSCOPE WITH SPECULA AND LITHIUM ION RECHARGEABLE HANDLE WELCH ALLYN - USA 21700 UNIT AKL 10703303618 Rp. 12,461,000.00
736 POCKETSCOPE OTOSCOPE WITH PEN TORCH/THROAT ILLUM., "AA" HANDLE WELCH ALLYN - USA 22821 UNIT DALAM PROSES Rp. 5,033,000.00
WITH BATTERIES AND SOFT CASE
737 COMPAC VIDEO OTOSCOPE COMPLETE WITH NICAD HANDLE, NTSC WELCH ALLYN - USA 23102 UNIT DALAM PROSES Rp. 36,105,000.00
738 3.5V BIVALVE NASAL SPECULUM WITH THROAT ILLUMINATOR (23557) WELCH ALLYN - USA 26030 UNIT DALAM PROSES Rp. 11,047,000.00
AND LITHIUM ION RECHARGEABLE HANDLE
739 AUDIOSCOPE 3 SET INCLUDING CHARGING STAND WELCH ALLYN - USA 92682 UNIT DALAM PROSES Rp. 20,680,000.00
740 MANUAL AUDIOMETER, WITH AC AND RECHARGEABLE BATTERY WELCH ALLYN - USA 23212 UNIT AKL 20701304294 Rp. 34,404,000.00
741 MICROTYMP 2 SET WITH CHARGING STAND AND PRINTER WELCH ALLYN - USA 93692 UNIT DALAM PROSES Rp. 108,149,000.00
742 TM262 AUTO TYMP WITH IPSI REFLEX, AUDIOMETER (VERSION 4) WELCH ALLYN - USA 26232 UNIT DALAM PROSES Rp. 129,914,000.00
743 EAR WASH SYSTEM-ENGLISH (ASIA/JAPAN) (INCLUDES NTSC VIDEO) WELCH ALLYN - USA 29350E-ID UNIT AKL 10704304295 Rp. 12,780,000.00
744 EARTIPS (CASE OF 4 BOXES OF 25 EA.= 100) FOR EAR WASH WELCH ALLYN - USA 29360 UNIT AKL 10704304295 Rp. 4,231,000.00
745 DIRECT FOCUSING HEADLIGHT COMPLETE WELCH ALLYN - USA 46022 UNIT AKL 21203304292 Rp. 9,282,000.00
746 MFI HEADLIGHT WITH TURRET FOR WOLF, ACMI, STORZ, OLYMPUS WELCH ALLYN - USA 49522TW UNIT DALAM PROSES Rp. 105,511,000.00
747 MFI FIBER OPTIC HEADLIGHT, COMPLETE SYSTEM WELCH ALLYN - USA 49522 SET DALAM PROSES Rp. 92,386,000.00
748 3.5V EPISCOPE SET (SKIN SURFACE MICROSCOPE) WELCH ALLYN - USA 47351 SET AKL 10903304174 Rp. 15,623,000.00
749 FIBEROPTIC EXAMINATION LIGHT WELCH ALLYN - USA EXAM III UNIT AKL 10704304171 Rp. 58,593,000.00
750 MOBILE PROCEDURE LIGHT WELCH ALLYN - USA LS 200 UNIT DALAM PROSES Rp. 37,602,000.00

DOC/PT. PPH/200905 Page 20 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

751 WALL PROCEDURE LIGHT WELCH ALLYN - USA LS 200 UNIT DALAM PROSES Rp. 34,135,000.00
752 FIBER OPTIC SIGMOIDOSCOPE / ANOSCOPE SET WELCH ALLYN - USA 35323 SET DALAM PROSES Rp. 59,036,000.00
753 SIGMOIDOSCOPE, ADULT WELCH ALLYN - USA 32862 UNIT DALAM PROSES Rp. 20,924,000.00
754 DISPOSABLE SIGMOIDOSCOPE WELCH ALLYN - USA VARIOUS UNIT DALAM PROSES Rp. 21,551,000.00
755 DISPOSABLE ANOSCOPE WELCH ALLYN - USA VARIOUS UNIT DALAM PROSES Rp. 17,114,000.00
756 DEFIBRILLATOR STANDARD MANUAL-BIPHASIC W/ ECG ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 257,412,000.00
757 DEFIBRILLATOR MANUAL-BIPHASIC W/ ECG AND SPO2 ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 305,862,000.00
758 DEFIBRILLATOR MANUAL-BIPHASIC W/ ECG, SPO2 AND NIBP ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 405,612,000.00
759 DEFIBRILLATOR MANUAL-BIPHASIC W/ ECG, SPO2, ETCO2, & NIBP ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 539,562,000.00
760 DEFIBRILLATOR MANUAL-BIPHASIC W/ ECG AND PACING ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 312,246,000.00
761 DEFIBRILLATOR MANUAL-BIPHASIC W/ 12 LEAD ECG ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 413,524,000.00
762 DEFIBRILLATOR MANUAL-BIPHASIC W/ 12 LEAD ECG AND SPO2 ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 461,974,000.00
763 DEFIBRILLATOR MANUAL-BIPHASIC W/ 12 LEAD ECG, SPO2, NIBP ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 561,724,000.00
764 DEFIBRILLATOR MANUAL-BIPHASIC W/ 12 LEAD ECG AND PACING ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 468,358,000.00
765 DEFIBRILLATOR MAN-BIPHASIC W/12 LEAD ECG,SPO2, EtCO2,NIBP&PACING ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 750,508,000.00
766 DEFIBRILLATOR ADVISORY-BIPHASIC W/ ECG MONITOR ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 269,496,000.00
767 DEFIBRILLATOR ADVISORY-BIPHASIC W/ ECG AND SPO2 ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 317,946,000.00
768 DEFIBRILLATOR ADVISORY-BIPHASIC W/ ECG, SPO2 AND NIBP ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 417,696,000.00
769 DEFIBRILLATOR ADVISORY-BIPHASIC W/ ECG, SPO2, EtCO2, NIBP ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 551,646,000.00
770 DEFIBRILLATOR ADVISORY-BIPHASIC W/ ECG AND PACING ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 312,246,000.00
771 DEFIBRILLATOR ADVISORY-BIPHASIC W/ 12 LEAD ECG ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 425,608,000.00
772 DEFIBRILLATOR ADVISORY-BIPHASIC W/ 12 LEAD ECG & PACING ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 468,358,000.00
773 DEFIB. ADV-BIPHASIC W/12 LEAD ECG,PACING,SPO2,EtCO2,NIBP ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 750,508,000.00
774 DEFIBRILLATOR AED BIPHASIC WITH ECG ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 289,446,000.00
775 DEFIBRILLATOR AED BIPHASIC W/ ECG AND SPO2 ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 337,896,000.00
776 DEFIBRILLATOR AED BIPHASIC W/ ECG, SPO2, AND NIBP ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 437,646,000.00
777 DEFIBRILLATOR AED BIPHASIC W/ ECG, SPO2, EtCO2, NIBP ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 571,596,000.00
778 DEFIBRILLATOR AED BIPHASIC W/ ECG MONITOR AND PACING ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 332,196,000.00
779 DEFIBRILLATOR AED BIPHASIC W/ 12 LEAD ECG. ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 445,558,000.00
780 DEFIBRILLATOR AED BIPHASIC W/ 12 LEAD ECG, SPO2 & NIBP ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 593,758,000.00
781 DEFIBRILLATOR AED BIPHASIC 12 LEAD,PACING,SPO2,EtCO2 & NIBP ZOLL MEDICAL - USA M - SERIES UNIT AKL 20505300559 Rp. 670,708,000.00
782 DEFIBRILLATOR BIPHASIC CCT W/ ECG,SPO2 MONITOR ZOLL MEDICAL - USA M-SERIES CCT UNIT AKL 20505300558 Rp. 369,178,000.00
783 DEFIBRILLATOR BIPHASIC CCT W/ ECG,SPO2,ETCO2 MONITOR ZOLL MEDICAL - USA M-SERIES CCT UNIT AKL 20505300558 Rp. 563,251,000.00
784 DEFIBRILLATOR BIPHASIC CCT W/ ECG,SPO2,NIBP MONITOR ZOLL MEDICAL - USA M-SERIES CCT UNIT AKL 20505300558 Rp. 477,728,000.00
785 DEFIBRILLATOR BIPHASIC CCT W/ ECG,SPO2,ETCO2,NIBP ZOLL MEDICAL - USA M-SERIES CCT UNIT AKL 20505300558 Rp. 671,802,000.00
786 DEFIBRILLATOR BIPHASIC CCT W/ ECG,SPO2 & PACING ZOLL MEDICAL - USA M-SERIES CCT UNIT AKL 20505300558 Rp. 424,012,000.00
787 DEFIBRILLATOR BIPHASIC CCT W/ ECG,SPO2,ETCO2,NIBP&PACING ZOLL MEDICAL - USA M-SERIES CCT UNIT AKL 20505300558 Rp. 720,936,000.00
788 DEFIBRILLATOR BIPHASIC CCT W/ 12 LEAD ECG AND SPO2 ZOLL MEDICAL - USA M-SERIES CCT UNIT AKL 20505300558 Rp. 497,428,000.00

DOC/PT. PPH/200905 Page 21 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

789 DEFIB. BIPHASIC CCT W/ 12 LEAD ECG,SPO2,ETCO2,NIBP&PACING ZOLL MEDICAL - USA M-SERIES CCT UNIT AKL 20505300558 Rp. 837,102,000.00
790 STANDARD M-SERIES BATTERY ZOLL MEDICAL - USA 8000-0299-01 PC AKL 20505300559 Rp. 3,466,000.00
791 AC POWER CHARGER 220 V ZOLL MEDICAL - USA 8040-0040 PC AKL 20505300559 Rp. 34,200,000.00
792 PRIMARY CARRY CASE, BLUE CANVAS ZOLL MEDICAL - USA 8000-0056-01 PC AKL 20505300559 Rp. 5,472,000.00
793 XTREME PACK I CARRY CASE FOR USE WITH HANDSFREE ZOLL MEDICAL - USA 8000-0593-01 PC AKL 20505300559 Rp. 8,208,000.00
794 XTREME PACK I CARRY CASE FOR USE WITH PADDLES ZOLL MEDICAL - USA 8000-0594-01 PC AKL 20505300559 Rp. 11,856,000.00
795 RECORDER PAPER 80 MM FAN FOLD, 10 PACKAGES ZOLL MEDICAL - USA 8000-0302 PACKAGE AKL 20505300559 Rp. 1,322,000.00
796 4 MEG PCMCIA DATA CARD ( 2 PER PACK ) ZOLL MEDICAL - USA 8000-1607 PACKAGE AKL 20505300559 Rp. 10,944,000.00
797 16 MEG PCMCIA DATA CARD ( 2 PER PACK ) ZOLL MEDICAL - USA 8000-0167 PACKAGE AKL 20505300559 Rp. 20,064,000.00
798 ZOLL DATA CONTROL FOR WINDOWS STAND-ALONE ZOLL MEDICAL - USA 8000-0601-01 UNIT AKL 20505300559 Rp. 90,972,000.00
799 XTREME PACK II CARRY CASE, MOLDED RUBBER CASE W/ REAR POUCH ZOLL MEDICAL - USA 8000-0592-01 PC AKL 20505300559 Rp. 10,032,000.00
800 STAT-PADZ ADULT MFE WITH PRE-CONNECT, 12 PAIR/PER CASE ZOLL MEDICAL - USA 8900 - 4003 PACKAGE AKL 20505300559 Rp. 12,084,000.00
801 AUTOMATIC EXTERNAL DEFIBRILLATOR WITH CPR ZOLL MEDICAL - USA AED PLUS UNIT AKL 20505300561 Rp. 100,178,000.00
802 AUTOMATIC EXTERNAL DEFIBRILLATOR WITH CPR & VOICE RECORDING ZOLL MEDICAL - USA AED PLUS UNIT AKL 20505300561 Rp. 108,728,000.00
803 OPERATING MICROSCOPE (3 STEP MAGNIFICATION), MOBILE ALBERT WETZLAR - GERMANY OSMI 311 UNIT AKL.11603300335 Rp. 306,384,000.00
804 OPERATING MICROSCOPE (3 STEP MAGNIFICATION ), CEILING ALBERT WETZLAR - GERMANY OSMI 355 UNIT AKL.11603300335 Rp. 314,715,000.00
805 ELECTRO SURGICAL UNIT MAJOR, USE MAX. POWER 280 W RMS, ALSA - ITALY EXCELL-250 MCD UNIT AKL 21603300586 Rp. 154,960,000.00
806 ELECTRO SURGICAL UNIT MAJOR, USE MAX. POWER 380 W RMS ALSA - ITALY EXCELL-350 MCD UNIT AKL 21603300585 Rp. 162,689,000.00
807 ELECTRO SURGICAL UNIT MAJOR, USE MAX. POWER 400 W RMS, ALSA - ITALY EXCELL-400 MCD UNIT AKL 21603300584 Rp. 197,779,000.00
808 ELECTRO SURGICAL UNIT MAJOR, USE B610/A MAX.280 W ALSA - ITALY EXCELL-200 MCDS UNIT AKL 21603300583 Rp. 154,892,000.00
809 ELECTRO SURGICAL UNIT MAJOR, USE B600/A MAX. 280 W ALSA - ITALY EXCELL-250 MCDS UNIT AKL 21603300583 Rp. 170,932,000.00
810 ELECTRO SURGICAL UNIT MAJOR, USE B610/A MAX 400 W ALSA - ITALY EXCELL-350 MCDS UNIT AKL 21603300583 Rp. 167,272,000.00
811 ELECTRO SURGICAL UNIT MAJOR, USE B600/A MAX 400 W ALSA - ITALY EXCELL-400 MCDS UNIT AKL 21603300583 Rp. 213,271,000.00
812 ELECTRO SURGICAL UNIT MEDIUM, USE MAX. 150 W RMS. ALSA - ITALY MB-1/MC UNIT DALAM PROSES Rp. 45,315,000.00
813 ELECTRO SURG UNIT MEDIUM, MAX 150 W RMS W/ MICROPROCESSOR ALSA - ITALY MB-1-A/MC UNIT AKL 21603304298 Rp. 49,829,000.00
814 TROLLEY FOR ELECTRO SURGICAL UNIT ALSA - ITALY H 10 UNIT DALAM PROSES Rp. 4,908,000.00
815 ELECTRO SURGICAL UNIT MINOR, USE MAX. POWER 50 W RMS ALSA - ITALY SU-50MB UNIT AKL 21603300588 Rp. 23,974,000.00
816 ELECTRO SURGICAL UNIT MINOR, USE MAX POWER 120 W RMS ALSA - ITALY SU-100M UNIT AKL 21603300587 Rp. 24,453,000.00
817 AUTOCLAVE, STERILIZING & WARMING, 46 LTR. ALP - JAPAN MC-30L UNIT DALAM PROSES Rp. 265,050,000.00
818 AUTOCLAVE, STERILIZING & CIRCULATING DRYING, 82 LTR. ALP - JAPAN MC-40DP UNIT DALAM PROSES Rp. 572,508,000.00
819 AUTOCLAVE, STERILIZING & CIRCULATING DRYING, 46 LTR. ALP - JAPAN MC-30LDP UNIT DALAM PROSES Rp. 339,264,000.00
820 HOT AIR STERILIZER, 32 LTR ALP - JAPAN CS-35H UNIT DALAM PROSES Rp. 95,418,000.00
821 HOT AIR STERILIZER, MICROCOMPUTED CONTROLLER, 480 LTR ALP - JAPAN KMD-120HL UNIT DALAM PROSES Rp. 375,841,000.00
822 HOT AIR STERILIZER, 72 LTR ( HOT AIR CIRCULATING DRYING ) ALP - JAPAN CS-45H UNIT DALAM PROSES Rp. 113,972,000.00
823 HOT AIR STERILIZER, 150 LTR ( HOT AIR CIRCULATING DRYING ) ALP - JAPAN CS-60H UNIT DALAM PROSES Rp. 145,778,000.00
824 OVEN VERTICAL 270 L, W/ OBSERVATION WINDOW, 0.6 KW ALP - JAPAN RT-120HS UNIT DALAM PROSES Rp. 265,050,000.00
825 OVEN VERTICAL 720 LTR, W/ OBSERVATION WINDOW, 1.8 KW ALP - JAPAN RT-120HG UNIT DALAM PROSES Rp. 490,343,000.00
826 OVEN VERTICAL 480 LTR, W/ OBSERVATION WINDOW, 1.2 KW ALP - JAPAN RT-120HL UNIT DALAM PROSES Rp. 384,323,000.00

DOC/PT. PPH/200905 Page 22 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

827 INCUBATOR ITD SERIES, 150 LTR ALP - JAPAN ITD-60K UNIT DALAM PROSES Rp. 108,671,000.00
828 INCUBATOR ITD SERIES, 22.5 LTR ALP - JAPAN ITD-30K UNIT DALAM PROSES Rp. 82,166,000.00
829 INCUBATOR ITD SERIES, 72 LTR ALP - JAPAN ITD-45K UNIT DALAM PROSES Rp. 87,467,000.00
830 INCUBATOR VERTICAL, 360 LTR, VERTICAL FLOW ALP - JAPAN IF-120HM UNIT DALAM PROSES Rp. 280,423,000.00
831 INCUBATOR VERTICAL , 480 LTR, HORIZONTAL FLOW ALP - JAPAN IFY-120HL UNIT DALAM PROSES Rp. 402,346,000.00
832 INCUBATOR VERTICAL, 480 LTR, VERTICAL FLOW ALP - JAPAN IF-120HL UNIT DALAM PROSES Rp. 343,505,000.00
833 FIVE INFANT MANIKINS W/ 100 DISPOSABLE LUNG & 5 ADAPTER CAPS ARMSTRONG MEDICAL - USA AA-1855 SET DALAM PROSES Rp. 13,538,000.00
834 SIX CHANNEL ECG / ARRHYTHMIA / PRESSURE PATIENT SIMULATOR ARMSTRONG MEDICAL - USA AA-820 SET DALAM PROSES Rp. 290,703,000.00
835 DEFIB &CPR MANIKIN W/ IV TRAINING ARM,AIRWAY MANAG & SIMULATOR ARMSTRONG MEDICAL - USA AA-6000 SET DALAM PROSES Rp. 174,523,000.00
836 INFANT CRISIS MANIKIN WITH ECG CHEST COVER ARMSTRONG MEDICAL - USA AB-1930 SET DALAM PROSES Rp. 62,843,000.00
837 LARRY HEAD WITH MOUNTING BOARD (INTUBATION TRAINER) ARMSTRONG MEDICAL - USA AB-1875 SET DALAM PROSES Rp. 33,935,000.00
838 INFANT AIRWAY MANAGEMENT TRAINER ARMSTRONG MEDICAL - USA AB-2000 SET DALAM PROSES Rp. 24,886,000.00
839 ARTERIAL PUNCTURE ARM, ADULT ARMSTRONG MEDICAL - USA AB-1005 SET DALAM PROSES Rp. 23,180,000.00
840 IV ARM, ADULT ARMSTRONG MEDICAL - USA AB-1000 SET DALAM PROSES Rp. 22,097,000.00
841 PNEUMOTHORAX SIMULATOR ARMSTRONG MEDICAL - USA AA-9500 SET DALAM PROSES Rp. 21,187,000.00
842 SUTURE PRACTICE ARM ARMSTRONG MEDICAL - USA AB-1075 SET DALAM PROSES Rp. 5,135,000.00
843 SURGICAL BANDAGING SIMULATOR ARMSTRONG MEDICAL - USA AB-1130 SET DALAM PROSES Rp. 29,913,000.00
844 GERIATRIC AND NURSING MANIKIN ARMSTRONG MEDICAL - USA AB-2425 SET DALAM PROSES Rp. 100,297,000.00
845 OBSTETRIC MANIKIN ARMSTRONG MEDICAL - USA AA-9505 SET DALAM PROSES Rp. 25,137,000.00
846 FORCEPS OBSTETRIC DELIVERY MANIKIN ARMSTRONG MEDICAL - USA AA-9550 SET DALAM PROSES Rp. 30,272,000.00
847 CPR &AED TRAINING 5 PACK W/ NYLON BACKPACK &50 LUNG/MOUTHSHIELD ARMSTRONG MEDICAL - USA ACTAR D-FIB AA-1305 SET DALAM PROSES Rp. 17,973,000.00
848 LUNG/MOUTHSHIELD 50 PCS/PKG FOR CPR/AED TRAINING ARMSTRONG MEDICAL - USA ACTAR D-FIB AA-1312 SET DALAM PROSES Rp. 934,000.00
849 CRISIS RESUS. SYS MANIKIN UPDATE PACKAGE+OPTIONAL ARMSTRONG MEDICAL - USA AB-1705 + AB-1701 SET DALAM PROSES Rp. 103,888,000.00
850 CHILD CRISIS MANIKIN + OPTIONAL HARD CASE ARMSTRONG MEDICAL - USA AB-1950 + AB-1950C SET DALAM PROSES Rp. 150,463,000.00
851 I.V. ARM, + REPALCEMENT SKIN AND VEIN KIT ARMSTRONG MEDICAL - USA AB-10001 + AB -1003 SET DALAM PROSES Rp. 22,097,000.00
852 PATIENT EDUCATION TRACHEOTOMY CARE SET ARMSTRONG MEDICAL - USA AB-1136 SET DALAM PROSES Rp. 31,421,000.00
853 TERRY TRAUMA ADULT AND CPR MANIKIN ARMSTRONG MEDICAL - USA AA - 7200 SET DALAM PROSES Rp. 57,456,000.00
854 DELUXE O.B. MANIKIN ARMSTRONG MEDICAL - USA AA - 9505 B SET DALAM PROSES Rp. 25,137,000.00
855 FEMALE CATHETER SIMULATOR IN CARRYING CASE + LUBRICANT, 6/PKG ARMSTRONG MEDICAL - USA AB-1045+LF-985 UA SET DALAM PROSES Rp. 19,493,000.00
856 MALE CATHETHER SIMULTAN SIMULATOR ARMSTRONG MEDICAL - USA AB-1050+LF-985 UA SET DALAM PROSES Rp. 19,493,000.00
857 ACTAR D-FIB 10 PACK WITH CARRY BAG ARMSTRONG MEDICAL - USA AA-1310 SET DALAM PROSES Rp. 32,445,000.00
858 ACTAR 911 SQUADRON PLUS ARMSTRONG MEDICAL - USA AA-1845 SET DALAM PROSES Rp. 37,113,000.00
859 ACTAR 911 INFANTRY 10 PACK ARMSTRONG MEDICAL - USA AA-1860 SET DALAM PROSES Rp. 25,442,000.00
860 INFANTRY LUNGS, 100 / PKG ARMSTRONG MEDICAL - USA AA-1862 SET DALAM PROSES Rp. 1,167,000.00
861 INFANTRY ADAPTER CAPS, 10 / PKG ARMSTRONG MEDICAL - USA AA-1865 SET DALAM PROSES Rp. 563,000.00
862 ACTAR 911 INFANTRY CHEST PLATE ARMSTRONG MEDICAL - USA AA-1871 SET DALAM PROSES Rp. 503,000.00
863 CPR MANIKIN WITH ELECTRONIC SYSTEM ARMSTRONG MEDICAL - USA AA-5885 SET DALAM PROSES Rp. 23,270,000.00
864 EMERGENCY CART ARMSTRONG MEDICAL - USA APE 2 UNIT DALAM PROSES Rp. 80,127,000.00

DOC/PT. PPH/200905 Page 23 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

865 EMERGENCY / ANESTHESI CART ARMSTRONG MEDICAL - USA PAPE-1 UNIT DALAM PROSES Rp. 83,269,000.00
866 MEDICATION CART ARMSTRONG MEDICAL - USA PAMS 100 UNIT DALAM PROSES Rp. 64,417,000.00
867 ENT UNIT SET (COMPLETE) ATMOS - GERMANY ATMOS C 31 SET DALAM PROSES Rp. 1,164,520,000.00
868 ENT UNIT SET (SUPER COMPLETE) ATMOS - GERMANY ATMOS C 31 SET DALAM PROSES Rp. 1,787,412,000.00
869 VARIOTHERM PLUS MODULE, ATMOS - GERMANY 506.6002.0 UNIT DALAM PROSES Rp. 201,545,000.00
870 DIGITAL CCD COLOUR VIDEO CAMERA WITH IMAGE MEMORY ATMOS - GERMANY CH - 01 D UNIT DALAM PROSES Rp. 501,483,000.00
871 DIGITAL CCD CAMERA W/ IMAGE MEMORY+HALOGEN LIGHT SOURCE ATMOS - GERMANY LCH - 01 D UNIT DALAM PROSES Rp. 535,598,000.00
872 TFT LCD VIDEO MONITOR 15 INCH. ATMOS - GERMANY 507.3008.0 UNIT DALAM PROSES Rp. 442,232,000.00
873 SONY VIDEO MONITOR 14 INCH. TRINITRON ATMOS - GERMANY SONY UNIT DALAM PROSES Rp. 522,895,000.00
874 LARYNGOSCOPE 70 DEGREE WITH LIGHT GUIDE ATMOS - GERMANY 950.0150.0 UNIT DALAM PROSES Rp. 295,809,000.00
875 LARYNGOSCOPE 90 DEGREE WITH LIGHT GUIDE ATMOS - GERMANY 950.0163.0 UNIT DALAM PROSES Rp. 295,809,000.00
876 NASOPHARYNGOSCOPE WITH FIXED LIGHT GUIDE CABLE ATMOS - GERMANY 950.0162.0 UNIT DALAM PROSES Rp. 491,518,000.00
877 NASOPHARYNGOSCOPE WITH REMOVABLE LIGHT GUIDE CABLE ATMOS - GERMANY 950.0162.0 UNIT DALAM PROSES Rp. 720,893,000.00
878 ENT MICROSCOPE ATMOS - GERMANY 510.0634.0 SET DALAM PROSES Rp. 604,500,000.00
879 ENT INSTRUMENT SET ATMOS - GERMANY 507.0403.0 UNIT DALAM PROSES Rp. 59,584,000.00
880 ULTRASOUND UNIT FOR DIAGNOSTICS OF PARANASAL SINUS DISEASE ATMOS - GERMANY SINUSCOPE 4 D UNIT DALAM PROSES Rp. 457,404,000.00
881 ULTRASOUND UNIT FOR DIAGNOSTICS OF PARANASAL SINUS DISEASE ATMOS - GERMANY SINUSCOPE 4 PD UNIT DALAM PROSES Rp. 547,684,000.00
882 RHINOMANOMETRY ATMOS - GERMANY RHINOMANOMETER 300 UNIT DALAM PROSES Rp. 393,765,000.00
883 IRRIGATION UNIT W/ THERMAL PROCES F REDUCING BACTERIAL COUNT ATMOS - GERMANY HYGROTHERM PLUS UNIT DALAM PROSES Rp. 222,328,000.00
884 THERMIC STIMULATION UNIT W/ THERMAL PROCESS ATMOS - GERMANY VARIOTHERM PLUS UNIT DALAM PROSES Rp. 312,552,000.00
885 VARIOAIR, ELECTRONICALLY CONTROLLED AIR CATALISATOR ATMOS - GERMANY 502.1100.0 UNIT DALAM PROSES Rp. 237,599,000.00
886 ENDO STROBOSCOPE ATMOS - GERMANY ENDOSTROB UNIT DALAM PROSES Rp. 867,227,000.00
887 ENDO STROBOSCOPE AND HALOGEN LIGHT SOURCE ATMOS - GERMANY ENDOSTROB UNIT DALAM PROSES Rp. 860,942,000.00
888 CAMERA SUPPORT WITH INTEGRATED SWITCHING OF THE LIGHT SOURCE. ATMOS - GERMANY 950.0168.0 UNIT DALAM PROSES Rp. 22,623,000.00
889 ENDO STROBOSCOPE L ATMOS - GERMANY ENDOSTROB L UNIT DALAM PROSES Rp. 383,160,000.00
890 MEDIA STROBOSCOPE ATMOS - GERMANY MEDIA STROBOSCOPE UNIT DALAM PROSES Rp. 1,398,246,000.00
891 ADAPTER ( f = 16 mm ) FOR LARYNGO-PHARUNGOSCOPE ATMOS - GERMANY 507.1871.5* UNIT DALAM PROSES Rp. 35,910,000.00
892 FOCUSING ADAPTER (f = 25mm) F RIGID & FLEXIBLE ENDOSCOPE ATMOS - GERMANY 507.1873.5* UNIT DALAM PROSES Rp. 49,376,000.00
893 VOICE & SPEECH ANALYSIS SOFT. WinSAL - V (F WIN 95/NT) ATMOS - GERMANY 700.0001.B* UNIT DALAM PROSES Rp. 26,035,000.00
894 CONNECTION CABLE FROM MEDIASTROBOSCOPE TO ENDOSTROBOSCOPE 4 ATMOS - GERMANY 507.3024.0 UNIT DALAM PROSES Rp. 8,439,000.00
895 IOMEGA DISKETTE 2 GB FOE JAZ DRIVE ATMOS - GERMANY 507.3063.0* UNIT DALAM PROSES Rp. 8,888,000.00
896 PC WORKING TABLE ATMOS - GERMANY 507.3010.0* UNIT DALAM PROSES Rp. 35,461,000.00
897 CHIP CARD READER ATMOS - GERMANY 507.3013.0 UNIT DALAM PROSES Rp. 14,813,000.00
898 DVD RAM DRIVE FOR ARCHIVING ATMOS - GERMANY 507.3004.0* UNIT DALAM PROSES Rp. 20,648,000.00
899 DISK DVD RAM ( 5.2 GB, REWRITABLE ) ATMOS - GERMANY 507.3066.0* UNIT DALAM PROSES Rp. 4,219,000.00
900 SMOKE EVACUATION (SURGICAL) ATMOS - GERMANY ATMOSAFE UNIT DALAM PROSES Rp. 178,114,000.00
901 AUTOMATIC WASHING MACHINE BELIMED - SWISS LA 110 UNIT DALAM PROSES Rp. 275,938,000.00
902 AUTOMATIC WASHING MACHINE BELIMED - SWISS WD 130 UNIT DALAM PROSES Rp. 494,331,000.00

DOC/PT. PPH/200905 Page 24 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

903 AUTOMATIC WASHING MACHINE WITH TWO HINGED DOOR BELIMED - SWISS WD 220 UNIT DALAM PROSES Rp. 1,226,925,000.00
904 AUTOMATIC WASHING MACHINE WITH TWO FRONT BELIMED - SWISS WD 250 UNIT DALAM PROSES Rp. 1,597,653,000.00
905 BED PAN CLEANING MACHINE BELIMED - SWISS WD 550 UNIT DALAM PROSES Rp. 306,133,000.00
906 WASHING & DISINFECTING MACHINE FOR FLEXIBLE ENDOSCOPE BELIMED - SWISS WD 420 UNIT DALAM PROSES Rp. 980,044,000.00
907 ULTRASONIC CLEANER 28 LITERS BELIMED - SWISS DL 1028 P UNIT DALAM PROSES Rp. 182,521,000.00
908 STERILIZER 6-6-6 VS2, 300 L BELIMED - SWISS MSTV 6-6-6 VS2 UNIT DALAM PROSES Rp. 3,094,544,000.00
909 STERILIZER 6-6-6 VS1, 300 L BELIMED - SWISS MSTV 6-6-6 VS1 UNIT DALAM PROSES Rp. 2,944,492,000.00
910 STERILIZER BELIMED - SWISS MST-S, 010461 UNIT DALAM PROSES Rp. 1,245,671,000.00
911 AUTOMATIC FILM PROCESSOR ELK - JAPAN CP-345 UNIT DALAM PROSES Rp. 280,529,000.00
912 MICRO FLOW CELL PHOTOMETER ERMA - JAPAN AE-600 UNIT AKL 1010230339 Rp. 148,428,000.00
913 PARTICLE ( BLOOD CELL ) COUNTER 18 PARAMETER ERMA - JAPAN PCE-170 UNIT AKL 20205303135 Rp. 262,930,000.00
914 FULL AUTOMATIC PARTICLE COUNTER ERMA - JAPAN PCE-210 UNIT AKL 20205500274 Rp. 466,488,000.00
915 DIGITAL HEMOGLOBINMETER ERMA - JAPAN HB-20 UNIT AKL 20207300330 Rp. 26,293,000.00
916 BILIRUBIN METER ERMA - JAPAN B - 105 UNIT AKL 10207300331 Rp. 84,816,000.00
917 PHOTOELECTRIC COLORIMETER ERMA - JAPAN AE-15F UNIT DALAM PROSES Rp. 19,508,000.00
918 DIGITAL PHOTOELECTRIC COLORIMETER ERMA - JAPAN AE-30F UNIT AKL 10102500273 Rp. 25,445,000.00
919 PRECISSION ROTARY MICROTOME ERMA - JAPAN ERM-200P UNIT DALAM PROSES Rp. 205,255,000.00
920 LARGE ROTARY MICROTOME ERMA - JAPAN ERM-230L UNIT DALAM PROSES Rp. 102,627,000.00
921 SMALL ROTARY MICROTOME ERMA - JAPAN ERM-260S UNIT DALAM PROSES Rp. 81,932,000.00
922 FREEZING MICROTOME ERMA - JAPAN 08-300-0 UNIT DALAM PROSES Rp. 83,120,000.00
923 ABBE REFRACTOMETER ERMA - JAPAN ER - 1 UNIT DALAM PROSES Rp. 67,853,000.00
924 BINOCULAR MICROSCOPE ERMA - JAPAN ERMAX - I UNIT AKL 10203300555 Rp. 64,460,000.00
925 BINOCULAR MICROSCOPE ERMA - JAPAN ERMAX - II UNIT DALAM PROSES Rp. 67,683,000.00
926 TRINOCULAR MICROSCOPE ERMA - JAPAN ERMAX - III UNIT DALAM PROSES Rp. 90,075,000.00
927 BLOOD CELL CALCULATOR ERMA - JAPAN F 410 N UNIT DALAM PROSES Rp. 2,837,000.00
928 HAND PROTEIN REFRACTOMETER ERMA - JAPAN MODEL D UNIT DALAM PROSES Rp. 3,393,000.00
929 DIGITAL CLINICAL REFRACTOMETER ERMA - JAPAN SU-202 UNIT DALAM PROSES Rp. 23,324,000.00
930 PARTICLE COUNTER ERMA - JAPAN PA-2000 UNIT DALAM PROSES Rp. 551,304,000.00
931 POLARIMETER ERMA - JAPAN 12-150-0 UNIT DALAM PROSES Rp. 72,093,000.00
932 OPERATING TABLE ELECTRICAL W/ BATTERY SUPPLYING, 5 SECTION FAMED - POLAND SU - 04 UNIT AKL 11603300576 Rp. 823,126,000.00
933 OPERATING TABLE ORTHOPEDIC ELECTRICAL 5 SECTION FAMED - POLAND SU - 04 UNIT AKL 11603300576 Rp. 955,776,000.00
934 OPERATING TABLE HYDRAULIC 5 SECTION FAMED - POLAND SU - 02 UNIT AKL 10903300359 Rp. 414,094,000.00
935 OPERATING TABLE ORTHOPEDIC, HYDRAULIC , 4 SECTION FAMED - POLAND SU - 02 UNIT AKL 10903300359 Rp. 452,352,000.00
936 LARGE CASTOR FOR SU-02 FAMED - POLAND UNIT DALAM PROSES Rp. 34,200,000.00
937 OPERATING TABLE, UNIVERSAL HYDRAULIC, CHROMIUM ACC. FAMED - POLAND SJ - 21 UNIT AKL 10903300358 Rp. 253,764,000.00
938 HYDRAULIC ORTHOPEDIC OPERATING TABLE FAMED - POLAND SJ-21 UNIT AKL 10903300358 Rp. 332,424,000.00
939 MOBILE OPERATING TABLE FAMED - POLAND SO-10 UNIT AKL 10903300360 Rp. 183,540,000.00
940 MOBILE ORTHOPEDIC OPERATING TABLE FAMED - POLAND SO-10 UNIT AKL 10903300360 Rp. 254,448,000.00

DOC/PT. PPH/200905 Page 25 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

941 DRIP BOTTLE HOLDER + CLAMP MECHANISM /1 SET/ FAMED - POLAND WK-01.0 PC DALAM PROSES Rp. 1,824,000.00
942 SCHANK RESTS + CLAMP MECHANISMS / 2 SET/ FAMED - POLAND WS-04.0 PC DALAM PROSES Rp. 6,156,000.00
943 ARM SUPPORT + MULTIPOSITION CLAMP MECHANISMS /1 SET/ FAMED - POLAND PR-01.0 PC DALAM PROSES Rp. 4,697,000.00
944 ANGLE ARM REST + CLAMP MECHANISM /1 SET/ FAMED - POLAND WS-07.0 PC DALAM PROSES Rp. 5,609,000.00
945 TROLLEY F ACC /1 PCE/, FOR SJ-21 & SO-10 (F LACQUIRED VERSION) FAMED - POLAND WS-13.0 PC DALAM PROSES Rp. 19,243,000.00
946 HOLDER F ANESTHESI TUBE+CLAMP MECH/1/ F SJ-21 &SO-10 FAMED - POLAND WS-14.0 PC DALAM PROSES Rp. 2,554,000.00
947 TRAY F INST + CLAMP MECH. /1 SET/ FOR SJ-21 & SO-10 FAMED - POLAND WS-15.0 PC DALAM PROSES Rp. 5,746,000.00
948 TRAY FOR X-RAY PLATE I /1 PCE/ FOR SJ-21 FAMED - POLAND WS-09.0 PC DALAM PROSES Rp. 1,231,000.00
949 TRAY FOR X-RAY PLATE III /1 PCE/ FOR SO-10 FAMED - POLAND WS-11.0 PC DALAM PROSES Rp. 1,231,000.00
950 GRIP F X-RAY PLATE FOR BACK SECTION /SET/ FOR SO-10 FAMED - POLAND WS-12.0 PC DALAM PROSES Rp. 3,420,000.00
951 LARYNGOLOGY-OPTHALMIC HEADREST /1 PCE/ F SJ-21&SO-10 FAMED - POLAND WS-21.0 PC DALAM PROSES Rp. 14,957,000.00
952 HAND SUPPORT F OPERATOR /1/+ MULTIPOS. CLAMP MECH./2/ FAMED - POLAND WS-22.0 PC DALAM PROSES Rp. 8,664,000.00
953 BODY STRAP L = 1650 mm LENGTH FAMED - POLAND WS-23.0 PC DALAM PROSES Rp. 456,000.00
954 KIDNEY SUPPORT / 1 PCE / FOR SJ-21 FAMED - POLAND WS-24.0 PC DALAM PROSES Rp. 8,162,000.00
955 GYNAECOLOGICAL ATTACH. /1 PCE/ FOR SJ-21 FAMED - POLAND WS-25.0 PC DALAM PROSES Rp. 5,746,000.00
956 UROLOGICAL ATTACHMENT /1 PCE / FOR SJ-21 FAMED - POLAND WS-26.0 PC DALAM PROSES Rp. 6,475,000.00
957 UROLOGICAL ATTACH. /1 PCE / FOR SJ-21 & SO-10 FAMED - POLAND WS-29.0 PC DALAM PROSES Rp. 6,430,000.00
958 PROCTOLOGICAL ATTACH. /1/ + CLAMP MECH. /2/ F SJ-21&SO-10 FAMED - POLAND WS-30.0 PC DALAM PROSES Rp. 10,260,000.00
959 CLAMP MECHANISM / 1 SET/ FOR SJ-21 AND SO-10 FAMED - POLAND WS-16.0 PC DALAM PROSES Rp. 1,003,000.00
960 MULTIPOSITION CLAMP MECH. /1 SET/ FOR SJ-21 & SO-10 FAMED - POLAND WS-17.0 PC DALAM PROSES Rp. 2,098,000.00
961 DRIP BOTTLE HOLDER WITH CLAMP MECHANISM (1 SET) FAMED - POLAND WK-01.5 PC DALAM PROSES Rp. 3,466,000.00
962 SCHANK REST WITH CLAMP MECHANISM (2 SET) FAMED - POLAND WS-04.5 PC DALAM PROSES Rp. 10,807,000.00
963 ANGLE ARM REST WITH CLAMP MECHANISM (1 SET) FAMED - POLAND WS-07.5 PC DALAM PROSES Rp. 11,537,000.00
964 TROLLEY FOR ACCESSORIES FAMED - POLAND WS-13.5 PC DALAM PROSES Rp. 26,858,000.00
965 ANAESTHETIC FRAME W/ WIDTH REGULATION & CLAMP MECH. (1) FAMED - POLAND WS-01.6 PC DALAM PROSES Rp. 11,309,000.00
966 HOLDER FOR ANAESTHESION TUBES WITH CLAMP MECHANISM (1) FAMED - POLAND WS-14.5 PC DALAM PROSES Rp. 5,381,000.00
967 TRAY FOR INSTRUMENT WITH CLAMP MECHANISM FAMED - POLAND WS-15.5 PC DALAM PROSES Rp. 7,250,000.00
968 TRAY FOR X-RAY PLATE FOR SU-04 / SU-03 / SU-02 FAMED - POLAND WS-11.5 PC DALAM PROSES Rp. 2,827,000.00
969 X-RAY TRAY FOR SU-04 / SU-03 / SU-02 FAMED - POLAND WS-19.6 PC DALAM PROSES Rp. 3,101,000.00
970 LARYNGOLOGY-OPHTHALMIC HEADREST FAMED - POLAND WS-21.5 PC DALAM PROSES Rp. 22,891,000.00
971 HAND SUPPORT FOR OPERATOR FAMED - POLAND WS-22.5 PC DALAM PROSES Rp. 16,553,000.00
972 BODY STRAP 1650 MM LENGTH FAMED - POLAND WS-23.0 PC DALAM PROSES Rp. 456,000.00
973 ABDOMINAL STRAP FAMED - POLAND WS-41.0 PC DALAM PROSES Rp. 2,006,000.00
974 PATIENT LEG STRAP FAMED - POLAND WS-42.0 PC DALAM PROSES Rp. 2,873,000.00
975 HAND REST (HANGED ON ANESTHETIC FRAME) FAMED - POLAND WS-43.0 PC DALAM PROSES Rp. 2,052,000.00
976 HOLDER FOR THIGH FAMED - POLAND WS-44.0 PC DALAM PROSES Rp. 1,733,000.00
977 GYNAECOLOGICAL ATTACHMENT FOR SU-04 / SU-03 / SU-02 FAMED - POLAND WS-28.5 PC DALAM PROSES Rp. 5,335,000.00
978 UROLOGICAL BOWL FOR SU-04 / SU-03 / SU-02 FAMED - POLAND WS-29.5 PC DALAM PROSES Rp. 5,791,000.00

DOC/PT. PPH/200905 Page 26 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

979 PROCTOLOGICAL ATTACHMENT FOR SU-04 / SU-03 / SU-02 FAMED - POLAND WS-30.5 PC DALAM PROSES Rp. 17,100,000.00
980 HANDRAlLS FOR SJ-21 / SO-10 FAMED - POLAND WS-32.5 PC DALAM PROSES Rp. 16,690,000.00
981 WRIST GRIP FAMED - POLAND WS-34.5 PC DALAM PROSES Rp. 4,058,000.00
982 HAND WIRED CONTROLLER FAMED - POLAND WS-35.0 PC DALAM PROSES Rp. 9,804,000.00
983 FOOT WIRED CONTROLLER FAMED - POLAND WS-36.0 PC DALAM PROSES Rp. 23,940,000.00
984 WIRELESS HAND CONTROLLER FAMED - POLAND WS-37.0 PC DALAM PROSES Rp. 13,589,000.00
985 ATTACHMENT FOR ARTHROSCOPIC TREATMENT FAMED - POLAND WS-39.5 PC DALAM PROSES Rp. 12,038,000.00
986 ATTACHMENT FOR MENISCUS TREATMENT FAMED - POLAND WS-40.5 PC DALAM PROSES Rp. 14,090,000.00
987 LARYNGOLIC-OPHTHALMIC NARROW HEAD REST FAMED - POLAND WS-45.5 PC DALAM PROSES Rp. 13,726,000.00
988 LARYNGOLIC-OPHTHALMIC WIDE HEAD REST FAMED - POLAND WS-46.5 PC DALAM PROSES Rp. 14,501,000.00
989 HAND TRACTION DEVICE FAMED - POLAND WS-47.5 PC DALAM PROSES Rp. 17,419,000.00
990 HAND OPERATING TABLE FAMED - POLAND WS-48.5 PC DALAM PROSES Rp. 12,449,000.00
991 PUBIC REST+MULTIPOSITION CLAMP MECHANISM 2/SET FAMED - POLAND WS-49.5 PC DALAM PROSES Rp. 16,690,000.00
992 SIDE REST + CLAMP MECHANISM 2/SET FAMED - POLAND WS-50.5 PC DALAM PROSES Rp. 7,843,000.00
993 HIP REST + CLAMP MECHANISM FAMED - POLAND WS-51.5 PC DALAM PROSES Rp. 2,234,000.00
994 CHEST SUPPORT + CLAMP MECHANLSM FAMED - POLAND WS-52.5 PC DALAM PROSES Rp. 4,195,000.00
995 ATTACHMENT FOR SIDE RAlL FAMED - POLAND WS-53.0 PC DALAM PROSES Rp. 7,296,000.00
996 HIP SUPPORT FAMED - POLAND WS-60.5 PC DALAM PROSES Rp. 9,850,000.00
997 LITHOTOMIC STIRRUPS + MULTI POSITION CLAMP MECHANISM. FAMED - POLAND WS-64.5 PC DALAM PROSES Rp. 17,374,000.00
998 SPINAL MATTRESS FAMED - POLAND WS-65.0 PC DALAM PROSES Rp. 4,925,000.00
999 HALF ROLL FAMED - POLAND WS-66.0 PC DALAM PROSES Rp. 1,186,000.00
1000 FlLLlNG MATTRESS FAMED - POLAND WS-67.0 PC DALAM PROSES Rp. 2,508,000.00
1001 ROLL UNDER NECK FAMED - POLAND WS-68.0 PC DALAM PROSES Rp. 1,778,000.00
1002 WIDE HEAD REST FAMED - POLAND SG-01.1 PC DALAM PROSES Rp. 15,094,000.00
1003 HEAD REST FAMED - POLAND WS-69.0 PC DALAM PROSES Rp. 1,596,000.00
1004 ORTHOPEDIC ATTACHMENT FOR SU-04 FAMED - POLAND SO-11.0 PC DALAM PROSES Rp. 215,688,000.00
1005 ORTHOPEDIC ATTACHMENT FOR SU-02 FAMED - POLAND SO-09.0 PC DALAM PROSES Rp. 225,264,000.00
1006 ORTHOPEDIC ATTACHMENT FOR SU-02 FAMED - POLAND SO-08.3 PC DALAM PROSES Rp. 134,976,000.00
1007 ORTHOPEDIC ATTACHMENT FOR SJ-21 FAMED - POLAND SO-08.2 PC DALAM PROSES Rp. 125,856,000.00
1008 ORTHOPEDIC ATTACHMENT FOR SO-10 FAMED - POLAND SO-07.2 PC DALAM PROSES Rp. 118,104,000.00
1009 Knee Operation Attachment for SU-02 / SJ-21 / SO-10 FAMED - POLAND WS-79.5 PC DALAM PROSES Rp. 6,202,000.00
1010 Knee Support for SU-02 / SJ-21 / SO-10 FAMED - POLAND WS-78.5 PC DALAM PROSES Rp. 5,472,000.00
1011 Knee Support for SU-02 / SU-03 / SU-04 FAMED - POLAND WS-75.5 PC DALAM PROSES Rp. 5,563,000.00
1012 Hip Support for SU-02 / SU-03 / SU-04 / SJ-21 / SO-10 FAMED - POLAND WS-60.5 PC DALAM PROSES Rp. 9,850,000.00
1013 MODULAR TROLLEY FOR OPERATING THEATRES ( SS ) FAMED - POLAND SM-01.0 PC DALAM PROSES Rp. 12,859,000.00
1014 EXAMINATION TABLE FAMED - POLAND SZ-02.0 PC AKL 10903300361 Rp. 77,566,000.00
1015 GYNAECOLOGICAL CHAIR W/ ANGLE ARM REST+CLAMP MECHANISM FAMED - POLAND FG-1 PC DALAM PROSES Rp. 44,221,000.00
1016 GYNAECOLOGICAL CHAIR, ELECTRIC FAMED - POLAND FG-04.0 PC DALAM PROSES Rp. 178,678,000.00

DOC/PT. PPH/200905 Page 27 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

1017 GYNAECOLOGICAL CHAIR, ELECTRIC FAMED - POLAND FG-04.0 ERATO PC DALAM PROSES Rp. 184,372,000.00
1018 GYNAECOLOGICAL CHAIR FAMED - POLAND FG-06.0 PC DALAM PROSES Rp. 80,644,000.00
1019 GYNAECOLOGICAL CHAIR W/ SEAT HEIGHT ADJUSTMENT FAMED - POLAND FG-05.0 PC AKL 211404400185 Rp. 107,730,000.00
1020 FOOT STOOL - TWO STEP FAMED - POLAND WF-03.1 PC DALAM PROSES Rp. 3,283,000.00
1021 OPTHALMIC AND LARYNGOLOGY CHAIR FAMED - POLAND SM-14 A PC DALAM PROSES Rp. 54,019,000.00
1022 CHAIR FOR BLOOD DONORS WITH ARM SUPPORT FAMED - POLAND SM-14 K PC DALAM PROSES Rp. 60,175,000.00
1023 DENTAL UNIT - ELECTRIC FAMED - POLAND PEGAZ EG UNIT DALAM PROSES Rp. 415,992,000.00
1024 DENTAL UNIT - PNEUMATIC FAMED - POLAND PEGAZ PD (US-02.3) UNIT DALAM PROSES Rp. 277,225,000.00
1025 DENTAL UNIT - ELECTRIC FAMED - POLAND FENIKS EG (US-03) UNIT DALAM PROSES Rp. 502,176,000.00
1026 DENTAL SWIVEL STOOL FAMED - POLAND FO-30 UNIT DALAM PROSES Rp. 12,261,000.00
1027 DENTAL SWIVEL STOOL FAMED - POLAND FO-40 UNIT DALAM PROSES Rp. 9,901,000.00
1028 INSTRUMENT TROLLEY (STAINLESS STEEL) FAMED - POLAND ZG-2 UNIT DALAM PROSES Rp. 13,492,000.00
1029 SWIVEL STOOL FAMED - POLAND ZG-3 UNIT DALAM PROSES Rp. 5,335,000.00
1030 EXAMINATION COUCH FAMED - POLAND KL-2 UNIT DALAM PROSES Rp. 8,259,000.00
1031 EXAMINATION COUCH WITH LOCKER FAMED - POLAND KL-4 UNIT DALAM PROSES Rp. 15,134,000.00
1032 EXAMINATION COUCH FAMED - POLAND WG-05.7 UNIT DALAM PROSES Rp. 20,623,000.00
1033 SCREEN FAMED - POLAND PF-1 UNIT DALAM PROSES Rp. 3,335,000.00
1034 SWADDLING TABLE FAMED - POLAND ARTICLE NO. WG-22.0 UNIT DALAM PROSES Rp. 10,260,000.00
1035 BABY CRIB FAMED - POLAND LN-09.0 UNIT DALAM PROSES Rp. 16,467,000.00
1036 TROLLEY PATIENT W/ DRIP BOTTLE HOLDER FAMED - POLAND WP-02.0 UNIT DALAM PROSES Rp. 86,954,000.00
1037 TROLLEY PATIENT W/ DRIP BOTTLE HOLDER, HYD HEIGHT REGULATION FAMED - POLAND WP-03.1 UNIT DALAM PROSES Rp. 48,479,000.00
1038 TROLLEY PATIENT W/ DRIP BOTTLE HOLDER FAMED - POLAND WP-05.0 UNIT DALAM PROSES Rp. 210,587,000.00
1039 DELIVERY BED W/ FOOT REST, KNEE CRUTCHES, HAND GRIP FAMED - POLAND LM-01.3 UNIT AKL 21104300571 Rp. 330,629,000.00
1040 REHABILITATION BED . FAMED - POLAND X-40 DA UNIT AKL 10902300354 Rp. 21,341,000.00
1041 REHABILITATION BED, TOPS FILLED WITH CHIPBOARD, FAMED - POLAND X-46 D UNIT AKL 10902300353 Rp. 32,986,000.00
1042 HOSPITAL BED, ADJUSTABLE THREE SECTIONAL & HEIGHT FAMED - POLAND LW-01.11 UNIT DALAM PROSES Rp. 58,226,000.00
1043 REHAB. BED W/ ELECTRIC DRIVE/WOODEN-TOPS & LOWERING SIDE RAIL FAMED - POLAND LR-03.7 UNIT AKL 10902300356 Rp. 66,639,000.00
1044 REHAB. BED W/ ELECT. DRIVE, CENTRAL WHEEL BLOCKADE FAMED - POLAND LE-02.0 UNIT AKL 209023000338 Rp. 136,304,000.00
1045 REHAB. BED W/ ELECT. DRIVE CENTRAL WHEEL BLOCKADE, SS FAMED - POLAND LE-02.5 UNIT AKL 209023000338 Rp. 244,906,000.00
1046 REHAB. BED W/ ELECT. DRIVE, CENTRAL CONTROL PANEL FAMED - POLAND LE-03 UNIT AKL 20905300156 Rp. 433,485,000.00
1047 REHAB BED W/ ELECT. DRIVE, CENTRAL CONTROL PANEL, SS FAMED - POLAND LE-03 UNIT AKL 20905300156 Rp. 474,525,000.00
1048 REHABILITATION BED W/ ELECTRIC DRIVE, CHROMIUM FAMED - POLAND LE-04 UNIT AKL 20905300156 Rp. 310,365,000.00
1049 REHABILITATION BED W/ ELECTRIC DRIVE, STAINLESS FAMED - POLAND LE-04 UNIT AKL 20905300156 Rp. 351,405,000.00
1050 MULTIPOSITION HOSPITAL BED FOR DIALYSIS FAMED - POLAND LE-01.1 UNIT DALAM PROSES Rp. 61,406,000.00
1051 MULTIPOSITION BED W/ FOLDING SIDE RAIL CHROMIUM PLATE FAMED - POLAND LR-07.0 UNIT DALAM PROSES Rp. 92,443,000.00
1052 REHABILITATION BED W/ HYDRAULIC HEIGHT ADJ. FAMED - POLAND LR-10.0 UNIT AKL 10902300355 Rp. 129,379,000.00
1053 HOSPITAL CHILDREN BED WITH DRIP BOTTLE HOLDER FAMED - POLAND LD-31 UNIT DALAM PROSES Rp. 46,580,000.00
1054 BEDSIDE LOCKER FAMED - POLAND SP-1 UNIT DALAM PROSES Rp. 7,131,000.00

DOC/PT. PPH/200905 Page 28 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

1055 BEDSIDE LOCKER FAMED - POLAND SP-2.2 UNIT DALAM PROSES Rp. 12,825,000.00
1056 WOODEN BEDSIDE LOCKER WITH OVERBED TABLE FAMED - POLAND PW-13 UNIT DALAM PROSES Rp. 17,647,000.00
1057 BEDSIDE TABLE (OVERBED) FAMED - POLAND SP-04.0 UNIT DALAM PROSES Rp. 6,361,000.00
1058 STAND INFUSION HOLDER (MOVABLE) WITH BASKET FAMED - POLAND SK-2 UNIT DALAM PROSES Rp. 3,540,000.00
1059 TRANSPORT TROLLEY FOR DIRTY CLOTHES AND LINEN FAMED - POLAND PW-12 UNIT DALAM PROSES Rp. 8,105,000.00
1060 WATER BATH, CONTENTS 14 LITRES, MICROPROCESSOR CONTROL GFL - GERMANY 1003 UNIT DALAM PROSES Rp. 32,832,000.00
1061 WATER BATH, CONTENTS 40 LITRES, MICROPROCESSOR CONTROL GFL - GERMANY 1005 UNIT DALAM PROSES Rp. 41,450,000.00
1062 MULTIPLE WATERBATH WITH 6 OPENINGS OF 130 MM EACH GFL - GERMANY 1042 UNIT DALAM PROSES Rp. 39,398,000.00
1063 SHAKING WATER BATH, WITH ORBITAL MOTION GFL - GERMANY 1092 UNIT DALAM PROSES Rp. 152,156,000.00
1064 QUADROTHERMAL SHAKING WATER BATH GFL - GERMANY 1070 UNIT DALAM PROSES Rp. 178,083,000.00
1065 WATER STILLS WITH 16 L STORAGE TANK, CAPACITY 8 L/H GFL - GERMANY 2008 UNIT DALAM PROSES Rp. 78,489,000.00
1066 BI DISTILLER, CAPACITY 8 L/H GFL - GERMANY 2108 UNIT DALAM PROSES Rp. 220,334,000.00
1067 SHAKER, RECIPROCATING MOTION, LOAD 8 KG GFL - GERMANY 3006 UNIT DALAM PROSES Rp. 42,887,000.00
1068 SHAKING INCUBATOR W/ MICROPROC. CONTROL 45 L GFL - GERMANY 3032 UNIT DALAM PROSES Rp. 317,444,000.00
1069 TEST TUBE ROTATOR GFL - GERMANY 3025 UNIT DALAM PROSES Rp. 37,603,000.00
1070 CHEST FREEZER, - 50° C TO -85°C, CAPACITY 70 L GFL - GERMANY 6380 UNIT DALAM PROSES Rp. 321,152,000.00
1071 CHEST FREEZER, - 50° C TO -85°C, CAPACITY 30 L GFL - GERMANY 6381 UNIT DALAM PROSES Rp. 312,834,000.00
1072 CHEST FREEZER, - 50° C TO -85°C, CAPACITY 500 L GFL - GERMANY 6385 UNIT DALAM PROSES Rp. 416,364,000.00
1073 OVEN BENCH TOP 5.1 CU.FT. 40 - 350 C W/ DIGITAL CONTROL. HOTPACK - USA 213024 UNIT DALAM PROSES Rp. 294,462,000.00
1074 OVEN FLOOR 9.5 CU.FT SINGLE DOOR W/ DIGITAL CONTROL. HOTPACK - USA 212034 UNIT DALAM PROSES Rp. 714,449,000.00
1075 GLASSWARE DRYER 41 CU. FT., 35 - 180 C HOTPACK - USA 206260 UNIT DALAM PROSES Rp. 368,676,000.00
1076 OVEN, SAFETY . 33 CU.FT., 35 - 120 C HOTPACK - USA 217602 UNIT DALAM PROSES Rp. 881,710,000.00
1077 OVEN, VACUUM 2,3 CU. FT., 40 - 280 C HOTPACK - USA 273800 UNIT DALAM PROSES Rp. 259,270,000.00
1078 INCUBATOR DRYWALL CO2 10 CU. FT. BENCH TOP, 5 - 60 C, HOTPACK - USA 351921 UNIT DALAM PROSES Rp. 664,295,000.00
1079 INCUBATOR DRYWALL CO2 33 CU. FT. FLOOR MODEL, 0 - 60 C HOTPACK - USA 317563 UNIT DALAM PROSES Rp. 869,700,000.00
1080 INCUBATOR SINGLE DOOR 22 CU.FT. 2 TO 55 C HOTPACK - USA 305110 UNIT DALAM PROSES Rp. 337,754,000.00
1081 LIGHT CHAMBER 19 CU. FT., -20 TO 50 C, HOTPACK - USA 352642 UNIT DALAM PROSES Rp. 351,519,000.00
1082 BENCH TOP HUMIDITY CHAMBER 9,7 CU. FT. HOTPACK - USA 435304 UNIT DALAM PROSES Rp. 548,306,000.00
1083 10" CHART RECORDER, 2 PEN CIRC. SIDE MOUNTED OR PLUG IN HOTPACK - USA 890017 UNIT DALAM PROSES Rp. 73,695,000.00
1084 10" CHART RECORDER, 2 PEN CIRC. TOP MOUNTED HOTPACK - USA 890018 UNIT DALAM PROSES Rp. 89,296,000.00
1085 MICROPROCESSOR PROGRAMMER FOR REFRIGERATED MODEL HOTPACK - USA 890014 UNIT DALAM PROSES Rp. 186,812,000.00
1086 CONDENSATE PUMP HOTPACK - USA 103463 UNIT DALAM PROSES Rp. 14,005,000.00
1087 INTERNAL VAPOOR-PROOF DUPLEX RECEPTACLE FOR 33 CU. FT. HOTPACK - USA 890009 UNIT DALAM PROSES Rp. 14,204,000.00
1088 INTERNAL VAPOOR PROOF LIGHT, OPERABLE FROM EXTERNAL SWC. HOTPACK - USA 890000 UNIT DALAM PROSES Rp. 20,469,000.00
1089 DEIONIZED ( DI ) WALL MOUNTED INCLUDES 3 RESIN PACK. HOTPACK - USA 485025 UNIT DALAM PROSES Rp. 47,401,000.00
1090 ACCESS PORT 1" OUTSIDE DIAMETER HOTPACK - USA 890004 PC DALAM PROSES Rp. 19,591,000.00
1091 ACCESS PORT 2" OUTSIDE DIAMETER HOTPACK - USA 890005 PC DALAM PROSES Rp. 19,591,000.00
1092 ACCESS PORT 3" OUTSIDE DIAMETER HOTPACK - USA 890006 PC DALAM PROSES Rp. 19,591,000.00

DOC/PT. PPH/200905 Page 29 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

1093 BIOLOGICAL SAFETY CABINET 4 FT. WIDE FLOOR MODEL HOTPACK - USA CLASS II TYPE A/B3 UNIT DALAM PROSES Rp. 484,147,000.00
1094 REFRIGERATOR FLOOR MODEL 19 CU FT HOTPACK - USA 852600 UNIT DALAM PROSES Rp. 94,962,000.00
1095 FREEZER FLOOR MODEL 19 CU FT HOTPACK - USA 952600 UNIT DALAM PROSES Rp. 108,129,000.00
1096 FREEZER FLOOR MODEL 22 CU FT HOTPACK - USA 901100 UNIT DALAM PROSES Rp. 203,809,000.00
1097 BLOOD STORAGE REFRIGERATOR 27 CU. FT HOTPACK - USA 827170 UNIT DALAM PROSES Rp. 406,701,000.00
1098 BLOOD STORAGE REFRIGERATOR, 49 CU FT HOTPACK - USA 849170 UNIT DALAM PROSES Rp. 523,209,000.00
1099 STERILIZER, SINGLE VERTICAL SLIDING DOOR, ELECTRIC,113 L HOTPACK - USA HL 161626 - SCE UNIT DALAM PROSES Rp. 2,175,787,000.00
1100 STERILIZER, SINGLE VERTICAL SLIDING DOOR, ELECTRIC, 250 L HOTPACK - USA HL 202038 - SCE UNIT DALAM PROSES Rp. 2,393,681,000.00
1101 STERILIZER, STEAM POWER, 432 L. (REQUIRED STEAM BOILER) HOTPACK - USA HL 262639 - DRS UNIT DALAM PROSES Rp. 4,006,239,000.00
1102 STERILIZER, STEAM POWER, 598 L. (REQUIRED STEAM BOILER) HOTPACK - USA HL 263639 - DRS UNIT DALAM PROSES Rp. 4,327,793,000.00
1103 STERILIZER, STEAM POWER, 920 L. (REQUIRED STEAM BOILER) HOTPACK - USA HL 263660 - DRS UNIT DALAM PROSES Rp. 4,834,922,000.00
1104 PROTECTIVE GLOVE, 0.35 MMPB NANKAI - JAPAN G-1 PC DALAM PROSES Rp. 13,120,000.00
1105 PROTECTIVE GLOVE, 0,42 MMPB NANKAI - JAPAN G-1 PC DALAM PROSES Rp. 13,878,000.00
1106 PROTECTIVE GLOVE, 0,50 MMPB NANKAI - JAPAN G-1 PC DALAM PROSES Rp. 17,202,000.00
1107 SAFE LIGHT, ONE SIDE NANKAI - JAPAN N1602 PC DALAM PROSES Rp. 3,207,000.00
1108 SAFE LIGHT, THREE SIDE NANKAI - JAPAN N1602 PC DALAM PROSES Rp. 8,863,000.00
1109 SAFETY LIGHT/DARK ROOM LAMP, ONE FACE NANKAI - JAPAN NH-30 PC DALAM PROSES Rp. 2,969,000.00
1110 LEAD APRON, 0.25 MMPB, SIZE S NANKAI - JAPAN SA 1B PC DALAM PROSES Rp. 15,452,000.00
1111 LEAD APRON, 0.25 MMPB, SIZE M NANKAI - JAPAN SA 1B PC DALAM PROSES Rp. 16,910,000.00
1112 LEAD APRON, 0.25 MMPB, SIZE L NANKAI - JAPAN SA 1B PC DALAM PROSES Rp. 17,493,000.00
1113 LEAD APRON, 0.35 MMPB, SIZE S NANKAI - JAPAN SA 1B PC DALAM PROSES Rp. 17,143,000.00
1114 LEAD APRON, 0.35 MMPB, SIZE M NANKAI - JAPAN SA 1B PC DALAM PROSES Rp. 20,409,000.00
1115 LEAD APRON, 0.35 MMPB, SIZE L NANKAI - JAPAN SA 1B PC DALAM PROSES Rp. 21,692,000.00
1116 LEAD APRON, 0.50 MMPB, SIZE S NANKAI - JAPAN SA 1B PC DALAM PROSES Rp. 20,001,000.00
1117 LEAD APRON, 0.50 MMPB, SIZE M NANKAI - JAPAN SA 1B PC DALAM PROSES Rp. 21,284,000.00
1118 LEAD APRON, 0.50 MMPB, SIZE L NANKAI - JAPAN SA 1B PC DALAM PROSES Rp. 21,808,000.00
1119 INTENSIFYING SCREEN, BLUE SENSITIVE 18 X 24 CM NANKAI - JAPAN DMS (N1210) PC DALAM PROSES Rp. 1,808,000.00
1120 INTENSIFYING SCREEN, BLUE SENSITIVE 24 X 30 CM NANKAI - JAPAN DMS (N1210) PC DALAM PROSES Rp. 2,857,000.00
1121 INTENSIFYING SCREEN, BLUE SENSITIVE 30 X 40 CM NANKAI - JAPAN DMS (N1210) PC DALAM PROSES Rp. 4,723,000.00
1122 INTENSIFYING SCREEN, BLUE SENSITIVE 35 X 35 CM NANKAI - JAPAN DMS (N1210) PC DALAM PROSES Rp. 4,723,000.00
1123 INTENSIFYING SCREEN, BLUE SENSITIVE 35 X 43 CM NANKAI - JAPAN DMS (N1210) PC DALAM PROSES Rp. 8,047,000.00
1124 INTENSIFYING SCREEN, BUT GREEN SENSITIVE 18 X 24 CM NANKAI - JAPAN LUS (1210) PC DALAM PROSES Rp. 4,432,000.00
1125 INTENSIFYING SCREEN, BUT GREEN SENSITIVE 24 X 30 CM NANKAI - JAPAN LUS (1210) PC DALAM PROSES Rp. 6,881,000.00
1126 INTENSIFYING SCREEN, BUT GREEN SENSITIVE 30 X 40 CM NANKAI - JAPAN LUS (1210) PC DALAM PROSES Rp. 11,487,000.00
1127 INTENSIFYING SCREEN, BUT GREEN SENSITIVE 35 X 35 CM NANKAI - JAPAN LUS (1210) PC DALAM PROSES Rp. 11,487,000.00
1128 INTENSIFYING SCREEN, BUT GREEN SENSITIVE 35 X 43 CM NANKAI - JAPAN LUS (1210) PC DALAM PROSES Rp. 23,674,000.00
1129 FILM CASSETTE 18 X 24 CM NANKAI - JAPAN PL-B (N1203) PC DALAM PROSES Rp. 4,607,000.00
1130 FILM CASSETTE 24 X 30 CM NANKAI - JAPAN PL-B (N1203) PC DALAM PROSES Rp. 5,207,000.00

DOC/PT. PPH/200905 Page 30 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

1131 FILM CASSETTE 30 X 40 CM NANKAI - JAPAN PL-B (N1203) PC DALAM PROSES Rp. 6,706,000.00
1132 FILM CASSETTE 35 X 35 CM NANKAI - JAPAN PL-B (N1203) PC DALAM PROSES Rp. 6,706,000.00
1133 FILM CASSETTE 35 X 43 CM NANKAI - JAPAN PL-B (N1203) PC DALAM PROSES Rp. 7,872,000.00
1134 FILM HANGER (ANY SIZE) NANKAI - JAPAN N1506 PC DALAM PROSES Rp. 1,050,000.00
1135 X-RAY FILM DRYER 16 FILMS NANKAI - JAPAN FD-16 (N1517) PC DALAM PROSES Rp. 128,284,000.00
1136 X-RAY FILM DRYER 24 FILMS NANKAI - JAPAN FD-24 (N1518) PC DALAM PROSES Rp. 157,440,000.00
1137 FILM MARKER SET, ALPHA NUMBER NANKAI - JAPAN N1462 PC DALAM PROSES Rp. 5,714,000.00
1138 FILM VIEWER NANKAI - JAPAN LH-2K PC DALAM PROSES Rp. 30,216,000.00
1139 ID PRINTER TYPE A2 NANKAI - JAPAN 28 PC DALAM PROSES Rp. 137,031,000.00
1140 X RAY GRID, 34 LINES SIZE 18 X 24 CM NANKAI - JAPAN 1301 PC DALAM PROSES Rp. 8,164,000.00
1141 X RAY GRID, 34 LINES SIZE 24 X 30 CM NANKAI - JAPAN 1301 PC DALAM PROSES Rp. 9,446,000.00
1142 X RAY GRID, 34 LINES SIZE 35 X 35 CM NANKAI - JAPAN 1301 PC DALAM PROSES Rp. 21,284,000.00
1143 X RAY GRID, 34 LINES SIZE 30 X 40 CM NANKAI - JAPAN 1301 PC DALAM PROSES Rp. 13,586,000.00
1144 X RAY GRID, 34 LINES SIZE 35 X 43 CM NANKAI - JAPAN 1301 PC DALAM PROSES Rp. 23,674,000.00
1145 DRESSING STERILIZING CASE NANKAI - JAPAN B-1 PC DALAM PROSES Rp. 4,347,000.00
1146 DRESSING STERILIZING CASE NANKAI - JAPAN B-2 PC DALAM PROSES Rp. 4,750,000.00
1147 LENSMETER, OCULAR TYPE NIKON - JAPAN OL-7 UNIT DALAM PROSES Rp. 68,092,000.00
1148 SLIT LAMP ( Mag 33 X Without Motorized Table ) NIKON - JAPAN NS-1V UNIT DALAM PROSES Rp. 250,098,000.00
1149 SLIT LAMP ( Mag 33 X Without Motorized Table ) NIKON - JAPAN FS-3V UNIT DALAM PROSES Rp. 382,262,000.00
1150 ASPHERICAL LENS IN CASE NIKON - JAPAN 20D UNIT DALAM PROSES Rp. 7,975,000.00
1151 ASPHERICAL LENS IN CASE NIKON - JAPAN 28D UNIT DALAM PROSES Rp. 9,330,000.00
1152 ASPHERICAL LENS IN CASE NIKON - JAPAN 90D UNIT DALAM PROSES Rp. 12,979,000.00
1153 AUTOREFRACTO-KERATOMETER Without Motorized Table NIKON - JAPAN SPEEDY K UNIT DALAM PROSES Rp. 518,109,000.00
1154 SNELLEN CHART ELECTRIC, STAND TYPE NIKON - JAPAN CLEMENT CLARKE - UK UNIT DALAM PROSES Rp. 59,252,000.00
1155 SNELLEN CHART ELECTRIC, WALL TYPE NIKON - JAPAN CLEMENT CLARKE - UK UNIT DALAM PROSES Rp. 49,197,000.00
1156 MOTORIZED INSTRUMENT TABLE NIKON - JAPAN UNIT DALAM PROSES Rp. 24,453,000.00
1157 RESPIRATORY POLIGRAPH WITH ANALYSIS SOFTWARE SIBELMED - SPAIN SIBELHOME-300 UNIT DALAM PROSES Rp. 313,380,000.00
1158 MECHANICAL SCALE FOR MEDICAL USE SIBELMED - SPAIN MB201 UNIT DALAM PROSES Rp. 12,398,000.00
1159 MECHANICAL SCALE FOR MEDICAL USE WITH HEIGHT ROD SIBELMED - SPAIN MB201T (403-100-00T) UNIT DALAM PROSES Rp. 33,891,000.00
1160 MECHANICAL SCALE WITH TILTABLE HEADSTOCK SIBELMED - SPAIN MB301 (403-200-000) UNIT DALAM PROSES Rp. 10,784,000.00
1161 ELECTRONIC PERSONAL SCALE SIBELMED - SPAIN MB401 (403-300-000) UNIT DALAM PROSES Rp. 42,454,000.00
1162 BABY SCALES SIBELMED - SPAIN BASIC SP2 UNIT DALAM PROSES Rp. 22,176,000.00
1163 MICROPACH PACHYMETER SONOMED - USA SONOMED 200 P UNIT DALAM PROSES Rp. 293,531,000.00
1164 SCAN SYSTEM SONOMED - USA A-1500 A UNIT DALAM PROSES Rp. 343,441,000.00
1165 SCAN SYSTEM PORTABLE SONOMED - USA B-1500 B UNIT DALAM PROSES Rp. 676,546,000.00
1166 PACHYMETER, WITHOUT PRINTER SONOMED - USA MICROPACH 2 UNIT DALAM PROSES Rp. 238,033,000.00
1167 PRINTER SONOMED - USA UNIT DALAM PROSES Rp. 38,706,000.00
1168 SCAN ULTRASOUND SONOMED - USA A - 5500 A UNIT DALAM PROSES Rp. 409,042,000.00

DOC/PT. PPH/200905 Page 31 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

1169 SCAN ULTRASOUND SONOMED - USA A - 5500 B UNIT DALAM PROSES Rp. 794,593,000.00
1170 SCAN SYSTEM SONOMED - USA A/B - 5500 A/B UNIT DALAM PROSES Rp. 1,088,808,000.00
1171 PACHYMETER SONOMED - USA SONOMED 300 P UNIT DALAM PROSES Rp. 235,503,000.00
1172 EMERGENCY VENTILATOR ELECTRONIC, NO OVERPRESSURE ALARM SPENCER - ITALY SPENCER 170 UNIT DALAM PROSES Rp. 76,334,000.00
1173 EMERGENCY VENTILATOR ELECTRONIC, 55 CM H20 ELECTRO.OVERPRESS ALRM SPENCER - ITALY SPENCER 190 UNIT AKL 20403403352 Rp. 113,270,000.00
1174 EMERGENCY VENTILATOR ELECTRONIC, NO OVERPRESSURE ALARM, WITH OXYGEN TANK, FACEM SPENCER - ITALY KOMPAK 170 UNIT DALAM PROSES Rp. 102,805,000.00
1175 SILICON MANUAL RESUSCITATOR WITH OVERPRESSURE VALVE AND RESERVOIR, TWO MASK, AD SPENCER - ITALY BG-04010 A B-LIFE SET DALAM PROSES Rp. 9,911,000.00
1176 SILICON MANUAL RESUSCITATOR WITH OVERPRESSURE VALVE AND RESERVOIR, TWO MASK, PE SPENCER - ITALY BG-04020 A B-LIFE SET DALAM PROSES Rp. 9,911,000.00
1177 SILICON MANUAL RESUSCITATOR WITH OVERPRESSURE VALVE AND RESERVOIR, TWO MASK, NE SPENCER - ITALY BG-04040 A B-LIFE SET DALAM PROSES Rp. 9,911,000.00
1178 INTUBATION KIT COMPLETE WITH FIBER OPTIC LARYNGOSCOPE SPENCER - ITALY SPENCER DG-80014 E SET DALAM PROSES Rp. 26,594,000.00
1179 EMERGENCY MEDICAL SET, ADULT (0,5 L OXYGEN TANK) SPENCER - ITALY ALERT CB-06020 A SET DALAM PROSES Rp. 31,396,000.00
1180 EMERGENCY MEDICAL SET, PEDIATRIC (0,5 L OXYGEN TANK) SPENCER - ITALY ALERT CB-06025 A SET DALAM PROSES Rp. 31,519,000.00
1181 EMERGENCY MEDICAL SET, ADULT (2 L OXYGEN TANK) SPENCER - ITALY LIENZ CB-06022 A SET DALAM PROSES Rp. 38,413,000.00
1182 EMERGENCY MEDICAL SET, PEDIATRIC (2 L OXYGEN TANK) SPENCER - ITALY LIENZ CB-06029 A SET DALAM PROSES Rp. 38,229,000.00
1183 TONGUE SEIZING FORCEPS-STAINESS STEEL, COLLIN SPENCER - ITALY RM-30300 A PC DALAM PROSES Rp. 394,000.00
1184 TONGUE FORCEPS STAINLESS STEEL YOUNG SPENCER - ITALY RM-30400 A PC DALAM PROSES Rp. 431,000.00
1185 MAGILL FORCEPS ADULT SPENCER - ITALY FG-00605 A PC DALAM PROSES Rp. 369,000.00
1186 MAGILL FORCEPS PEDIATRIC SPENCER - ITALY FG-00607 A PC DALAM PROSES Rp. 369,000.00
1187 EMRGENCY ORAL AIRWAY SET SPENCER - ITALY BERMAN RM-10210 A SET DALAM PROSES Rp. 259,000.00
1188 EMRGENCY ORAL AIRWAY SET SPENCER - ITALY GUEDEL RM-10310 A SET DALAM PROSES Rp. 374,000.00
1189 MOUTHWEDGE SPENCER - ITALY FG-08810 A PC DALAM PROSES Rp. 123,000.00
1190 JAW SPREADER SPENCER - ITALY RM-30700 A PC DALAM PROSES Rp. 203,000.00
1191 EMERGENCY BOARD (RESCUE BOARD) SPENCER - ITALY RB-70000 A UNIT DALAM PROSES Rp. 1,954,000.00
1192 ROLL-IN-COT STRETCHER SPENCER - ITALY ST-40010 A + 40300 A UNIT DALAM PROSES Rp. 89,156,000.00
1193 ROLL-IN-COT STRETCHER VARIABLE HEIGHT WITH FOWLER SPENCER - ITALY ST-40020 A + 40400 A UNIT DALAM PROSES Rp. 104,099,000.00
1194 ROLL-ON ROLL-OFF STRETCHER SPENCER - ITALY 510-506 UNIT DALAM PROSES Rp. 113,917,000.00
1195 EMERGENCY EASY-FOLDING STRETCHER, WITH ADJUSTABLE BACKREST SPENCER - ITALY ST30310A UNIT DALAM PROSES Rp. 16,867,000.00
1196 SCOOP STRETCHER FOLDING ORANGE, AND CARRYING CASE SPENCER - ITALY ST05100A UNIT DALAM PROSES Rp. 18,468,000.00
1197 BASKET STRETCHER TWIN SHELL, AND CARRYING CASE SPENCER - ITALY ST04020A UNIT DALAM PROSES Rp. 26,101,000.00
1198 SPINE BOARD SPENCER ROCK, ORANGE SPENCER - ITALY ST02030A UNIT DALAM PROSES Rp. 7,449,000.00
1199 FOLDING ALUMINIUM SPINE BOARD, PORTA-LOC SPENCER - ITALY ST02000B UNIT DALAM PROSES Rp. 16,437,000.00
1200 SPINE BOARD ABS TECH, BLUE SPENCER - ITALY ST02072C UNIT DALAM PROSES Rp. 11,450,000.00
1201 IMMOBILIZER UNIVERSAL HEAD, SPENCER CONTOUR SPENCER - ITALY SH00200A UNIT DALAM PROSES Rp. 4,494,000.00
1202 IMMOBOLIZER SYSTEM PAEDIATRIC, PEDI-LOC SPENCER - ITALY ST02600C UNIT DALAM PROSES Rp. 10,342,000.00
1203 EXTRICATION COLLAR SET OF 3 SIZE, WITH BAG SPENCER - ITALY QC22500A SET DALAM PROSES Rp. 2,278,000.00
1204 EXTRICATION COLLAR SET OF 5 SIZE, WITH BAG SPENCER - ITALY QC22506A SET DALAM PROSES Rp. 3,817,000.00
1205 EMERGENCY VACUUM COLLAR (RESCUE CERVI) SPENCER - ITALY QC22150A PC DALAM PROSES Rp. 1,416,000.00
1206 EXTRICATION SPINE SPLINT SPENCER - ITALY SR00170A PC DALAM PROSES Rp. 7,510,000.00

DOC/PT. PPH/200905 Page 32 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

1207 EXTRICATION DEVICE, SED SPENCER - ITALY SR00111B PC DALAM PROSES Rp. 5,171,000.00
1208 TRAUMA AIR PANTS, ADULT SPENCER - ITALY AK01000A PC DALAM PROSES Rp. 26,286,000.00
1209 TRAUMA AIR PANTS, CHILD SPENCER - ITALY AK01011A PC DALAM PROSES Rp. 26,286,000.00
1210 AIR/PNEUMATIC SPLINT SET OF 6 SIZE WITH BAG, ECO SPENCER - ITALY QS24200A SET DALAM PROSES Rp. 3,644,000.00
1211 SPLINT 2 SIZES WITH BAG (FRACTUR KIT) SPENCER - ITALY QC70090A SET DALAM PROSES Rp. 4,248,000.00
1212 ADULT TRACTION SPLINT SPENCER - ITALY SR-01010 A PC DALAM PROSES Rp. 8,988,000.00
1213 PEDIATRIC TRACTION SPLINT SPENCER - ITALY SR-02020D PC DALAM PROSES Rp. 8,557,000.00
1214 VACUUM RESCUE SPLINT SPENCER - ITALY QM-22500 A PC DALAM PROSES Rp. 10,356,000.00
1215 VACUUM MATTRESS SPENCER - ITALY QM-22206 A RES-Q-MATT PC DALAM PROSES Rp. 7,530,000.00
1216 VACUUM MATTRESS WITH POHRETEX SPENCER - ITALY QM-22100 A RES-Q-MATT PLUS PC DALAM PROSES Rp. 14,159,000.00
1217 VACUUM MATTRESS POLYSTIRENE SPENCER - ITALY QM-22101 A RES-Q-MATT PLUS PC DALAM PROSES Rp. 11,635,000.00
1218 BURN KIT SPENCER - ITALY BS-05000 D SET DALAM PROSES Rp. 3,971,000.00
1219 FIRST AID KIT SPENCER - ITALY MX-03005 G SET DALAM PROSES Rp. 9,049,000.00
1220 AUTOMATIC TOURNIQUET SPENCER - ITALY IF - 00100 C SET DALAM PROSES Rp. 419,000.00
1221 INSTRUMENT TRAY W/COVER, 325 L X 265 X 640 MM SUGICO - JAPAN SH 1502/1500 PC DALAM PROSES Rp. 1,696,000.00
1222 INSTRUMENT TRAY W/COVER, 530 L X 162 X 64 MM SUGICO - JAPAN SH 1502L/1500L PC DALAM PROSES Rp. 1,961,000.00
1223 INSTRUMENT TRAY W/COVER, 325 L X 265 X 102 MM SUGICO - JAPAN SH 1504/1500 PC DALAM PROSES Rp. 2,067,000.00
1224 INSTRUMENT TRAY W/COVER, 530 L X 162 X 102 MM SUGICO - JAPAN SH 1504L/1500L PC DALAM PROSES Rp. 2,385,000.00
1225 THERMOMETER JAR, 28 MM DIA. X 93 MM H SUGICO - JAPAN SH 504 PC DALAM PROSES Rp. 387,000.00
1226 BASIN KIDNEY, 254 MM L X 115 MM W X 52 MM H SUGICO - JAPAN SH 505 PC DALAM PROSES Rp. 429,000.00
1227 CATHETER TRAY 217 L X 80 W X 386 MM SUGICO - JAPAN SH 508 PC DALAM PROSES Rp. 742,000.00
1228 DRESSING JAR 2,2L CAP 124 MM DIA. X 175 MM H SUGICO - JAPAN SH 514 PC DALAM PROSES Rp. 1,219,000.00
1229 BOWL SPONGE 0,9 L 149 MM DIA. X 64 MM H SUGICO - JAPAN SH 519 PC DALAM PROSES Rp. 403,000.00
1230 FORCEPS JAR, 964 DIA X 187 MM H SUGICO - JAPAN SH 532 PC DALAM PROSES Rp. 1,166,000.00
1231 MALE URINALS 1.5 LT SUGICO - JAPAN SH 550 PC DALAM PROSES Rp. 1,971,000.00
1232 FEMALE URINALS 1.2 LT SUGICO - JAPAN SH 550 E PC DALAM PROSES Rp. 1,854,000.00
1233 FEMALE URINALS 1.1 LT SUGICO - JAPAN SH 550 F PC DALAM PROSES Rp. 1,854,000.00
1234 FEMALE URINALS 1.7 LT SUGICO - JAPAN SH 550 U PC DALAM PROSES Rp. 1,714,000.00
1235 BED PANS 356 X 289 X 104 MM SUGICO - JAPAN SH 600 PC DALAM PROSES Rp. 2,741,000.00
1236 BED PANS CHILD 311 X 241 X 91 MM SUGICO - JAPAN SH 600 C PC DALAM PROSES Rp. 2,309,000.00
1237 FRACTURE BED PANS SUGICO - JAPAN SH 600 F PC DALAM PROSES Rp. 1,353,000.00
1238 BED PANS WITH HANDLE ADULT 356 X 289 X 104 MM SUGICO - JAPAN SH 600 H PC DALAM PROSES Rp. 2,916,000.00
1239 ROUND BED PANS W/ COVER OUTSIDE TOP DIA. 309 MM SUGICO - JAPAN SH 600 R PC DALAM PROSES Rp. 2,099,000.00
1240 FRACTURE BED PANS WITH COVER SUGICO - JAPAN SH 600 WF PC DALAM PROSES Rp. 1,825,000.00
1241 BED PANS WITH HANDLE ADULT 356 X 289 X 104 MM SUGICO - JAPAN SH 600 WH PC DALAM PROSES Rp. 3,073,000.00
1242 DRESSING DRUM, 270 MM DIA X 180 MM (MEDIUM) SUGICO - JAPAN SH 6014 B PC DALAM PROSES Rp. 3,650,000.00
1243 DRESSING DRUM, 90 MM DIA X 75 MM (SMALL) SUGICO - JAPAN SH 6014 C PC DALAM PROSES Rp. 1,510,000.00
1244 DRESSING DRUM, 390 MM DIA X 250 MM (LARGE) SUGICO - JAPAN SH 6014 K PC DALAM PROSES Rp. 13,586,000.00

DOC/PT. PPH/200905 Page 33 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

1245 INSTRUMENT CASE BOXES, 240 MM L X 180 MM W X 70 MM D SUGICO - JAPAN SH 6015 A PC DALAM PROSES Rp. 2,916,000.00
1246 INSTRUMENT CASE BOXES, 270 MM L X 210 MM W X 70 MM D SUGICO - JAPAN SH 6015 B PC DALAM PROSES Rp. 3,044,000.00
1247 DRESSING STERILIZING CASES, 300 MM L X 240 MM W X 75 H SUGICO - JAPAN SH 6115 PC DALAM PROSES Rp. 4,566,000.00
1248 DRESSING STERILIZING CASES, 360 MM L X 300 MM W X 75 H SUGICO - JAPAN SH 6117 PC DALAM PROSES Rp. 5,633,000.00
1249 DRESSING JAR W/ COVER CAPACITY 235 CC SUGICO - JAPAN SH 621 PC DALAM PROSES Rp. 846,000.00
1250 DRESSING JAR W/ COVER CAPACITY 530 CC SUGICO - JAPAN SH 622 PC DALAM PROSES Rp. 933,000.00
1251 STAINLESS STEEL WARE SET (8 ITEM) SUGICO - JAPAN VARIOUS PC DALAM PROSES Rp. 9,844,000.00
1252 CHART PROJECTOR, TABLE TYPE W/ R. CONTROL & SCREEN BOARD TAKAGI - JAPAN CP-30B UNIT DALAM PROSES Rp. 93,143,000.00
1253 OPERATING MICROSCOPE WALL TYPE TAKAGI - JAPAN OM-5 W UNIT DALAM PROSES Rp. 282,025,000.00
1254 OPERATING MICROSCOPE FLOOR STAND ENT TYPE TAKAGI - JAPAN OM-5 S - ENT UNIT DALAM PROSES Rp. 311,705,000.00
1255 OPERATING MICROSCOPE FLOOR STAND TYPE TAKAGI - JAPAN OM-5 S UNIT DALAM PROSES Rp. 298,920,000.00
1256 OPERATING MICROSCOPE FLOOR STAND TYPE TAKAGI - JAPAN OM-10 UNIT DALAM PROSES Rp. 438,677,000.00
1257 LENSMETER, OCULAR TYPE TMI - JAPAN LMCT UNIT DALAM PROSES Rp. 36,628,000.00
1258 PHOROPTER TMI - JAPAN ST-VX UNIT DALAM PROSES Rp. 156,927,000.00
1259 SLIT LAMP, WITHOUT MOTORIZED TABLE TMI - JAPAN SL-7X UNIT DALAM PROSES Rp. 148,955,000.00
1260 TRIAL FRAME, UNIVERSAL TMI - JAPAN # 26 UNIT DALAM PROSES Rp. 7,469,000.00
1261 TRIAL LENS SET TMI - JAPAN # 94 SET DALAM PROSES Rp. 59,539,000.00
1262 TRIAL FRAME TMI - JAPAN UNIVERSAL UNIT DALAM PROSES Rp. 7,900,000.00
1263 MORTUARY REFRIGERATION UNIT UFSK - GERMANY LKZ HS 4D UNIT DALAM PROSES Rp. 375,516,000.00
1264 DISSECTING TABLE HEIGHT ADJ. & REVOLVING W/ COLOMN UFSK - GERMANY ST HS 1 UNIT DALAM PROSES Rp. 432,288,000.00
1265 DISSECTING TABLE FIXED TYPE WITHOUT SINK UFSK - GERMANY ST HS 6 UNIT DALAM PROSES Rp. 55,404,000.00
1266 DISSECTING TABLE W/ INSTAL. COLUMN DISS PLATE &MOVEABLE RACK UFSK - GERMANY ST 8043 UNIT DALAM PROSES Rp. 263,340,000.00
1267 UNIVERSAL-HYDRAULIC-TRANSPORTER UFSK - GERMANY HT 2000 UNIT DALAM PROSES Rp. 122,436,000.00
1268 ORGAN TABLE, STAINLESS STEEL UFSK - GERMANY Organ Table UNIT DALAM PROSES Rp. 34,884,000.00
1269 NECK SUPPORT, STAINLESS STEEL UFSK - GERMANY Neck Support UNIT DALAM PROSES Rp. 3,762,000.00
1270 BODY SUPPORT, PVC UFSK - GERMANY Body Support UNIT DALAM PROSES Rp. 6,156,000.00
1271 CLEAN CUT W/ EXTRACTOR SYSTEM COMPLETE & 5 KIND OF BLADE UFSK - GERMANY CNS3A-230 EU UNIT DALAM PROSES Rp. 269,154,000.00
1272 CLEAN CUT W/ EXTRACTOR SYSTEM COMPLETE & 1 KIND OF BLADE UFSK - GERMANY CNS3A-230 EU UNIT DALAM PROSES Rp. 245,556,000.00
1273 DEPTH GUAGE DIAM 63,5 MM UFSK - GERMANY 27272 UNIT DALAM PROSES Rp. 6,498,000.00
1274 HEXAGON WRENCH FOR CLADE CLAMPING UFSK - GERMANY 204903 UNIT DALAM PROSES Rp. 2,736,000.00
1275 BLOOD BANK REFRIGERATOR, SS. W/ 2 DRAWERS UFSK - GERMANY TC 501-1 C UNIT DALAM PROSES Rp. 261,288,000.00
1276 BLOOD BANK REFRIGERATOR, SS. W/ 5 DRAWERS UFSK - GERMANY TC 504-1 C UNIT DALAM PROSES Rp. 409,716,000.00
1277 REFRIGERATOR, MEDICAL SS. W/ 4 STANDARD GRIDS UFSK - GERMANY TC 105-1 C UNIT DALAM PROSES Rp. 270,180,000.00
1278 FREEZER, LABORATORY DEEP SS. W/ 4 STANDARD GRIDS UFSK - GERMANY TC 211-1 C UNIT DALAM PROSES Rp. 327,636,000.00
1279 MOBILE OPERATING TABLE UFSK - GERMANY 600 XLE UNIT DALAM PROSES Rp. 759,620,000.00
1280 MOBILE OPERATING TABLE UFSK - GERMANY BL-400 UNIT DALAM PROSES Rp. 393,851,000.00
1281 MOBILE OPERATING TABLE UFSK - GERMANY BL-400 XL UNIT DALAM PROSES Rp. 464,645,000.00
1282 MOBILE OPERATING TABLE UFSK - GERMANY BL-400XLE UNIT DALAM PROSES Rp. 626,055,000.00

DOC/PT. PPH/200905 Page 34 of 35


DAFTAR HARGA & KEAGENAN ALAT-ALAT MEDIS
PT PUTRIA PRATAMA HAYU
Kondisi harga :
- Kurs US $ = Rp 9.500,-
- Franko lokasi
- Sudah termasuk PPN 10%
- Sudah termasuk biaya instalasi, uji coba, uji fungsi, training operator dan training teknisi
- Garansi 2 (dua) tahun dan layananafter sales service 8 (delapan) tahun
- Preventive maintenance 4 (empat) kali kunjungan per tahun selama 2 (dua) tahun dan 2 (dua) kali kunjungan per tahun selama 8 (delapan) tahun

NO. NAMA BARANG / PRODUK MERK & NEGARA ASAL TYPE SATUAN NO. REGISTRASI HARGA

1283 MOBILE STRETCHER UFSK - GERMANY STRETCHER XLE UNIT DALAM PROSES Rp. 365,061,000.00
1284 MOBILE STRETCHER UFSK - GERMANY BL-2002 UNIT DALAM PROSES Rp. 336,272,000.00
1285 TWO STATION SCRUB SINK WHITE HALL - USA 4102 UNIT DALAM PROSES Rp. 328,491,000.00
1286 MOUNTING CARRIER (ACCESSORIES FOR TWO SCRUB) WHITE HALL - USA MC UNIT DALAM PROSES Rp. 21,147,000.00
1287 PEDESTAL BASE (ACCESSORIES FOR TWO SCRUB) WHITE HALL - USA PB UNIT DALAM PROSES Rp. 27,645,000.00
1288 SOAP DISPENSER (ACCESSORIES FOR TWO SCRUB) WHITE HALL - USA PDM UNIT DALAM PROSES Rp. 28,785,000.00
1289 ONE STATION SCRUB SINK WHITE HALL - USA 4101 UNIT DALAM PROSES Rp. 267,045,000.00
1290 MOUNTING CARRIER (ACCESSORIES) WHITE HALL - USA MC UNIT DALAM PROSES Rp. 19,380,000.00
1291 PEDESTAL BASE (ACCESSORIES) WHITE HALL - USA PB UNIT DALAM PROSES Rp. 20,406,000.00
1292 SOAP DISPENSER (ACCESSORIES) WHITE HALL - USA PDM UNIT DALAM PROSES Rp. 14,421,000.00

DOC/PT. PPH/200905 Page 35 of 35


PRICE LIST
SCHMIDT BIOMEDTECH INDONESIA
SURGICAL, CRITICAL CARE, DIAGNOSTIG IMAGING AND AGFA
NO MERK/PABRIK TYPE COUNTRY REGISTRASI SATUAN CURRENCY HJSA SOLE AGENT

CRITICAL CARE
1 VERSAMED VENTILATOR Ivent 201 IC/AB USA AKL20403500096 Unit US$ 37,000 Schmidt Biomedtech Indonesia
2 ANALOGIC PATIENT MONITOR
LIGFEGARD AN4000C USA AKL20502500171 unit US$ 9,000 Schmidt Biomedtech Indonesia
AN4000CP USA AKL20502500171 unit US$ 11,250 Schmidt Biomedtech Indonesia
FETALGARD (CTG) AP1S USA AKL 20902500173 unit US$ 7,600 Schmidt Biomedtech Indonesia
AP1T USA AKL 20902500173 unit US$ 8,850 Schmidt Biomedtech Indonesia
HCS USA AKL 20902500173 unit US$ 6,225 Schmidt Biomedtech Indonesia
HCT USA AKL 20902500173 unit US$ 7,876 Schmidt Biomedtech Indonesia
LIFEGARD II AN 4320 USA AKL 20502500172 unit US$ 11,714 Schmidt Biomedtech Indonesia
LIFEGARD II +PRINTER AN4320 USA AKL 20502500172 unit US$ 14,857 Schmidt Biomedtech Indonesia
LIFEGARD II+CO2 AN321P USA AKL 20502500172 unit US$ 18,570 Schmidt Biomedtech Indonesia
LIFEGARD II+ICG AN4322P USA AKL 20502500172 unit US$ 40,290 Schmidt Biomedtech Indonesia
LIFEGARD II_CO2+ICG AN4322P USA AKL 20502500172 unit US$ 50,000 Schmidt Biomedtech Indonesia
3 HEYER ANASTHESIA MACHINE 2 GAS Germany AKL 20403500268 1 unit-set Euro 48,000 Schmidt Biomedtech Indonesia
3 GAS Germany AKL 20403500268 1 unit-set Euro 50,400 Schmidt Biomedtech Indonesia
4 GOMCO SUCTION G180 USA Process registration 1 Set US$ 1,700 Schmidt Biomedtech Indonesia
Allied Health care 01.63.3040 USA Process registration 1 Set US$ 2,800 Schmidt Biomedtech Indonesia
01 73 6020 USA Process registration 1 Set US$ 3,400 Schmidt Biomedtech Indonesia
01 33 6050 USA Process registration 1 Set US$ 3,500 Schmidt Biomedtech Indonesia
01 23 3810 USA Process registration 1 Set US$ 6,700 Schmidt Biomedtech Indonesia
nebulizer USA Process registration 1 Set US$ 2,000 Schmidt Biomedtech Indonesia
Pulse Oxymeter USA Process registration 1 Set US$ 2,500 Schmidt Biomedtech Indonesia
resuscitator-175 USA Process registration 1 Set US$ 2,200 Schmidt Biomedtech Indonesia

SURGICAL-EQUIPMENT AND CONSUMABLE


Schmidt Biomedtech Indonesia
5 CONMED ELECTROCAUTERY Sabre 180 USA Process registration US$ 16,240 Schmidt Biomedtech Indonesia
System 2500 USA Process registration US$ 22,000 Schmidt Biomedtech Indonesia
Sytem 5000 USA Process registration US$ 26,000 Schmidt Biomedtech Indonesia

6 OT LIGHT Mach 380F+380F Germany Process registration Euro 25,299 Schmidt Biomedtech Indonesia
DR MACH Mach 500F+380F Germany Process registration Euro 25,900 Schmidt Biomedtech Indonesia
Mach M3DF Double Germany Process registration Euro 26,870 Schmidt Biomedtech Indonesia
Mach M3F + M2 Germany Process registration Euro 24,147 Schmidt Biomedtech Indonesia
Mach 500 F Germany Process registration Euro 15,196 Schmidt Biomedtech Indonesia
Mach 380 F Germany Process registration Euro 12,066 Schmidt Biomedtech Indonesia
M2 Ceiling Germany Process registration Euro 6,582 Schmidt Biomedtech Indonesia
M3 F Ceiling Germany Process registration Euro 10,607 Schmidt Biomedtech Indonesia
Traiflex Germany Process registration Euro 8,097 Schmidt Biomedtech Indonesia
Macrolux Process registration Euro 600 Schmidt Biomedtech Indonesia
Mach 115 Germany Process registration Euro 920 Schmidt Biomedtech Indonesia
Mach 120 Germany Process registration Euro 1,200 Schmidt Biomedtech Indonesia
Mach 130 Germany Process registration Euro 1,800 Schmidt Biomedtech Indonesia

7 OT TABLE Technomed Spanyol Process Registration Euro 8,000 Schmidt Biomedtech Indonesia

8 MULLER INSTRUMENT Muller Germany Process Registration As Per Price List Attached Schmidt Biomedtech Indonesia

9 BIOPSY SYSTEM-BARD
VACORA USA Process registration PCS US$ 25000 Schmidt Biomedtech Indonesia
MAGNUM USA Process registration US$ 3000 Schmidt Biomedtech Indonesia
maxcore USA Process registration US$ 1000 Schmidt Biomedtech Indonesia
GRAFT Felt and fabrics USA Process registration US$ 120 Schmidt Biomedtech Indonesia
Uncoated Graft USA Process registration US$ 300 Schmidt Biomedtech Indonesia
Peripheral vascular Graf USA Process registration US$ 1300 Schmidt Biomedtech Indonesia
Venflo vascular graft USA Process registration US$ 800 Schmidt Biomedtech Indonesia
Impra carboflo periphera USA Process registration US$ 1500 Schmidt Biomedtech Indonesia
Mesh bard Flat Mesh USA Process registration US$ 200 Schmidt Biomedtech Indonesia
Bard perfix USA Process registration US$ 200 Schmidt Biomedtech Indonesia
bard 3D max USA Process registration US$ 1200 Schmidt Biomedtech Indonesia
Bard Composive USA Process registration US$ 1400 Schmidt Biomedtech Indonesia
DIAGNOSTIK IMAGING
No Contry of
Merk/Pabrik Type Registrasi Satuan Currency HJSA Sole Agent
Urut Origin
1 Sonosite Titan USA AKL 21501502730 1 USD 56,250.00 SCHMIDT BioMedtech Indonesia
2 Sonosite 180 USA AKL 21501502737 1 USD 50,250.00 SCHMIDT BioMedtech Indonesia
3 Hologic Discovery C USA On Process 1 USD 169,500.00 SCHMIDT BioMedtech Indonesia
4 Hologic Discovery W USA On Process 1 USD 178,500.00 SCHMIDT BioMedtech Indonesia
5 Hologic Discovery SL USA On Process 1 USD 250,500.00 SCHMIDT BioMedtech Indonesia
6 Hologic Discovery A USA On Process 1 USD 268,500.00 SCHMIDT BioMedtech Indonesia
7 Hologic Discovery Ci USA On Process 1 USD 154,500.00 SCHMIDT BioMedtech Indonesia
8 Hologic Discovery Wi USA On Process 1 USD 163,500.00 SCHMIDT BioMedtech Indonesia
9 Hologic Explorer USA On Process 1 USD 106,500.00 SCHMIDT BioMedtech Indonesia
10 Hologic Sahara USA On Process 1 USD 24,750.00 SCHMIDT BioMedtech Indonesia
11 Ultrasonix SP for 3D/4D CANADA On Process 1 USD 139,875.00 SCHMIDT BioMedtech Indonesia
12 Ultrasonix OP with Color CANADA On Process 1 USD 72,375.00 SCHMIDT BioMedtech Indonesia
13 Ultrasonix OP B/W CANADA On Process 1 USD 66,375.00 SCHMIDT BioMedtech Indonesia
14 Medicanvas HSVB-1L (1 bank) Korea On Process 1 USD 1,305.00 SCHMIDT BioMedtech Indonesia
15 Medicanvas HSVB-2L (2 banks) Korea On Process 1 USD 2,055.00 SCHMIDT BioMedtech Indonesia
16 Medicanvas HSVB-3L (3 banks) Korea On Process 1 USD 3,075.00 SCHMIDT BioMedtech Indonesia
17 Medicanvas HSVB-4L (4 banks) Korea On Process 1 USD 3,525.00 SCHMIDT BioMedtech Indonesia

AGFA
No.Urut Merk / Pabrik Type COUNTRY Registrasi Satuan Currency HJSA Sole Agent
1 CR 25.0 CR 25.0 Belgium On the process Unit US $ 112,500.00 PT.SCHMIDT BioMedTech Indonesia
2 CR 75.0 CR 75.0 Belgium On the process Unit US $ 247,500.00 PT.SCHMIDT BioMedTech Indonesia
3 Dry Printer Drystar 5300 Belgium On the process Unit US $ 38,250.00 PT.SCHMIDT BioMedTech Indonesia
4 Dry Printer Drystar 5500 Belgium On the process Unit US $ 56,250.00 PT.SCHMIDT BioMedTech Indonesia
5 Dicom coverter Paxport Digital Belgium On the process Unit US $ 22,500.00 PT.SCHMIDT BioMedTech Indonesia
6 Dicom coverter Paxport Analog Belgium On the process Unit US $ 22,500.00 PT.SCHMIDT BioMedTech Indonesia
14 Drystar DT 2B Film 35 X 43 Belgium On the process Box US $ 421.43 PT.SCHMIDT BioMedTech Indonesia
15 Drystar DT 2B Film 24 X 30 Belgium On the process Box US $ 289.71 PT.SCHMIDT BioMedTech Indonesia
16 Drystar DT 2B Film 18 X 24 Belgium On the process Box US $ 145.62 PT.SCHMIDT BioMedTech Indonesia
17 CR Cassette 35 X 43 Belgium On the process Pcs US $ 1,120.50 PT.SCHMIDT BioMedTech Indonesia
18 CR Cassette 35 X 35 Belgium On the process Pcs US $ 1,179.90 PT.SCHMIDT BioMedTech Indonesia
19 CR Cassette 24 X 30 Belgium On the process Pcs US $ 726.30 PT.SCHMIDT BioMedTech Indonesia
20 CR Cassette 18 X 24 Belgium On the process Pcs US $ 502.20 PT.SCHMIDT BioMedTech Indonesia
21 CR Cassette 15 X 30 Belgium On the process Pcs US $ 572.40 PT.SCHMIDT BioMedTech Indonesia
PT. DIPA PHARMALAB INTERSAINS
Jl. Kebon Jeruk Raya No. 66, Jakarta Barat 11530
Telp. 021-5350535 (Hunting), Fax. 021-5481322

DAFTAR INFORMASI HARGA PERALATAN KESEHATAN & LABORATORIUM


EFFECTIVE : 1 SEPTEMBER S/D 31 DESEMBER 2005

No. Nama Peralatan Kesehatan Model/Type Merk Negara Asal/ No. Registrasi Satuan HJSA Sole
Urut Pabrikan Dep.Kes RI Rp. Agent
1 a. Ultrasound Bone Densitometry Sahara HOLOGIC, INC. USA AKL 21501402761 Unit 189,420,000
b. Mammography LORAD HOLOGIC, INC. USA
Affinity Series :
1. Small Liear (SLI) AKL 21501301135 Unit 817,845,000
2. Dual Linear (DLI) AKL 21501301136 Unit 938,070,000
3. Small HTC (SHI) Dalam proses Unit 986,160,000
4. Small HTC Large Linear Dalam proses Unit 1,034,250,000
5. Dual HTC Dalam proses Unit 1,130,535,000
M-IV Series :
1. Small Liear AKL 21501301142 Unit 1,010,205,000
2. Dual Linear AKL 21501301141 Unit 1,130,535,000
3. Small HTC Dalam proses Unit 1,202,670,000
4. Small HTC Large Linear Dalam proses Unit 1,250,760,000
5. Dual HTC Dalam proses Unit 1,388,730,000

2 a. Extracorporeal Shock Wave 1. Econolith 2000 MEDISPEC, LTD. USA KL 0804100089 Unit 3,205,755,000
Lithotripsy (ESWL) * Shock Wave Generator W 7
* U-Arm Monitor 17" (Zoom 9"/6"/4")
* TT-3 Axis Multipurpose Urology
* Computerized Console
* USG GE 200 Alpha
2. Econolith 3000 AKL 20804502775 Unit 3,522,960,000
* Shock Wave Generator W 6
* TT-3 Axis Multipurpose Urology
* U-Arm Monitor 17" (Zoom 9"/6"/4")
* Computerized Console
* USG GE 200 Alpha
b. Extracorporeal Shock Wave Orthospec AKL 21301502726 Unit 1,542,240,000
Therapy (ESWT)
c. Intracorporeal Lithotripsy System Lithospec Dalam proses Unit 144,690,000
d. Uroflowmetry Urospec Dalam proses Unit 58,590,000
e. BPH Thermotherapy Thermaspec Dalam proses Unit 1,423,590,000

No. Nama Peralatan Kesehatan Model/Type Merk Negara Asal/ No. Registrasi Satuan HJSA Sole
Urut Pabrikan Dep.Kes RI Rp. Agent
3 Radiographic Imaging : QUANTUM MEDICAL USA
I. Q-RAD, CS SYSTEM IMAGING, LLC.
(Ceiling Types) 1. Q-Rad CS-1-65-150 kVp; mA range Dalam proses Unit 1,594,845,000
25-800 - Digital Imaging - ODESSEY HF
2. Q-Rad CS-2-50-125 kVp; mA range Dalam proses Unit 1,249,920,000
25-650 - Digital Imaging - ODESSEY HF
II. Q-RAD, DS SYSTEM
(Floor Mounted) 3. Q-Rad DS-3; 50-125 kVp; mA range AKL 21501502264 Unit 813,225,000
25-650 - ODESSEY HF
4. Q-Rad DS-4; 32-125 kVp; mA range AKL 21501502265 Unit 659,610,000
25-500 - ODESSEY HF
III. Q-RAD, TS SYSTEM
(Ceiling & Tomo Types) 5. Q-Rad TS-1 Ceiling Mounted/Tomography Dalam proses Unit 2,294,145,000
System - kVp 65-150; mA range 25-800
6. Q-Rad TS-2 Dalam proses Unit 2,412,795,000
7. Q-Rad TS-3 Ceiling Mounted/Tomography Dalam proses Unit 1,289,505,000
System - kVp 50-125; mA range 25-650
IV. RAD-X SYSTEM
8. Rad X Es-6-Tube Stand - QUEST HF; Dalam proses Unit 442,995,000
kVp 25-125; mA range 25-400
9. QV-800 UNIVERSAL (QV-R1) - Manual Dalam proses Unit 1,582,140,000
Collimator; kVp 65-150; mA range 25-800
10. QV-800 UNIVERSAL (QV-R2) - Dalam proses Unit 1,347,990,000
Universal Structure & Manual Collimator
11. CH-1 CHESTRADIOGRAPHIC SYSTEM - Dalam proses Unit 569,625,000
Tube Stand & Manual Collimator;
kVp 50-125; mA 25-650
12. COSMOS VS-1 SYSTEM - Universal Stand Dalam proses Unit 917,700,000
& Collimator; kVp 50-125; mA 25-650
13. COSMOS VS-2 SYSTEM - Universal Stand Dalam proses Unit 810,075,000
Collimator; kVp 32-125; mA 25-500
14. CHIRO-X 14' x 17' SYSTEM - Tubestand; Dalam proses Unit 367,080,000
Vertical Wall Frame & Collimator
15. CHIRO-X 14' x 36' SYSTEM; kVp 25-125; Dalam proses Unit 382,935,000
mA 25-400
No. Nama Peralatan Kesehatan Model/Type Merk Negara Asal/ No. Registrasi Satuan HJSA Sole
Urut Pabrikan Dep.Kes RI Rp. Agent
4 Body Composition Analyzer InBody 3.0 BIOSPACE CO., LTd. Korea KL 0901100370 Unit 183,540,000

5 Pediatric Bone Densitometry Omnisense SUNLIGHT Hongkong Dalam proses Unit 241,290,000

6 Automatic cleaning and KD 20.2 AP/A-Thermal MEIKO Germany Dalam proses Unit 136,125,000
disinfecting appliances

Catatan :
1. Harga Franco Jakarta
2. Harga belum termasuk PPN 10%
3. Harga sudah termasuk :
a. Biaya pemasangan dan training untuk user
b. Garansi 1 (satu) tahun sejak unit siap dioperasikan
4. Harga sewaktu-waktu dapat berubah tanpa pemberitahuan terlebih dahulu dan disesuaikan dengan nilai tukar Rupiah
CV. PANCA FARMA JAYA
Kav. Polri Blok C No.751
Jelambar, Grogol Petamburan
Jakarta Barat
Phone / Fax No. : 021-5671672

Date : 15 September, 2005 Our Ref.: 002/PFJ/IX/2005

Kepada Yth
Gakeslab Indonesia
Gedung Wisma Tiara Lt.111
Jalan Raya Pasar Minggu No.17
Jakarta Selatan

U.p.: Bagian Sekretariat Gakeslab Indonesia.


HP.0818120373 / Fax 8631235

Hal : Informasi Harga Alat Alat Kesehatan Dan Laboratorium.

Dengan hormat,
Sesuai dengan permintaan Bapak bersama ini kami sampaikan daftar harga untuk Alat Kesehatan
Dan Laboratorium dari Alat Uji / Tes Kehamilan Merk Super Biolab adalah sebagai berikut :

DAFTAR HARGA

No. Nama Barang/Produk Merk & Negara Asal Satuan No. Registrasi Harga
(1) (2) (3) (4) (5) (6)
Rupiah
1. Alat Uji / Tes Kehamilan Super Biolab Hcg buah AKL 20101200605 6,500.00
Super Biolab Pregnancy Test
hCG Pregnancy Test Strip - Type 5050S
Strip - Type 5050S
Negara Asal :
Cara pakai : Asli di Import dari USA
Alat Uji / Tes dicelupkan
kedalam air seni (urine)
2 garis merah adalah positip
1 garis merah adalah negatip

Sensitivity & Standardization : 25 mlU/ml or Greater


WHO 3rd IS 75/537
Accuracy : 99.999%

2. Alat Uji / Tes Kehamilan Super Biolab Hcg buah AKL 20101200604 11,250.00
Super Biolab Pregnancy Test
hCG Pregnancy Test Device - Type 5050D
Device - Type 5050D
Negara Asal :
Cara pakai : Asli di Import dari USA
air seni (urine) diteteskan
kedalam wadah yang telah
tersedia dalam setiap
bungkusan.
2 garis merah adalah positip
1 garis merah adalah negatip

Sensitivity & Standardization : 25 mlU/ml or Greater


WHO 3rd IS 75/537
Accuracy : 99.999%

Catatan :
- Harga tersebut diatas belum termasuk PPN Tax 10%
- Harga tersebut diatas adalah Harga Jual Sole Agent (HJSA)
- Sampai saat ini belum ada penunjukan Distributor Daerah
- Harga tersebut diatas se-waktu2 biasa berubah

Demikian informasi Harga Alat-Alat Kesehatan Dan Laboratorium kami sampaikan kepada Bapak
semoga dapat dipakai dimana seperlunya.

Atas perhatian serta kerja sama yang Bapak berikan, terlebih dahulu kami ucapkan terima kasih.

Hormat Kami,

Subagdja P.
Pimpinan
HARGA JUAL SOLE AGENT (HJSA)

No. Nama Peralatan Kesehatan Merk & Negara Asal Satuan No Registrasi HJSA Sole Agent
(1) (2) (3) (4) (5) (6)
EVIS EXERA BRONCHOVIDEOSCOPE BF-160 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 775,690,000 PT.Setio Harto Ltd.
EVIS EXERA BRONCHOVIDEOSCOPE BF-1T160 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 775,690,000 PT.Setio Harto Ltd.
EVIS EXERA BRONCHOVIDEOSCOPE BF-3C160 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 775,690,000 PT.Setio Harto Ltd.
EVIS EXERA BRONCHOVIDEOSCOPE BF-P160 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 775,690,000 PT.Setio Harto Ltd.
EVIS EXERA BRONCHOVIDEOSCOPE BF-XT160 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 814,670,000 PT.Setio Harto Ltd.
EVIS EXERA BRONCHOFIBERVIDEOSCOPE BF-XP160F OLYMPUS - JAPAN UNIT DALAM PROSES Rp 775,690,000 PT.Setio Harto Ltd.
EVIS EXERA BRONCHOFIBERVIDEOSCOPE BF-MP160F OLYMPUS - JAPAN UNIT DALAM PROSES Rp 775,690,000 PT.Setio Harto Ltd.

EVIS EXERA VIDEO SYSTEM CENTRE CV-160 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 706,790,000 PT.Setio Harto Ltd.
EVIS EXERA UNIVERSAL LIGHT SOURCE CLV-160 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 395,550,000 PT.Setio Harto Ltd.
EVIS EXERA COLONOVIDEOSCOPE STANDARD SET CF-2T160I OLYMPUS - JAPAN UNIT DALAM PROSES Rp 1,036,510,000 PT.Setio Harto Ltd.
EVIS EXERA COLONOVIDEOSCOPE STANDARD SET CF-2T160L OLYMPUS - JAPAN UNIT DALAM PROSES Rp 1,100,210,000 PT.Setio Harto Ltd.
EVIS EXERA COLONOVIDEOSCOPE STANDARD SET CF-Q160AI OLYMPUS - JAPAN UNIT DALAM PROSES Rp 1,149,170,000 PT.Setio Harto Ltd.
EVIS EXERA COLONOVIDEOSCOPE STANDARD SET CF-Q160AL OLYMPUS - JAPAN UNIT DALAM PROSES Rp 1,206,420,000 PT.Setio Harto Ltd.
EVIS EXERA COLONOVIDEOSCOPE STANDARD SET CF-Q160DI OLYMPUS - JAPAN UNIT DALAM PROSES Rp 1,239,530,000 PT.Setio Harto Ltd.
EVIS EXERA COLONOVIDEOSCOPE STANDARD SET CF-Q160DL OLYMPUS - JAPAN UNIT DALAM PROSES Rp 1,320,550,000 PT.Setio Harto Ltd.
EVIS EXERA COLONOVIDEOSCOPE STANDARD SET CF-Q160I OLYMPUS - JAPAN UNIT DALAM PROSES Rp 1,094,010,000 PT.Setio Harto Ltd.
EVIS EXERA COLONOVIDEOSCOPE STANDARD SET CF-Q160L OLYMPUS - JAPAN UNIT DALAM PROSES Rp 1,149,170,000 PT.Setio Harto Ltd.
EVIS EXERA COLONOVIDEOSCOPE STANDARD SET CF-Q160S OLYMPUS - JAPAN UNIT DALAM PROSES Rp 880,620,000 PT.Setio Harto Ltd.
EVIS EXERA COLONOVIDEOSCOPE STANDARD SET CF-Q160ZI OLYMPUS - JAPAN UNIT DALAM PROSES Rp 1,049,250,000 PT.Setio Harto Ltd.
EVIS EXERA COLONOVIDEOSCOPE STANDARD SET CF-Q160ZL OLYMPUS - JAPAN UNIT DALAM PROSES Rp 1,124,190,000 PT.Setio Harto Ltd.
EVIS EXERA GASTROINTESTINAL VIDEOSCOPE STANDARD SET GIF-160 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 917,340,000 PT.Setio Harto Ltd.
EVIS EXERA GASTROINTESTINAL VIDEOSCOPE STANDARD SET GIF-2T160 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 938,810,000 PT.Setio Harto Ltd.
EVIS EXERA GASTROINTESTINAL VIDEOSCOPE STANDARD SET GIF-Q160 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 983,290,000 PT.Setio Harto Ltd.
EVIS EXERA GASTROINTESTINAL VIDEOSCOPE STANDARD SET GIF-1TQ160 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 1,006,690,000 PT.Setio Harto Ltd.
EVIS EXERA GASTROINTESTINAL VIDEOSCOPE STANDARD SET GIF-Q160Z OLYMPUS - JAPAN UNIT DALAM PROSES Rp 1,081,470,000 PT.Setio Harto Ltd.
EVIS EXERA GASTROINTESTINAL VIDEOSCOPE STANDARD SET GIF-XP160 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 894,110,000 PT.Setio Harto Ltd.
EVIS EXERA GASTROINTESTINAL VIDEOSCOPE STANDARD SET GIF-XTQ160 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 1,086,720,000 PT.Setio Harto Ltd.
EVIS EXERA COLONOVIDEOSCOPE PCF-160AI OLYMPUS - JAPAN UNIT DALAM PROSES Rp 1,129,400,000 PT.Setio Harto Ltd.
EVIS EXERA COLONOVIDEOSCOPE PCF-160AL OLYMPUS - JAPAN UNIT DALAM PROSES Rp 1,186,650,000 PT.Setio Harto Ltd.
EVIS DUODENOVIDEOSCOPE STANDARD SET TJF-160R OLYMPUS - JAPAN UNIT DALAM PROSES Rp 1,094,010,000 PT.Setio Harto Ltd.
EVIS DUODENOVIDEOSCOPE STANDARD SET TJF-160VR OLYMPUS - JAPAN UNIT DALAM PROSES Rp 1,094,010,000 PT.Setio Harto Ltd.

EVIS VIDEO SYSTEM CENTER CV-145 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 590,580,000 PT.Setio Harto Ltd.
EVIS EXERA HALOGEN LIGHT SOURCE CLE-145 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 227,090,000 PT.Setio Harto Ltd.
EVIS COLONOVIDEOSCOPE STANDARD SET CF-Q145I OLYMPUS - JAPAN UNIT DALAM PROSES Rp 676,770,000 PT.Setio Harto Ltd.
EVIS COLONOVIDEOSCOPE STANDARD SET CF-Q145L OLYMPUS - JAPAN UNIT DALAM PROSES Rp 721,730,000 PT.Setio Harto Ltd.
EVIS GASTROINTESTINAL VIDEOSCOPE STANDARD SET GIF-Q145 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 652,780,000 PT.Setio Harto Ltd.
EVIS DUODENOVIDEOSCOPE STANDARD SET TJF-145 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 791,210,000 PT.Setio Harto Ltd.

1
HARGA JUAL SOLE AGENT (HJSA)

No. Nama Peralatan Kesehatan Merk & Negara Asal Satuan No Registrasi HJSA Sole Agent
(1) (2) (3) (4) (5) (6)
SUCTION PUMP 220V / K7501890 KV-5 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 120,920,000 PT.Setio Harto Ltd.
SUCTION PUMP 220V SSU-2 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 47,870,000 PT.Setio Harto Ltd.

ENDOSONIC CLEANER ( 220-240V ) 7500620S OLYMPUS - JAPAN UNIT DALAM PROSES Rp 160,710,000 PT.Setio Harto Ltd.
ENDOSCOPIC WASHER EW-30 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 1,187,150,000 PT.Setio Harto Ltd.
ENDOSCOPIC REPROCESSOR OER A OLYMPUS - JAPAN UNIT DALAM PROSES Rp 1,092,960,000 PT.Setio Harto Ltd.
MANUAL DISINFECTOR TD-20 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 133,520,000 PT.Setio Harto Ltd.
ELECTRO SURGICAL UNIT PSD-60 OLYMPUS - JAPAN UNIT DALAM PROSES PT.Setio Harto Ltd.
ELECTRO SURGICAL UNIT PSD-30 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 249,570,000 PT.Setio Harto Ltd.

OES BRONCHOFIBERSCOPE STANDARD SET BF-1T60 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 592,080,000 PT.Setio Harto Ltd.
OES BRONCHOFIBERSCOPE STANDARD SET BF-3C40 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 646,790,000 PT.Setio Harto Ltd.
OES BRONCHOFIBERSCOPE STANDARD SET BF-40 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 592,080,000 PT.Setio Harto Ltd.
OES BRONCHOFIBERSCOPE STANDARD SET BF-P60 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 592,080,000 PT.Setio Harto Ltd.
OES BRONCHOFIBERSCOPE STANDARD SET BF-MP60 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 592,080,000 PT.Setio Harto Ltd.
OES BRONCHOFIBERSCOPE STANDARD SET BF-XP60 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 674,520,000 PT.Setio Harto Ltd.
OES BRONCHOFIBERSCOPE STANDARD SET BF-XT40 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 658,030,000 PT.Setio Harto Ltd.
OES COLONOFIBERSCOPE STANDARD SET CF-40I OLYMPUS - JAPAN UNIT DALAM PROSES Rp 764,450,000 PT.Setio Harto Ltd.
OES COLONOFIBERSCOPE STANDARD SET CF-40L OLYMPUS - JAPAN UNIT DALAM PROSES Rp 914,340,000 PT.Setio Harto Ltd.
OES GASTROINTESTINAL FIBERSCOPE STANDARD SET GIF-Q40 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 704,500,000 PT.Setio Harto Ltd.
OES GASTROINTESTINAL FIBERSCOPE STANDARD SET GIF-XQ40 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 697,000,000 PT.Setio Harto Ltd.
OES DUODENOFIBERSCOPE STANDARD SET JF-1T40 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 899,350,000 PT.Setio Harto Ltd.
COLONOFIBERSCOPE STANDARD SET CF-EI OLYMPUS - JAPAN UNIT DALAM PROSES Rp 494,650,000 PT.Setio Harto Ltd.
COLONOFIBERSCOPE STANDARD SET CF-EL OLYMPUS - JAPAN UNIT DALAM PROSES Rp 592,080,000 PT.Setio Harto Ltd.
GASTROINTESTINAL FIBERSCOPE STANDARD SET GIF-E3 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 449,680,000 PT.Setio Harto Ltd.
DUODENOFIBERSCOPE STANDARD SET JF-E OLYMPUS - JAPAN UNIT DALAM PROSES Rp 584,580,000 PT.Setio Harto Ltd.
SIGMOIDOFIBERSCOPE STANDARD SET OSF-3 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 383,430,000 PT.Setio Harto Ltd.

ULTRASONIC BRONCHOFIBERSCOPE BF-UM40 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 1,498,920,000 PT.Setio Harto Ltd.
ULTRASONIC COLONOFIBERSCOPE CF-UM20 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 2,847,950,000 PT.Setio Harto Ltd.
ENDOSCOPIC ULTRASOUND CENTER EU-C60 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 1,483,930,000 PT.Setio Harto Ltd.
ENDOSCOPIC ULTRASOUND CENTER EU-M30S OLYMPUS - JAPAN UNIT DALAM PROSES Rp 966,810,000 PT.Setio Harto Ltd.
ENDOSCOPIC ULTRASOUND CENTER EU-M60 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 1,896,130,000 PT.Setio Harto Ltd.
ULTRASONIC GASTROVIDEOSCOPE GF-UC140P-AL5 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 3,222,680,000 PT.Setio Harto Ltd.
ULTRASONIC GASTROVIDEOSCOPE GF-UC160P-OL5 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 3,222,680,000 PT.Setio Harto Ltd.
ULTRASONIC GASTROVIDEOSCOPE GF-UC2000P-OL5 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 3,597,400,000 PT.Setio Harto Ltd.
ULTRASONIC GASTROVIDEOSCOPE GF-UC240P-AL5 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 3,597,400,000 PT.Setio Harto Ltd.
ULTRASONIC GASTROVIDEOSCOPE GF-UCT140-AL5 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 3,383,810,000 PT.Setio Harto Ltd.
ULTRASONIC GASTROVIDEOSCOPE GF-UCT160-OL5 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 3,383,810,000 PT.Setio Harto Ltd.
ULTRASONIC GASTROVIDEOSCOPE GF-UCT2000-OL5 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 3,777,270,000 PT.Setio Harto Ltd.

2
HARGA JUAL SOLE AGENT (HJSA)

No. Nama Peralatan Kesehatan Merk & Negara Asal Satuan No Registrasi HJSA Sole Agent
(1) (2) (3) (4) (5) (6)
ULTRASONIC GASTROVIDEOSCOPE GF-UCT240-AL5 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 3,777,270,000 PT.Setio Harto Ltd.
ULTRASONIC GASTROVIDEOSCOPE GF-UM130 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 3,222,680,000 PT.Setio Harto Ltd.
ULTRASONIC GASTROVIDEOSCOPE GF-UM160 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 3,642,370,000 PT.Setio Harto Ltd.
ULTRASONIC GASTROFIBERSCOPE GF-UM20 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 2,847,950,000 PT.Setio Harto Ltd.
ULTRASONIC GASTROVIDEOSCOPE GF-UM240 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 3,597,400,000 PT.Setio Harto Ltd.
ULTRASONIC GASTROFIBERSCOPE GF-UM30P OLYMPUS - JAPAN UNIT DALAM PROSES Rp 2,847,950,000 PT.Setio Harto Ltd.
ULTRASONIC GASTROVIDEOSCOPE GF-UMD140P OLYMPUS - JAPAN UNIT DALAM PROSES Rp 3,222,680,000 PT.Setio Harto Ltd.
ULTRASONIC GASTROVIDEOSCOPE GF-UMD240P OLYMPUS - JAPAN UNIT DALAM PROSES Rp 3,597,400,000 PT.Setio Harto Ltd.
ULTRASONIC GASTROVIDEOSCOPE GF-UMQ130 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 3,222,680,000 PT.Setio Harto Ltd.
ULTRASOUND GASTROVIDEOSCOPE GF-UMQ240 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 3,597,400,000 PT.Setio Harto Ltd.
ULTRASONIC DUODENOFIBERSCOPE JF-UM20 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 2,847,950,000 PT.Setio Harto Ltd.
ULTRASONIC PROBE SET MH-247-2 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 868,250,000 PT.Setio Harto Ltd.
ULTRASONIC PROBE FOR ESOPHAGUS MH-908 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 1,292,820,000 PT.Setio Harto Ltd.
ULTRASONIC PROBE (12 MHz) RU-12M-R1 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 367,240,000 PT.Setio Harto Ltd.
ULTRASONIC PROBE (7.5 MHz) RU-75M-R1 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 367,240,000 PT.Setio Harto Ltd.
ULTRASONIC PROBE (2.4MM/12MHz) UM-2R OLYMPUS - JAPAN UNIT DALAM PROSES Rp 194,860,000 PT.Setio Harto Ltd.
ULTRASONIC PROBE (2.4MM/20MHz) UM-3R OLYMPUS - JAPAN UNIT DALAM PROSES Rp 194,860,000 PT.Setio Harto Ltd.
ULTRASONIC PROBE UM-BS20-26R OLYMPUS - JAPAN UNIT DALAM PROSES Rp 232,340,000 PT.Setio Harto Ltd.
ULTRASONIC PROBE UM-DP12-25R OLYMPUS - JAPAN UNIT DALAM PROSES Rp 233,800,000 PT.Setio Harto Ltd.
ULTRASONIC PROBE UM-DP20-25R OLYMPUS - JAPAN UNIT DALAM PROSES Rp 233,800,000 PT.Setio Harto Ltd.
ULTRASONIC PROBE UM-G20-29R OLYMPUS - JAPAN UNIT DALAM PROSES Rp 179,870,000 PT.Setio Harto Ltd.
ULTRASONIC PROBE UM-S20-20R OLYMPUS - JAPAN UNIT DALAM PROSES Rp 146,150,000 PT.Setio Harto Ltd.
ULTRASONIC PROBE UM-S20-20R-3 OLYMPUS - JAPAN UNIT DALAM PROSES Rp 104,930,000 PT.Setio Harto Ltd.
ULTRASONIC PROBE UM-S30-20R OLYMPUS - JAPAN UNIT DALAM PROSES Rp 194,860,000 PT.Setio Harto Ltd.
ULTRASONIC PROBE UM-S30-25R OLYMPUS - JAPAN UNIT DALAM PROSES Rp 194,860,000 PT.Setio Harto Ltd.

COLPOSCOPY OCS OLYMPUS - JAPAN SET KL1101291247 Rp 657,000,000 PT.Setio Harto Ltd.
LAPAROSCOPE OPERATIP SET FOR SURGERY OES OLYMPUS - JAPAN/GERMANY SET KL1101291251 Rp 1,250,000,000 PT.Setio Harto Ltd.
DIGITAL HIGH FLOW INSUFLATOR CO2 UHI3 OLYMPUS - JAPAN SET DALAM PROSES Rp 278,450,000 PT.Setio Harto Ltd.
SURGIPUMP FOR SUCTION IRRIGATION SURGIPUMP OLYMPUS - GERMANY SET DALAM PROSES Rp 268,500,000 PT.Setio Harto Ltd.
SURG MASTER ELECTRO COUTER UES 40 OLYMPUS - JAPAN SET DALAM PROSES Rp 358,400,000 PT.Setio Harto Ltd.

LAPAROSCOPY OPERATIP FOR GYNAECOLOGY &DIAGNOSTIC OES OLYMPUS - JAPAN/GERMANY SET DALAM PROSES Rp 1,350,000,000 PT.Setio Harto Ltd.
HYSTEROSCOPY OPERATIVE & DIAGNOSTIC OES OLYMPUS - JAPAN/GERMANY SET DALAM PROSES Rp 486,500,000 PT.Setio Harto Ltd.
TCRIS OES OLYMPUS - JAPAN/GERMANY SET DALAM PROSES Rp 653,600,000 PT.Setio Harto Ltd.

ENDO - UROLOGY DOWN TRACT OES OLYMPUS - JAPAN/GERMANY SET DALAM PROSES Rp 1,956,000,000 PT.Setio Harto Ltd.
CYSTOSCOPY SET OES OLYMPUS - JAPAN/GERMANY SET DALAM PROSES Rp 228,000,000 PT.Setio Harto Ltd.
TUR/TURIS OES OLYMPUS - JAPAN/GERMANY SET DALAM PROSES Rp 465,000,000 PT.Setio Harto Ltd.
URS & LITHOTRIPTOR OES OLYMPUS - JAPAN/GERMANY SET DALAM PROSES Rp 647,805,000 PT.Setio Harto Ltd.
NEPROSCOPY SET OES OLYMPUS - JAPAN/GERMANY SET DALAM PROSES Rp 765,400,000 PT.Setio Harto Ltd.

3
HARGA JUAL SOLE AGENT (HJSA)

No. Nama Peralatan Kesehatan Merk & Negara Asal Satuan No Registrasi HJSA Sole Agent
(1) (2) (3) (4) (5) (6)
PEDIATRIC UROOLOGY OES OLYMPUS - JAPAN/GERMANY SET DALAM PROSES Rp 567,400,000 PT.Setio Harto Ltd.

FESS ( FUCTIONAL ENDOSCOPY SINUS SURGERY) OES OLYMPUS - JAPAN/GERMANY SET DALAM PROSES Rp 598,400,000 PT.Setio Harto Ltd.
RHINOSCOPY/RHINOLARYNGOSCOPE( OFFICE ENT) OES OLYMPUS - JAPAN/GERMANY SET DALAM PROSES Rp 657,400,000 PT.Setio Harto Ltd.
CELON (RFITT) OES OLYMPUS - JAPAN/GERMANY SET DALAM PROSES Rp 800,400,000 PT.Setio Harto Ltd.

ARTHROSCOPY OLYMPUS - JAPAN SET DALAM PROSES Rp 2,700,000,000 PT.Setio Harto Ltd.
THORAXOSCOPY OLYMPUS - JAPAN SET DALAM PROSES Rp 1,200,000,000 PT.Setio Harto Ltd.
ULTRASOUND COUTERY OLYMPUS - JAPAN SET DALAM PROSES Rp 800,000,000 PT.Setio Harto Ltd.
ULTRASOUND ASPIRATION OLYMPUS - JAPAN SET DALAM PROSES Rp 1,100,000,000 PT.Setio Harto Ltd.

25 LTR. HICLAVE WITH 2 PCS. SS. WIRE BASKETS HV-25 HIRAYAMA - JAPAN UNIT AKL20903502990 Rp 201,874,200 PT.Setio Harto Ltd.
50 LTR. HICLAVE WITH 3 PCS. SS. WIRE BASKETS HV-50 HIRAYAMA - JAPAN UNIT DALAM PROSES Rp 238,646,000 PT.Setio Harto Ltd.
85 LTR. HICLAVE WITH 2 PCS. SS. WIRE BASKETS HV-85 HIRAYAMA - JAPAN UNIT DALAM PROSES Rp 323,629,800 PT.Setio Harto Ltd.
110 LTR. HICLAVE WITH 2 PCS. SS. WIRE BASKETS HV-110 HIRAYAMA - JAPAN UNIT DALAM PROSES Rp 384,822,800 PT.Setio Harto Ltd.

50 LTR. HICLAVE WITH 3 PCS. SS. WIRE BASKETS HVE-50 HIRAYAMA - JAPAN UNIT DALAM PROSES Rp 213,229,700 PT.Setio Harto Ltd.
50 LTR. HICLAVE WITH VACUM PUMP FOR DRYING HVP-50 HIRAYAMA - JAPAN UNIT DALAM PROSES Rp 462,418,200 PT.Setio Harto Ltd.
85 LTR. HICLAVE WITH COOLING FAN & 2 PCS. SS.WIRE BASKETS HVA-85 HIRAYAMA - JAPAN UNIT DALAM PROSES Rp 290,194,200 PT.Setio Harto Ltd.
110 LTR. HICLAVE WITH COOLING FAN & 2 PCS. SS.WIRE BASKETS HVA-110 HIRAYAMA - JAPAN UNIT DALAM PROSES Rp 346,971,400 PT.Setio Harto Ltd.
50 LTR. HICLAVE WITH 3 PCS. SS. WIRE BASKETS HVN-50 HIRAYAMA - JAPAN UNIT DALAM PROSES Rp 294,610,200 PT.Setio Harto Ltd.
85 LTR. HICLAVE WITH 2 PCS. SS.WIRE BASKETS HVN-85 HIRAYAMA - JAPAN UNIT DALAM PROSES Rp 426,459,400 PT.Setio Harto Ltd.
63 LTR. HICLAVE WITH 3 PCS. SS WIRE BASKETS HLM-36 HIRAYAMA - JAPAN UNIT DALAM PROSES Rp 984,768,000 PT.Setio Harto Ltd.
6 LTR. HANDY AUTOCLAVE HP-16 HIRAYAMA - JAPAN UNIT DALAM PROSES Rp 85,165,700 PT.Setio Harto Ltd.

20 LTR. AUTOCLAVE WITH 2 PCS. SS WIRE BASKETS HA-240MIV HIRAYAMA - JAPAN UNIT DALAM PROSES Rp 177,901,700 PT.Setio Harto Ltd.
47 LTR. AUTOCLAVE WITH 3 PCS. SS WIRE BASKETS HA-300MIV HIRAYAMA - JAPAN UNIT DALAM PROSES Rp 211,337,100 PT.Setio Harto Ltd.
47 LTR. AUTOCLAVE WITH DRYING HA-300MD HIRAYAMA - JAPAN UNIT DALAM PROSES Rp 280,100,500 PT.Setio Harto Ltd.
47 LTR. AUTOCLAVE WITH VACUM PUMP & DRYING HA-300P HIRAYAMA - JAPAN UNIT DALAM PROSES Rp 472,512,000 PT.Setio Harto Ltd.
16 LTR. BENCH TOP AUTOCLAVE WITH DRYING HRM-242II HIRAYAMA - JAPAN UNIT DALAM PROSES Rp 252,342,800 PT.Setio Harto Ltd.
16 LTR. BENCH TOP AUTOCLAVE WITH AIR PUMP HRM-242IIP HIRAYAMA - JAPAN UNIT DALAM PROSES Rp 296,502,800 PT.Setio Harto Ltd.
110 LTR. HORIZONTAL AUTOCLAVE WITH STANDAR SET HRH-110 HIRAYAMA - JAPAN UNIT DALAM PROSES Rp 999,908,500 PT.Setio Harto Ltd.

61 LTR. AUTOCLAVE WITH 2 PCS. SS WIRE BASKETS HL-36AE HIRAYAMA - JAPAN UNIT DALAM PROSES Rp 223,954,200 PT.Setio Harto Ltd.
61 LTR. AUTOCLAVE WITH DRYING + STANDARD SET HL-36ADY HIRAYAMA - JAPAN UNIT DALAM PROSES Rp 293,979,400 PT.Setio Harto Ltd.
83 LTR. AUTOCLAVE WITH 2 PCS. SS WIRE BASKETS HL-42AE HIRAYAMA - JAPAN UNIT DALAM PROSES Rp 345,709,700 PT.Setio Harto Ltd.
83 LTR. AUTOCLAVE WITH DRYING + STANDARD SET HL-42ADY HIRAYAMA - JAPAN UNIT DALAM PROSES Rp 398,701,700 PT.Setio Harto Ltd.

MULTI-PURPOSE HEADFRAME SET MIZUHO - JAPAN SET DALAM PROSES Rp 648,521,100 PT.Setio Harto Ltd.
RADIOLUCENT MULTI-PURPOSE HEADFRAME SET MIZUHO - JAPAN SET DALAM PROSES Rp 1,312,182,800 PT.Setio Harto Ltd.
TRANSPHENOIDAL-HYPOPHYSECTOMY INSTRUMENT SET MIZUHO - JAPAN SET DALAM PROSES Rp 854,937,600 PT.Setio Harto Ltd.

4
HARGA JUAL SOLE AGENT (HJSA)

No. Nama Peralatan Kesehatan Merk & Negara Asal Satuan No Registrasi HJSA Sole Agent
(1) (2) (3) (4) (5) (6)
KOMAI'S STEREOTACTIC APPARATUS MIZUHO - JAPAN SET DALAM PROSES Rp 1,175,539,200 PT.Setio Harto Ltd.
SUGITA TITANIUM CLIP SET MIZUHO - JAPAN SET DALAM PROSES Rp 787,057,300 PT.Setio Harto Ltd.
SUGITA TITANIUM APPLIER SET MIZUHO - JAPAN SET DALAM PROSES Rp 221,367,700 PT.Setio Harto Ltd.
SUGITA TITANIUM CLIP APPLIER SET MIZUHO - JAPAN SET DALAM PROSES Rp 335,035,600 PT.Setio Harto Ltd.
SUGITA ELGILOY CLIP C SET MIZUHO - JAPAN SET DALAM PROSES Rp 554,737,900 PT.Setio Harto Ltd.
SUGITA ELGILOY CLIP D SET MIZUHO - JAPAN SET DALAM PROSES Rp 1,005,939,500 PT.Setio Harto Ltd.

MIZUHO SUCTION PUMP MSP-205A MIZUHO - JAPAN UNIT KL1603291334 Rp 179,037,200 PT.Setio Harto Ltd.
MIZUHO SUCTION PUMP MSP-205B MIZUHO - JAPAN UNIT DALAM PROSES Rp 246,034,200 PT.Setio Harto Ltd.
MIZUHO SUCTION PUMP MSP-103B MIZUHO - JAPAN UNIT DALAM PROSES Rp 132,732,300 PT.Setio Harto Ltd.
MIZUHO CONTINUOS SUCTION PUMP MSP-210 MIZUHO - JAPAN UNIT KL1603291335 Rp 55,830,800 PT.Setio Harto Ltd.
MIZUHO SUCTION PUMP MSP-207 MIZUHO - JAPAN UNIT KL1603291333 Rp 33,877,000 PT.Setio Harto Ltd.
MIZUHO SUCTION PUMP MSP-207M MIZUHO - JAPAN UNIT DALAM PROSES Rp 50,720,900 PT.Setio Harto Ltd.
MIZUHO SUCTION PUMP MSP-212 MIZUHO - JAPAN UNIT DALAM PROSES Rp 134,688,000 PT.Setio Harto Ltd.

ULTRASOUND 1 & 3 MHZ US 700 ITO. CO - JAPAN UNIT DALAM PROSES Rp 1,390,902,800 PT.Setio Harto Ltd.
ULTRASOUND 1 MHZ US 7P ITO. CO - JAPAN UNIT DALAM PROSES Rp 78,857,100 PT.Setio Harto Ltd.
MICROWAVE DIATHERMY 2 CH PM 800W ITO. CO - JAPAN UNIT DALAM PROSES Rp 321,737,100 PT.Setio Harto Ltd.
MICROWAVE DIATHERMY 1 CH PM 800S ITO. CO - JAPAN UNIT DALAM PROSES Rp 150,774,800 PT.Setio Harto Ltd.
SHORTWAVE DIATHERMY SW 400S ITO. CO - JAPAN UNIT DALAM PROSES Rp 403,748,500 PT.Setio Harto Ltd.
SHORTWAVE DIATHERMY SW 180 ITO. CO - JAPAN UNIT DALAM PROSES Rp 205,028,500 PT.Setio Harto Ltd.
SHORTWAVE DIATHERMY SW 101 ITO. CO - JAPAN UNIT DALAM PROSES Rp 182,948,500 PT.Setio Harto Ltd.
INTERFERENTIAL CURRENT IF 7P ITO. CO - JAPAN UNIT DALAM PROSES Rp 78,857,100 PT.Setio Harto Ltd.
NEURO MUSCULAR STIMULATOR CS 210 ITO. CO - JAPAN UNIT DALAM PROSES Rp 102,514,200 PT.Setio Harto Ltd.
TENS 240Z ITO. CO - JAPAN UNIT DALAM PROSES Rp 9,084,300 PT.Setio Harto Ltd.
LASER ACUPUNCTURE STIMULATOR LP 5F1 ITO. CO - JAPAN UNIT DALAM PROSES Rp 9,462,800 PT.Setio Harto Ltd.
POWERED TRACTION TM300 ITO. CO - JAPAN UNIT DALAM PROSES Rp 258,020,500 PT.Setio Harto Ltd.
COMPRESSION MEDOMER ITO. CO - JAPAN UNIT DALAM PROSES Rp 43,371,400 PT.Setio Harto Ltd.
VIBRATOR VITER VR 7N ITO. CO - JAPAN UNIT DALAM PROSES Rp 11,986,200 PT.Setio Harto Ltd.
STRESS MANAGEMENT ZEN TRAINER ITO. CO - JAPAN UNIT DALAM PROSES Rp 56,777,100 PT.Setio Harto Ltd.
INFRARED LAMP DESKTOP T 300 ITO. CO - JAPAN UNIT DALAM PROSES Rp 59,300,500 PT.Setio Harto Ltd.
INFRARED LAMP STAND ALONE S 300 ITO. CO - JAPAN UNIT DALAM PROSES Rp 63,085,700 PT.Setio Harto Ltd.
ULTRAVIOLET LAMP SH 30 ITO. CO - JAPAN UNIT DALAM PROSES Rp 166,546,200 PT.Setio Harto Ltd.
COMBINED ULTRAVIOLET & INFRARED LAMP SB 40 ITO. CO - JAPAN UNIT DALAM PROSES Rp 195,565,700 PT.Setio Harto Ltd.
LOW FREQUENCY STIMULATION CURRENT ES 420 ITO. CO - JAPAN UNIT DALAM PROSES Rp 44,412,300 PT.Setio Harto Ltd.
TENS PROGRAMMABLE ES 320 ITO. CO - JAPAN UNIT DALAM PROSES Rp 7,633,300 PT.Setio Harto Ltd.
ELECTRIC LOW & MEDIUM FREQUENCY STIMULATOR CURRENT ES 520 ITO. CO - JAPAN UNIT DALAM PROSES Rp 132,480,000 PT.Setio Harto Ltd.

EEG 32 CH E SERIES NEUROSCAN - AUSTRALIA UNIT DALAM PROSES Rp 1,135,542,800 PT.Setio Harto Ltd.
EEG 40 CH SCAN LT COMPUMEDICS - AUSTRALIA UNIT DALAM PROSES Rp 1,135,542,800 PT.Setio Harto Ltd.

5
HARGA JUAL SOLE AGENT (HJSA)

No. Nama Peralatan Kesehatan Merk & Negara Asal Satuan No Registrasi HJSA Sole Agent
(1) (2) (3) (4) (5) (6)
EMG 2 CH T2 CH VIASYS - ENGLAND UNIT DALAM PROSES Rp 2,372,285,700 PT.Setio Harto Ltd.
EMG 5 CH T5 CH VIASYS - ENGLAND UNIT AKL21401301970 Rp 2,809,285,700 PT.Setio Harto Ltd.
EMG 10 CH T10 CH VIASYS - ENGLAND UNIT DALAM PROSES Rp 3,620,857,100 PT.Setio Harto Ltd.
AMBULATORY HOLTER ECG MONITORING MEDILOG VIASYS - ENGLAND UNIT AKL21001301978 Rp 249,714,200 PT.Setio Harto Ltd.

VITAL SIGN MONITOR POET PLUS 8100 CRITICARE - USA UNIT DALAM PROSES Rp 394,285,700 PT.Setio Harto Ltd.
SPO2 & HR MONITOR 504 DX CRITICARE - USA UNIT DALAM PROSES Rp 138,000,000 PT.Setio Harto Ltd.
MINI SPO2 503 DX CRITICARE - USA UNIT DALAM PROSES Rp 98,571,400 PT.Setio Harto Ltd.
NIBP MONITOR 506 N2 SERIES CRITICARE - USA UNIT DALAM PROSES Rp 126,171,400 PT.Setio Harto Ltd.
EKG MONITOR SCHOLAR III CRITICARE - USA UNIT DALAM PROSES Rp 335,142,800 PT.Setio Harto Ltd.
DEFIBRILATOR DC SHOCK POWERHEART AEDG CRITICARE - USA UNIT DALAM PROSES Rp 177,428,500 PT.Setio Harto Ltd.

SPIROMETER SPIROLAB II MIR - ITALY UNIT DALAM PROSES Rp 197,142,800 PT.Setio Harto Ltd.

BIOLOGICAL MICROSCOPE BINOCULAR SZM 45-ST3T SCICHEMCO - USA UNIT AKL10203502972 Rp 39,400,000 PT.Setio Harto Ltd.

PERALATAN RADIOLOGY OMNISENSE 7000 S SUNLIGHT - HONGKONG UNIT AKL21501200013 Rp 750,000,000 PT.Setio Harto Ltd.

PERALATAN RADIOLOGY COBALT SOURCE COMPLETE SET MDS NORDION CANADA SET AKL11502300956 Rp 11,500,000,000 PT.Setio Harto Ltd.

KETERANGAN :
- HARGA SEWAKTU-WAKTU DAPAT BERUBAH
- HARGA JUAL SOLE AGENT ( HJSA )
- BELUM TERMASUK PPN
- LAYANAN GARANSI PURNA JUAL 1 ( SATU) TAHUN DILUAR SPAREPART
- BIAYA TRAINING DARI PERUSAHAAN OLEH TEHNISI DI DALAM NEGERI
Jakarta, Sept'05

6
DAFTAR INFORMASI HARGA PERALATAN KESEHATAN & LABORATORIUM

No.Registrasi HJSA
No. Urut Nama Peralatan Kesehatan Model/Type Merk Negara Asal/Pabrikan DepKes RI Satuan (Rp) Sole Agent
1 Electrocardiograph C120 FUKUDA M.E. KOGYO Japan AKL 20502502729 unit Rp 33.898.500,- PT. Karindo Alkestron
2 Electrocardiograph C110 FUKUDA M.E. KOGYO Japan AKL 20502502728 unit Rp 22.100.000,- PT. Karindo Alkestron
3 Electrocardiograph C 300 BX FUKUDA M.E. KOGYO Japan AKL 20502502170 unit Rp 81.600.000,- PT. Karindo Alkestron
4 Electrocardiograph C 300 BM FUKUDA M.E. KOGYO Japan AKL 20502502158 unit Rp 79.100.000,- PT. Karindo Alkestron
5 Multi Function Monitor - COLIN Japan KL 0501290965 unit Rp 74.382.000,- PT. Karindo Alkestron
6 Press Mate BP-8800 COLIN Japan KL 0501290964 unit Rp 41.358.600,- PT. Karindo Alkestron
7 BP Monitor BP-203 RV II COLIN Japan AKL 20501400925 unit Rp 48.251.700,- PT. Karindo Alkestron
8 Microtizer MT-SDi MINATO MEDICAL SCIENCE Japan KL 1403291060 unit Rp 28.473.000,- PT. Karindo Alkestron
9 Traction TC-MI MINATO MEDICAL SCIENCE Japan KL 1403290960 unit Rp 105.202.000,- PT. Karindo Alkestron
10 Superkine SK-3 MINATO MEDICAL SCIENCE Japan KL 1403291062 unit Rp 178.193.000,- PT. Karindo Alkestron
11 Prestige Washbasin ALB1002, ALB 1001 SUBTIL France KL 0903690018 unit Rp 91.854.000,- PT. Karindo Alkestron
12 Vertical Sterilizer - SUBTIL France KL 0903590557 unit Rp 279.216.000,- PT. Karindo Alkestron

Ket:
*Harga belum termasuk PPN 10%
*Harga tersebut di atas tidak terikat dan sewaktu-waktu bisa berubah
DAFTAR INFORMASI HARGA PERALATAN KESEHATAN & LABORATORIUM
EFFECTIVE : September 2005 S/D Maret 2006
No.Registrasi
No Urut Nama Peralatan Kesehatan Model/Type Merk Negara Asal/Pabrikan H J S A (Rp.) Sole Agent
DepKes RI
1 Patient Monitor Dinamap Pro 1000 GE Medical Systems USA AKL 20502400188 79,200,000 PT.Fondaco Mitratama
2 Patient Monitor Dash 2000 GE Medical Systems USA AKL 20502301010 99,000,000 PT.Fondaco Mitratama
3 Patient Monitor Dash 3000 GE Medical Systems USA AKL 20502300899 118,800,000 PT.Fondaco Mitratama
4 Patient Monitor Dash 4000 GE Medical Systems USA AKL 20502300898 139,920,000 PT.Fondaco Mitratama
5 Patient Monitor Solar 8000M GE Medical Systems USA Dalam proses daftar 264,000,000 PT.Fondaco Mitratama
6 Transport Monitor Dash Transport Pro GE Medical Systems USA Dalam proses daftar 198,000,000 PT.Fondaco Mitratama
7 Central Station CIC Central Station GE Medical Systems USA Dalam proses daftar 198,000,000 PT.Fondaco Mitratama
8 Telemetry System Telemetry GE Medical Systems USA Dalam proses daftar 541,200,000 PT.Fondaco Mitratama
9 NIBP Monitor Dinamap Pro Care 100 GE Medical Systems USA AKL 20502301016 26,400,000 PT.Fondaco Mitratama
10 NIBP Monitor Dinamap Pro Care 300 GE Medical Systems USA AKL 20502301030 39,600,000 PT.Fondaco Mitratama
11 Fetal Monitor Corometrics 170 Series GE Medical Systems USA Dalam proses daftar 85,800,000 PT.Fondaco Mitratama
12 Fetal Monitor Corometrics 120 Series GE Medical Systems USA Dalam proses daftar 198,000,000 PT.Fondaco Mitratama
13 Pulse Oximeter TuffSat GE Medical Systems USA Dalam proses daftar 11,880,000 PT.Fondaco Mitratama
14 Pulse Oximeter Trusat GE Medical Systems USA Dalam proses daftar 26,400,000 PT.Fondaco Mitratama
15 Resting ECG Mac 500 GE Medical Systems USA AKL 20502300858 26,400,000 PT.Fondaco Mitratama
16 Resting ECG Mac 1200ST GE Medical Systems USA AKL 20502300859 79,200,000 PT.Fondaco Mitratama
17 Resting ECG Mac 5000 GE Medical Systems USA AKL 20502300857 250,800,000 PT.Fondaco Mitratama
18 Stress Test System Case GE Medical Systems USA AKL 20502300855 396,000,000 PT.Fondaco Mitratama
19 Stress Test System CardioSoft GE Medical Systems USA Dalam proses daftar 277,200,000 PT.Fondaco Mitratama
20 Stress Test System CardioSoft + e-Bike GE Medical Systems USA Dalam proses daftar 184,800,000 PT.Fondaco Mitratama
21 Holter System Mars PC GE Medical Systems USA Dalam proses daftar 237,600,000 PT.Fondaco Mitratama
22 Defibrillator Cardioserv Std GE Medical Systems USA AKL 20505300856 81,840,000 PT.Fondaco Mitratama
23 Defibrillator Cardioserv S GE Medical Systems USA AKL 20505300856 102,960,000 PT.Fondaco Mitratama
24 Defibrillator Cardioserv P GE Medical Systems USA AKL 20505301048 97,680,000 PT.Fondaco Mitratama
25 Defibrillator Cardioser PS GE Medical Systems USA AKL 20505301049 118,800,000 PT.Fondaco Mitratama
26 Defibrillator Responder AED GE Medical Systems USA Dalam proses daftar 52,800,000 PT.Fondaco Mitratama
27 Defibrillator Responder AED Pro GE Medical Systems USA Dalam proses daftar 73,920,000 PT.Fondaco Mitratama
28 ABP Monitor Tonoport V GE Medical Systems USA Dalam proses daftar 21,120,000 PT.Fondaco Mitratama
29 Ventilator Galileo Gold Hamilton Medical Switzerland Dalam proses daftar 594,000,000 PT.Fondaco Mitratama
30 Ventilator Galileo Classic Hamilton Medical Switzerland KL 0403100332 528,000,000 PT.Fondaco Mitratama
31 Ventilator Raphael Basic Hamilton Medical Switzerland KL 0403100333 290,400,000 PT.Fondaco Mitratama
32 Ventilator Raphael Color Hamilton Medical Switzerland Dalam proses daftar 343,200,000 PT.Fondaco Mitratama
33 Ventilator Ventilair II Hamilton Medical Switzerland Dalam proses daftar 56,760,000 PT.Fondaco Mitratama
34 Operating Lights Hanaulux Blue 30 Stand Maquet Germany Dalam proses daftar 30,360,000 PT.Fondaco Mitratama
35 Operating Lights Hanaulux Blue 30S Stand Maquet Germany Dalam proses daftar 35,640,000 PT.Fondaco Mitratama
36 Operating Lights Hanaulux Blue 30S Hospital Maquet Germany Dalam proses daftar 74,580,000 PT.Fondaco Mitratama
37 Operating Lights Hanaulux Blue 80 Stand Maquet Germany Dalam proses daftar 81,840,000 PT.Fondaco Mitratama
38 Operating Lights Hanaulux Blue 80 Hospital Maquet Germany Dalam proses daftar 134,640,000 PT.Fondaco Mitratama
39 Operating Lights Hanaulux Blue 30 Wall Maquet Germany Dalam proses daftar 46,200,000 PT.Fondaco Mitratama
40 Operating Lights Hanaulux Blue 30S Wall Maquet Germany Dalam proses daftar 51,480,000 PT.Fondaco Mitratama
41 Operating Lights Hanaulux Blue 80 Wall Maquet Germany Dalam proses daftar 88,440,000 PT.Fondaco Mitratama
42 Operating Lights Hanaulux Blue 30 Single Ceiling Maquet Germany Dalam proses daftar 57,420,000 PT.Fondaco Mitratama
43 Operating Lights Hanaulux Blue 30S Single Ceiling Maquet Germany Dalam proses daftar 71,940,000 PT.Fondaco Mitratama
44 Operating Lights Hanaulux Blue 80 Single Ceiling Maquet Germany Dalam proses daftar 123,420,000 PT.Fondaco Mitratama
45 Operating Lights Hanaulux Blue 90 Single Ceiling Maquet Germany Dalam proses daftar 194,040,000 PT.Fondaco Mitratama
46 Operating Lights Hanaulux Blue 130 Single Ceiling Maquet Germany Dalam proses daftar 226,380,000 PT.Fondaco Mitratama
47 Operating Lights Hanaulux Blue 30S/30S Duo Ceiling Maquet Germany Dalam proses daftar 118,800,000 PT.Fondaco Mitratama
48 Operating Lights Hanaulux Blue 80/30S Duo Ceiling Maquet Germany Dalam proses daftar 170,280,000 PT.Fondaco Mitratama
49 Operating Lights Hanaulux Blue 80/80 Duo Ceiling Maquet Germany Dalam proses daftar 220,440,000 PT.Fondaco Mitratama
50 Operating Lights Hanaulux Blue 90/90 Duo Ceiling Maquet Germany Dalam proses daftar 342,540,000 PT.Fondaco Mitratama
51 Operating Lights Hanaulux Blue 130/90 Duo Ceiling Maquet Germany Dalam proses daftar 380,160,000 PT.Fondaco Mitratama
52 Operating Lights Hanaulux Blue 130/130 Duo Ceiling Maquet Germany Dalam proses daftar 421,080,000 PT.Fondaco Mitratama
53 Operating Lights Hanaulux Blue 130TV/90 Duo Ceiling Maquet Germany Dalam proses daftar 710,820,000 PT.Fondaco Mitratama
54 Operating Lights Hanaulux Blue 130TV/130 Duo Ceiling Maquet Germany Dalam proses daftar 743,160,000 PT.Fondaco Mitratama

Page 1 of 2
DAFTAR INFORMASI HARGA PERALATAN KESEHATAN & LABORATORIUM
EFFECTIVE : September 2005 S/D Maret 2006
No.Registrasi
No Urut Nama Peralatan Kesehatan Model/Type Merk Negara Asal/Pabrikan H J S A (Rp.) Sole Agent
DepKes RI
55 Operating Lights Hanaulux Blue 130/130/90 Triple Ceiling Maquet Germany Dalam proses daftar 545,160,000 PT.Fondaco Mitratama
56 Operating Lights Hanaulux Blue 130/90/90 Triple Ceiling Maquet Germany Dalam proses daftar 512,820,000 PT.Fondaco Mitratama
57 Operating Lights Hanaulux G-8 Single Maquet Germany Dalam proses daftar 306,900,000 PT.Fondaco Mitratama
58 Operating Lights Hanaulux G-8 Single Low Ceiling Height Maquet Germany Dalam proses daftar 309,870,000 PT.Fondaco Mitratama
59 Operating Lights Hanaulux G-8 Duo Maquet Germany Dalam proses daftar 543,180,000 PT.Fondaco Mitratama
60 Operating Lights Hanaulux G-8 Duo Low Ceiling Height Maquet Germany Dalam proses daftar 557,700,000 PT.Fondaco Mitratama
61 Operating Lights Hanaulux G-8 Duo TV Maquet Germany Dalam proses daftar 997,920,000 PT.Fondaco Mitratama
62 Operating Lights Hanaulux G-8 TV Low Ceiling Height Maquet Germany Dalam proses daftar 1,012,440,000 PT.Fondaco Mitratama
63 Operating Table Delta Classic 1115 Standard Maquet Germany Dalam proses daftar 336,600,000 PT.Fondaco Mitratama
64 Operating Table Beta Classic 1118.01 Maquet Germany Dalam proses daftar 455,400,000 PT.Fondaco Mitratama
65 Operating Table Alpha Classic 1118.03 Maquet Germany Dalam proses daftar 587,400,000 PT.Fondaco Mitratama
66 Operating Table Alpha Star 1132 Maquet Germany Dalam proses daftar 699,600,000 PT.Fondaco Mitratama
67 Operating Table Beta Star Maquet Germany Dalam proses daftar 699,600,000 PT.Fondaco Mitratama
68 Surgeon's Head Lamp 9300XDP 300W Luxtec USA Dalam proses daftar 277,200,000 PT.Fondaco Mitratama
69 Surgeon's Head Lamp 9100 Xenon 100W Luxtec USA Dalam proses daftar 132,000,000 PT.Fondaco Mitratama
70 Surgeon's Head Lamp LX300 Luxtec USA Dalam proses daftar 178,200,000 PT.Fondaco Mitratama
71 Blood Gas Analyzer i-Stat Abbott USA Dalam proses daftar 198,000,000 PT.Fondaco Mitratama
72 Suction Machine Twista SP 1070 Maquet Germany Dalam proses daftar 123,552,000 PT.Fondaco Mitratama
73 Suction Machine Bora UP 2080 Universal Maquet Germany Dalam proses daftar 102,960,000 PT.Fondaco Mitratama
74 Suction Machine Bora UP 2080 Surgical Maquet Germany Dalam proses daftar 106,128,000 PT.Fondaco Mitratama
75 Suction Machine Bora UP 2080 OP Universal Maquet Germany Dalam proses daftar 102,960,000 PT.Fondaco Mitratama
76 Suction Machine Bora UP 2080 OP Surgical Maquet Germany Dalam proses daftar 109,296,000 PT.Fondaco Mitratama
77 Suction Machine Ambulance Suction P 7020 Maquet Germany Dalam proses daftar 63,360,000 PT.Fondaco Mitratama
78 Suction Machine Septic Fluid Suction Pump P 7030 Maquet Germany Dalam proses daftar 71,280,000 PT.Fondaco Mitratama
79 Suction Machine Septic Fluid Suction Pump P 7050 Maquet Germany Dalam proses daftar 39,600,000 PT.Fondaco Mitratama
80 Suction Machine Drainage Suction Pump P 4020 Maquet Germany Dalam proses daftar 72,864,000 PT.Fondaco Mitratama
81 Suction Machine Ambulance Drainage Suction Pump P 4030 Maquet Germany Dalam proses daftar 74,448,000 PT.Fondaco Mitratama
82 Suction Machine Venta MC 16 without battery Maquet Germany Dalam proses daftar 20,592,000 PT.Fondaco Mitratama
83 Suction Machine Venta CC 16 with battery Maquet Germany Dalam proses daftar 38,016,000 PT.Fondaco Mitratama
84 Suction Machine Venta MC 26 without battery Maquet Germany Dalam proses daftar 28,512,000 PT.Fondaco Mitratama
85 Adult Oxygenator (Coated) Trillium Affinity Oxygenator (Coated) Medtronic USA Dalam proses daftar 8,316,000 PT.Fondaco Mitratama
86 Adult Oxygenator (Non-Coated) Affinity Oxygenator ( Non Coated) Medtronic USA Dalam proses daftar 7,260,000 PT.Fondaco Mitratama
87 Pediatric/Infant Oxygenator Minimax Oxygenator (Pediatric Infant) Medtronic USA Dalam proses daftar 7,524,000 PT.Fondaco Mitratama
88 Heart Stabilizer Octopus 4 Medtronic USA Dalam proses daftar 19,800,000 PT.Fondaco Mitratama
89 Heart Positioner Starfish 2 Medtronic USA Dalam proses daftar 15,840,000 PT.Fondaco Mitratama
90 Tissue Valve Hancock II Tissue Valve Medtronic USA Dalam proses daftar 19,800,000 PT.Fondaco Mitratama
92 PTCA Balloon Ma'sla Just PTCA Balloon Asahi Intecc Japan Dalam proses daftar 4,620,000 PT.Fondaco Mitratama
93 PTCA Guidewire ASAHI WIRE Asahi Intecc Japan Dalam proses daftar 1,452,000 PT.Fondaco Mitratama
94 PTCA Catheter TORNUS CATHETER Asahi Intecc Japan Dalam proses daftar 5,940,000 PT.Fondaco Mitratama
95 PTCA Guiding Catheter ASAHI INTECC ANGIOGRAPHIC CATHETERS Asahi Intecc Japan Dalam proses daftar 237,600 PT.Fondaco Mitratama
96 PTCA Guiding Catheter PTCA Guiding catheters Asahi Intecc Japan Dalam proses daftar 1,320,000 PT.Fondaco Mitratama
97 PTCA Stent GAZELLE Coronory Stent Biosensors Singapore Dalam proses daftar 7,524,000 PT.Fondaco Mitratama
98 PTCA Balloon Power Line PTCA Balloon Biosensors Singapore Dalam proses daftar 5,544,000 PT.Fondaco Mitratama
99 PTCA Wire Asahi Neo PTCA Wire Biosensors Singapore Dalam proses daftar 1,452,000 PT.Fondaco Mitratama
100 PTCA Wire Asahi Miracle PTCA Wire Biosensors Singapore Dalam proses daftar 2,640,000 PT.Fondaco Mitratama
101 Drug Eluting Stent Excel Drug Stent Biosensors Singapore Dalam proses daftar 27,720,000 PT.Fondaco Mitratama

Page 2 of 2
DAFTAR HARGA ALAT-ALAT KESEHATAN DAN LABORATORIUM
PT. ABADINUSA USAHASEMESTA

Product Socorex - Switzerland

No Cat. Description Registrasi Harga

1 815 0001 Acura fix micropipette vol. 1 ul - Rp. 2,700,000.00


2 815 0005 Acura fix micropipette vol. 5 ul - Rp. 2,700,000.00
3 815 0010 Acura fix micropipette vol. 10 ul - Rp. 2,700,000.00
4 815 0015 Acura fix micropipette vol. 15 ul - Rp. 2,700,000.00
5 815 0020 Acura fix micropipette vol. 20 ul - Rp. 2,700,000.00
6 815 0025 Acura fix micropipette vol. 25 ul - Rp. 2,700,000.00
7 815 0030 Acura fix micropipette vol. 30 ul - Rp. 2,700,000.00
8 815 0040 Acura fix micropipette vol. 40 ul - Rp. 2,700,000.00
9 815 0050 Acura fix micropipette vol. 50 ul - Rp. 2,700,000.00
10 815 0060 Acura fix micropipette vol. 60 ul - Rp. 2,700,000.00
11 815 0070 Acura fix micropipette vol. 70 ul - Rp. 2,700,000.00
12 815 0075 Acura fix micropipette vol. 75 ul - Rp. 2,700,000.00
13 815 0080 Acura fix micropepette vol. 80 ul - Rp. 2,700,000.00
14 815 0090 Acura fix micropipette vol. 90 ul - Rp. 2,700,000.00
15 815 0100 Acura fix micropipette vol. 100 ul - Rp. 2,700,000.00
16 815 0120 Acura fix micropipette vol. 120 ul - Rp. 2,700,000.00
17 815 0150 Acura fix micropipette vol. 150 ul - Rp. 2,700,000.00
18 815 0200 Acura fix micropipette vol. 200 ul - Rp. 2,700,000.00
19 815 0250 Acura fix micropipette vol. 250 ul - Rp. 2,700,000.00
20 815 0300 Acura fix micropipette vol. 300 ul - Rp. 2,700,000.00
21 815 0400 Acura fix micropipette vol. 400 ul - Rp. 2,700,000.00
22 815 0500 Acura fix micropipette vol. 500 ul - Rp. 2,700,000.00
23 815 0600 Acura fix micropipette vol. 600 ul - Rp. 2,700,000.00
24 815 0700 Acura fix micropipette vol. 700 ul - Rp. 2,700,000.00
25 815 0750 Acura fix micropipette vol. 750 ul - Rp. 2,700,000.00
26 815 0800 Acura fix micropipette vol. 800 ul - Rp. 2,700,000.00
27 815 0900 Acura fix micropipette vol. 900 ul - Rp. 2,700,000.00
28 815 1000 Acura fix micropipette vol. 1000 ul - Rp. 2,700,000.00
29 835 F02 Acura fix macropipette vol. 2 ml - Rp. 3,235,000.00
30 835 F02.5 Acura fix macropipette vol. 2.5 ml - Rp. 3,235,000.00
31 835 F05 Acura fix macropipette vol. 5 ml - Rp. 3,235,000.00
32 835 F10 Acura fix macropipette vol. 10 ml - Rp. 3,235,000.00
33 825 0002 Acura digital micropipette vol. 0.1 - 2 ul - Rp. 4,200,000.00
34 825 0010 Acura digital micropipette vol. 0.5 - 10 ul - Rp. 4,200,000.00
35 825 0010Y Acura digital micropipette vol. 1 - 10 ul - Rp. 3,873,000.00
36 825 0020 Acura digital micropipette vol. 2 - 20 ul - Rp. 3,873,000.00
37 825 0050 Acura digital micropipette vol. 5 - 50 ul - Rp. 3,873,000.00
38 825 0100 Acura digital micropipette vol. 10 - 100 ul - Rp. 3,873,000.00
39 825 0200 Acura digital micropipette vol. 20 - 200 ul - Rp. 3,873,000.00
40 825 1000 Acura digital micropipette vol. 100 - 1000 ul - Rp. 3,873,000.00
No Cat. Description Registrasi Harga

41 835 05 Acura digital macropipette vol. 0.5 - 5 ml - Rp. 4,315,000.00


42 835 10 Acura digital macropipette vol. 1 - 10 ml - Rp. 4,315,000.00
43 822 0002 Calibra pipette vol. 0.2 - 2 ul - Rp. 4,865,000.00
44 822 0010 Calibra pipette vol. 1 - 10 ul - Rp. 4,865,000.00
45 822 0020 Calibra pipette vol. 2 - 20 ul - Rp. 4,600,000.00
46 822 0100 Calibra pipette vol. 10 - 100 ul - Rp. 4,600,000.00
47 822 0200 Calibra pipette vol. 20 - 200 ul - Rp. 4,600,000.00
48 822 1000 Calibra pipette vol. 100 - 1000 ul - Rp. 4,600,000.00
49 832.02 Cal. Digital macro pipette vol. 0,2 - 2 ml - Rp. 5,100,000.00
50 832.10 Cal. Digital macro pipette vol. 1 - 10 ml - Rp. 5,100,000.00
51 855.08.010 Acura Digital multi 8 channel vol. 0,5-10 ul - Rp. 11,200,000.00
52 855.08.050 Acura Digital multi 8 channel vol. 5-50 ul - Rp. 10,600,000.00
53 855.08.350 Acura Digital multi 8 channel vol. 40-350 ul - Rp. 10,600,000.00
54 855.12.010 Acura Digital multi 12 channel vol. 0,5-10 ul - Rp. 12,900,000.00
55 855.12.050 Acura Digital multi 12 channel vol. 5-50 ul - Rp. 12,080,000.00
56 855.12.350 Acura Digital multi 12 channel vol. 40-350 ul - Rp. 12,080,000.00
57 852.08.010 Cal. Digital multi 8 channel, 1 - 10 ul - Rp. 13,400,000.00
58 852.08.100 Cal. Digital multi 8 channel, 10 - 100 ul - Rp. 12,600,000.00
59 852.08.200 Cal. Digital multi 8 channel, 20 - 200 ul - Rp. 12,600,000.00
60 852.12.100 Cal. Digital multi 12 channel, 10 - 100 ul - Rp. 14,450,000.00
61 852.12.200 Cal. Digital multi 12 channel, 20 - 200 ul - Rp. 14,450,000.00
62 520.02 Calibrex digital top dispenser 0,25 - 2 ml - Rp. 5,000,000.00
63 520.05 Calibrex digital top dispenser 1 - 5 ml - Rp. 5,000,000.00
64 520.10 Calibrex digital top dispenser 1 - 10 ml - Rp. 5,000,000.00
65 521.020 Calibrex digital top dispenser 2 - 20 ml - Rp. 8,550,000.00
66 521.050 Calibrex digital top dispenser 10 - 50 ml - Rp. 9,400,000.00
67 521.100 Calibrex digital top dispenser 10 - 100 ml - Rp. 11,400,000.00
68 411.5000 Stepper - Rp. 5,050,000.00
69 435 Profiller - Rp. 1,580,000.00
70 312.02 Macro tips 2 ml for 832.02 bag of 2x250 - Rp. 1,412,000.00
71 312.05 Macro tips 5 ml for 835.05, bag of 2x250 - Rp. 1,412,000.00
72 312.1 Macro tips 10 ml for 832.10&835.10, bag of 3x100 - Rp. 1,600,000.00
73 308.0200B Natural tips 200 ul, 1000/pack - Rp. 1,040,000.00
74 309.0010B Natural ultra micro tips 10 ul, 1000/pack - Rp. 736,000.00
75 320.337 Work station F / 7 pipette - Rp. 1,785,000.00
76 320.340 Work station F / 3 pipette - Rp. 1,785,000.00
77 328.0200B Yellow tips, bags of 2x500 Pcs - Rp. 620,000.00
78 319.1000B Blue tips, bag of 4x250 Pcs - Rp. 630,000.00
79 302.0020B Microtips natural 20 ul, bag of 1000 Pcs - Rp. 716,000.00
80 307.0200B Natural universal tips, bag of 2x500 Pcs - Rp. 620,000.00
81 307.1000B Natural universal tips, bag of 4x250 Pcs - Rp. 808,000.00
82 309.0010R Natural Ultra Microtip, 96 pcs/Rack - Rp. 160,000.00
83 328.0200R Yellow Tips, 96 pcs/Rack - Rp. 123,000.00
84 319.1000R Blue Tips, 60 pcs/Rack - Rp. 126,500.00
Acura Electro 925 micropipette
85 925.001 Volume 0.5-10 ul - Rp. 9,706,000.00
86 925.0050 Volume 2.5-50 ul - Rp. 9,706,000.00
87 925.02 Volume 10-200 ul - Rp. 9,706,000.00
No Cat. Description Registrasi Harga

88 925.1000 Volume 50-1000 ul - Rp. 9,706,000.00


Acura Electro 935 macropipette
89 935.05X Volume 0.25- 5 ml - Rp. 10,042,000.00
90 935.10X Volume 0.5-10 ml - Rp. 10,042,000.00
91 Acura Electro 955 micropipette -
92 955.08.010X Volume 0.5- 10 ul - Rp. 16,750,000.00
93 955.08.050X Volume 2.5-50 ul - Rp. 16,100,000.00
94 955.08.350X Volume 20- 350 ul - Rp. 16,100,000.00
Acura Electro 925 micropipette Basic Package
95 925.0010X Volume 0.5-10 ul - Rp. 13,160,000.00
96 925.0050X Volume 2.5-50 ul - Rp. 13,160,000.00
97 925.0200X Volume 10-200 ul - Rp. 13,160,000.00
98 925.1000X Volume 50-1000 ul - Rp. 13,160,000.00
Acura Electro 935 macropipette Basic Package
99 935.05X Volume 0.25- 5 ml - Rp. 13,512,000.00
100 935.10X Volume 0.5-10 ml - Rp. 13,512,000.00
101 Acura Electro 955 micropipette Basic Package -
102 955.08.010X Volume 0.5- 10 ul - Rp. 19,412,000.00
103 955.08.050X Volume 2.5-50 ul - Rp. 18,924,000.00
104 955.08.350X Volume 20- 350 ul - Rp. 18,924,000.00
105 955.12.010X Volume 0.5- 10 ul - Rp. 21,000,000.00
106 955.12.050X Volume 2.5-50 ul - Rp. 19,700,000.00
107 955.12.350X Volume 20- 350 ul - Rp. 19,700,000.00
108 155.0301 Dosys luer nozzle 0.1 - 1 ml - Rp. 346,000.00
109 155.0305 Dosys luer nozzle 0.2 - 5 ml - Rp. 230,000.00
110 155.0310 Dosys luer nozzle 1 - 10 ml - Rp. 346,000.00
111 155.032 Dosys luer nozzle 1 - 20 ml - Rp. 346,000.00
112 155.0501 Dosys luer lock metal 0.1 - 1 ml - Rp. 412,000.00
113 155.0502 Dosys luer lock metal 0.5 - 2 ml - Rp. 412,000.00
114 155.0505 Dosys luer lock metal 0.2 - 5 ml - Rp. 445,000.00
115 155.051 Dosys luer lock metal 1 - 10 ml - Rp. 530,000.00
116 155.0520 Dosys luer lock metal 1 - 20 ml - Rp. 530,000.00
117 155.0550 Dosys luer lock metal 1 - 50 ml - Rp. 570,000.00
118 162.0501 Dosys basic automatic syringe 0.1 - 1 ml - Rp. 1,745,000.00
119 162.0502 Dosys basic automatic syringe 0.3 - 2 ml - Rp. 1,745,000.00
120 162.0505 Dosys basic automatic syringe 0.5 - 5 ml - Rp. 1,903,000.00
121 163.05003 Dosys classic automatic syringe 0.025 - 0.3 ml - Rp. 2,042,000.00
122 163.05005 Dosys classic automatic syringe 0.01 - 0.5 ml - Rp. 2,042,000.00
123 163.0501 Dosys classic automatic syringe 0.1 - 1 ml - Rp. 1,805,000.00
124 163.0502 Dosys classic automatic syringe 0.3 - 2 ml - Rp. 1,805,000.00
125 164.0501 Dosys premium automatic syringe 0.1 - 1 ml - Rp. 3,100,000.00
126 164.0502 Dosys premium automatic syringe 0.3 - 2 ml - Rp. 3,100,000.00
127 164.0505 Dosys premium automatic syringe 0.5 - 5 ml - Rp. 3,315,000.00
128 164.051 Dosys premium automatic syringe 1 - 10 ml - Rp. 3,690,000.00
129 172.0501 Dosys basic automatic syringe 0.1 - 1 ml - Rp. 1,765,000.00
130 172.0502 Dosys basic automatic syringe 0.3 - 2 ml - Rp. 1,765,000.00
131 172.0505 Dosys basic automatic syringe 0.5 - 5 ml - Rp. 1,942,000.00
132 172.051 Dosys basic automatic syringe 1 - 10 ml - Rp. 2,235,000.00
No Cat. Description Registrasi Harga

133 173.05003 Dosys classic automatic syringe 0.025 - 0.3 ml - Rp. 2,079,000.00
134 173.05005 Dosys classic automatic syringe 0.01 - 0.5 ml - Rp. 2,040,000.00
135 173.0501 Dosys classic automatic syringe 0.1 - 1 ml - Rp. 1,864,000.00
136 173.0502 Dosys classic automatic syringe 0.3 - 2 ml - Rp. 1,864,000.00
137 173.0505 Dosys classic automatic syringe 0.3 - 2 ml - Rp. 2,040,000.00
138 173.051 Dosys classic automatic syringe 1 - 10 ml - Rp. 2,315,000.00
139 173.0520 Dosys classic automatic syringe 5 - 20 ml - Rp. 4,000,000.00
140 174.0501 Dosys premium automatic syringe 0.1 - 1 ml - Rp. 3,285,000.00
141 174.0502 Dosys premium automatic syringe 0.3 - 2 ml - Rp. 3,285,000.00
142 174.0505 Dosys premium automatic syringe 0.5 - 5 ml - Rp. 3,490,000.00
143 174.0510 Dosys premium automatic syringe 1 - 10 ml - Rp. 3,903,000.00
144 371.081 Bevelled Needle, 12 pcs/pack - Rp. 294,000.00
145 309.0010 FR Sterile ultra microtip - Rp. 4,832,000.00
146 302.0010 FR Sterile microtip - Rp. 4,832,000.00
147 302.0010 AFR Autoclavable microtip, non sterile - Rp. 4,077,000.00
148 302.0010 AFB Autoclavable microtip, non sterile - Rp. 2,735,000.00
149 302.0010 GR Sterile Gel loading tip - Rp. 1,765,000.00
150 308.0020 FR Sterile tip - Rp. 4,832,000.00
151 308.0020 FS Single wrapped - Rp. 3,234,000.00
152 308.0020 AFR Autoclavable tip, non sterile - Rp. 4,077,000.00
153 308.0020 GFR Sterile Gel loading tip - Rp. 4,832,000.00
154 308.0100 FR Sterile tip - Rp. 4,832,000.00
155 308.0100 AFR Autoclavable tip, non sterile - Rp. 4,077,000.00
156 308.0100 AFB Autoclavable tip, non sterile - Rp. 2,735,000.00
157 308.0100 GFR Sterile Gel loading tip - Rp. 3,200,000.00
158 308.0200 LFR Sterile extended tip - Rp. 8,773,000.00
159 308.0200 LFS Single wrapped - Rp. 3,490,000.00
160 308.0300 FR Sterile, natural tip - Rp. 4,800,000.00
161 308.0300 AFR Autoclavable tip, non sterile - Rp. 4,100,000.00
162 308.0300 AFB Autoclavable tip, non sterile - Rp. 2,735,000.00
163 309.1000 FR Sterile, natural tip - Rp. 5,250,000.00
164 309.1000 FS Single wrapped - Rp. 3,390,000.00
165 309.1000 AFB Autoclavable tip, non sterile - Rp. 2,735,000.00
DAFTAR HARGA ALAT-ALAT KESEHATAN DAN LABORATORIUM
PT. ABADINUSA USAHASEMESTA

Product Thermo Jouan - France

No Cat. Description Registrasi Harga

1 11174540 Microtubes Bench Top Ventilated Centrifuge A.12 - EUR 3,927.00


2 11174542 Microtubes Bench Top Ventilated Centrifuge A.14 - EUR 4,446.00
3 11174544 Microhaematocrit Centrifuge A.13 - EUR 4,090.00
4 11174300 Universal Small Centrifuge Type : BBVV - EUR 3,386.00
5 11174510 Bench Top ventilated Cnetrifuge B.311 - EUR 6,636.00
6 11175770 C3i Multi Function Ventilated Bench Top Centrifuge - EUR 10,255.00
7 11175774 CR 3i Multi-Function Refrigerated Bench Top Centrifuge - EUR 15,200.00
8 11175670 B4i Multi Function Bench Top Centrifuge - EUR 7,636.00
9 11175674 BR 4i Multi Function Refrigerated Bench Top Centrifuge - EUR 12,309.00
10 11174729 MR 23i Multi Function Refrigerated High Speed Centrifuge - EUR 20,527.00
with Auto-Lock
11 11175318 C 4.22 Programmable Bench Top Ventilated Centrifuge - EUR 15,690.00
4 x 750 ml, 148 x 5 ml
12 11175336 Bench Top Centrifuge Refrigerated - EUR 16,490.00
13 11175330 Programmable Bench Top Centrifuge Refrigerated - EUR 22,610.00
4 x 750 ml, 148 x 5 ml 18,182.00
17 11176913 Floor Standing Centrifuge Refrigerated 4 x 750 ml, 148 x 5 ml - EUR 24,364.00
18 11176917 Programmable Floor Standing Centrifuge Refrigerated 4 x 750 - EUR 24,364.00
ml, 148 x 5 ml
19 11174650 High Speed Floor Standing Refrigerate Centrifuge - EUR 33,218.00
20 11178066 KR 422 Floor Standing Refrigerated Centrifuge 6 x 1000 ml, - EUR 58,909.00
12 blood bags
21 11178160 KR 4i Refrigerated Centrifuges 6 x 1000 ml - EUR 55,636.00
22 11177390 KR25i High Speed Floor Standing Refrigerated - EUR 54,000.00
23 52210001 IG 650 CO2 Incubator With RH Control - EUR 29,455.00
24 52210003 IG 750 3 GAS / RH / CO2 Incubator - EUR 35,364.00
25 42723000 Innovens EU2-77 - EUR 5,073.00
26 42713000 Innovens EU1-77 - EUR 4,709.00
27 42724000 Innovens EU2-118 - EUR 5,618.00
28 42714000 Innovens EU1-118 - EUR 4,890.00
29 42725000 Innovens EU2-162 - EUR 7,200.00
30 42715000 Innovens EU1-162 - EUR 5,982.00
31 42726000 Innovens EU2-234 - EUR 8,818.00
32 42716000 Innovens EU1-234 - EUR 8,255.00
33 42733000 Innovens EU3-77 - EUR 7,018.00
34 42734000 Innovens EU3-118 - EUR 7,928.00
35 42735000 Innovens EU3-162 - EUR 9,073.00
36 42736000 Innovens EU3-234 - EUR 11,527.00
37 461151202 Oven Type EU-500 - EUR 14,727.00
38 46161202 Oven Type EU-720 - EUR 17,255.00
No Cat. Description Registrasi Harga

39 42752000 InnovensTM EB2-55 - EUR 3,946.00


TM
40 42742000 Innovens EB1-55 - EUR 3,500.00
41 42753000 Innovens TM EB2-77 - EUR 4,673.00
TM
42 42743000 Innovens EB1-77 - EUR 4,346.00
TM
43 42763000 Innovens EB3-77 - EUR 6,527.00
TM
44 42754000 Innovens EB2-118 - EUR 5,400.00
TM
45 42744000 Innovens EB1-118 - EUR 4,855.00
TM
46 42764000 Innovens EB3-118 - EUR 7,364.00
TM
47 42755000 Innovens EB2-162 - EUR 7,437.00
TM
48 42745000 Innovens EB3-162 - EUR 5,946.00
TM
49 42765000 Innovens EB3-162 - EUR 9,746.00
TM
50 42756000 Innovens EB2-234 - EUR 9,709.00
TM
51 42746000 Innovens EB1-234 - EUR 7,436.00
TM
52 42766000 Innovens EB3-234 - EUR 11,800.00
53 41353000 Incubator Type EB-500 - EUR 12,890.00
54 41363000 Incubator Type EB-720 - EUR 14,527.00
55 41373000 Incubator Type EB-950 - EUR 18,509.00
56 41093014 Waterbath Type J-12 - EUR 2,527.00
57 41093015 Waterbath Type J-18 - EUR 2,890.00
58 41093016 Waterbath Type J-30 - EUR 3,236.00
59 52070000 MSC.9 Microbiological Safety Cabinet - EUR 18,490.00
60 52010000 MSC.12 Microbiological Safety Cabinet - EUR 19,818.00
61 11326301 Mini Artic Cooled Incubator - EUR 9,073.00
62 11326351 Maxi Artic Cooled Incubator - EUR 11,618.00
63 51500724 Power Freeze Deep Freezer VX-380S - EUR 29,964.00
64 51500728 Power Freeze Deep Freezer VX490S - EUR 32,546.00
65 51500732 Powerfreeze Deep Freezer Model VX570S - EUR 35,636.00
66 51500712 Deep Freezer VXE 380 - EUR 26,182.00
67 51500716 Deep Freezer VXE 490 - EUR 28,346.00
68 11176780 RC 10.09 Centrifugal Evaporator - EUR 7,436.00
69 11176720 RC 10.10 Centrifugal Evaporator - EUR 10,890.00
70 11176713 RC 10.22 Centrifugal Evaporator - EUR 18,395.00
71 51890078 Decontakit (Microbiological Decontamination) - EUR 5,690.00
DAFTAR HARGA
PT. TRIASTRI MEDITAMA

No Nama Peralatan Kesehatan Model / Type Merk Negara Asal / No. Registrasi Satuan HJSA Sole Agent
Pabrikan DepKes RI (Rp)

1. Slit lamp 900 BQ for video & photo 900 BQ HAAG STREIT Switzerland HK.01.02.SK.I.82unit 180,378,000 TRIASTRI MEDITAMA
Slit lamp BP 900 for video & photo BP 900 HAAG STREIT Switzerland HK.01.02.SK.I.82unit 148,555,000 TRIASTRI MEDITAMA
Slit lamp BD 900 for video BD 900 HAAG STREIT Switzerland HK.01.02.SK.I.82unit 122,045,000 TRIASTRI MEDITAMA
Slit lamp 900 BM 900 BM HAAG STREIT Switzerland HK.01.02.SK.I.82unit 140,338,000 TRIASTRI MEDITAMA
Slit lamp BX 900 for photo BX 900 HAAG STREIT Switzerland HK.01.02.SK.I.82unit 450,692,000 TRIASTRI MEDITAMA
Ophthalmometer OM900 OM 900 HAAG STREIT Switzerland HK.01.02.SK.I.82unit 119,988,000 TRIASTRI MEDITAMA
Keratograph CTK 922 CTK 922 HAAG STREIT Switzerland HK.01.02.SK.I.82unit 333,905,000 TRIASTRI MEDITAMA
Goldmann Perimeter 940-K7 940-K7 HAAG STREIT Switzerland HK.01.02.SK.I.82unit 302,984,000 TRIASTRI MEDITAMA
Goldmann Perimeter 940-ST 940-ST HAAG STREIT Switzerland HK.01.02.SK.I.82unit 362,648,000 TRIASTRI MEDITAMA
Lotmar Visometer/Retinometer LOTMAR HAAG STREIT Switzerland HK.01.02.SK.I.82unit 64,779,000 TRIASTRI MEDITAMA
Applanation Tonometer AT 900 HAAG STREIT Switzerland HK.01.02.SK.I.82unit 17,754,000 TRIASTRI MEDITAMA
Lensa Gonioscopy 902 one mirror 902 HAAG STREIT Switzerland HK.01.02.SK.I.82unit 3,289,000 TRIASTRI MEDITAMA
Lensa Gonioscopy 905 two mirror 905 HAAG STREIT Switzerland HK.01.02.SK.I.82unit 3,795,000 TRIASTRI MEDITAMA
Lensa Gonioscopy 903 three mirror 903 HAAG STREIT Switzerland HK.01.02.SK.I.82unit 5,368,000 TRIASTRI MEDITAMA
Lensa three mirror 906 906 HAAG STREIT Switzerland HK.01.02.SK.I.82unit 6,347,000 TRIASTRI MEDITAMA
Lensa three mirror 907 11mm 907 HAAG STREIT Switzerland HK.01.02.SK.I.82unit 4,895,000 TRIASTRI MEDITAMA
Lensa four mirror 908 908 HAAG STREIT Switzerland HK.01.02.SK.I.82unit 6,732,000 TRIASTRI MEDITAMA
Laser contact glass Retina 145 145 HAAG STREIT Switzerland HK.01.02.SK.I.82unit 9,647,000 TRIASTRI MEDITAMA
Laser Three mirror contact glass 903L903L HAAG STREIT Switzerland HK.01.02.SK.I.82unit 5,445,000 TRIASTRI MEDITAMA
Laser Three mirror contact glass 630L630L HAAG STREIT Switzerland HK.01.02.SK.I.82unit 4,532,000 TRIASTRI MEDITAMA
Laser Three mirror contact glass 906L906L HAAG STREIT Switzerland HK.01.02.SK.I.82unit 5,863,000 TRIASTRI MEDITAMA
Laser Three mirror contact glass 907L907L HAAG STREIT Switzerland HK.01.02.SK.I.82unit 5,863,000 TRIASTRI MEDITAMA
Laser contact glass CGIL CGIL HAAG STREIT Switzerland HK.01.02.SK.I.82unit 6,974,000 TRIASTRI MEDITAMA
Laser contact glass CGAL CGAL HAAG STREIT Switzerland HK.01.02.SK.I.82unit 20,284,000 TRIASTRI MEDITAMA
Laser contact glass CGPL CGPL HAAG STREIT Switzerland HK.01.02.SK.I.82unit 5,863,000 TRIASTRI MEDITAMA
Laser contact glass CGRL CGRL HAAG STREIT Switzerland HK.01.02.SK.I.82unit 7,480,000 TRIASTRI MEDITAMA
Laser contact glass CGVL CGVL HAAG STREIT Switzerland HK.01.02.SK.I.82unit 12,265,000 TRIASTRI MEDITAMA

2. Cataract Set JOHNWEISS England HK.01.02.SK.I.82set 90,387,000 TRIASTRI MEDITAMA


Hordeolum & Pterygium set JOHNWEISS England HK.01.02.SK.I.82set 30,855,000 TRIASTRI MEDITAMA
Strabismus Set JOHNWEISS England HK.01.02.SK.I.82set 37,928,000 TRIASTRI MEDITAMA
DAFTAR HARGA
PT. TRIASTRI MEDITAMA

Minor set JOHNWEISS England HK.01.02.SK.I.82set 41,107,000 TRIASTRI MEDITAMA


Cataract & Phaco set JOHNWEISS England HK.01.02.SK.I.82set 103,503,000 TRIASTRI MEDITAMA

3. Fundus Camera RC-XV3 RC-XV3 KOWA Japan HK.01.02.SK.I.82unit 323,554,000 TRIASTRI MEDITAMA
Fundus Camera Myd & Non Myd VX- VX-10 KOWA Japan HK.01.02.SK.I.82unit 430,518,000 TRIASTRI MEDITAMA
Fundus Camera VX-10i with ICG Ang VX-10i KOWA Japan HK.01.02.SK.I.82unit 520,058,000 TRIASTRI MEDITAMA
Fundus Camera Non myd α D NON MYD α D KOWA Japan HK.01.02.SK.I.82unit 485,408,000 TRIASTRI MEDITAMA
Handheld Fundus Camera GENESIS GENESIS KOWA Japan HK.01.02.SK.I.82unit 259,666,000 TRIASTRI MEDITAMA
Digital Imaging System VK-2 VK-2 KOWA Japan HK.01.02.SK.I.82unit 433,378,000 TRIASTRI MEDITAMA
Auto Refractometer KA-1000 KA-1000 KOWA Japan HK.01.02.SK.I.82unit 115,434,000 TRIASTRI MEDITAMA
Auto Refracto-Keratometer KW-2000 KW-2000 KOWA Japan HK.01.02.SK.I.82unit 143,264,000 TRIASTRI MEDITAMA
Non Contact Tonometer KT-500 KT-500 KOWA Japan HK.01.02.SK.I.82unit 178,838,000 TRIASTRI MEDITAMA
Automatic Perimeter AP-5000C AP-5000C KOWA Japan HK.01.02.SK.I.82unit 250,668,000 TRIASTRI MEDITAMA
Handheld Slit lamp SL-15 SL-15 KOWA Japan HK.01.02.SK.I.82unit 92,928,000 TRIASTRI MEDITAMA
Digital Lensmeter LK-1 LK-1 KOWA Japan HK.01.02.SK.I.82unit 29,766,000 TRIASTRI MEDITAMA
Laser Flare meter FM-500 FM-500 KOWA Japan HK.01.02.SK.I.82unit 707,608,000 TRIASTRI MEDITAMA
Laser Flare meter FC-2000 RC-2000 KOWA Japan HK.01.02.SK.I.82unit ########## TRIASTRI MEDITAMA

4. Operation Microscope KOM-300S KOM-300S KONAN Japan HK.01.02.SK.I.82unit 145,442,000 TRIASTRI MEDITAMA
Operation Microscope KOM-300X KOM-300X KONAN Japan HK.01.02.SK.I.82unit 224,818,000 TRIASTRI MEDITAMA
Operation Microscope KOM-300CA-E KOM-300CA-E KONAN Japan HK.01.02.SK.I.82unit 145,442,000 TRIASTRI MEDITAMA
Portable Operation Microscope POM- POM-50 II KONAN Japan HK.01.02.SK.I.82unit 61,468,000 TRIASTRI MEDITAMA
Non contact specular microsope SP-9SP-9000 KONAN Japan HK.01.02.SK.I.82unit 605,000,000 TRIASTRI MEDITAMA
Non contact specular microsope CC-7CC-7000 KONAN Japan HK.01.02.SK.I.82unit 532,400,000 TRIASTRI MEDITAMA

5. Refracting Unit DUET DUET LUNEAU France HK.01.02.SK.I.82unit 262,746,000 TRIASTRI MEDITAMA
Chart projector L-29 L-29 LUNEAU France HK.01.02.SK.I.82unit 45,342,000 TRIASTRI MEDITAMA
Auto Lensmeter L-50 L-50 LUNEAU France HK.01.02.SK.I.82unit 106,975,000 TRIASTRI MEDITAMA
Javal Schiot JVL 1 Keratometer JAVAL SCHIOT J LUNEAU France HK.01.02.SK.I.82unit 46,618,000 TRIASTRI MEDITAMA
Hand Held Auto Keratometer LUNEAU France HK.01.02.SK.I.82unit 213,466,000 TRIASTRI MEDITAMA
Hand Held Auto Keratometer K+2 LUNEAU France HK.01.02.SK.I.82unit 265,672,000 TRIASTRI MEDITAMA
L-2 Pair of Retinoscopy racks L-29 LUNEAU France HK.01.02.SK.I.82pair 2,585,000 TRIASTRI MEDITAMA

6. Synoptophore 2001 2001 CLEMENT CLAEngland HK.01.02.SK.I.82unit 178,805,000 TRIASTRI MEDITAMA


Perkins MK2 Handheld Applanation T PERKINS MK2 CLEMENT CLAEngland HK.01.02.SK.I.82unit 29,315,000 TRIASTRI MEDITAMA
TNO Stereotest with red/green spectaTNO CLEMENT CLAEngland HK.01.02.SK.I.82unit 4,730,000 TRIASTRI MEDITAMA
DAFTAR HARGA
PT. TRIASTRI MEDITAMA

Cambridge low contrast gratings CAMBRIDGE CLEMENT CLAEngland HK.01.02.SK.I.82unit 2,508,000 TRIASTRI MEDITAMA
Pelli robson contrast sensitifity test PELLI ROBSON CLEMENT CLAEngland HK.01.02.SK.I.82unit 6,600,000 TRIASTRI MEDITAMA
Electric Hess screen ELECTRIC HESS CLEMENT CLAEngland HK.01.02.SK.I.82unit 40,920,000 TRIASTRI MEDITAMA
Grey hess screen MANUAL HESS SCLEMENT CLAEngland HK.01.02.SK.I.82unit 7,788,000 TRIASTRI MEDITAMA
7. A Scan Biometry A-100 A-100 SONOMED USA HK.01.02.SK.I.82unit 60,500,000 TRIASTRI MEDITAMA
A Scan Biometry A-300 A-300 SONOMED USA HK.01.02.SK.I.82unit 84,700,000 TRIASTRI MEDITAMA
A Scan Biometry A-5500 A-5500 SONOMED USA HK.01.02.SK.I.82unit 105,270,000 TRIASTRI MEDITAMA
B Scan Ultrasonography B-5500 B-5500 SONOMED USA HK.01.02.SK.I.82unit 205,700,000 TRIASTRI MEDITAMA
Digital E-Z Scan B Scan USG B-5500 B-5500+ SONOMED USA HK.01.02.SK.I.82unit 314,600,000 TRIASTRI MEDITAMA
A/B Scan Biometry & Ultrasoraphy A/ A/B 5500 SONOMED USA HK.01.02.SK.I.82unit 311,212,000 TRIASTRI MEDITAMA
E-Z A/B Scan Digital Biometry & USG A/B 5500+ SONOMED USA HK.01.02.SK.I.82unit 399,300,000 TRIASTRI MEDITAMA
Pachymeter 300P 300P SONOMED USA HK.01.02.SK.I.82unit 67,760,000 TRIASTRI MEDITAMA
A Scan + Pachymeter 300AP 300AP SONOMED USA HK.01.02.SK.I.82unit 134,310,000 TRIASTRI MEDITAMA

8. Vision Testing system Day/night & Gla6500P STEREO OPTI USA HK.01.02.SK.I.82unit 123,783,000 TRIASTRI MEDITAMA
Vision Testing system 5500P 5500P STEREO OPTI USA HK.01.02.SK.I.82unit 46,310,000 TRIASTRI MEDITAMA
Vision Testing system 5000P 5000P STEREO OPTI USA HK.01.02.SK.I.82unit 39,633,000 TRIASTRI MEDITAMA
Stereotest Stereo fly SO-001 SO-001 STEREO OPTI USA HK.01.02.SK.I.82unit 2,673,000 TRIASTRI MEDITAMA
Stereotest Randot SO-002 SO-002 STEREO OPTI USA HK.01.02.SK.I.82unit 2,673,000 TRIASTRI MEDITAMA
Stereotest Random Dot E SO-003 SO-003 STEREO OPTI USA HK.01.02.SK.I.82unit 2,046,000 TRIASTRI MEDITAMA
Stereotest Reindeer SO-004 SO-004 STEREO OPTI USA HK.01.02.SK.I.82unit 2,123,000 TRIASTRI MEDITAMA
Stereotest Butterfly SO-005 SO-005 STEREO OPTI USA HK.01.02.SK.I.82unit 2,673,000 TRIASTRI MEDITAMA

9. Operation Microscope YZ20P5 YZ20P5 CRANE RRC HK.01.02.SK.I.82unit 45,980,000 TRIASTRI MEDITAMA
Slit lamp YZ5E YZ5E CRANE RRC HK.01.02.SK.I.82unit 32,329,000 TRIASTRI MEDITAMA
Slit lamp YZ5F YZ5F CRANE RRC HK.01.02.SK.I.82unit 37,950,000 TRIASTRI MEDITAMA
Slit lamp YZ5F-1 for video YZ5F-1 CRANE RRC HK.01.02.SK.I.82unit 46,398,000 TRIASTRI MEDITAMA
10. 532nm Green Laser INTEGRE INTEGRE LASEREX Australia HK.01.02.SK.I.82unit 809,490,000 TRIASTRI MEDITAMA
532nm Green Laser SOLITAIRE SOLITAIRE LASEREX Australia HK.01.02.SK.I.82unit 385,000,000 TRIASTRI MEDITAMA
Nd: Yag Laser SUPER -Q SUPER-Q LASEREX Australia HK.01.02.SK.I.82unit 535,062,000 TRIASTRI MEDITAMA
Nd: Yag Laser & SLT TANGO TANGO LASEREX Australia HK.01.02.SK.I.82unit ########## TRIASTRI MEDITAMA
Ophthalmic SLT Laser system SOLO SOLO LASEREX Australia HK.01.02.SK.I.82unit ########## TRIASTRI MEDITAMA
Laser Indirect Ophthalmoscope LIO LASEREX Australia HK.01.02.SK.I.82unit 166,980,000 TRIASTRI MEDITAMA

11. Automatic Perimeter EASYFIELD EASYFILED OCULUS Germany YF-05.03.V.A.965unit 137,016,000 TRIASTRI MEDITAMA
Automatic Perimeter CENTERFIELD CENTERFIELD II OCULUS Germany YF-05.03.V.A.965unit 225,764,000 TRIASTRI MEDITAMA
DAFTAR HARGA
PT. TRIASTRI MEDITAMA

Automatic Perimeter TWINFIELD TWINFIELD OCULUS Germany YF-05.03.V.A.965unit 365,717,000 TRIASTRI MEDITAMA
Topograph-Keratograph KERATOGRAPH OCULUS Germany YF-05.03.V.A.965unit 260,249,000 TRIASTRI MEDITAMA
Topograph-Easygraph with pupillome EASYGRAPH OCULUS Germany YF-05.03.V.A.965unit 194,876,000 TRIASTRI MEDITAMA
Tophography-Pachymeter PENTACA PENTACAM E OCULUS Germany YF-05.03.V.A.965unit 654,621,000 TRIASTRI MEDITAMA
Binoptometer 3 BINOPTOMETEROCULUS Germany YF-05.03.V.A.965unit 100,265,000 TRIASTRI MEDITAMA
Vision tester apparatus MESOTEST I MESOTEST II OCULUS Germany YF-05.03.V.A.965unit 213,785,000 TRIASTRI MEDITAMA
Vision tester apparatus BINOTEST BINOTEST OCULUS Germany YF-05.03.V.A.965unit 50,776,000 TRIASTRI MEDITAMA
Heidelberger Multi Color anomaloskopANOMALOSKOP OCULUS Germany YF-05.03.V.A.965unit 124,542,000 TRIASTRI MEDITAMA
Vitreo Retinal Surgery BIOM 3 ElectricBIOM3 e OCULUS Germany YF-05.03.V.A.965unit 355,058,000 TRIASTRI MEDITAMA
Vitreo Retinal Surgery BIOM 3 ManuaBIOM3 m OCULUS Germany YF-05.03.V.A.965unit 290,950,000 TRIASTRI MEDITAMA

12. Phacoemulsification PULSAR PULSAR OPTIKON Italy YF-05.03.V.A.965unit 344,377,000 TRIASTRI MEDITAMA
Phacoemulsification PULSAR II PULSAR II OPTIKON Italy YF-05.03.V.A.965unit 441,793,000 TRIASTRI MEDITAMA
Phacoemulsification ANTARES 2000 ANTARES 2000 OPTIKON Italy YF-05.03.V.A.965unit 521,895,000 TRIASTRI MEDITAMA
Phacoemulsification + Vitrectomy ASSASSISTANT OPTIKON Italy YF-05.03.V.A.965unit 661,122,000 TRIASTRI MEDITAMA
Cryo line CRYO LINE OPTIKON Italy YF-05.03.V.A.965unit 194,865,000 TRIASTRI MEDITAMA
Keratron Corneal Topography KERATRON/KER OPTIKON Italy YF-05.03.V.A.965unit 250,250,000 TRIASTRI MEDITAMA
Full A/B Scan Ultrasound diagnostic HHISCAN OPTIKON Italy YF-05.03.V.A.965unit 445,808,000 TRIASTRI MEDITAMA

13. Indirect Ophthalmoscope IO α IO α NEITZ Japan YF-05.03.V.A.965unit 20,273,000 TRIASTRI MEDITAMA


Direct Ophthalmoscope BX α 13 BX α 13 NEITZ Japan YF-05.03.V.A.965unit 3,729,000 TRIASTRI MEDITAMA
Streak Retinscope with rechargeable RX-2 K
Streak Retinscope with battery handleRX-3 NEITZ Japan YF-05.03.V.A.965unit 4,719,000 TRIASTRI MEDITAMA
Indirect Ophthalmoscope with Video oIO α TV NEITZ Japan YF-05.03.V.A.965unit 106,480,000 TRIASTRI MEDITAMA
Cataract screener CT-S CT-S NEITZ Japan YF-05.03.V.A.965unit 58,806,000 TRIASTRI MEDITAMA
Slit lamp SL-H1 SL-H1 NEITZ Japan YF-05.03.V.A.965unit 72,600,000 TRIASTRI MEDITAMA
Slit lamp SL-H2 SL-H2 NEITZ Japan YF-05.03.V.A.965unit 88,330,000 TRIASTRI MEDITAMA
Low vision reading Aid VS-5 NEITZ Japan YF-05.03.V.A.965unit 29,040,000 TRIASTRI MEDITAMA

14. Polyvisus Universal with chair 88-AD UNIVERSAL FRASTEMA Italy Diproses unit 144,320,000 TRIASTRI MEDITAMA
Polyvisus New Three Stars 2 with ChaNEW THREE STAFRASTEMA Italy unit 170,973,000 TRIASTRI MEDITAMA
Polyvisus Master with chair 88-AD MASTER FRASTEMA Italy unit 221,485,000 TRIASTRI MEDITAMA
Polyvisus New Omega with chair 88-ANEW OMEGA FRASTEMA Italy unit 109,340,000 TRIASTRI MEDITAMA
Polyvisus Simplex 2 with chair 88-AD SIMPLEX 2 FRASTEMA Italy unit 66,715,000 TRIASTRI MEDITAMA
ABS briefcase complete with a set of ABS 232 FRASTEMA Italy unit 22,550,000 TRIASTRI MEDITAMA
ABS briefcase complete with a set of ABS 160 FRASTEMA Italy unit 14,740,000 TRIASTRI MEDITAMA
DAFTAR HARGA
PT. TRIASTRI MEDITAMA

15. Auto Refracto-Keratometer REKTO O REKTO ORK-II DONGYANG Korea Diproses unit 95,348,000 TRIASTRI MEDITAMA
Auto Refracto-Keratometer VITZRO KVITZRO K-7100 DONGYANG Korea unit 95,348,000 TRIASTRI MEDITAMA
Lensmeter Internal Reading LM-9 LM-9 DONGYANG Korea unit 16,456,000 TRIASTRI MEDITAMA
Auto Chart Projector CP-1000 CP-1000 DONGYANG Korea unit 19,118,000 TRIASTRI MEDITAMA

16. Operation Microscope with Zoom SM2SM2002Z OPTO Brazil /Australia Diproses unit 283,140,000 TRIASTRI MEDITAMA
Nd: Yag Laser ADVANT ADVANT OPTO Brazil /Australia unit 326,700,000 TRIASTRI MEDITAMA
Perimeter AP-100 with computer AP-100 OPTO Brazil /Australia unit 158,708,000 TRIASTRI MEDITAMA
Laser Photocoagulator console TRIPLE T OPTO Brazil /Australia unit 266,200,000 TRIASTRI MEDITAMA

17. Aspheric Lens 20D (V20LC) V20V VOLK USA Diproses unit 2,618,000 TRIASTRI MEDITAMA
Aspheric Lens 28D (V28LC) V28C VOLK USA unit 2,618,000 TRIASTRI MEDITAMA
Aspheric Lens 90D (V90C) V90C VOLK USA unit 3,102,000 TRIASTRI MEDITAMA
Aspheric Lens 78D (V78C) V78C VOLK USA unit 3,102,000 TRIASTRI MEDITAMA
Pan Retinal Lens 2.2 (VPRC) VPRC VOLK USA unit 2,618,000 TRIASTRI MEDITAMA
SuperPupil Lens XL (VSPXL) VSPXL VOLK USA unit 4,477,000 TRIASTRI MEDITAMA
Digital 1.0X Image Lens (VDGTL1) VDGTL1 VOLK USA unit 4,477,000 TRIASTRI MEDITAMA
Volk Iridectomy Lens (VIRID) VIRID VOLK USA unit 6,655,000 TRIASTRI MEDITAMA
Volk Fundus Lens (VFUNDUS) VFUNDUS VOLK USA unit 3,509,000 TRIASTRI MEDITAMA
Volk Capsulotomy Lens ( VCAPS) CVAPS VOLK USA unit 6,655,000 TRIASTRI MEDITAMA
Cental Retinal Lens SSV (VCRLVITS CVRLVITSSV VOLK USA unit 10,769,000 TRIASTRI MEDITAMA
Mini Quad XL VIT SSV Lens (VMQXL VMQXLVITSSV VOLK USA unit 10,769,000 TRIASTRI MEDITAMA
Zeiss+ Volk Rols unit (Vrols-Z) VROLS-Z VOLK USA unit 64,130,000 TRIASTRI MEDITAMA

18. Photo Screener PHOTO SCREENMTI USA Diproses unit 88,000,000 TRIASTRI MEDITAMA
DAFTAR INFORMASI HARGA PERALATAN KESEHATAN & LABORATORIUM

No Nama Peralatan Kesehatan Model / No. Code Merk Negara Asal No. Registrasi Depkes Satu HJSA (Rp.) Sole Agent s/d
Urut RI an
1 Dental Unit & Chair Clesta Belmont Japan KL. 0605290916 Set 165,000,000 5-Jul-2007
2 Dental Unit & Chair Clesta II Belmont Japan AKL 20601400830 Set 240,000,000 5-Jul-2007
3 Dental Unit & Chair SP-Cleo Belmont Japan KL. 0605690259 Set 240,000,000 5-Jul-2007
4 Dental Unit & Chair Cp-One Belmont Japan KL. 0605200165 Set 365,000,000 5-Jul-2007
5 Dental Unit & Chair Rapport Belmont Japan KL. 0605200164 Set 450,000,000 5-Jul-2007
6 Dental Unit & Chair S2302 Northwest RRC AKL. 10605303907 Set 50,000,000 8-Jun-2008
7 Dental Unit & Chair S2315 Northwest RRC AKL. 10605303906 Set 66,000,000 8-Jun-2008
8 Dental Unit & Chair Quality Olsen Brazil KL. 0605200232 Set 45,000,000 1-Feb-2007
9 Dental Unit & Chair Turim Olsen Brazil KL. 0605200231 Set 50,000,000 1-Feb-2007
10 Dental Unit & Chair Taurus Z Shinhung Korea Dalam Proses Set 125,000,000 28-Jun-2010
11 Dental Unit & Chair Taurus F/S Shinhung Korea Dalam Proses Set 200,000,000 28-Jun-2010
12 Dental Unit & Chair A3 Anthos Italy Dalam Proses Set 250,000,000 18-Nov-2007
13 Dental Unit & Chair AL-398AA Foshan RRC Dalam Proses Set 35,000,000
14 X-Ray Dental Unit Phot II Belmont Japan Dalam Proses Set 42,000,000 5-Jul-2007
15 X-Ray Panoramic Caliber EX-2000 Belmont Japan AKL 20601400831 Set 332,000,000 5-Jul-2007
16 X-Ray Panoramic Caliber EX-1000 Belmont Japan Dalam Proses Set 285,000,000 5-Jul-2007
17 Dental Light 048 Belmont Japan KL. 0903292332 Pc 14,000,000 5-Jul-2007
18 Dental Light IQ 5000 Belmont Japan KL. 0603290912 Pc 15,000,000 5-Jul-2007
19 Mini Jet Two Handpiece Manual ADU-04 Aseptico USA AKL. 10603303826 Set 20,000,000 30-Jun-2008
Control System
20 Portable Dental Unit System ADU-02 Task Force Aseptico USA AKL. 10603303827 Set 35,000,000 30-Jun-2008
21 Compressor Airmed 1 HP Fiac Italy Pc 6,000,000 1-Nov-2008
22 Compressor Airmed 1,5 HP Fiac Italy Pc 8,500,000 1-Nov-2008
23 Compressor Airmed 2 HP Fiac Italy Pc 12,000,000 1-Nov-2008
24 Operating Stool Belmont Japan Dalam Proses Pc 6,000,000 5-Jul-2007
25 Operating Stool Ergonomic Chair Support Stool Swedent Dalam Proses Pc 11,000,000
26 Extracting Forceps 0100-1, 2, 7, 13, 17, 18, 19, Asa Italy Pc 454,800 6-Jun-2005
22, 29 AKL. 10603301429
27 Extracting Forceps 0100-151,30,51 1/2,75, 151 Asa Italy Pc 506,400 6-Jun-2005
1/2, 87 AKL. 10603301429
28 Extracing Forceps 0100-22 L/R Set Asa Italy AKL. 10603301429 Pc 2,268,000 6-Jun-2005
No Nama Peralatan Kesehatan Model / No. Code Merk Negara Asal No. Registrasi Depkes Satu HJSA (Rp.) Sole Agent s/d
Urut RI an
29 Extracting Forceps 0100-33, 33L, 51, 51A, 67A, Asa Italy Pc 454,800 6-Jun-2005
74, 79, 51, 67, 73 AKL. 10603301429
30 Extracting Forceps 0100-4,45,86C,89,90,145 Asa Italy AKL. 10603301429 Pc 454,800 6-Jun-2005
31 Extracting Forceps 0101-1,2(503,504) Asa Italy AKL. 10603301429 Pc 498,000 6-Jun-2005
32 Pliers For Orthodontics 0103-20,30 Asa Italy Pc 656,000 6-Jun-2005
33 Bone Rongerous 0103-50 Asa Italy Pc 744,000 6-Jun-2005
34 Extracing Forceps for Children 0112-1,2,3,4,5,6,7 Asa Italy AKL. 10603301427 Pc 496,000 6-Jun-2005
35 Root Elevators Bein 0200-6 Asa Italy AKL. 10603301428 Pc 236,000 6-Jun-2005
36 Root Elevators R/L 0202-320/321, 322/323 Asa Italy Pc 619,200 6-Jun-2005
37 Inox Root Elevator Winter 0204-11L/R Asa Italy Pc 619,200 6-Jun-2005
38 Root Elevators Seldin 0208-2S, 3S Asa Italy Pc 320,000 6-Jun-2005
39 Bradley Root Elevators 0213-12 Asa Italy Pc 248,000 6-Jun-2005
40 Root Elevators 0232-1 Asa Italy AKL. 10603301428 Pc 268,000 6-Jun-2005
41 Root Elevators 0234-1,2,3,4 Asa Italy AKL. 10603301428 Pc 236,000 6-Jun-2005
42 Root Elevators 0240-1,2,3,4,5,6 Asa Italy AKL. 10603301428 Pc 236,000 6-Jun-2005
43 Root Elevator R/L 0241-1,2,3 / 0242-1,2,3 Asa Italy AKL. 10603301428 Pc 236,000 6-Jun-2005
44 Root Elevator 0243-7,8 Asa Italy AKL. 10603301428 Pc 236,000 6-Jun-2005
45 Gunting 0300 - 1,2 Asa Italy AKL. 20603301430 Pc 120,000 6-Jun-2005
46 Iris Gum Scissors/Gunting 0305-1 Asa Italy AKL. 20603301430 Pc 248,000 6-Jun-2005
47 Iris Gum Scissors/Gunting 0305-2 Asa Italy AKL. 20603301430 Pc 248,000 6-Jun-2005
48 Iris Gum Scissors/Gunting 0305-3 Asa Italy AKL. 20603301430 Pc 248,000 6-Jun-2005
49 Gunting 0308-1 Asa Italy AKL. 20603301430 Pc 260,000 6-Jun-2005
50 Gunting 0308-2 Asa Italy AKL. 20603301430 Pc 260,000 6-Jun-2005
51 Gum Scissors Kelly 0309-1 Asa Italy AKL. 20603301430 Pc 248,000 6-Jun-2005
52 Gum Scissors Kelly 0309-2 Asa Italy AKL. 20603301430 Pc 248,000 6-Jun-2005
53 Spencer Gim Scissors/Gunting 0320-1 Asa Italy AKL. 20603301430 Pc 188,000 6-Jun-2005
54 Spencer Gim Scissors/Gunting 0320-2 Asa Italy AKL. 20603301430 Pc 188,000 6-Jun-2005
55 Scalpel Handles No. 3 0350-3 Asa Italy Pc 64,000 6-Jun-2005
56 Needle Holder Baumbartner 0404-14 Asa Italy AKL. 10603301426 Pc 364,000 6-Jun-2005
57 Needle Holder Crile Wood 0410-15 Asa Italy AKL. 10603301426 Pc 348,000 6-Jun-2005
58 Needle Holder Baumbartner 0414-16 Asa Italy AKL. 10603301426 Pc 388,000 6-Jun-2005
59 Needle Holder Mathieu 0430-14 Asa Italy AKL. 10603301426 Pc 508,000 6-Jun-2005
60 Needle Holders 0430-17 Asa Italy AKL. 10603301426 Pc 508,000 6-Jun-2005
61 Needle Holders 0431-14 Asa Italy AKL. 10603301426 Pc 508,000 6-Jun-2005
62 Needle Holders 0431-17 Asa Italy AKL. 10603301426 Pc 508,000 6-Jun-2005
No Nama Peralatan Kesehatan Model / No. Code Merk Negara Asal No. Registrasi Depkes Satu HJSA (Rp.) Sole Agent s/d
Urut RI an
63 Haemostatic Forceps Halstead 0500-1 Asa Italy Pc 148,000 6-Jun-2005
Mosqito
64 Haemostatic Forceps Halstead 0500-2 Asa Italy Pc 148,000 6-Jun-2005
Mosqito
65 Haemostatic Forceps Halstead 0505-1 Asa Italy Pc 168,000 6-Jun-2005
Mosqito
66 Haemostatic Forceps Halstead 0505-2 Asa Italy Pc 168,000 6-Jun-2005
Mosqito
67 Haemostatic Forceps 0510-1 Asa Italy Pc 176,000 6-Jun-2005
68 Haemostatic Forceps 0510-2 Asa Italy Pc 176,000 6-Jun-2005
69 Haemostatic Forceps Kocher 0530-1 Asa Italy Pc 212,000 6-Jun-2005
70 Haemostatic Forceps Kocher 0530-2 Asa Italy Pc 212,000 6-Jun-2005
71 Haemostatic Forceps 0540-1 Asa Italy Pc 176,000 6-Jun-2005
72 Haemostatic Forceps 0540-2 Asa Italy Pc 176,000 6-Jun-2005
73 Towel Clamps 8 cm 0550-1 Asa Italy Pc 156,000 6-Jun-2005
74 Towel Clamps 11 cm 0550-2 Asa Italy Pc 156,000 6-Jun-2005
75 Towel Clamps 13 cm 0550-3 Asa Italy Pc 156,000 6-Jun-2005
76 Dressing Forceps (straight) 0557-1 Asa Italy Pc 288,000 6-Jun-2005
77 Dressing Forceps (curved) 0557-2 Asa Italy Pc 288,000 6-Jun-2005
78 Cotton Plier / Pinset 0601-1,2,3,4,5 Asa Italy Pc 72,000 6-Jun-2005
79 Dissecting Forceps 0602-1,2 Asa Italy Pc 157,200 6-Jun-2005
80 Cotton Plier / Pinset 0620-1 / 0621-1 Asa Italy Pc 112,000 6-Jun-2005
81 Cotton Plier / Pinset 0622-1 Asa Italy Pc 193,600 6-Jun-2005
82 Cotton Plier / Pinset 0623-1 Asa Italy Pc 193,600 6-Jun-2005
83 Cotton Plier / Pinset 0630-1,2 / 0631-1,2 Asa Italy Pc 104,000 6-Jun-2005
84 Tissue Pliers 0635-1 Asa Italy Pc 108,000 6-Jun-2005
85 Tissue Pliers 0635-2 Asa Italy Pc 108,000 6-Jun-2005
86 Tissue Pliers 0635-3 Asa Italy Pc 108,000 6-Jun-2005
87 Pinset 0650 - 1,2 Asa Italy Pc 142,400 6-Jun-2005
88 Explorers/Sonde Half Moon 0700-6,8,9,11,23 Asa Italy Pc 44,000 6-Jun-2005
89 Explorers Sonde 0701-6, 8, 9, 12, 16, 23 Asa Italy Pc 48,000 6-Jun-2005
90 Periodontal Pocket Probes S/E 0702-12S,C Asa Italy Pc 108,000 6-Jun-2005
91 Pocket Probes 0703-1,4,6 Asa Italy Pc 84,000 6-Jun-2005
92 Double Ended Expl. Probes D/E 0707L-GFW Asa Italy Pc 104,000 6-Jun-2005
93 Sonde P/E 0710-6 D1,2,3 Asa Italy Pc 73,600 6-Jun-2005
No Nama Peralatan Kesehatan Model / No. Code Merk Negara Asal No. Registrasi Depkes Satu HJSA (Rp.) Sole Agent s/d
Urut RI an
94 Endodontic Instrument/Spreader 0800-1,2,3,4,5,6,7 Asa Italy Pc 73,600 6-Jun-2005
95 Endodontic Instrument 0801-1, 2, 3, 4 Asa Italy Pc 52,000 6-Jun-2005
96 Cement Spatulas 0903-1,2,3 Asa Italy Pc 84,000 6-Jun-2005
97 Amalgam Caries D/E Italy (Small) 1015-1 Asa Italy Pc 248,000 6-Jun-2005

98 Amalgam Caries D/E Italy (Large) 1015-2 Asa Italy Pc 248,000 6-Jun-2005

99 Amalgam Caries D/E Italy (Jumbo) 1015-3 Asa Italy Pc 248,000 6-Jun-2005

100 Amalgam Pistol 1020-1,2,3 Asa Italy Pc 248,000 6-Jun-2005


101 Metal Tip 1020-2P Asa Italy Pc 48,000 6-Jun-2005
102 Amalgam Well 1030-1,2,3 Asa Italy Pc 136,000 6-Jun-2005
103 Plastic Filling Instrument D/E 1100-1,2,3 Asa Italy Pc 76,000 6-Jun-2005
104 Plastic Filling Instrument D/E 1101-1,2,3 Asa Italy Pc 80,000 6-Jun-2005
105 Plastic Filling Instrument D/E 1102-1,2,3 Asa Italy Pc 84,000 6-Jun-2005
106 Burnisher D/E 1200,1,2,3,4,5 Asa Italy Pc 76,800 6-Jun-2005
107 Amalgam Stopper 1201-1,2,3 Asa Italy Pc 76,800 6-Jun-2005
108 Amalgam Stopper 1202-1,2,3,5,6,7 Asa Italy Pc 76,800 6-Jun-2005
109 Cement Stopper 1203-1,2,3 Asa Italy Pc 76,800 6-Jun-2005
110 Filling Instrument 1204-1,2 Asa Italy Pc 76,800 6-Jun-2005
111 Cement Stopper 1205-1,2 Asa Italy Pc 76,800 6-Jun-2005
112 Filling Instrument 1208-1,2,3 Asa Italy Pc 80,400 6-Jun-2005
113 Filling Instrument 1210-1,2,3 Asa Italy Pc 80,000 6-Jun-2005
114 Filling Instrument 1211-OT Asa Italy Pc 76,800 6-Jun-2005
115 Filling Instrument/Burnisher 1215-29 Asa Italy Pc 100,000 6-Jun-2005
116 Applicator S/E 1300 Asa Italy Pc 40,000 6-Jun-2005
117 Placement Instruments 1301/1302 Asa Italy Pc 80,000 6-Jun-2005
118 Amalgam Instruments 1400-1,2,3,4 Asa Italy Pc 80,000 6-Jun-2005
119 Amalgam Carvers D/E 1500-2, 3, 3S Asa Italy Pc 100,000 6-Jun-2005
120 Amalgam Carver Frahm 1502-1 Asa Italy Pc 116,000 6-Jun-2005
121 Periodental - Gracey D/E 1600-1,2,3,4 Asa Italy Pc 100,000 6-Jun-2005
122 Excavators 1700-0,1,2,3,4 Asa Italy Pc 92,000 6-Jun-2005
123 Periodontia Instrument S/E 1801-1,2 Asa Italy Pc 123,600 6-Jun-2005
124 Periodontia Instrument S/E 1801-D Asa Italy Pc 123,600 6-Jun-2005
125 Periodontia Instrument S/E 1803-1,2 Asa Italy Pc 123,600 6-Jun-2005
No Nama Peralatan Kesehatan Model / No. Code Merk Negara Asal No. Registrasi Depkes Satu HJSA (Rp.) Sole Agent s/d
Urut RI an
126 Periodontia Double End 1803-15/16 Asa Italy Pc 156,000 6-Jun-2005
127 Periodontia Instrument D/E 1803-D/1804-D Asa Italy Pc 156,000 6-Jun-2005
128 Periodontia Instrument D/E 1806 - 2, 2RL, 4RL, 14, 412, Asa Italy Pc 115,200 6-Jun-2005
414
129 Periodontia Instrument 1807-02, 04, 06, 08, 10, 12, Asa Italy Pc 112,000 6-Jun-2005
14
130 Currettes Surfing Chisel 1820-Z Asa Italy Pc 92,000 6-Jun-2005
131 Crane-Caplan 1829-CK6 Asa Italy Pc 202,000 6-Jun-2005
132 Wax Spatula & Carvers MV1850-M9 Asa Italy Pc 332,000 6-Jun-2005
133 Raspatorium 1855-22,23 Asa Italy Pc 168,000 6-Jun-2005
134 Periodontia Instrument/ 1857-1 Asa Italy Pc 172,000 6-Jun-2005
Raspatorium
135 Periodontia Instrument/ 1857-2 Asa Italy Pc 172,000 6-Jun-2005
Raspatorium
136 Scallers 1900-1L/R, 2L/R Asa Italy Pc 168,000 6-Jun-2005
137 Scallers 1900-1,1L, 2L,R Asa Italy Pc 82,400 6-Jun-2005
138 Bone Currets 2000-1,2,3,4 Asa Italy Pc 120,000 6-Jun-2005
139 Bone Currets 2001-85,86,87,88 Asa Italy Pc 128,000 6-Jun-2005
140 Bone Files MV 2002-1,2 Asa Italy Pc 448,000 6-Jun-2005
141 Bone Files 2003-1 Asa Italy Pc 312,000 6-Jun-2005
142 Bone Files 2004-33 Asa Italy Pc 312,000 6-Jun-2005
143 Bone Files 2005-64, 2006-10 Asa Italy Pc 312,000 6-Jun-2005
144 Bone Currets Fig. 2cm 17 2014-2 Asa Italy Pc 352,800 6-Jun-2005
145 Handles For Mouth Mirror 2100 CS Asa Italy Pc 48,000 6-Jun-2005
146 Handles For Mouth Mirror 2101 CS Asa Italy Pc 42,400 6-Jun-2005
147 Mirror Handles : White/Black 2103-B/N Asa Italy Pc 24,000 6-Jun-2005
148 Mouth Mirrors 2200-4,5,6 Asa Italy Pc 20,400 6-Jun-2005
149 Crown Removers 2300-Double Asa Italy Pc 295,200 6-Jun-2005
150 Crown Removers 2300-Single Asa Italy Pc 268,000 6-Jun-2005
151 Crown Spreader & Remover 2320 Asa Italy Pc 668,000 6-Jun-2005
152 Crown Instrument/Band Plaster 2410 Asa Italy Pc 292,000 6-Jun-2005
153 Iwanson Demical Caliper 2550-1,2 Asa Italy Pc 180,000 6-Jun-2005
154 Tongue Depressors 2605, 2606, 2607, 2608 Asa Italy Pc 96,000 6-Jun-2005
155 Retractors 2618 - 13, 23, 33 Asa Italy Pc 269,600 6-Jun-2005
156 Finger Protectors 2645 - 1,2 Asa Italy Pc 276,000 6-Jun-2005
No Nama Peralatan Kesehatan Model / No. Code Merk Negara Asal No. Registrasi Depkes Satu HJSA (Rp.) Sole Agent s/d
Urut RI an
157 Sendok Cetak Almunium 2800 -1,2,3,4,5,6 U/L Asa Italy Pc 50,400 6-Jun-2005
158 Sendok Cetak Almunium 12'S 2800-12 Asa Italy Pc 273,600 6-Jun-2005
159 Sendok Cetak St.Steel 2801 -1,2,3,4,5,6 U/L Asa Italy Pc 104,000 6-Jun-2005
160 Sendok Cetak St.Steel 12'S 2801-12, 12A Asa Italy Pc 546,400 6-Jun-2005
161 Impression Trays Stainles 2803-3, 4 Asa Italy Pc 172,800 6-Jun-2005
162 Sendok Cetak Refill 2804 -4,5,6 U/L Asa Italy Pc 172,800 6-Jun-2005
163 Sendok Cetak Universal 12'S 2804A-12S Asa Italy Pc 1,036,800 6-Jun-2005
164 Sendok Cetak St.Steel Refill 2804-4A, 5A, 6A Asa Italy Pc 172,800 6-Jun-2005
165 Sendok Cetak Anatomi 8'S 2804A-8 Asa Italy Pc 691,200 6-Jun-2005
166 Sendok Cetak Full Refill 2806 Asa Italy Pc 248,000 6-Jun-2005
167 Sendok Cetak Full Stainless 8'S 2806-8'S Asa Italy Pc 979,200 6-Jun-2005
168 Sendok Cetak Free and St.Steel 6'S 2809-6 ART S Asa Italy Pc 720,000 6-Jun-2005

169 Saliva Ejector Biru 2900-TCS15, VT15, BBS15 Asa Italy Pc 36,000 6-Jun-2005

170 Adaptor White 2905 - AD Asa Italy Pc 14,400 6-Jun-2005


171 Aspirator Tips 2905 - 155 Asa Italy Pc 161,600 6-Jun-2005
172 Rubber Dum Instrument 3032 Asa Italy Pc 652,000 6-Jun-2005
173 Rubber Dum Instrument 3033 Asa Italy Pc 652,000 6-Jun-2005
174 Ivory & Matrix Retainer 3070-5,6,7 Asa Italy Pc 152,000 6-Jun-2005
175 Matrix band 3082-5,6,7 Asa Italy Pc 46,400 6-Jun-2005
176 Alcohol Burner 3101 Asa Italy Pc 181,600 6-Jun-2005
177 Articulators 5000 Asa Italy Pc 590,400 6-Jun-2005
178 Articulators 5000-1M + 5000-25 + 5011 Asa Italy Pc 1,212,800 6-Jun-2005

179 Magnetic Mounting Plate 5000-1M Asa Italy Pc 144,800 6-Jun-2005


180 10 Cast Fastening Washer 5000-25 Asa Italy Pc 12,000 6-Jun-2005
181 Articulators Asa Warna Kuning 5011 Asa Italy Pc 1,056,000 6-Jun-2005
182 Wax and Modelling Carver/Inst 5103/5109/5110 Asa Italy Pc 84,800 6-Jun-2005
183 Wax and Modelling Carver/Lecron 5106/5107 Asa Italy Pc 82,800 6-Jun-2005

184 P.K. Thomas Instruments 5112-3 Asa Italy Pc 70,800 6-Jun-2005


185 Wax Knives 5200-1 Asa Italy Pc 44,800 6-Jun-2005
186 Wax Knives 5200-2 Asa Italy Pc 44,800 6-Jun-2005
187 Wax Knives 5201-1 Asa Italy Pc 48,000 6-Jun-2005
No Nama Peralatan Kesehatan Model / No. Code Merk Negara Asal No. Registrasi Depkes Satu HJSA (Rp.) Sole Agent s/d
Urut RI an
188 Wax Knives 5202-1 Asa Italy Pc 61,200 6-Jun-2005
189 Wax Knives 5202-2 Asa Italy Pc 61,200 6-Jun-2005
190 Plaster Knives 5300-1 Asa Italy Pc 67,200 6-Jun-2005
191 Plaster Knives 5300-2 Asa Italy Pc 67,200 6-Jun-2005
192 Spatulas For Plaster 5400-3,4,7,8 Asa Italy Pc 85,600 6-Jun-2005
193 Spatulas For Plaster 5400-9 Asa Italy Pc 85,600 6-Jun-2005
194 Mixing Bowls For Plaster 5500-12 Asa Italy Pc 32,000 6-Jun-2005
195 Mixing Bowls For Plaster 5500-14 Asa Italy Pc 32,000 6-Jun-2005
196 Mixing Bowls For Plaster 5500-16 Asa Italy Pc 57,600 6-Jun-2005
197 Mixing Bowls 5501-12 Asa Italy Pc 32,000 6-Jun-2005
198 Mixing Bowls 5501-14 Asa Italy Pc 40,000 6-Jun-2005
199 Mixing Bowls 5501-16 Asa Italy Pc 57,600 6-Jun-2005
200 Crown Scissors 5600-1,2 Asa Italy Pc 92,000 6-Jun-2005
201 Foil-Wire-Plate Scissors/Gunting 5700 Asa Italy Pc 182,400 6-Jun-2005
Klammer
202 Pliers For Orthodontics 5801 Asa Italy Pc 432,000 6-Jun-2005
203 Pliers For Orthodontics 5802 Asa Italy Pc 432,000 6-Jun-2005
204 Pliers For Orthodontics 5803 Asa Italy Pc 424,000 6-Jun-2005
205 Pliers For Orthodontics 5806-2 Asa Italy Pc 440,000 6-Jun-2005
206 Pliers For Orthodontics 5812 Asa Italy Pc 492,000 6-Jun-2005
207 Pliers For Orthodontics 5832 Asa Italy Pc 725,600 6-Jun-2005
208 Pliers For Orthodontics 5863 Asa Italy Pc 444,800 6-Jun-2005
209 Pliers For Orthodontics 5866 Asa Italy Pc 340,000 6-Jun-2005
210 Pliers For Orthodontics 5867-1 Asa Italy Pc 420,000 6-Jun-2005
211 Pliers For Orthodontics 5869-2 Asa Italy Pc 420,000 6-Jun-2005
212 Pliers For Orthodontics 5870 Asa Italy Pc 427,600 6-Jun-2005
213 Pliers For Orthodontics 5871 Asa Italy Pc 376,000 6-Jun-2005
214 Pliers For Orthodontics 5880-1,2 Asa Italy Pc 512,000 6-Jun-2005
215 Plaster Cutting Filters 5900 Asa Italy Pc 316,000 6-Jun-2005
216 Plastic Box For Protesa 6900 - C, B, R Asa Italy Pc 8,400 6-Jun-2005
217 Excavators Set of 5 S1700 Asa Italy Pc 422,400 6-Jun-2005
218 Gracey Instr. Set of 7 S1807 Asa Italy Pc 744,000 6-Jun-2005
219 Periodontal Instrument Set of S1899 Asa Italy Pc 1,940,000 6-Jun-2005
220 Endodontic Instrument AL2746-1 Asa Italy Pc 128,000 6-Jun-2005
221 Endodontic Instrument AL2746-2 Asa Italy Pc 128,000 6-Jun-2005
No Nama Peralatan Kesehatan Model / No. Code Merk Negara Asal No. Registrasi Depkes Satu HJSA (Rp.) Sole Agent s/d
Urut RI an
222 Prichard MV 1851-PR Asa Italy Pc 400,000 6-Jun-2005
223 Lecron LS 5109 Asa Italy Pc 64,000 6-Jun-2005
224 Extract. Forceps Engl. Pattern 3600/1, 2, 7, 17, 18 Ernst. Krauskopf Germany KL. 0603690052 Pc 763,500 21-Aug-2007
225 Extract. Forceps Engl. Pattern 3600/3 Ernst. Krauskopf Germany KL. 0603690052 Pc 1,080,000 21-Aug-2007
226 Extract. Forceps Engl. Pattern 3600/4 Ernst. Krauskopf Germany KL. 0603690052 Pc 930,000 21-Aug-2007
227 Extract. Forceps Engl. Pattern 3600/13, 22, 33, 51, 79 Ernst. Krauskopf Germany KL. 0603690052 Pc 825,600 21-Aug-2007
228 Extract. Forceps Engl. Pattern 3600/18A Ernst. Krauskopf Germany KL. 0603690052 Pc 1,080,000 21-Aug-2007
229 Extract. Forceps Engl. Pattern 3600/19, 23, 24, 33 1/2, 55, Ernst. Krauskopf Germany Pc 1,080,000 21-Aug-2007
56, 65L, 65R KL. 0603690052
230 Extract. Forceps Engl. Pattern 3600/29 Ernst. Krauskopf Germany KL. 0603690052 Pc 763,500 21-Aug-2007
231 Extract. Forceps Engl. Pattern 3600/30, 31 Ernst. Krauskopf Germany KL. 0603690052 Pc 930,000 21-Aug-2007
232 Extract. Forceps Engl. Pattern 3600/41 Ernst. Krauskopf Germany KL. 0603690052 Pc 930,000 21-Aug-2007
233 Extract. Forceps Engl. Pattern 3600/44, 45, 51 1/2 Ernst. Krauskopf Germany KL. 0603690052 Pc 930,000 21-Aug-2007
234 Extract. Forceps Engl. Pattern 3600/46LX Ernst. Krauskopf Germany KL. 0603690052 Pc 1,080,000 21-Aug-2007
235 Extract. Forceps Engl. Pattern 3600/51LX Ernst. Krauskopf Germany KL. 0603690052 Pc 1,080,000 21-Aug-2007
236 Extract. Forceps Engl. Pattern 3600/67 Ernst. Krauskopf Germany KL. 0603690052 Pc 825,600 21-Aug-2007
237 Extract. Forceps Engl. Pattern 3600/73 s Ernst. Krauskopf Germany KL. 0603690052 Pc 1,080,000 21-Aug-2007
238 Extract. Forceps Engl. Pattern 3600/74 Ernst. Krauskopf Germany KL. 0603690052 Pc 1,080,000 21-Aug-2007
239 Extract. Forceps Engl. Pattern 3600/74M Ernst. Krauskopf Germany KL. 0603690052 Pc 1,080,000 21-Aug-2007
240 Extract. Forceps Engl. Pattern 3600/75 Ernst. Krauskopf Germany KL. 0603690052 Pc 1,080,000 21-Aug-2007
241 Extract. Forceps Engl. Pattern 3600/86C Ernst. Krauskopf Germany KL. 0603690052 Pc 1,080,000 21-Aug-2007
242 Extract. Forceps Engl. Pattern 3600/87 Ernst. Krauskopf Germany KL. 0603690052 Pc 1,080,000 21-Aug-2007
243 Extract. Forceps Engl. Pattern 3600/89, 90, 99 Ernst. Krauskopf Germany KL. 0603690052 Pc 1,080,000 21-Aug-2007
244 Felsch Extracting Forceps 3600/121 Ernst. Krauskopf Germany KL. 0603690052 Pc 1,320,000 21-Aug-2007
245 Routorier Forceps 3614/22 1/2 L & R Ernst. Krauskopf Germany KL. 0603690052 Pc 3,660,000 21-Aug-2007
246 Extract. Forceps Engl. Pattern 3620 semua ukuran 1, 2, 7, Ernst. Krauskopf Germany Pc 1,056,000 21-Aug-2007
17, 18, 13, 22, 23, 33A KL. 0603690052
247 Forceps Children's 3700/13S, 22S, 33S, 38, 40, Ernst. Krauskopf Germany Pc 1,041,600 21-Aug-2007
51S KL. 0603690052
248 Forceps Children's 3700/29S, 30S, 37, 39,391/2, Ernst. Krauskopf Germany Pc 1,041,600 21-Aug-2007
39L, 39R KL. 0603690052
249 Forceps Children's 3700/161,162 Ernst. Krauskopf Germany KL. 0603690052 Pc 1,041,600 21-Aug-2007
250 Klein Children Forceps 3710/1,2,3,4,5,6,7 Ernst. Krauskopf Germany KL. 0603690052 Pc 914,500 21-Aug-2007
251 Klein Children Forceps 3711/1,2,3,4,5,6,7 Ernst. Krauskopf Germany KL. 0603690052 Pc 963,600 21-Aug-2007
252 Pinset Smooth 3750 Ernst. Krauskopf Germany KL. 0603690052 Pc 468,000 21-Aug-2007
No Nama Peralatan Kesehatan Model / No. Code Merk Negara Asal No. Registrasi Depkes Satu HJSA (Rp.) Sole Agent s/d
Urut RI an
253 Witzel Root Fragment Forceps 3751, 3753 Ernst. Krauskopf Germany KL. 0603690052 Pc 960,000 21-Aug-2007
254 Witzel Root Fragment Forceps 3754 Ernst. Krauskopf Germany KL. 0603690052 Pc 1,260,000 21-Aug-2007
255 Root Fragments Forceps 3755 Ernst. Krauskopf Germany KL. 0603690052 Pc 852,000 21-Aug-2007
256 Root Fragments Forceps 3759 Ernst. Krauskopf Germany KL. 0603690052 Pc 852,000 21-Aug-2007
257 Extracting Forceps 3805/17 Ernst. Krauskopf Germany KL. 0603690052 Pc 990,000 21-Aug-2007
258 Extracting Forceps 3805/210 Ernst. Krauskopf Germany KL. 0603690052 Pc 990,000 21-Aug-2007
259 Bone Ronger 17 cm 3880 Ernst. Krauskopf Germany KL. 0603690052 Pc 1,260,000 21-Aug-2007
260 Bone Ronger 1/4 cm 3887 Ernst. Krauskopf Germany KL. 0603690052 Pc 1,260,000 21-Aug-2007
261 Bone Ronger Buyer 3920 Ernst. Krauskopf Germany KL. 0603690052 Pc 3,180,000 21-Aug-2007
262 Bone Cutting Forceps 3945 Ernst. Krauskopf Germany KL. 0603690052 Pc 1,453,500 21-Aug-2007
263 Root Elevator " Bein " 3963/16, 19 Ernst. Krauskopf Germany KL. 0603690052 Pc 377,000 21-Aug-2007
264 Seldin / Berten Elevator 3965, 3966, 3968/1 Ernst. Krauskopf Germany KL. 0603690052 Pc 410,000 21-Aug-2007
265 Bein Root Elevator 2,5 mm / 4 mm 3969/1,2,3,4,5,6 Ernst. Krauskopf Germany Pc 344,500 21-Aug-2007
KL. 0603690052
266 Seldin / Berten Elevator 3970/1,2,3,4 Ernst. Krauskopf Germany KL. 0603690052 Pc 410,000 21-Aug-2007
267 Root Elevator 3971/1,2,3,4 Ernst. Krauskopf Germany KL. 0603690052 Pc 504,000 21-Aug-2007
268 Root Elevator 3978/1,2,3,4 Ernst. Krauskopf Germany KL. 0603690052 Pc 504,000 21-Aug-2007
269 Root Elevator 4066 Ernst. Krauskopf Germany KL. 0603690052 Pc 379,500 21-Aug-2007
270 Root Elevator 4066/1,2,3 Ernst. Krauskopf Germany KL. 0603690052 Pc 402,000 21-Aug-2007
271 Root Elevator 4052/1 Ernst. Krauskopf Germany KL. 0603690052 Pc 402,000 21-Aug-2007
272 Root Elevator 4063/2,3 Ernst. Krauskopf Germany KL. 0603690052 Pc 402,000 21-Aug-2007
273 Root Elevator " Bein " 4068/1,2, 3,5,8,9 Ernst. Krauskopf Germany KL. 0603690052 Pc 372,000 21-Aug-2007
274 Root Elevator 4075 L& R 1,2,3,4 Ernst. Krauskopf Germany KL. 0603690052 Pc 810,000 21-Aug-2007
275 Root Elevator (T) "Winter/Cryer" 4086/11L / R Ernst. Krauskopf Germany Pc 930,000 21-Aug-2007
KL. 0603690052
276 Root Elevator / R. Tip Pick ( Set ) 4091/,2,3,4,5 Ernst. Krauskopf Germany Pc 349,500 21-Aug-2007
KL. 0603690052
277 Root Teaser Only 4093/1 Ernst. Krauskopf Germany KL. 0603690052 Pc 307,500 21-Aug-2007
278 Gum Guillotine Forceps 4107 Ernst. Krauskopf Germany KL. 0603690052 Pc 2,868,000 21-Aug-2007
279 Lecron 4153 Ernst. Krauskopf Germany KL. 0603690052 Pc 180,000 21-Aug-2007
280 Handle + Blade 4165/3,4,5,10,11,12, 4135 Ernst. Krauskopf Germany KL. 0603690052 Pc 264,000 21-Aug-2007
281 Gum Scissors 4188, 4189 Ernst. Krauskopf Germany KL. 0603690052 Pc 216,000 21-Aug-2007
282 Gum Scissors Std. Cvd.-10,5 cm. 4202 Ernst. Krauskopf Germany KL. 0603690052 Pc 300,000 21-Aug-2007
283 Gum Scissors Std.Cvd.-10,5 cm. 4204 Ernst. Krauskopf Germany KL. 0603690052 Pc 300,000 21-Aug-2007
284 Gum Scissors Cvd. - 11 cm. 4208 Ernst. Krauskopf Germany KL. 0603690052 Pc 336,000 21-Aug-2007
No Nama Peralatan Kesehatan Model / No. Code Merk Negara Asal No. Registrasi Depkes Satu HJSA (Rp.) Sole Agent s/d
Urut RI an
285 Gum Scissors Cvd. - 11 cm. 4210 Ernst. Krauskopf Germany KL. 0603690052 Pc 336,000 21-Aug-2007
286 Gum Scissors 4212 Ernst. Krauskopf Germany KL. 0603690052 Pc 498,000 21-Aug-2007
287 Gebogen Gum Scissor 4217 Ernst. Krauskopf Germany KL. 0603690052 Pc 450,000 21-Aug-2007
288 Gum Scissors 4218 Ernst. Krauskopf Germany KL. 0603690052 Pc 390,000 21-Aug-2007
289 Gum Scissors 4219 Ernst. Krauskopf Germany KL. 0603690052 Pc 390,000 21-Aug-2007
290 Gum Scissors 4226 Ernst. Krauskopf Germany KL. 0603690052 Pc 624,000 21-Aug-2007
291 Gum Scissors 4230 Ernst. Krauskopf Germany KL. 0603690052 Pc 312,000 21-Aug-2007
292 Gebogen Gum Scissor 4232 Ernst. Krauskopf Germany KL. 0603690052 Pc 336,000 21-Aug-2007
293 Gum Scissors Cvd. - 12 cm. 4236 Ernst. Krauskopf Germany KL. 0603690052 Pc 392,500 21-Aug-2007
294 Gum Scissors Cvd. - 12 cm. 4238 Ernst. Krauskopf Germany KL. 0603690052 Pc 392,500 21-Aug-2007
295 Gum Scissors 4242 Ernst. Krauskopf Germany KL. 0603690052 Pc 366,000 21-Aug-2007
296 Joseph Gum Scissors 4266 Ernst. Krauskopf Germany KL. 0603690052 Pc 492,000 21-Aug-2007

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