PEMELIHARAAN PERALATAN MEDIS PRIORITAS 1

NO NAMA ALAT JML ESTIMASI BIAYA KETERANGAN KEGIATAN PERBAIKAN ESTIMASI BIAYA PRIORITAS
BAIK PEMELIHARAAN RUSAK PERBAIKAN

Penggantian Disc Valve, Tubing dan

1 Anaesthesy Machine 27 21 120,000,000 Sparepart (Swakelola) 6 Connector, N2O Safety Device, APL
Module, Gasket 270,000,000 1
16 15 180,000,000 Sparepart (flow sensor, 1 Penggantian Flow sensor, Disc Valve, Below
2 Anaesthesy Ventilator valve tube) Ventilator, Gasket 70,000,000 1
3 Autoclave CSSD 3 3 880,000,000 Kontrak Service - 1
4 Bio Safety Cabinet 5 5 60,000,000 Kontrak Service - 1
5 Bor Micro 5 4 100,000,000 Rekanan 1 Penggantian micro motor 16,500,660 1
6 Cobalt 60 1 1 1,548,000,000 Kontrak Service - 1
7 CT Scan 1 1 750,000,000 Kontrak Service - 1
8 Fibroscan 1 1 192,500,000 Kontrak Service - 1
9 X-Ray Simulator 1 1 350,000,000 Kontrak Service - 1
10 Mammografi 1 1 120,000,000 0 1
11 Mesin IABP 1 1 15,000,000 rekanan - 1
12 MRI 1 1 900,000,000 Pengisian helium - 1
13 Hyperbarik chamber 1 1 100,000,000 Rekanan 1
14 Low Pressure Sterilizer (CASP) 1 1 330,000,000 Kontrak Service - 1

JUMLAH 5,645,500,000
 PEMELIHARAAN PERALATAN MEDIS PRIORITAS 2
NO NAMA ALAT JML ESTIMASI BIAYA KETERANGAN KEGIATAN PERBAIKAN ESTIMASI BIAYA PRIORITAS
BAIK PEMELIHARAAN RUSAK PERBAIKAN
1 Anti Decubitus 3 1 10,000,000 Sparepart (Swakelola) 2 Penggantian bed decubitus 40,000,000 2
2 Automatic Chart Projector 2 2 6,000,000 Sparepart (Swakelola) - 2
3 Baby Incubator 63 46 250,000,000 Sparepart (Swakelola) 15 Penggantian Filter, Seal Rubber 135,000,000 2

Sparepart (Rekanan) NIBP Cable, SpO2 Cable, Manset, ECG cable,

4 Patient Monitor 320 320 200,000,000 0 temperature probe - 2
5 C-Arm Mobile 5 2 240,000,000 Sparepart (Rekanan) 3 Pemanggilan rekanan 150,000,000 2
Sparepart (Rekanan)
6 CPAP 13 11 50,000,000 2 Penggantian spare part - 2
Sparepart (Rekanan)
7 CRRT 2 1 30,000,000 1 Pemanggilan rekanan 70,000,000 2

8 CTG / NST 15 12 60,000,000 Sparepart (Rekanan) 3 Penggantian Control Board, tranduser 45,000,000 2
9 EEG 3 3 66,000,000 Sparepart (Swakelola) - 2
10 Hyper-Hypothermia Unit 1 1 15,000,000 Sparepart (Swakelola) - 2
11 Lensometer 3 2 10,000,000 Sparepart (Swakelola) 1 Penggantian lampu lensometri - 2
12 Light Curing Lamp 3 3 10,500,000 Sparepart (Swakelola) Penggantian lampu curing - 2
13 WSD 30 27 40,500,000 Sparepart (Swakelola) 3 Penggantian filter WSD - 2
14 Parafin Bath 1 0 3,000,000 1 Pemanggilan rekanan - 2
15 Flowmeter O2 530 480 96,000,000 Sparepart (Swakelola) 30 Filter, Seal 10500000 2
16 Slit Lamp 12 11 60,500,000 Sparepart (Swakelola) 1 lampu power supply - 2
17 Suction Jar 90 80 60,000,000 Sparepart (Swakelola) 10 Penggantian botol suction - 2

Sparepart (Swakelola) Penggantian Hydropobic Filter, Suction Jar,

18 Suction Pump 153 142 78,100,000 4 Seal 14000000 2
Sparepart (Swakelola)
19 Tensimeter 449 416 83,200,000 17 Air Raksa, Tabung Kapiler, Connector 8500000 2
 Sparepart (Swakelola)
20 WSD 30 26 91,000,000 - 2

21 Bed Electric 200 190 - 10 Remote Bed Electric 70000000 2

jumlah 1,459,800,000 jumlah 543,000,000

Jumlah Total 2,002,800,000
 PEMELIHARAAN PERALATAN MEDIS PRIORITAS
NO NAMA ALAT JML ESTIMASI BIAYA KETERANGAN
BAIK PEMELIHARAAN
1 ECG Penggantian Patient cable,
160 139 Rp 250,000,000 dan baterai ECG
5 Blanket Warmer (air)
10 7 Rp 14,000,000 Blanket Roll, Double Tubing
6 Bone Mass Densitometer (BMD)
1 0 -
8 Cardiac reader
4 3 Rp 22,500,000
9 Centrifuge Sparepart (Swakelola)
15 13 Rp 28,600,000
11 Defibrilator Sparepart (Swakelola)
80 71 Rp 355,000,000
12 Dental Unit Sparepart (Swakelola)
9 6 Rp 90,000,000
13 ESU Sparepart (Swakelola)
40 35 Rp 300,000,000
16 Fototerapi 24 18 Rp 39,600,000 Sparepart (Swakelola)

17 Generator TPM Sparepart (rekanan)

4 3 Rp 30,000,000
19 Infusion Pump Sparepart (Swakelola)
202 183 Rp 457,500,000
21 Microwave Diathermi (MWD) Sparepart (Swakelola)
2 1 Rp 20,000,000
23 Nebulizer Sparepart (Swakelola)
93 76 Rp 262,500,000
30 Syringe Pump Sparepart (Swakelola)
450 418 Rp 200,000,000
31 Traction Unit Sparepart (Swakelola)
2 1 Rp 11,000,000
32 Ultrasonic Theraphy Unit Sparepart (Swakelola)
2 1 Rp 30,000,000
Jumlah
Jumlah Total Rp 677,000,000
AN MEDIS PRIORITAS 3
KEGIATAN PERBAIKAN ESTIMASI BIAYA PRIORITAS
RUSAK PERBAIKAN

14 Ganti board power supply, pre AMP Rp 120,000,000 3

3 Blanket Roll, Double Tubing Rp 9,000,000 3

1 Penggantian Power Supply Board Rp 50,000,000 3

1 Pemanggilan rekanan - 3

2 - 3

6 Penggantian I/O Board Rp 120,000,000 3

Penggantian motor handpiece dan
3 curing light - 3

5 - 3
6 Penggantian lampu, dan Balast Rp 18,000,000 3

1 Penggantian board dan kalibrasi - 3

12 Drip Sensor, Battery, Rp 90,000,000 3

1 - 3

10 Osilator Board, Tranduser Rp 120,000,000 3

Penggantian Battery, sensor Plunger,
20 syringe sensor Rp 150,000,000 3

1 - 3

1 - 3
Jumlah Rp 677,000,000
 PEMELIHARAAN PERALATAN MEDIS PRIOR
NO NAMA ALAT JML ESTIMASI BIAYA
BAIK PEMELIHARAAN
1 Analitic balance 3 3 Rp 7,500,000
2 Audiometer 3 3 Rp 33,000,000
3 Auto processor (imunostainer) 1 1 Rp 5,000,000
4 Auto Refrakto-Keratometer 2 2 Rp 22,000,000
5 Auto Vision Opthalmic 1 1 Rp 11,000,000
6 Automatic Blod Pressure Monitor 10 10 Rp 10,000,000
7 Bio Laser 1 1 Rp 50,000,000
8 Biometri 2 2 Rp 80,000,000
9 Body Lifter 2 2 Rp 30,000,000
10 Bor Gigi Palsu / Mesin Slip Join 2 2 Rp 3,000,000
11 Broncoscopy 3 3 Rp 225,000,000
12 Central Monitor 3 3 Rp 22,500,000
13 Combination Theraphy Unit 2 2 Rp 80,000,000
14 Doppler 11 11 Rp 16,500,000
15 Dry Sterilisator 3 2 Rp 15,000,000
16 Echocardiograph (USG Jantung) 1 1 Rp 250,000,000
17 Electro Theraphy Unit 3 2 Rp 44,000,000
18 Electro aferesis 1 1 Rp 22,000,000
19 Electrolit analyzer 1 1 Rp 22,000,000
20 EMG 1 1 Rp 30,000,000
21 Endoscopy Unit 8 8 Rp 600,000,000
22 ENT Treatment Unit 4 4 Rp 40,000,000
23 Exercise Pulley 1 1 Rp 25,000,000
24 Exercise Treadmill 3 3 Rp 99,000,000
25 Foto Fundus 2 2 Rp 30,000,000
26 Freezer biomedical 3 3 Rp 33,000,000
27 Gastro intestinal Fiberscope 2 2 Rp 50,000,000
28 General X-Ray 1 1 Rp 200,000,000
29 Mobile X-Ray 8 4 Rp 200,000,000
30 Incubator Lab 15 15 Rp 180,000,000
31 Infant Radiant Warmer 10 10 Rp 22,000,000
32 Infra Red Unit 4 4 Rp 20,000,000
33 Kolposkopi 1 1 Rp 3,500,000
34 Laringoskop 43 43 Rp 150,500,000
35 Laser kulit 1 1 Rp 40,000,000
36 Magnetic stirrer 2 2 Rp 3,000,000
37 Mesin gergaji gips 1 1 Rp 2,500,000
38 Mesin Stimulator / Akupuntur 3 3 Rp 7,500,000
39 Microscope 33 33 Rp 82,500,000
40 Natus Hearing Diagnostics 1 1 Rp 11,000,000
41 Nasopharyngo Laryngo Fiberscope 1 1 Rp 11,000,000
42 Tonometri 3 3 Rp 33,000,000

43 Optical Choherence Tomography (OCT)

(Poli mata) 1 1 Rp 11,000,000
44 Optalmoskop 5 5 Rp 17,500,000
45 Ovum Pick Craf Suction Unit 1 1 Rp 25,000,000
46 Oxymeter 2 2 Rp 4,000,000
47 Panoramic Dental x-ray 1 1 Rp 50,000,000
48 PCR merk biorat 1 1 Rp 15,000,000
49 Perimetri 1 1 Rp 11,000,000
50 Pulse Oximeter 110 105 Rp 100,000,000
51 Radiant Heater 3 3 Rp 4,500,000
52 ROTATOR 1 1 Rp 1,500,000
53 Retinometri 1 1 Rp 40,000,000
54 Scaller / Endo 5 5 Rp 12,500,000
55 Shaker 2 2 Rp 5,000,000
56 Snellen Cart 3 3 Rp 13,500,000
57 Spiro Analyzer 2 2 Rp 3,000,000
58 Trans Cranial Doppler (TCD) 1 1 Rp 20,000,000
59 Thermoplate 1 1 Rp 3,500,000
60 Tympanometri 2 2 Rp 22,000,000
61 Treatment Planning System (TPS) 2 2 -
62 USG Mata 1 1 Rp 40,000,000
63 USG 22 21 Rp 210,000,000

64 Ventilator
83 80 Rp 337,500,000
65 Harmonic Scapel 1 1 Rp 250,000,000
Jumlah Rp 4,018,500,000
Jumlah Total Rp 4,395,500,000
AN PERALATAN MEDIS PRIORITAS 4
KETERANGAN KEGIATAN PERBAIKAN ESTIMASI BIAYA PRIORITAS
RUSAK PERBAIKAN
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (swakelola) 0 - 4
Sparepart (swakelola) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 1 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 4 Pemanggilan rekanan Rp 200,000,000 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (swakelola) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4

Sparepart (rekanan)
0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (swakelola) 2 SpO2 Cable Rp 7,000,000 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (swakelola) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 0 - 4
Sparepart (rekanan) 1 Pemanggilan rekanan Rp 35,000,000 4
Sparepart (rekanan)
3 Inspiration Cassete, O2 Cell Rp 135,000,000 4
Sparepart (rekanan) 0 - 4
Jumlah Rp 377,000,000
 DAFTAR ALAT RUSAK TAHUN 2017 ( Per Desember
NO NAMA ALAT MERK/TYPE LOKASI
1 Anaesthesy Machine

2 Anaesthesy Ventilator
3 Autoclave CSSD Hanshin ISS
5 Bor Micro Karl Storz IBS
Anti Decubitus Dyna Care Nagasari
Nakamura, N-Ideal H-
Baby Incubator 2000, Jepang NICU, Neonatus
Patient Monitor Dash
X-Ray Mobile Listem/Mobix1000 Radiologi
CPAP Sechrist, 3600, NICU
CRRT B-Braun IRD
Nihon Kohden, OMF -
CTG / NST 8100 K IRD-VK
Carefusion, vEEG 32 Ch.
EEG Portable Desktop Poli Saraf
Lensometer Inami Japan Poli Mata

Light Curing Lamp Dentamerica, Litex 680 A Poli Gigi

Shin Ei, Constant 1400,
WSD Jepang IRD
Enraf Nonius, au baine
Parafin Bath marie IRM
Flowmeter O2 C & U, Japan Angsoka
Slit Lamp Appasamy Poli Mata
Suction Jar C & U, Jepang Neonatus
Suction Pump SAM 35 IRD
Tensimeter Riester Beberapa ruangan
Bed Electric MAC VK-Wing, PICU
ECG Bionet, Cardiotouch
3000 ICU-IRIT
Blanket Warmer (air) Gaymar Industry,
Thermacare IBS
Bone Mass Densitometer (BMD) Lunar Wing-Radiologi
Cardiac reader Roche, H232 Lab PK
Centrifuge Hettich, EBA 20 Lab PK
Defibrilator Hearts XL PJT
Dental Unit Gnatus Poli Gigi
ESU Meditom, Daiwha, DT-
400P, Korea IRD
Fototerapi Fanem Bilitron 3006 NICU
Generator TPM Medtronic PJT/ Cathlab
Infusion Pump Enraf Nonius, Radarmed
950 IRM
Microwave Diathermi (MWD)
Nebulizer
Syringe Pump
Traction Unit
Ultrasonic Theraphy Unit
JUMLAH
SAK TAHUN 2017 ( Per Desember 2017)
TINDAKLANJUT PERKIRAAN BIAYA
Penggantian Disc Valve, Tubing dan Connector, N2O Safety Device,
APL Module, Gasket 270,000,000

Penggantian Flow sensor, Disc Valve, Below Ventilator, Gasket 70,000,000

Perbaikan modul 800,000,000
Penggantian micro motor 16,500,660
Penggantian bed decubitus 40,000,000

Penggantian Filter, Seal Rubber 135,000,000

NIBP Cable, SpO2 Cable, Manset, ECG cable, temperature probe -
Pemanggilan rekanan 150,000,000
Penggantian spare part -
Pemanggilan rekanan 70,000,000

Penggantian Control Board, tranduser 45,000,000

-
Penggantian lampu lensometri -

Penggantian lampu curing -

Penggantian filter WSD 40,500,000

Pemanggilan rekanan -
Filter, Seal 10,500,000
lampu power supply -
Penggantian botol suction -
Penggantian Hydropobic Filter, Suction Jar, Seal 14,000,000
Air Raksa, Tabung Kapiler, Connector 8,500,000
Remote Bed Electric 35,000,000

Ganti board power supply, pre AMP Rp 120,000,000

Blanket Roll, Double Tubing Rp 3,000,000

Penggantian Power Supply Board Rp 50,000,000
Pemanggilan rekanan -
-
Penggantian I/O Board Rp 120,000,000
Penggantian motor handpiece dan curing light -

-
Penggantian lampu, dan Balast Rp 18,000,000
Penggantian board dan kalibrasi -

Drip Sensor, Battery, Rp 90,000,000

-
Osilator Board, Tranduser Rp 120,000,000
Penggantian Battery, sensor Plunger, syringe sensor Rp 150,000,000

2,376,000,660