PT. MITRA BAHAGIA CITRA MEDIKA JI. Raya Kalirungkut 27 Blok C No. 63 SURABAYA EAST JAVA—-INDONESIA Phone : 62.31.8782078 ; 62.31.8782079 Email : ptmbem2008@email.com Nomor : 0367/SPH-MBCMIIV/19 Tanggal : 23 April 2019 Perihal : Penawaran Harga Kepada Yth — RSUD ASY - SYIFA Jl, Lang Sesat, Taliwang, Dalam SUMBAWA BARAT Dengan hormat, Bersama ini kami PT. Mitra Bahagia Citra Medika Surabaya, Distributor resmi alat — alat kesehatan untuk wilayah Indonesia. Mengajukan penawaran harga, dengan perincian seperti tersebut dibawah ini : No. Nama Reagent Merk Harga/Kit | Harga/Test 1._| Free 13 2x 50 test CLIA a Mindray | Rp. 2.515.968 | Rp. _25.160- [2._ | Free T4 2 x 50 test CLIA — Mindray | Rp. 2.515.968, | Rp. 25.160. 3._| Total T3 2 x 50 test CLIA — Mindray [ Rp. 2.515.968.— [ Rp. 25.160.- 4. | Total T4 2x 50 test CLIA Mindray | Rp. 2.515.968,-_| Rp. 25.160,- 3._| TSH 2 x 50 test CLIA Mindray | Rp. 2.515.968,-_| Rp. 25.160,- 6._| Cancer Antigen CA125 2 x 50 test CLIA Mindray | Rp. 7.547.904- | Rp._75.480,- 7._| Cancer Antigen CA19-9 2 x 50 test CLIA | Mindray | Rp. 7.547.904- | Rp._75.480.- 8._| Total PSA 2 x 50 Test CLIA Mindray | Rp._5.750.784,-_| Rp. 57.508. 9, | CEA 2 x 50 Test CLIA Mindray [ Rp. 4.852.224,- | Rp. 48.523, AFP 2 x 50 Test CLIA Mindray | Rp. 3.833.856, | Rp. 38.339,- 11. | Cancer Antigen CA15-3 2 x 50 test CLIA idray | Rp. _7.547.904,- | Rp. 75.480,- 12. | Troponin 2 x 50 Test CLIA idray | Rp._4.313.088,- | Rp. 43.130,- 13. | CK-MB 2 x 50 Test CLIA Mindray | Rp. 2.683.699, | Rp. _26.837,- 14, | B-type natriuretic peptide BNP 2 x 50 Test CLIA Mindray | Rp. 18.905.702,-_| Rp. 189.058,- 15. | Antibody to Hepatitis B Surface Antigen 2 x 50 Test CLIA Rp. 2.396.160.- | Rp._23.962,- 16. | Hepatitis B e Antigen 2 x 50 Test CLIA Rp. 3.833.856. | Rp._38.339.- 17. | Hepatitis B Surface Antigen 2 x 50 Test CLIA Mindray [ Rp. 1.996.800, | Rp. 19.968. 18. | Antigen and Antibodies HIV 2 x 50 Test CLIA Mindray | Rp. 3.314.688,- | Rp. 33.147,- 19. | Anti HCV 2 x 50 Test CLIA Mindray | Rp. 2.396.160,-_| Rp. _23.962,- 20. | Anti TP 2.x 50 Test CLIA Mindray | Rp. 2.795.520, | Rp._27.956,- 21. | Free T3 Calibrator 1 x 2 mV/I x2 mV/I x2 ml CLIA Mindray _[ Rp. _2.156.544,- - 22. | Free T4 Calibrator 1x 2 mV/1 x 2 mV/I x2 mI CLIA Mindray —[ Rp. 2.156.544,- = 23. | Total T3 Calibrator 1 x 2 mV/i x 2 mi/I x2 ml CLIA Mindray | Rp. 2.156.544,- = 24, | Total T4 Calibrator 1x 2 mV/I x 2 ml/I x2 mI CLIA Mindray | Rp. 2.156.544.- 5 25. | TSH Calibrator | x 2 mV/I x 2 mi/I x2 ml CLIA Mindray | Rp. 2.156.544- - 26. | CA125 Calibrator 1 x 2 mi/I x2 mi/I x2 mi CLIA Mindray | Rp. 3.594.240,- = 27. | CA19-9 Calibrator 1 x 2 mill x2 mi/1 x2 ml CLIA Mindray — | Rp. 3.594.240, = 28. | TPSA Calibrator 1x 2 mV/I x2 ml/I x2 mI CLIA Mindray | Rp._3.594.240,- : 29. | CEA Calibrator I x 2 mi/1 x 2 mV/I x 2 ml CLIA Mindray | Rp. 2.875.392.- 5 30. [AFP Calibrator | x 2 mV/I x2 mV/I x 2 ml CLIA Mindray | Rp. _2.875.392.- =