RUMAH SAKIT ANAK DAN BUNDA HARAPAN KITA Jl. Let. Jen. S. Parman Kav. 87, Jakarta Barat UNIT LAYANAN PENGADAAN BARANG/JASA KELOMPOK KERJA PENGADAAN BARANG BERITA ACARA HASIL LELANG PENGADAAN ALKES HABIS PAKAI SEMESTER II TAHUN 2015 RSAB HARAPAN KITA Nomor : ULP.00.03.11.040.12
Pada hari ini Senin tanggal Enam bulan Juli tahun dua ribu lima belas, yang bertanda tangan dibawah ini Kelompok Kerja Pengadaan Barang RSAB Harapan Kita, berdasarkan Surat Tugas Nomor : ULP.02.14.014 tanggal 28 Februari 2014 tentang Personalia Kelompok Kerja Unit Layanan Pengadaan Barang/Jasa, telah selesai melaksanakan proses lelang, dengan rincian sebagai berikut : 1.
Jenis Pengadaan
2.
Sumber Dana
3.
HPS
: Pengadaan ALKES Habis Pakai Semester II Tahun 2015 RSAB Harapan Kita : DIPA RM RSAB Harapan Kita Tahun 2015. : Rp. 5.892.239.529,- (lima milyar delapan ratus sembilan puluh dua juta dua ratus tiga puluh sembilan ribu lima ratus dua puluh sembilan rupiah).
4. Jumlah peserta yang mendaftar sebanyak 69 (Enam Puluh Sembilan) peserta dan jumlah peserta yang memasukkan dokumen penawaran sebanyak 14 (Empat Belas) peserta, sebagai berikut :
PT. Cipta Sukses Medika................../2
-2-
PT. Otonomia Bangun............../3
-3-
PT. Manunggaling................./4
-4-
5. Dari hasil koreksi aritmatik : No Nama Perusahaan 1. PT. Medquest Jaya Global 2. PT. Dos Ni Roha 3.
4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14
PT. Cipta Sukses Medika
PT. Restu Ibu Sejati PT. Bumi Indah Medika PT. Parazelsus Indonesia PT. Mensa Bina Sukses PT. Promedika Sejahtera PT. Cita Vita Buana PT. Hospi Medik Indonesia PT. Sentra Asia Gemilang PT. IDS Medical System Indonesia PT. AMPM Healthcare Indonesia PT. Golden Globe Medika
Harga Penawaran Rp.134.180.350,00 Rp. 297.694.529,00 Rp. 4.438.871.726,00 Rp. 687.943.300,00 Rp.1.800.724.750,00 Rp. 177.212.448,00 Rp 304.606.005,00
Harga Koreksi Aritmatik Rp.134.180.350,00 Rp. 297.694.529,00 Rp. 4.438.871.726,00 Rp. 687.943.300,00 Rp.1.800.724.750,00 Rp 177.212.449,13 Rp 304.606.005,00
Rp. 47.520.000,00 Rp 93.570.400,00 Rp. 348.444.645,00 Rp. 258.258.101,00
Rp. 47.520.000,00 Rp 93.570.400,00 Rp. 348.444.645,00 Rp. 258.258.101,00
Rp. 31.715.145,00 Rp. 102.055.140,00
Rp. 31.715.145,00
6. Metode evaluasi yang digunakan sistem gugur. 7. Pokja ULP RSAB Harapan Kita melakukan Evaluasi penawaran terhadap Administrasi, Teknis, Harga dan Kualifikasi terhadap 14 ( Empat Belas ) Peserta dengan hasil sebagai berikut:
‘a. Hasil evaluasi.............../5
-5a. Hasil evaluasi administrasi No.
Nama Penyedia
1. 2. 3. 4. 5. 6. 7.
PT. Medquest Jaya Global PT. Dos Ni Roha PT. Cipta Sukses Medika
PT. Restu Ibu Sejati PT. Bumi Indah Medika PT. Parazelsus Indonesia PT. Mensa Bina Sukses PT. Promedika Sejahtera
8.
PT. Citra Vita Buana
9.
PT. Hospi Medik Indonesia
10.
PT. Sentra Asia Gemilang 11. 12. 13. 14.
PT. IDS Medical System Indonesia PT. AMPM Healthcare Indonesia PT. Golden Globe Medica
b.
Hasil evaluasi administrasi Memenuhi syarat Memenuhi syarat Memenuhi syarat Memenuhi syarat Memenuhi syarat Memenuhi syarat Memenuhi syarat Tidak ditemukan file Dokumen Penawaran dari hasil apendo panitia Masa berlaku penawaran kurang dari yang dipersyaratkan dalam Dokumen Pengadaan Tidak ada Jangka waktu penawaran, tidak upload ijin PAK Tidak ada jangka waktu penawaran, tidak upload pengalaman perusahaan dalam kurun waktu 4 (empat) tahun terakhir, tidak upload SPT 2014 Memenuhi syarat Memenuhi syarat Memenuhi syarat
Hasil evaluasi teknis : Pada Saat Evaluasi Teknis ada beberapa item barang yang perlu dilakukan klarifikasi dan hasil klarifikasi dinyatakan memenuhi syarat. Hasil Evaluasi teknis sebagai berikut : No. 1. 2. 3. 4. 5. 6. 7. 8.
9. 10. c.
Nama Penyedia PT. Medquest Jaya Global PT. Dos Ni Roha PT. Cipta Sukses Medika
PT. Restu Ibu Sejati PT. Bumi Indah Medika PT. Parazelsus Indonesia PT. Mensa Bina Sukses PT. IDS Medical System Indonesia PT. AMPM Healthcare Indonesia PT. Golden Globe Medica
Hasil Evaluasi Teknis Memenuhi syarat Memenuhi syarat Memenuhi syarat Memenuhi syarat Memenuhi syarat Memenuhi syarat Memenuhi syarat Memenuhi syarat Memenuhi syarat Memenuhi syarat
Hasil evaluasi harga : Dilakukan klarifikasi dan negosiasi harga (harga satuan) dengan hasil sebagai berikut :
No
Nama Penyedia
1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
PT. Medquest Jaya Global PT. Dos Ni Roha PT. Cipta Sukses Medika
PT. Restu Ibu Sejati PT. Bumi Indah Medika PT. Parazelsus Indonesia PT. Mensa Bina Sukses PT. IDS Medical System Indonesia PT. AMPM Healthcare Indonesia PT. Golden Globe Medica
Hasil evaluasi harga Rp. 133.749.192,50 Rp. 274.656.129,00 Rp. 3.770.181.176,30 Rp. 637.832.800,00 Rp.1.723.128.000,00 Rp. 177.212.448,00 Rp 279.845.445,00 Rp. 258.258.101,00 Rp. 31.715.145,00 Rp. 102.055.140,00
Hasil Negosiasi Rp. 128.987.925,00 Rp. 273.503.769,00 Rp. 1.183.820.688,05 Rp. 636.655.800,00 Rp. 1.698.573.800,00 Rp. 177.212.449,13 Rp. 276.405.987,00 Rp. 258.258.101,00 Rp. 31.715.145,00 Rp. 102.055.140,00 ‘d. Hasil evaluasi................/6
d.
Hasil evaluasi kualifikasi : No.
Nama Penyedia
Hasil evaluasi Kualifikasi
1. 2. 3. 4. 5. 6. 7.
PT. Medquest Jaya Global PT. Dos Ni Roha
Memenuhi syarat Memenuhi syarat Memenuhi syarat Memenuhi syarat Memenuhi syarat Memenuhi syarat Memenuhi syarat Tidak melampirkan dokumen LDK Persyaratan Kualifikasi : SPT 2014 Tidak melampirkan dokumen LDK b. Persyaratan Kualifikasi : SPT 2014 Tidak melampirkan dokumen LDK b. Persyaratan Kualifikasi : SPT 2014
8. 9. 10.
PT. Cipta Sukses Medika
PT. Restu Ibu Sejati PT. Bumi Indah Medika PT. Parazelsus Indonesia PT. Mensa Bina Sukses PT. IDS Medical System Indonesia PT. AMPM Healthcare Indonesia PT. Golden Globe Medica
e. Hasil pembuktian kualifikasi : No. 1. 2. 3. 4. 5. 6. 7.
Nama Penyedia PT. Medquest Jaya Global PT. Dos Ni Roha PT. Cipta Sukses Medika
PT. Restu Ibu Sejati PT. Bumi Indah Medika PT. Parazelsus Indonesia PT. Mensa Bina Sukses
Hasil pembuktian Kualifikasi Memenuhi syarat Memenuhi syarat Memenuhi syarat Memenuhi syarat Memenuhi syarat Memenuhi syarat Memenuhi syarat
f. Berdasarkan hal tersebut diatas, maka pokja pengadaan barang menetapkan 7( Tujuh ) pemenang lelang Pengadaan ALKES Habis Pakai Semester II Tahun 2015 RSAB Harapan Kita ( item barang terlampir ). Demikianlah Berita Acara Hasil Lelang ini dibuat dengan sebenarnya dan penuh rasa tanggung jawab, merupakan bagian yang tidak terpisahkan dari dokumen lelang yang bersifat mengikat untuk dipergunakan sebagai mana mestinya. Ttd. Kelompok Kerja Pengadaan Barang ULP RSAB Harapan Kita 1. Agustin Tuti Riana, S.Si
Ketua
2 Efvi Miaristi, ST
Sekretaris
3. I Ketut Subagia, SE
Anggota
4. Stevanus Wahyu BS, BE
Anggota
5. Ismail
Anggota
1….................. 2.…............... 3..................... 4. ..................... 5.......................
b.
LAMPIRAN BERITA ACARA HASIL LELANG PT. Cipta Sukses Medika No 6 12 17 19 20 35 48 52 54 739 740 744 757 772 797 798 826 827 828 829 830 831 832 833 834 835 836 837 838 839 840 841 842 843 844 845 846 850 851 852 855 856 857 858 859 860 861 865 866 867 869 871 872 878 879 880 888 889 909 927 928 929 931 940 941 942 943 950 952 953 954 955 959 960 963 964 965 977 979 989 997 998 999 1015 1030 1032 1034 1035 1037 1038 1042 1044 1046 1047 1057 1069
Nama Barang Sarung Tangan Panjang sampai siku steril Sarung tangan ,100 (L) Kertas ECG 1 Chaenel Kertas Spirometer ( 114 x 30 ) Kertas ECG Multi Channel Buli-Buli Panas Ice Cup Disp. Hand Scone XS Sarung Tangan ,100 ( XL) Needle Flashback 22 x 1 Tube PLN 13 X 75 4,0 K3 EDTA 0,5 ml / 50 pcs Lancet blood ,200 Pcs Turniquet Deck Glass 18x18mm, 1000pc/pak Deck Glass 24 x 24 mm , 1000 pc/pak DRAINAGE BAG ADULT JMS E T T CUFF 5.0 PORTEX E T T CUFF 5.5 PORTEX E T T CUFF 6.5 PORTEX E T T CUFF 7.0 PORTEX E T T CUFF 7.5 PORTEX E T T NO 2.5 PORTEX E T T NO 3.0 PORTEX E T T NO 3.5 PORTEX E T T NO 4.0 PORTEX E T T NO 4.5 PORTEX EXTENSION TUBE 1 EXTENSION TUBE 2 FEEDING TUBE 3/40 CM JMS FEEDING TUBE 5/120CM JMS FEEDING TUBE 5/40 CM JMS FEEDING TUBE 6/40 CM JMS FEEDING TUBE 8/120CM JMS FEEDING TUBE 8/40 CM JMS FEEDING TUBE 10/120CM JMS FEEDING TUBE 12/120CM JMS FOLLEY CATH FR 6 NORTA FOLLEY CATH FR 8 NORTA FOLLEY CATH FR 10 NORTA FOLLEY CATH FR 14 WRP FOLLEY CATH FR 16 NORTA FOLLEY CATH FR 18 NORTA GUIDEL AIRWAY NO. 00 GUIDEL AIRWAY NO. 0 GUIDEL AIRWAY NO. 1 GUIDEL AIRWAY NO.4 HYPAFIX 10CM X 5 M HYPAFIX 5CM X 5 M INF SET WITH BURET JMS INFUSION SET PAED 500 INFUSION SET TYPE 500 INJECTION PLUG / IN-STOPPER LUER LOCK KASA STERIL 1/16 (husada) LAMINARIA STICK L LAMINARIA STICK M MUCUS EXTRACTOR FR.10 JMS NELATON CATHETER NO 12 rusch PULVERIZER SPINOCAN G 25 NEEDLE SPINOCAN G 26 NEEDLE SPINOCAN G 27 NEEDLE SPUIT 3 CC BD STOMACH TUBE FR 12 (120cm) JMS STOMACH TUBE FR 14 (120cm) JMS STOMACH TUBE FR 16 (120cm) JMS STOMACH TUBE FR 18 (120cm) JMS SURGICEL GAUZE 5 X 7.5 CM W 1913T TEGADERM 1627 TENSOCREPE 3 INCH TENSOCREPE 4 INCH TENSOCREPE 6 INCH UNDERPADS UP-150 23"X36" NS/ SC 849 URINE COLECTOR PEDIATRIC (UDPS) JMS VENFLON 18 G /Venflon Pro VENFLON 20 G /Venflon Pro VENFLON 22 G /Venflon pro WING NEEDLE 25 G JMS E T T CUFF 6.0 PORTEX ANSELL NON STERILE SIZE L FOLLEY CATH FR 12 WRP NASSAL CANNULA ADULT (hospitech) NASSAL CANNULA CHILD (hospitech) UMBILICAL CORD CLAMP (JMS) CONNECTING TUBE 2-TUNEL (hospitech) FOLLEY CATH FR 16 WRP IVENA 22 G IVENA 24 G IVENA 18 G IVENA 20 G SUCTION CATH. FR 8 hospitech HYPAFIX 15 X 5 CM GUIDEL AIRWAY NO. 2 SUCTION CATH. FR 10 hospitech SUCTION CATH .FR 6 hospitech SUCTION CATH CH. 12 hospitech
Spesifikasi Remedi Ansell Fukuda ME pILOT Fukuda ME lokal Ansell Sensi Gloves BD BD Intherma Misawa. lokal Asistant Asistant jms, box isi 10 portex portex portex portex portex portex portex portex portex portex jms, 100cm, 0.79ml ,box isi 50 jms, 100 cm, 4.90ml, box isi 25 jms, box isi 50 jms, box isi 50 jms, box isi 50 jms, box isi 50 jms, box isi 50 jms, box isi 50 jms, box isi 50 jms, box isi 50 2way,norta ,bsn, box 10 2way,norta ,bsn, box isi 10 2way,norta, bsn, box isi 10 2way,wrp, box isi 10 2way,norta, bsn, box isi 10 2way,norta, bsn, box isi 10 portex / sumi portex / sumi portex / sumi portex / sumi 1pcs/20, BSN BSN jms, box isi 10 jms, box isi 25 jms, box isi 25 zontic/bbraun, box isi 100 husada 16x16 box isi 12 box isi 12 jms, box isi 25 rusch sci bbraun bbraun bbraun BD, box isi 100 jms, box isi 20 jms, box isi 20 jms, box isi 20 jms, box isi 20 box isi 24, J&J 3M,box isi 20 BSN BSN BSN Prevail,802493, carton isi 150 jms, box isi 25 BD BD BD jms, box isi 100 portex microtouch dermaclean pwd free 2WAY, wrp hospitech hospitech
jms ,box isi 50 jms, box isi 50 jms, box isi 50 jms, box isi 50 hospitech bsn portex / sumi
-
Page 1 of 11
Jumlah 12 20 40 1 40 12 8 150 15 75 80 80 15 15 18 180 800 40 30 20 10 20 50 70 150 100 80 6.000 50 50 100 100 50 1.200 2.100 250 100 130 130 130 10 400 150 5 10 3 5 400 250 400 500 2.800 800 4.200 36 12 400 5 5 200 100 500 900 10 40 40 20 5 600 10 15 5 6.000 500 600 400 400 1.000 25 1.000 60 400 200 700 1.000 150 150 1.000 36 160 2.000 400 15 600 550 50
Satuan Pasang Doos Roll Buku Pak Buah Unit Doos Box Box Box Pak Box Buah Pak Pak Pieces Pieces Pieces Pieces Pieces Pieces Pieces Roll Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Set Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Roll Roll Roll Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Roll Pieces Pieces Pieces Pieces
Harga Satuan (Rp) 22.000,00 110.450,00 44.000,00 562.100,00 99.000,00 27.500,00 22.000,00 44.000,00 44.000,00 121.000,00 251.000,00 132.000,00 110.000,00 44.000,00 385.000,00 600.000,00 60.500,00 78.756,10 78.756,10 78.756,10 80.411,50 80.473,80 61.689,60 70.958,00 70.958,00 70.507,50 70.507,50 27.260,00 27.260,00 8.460,00 8.460,00 8.460,00 8.460,00 8.460,00 8.460,00 8.460,00 8.460,00 66.000,00 66.000,00 66.000,00 9.900,00 15.400,00 15.400,00 21.870,00 21.870,00 21.870,00 21.870,00 108.350,00 56.870,00 64.900,00 23.500,00 19.740,00 3.300,00 6.600,00 99.000,00 99.000,00 29.375,00 13.200,00 1.650.000,00 22.000,00 22.000,00 22.000,00 880,00 9.400,00 9.400,00 9.400,00 9.400,00 66.000,00 24.200,00 56.210,00 67.650,00 88.825,00 4.950,00 27.025,00 18.700,00 18.700,00 18.700,00 6.345,00 78.756,10 1.104,50 10.450,00 9.900,00 9.900,00 18.800,00 38.500,00 9.900,00 9.518,00 9.518,00 9.518,00 9.518,00 5.500,00 149.765,00 21.870,00 5.500,00 5.500,00 5.500,00
Jumlah
(Rp)
264.000,00 2.209.000,00 1.760.000,00 562.100,00 3.960.000,00 330.000,00 176.000,00 6.600.000,00 660.000,00 9.075.000,00 20.080.000,00 10.560.000,00 1.650.000,00 660.000,00 6.930.000,00 108.000.000,00 48.400.000,00 3.150.244,00 2.362.683,00 1.575.122,00 804.115,00 1.609.476,00 3.084.480,00 4.967.060,00 10.643.700,00 7.050.750,00 5.640.600,00 163.560.000,00 1.363.000,00 423.000,00 846.000,00 846.000,00 423.000,00 10.152.000,00 17.766.000,00 2.115.000,00 846.000,00 8.580.000,00 8.580.000,00 8.580.000,00 99.000,00 6.160.000,00 2.310.000,00 109.350,00 218.700,00 65.610,00 109.350,00 43.340.000,00 14.217.500,00 25.960.000,00 11.750.000,00 55.272.000,00 2.640.000,00 27.720.000,00 3.564.000,00 1.188.000,00 11.750.000,00 66.000,00 8.250.000,00 4.400.000,00 2.200.000,00 11.000.000,00 792.000,00 94.000,00 376.000,00 376.000,00 188.000,00 330.000,00 14.520.000,00 562.100,00 1.014.750,00 444.125,00 29.700.000,00 13.512.500,00 11.220.000,00 7.480.000,00 7.480.000,00 6.345.000,00 1.968.902,50 1.104.500,00 627.000,00 3.960.000,00 1.980.000,00 13.160.000,00 38.500.000,00 1.485.000,00 1.427.700,00 9.518.000,00 342.648,00 1.522.880,00 11.000.000,00 59.906.000,00 328.050,00 3.300.000,00 3.025.000,00 275.000,00
No 1097 1125 1130 1132 1142 1147
Nama Barang ALCOHOL SWABB (onemed) TEGADERM 1623 ANSELL NON STERILE SIZE S ANSELL NON STERILE SIZE M FEEDING DRIP TYPE 100 ML/ FEED BURET SET FOLLEY CATH FR 26 WRP
Spesifikasi
Jumlah
onemed 3M,box isi 100 microtouch dermaclean pwd free microtouch dermaclean pwd free jms, box isi 50 2way,wrp, box isi 10
50.000 1.500 10.000 10.000 500 10
Page 2 of 11
Satuan Lembar Lembar Pieces Pieces Pieces Pieces
Harga Satuan (Rp) 110,00 4.400,00 1.104,50 1.104,50 149.600,00 11.163,00 Subtotal PPN Total
Jumlah
(Rp)
5.500.000,00 6.600.000,00 11.045.000,00 11.045.000,00 74.800.000,00 111.630,00 1.076.200.625,50 107.620.062,55 1.183.820.688,05
No
Nama Barang
Spesifikasi
Jumlah
Satuan
Harga Satuan (Rp)
Jumlah
(Rp)
Jumlah
(Rp)
PT. DOS NI ROHA No 812 814 815 816 817 882 887 893 894 895 896 898 912 913 914 915 916 917 918 919 920 921 922 923 924 1011 1016 1049 1065 1108 1115 1145 1168 1171
Nama Barang CERTOFIX MONO PAED + ACCES CHROMIC 1 HR 43 CHROMIC 2 HR 48 CHROMIC 2/0 HR 37 S CHROMIC 3/0 TAP HR 26 MEDIFIX LUER LUCK MONOSYN 3-0 DS 24 PLAIN 0 HR 43 TAPER PLAIN 3/0 CUTT DS 24 PLAIN 3/0 TAP HR 26 PLAIN 4/0 TAPER HR 17 PREMILENE 3/0 DS 24 SAFIL 0 HR 40 S SAFIL 1 HR 40 S SILK 0 HR 30 TAP SILK 1 HR 48 TAP SILK 2/0 CUTT DS 30 SILK 2/0 TAP HR 26 SILK 2/0 W.O NEEDLE 13X60 SILK 3/0 CUTT DS 24 SILK 3/0 TAP HR 17 SILK 3/0 TAP HR 26 SILK 3/0 W.O NEEDLE 13X60 SILK 4/0 CUTT DS 19 SILK 4/0 TAP HR 17 CERTOFIX DUO V 720 SPINOCAN G 29 NEEDLE CERTOFIX MONO V 220 MEDIFIX MANOMETER SCALA SILK 5/0 CUTT DS 16 LYOSTYPT 5 x 8cm SAFIL 4/0 HR 17 CHROMIC 2 HR 43 HYSTOACRYL 0.5 ML
Spesifikasi bbraun box isi 24, bbraun box isi 24, bbraun bbraun bbraun bbraun bbraun, isi 36 bbraun bbraun bbraun bbraun bbraun bbraun, box isi 36 bbraun, box isi 36 bbraun bbraun bbraun bbraun bbraun bbraun bbraun bbraun bbraun bbraun bbraun bbraun bbraun ,box isi 25 Bbraun bbraun bbraun box isi 6pc, bbraun bbraun, box isi 36 box isi 24, bbraun box isi 5, bbraun
Jumlah
Satuan
80 60 200 840 30 10 180 24 112 24 250 15 150 380 72 56 6 120 84 220 132 24 32 12 280 5 50 40 5 72 60 100 15 12
Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces SACHET
Jumlah
Satuan
1.200 4 2.200 800 400 60 400 200 450 3.500 9.000 1.500 50 1.500 2.000 100 120
Pieces Pak Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pak Isi 4 Pieces Pieces Pieces
Jumlah
Satuan
Harga Satuan (Rp) 450.225,00 58.450,00 51.900,00 53.200,00 48.650,00 106.590,00 82.288,00 47.250,00 45.150,00 48.300,00 52.850,00 64.400,00 73.450,00 68.250,00 41.700,00 51.350,00 51.300,00 39.200,00 39.300,00 36.400,00 41.100,00 43.400,00 37.500,00 37.700,00 44.850,00 518.400,00 41.460,00 314.010,00 199.410,00 39.200,00 80.500,00 65.975,00 52.000,00 175.000,00 Subtotal PPN Total
36.018.000,00 3.507.000,00 10.380.000,00 44.688.000,00 1.459.500,00 1.065.900,00 14.811.840,00 1.134.000,00 5.056.800,00 1.159.200,00 13.212.500,00 966.000,00 11.017.500,00 25.935.000,00 3.002.400,00 2.875.600,00 307.800,00 4.704.000,00 3.301.200,00 8.008.000,00 5.425.200,00 1.041.600,00 1.200.000,00 452.400,00 12.558.000,00 2.592.000,00 2.073.000,00 12.560.400,00 997.050,00 2.822.400,00 4.830.000,00 6.597.500,00 780.000,00 2.100.000,00 248.639.790,00 24.863.979,00 273.503.769,00
PT. MENSA BINA SUKSES No 16 26 809 870 884 886 897 946 947 948 949 957 961 1028 1033 1084 1122
Nama Barang Disp Stik Pengukur Kdr Gula Dlm Darah Internal Comply EO TM 1251 BLOOD ADM.SET (TERUMO) TBU800 INFUSION SET PUMP TERUMO MICRODRIP/BURET TSPM 270L MICROPORE 1/2"X 10 YD DISPENSER 15350 PLESTER NA/ TRANSPORE 1/2 X 10 YARD SURFLO 18 G X 1 1/4 SURFLO 20 G X 2 SURFLO 22 G X 1 SURFLO 24 G X 3/4 THREE WAY STOP COCK (TRM) UROGARD ADULT/URINE BAG DOCARE WASH GLOVES ELECTRODE TM 2560 RED DOT TERUFUSION BLOOD SET FOR PUMP TEGADERM 1626
Spesifikasi Tube Isi 30,Gluko DR,Terumo 3M terumo, box isi 50 terumo, box isi 20 terumo, box isi 10 3M, type 1535-0, box isi 24 3M, box isi 24 terumo, box isi 50 terumo, box isi 50 terumo, box isi 50 terumo, box isi 50 terumo, box isi 50 terumo latex free 3M, pak isi 50 TB PU300L 3M,box isi 50
Harga Satuan (Rp) 5.417,00 423.360,00 12.705,00 25.740,00 61.880,00 7.000,00 7.500,00 7.595,00 7.595,00 7.595,00 7.595,00 15.730,00 48.100,00 17.850,00 4.363,00 38.818,00 9.269,00 Subtotal PPN Total
Jumlah
(Rp)
6.500.400,00 1.693.440,00 27.951.000,00 20.592.000,00 24.752.000,00 420.000,00 3.000.000,00 1.519.000,00 3.417.750,00 26.582.500,00 68.355.000,00 23.595.000,00 2.405.000,00 26.775.000,00 8.726.000,00 3.881.800,00 1.112.280,00 251.278.170,00 25.127.817,00 276.405.987,00
PT. MEDQUEST JAYA GLOBAL No
Nama Barang
1082 CLAVE CONNECTOR CS 10 1083 CLAVE CONNECTOR CS 50 1131 MICROCLAVE-T
Spesifikasi
100 Pieces 150 Pieces 2.500 Pieces
icu medical icu medical ICU medical
Harga Satuan (Rp) 32.555,00 44.625,00 42.925,00 Subtotal PPN Total
Jumlah
(Rp)
3.255.500,00 6.693.750,00 107.312.500,00 117.261.750,00 11.726.175,00 128.987.925,00
PT. PARAZELSUS INDONESIA No 810 890 891 899 900 901 902 903 904 905 906 907 908 966 967 968 969 970
Nama Barang BONE WAX 2.5 GM W 810 PDS II 0 USP 0 150CM CTX 1/2C W 9261 T PDS II 6-0 45CM 13MM 2ARM W 9096 H PROLENE 3-0 16 MM 1/2R D/A W 8558 PROLENE 3-0 26MM REV CUT W 8684 PROLENE 4-0 8604 G CLEAR PROLENE BLU 4-0 45CM 3/8 8619 G PROLENE 4-0 17MM 1/2 D/A W 8935 PROLENE BLU 5-0 60CM 1/2 13 8205 H PROLENE BLU 5-0 45CM 3/8 13 8605 G PROLENE BLU 5-0 45CM 3/8 13 8698 G PROLENE UND 45 CM MO.7 8606 G PROLENE BLU 6-0 45CM 3/8 13 8617 G VICRYL CTD 1 40 1/2C RB W 9431 VICRYL CTD 2/0 25MM 0.5C O W 9121 VICRYL VIO 2/0 90MM M3V-34 W 9463 VICRYL CTD 3/0 26MM RE CT W 9890 VICRYL CTD 3/0 20MM 0.5C O W 9114
Spesifikasi ethicon, ethicon, isi 24 ethicon, isi 36 ethicon, box isi 12 ethicon, box isi 12 ethicon, box isi 12 ethicon,box isi 12 ethicon, box isi 12 ethicon, box isi 36 ethicon, box isi 12 ethicon, box isi 12 ethicon, box isi 12 ethicon, box isi 12 ethicon, box isi 12/ vcp359H ethicon ,box isi 12 /vcp317H ethicon, box isi 12/ vcp517H/isi 36 ethicon, box isi 12 ethicon, box isi 12
Page 3 of 11
Jumlah 20 15 20 24 48 6 36 6 24 24 12 204 12 10 30 20 10 240
Satuan Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces
Harga Satuan (Rp) 59.570,00 122.597,19 159.562,50 131.272,92 76.929,17 114.545,83 115.239,58 113.004,17 199.260,42 114.545,83 111.154,17 114.545,83 115.239,58 85.485,42 76.312,50 84.329,17 71.533,33 85.020,37
Jumlah
(Rp)
1.191.400,00 1.838.957,81 3.191.250,00 3.150.550,00 3.692.600,00 687.275,00 4.148.625,00 678.025,00 4.782.250,00 2.749.100,00 1.333.850,00 23.367.350,00 1.382.875,00 854.854,17 2.289.375,00 1.686.583,33 715.333,33 20.404.889,50
No 971 972 973 974 975 991 1000 1023 1109
Nama Barang VICRYL CTD 4/0 19MM RE CUT W 9386 VICRYL CTD 4/0 16MM 0.5C O W 9106 VICRYL CTD 5/0 12MM CUR REV W 9501 T VICRYL CTD 5/0 16MM 0.5C O W 9105 VICRYL CTD UND 6/0 11MM P-1 W 9500 T PDS II VIO 5-0 70CM C-1 Z 1013 H DERMABOND 2 SKIN ADHESIVE HV PRECISION PROLENE 0 W 486 PROLENE BLU 4-0 90CM RB-1 W8557
Spesifikasi ethicon, box isi 36 /vcp392H ethicon, box isi 12 /vcp304H ethicon, box isi 24 ethicon ,box isi 12 /vcp303H box isi 36 ethicon, box isi 24 ethicon, box isi 36 ethicon AHV6 box isi 6 ethicon ethicon, box isi 36, box isi 12
Jumlah 10 360 144 360 10 10 6 48 40
Satuan Pieces Pieces Pieces Pieces Pieces Pieces Tube Pieces Pieces
Harga Satuan (Rp) 67.679,17 75.695,83 109.265,63 74.770,83 109.304,17 91.143,33 229.708,33 78.008,33 131.272,92 Subtotal PPN Total
Jumlah
(Rp)
676.791,67 27.250.500,00 15.734.250,00 26.917.500,00 1.093.041,67 911.433,33 1.378.250,00 3.744.400,00 5.250.916,67 161.102.226,48 16.110.222,65 177.212.449,13
PT. RESTU IBU SEJATI No 7 8 25 28 29 30 31 36 40 44 56 734 753 807 808 811 813 824 825 892 930 932 933 935 936 937 938 939 951 984 995 996 1013 1025 1059 1107 1111 1124 1133 1134 1135 1140 1144 1153 1158 1164 1165
Nama Barang Pembalut Wanita Post Partum Kapas Lemak 1 kg Kertas USG Echo UPC- 21 L Masker tie on 50 Masker ear loop 50 Tutup Kepala Disp. Pria (Doos Isi 100) Tutup Kepala Disp.Wanita (Doos Isi 100) Benang Tali Pusat Cervix Brush Kantong Plastik Uk. 0,25 Kg Tmpt Obat/alkes Cotton Tripped Applicator,Surgilab Tip Blue ,1000 Bh Printer Ppr.57x30 mm BARAKSCORT DISP.(APRON) BASIC BREATH SYSTEM 4508 BREATH SYSTEM T-KIT 2506 CHAMBER MR290 DISP NEEDLE 18 G NIPRO DISP NEEDLE 24 G NIPRO PISAU CUKUR ( RAZOR ) SPUIT 1 CC TB NIPRO SPUIT 3 CC NIPRO SPUIT 5 CC NIPRO SPUIT 20 CC NIPRO SPUIT 30 CC TERUMO SPUIT 50 CC NIPRO SPUIT 50CC CATH TIP NIPRO SPUIT 50CC CATH TIP TRM SURGILAB FACE MASK/LEMBAR (OK) LARYNGEAL MASK AMBU NO.3.0 JACKSON REES/ADULT T-PIECE 2 L 2108 JACKSON REES/INFANT T-PIECE 0.5 L 2122 PAMPERS BABY SWEETY S TISSUE LIVI EVO HAND TOWEL OXICENCOR LCS OXICENSOR II SP02 COM N MASKER PAED 1122 SPUIT 10 CC NIPRO BASIC BREATH PAED 2142 BASIC BREATH SYSTEM 4504 BASIC BREATH SYSTEM 2019 FILTER 1644 LARYNGEAL MASK AMBU NO.2 LARYNGEAL MASK AMBU NO.2.5 LARYNGEAL MASK AMBU NO.1.5 MASKER PAED 1123 MASKER PAED 1124
Spesifikasi 12/ Pak, Chichi Lokal Sony / Color printing ,4 dimensi OneMed,Sensi,Win,Remedi Crona , OneMed.Sensi,Win.Remedi Hospilab. Hospilab Lokal Lokal Applicator,Surgilab Italiana Termalindo surgilab intersurgical intersurgical fisher & paykel nipro, box isi 100 nipro, box isi 100 dahlhausen, box isi 100 nipro, box isi 100 nipro, box isi 100 nipro, box isi 100 nipro, box isi 50 terumo, box isi 50 nipro, box isi 25 nipro, box isi 25 terumo box isi 50 intersurgical intersurgical box isi 24 masimo intersurgical nipro, box isi 100 intersurgical intersurgical intersurgical intersurgical intersurgical intersurgical
Jumlah Satuan 240 10 6 160 50 45 40 20 200 30 2 30 100 8.000 160 80 230 1.500 14.000 500 22.000 45.000 20.000 2.500 500 13.000 300 400 30.000 8 6 6 450 4.000 10 80 20 22.500 50 60 10 150 10 10 5 20 6
Pak Roll Pak Doos Doos Doos Doos Roll Buah Kilogram Box Pak Roll Lembar Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Lembar Pieces Pieces Pieces Pak Roll Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces
Harga Satuan (Rp) 18.500,00 50.000,00 1.600.000,00 22.000,00 22.000,00 88.000,00 76.000,00 9.000,00 1.700,00 36.000,00 240.000,00 120.000,00 18.000,00 2.800,00 385.000,00 47.000,00 275.000,00 400,00 400,00 3.700,00 1.050,00 840,00 1.040,00 2.700,00 11.400,00 5.940,00 15.400,00 26.400,00 1.720,00 300.000,00 235.000,00 420.000,00 17.500,00 7.000,00 310.000,00 280.000,00 130.000,00 1.350,00 119.000,00 330.000,00 270.000,00 54.000,00 300.000,00 300.000,00 300.000,00 123.000,00 123.000,00 Subtotal PPN Total
Jumlah
(Rp)
4.440.000,00 500.000,00 9.600.000,00 3.520.000,00 1.100.000,00 3.960.000,00 3.040.000,00 180.000,00 340.000,00 1.080.000,00 480.000,00 3.600.000,00 1.800.000,00 22.400.000,00 61.600.000,00 3.760.000,00 63.250.000,00 600.000,00 5.600.000,00 1.850.000,00 23.100.000,00 37.800.000,00 20.800.000,00 6.750.000,00 5.700.000,00 77.220.000,00 4.620.000,00 10.560.000,00 51.600.000,00 2.400.000,00 1.410.000,00 2.520.000,00 7.875.000,00 28.000.000,00 3.100.000,00 22.400.000,00 2.600.000,00 30.375.000,00 5.950.000,00 19.800.000,00 2.700.000,00 8.100.000,00 3.000.000,00 3.000.000,00 1.500.000,00 2.460.000,00 738.000,00 578.778.000,00 57.877.800,00 636.655.800,00
PT. BUMI INDAH MEDIKA No 1 2 3 5 10 18 24 42 45 46 47 55 57 58 61 62 63 64 65 66 67 68 69 70 71
Nama Barang Nelaton Catheter Karet No. 8 Nelaton Catheter Karet No. 10 Nelaton Catheter Karet No. 12 Slang Suction Full Silicon Non Steril Spatula lidah kayu Kertas CTG M 1913 A Kertas USG UPP-110 HG Spatula Vagina Kayu Kertas Saring Aluminium Cup Tutup Karet Flakon 10 cc Dental X- Ray Film Strip Crown ( Arterior Crown ) Mouth Mirror # 4 Spreader # 40 Diamond Inst Bur Mani TF-12 EF Molar Band + buccal tube 13 LR Self - Locking Separating Springe Open Coil Spring Articulating Paper Double Cheek Mouth mirror # 3 Gates Drills No.2 Mini Endo Box Acto Star/Densplay Paper Points # 20 Inline/Reokoe/Swedent Paper Points # 25 Inline/Reokoe/Swedent
Spesifikasi Nelaton Nelaton Nelaton , Lokal Philips Sony OneMed Brataco Hansin TDV Hahnenkratt Mani 0199 Mani TF-12 EF Ormco TP Orthodontics 853 - 018 Ni-Ti Orthoorganizer Swedent Asa D Mani Densplay Inline Inline
Page 4 of 11
Jumlah 10 10 10 20 4.000 60 100 2.000 10 1.000 1.000 15 1 50 1 5 1 2 2 12 50 1 1 10 10
Satuan Buah Buah Pieces Meter Buah Pak Roll Buah Lembar Buah Buah Pieces Box Pieces Pak Pieces Pieces Pak Roll Pak Pieces Pak Buah Pieces Pieces
Harga Satuan (Rp) 7.000,00 7.000,00 7.000,00 85.000,00 340,00 130.000,00 130.000,00 750,00 6.500,00 850,00 950,00 210.000,00 495.000,00 105.000,00 140.000,00 90.000,00 165.000,00 350.000,00 1.155.000,00 142.000,00 105.000,00 82.000,00 340.000,00 75.000,00 75.000,00
Jumlah
(Rp)
70.000,00 70.000,00 70.000,00 1.700.000,00 1.360.000,00 7.800.000,00 13.000.000,00 1.500.000,00 65.000,00 850.000,00 950.000,00 3.150.000,00 495.000,00 5.250.000,00 140.000,00 450.000,00 165.000,00 700.000,00 2.310.000,00 1.704.000,00 5.250.000,00 82.000,00 340.000,00 750.000,00 750.000,00
No 72 74 75 76 77 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 100 109 117 118 119 120 121 122 123 124 125 126 128 129
Nama Barang Molar Band + Buccal Tube 20 LL Power O 3M Unitek / Ormco / OO Sterilization Bags Runyes 5 cm Sterilization Bags/ Medipack Runyes 7 cm Sterilization Bags Runyes 10 cm Stainles Steel Archwire 016 Low Single Separators 00 400 - 355 / 3 M Unitex Molar Band + Buccal Tube 17 LL Molar Band + Buccal Tube 19 LL Molar Band + buccal Tube 27 LR Molar Band + Buccal Tube 20 LR Molar Band + Buccal Tube 19 UL Molar Band + Buccal Tube 29 UL Molar Band + buccal Tube 27 UL Molar Band + buccal Tube 27 UR Molar Band + Buccal Tube 29 UR Molar Band + Buccal Tube 19 LR Paper Points # 30 Power Chain Shorty 400-386 Kotak Model Plastik O-Ring Asorted Bracket Intique Silk Ceramic Silver Solder Power chain Arch Bar 1 m Com Indikator Hansin Direct Band Buccal Tube 022 LR Exelent Disp Bibs / slaberce Molar Band + Buccal Tube 13 UR Molar Band + Buccal Tube 33 UR Molar Band + Buccal Tube 34 UR Molar Band + Buccal Tube 35 UR Molar Band + Buccal Tube 36 UR Molar Band + Buccal Tube 13 UL Molar Band + Buccal Tube 36 UL Molar Band + Buccal Tube 10 LR Remanium Soft Diamond Inst Bur@ BR-40/D+Z 801.314.016
Spesifikasi Ormco 3M Unitek / Ormco / OO Runyes 5 cm Runyes 7 cm x 200 Runyes 10 cm 3M Unitex 301 - / Ormco 211-0026 00 400 - 355 / 3 M Unitex Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Inline OO 400-386 Lion Star 3 M / GAC OT-18-1340 759-0025 025 wire/OMRMCO / 3M 3M, UNITEX Dentaurum Hansin Ormco Runies Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Dentaurum 500-025-00 Mani BR-40/D+Z 801.314.016/Maisinger/SS White
Jumlah 8 10 5 5 5 4 4 8 8 8 8 8 5 8 5 4 8 8 1 100 3 2 3 2 1 1 1 40 1 2 2 2 2 1 2 1 1 5
Pieces Pak Roll Roll Roll Pieces Pak Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Roll Pieces Pak Case Roll Set Roll Pak Doos Pak Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces
Harga Satuan (Rp) 165.000,00 600.000,00 600.000,00 600.000,00 700.000,00 390.000,00 285.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 75.000,00 320.000,00 16.000,00 420.000,00 600.000,00 530.000,00 370.000,00 770.000,00 1.075.000,00 1.780.000,00 105.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 400.000,00
Pieces
90.000,00
Pieces
90.000,00
Pieces
90.000,00
Pieces
90.000,00
Pieces
90.000,00
Pieces
90.000,00
Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces
90.000,00 90.000,00 90.000,00 90.000,00 90.000,00 90.000,00 90.000,00 90.000,00 90.000,00
Pieces
90.000,00
Satuan
130 Diamond Inst Bur@ BR-49/D+Z CB 1.314.012
Mani BR-49/D+Z CB 1.314.012/Maisinger/SS White
5
131 Diamond Inst Bur@ Mani BR-46/D+Z CB
Mani BR-46/D+Z CB 7.314.010/Maisinger/SS White
5
132 Diamond Inst Bur@ BR-31/D+Z CB 7.314.012
Mani BR-31/D+Z CB 7.314.012/Maisinger.SS White
5
133 Diamond Inst Bur@ BR-41/D+Z CB 1.314.014
Mani BR-41/D+Z CB 1.314.014/Maisinger/SS White
5
134 Diamond Inst Bur@ Mani BR-42/D+Z CB
Mani BR-42/D+Z CB 1.314.016/Maisinger/SS White
5
135 136 137 138 139 140 141 142 143 144
Mani Mani Mani Mani Mani Mani Mani Mani Mani Mani
TR-11EF/D+Z /Maisinger/SS White TC-11EF/D+Z/Maisinger/SS White EX-21EF/D+Z/Maisinger/SS White TR-11F/D+Z/Maisinger/SS White TF-12F/D+Z/Maisinger/SS White TC-11C/D+Z/Maisinger/SS White SI-46/D+Z 805.314.012/Maisinger/SS White SI-47/D+Z 805.314.014/Maisinger/SS White SI-48/D+Z 805.314.016/Maisinger/SS White SI-S46/D+Z 807.314.012/Maisinger/SS White
5 5 5 5 5 5 5 5 5 5
145 Diamond Inst Bur (I) SI-47C/D+Z 805.314.018
Mani SI-47C/D+Z 805.314.018/Maisinger/SS White
5
Pieces
90.000,00
146 Diamond Inst Bur Mani SF-41/D+Z (FO) 147 DiamondInst Bur(F) Mani SF-11 837 KR.314.010
Mani SF-41/D+Z/Maisinger/SS White Mani SF-11/D+Z 837 KR.314.010/Maisinger/SS White
5 Pieces 5 Pieces
90.000,00
148 DiamondInst Bur(F)Mani -SF 12 837 KR.314.012
Mani SF-12/D+Z 837 KR.314.012/Maisinger/SS White
5
149 Diamond Inst Bur (F)SF-31/D+Z 836.314.012
Mani SF-31/D+Z 836.314.012/Maisinger/SS White
5
150 Diamond Inst Bur (F) SO-21/D+Z 863.314.012
Mani SO-21/D+Z 863.314.012/Maisinger/SS White
3
151 Diamond Inst Bur (F) RS-21/D+Z 847 KR.314
Mani RS-21/D+Z 847 KR.314.014/Maisinger/SS White
4
152 Diamond Inst Bur (F)TF-S23/D+Z 845.314.016
Mani TF-S23/D+Z 845.314.016/Maisinger/SS White
5
154 Diamond Inst Bur (F) TF-11/D+Z 850.314.014
Mani TF-11/D+Z 850.314.014/Maisinger/SS White
5
155 Diamond Inst Bur (F) Mani TF-12F/D+Z 886,314
Mani TF-12F/D+Z 886.314.014/Maisinger/SS White
3
156 Diamond Inst Bur (F) Mani TC-S21 D+Z 884
Mani TC-S21/D+Z 884.314.012/Maisinger/SS White
2
157 Diamond Inst Bur (F)D+Z 882.314.014
Mani/ D+Z 882.314.014/Maisinger/SS White RA.37 L/1 Mani/D+Z 879.314.014/Maisinger/SS White PA4/1472 Mani/ D+Z 878.314.016/Maisinger/SS White /K 016 X 016 upper,ormco,210-0706 016 X 016 lower,ormco,211-0706 Inline/Roeko/Swedent Inline/Roeko/Swedent Inline/Roeko/Swedent Dentsply AO16D 021 015 Inline/Roeko/Swedent Heraeus Kulzer Kohler / Asa Dental / Aesculap Jiffy/Meisinger 116/Komet/Lokal/OT/Ultradent Mani 0194
2
Diamond Diamond Diamond Diamond Diamond Diamond Diamond Diamond Diamond Diamond
Inst Inst Inst Inst Inst Inst Inst Inst Inst Inst
Bur (EF)Mani TR-11EF/D+Z Bur (EF)Mani TC-11EF/D+Z Bur (EF)Mani EX-21EF/D+Z Bur (Fine) Mani TR-11F/D+Z Burs (Fine) Mani TF 12F/D+Z Bur Mani TC-11C/D+Z(Coarse) Bur (I) SI-46/D+Z 805.314.012 Bur (I) Mani SI-47/D+Z 805.314 Bur (I) SI-48/D+Z 805.314.016 Bur (I) SI-S46/D+Z 807.314.012
158 Diamond Inst Bur (F)Mani/D+Z 879.314.014 159 160 162 163 164 165 166 167 168 169 170 171 172 173
Diamond Inst Bur (F)Mani/ D+Z 878.314.016 Medipac uk. 10 x 200 Amplas Kain Tipis P.100 Thee Star Arch Wire SS 016 X 016 upper Arch Wire SS 016 X 016 lower Paper Points # 45-80 Paper Points # 35 Paper Points # 15 Hedstroem File # 15, 21 mm AO16D 021 015 Paper Points # 40 Carpule 0,3 x 12 mm No. 12 Heraeus Kulzer Matrix Band 7 mm Brush Nillor/Brushes Spreader # 15
Page 5 of 11
2 2 1 5 3 2 1 8 8 8 8 5 3 50 1
90.000,00
Pieces
90.000,00
Pieces
90.000,00
Pieces
90.000,00
Pieces
90.000,00
Pieces
90.000,00
Pieces
90.000,00
Pieces
90.000,00
Pieces
90.000,00
Pieces
90.000,00
Pieces
90.000,00
Pieces Roll Lembar Box Box Pak Pieces Pieces Pak Pieces Doos Roll Pieces Pak
90.000,00 540.000,00 22.000,00 520.000,00 520.000,00 75.000,00 75.000,00 75.000,00 85.000,00 75.000,00 150.000,00 450.000,00 15.000,00 140.000,00
Jumlah
(Rp)
1.320.000,00 6.000.000,00 3.000.000,00 3.000.000,00 3.500.000,00 1.560.000,00 1.140.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 825.000,00 1.320.000,00 825.000,00 660.000,00 1.320.000,00 600.000,00 320.000,00 1.600.000,00 1.260.000,00 1.200.000,00 1.590.000,00 740.000,00 770.000,00 1.075.000,00 1.780.000,00 4.200.000,00 165.000,00 330.000,00 330.000,00 330.000,00 330.000,00 165.000,00 330.000,00 165.000,00 400.000,00 450.000,00 450.000,00 450.000,00 450.000,00 450.000,00 450.000,00 450.000,00 450.000,00 450.000,00 450.000,00 450.000,00 450.000,00 450.000,00 450.000,00 450.000,00 450.000,00 450.000,00 450.000,00 450.000,00 450.000,00 450.000,00 270.000,00 360.000,00 450.000,00 450.000,00 270.000,00 180.000,00 180.000,00 180.000,00 180.000,00 540.000,00 110.000,00 1.560.000,00 1.040.000,00 75.000,00 600.000,00 600.000,00 680.000,00 600.000,00 750.000,00 1.350.000,00 750.000,00 140.000,00
No 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 266 267 269 270 271 272 273 276 280
Nama Barang Spreader # 20 Spreader # 25 Steell Separating Strips R Art. # 570004 Oclusal Film , Size 4 DF 50 TMA -CNA 016 x 022 Upper Hedstroem File #35, 21 mm AO16D 021 035 Separator Triple Flex Archwires Spreaders # 30 Spreaders 35 Ormesh Flat Lingua Button Ormesh Curve Lingua Button Ni-Ti Broad Arch 0,16 upper Ni-Ti Broad Arch 0,16 Lower Ni-Ti Broad Arch 0,14 lower super elastic Ni-Ti Broad Arch 0,18 upper Ni-Ti Broad Arch 0,18 lower Hedstroem File #10, 21 mm AO16D 021 010 Hedstroem File #20, 21 mm AO16D 021 020 Hedstroem File #25, 21 mm AO16D 021 025 Hedstroem File #35, 25 mm AO16D 025 035 TMA-CNA 016 x 022 Lower Cephalometric Tracing Paper 630-020 Hedstroem File #8, 21 mm AO16D 021 008 Hedstroem File #30, 21 mm AO16D 021 030 Hedstroem File #40, 21 mm AO16D 021 040 Hedstroem File #8, 25 mm AO16D 025 008 Hedstroem File #10, 25 mm AO16D 025 010 Hedstroem File #20, 25 mm AO16D 025 020 Hedstroem File #30, 25 mm AO16D 025 030 Hedstroem File #40, 25 mm AO16D 025 040 Box For 68 Hole (TJ ) Shade Guide Karet ortho seal 1/4, 3.OZ Niti Open Coil Spring Silkam / Silk Black 3-0 Chirurge - Sec I / Section Surgi Tip Micro Matrix Band Ivory Hedstroem File #45-80, 21 mm AO16D 021 901 Spray Nozzle EX-6 Napkin Nitinol Super Elastic 016 x 022 lower 4297-954 Nitinol Super Elastic 016 x 022 upper Stainless stell Archwire 016 x 022 upper Stainless Stell Archwire 016 x 022 lower300-172 Exterpatie/Spiro Colorinox #20 Exterpatie/Spiro Colorinox #25 Hedstroem File #15, 25 mm AO16D 025 015 Molar Band + buccal tube 25 UR Molar Band + buccal tube 25 UL Molar Band + buccal tube 30 UR Molar Band + buccal tube 30 UL Molar Band + buccal tube 11 UR Molar Band + buccal tube 11 UL Molar Band + buccal tube 12 UR Molar Band + buccal tube 12 UL Molar Band + buccal tube 14 UR Molar Band + buccal tube 14 UL Molar Band + buccal tube 16 UR Molar Band + buccal tube 16 UL Molar Band + buccal tube 18 UR Molar Band + buccal tube 18 UL Molar Band + buccal tube 20 UL Molar Band + buccal tube 22 UL Molar Band + buccal tube 23 UL Molar Band + buccal tube 24 UR Molar Band + buccal tube 24 UL Molar Band + buccal tube 15 LL Molar Band + buccal tube 15 LR Molar Band + buccal tube 16 LL Molar Band + buccal tube 16 LR Molar Band + buccal tube 21 LL Molar Band + buccal tube 21 LR Molar Band + buccal tube 23 LL Molar Band + buccal tube 23 LR Molar Band + buccal tube 24 LL Molar Band + buccal tube 24 LR Molar Band + buccal tube 31 LL Molar Band + buccal tube 31 LR Molar Band + buccal tube 32 LL Molar Band + buccal tube 32 LR Molar Band + buccal tube 34 LL Molar Band + buccal tube 34 LR Molar Band + buccal tube 35 LL Molar Band + buccal tube 35 LR Molar Band + buccal tube 31 UR Molar Band + buccal tube 31 UL Molar Band + buccal tube 32 UR Molar Band + buccal tube 32 UL Tracing paper Sterile Surgical Blades 515 Bonding Brush Tips 3/4 FN Plash 1048 SR Facebow short outer bow Brite-gear cervical neck pads blue Break-away Release Modules Medium (white) 1 St Molar Band Combination 018 UR 1 St Molar Band Combination 018 UL Shorty Ligature Twist 010 Intra Oral Elastics
Spesifikasi Mani 0195 Mani 0196 R Art. # 570004 Kodak Ormco 210-D402/OO 100-944 (5) DentsplyAO16D 021 035 Ormo/3M Unitex / OO 3M Unitex 260-032 / Ormco 0215 264-0215 Mani 0197 Mani 0198 GAC GAC 0,16 upper ;super elastc / 3 M unitex,Ormco 0,16 Lower;super elastic / 3 M ,Ormco 205-0005 0,14 lower ;Ormco,3m unitex 0,18 upper;Ormco 205-0003 0,18 lower ;Ormco ,205-007 Dentsply AO16D 021 010 Dentsply AO16D 021 020 Dentsply AO16D 021 025 Dentsply AO16D 025 035 Ormco 211-D402/OO 100-954 (5) OO 630-020/RMO/Dentaurum Dentsply AO16D 021 008 Dentsply AO16D 021 030 Dentsply AO16D 021 040 Dentsply AO16D 025 008 Densply AO16D 025 010 Dentsply AO16D 025 020 Dentsply AO16D 025 030 Dentsply AO16D 025 040 TJ Vita 1/4, 3.OZ l, Ormco Ormco Medium 221-5512 B.Braun F 1134043 / Aesculaps Hager Werken / Roeko Kohler / Asa Dental / Aesculaps Dentsply AO16D 021 901 NSK H 019711 Dispotech/Runies 3M Unitek Ref 4297-954/Ormco/OT/OO 3M Unitek Ref 4297-953/Ormco/OT/OO 3M Unitek Ref 300-171 / Ormco 210-0701 3M Unitek Ref 300-172 / Ormco Dentsply A0004B 021.020.01 Dentsply A0004B 021.025.01 Dentsply AO16D 025 015 Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco ORTHO ORGANIZER Aesculap Ortho Tecnology Ormco Size Ormco Ormco Ormco Ormco OO 100-412,3M 3900-100 Ormco
Page 6 of 11
Jumlah 1 1 2 4 6 4 1 1 1 1 1 1 3 2 2 3 2 5 8 4 4 6 1 5 4 4 4 4 4 4 4 2 1 1 1 2 80 1 2 1 10 6 6 6 6 3 2 4 8 8 4 5 1 1 1 1 5 2 5 2 8 8 8 10 5 8 8 8 8 2 2 8 8 5 5 8 8 8 8 4 8 1 4 1 2 4 6 4 2 1 2 5 2 2 1 1 2 2 1
Satuan Pak Pak Pak Box Pak Pak Pak Pak Pak Pak Set Set Box Box Box Box Box Pak Pak Pak Pak Pak Pieces Pak Pak Pak Pak Pak Pak Pak Pak Pieces Set KOTAK Pak Box Pak Pieces Pak Pieces Roll Pak Pak Pak Pak Pak Pak Pak Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Buah Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pak Pak Pak Pak Pak Pak Buah Buah Tabung Pak
Harga Satuan (Rp) 140.000,00 140.000,00 400.000,00 790.000,00 675.000,00 85.000,00 1.420.000,00 870.000,00 140.000,00 140.000,00 750.000,00 750.000,00 800.000,00 800.000,00 800.000,00 850.000,00 850.000,00 85.000,00 85.000,00 85.000,00 85.000,00 675.000,00 900.000,00 85.000,00 85.000,00 85.000,00 85.000,00 85.000,00 85.000,00 85.000,00 85.000,00 117.000,00 1.750.000,00 1.825.000,00 850.000,00 1.500.000,00 640.000,00 70.000,00 85.000,00 230.000,00 105.000,00 545.000,00 420.000,00 420.000,00 140.000,00 135.000,00 135.000,00 85.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 1.400.000,00 350.000,00 250.000,00 275.000,00 725.000,00 190.000,00 260.000,00 260.000,00 540.000,00 230.000,00
Jumlah
(Rp)
140.000,00 140.000,00 800.000,00 3.160.000,00 4.050.000,00 340.000,00 1.420.000,00 870.000,00 140.000,00 140.000,00 750.000,00 750.000,00 2.400.000,00 1.600.000,00 1.600.000,00 2.550.000,00 1.700.000,00 425.000,00 680.000,00 340.000,00 340.000,00 4.050.000,00 900.000,00 425.000,00 340.000,00 340.000,00 340.000,00 340.000,00 340.000,00 340.000,00 340.000,00 234.000,00 1.750.000,00 1.825.000,00 850.000,00 3.000.000,00 51.200.000,00 70.000,00 170.000,00 230.000,00 1.050.000,00 3.270.000,00 2.520.000,00 2.520.000,00 840.000,00 405.000,00 270.000,00 340.000,00 1.320.000,00 1.320.000,00 660.000,00 825.000,00 165.000,00 165.000,00 165.000,00 165.000,00 825.000,00 330.000,00 825.000,00 330.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.650.000,00 825.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 330.000,00 330.000,00 1.320.000,00 1.320.000,00 825.000,00 825.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 660.000,00 1.320.000,00 165.000,00 660.000,00 165.000,00 330.000,00 660.000,00 990.000,00 660.000,00 330.000,00 1.400.000,00 700.000,00 1.250.000,00 550.000,00 1.450.000,00 190.000,00 260.000,00 520.000,00 1.080.000,00 230.000,00
No
Nama Barang
Spesifikasi
281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 337 338 339 340 342 343 344 346 347 348 349 350 351 352 353 354 355 356 357 360 367 368 369 370 371 372 373 374
Impression Partial Trays Impression Trays D Impression Trays C Impression Trays B Mixing Pad 2,5" x 2,5" Molar Band + buccal tube 22 LL Molar Band + buccal tube 22 LR Molar Band + buccal tube 25 LL Molar Band + buccal tube 25 LR Molar Band + buccal tube 26 LL Molar Band + buccal tube 26 LR Molar Band + buccal tube 29 LL Molar Band + buccal tube 29 LR Molar Band + buccal tube 30 LL Molar Band + buccal tube 30 LR Molar Band + buccal tube 33 LL Molar Band + buccal tube 33 LR Molar Band + buccal tube 17 UR Molar Band + buccal tube 17 UL Molar Band + buccal tube 21 UR Molar Band + buccal tube 21 UL Molar Band + buccal tube 26 UR Molar Band + buccal tube 26 UL Molar Band + buccal tube 28 UL Power Chain Shorty 400-339 Power Chain Shorty 400-337 Medipac Uk. 15 x 200 Rubber besar Rubber sedang Rubber kecil AF Slopan Bracket slot 0,22 Karet ortho dolpin 5/16 3.OZ Power Chain Shorty 400-382 Extra oral Cheeck Retractors Super-Snap Polysttrips Super-Snap Polystrips Disp.gelas kumur Molar Band + buccal Tube 10 LL Molar Band + buccal tube 13 LL Molar Band + buccal tube 27 LL Molar Band + buccal tube 36 LR Molar Band + buccal tube 36 LL Molar Band + buccal tube 10 UR Molar Band + buccal Tube 10 UL Molar Band + buccal tube 11 LR Molar Band + buccal tube 11 LL Molar Band + buccal tube 12 LL Molar Band + buccal tube 12 LR Molar Band + buccal tube 14 LR Molar Band + buccal tube 14 LL Molar Band + buccal tube 18 LR Molar Band + buccal tube 18 LL Molar Band + buccal tube 28 LL Molar Band + buccal tube 33 UL Molar Band + buccal tube 34 UL Molar Band + buccal tube 35 UL Niti Spring Extension F.00325 (12 mm) Molar Band + buccal tube 15 UR Molar Band + buccal tube 15 UL High Puff Headgear W Strong Chincap Intra Oral Elastic / Chipmunk (1/8") Intra Oral Elastic / Rabbit (3/16") Molar Band + Buccal Tube Lipe Bumper Molar Band Combination (1 set) Mini Endo Bloc Dentsply A0327.000.000 Niti Dictllzing Spring 10 x 45 Niti Spring Extention F 00325 (9 mm) Power Chain Shorty 400-318LF Power Chain Shorty 400-342 Power Chain Shorty 400-388 Plastic Pins Remanium 016 x 016 Remanium Splint with Hooks SK Facebow Short 1 St Molar Band Combination 022 UR Wooden tongue depressor Cotton Roll coden Elastic Thread / Power tread grey NI-TI Broad Arch 0,14 upper super elastic Diamond Instrument Burs (EF)Mani TR - 13 EF Diamond Instrument Burs ( EF )Mani TR - 26 EF Diamond Instrument Burs (FINE )Mani TF - 13 C Diamond Instrument Bur ( F ) Mani SF -41
Asco / ASA Dental osung Hayasi D Hayasi C Hayasi OT 600-600/Kuraray 945-WD Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco OO 400-339 OO 400-337 komet,M,fota,shofu Plastik tahu 2kg Forestadent 5/16 3.OZ OO 400-382 OT Pedo 602-229 Shopu - L 525 Shopu - L 526 plastik Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco RMO F.00325 (12 mm),Ormco 222-5612 Ormco Ormco Dentaurum 744-709-00 Ormco 1D(1/8")OO/3M Unitex Ormco 1D(3/16")OO/3M Unitex Ormco Ormco Dentsply A0327.000.000 3M RMO F 00325 (9 mm), Ormco 222-5612 OO 400-318LF OO 400-342 OO 400-388 Sjoding Sweeden Dentaurum 537-340-00 Dentaurum Ormco Size 3 Ormco general care / TJ Coden grey 0,14 upper super elastic, 3 M , Unitex Mani TR - 13 EF Mani TR - 26 EF Mani TF - 13 C Mani SF -41/ D+Z 837.314.010/ Maisinger/SS White
375 376 377 378 379 380 381 382 383 384 385 386 387 388
Diamond Instrument Bur ( F ) Mani TF-12 Disp Gelas Kumur Enchance Finishing System 624055 X Enchance Finishing System # 624065 Enchance Finshing System 624045 X Bouffant Nurse 's Cap Hospilab Gips Spatula Plastik Impression Trays Hayasi A Exterpatie / Spiro Colorinox # 35 Exterpatie / Spiro Coloronix # 40 Bracket Mini 2000 Ortho Classic 022 Ormco Polybib/Disp Bibs Wedge M/L Matrix Band / Tab Matrix 5,5mm/4,5mm/7mm
Mani TF-12 Lokal , isi 50 pcs Densply # 624055 X Densply # 624065 Densply # 624045 X Hospilab Prudental Hayasi A Dentsply AOOO4B.021.035.01 Dentsply AOOO4B.021.040.01 Ortho Classic 022 Ormco Dentamerica 878A Triodent UK.M( 2064 ) Triodent M
Page 7 of 11
Jumlah 3 3 3 3 1 10 10 8 8 5 5 5 5 8 8 2 4 8 8 8 8 8 5 8 1 1 1 15 9 3 2 10 1 1 1 1 1 75 1 1 8 1 1 1 1 1 1 1 1 1 2 2 8 8 2 2 2 1 5 2 1 1 1 1 3 1 1 1 1 1 1 3 1 1 3 1 30 2 2 6 5 5 5 3 5 150 1 1 1 1 3 3 2 2 20 26 1 1
Satuan Set Set Set Set Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Roll Pak Roll Buah Buah Buah Kilogram Set KOTAK Roll Pieces Pak Pak Pak Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pak Pieces Pieces Set Pak Pak Pieces Pieces Pieces Tabung Pak Pak Pak Roll Pak Pieces Pak Pak Pieces Box Doos Roll Box Pieces Pieces Pieces
Harga Satuan (Rp) 345.000,00 135.000,00 135.000,00 135.000,00 115.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 320.000,00 320.000,00 520.000,00 21.000,00 21.000,00 21.000,00 36.000,00 800.000,00 1.900.000,00 340.000,00 330.000,00 375.000,00 375.000,00 15.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 1.250.000,00 165.000,00 165.000,00 650.000,00 240.000,00 240.000,00 165.000,00 165.000,00 500.000,00 1.000.000,00 320.000,00 320.000,00 320.000,00 320.000,00 210.000,00 750.000,00 440.000,00 358.000,00 240.000,00 40.000,00 85.000,00 400.000,00 900.000,00 90.000,00 90.000,00 90.000,00
Pieces
90.000,00
Pieces Pak Doos Doos Pak Pak Pieces Set Pak Pak Case Pak Pak Box
90.000,00 15.000,00 600.000,00 600.000,00 600.000,00 135.000,00 100.000,00 135.000,00 135.000,00 135.000,00 540.000,00 87.000,00 760.000,00 1.000.000,00
Jumlah
(Rp)
1.035.000,00 405.000,00 405.000,00 405.000,00 115.000,00 1.650.000,00 1.650.000,00 1.320.000,00 1.320.000,00 825.000,00 825.000,00 825.000,00 825.000,00 1.320.000,00 1.320.000,00 330.000,00 660.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 825.000,00 1.320.000,00 320.000,00 320.000,00 520.000,00 315.000,00 189.000,00 63.000,00 72.000,00 8.000.000,00 1.900.000,00 340.000,00 330.000,00 375.000,00 375.000,00 1.125.000,00 165.000,00 165.000,00 1.320.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 330.000,00 330.000,00 1.320.000,00 1.320.000,00 330.000,00 330.000,00 330.000,00 1.250.000,00 825.000,00 330.000,00 650.000,00 240.000,00 240.000,00 165.000,00 495.000,00 500.000,00 1.000.000,00 320.000,00 320.000,00 320.000,00 320.000,00 630.000,00 750.000,00 440.000,00 1.074.000,00 240.000,00 1.200.000,00 170.000,00 800.000,00 5.400.000,00 450.000,00 450.000,00 450.000,00 270.000,00 450.000,00 2.250.000,00 600.000,00 600.000,00 600.000,00 135.000,00 300.000,00 405.000,00 270.000,00 270.000,00 10.800.000,00 2.262.000,00 760.000,00 1.000.000,00
No 389 391 392 393 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 438 439 442 443 444 445 446 447 448 449 450 451 452 453 454 455 456 457 458 459 460 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 477 478 479 480 481 482 483 484 485 486 487 488 489 490 491 492 493 494 495 496 498
Nama Barang Stainlees Steel Archwire 016 Up Titan Mini Screw 1014 - 1608 Titan Mini Screw 1014-1606 Sterilization Bags 15cm Diamond Instrument Burs ( R )6801 314 014 Diamond instrument Burs ( R )6801 314 012 Diamond Instrument Burs ( R )S 6801 314 014 Diamond Instrument Burs ( R )S 6801 314 012 Diamond Instrument Burs ( F )6835 KR 314 010 Diamond Instrument Burs ( F )6835 314 012 Diamond Instrument Burs ( F )6830 314 010 Diamond Instrument Burs ( F )807 314 012 Diamond Instrument Burs ( F )6836 KR 314 012 Diamond Instrument Burs ( F )6836 KR 314 014 Diamond Instrument Bur (Coarse)Mani TR - 13 C K - Flexofile # 15.21 mm K - Flexofile # 20.21 mm K - Flexofile # 25.21 mm K - Flexofile # 30.21 mm K - Flexofile # 35.21 mm K - Flexofile # 15.25 mm K - Flexofile # 40.21 mm K - Flexofile # 20.25 mm K - Flexofile # 25.25 mm K - Flexofile # 30.25 mm K - Flexofile # 40.25 mm K - Flexofile # 35.25 mm Diamond Instrument Burs ( F )6846 314 012 Diamond Instrument Burs ( F )6850 314 014 Diamond Instrument Burs ( EF ) 859 EF 314 014 Diamond Instrument Burs ( F )6859 314 018 Diamond Instrument Burs ( Ef )858 EF 314 014 Diamond Instrument Burs(F)8878 K 314 012 C47 Diamond Instrument Burs ( F )6855 314 012 Diamond Instrument Burs ( F )6856 314 014 Diamond Instrument Burs ( F )6849 314 012 Diamond Instrument Burs ( F )6848 314 016 Diamond Instrument Burs ( F )2850 314 016 Diamond Instrument Burs2858 314 014 Diamond Instrument Burs2879 K 314 018 Metal Crowns Soft Eva / Sopt Tray 0,007 Disp.saliva Ejector BrushTip(50)Dentarium163-41700/bond.brush L K - Flexofile # 15 - 40,21mm K - Flexofile # 15 -40,25mm Brush Holder / Bonding Brush tip Holder Molar Band + Buccal Tube 22 UR Molar Band + Buccal Tube 23 UR Molar Band + Buccal Tube 28 UR NIti Super Elastic 014 Up . 3M UNitex 296-912 Niti Super Elastic 014 Low. 3M Unitex 296-912 Niti Super Elastic 016 Up. 3M Unitex 4296-913 Coform Crown Plastic .( SDI ) Bracket Slot 0.22 Upp 5-5W/CSBCHK-KIT310551 Oclusal Foto kodak isi 25 bump -R sleeve Tubing TP 100-240/238 Carvule 0,3 x 16mm Jiffy Polisher Variety ( Ultradent # 848 ) Micro Aplicator Molar Band + Buccal Tube 19 UR Molar Band + Buccal Tube 20 UR Tab - Matrix 5,5 mm Utility Glove HU-Friedy 40-060 Applyfix 4 Dispensing Gun System Push Button Karet Ortho Dolpin Karet Ortho Otter Alumunium Tray 28 X 18 cm Alumunium Tray 20 x 15 cm NI-TI 012 UPPER NI-TI 012 Lower NI-TI 014 Upper NI-TI 014 Lower NI-TI 016 x 022 Upper NI-TI 016 X 022 Lower CNA Broad Arch /TMA 016 x 022 Upper CNA Broad Arch /TMA 016 x 022 Lower CNA Broad Arch / TMA 0.18 Upper CNA Broad Arch / TMA 0.18 Lower CNA Broad Arch / TMA 016 x 016 Upper CNA Broad Arch / TMA 016 x 016 Lower Arch Wire SS 018 Upper Arch wire SS 018 Lower Arch Wire SS 016 x 022 Upper Arch Wire SS 016 x 022 Lower Crimpabley hook Arch Wire SS 016 Upper Arch Wire SS 016 Lower Tube Molar Band Slot 0.022 Rectg atas kanan Tube Molar Band slot 0.022 Rectg Atas Kiri Stainless Steel Round Arch 0120 0.36-266-1336 Stainless Steel Round Arch 0130 0.30-266-1330 Polisher for Acrylic (0664HP,) Medipac uk. 20 x 200 Crown & Bridge Preparation Ligature wire Bring Sectional Matrix System/Matrix Ring Kawat Klamer 0.6 MM
Spesifikasi 3M Unitex 301-161 Forestadent 1014 - 1608 Forestadent 1014-1606 Runyes 6801 314 014 6801 314 012 S 6801 314 014 S 6801 314 012 6835 KR 314 010 6835 314 012 6830 314 010 807 314 012 6836 KR 314 012 6836 KR 314 014 Mani TR - 13 C / D + Z /Maisinger / SS White /K Dentsply AO12C 021.015 Dentsply AO12C 021. 020 Dentsply AO12C 021.025 Dentsply AO12C 021.030 Dentsply AO12C 021. 035 Dentsply AO12C 025 . 015 Dentsply AO12C 021. 040 Dentsply AO12C 025 . 020 Dentsply AO12C 025 . 025 Dentsply AO12C 025 . 030 Dentsply AO12C 025. 040 Dentsply AO12C 025 .035 6846 314 012 6850 314 014 859 EF 314 014 6859 314 018 858 EF 314 014 8878 K 314 012 + C 47 6855 314 012 6856 314 014 6849 314 012 6848 314 016 2850 314 016 2858 314 014 2879 K 314 018 Stainles steel Primary Molar Crown Ultradent 227 ASA Dental Dentarium 163-417 OO/OT # 610 - 100 Dentsply AO12C 021 900 Dentsply AO12C 025 900 Dentaurum 163-149 00/OT/FN/ Ultradent Ormco Ormco Ormco 3M UNitex 296-912 3M Unitex 296-912 3M Unitex 4296-913 SDI CSBCHK-KIT31 055 10B kodak isi 25 TP. Orthodontic ,grey Heraus Kulzer ( Ultradent # 848 ) Ultradent #1106 Ormco Ormco Triodent HU - Friedy 40 - 060 Kettenbach - Germany # 17203 Ormco Ormco 5/16 6.OZ Ormco 3/16 3.OZ nichrominox 181450-3 nichrominox 181480-2/3/4/5 ormco ormco ormco 205-009 ormco 205-0011 Ormco 210-0502 Ormco 211-0502 ormco 210-0402/GAC Ormco 211-0402 /GAC Ormco 210-0302/GAC Ormco/GAC Ortho Organizer 100-960 Ortho Organizer 100-961 Ormco 210-0028 Ormco 211-0028 Ormco 210-0701 Ormco 211-0701 GAC 47-601-21 , isi 500 Ormco 210-0026 Ormco 210-0026 Dentsply Ref 68-162-43 , isi 10 Dentsply Ref 68-262-43 , isi 10 PK 0120 (0.36-266-1336) pk 0130 (0.30-266-1330) edenta shopu dentarium 537-340-00 triodent Uk S,M,L remanium/524060
Page 8 of 11
Jumlah 6 1 1 5 3 3 3 3 3 3 3 3 3 3 5 2 2 2 2 2 2 2 2 2 2 2 2 3 3 3 2 3 2 3 3 3 3 5 5 5 1 1 50 5 2 2 3 8 8 5 6 6 6 1 1 2 1 5 1 2 8 8 1 1 1 1 1 1 5 5 3 2 3 2 3 2 2 2 2 2 2 2 2 2 2 2 1 2 2 1 1 1 1 10 1 1 1 1 1
Satuan Pak Pak Pak Roll Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pak Pak Pak Pak Pak Pak Pak Pak Pak Pak Pak Pak Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Pieces Box Pak Pak Pak Pak Pak Pieces Pieces Pieces Pieces Roll Pak Pak Set Set Box Roll Doos Pak Pak Pieces Pieces Pak Pak Pieces Pak KOTAK KOTAK Pieces Pieces Box Box Box Box Box Box Box Box Box Box Box Box Box Box Box Box Pak Box Box Pak Pak Tube Tube Buah Roll Set Roll Box Roll
Harga Satuan (Rp) 400.000,00 2.850.000,00 2.850.000,00 670.000,00 90.000,00 90.000,00 90.000,00 90.000,00 90.000,00 90.000,00 90.000,00 90.000,00 90.000,00 90.000,00 90.000,00 140.000,00 140.000,00 140.000,00 140.000,00 140.000,00 140.000,00 140.000,00 140.000,00 140.000,00 140.000,00 140.000,00 140.000,00 90.000,00 90.000,00 90.000,00 90.000,00 90.000,00 90.000,00 90.000,00 90.000,00 90.000,00 90.000,00 90.000,00 90.000,00 90.000,00 4.000.000,00 725.000,00 94.000,00 170.000,00 140.000,00 140.000,00 50.000,00 165.000,00 165.000,00 165.000,00 470.000,00 500.000,00 500.000,00 3.250.000,00 540.000,00 360.000,00 770.000,00 150.000,00 1.050.000,00 250.000,00 165.000,00 165.000,00 590.000,00 685.000,00 1.450.000,00 900.000,00 1.850.000,00 1.850.000,00 250.000,00 250.000,00 875.000,00 875.000,00 875.000,00 875.000,00 1.150.000,00 1.150.000,00 1.200.000,00 1.200.000,00 1.200.000,00 1.200.000,00 1.200.000,00 1.200.000,00 940.000,00 940.000,00 940.000,00 940.000,00 1.550.000,00 940.000,00 940.000,00 1.480.000,00 1.480.000,00 2.450.000,00 2.450.000,00 40.000,00 650.000,00 1.100.000,00 400.000,00 1.275.000,00 580.000,00
Jumlah
(Rp)
2.400.000,00 2.850.000,00 2.850.000,00 3.350.000,00 270.000,00 270.000,00 270.000,00 270.000,00 270.000,00 270.000,00 270.000,00 270.000,00 270.000,00 270.000,00 450.000,00 280.000,00 280.000,00 280.000,00 280.000,00 280.000,00 280.000,00 280.000,00 280.000,00 280.000,00 280.000,00 280.000,00 280.000,00 270.000,00 270.000,00 270.000,00 180.000,00 270.000,00 180.000,00 270.000,00 270.000,00 270.000,00 270.000,00 450.000,00 450.000,00 450.000,00 4.000.000,00 725.000,00 4.700.000,00 850.000,00 280.000,00 280.000,00 150.000,00 1.320.000,00 1.320.000,00 825.000,00 2.820.000,00 3.000.000,00 3.000.000,00 3.250.000,00 540.000,00 720.000,00 770.000,00 750.000,00 1.050.000,00 500.000,00 1.320.000,00 1.320.000,00 590.000,00 685.000,00 1.450.000,00 900.000,00 1.850.000,00 1.850.000,00 1.250.000,00 1.250.000,00 2.625.000,00 1.750.000,00 2.625.000,00 1.750.000,00 3.450.000,00 2.300.000,00 2.400.000,00 2.400.000,00 2.400.000,00 2.400.000,00 2.400.000,00 2.400.000,00 1.880.000,00 1.880.000,00 1.880.000,00 1.880.000,00 1.550.000,00 1.880.000,00 1.880.000,00 1.480.000,00 1.480.000,00 2.450.000,00 2.450.000,00 400.000,00 650.000,00 1.100.000,00 400.000,00 1.275.000,00 580.000,00
No 499 500 501 502 503 504 505 506 507 508 509 510 511 512 513 514 515 516 517 519 520 521 522 523 524 525 526 527 528 529 532 533 538 539 540 541 542 543 544 545 546 547 548 549 551 552 553 554 555 556 557 558 559 560 561 562 563 564 565 566 567 568 569 570 571 572 573 574 575 576 577 578 579 580 581 582 583 584 585 586 587 588 589 590 591 592 593 594 595 596 597 598 599 600 601 602 603 604 605
Nama Barang Mixing Pads Niti Super Elastic 016 Low Crimpable Split Power Chain Shortly Diamond Instrument Bur (F) Agate Spatula Diamond Instrument Burs (FINE)TC-11F Brite Gear Cervical Neck Pads Bur wrench Mandalaris Marquis Roth 022 Direct Band Buccal Tube 022 UL Intra oral Elastic / Fox Tab - Matrix 6,5mm Remanium V 3 Ring Neuro V 3 Ring Universal Study Model Pertumbuhan Gigi Study Model Gigi Implaksi Ultrasonic Scaler Tips 1 St Molar Band Combination 018 UR # 25 1 St Molar Band Combination 018 UL # 24 SR Facebow Short outer Bow size 4 Protaper sequence Diamond Instrument Bur (C) Diamond Instrument Burs (F) Diamond Instrument Burs (F) Diamond Instrument Burs (F) Diamond Instrument Burs (F) diamond Instrument Burs Koas Kecil Self Cure Acrylic Repair Material Polisher For Acrylic Polisher For Acrylic Ni-Ti 016 Upper Super Elastic Ni-Ti 016 Lower Super Elastic Refil Bracket Slot 0.022 Canninus atas kanan Refil Bracket Slot 0.022 Canninus Atas Kiri Refil Bracket Slot 0.022 insisive 2 atas Kanan Refil Bracket Slot 0.022 Insisive 1 Atas Kanan Refil Bracket Slot 0.022 Insisive 2 Atas Kiri Refil Bracket Slot 0.022 Insisive 1 Atas Kiri TLD / Film Badge Wix Lip Bumper Ni-Ti 016 x 016 Uppwer Super Elastic Scaler Tip Satelec 10 x Blades No 12 Ni-Ti 016 x 016 Lower Super Elastic Ni-Ti 016 x 022 Upper Super Elastic Ni-Ti 016 x 022 Lower Super Elastic Refil Bracket Slot 0.022 Premolar 2 atas kanan Refil Bracket Slot 0.022 Premolar 1 atas kanan Refil Bracket Slot 0.022 Premolar 2 Atas Kiri Refil Bracket Slot 0.022 Premolar 1 atas kiri Band Molar 0.022 Single tube Cleat Atas Kanan Band Molar 0.022 Single tube Cleat Atas Kanan Band Molar 0.022 Single tube Cleat Atas Kanan Band Molar 0.022 Single tube Cleat Atas Kanan Band Molar 0.022 Single tube Cleat Atas Kanan Band Molar 0.022 Single tube Cleat Atas Kanan Band Molar 0.022 Single tube Cleat Atas Kanan Band Molar 0.022 Single tube Cleat Atas Kanan Band Molar 0.022 Single tube Cleat Atas Kanan Band Molar0.022 Single tube Cleat Ats Kanan 18 Band Molar 0.022 Single tube Cleat Atas Kanan Band Molar 0.022 Single tube Cleat Atas Kanan Band Molar 0.022 Single tube Cleat Atas Kanan Band Molar 0.022 Single tube Cleat Atas Kanan Band Molar 0.022 Single tube Cleat Atas Kanan Band Molar 0.022 Single tube Cleat Atas Kanan Band Molar 0.022 Single tube Cleat Atas Kanan Band Molar 0.022 Single tube Cleat Atas Kanan Band Molar 0.022 Single tube Cleat Atas Kanan Band Molar 0.022 Single tube Cleat Atas Kanan Band Molar 0.022 Single tube Cleat Atas Kanan Band Molar 0.022 Single tube Cleat Atas Kanan Band Molar 0.022 Single tube Cleat Atas Kanan Band Molar 0.022 Single tube Cleat Atas Kanan Band Molar 0.022 Single tube Cleat Ats kiri 9 Band Molar 0.022 Single tube Cleat Atas kiri Band Molar 0.022 Single tube Cleat Atas kiri Band Molar 0.022 Single tube Cleat Atas kiri Band Molar 0.022 Single tube Cleat Atas kiri Band Molar 0.022 Single tube Cleat Atas kiri Band Molar 0.022 Single tube Cleat Atas kiri Band Molar 0.022 Single tube Cleat Atas kiri Band Molar 0.022 Single tube Cleat Atas kiri Band Molar 0.022 Single tube Cleat Ats kiri 18 Band Molar 0.022 Single tube Cleat Atas kiri Band Molar 0.022 Single tube Cleat Atas kiri Band Molar 0.022 Single tube Cleat Atas kiri Band Molar 0.022 Single tube Cleat Atas kiri Band Molar 0.022 Single tube Cleat Ats kiri 23 Band Molar 0.022 Single tube Cleat Atas kiri Band Molar 0.022 Single tube Cleat Ats kiri 25 Band Molar 0.022 Single tube Cleat Atas kiri Band Molar 0.022 Single tube Cleat Atas kiri Band Molar 0.022 Single tube Cleat Atas kiri Band Molar 0.022 Single tube Cleat Atas kiri
Spesifikasi Exaflex 3M / unitex 4296-914 OT # 020 - 100 00 400-384 Mani TR-20/D+Z 864.314.016/maisinger/SS/W/K Prudenta Mani TC-11F / D+Z/ Maisinger/SS/White/K ORMCO K OT # M.18-1340 ORMCO ORMCO 1D (3/16")OO/3M Unitex Triodent Dentaurum 580-040-00 Triodent # 3301 Triodent # 3302 YGKI YGKI NSK / EMS Ormco / OO Ormco / OO Ormco Dentsply / Mailefer 6805 314 014 6836 314 014 6836 314 014 6837 314 012 6856 314 012 2862 314 014 TJ Hillon S Court Limited Edenta 0665 HP Edenta 0666HP 3M Unitex 3M Unitex Densply 31-132-00 Dentsply 31-232-00 Dentsply 31-122-00 Dentsply 31-112-00 Dentsply 31-222-00 Dentsply 31-212-00 Ormco Size 3M , UNITEX beltmont Satelec 10 x - F00359 Swan Morton / B. Braun 3M , UNITEX 3M , UNITEX 3M , UNITEX Forestadent / Densply Forestadent , Densply Forestadent , Densply Forestadent , Densply No 9 Ormco No 10 Ormco No 11 Ormco no 12 Ormco No 13 Ormco No 14 Ormco No 15 Ormco NO 16 Ormco No 17 Ormco No 18 Ormco no 19 Ormco No 20 Ormco No 21 Ormco No 22 Ormco No 23 Ormco No 24 Ormco No 25 Ormco No 26 Ormco No 27 Ormco No 28 Ormco No 29 Ormco No 30 Ormco No 31 Ormco No 32 Ormco No 9 Ormco No 10 Ormco No 11 Ormco No 12 Ormco No 13 ormc o No 14 Ormco No 15 Ormco No 16 Ormco No 17 Ormcoi No 18 Ormco No 19 Ormco No 20 Ormco No 21 Ormco No 22 Ormco No 23 Ormco No 24 Ormco No 25 Ormco No 26 Ormco No 27 Ormco No 28 Ormco No 29 Ormco
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Jumlah 6 5 1 1 5 6 5 1 1 1 8 1 1 1 1 1 1 1 1 4 3 3 2 1 2 3 3 3 3 5 2 1 10 10 2 2 20 20 20 20 20 20 5 3 2 2 1 2 3 2 20 20 20 20 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 5 5 5 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8
Satuan Pieces Pak Pak Pak Pieces Pieces Pieces Pieces Pieces Pieces Pak Pak Pak Pak Roll Pak Pak Set Pieces Pieces Pieces Pieces Pak Pak Pieces Pieces Pieces Pieces Pieces Pieces Buah Set Buah Buah Box Box Buah Buah Buah Buah Buah Buah Pieces Pieces Box Buah Box Box Box Box Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah
Harga Satuan (Rp) 55.000,00 460.000,00 300.000,00 320.000,00 90.000,00 80.000,00 90.000,00 180.000,00 200.000,00 105.000,00 550.000,00 1.550.000,00 235.000,00 750.000,00 360.000,00 3.500.000,00 3.500.000,00 350.000,00 350.000,00 1.925.000,00 170.000,00 170.000,00 240.000,00 910.000,00 90.000,00 90.000,00 90.000,00 90.000,00 90.000,00 90.000,00 17.000,00 260.000,00 25.000,00 25.000,00 900.000,00 45.000,00 45.000,00 45.000,00 45.000,00 45.000,00 45.000,00 45.000,00 325.000,00 240.000,00 900.000,00 1.950.000,00 350.000,00 900.000,00 900.000,00 900.000,00 45.000,00 45.000,00 45.000,00 45.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00
Jumlah
(Rp)
330.000,00 2.300.000,00 300.000,00 320.000,00 450.000,00 480.000,00 450.000,00 180.000,00 200.000,00 105.000,00 4.400.000,00 1.550.000,00 235.000,00 750.000,00 360.000,00 3.500.000,00 3.500.000,00 350.000,00 350.000,00 7.700.000,00 510.000,00 510.000,00 480.000,00 910.000,00 180.000,00 270.000,00 270.000,00 270.000,00 270.000,00 450.000,00 34.000,00 260.000,00 250.000,00 250.000,00 1.800.000,00 90.000,00 900.000,00 900.000,00 900.000,00 900.000,00 900.000,00 900.000,00 1.625.000,00 720.000,00 1.800.000,00 3.900.000,00 350.000,00 1.800.000,00 2.700.000,00 1.800.000,00 900.000,00 900.000,00 900.000,00 900.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 825.000,00 825.000,00 825.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00
No 606 607 608 609 610 611 612 613 614 615 616 617 618 619 620 621 622 623 624 625 626 627 628 629 630 631 632 633 634 635 636 637 638 639 640 641 642 643 644 645 646 647 648 649 650 651 652 653 654 655 656 657 658 659 660 661 662 663 664 665 666 667 668 669 670 671 672 673 674 675 676 677 678 679 680 681 682 683 684 685 686 687 688 689 690 691 692 693 694 695 696 697 698 699 700 701 702 703 710
Nama Barang Band Molar 0.022 Single tube Cleat Atas kiri Band Molar 0.022 Single tube Cleat Atas kiri Band Molar 0.022 Single tube Cleat Atas kiri Band Molar 0.022 Singletube Rect Cleat bwh ka Band Molar 0.022 Singletube Rect Cleat Bwh Ka Band Molar 0.022 Singletube Rect Cleat Bwh Ka Band Molar 0.022 Singletube Rect Cleat Bwh Ka Band Molar 0.022 Singletube Rect Cleat Bwh Ka Band Molar 0.022 Singletube Rect Cleat Bwh Ka Band Molar 0.022 Singletube Rect Cleat Bwh Ka Band Molar 0.022 Singletube Rect Cleat Bwh Ka Band Molar 0.022 Singletube Rect Cleat Bwh Ka Band Molar 0.022 Singletube Rect Cleat Bwh Ka Band Molar 0.022 Singletube Rect Cleat Bwh Ka Band Molar 0.022 Singletube Rect Cleat Bwh Ka Band Molar 0.022 Singletube Rect Cleat Bwh Ka Band Molar 0.022 Singletube Rect Cleat Bwh Ka Band Molar 0.022 Singletube Rect Cleat Bwh Ka Band Molar 0.022 Singletube Rect Cleat Bwh Ka Band Molar 0.022 Singletube Rect Cleat Bwh Ka Band Molar 0.022 Singletube Rect Cleat Bwh Ka Band Molar 0.022 Singletube Rect Cleat Bwh Ka Band Molar 0.022 Singletube Rect Cleat Bwh Ka Band Molar 0.022 Singletube Rect Cleat Bwh Ka Band Molar 0.022 Singletube Rect Cleat Bwh Ka Band Molar 0.022 Singletube Rect Cleat Bwh Ka Band Molar 0.022 Singletube Rect Cleat Bwh Ki Band Molar 0.022 Singletube Rect Cleat Bwh Ki Band Molar 0.022 Singletube Rect Cleat Bwh Ki Band Molar 0.022 Singletube Rect Cleat Bwh Ki Band Molar 0.022 Singletube Rect Cleat Bwh Ki Band Molar 0.022 Singletube Rect Cleat Bwh Ki Band Molar 0.022 Singletube Rect Cleat Bwh Ki Band Molar 0.022 Singletube Rect Cleat Bwh Ki Band Molar 0.022 Singletube Rect Cle Bwh Ki 17 Band Molar 0.022 Singletube Rect Cleat Bwh Ki Band Molar 0.022 Singletube Rect Cleat Bwh Ki Band Molar 0.022 Singletube Rect Cleat Bwh Ki Band Molar 0.022 Singletube Rect Cle Bwh Ki 21 Band Molar 0.022 Singletube Rect Cleat Bwh Ki Band Molar 0.022 Singletube Rect Cleat Bwh Ki Band Molar 0.022 Singletube Rect Cle Bwh Ki 24 Band Molar 0.022 Singletube Rect Cleat Bwh Ki Band Molar 0.022 Singletube Rect Cle Bwh Ki 26 Band Molar 0.022 Singletube Rect Cleat Bwh Ki Band Molar 0.022 Singletube Rect Cle Bwh Ki 28 Band Molar 0.022 Singletube Rect Cleat Bwh Ki Band Molar 0.022 Singletube Rect Cleat Bwh Ki Band Molar 0.022 Singletube Rect Cleat Bwh Ki Band Molar 0.022 Singletube Rect Cleat Bwh Ki Band Premolar Atas No 9 Ormco Band Premolar Atas No 10 Ormco Band Premolar Atas No 11 Ormco Band Premolar Atas No 12 Ormco Band Premolar Atas No 13 Ormco Band Premolar Atas No 14 Ormco Band Premolar Atas No 15 Ormco Band Premolar Atas No 16 Ormco Band Premolar Atas No 17 Ormco Band Premolar Atas No 18 Ormco Band Premolar Atas No 19 Ormco Band Premolar Atas No 20 Ormco Band Premolar Atas No 21 Ormco Band Premolar Atas No 22 Ormco Band Premolar Atas No 23 Ormco Band Premolar Atas No 24 Ormco Band Premolar Atas No 25 Ormco Band Premolar Atas No 26 Ormco Band Premolar Atas No 27 Ormco Band Premolar Atas No 28 Ormco Band Premolar Atas No 29 Ormco Band Premolar Atas No 30 Ormco Band Premolar Atas No 31 Ormco Band Premolar Atas No 32 Ormco Band Premolar Bawah No 9 Ormco Band Premolar Bawah No 10 Ormco Band Premolar Bawah No 11 Ormco Band Premolar Bawah No 12 Ormco Band Premolar Bawah No 13 Ormco Band Premolar Bawah No 14 Ormco Band Premolar Bawah No 15 Ormco Band Premolar Bawah No 16 Ormco Band Premolar Bawah No 17 Ormco Band Premolar Bawah No 18 Ormco Band Premolar Bawah No 19 Ormco Band Premolar Bawah No 20 Ormco Band Premolar Bawah No 21 Ormco Band Premolar Bawah No 22 Ormco Band Premolar Bawah No 23 Ormco Band Premolar Bawah No 24 Ormco Band Premolar Bawah No 25 Ormco Band Premolar Bawah No 26 Ormco Band Premolar Bawah No 27 Ormco Band Premolar Bawah No 28 Ormco Band Premolar Bawah No 29 Ormco Band Premolar Bawah No 30 Ormco Band Premolar Bawah No 31 Ormco Band Premolar Bawah No 32 Ormco Diamond Instrument Burs (FINE)
Spesifikasi No 30 ormco No 31 Ormco No 32 Ormco No 09 Ormco R.Slot Bawah kanan No 10 Ormco R.Slot bawah Kanan No 12 ormco R.Slot Bawah Kanan No 13 Ormco R.Slot Bawah Kanan No 14 Ormco R.Slot Bawah kanan No 15 Ormco R.Slot Bawah Kanan no 16 Ormco R.Slot Bawah kanan No 17 Ormco R.Slot Bawah kanan No 18 Ormco R.Slot Bawah Kanan No 19 Ormco No 20 Ormco R.Slot Bawah Kanan No 21 Ormco R.Slot Bawah Kanan No 22 Ormco R. Slot bawah Kanan No 23 Ormco R.Slot Bawah Kanan No 24 Ormco R.Slot Bawah Kanan No 25 Ormco R. Slot Bawah kanan No 26 Ormco R. Slot Bawah kanan No 27 Ormco R.Slot Bawah kanan No 28 Ormco R.Slot Bawah kanan No 29 Ormco R. Slot Bawah Kanan No 30 Ormco R. Slot Bawah kanan No 31 Ormco R.Slot Bawah Kanan No 32 Ormco R.Slot Bawah Kanan No 9 Ormco No 10 Ormco R. Slot bawah Kiri No 11 Ormco R. Slot Bawah Kiri No 12 Ormco R.Slot Bawah Kiri No 13 Ormco R.Slot Bawah Kiri No 14 Ormco R.Slot Bawah Kiri No 15 Ormco R.Slot bawah kiri No 16 Ormco R.Slot Bawah Kiri No 17 Ormco R. Slot Bawah Kiri No 18 Ormco R. Slot bawah Kiri No 19 Ormco R. slot Bawah Kiri No 20 Ormco r. Slot Bawah Kiri No 21 Ormco R. Slot Bawah Kiri No 22 Ormco R. slot Bawah Kiri No 23 Ormco R. Slot Bawah Kiri No 24 Ormco R. Slot Bawah Kiri No 25 Ormco R. Slot Bawah Kiri No 26 Ormco R. Slot Bawah kiri No 27 Ormco R.Slot Bawah kiri No 28 Ormco R. Slot Bawah Kiri No 29 Ormco R.Slot Bawah Kiri No 30 Ormco R. Slot Bawah Kiri No 31 Ormco R. Slot Bawah Kiri No 32 Ormco R. Slot Bawah Kiri Ormco Ormco Ormco Ormco ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco oRMCO oRMCO Ormco Ormco ormco Ormco Ormco Ormco Ormco ORMCO Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco Ormco ormco Ormco Ormco Ormco Ormco Ormco Mani EX21/ D+Z Maiss/SS white
Page 10 of 11
Jumlah 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
Satuan Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Buah Pieces
Harga Satuan (Rp) 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 165.000,00 90.000,00
Jumlah
(Rp)
825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 1.320.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 825.000,00 450.000,00
No 711 712 715 716 717 718 719 720 723 724 725 726 727 728 729 730 731 732 733 735 736 737 738 741 742 743 745 746 747 748 749 750 751 752 754 755 756 758 759 760 761 762 763 764 765 766 767 768 769 770 771 773 774 775 776 777 778 779 780 781 782 783 784 785 786 787 788 789 790 791 792 793 794 799 800 802 803 804 805 806 820 821 822 823 934 1017 1018 1019 1020 1021
Nama Barang Diamond Instrument Burs Diamond Instrument Burs Diamond Instrument Burs (FO) Diamond Instrument Burs (Metal Crown) Hedstroem File # 15-45.21 mm Hedstroem File # 15-45.25 mm K - Flexofile # 15 - 40,31 mm Niti Super Elastics 017 x 025 Low Molar Band + Buccal Tube 17 LR CO2 Refil Kit 11-7047 Sodium Citrate ESR Kapiler Hematokrit 10 tube/pak Centrifuge Tube Steril 15 ml /25 bh 430791 Cryos 4,5 ml , 50 bh 7946 Micro Filter 02 UL,50 Sample Cup 1,5ml 1000 cup Sample Cup 1,5 ml ,1000 pc Tabung Durham Tabung Reaksi 18X180 Mm Gelas Proses Caver Stainles,25 bh Kartu Golongan Darah Sodium Citrat 3,2% (2ml 100bh) Transfer Pipet 3 ml , 500 buah Citrat 3 NA 1ml 1501306 Cloth Factor 100pcs Feses Container + sendok Lancet Acti lane 17.G (2 mm) Spesial Culture Swab Plus Amies 220116 Cuvette Cartrige D 828 ESR Pipet + Citrate 0,32 ml 1501226 Wingset 25x75 , 367294 Sarung Tangan Nitrilie , S Sarung Tangan Nitrile , M Sarung Tangan Nitrile , L Objeck Glass Preclean Biozatic Microtome Blade / 819 ( 50 BH ) Printer Paper 110 X 30 ml. Seamless Ribbon (ERC-09) K3 EDTA ,2 ml .IDO 30-E2P / 100 bh Pisau AA 225 R Sample Cup Conical 4 ml 42412510 (100/pak) Cassette Embeding B. 1003500/500 bh Reaction Tube SU 40 90407219 (1000/pak) Objeck Gelas Preaclean & Frosted Cryos 1,8 ml Tip Yellow ,1000 bh Box Plastik tempat parafin TC Flask , 25cm Plug seal Cap 430168 Cell Culture Dish , 100 x 20 mm 430167 Kertas Pembersih Lensa Tabung Kaca 13 x 100mm Urine Container Non steril 60ml Tabung kaca 12 x 75 mm Tube Micro 365974 Kertas Saring Cat . 1001 185 diameter 18,5 Cuvette & Steel Ball Tabung Plastik 12 x 75 mm / 1000pc Syringe Clot cather Phox Urine Container Steril 60ml Transfer Pipet 3 ml Steril, 31027003A Cotton Swab Steril, 231110 Petri Dish 90 mm Steril, S90001 Inoculation Loops 10 ul, 33210010D K3 EDTA 0,5ML / 50 PCS Lithium Heparin 1 ml Tube / 100 bh Parafilm 4 x 1,25 Transfer Pipet 1 ml Steril , 31027001A Laminating Film 70 x 97 x 100 mikron Lancet Cont_ACT Blue ( 2 mm ) Lensa Tissu Lithium Heparin 4ml Tube / 100 bh Syringe ABG Aline 1 ml Syringe ABG Preset 1 ml Centrifuge Tube Conical Graduation 15 ml Plastik Laminating ALCOHOL SWAB (BD) ANSELL STERIL NO. 6.0 PF / SARUNG TANGAN ANSELL STERIL NO. 6.5 PF / SARUNG TANGAN ANSELL STERIL NO. 7.0 PF / SARUNG TANGAN ANSELL STERIL NO. 7.5 PF/ SARUNG TANGAN ANSELL STERIL NO. 8.0 PF/ SARUNG TANGAN DISP BLADE 10 AESCULAP DISP BLADE 11 AESCULAP DISP BLADE 15 AESCULAP DISP BLADE 20 AESCULAP SPUIT 10 CC TERUMO MEDIGRIP PLUS 6.0 MEDIGRIP PLUS 6.5 MEDIGRIP PLUS 7.0 MEDIGRIP PLUS 7.5 MEDIGRIP PLUS 8.0
Spesifikasi K. 310.204.012 K.310.204.014 Mani FO - 32/D+Z/ K8851 314 012 Dentsply AO16D. 021 900 Dentsply AO 16D. 025 900 Dentsply AO 12C 031. 900 3M , Unitex ormco/oo/RMO/dentaurum Bacharach GD Asisten Corning NUNC Gelman Siemens lokal Lokal Pyrex Shandon AIM / 100 pc Greieener NAZ Aquasel Lokal Strefa BD Siemens Vectube BD H Seal H Seal H Seal Biogear / Essco Leica Thermalindo seamles Indolab Aesculap Sysmex Shandon Sysmex BE NUNC Italiana Lion Corning Corning Pyrex OM Pyrex BD Wathman TECO GmbH Lokal OM microgen microgen microgen microgen Aquisel Aquisel Microgen Lokal BD Lokal BD BD BD corning Bening,100 lbr/dos,uk.68,5x97mm BD gammex Powder Free, box isi 40 gammex powder free, box isi 40 gammex powder free, box isi 40 gammex powder free, box isi 40 gammex powder free, box isi 40 aesculap, box 100 aesculap, box isi 100 aesculap, box isi 100 aesculap, box isi 100 terumo, box isi 100 ansell ansell ansell ansell ansell
Jumlah 5 5 5 2 2 2 2 2 2 1 25 15 18 3 4 15 12 6 4 6 90 18 10 30 1.800 20 12 20 3 5 150 30 18 70 12 200 18 50 2 6 8 5 20 12 40 10 9 12 6 5 5.000 5 16 6 1 12 3 1.800 5 22 12 6 200 18 20 5 30 30 12 18 600 1.200 25 40 70.000 700 8.000 8.000 4.000 600 600 700 800 1.000 1.500 100 150 100 100 50
Satuan Pieces Pieces Pieces Pieces Pak Pak Pak Pak Pieces Botol Box Pak Pak Pak Pak Box Pak Pak Pak Pak Pak Pak Pak Box Buah Box Box Buah Pak Box Pak Pak Pak Pak Pak Roll Buah Pak Buah Pak Box Pak Pak Pak Pak Buah Pak Pak Pak Pak Buah Pak Box Pak Kit Pak Pak Buah Pak Pak Pak Pak Pak Vial Buah Pak Pak Box Buah Box Pieces Pieces Pak Pak Lembar Pasang Pasang Pasang Pasang Pasang Pieces Pieces Pieces Pieces Pieces Pasang Pasang Pasang Pasang Pasang
Harga Satuan (Rp) 90.000,00 90.000,00 90.000,00 90.000,00 85.000,00 85.000,00 140.000,00 460.000,00 165.000,00 7.500.000,00 700.000,00 430.000,00 150.000,00 580.000,00 2.300.000,00 950.000,00 450.000,00 400.000,00 1.750.000,00 1.450.000,00 70.000,00 245.000,00 500.000,00 290.000,00 2.550,00 870.000,00 885.000,00 4.700.000,00 1.050.000,00 550.000,00 52.000,00 52.000,00 52.000,00 145.000,00 1.790.000,00 25.000,00 86.000,00 220.000,00 4.100.000,00 920.000,00 1.200.000,00 4.050.000,00 200.000,00 550.000,00 110.000,00 40.000,00 475.000,00 160.000,00 75.000,00 1.100.000,00 1.000,00 1.000.000,00 250.000,00 600.000,00 7.000.000,00 980.000,00 1.000.000,00 2.400,00 1.000.000,00 120.000,00 1.520.000,00 1.050.000,00 190.000,00 390.000,00 425.000,00 1.000.000,00 50.000,00 740.000,00 60.000,00 450.000,00 9.850,00 13.000,00 650.000,00 45.000,00 210,00 12.200,00 12.200,00 12.200,00 12.200,00 12.200,00 1.900,00 1.900,00 1.900,00 1.900,00 1.400,00 6.950,00 6.950,00 6.950,00 6.950,00 6.950,00 Subtotal PPN Total
Jumlah
ttd. Kelompok Kerja Pengadaan Barang ULP RSAB Harapan Kita
Page 11 of 11
(Rp)
450.000,00 450.000,00 450.000,00 180.000,00 170.000,00 170.000,00 280.000,00 920.000,00 330.000,00 7.500.000,00 17.500.000,00 6.450.000,00 2.700.000,00 1.740.000,00 9.200.000,00 14.250.000,00 5.400.000,00 2.400.000,00 7.000.000,00 8.700.000,00 6.300.000,00 4.410.000,00 5.000.000,00 8.700.000,00 4.590.000,00 17.400.000,00 10.620.000,00 94.000.000,00 3.150.000,00 2.750.000,00 7.800.000,00 1.560.000,00 936.000,00 10.150.000,00 21.480.000,00 5.000.000,00 1.548.000,00 11.000.000,00 8.200.000,00 5.520.000,00 9.600.000,00 20.250.000,00 4.000.000,00 6.600.000,00 4.400.000,00 400.000,00 4.275.000,00 1.920.000,00 450.000,00 5.500.000,00 5.000.000,00 5.000.000,00 4.000.000,00 3.600.000,00 7.000.000,00 11.760.000,00 3.000.000,00 4.320.000,00 5.000.000,00 2.640.000,00 18.240.000,00 6.300.000,00 38.000.000,00 7.020.000,00 8.500.000,00 5.000.000,00 1.500.000,00 22.200.000,00 720.000,00 8.100.000,00 5.910.000,00 15.600.000,00 16.250.000,00 1.800.000,00 14.700.000,00 8.540.000,00 97.600.000,00 97.600.000,00 48.800.000,00 7.320.000,00 1.140.000,00 1.330.000,00 1.520.000,00 1.900.000,00 2.100.000,00 695.000,00 1.042.500,00 695.000,00 695.000,00 347.500,00 1.544.158.000,00 154.415.800,00 1.698.573.800,00
