DEPARTEMEN KESEHATAN DIREKTORAT JENDERAL BINA PELAYANAN MEDIK RSUP Dr. HASAN SADIKIN BANDUNG Jalan Pasteur No. 38 , Bandung 40161 Telepon : (022) 2034953, 2034954 (hunting) Faksimile : (022) 2032216, 2032533 e-mail :
[email protected],
[email protected] SMS hotline : 081220050547
PENGUMUMAN PEMENANG PELELANGAN UMUM PASCA KUALIFIKASI PENGADAAN ALKES KHUSUS STENT PRO MOUST ELEMENT DLL INST. PELAYANAN JANTUNG (IPJ) UNTUK SEMESTER 1 TA 2016 (PRA DIPA) RSUP Dr. HASAN SADIKIN BANDUNG Nomor : BN.01.02/PNBP-PDA/11903/XII/2015 Tanggal : 22 Desember 2015 Berdasarkan Berita Acara Hasil Pelelangan nomor : BN.01.02/PNBP-PDA/11901/XII/2015, tanggal 22 Desember 2015 serta surat Penetapan Pemenang Nomor : BN.01.02/PNBP-PDA/11902/XII/2015, tanggal 22 Desember 2015, maka Kelompok Kerja III ULP RSUP Dr. Hasan Sadikin Bandung, mengumumkan hasil pelaksanaan Pelelangan Umum Pasca Kualifikasi Pengadaan Alkes Khusus Stent Pro Moust Element dll Inst. Pelayanan Jantung (IPJ) Untuk Semester 1 TA 2016 (Pra DIPA) RSUP Dr. Hasan Sadikin Bandung dengan cara itemized secara elektronik melalui web site LPSE Prop Jabar dengan alamat situs internet : http://lpse.Prop Jabar.go.id dengan metode sistem itemized dengan hasil sebagai berikut : 1. Nama Perusahaan Alamat NPWP
: Rekamileniumindo Selaras : Jl. Tomang Raya 51B Jakarta 11440 : 01.849.445.0-038.000 KET.
No.
48 49 50 51 52 53 54 55 56
URAIAN BMHP MERK/SPEK/UKURAN
ASAL NEGARA
Cre 8 Drug Eluting Stent
CID
Italy
AvantGarde Bare Metal Stent
CID
Italy
CID
Italy
Merit Medical (uk.6F, 7F)
USA
Merit Medical (uk.5R, 6R)
USA
Merit Medical
USA
Merit Medcal
USA
Merit Medcal
USA
Merit Medcal
USA
Fluydo Ballon Prelude Introducer (Femoral) Sheath 6Fr,7Fr Prelude Introducer (Transradial) Sheath 5Fr,6Fr Manifold (Two Port, Three Port) High Pressure Flex Tubing Injection 200 High Pressure Flex Tubing Injection 480 Accessories Kit (MAP)
VOL.
100 25 25 350 350 375 350 350 250
HARGA SAT.
JUMLAH
13.587.760
1.358.776.000
Calon Pemenan
6.969.450
174.236.250
Calon Pemenan
3.880.000
97.000.000
Calon Pemenan
279.864
97.952.400
Calon Pemenan
589.500
206.325.000
Calon Pemenan
121.455
45.545.625
Calon Pemenan
159.091
55.681.850
Calon Pemenan
159.091
55.681.850
Calon Pemenan
365.000
91.250.000
Calon Pemenan
57
Basic Inflation Syringe (Indeflator)IN4130
58
Angiographic Needle
59 60 61 62
Guide Wire 0.035/0.038" (Inqwire) 150cm Guide Wire 0.035/0.038" (Inqwire) 260cm Guide Wire hIidrophilic 0.035"/0.038" (Laurette) 150cm Guide Wire hidrophilic 0.035"(Laurette) 260cm
63
Performa Catheter JR 3.5 6Fr
64
Performa Catheter JR 4.0 6Fr
65
Performa Catheter JL 3.5 6Fr
66
Performa Catheter JL 4.0 6Fr
67 68 69
Performa Catheter MPA I/II 4Fr, 5Fr, 6Fr Performa Catheter Pigtail 4Fr, 5Fr,6Fr Concierge Guiding Catheter JL/JR 3.5-4.0 6Fr
70
Bipolar Temporary Lead 4Fr, 5Fr,6Fr
71
Livewire Steerable Electrophysiology Catheters Tip 2mm Quadripolar 6F Med Sweep
72
Livewire Steerable Electrophysiology Catheters Decapolar 6F Med Sweep
73
Livewire Steerable Duo-Decapolar (20 electrodes) 7F
74
Connecting Cable Therapy Dual-8 Ablation Catheters
75
Fast Cath Lock Short Sheath 5F,6F,7F
76
BRK / BRK-1 Transeptal Needle
77
Swartz Transeptal SLO Braided
78 79
ADO ASO
Merit Medcal
USA
Merit Medcal Merit Medical (uk.00.35"/0.038",150cm) Merit Medical (uk.00.35"/0.038",260cm) Merit Medical (uk.00.35"/0.038",1500cm) Merit Medical (uk.00.35"/0.038",260cm)
USA
Merit Medical (uk. JR 3.5 6Fr)
USA
Merit Medical (uk. JR 4.0 6Fr)
USA
Merit Medical (uk. JL 3.5 6Fr)
USA
Merit Medical (uk. JL 3.5 6Fr) Merit Medical (MPA I/II 4Fr, 5Fr, 6Fr) Merit Medical (ukuran 4F, 5F, 6F)
USA
Merit Medical (JL/JR 3.5-4.0 6Fr)
USA
ST Jude Medical (uk. 4F, 5F, 6F) 6F Electrode Specing 2-5-2mm, Electrode Tip 2mm, Med Sweep, Length 115 cm, Ergonomic Handle 6F Electrode Specing 2-5-2 mm, Electrode Tip 2 mm, Med Sweep, Length 115 cm, Ergonomic Handle, Decapolar (10 Electrodes) 7F Electrode Specing 2-10-2 mm, Electrode Tip 2 mm, Super Lange curi/Med Curi, Length 95 cm/115 cm, 20 Electrode Connecting ablation catheter for 4 mm and 8 mm (SIM) Zise 5F, 6F, 7F snap lock feature secure dilator In sheath during Insertion Cath Lock Locking hub secures Indweling catheters in positions
USA
ST Jude Medical
USA
ST Jude Medical Lifetech Scientific (uk. 4-16/618)
USA China
Lifetech Scientific (uk. 2-38)
China
USA USA USA USA
USA USA
USA
225 600 180 200 10 10 175 50 175 50 200 175 275 10
45
1.500.000
337.500.000
Calon Pemenan
62.500
37.500.000
Calon Pemenan
177.273
31.909.140
Calon Pemenan
345.000
69.000.000
Calon Pemenan Calon Pemenan
575.000
5.750.000
957.500
9.575.000
Calon Pemenan
318.182
55.681.850
Calon Pemenan
318.182
15.909.100
Calon Pemenan
318.182
55.681.850
Calon Pemenan
318.182
15.909.100
Calon Pemenan
318.182
63.636.400
Calon Pemenan
440.000
77.000.000
Calon Pemenan
1.668.636
458.874.900
Calon Pemenan
2.171.455
21.714.550
Calon Pemenan Calon Pemenan
13.095.000
589.275.000 Calon Pemenan
USA
15
16.150.500
242.257.500 Calon Pemenan
USA
3
USA
10
19.390.300
5.019.750
58.170.900
50.197.500
Calon Pemenan Calon Pemenan
USA
30
10 10 15 10
763.875
22.916.250
6.305.000
63.050.000
Calon Pemenan
4.365.000
43.650.000
Calon Pemenan
13.302.871
199.543.065
Calon Pemenan
22.171.484
221.714.840
Calon Pemenan
80
ASD Ceraflex
81
VSD
82 83 84 85
86
87 88
Lifetech Scientific
China
Lifetech Scientific Lifetech Scientific (uk. 24, 26, 28)
China
Lifetech Scientific
China
ST Jude Medical (uk. 6F, 8F)
USA
JHT Zise 7F snap lock feature secure dilator In sheath during Insertion Cath Lock Locking hub secures Indweling catheters in positions
Spain
Sizing Ballon
Lifetech Scientific
China
Delivery System
Lifetech Scientific
China
BMV Snare Kit Angioseal 6 Fr, 8Fr Hunter Hydrophilic Extraction Catheter 6F Fast Cath-Cath Lock 7Fr 40 cm
3 10 10
China
10 75 12
25.918.400
77.755.200
Calon Pemenan
22.171.484
221.714.840
Calon Pemenan
21.617.226
216.172.260
Calon Pemenan
3.880.000
38.800.000
Calon Pemenan
2.400.000
180.000.000
Calon Pemenan
6.890.849
82.690.188
Calon Pemenan Calon Pemenan
USA
15
30 15
763.875
11.458.125
3.690.462
110.713.860
Calon Pemenan
3.106.813
46.602.195
Calon Pemenan
5.914.772.588 591.477.259 6.506.249.847
2. Nama Perusahaan Alamat NPWP
No.
8 9 10 11
12
13 14 15
: PT. MENSA BINA SUKSES : Jl. H. Ibrahim ajie nO.358 Bandung : 01.315.708.6-007.000
URAIAN BMHP
ASAL NEGARA
MERK/SPEK/UKURAN Bare Metal Chromium
Kaname CoCr Stent
Monorall Ballon Chateter For CTO NS-PTCA NS-PTCA
Runthrough NS-PTCA W. Intermediate Runthrough NS-PTCA Wire Hypercoat Finecross (1,8 Fr 130 cm / 1,8 Fr 150 cm) Ultimaster DES
Cobalt
High Pressure Chateter
Hiryu HP Balloon Tazuna Balloon Runthrough WireFloopy / W.Extra Floopy
Stent
Monorall Ballon Chateter For CTO PCI Wire 1st Choice For pci Case With Tip Load Extra floppy 6.0GF Floopy 1.0GF and Extra Hidrophilic coating for extra floppy PCI Wire Tip Load 1.0 GF For Turious Lession / Terumo Micro Chateter / Terumo Drug Eluting Stent Limus Family 15 / Terumo
Terumo Japan Terumo Japan Terumo Japan Terumo Japan Terumo Japan
VOL.
25 25 25
HARGA SAT.
JUMLAH
6.468.000
161.700.000
3.394.160
84.854.000
3.394.160
84.854.000
1.908.742
190.874.200
100
100
Terumo Japan Terumo Belgium
25
Terumo Belgium
25
30
KET. Calon Pemenang Calon Pemenang Calon Pemenang Calon Pemenang Calon Pemenang
1.908.742
190.874.200
1.908.742
47.718.550
5.990.490
179.714.700
10.350.912
258.772.800
Calon Pemenang Calon Pemenang Calon Pemenang
61
Guide Wire hIidrophilic 0.035"/0.038" (Laurette) 150cm
62
Guide Wire hidrophilic 0.035"(Laurette) 260cm
154
CATH DIAGNOSTIC Pigtail
155
CATH DIAGNOSTIC JR 3,5 6F
156
CATH DIAGNOSTIC JR 4 6F
157
CATH DIAGNOSTIC JL 3,5 6F
158
CATH DIAGNOSTIC JL 4 6F
3. Nama Perusahaan Alamat NPWP
No.
21
22
URAIAN BMHP
3V Neil - Sirolimus Drug Eluting Stent System
3V PAULO / PAULO NC Balloon Dilatation Catheter
Hydrophilic oating M (mucus) coating Mengurangi friksi, Super elastic alloy (Nitinol) core anti kingking. Radiopaguc polyuructhane jacket. Tapered distal core Hydrophilic oating M (mucus) coating Mengurangi friksi, Super elastic alloy (Nitinol) core anti kingking. Radiopaguc polyuructhane jacket. Tapered distal core Terdiri 2 lapis Nylon Poluethylene & stainless steel mesh, Diameter (Luar/Dalam = 6 Fr/1.30 mm), Panjang 110 cm Terdiri 2 lapis Nylon Poluethylene & stainless steel mesh, Diameter (Luar/Dalam = 6 Fr/1.30 mm) kateter untuk femoral dengan kurve 3.5 cm, panjang 100 cm Terdiri 2 lapis Nylon Poluethylene & stainless steel mesh, Diameter (Luar/Dalam = 6 Fr/1.30 mm) kateter untuk femoral dengan kurve 4.0 cm, panjang 100 cm Terdiri 2 lapis Nylon Poluethylene & stainless steel mesh, Diameter (Luar/Dalam = 6 Fr/1.30 mm) kateter untuk femoral dengan kurve 3.5 cm, panjang 100 cm Terdiri 2 lapis Nylon Poluethylene & stainless steel mesh, Diameter (Luar/Dalam = 6 Fr/1.30 mm) kateter untuk femoral dengan kurve 4.0 cm, panjang 100 cm
Terumo Japan
10
380.000
3.800.000
Calon Pemenang
Teruo Japan
10
717.250
7.172.500
Calon Pemenang
326.400
48.960.000
Terumo Japan
150
Calon Pemenang
Terumo Japan
150
326.400
48.960.000
Calon Pemenang
Terumo Japan
50
326.400
16.320.000
Calon Pemenang
Terumo Japan
150
326.400
48.960.000
Calon Pemenan
Terumo Japan
50
326.400
16.320.000
Calon Pemenang
Jumlah
1.389.854.950
PPN 10%
138.985.495
Total
1.528.840.445
: PT. Girisakti Utama : Komp Girimekar Permai Blok D No.15 Cilengkrang Ka. Bandung : 01.849.445.0-038.000
MERK/SPEK/UKURAN
Stent : Cobal Cromium, Drug : Biodegradable Polimer Eluing Sirolimus Drug Diameter 2.25 s/d 4.00 mm Panjang 08 mm s/d 40 mm type Stent DES /Merk S3V Balloon : Semi Complain Diameter 1.0 s/d 4.00 mm, Panjang 10 s/d 30 mm / Type Balloon / S3V
ASAL NEGARA
VOL.
India
225
India
50
HARGA SAT.
JUMLAH
14.404.500
3.241.012.50 0
4.214.650
210.732.500
23
DEMAX - Gusta RX / Gusta NC. Balloon Dilatation Catheter
Balloon : Non Complain Diameter 1.00 s/d 4.00 mm, Panjang 10 s/d 30 mm / Type Balloon / Demax Medical Femoral Sheath Panjang 8 s/d 13 cm, Ukuran 4 s/d 10 Fr / Sheath / Biotec Coorporation Radial Sheath Panjang 8 s/d 13 cm, Ukuran 4 s/d 7 Fr / Sheath / Biotec Coorporation
Australia
25
Taiwan
500
Taiwan
500
24
BIOTEQ - Introducer Sheath Femoral 4Fr, 5Fr, 6 Fr, 7 Fr
25
BIOTEQ - Introducer Sheath Radial 4Fr, 5Fr, 6 Fr,7Fr
26
BIOTEQ - Long Sheath 23cm 6Fr, 7Fr
Femoral Sheath Panjang 23 s/d 40 cm, / Sheath / Biotec Coorporation
Taiwan
27
DEMAX - Manifolds 3 Port OFF
Manifold 3 Port Off Peasure : 500 psi /type Ascessories / Demax Medical
Australia
500
28
Pressure Line 60cm 1200psi/120cm 1200psi
Panjang 60 s/d 120 cm, Presure : Max 1200psi / type Ascessories / Demax Medical
Australia
750
29
DEMAX - Accessories Kit YConnector
Y Conector, Torque, Needle / Type Ascessories / Demax Medical
Australia
250
30
DEMAX - In-Deflation Device
Max Preasure Input : 30 Am, Volume 20 ml / type Ascesories / Demax Medical
Australia
300
31
BIOTEQ - Guide Wire PTFE JTip Fixed Core 150cm
Diameter 0.035", Panjang : 150 cm / Type Ascessories / Bioteq Coorporation
Taiwan
200
32
BIOTEQ - Guide Wire PTFE J3Type 0.035" 260cm
Diameter 0.035", Panjang : 260 cm / Type Ascessories / Bioteq Coorporation
Taiwan
200
33
BIOTEQ - Angiographic Cath. TIGER-1
Taiwan
600
34
BIOTEQ - Angiographic Cath. PIGTAIL
Taiwan
175
35
BIOTEQ - Angiographic Cath. MP-2
Taiwan
200
36
BIOTEQ - Angiographic Cath. JR 3.5 6Fr
Taiwan
175
37
BIOTEQ - Angiographic Cath. JR 4.0 6Fr
Taiwan
50
38
BIOTEQ - Angiographic Cath. JL 3.5 6Fr
Taiwan
175
39
BIOTEQ - Angiographic Cath. JL 4.0 6Fr
Taiwan
50
40
Cocoon PDA
Thailand
35
41
Cocoon ASD Occluder
Catheter
15
Panjang : 100 cm, Fs : 5 Fr, Side Holes : 1 / Type Diagnostic Catheter / Bioteq Coorporation Panjang : 110 cm, Fs : 4 Fr, 5 Fr, 6 Fr Side Holes : 5 / Type Diagnostic Catheter / Bioteq Coorporation Panjang : 100 cm, Fs : 45 Fr, 6 Fr Side Holes : 2 / Type Diagnostic Catheter / Bioteq Coorporation Panjang : 100 cm, Fs : 6 Fr / Type Diagnostic Catheter / Bioteq Coorporation Panjang : 100 cm, Fs : 6 Fr / Type Diagnostic Catheter / Bioteq Coorporation Panjang : 100 cm, Fs : 6 Fr / Type Diagnostic Catheter / Bioteq Coorporation Panjang : 100 cm, Fs : 6 Fr / Type Diagnostic Catheter / Bioteq Coorporation Diameter : 4 mm s/d 20 mm, FS : 6 Fr s/d 10 Fr, Panjang 7 mm s/d 8 mm / Type Duct Occluder /Vascular Innovation Diameter : 8 mm s/d 40 mm, FS : 6 Fr s/d 14 Fr, Panjang 3 mm s/d 4 mm / Type Septal Occluder /Vascular I+C15nnovation
3
4.214.650
105.366.250
383.150
191.575.000
543.200
271.600.000
629.530
1.888.590
133.375
66.687.500
248.320
186.240.000
373.450
93.362.500
1.227.050
368.115.000
508.765
101.753.000
693.550
138.710.000
543.200
325.920.000
543.200
95.060.000
543.200
108.640.000
384.120
67.221.000
384.120
19.206.000
384.120
67.221.000
384.120
19.206.000
14.404.500
504.157.500
29.342.500
440.137.500
42
Cocoon VSD Occluder (Diameter 20 s/d 56)
43
ACCURA BMW Balloon Catheter
44
3V XTRA HYDRO 6F S STIFFAspiration catheter 6Fr, 7Fr
45
BIOTEQ - Angiographic Cath. Cobra/Headhunter
46
Cocoon Ascessory Set + Delivery Cable + Pusher
47
Cocoon Sizing Ballon Catheter
Diameter : 12 mm s/d 22 mm, FS : 6 Fr s/d 8 Fr, Panjang 4 mm s/d 10 mm / Type VSD Occluder /Vascular Innovation Diameter : 22 mm s/d 29 mm, Panjang 19 mm s/d 30 mm / Type Valve Mitral /Vascular Innovation Panjang 145 cm, Diameter 0.014" FS : 6 Fr, s/d 7 Fr / type Aspiration Catheter / S3V Panjang : 80 cm / 100 cm FS : 5 Fr / type Diagnostic Catheter / Bioteq Coorporation Panjang 30.75" s/d 32.75", FS : 6 Fr s/d 14 Fr / type Ascessories / Vascular Innovation Diameter : 24 mm s/d 34 mm / typeBalloon Catheter / Vascular Innovation
4. Nama Perusahaan Alamat NPWP No 1 2 3 4 5 6 7
NAMA BMHP
Flextome Cutting Ballon Runway / Convey Rotalink Plus Rotawire Floopy / Extra support Opticross+Pullback Sled
101
Sensia DR (PPM Dual Chamber)
104 105
Thailand
10
India
12
Taiwan
15
Thailand
50
Thailand
13
29.342.500
293.425.000
28.755.650
287.556.500
8.322.600
99.871.200
597.520
8.962.800
8.322.600
416.130.000
4.214.650
54.790.450
Jumlah
7.784.547.79 0
SAT.
VOL
HARGA SAT.
JUMLAH
50
14.550.000
727.500.000
25
4.850.000
121.250.000
15
8.730.000
130.950.000
1.649.000
9.894.000
19.400.000
116.400.000
1.649.000
9.894.000
Pcs Stent Promus Element /PE PLUS Maverick 2 Monorail / Quantum Apex /Quantum Mav
Sensia SR (PPM Single Chamber) (VVIR/AAIR)
103
10
: Nugra Karsera : GRAHA MAS PEMUDA Blok AA No.10 Jl. Pemuda , Jakarta Timur : 02.508.837.837.003.000
100
102
Thailand
Ensura DR MRI (PPM Dual Chamber MRI) Adapta DR
Pcs Pcs Pcs Pcs Pcs Pcs
6 6 6 3
16.490.000
49.470.000
5
27.315.200
136.576.000
5
41.026.150
205.130.750
5
61.672.600
308.363.000
15
54.417.000
816.255.000
10
80.193.473
801.934.730
5
86.091.332
430.456.660
10
13.337.500
133.375.000
15
17.605.500
264.082.500
Pcs Pcs Pcs Pcs Pcs
Syncra CRT-P (DDD/DDDR) Pcs Maximo II VR (ICD Single Chamber) (VVI)
106
AMPLATZER Duct Occluder (ADO)
107
AMPLATZER Duct Occluder II (ADO II)
Pcs Pcs
KET. Calon Pemenang Calon Pemenang Calon Pemenang Calon Pemenang Calon Pemenang Calon Pemenang Calon Pemenang Calon Pemenang Calon Pemenang Calon Pemenang Calon Pemenang Calon Pemenang Calon Pemenang Calon Pemenang Calon Pemenang
108 109 110 111 112 113 114 115
Pcs AMPLATZER Septal Occluder (ASO) AMPLATZER Membranus / Muscular VSD Occluder (AMVO)
15
29.342.500
440.137.500
10
35.211.000
352.110.000
15
8.633.000
129.495.000
60
824.500
49.470.000
50
2.716.000
135.800.000
60
5.432.000
325.920.000
15
7.760.000
116.400.000
5
11.931.000
59.655.000
Calon Pemenang Calon Pemenang
Pcs Pcs
Z-5 (Ballon Atrioseptostomy/BAS)
Calon Pemenang Calon Pemenang Calon Pemenang Calon Pemenang Calon Pemenang Calon Pemenang
Pcs AMPLATZER Guide Wire Pcs AMPLATZET Sizing Ballon Pcs AMPLATZER Torque 45/180 Delivery System Pcs Thysak (PTV Ballon Catheter) Pcs Amplatz Goose Neck (Snare Kit)
5.870.519.140 587.051.914 6.457.571.054
5. Nma Perusahaan Alamat NPWP
NO
134 135 136 137
URAIAN BMHP
Helistent TITAN 2 Balloon Accross CTO /Acrostak Balloon Across HP /Acrostak Balloon GRIP /Acrostak
138 Syvek SP 139 Syvek NT
140
Syvek Excel
: PT. HARMONI PRIMA MEDIKA : Jl. Tanjung Selor 1A, Roxy Jakarta : 02.191.695.2-028.000
MERK/TYPE/UKURAN Hexacath /D : 2,5 s/d 4,5 ; L : 7 s/d 38 mm Acrostak ukuran D : 1,1 s/d 3,5 ; L : 5 s/d 20 mm Acrostak ukuran D : 1,5 s/d 3,5 ; L : 10 s/d 20 mm Acrostak ukuran D : 2,5 s/d 4.0 ; L : 8 s/d 16 mm Marine Polymer Technologies /3x3 cm PER 1 Patch Marine Polymer Technologies /3x3 cm PER 1 Patch Marine Polymer Technologies /3x3 cm PER 1rmasuk PlexiGlas) Patch / Exel Vascular Access Hemostasis System 1 set (tidak te
NEGARA ASAL
VOL.
SAT.
Perancis
100
Pcs
25
Pcs
30
Pcs
3
Pcs
25
Pcs
Swizerland Swizerland Swizerland USA
USA
25
HARGA
JUMLAH
11.243.182
1.124.318.200
2.821.818
70.545.450
2.821.818
84.654.540
3.527.273
10.581.819
1.278.636
31.965.900
25
Pcs
Calon Pemenang Calon Pemenang Calon Pemenang Calon Pemenang Calon Pemenang Calon Pemenang
Pcs 1.455.000
USA
KET
36.375.000
2.619.000
65.475.000
Jumlah
1.423.915.909
PPN 10%
142.391.591
Jumlah
1.566.307.500
Calon Pemenang
6. Nama Perusahaan Alamat NPWP
NO
URAIAN BMHP
: PT. BISAWI TUMBUH SELARAS : Jl. Raya Pejuangan No.88 Kebon Jeruk Jakarta : 03.042.216.6-035.000
MERK/TYPE/UKURAN
NEGARA ASAL
VOL.
27
Manifolds 3 Port OFF
BL Lifescinences/3 port off BNM 3RF
India/Italy
500
28
Pressure Line 60cm 1200psi/120cm 1200psi
BL Lifescinences/ BHPT/48"
India/Italy
750
30
Deflation Device
BL Lifescinences/B-ID-20
India/Italy
300
34
BIOTEQ - Angiographic Cath. PIGTAIL
Alvimedica/PIGTAIL 6FR
Turkey
175
35
BIOTEQ - Angiographic Cath. MP-2
Alvimedica/MPAPP 5 Fr
Turkey
200
36
BIOTEQ - Angiographic Cath. JR 3.5 6Fr
Alvimedica/JR 3.5 6Fr
Turkey
175
37
BIOTEQ - Angiographic Cath. JR 4.0 6Fr
Alvimedica/JR 4,0 6Fr
Turkey
50
38
BIOTEQ - Angiographic Cath. JL 3.5 6Fr
Alvimedica/JL 3,5 6FR
Turkey
175
39
BIOTEQ - Angiographic Cath. JL 4.0 6Fr
Alvimedica/JL 4,0 6FR
Turkey
50
53
Manifold (Two Port, Three Port)
BL Lifescinences/BMN 2 RF/3 RF
India/Italy
375
54
High Pressure Flex Tubing Injection 200
BL Lifescinences/BHPT 48
India/Italy
350
55
High Pressure Flex Tubing Injection 480
BL Lifescinences/BKT-20
India/Italy
350
56
Accessories Kit (MAP)
BL Lifescinences/BKT 342
India/Italy
250
57
Basic Inflation Syringe (Indeflator)IN4130
BL Lifescinences/B-ID-30
India/Italy
225
58
Angiographic Needle
BL Lifescinences/BIN 18G7
India/Italy
600
63
Performa Catheter JR 3.5 6Fr
Alvimedica/ JR 3,5 6Fr
Turkey
175
64
Performa Catheter JR 4.0 6Fr
Alvimedica/ JR 4,0 6Fr
Turkey
50
65
Performa Catheter JL 3.5 6Fr
Alvimedica/ JL 3,5 6Fr
Turkey
175
66
Performa Catheter JL 4.0 6Fr
Alvimedica/ JL 4,0 6Fr
Turkey
50
HARGA
JUMLAH
120.000
60.000.000
120.000
90.000.000
800.000
240.000.000
290.000
50.750.000
290.000
58.000.000
290.000
50.750.000
290.000
14.500.000
290.000
50.750.000
290.000
14.500.000
120.000
45.000.000
120.000
42.000.000
120.000
42.000.000
390.000
97.500.000
800.000
180.000.000
40.000
24.000.000
290.000
50.750.000
290.000
14.500.000
290.000
50.750.000
290.000
14.500.000
67
Performa Catheter MPA I/II 4Fr, 5Fr, 6Fr
Alvimedica/ MPAI/II 4Fr, 5Fr, 6Fr
Turkey
200
68
Performa Catheter Pigtail 4Fr, 5Fr,6Fr
Alvimedica/ Pigtail 4Fr, 5Fr, 6Fr 3
Turkey
175
69
Concierge Guiding Catheter JL/JR 3.5-4.0 6Fr
Alvimedica/ JL/JR 3,5-4,0 6Fr
Turkey
275
Nit Occlude PDA-R
PFM/ PDA-R
Jerman
Nit Occluder PDA Coil System
PFM/ PDA Coll System
Jerman
Nit Occlude ASD-R
PFM/ ASD-R
Jerman
Nit Occluder Le VSD System
PFM/ Le VSD System
Jerman
Mullins Long Sheat All Size Length 63 cm
Cook/Mullins Long Sheat All Size 63 cm
Multi Snare
PFM/147315
Jerman
95
Multi Snare VSD Loop Set
PFM/147015
Jerman
8
147
Manifold
BL Lifescinences/BMN-3RF
India/Italy
375
148
High Pressure Flex Tubing 20"/48"
BL Lifescinences/BHPT 48"
India/Italy
750
150
Basix Indeflator COMPAK (IN4130)
BL Lifescinences/BHD-30
India/Italy
225
152
One Wall Needle 18 Ga
BL Lifescinences/BIN-18G7
India/Italy
600
154
CATH DIAGNOSTIC Pigtail
Alvimedica/ Pigtail
Turkey
150
155
CATH DIAGNOSTIC JR 3,5 6F
Alvimedica/ JR 3,5 6Fr
Turkey
150
156
CATH DIAGNOSTIC JR 4 6F
Alvimedica/ JR 4 6F
Turkey
50
157
CATH DIAGNOSTIC JL 3,5 6F
Alvimedica/ JR 3,5 6Fr
Turkey
150
158
CATH DIAGNOSTIC JL 4 6F
Alvimedica/ JR 4 6Fr
Turkey
50
89 90 91 92
93
USA
94
3 3 10 10 38 12
290.000
58.000.000
290.000
50.750.000
1.200.000
330.000.000
12.500.000
37.500.000
12.125.000
36.375.000
29.950.000
299.500.000
29.950.000
299.500.000
4.650.000
176.700.000
7.760.000 11.640.000
93.120.000 93.120.000
120.000
45.000.000
120.000
90.000.000
800.000
180.000.000
40.000
24.000.000
290.000
43.500.000
290.000
43.500.000
290.000
14.500.000
290.000
43.500.000
290.000
14.500.000
Jumlah
3.163.315.000
PPN 10%
316.331.500
Total
3.479.646.500
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