Program : 1.02.

14 Program Peningkatan Kualitas Pelayanan Publik Urusan Kesehatan

Kegiatan : Pengadaan Belanja Modal Sarana dan Prasarana Layanan Kesehatan
Anggaran 0

Koefisien
No Komponen Merk Type Harga Jumlah Ket
Volume Satuan
5.2.2 BELANJA BARANG DAN JASA
5.2.2.01 Belanja Bahan Pakai Habis
5.2.2.01.14 Belanja Perkakas Kerja

Wastafel alat
Spesifikasi: bahan stainless, ukuran 1200 x 750 x 870/970 mm,
1 Nayati DW 2 sink SQ leg w/ soiled table 4 unit Gea
w/ splasg back, ADWSOS 1275
L/RO

Wastafel cuci tangan

Spesifikasi: ukuran 430 x 392 x 420 mm, dilengkapi dengan sensor.
2 Nayati hand wash sink w/ sensor 3 unit AGS ANU0101 132,000,000 396,000,000 Non E Catalog
operated, NHWS 4.339
W/SOP

TOTAL
5.2.3 BELANJA MODAL
5.2.3.11 Belanja Modal Pengadaan Perlengkapan Kantor
5.2.3.11.13 Belanja Modal Pengadaan Rak Besi
Rak Besi
1 Spesifikasi: Rak Pallet Untuk Obat, Berbahan Besi Dimensi : 90 Cm 4 buah ERSA 53800MdT 7,299,336 29,197,344 E Catalog
X 200 Cm X 180 Cm
TOTAL
5.2.3.13 Belanja Modal Pengadaan Mebeulair
5.2.3.13.10 Belanja Modal Pengadaan Lemari
Lemari Instrumen
1 Spesifikasi: Bahan Duco Finished Steel + Kaca 2 Pintu, 4 Rak (Satu 2 buah AGS AN C0101 7,028,505 14,057,010 E Catalog
Rak Terbawah Berupa Kabinet)
TOTAL
5.2.3.19.01 Belanja Modal Pengadaan AlatAlat Kedokteran Umum

1 Defibrillator 1 unit OSATU/Bexen Reanibex-700 164,274,000,000 164,274,000,000 E Catalog

Spesifikasi : Bifasik, Monitor, Ekg, Saturasi Oksigen

Laringoscope Anak
Spesifikasi : Fiber Optic Baby Blade 0 , Inside Vertical +/- 8mm,
Inside Base to Tip +/-53mm, Fiber Optic Pediatric Blade 1, Inside F-000,22.111 , F-000.22.101,F-
2 Vertical +/- 8mm, Inside Base to Tip +/-79mm, Fiber Optic Infant 1 set Heine - German 000.22.102,F001.22.800,F- 16,943,657 16,943,657 Non E Catalog
Blade 00, Inside Vertical +/-8mm, Inside Base to Tip +/-37mm, 179.00.000,X-001.88.035
Medium 'C' Size Light Weight Handle , Penlight 'AA' Size Light
Weight Handle , Fiber Optic Laryngoscope Case

F-000,22.110 , F-000.22.119,F-
3 Laringoskop Neonatus 000.22.120,F001.22.800,F-
1 set Heine - German 19,061,177 19,061,177 Non E Catalog
Spesifikasi : 3 ukuran 179.00.000,X-001.88.035, F-
001,22,800

Medical Printer
4 Spesifikasi : Dry Image Recording Films-Kompatibel untuk print film 1 unit
dari alat CT Scan, Digital X-Ray, MRI dan CR (Computed
Radiography)

Spirometri
Spesifikasi : Parameter VC : VC, ERV, IRV, TV, FRC(Manual input), RV,
5 TLC, RV/TLC,Parameter FVC : FVC, FEV.5, FEV1, FEV1%T or G, FEV3, 1 set BTL BTL-08 Spiro 30,500,000 30,500,000 E Catalog
FEV3%T or G, FEV6, FEF25-75, EX Time, V ext, FIVC, FUV.5, PIF,
FIF50FIV1,FIV1/FIVC, PEF, FEF25, FEF50 FEF75, FIV1/FVC,Software
original :Eropa

Dressing Trolley
6 Spesifikasi: SS pipe, polished, castor with brake, 2 SS drawer with 5 unit AGS AN T0301 4,541,816 22,709,080 E Catalog
alumunium handle, push SS handle
pipe, bottle rack, bowl SS, rack bucket SS
 EKG Dewasa
Spesifikasi: Japan,lenahC 6 ro,4.3 1 4 2 1 1020502>LKA.IR.peD
ECG recording with analysis, Touch Screen Operation and
Information entry, 12-Channel display of ECG wavefom,
Arrthymia Monitoring
Dry Sterilisator/ Lemariand Sumamary mode, Usb Data
Alkes
7 Trasmission , BUld in memory for 40ECG data. 3,4 or 6 channel 2 buah AGS AN C0101 7,028,505 14,057,010 E Catalog
Spesifikasi: 2 Pintu
printing on 112 mm widw paper Adult : Over 19 Years Old .,
Interpretation : 147 Cass Of Diagnostic Statemen, Standard 12
Leads and Cabrera Leads Simultaneos or Real-Time Input,
Input Imedance : Over 10 M, CNR : Over 10 0 dB, Frequency
Response : 0.02-150HZ within 3dB, Patient Leakage : Less then
10 uA, Safety : Class 1 Type CF, Sensitivy : 2,5 -5-10-20mm/mv,
Digital Filter : Hum : -30db,50/60Hz Drift :-3db, 0,5
8 Hz Muscle 1 : -3 db,50/60Hz , Musle 2 : -3dB, 25 Hz, Display 1 unit BTL-UK BTL-08 LC 85,000,000 85,000,000 E Catalog
Screen : Toch-Screen 3,8" LCD : sdaeL yalpsiD ,stod 042x023
4,6,12 leads ch simultaneous, Recording System : Thermal
Array 8 Dots/mm , Chart Speeds : 5.10.12,5.25.50 mm/sec
Long Time Mode : 12.5 Mm/sec , Print Mode : 3ch, 4 4ch,6ch
Arrthymia Detection , Rocording Paper : Roll Type R112 x27R-
c , Z-fold type R112x27Z-C2 , Sampling rate : 1 msec , A/D
conversion : 12 bit , Defibrilator Protection : to 500 V , 400J ,
Emergency
Interl Memory kit : 40 resting ECG data Storage, Serial : USB port
9 1 set Pentamed(l ndonesia) OXY-TOK 20,449,000 20,449,000 Non E Catalog
Spesifikasi: Trauma bag complete
xl , Intepretation Statement : 147 Cases , Power Saource : AC
110 - 240V
Emergency Kit : 50-60Hz , DC 12 V Ni-MH Rechargeable Battry ,
10 Operating 1 set Pentamed(l ndonesia) OXY-TOK 20,449,000 20,449,000 Non E Catalog
Spesifikasi: Emergency Kit 10-40 C , Humidity : 25-95%
Condition : Temp :
R.H , Diminsion : 12 thgieW . mm 7 Hx002D 0 x 092 W
kg.
Infus pump
Spesifikasi: "keep vein open" function, tubing clamp function,
11 volume delivered clear function, time 3 unit FRESENIUS KABI Optima PT IS 22,437,000 67,311,000 E Catalog
remaining display, battery capacity indicator, start reminder
function

12 Lampu pemeriksaan 2 unit AGS AN U1002 2,200,000 4,400,000 Non E Catalog

13 Steam sterilisator/autoclave 1 unit Nuve Turki OT 90 L 171,200,000 171,200,000 Non E Catalog

Spesifikasi: made in german

14 Sterilisator 2 unit -
Spesifikasi: 12 Liter
MDF INSTRUMEN USA,
15 Stetoskop Anak 6 buah INC Classic Cardiology MDF797 1,438,600 8,631,600 E Catalog
Stethoscope

MDF INSTRUMEN USA,

16 Stetoskop Bayi 3 buah INC Classic Cardiology MDF797 1,438,600 4,315,800 E Catalog
Stethoscope

Syringe pump
17 Spesifikasi: Compatible syringe (10,20,30,50 ml), occlusion 3 unit Argus 606S Argus 25,455,404 76,366,212 E Catalog
detection pressure, alarm setting, baterai
18 Tensimeter mobile stand 2 buah MDF INSTRUMEN USA, INC MDF830 2,282,850 4,565,700 E Catalog

19 Tensimeter/ Sphynomanometer 4 buah MDF INSTRUMEN USA, INC MDF800 852,150 3,408,600 E Catalog
Spesifikasi: Air Raksa, Type R

Timbangan BB + TB
Spesifikasi: Presisi yang tepat, sensitivitas yang tinggi, akurasi dan
trendi, Bisa di knockdown
20 ,ringan
dilipatdan 1 unit SECA 703 & 220 16,227,539 16,227,539 E Catalog
, Pijakan kaki tersebut dari bahan pelastik anti slip dan
meredam guncangan, rangka dari
plastik yang dicetak ,alumunium , besi dan cat epoxy powder
coating.

21 Trolley Emergency 3 unit AGS AN T0101 6,642,193 19,926,579 E Catalog

TOTAL
5.2.3.19.07 Belanja Modal Pengadaan AlatAlat Kebidanan dan Penyakit Kandungan

1 Incubator 1 unit Ertunc Oscan Baby Nest I-70 278,321,000 278,321,000 E Catalog
Spesifikasi:

2 Infant Pifce Resusitator + Peep 1 unit Fisher & Paykel Haealtacare RD900 34,980,000 34,980,000 E Catalog
Spesifikasi: Neopuf

USG 3 D
Spesifikasi : Automatic Tissu optimization, B modes, M modes,
Doppler, HD flow, Speckle reduction imaging, compound resolution SIEMENS ACUSON P300 w/ 2
3 imaging, focus frequency composite, high resolution,min 3 active 1 unit ACUSON P300 w/ 2 Probes 603,414,000 603,414,000 E Catalog
Probes
probe port, 5 usb ports, integrated HDD, integrated DVD/CD, gel
holder zoom, virtual convex, auto focus, real time automatic
doppler calculations, advanced 3 D. Made in Eropa, Japan, USA
4 Alat ukur panjang badan bayi 2 buah

Partus set
Spesifikasi: Bergmann Plaster Scissor 230 mm, Pean forceps STR
5 249 mm, umbilical cord scissors LATCVD 2 set Dimeda Various 14,783,000 29,566,000 E Catalog
160mm, Female catheter metal chard 18 160 mm, Beacham
Amniotome 250mm, Galss box w.
18/8lid 300x180x65

6 Pulse Oxymeter Neonatus 3 unit Bionet 5,995,000 17,985,000 E Catalog

TOTAL 964,266,000
5.2.3.19.18 Belanja Modal Pengadaan AlatAlat Ruang HCU/ICCU
F-000,22,102,F-
Laringoscope Dewasa 000.22.103,F000.22.104,F-
1 Spesifikasi : Blades,Handle : 1, 2, 3 and 4,Medium uses two 'C' sizes 3 set Heine - German 17,785,669 53,357,007 Non E Catalog
179.00.000,F-001.22.860,F-
batteries ,Penlight uses two 'AA' sizes batteries ,USA X001.188.035

Patient Monitor
2 Spesifikasi: SpO2, ECG, NIBP, HR, Suhu, Respirasi, EtCO2. Made in 2 unit UTAS UM-300 i 104,500,000 209,000,000 E Catalog
Eropa, Japan, USA
TOTAL
5.2.3.19.02 Belanja Modal Pengadaan AlatAlat Kedokteran Gigi

1 Hand Piece 3 unit NSK-Japan 2,500,000 7,500,000 Non E Catalog

Spesifikasi: 4 Hole, High Speed, Stainless Steel

light cure unit

2 Spesifikasi: Tegangan : +/93V 1 buah Dentamerica - Taiwan 3,300,000 3,300,000 Non E Catalog
260V
10 %
TOTAL
5.2.3.19.13 Belanja Modal Pengadaan AlatAlat Farmasi
1 Alat Pengisi Kapsul 1 unit
TOTAL
5.2.3.19.16 Belanja Modal Pengadaan AlatAlat Radiologi

1 Personal Dosimeter 1 buah

Spesifikasi: Sesuai standar Batan / Bapeten
TOTAL
5.2.3.19.17 Belanja Modal Pengadaan AlatAlat Kamar Operasi
1 Instrument Set, Dilatation and Curatage 2 set Rudolf Various 29,972,869 59,945,738 E Catalog
2 Instrument Set, Forceps Delivery 1 set ASANUS / GERMANY VARIOUS 27,382,300 27,382,300 Non E Catalog
3 Instrument Set, Gynaecological 1 set Rudolf Various 51,579,914 51,579,914 E Catalog
4 Instrument Set, Hysterectomy 1 set Rudolf Various 99,609,320 99,609,320 E Catalog
5 Instrument Set, Sectio Caesarian 1 set Rudolf Various 99,609,320 99,609,320 E Catalog
TOTAL
5.2.3.19.19 Belanja Modal Pengadaan AlatAlat Ruang Kamar Perawatan
1 EKG anak 1 unit BTL-UK BTL-08 SD3 15,800,000 15,800,000 E Catalog

INFANT WARMER MULTI SISTEM (compact)

Spesifikasi: menggunakan Mikroprocessor kontrol, manual dan
otomatis, kontrol dengan apgar timer,
terdapat alarm, tempat tidur yang bisa naik turun termasuk : laci
untuk fhoto ronsen,tempat tidur
2 dengan pelindung acrilik transparent, tempat tidur sistem 2 unit Cobams LR 88 121,547,585 243,095,170 E Catalog
Hydraulic, ukuran tempat tidur (mm)= +/565
X 810ukuran nampan : +/300
X 300 mm, Monitor kontrol penghangat otomatis Dengan
timbangan
unit kontrol microprocessed.

F-000,22.111 , F-000.22.101,F-
3 LARINGOSCOPE ANAK 2 unit Heine - German 000.22.102,F001.22.800,F- 16,943,657 33,887,314 Non E Catalog
Spesifikasi: FOO122800, F17900000, X00188035 179.00.000,X-001.88.035

4 TROMOL BESAR 6 buah Asanus-Germany Various 4,746,500 28,479,000 Non E Catalog

Spesifikasi: Stenless Steel Uk. 240X290MM

5 TROMOL KECIL 10 buah Asanus-Germany Various 1,405,800 14,058,000 Non E Catalog

Spesifikasi: Stenless Steel Uk.150X150 MM

6 TROMOL SEDANG 6 buah Asanus-Germany Various 1,854,600 14,058,000 Non E Catalog

Spesifikasi: Stenless Steel Uk.240X240 MM
Dressing
Trolley
Spesifikas
i: SS pipe,
polished,
castor
with
brake, 2
SS drawer
with 5 unit
alumuniu
m handle,
push SS
handle
pipe,
bottle
rack,
bowl SS,
rack
bucket SS

Dry
Sterilisato
r/ Lemari 2 buah
Alkes
Spesifikas
i: 2 Pintu
Less then
10 uA,
Safety :
Class 1
Type CF,
Sensitivy :
2,5 -5-10-
20mm/m
v, Digital
Filter :
Hum : -
30db,50/
60Hz Drift
:-3db, 0,5
Hz
Muscle
1 : -3
db,50/60
Hz ,
Musle 2 : 1 unit
-3dB, 25
Hz,
Display
Screen :
Toch-
Screen
3,8" LCD :
sdaeL
yalpsiD ,
stod
042x023
4,6,12
leads ch
simultane
ous,
Recording
System :
Thermal
Array 8

Emergenc
y kit
Spesifikas 1 set
i: Trauma
bag
complete

Emergenc
y Kit
Spesifikas 1 set
i:
Emergenc
y Kit
Infus
pump
Spesifikas
i: "keep
vein
open"
function,
tubing
clamp
function,
volume
delivered 3 unit
clear
function,
time
remaining
display,
battery
capacity
indicator,
start
reminder
function

Lampu
pemeriks 2 unit
aan

Steam
sterilisato
r/autocla
ve 1 unit
Spesifikas
i: made in
german

Sterilisato
r 2 unit
Spesifikas
i: 12 Liter

Stetoskop 6 buah
Anak
Stetoskop 3 buah
Syringe
pump
Spesifikas
i:
Compatib
le syringe
(10,20,30, 3 unit
50 ml),
occlusion
detection
pressure,
alarm
setting,
baterai

Tensimet
er mobile 2 buah
stand

Tensimet
er/
Sphynom
anometer 4 buah
Spesifikas
i: Air
Raksa,
Type R
Timbanga
n BB + TB
Spesifikas
i: Presisi
yang
tepat,
sensitivita
s yang
tinggi,
akurasi
dan
trendi,
Bisa di
knockdo
wn
,
dilipatdan
ringan ,
Pijakan
kaki 1 unit
tersebut
dari
bahan
pelastik
anti slip
dan
meredam
guncanga
n, rangka
dari
plastik
yang
dicetak
,alumuniu
m , besi
dan cat
epoxy
powder
coating.
Trolley
Emergenc 3 unit
y
### 6,180,000 ###

### 3,332,340 ###

### 8,250,000 ###

### 2,450,000 ###

### 2,914,200 ###

 ### 4,140,000 ###

5,258,250 1,051,650 ###

### ### ###

### 3,000,000 ###

1,955,000 1,173,000 ###

1,955,000 586,500 6,451,500

 ### 3,240,000 ###

4,550,000 910,000 ###

2,475,000 990,000 ###

9,147,600 914,760 ###

### ### ###