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REKAPITULASI RAB KASIH MULIA HOSPITAL

NO. LAMPIRAN KETERANGAN JUMLAH


1 LAMPIRAN B UGD & AMBULANCE 12,460,500,000
2 LAMPIRAN C OK & CSSD 57,418,860,000
3 LAMPIRAN D K. BERSALIN & NURSERY 5,772,240,000
4 LAMPIRAN E INTENSIVE CARE 46,329,300,000
5 LAMPIRAN F ENDOSCOPY 46,123,200,000
6 LAMPIRAN G HAEMODIALISASI 8,508,780,000
7 LAMPIRAN H POLIKLINIK RAWAT JALAN 22,843,800,000
8 LAMPIRAN I PERLENGKAPAN WARD 9,454,860,000
9 LAMPIRAN J LAB & RADIOLOGI 78,799,554,000
10 LAMPIRAN K OFFICE 3,261,240,000
11 LAMPIRAN L FARMASI 396,000,000
12 LAMPIRAN M REHAB MEDIK 514,080,000
13 LAMPIRAN N KICHEN 1,785,600,000
14 LAMPIRAN O LAUNDRY 982,800,000
15 LAMPIRAN P MORTUARY 27,000,000
16 LAMPIRAN Q ANASTESI 24,618,262,500
17 LAMPIRAN R FISIOTERAPI 9,233,581,500
18 LAMPIRAN S POLIKLINIK 3,318,250,000
331,847,908,000
Lampiran B Peralatan dan Perlengkapan medis (UGD dan Ambulance)

SubArea Deskripsi Harga Per Unit Jml Kebutuhan Total Biaya


ER - Ambulance Ambubag anak 8,100,000 5 40,500,000
ER - Ambulance Ambubag bayi 8,100,000 5 40,500,000
ER - Ambulance Ambubag dewasa 8,100,000 5 40,500,000
ER - Ambulance Flow Meter Oksigen 3,240,000 5 16,200,000
ER - Ambulance Laryngoscope - adult 9,900,000 5 49,500,000
ER - Ambulance Laryngoscope - children 9,900,000 5 49,500,000
ER - Ambulance Laryngoscope - infant 9,900,000 5 49,500,000
ER - Ambulance Mobil Ambulance 450,000,000 5 2,250,000,000
ER - Ambulance Mobile Suction pump 72,000,000 5 360,000,000
ER - Ambulance Others 36,000,000 5 180,000,000
ER - Ambulance Stetoskop dewasa 1,620,000 5 8,100,000
ER - Ambulance Tabung oksigen 1/2 m3 1,800,000 5 9,000,000
ER - Ambulance Tensimeter BIasa 1,800,000 5 9,000,000
ER - Emergency bed Chair - patient 900,000 15 13,500,000
ER - Emergency bed Flow Meter Oksigen 3,240,000 15 48,600,000
ER - Emergency bed Others 18,000,000 15 270,000,000
ER - Emergency bed Patient curtain 3,600,000 15 54,000,000
ER - Emergency bed Stretcher 67,320,000 15 1,009,800,000
ER - Emergency bed Tensimeter Dinding 2,520,000 15 37,800,000
ER - Emergency bed Tiang Infus Beroda SS 1,980,000 15 29,700,000
ER - Emergency Room Ambubag anak 7,200,000 10 72,000,000
ER - Emergency Room Ambubag bayi 7,200,000 10 72,000,000
ER - Emergency Room Ambubag dewasa 7,200,000 10 72,000,000
ER - Emergency Room Chair - doctor 1,800,000 10 18,000,000
ER - Emergency Room Chair - nurse 1,260,000 10 12,600,000
ER - Emergency Room Defibrillator 158,400,000 10 1,584,000,000
ER - Emergency Room Diagnostic Set - Basic 18,000,000 10 180,000,000
ER - Emergency Room ECG - 3 channel 27,000,000 10 270,000,000
ER - Emergency Room Emergency Trolley 45,000,000 10 450,000,000
ER - Emergency Room Examination lamp 9,900,000 10 99,000,000
ER - Emergency Room Gergaji Gips 11,880,000 10 118,800,000
ER - Emergency Room Gunting gips 45,000,000 10 450,000,000
ER - Emergency Room Infusion Pump 36,000,000 10 360,000,000
ER - Emergency Room Instrument Set - emergenc 18,000,000 10 180,000,000
ER - Emergency Room Laryngoscope - adult 9,900,000 10 99,000,000
ER - Emergency Room Laryngoscope - children 9,900,000 10 99,000,000
ER - Emergency Room Laryngoscope - infant 9,900,000 10 99,000,000
ER - Emergency Room Lemari alat steril 9,000,000 10 90,000,000
ER - Emergency Room Meja dokter 2,700,000 10 27,000,000
ER - Emergency Room Mobile Suction pump 72,000,000 10 720,000,000
ER - Emergency Room Monitor 81,000,000 10 810,000,000
ER - Emergency Room Others 18,000,000 10 180,000,000
ER - Emergency Room Otoscope 3,600,000 10 36,000,000
ER - Emergency Room Patslide - patient transfer 5,400,000 10 54,000,000
ER - Emergency Room Pulse Oxymetri 12,060,000 10 120,600,000
ER - Emergency Room Reflex Hammer 360,000 10 3,600,000
ER - Emergency Room Stetoskop anak 1,620,000 10 16,200,000
ER - Emergency Room Stetoskop bayi 1,620,000 10 16,200,000
ER - Emergency Room Stetoskop dewasa 1,620,000 10 16,200,000
ER - Emergency Room Syringe Pump 32,400,000 10 324,000,000
ER - Emergency Room Tabung oksigen 1/2 m3 1,800,000 10 18,000,000
ER - Emergency Room Tensimeter Beroda 5,400,000 10 54,000,000
ER - Emergency Room Termometer Telinga 1,440,000 10 14,400,000
ER - Emergency Room Timbangan Bayi 3,600,000 10 36,000,000
ER - Emergency Room Timbangan Dewasa 4,680,000 10 46,800,000
ER - Emergency Room Trolley Alat 13,680,000 10 136,800,000
ER - Emergency Room Trolley ECG 13,680,000 10 136,800,000
ER - Emergency Room Trolley instrumen 13,680,000 10 136,800,000
ER - Emergency Room Wheel Chair SS 3,960,000 10 39,600,000
ER - Emergency Room Window curtain 5,400,000 10 54,000,000
ER - Emergency Room X-ray Illuminator 5,040,000 10 50,400,000
ER - Ruang Tunggu Chair - waiting room 27,000,000 10 270,000,000
ER - Ruang Tunggu Others 18,000,000 10 180,000,000
ER - Ruang Tunggu TV 32"+ hanger 7,200,000 10 72,000,000
Total (Rp) 12,460,500,000
Lampiran C Peralatan dan perlengkapan OK dan CSSD

SubArea Deskripsi Harga Per Unit Jml Kebutuhan Total Biaya


OT - CSSD Autoclave 630,000,000 5 3,150,000,000
OT - CSSD Lemari alat steril di CSSD 18,000,000 5 90,000,000
OT - CSSD Meja CSSD 9,000,000 5 45,000,000
OT - CSSD Others 18,000,000 5 90,000,000
OT - Doctor's lounge Chair - doctor 1,800,000 5 9,000,000
OT - Doctor's lounge Meja dokter 2,700,000 5 13,500,000
OT - Doctor's lounge Others 18,000,000 5 90,000,000
OT - Doctor's lounge Sofa 9,000,000 5 45,000,000
OT - Doctor's lounge TV 32"+ hanger 7,200,000 5 36,000,000
OT - Theatre Ambubag anak 7,200,000 8 57,600,000
OT - Theatre Ambubag bayi 7,200,000 8 57,600,000
OT - Theatre Ambubag dewasa 7,200,000 8 57,600,000
OT - Theatre Anesthesi Cart 37,260,000 8 298,080,000
OT - Theatre Bed - ODS 31,500,000 8 252,000,000
OT - Theatre Blanket warmer 51,840,000 8 414,720,000
OT - Theatre Blood warmer 27,000,000 8 216,000,000
OT - Theatre Brush dispenser 9,000,000 8 72,000,000
OT - Theatre Cauter 243,000,000 8 1,944,000,000
OT - Theatre Chair - ODS 7,200,000 8 57,600,000
OT - Theatre Defibrillator 158,400,000 8 1,267,200,000
OT - Theatre Infant Warmer 63,000,000 8 504,000,000
OT - Theatre Infusion Pump 36,000,000 8 288,000,000
OT - Theatre Instrument Set - OT 1,440,000,000 8 11,520,000,000
OT - Theatre Laryngoscope - adult 9,900,000 8 79,200,000
OT - Theatre Laryngoscope - children 9,900,000 8 79,200,000
OT - Theatre Laryngoscope - infant 9,900,000 8 79,200,000
OT - Theatre Mesin Anestesi 1,406,600,000 15 21,099,000,000
OT - Theatre Mobile Suction pump 81,000,000 8 648,000,000
OT - Theatre Monitor 81,000,000 8 648,000,000
OT - Theatre Operating Light 450,000,000 8 3,600,000,000
OT - Theatre Operating table 615,600,000 8 4,924,800,000
OT - Theatre Others 36,000,000 8 288,000,000
OT - Theatre Patslide - patient transfer 3,240,000 8 25,920,000
OT - Theatre Pendant 48,600,000 8 388,800,000
OT - Theatre Stetoskop anak 1,620,000 8 12,960,000
OT - Theatre Stetoskop bayi 1,620,000 8 12,960,000
OT - Theatre Stetoskop dewasa 1,620,000 8 12,960,000
OT - Theatre Stretcher 67,320,000 8 538,560,000
OT - Theatre Suction pump untuk bayi 52,200,000 8 417,600,000
OT - Theatre Syringe Pump 32,400,000 8 259,200,000
OT - Theatre Tensimeter Beroda 5,400,000 8 43,200,000
OT - Theatre Tiang Infus Beroda SS 1,980,000 8 15,840,000
OT - Theatre Timbangan Bayi 3,600,000 8 28,800,000
OT - Theatre Transport Incubator 216,000,000 15 3,240,000,000
OT - Theatre Trolley instrument 13,680,000 8 109,440,000
OT - Theatre X-ray Illuminator 4,500,000 8 36,000,000
OT - Waiting Room Chair - waiting room 3,240,000 8 25,920,000
OT - Waiting Room Meja TV 3,600,000 8 28,800,000
OT - Waiting Room Others 18,000,000 8 144,000,000
OT - Waiting Room TV 32"+ hanger 7,200,000 8 57,600,000
Total (Rp) 57,418,860,000
Lampiran D Peralatan dan perlengkapan Kamar bersalin dan Nursery

SubArea Deskripsi Harga Per Unit Jml Kebutuhan Total Biaya


Ruang Bersalin Ambubag bayi 8,100,000 4 32,400,000
Ruang Bersalin Ambubag dewasa 8,100,000 4 32,400,000
Ruang Bersalin Bed - observation room 31,500,000 4 126,000,000
Ruang Bersalin Cardiotocography 121,500,000 4 486,000,000
Ruang Bersalin Cauter 243,000,000 4 972,000,000
Ruang Bersalin Chair - doctor 1,800,000 4 7,200,000
Ruang Bersalin Chair - patient 900,000 4 3,600,000
Ruang Bersalin Emergency Trolley 45,000,000 4 180,000,000
Ruang Bersalin Examination lamp 9,900,000 4 39,600,000
Ruang Bersalin Flow Meter Oksigen 3,240,000 4 12,960,000
Ruang Bersalin Infant Warmer 63,000,000 4 252,000,000
Ruang Bersalin Infusion Pump 36,000,000 4 144,000,000
Ruang Bersalin Instrument Set - delivery 45,000,000 4 180,000,000
Ruang Bersalin Laryngoscope - adult 9,900,000 4 39,600,000
Ruang Bersalin Laryngoscope - infant 9,900,000 4 39,600,000
Ruang Bersalin Maternity Bed 209,880,000 4 839,520,000
Ruang Bersalin Mobile Suction pump 72,000,000 4 288,000,000
Ruang Bersalin Patient curtain 3,600,000 4 14,400,000
Ruang Bersalin Phototeraphy 63,000,000 4 252,000,000
Ruang Bersalin Sofa 9,000,000 4 36,000,000
Ruang Bersalin Stetoskop bayi 1,620,000 4 6,480,000
Ruang Bersalin Stetoskop dewasa 1,620,000 4 6,480,000
Ruang Bersalin Stretcher 67,320,000 4 269,280,000
Ruang Bersalin Suction pump untuk bayi 36,000,000 4 144,000,000
Ruang Bersalin Syringe Pump 32,400,000 4 129,600,000
Ruang Bersalin Tabung oksigen 1/2 m3 1,800,000 4 7,200,000
Ruang Bersalin Tensimeter Beroda 5,400,000 4 21,600,000
Ruang Bersalin Tiang Infus Beroda SS 1,980,000 4 7,920,000
Ruang Bersalin Timbangan Bayi 3,600,000 4 14,400,000
Ruang Bersalin Timbangan Dewasa 4,680,000 4 18,720,000
Ruang Bersalin Transport Incubator 225,000,000 4 900,000,000
Ruang Bersalin Trolley instrument 7,920,000 4 31,680,000
Ruang Bersalin TV 21"+ hanger 4,500,000 4 18,000,000
Ruang Bersalin TV 32"+ hanger 7,200,000 4 28,800,000
Ruang Bersalin Window curtain 5,400,000 4 21,600,000
DR - Nursery Baby cot 4,500,000 4 18,000,000
DR - Nursery Fetal Doppler 15,300,000 4 61,200,000
DR - Nursery Others 9,000,000 10 90,000,000
Total (Rp) 5,772,240,000
Peralatan dan perlengkapan Intensive Care

SubArea Deskripsi Harga Per Unit Jml Kebutuhan Total Biaya


IPO - HCU Bed Bed - HCU 67,320,000 10 673,200,000
IPO - HCU Bed Chair - patient 900,000 10 9,000,000
IPO - HCU Bed Flow Meter Oksigen 3,240,000 10 32,400,000
IPO - HCU Bed Infusion Pump 36,000,000 10 360,000,000
IPO - HCU Bed Monitor 129,600,000 10 1,296,000,000
IPO - HCU Bed Patient curtain 3,600,000 10 36,000,000
IPO - HCU Bed Pulse Oxymetri 10,800,000 10 108,000,000
IPO - HCU Bed Syringe Pump 32,400,000 10 324,000,000
IPO - HCU Bed Tensimeter Beroda 5,400,000 10 54,000,000
IPO - HCU Bed Tiang Infus Beroda SS 1,980,000 10 19,800,000
IPO - HCU Bed Trolley instrument 13,680,000 10 136,800,000
IPO - HCU Bed Trolley status 4,500,000 10 45,000,000
IPO - HCU Room Ambubag anak 8,100,000 10 81,000,000
IPO - HCU Room Ambubag dewasa 8,100,000 10 81,000,000
IPO - HCU Room Chair - nurse 1,260,000 10 12,600,000
IPO - HCU Room Chair - waiting room 3,240,000 10 32,400,000
IPO - HCU Room Emergency Trolley 45,000,000 10 450,000,000
IPO - HCU Room Examination lamp 9,900,000 10 99,000,000
IPO - HCU Room Intubator 74,700,000 10 747,000,000
IPO - HCU Room Mobile Suction pump 72,000,000 10 720,000,000
IPO - HCU Room Others 18,000,000 10 180,000,000
IPO - HCU Room Patslide - patient transfer 5,400,000 10 54,000,000
IPO - HCU Room Stetoskop anak 1,620,000 10 16,200,000
IPO - HCU Room Stetoskop dewasa 1,620,000 10 16,200,000
IPO - HCU Room Ventilator 810,000,000 10 8,100,000,000
IPO - HCU Room Window curtain 5,400,000 10 54,000,000
IPO - HCU Room X-ray Illuminator 4,500,000 10 45,000,000
IPO - ICU Bed Bed - ICU/ICCU/PICU 67,320,000 5 336,600,000
IPO - ICU Bed Chair - patient 900,000 15 13,500,000
IPO - ICU Bed Chair - waiting room 3,240,000 15 48,600,000
IPO - ICU Bed Flow Meter Oksigen 3,240,000 15 48,600,000
IPO - ICU Bed Infusion Pump 36,000,000 15 540,000,000
IPO - ICU Bed Monitor 129,600,000 15 1,944,000,000
IPO - ICU Bed Others 9,000,000 15 135,000,000
IPO - ICU Bed Patient curtain 3,600,000 15 54,000,000
IPO - ICU Bed Pulse Oxymetri 12,600,000 15 189,000,000
IPO - ICU Bed Syringe Pump 32,400,000 15 486,000,000
IPO - ICU Bed Tensimeter Beroda 5,400,000 15 81,000,000
IPO - ICU Bed Tiang Infus Beroda SS 1,980,000 15 29,700,000
IPO - ICU Bed Trolley instrument 13,680,000 15 205,200,000
IPO - ICU Bed Trolley status 4,500,000 15 67,500,000
IPO - ICU Room Ambubag anak 8,100,000 5 40,500,000
IPO - ICU Room Ambubag dewasa 8,100,000 5 40,500,000
IPO - ICU Room Chair - nurse 1,260,000 2 2,520,000
IPO - ICU Room Complete Set CPAP 138,600,000 5 693,000,000
IPO - ICU Room Defibrillator 158,400,000 4 633,600,000
IPO - ICU Room Emergency Trolley 45,000,000 4 180,000,000
IPO - ICU Room Examination lamp 9,900,000 4 39,600,000
IPO - ICU Room Instrument Set - intensive care 18,000,000 4 72,000,000
IPO - ICU Room Intubator 74,700,000 4 298,800,000
IPO - ICU Room Laryngoscope - adult 9,900,000 4 39,600,000
IPO - ICU Room Laryngoscope - children 9,900,000 4 39,600,000
IPO - ICU Room Mobile Suction pump 72,000,000 4 288,000,000
IPO - ICU Room Others 18,000,000 4 72,000,000
IPO - ICU Room Patslide - patient transfer 5,400,000 4 21,600,000
IPO - ICU Room Stetoskop anak 1,620,000 4 6,480,000
IPO - ICU Room Stetoskop dewasa 1,620,000 4 6,480,000
IPO - ICU Room TV 32"+ hanger 7,200,000 4 28,800,000
IPO - ICU Room Ventilator 810,000,000 4 3,240,000,000
IPO - ICU Room Window curtain 5,400,000 4 21,600,000
IPO - ICU Room X-ray Illuminator 4,500,000 4 18,000,000
IPO - Isolation Bed Bed - class 1 53,460,000 4 213,840,000
IPO - Isolation Bed Bedside cabinet & overbed table - 7,020,000 4 28,080,000
IPO - Isolation Bed Chair - patient 900,000 4 3,600,000
IPO - Isolation Bed Dispenser - kamar pasien 720,000 4 2,880,000
IPO - Isolation Bed Sofa 9,000,000 4 36,000,000
IPO - Isolation Bed Tiang Infus Beroda SS 1,980,000 4 7,920,000
IPO - Isolation Bed TV 26"+ hanger 5,400,000 4 21,600,000
IPO - Isolation Bed Window curtain 5,400,000 4 21,600,000
IPO - NICU Bed Flow Meter Oksigen 3,240,000 5 16,200,000
IPO - NICU Bed Incubator untuk NICU 270,000,000 10 2,700,000,000
IPO - NICU Bed Infusion Pump 36,000,000 10 360,000,000
IPO - NICU Bed Monitor 129,600,000 10 1,296,000,000
IPO - NICU Bed Others 9,000,000 10 90,000,000
IPO - NICU Bed Phototeraphy 63,000,000 10 630,000,000
IPO - NICU Bed Syringe Pump 32,400,000 10 324,000,000
IPO - NICU Bed Termometer Telinga 1,440,000 10 14,400,000
IPO - NICU Bed Tiang Infus Beroda SS 1,980,000 10 19,800,000
IPO - NICU Bed Trolley instrument 7,920,000 10 79,200,000
IPO - NICU Bed Trolley status 4,500,000 10 45,000,000
IPO - NICU Bed Ventilator 810,000,000 20 16,200,000,000
IPO - NICU Room Ambubag bayi 8,100,000 10 81,000,000
IPO - NICU Room Chair - nurse 1,260,000 10 12,600,000
IPO - NICU Room Chair - waiting room 3,240,000 10 32,400,000
IPO - NICU Room Laryngoscope - infant 9,900,000 10 99,000,000
IPO - NICU Room Others 18,000,000 10 180,000,000
IPO - NICU Room Stetoskop bayi 1,620,000 10 16,200,000
IPO - NICU Room X-ray Illuminator 5,400,000 10 54,000,000
Total (Rp) 46,329,300,000
Lampiran F Peralatan dan perlengkapan Endoscopy

SubArea Deskripsi Harga Per Unit Jml Kebutuhan Total Biaya


Endoskopi Instrument Set - endoscopy 27,000,000 8 216,000,000
Endoskopi Meja Operasi 63,000,000 8 504,000,000
Endoskopi Peralatan Endoscopy 5,670,000,000 8 45,360,000,000
Endoskopi X-ray Illuminator 5,400,000 8 43,200,000
Total (Rp) 46,123,200,000
Lampiran G Peralatan dan perlengkapan Haemodialisa

SubArea Deskripsi Harga Per Unit Jml Kebutuhan


Hemodialisa Bed 53,460,000 12
Hemodialisa Bedside cabinet & overbed table 7,020,000 12
Hemodialisa Chair - patient 900,000 12
Hemodialisa Mesin hemodialisa 450,000,000 12
Hemodialisa Others 9,000,000 12
Hemodialisa Patient curtain 3,600,000 12
Hemodialisa Tensimeter BIasa 1,800,000 12
Hemodialisa TV 21"+ hanger 4,500,000 12
Hemodialisa Ambubag anak 13,680,000 5
Hemodialisa Ambubag dewasa 8,100,000 5
Hemodialisa Chair - nurse 1,260,000 5
Hemodialisa Counter NS 22,500,000 5
Hemodialisa Emergency Trolley 45,000,000 5
Hemodialisa Laryngoscope - adult 9,900,000 5
Hemodialisa Laryngoscope - children 9,900,000 5
Hemodialisa Mobile Suction pump 72,000,000 5
Hemodialisa Others 18,000,000 5
Hemodialisa Stainless steel set 18,000,000 5
Hemodialisa Stetoskop anak 1,620,000 5
Hemodialisa Stetoskop dewasa 1,620,000 5
Hemodialisa Syringe Pump 32,400,000 5
Hemodialisa Termometer Telinga 144,000 5
Hemodialisa Tiang Infus Beroda SS 1,980,000 5
Hemodialisa Trolley medication 13,500,000 5
Hemodialisa Trolley Set 13,680,000 5
Hemodialisa Water treatment untuk hemodialisa 135,000,000 5
Hemodialisa Window curtain 5,400,000 5
Hemodialisa X-ray Illuminator 5,400,000 5
Total (Rp)
dialisa

Total Biaya
641,520,000
84,240,000
10,800,000
5,400,000,000
108,000,000
43,200,000
21,600,000
54,000,000
68,400,000
40,500,000
6,300,000
112,500,000
225,000,000
49,500,000
49,500,000
360,000,000
90,000,000
90,000,000
8,100,000
8,100,000
162,000,000
720,000
9,900,000
67,500,000
68,400,000
675,000,000
27,000,000
27,000,000
8,508,780,000
Lampiran H Peralatan dan perlengkapan Poliklinik Rawat Jalan

SubArea Deskripsi Harga Per Unit Jml Kebutuhan


Ruang Konsultasi Chair - doctor 1,800,000 20
Ruang Konsultasi Chair - patient 900,000 20
Ruang Konsultasi Examination table (bed kons 13,500,000 20
Ruang Konsultasi LCD - queuing system 6,300,000 20
Ruang Konsultasi Lemari alat 3,240,000 20
Ruang Konsultasi Meja dokter 3,240,000 20
Ruang Konsultasi Others 9,000,000 20
Ruang Konsultasi Patient curtain 3,600,000 20
Ruang Konsultasi Timbangan Dewasa 4,680,000 20
Ruang Konsultasi Trolley instrument 7,920,000 20
Ruang Konsultasi Window curtain 5,400,000 20
Klinik - General 3D Color General & OBGYN 752,400,000 5
Klinik - General Audiometer 66,600,000 5
Klinik - General Baby Hearing Test 153,000,000 5
Klinik - General Copolscope 540,000,000 5
Klinik - General ECG - 12 channel 54,000,000 5
Klinik - General Others 18,000,000 5
Klinik - General Ruang Kedap Audiometer 31,500,000 5
Klinik - General Treadmill 486,000,000 5
Ruang Tunggu Chair - waiting room 3,240,000 5
Ruang Tunggu Others 18,000,000 5
Ruang Tunggu Play area 27,000,000 5
Ruang Tunggu TV 32"+ hanger 7,200,000 5
SP - Cardiology Diagnostic Set - Basic 18,000,000 5
SP - Cardiology Examination lamp 9,900,000 5
SP - Cardiology Instrument Cabinet 9,000,000 5
SP - Cardiology Others 18,000,000 5
SP - Cardiology Pocket Doppler 11,700,000 5
SP - Cardiology Stainless Steel Ware 9,000,000 5
SP - Cardiology Trolley instrument 7,920,000 5
SP - Cardiology X-ray Illuminator 5,040,000 5
SP - Dental Chair - round 1,260,000 5
SP - Dental Dentist chair unit 450,000,000 5
SP - Dental Dentist Instrument 270,000,000 5
SP - Dental Instrument Cabinet 9,000,000 5
SP - Dental Others 9,000,000 5
SP - Dental Portable Steam Sterilizer 18,000,000 5
SP - Dental Stainless Steel Ware 9,000,000 5
SP - Dental Trolley instrument 7,920,000 5
SP - ENT Drainage Pump 5,400,000 5
SP - ENT Ent Unit & Chair ( Basic ) 99,000,000 5
SP - ENT Garputala set 1,800,000 5
SP - ENT Head Lamp Suspenson 9,000,000 5
SP - ENT Instrument Set - ENT 18,000,000 5
SP - ENT Irrigation Unit With Thermal 9,000,000 5
SP - ENT Others 9,000,000 5
SP - ENT Otoscope 3,600,000 5
SP - ENT Sinuscope 18,000,000 5
SP - ENT Stainless Steel Ware 9,000,000 5
SP - ENT Trolley instrument 7,920,000 5
SP - ENT X-ray Illuminator 5,400,000 5
SP - Internal Medicine Diagnostic Set - Basic 18,000,000 5
SP - Internal Medicine Examination lamp 9,900,000 5
SP - Internal Medicine Instrument Cabinet 9,000,000 5
SP - Internal Medicine Others 9,000,000 5
SP - Internal Medicine Stainless Steel Ware 9,000,000 5
SP - Internal Medicine Trolley instrument 7,920,000 5
SP - Internal Medicine X-ray Illuminator 5,400,000 5
SP - Neurology Diagnostic Set - Basic 18,000,000 5
SP - Neurology Instrument Cabinet 9,000,000 5
SP - Neurology Others 18,000,000 5
SP - Neurology Reflex Hammer 360,000 5
SP - Neurology Stainless Steel Ware 9,000,000 5
SP - Neurology Trolley instrument 7,920,000 5
SP - Neurology X-ray Illuminator 5,040,000 5
SP - Obgyn Examination lamp 9,900,000 5
SP - Obgyn Gynaecolog Exam Table 90,000,000 5
SP - Obgyn Gynaecological Examination I 36,000,000 5
SP - Obgyn Instrument Cabinet 9,000,000 5
SP - Obgyn Instrument Set - Obgyn 27,000,000 5
SP - Obgyn Obstetric Diagnostic Kit 36,000,000 5
SP - Obgyn Others 9,000,000 5
SP - Obgyn Stainless Steel Ware 18,000,000 5
SP - Obgyn Stainless Steel Ware 9,000,000 5
SP - Obgyn Trolley instrument 7,920,000 5
SP - Obgyn X-ray Illuminator 5,400,000 5
SP - Ophtalmology Auto Chart Projector 34,200,000 5
SP - Ophtalmology Colour Blindness Test 2,520,000 5
SP - Ophtalmology Funduscope Direct 5,400,000 5
SP - Ophtalmology Instrument Cabinet 9,000,000 5
SP - Ophtalmology Opthalmic Unit 315,000,000 5
SP - Ophtalmology Others 9,000,000 5
SP - Ophtalmology Stainless Steel Ware 9,000,000 5
SP - Others Diagnostic Set - Basic 18,000,000 5
SP - Others Examination lamp 9,900,000 5
SP - Others Instrument Cabinet 9,000,000 5
SP - Others Others 9,000,000 5
SP - Others Stainless Steel Ware 9,000,000 5
SP - Others Trolley instrument 7,920,000 5
SP - Others X-ray Illuminator 5,400,000 5
SP - Pediatric Diagnostic Set - Basic 18,000,000 5
SP - Pediatric Examination lamp 9,900,000 5
SP - Pediatric Instrument Cabinet 9,000,000 5
SP - Pediatric Others 9,000,000 5
SP - Pediatric Pengukur kepala bayi 180,000 5
SP - Pediatric Pengukur panjang bayi 900,000 5
SP - Pediatric Pengukur panjang dewasa 720,000 5
SP - Pediatric Sphygmomanometer For Ped 5,400,000 5
SP - Pediatric Stainless Steel Ware 18,000,000 5
SP - Pediatric Stainless Steel Ware 9,000,000 5
SP - Pediatric Stesthoscope Pediatric 1,620,000 5
SP - Pediatric Timbangan bayi 4,680,000 5
SP - Pediatric Timbangan bayi 3,600,000 5
SP - Pediatric Trolley instrument 7,920,000 5
SP - Pediatric X-ray Illuminator 5,400,000 5
SP - Surgery Bandage Instrument Set 13,500,000 5
SP - Surgery Examination lamp 9,900,000 5
SP - Surgery Examination table (bed kons 13,500,000 5
SP - Surgery Instrument Cabinet 9,000,000 5
SP - Surgery Minor Surgery Instrument Se 90,000,000 5
SP - Surgery Others 9,000,000 5
SP - Surgery Stainless Steel Ware 9,000,000 5
SP - Surgery Trolley instrument 7,920,000 5
SP - Surgery X-ray Illuminator 5,400,000 5
Total (Rp)
k Rawat Jalan

Total Biaya
36,000,000
18,000,000
270,000,000
126,000,000
64,800,000
64,800,000
180,000,000
72,000,000
93,600,000
158,400,000
108,000,000
3,762,000,000
333,000,000
765,000,000
2,700,000,000
270,000,000
90,000,000
157,500,000
2,430,000,000
16,200,000
90,000,000
135,000,000
36,000,000
90,000,000
49,500,000
45,000,000
90,000,000
58,500,000
45,000,000
39,600,000
25,200,000
6,300,000
2,250,000,000
1,350,000,000
45,000,000
45,000,000
90,000,000
45,000,000
39,600,000
27,000,000
495,000,000
9,000,000
45,000,000
90,000,000
45,000,000
45,000,000
18,000,000
90,000,000
45,000,000
39,600,000
27,000,000
90,000,000
49,500,000
45,000,000
45,000,000
45,000,000
39,600,000
27,000,000
90,000,000
45,000,000
90,000,000
1,800,000
45,000,000
39,600,000
25,200,000
49,500,000
450,000,000
180,000,000
45,000,000
135,000,000
180,000,000
45,000,000
90,000,000
45,000,000
39,600,000
27,000,000
171,000,000
12,600,000
27,000,000
45,000,000
1,575,000,000
45,000,000
45,000,000
90,000,000
49,500,000
45,000,000
45,000,000
45,000,000
39,600,000
27,000,000
90,000,000
49,500,000
45,000,000
45,000,000
900,000
4,500,000
3,600,000
27,000,000
90,000,000
45,000,000
8,100,000
23,400,000
18,000,000
39,600,000
27,000,000
67,500,000
49,500,000
67,500,000
45,000,000
450,000,000
45,000,000
45,000,000
39,600,000
27,000,000
22,843,800,000
Lampiran I Peralatan dan perlengkapan Ward

SubArea Deskripsi Harga Per Unit Jml Kebutuhan


IP - Kelas 1 Bed - class 1 53,460,000 35
IP - Kelas 1 Bedside cabinet & overbed table - Class 1 7,020,000 35
IP - Kelas 1 Chair - patient 900,000 35
IP - Kelas 1 Dispenser - kamar pasien 720,000 35
IP - Kelas 1 Sofa 5,400,000 35
IP - Kelas 1 Tiang Infus Beroda SS 1,980,000 35
IP - Kelas 1 TV 26"+ hanger 5,400,000 35
IP - Kelas 1 Window curtain 5,400,000 35
IP - Kelas 2 Bed - class 2 31,500,000 16
IP - Kelas 2 Bedside cabinet & overbed table - Class 2 7,020,000 16
IP - Kelas 2 Chair - patient 900,000 16
IP - Kelas 2 Dispenser - kamar pasien 720,000 16
IP - Kelas 2 Patient curtain 3,600,000 16
IP - Kelas 2 Sofa 5,400,000 16
IP - Kelas 2 Tiang Infus Beroda SS 1,980,000 16
IP - Kelas 2 TV 21"+ hanger 4,500,000 16
IP - Kelas 2 Window curtain 5,400,000 16
IP - Kelas 3 Bed - class 3 31,500,000 9
IP - Kelas 3 Bedside cabinet & overbed table - Class 3 7,020,000 9
IP - Kelas 3 Chair - patient 900,000 9
IP - Kelas 3 Dispenser - kamar pasien 720,000 9
IP - Kelas 3 Patient curtain 3,600,000 9
IP - Kelas 3 Sofa 5,400,000 9
IP - Kelas 3 Tiang Infus Beroda SS 1,980,000 9
IP - Kelas 3 TV 21"+ hanger 4,500,000 9
IP - Kelas 3 Window curtain 5,400,000 9
IP - VIP Bed - VIP 67,320,000 22
IP - VIP Bedside cabinet & overbed table - VIP 9,000,000 22
IP - VIP Cupboards 5,400,000 22
IP - VIP Dispenser - kamar pasien 720,000 22
IP - VIP Phone 900,000 22
IP - VIP Refridgerator - VIP 3,600,000 22
IP - VIP Sofa 5,400,000 22
IP - VIP Tiang Infus Beroda SS 1,980,000 22
IP - VIP TV 32"+ hanger 7,200,000 22
IP - VIP Window curtain 5,400,000 22
IP - VVIP Bed - VVIP 67,320,000 2
IP - VVIP Bedside cabinet & overbed table - VVIP 12,600,000 2
IP - VVIP Cupboards 5,400,000 2
IP - VVIP Dinning set 9,000,000 2
IP - VVIP Dispenser - kamar pasien 720,000 2
IP - VVIP Entertainment equipment 36,000,000 2
IP - VVIP Phone 900,000 2
IP - VVIP Refridgerator - VVIP 5,400,000 2
IP - VVIP Sofa 8,100,000 2
IP - VVIP Tiang Infus Beroda SS 1,980,000 2
IP - VVIP TV 32"+ hanger 7,200,000 2
IP - VVIP Window curtain 5,400,000 2
IP - Wards Ambubag dewasa 8,100,000 6
IP - Wards Chair - nurse 1,260,000 6
IP - Wards Counter NS 22,500,000 6
IP - Wards Dressing trolley 13,500,000 6
IP - Wards ECG - 3 channel 27,000,000 6
IP - Wards Emergency Trolley 45,000,000 6
IP - Wards Glucometer 1,800,000 6
IP - Wards Infusion Pump 36,000,000 6
IP - Wards Laryngoscope - adult 9,900,000 6
IP - Wards Linen locker 12,600,000 6
IP - Wards Linen trolley 18,000,000 6
IP - Wards Medicine cabinet 12,600,000 6
IP - Wards Mobile brancard 45,000,000 6
IP - Wards Others 18,000,000 6
IP - Wards Pulse Oxymetri 27,000,000 6
IP - Wards Refridgerator - medicine 13,500,000 6
IP - Wards Stainless steel set 9,000,000 6
IP - Wards Stetoskop dewasa 1,620,000 6
IP - Wards Suction pump 9,000,000 6
IP - Wards Syringe Pump 32,400,000 6
IP - Wards Tensimeter BIasa 1,800,000 6
IP - Wards Termometer dewasa 1,440,000 6
IP - Wards Trolley - laundry 18,000,000 6
IP - Wards Trolley medication 13,500,000 6
IP - Wards Wheel Chair SS 3,960,000 6
IP - Wards X-ray Illuminator 5,400,000 6
Total (Rp)
Total Biaya
1,871,100,000
245,700,000
31,500,000
25,200,000
189,000,000
69,300,000
189,000,000
189,000,000
504,000,000
112,320,000
14,400,000
11,520,000
57,600,000
86,400,000
31,680,000
72,000,000
86,400,000
283,500,000
63,180,000
8,100,000
6,480,000
32,400,000
48,600,000
17,820,000
40,500,000
48,600,000
1,481,040,000
198,000,000
118,800,000
15,840,000
19,800,000
79,200,000
118,800,000
43,560,000
158,400,000
118,800,000
134,640,000
25,200,000
10,800,000
18,000,000
1,440,000
72,000,000
1,800,000
10,800,000
16,200,000
3,960,000
14,400,000
10,800,000
48,600,000
7,560,000
135,000,000
81,000,000
162,000,000
270,000,000
10,800,000
216,000,000
59,400,000
75,600,000
108,000,000
75,600,000
270,000,000
108,000,000
162,000,000
81,000,000
54,000,000
9,720,000
54,000,000
194,400,000
10,800,000
8,640,000
108,000,000
81,000,000
23,760,000
32,400,000
9,454,860,000
Lampiran J Peralatan dan perlengkapan Laboratorium & Radiologi

SubArea Deskripsi Harga Per Unit


Laboratorium One sufficient laboratory 1,800,000,000
Laboratorium Repaid Test 150,000,000
Laboratorium Alat Pengerjaan Darah 185,000,000
Laboratorium Hematology Analyzer 80,000,000
Laboratorium Urine Analyzer, Mikropipet, Alat Imunologi, Kulkas Medis, Mikroskop, R 580,000,000
Radiologi Apron 7,020,000
Radiologi Apron Hanger 1,260,000
Radiologi Apron Racks 30,600,000
Radiologi Automatic Processor 270,000,000
Radiologi Cassette (ukuran lengkap) 31,500,000
Radiologi Colposcopy 594,000,000
Radiologi Computerized Radiographyc (CR) 1,386,000,000
Radiologi CT Scan 64 Slice 14,483,700,000
Radiologi Emergency Trolley 45,000,000
Radiologi General X-ray dg fluroscopy 2,227,500,000
Radiologi Hystroscopy 720,000,000
Radiologi Mammography - MAMMOMAT 3000 Nova 1,758,735,000
Radiologi Mobile X-ray - 250 mA 682,803,000
Radiologi Others 18,000,000
Radiologi USG 4 D - GE P5 1,080,000,000
Radiologi X-ray Illuminator 5,400,000
Radiologi Probe Comvex Array 2-5MHZ Abdominal,Obstetrics,Gynecologi 130,000,000
Jml Kebutuhan Total Biaya
3 5,400,000,000
3 450,000,000
3 555,000,000
3 240,000,000
3 1,740,000,000
3 21,060,000
3 3,780,000
3 91,800,000
3 810,000,000
3 94,500,000
3 1,782,000,000
3 4,158,000,000
3 43,451,100,000
3 135,000,000
3 6,682,500,000
3 2,160,000,000
3 5,276,205,000
3 2,048,409,000
3 54,000,000
3 3,240,000,000
3 16,200,000
3 390,000,000
Total (Rp) 78,799,554,000
Lampiran K Peralatan dan perlengkapan Office

SubArea Deskripsi Harga Per Unit Jml Kebutuhan Total Biaya


Lainnya - Office Auditorium Sound System 225,000,000 1 225,000,000
Lainnya - Office Chair - auditorium 900,000 150 135,000,000
Lainnya - Office Computers 13,500,000 50 675,000,000
Lainnya - Office Dispenser - karyawan 720,000 80 57,600,000
Lainnya - Office Hospital information system 720,000,000 1 720,000,000
Lainnya - Office Mesin Absensi 9,000,000 2 18,000,000
Lainnya - Office Office Equipment (shredder, fax) 27,000,000 2 54,000,000
Lainnya - Office Office Furniture (meja & kursi) 3,600,000 50 180,000,000
Lainnya - Office Others 18,000,000 1 18,000,000
Lainnya - Office PABX 540,000,000 1 540,000,000
Lainnya - Office Perlengkapan Maintenance 27,000,000 2 54,000,000
Lainnya - Office Printers 5,400,000 20 108,000,000
Lainnya - Office Projector 9,000,000 2 18,000,000
Lainnya - Office Public Address System 36,000,000 1 36,000,000
Lainnya - Office Refridgerator - staf 4,140,000 16 66,240,000
Lainnya - Office Server and network 180,000,000 1 180,000,000
Lainnya - Office Training equipment 90,000,000 1 90,000,000
Lainnya - Office Wall clock 540,000 160 86,400,000
Total (Rp) 3,261,240,000
Lampiran L Peralatan dan perlengkapan Farmasi

SubArea Deskripsi Harga Per Unit Jml Kebutuhan Total Biaya


Farmasi Alat Pembuat Puyer 9,000,000 1 9,000,000
Farmasi Others 36,000,000 1 36,000,000
Farmasi Perlengkapan kerja 18,000,000 1 18,000,000
Farmasi Rak obat 135,000,000 2 270,000,000
Farmasi Refridgerator - medicine 13,500,000 3 40,500,000
Farmasi Timbangan Digital 22,500,000 1 22,500,000
Total (Rp) 396,000,000
Lampiran M Peralatan dan perlengkapan Rehab Medik

SubArea Deskripsi Harga Per Unit Jml Kebutuhan Total Biaya


Rehab Medic Bed 8,100,000 2 16,200,000
Rehab Medic Heating Unit 14,940,000 2 29,880,000
Rehab Medic Microwave 63,000,000 2 126,000,000
Rehab Medic Nebulizer 9,000,000 2 18,000,000
Rehab Medic Others 18,000,000 2 36,000,000
Rehab Medic Parallel bar 27,000,000 2 54,000,000
Rehab Medic Shortwave 117,000,000 2 234,000,000
Total (Rp) 514,080,000
Lampiran N Peralatan dan perlengkapan Kitchen

SubArea Deskripsi Harga Per Unit Jml Kebutuhan


Kitchen Chest Freezer 36,000,000 1
Kitchen Floor Scale 3,600,000 1
Kitchen Gas Stove Portable - 2 burners 3,600,000 1
Kitchen Gas Char Broiler 35,100,000 1
Kitchen Gas Deep Fryer 27,000,000 1
Kitchen Gas Fry Top Smooth Type 35,100,000 1
Kitchen Gas Kwalie Range High Pressure - 2 burners 30,600,000 1
Kitchen Gas Range w/ Oven - 4 Burners 90,000,000 1
Kitchen Gas Rice Cooker - 3 decks 81,000,000 1
Kitchen Gas Stock Pot Stove 9,900,000 1
Kitchen Gas Tilting Pan 108,000,000 1
Kitchen Insect Killer 3,600,000 1
Kitchen Insect Killer 3,600,000 1
Kitchen Others 720,000,000 1
Kitchen Rack - 4 Tiers 18,000,000 1
Kitchen S/S Adjustable Double Solid Wall Shelfs 6,300,000 1
Kitchen S/S Adjustable Double Solid Wall Shelfs 5,400,000 1
Kitchen S/S Adjustable Punched Pan Rack 8,100,000 1
Kitchen S/S Adjustable Punched Pan Rack 8,100,000 1
Kitchen S/S Adjustable Solid Wall Shelfs - 2 Tiers 3,600,000 1
Kitchen S/S Double Sink w/ Splash Back + Mix Faucet 14,400,000 1
Kitchen S/S Double Table Over Shelfs 4,500,000 1
Kitchen S/S Exhaust Hood Island Type 81,000,000 1
Kitchen S/S Exhaust Hood Wall Type 16,200,000 1
Kitchen S/S Food Service Trolley 4,500,000 1
Kitchen S/S Load Transfer Trolley 6,300,000 1
Kitchen S/S Open Counter Cabinet 12,600,000 1
Kitchen S/S Portable Grease Trap 4,500,000 1
Kitchen S/S Portable Grease Trap 4,500,000 1
Kitchen S/S Portable Grease Trap 6,300,000 1
Kitchen S/S Portable Grease Trap 6,300,000 1
Kitchen S/S Pot Sink w/ Splash Back + Mix Faucet 10,800,000 1
Kitchen S/S Pot Sink w/ Splash Back + Single Faucet 8,100,000 1
Kitchen S/S Pot Sink w/o Splash Back + Single Faucet 8,100,000 1
Kitchen S/S Single Sink Table w/ Splash Back + Single Faucet 9,000,000 1
Kitchen S/S Soiled Table with Scrap Hole 6,300,000 1
Kitchen S/S Spreader Table 3,600,000 1
Kitchen S/S Work Table w/ Splash Back 6,300,000 1
Kitchen S/S Work Table w/ Splash Back 4,500,000 1
Kitchen S/S Work Table w/o Splash Back 6,300,000 1
Kitchen S/S Work Table with Splash Back 5,400,000 1
Kitchen S/S Work Table with Splash Back 4,500,000 1
Kitchen Trolley - food distribution with heater 45,000,000 1
Kitchen Undercounter Chiller - 2 Solid Doors 54,000,000 1
Kitchen Upright Chiller - 2 Half Solid Doors 54,000,000 1
Kitchen Upright Chiller - 4 Half Solid Doors 81,000,000 1
Kitchen Upright Freezer - 4 Half Solid Doors 81,000,000 1
Total (Rp)
Total Biaya
36,000,000
3,600,000
3,600,000
35,100,000
27,000,000
35,100,000
30,600,000
90,000,000
81,000,000
9,900,000
108,000,000
3,600,000
3,600,000
720,000,000
18,000,000
6,300,000
5,400,000
8,100,000
8,100,000
3,600,000
14,400,000
4,500,000
81,000,000
16,200,000
4,500,000
6,300,000
12,600,000
4,500,000
4,500,000
6,300,000
6,300,000
10,800,000
8,100,000
8,100,000
9,000,000
6,300,000
3,600,000
6,300,000
4,500,000
6,300,000
5,400,000
4,500,000
45,000,000
54,000,000
54,000,000
81,000,000
81,000,000
1,785,600,000
Lampiran O Peralatan dan perlengkapan Laundry

SubArea Deskripsi Harga Per Unit Jml Kebutuhan


Laundry Bak Rendam 9,000,000 1
Laundry Coat Hanger 18,000,000 1
Laundry Coat Hanger 18,000,000 1
Laundry Dryer Machine 194,400,000 1
Laundry Ironer Machine 174,600,000 1
Laundry M/S House Keeping Trolley 23,400,000 1
Laundry Manual Ironer Table 9,000,000 1
Laundry Modular Shelving System 2001 5,400,000 1
Laundry Modular Shelving System 2001 5,400,000 1
Laundry Others 18,000,000 1
Laundry S/S Canvas Trolley 12,600,000 1
Laundry S/S Pot Sink w/ Splash Back + Mix Faucet 12,600,000 1
Laundry S/S Work Table w/ Splash Back 5,400,000 1
Laundry S/S Work Table w/o Splash Back 9,000,000 1
Laundry Sewing Machine 9,000,000 1
Laundry Washing Machine 441,000,000 1
Laundry Wire Mesh Trolley 18,000,000 1
Total (Rp)
Total Biaya
9,000,000
18,000,000
18,000,000
194,400,000
174,600,000
23,400,000
9,000,000
5,400,000
5,400,000
18,000,000
12,600,000
12,600,000
5,400,000
9,000,000
9,000,000
441,000,000
18,000,000
982,800,000
Lampiran P Peralatan dan perlengkapan Mortuary

SubArea Deskripsi Harga Per Unit Jml Kebutuhan


Other - Mortuary Mortuary Carriage Stainless Steel 18,000,000 1
Other - Mortuary Others 9,000,000 1
Total (Rp)
Total Biaya
18,000,000
9,000,000
27,000,000
Lampiran Q Peralatan dan perlengkapan Anastesi

SubArea Deskripsi
Anastesi Terapetik Pigeon Bubble
Bedah Umum & Plastik Deltronlx Electrosurgical Unit 400 Watt
Bedah Umum & Plastik Emaled Lampu Operasi Examination Lamp
Bedah Umum & Plastik Emaled Lampu Operasi Single Operating Light
Bedah Umum & Plastik Emaled Lampu Operasi Double Operating Light with camera & monitor
Bedah Umum & Plastik Meja operasi electrik operating table
Bedah Umum & Plastik Radiologi Operating table
Bedah Umum & Plastik Optional Orthopedic kit
Bedah Umum & Plastik Optional Oralodika Kit
Bedah Umum & Plastik Optional Opthalmonologi Kit
Bedah Umum & Plastik Sysmed Oxygen Concentrataor
Bedah Umum & Plastik Electrocauter Apro AKB 400
Bedah Umum & Plastik Infusion Pump
Bedah Umum & Plastik Syringe Pump
Bedah Umum & Plastik Digital Colposcopy
Hematologi dan Pathologi Nuova Blood and infusion Warmer
Kardiologi Cmosdrake Biphasic Defibrillator Monitor and Printer + AED
Kardiologi 3Ray Ecg 12Channel
Kardiologi DST Pasient Monitor
Obstetrik dan Ginekologi Zondan Fetal Doppler
Obstetrik dan Ginekologi Zondan Fetal Monitor
engkapan Anastesi

Harga Per Unit Jml Kebutuhan Total Biaya


92,040,000 5 460,200,000
230,100,000 5 1,150,500,000
63,960,000 5 319,800,000
345,852,000 5 1,729,260,000
1,499,160,000 5 7,495,800,000
461,760,000 5 2,308,800,000
970,320,000 5 4,851,600,000
82,680,000 5 413,400,000
34,320,000 5 171,600,000
21,840,000 5 109,200,000
32,760,000 5 163,800,000
159,308,500 5 796,542,500
39,000,000 5 195,000,000
42,120,000 5 210,600,000
438,698,000 5 2,193,490,000
37,440,000 5 187,200,000
168,480,000 5 842,400,000
31,200,000 5 156,000,000
136,500,000 5 682,500,000
4,914,000 5 24,570,000
31,200,000 5 156,000,000
24,618,262,500
Lampiran Q Peralatan Fisioterapi

SubArea Deskripsi
Ortopedi Osteo Pro DEXA For Osteoporosis
Ortopedi Bone Densitometer Osteo Pro Smart
Ortopedi Surgical Bone Drill Driller PWD 10
Ortopedi OSTEO Master+ 7" Touch Panel LCD
Fototerapi Lampu Fototerapi LED TSE Lilly
Fototerapi Alat Fototerapi Bilirubin Neonatus
Fisioterapi Laser Terapi Laser Terapi Fisioler
isioterapi

Harga Per Unit Jml Kebutuhan Total Biaya


723,125,000 5 3,615,625,000
175,500,000 5 877,500,000
193,172,200 5 965,861,000
363,964,900 5 1,819,824,500
146,554,200 5 732,771,000
104,000,000 5 520,000,000
140,400,000 5 702,000,000
9,233,581,500
Lampiran Q Peralatan Poliklinik

SubArea Deskripsi
Poli THT Audiometer Skrining
Poli THT Audiometer Diagnostik
Poli THT Otoskop Set
Poli THT Laringoskop Anak
Poli THT Laringoskop Bayi
Poli THT Unit THT Treatment Strudy And Topster
Poli THT Kursi THT Strudy And Topster
Poli THT Set THT dengan Handle Stainless Steel
Poliklinik

Harga Per Unit Jml Kebutuhan Total Biaya


66,300,000 5 331,500,000
84,500,000 5 422,500,000
1,950,000 5 9,750,000
3,250,000 5 16,250,000
3,250,000 5 16,250,000
373,100,000 5 1,865,500,000
124,800,000 5 624,000,000
6,500,000 5 32,500,000
3,318,250,000