ANGGARAN GEDUNG BEDAH (Revisi 1 Desember 2009)

A. ICU (Kap : 20 tt)

No Nama Alat Merek No Katalog Supplier Jml HNA Disc Disc+PPn Jumlah PLUS 10% Keterangan
1 4 Motor Electric Bed Paramount PA- 54230 C PT. Merapi UP 14 27,762,500 0% 30,538,750 427,542,500 470,296,750
2 Urethane Mattres Paramount PE-5200 PT. Merapi UP 14 850,000 0% 935,000 13,090,000 14,399,000
3 Bed side kabinet Paramount PF-1100 PT. Merapi UP 14 2,487,500 0% 2,736,250 38,307,500 42,138,250
4 Over bed table Paramount KF 190 PT. Merapi UP 14 4,290,000 0% 4,719,000 66,066,000 72,672,600
5 IV Hanger Rod Paramount KC-56 PT. Merapi UP 21 575,000 0% 632,500 13,282,500 14,610,750
6 Bed Side rail Paramount PA-025 PT. Merapi UP 14 1,650,000 0% 1,815,000 25,410,000 27,951,000
7 Bedside Monitor Philips Intelivue MP 20 PT. Berca Surabaya 20 78,400,000 0% 86,240,000 1,724,800,000 1,897,280,000
8 Central Monitor Philips Intellivue Inf.Ctr. PT. Berca Surabaya 1 70,000,000 0% 77,000,000 77,000,000 84,700,000
9 Defibrilator Philips Heart Start XL PT. Berca Surabaya 1 - 0% - - -
10 Ventilator Maquet Servo i PT. Berca Surabaya 2 250,000,000 0% 275,000,000 550,000,000 605,000,000
11 Blanket Warmer Rusch Life Air 1000S Cat PT. Labora 1 31,695,500 10% 31,378,545 31,378,545 34,516,400
12 ECG 12 Lead Kenz 57.11.00
108 Penta Valent 1 39,096,750 10% 38,705,783 38,705,783 42,576,361
13 Infus Pump B.Braun Infusomat P PT. B.Braun 6 25,000,000 20% 22,000,000 132,000,000 145,200,000
14 Syringe Pump B.Braun Compact,S PT. B.Braun 7 20,000,000 20% 17,600,000 123,200,000 135,520,000
15 Blood Warmer Animec AM 2-13-5 CV. Medisa Jaya 1 10,625,000 20% 9,350,000 9,350,000 10,285,000
16 Kasur anti dikubitus Alphabed Endang Medica 2 8,000,000 20% 7,040,000 14,080,000 15,488,000
Jumlah 3,284,212,828 3,612,634,110

B. PICU/NICU (Kap: 11tt, Nicu: 7, Picu: 4) Ket: Tahap awal NICU 5 PICU 4
No Nama Alat Merek No Katalog Supplier Jml HNA Disc Disc+PPn Jumlah PLUS 10% Keterangan
1 Defibrilator Philips Heart Start XL PT. Berca Surabaya 1 77,000,000 0% 84,700,000 84,700,000 93,170,000
2 IV Stand For Bed MAK PT. ALNAN 4 247,500 0% 272,250 1,089,000 1,197,900
3 Inkubator Bayi Choongwae CHS I 1000 PT. Bhineka Usada R 5 104,000,000 25% 85,800,000 429,000,000 471,900,000
4 Bedside Monitor Philips Intellivue MP20 PT. Berca Surabaya 11 78,400,000 0% 86,240,000 948,640,000 1,043,504,000
5 Central Monitor Philips Intellivue Inf.Ctr. PT. Berca Surabaya 1 70,000,000 0% 77,000,000 77,000,000 84,700,000
6 Ventilator Maquet Servo i PT. Berca Surabaya 2 250,000,000 0% 275,000,000 550,000,000 605,000,000
7 Infus Pump B.Braun Infusomat P PT. B.Braun 9 25,000,000 20% 22,000,000 198,000,000 217,800,000
8 Syring Pump B.Braun Compact,S PT. B.Braun 5 20,000,000 20% 17,600,000 88,000,000 96,800,000
9 Blanket Warmer Rusch LifeAir 1000S Cat 57.11.00 PT. Labora 1 31,695,500 10% 31,378,545 31,378,545 34,516,400
10 Blood Warmer Animec AM 2-13-5 CV. Medisa Jaya 2 10,625,000 20% 9,350,000 18,700,000 20,570,000
11 ECG Kenz 108 Penta Valent 1 39,096,750 10% 38,705,783 38,705,783 42,576,361
12 Blue Light Yondon YD-P-222 Trident Endang Medica 1 22,500,000 20% 19,800,000 19,800,000 21,780,000
13 CPAP
Jumlah 2,485,013,328 2,733,514,660
C. VK (Kap 22tt. Iso:2, VIP: 5, Kls I-III: 8, Tindakan: 4, Observasi:3)
No Nama Alat Merek No Katalog Supplier Jml HNA Disc Disc+PPn Jumlah PLUS 10% Keterangan
1 Transfer Stretcher Paramount KK - 728 E PT. Merapi UP 1 34,830,000 0% 38,313,000 38,313,000 42,144,300
2 Bed Ginekologi MAK 34102 PT. ALNAN 9 13,266,000 35% 9,485,190 85,366,710 93,903,381
3 Bed Ginekologi ATMI 212000 ATMI 2 6,570,000 0% 7,227,000 14,454,000 15,899,400
4 Manual Op Table MAK 520 MP (525.01.M) PT. ALNAN 4 37,620,000 35% 26,898,300 107,593,200 118,352,520
5 Bed side kabinet MAK 31811 PT. ALNAN 12 3,366,000 35% 2,406,690 28,880,280 31,768,308
6 Over bed table MAK 31812 PT. ALNAN 6 2,079,000 35% 1,486,485 8,918,910 9,810,801
7 Vacuum Extractor MEDELA Basic-30 Portab Buana Alkes 1 57,279,375 0% 63,007,313 63,007,313 69,308,044
8 Infant Warmer TESENA TSN 89 IW PT.Enseval 1 34,000,000 25% 28,050,000 28,050,000 30,855,000
10 Inkubator TESENA TSN 87 PT.Enseval 5 29,500,000 25% 24,337,500 121,687,500 133,856,250
11 Blood Warmer Animec AM 2-13-5 CV Medisa Jaya 1 10,625,000 20% 9,350,000 9,350,000 10,285,000
12 Examination Lamp LEL-2231 Aneka Gas 19 5,850,000 0% 6,435,000 122,265,000 134,491,500
Jumlah 627,885,913 690,674,504

D. OK 3 Kmr (2 dari OK lama, 1 Order Baru)

No Nama Alat Merek No Katalog Supplier Jml HNA Disc Disc+PPn Jumlah PLUS 10% Keterangan
1 Mesin Anestesi Drager Fabius PLUS Dos Ni Roha 1 435,500,000 0% 479,050,000 479,050,000 526,955,000
2 Meja Operasi Mediland Smart P.2000 PT. Surgica Alkesindo 1 381,132,000 20% 335,396,160 335,396,160 368,935,776
3 Asesori Meja OP untuk Ortho Mediland P700 PT. Surgica Alkesindo 1 161,014,320 0% 177,115,752 177,115,752 194,827,327
4 Lampu Operasi Medilux ML - 600 PT. Surgica Alkesindo 1 99,450,000 20% 87,516,000 87,516,000 96,267,600
5 Electro Surgical/Cauter Martin Maxium M 220-240 Atra Widiya A 1 395,325,000 5% 413,114,625 413,114,625 454,426,088
6 C. Arm Mobile Villa Arcovis 3000S Compact PT.Citra Medika Lestari 1 - 30% - - - ###
7 Apron Rad Mart Black Belt Wrap PT Dipa Pharmalab 5 - 25% - - -
8 Torniquet elektric Mizuho MT-720 Intersans
Restu Buana 1 52,000,000 10% 51,480,000 51,480,000 56,628,000
9 Mesin Bor Neuro :
Control unit Microspeed uni Aesculap GD 670 PT. B.Braun 1 173,264,000 20% 152,472,320 152,472,320 167,719,552
Microspeed unimotor cable F/Foot Ctrl Aesculap GD 672 PT. B.Braun 1 41,823,000 20% 36,804,240 36,804,240 40,484,664
Microspeed uni Foot control two pedals Aesculap GD 671 PT. B.Braun 1 57,557,000 20% 50,650,160 50,650,160 55,715,176
Mains Cord 5M Long Aesculap TE 730 PT. B.Braun 1 425,000 20% 374,000 374,000 411,400
Eccos set F/Microspeed unimotors Aesculap GB 251R PT. B.Braun 1 26,347,000 20% 23,185,360 23,185,360 25,503,896
Sterilit Power Systems Oil Spray 300ml Aesculap GB 600 PT. B.Braun 2 1,672,000 20% 1,471,360 2,942,720 3,236,992
Microspeed unimotor micro 150 motor Aesculap GD 678 PT. B.Braun 1 47,798,000 20% 42,062,240 42,062,240 46,268,464
Micro-line Drill HDPC Aesculap GB 169 R PT. B.Braun 1 27,058,000 20% 23,811,040 23,811,040 26,192,144
Hudson Chuck Aesculap GB 106 R PT. B.Braun 1 7,974,000 20% 7,017,120 7,017,120 7,718,832
Cranial Perforator 12/15mm Hudson Shank Aesculap GB 304 R PT. B.Braun 1 31,410,000 20% 27,640,800 27,640,800 30,404,880
Micro-line Craniotome/Fixed duraguard Aesculap GB 268 R PT. B.Braun 1 35,562,000 20% 31,294,560 31,294,560 34,424,016
Craniotome Cutter Aesculap GC 303 R PT. B.Braun 5 1,247,000 20% 1,097,360 5,486,800 6,035,480
 11 Suction WSD Sharp Constant 200 Endang Medica 1 15,500,000 20% 13,640,000 13,640,000 15,004,000
12 Blanket Warmer Dws&anak Rusch LifeAir 1000S Cat 57.11.00 PT. Labora 1 31,695,500 10% 31,378,545 31,378,545 34,516,400
13 Infant Warmer TESENA TSN 89 IW PT. Enseval 1 34,000,000 25% 28,050,000 28,050,000 30,855,000
14 Blood Warmer Animec AM 2-13-5 CV. Medisa Jaya 1 10,625,000 20% 9,350,000 9,350,000 10,285,000
15 Scrub station Choongwae ChoongwaeMatic II PT. Bhineka Usada R 1 75,670,000 0% 83,237,000 83,237,000 91,560,700
16 Brush Dispenser Martin 54-150-20 Atra Widiya A 2 9,126,000 5% 9,536,670 19,073,340 20,980,674
17 Pendant Maquet Modutec PT. Berca Surabaya 3 95,454,545 0% 105,000,000 314,999,999 346,499,998
18 Transfer Stretcher Paramount KK - 728 E PT. Merapi UP 1 34,830,000 0% 38,313,000 38,313,000 42,144,300
Jumlah 2,485,455,781 2,734,001,359

E. RADIOLOGI
No Nama Alat Merek No Katalog Supplier Jml HNA Disc Disc+PPn Jumlah PLUS 10% Keterangan
1 Apron X-Ray-single Radmart-USA Weight Adjuster PT Dipa Pharma Lab 2 7,850,000 25% 6,476,250 12,952,500 14,247,750
2 X-Ray Viewer Dr.Tajima Triple CV Medika Tehnik 1 4,800,000 20% 4,224,000 4,224,000 4,646,400
3 Biaya pindah X-Ray& CT Scan Siemens PT. Siemens Indonesia 1 90,000,000 0% 99,000,000 99,000,000 108,900,000
4 Rak Apron X-Ray Protective Acc-Rock PT Dipa Pharma Lab 1 4,100,000 25% 3,382,500 3,382,500 3,720,750
119,559,000 131,514,900

F. CSSD
No Nama Alat Merek No Katalog Supplier Jml HNA Disc Disc+PPn Jumlah PLUS 10% Keterangan
1 Autoclave ( 80 lt) Choongwae CHS-AC 80 PT. Bhineka Usada R 1 137,000,000 25% 113,025,000 113,025,000 124,327,500
2 Instrumen set (Gabungan) Aesculap PT B Braun 1 132,717,273 20% 116,791,200 116,791,200 128,470,320
3 Instrumen set OK Aesculap PT B Braun 1 692,429,091 20% 609,337,600 609,337,600 670,271,360
Jumlah 839,153,800 923,069,180

G. Umum Gedung Bedah

No Nama Alat Merek No Katalog Supplier Jml HNA Disc Disc+PPn Jumlah PLUS 10% Keterangan
1 Meubelair - 798,800,000 878,680,000
2 Linen - 211,118,363 232,230,199
3 Rel kordyn + kordyn - 108,890,000 119,779,000
4 TV - 34,750,000 38,225,000
5 Bracket TV - 3,900,000 4,290,000
6 Kulkas - 6,400,000 7,040,000
7 Dispencer - 4,020,000 4,422,000
8 Peralatan makan - 10,031,900 11,035,090
9 Gantungan infus 27,000,000 29,700,000
10 Signage (Papan Petunjuk) 30,000,000 33,000,000
1,234,910,263 1,358,401,289
H. Workstation Untuk Gedung Baru (Minimal Kebutuhan 18 Unit)
No Nama Alat Merek No Katalog Supplier Jml HNA Disc Disc+PPn Jumlah PLUS 10% Keterangan
1 CPU Core 2 Duo E 7500 18 3,325,000 0% 59,850,000 65,835,000
2 LCD 19" LG 18 1,600,000 0% 28,800,000 31,680,000
3 UPS Power Tree 650 VA 18 545,000 0% 9,810,000 10,791,000
4 Printer LQ 300 + II 18 3,385,000 0% 60,930,000 67,023,000
5 Scanner Microtek Scan Maker 5800 5 850,000 0% 4,250,000 4,675,000
163,640,000 180,004,000

JUMLAH DI ATAS 11,239,830,911 12,363,814,002

ALAT RUMAH TANGGA 74,953,000 82,448,300
ALAT KEPERAWATAN 541,243,600 595,367,960
TOTAL ANGGARAN GEDUNG BEDAH 11,856,027,511 13,041,630,262