PENGUMUMAN PEMENANG
PELELANGAN UMUM PASCAKUALIFIKASI PENGADAAN KEBUTUHAN AMHP KHUSUS
SMF ORTHOPAEDI TAHUN 2017(LELANG ULANG)
RSUP Dr. HASAN SADIKIN BANDUNG
Nomor : BN.01.02/PNBP-POKJA III/2583/IV/2017
Tanggal : 7 April 2017
Berdasarkan
Berita
Acara
Hasil
Pelelangan
nomor
:
BN.01.02/PNBP-POKJA
III/2547/IV/2017, tanggal 6 April 2017 serta surat Penetapan Pemenang Nomor :
BN.01.02/PNBP-POKJA III/2582/IV/2017, tanggal 7 April 2017, maka Kelompok Kerja III
ULP RSUP Dr. Hasan Sadikin Bandung, mengumumkan hasil pelaksanaan Pelelangan Umum
Pasca Kualifikasi Pengadaan Kebutuhan AMHP Khusus SMF Orthopaedi Tahun 2017 (Lelang
Ulang) RSUP Dr. Hasan Sadikin Bandung dengan secara elektronik melalui web site LPSE
Kemenkes dengan alamat situs internet :
http://lpse.kemenkes.go.id
dengan metode sistem
itemazed dengan hasil sebagai berikut :
Berdasarkan hasil evaluasi tersebut diatas, maka Kelompok Kerja III ULP RSUP Dr. Hasan
Sadikin Bandung sepakat :
1.
Nama Perusahaan
: PT.BINA ARTHA SEMESTA
Alamat Perusahaan
: Ruko Perumahan Green Area KAV.C, Jl. Gandul PLN
RT.025/005, Kel. Gandul, Kec. Cinere, Jawa Barat
NPWP
: 31.475.167.8-412.000
NO NAMA BMHP MERK JUMLAH HARGA
SATUAN JUMLAH Ket TINDAKAN ILIZAROF DAN EXTERNAL
FIXATION
1 Combination external fixator straight type
Health-Joy / China 9
2.880.000 25.920.000 Pemenang
Pin to rod coupling (4bh)
Connecting rod (1bh)
Standard screw 5x130 (4bh)
2 Combination external fixator T Type Health-Joy / China 9
3.660.000 32.940.000 Pemenang
Ringent rod to rod coupling (4bh)
T clamp (1bh)
Connecting rod (1bh)
Standard screw 5x130 (2bh)
Standard screw HB 5x150 (2bh)
3 Combination external fixator Z type (Enhancement mode)
Health-Joy / China 5
4.860.000 24.300.000 Pemenang
Rod to rod coupling (2bh)
Pin to rod coupling (4bh)
Connecting rod (1bh)
Standard screw 5x130 (4bh)
4 Limb reconstruction system A type Health-Joy / China 4
6.000.000 24.000.000 Pemenang
Matching bone screws : 6x150mm (6bh)
Matching instruments : 6mm hex
wrench,6mm screw driver
5 Spanning knee joint external fixator Health-Joy / China 4
6.000.000 24.000.000 Pemenang
Matching bone screws : 6x150mm (2bh)
Matching bone screws : 6x130mm (2bh)
Matching instruments : 6mm hex wrench
Matching instruments : 3mm hex wrench
Matching instruments : 6mm screw
driver
6 Ulna, radius, wrist external fixator (straight type)
Health-Joy / China 5
3.600.000 18.000.000 Pemenang
Matching bone screws : 2.5x60mm (2bh)
Matching bone screws : 3.5x80mm (2bh)
Matching instruments : 3.5mm screw
driver
Matching instruments : 4mm hex wrench
7 Dynamic axial external fixator (Straight type) Size M
Health-Joy / China 4
4.800.000 19.200.000 Pemenang
Matching bone screws : 6x130mm (4bh)
Matching instruments : 6mm hex wrench
Matching instruments : 6mm screw
driver
8 Dynamic axial external fixator (Straight type) Size XS
Health-Joy / China 2
4.800.000 9.600.000 Pemenang
Matching bone screws : 4x100mm (4bh)
Matching instruments : 4mm hex wrench
Matching instruments : 4mm screw
driver
9 Mini fixator (Finger & Palm) C type Health-Joy / China 2
2.100.000 4.200.000 Pemenang
Matching bone screws : 2x70mm (4bh)
Matching instruments : 3mm hex wrench
Matching instruments : 2mm screw
driver
10 Annular ring external fixator 140mm Health-Joy / China 4
Half rings (6bh) M6x300 threaded rod (3bh) M6x20 thread (6h) M6x20 nut (6bh) Pin clamp (16bh) K-Wire 1.8mm L.300 (8bh)
11 Annular ring external fixator 160mm Health-Joy / China 1 10.300.000 10.300.000 Pemenang Rings (4bh) M6x400 threaded rod (4bh) Adjusting nut (4bh) Pin clamp (16bh) 2/3 ring (1bh)
Post with 4 edges (4bh)
Bush (4bh)
Standar screw (4bh)
K-Wire 1.8mm L.300 (8bh)
Wire with olive 1.8mm L360 (2bh)
Hex Nut M6 (8bh)
M6X10 Thread (8bh)
12 Annular ring external fixator 180mm Health-Joy / China 1 10.300.000 10.300.000 Pemenang Rings (4bh) M6x400 threaded rod (4bh) Adjusting nut (4bh) Pin clamp (16bh) 2/3 ring (1bh)
Post with 4 edges (4bh)
Bush (4bh)
Standar screw (4bh)
K-Wire 1.8mm L.300 (8bh)
Wire with olive 1.8mm L360 (2bh)
Hex Nut M6 (8bh)
M6X10 Thread (8bh)
13 Annular ring external fixator 200mm Health-Joy / China 2 10.300.000 20.600.000 Pemenang Rings (4bh) M6x400 threaded rod (4bh) Adjusting nut (4bh) Pin clamp (16bh)
2/3 ring (1bh)
Post with 4 edges (4bh)
Bush (4bh)
Standar screw (4bh)
K-Wire 1.8mm L.300 (8bh)
Wire with olive 1.8mm L360 (2bh)
Hex Nut M6 (8bh)
M6X10 Thread (8bh)
14 Annular elbow joint fixator ring 160mm Health-Joy / China 1
12.700.000 12.700.000 Pemenang
Rings (6bh)
Annular diagonal tie (1bh)
Single joint (2bh)
M6x200 threaded rod (8bh)
Pin clamp (16bh)
2-hole connecting plate (1bh)
Post with 4 edges (4bh)
Bush (4bh)
Standar screw (4bh)
K-Wire 1.8mm L.300 (8bh)
Wire with olive 1.8mm L.360 (2bh)
Hex Nut MG (16bh)
MGx10 Thread (8bh)
15 Annular ankle joint fixator Health-Joy / China 2 10.320.000 20.640.000 Pemenang Rings (2bh) Foot ring (1bh) L connecting (2bh) Half rings (1bh)
Annular diagonal tie
Single joint (2bh)
M6x200 threaded rod (3bh)
Pin clamp (14bh)
K-Wire 1.8mm L.300 (7bh)
Post with 4 edges (2bh)
Bush (2bh)
Standar screw (2bh)
M6X10 Thread (4bh)
16 Pelvic external fixator C type Health-Joy / China 1
Matching bone screws : HB6x150mm
(4bh)
Matching instruments : 6mm hex wrench Matching instruments : 6mm screw
driver
17 Dynamic axial pertochanteric external fixator
Health-Joy / China 1
4.800.000 4.800.000 Pemenang
Matching bone screws : 6x150mm (2bh)
Matching bone screws : HB6x180mm
(2bh)
Matching instruments : 5mm hex wrench Matching instruments : 6mm screw
driver
18 Ankle joint type fixator Health-Joy / China 1
3.840.000 3.840.000
Pemenang
Matching bone screws : 6x130mm (4bh) Pemenang Matching instruments : 6mm hex wrench Matching instruments : 5mm screw
driver
19 Pin ro ring coupling Health-Joy /
China 50
90.000 4.500.000
Pemenang
20 Hex nut M6 Health-Joy /
China 350 30.000 10.500.000 Pemenang 21 K-wire 1.8mm L300mm Health-Joy / China 90 60.000 5.400.000 Pemenang
22 Wire with Olive 1.8mm L350mm Health-Joy /
China 40
290.000 11.600.000
Pemenang
23 Post with 4 edges 2 holes Health-Joy /
China 15
450.000 6.750.000
Pemenang
24 Post with 4 edges 3 holes Health-Joy /
China 15
450.000 6.750.000
Pemenang
25 Post with 4 edges 4 holes Health-Joy /
China 15 450.000 6.750.000 Pemenang 26 Bush Ø5mm Health-Joy / China 5 90.000 450.000 Pemenang 27 M6X10 Thread Health-Joy / China 155 30.000 4.650.000 Pemenang
28 Standard screw Ø5.0x200 Health-Joy /
China 51 150.000 7.650.000 Pemenang 29 2/3 ring 140mm Health-Joy / China 8 720.000 5.760.000 Pemenang 30 2/3 ring 160mm Health-Joy / China 8 720.000 5.760.000 Pemenang 31 2/3 ring 180mm Health-Joy / China 8 720.000 5.760.000 Pemenang 32 2/3 ring 200mm Health-Joy / China 8 720.000 5.760.000 Pemenang
TINDAKAN TRAUMA DCP TITANIUM
1 Ф3.5 cortex screw 12-50mm,Self-Taping,Titanium
Health-Joy /
China 8 120.000 960.000
Pemenang
2 Ф4.0 fully cancellous screw 14-50mm,Titanium Health-Joy / China 8 120.000 960.000 Pemenang 3 3.5 Clavicle S Reconstruction 7-10H Left/Right Health-Joy / China 3 1.500.000 4.500.000 Pemenang
4 Clavicle Hook Plate(II)4-5H L/R Health-Joy /
China 3 1.800.000 5.400.000
5 Proximal Humerus Plate4-6H Health-Joy /
China 3 1.920.000 5.760.000
Pemenang
6 Humerus LC-DCP 6-10H Health-Joy /
China 3 1.200.000 3.600.000
Pemenang
7 Humerus-Y Plate 5H L/R Health-Joy /
China 3 1.680.000 5.040.000
Pemenang
8 Olecranon Hook Plate (II) 5H L/R Health-Joy /
China 3 1.500.000 4.500.000
Pemenang
9 Ulnaradious LC-DCP 5-8H Health-Joy /
China 3 1.200.000 3.600.000
Pemenang
10 1/3 Tubular Plate 4-10H Health-Joy /
China 3 1.200.000 3.600.000
Pemenang
11 Oblique-T Radiius Plate 3-5H Health-Joy /
China 3 1.200.000 3.600.000
Pemenang
12 Radius T Plate(3 head-holes) 3-5H Health-Joy /
China 3 1.200.000 3.600.000
Pemenang
13 Reconstruction Plate 4-10H Health-Joy /
China 3 1.320.000 3.960.000
Pemenang
14 Pelvis Plate 6-10H Health-Joy /
China 3 1.680.000 5.040.000
Pemenang
15 Distal Medial Tibial Plate(III) 5-9H L/R Health-Joy /
China 3 2.100.000 6.300.000
Pemenang
16 Distal Fibula Plate(II)5H Health-Joy /
China 3 1.800.000 5.400.000
Pemenang
17 Ф4.5 cortex screw 20-50mm,Self-Taping,Titanium
Health-Joy /
China 10 120.000 1.200.000
Pemenang
18 Ф6.5 partly cancellous screw 55-90mm,Titanium
Health-Joy /
China 10 120.000 1.200.000
Pemenang
19 Ф6.5 fully cancellous screw 40-90mm,Titanium
Health-Joy /
China 10 150.000 1.500.000
Pemenang
20 Proximal Femoral Plate 5-9H Health-Joy /
China 3 2.400.000 7.200.000
Pemenang
21 Femoral LC-DCP 8-16H Health-Joy /
China 3 1.800.000 5.400.000
Pemenang
22 Distal Femoral dissection Plate5-9H L/R Health-Joy /
China 3 2.400.000 7.200.000
Pemenang
23 ￠4.5 /￠6.5 Proximal Medial T Tibial 4-8H
Health-Joy /
China 3 1.680.000 5.040.000
Pemenang
24 Proximal Tibial Plate 4-10H L/R Health-Joy /
China 3 2.280.000 6.840.000 Pemenang 25 Tibial LC-DCP 6-14H Health-Joy / China 3 1.500.000 4.500.000 Pemenang Jumlah 491.680.000 Ppn 10% 49.168.000 Total 540.848.000
2.
Nama Perusahaan
:
PT.
BINA MAKMUR ABADI
Alamat Perusahaan
:
Jl. Raya Pasar Jumat No. 41 E Pondok Pinang Kebayoran
Lama
Jakarta
NPWP
:
02.623.297.5-013.000
NO NAMA BMHP MERK / NEGARA ASAL JUMLAH HARGASATUAN JUMLAH
Ket
1
Maxican Cannulated titanium screw partial Thread 4,5mm L 26-60 mm
Agomed/Germany 1 2.416.173 2.416.173 Pemenang
2
Maxican Cannulated titanium screw full Thread 4,5mm L 26-60 mm
3 Titanium Locking Screw 2.7 mm L
8-30 mm Agomed/Germany 1 916.651 916.651 Pemenang
4 Titanium Standard Screw 2.7mm
L 8-30mm Agomed/Germany 3 773.424 2.320.272 Pemenang
5
Forefoot System 2.7-Scarf Micro Screw Canulated TX-Lock TX6, L10-28mm
Agomed/Germany 2 2.422.400 4.844.800 Pemenang
6
Forefoot System 2.7-Scarf Std Compress.Screw, Cann TX-Lock TX 8, L10-30mm
Agomed/Germany 2 2.422.400 4.844.800 Pemenang
7
Forefoot System 2.7-Scarf High Compress.Screw, Cann TX-Lock TX 8, L10-30mm
Agomed/Germany 2 2.422.400 4.844.800 Pemenang
8 Forefoot System 2.7-Tit Universal
Plate 1.4 mm, 10-30mm Agomed/Germany 2 5.803.797 11.607.594 Pemenang
9
Forefoot System 2.7-Tit MP Joint Fusion plate 1.2 mm, 5-6H,28-45mm
Agomed/Germany 2 3.842.213 7.684.426 Pemenang
10 Forefoot System 2.7-Reconstruksi
Plate 6 H 35-40mm Conical Agomed/Germany 2 3.842.213 7.684.426 Pemenang
11 Forefoot System 2.7-Standard
screw 2.7 mm TX Lock, L8-30mm Agomed/Germany 3 773.424 2.320.272 Pemenang
12 Rearfoot System 3.5-Calcaneus
plate S/M/L/XS Agomed/Germany 2 5.803.797 11.607.594 Pemenang
13 Rearfoot System 3.5-Locking
Screw 3.5mm,L12-20mm Agomed/Germany 1 845.661 845.661 Pemenang
14 Rearfoot System 3.5-Locking
Screw 3.5mm,L22mm Agomed/Germany 1 871.815 871.815 Pemenang
15 Rearfoot System 3.5-Locking
Screw 3.5mm,L24mm Agomed/Germany 1 900.460 900.460 Pemenang
16 Rearfoot System 3.5-Locking
Screw 3.5mm,L26mm Agomed/Germany 1 916.651 916.651 Pemenang
17 Rearfoot System 3.5-Locking
Screw 3.5mm,L28mm Agomed/Germany 1 931.597 931.597 Pemenang
18 Rearfoot System 3.5-Standard
Screw 3.5 mm,L22mm Agomed/Germany 1 747.270 747.270 Pemenang
19 Rearfoot System 3.5-Standard
Screw 3.5 mm,L24mm Agomed/Germany 1 765.952 765.952 Pemenang
20 Rearfoot System 3.5-Standard
Screw 3.5 mm,L26mm Agomed/Germany 1 778.406 778.406 Pemenang
21 Rearfoot System 3.5-Standard
Screw 3.5 mm,L28mm Agomed/Germany 1 793.352 793.352 Pemenang
22 Rearfoot System 3.5-Standard
Screw 3.5 mm,L30-35mm Agomed/Germany 1 821.997 821.997 Pemenang
23 Rearfoot System 3.5-Standard
Screw 3.5 mm,L40-50mm Agomed/Germany 1 838.188 838.188 Pemenang
24
Rearfoot System 3.5-Cann Screw Partially or Full Threaded Hex-Lock 3.5 mm,L25-60mm
25 Rearfoot System 3.5-Titan.Washer
for Screw 3.5mm Pack of 5 Pcs Agomed/Germany 2 934.088 1.868.176 Pemenang
26
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-2H,Short/Long Stem
Agomed/Germany 3 834.452 2.503.356 Pemenang
27
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-4H,w/o or 6-110mm Stem
Agomed/Germany 2 996.360 1.992.720 Pemenang
28
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-6H,w/o Stem
Agomed/Germany 2 1.114.678 2.229.356 Pemenang
29
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-6H,w/ Stem
Agomed/Germany 2 1.232.996 2.465.992 Pemenang
30
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-8H,w/o Stem
Agomed/Germany 2 1.438.495 2.876.990 Pemenang
31
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-12H,w/o Stem
Agomed/Germany 2 1.556.813 3.113.626 Pemenang
32
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-16H,w/o Stem
Agomed/Germany 2 2.148.401 4.296.802 Pemenang
33
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-18H,w/o Stem
Agomed/Germany 2 2.771.126 5.542.252 Pemenang
34
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-24-30H,w/o Stem
Agomed/Germany 2 3.294.215 6.588.430 Pemenang
35
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-L Plate 4H,Right/Left,w/o Stem
Agomed/Germany 2 1.606.631 3.213.262 Pemenang
36
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-L Plate 4H,Right/Left,6mm Stem
Agomed/Germany 2 1.606.631 3.213.262 Pemenang
37
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-L Plate 4H,Right/Left,8mm Stem
Agomed/Germany 2 1.637.767 3.275.534 Pemenang
38
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-L Plate 4H,Right/Left,10mm Stem
Agomed/Germany 2 1.687.585 3.375.170 Pemenang
39
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-L Plate 5H,Right/Left,12mm Stem
Agomed/Germany 2 1.756.085 3.512.170 Pemenang
40
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-T Plate 4H,Right/Left,8mm Stem
Agomed/Germany 2 1.837.039 3.674.078 Pemenang
41
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-T Plate 4H,Right/Left,12mm Stem
42
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-T Plate 6H,w/o Stem
Agomed/Germany 2 1.980.266 3.960.532 Pemenang
43
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-T Plate 5H,10mm Stem
Agomed/Germany 2 1.980.266 3.960.532 Pemenang
44
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-Double T Plate 6H,w/o Stem
Agomed/Germany 2 2.030.084 4.060.168 Pemenang
45
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-Y Plate 5H,w/o & 8mm Stem
Agomed/Germany 2 1.980.266 3.960.532 Pemenang
46
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-Y Plate 5H,12 mm Stem
Agomed/Germany 2 2.030.084 4.060.168 Pemenang
47
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-Double Y Plate 6H,w/o Stem
Agomed/Germany 2 2.092.356 4.184.712 Pemenang
48
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-Double Y Plate 6H,8mm Stem
Agomed/Germany 2 2.179.538 4.359.076 Pemenang
49
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-Double Y Plate 7H,w/o Stem
Agomed/Germany 2 2.335.219 4.670.438 Pemenang
50
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-Orbital Plate 4H,cvd,6mm Stem
Agomed/Germany 2 1.388.677 2.777.354 Pemenang
51
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-Orbital Plate 6H,cvd,8mm Stem
Agomed/Germany 2 1.974.038 3.948.076 Pemenang
52
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-Orbital Plate 8H,cvd,w/o Stem
Agomed/Germany 2 1.974.038 3.948.076 Pemenang
53
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-Orbital Plate 10H,cvd,w/o Stem
Agomed/Germany 2 2.098.583 4.197.166 Pemenang
54
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-Burr Hole Plate
7-14mm,Small/Medium/Big
Agomed/Germany 2 2.708.854 5.417.708 Pemenang
55
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-2x2H,Square/Rectangular
Agomed/Germany 2 1.780.994 3.561.988 Pemenang
56
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-3x2H,Square/Rectangular
Agomed/Germany 2 2.609.218 5.218.436 Pemenang
57
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-4x2H,Square/Rectangular
58
Osteosynthesis Mid System 1.7-Titan Plate Height 1.0 mm-6x2H,Square/Rectangular
Agomed/Germany 3 7.559.882 22.679.646 Pemenang
59 Titanium Screws - Cross Lock
1.7x3-4mm Agomed/Germany 3 325.062 975.186 Pemenang
60 Titanium Screws - Cross Lock
1.7x5-6mm Agomed/Germany 3 340.008 1.020.024 Pemenang
61 Titanium Screws - Cross Lock
1.7x7-8mm Agomed/Germany 3 371.144 1.113.432 Pemenang
62 Titanium Screws - Cross Lock
1.7x9mm Agomed/Germany 3 374.880 1.124.640 Pemenang
63 Titanium Screws - Cross Lock
1.7x11-15mm Agomed/Germany 3 404.771 1.214.313 Pemenang
64
Osteosynthesis Mini System 2.0-Titanium Plate Height 1.0 mm-Double Y Plate 7H-w/o Stem
Agomed/Germany 2 2.279.174 4.558.348 Pemenang
65 Emergency Screw 2.3 x 7-9 mm Agomed/Germany 2 307.626 615.252 Pemenang
66
Plate Fixation System 3.5-Malleolar Plate 1.8x72-80mm,5-6 holes
Agomed/Germany 2 5.996.842 11.993.684 Pemenang
67 Plate Fixation System
3.5-Malleolar Plate 1.8x95mm,8 holes Agomed/Germany 2 6.382.931 12.765.862 Pemenang
68
Plate Fixation System 3.5-Malleolar Plate 1.8x110mm,10 holes
Agomed/Germany 2 6.382.931 12.765.862 Pemenang
69 Plate Fixation System 3.5-Locking
Screw, HEX-Lock 3.5x8-20mm Agomed/Germany 2 845.661 1.691.322 Pemenang
70
Plate Fixation System
3.5-Standard Screw, HEX-Lock 3.5x8-20mm
Agomed/Germany 2 719.870 1.439.740 Pemenang
71
Plate Fixation System 3.5-Minican 3.5 screw, partial thread, HEX-Lock (pack/1),8-24mm
Agomed/Germany 2 2.416.173 4.832.346 Pemenang
72 Tarsalis System 2.7-Titan Plate
4-5H,Straight Agomed/Germany 2 3.481.033 6.962.066 Pemenang
73 Tarsalis System 2.7-Titan Plate
5H,T Shaped Agomed/Germany 2 3.481.033 6.962.066 Pemenang
74 Tarsalis System 2.7-Titan Screw,
Threated Head, TX 8, 8-30mm Agomed/Germany 2 4.583.256 9.166.512 Pemenang
75 Tarsalis System 2.7-Titan Screw,
Standard, TX 8, 8-30mm Agomed/Germany 2 3.867.122 7.734.244 Pemenang
76 CBS High Compression Screw,
Cannulated TX8, 10-36mm Agomed/Germany 2 2.422.400 4.844.800 Pemenang
77
Herberth Screw-Scarf Micro Screw Canulated TX-Lock , TX6, 10-28mm
Agomed/Germany 2 2.422.400 4.844.800 Pemenang
78
Herberth Screw-Scarf Std Compress.Screw, Cann TX-Lock TX 8,10-30mm
79
Neumann Wrist Arthrodesis system-Titan Screw Treaded Head 2.7x8-30mm,TX8
Agomed/Germany 2 916.651 1.833.302 Pemenang
80 Micro System 1.2- Titanium Plate
0.55 mm, Plate 4 H, Straight Agomed/Germany 2 1.052.405 2.104.810 Pemenang
81 Micro System 1.2- Titanium Plate
0.55 mm, Plate 6 H, Straight Agomed/Germany 2 1.145.814 2.291.628 Pemenang
82 Micro System 1.2- Titanium Plate
0.55 mm, Plate 8 H, Straight Agomed/Germany 2 1.239.223 2.478.446 Pemenang
83 Micro System 1.2- Titanium Plate
0.55 mm, Plate 12 H, Straight Agomed/Germany 2 1.974.038 3.948.076 Pemenang
84 Micro System 1.2- Titanium Plate
0.55 mm, Plate 16 H, Straight Agomed/Germany 2 2.422.400 4.844.800 Pemenang
85 Micro System 1.2- Titanium Plate
0.55 mm, Plate 24 H, Straight Agomed/Germany 2 3.331.579 6.663.158 Pemenang
86 Micro System 1.2- L Plate, 5 H,
Right/Left Agomed/Germany 2 1.643.994 3.287.988 Pemenang
87 Micro System 1.2- L Plate, 8 H,
Right/Left Agomed/Germany 2 1.861.948 3.723.896 Pemenang
88 Micro System 1.2- T Plate, 5 H,
90° Agomed/Germany 2 1.774.766 3.549.532 Pemenang
89 Micro System 1.2- T Plate, 7 H,
90° Agomed/Germany 2 1.992.720 3.985.440 Pemenang
90 Micro System 1.2- H Plate, 9 H Agomed/Germany 2 2.447.309 4.894.618 Pemenang
91 Micro System 1.2- Y Plate, 6 H Agomed/Germany 2 1.974.308 3.948.616 Pemenang
92 Micro System 1.2-Double Y Plate,
6 H Agomed/Germany 2 2.304.083 4.608.166 Pemenang
93 Micro System 1.2-Double Y Plate,
7 H Agomed/Germany 2 2.422.400 4.844.800 Pemenang
94 Micro System 1.2-Orbital Plate, 8
H Agomed/Germany 2 1.743.630 3.487.260 Pemenang
95 Micro System 1.2-2 x 2 H Plate,
Square/Rectangular Agomed/Germany 2 1.780.994 3.561.988 Pemenang
96 Micro System 1.2-3 x 2 H Plate,
Square/Rectangular Agomed/Germany 2 2.609.218 5.218.436 Pemenang
97 Micro System 1.2-4 x 2 H Plate,
Square/Rectangular Agomed/Germany 2 3.431.215 6.862.430 Pemenang
98 Micro System 1.2-6 x 4 H Plate,
Square/Rectangular Agomed/Germany 2 7.559.882 15.119.764 Pemenang
99 Titanium Screws - Cross
Lock-1.2x3-6mm Agomed/Germany 2 601.552 1.203.104 Pemenang
100 Titanium Screws - Cross
Lock-1.2x7-10mm Agomed/Germany 3 638.916 1.916.748 Pemenang
101 Titanium Screws - Cross
Lock-1.2x11-13mm Agomed/Germany 3 676.279 2.028.837 Pemenang
127
Minican Cannulated Tit Screw partial Thread 2.7mm L 20-60mm
128
Minican cannulated titanium screw partial or full thread 3,5mm L 25-60mm
Agomed/Germany 1 2.416.173 2.416.173 Pemenang
129 Forefoot System 2.7-Tit
Open-Wedge Plate 1.1 mm, 0-8mm Agomed/Germany 1 5.156.163 5.156.163 Pemenang
130 Radius Plate, Small or Large,
Palmar, Right/Left Agomed/Germany 3 4.502.302 13.506.906 Pemenang
131
Osteosynthesis Mini System 2.0-Titanium Plate Height 1.0 mm-Plate 16H-w/o Stem
Agomed/Germany 1 1.531.904 1.531.904 Pemenang
132 Forefoot System 2.7-Locking
screw 2.7 mm TX Lock, L8-30mm Agomed/Germany 15 916.651 13.749.765 Pemenang
Jumlah 464.585.780
Ppn 10% 46.458.578
Total 511.044.358
3.
Nama Perusahaan
: PT. BINTANG BIOCARE INDONESIA
Alamat Perusahaan
: Graha Malaka Lt 1 Jl Malaka Merah III Blok D /17 PD
Kopi Jakarta Timur
NPWP
: 03.313.000.6-008.000
NO NAMA BMHP
MERK / NEGARA
ASAL JUMLAH SATUAN HARGA JUMLAH Ket TINDAKAN TRAUMA DCP STAINLESS
1 DCP 4.5, broad, 6-9 Holes, Stainless
Steel Baide / China 23
990.000 22.770.000
Pemenang
2 DCP 4.5, broad, 10-18 Holes, Stainless
Steel Baide / China 8
1.125.000 9.000.000
Pemenang
3 DCP 4.5, narrow, 4-9 Holes, Stainless
Steel Baide / China 21
900.000 18.900.000
Pemenang
4 DCP 4.5, narrow, 10-16 Holes,
Stainless Steel Baide / China 4
1.049.940 4.199.760
Pemenang
5 Semi tubular Plate, 3-7 Holes,
Stainless Steel Baide / China 4
675.000 2.700.000
Pemenang
6 Semi Tubular Plate,8-10 Holes,
Stainless Steel Baide / China 4
712.530 2.850.120
Pemenang
7 T-Plate 4,5, shaft 3-8 Holes, Stainless
Steel Baide / China 8
945.000 7.560.000
Pemenang
8 Cortex Screw Ø4,5mm, length 14-50
mm, Stainless Steel Baide / China 570
108.000 61.560.000
Pemenang
9 Cortex Screw Ø4,5mm, length 52-60
mm, Stainless Steel Baide / China 21
117.000 2.457.000
Pemenang
10 Cancellous Screw Ø6,5mm ,length
25-80/16 mm, Stainless Steel Baide / China 14
173.250 2.425.500
Pemenang
11 Cancellous Screw Ø6,5mm ,length
85-120/16 mm, Stainless Steel Baide / China 6
187.470 1.124.820
Pemenang
12 Cancellous Screw Ø6,5mm ,length
25-80/32 mm, Stainless Steel Baide / China 8
173.250 1.386.000
13 Cancellous Screw Ø6,5mm ,length
85-120/32 mm, Stainless Steel Baide / China 8
187.470 1.499.760
Pemenang
14
Cancellous Screw Ø6,5mm, Fully Threaded ,length 25-80 mm, Stainless Steel
Baide / China 38
173.250 6.583.500
Pemenang
15
Cancellous Screw Ø6,5mm, Fully Threaded ,length 85-120 mm, Stainless Steel
Baide / China 9
187.470 1.687.230
Pemenang
16 Malleolar Screw Ø4,5mm,length
25-70 mm,Stainless Steel Baide / China 8
150.030 1.200.240
Pemenang
17 DCP 3.5 , 4-8 Holes, Stainless Steel Baide / China 8
824.940 6.599.520
Pemenang
18 DCP 3.5 , 9-10 Holes, Stainless Steel Baide / China 4
900.000 3.600.000
Pemenang
19 One-Third tubular plate 3,5 , 2-8
Holes , Stainless Steel Baide / China 48
712.530 34.201.440
Pemenang
20 Reconstruction plate 3,5, 6-14 Holes,
Stainless Steel Baide / China 30
1.649.970 49.499.100
Pemenang
21 T-Plate ,right-angled/oblique-angled,
shaft 3-5 Holes, stainless steel Baide / China 1
824.940 824.940
Pemenang
22 Reconstruction Y Plate 3,5, 3-7 Holes,
Stainless Steel Baide / China 4
1.800.000 7.200.000
Pemenang
23 S-Reconstruction plate 3,5, 6-9 Holes,
Right/Left, stainless steel Baide / China 4
1.800.000 7.200.000
Pemenang
24 Cortex Screw Ø3,5mm, length 12-30
mm, Stainless Steel Baide / China 530
108.000 57.240.000
Pemenang
25 Cortex Screw Ø3,5mm, length 32-40
mm, Stainless Steel Baide / China 40
117.720 4.708.800
Pemenang
26
Cancellous Screw Ø4,0mm, Partially Threaded,length 14-50 mm, Stainless Steel Baide / China 4 155.250 621.000 Pemenang 27
Cancellous Screw Ø4,0mm, Fully Threaded ,length 14-50 mm, Stainless Steel Baide / China 25 155.250 3.881.250 Pemenang 28 K-Wire Dia : 0,6 ; 0,8 ; 1,0 ; 1,2 ; 1,4 ; 1,6 ; 1,8 ; 2,0 ;2,4 ;2,8; 3,0m Baide / China 42 247.500 10.395.000 Pemenang 29 SS. Wire Dia. 0,6 0,8 1,0 1,2 1,4 1,6 1,8 2,0 2,2 2,4 2,6 2,8 , 3,0 Baide / China 9 2.430.000 21.870.000 Pemenang Jumlah 355.744.980 Ppn 10% 35.574.498 Total 391.319.478
4.
Nama Perusahaan
: PT. TIARA KENCANA
Alamat Perusahaan
: Wisma Tiara Lantai 5, Jl. Raya Pasar Minggu Km.18
No.17 Jakarta
NPWP
: 01.315.659.1-062.000
NO NAMA BMHP MERK /
NEGARA ASAL JUMLAH
HARGA
SATUAN JUMLAH Ket
TINDAKAN ARTHROPLASTY
2 Megasystem C Condylar
Replacement Cemented Stem Link / Germany 1
140.582.000 140.582.000
Pemenang
3 Megasystem C Proximal Tibia
Replacement Cemented Stem Link / Germany 1
172.432.000 172.432.000
Pemenang
4 Megasystem C Condylar
Replacement Cementless Stem Link / Germany 1
143.650.000 143.650.000
Pemenang
5 Megasystem C Proximal Tibia
Replacement Cementless Stem Link / Germany 1
175.500.000 175.500.000
Pemenang
7 Hemihip Arthroplasty Bipolar
Sementles Link / Germany 25 16.281.500 407.037.500
Pemenang
8 Total Hip Replacement (THR) Link / Germany 40 21.224.500 848.980.000 Pemenang
Jumlah 1.888.181.500
Ppn 10% 188.818.150
Total 2.076.999.650
