PENGUMUMAN PEMENANG PELELANGAN PEKERJAAN PENGADAAN OBAT NON ECATALOG TAHUN ANGGARAN 2015 KEBUTUHAN RSK DR. SITANALA Nomor : BN.01.03/VII.1.2/06202/2015 Tanggal 13 Oktober 2015 Sesuai dengan Berita Acara Hasil Pelelangan (BAHP) nomor BN.01.03/VII.1.2/06190/2015 tanggal 12 oktober 2015, Pokja Non Konstruksi Unit Layanan Pengadaan RSK Dr. Sitanala menetapkan Pemenang Pelelangan pekerjaan Pengadaan ObatObatan Non ECatalog Tahun Anggaran 2015 Kebutuhan RSK Dr.Sitanala dengan HPS sebesar Rp. 1.478.492.000, ( satu milyar empat ratus tujuh puluh delapan juta empat ratus Sembilan puluh dua ribu rupiah), adalah sebagai berikut : Hasil Evaluasi seluruh peserta adalah Terlampir: Kepada peserta lelang yang berkeberatan terhadap pelaksanaan prosedur pelelangan diberikan kesempatan untuk mengajukan sanggahan secara tertulis selambatlambatnya dalam waktu 3 (tiga) hari kalender sejak tanggal dikeluarkannya pengumuman ini melalui aplikasi LPSE Kementerian Kesehatan RI Demikian Pengumuman ini untuk diketahui dan dapat dipergunakan sebagaimana mestinya. Pokja Non Konstruksi Unit Layanan Pengadaan (ULP) RSK Dr.Sitanala Tahun Anggaran 2015
LAMPIRAN PENGUMUMAN PEMENANG PELELANGAN SEDERHANA PENGADAAN OBAT NON ECATALOG TA 2015 KEBUTUHAN RSK DR.SITANALA NO NAMA PERUSAHAAN 1 PT. Antar Mitra Sembada 93.737.210 2 PT. Anugerah Argon Medika 79.418.020 3 PT. Bina San Prima 146.466.389 4 PT. Brataco 28.945.000 5 PT. Distriversa Buana Mas 233.999.700 6 PT. Dos Ni Roha 12.179.695 7 PT. Enseval Putera Megatrading 98.849.576 8 PT. Indofarma Global Medika 17.873.700 9 PT. Kimia Farma TD 125.884.917 10 PT. Mensa Bina Sukses 15.142.886 11 PT. Merapi Utama Pharma 29.629.950 12 PT. Parit Padang Global 41.645.870 13 PT. Penta Valent 51.643.268 14 PT. Rajawali Nusindo 9.882.536 TOTAL 985.298.718
LAMPIRAN PENGUMUMAN PEMENANG PELELANGAN SEDERHANA PENGADAAN OBAT NON ECATALOG TA 2015 KEBUTUHAN RSK DR.SITANALA NO NAMA PERUSAHAAN NAMA OBAT VOLUME 1 PT.Anugerah Argon Medica Kalium Diklofenak 25 mg Tablet 500 302 151.000 2 PT.Anugerah Argon Medica Methyl Prednisolone 16 mg Tablet 10000 577 5.770.000 3 PT.Anugerah Argon Medica Triamcinolon 4 mg tab (novell) Tablet 500 616 308.000 4 PT.Anugerah Argon Medica Dobutamin 50 mg/ml Ampul 50 33.368 1.668.400 5 PT.Anugerah Argon Medica Antasida Doen Susp. botol 300 3.150 945.000 6 PT.Anugerah Argon Medica Asam valproat syr ( dexa) botol 50 39.900 1.995.000 7 PT.Anugerah Argon Medica Aspar K Tablet 2000 1.839 3.678.000 8 PT.Anugerah Argon Medica Folavit 400 mcg Tablet 5000 100 500.000 9 PT.Anugerah Argon Medica Histrine Tablet 600 3.175 1.905.000 10 PT.Anugerah Argon Medica Primolut N Tablet 800 2.380 1.904.000 11 PT.Anugerah Argon Medica Seloxy Capsul 1500 3.285 4.927.500 12 PT.Anugerah Argon Medica Seloxy AA Tablet 4200 4.623 19.416.600 15 PT.Anugerah Argon Medica Levemir FlexPen Buah 100 77.272 7.727.200 16 PT.Anugerah Argon Medica Sevodex 250 ml Botol 1 1.960.000 1.960.000 17 PT.Anugerah Argon Medica Termisil 1 % Cr Tube 100 36.225 3.622.500 18 PT.Anugerah Argon Medica Hialid 5 ml TM Botol 250 55.200 13.800.000 19 PT.Anugerah Argon Medica Kary Uni 0,05 mg/ml 5 ml TM Botol 55 27.200 1.496.000 20 PT.Anugerah Argon Medica Tarivid opth sol2 Botol 10 42.400 424.000 TOTAL 72.198.200 7.219.820 79.418.020
NO NAMA PERUSAHAAN NAMA OBAT VOLUME NO NAMA PERUSAHAAN NAMA OBAT VOLUME 1 PT. Antar Mitra Sembada Ursodeoxycholic acyd 250 mg (Novell) Tablet 2100 3.834 8.051.400 2 PT. Antar Mitra Sembada Bisacodyl 5 mg tab (novell) Tablet 1000 329 329.000 3 PT. Antar Mitra Sembada Mecobalamin Capsul 15000 600 9.000.000 4 PT. Antar Mitra Sembada Lacto B Sachet 4400 4.090 17.996.000 5 PT. Antar Mitra Sembada Trilac tablet Tablet 500 2.805 1.402.500 6 PT. Antar Mitra Sembada Candistin susp oral Botol 60 35.321 2.119.260 7 PT. Antar Mitra Sembada Acne Feldin Lotion 110 ml Botol 100 33.264 3.326.400 8 PT. Antar Mitra Sembada Albothyl 5 ml sol Botol 80 22.407 1.792.560 9 PT. Antar Mitra Sembada Faktu supp Supp 50 7.837 391.850 10 PT. Antar Mitra Sembada Scabimite cream 30 gr Tube 120 66.528 7.983.360 11 PT. Antar Mitra Sembada Topicare Crm 30gr Tube 80 66.646 5.331.680 12 PT. Antar Mitra Sembada Tramal supp Supp 250 15.675 3.918.750 13 PT. Antar Mitra Sembada Blistra 10 mg / 10 ml Ampul 150 213.963 32.094.450 TOTAL 93.737.210 93.737.210 NO NAMA PERUSAHAAN NAMA OBAT VOLUME 1 PT. BRATACO Capsul kosong No. 0 Capsul 15.000 38 562.500 2 PT. BRATACO Capsul kosong No. 00 Capsul 20.000 67 1.340.000 3 PT. BRATACO Capsul kosong No. 1 Capsul 20.000 35 700.000 4 PT. BRATACO Capsul kosong No. 2 Capsul 10.000 33 330.000 5 PT. BRATACO Capsul kosong No. 3 Capsul 5.000 33 165.000 6 PT. BRATACO Aqua DM @ 20 ltr Gallon 250 75.000 18.750.000 7 PT. BRATACO Formalin 37% Ltr 40 47.500 1.900.000 8 PT. BRATACO Lanolin pot 1 kg Pot 5 472.500 2.362.500 9 PT. BRATACO Vaselin putih pot 1 kg Pot 30 94.500 2.835.000 TOTAL 28.945.000 28.945.000 NO NAMA PERUSAHAAN NAMA OBAT VOLUME 1 PT. Bina San Prima Analsik Tablet 1.500 1.025 1.537.500 2 PT. Bina San Prima Erysanbe 500 mg Capsul 200 2.162 432.400 3 PT. Bina San Prima Glukolos tablet 20.000 891 17.820.000 4 PT. Bina San Prima Neurosanbe Kaplet 15.000 887 13.305.000 5 PT. Bina San Prima Neurosanbe 5000 Kaplet 10.000 1.923 19.230.000 6 PT. Bina San Prima Neurosanbe Plus Kaplet 300 836 250.800 7 PT. Bina San Prima Plasminex 500 mg Tablet 3.000 2.195 6.585.000 8 PT. Bina San Prima Tuzalos Tablet 3.000 620 1.860.000 9 PT. Bina San Prima Amoxsan ped drops Botol 24 18.588 446.112 10 PT. Bina San Prima Cefat dry syrup Botol 24 35.645 855.480
NO NAMA PERUSAHAAN NAMA OBAT VOLUME 11 PT. Bina San Prima Sanadryl Syrup 60 ml Botol 24 8.504 204.096 12 PT. Bina San Prima Sanmol Infus Botol 125 49.455 6.181.875 13 PT. Bina San Prima Sanpicillin inj Vial 400 12.985 5.194.000 14 PT. Bina San Prima Santocyn inj Ampul 1.000 6.434 6.434.000 15 PT. Bina San Prima Hydromal Soft Bag 750 49.500 37.125.000 16 PT. Bina San Prima Sanbe haes Botol 100 146.370 14.637.000 17 PT. Bina San Prima Sanprima tab Tablet 1.500 702 1.053.000 TOTAL 133.151.263 13.315.126 146.466.389 NO NAMA PERUSAHAAN NAMA OBAT VOLUME 1 PT. Distriversa Buana Mas Alernitis tab Tablet 1.000 3.600 3.600.000 2 PT. Distriversa Buana Mas Ikaneuron 5000 tab Tablet 65.000 1.944 126.340.500 3 PT. Distriversa Buana Mas Ikaneuron tab Tablet 35.000 950 33.250.000 4 PT. Distriversa Buana Mas Metifer 500 mg Tablet 10.000 1.663 16.625.000 5 PT. Distriversa Buana Mas Nomika 100 mg tablet 2.000 8.325 16.650.000 6 PT. Distriversa Buana Mas Ulsicral 120 ml Botol 100 33.600 3.360.000 7 PT. Distriversa Buana Mas Ikaneuron 5000 inj Ampul 200 4.703 940.500 8 PT. Distriversa Buana Mas Bactoderm oint 5 g Tube 200 36.900 7.380.000 9 PT. Distriversa Buana Mas Biomoist cream 30 gr Tube 10 60.300 603.000 10 PT. Distriversa Buana Mas Octedin botol 10 37.800 378.000 11 PT. Distriversa Buana Mas Zoloral SS 80 ml Botol 80 45.000 3.600.000 212.727.000 21.272.700 TOTAL 233.999.700 NO NAMA PERUSAHAAN NAMA OBAT VOLUME 1 PT. Dos Ni Roha Eperisone HCl tab (novell) Tablet 1.500 858 1.287.000 2 PT. Dos Ni Roha Citicoline 250 mg/ 2 ml Ampul 300 5.775 1.732.500 3 PT. Dos Ni Roha Parasetamol infus Botol 100 30.002 3.000.195 4 PT. Dos Ni Roha Lar. Infus BBraun NS/100 ml (NaCl 100 ml) Botol 1.000 6.160 6.160.000 12.179.695 TOTAL 12.179.695 NO NAMA PERUSAHAAN NAMA OBAT VOLUME 1 PT. Enseval Putera Megatrading Asam Mefenamat 500 mg Kaplet 15.000 160 2.400.000 2 PT. Enseval Putera Megatrading Forres 50 mg Tablet 5.000 3.308 16.540.000 3 PT. Enseval Putera Megatrading Hepamax Kapsul 4.500 6.750 30.375.000 4 PT. Enseval Putera Megatrading Kalmeco 500 ug Capsul 3.000 1.538 4.614.660 5 PT. Enseval Putera Megatrading Kalnex 250 mg Capsul 2.000 1.323 2.646.400
NO NAMA PERUSAHAAN NAMA OBAT VOLUME 6 PT. Enseval Putera Megatrading Kalnex 500 mg tablet 3.000 2.316 6.946.800 7 PT. Enseval Putera Megatrading Nephrolit Tablet 300 585 175.500 8 PT. Enseval Putera Megatrading Nutrivision Capsul 1.500 5.667 8.500.005 9 PT. Enseval Putera Megatrading Rillus Tablet 600 5.100 3.060.066 10 PT. Enseval Putera Megatrading Venosmil Tablet 1.000 6.203 6.202.500
NO NAMA PERUSAHAAN NAMA OBAT VOLUME 11 PT. Enseval Putera Megatrading Kaltrofen supp Supp 500 9.511 4.755.250 12 PT. Enseval Putera Megatrading Neo Gynoxa Supp 350 10.420 3.647.070 TOTAL 89.863.251 8.986.325 98.849.576 NO NAMA PERUSAHAAN NAMA OBAT VOLUME 1 PT. Indofarma Global Medika Ambroxol 30 mg Tablet 30.000 106 3.180.000 2 PT. Indofarma Global Medika Cefixime 200 mg Capsul 3.000 1.555 4.665.000 3 PT. Indofarma Global Medika Salbutamol Sirup 2 mg/5 ml botol 10 4.950 49.500 4 PT. Indofarma Global Medika Urispas 200 mg tab Tablet 2.400 4.158 9.979.200 17.873.700 TOTAL 17.873.700 NO NAMA PERUSAHAAN NAMA OBAT VOLUME 1 PT. Kimia Farma TD Albendazole 400 mg Tablet 100 406 40.600 2 PT. Kimia Farma TD Natrium Diklofenak 50 mg Tablet 2.000 119 237.460 3 PT. Kimia Farma TD Phenytoin 100 mg Tablet 10.000 121 1.209.100 4 PT. Kimia Farma TD Thiamine HCl (Vit. B 1) 50 mg Tablet 9.000 124 1.112.760 5 PT. Kimia Farma TD Tramadol 50 mg Capsul 900 146 131.724 6 PT. Kimia Farma TD Vitamin A 200.000 IU (Retinol) Capsul 100 502 50.200 7 PT. Kimia Farma TD Vit K3 (Menadion) 10mg/ml Ampul 500 1.318 659.090 8 PT. Kimia Farma TD Aspilet Tablet 20.000 5.300 106.000.000 9 PT. Kimia Farma TD Duvadilan tab tablet 0 5.000 14 PT. Kimia Farma TD Dopamin Giulini inj 200 mg 10 ml Ampul 20 65.870 1.317.400 10 PT. Kimia Farma TD New Diatab Tablet 7.000 507 3.545.500 11 PT. Kimia Farma TD Betadine Salep Antiseptik Botol 20 6.850 137.000 114.440.834 11.444.083 TOTAL 125.884.917 NO NAMA PERUSAHAAN NAMA OBAT VOLUME 1 PT. Mensa Bina Sukses Dopamet Tablet 300 797 238.986 2 PT. Mensa Bina Sukses Decubal cr 20 g Tube 500 18.731 9.365.400 3 PT. Mensa Bina Sukses Dumin rectal tube 125 mg/2,5 ml Tube 500 11.077 5.538.500 TOTAL 15.142.886 15.142.886
NO NAMA PERUSAHAAN NAMA OBAT VOLUME NO NAMA PERUSAHAAN NAMA OBAT VOLUME 1 PT. Merapi Utama Pharma Meloxicam 15 mg Tablet 3.500 347 1.214.500 2 PT. Merapi Utama Pharma Glucosamin MPL 500 mg Tablet 15.000 1.106 16.590.000 3 PT. Merapi Utama Pharma ATS 1500 IU Ampul 50 107.525 5.376.250 4 PT. Merapi Utama Pharma Serum Anti Bisa Ular 5 ml Vial 2 402.050 804.100 5 PT. Merapi Utama Pharma Lar. Infus D5, 1/4 NS ( OTSUKA ) Botol 150 10.300 1.545.000 6 PT. Merapi Utama Pharma Lar. Infus NaCl 3 % 500 ml ( OTSUKA ) Botol 60 12.018 721.080 7 PT. Merapi Utama Pharma Lar. Infus Otsu D 40 25 ml Botol 400 3.762 1.504.800 8 PT. Merapi Utama Pharma Betadine Gargle 100 ml Botol 20 9.075 181.500 9 PT. Merapi Utama Pharma Betason cream Tube 50 7.770 388.500 7 PT. Merapi Utama Pharma Dopamin Giulini inj 200 mg 10 ml Ampul 20 65.211 1.304.220 TOTAL 29.629.950 29.629.950 NO NAMA PERUSAHAAN NAMA OBAT VOLUME 1 PT. Parit Padang Global Curcuma Tablet 35.000 792 27.720.000 2 PT. Parit Padang Global Stobled Capsul 240 6.683 1.603.920 3 PT. Parit Padang Global Emla 5 % Cream 5 gr Tube 10 50.216 502.160 4 PT. Parit Padang Global Curvit CL susp 175 ml Botol 120 44.550 5.346.000 5 PT. Parit Padang Global Curvit syr 60 ml Botol 120 21.780 2.613.600 41.645.870 TOTAL 41.645.870 NO NAMA PERUSAHAAN NAMA OBAT VOLUME 1 PT. PENTA VALENT Cendobery Tablet 36.000 3.150 113.400.000 2 PT. PENTA VALENT Glaucon Tablet 2.000 3.800 7.600.000 3 PT. PENTA VALENT Glaucon 250 mg (askes) Tablet 5.200 1.636 8.509.072 4 PT. PENTA VALENT Vitanorm Tablet 5.400 3.330 17.982.000 5 PT. PENTA VALENT Bactoderm oint 10 g (Pirotop) Tube 100 52.975 5.297.500 6 PT. PENTA VALENT Carmed cr 20 % Tube 600 30.750 18.450.000 7 PT. PENTA VALENT Desolex cr 10 gr Tube 100 18.755 1.875.500 8 PT. PENTA VALENT Glikoderm 8% SS Cr 20gr pot 10 25.850 258.500 9 PT. PENTA VALENT Glikoderm CFC 100 ml Botol 30 16.940 508.200 10 PT. PENTA VALENT Glikoderm CFC Glycolid Acid 4% 100 ml Botol 20 47.300 946.000 11 PT. PENTA VALENT Kloderma gel 5 gr Supp 10 16.800 168.000 12 PT. PENTA VALENT Kloderma oint 10 gr Tube 1.200 25.000 30.000.000 13 PT. PENTA VALENT Medicort cr 10 g Tube 200 45.650 9.130.000 14 PT. PENTA VALENT Mediklin gel Tube 50 18.900 945.000 15 PT. PENTA VALENT Mediquin 15 gr Tube 15 23.980 359.700 16 PT. PENTA VALENT Melanox ES Tube 15 49.500 742.500
NO NAMA PERUSAHAAN NAMA OBAT VOLUME 17 PT. PENTA VALENT Mofacort 10 gr cr Tube 100 55.000 5.500.000 18 PT. PENTA VALENT Mofacort 5 gr cr Tube 200 28.750 5.750.000 19 PT. PENTA VALENT Parasol Lotion SPF 45 30 ml Tube 90 59.850 5.386.500 20 PT. PENTA VALENT Pirotop 10 gr Tube 600 52.975 31.785.000 21 PT. PENTA VALENT Refaquin 15 gr Tube 20 51.700 1.034.000 22 PT. PENTA VALENT Vitacid cr 0,025 % Tube 75 18.975 1.423.125 23 PT. PENTA VALENT Vitacid cr 0,05 % Tube 20 27.850 557.000 24 PT. PENTA VALENT Vitacid cr 0,1 % Tube 5 35.750 178.750 25 PT. PENTA VALENT Cendo Augentonic 0,6 ml MNDS Strip 120 21.625 2.595.000 26 PT. PENTA VALENT Cendo Carpine 1 % 5 cc Botol 20 15.500 310.000 27 PT. PENTA VALENT Cendo Mydriatyl 0,5 % 5 ml Botol 100 28.875 2.887.500 28 PT. PENTA VALENT Cendo Protagenta ED 5 ml Botol 300 42.000 12.600.000 29 PT. PENTA VALENT Cendo Xytrol 3,5 gr Eye oint Tube 40 22.545 901.800 30 PT. PENTA VALENT Eye Fresh Plus 0,6 ml MNDS Strip 500 6.975 3.487.500 31 PT. PENTA VALENT Giflox 0,6 ml MNDS Strip 100 16.050 1.605.000 32 PT. PENTA VALENT Hyalub ED MNDS Btl 1.200 11.400 13.680.000 33 PT. PENTA VALENT Lentikular 0,6 ml MNDS Botol 700 33.250 23.275.000 34 PT. PENTA VALENT LFX MNDS Strip 250 69.000 17.250.000 35 PT. PENTA VALENT Noncort MNDS Strip 750 42.250 31.687.500 36 PT. PENTA VALENT Oculenta gel 5 gr Tube 250 63.875 15.968.750 37 PT. PENTA VALENT Ophtalgon 3 ml Botol 30 11.000 330.000 38 PT. PENTA VALENT Pantocain 2 % 5 cc Botol 20 13.250 265.000 39 PT. PENTA VALENT Polydex TM 5 ml Botol 500 35.750 17.875.000 40 PT. PENTA VALENT Polygran 5 cc tetes mata Botol 15 31.625 474.375 41 PT. PENTA VALENT Siloxan 5 cc Botol 40 52.750 2.110.000 6 PT. PENTA VALENT Timol 0,25 % 5 cc Botol 130 30.500 3.965.000 3 PT. PENTA VALENT Timol 0,5 % 5 cc Botol 275 47.750 13.131.250 42 PT. PENTA VALENT Vasacon 15 ml Botol 20 16.250 325.000 43 PT. PENTA VALENT Vitrolenta MNDS Strip 40 28.625 1.145.000 44 PT. PENTA VALENT Alkohol 70 % BOTOL 1 Lt Botol 200 36.364 7.272.800 45 PT. PENTA VALENT PK Pot 200 3.250 650.000 46.948.425 4.694.843 TOTAL 51.643.268 NO NAMA PERUSAHAAN NAMA OBAT VOLUME 1 PT. Rajawali Nusindo Streptomycin inj 1 gr Ampul 700 4.977 3.484.124 2 PT. Rajawali Nusindo Cefixime 100 mg / 5 ml botol 400 13.750 5.500.000 TOTAL 8.984.124 898.412 9.882.536