pengobatan masal di 6 kabupaten bagus
DESCRIPTION
LUKMENTRANSCRIPT
TABEL IHONORARIUM DAN BIAYA PERJALANAN
NO URAIAN
1 2 3 4
1. Honorarium Tim6 Kab 5,000,000.00 6 Kab 4,500,000.00 6 Kab 4,500,000.00
2
a.Honor Tenaga Medis 3 Orang 18 OH 4,000,000.00
18 OH 3,000,000.00
3 10 BH 150,000.00
4 12 BH 200,000.00
5 14 Org 500,000.00
3. Transportasi pesawat & lokal
a) DJJ – Wamena (PP) 14 Org 28 OT 800,000
28 OT 800,000
28 OT 300000 Serui – Nabire (14 Orang) 28 OT 150000C.Transportasi –lokal
28 OT 250,000
28 OT 1,000,000
14 Orang di 6 Kabupaten (14 Org x 30 Hari x 3) 1260 OH 50,000
f. Uang Saku Tim di Lapangan 420 OH 200,000
4 12 Krjng 150,000
5. 25 Krtn/Bgasi 150,000
6. Transportasi Udara4 OT 5,000,000
Transportasi Darat4 OT 1,000,000
1 Mobil 1000000
SUB JUMLAH I
VOLUME KEGIATAN
HARGA SATUAN Rp.
a. Honor ketua Timb. Honor sekretarisc. Honor Bendahara
Honorarium Tenaga Medis/Paramedis
b.Honor Tenaga Paramedis 3 OrangBiaya Cetak Spanduk/Logo ukuran 1 M x 2 M (1 Paket)
Biaya Cetak Spanduk/Logo ukuran 1 M x 3 M (1 Paket)
Pengadaan Celana, kaos,Topi ( logo & warna Rasta).
a. Transportasi - Udara
b) Wamena – Yahukimo (PP) 14 Orang
b.Transportasi Laut DJJ – Serui (PP) 14 Orang
b. Jayapura – Sarmi (PP) 14 Orang
c. Nabire – Deyai (PP) 14 Orang
e. Konsumsi Tim di Lapangan
Pengadaan Keranjang Angkut Obat untuk 6 Kabupaten
Transportasi belanja Obat/ bagasi pesawat
a. DJJ – Jakarta (PP) 2 Orang
b. Jakarta – Bandung (PP) 2 Org
c. Ongkos bagasi mobil
TABEL II
PENGADAAN PERALATAN PENUNJANG
NO URAIAN1 2 3 4
1 Genset Merk Yamaha 1 Buah 2,500,000 2 Stavol Merk Matsuka 1 Buah 600,000 3 Megapon 1 Buah 500,000 4 Kabel Rol 25 Meter 1 Buah 400,000 5 Toa Kecil 1 Buah 400,000 6 Ampli Kecil 1 Buah 600,000 7 Hamer / Palu 2 Buah 55,000 8 Obeng Plat 2 Buah 8,000 9 Obeng Bintang 2 Buah 8,000
10 Parang 2 Buah 90,000 11 Pisau Dapur 2 Buah 12,500 12 Terpal Plastik 2 Buah 300,000 13 Tali Jemuran 10 Buah 10,000 14 Lampu Philips 23 watt 10 Buah 50,000 15 Bensin Campur 360 Liter 6,000 16 Obeng Test sedang 1 Buah 125,000 17 GergajiTangan 1 Buah 60,000 18 Lem Tachol 5 Buah 5,000 19 Gunting Besar 3 Buah 15,000 20 Hecter Besar 3 Buah 23,000 21 Hecter Kecil 3 Buah 8,000 22 Isi Hecter Besar No 3 20 Dos 2,500 23 Isi Hecter Kecil No 10 20 Dos 1,500 24 Kertas Folio Bergaris 1 Rim 60,000 25 Kertas F4 1 Rim 50,000 26 Map Plastik 6 Pak 45,000 27 Flas Dish 2 GB 3 Buah 100,000 28 Laptop Toshiba 1 Buah 4,000,000 29 LCD 1 Buah 5,000,000 30 Lampu Senter 6 Buah 30,000 31 Batery Senter 18 Buah 5,000 32 Percis Senter 100 Buah 1,500 33 Printer HP 1 Buah 1,500,000 34 Cartriage HP Black & Color 4 Buah 150,000 35 Tip Ex 6 Buah 7,500 36 Stif Penghapuss 6 Buah 2,500 37 Serutan Pencil 1 Buah 125,000 38 Pencil 2 B 1 Dos 45,000 39 Penggaris Plastik 30 Cm 3 Buah 12,500 40 Spidol Artline 70 1 Dos 75,000 41 Pisau Kater 6 Buah 15,000 42 Balok Kayu Matoa 5/5/x 4 Meter 7 Btg 10,000
43 Paku Campur 2 Kg 17,000 44 Stempel Tim 1 Buah 150,000 45 Buku Folio Bergaris @ 100 Lbr 6 Buku 50,000
SUB JUMLAH II
VOLUME KEGIATAN
HARGA SATUAN Rp.
TABEL IHONORARIUM DAN BIAYA PERJALANAN
JUMLAH Rp.
5
30,000,000.00 27,000,000.00 27,000,000.00
72,000,000.00
54,000,000.00
1,500,000.00
2,400,000.00
7,000,000.00
22,400,000
22,400,000
8,400,000 4,200,000
7,000,000
28,000,000
63,000,000
84,000,000
1,800,000
3,750,000
20,000,000
4,000,000
1,000,000
490,850,000.00
TABEL II
PENGADAAN PERALATAN PENUNJANG
JUMLAH Rp.5
2,500,000 600,000 500,000 400,000 400,000 600,000 110,000 16,000 16,000 180,000 25,000 600,000 100,000 500,000 2,160,000 125,000 60,000 25,000 45,000 69,000 24,000 50,000 30,000 60,000 50,000 270,000 300,000 4,000,000 5,000,000 180,000 90,000 150,000 1,500,000 600,000 45,000 15,000 125,000 45,000 37,500 75,000 90,000 70,000
34,000 150,000 300,000 22,321,500.00
TABEL III
PENGADAAN OBAT-OBATAN DAN ALAT/BAHAN HABIS PAKAI
No. Jenis Obat Nama Obat Volume Jumlah Rp.1 2 3 4 5 6'
1. 5 Btl 127,000 635,000
2000 Btl 6,550 13,100,000
5 Btl 47,250 236,250
1 Btl 12,500 12,500
Allopurinal tab 300 mg 5000 Tablet 8,500 42,500,000
Na. Diklofenak 25 mg 5000 Tablet 6,250 31,250,000
Ketoprofen 50 mg 3000 Tablet 7,250 21,750,000
Meloxicam tablet 7,5 mg 5000 Tablet 9,350 46,750,000
Diazepam 2mg 1000 Tablet 7,750 7,750,000
Stesolid Supp 10 mg 80 Tube 11,530 922,400
Karbamazepin 200 mg 1000 Tablet 8,630 8,630,000
Alprazolam 0,25 mg 2000 Tablet 9,620 19,240,000
Alprazolam 0.50 mg 2000 Tablet 9,550 19,100,000
Domperidon 10 mg 3000 Tablet 14,325 42,975,000
Syr 5 mg/60ml 500 Botol 16,550 8,275,000
Kaptropil 12.5 mg 3000 Vial 5,650 16,950,000
Nifedipin 10 mg 600 Tablet 8,650 5,190,000
Dekstrometrofan 15 mg 3000 Tablet 6,550 19,650,000
3 Botol 55,000 165,000
3 Botol 48,650 145,950
OBH syr 100 ml 300 Botol 6,500 1,950,000
2 Botol 58,650 117,300
Harga Satuan
Obat Tablet / Kaplet
Paracetamol Tab 500 mg/@1000/BtLParacetamol syr 120 mg 1000 Tab/BtlAsam mefenamat tab 500 Mg/@1000Tab/BtlTramadol Kaps 50 mg/@1000 Kaps/Btl
Gliseril qualakolat 100 mg (1000 Tab/Btl)Ambroxol HCL 30 mg (1000 Tab/Btl)
Aminofilina 200 mg (1000 Tab/Btl)
1 2 3 4 5 6'
2 Botol 55,525 111,050
2 Botol 76,000 152,000
3 Botol 56,550 169,650
3 Botol 66,550 199,650
3 Botol 76,650 229,950
Susp 400 g / 5 ml 1000 Botol 24,660 24,660,000
5 Botol 19,550 97,750
3 Botol 17,650 52,950
Oralit (Low osm) sachet 200 ml 3000 Saset 2,000 6,000,000
Imodium 2 mg 1000 Tab/Doz 1 Doz 15,550 15,550
Neo Kaolana susp 700 g 500 Botol 16,500 8,250,000
Zinc 20 mg 3000 Tablet 6,550 19,650,000
Buscopan 10 mg 3000 Tablet 9,550 28,650,000
Furusedamida 40 mg 3000 Tablet 6,750 20,250,000
HCT 25 mg 4000 Tablet 3,550 14,200,000
3 Botol 42,550 127,650
3 Botol 125,000 375,000
3 Botol 89,000 267,000
1 Botol 89,000 89,000
1 Botol 66,000 66,000
1 Botol 187,500 187,500
Thiamin 50 mg (vit B 1) 1 Botol 79,000 79,000
3 Botol 86,550 259,650
Deksamethasone 0.5 mg (1000 Tab/Btl)Efedrin HCL 25 mg (1000 Tab/Btl)Salbutamol Sulfat 4 mg (1000 Tab/Botol)Metil Prednisolon 4 mg (1000 Tab/Btl)Antasida DOEN 400 mg (1000 Tab/Btl)
Ranitidin HCL 150 mg (1000 Tab/Btl)Omeprazol 20 mg (1000 Tab/Btl
Anti Hemoroid DOEN supp 2mg (1000/Btl)Klorfeniramin maleat 4 mg (1000/Btl)Deksamethason 0,5 mg (1000/Btl)Asam Askorbat (vit c) 50 mg (1000/Btl)Piridoksin HCL (vit 6 )10 mg (1000/Btl)Retinol 100.000 iu ( vit A ) (1000/Btl)
Sianokobalamin 50 mg (vit B12 )
1 2 3 4 5 6'
Multivitamin (1000 Tab /Btl) 5 Botol 85,650 428,250
2 Botol 135,000 270,000
1 Botol 98,000 98,000
1 Botol 146,000 146,000
2 Botol 49,550 99,100
5 Botol 86,500 432,500
5 Botol 89,000 445,000
5 Botol 165,000 825,000
5 Botol 235,000 1,175,000
5 Botol 135,000 675,000
5 Botol 148,000 740,000
3 Botol 186,000 558,000
1 Botol 126,000 126,000
Nistatin 500 mg (1000 Tab/Btl) 3 Botol 96,000 288,000
3 Botol 147,000 441,000
3 Botol 87,665 262,995
2. Obat Injeksi 1 Doz 94,000 94,000
2 Doz 66,000 132,000
1 Doz 63,000 63,000
Thiamin (vit B1) 100 Amp 1 Doz 64,000 64,000
60 Botol 135,000 8,100,000
2 Doz 98,000 196,000
Buscupan inj 20 ml 1000 Amp 10 Doz 126,000 1,260,000
Ratan inj 25 ml 1000 Amp 10 Doz 132,000 1,320,000
Lasix inj 10 mg 3000 Amp 30 Doz 126,000 3,780,000
Asam folat 250 mg (1000 Tab/Btl)Ampisillin 250 mg (1000 Tab/Btl)Ampisisillin 500 mg (1000 Tab/Btl)Eritromisin 250 mg (1000 Tab / Btl)Tetrasiklin 250 mg (1000 Kaps/Btl)Tetrasiklin 500 mg (1000 Kaps/Btl)Kloroquin 250 mg (1000 Tab/Btl)Primaquin 15 mg (1000 Tab/Btl)Doksisiklin 100 mg (1000 Tab/Btl)Sefadroxyl 250.mg (1000 Kaps/Btl)Kloramfenikol 250 mg (1000 Kaps/Btl)Metronidazole 500 mg (1000 Tab/Btl)
Ketokonasol 200 mg (1000 Tab/Btl)Papaverin HCL 40 mg (1000 Tab/Btl)Papaverin HCL inj 40 mg/ml 100 AmpSianokobalamin ( vit 12 ) 500 mg 200 AmpPiridoksin HCL 50 mg/ml 100 Amp
Hidrokortison Na Suksinat inj 100 mgDeksamethason 0,5 ml / inj 200 Amp
1 2 3 4 5 6'
2 Doz 97,000 194,000
3 Doz 89,000 267,000
Duradryl 10 mg/ml 50 136,000 6,800,000
Xylomidon inj 15 mg/ml 50 147,000 7,350,000
Ondansetron inj 4 mg/2 ml 50 128,000 6,400,000
1 Doz 188,000 188,000
Torasic inj 30 mg 100 Amp 1 Doz 267,000 267,000
1 Doz 260,000 260,000
3. Hidrokortison asetat krim 2,5 % 300 Tube 116,000 34,800,000
Oksitetrasiklin HCL 3%/5 gr 300 Tube 103,000 30,900,000
300 Tube 97,000 29,100,000
Gentamicin 1% 300 Tube 123,000 36,900,000
Mikonazol salep 2 % 300 Tube 147,000 44,100,000
Ketokonazol krim 2 % 300 Tube 135,000 40,500,000
Burnazin krim 500 g 10 Pot 66,000 660,000
Daryan tulle 50 Doz 85,000 4,250,000
Kloramfenikol salep mata 1% 1000 Tube 28,000 28,000,000
Kloramfenikol tetes mata 1% 100 Drop 27,350 2,735,000
50 Tube 18,500 925,000
Xytrol cendo 200 Drop 13,500 2,700,000
Pantocain 2% 20 Drop 13,500 270,000
Kloramfenikol tetes telinga 3% 200 Drop 31,500 6,300,000
Otopain 5 ml 50 Drop 22,350 1,117,500
Chinin Antipirin 2 ml/mg 200 AmpDiphenhydramin inj 10 mg 300 Amp
FlaconFlaconFlacon
Lidocain HCL inj 20 mg 100 Amp
Serum Anti Tetanus inj 1500 iu /ml 100 Amp
Obat salep / krim
Betametason Dipropionat 0,05 %
Oksitetrasiklin 1% HCL salep mata
1 2 3 4 5 6'
Gentian Violet Lar 5% 50 Botol 5,500 275,000
Albothyl 10 ml 50 Botol 26,500 1,325,000
20 Botol 18,000 360,000
4. Rivanol lar 300ml 50 Botol 8,000 400,000
Hydrogen Peroksida 3% 10 Botol 22,000 220,000
Etanol 70% 100 Botol 18,550 1,855,000
Kalium Permanganat 5g 20 Bgks 8,000 160,000
50 Botol 15,500 775,000
Etiklorida Spray/500 Ml 5 Botol 32,000 160,000
Reagen serbuk 500 Gram 100,000 50,000,000
Etaa serbuk (100 gr) 100 Bks 100,000 10,000,000
Mikroscope 1 Buah Pinjam
Tensi meter/ Stetoscope 4 Buah 450,000 1,800,000
Tensi Meter Manual 5 Buah 300,000 1,500,000
Atropin Sulfat 0,25 mg 50 Ampul 97,000 4,850,000
Minor bedah 2 Zet 250,000 500,000
Face Mask 50 Doz 47,350 2,367,500
Kapas / cootton 250 mg 20 Baal 22,150 443,000
Plaster Hypafix 100 Roll 56,000 5,600,000
Plester Tenzotape 100 Roll 7,500 750,000
Micropore Surgigal Tape 50 Buah 17,500 875,000
Hidrocortizone Salf 2,5 % 50 Tube 36,600 1,830,000
Terumo syringe 1 cc 50 Buah 1,500 75,000
Natrium bikarbonat inj 0,83 mEq/25 ml
Bahan Habis Pakai(BHP)
Yodium Povidin lar 10 % 500 Ml
1 2 3 4 5 6'
Terumo syringe 3 cc 300 Buah 3,500 1,050,000
Terumo syringe 5 cc 100 Buah 4,500 450,000
Terumo syringe 10 cc 50 Buah 6,550 327,500
300 Buah 135,500 40,650,000
5. SUB JUMLAH III 867,034,095
JUMLAH TOTAL I + II + III 1,380,205,595
PPN 10 % 138,020,560
JUMLAH TOTAL 1,518,226,155
JAYAPURA, 03 APRIL 2012
PENANGGUNG JAWAB KEGIATAN
Dr. ANTON T MOTE
KETUA
Tensocrepe pembalut elastis 10 cm x4,45 m
Rp 3.750.000.00.
Rp 425.000.00,
Rp 331.250.00,
Rp 362.500.00,
Rp467.500.00,
Rp 387.500.00,
Rp 576.500.00,
Rp 431.500.00,
Rp 481.000.00,
Rp477.500.00,
Rp 662.500.00,
Rp 827.500.00,
Rp 283.500.00,
Rp 432.500.00,
Rp 327.500.00,
Rp 1.375.000.00,
Rp 14.595.000,00,
Rp 3.250.000.00,
Rp 3.250.000.00,
Rp 13.881.000.00,
Rp 11.490.000.00,
Rp 2.827.500.00,
Rp 976.250.000.00,
Rp 1.149.975.00,
Rp 1.233.000.00,
Rp 997.500.00,
Rp 8.725.000.00,
Rp 1.000.000.00,
Rp 7.775.000.00,
Rp 8.250.000.00,
3.325.000.00,
Rp 477.500.00,
Rp 337.500.00,
Rp 177.500.00,
21,275,000
Rp 3.125.000.00,
Rp 2.225.000.00,
Rp 2.225.500.00,
Rp1.650.000.00,
Rp 4.675.000.00,
Rp 1.975.000.00,
Rp 2.163.750.00,
Rp 2.141.250.00,
Rp 6.750.000.00,
Rp 490.000.00,
Rp 730.000.00,
Rp 2.477.500.00,
Rp 2.163.750.00,
Rp 2.225.000.00,
1,650,000
2,350,000
Rp 6.750.000.00,
Rp 7.400.000.00,
Rp 465.000.00,
Rp 630.000.00,
Rp 4.800.000.00,
Rp 7.350.000.00,
Rp 1.740.000.00,
Rp 9.400.000.00,
Rp 6.600.000.00,
Rp 6.300.000.00,
Rp 6.400.000.00,
Rp 1.350.000.00,
Rp 9.800.000.00,
Rp 663.000.00,
Rp 660.000.00,
Rp 663.000.00,
Rp 2.037.000.00,
Rp 454.890.00,
Rp 1.360.000.00,
Rp 1.470.000.00,
Rp 740.000.00,
Rp 1.880.000.00,
Rp 5.340.000.00,
Rp 2.260.000.00,
Rp 5.800.000.00,
Rp 5.650.000.00,
Rp 4.850.000.00,
Rp 6.150.000.00,
Rp 7.350.000;00,
Rp 406.650.000.00,
Rp 1.980.000.00,
Rp 1.700.000.00,
Rp 5.600.000.00,
Rp 8.205.000.00,
Rp 925.000.00,
Rp 4.050.000.00,
Rp 775.000.00,
Rp 945.000.00,
Rp 6.750.000.00,
Rp 2.275.000.00,
Rp 7.950.000.00,
Rp 400.000.00,
Rp 240.000.00,
Rp 2.200.000.00,
Rp 3.700.000.00,
Rp 1.600.000.00,
Rp7.750.000.00,
Rp 1.600.000.00,
Rp 1.800.000.00,
Rp 2.910.000.00,
Rp 500.000.00
Rp 7.102.500.00,
Rp 11.075.000.00,
Rp 11.200.000.00,
Rp 1.500.000.00,
Rp 3.500.000.00,
Rp 1.080.000.00,
Rp 7.500.000.00,
Rp 17.500.000.00,
Rp 22.500.000.00,
Rp 32.750.000.00,
Rp 13.500.000.00,
Rp. 2.200.000.000,-