DAFTAR PEMBAGIAN JASA PELAYANAN KESEHATAN

PADA PUSKESMAS BERU-BERU

BULAN APRIL 2018

Total Hari Kerja 23

Jumlah peserta JKN 8,376
Besaran / Norma Kapitasi Rp 5,000
Jumlah Penerimaan Kapitasi Rp 41,879,375
Jumlah Jasa Pelayanan Rp 25,127,625

MASA MASA POINT

POINT NILAI
RANGKAP POINT PJ
JML POINT JML HR JML TOTAL JASA
KERJA KERJA/ TIDAK %
No. NAMA PEGAWAI
PNS/PTT KONTRAK KETENAG
MASA
TUGAS PROGRAM
PENDIDIKAN / JABATAN VARIABEL MSK KEHADIRAN SELURUH PELAYANAN
HADIR
(TAHUN) (TAHUN) AAN KERJA ADM / SETARA KETENAGAAN KERJA POINT 60%

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 HAFSAH AKIL, S.Kep, Ns PERAWAT S1/ KAPUS 11 - 50 10 100 - 160 - 23 100% 160 25,127,625
2 Hj. AISYAH,S.Pd NON KES S1 / TU 8 - 50 5 30 - 85 - 23 100% 85 25,127,625
3 RASMAWATI, S.Kep PERAWAT S1 8 - 50 5 50 10 115 - 23 100% 115 25,127,625
4 Dr. INDAH LIBRYAN SEPTIANI DOKTER / PJ POLI UMUM 3 - 150 - - 10 160 - 23 100% 160 25,127,625
5 Drg. ANDI ASMIRA, AK DOKTER / PJ POLI GIGI - - 150 - - 10 160 - 23 100% 160 25,127,625
6 MASNI, SKM KESMAS S1 14 - 80 10 - 10 100 - 23 100% 100 25,127,625
7 FATMAWATY, SKM KESMAS S1 / PJ. KESLING 6 - 80 5 - 10 95 - 23 100% 95 25,127,625
8 Hj. ARIFAH RAHIM, A.Md.Kep PERAWAT D3 29 - 50 25 - - 75 - 23 100% 75 25,127,625
9 MULIAWAN, S.Kep PERAWAT S1 8 - 60 5 - - 65 - 23 100% 65 25,127,625
10 HASNAWATI, A.Md.Keb BIDAN D3 7 - 50 5 - 10 65 - 13 57% 37 25,127,625
11 Hj. YEMMY DJALIL, S.Kep PERAWAT S1 15 - 80 10 - 10 100 - 23 100% 100 25,127,625
12 JAMILAH, A.Md.Kep PERAWAT D3 6 - 50 5 - 10 65 - 23 100% 65 25,127,625
13 RAHMAT HIDAYAT, A.Md.Kep PERAWAT D3 2 - 60 - - - 60 - 23 100% 60 25,127,625
14 SUKASIH, S.ST BIDAN S1 11 - 60 10 - 10 80 - 23 100% 80 25,127,625
15 ERNAWATI, S.Kep PERAWAT S1 12 - 50 10 - 10 70 - 13 57% 40 25,127,625
16 MARWIAH, S.Kep PERAWAT S1 11 - 50 10 - 10 70 - 23 100% 70 25,127,625
17 HAMRIYANA, S.Kep PERAWAT S1 26 - 60 25 - 10 95 - 23 100% 95 25,127,625
18 MARLIANI, S.Kep PERAWAT S1 11 - 60 10 - 10 80 - 23 100% 80 25,127,625
19 NIRWANA ULFA, A.Md.Keb BIDAN D3 7 - 50 - - 10 60 - 19 83% 50 25,127,625
20 YULIANTI MANDASARI, A.Md.Keb BIDAN D3 7 - 50 - - 10 60 - 23 100% 60 25,127,625
21 SALMAH, A.Md.Keb BIDAN D3 11 50 - - - 50 - 23 100% 50 25,127,625
22 A. SARAPA, A.Md.Keb BIDAN D3 7 - 50 - - - 50 - 23 100% 50 25,127,625
23 NIRMAWATI, A.Md.Keb BIDAN D3 7 - 60 - - - 60 - 19 83% 50 25,127,625
24 MARDA MARSUKI, A.Md.Keb BIDAN D3 7 - 50 - - - 50 - 23 100% 50 25,127,625
25 RIZKA, A.Md.Keb BIDAN D3 9 - 50 - - - 50 - 23 100% 50 25,127,625
26 REZA PAHLEVI, A.Md.Kep PERAWAT D3 - 8 25 2.5 - 10 37.5 - 23 100% 37.5 25,127,625
27 INDRAWATI, S.Kep PERAWAT S1 - 8 25 2.5 - - 27.5 - 23 100% 27.5 25,127,625
28 HAMDANA, AMK PERAWAT D3 - 8 30 2.5 - - 32.5 - 23 100% 32.5 25,127,625
29 JUSRIANI, A.Md.Kep PERAWAT D3 - 7 25 2.5 - - 27.5 - 23 100% 27.5 25,127,625
30 MARDEWI, A.Md.Keb BIDAN D3 - 6 25 2.5 - - 27.5 - 23 100% 27.5 25,127,625
31 MAMAN WAHYU SAPUTRA, A.Md.Kep PERAWAT D3 - 6 25 2.5 - 10 37.5 - 23 100% 37.5 25,127,625
32 SARTIWI AS, A.Md.Kep PERAWAT D3 5 30 2.5 - - 32.5 - 23 100% 32.5 25,127,625
33 SUKMAWATI, A.Md.Kep PERAWAT D3 - 8 30 2.5 - - 32.5 - 23 100% 32.5 25,127,625
34 MARIANA, A.Md.Kep PERAWAT D3 - 4 30 - - 10 40 - 23 100% 40 25,127,625
35 HERAWATI AS, A.Md.Kep PERAWAT D3 - 1 25 - - - 25 - 23 100% 25 25,127,625
36 RAHMAWATI, A.Md.Gz GIZI D3 - 1 30 - - - 30 - 23 100% 30 25,127,625
37 KASMAWATI.R, A.Md. Keb BIDAN D3 - 4 30 - - - 30 - 23 100% 30 25,127,625
38 SRI MURNIATI NENGSI, A.Md.Keb BIDAN D3 - 1 25 - - - 25 - 23 100% 25 25,127,625
39 ROSIDAH, S.Kep PERAWAT S1 - 3 25 - - - 25 - 23 100% 25 25,127,625
40 NURFIANTI, A.Md.Kep PERAWAT D3 - 2 25 - - - 25 - 23 100% 25 25,127,625
41 SANTRI YULMIATI, A.Md.Keb BIDAN D3 - 4 30 - - - 30 - 23 100% 30 25,127,625
42 WIKA MAYANGSARI, A.Md.Keb BIDAN D3 - 1 25 - - - 25 - 23 100% 25 25,127,625
43 SUNARTI,Amd.Kep PERAWAT D3 - 25 - - - 25 23 100% 25 25,127,625
44 INDAH, A.Md.Keb BIDAN D3 - 1 25 - - - 25 - 23 100% 25 25,127,625
45 MUNIRAH, A.Md.Kep PERAWAT D3 - 3 30 - - - 30 - 23 100% 30 25,127,625
46 NIRMALA DEWI, A.Md.Keb BIDAN D3 - 2 25 - - - 25 - 23 100% 25 25,127,625
47 ROSDIANA ISHAR, A.Md.Keb BIDAN D3 - 2 30 - - - 30 - 23 100% 30 25,127,625
48 WAHIDAH, A.Md.Keb BIDAN D3 - 2 30 - - - 30 - 23 100% 30 25,127,625
49 ST. RAMLAH, A.Md.Keb BIDAN D3 - 3 30 - - - 30 - 23 100% 30 25,127,625
50 MARDIANI, A.Md.Keb BIDAN D3 - 3 30 - - - 30 - 23 100% 30 25,127,625
51 MUSRAWATI, A.Md.Keb BIDAN D3 - 3 30 - - - 30 - 23 100% 30 25,127,625
52 RISDA SENIWATI, A.Md.Keb BIDAN D3 - 3 30 - - - 30 - 23 100% 30 25,127,625
53 NASRAH, A.Md.Kep PERAWAT D3 - 2 30 - - - 30 - 23 100% 30 25,127,625
54 MARINA MATASIK, Apt FARMASI D3 - 2 25 - - - 25 - 23 100% 25 25,127,625
55 FITRIANI. M, A.Md.Keb BIDAN D3 - 3 25 - - - 25 - 23 100% 25 25,127,625
56 RISMA HAMNUR UTAMI, A.Md.Keb BIDAN D3 - 3 30 - - - 30 - 23 100% 30 25,127,625
57 ALI ALATAS, A.Md.KL KESLING D3 - 1 30 - - - 30 - 15 65% 20 25,127,625
58 MUSTAJAR, S.Kep PERAWAT S1 - 1 25 - - - 25 - 23 100% 25 25,127,625
59 MULIADI. R, A.Md.Kep PERAWAT D3 - 2 25 - - 10 35 - 23 100% 35 25,127,625
60 YELLAH, A.Md.Keb BIDAN D3 - 3 30 - - - 30 - 23 100% 30 25,127,625
61 IRWANDI, A.Md.Kep PERAWAT D3 - 3 30 - - - 30 - 23 100% 30 25,127,625
62 ABD. SALIM, A.Md.Kep PERAWAT D3 - 3 30 - - - 30 - 23 100% 30 25,127,625
63 ST. RAHMAWATI. G, A.Md.Kep PERAWAT D3 - 1 30 - - - 30 - 23 100% 30 25,127,625
64 FAJRIAH, A.Md.Keb BIDAN D3 - 1 30 - - - 30 - 23 100% 30 25,127,625
65 SARTIWI RAMLI, A.Md, Kep PERAWAT D3 - 1 25 - - - 25 - 15 100% 25 25,127,625
66 MAEDINAH, A.Md.Keb BIDAN D3 - 1 30 - - - 30 - 23 100% 30 25,127,625
67 RUSNI, A.Md.Kep PERAWAT D3 - 3 30 - - 10 40 - 23 100% 40 25,127,625
68 IDHAN, A.Md.Kep PERAWAT D3 - 3 25 - - - 25 - 23 100% 25 25,127,625
69 SUGIANTI, A.Md.Kep PERAWAT D3 - 3 30 - - - 30 - 23 100% 30 25,127,625
70 HERLI, S.Kep PERAWAT S1 - 2 25 - - - 25 - 23 100% 25 25,127,625
71 ARFIANTI, A.Md. GZ GIZI D3 - 2 30 - - - 30 - 23 100% 30 25,127,625
72 IRMAYANTI, S.Kep PERAWAT S1 - 2 25 - - - 25 - 23 100% 25 25,127,625
73 ROSMAYANTI,S.Kep PERAWAT S1 - 2 25 - - - 25 - 23 100% 25 25,127,625
74 TRI PUTRI, A.Md.Kep PERAWAT D3 - 2 30 - - - 30 - 20 87% 26 25,127,625
75 ST. HUMAERAH, A.Md.KL KESLING D3 - 2 30 - - - 30 - 15 65% 20 25,127,625
76 MURNIWATI, A.Md.Keb BIDAN D3 - 2 25 - - - 25 - 23 100% 25 25,127,625
77 FADIA ULFA, AMG GIZI D3 - 2 30 - - - 30 - 23 100% 30 25,127,625
78 CITRA S, A.Md.Kep PERAWAT D3 - 2 30 - - - 30 - 23 100% 30 25,127,625
79 HUSNAENI, A.Md.Kep PERAWAT D3 - 2 25 - - - 25 - 15 65% 16 25,127,625
80 JURLIAH, A.Md.Keb BIDAN D3 - 2 25 - - - 25 - 23 100% 25 25,127,625
81 NURASIA, A.Md.Kep PERAWAT D3 - 2 25 - - - 25 - 23 100% 25 25,127,625
82 HASMINA, A.Md.Keb BIDAN D3 - 2 25 - - - 25 - 15 65% 16 25,127,625
83 ROSMIATI, A.Md.Kep PERAWAT D3 - 4 30 - - 10 40 - 23 100% 40 25,127,625
TOTAL : 3,643 25,127,625
JASA PELAYANAN
YANG DITERIMA

16
Rp 1,103,522
Rp 586,246
Rp 793,157
Rp 1,103,522
Rp 1,103,522
Rp 689,702
Rp 655,216
Rp 517,276
Rp 448,306
Rp 253,390
Rp 689,702
Rp 448,306
Rp 413,821
Rp 551,761
Rp 272,882
Rp 482,791
Rp 655,216
Rp 551,761
Rp 341,852
Rp 413,821
Rp 344,851
Rp 344,851
Rp 341,852
Rp 344,851
Rp 344,851
Rp 258,638
Rp 189,668
Rp 224,153
Rp 189,668
Rp 189,668
Rp 258,638
Rp 224,153
Rp 224,153
Rp 275,881
Rp 172,425
Rp 206,910
Rp 206,910
Rp 172,425
Rp 172,425
Rp 172,425
Rp 206,910
Rp 172,425
Rp 172,425
Rp 172,425
Rp 206,910
Rp 172,425
Rp 206,910
Rp 206,910
Rp 206,910
Rp 206,910
Rp 206,910
Rp 206,910
Rp 206,910
Rp 172,425
Rp 172,425
Rp 206,910
Rp 134,942
Rp 172,425
Rp 241,396
Rp 206,910
Rp 206,910
Rp 206,910
Rp 206,910
Rp 206,910
Rp 172,425
Rp 206,910
Rp 275,881
Rp 172,425
Rp 206,910
Rp 172,425
Rp 206,910
Rp 172,425
Rp 172,425
Rp 179,922
Rp 134,942
Rp 172,425
Rp 206,910
Rp 206,910
Rp 112,451
Rp 172,425
Rp 172,425
Rp 112,451
Rp 275,881
Rp 25,127,625
 DAFTAR PENERIMA BPJS KAPITASI
PADA PUSKESMAS BERU-BERU
BULAN APRIL 2021

Total Hari Kerja 25

Jumlah peserta JKN 11,684
Besaran / Norma Kapitasi Rp 5,000
Jumlah Penerimaan Kapitasi Rp 58,420,500
Jumlah Jasa Pelayanan Rp 35,052,300

MASA
POINT NILAI POINT POINT PJ JML POINT JML TOTAL
No. NAMA PEGAWAI PENDIDIKAN / JABATAN
KERJA/ KETENAGA MASA RANGKAP PROGRAM/ VARIABEL TIDAK JML HR % KEHADIRAN SELURUH JASA PELAYANAN 60% JASA PELAYANAN
KONTRAK AN KERJA TUGAS ADM SETARA KETENAGAAN HADIR MSK KERJA POINT YANG DITERIMA
(TAHUN)

1 2 3 5 6 7 8 9 10 11 12 13 14 15 16
1 MARDINA CEGA, SKM KESMAS S1/ KAPUS 8 80 5 100 - 185 - 25 100% 185 35,052,300 Rp 2,422,729
2 SEMUEL S1/KASUBAG TU 14 50 - 30 - 80 - 25 100% 80 35,052,300 Rp 1,047,666
3 RASMAWATI, S.Kep.Ns PERAWAT S1/BENDAHARA 8 100 5 50 - 155 - 25 100% 155 35,052,300 Rp 2,029,854
4 dr.MAYA ANGELA LISAL DOKTER / PJ POLI UMUM - 150 - - 10 160 - 25 100% 160 35,052,300 Rp 2,095,333
5 drg. A.ASMIRA.AK,S.KG DOKTER / PJ POLI GIGI 4 150 - - 10 160 4 21 84% 134 35,052,300 Rp 1,760,080
6 dr.DEWI SARTIKA MULIADI DOKTER / POLI UMUM - 150 - - 150 - 25 100% 150 35,052,300 Rp 1,964,375
7 MASNI, SKM KESMAS S1/KASUBAG TU 14 80 10 - 10 100 - 25 100% 100 35,052,300 Rp 1,309,583
8 FATMAWATY, SKM KESMAS S1 / PJ. KESLING 6 80 5 - 10 95 - 25 100% 95 35,052,300 Rp 1,244,104
9 Hj. ARIFAH RAHIM, A.Md.Kep PERAWAT D3 29 50 25 - 10 85 - 25 100% 85 35,052,300 Rp 1,113,146
10 MULIAWAN, S.Kep PERAWAT S1 8 60 5 - 10 75 - 25 100% 75 35,052,300 Rp 982,187
11 HASNAWATI, A.Md.Keb BIDAN D3 7 60 5 - - 65 - 25 100% 65 35,052,300 Rp 851,229
12 Hj. YEMMY DJALIL, S.Kep.Ns PERAWAT S1/Ners 15 100 10 - 10 120 - 25 100% 120 35,052,300 Rp 1,571,500
13 JAMILAH, A.Md.Kep PERAWAT D3 6 60 5 - 10 75 - 25 100% 75 35,052,300 Rp 982,187
14 RAHMAT HIDAYAT, A.Md.Kep PERAWAT D3 6 60 5 - 10 75 - 25 100% 75 35,052,300 Rp 982,187
15 SUKASIH, S.ST BIDAN S1 11 80 10 - 10 100 - 25 100% 100 35,052,300 Rp 1,309,583
16 MARWIAH, S.Kep.Ns PERAWAT S1 11 60 10 - 10 80 - 25 100% 80 35,052,300 Rp 1,047,666
17 MARLIANI, S.Kep.Ns PERAWAT S1 11 60 10 - 10 80 - 25 100% 80 35,052,300 Rp 1,047,666
18 HAMRIYANA, S,Kep.Ns PERAWAT S1 26 60 25 - 10 95 - 25 100% 95 35,052,300 Rp 1,244,104
19 NURHAEDAH, A.Md. Keb BIDAN D3 11 60 10 - 10 80 - 25 100% 80 35,052,300 Rp 1,047,666
20 NIRMAWATI, A.Md.Keb BIDAN D3 2 60 - - 10 70 - 25 100% 70 35,052,300 Rp 916,708
21 YULIANTI MANDASARI, A.Md.Keb BIDAN D3 2 60 - - 10 70 - 25 100% 70 35,052,300 Rp 916,708
22 MARDA MARSUKI,A.Md.Keb BIDAN D3 2 60 - - 10 70 - 25 100% 70 35,052,300 Rp 916,708
23 SALMAH, A.Md.Keb BIDAN D3 2 60 - - - 60 - 25 100% 60 35,052,300 Rp 785,750
24 NIRWANA ULFA, A.Md.Keb BIDAN D3 2 60 - - 10 70 - 25 100% 70 35,052,300 Rp 916,708
25 RIZKA, A.Md.Keb BIDAN D3 2 60 - - 10 70 1 24 96% 67 35,052,300 Rp 880,040
26 DOMINIKA DEWI SANAPANG, AMAK ANALIS D3 - 60 - - 10 70 - 25 100% 70 35,052,300 Rp 916,708
27 NUR FADHILA HAJAR PUTERI,SKM KESMAS S1 - 80 - - 10 90 - 25 100% 90 35,052,300 Rp 1,178,625
28 RAHMAWATI, A.Md.Gz GIZI D3 2 30 - - - 30 - 25 100% 30 35,052,300 Rp 392,875
29 MASDAYALI SADDAM, A.Md.Gz GIZI D3 - 30 - - - 30 - 25 100% 30 35,052,300 Rp 392,875
30 KAHAR,A.Md.KL KESLING D3 1 30 - - - 30 - 25 100% 30 35,052,300 Rp 392,875
31 HARIATI,SKM KESMAS S1 2 30 - - - 30 - 25 100% 30 35,052,300 Rp 392,875

Jumlah : 2,677 35,052,300 Rp 35,052,300

Beru-Beru, 30 April 2021

Ka. Puskesmas Beru- beru

MARDINA CEGA, SKM

Pangkat/ Gol : Penata, III/c
Nip : 198111282011012005
 DAFTAR PENERIMAAN BPJS KAPITASI
PADA PUSKESMAS BERU-BERU
BULAN APRIL 2021

JUMLAH YANG PAJAK (15,5 TOTAL JUMLAH

No. NAMA
DIBAYARKAN &3%) JUMLAH SETOR YANG DITERIMA KETERANGAN

1 MARDINA CEGA, SKM Rp 2,301,592 35% Rp 805,557 Rp 1,496,035

2 SEMUEL Rp 995,283 35% Rp 348,349 Rp 646,934

3 RASMAWATI, S.Kep.Ns Rp 1,928,361 35% Rp 674,926 Rp 1,253,435

4 dr.MAYA ANGELA LISAL Rp 1,990,566 35% Rp 696,698 Rp 1,293,868

5 drg. A.ASMIRA.AK,S.KG Rp 1,672,076 35% Rp 585,227 Rp 1,086,849

6 dr.DEWI SARTIKA MULIADI Rp 1,964,375 35% Rp 687,531 Rp 1,276,843

7 MASNI, SKM Rp 1,244,104 35% Rp 435,436 Rp 808,668

8 FATMAWATY, SKM Rp 1,181,899 35% Rp 413,665 Rp 768,234

9 Hj. ARIFAH RAHIM, A.Md.Kep Rp 1,057,488 35% Rp 370,121 Rp 687,367

10 MULIAWAN, S.Kep Rp 933,078 35% Rp 326,577 Rp 606,501

11 HASNAWATI, A.Md.Keb Rp 808,668 35% Rp 283,034 Rp 525,634

12 Hj. YEMMY DJALIL, S.Kep.Ns Rp 1,492,925 35% Rp 522,524 Rp 970,401

13 JAMILAH, A.Md.Kep Rp 933,078 35% Rp 326,577 Rp 606,501

14 RAHMAT HIDAYAT, A.Md.Kep Rp 982,187 35% Rp 343,765 Rp 638,422

15 SUKASIH, S.ST Rp 1,244,104 35% Rp 435,436 Rp 808,668

16 MARWIAH, S.Kep.Ns Rp 995,283 35% Rp 348,349 Rp 646,934

17 MARLIANI, S.Kep.Ns Rp 995,283 35% Rp 348,349 Rp 646,934

18 HAMRIYANA, S,Kep.Ns Rp 1,057,488 35% Rp 370,121 Rp 687,367

19 NURHAEDAH, A.Md. Keb Rp 995,283 35% Rp 348,349 Rp 646,934

20 NIRMAWATI, A.Md.Keb Rp 916,708 35% Rp 320,848 Rp 595,860

21 YULIANTI MANDASARI, A.Md.Keb Rp 916,708 35% Rp 320,848 Rp 595,860

22 MARDA MARSUKI,A.Md.Keb Rp 916,708 35% Rp 320,848 Rp 595,860

23 SALMAH, A.Md.Keb Rp 785,750 35% Rp 275,012 Rp 510,737

24 NIRWANA ULFA, A.Md.Keb Rp 916,708 35% Rp 320,848 Rp 595,860

25 RIZKA, A.Md.Keb Rp 880,040 35% Rp 308,014 Rp 572,026

26 DOMINIKA DEWI SANAPANG, AMAK Rp 916,708 35% Rp 320,848 Rp 595,860

27 NUR FADHILA HAJAR PUTERI,SKM Rp 1,119,694 35% Rp 391,893 Rp 727,801

28 RAHMAWATI, A.Md.Gz Rp 392,875 35% Rp 137,506 Rp 255,369

29 MASDAYALI SADDAM, A.Md.Gz Rp 392,875 35% Rp 137,506 Rp 255,369

30 KAHAR,A.Md.KL Rp 392,875 35% Rp 137,506 Rp 255,369

31 HARIATI,SKM Rp 392,875 35% Rp 137,506 Rp 255,369

JUMLAH Rp 33,713,645 Rp 11,799,776 Rp 21,913,869

Beru-Beru, 30 April 2021

Mengetahui,
Kepala Puskesmas Yang Menerimakan

MARDINA CEGA, SKM M A S N I, SKM

Nip : 19811128 201101 2 005 NIP: 19801102 200312 2 008