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DAFTAR TERIMA JASA PELAYANAN BPJS

BULAN AGUSTUS TAHUN 2019


PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,789,250

Pendidi
No Nama Pegawai Jabatan Sisa Terima Jasa Paraf
kan
POTONGAN 10% Trima Bersih

Pajak
14 15

1 Sutriyanti Sartoso, SKM KTU Kesling / IIIb S1 Rp 961,109 1 96,111 864,998 2 40,000 2023.7692308
2 dr. Ami Kangela Baba Dokter S1 Rp 295,819 2 29,582 266,237
3 Asmawati Yusup, S.Tr. Keb KB, / IIId D4 Rp 553,402 3 55,340 498,062 1 20,000 2023.7692308 Rp 29,126 Rp 22,405 Rp 530,997
4 Masriati Cein, AMK P. SP2TP, , ,/IIIb D1 Rp 420,586 4 42,059 378,527 4 80,000 2023.7692308 Rp 22,136 Rp 17,028 Rp 403,558
Iriyani Sartoso , Amd.Keb , Batra, B JKN /IIIc
5 D3 Rp 708,355 5 70,836 637,520 4 80,000 2023.7692308 Rp 37,282 Rp 708,355
6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 Rp 427,629 6 42,763 384,866 1 20,000 2023.7692308 Rp 22,507 Rp 17,313 Rp 410,316
7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 Rp 382,351 7 38,235 344,116 7 140,000 2023.7692308 Rp 19,118 Rp 14,706 Rp 367,645
8 Naisa Tauda , Amd. Keb CPNS , Usila D3 Rp 381,292 8 38,129 343,162 2 40,000 2023.7692308 Rp 19,065 Rp 14,665 Rp 366,627
9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 Rp 261,608 9 26,161 235,448 7 140,000 2023.7692308 Rp 13,080 Rp 10,062 Rp 251,547
10 Regina Amralia Ali, Amd. Keb CPNS D3 Rp 344,222 10 34,422 309,799 1 20,000 2023.7692308 Rp 17,211 Rp 13,239 Rp 330,982
11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS/P Aset D3 Rp 301,856 11 30,186 271,670 7 140,000 2023.7692308 Rp 15,093 Rp 11,610 Rp 290,246
12 Rusni GaertiAmd. Keb CPNS D3 Rp 357,990 12 35,799 322,191 0 0 2023.7692308 Rp 17,900 Rp 13,769 Rp 344,222
13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 Rp 381,292 13 38,129 343,162 2 40,000 2023.7692308 Rp 19,065 Rp 14,665 Rp 366,627
14 Endah P. W, Amd. Keb Korim D3 Rp 397,179 14 Rp 397,179 1 20,000 2023.7692308
15 Gusti Ulandari D., AMG TKD, P. Gizi D3 Rp 281,732 15 28,173 253,559 7 140,000 2023.7692308
16 Nikmat Triandini Pataha, Amd. Kep PNS / ISPA / Diare D3 Rp 101,678 16 10,168 91,510 20 400,000 2023.7692308
17 Sarifa Soabangsa, Amd. Kep TKD/Gimul/SP2TP D3 Rp 355,872 17 35,587 320,285 5 100,000 2023.7692308
18 Siti Aisyah Sarita, Amd. Kep TKD/PTM/UKS D3 Rp 338,926 18 33,893 305,033 6 120,000 3
Hendra Rahman, S. Farm., M.
Apotek
19 Kes., Apt S2 Rp 487,206 19 48,721 438,485 3 60,000

20 Siti Magfirah Nurdin, A.Md. KL Kesling D3 Rp 355,872 20 35,587 320,285 2 40,000

21 Fadila Tarate, SKM Kesling/promkes S1 Rp 342,103 21 34,210 307,893 7 140,000


22 Ivana Namotemo Talaba, Akuntansi D3 Rp 317,743 22 31,774 285,969 1 20,000

23 Nurlaila Samad, A. Md Keb D4 Rp 317,743 23 317,743 1 20,000

24 Nurfani D5 Rp 305,033 24 305,033 2 40,000

25 Indah S. G D6 Rp 114,387 25 114,387 17 340,000

26 Fatima Ngongira D7 Rp 177,936 26 177,936 12 240,000

27 Sitti Fatima Lego Rp 211,829 27 211,829 6 120,000

28 Siti Riskiya Rp 183,020 28 183,020 8 160,000

29 Tazkir Nyong Rp 274,530 29 274,530 2 40,000

30 Manja H. Usman Rp 169,251 30 169,251 9 180,000

31 Siti Aisya Umar Rp 183,020 31 183,020 8 160,000

32 Suratmi Rp 64,396 32 64,396 18 360,000

33 Sumi Panganro Rp 211,829 33 211,829 6 120,000


Rp 10,968,795 835,864 10,132,931 Rp 231,582 Rp 149,461 Rp 4,371,121
Soakonora, 31 AGUSTUS 2019 = =
a.n Kepala Puskesmas Soakonora Bendahara Kapitasi JKN \ Rp 10,968,795

Rp -
KTU, Sutriyanti Sartoso,SKM Iriyani Sartoso, Amd. Keb
NIP. 198305132011012007 Nip.19790320 20032 2 011
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN AGUSTUS TAHUN 2019
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,789,250
Penerimaan Kapitasi dengan
Kehadiran
Presentas Jumlah peserta 6.213
Rangk Tanggu Jumlah Poin e Jumlah Jasa Pelayanan
Jenis ap ng Variabel Kehadiran Total yang diterima
Pendidi Masa Jumlah
No Nama Pegawai Jabatan Ketena Jumlah Tugas Jawab Ketenagaan (%Pembag Seluruh Biaya dengan Peserta Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Jasa Pelayanan Total Sisa Jasa Yang Di
gaan Hari Admini Progra (= ian Kolom Point Operasional ( Klm 9 x klm 10
Masuk (60 %) Terima
Kerja stratif m klm 1+2+5+6) 3 dibagi (Kolm 8x7) ( 40 %) dibagi jumlah klm 9)
Kerja klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Sutriyanti Sartoso, SKM KTU Kesling / IIIb S1 80 9 24 26 100 10 199 0.923077 183.69231 Rp 11,146,000 Rp 5,515,700 Rp 1,150,219 Rp 57,511 Rp 1,092,708 Rp 1,052,708 1
2 dr. Ami Kangela Baba Dokter S1 100 10 6 26 100 0 210 0.23077 48.461538 Rp 11,146,001 Rp 5,515,700 Rp 303,450 Rp 15,172 Rp 288,277 Rp 288,277 2
3 Asmawati Yusup, S.Tr. Keb KB, / IIId D4 80 20 25 26 0 10 110 0.961538 105.76923 Rp 11,146,000 Rp 5,515,700 Rp 662,291 Rp 33,115 Rp 629,177 Rp 609,177 3
4 Masriati Cein, AMK P. SP2TP, , ,/IIIb D1 60 25 22 26 10 95 0.846154 80.384615 Rp 11,146,000 Rp 5,515,700 Rp 503,341 Rp 25,167 Rp 478,174 Rp 398,174 4

Iriyani Sartoso , Amd.Keb , Batra, B JKN /IIIc


5 D3 60 10 22 26 50 40 160 0.846154 135.38462 Rp 11,146,000 Rp 5,515,700 Rp 847,733 Rp 42,387 Rp 805,346 Rp 725,346 5

6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 25 26 20 85 0.961538 81.730769 Rp 11,146,000 Rp 5,515,700 Rp 511,770 Rp 25,589 Rp 486,182 Rp 466,182 6

7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 19 26 30 95 0.730769 69.423077 Rp 11,146,000 Rp 5,515,700 Rp 434,704 Rp - Rp 434,704 Rp 294,704 7

8 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 24 26 10 75 0.923077 69.230769 Rp 11,146,000 Rp 5,515,700 Rp 433,500 - Rp 433,500 Rp 393,500 8

9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 19 26 0 65 0.730769 47.5 Rp 11,146,000 Rp 5,515,700 Rp 297,429 Rp - Rp 297,429 Rp 157,429 9

10 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 25 26 0 65 0.961538 62.5 Rp 11,146,000 Rp 5,515,700 Rp 391,354 Rp - Rp 391,354 Rp 371,354 10

11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS/P Aset D3 60 5 19 26 10 75 0.730769 54.807692 Rp 11,146,000 Rp 5,515,700 Rp 343,187 Rp - Rp 343,187 Rp 203,187 11

12 Rusni GaertiAmd. Keb CPNS D3 60 5 26 26 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 407,008 Rp - Rp 407,008 Rp 407,008 12

13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 24 26 10 75 0.923077 69.230769 Rp 11,146,000 Rp 5,515,700 Rp 433,500 Rp - Rp 433,500 Rp 393,500 13

14 Endah P. W, Amd. Keb Korim D3 60 5 25 26 10 75 0.961538 72.115385 Rp 11,146,000 Rp 5,515,700 Rp 451,562 Rp - Rp 451,562 Rp 431,562 14

15 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 19 26 10 70 0.730769 51.153846 Rp 11,146,000 Rp 5,515,700 Rp 320,308 Rp - Rp 320,308 Rp 180,308 15

16 Nikmat Triandini Pataha, Amd. Kep PNS / ISPA / Diare D3 60 0 6 26 20 80 0.230769 18.461538 Rp 11,146,000 Rp 5,515,700 Rp 115,600 Rp - Rp 115,600 Rp (284,400) 16

17 Sarifa Soabangsa, Amd. Kep TKD/Gimul/SP2TP D3 60 0 21 26 20 80 0.807692 64.615385 Rp 11,146,000 Rp 5,515,700 Rp 404,600 Rp - Rp 404,600 Rp 304,600 17

18 Siti Aisyah Sarita, Amd. Kep TKD/PTM/UKS D3 60 0 20 26 20 80 0.769231 61.538462 Rp 11,146,000 Rp 5,515,700 Rp 385,333 Rp - Rp 385,333 Rp 265,333 18
Hendra Rahman, S. Farm., M.
Apotek
19 Kes., Apt S2 100 0 23 26 100 0.884615 88.461538 Rp 11,146,000 Rp 5,515,700 Rp 553,916 Rp - Rp 553,916 Rp 493,916 19
20 Siti Magfirah Nurdin, A.Md. KL Kesling D3 60 0 24 26 10 70 0.923077 64.615385 Rp 11,146,000 Rp 5,515,700 Rp 404,600 Rp - Rp 404,600 Rp 364,600 20

21 Fadila Tarate, SKM Kesling/promkes S1 80 0 19 26 5 85 0.730769 62.115385 Rp 11,146,000 Rp 5,515,700 Rp 388,946 Rp - Rp 388,946 Rp 248,946 21

22 Ivana Namotemo Talaba, Akuntansi D3 60 0 25 26 60 0.961538 57.692308 Rp 11,146,000 Rp 5,515,700 Rp 361,250 Rp - Rp 361,250 Rp 341,250 22

23 Nurlaila Samad, A. Md Keb D4 60 0 25 26 60 0.961538 57.692308 Rp 11,146,001 Rp 5,515,700 Rp 361,250 Rp - Rp 361,250 Rp 341,250

24 Nurfani S. G D5 60 0 24 26 60 0.923077 55.384615 Rp 11,146,002 Rp 5,515,700 Rp 346,800 Rp - Rp 346,800 Rp 306,800

25 Indah D6 60 0 9 26 60 0.346154 20.769231 Rp 11,146,003 Rp 5,515,700 Rp 130,050 Rp - Rp 130,050 Rp (209,950)

26 Fatima Ngongira D7 60 0 14 26 60 0.538462 32.307692 Rp 11,146,004 Rp 5,515,700 Rp 202,300 Rp - Rp 202,300 Rp (37,700)


1780.0385 Rp 11,146,000 Rp 198,940 Rp 10,947,060 Rp 8,507,060
Soakonora, 31 AGUSTUS 2019
a.n Kepala Puskesmas Soakonora Bendahara Kapitasi JKN
Rp 2,440,000
Rp 11,146,000 Rp 3,380,000
KTU, Sutriyanti Sartoso,SKM Iriyani Sartoso, Amd. Keb
NIP. 198305132011012007 Nip.19790320 20032 2 011
Pajak

2 40,000 1780.0384615

1 20,000 1780.0384615 Rp 33,115 Rp 25,473 Rp 603,704


4 80,000 1780.0384615 Rp 25,167 Rp 19,359 Rp 458,815

4 80,000 1780.0384615 Rp 42,387 Rp 805,346


1 20,000 1780.0384615 Rp 25,589 Rp 19,683 Rp 466,498
7 140,000 1780.0384615 Rp 21,735 Rp 16,719 Rp 417,984
2 40,000 1780.0384615 Rp 21,675 Rp 16,673 Rp 416,827
7 140,000 1780.0384615 Rp 14,871 Rp 11,440 Rp 285,989
1 20,000 1780.0384615 Rp 19,568 Rp 15,052 Rp 376,302
7 140,000 1780.0384615 Rp 17,159 Rp 13,200 Rp 329,988
0 0 1780.0384615 Rp 20,350 Rp 15,654 Rp 391,354
2 40,000 1780.0384615 Rp 21,675 Rp 16,673 Rp 416,827
1 20,000 1780.0384615
7 140,000 1780.0384615
20 400,000 1780.0384615
5 100,000 1780.0384615
6 120,000 3

3 60,000
2 40,000

7 140,000

1 20,000

1 20,000

2 40,000

17 340,000

12 240,000
Rp 263,291 Rp 169,926 Rp 4,969,634

Rp 2,440,000 uang sisa

Rp 225,333
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN AGUSTUS TAHUN 2019
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,789,250
Penerimaan Kapitasi dengan
Kehadiran
Presentas Jumlah peserta 6.213
Rangk Tanggu Jumlah Poin e Jumlah Jasa Pelayanan
Jenis ap ng Variabel Kehadiran Total yang diterima
Pendidi Masa Jumlah
No Nama Pegawai Jabatan Ketena Jumlah Tugas Jawab Ketenagaan (%Pembag Seluruh Biaya dengan Peserta Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Jasa Pelayanan Total Sisa Jasa Yang Di
gaan Hari Admini Progra (= ian Kolom Point Operasional ( Klm 9 x klm 10
Masuk (60 %) Terima
Kerja stratif m klm 1+2+5+6) 3 dibagi (Kolm 8x7) ( 40 %) dibagi jumlah klm 9)
Kerja klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Sutriyanti Sartoso, SKM KTU Kesling / IIIb S1 80 9 24 26 100 10 199 0.923077 183.69231 Rp 11,146,000 Rp 5,515,700 Rp 1,271,516 Rp 63,576 Rp 1,207,940 Rp 1,167,940 1
2 dr. Ami Kangela Baba Dokter S1 100 10 6 26 100 0 210 0.23077 48.461538 Rp 11,146,001 Rp 5,515,700 Rp 335,450 Rp 16,773 Rp 318,678 Rp 318,678 2
3 Asmawati Yusup, Amd.Keb KB, / IIIc D4 80 20 25 26 0 10 110 0.961538 105.76923 Rp 11,146,000 Rp 5,515,700 Rp 732,133 Rp 36,607 Rp 695,527 Rp 675,527 3

Masriati Cein, AMK P. SP2TP, , Pneumonia,/IIIb


4 D1 60 25 22 26 20 105 0.846154 88.846154 Rp 11,146,000 Rp 5,515,700 Rp 614,992 Rp 30,750 Rp 584,243 Rp 504,243 4

Iriyani Sartoso , Amd.Keb , Batra, B JKN /IIIc


5 D3 60 10 22 26 50 40 160 0.846154 135.38462 Rp 11,146,000 Rp 5,515,700 Rp 937,131 Rp 46,857 Rp 890,274 Rp 810,274 5

6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 25 26 20 85 0.961538 81.730769 Rp 11,146,000 Rp 5,515,700 Rp 565,740 Rp 28,287 Rp 537,453 Rp 517,453 6

7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 19 26 30 95 0.730769 69.423077 Rp 11,146,000 Rp 5,515,700 Rp 480,546 Rp - Rp 480,546 Rp 340,546 7

8 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 24 26 10 75 0.923077 69.230769 Rp 11,146,000 Rp 5,515,700 Rp 479,215 - Rp 479,215 Rp 439,215 8

9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 19 26 0 65 0.730769 47.5 Rp 11,146,000 Rp 5,515,700 Rp 328,794 Rp - Rp 328,794 Rp 188,794 9

10 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 25 26 0 65 0.961538 62.5 Rp 11,146,000 Rp 5,515,700 Rp 432,624 Rp - Rp 432,624 Rp 412,624 10

11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS/P Aset D3 60 5 19 26 10 75 0.730769 54.807692 Rp 11,146,000 Rp 5,515,700 Rp 379,378 Rp - Rp 379,378 Rp 239,378 11

12 Rusni GaertiAmd. Keb CPNS D3 60 5 26 26 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 449,929 Rp - Rp 449,929 Rp 449,929 12

13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 24 26 10 75 0.923077 69.230769 Rp 11,146,000 Rp 5,515,700 Rp 479,215 Rp - Rp 479,215 Rp 439,215 13

14 Endah P. W, Amd. Keb Korim D3 60 5 25 26 10 75 0.961538 72.115385 Rp 11,146,000 Rp 5,515,700 Rp 499,182 Rp - Rp 499,182 Rp 479,182 14

15 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 19 26 10 70 0.730769 51.153846 Rp 11,146,000 Rp 5,515,700 Rp 354,086 Rp - Rp 354,086 Rp 214,086 15

16 Nikmat Triandini Pataha, Amd. Kep PNS / ISPA / Diare D3 60 0 6 26 20 80 0.230769 18.461538 Rp 11,146,000 Rp 5,515,700 Rp 127,791 Rp - Rp 127,791 Rp (272,209) 16

17 Sarifa Soabangsa, Amd. Kep TKD/Gimul D3 60 0 21 26 10 70 0.807692 56.538462 Rp 11,146,000 Rp 5,515,700 Rp 391,359 Rp - Rp 391,359 Rp 291,359 17

18 Siti Aisyah Sarita, Amd. Kep TKD/PTM D3 60 0 20 26 10 70 0.769231 53.846154 Rp 11,146,000 Rp 5,515,700 Rp 372,722 Rp - Rp 372,722 Rp 252,722 18
Hendra Rahman, S. Farm., M.
Apotek
19 Kes., Apt S2 100 0 23 26 100 0.884615 88.461538 Rp 11,146,000 Rp 5,515,700 Rp 612,330 Rp - Rp 612,330 Rp 552,330 19
20 Siti Magfirah Nurdin, A.Md. KL Kesling D3 60 0 24 26 10 70 0.923077 64.615385 Rp 11,146,000 Rp 5,515,700 Rp 447,267 Rp - Rp 447,267 Rp 407,267 20

21 Fadila Tarate, SKM Kesling/promkes S1 80 0 19 26 10 90 0.730769 65.769231 Rp 11,146,000 Rp 5,515,700 Rp 455,254 Rp - Rp 455,254 Rp 315,254 21

22 Ivana Namotemo Talaba, Akuntansi D3 60 0 25 26 60 0.961538 57.692308 Rp 11,146,000 Rp 5,515,700 Rp 399,346 Rp - Rp 399,346 Rp 379,346 22
1610.2308 Rp 11,146,000 Rp 222,848 Rp 10,923,152 Rp 9,123,152
Soakonora, 31 AGUSTUS 2019
a.n Kepala Puskesmas Soakonora Bendahara Kapitasi JKN
Rp 1,800,000
Rp 2,740,000
KTU, Sutriyanti Sartoso,SKM Iriyani Sartoso, Amd. Keb
NIP. 198305132011012007 Nip.19790320 20032 2 011
Pajak

2 40,000 1610.2307692

1 20,000 1610.2307692 Rp 36,607 Rp 28,159 Rp 667,368

4 80,000 1610.2307692 Rp 30,750 Rp 23,654 Rp 560,589

4 80,000 1610.2307692 Rp 46,857 Rp 890,274


1 20,000 1610.2307692 Rp 28,287 Rp 21,759 Rp 515,693
7 140,000 1610.2307692 Rp 24,027 Rp 18,483 Rp 462,063
2 40,000 1610.2307692 Rp 23,961 Rp 18,431 Rp 460,783
7 140,000 1610.2307692 Rp 16,440 Rp 12,646 Rp 316,149
1 20,000 1610.2307692 Rp 21,631 Rp 16,639 Rp 415,985
7 140,000 1610.2307692 Rp 18,969 Rp 14,591 Rp 364,787
0 0 1610.2307692 Rp 22,496 Rp 17,305 Rp 432,624
2 40,000 1610.2307692 Rp 23,961 Rp 18,431 Rp 460,783
1 20,000 1610.2307692
7 140,000 1610.2307692
20 400,000 1610.2307692
5 100,000 1610.2307692
6 120,000 3

3 60,000
2 40,000

7 140,000

1 20,000
Rp 293,985 Rp 190,099 Rp 5,547,099

Rp 1,800,000 uang sisa

Rp 182,667
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN JULI TAHUN 2019
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,789,250
Penerimaan Kapitasi dengan
Kehadiran
Presentas Jumlah peserta 6.213
Rangk Tanggu Jumlah Poin e Jumlah Jasa Pelayanan
Jenis ap ng Variabel Kehadiran Total yang diterima
Pendidi Masa Jumlah
No Nama Pegawai Jabatan Ketena Jumlah Tugas Jawab Ketenagaan (%Pembag Seluruh Biaya dengan Peserta Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Jasa Pelayanan Total Sisa Jasa Yang Di
gaan Hari Admini Progra (= ian Kolom Point Operasional ( Klm 9 x klm 10
Masuk (60 %) Terima
Kerja stratif m klm 1+2+5+6) 3 dibagi (Kolm 8x7) ( 40 %) dibagi jumlah klm 9)
Kerja klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Sutriyanti Sartoso, SKM KTU Kesling / IIIb S1 80 9 26 26 100 10 199 1 199 Rp 11,146,000 Rp 5,515,700 Rp 1,082,506 Rp 54,125 Rp 1,028,380 Rp 1,028,380 1 0
2 dr. Ami Kangela Baba Dokter S1 80 10 26 26 100 0 190 1.00000 190 Rp 11,146,001 Rp 5,515,700 Rp 1,033,548 Rp 51,677 Rp 981,871 Rp 981,871
3 Asmawati Yusup, Amd.Keb KB, / IIIc D4 80 20 26 26 0 10 110 1 110 Rp 11,146,000 Rp 5,515,700 Rp 598,370 Rp 29,918 Rp 568,451 Rp 568,451 2 0

Masriati Cein, AMK P. SP2TP, , Pneumonia,/IIIb


4 D1 60 25 26 26 20 105 1 105 Rp 11,146,000 Rp 5,515,700 Rp 571,171 Rp 28,559 Rp 542,613 Rp 542,613 3 0

Iriyani Sartoso , Amd.Keb , Batra, B JKN /IIIc


5 D3 60 10 26 26 50 40 160 1 160 Rp 11,146,000 Rp 5,515,700 Rp 870,356 Rp 43,518 Rp 826,838 Rp 826,838 4 0

6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 26 26 20 85 1 85 Rp 11,146,000 Rp 5,515,700 Rp 462,377 Rp 23,119 Rp 439,258 Rp 439,258 5 0

7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 26 26 30 95 1 95 Rp 11,146,000 Rp 5,515,700 Rp 516,774 Rp - Rp 516,774 Rp 516,774 6 0

8 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 26 26 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 407,980 - Rp 407,980 Rp 407,980 7 0

9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 26 26 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 353,582 Rp - Rp 353,582 Rp 353,582 8 0

10 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 26 26 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 353,582 Rp - Rp 353,582 Rp 353,582 9 0

11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS/P Aset D3 60 5 26 26 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 407,980 Rp - Rp 407,980 Rp 407,980 10 0

12 Rusni GaertiAmd. Keb CPNS D3 60 5 26 26 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 353,582 Rp - Rp 353,582 Rp 353,582 11 0

13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 26 26 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 407,980 Rp - Rp 407,980 Rp 407,980 12 0

14 Endah P. W, Amd. Keb Korim D3 60 5 26 26 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 407,980 Rp - Rp 407,980 Rp 407,980 13 0

15 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 26 26 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 380,781 Rp - Rp 380,781 Rp 380,781 14 0

16 Nikmat Triandini Pataha, Amd. Kep PNS / ISPA / Diare D3 60 0 26 26 20 80 1 80 Rp 11,146,000 Rp 5,515,700 Rp 435,178 Rp - Rp 435,178 Rp 435,178 15 0

17 Sarifa Soabangsa, Amd. Kep TKD/Gimul D3 60 0 26 26 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 380,781 Rp - Rp 380,781 Rp 380,781 16 0

18 Siti Aisyah Sarita, Amd. Kep TKD/PTM D3 60 0 26 26 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 380,781 Rp - Rp 380,781 Rp 380,781 17 0
Hendra Rahman, S. Farm., M.
Apotek
19 Kes., Apt S2 100 0 26 26 100 1 100 Rp 11,146,000 Rp 5,515,700 Rp 543,973 Rp - Rp 543,973 Rp 543,973 18 0
20 Siti Magfirah Nurdin, A.Md. KL Kesling D3 60 0 26 26 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 380,781 Rp - Rp 380,781 Rp 380,781 19 0

21 Fadila Tarate, SKM Kesling/promkes S1 80 0 26 26 10 90 1 90 Rp 11,146,000 Rp 5,515,700 Rp 489,575 Rp - Rp 489,575 Rp 489,575 20 0

22 Ivana Namotemo Talaba, Akuntansi D3 60 0 26 26 60 1 60 Rp 11,146,000 Rp 5,515,700 Rp 326,384 Rp - Rp 326,384 Rp 326,384 21 0


2049 Rp 11,146,000 Rp 230,916 Rp 10,915,084 Rp 10,915,084
Soakonora, 31 Juli 2019
a.n Kepala Puskesmas Soakonora Bendahara Kapitasi JKN Rp -
Rp -
Rp 940,000 Rp 62,667
KTU, Sutriyanti Sartoso,SKM Iriyani Sartoso, Amd. Keb
NIP. 198305132011012007 Nip.19790320 20032 2 011
Pajak

0 2049

0 2049 Rp 29,918 Rp 23,014 Rp 545,437

0 2049 Rp 28,559 Rp 21,968 Rp 520,645

0 2049 Rp 43,518 Rp 826,838


0 2049 Rp 23,119 Rp 17,784 Rp 421,474
0 2049 Rp 25,839 Rp 19,876 Rp 496,898
0 2049 Rp 20,399 Rp 15,692 Rp 392,288
0 2049 Rp 17,679 Rp 13,599 Rp 339,983
0 2049 Rp 17,679 Rp 13,599 Rp 339,983
0 2049 Rp 20,399 Rp 15,692 Rp 392,288
0 2049 Rp 17,679 Rp 13,599 Rp 339,983
0 2049 Rp 20,399 Rp 15,692 Rp 392,288
0 2049
0 2049
0 2049
0 2049
0 3

0
0

0
Rp 265,187 Rp 170,515 Rp 5,008,105

uang sisa
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN JULI TAHUN 2019
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,789,250
Penerimaan Kapitasi dengan
Kehadiran
Presentas Jumlah peserta 6.213
Rangk Tanggu Jumlah Poin e Jumlah Jasa Pelayanan
Jenis ap ng Variabel Kehadiran Total yang diterima
Pendidi Masa Jumlah
No Nama Pegawai Jabatan Ketena Jumlah Tugas Jawab Ketenagaan (%Pembag Seluruh Biaya dengan Peserta Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Jasa Pelayanan Total Sisa Jasa Yang Di
gaan Hari Admini Progra (= ian Kolom Point Operasional ( Klm 9 x klm 10
Masuk (60 %) Terima
Kerja stratif m klm 1+2+5+6) 3 dibagi (Kolm 8x7) ( 40 %) dibagi jumlah klm 9)
Kerja klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Sutriyanti Sartoso, SKM KTU Kesling / IIIb S1 80 9 17 27 100 10 199 0.62963 125.2963 Rp 11,146,000 Rp 5,515,700 Rp 799,248 Rp 39,962 Rp 759,286 Rp 559,286 1 10
2 dr. Ami Kangela Baba Dokter S1 80 10 20 27 100 0 190 0.74074 140.74074 Rp 11,146,001 Rp 5,515,700 Rp 897,766 Rp 44,888 Rp 852,878 Rp 852,878
3 Asmawati Yusup, Amd.Keb KB, / IIIc D4 80 20 27 27 0 10 110 1 110 Rp 11,146,000 Rp 5,515,700 Rp 701,675 Rp 35,084 Rp 666,591 Rp 666,591 2 0

Masriati Cein, AMK P. SP2TP, , Pneumonia,/IIIb


4 D1 60 25 27 27 20 105 1 105 Rp 11,146,000 Rp 5,515,700 Rp 669,781 Rp 33,489 Rp 636,292 Rp 636,292 3 0

Iriyani Sartoso , Amd.Keb , Batra, B JKN /IIIc


5 D3 60 10 19 27 50 40 160 0.703704 112.59259 Rp 11,146,000 Rp 5,515,700 Rp 718,213 Rp 35,911 Rp 682,302 Rp 522,302 4 8

6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 26 27 20 85 0.962963 81.851852 Rp 11,146,000 Rp 5,515,700 Rp 522,122 Rp 26,106 Rp 496,016 Rp 476,016 5 1

7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 25 27 30 95 0.925926 87.962963 Rp 11,146,000 Rp 5,515,700 Rp 561,104 Rp - Rp 561,104 Rp 521,104 6 2

8 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 26 27 10 75 0.962963 72.222222 Rp 11,146,000 Rp 5,515,700 Rp 460,696 - Rp 460,696 Rp 440,696 7 1

9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 25 27 0 65 0.925926 60.185185 Rp 11,146,000 Rp 5,515,700 Rp 383,913 Rp - Rp 383,913 Rp 343,913 8 2

10 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 27 27 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 414,626 Rp - Rp 414,626 Rp 414,626 9 0

11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS/P Aset D3 60 5 23 27 10 75 0.851852 63.888889 Rp 11,146,000 Rp 5,515,700 Rp 407,538 Rp - Rp 407,538 Rp 327,538 10 4

12 Rusni GaertiAmd. Keb CPNS D3 60 5 20 27 0 65 0.740741 48.148148 Rp 11,146,000 Rp 5,515,700 Rp 307,130 Rp - Rp 307,130 Rp 167,130 11 7

13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 27 27 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 478,415 Rp - Rp 478,415 Rp 478,415 12 0

14 Endah P. W, Amd. Keb Korim D3 60 5 27 27 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 478,415 Rp - Rp 478,415 Rp 478,415 13 0

15 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 24 27 10 70 0.888889 62.222222 Rp 11,146,000 Rp 5,515,700 Rp 396,907 Rp - Rp 396,907 Rp 336,907 14 3

16 Nikmat Triandini Pataha, Amd. Kep PNS / ISPA / Diare D3 60 0 24 27 20 80 0.888889 71.111111 Rp 11,146,000 Rp 5,515,700 Rp 453,608 Rp - Rp 453,608 Rp 393,608 15 3

17 Sarifa Soabangsa, Amd. Kep TKD/Gimul D3 60 0 21 27 10 70 0.777778 54.444444 Rp 11,146,000 Rp 5,515,700 Rp 347,294 Rp - Rp 347,294 Rp 227,294 16 6

18 Siti Aisyah Sarita, Amd. Kep TKD/PTM D3 60 0 25 27 10 70 0.925926 64.814815 Rp 11,146,000 Rp 5,515,700 Rp 413,445 Rp - Rp 413,445 Rp 373,445 17 2
Hendra Rahman, S. Farm., M.
Apotek
19 Kes., Apt S2 100 0 24 27 100 0.888889 88.888889 Rp 11,146,000 Rp 5,515,700 Rp 567,010 Rp - Rp 567,010 Rp 507,010 18 3
20 Siti Magfirah Nurdin, A.Md. KL Kesling D3 60 0 20 27 10 70 0.740741 51.851852 Rp 11,146,000 Rp 5,515,700 Rp 330,756 Rp - Rp 330,756 Rp 190,756 19 7

21 Fadila Tarate, SKM Kesling/promkes S1 80 0 22 27 10 90 0.814815 73.333333 Rp 11,146,000 Rp 5,515,700 Rp 467,783 Rp - Rp 467,783 Rp 367,783 20 5

22 Ivana Namotemo Talaba, Akuntansi D3 60 0 26 27 60 0.962963 57.777778 Rp 11,146,000 Rp 5,515,700 Rp 368,557 Rp - Rp 368,557 Rp 348,557 21 1
1747.3333 Rp 11,146,000 Rp 215,440 Rp 10,930,560 Rp 9,630,560
Soakonora, 31 Juli 2019
a.n Kepala Puskesmas Soakonora Bendahara Kapitasi JKN Rp 1,300,000
Rp 1,300,000
Rp 2,240,000 Rp 149,333
KTU, Sutriyanti Sartoso,SKM Iriyani Sartoso, Amd. Keb
NIP. 198305132011012007 Nip.19790320 20032 2 011
Pajak

200,000 1747.3333333

0 1747.3333333 Rp 35,084 Rp 25,988 Rp 640,603

0 1747.3333333 Rp 33,489 Rp 24,807 Rp 611,485

160,000 1747.3333333 Rp 35,911 Rp 682,302


20,000 1747.3333333 Rp 26,106 Rp 19,338 Rp 476,678
40,000 1747.3333333 Rp 28,055 Rp 20,782 Rp 540,322
20,000 1747.3333333 Rp 23,035 Rp 17,063 Rp 443,633
40,000 1747.3333333 Rp 19,196 Rp 14,219 Rp 369,694
0 1747.3333333 Rp 20,731 Rp 15,357 Rp 399,270
80,000 1747.3333333 Rp 20,377 Rp 15,094 Rp 392,444
140,000 1747.3333333 Rp 15,357 Rp 11,375 Rp 295,755
0 1747.3333333 Rp 23,921 Rp 17,719 Rp 460,696
0 1747.3333333
60,000 1747.3333333
60,000 1747.3333333
120,000 1747.3333333
40,000 3

60,000
140,000

100,000

20,000
Rp 281,261 Rp 181,741 Rp 5,312,882

uang sisa
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN JUNI TAHUN 2019
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,789,250
Penerimaan Kapitasi dengan
Kehadiran
Presentas Jumlah peserta 6.213
Rangk Tanggu Jumlah Poin e Jumlah Jasa Pelayanan
Jenis ap ng Variabel Kehadiran Total yang diterima
Pendidi Masa Jumlah
No Nama Pegawai Jabatan Ketena Jumlah Tugas Jawab Ketenagaan (%Pembag Seluruh Biaya dengan Peserta Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Jasa Pelayanan Total Sisa Jasa Yang Di
gaan Hari Admini Progra (= ian Kolom Point Operasional ( Klm 9 x klm 10
Masuk (60 %) Terima
Kerja stratif m klm 1+2+5+6) 3 dibagi (Kolm 8x7) ( 40 %) dibagi jumlah klm 9)
Kerja klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Sutriyanti Sartoso, SKM KTU Kesling / IIIb S1 80 9 17 18 100 10 199 0.944444 187.94444 Rp 11,146,000 Rp 5,515,700 Rp 1,185,454 Rp 59,273 Rp 1,126,181 Rp 1,106,181 1 1
2 dr. Ami Kangela Baba Dokter S1 80 10 14 18 100 0 190 0.77778 147.77778 Rp 11,146,001 Rp 5,515,700 Rp 932,104 Rp 46,605 Rp 885,499 Rp 885,499
3 Asmawati Yusup, Amd.Keb KB, / IIIc D4 80 20 17 18 0 10 110 0.944444 103.88889 Rp 11,146,000 Rp 5,515,700 Rp 655,276 Rp 32,764 Rp 622,512 Rp 602,512 2 1
P. SP2TP, , Pneumonia,
Masriati Cein, AMK
4 /IIIb D1 60 25 16 18 20 105 0.888889 93.333333 Rp 11,146,000 Rp 5,515,700 Rp 588,697 Rp 29,435 Rp 559,262 Rp 519,262 3 2

Iriyani Sartoso , Amd.Keb , Batra, B JKN /IIIc


5 D3 60 10 12 18 50 40 160 0.666667 106.66667 Rp 11,146,000 Rp 5,515,700 Rp 672,797 Rp 33,640 Rp 639,157 Rp 519,157 4 6

6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 18 18 20 85 1 85 Rp 11,146,000 Rp 5,515,700 Rp 536,135 Rp 26,807 Rp 509,328 Rp 509,328 5 0

7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 15 18 30 95 0.833333 79.166667 Rp 11,146,000 Rp 5,515,700 Rp 499,341 Rp - Rp 499,341 Rp 439,341 6 3

8 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 16 18 10 75 0.888889 66.666667 Rp 11,146,000 Rp 5,515,700 Rp 420,498 - Rp 420,498 Rp 380,498 7 2

9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 13 18 0 65 0.722222 46.944444 Rp 11,146,000 Rp 5,515,700 Rp 296,101 Rp - Rp 296,101 Rp 196,101 8 5

10 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 18 18 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 409,986 Rp - Rp 409,986 Rp 409,986 9 0

11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS/P Aset D3 60 5 10 18 10 75 0.555556 41.666667 Rp 11,146,000 Rp 5,515,700 Rp 262,811 Rp - Rp 262,811 Rp 102,811 10 8

12 Rusni GaertiAmd. Keb CPNS D3 60 5 17 18 0 65 0.944444 61.388889 Rp 11,146,000 Rp 5,515,700 Rp 387,209 Rp - Rp 387,209 Rp 367,209 11 1

13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 16 18 10 75 0.888889 66.666667 Rp 11,146,000 Rp 5,515,700 Rp 420,498 Rp - Rp 420,498 Rp 380,498 12 2

14 Endah P. W, Amd. Keb Korim D3 60 5 18 18 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 473,060 Rp - Rp 473,060 Rp 473,060 13 0

15 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 18 18 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 441,523 Rp - Rp 441,523 Rp 441,523 14 0

16 Nikmat Triandini Pataha, Amd. Kep PNS / ISPA / Diare D3 60 0 16 18 20 80 0.888889 71.111111 Rp 11,146,000 Rp 5,515,700 Rp 448,531 Rp - Rp 448,531 Rp 408,531 15 2

17 Sarifa Soabangsa, Amd. Kep TKD/Gimul D3 60 0 16 18 10 70 0.888889 62.222222 Rp 11,146,000 Rp 5,515,700 Rp 392,465 Rp - Rp 392,465 Rp 352,465 16 2

18 Siti Aisyah Sarita, Amd. Kep TKD/Ptm D3 60 0 15 18 10 70 0.833333 58.333333 Rp 11,146,000 Rp 5,515,700 Rp 367,936 Rp - Rp 367,936 Rp 307,936 17 3
Hendra Rahman, S. Farm., M.
Apotek
19 Kes., Apt S2 100 0 16 18 100 0.888889 88.888889 Rp 11,146,000 Rp 5,515,700 Rp 560,664 Rp - Rp 560,664 Rp 520,664 18 2
20 Siti Magfirah Nurdin, A.Md. KL Kesling D3 60 0 14 18 10 70 0.777778 54.444444 Rp 11,146,000 Rp 5,515,700 Rp 343,407 Rp - Rp 343,407 Rp 263,407 19 4

21 Fadila Tarate, SKM Kesling/promkes S1 80 0 15 18 10 90 0.833333 75 Rp 11,146,000 Rp 5,515,700 Rp 473,060 Rp - Rp 473,060 Rp 413,060 20 3

22 Ivana Namotemo Talaba, Akuntansi D3 60 0 18 18 60 1 60 Rp 11,146,000 Rp 5,515,700 Rp 378,448 Rp - Rp 378,448 Rp 378,448 21 0


1767.1111 Rp 11,146,000 Rp 228,523 Rp 10,917,477 Rp 9,977,477
Soakonora, 30 Juni 2019
a.n Kepala Puskesmas Soakonora Bendahara Kapitasi JKN Rp 940,000
Rp 940,000
Rp -
KTU, Sutriyanti Sartoso,SKM Iriyani Sartoso, Amd. Keb
NIP. 198305132011012007 Nip.19790320 20032 2 011
Pajak

20,000 1767.1111111

20,000 1767.1111111 Rp 32,764 Rp 36,404 Rp 586,108

40,000 1767.1111111 Rp 29,435 Rp 32,705 Rp 526,557

120,000 1767.1111111 Rp 33,640 Rp 639,157


0 1767.1111111 Rp 26,807 Rp 29,785 Rp 479,543
60,000 1767.1111111 Rp 24,967 Rp 27,741 Rp 471,600
40,000 1767.1111111 Rp 21,025 Rp 23,361 Rp 397,137
100,000 1767.1111111 Rp 14,805 Rp 16,450 Rp 279,651
0 1767.1111111 Rp 20,499 Rp 22,777 Rp 387,209
160,000 1767.1111111 Rp 13,141 Rp 14,601 Rp 248,211
20,000 1767.1111111 Rp 19,360 Rp 21,512 Rp 365,697
40,000 1767.1111111 Rp 21,025 Rp 23,361 Rp 397,137
0 1767.1111111
0 1767.1111111
40,000 1767.1111111
40,000 1767.1111111
60,000 3

40,000
80,000

60,000

0
Rp 257,467 Rp 248,697 Rp 4,778,006

uang sisa
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN Mei TAHUN 2019
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,789,250
Penerimaan Kapitasi dengan
Kehadiran
Presentas Jumlah peserta 6.213
Rangk Tanggu Jumlah Poin e Jumlah Jasa Pelayanan
Jenis ap ng Variabel Kehadiran Total yang diterima
Pendidi Masa Jumlah Jumlah Biaya
No Nama Pegawai Jabatan Ketena Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan dengan Peserta Pajak 5 % Sisa Terima Jasa Total Sisa Jasa Yang Di Paraf
kan Kerja Hari Hari Admini Progra Operasional
gaan Masuk (= ian Kolom Point (60 %) ( Klm 9 x klm 10 Terima
Kerja stratif m klm 1+2+5+6) 3 dibagi (Kolm 8x7) ( 40 %) dibagi jumlah klm 9)
Kerja
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Sutriyanti Sartoso, SKM KTU Kesling / IIIb S1 80 9 16 25 100 10 199 0.64 127.36 Rp 11,146,000 Rp 5,515,700 Rp 888,132 Rp 44,407 Rp 843,725 Rp 663,725 1 9 180,000
2 Asmawati Yusup, Amd.Keb KB, / IIIc D4 80 20 19 25 0 10 110 0.76 83.6 Rp 11,146,000 Rp 5,515,700 Rp 582,976 Rp 29,149 Rp 553,827 Rp 433,827 2 6 120,000
Nurafni Kudo , SKM S1 80 9 23 23 0 89 1 89 Rp 11,146,000 Rp 5,515,700 Rp 620,632 Rp 31,032 Rp 589,601 Rp 589,601
P. SP2TP, , Pneumonia,
Masriati Cein, AMK
3 PTM/IIIb D1 60 25 23 25 30 115 0.92 105.8 Rp 11,146,000 Rp 5,515,700 Rp 737,785 Rp 36,889 Rp 700,896 Rp 660,896 3 2 40,000

Iriyani Sartoso , Amd.Keb , Batra, B JKN /IIIc


4 D3 60 10 22 25 50 40 160 0.88 140.8 Rp 11,146,000 Rp 5,515,700 Rp 981,854 Rp 49,093 Rp 932,762 Rp 872,762 4 3 60,000

5 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 15 25 20 85 0.6 51 Rp 11,146,000 Rp 5,515,700 Rp 355,643 Rp 17,782 Rp 337,861 Rp 137,861 5 10 200,000

6 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 21 25 30 95 0.84 79.8 Rp 11,146,000 Rp 5,515,700 Rp 556,477 Rp - Rp 556,477 Rp 476,477 6 4 80,000

7 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 20 25 10 75 0.8 60 Rp 11,146,000 Rp 5,515,700 Rp 418,404 - Rp 418,404 Rp 318,404 7 5 100,000

8 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 21 25 0 65 0.84 54.6 Rp 11,146,000 Rp 5,515,700 Rp 380,748 Rp - Rp 380,748 Rp 100,000 8 4 80,000

9 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 20 25 0 65 0.8 52 Rp 11,146,000 Rp 5,515,700 Rp 362,617 Rp - Rp 362,617 Rp 262,617 9 5 100,000

10 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS/P Aset D3 60 5 21 25 10 75 0.84 63 Rp 11,146,000 Rp 5,515,700 Rp 439,324 Rp - Rp 439,324 Rp 359,324 10 4 80,000

11 Rusni GaertiAmd. Keb CPNS D3 60 5 21 25 0 65 0.84 54.6 Rp 11,146,000 Rp 5,515,700 Rp 380,748 Rp - Rp 380,748 Rp 300,748 11 4 80,000

12 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 21 25 10 75 0.84 63 Rp 11,146,000 Rp 5,515,700 Rp 439,324 Rp - Rp 439,324 Rp 359,324 12 4 80,000

13 Endah P. W, Amd. Keb Korim D3 60 5 21 25 10 75 0.84 63 Rp 11,146,000 Rp 5,515,700 Rp 439,324 Rp - Rp 439,324 Rp 359,324 13 4 80,000

14 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 20 25 10 70 0.8 56 Rp 11,146,000 Rp 5,515,700 Rp 390,510 Rp - Rp 390,510 Rp 290,510 14 5 100,000

15 Nikmat Triandini Pataha PNS / ISPA / Diare D3 60 0 21 25 20 80 0.84 67.2 Rp 11,146,000 Rp 5,515,700 Rp 468,612 Rp - Rp 468,612 Rp 388,612 15 4 80,000

16 Sarifa Soabangsa TKD/Gimul D3 60 0 22 25 10 70 0.88 61.6 Rp 11,146,000 Rp 5,515,700 Rp 429,561 Rp - Rp 429,561 Rp 369,561 16 3 60,000

17 Aisyah TKD D3 60 0 22 25 10 70 0.88 61.6 Rp 11,146,000 Rp 5,515,700 Rp 429,561 Rp - Rp 429,561 Rp 369,561 17 3 60,000
Hendra Rahman, S. Farm., M.
Apotek
18 Kes., Apt S2 100 0 19 25 100 0.76 76 Rp 11,146,001 Rp 5,515,700 Rp 529,978 Rp - Rp 529,978 Rp 529,978 18
19 Siti Magfirah Nurdin, A.Md. KL Kesling S1 60 0 21 25 10 70 0.84 58.8 Rp 11,146,002 Rp 5,515,700 Rp 410,036 Rp - Rp 410,036 Rp 410,036 19

20 Fadila Tarate, SKM Kesling/promkes S1 80 0 20 25 10 90 0.8 72 Rp 11,146,003 Rp 5,515,700 Rp 502,085 Rp - Rp 502,085 Rp 502,085 20

21 Ivana Namotemo Talaba, Akuntansi D3 60 0 24 25 60 0.96 57.6 Rp 11,146,003 Rp 5,515,700 Rp 401,668 Rp - Rp 401,668 Rp 401,668 21
1598.36 Rp 11,146,000 Rp 208,351 Rp 10,937,649 Rp 9,156,902
Soakonora, 31 Mei 2019
a.n Kepala Puskesmas Soakonora Bendahara Kapitasi JKN Rp 1,780,748 uang sisa
Rp 1,780,748
Rp 3,384,704 Rp 2,370,348 Rp 2,440,748 Rp 162,717
KTU, Sutriyanti Sartoso,SKM Iriyani Sartoso, Amd. Keb
NIP. 198305132011012007 Nip.19790320 20032 2 011
Pajak

1598.36
1598.36 Rp 29,149 Rp 23,319 Rp 530,508

1598.36 Rp 36,889 Rp 29,511 Rp 671,385

1598.36 Rp 49,093 Rp 932,762


1598.36 Rp 17,782 Rp 14,226 Rp 323,635
1598.36 Rp 27,824 Rp 22,259 Rp 534,218
1598.36 Rp 20,920 Rp 16,736 Rp 401,668
1598.36 Rp 19,037 Rp 15,230 Rp 365,518
1598.36 Rp 18,131 Rp 14,505 Rp 348,112
1598.36 Rp 21,966 Rp 17,573 Rp 421,751
1598.36 Rp 19,037 Rp 15,230 Rp 365,518
1598.36 Rp 21,966 Rp 17,573 Rp 421,751
1598.36
1598.36
1598.36
1598.36
3
Rp 281,795 Rp 186,162 Rp 5,316,825
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN April TAHUN 2019
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,789,250
Penerimaan Kapitasi dengan
Kehadiran
Presentas Jumlah peserta 6.213
Rangk Tanggu Jumlah Poin e Jumlah
Jasa Pelayanan yang
Jenis ap ng Variabel Kehadiran Total
Pendidi Masa Jumlah Jumlah Biaya diterima dengan Peserta
No Nama Pegawai Jabatan Ketena Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Hari Admini Progra Operasional ( Klm 9 x klm 10 Total Sisa Jasa Yang Di
gaan Masuk (= ian Kolom Point (60 %) Terima
Kerja stratif ( 40 %) dibagi jumlah klm 9)
Kerja m klm 1+2+5+6) 3 dibagi (Kolm 8x7)
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

2 Sutriyanti Sartoso, SKM KTU Kesling / IIIb S1 80 9 22 23 100 10 199 0.956522 190.34783 Rp 11,146,000 Rp 5,515,700 Rp 1,152,780 Rp 57,639 Rp 1,095,141 Rp 1,075,141 2
3 Asmawati Yusup, Amd.Keb KB, / IIIc D4 80 20 22 23 0 10 110 0.956522 105.21739 Rp 11,146,000 Rp 5,515,700 Rp 637,215 Rp 31,861 Rp 605,354 Rp 585,354 3
Nurafni Kudo , SKM S1 80 9 23 23 0 89 1 89 Rp 11,146,000 Rp 5,515,700 Rp 539,000 Rp 26,950 Rp 512,050 Rp 512,050
P. SP2TP, , Pneumonia,
Masriati Cein, AMK
4 PTM/IIIb D1 60 25 18 23 30 115 0.782609 90 Rp 11,146,000 Rp 5,515,700 Rp 545,056 Rp 27,253 Rp 517,803 Rp 417,803 4

Iriyani Sartoso , Amd.Keb , Batra, B JKN /IIIc


5 D3 60 10 23 23 50 40 160 1 160 Rp 11,146,000 Rp 5,515,700 Rp 968,988 Rp 48,449 Rp 920,539 Rp 920,539 5

6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 23 23 20 85 1 85 Rp 11,146,000 Rp 5,515,700 Rp 514,775 Rp 25,739 Rp 489,036 Rp 489,036 6

7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 23 23 30 95 1 95 Rp 11,146,000 Rp 5,515,700 Rp 575,337 Rp - Rp 575,337 Rp 575,337 7

8 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 22 23 10 75 0.956522 71.73913 Rp 11,146,000 Rp 5,515,700 Rp 434,465 - Rp 434,465 Rp 414,465 8

9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 20 23 0 65 0.869565 56.521739 Rp 11,146,000 Rp 5,515,700 Rp 342,306 Rp - Rp 342,306 Rp 100,000 9

10 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 22 23 0 65 0.956522 62.173913 Rp 11,146,000 Rp 5,515,700 Rp 376,536 Rp - Rp 376,536 Rp 356,536 10

11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS/P Aset D3 60 5 23 23 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 454,213 Rp - Rp 454,213 Rp 454,213 11

12 Rusni GaertiAmd. Keb CPNS D3 60 5 23 23 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 393,652 Rp - Rp 393,652 Rp 393,652 12

13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 23 23 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 454,213 Rp - Rp 454,213 Rp 454,213 13

14 Endah P. W, Amd. Keb Korim D3 60 5 22 23 10 75 0.956522 71.73913 Rp 11,146,000 Rp 5,515,700 Rp 434,465 Rp - Rp 434,465 Rp 414,465 14

15 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 22 23 10 70 0.956522 66.956522 Rp 11,146,000 Rp 5,515,700 Rp 405,501 Rp - Rp 405,501 Rp 385,501 15

16 Nikmat Triandini Pataha PNS / ISPA / Diare D3 60 0 23 23 20 80 1 80 Rp 11,146,000 Rp 5,515,700 Rp 484,494 Rp - Rp 484,494 Rp 484,494 16

17 Sarifa Soabangsa TKD/Gimul D3 60 0 22 23 10 70 0.956522 66.956522 Rp 11,146,000 Rp 5,515,700 Rp 405,501 Rp - Rp 405,501 Rp 385,501 17

18 Aisyah TKD D3 60 0 22 23 10 70 0.956522 66.956522 Rp 11,146,000 Rp 5,515,700 Rp 405,501 Rp - Rp 405,501 Rp 385,501 18


Hendra Rahman, S. Farm., M.
Apotek
19 Kes., Apt S2 100 0 22 23 100 0.956522 95.652174 Rp 11,146,001 Rp 5,515,700 Rp 579,287 Rp - Rp 579,287 Rp 579,287 19
20 Siti Magfirah Nurdin, A.Md. KL Kesling S1 60 0 21 23 10 70 0.913043 63.913043 Rp 11,146,002 Rp 5,515,700 Rp 387,069 Rp - Rp 387,069 Rp 387,069 20

21 Fadila Tarate, SKM Kesling/promkes S1 80 0 19 23 10 90 0.826087 74.347826 Rp 11,146,003 Rp 5,515,700 Rp 450,264 Rp - Rp 450,264 Rp 450,264 21

22 Ivana N. Talaba, Amd. Akt Akuntansi D3 60 0 13 23 60 0.565217 33.913043 Rp 11,146,003 Rp 5,515,700 Rp 205,383 Rp - Rp 205,383 Rp 205,383 22
1840.4348 Rp 11,146,000 Rp 217,891 Rp 10,928,110 Rp 10,425,804
Soakonora, 30 April 2019
a.n Kepala Puskesmas Soakonora Bendahara Kapitasi JKN

Rp 502,306 Rp 1,014,356
KTU, Sutriyanti Sartoso,SKM Iriyani Sartoso, Amd. Keb
NIP. 198305132011012007 Nip.19790320 20032 2 011
Pajak

1 20,000 1840.4347826
1 20,000 1840.4347826 Rp 31,861 Rp 27,705 Rp 577,649

5 100,000 1840.4347826 Rp 27,253 Rp 23,698 Rp 494,105

0 0 1840.4347826 Rp 48,449 Rp 920,539


0 0 1840.4347826 Rp 25,739 Rp 22,382 Rp 466,655
0 0 1840.4347826 Rp 28,767 Rp 25,015 Rp 550,322
1 20,000 1840.4347826 Rp 21,723 Rp 18,890 Rp 415,575
3 60,000 1840.4347826 Rp 17,115 Rp 14,883 Rp 327,423
1 20,000 1840.4347826 Rp 18,827 Rp 16,371 Rp 360,165
0 0 1840.4347826 Rp 22,711 Rp 19,748 Rp 434,465
0 0 1840.4347826 Rp 19,683 Rp 17,115 Rp 376,536
0 0 1840.4347826 Rp 22,711 Rp 19,748 Rp 434,465
1 20,000 1840.4347826
1 20,000 1840.4347826
0 0 1840.4347826
1 20,000 1840.4347826
1 20,000 3
Rp 284,838 Rp 205,555 Rp 5,357,900

Rp 502,306 uang sisa


DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN April TAHUN 2019
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 1,208,664
Penerimaan Kapitasi dengan
Kehadiran
Presentas Jumlah peserta 6.213
Rangk Tanggu Jumlah Poin e Jumlah
Jasa Pelayanan yang
Jenis ap ng Variabel Kehadiran Total
Pendidi Masa Jumlah Jumlah Biaya diterima dengan Peserta
No Nama Pegawai Jabatan Ketena Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Hari Admini Progra Operasional ( Klm 9 x klm 10
gaan Masuk (= ian Kolom Point (60 %)
Kerja stratif ( 40 %) dibagi jumlah klm 9)
Kerja m klm 1+2+5+6) 3 dibagi (Kolm 8x7)
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

2 Siti Fatima D3 60 0 22 23 60 0.956522 57.391304 Rp 1,208,664 Rp 483,466 Rp 66,050 Rp - Rp 66,050 2 1


3 Asyuni D3 60 0 16 23 60 0.695652 41.73913 Rp 1,208,664 Rp 483,466 Rp 48,036 Rp - Rp 48,036 3 7
4 Christovel D3 60 0 19 23 60 0.826087 49.565217 Rp 1,208,664 Rp 483,466 Rp 57,043 Rp - Rp 57,043 4 4

Nurfani
5 D3 60 0 23 23 60 1 60 Rp 1,208,664 Rp 483,466 Rp 69,052 Rp - Rp 69,052 5 0

6 Fatims S1 80 0 23 23 80 1 80 Rp 1,208,664 Rp 483,466 Rp 92,070 Rp - Rp 92,070 6 0

7 Nurkhaida S1 80 0 23 23 80 1 80 Rp 1,208,664 Rp 483,466 Rp 92,070 Rp - Rp 92,070 7 0

8 Risma Ria D3 60 0 22 23 60 0.956522 57.391304 Rp 1,208,664 Rp 483,466 Rp 66,050 - Rp 66,050 8 1

9 Siti Riskiyah D3 60 0 20 23 60 0.869565 52.173913 Rp 1,208,664 Rp 483,466 Rp 60,045 Rp - Rp 60,045 9 3

10 Tazkir Nyong S1 80 0 22 23 80 0.956522 76.521739 Rp 1,208,664 Rp 483,466 Rp 88,067 Rp - Rp 88,067 10 1

11 Manja S1 80 0 23 23 80 1 80 Rp 1,208,664 Rp 483,466 Rp 92,070 Rp - Rp 92,070 11 0

12 Indah S. G D3 60 0 23 23 60 1 60 Rp 1,208,664 Rp 483,466 Rp 69,052 Rp - Rp 69,052 12 0

13 Siti Aisyah Umar S1 80 0 23 23 80 1 80 Rp 1,208,664 Rp 483,466 Rp 92,070 Rp - Rp 92,070 13 0

14 Siti Kalsum D3 60 0 22 23 60 0.956522 57.391304 Rp 1,208,664 Rp 483,466 Rp 66,050 Rp - Rp 66,050 14 1

15 Suratmi S1 80 0 22 23 80 0.956522 76.521739 Rp 1,208,664 Rp 483,466 Rp 88,067 Rp - Rp 88,067 15 1

16 Nurlaila Samad D3 60 0 23 23 5 65 1 65 Rp 1,208,664 Rp 483,466 Rp 74,807 Rp - Rp 74,807 16 0

17 Sitra S1 80 0 22 23 80 0.956522 76.521739 Rp 1,208,664 Rp 483,466 Rp 88,067 Rp - Rp 88,067 17 1


1050.2174 Rp 1,208,664 Rp - Rp 1,208,664
Soakonora, 30 April 2019
a.n Kepala Puskesmas Soakonora Bendahara Kapitasi JKN #REF!

KTU, Sutriyanti Sartoso,SKM Iriyani Sartoso, Amd. Keb


NIP. 198305132011012007 Nip.19790320 20032 2 011
Pajak

20,000 1050.2173913
140,000 1050.2173913 Rp 2,402 Rp 2,089 Rp 45,948
80,000 1050.2173913 Rp 2,852 Rp 2,480 Rp 54,563

0 1050.2173913 Rp 3,453 Rp 69,052


0 1050.2173913 Rp 4,603 Rp 4,003 Rp 88,067
0 1050.2173913 Rp 4,603 Rp 4,003 Rp 88,067
20,000 1050.2173913 Rp 3,302 Rp 2,872 Rp 63,178
60,000 1050.2173913 Rp 3,002 Rp 2,611 Rp 57,435
20,000 1050.2173913 Rp 4,403 Rp 3,829 Rp 84,238
0 1050.2173913 Rp 4,603 Rp 4,003 Rp 88,067
0 1050.2173913 Rp 3,453 Rp 3,002 Rp 66,050
0 1050.2173913 Rp 4,603 Rp 4,003 Rp 88,067
20,000 1050.2173913
20,000 1050.2173913
0 1050.2173913
20,000 1050.2173913
Rp 41,281 Rp 32,894 Rp 792,730

uang sisa
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN JULI TAHUN 2019
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,789,250
Penerimaan Kapitasi dengan
Kehadiran
Presentas Jumlah peserta 6.213
Rangk Tanggu Jumlah Poin e Jumlah Jasa Pelayanan
Jenis ap ng Variabel Kehadiran Total yang diterima
Pendidi Masa Jumlah
No Nama Pegawai Jabatan Ketena Jumlah Tugas Jawab Ketenagaan (%Pembag Seluruh Biaya dengan Peserta Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Jasa Pelayanan Total Sisa Jasa Yang Di
gaan Hari Admini Progra (= ian Kolom Point Operasional ( Klm 9 x klm 10
Masuk (60 %) Terima
Kerja stratif m klm 1+2+5+6) 3 dibagi (Kolm 8x7) ( 40 %) dibagi jumlah klm 9)
Kerja klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Sutriyanti Sartoso, SKM KTU Kesling / IIIb S1 80 9 22 27 100 10 199 0.814815 162.14815 Rp 11,146,000 Rp 5,515,700 Rp 1,007,311 Rp 50,366 Rp 956,946 Rp 856,946 1 5
2 dr. Ami Kangela Baba Dokter S1 80 10 20 27 100 0 190 0.74074 140.74074 Rp 11,146,001 Rp 5,515,700 Rp 874,322 Rp 43,716 Rp 830,606 Rp 830,606
3 Asmawati Yusup, Amd.Keb KB, / IIIc D4 80 20 27 27 0 10 110 1 110 Rp 11,146,000 Rp 5,515,700 Rp 683,352 Rp 34,168 Rp 649,184 Rp 649,184 2 0
P. SP2TP, , Pneumonia,
Masriati Cein, AMK
4 PTM/IIIb D1 60 25 27 27 30 115 1 115 Rp 11,146,000 Rp 5,515,700 Rp 714,413 Rp 35,721 Rp 678,693 Rp 678,693 3 0

Iriyani Sartoso , Amd.Keb , Batra, B JKN /IIIc


5 D3 60 10 19 27 50 40 160 0.703704 112.59259 Rp 11,146,000 Rp 5,515,700 Rp 699,458 Rp 34,973 Rp 664,485 Rp 504,485 4 8

6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 26 27 20 85 0.962963 81.851852 Rp 11,146,000 Rp 5,515,700 Rp 508,488 Rp 25,424 Rp 483,063 Rp 463,063 5 1

7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 25 27 30 95 0.925926 87.962963 Rp 11,146,000 Rp 5,515,700 Rp 546,451 Rp - Rp 546,451 Rp 506,451 6 2

8 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 26 27 10 75 0.962963 72.222222 Rp 11,146,000 Rp 5,515,700 Rp 448,665 - Rp 448,665 Rp 428,665 7 1

9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 25 27 0 65 0.925926 60.185185 Rp 11,146,000 Rp 5,515,700 Rp 373,888 Rp - Rp 373,888 Rp 333,888 8 2

10 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 27 27 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 403,799 Rp - Rp 403,799 Rp 403,799 9 0

11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS/P Aset D3 60 5 23 27 10 75 0.851852 63.888889 Rp 11,146,000 Rp 5,515,700 Rp 396,896 Rp - Rp 396,896 Rp 316,896 10 4

12 Rusni GaertiAmd. Keb CPNS D3 60 5 20 27 0 65 0.740741 48.148148 Rp 11,146,000 Rp 5,515,700 Rp 299,110 Rp - Rp 299,110 Rp 159,110 11 7

13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 27 27 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 465,922 Rp - Rp 465,922 Rp 465,922 12 0

14 Endah P. W, Amd. Keb Korim D3 60 5 27 27 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 465,922 Rp - Rp 465,922 Rp 465,922 13 0

15 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 24 27 10 70 0.888889 62.222222 Rp 11,146,000 Rp 5,515,700 Rp 386,543 Rp - Rp 386,543 Rp 326,543 14 3

16 Nikmat Triandini Pataha, Amd. Kep PNS / ISPA / Diare D3 60 0 24 27 20 80 0.888889 71.111111 Rp 11,146,000 Rp 5,515,700 Rp 441,763 Rp - Rp 441,763 Rp 381,763 15 3

17 Sarifa Soabangsa, Amd. Kep TKD/Gimul D3 60 0 21 27 10 70 0.777778 54.444444 Rp 11,146,000 Rp 5,515,700 Rp 338,225 Rp - Rp 338,225 Rp 218,225 16 6

18 Siti Aisyah Sarita, Amd. Kep TKD D3 60 0 25 27 10 70 0.925926 64.814815 Rp 11,146,000 Rp 5,515,700 Rp 402,648 Rp - Rp 402,648 Rp 362,648 17 2
Hendra Rahman, S. Farm., M.
Apotek
19 Kes., Apt S2 100 0 24 27 100 0.888889 88.888889 Rp 11,146,000 Rp 5,515,700 Rp 552,204 Rp - Rp 552,204 Rp 492,204 18 3
20 Siti Magfirah Nurdin, A.Md. KL Kesling S1 60 0 20 27 10 70 0.740741 51.851852 Rp 11,146,000 Rp 5,515,700 Rp 322,119 Rp - Rp 322,119 Rp 182,119 19 7

21 Fadila Tarate, SKM Kesling/promkes S1 80 0 22 27 10 90 0.814815 73.333333 Rp 11,146,000 Rp 5,515,700 Rp 455,568 Rp - Rp 455,568 Rp 355,568 20 5

22 Ivana Namotemo Talaba, Akuntansi D3 60 0 26 27 60 0.962963 57.777778 Rp 11,146,000 Rp 5,515,700 Rp 358,932 Rp - Rp 358,932 Rp 338,932 21 1
1794.1852 Rp 11,146,000 Rp 224,367 Rp 10,921,633 Rp 9,721,633
Soakonora, 31 Juli 2019
a.n Kepala Puskesmas Soakonora Bendahara Kapitasi JKN Rp 1,200,000
Rp 1,200,000
Rp 2,140,000 Rp 142,667
KTU, Sutriyanti Sartoso,SKM Iriyani Sartoso, Amd. Keb
NIP. 198305132011012007 Nip.19790320 20032 2 011
Pajak

100,000 1794.1851852

0 1794.1851852 Rp 34,168 Rp 25,309 Rp 623,875

0 1794.1851852 Rp 35,721 Rp 26,460 Rp 652,233

160,000 1794.1851852 Rp 34,973 Rp 664,485


20,000 1794.1851852 Rp 25,424 Rp 18,833 Rp 464,230
40,000 1794.1851852 Rp 27,323 Rp 20,239 Rp 526,213
20,000 1794.1851852 Rp 22,433 Rp 16,617 Rp 432,048
40,000 1794.1851852 Rp 18,694 Rp 13,848 Rp 360,040
0 1794.1851852 Rp 20,190 Rp 14,956 Rp 388,843
80,000 1794.1851852 Rp 19,845 Rp 14,700 Rp 382,196
140,000 1794.1851852 Rp 14,956 Rp 11,078 Rp 288,032
0 1794.1851852 Rp 23,296 Rp 17,256 Rp 448,665
0 1794.1851852
60,000 1794.1851852
60,000 1794.1851852
120,000 1794.1851852
40,000 3

60,000
140,000

100,000

20,000
Rp 277,022 Rp 179,296 Rp 5,230,862

uang sisa
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN Mei TAHUN 2019
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,789,250
Penerimaan Kapitasi dengan
Kehadiran
Presentas Jumlah peserta 6.213
Rangk Tanggu Jumlah Poin e Jumlah Jasa Pelayanan
Jenis ap ng Variabel Kehadiran Total yang diterima
Pendidi Masa Jumlah Jumlah Biaya
No Nama Pegawai Jabatan Ketena Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan dengan Peserta Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Hari Admini Progra Operasional
Total Sisa Jasa Yang Di
gaan Masuk (= ian Kolom Point (60 %) ( Klm 9 x klm 10 Terima
Kerja stratif m klm 1+2+5+6) 3 dibagi (Kolm 8x7) ( 40 %) dibagi jumlah klm 9)
Kerja
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Sutriyanti Sartoso, SKM KTU Kesling / IIIb S1 80 9 16 25 100 10 199 0.64 127.36 Rp 11,146,000 Rp 5,515,700 Rp 940,501 Rp 47,025 Rp 893,476 Rp 713,476 1 9
2 Asmawati Yusup, Amd.Keb KB, / IIIc D4 80 20 19 25 0 10 110 0.76 83.6 Rp 11,146,000 Rp 5,515,700 Rp 617,351 Rp 30,868 Rp 586,484 Rp 466,484 2 6
P. SP2TP, , Pneumonia,
Masriati Cein, AMK
3 PTM/IIIb D1 60 25 23 25 30 115 0.92 105.8 Rp 11,146,000 Rp 5,515,700 Rp 781,289 Rp 39,064 Rp 742,225 Rp 702,225 3 2

Iriyani Sartoso , Amd.Keb , Batra, B JKN /IIIc


4 D3 60 10 22 25 50 40 160 0.88 140.8 Rp 11,146,000 Rp 5,515,700 Rp 1,039,750 Rp 51,987 Rp 987,762 Rp 927,762 4 3

5 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 15 25 20 85 0.6 51 Rp 11,146,000 Rp 5,515,700 Rp 376,614 Rp 18,831 Rp 357,783 Rp 157,783 5 10

6 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 21 25 30 95 0.84 79.8 Rp 11,146,000 Rp 5,515,700 Rp 589,290 Rp - Rp 589,290 Rp 509,290 6 4

7 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 20 25 10 75 0.8 60 Rp 11,146,000 Rp 5,515,700 Rp 443,075 - Rp 443,075 Rp 343,075 7 5

8 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 21 25 0 65 0.84 54.6 Rp 11,146,000 Rp 5,515,700 Rp 403,198 Rp - Rp 403,198 Rp 323,198 8 4

9 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 20 25 0 65 0.8 52 Rp 11,146,000 Rp 5,515,700 Rp 383,999 Rp - Rp 383,999 Rp 283,999 9 5

10 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS/P Aset D3 60 5 21 25 10 75 0.84 63 Rp 11,146,000 Rp 5,515,700 Rp 465,229 Rp - Rp 465,229 Rp 385,229 10 4

11 Rusni GaertiAmd. Keb CPNS D3 60 5 21 25 0 65 0.84 54.6 Rp 11,146,000 Rp 5,515,700 Rp 403,198 Rp - Rp 403,198 Rp 323,198 11 4

12 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 21 25 10 75 0.84 63 Rp 11,146,000 Rp 5,515,700 Rp 465,229 Rp - Rp 465,229 Rp 385,229 12 4

13 Endah P. W, Amd. Keb Korim D3 60 5 21 25 10 75 0.84 63 Rp 11,146,000 Rp 5,515,700 Rp 465,229 Rp - Rp 465,229 Rp 385,229 13 4

14 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 20 25 10 70 0.8 56 Rp 11,146,000 Rp 5,515,700 Rp 413,537 Rp - Rp 413,537 Rp 313,537 14 5

15 Nikmat Triandini Pataha PNS / ISPA / Diare D3 60 0 21 25 20 80 0.84 67.2 Rp 11,146,000 Rp 5,515,700 Rp 496,244 Rp - Rp 496,244 Rp 416,244 15 4

16 Sarifa Soabangsa TKD/Gimul D3 60 0 22 25 10 70 0.88 61.6 Rp 11,146,000 Rp 5,515,700 Rp 454,891 Rp - Rp 454,891 Rp 394,891 16 3

17 Aisyah TKD D3 60 0 22 25 10 70 0.88 61.6 Rp 11,146,000 Rp 5,515,700 Rp 454,891 Rp - Rp 454,891 Rp 394,891 17 3


Hendra Rahman, S. Farm., M.
Apotek
18 Kes., Apt S2 100 0 19 25 100 0.76 76 Rp 11,146,000 Rp 5,515,700 Rp 561,229 Rp - Rp 561,229 Rp 441,229 18 6

19 Siti Magfirah Nurdin, A.Md. KL Kesling S1 60 0 21 25 10 70 0.84 58.8 Rp 11,146,000 Rp 5,515,700 Rp 434,214 Rp - Rp 434,214 Rp 354,214 19 4
20 Fadila Tarate, SKM Kesling/promkes S1 80 0 20 25 10 90 0.8 72 Rp 11,146,000 Rp 5,515,700 Rp 531,690 Rp - Rp 531,690 Rp 431,690 20 5

21 Ivana Namotemo Talaba, Akuntansi D3 60 0 24 25 60 0.96 57.6 Rp 11,146,000 Rp 5,515,700 Rp 425,352 Rp - Rp 425,352 Rp 405,352 21 1
1509.36 Rp 11,146,000 Rp 187,775 Rp 10,958,225 Rp 9,058,225
Soakonora, 31 Mei 2019
a.n Kepala Puskesmas Soakonora Bendahara Kapitasi JKN Rp 1,900,000
Rp 1,900,000
Rp 2,560,000 Rp 170,667
KTU, Sutriyanti Sartoso,SKM Iriyani Sartoso, Amd. Keb
NIP. 198305132011012007 Nip.19790320 20032 2 011
Pajak

180,000 1509.36
120,000 1509.36 Rp 30,868 Rp 24,694 Rp 561,790

40,000 1509.36 Rp 39,064 Rp 31,252 Rp 710,973

60,000 1509.36 Rp 51,987 Rp 987,762


200,000 1509.36 Rp 18,831 Rp 15,065 Rp 342,719
80,000 1509.36 Rp 29,465 Rp 23,572 Rp 565,718
100,000 1509.36 Rp 22,154 Rp 17,723 Rp 425,352
80,000 1509.36 Rp 20,160 Rp 16,128 Rp 387,071
100,000 1509.36 Rp 19,200 Rp 15,360 Rp 368,639
80,000 1509.36 Rp 23,261 Rp 18,609 Rp 446,620
80,000 1509.36 Rp 20,160 Rp 16,128 Rp 387,071
80,000 1509.36 Rp 23,261 Rp 18,609 Rp 446,620
80,000 1509.36
100,000 1509.36
80,000 1509.36
60,000 1509.36
60,000 3

120,000

80,000
100,000

20,000
Rp 298,411 Rp 197,139 Rp 5,630,334

uang sisa
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN April TAHUN 2019
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,789,250
Penerimaan Kapitasi dengan
Kehadiran
Presentas Jumlah peserta 6.213
Rangk Tanggu Jumlah Poin e Jumlah
Jasa Pelayanan yang
Jenis ap ng Variabel Kehadiran Total
Pendidi Masa Jumlah Jumlah Biaya diterima dengan Peserta
No Nama Pegawai Jabatan Ketena Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Hari Admini Progra Operasional ( Klm 9 x klm 10
gaan Masuk (= ian Kolom Point (60 %)
Kerja stratif ( 40 %) dibagi jumlah klm 9)
Kerja m klm 1+2+5+6) 3 dibagi (Kolm 8x7)
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

2 Sutriyanti Sartoso, SKM KTU Kesling / IIIb S1 80 9 22 23 100 10 199 0.956522 190.34783 Rp 11,146,000 Rp 5,515,700 Rp 1,211,359 Rp 60,568 Rp 1,150,791 2 1
3 Asmawati Yusup, Amd.Keb KB, / IIIc D4 80 20 22 23 0 10 110 0.956522 105.21739 Rp 11,146,000 Rp 5,515,700 Rp 669,596 Rp 33,480 Rp 636,116 3 1
P. SP2TP, , Pneumonia,
Masriati Cein, AMK
4 PTM/IIIb D1 60 25 18 23 30 115 0.782609 90 Rp 11,146,000 Rp 5,515,700 Rp 572,753 Rp 28,638 Rp 544,116 4 5

Iriyani Sartoso , Amd.Keb , Batra, B JKN /IIIc


5 D3 60 10 23 23 50 40 160 1 160 Rp 11,146,000 Rp 5,515,700 Rp 1,018,228 Rp 50,911 Rp 967,317 5 0

6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 23 23 20 85 1 85 Rp 11,146,000 Rp 5,515,700 Rp 540,934 Rp 27,047 Rp 513,887 6 0

7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 23 23 30 95 1 95 Rp 11,146,000 Rp 5,515,700 Rp 604,573 Rp - Rp 604,573 7 0

8 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 22 23 10 75 0.956522 71.73913 Rp 11,146,000 Rp 5,515,700 Rp 456,542 - Rp 456,542 8 1

9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 20 23 0 65 0.869565 56.521739 Rp 11,146,000 Rp 5,515,700 Rp 359,700 Rp - Rp 359,700 9 3

10 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 22 23 0 65 0.956522 62.173913 Rp 11,146,000 Rp 5,515,700 Rp 395,670 Rp - Rp 395,670 10 1

11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS/P Aset D3 60 5 23 23 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 477,294 Rp - Rp 477,294 11 0

12 Rusni GaertiAmd. Keb CPNS D3 60 5 23 23 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 413,655 Rp - Rp 413,655 12 0

13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 23 23 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 477,294 Rp - Rp 477,294 13 0

14 Endah P. W, Amd. Keb Korim D3 60 5 22 23 10 75 0.956522 71.73913 Rp 11,146,000 Rp 5,515,700 Rp 456,542 Rp - Rp 456,542 14 1

15 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 22 23 10 70 0.956522 66.956522 Rp 11,146,000 Rp 5,515,700 Rp 426,106 Rp - Rp 426,106 15 1

16 Nikmat Triandini Pataha PNS / ISPA / Diare D3 60 0 23 23 20 80 1 80 Rp 11,146,000 Rp 5,515,700 Rp 509,114 Rp - Rp 509,114 16 0

17 Sarifa Soabangsa TKD/Gimul D3 60 0 22 23 10 70 0.956522 66.956522 Rp 11,146,000 Rp 5,515,700 Rp 426,106 Rp - Rp 426,106 17 1

18 Aisyah TKD D3 60 0 22 23 10 70 0.956522 66.956522 Rp 11,146,000 Rp 5,515,700 Rp 426,106 Rp - Rp 426,106 18 1


Hendra Rahman, S. Farm., M.
Apotek
19 Kes., Apt S2 100 0 22 23 100 0.956522 95.652174 Rp 11,146,000 Rp 5,515,700 Rp 608,723 Rp - Rp 608,723 19 1

20 Siti Magfirah Nurdin, A.Md. KL Kesling S1 60 0 21 23 10 70 0.913043 63.913043 Rp 11,146,000 Rp 5,515,700 Rp 406,738 Rp - Rp 406,738 20 2
21 Fadila Tarate, SKM Kesling/promkes S1 80 0 19 23 10 90 0.826087 74.347826 Rp 11,146,000 Rp 5,515,700 Rp 473,144 Rp - Rp 473,144 21 4

22 Ivana N. Talaba, Amd. Akt Akuntansi D3 60 0 13 23 60 0.565217 33.913043 Rp 11,146,000 Rp 5,515,700 Rp 215,820 Rp - Rp 215,820 22 10
1751.4348 Rp 11,146,000 Rp 200,643 Rp 10,945,357
Soakonora, 30 April 2019
a.n Kepala Puskesmas Soakonora Bendahara Kapitasi JKN Rp 660,000

Rp 660,000
KTU, Sutriyanti Sartoso,SKM Iriyani Sartoso, Amd. Keb
NIP. 198305132011012007 Nip.19790320 20032 2 011
Pajak

20,000 1751.4347826
20,000 1751.4347826 Rp 33,480 Rp 29,113 Rp 607,003

100,000 1751.4347826 Rp 28,638 Rp 24,902 Rp 519,213

0 1751.4347826 Rp 50,911 Rp 967,317


0 1751.4347826 Rp 27,047 Rp 23,519 Rp 490,368
0 1751.4347826 Rp 30,229 Rp 26,286 Rp 578,287
20,000 1751.4347826 Rp 22,827 Rp 19,850 Rp 436,693
60,000 1751.4347826 Rp 17,985 Rp 15,639 Rp 344,061
20,000 1751.4347826 Rp 19,784 Rp 17,203 Rp 378,467
0 1751.4347826 Rp 23,865 Rp 20,752 Rp 456,542
0 1751.4347826 Rp 20,683 Rp 17,985 Rp 395,670
0 1751.4347826 Rp 23,865 Rp 20,752 Rp 456,542
20,000 1751.4347826
20,000 1751.4347826
0 1751.4347826
20,000 1751.4347826
20,000 3

20,000

40,000
80,000

200,000
Rp 299,312 Rp 216,001 Rp 5,630,164

uang sisa
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN Mei TAHUN 2019
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,789,250
Penerimaan Kapitasi dengan
Kehadiran
Presentas Jumlah peserta 6.213
Rangk Tanggu Jumlah Poin e Jumlah Jasa Pelayanan
Jenis ap ng Variabel Kehadiran Total yang diterima
Pendidi Masa Jumlah Jumlah Biaya
No Nama Pegawai Jabatan Ketena Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan dengan Peserta Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Hari Admini Progra Operasional
gaan Masuk (= ian Kolom Point (60 %) ( Klm 9 x klm 10
Kerja stratif m klm 1+2+5+6) 3 dibagi (Kolm 8x7) ( 40 %) dibagi jumlah klm 9)
Kerja
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Sutriyanti Sartoso, SKM KTU Kesling / IIIb S1 80 9 20 20 100 10 199 1 199 Rp 11,146,000 Rp 5,515,700 Rp 1,212,714 Rp 60,636 Rp 1,152,078 1 0 0 1829
2 Asmawati Yusup, Amd.Keb KB, / IIIc D4 60 20 20 20 0 10 90 1 90 Rp 11,146,000 Rp 5,515,700 Rp 548,464 Rp 27,423 Rp 521,040 2 0 0 1829
P. SP2TP, , Pneumonia,
Masriati Cein, AMK
3 PTM/IIIb D1 60 25 20 20 30 115 1 115 Rp 11,146,000 Rp 5,515,700 Rp 700,815 Rp 35,041 Rp 665,774 3 0 0 1829
Iriyani Sartoso , Amd.Keb , Batra, B JKN /IIIc
4 D3 60 10 20 20 50 40 160 1 160 Rp 11,146,000 Rp 5,515,700 Rp 975,046 Rp 48,752 Rp 926,294 4 0 0 1829
5 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 20 20 20 85 1 85 Rp 11,146,000 Rp 5,515,700 Rp 517,993 Rp 25,900 Rp 492,094 5 0 0 1829
6 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 20 20 30 95 1 95 Rp 11,146,000 Rp 5,515,700 Rp 578,934 Rp - Rp 578,934 6 0 0 1829
7 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 20 20 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 457,053 - Rp 457,053 7 0 0 1829
8 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 20 20 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 396,113 Rp - Rp 396,113 8 0 0 1829
9 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 20 20 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 396,113 Rp - Rp 396,113 9 0 0 1829
10 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS/P Aset D3 60 5 20 20 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 457,053 Rp - Rp 457,053 10 0 0 1829
11 Rusni GaertiAmd. Keb CPNS D3 60 5 20 20 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 396,113 Rp - Rp 396,113 11 0 0 1829
12 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 20 20 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 457,053 Rp - Rp 457,053 12 0 0 1829
13 Endah P. W, Amd. Keb Korim D3 60 5 20 20 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 457,053 Rp - Rp 457,053 13 0 0 1829
14 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 20 20 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 426,583 Rp - Rp 426,583 14 0 0 1829
15 Nikmat Triandini Pataha PNS / ISPA / Diare D3 60 0 20 20 20 80 1 80 Rp 11,146,000 Rp 5,515,700 Rp 487,523 Rp - Rp 487,523 15 0 0 1829
16 Sarifa Soabangsa TKD/Gimul D3 60 0 20 20 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 426,583 Rp - Rp 426,583 16 0 0 1829
17 Aisyah TKD D3 60 0 20 20 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 426,583 Rp - Rp 426,583 17 0 0 3
Hendra Rahman, S. Farm., M.
Apotek
18 Kes., Apt S2 80 0 20 20 80 1 80 Rp 11,146,001 Rp 5,515,700 Rp 487,523 Rp - Rp 487,523 18

19 Siti Magfirah Nurdin, A.Md. KL Kesling S1 60 0 20 20 10 70 1 70 Rp 11,146,002 Rp 5,515,700 Rp 426,583 Rp - Rp 426,583 19


20 Fardaila Tarate, SKM Kesling/promkes S1 80 0 20 20 10 90 1 90 Rp 11,146,003 Rp 5,515,700 Rp 548,464 Rp - Rp 548,464 20

21 Ivana Namotemo Talaba, Akuntansi D3 60 0 20 20 60 1 60 Rp 11,146,003 Rp 5,515,700 Rp 365,643 Rp - Rp 365,643 21


1829 Rp 11,146,000 Rp 197,752 Rp 10,948,249
Soakonora, 31 Mei 2019
a.n Kepala Puskesmas Soakonora Bendahara Kapitasi JKN Rp 1,210,219 uang sisa

KTU, Sutriyanti Sartoso,SKM Iriyani Sartoso, Amd. Keb


NIP. 198305132011012007 Nip.19790320 20032 2 011
Pajak

Rp 27,423 Rp 27,423 Rp 493,617

Rp 35,041 Rp 35,041 Rp 630,733

Rp 48,752 Rp 926,294
Rp 25,900 Rp 25,900 Rp 466,194
Rp 28,947 Rp 28,947 Rp 549,987
Rp 22,853 Rp 22,853 Rp 434,200
Rp 19,806 Rp 19,806 Rp 376,307
Rp 19,806 Rp 19,806 Rp 376,307
Rp 22,853 Rp 22,853 Rp 434,200
Rp 19,806 Rp 19,806 Rp 376,307
Rp 22,853 Rp 22,853 Rp 434,200
Rp 294,037 Rp 245,285 Rp 5,498,348
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN April TAHUN 2019
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,789,250
Penerimaan Kapitasi dengan
Kehadiran
Presentas Jumlah peserta 6.213
Rangk Tanggu Jumlah Poin e Jumlah
Jasa Pelayanan yang
Jenis ap ng Variabel Kehadiran Total
Pendidi Masa Jumlah Jumlah Biaya diterima dengan Peserta
No Nama Pegawai Jabatan Ketena Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Hari Admini Progra Operasional ( Klm 9 x klm 10 Total Sisa Jasa Yang Di
gaan Masuk (= ian Kolom Point (60 %) Terima
Kerja stratif ( 40 %) dibagi jumlah klm 9)
Kerja m klm 1+2+5+6) 3 dibagi (Kolm 8x7)
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 9 20 20 100 0 189 1 189 Rp 11,146,000 Rp 5,515,700 Rp 1,098,328 Rp 54,916 Rp 1,043,412 Rp 1,043,412 1
2 Sutriyanti Sartoso, SKM KTU Kesling / IIIb S1 80 9 20 20 0 10 99 1 99 Rp 11,146,000 Rp 5,515,700 Rp 575,315 Rp 28,766 Rp 546,549 Rp 546,549 2
3 Asmawati Yusup, Amd.Keb KB, / IIIc D4 60 20 20 20 0 10 90 1 90 Rp 11,146,000 Rp 5,515,700 Rp 523,014 Rp 26,151 Rp 496,863 Rp 496,863 3
P. SP2TP, , Pneumonia,
Masriati Cein, AMK
4 PTM/IIIb D1 60 25 20 20 30 115 1 115 Rp 11,146,000 Rp 5,515,700 Rp 668,295 Rp 33,415 Rp 634,880 Rp 634,880 4

Iriyani Sartoso , Amd.Keb , Batra, B JKN /IIIc


5 D3 60 10 20 20 50 40 160 1 160 Rp 11,146,000 Rp 5,515,700 Rp 929,802 Rp 46,490 Rp 883,312 Rp 883,312 5

6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 20 20 20 85 1 85 Rp 11,146,000 Rp 5,515,700 Rp 493,957 Rp 24,698 Rp 469,259 Rp 469,259 6

7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 20 20 30 95 1 95 Rp 11,146,000 Rp 5,515,700 Rp 552,070 Rp - Rp 552,070 Rp 552,070 7

8 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 20 20 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 435,845 - Rp 435,845 Rp 435,845 8

9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 20 20 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 377,732 Rp - Rp 377,732 Rp 100,000 9

10 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 20 20 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 377,732 Rp - Rp 377,732 Rp 377,732 10

11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS/P Aset D3 60 5 20 20 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 435,845 Rp - Rp 435,845 Rp 435,845 11

12 Rusni GaertiAmd. Keb CPNS D3 60 5 20 20 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 377,732 Rp - Rp 377,732 Rp 377,732 12

13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 20 20 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 435,845 Rp - Rp 435,845 Rp 435,845 13

14 Endah P. W, Amd. Keb Korim D3 60 5 20 20 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 435,845 Rp - Rp 435,845 Rp 435,845 14

15 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 20 20 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 406,788 Rp - Rp 406,788 Rp 406,788 15

16 Nikmat Triandini Pataha PNS / ISPA / Diare D3 60 0 20 20 20 80 1 80 Rp 11,146,000 Rp 5,515,700 Rp 464,901 Rp - Rp 464,901 Rp 464,901 16

17 Sarifa Soabangsa TKD/Gimul D3 60 0 20 20 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 406,788 Rp - Rp 406,788 Rp 406,788 17

18 Aisyah TKD D3 60 0 20 20 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 406,788 Rp - Rp 406,788 Rp 406,788 18


Hendra Rahman, S. Farm., M.
Apotek
19 Kes., Apt S2 80 0 20 20 80 1 80 Rp 11,146,001 Rp 5,515,700 Rp 464,901 Rp - Rp 464,901 Rp 464,901 19
20 Siti Magfirah Nurdin, A.Md. KL Kesling S1 60 0 20 20 10 70 1 70 Rp 11,146,002 Rp 5,515,700 Rp 406,788 Rp - Rp 406,788 Rp 406,788 20

21 Fardaila Tarate, SKM Kesling/promkes S1 80 0 20 20 10 90 1 90 Rp 11,146,003 Rp 5,515,700 Rp 523,014 Rp - Rp 523,014 Rp 523,014 21

22 Ivana N. Talaba, Amd. Akt Akuntansi D3 60 0 20 20 60 1 60 Rp 11,146,003 Rp 5,515,700 Rp 348,676 Rp - Rp 348,676 22


1918 Rp 11,146,000 Rp 214,436 Rp 10,931,565 Rp 9,782,143
Soakonora, 30 April 2019
a.n Kepala Puskesmas Soakonora Bendahara Kapitasi JKN

KTU, Sutriyanti Sartoso,SKM Iriyani Sartoso, Amd. Keb


NIP. 198305132011012007 Nip.19790320 20032 2 011
Pajak

0 0 1918 Rp 54,916 Rp 1,043,412


0 0 1918
0 0 1918 Rp 26,151 Rp 26,151 Rp 470,712

0 0 1918 Rp 33,415 Rp 33,415 Rp 601,466

0 0 1918 Rp 46,490 Rp 883,312


0 0 1918 Rp 24,698 Rp 24,698 Rp 444,562
0 0 1918 Rp 27,603 Rp 27,603 Rp 524,466
0 0 1918 Rp 21,792 Rp 21,792 Rp 414,052
0 0 1918 Rp 18,887 Rp 18,887 Rp 358,845
0 0 1918 Rp 18,887 Rp 18,887 Rp 358,845
0 0 1918 Rp 21,792 Rp 21,792 Rp 414,052
0 0 1918 Rp 18,887 Rp 18,887 Rp 358,845
0 0 1918 Rp 21,792 Rp 21,792 Rp 414,052
0 0 1918
0 0 1918
0 0 1918
0 0 1918
0 0 3
Rp 335,310 Rp 233,903 Rp 6,286,623

Rp 1,149,422 uang sisa


DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN Maret TAHUN 2019
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,789,250
Penerimaan Kapitasi dengan
Kehadiran
Presentas Jumlah peserta 6.213
Rangk Tanggu Jumlah Poin e Jumlah Jasa Pelayanan
Jenis ap ng Variabel Kehadiran Total yang diterima
Pendidi Masa Jumlah Jumlah Biaya
No Nama Pegawai Jabatan Ketena Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan dengan Peserta Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Hari Admini Progra Operasional
gaan Masuk (= ian Kolom Point (60 %) ( Klm 9 x klm 10
Kerja stratif m klm 1+2+5+6) 3 dibagi (Kolm 8x7) ( 40 %) dibagi jumlah klm 9)
Kerja
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 9 19 19 100 0 189 1 189 Rp 11,146,000 Rp 5,515,700 Rp 1,191,512 Rp 59,576 Rp 1,131,937 1 0 0 1768
2 Sutriyanti Sartoso, SKM KTU Kesling / IIIb S1 80 9 19 19 0 10 99 1 99 Rp 11,146,000 Rp 5,515,700 Rp 624,126 Rp 31,206 Rp 592,919 2 0 0 1768
3 Ferderika Lefara , Amd.Keb KB, / IIId D3 60 20 19 19 0 10 90 1 90 Rp 11,146,000 Rp 5,515,700 Rp 567,387 Rp 28,369 Rp 539,018 3 0 0 1768
P. SP2TP, , Pneumonia,
Masriati Cein, AMK
4 PTM/IIIb D1 60 25 19 19 30 115 1 115 Rp 11,146,000 Rp 5,515,700 Rp 724,994 Rp 36,250 Rp 688,745 4 0 0 1768
Iriyani Sartoso , Amd.Keb , Batra, B JKN /IIIc
5 D3 60 10 19 19 50 40 160 1 160 Rp 11,146,000 Rp 5,515,700 Rp 1,008,688 Rp 50,434 Rp 958,253 5 0 0 1768
7 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 19 19 20 85 1 85 Rp 11,146,000 Rp 5,515,700 Rp 535,865 Rp 26,793 Rp 509,072 7 0 0 1768
8 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 19 19 30 95 1 95 Rp 11,146,000 Rp 5,515,700 Rp 598,908 Rp - Rp 598,908 8 0 0 1768
9 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 19 19 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 472,822 - Rp 472,822 9 0 0 1768
10 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 19 19 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 409,779 Rp - Rp 409,779 10 0 0 1768
11 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 19 19 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 409,779 Rp - Rp 409,779 11 0 0 1768
12 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS/P Aset D3 60 5 19 19 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 472,822 Rp - Rp 472,822 12 0 0 1768
13 Rusni GaertiAmd. Keb CPNS D3 60 5 19 19 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 409,779 Rp - Rp 409,779 13 0 0 1768
14 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 19 19 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 472,822 Rp - Rp 472,822 14 0 0 1768
15 Endah P. W, Amd. Keb Jurim D3 60 5 19 19 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 472,822 Rp - Rp 472,822 15 0 0 1768
16 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 19 19 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 441,301 Rp - Rp 441,301 16 0 0 1768
17 Nikmat Triandini Pataha PNS / ISPA / Diare D3 60 0 19 19 20 80 1 80 Rp 11,146,000 Rp 5,515,700 Rp 504,344 Rp - Rp 504,344 17 0 0 1768
18 Sarifa Soabangsa TKD/Gimul D3 60 0 19 19 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 441,301 Rp - Rp 441,301 18 0 0 1768
19 Aisyah TKD D3 60 0 19 19 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 441,301 Rp - Rp 441,301 19 0 0 3
Hendra Rahman, S. Farm., M.
Apotek
21 Kes., Apt S2 80 0 19 19 80 1 80 Rp 11,146,001 Rp 5,515,700 Rp 504,344 Rp 1 Rp 504,343 21
22 Siti Magfirah Nurdin, A.Md. KL Kesling S1 60 0 19 19 10 70 1 70 Rp 11,146,002 Rp 5,515,700 Rp 441,301 Rp 2 Rp 441,299 22

23 Fardaila, Tarate, SKM Kesling/promkes S2 80 0 19 19 10 90 1 90 Rp 11,146,003 Rp 5,515,700 Rp 567,387 Rp 3 Rp 567,384 23


1768 Rp 11,146,000 Rp 232,632 Rp 10,913,369
Soakonora, 28 Maret 2019
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN Rp 309,779 uang sisa

Nurafni Kudo SKM Iriyani Sartoso, Amd. Keb


NIP. 198006162009032003 Nip.19790320 20032 2 011
Pajak

Rp 59,576 Rp 1,131,937

Rp 28,369 Rp 29,862 Rp 509,155

Rp 36,250 Rp 38,158 Rp 650,587

Rp 50,434 Rp 958,253
Rp 26,793 Rp 28,203 Rp 480,869
Rp 29,945 Rp 31,521 Rp 567,387
Rp 23,641 Rp 24,885 Rp 447,937
Rp 20,489 Rp 21,567 Rp 388,212
Rp 20,489 Rp 21,567 Rp 388,212
Rp 23,641 Rp 24,885 Rp 447,937
Rp 20,489 Rp 21,567 Rp 388,212
Rp 23,641 Rp 24,885 Rp 447,937
Rp 363,758 Rp 267,103 Rp 6,806,635
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN Februari TAHUN 2019
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,789,250
Penerimaan Kapitasi dengan
Kehadiran
Presentas Jumlah peserta 6.213
Rangk Tanggu Jumlah Poin e Jumlah Jasa Pelayanan
Jenis ap ng Variabel Kehadiran Total yang diterima
Pendidi Masa Jumlah Jumlah Biaya
No Nama Pegawai Jabatan Ketena Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan dengan Peserta Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Hari Admini Progra Operasional
gaan Masuk (= ian Kolom Point (60 %) ( Klm 9 x klm 10
Kerja stratif m klm 1+2+5+6) 3 dibagi (Kolm 8x7) ( 40 %) dibagi jumlah klm 9)
Kerja
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 9 19 19 100 0 189 1 189 Rp 11,146,000 Rp 5,515,700 Rp 1,191,512 Rp 59,576 Rp 1,131,937 1 0 0 1768
2 Sutriyanti Sartoso, SKM KTU Kesling / IIIb S1 80 9 19 19 0 10 99 1 99 Rp 11,146,000 Rp 5,515,700 Rp 624,126 Rp 31,206 Rp 592,919 2 0 0 1768
3 Ferderika Lefara , Amd.Keb KB, / IIId D3 60 20 19 19 0 10 90 1 90 Rp 11,146,000 Rp 5,515,700 Rp 567,387 Rp 28,369 Rp 539,018 3 0 0 1768
P. SP2TP, , Pneumonia,
Masriati Cein, AMK
4 PTM/IIIb D1 60 25 19 19 30 115 1 115 Rp 11,146,000 Rp 5,515,700 Rp 724,994 Rp 36,250 Rp 688,745 4 0 0 1768
Iriyani Sartoso , Amd.Keb , Batra, B JKN /IIIc
5 D3 60 10 19 19 50 40 160 1 160 Rp 11,146,000 Rp 5,515,700 Rp 1,008,688 Rp 50,434 Rp 958,253 5 0 0 1768
7 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 19 19 20 85 1 85 Rp 11,146,000 Rp 5,515,700 Rp 535,865 Rp 26,793 Rp 509,072 7 0 0 1768
8 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 19 19 30 95 1 95 Rp 11,146,000 Rp 5,515,700 Rp 598,908 Rp - Rp 598,908 8 0 0 1768
9 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 19 19 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 472,822 - Rp 472,822 9 0 0 1768
10 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 19 19 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 409,779 Rp - Rp 409,779 10 0 0 1768
11 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 19 19 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 409,779 Rp - Rp 409,779 11 0 0 1768
12 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS/ P Aset D3 60 5 19 19 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 472,822 Rp - Rp 472,822 12 0 0 1768
13 Rusni GaertiAmd. Keb CPNS D3 60 5 19 19 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 409,779 Rp - Rp 409,779 13 0 0 1768
14 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 19 19 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 472,822 Rp - Rp 472,822 14 0 0 1768
15 Endah P. W, Amd. Keb Jurim D3 60 5 19 19 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 472,822 Rp - Rp 472,822 15 0 0 1768
16 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 19 19 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 441,301 Rp - Rp 441,301 16 0 0 1768
17 Nikmat Triandini Pataha TKD Ispa / Diare D3 60 0 19 19 20 80 1 80 Rp 11,146,000 Rp 5,515,700 Rp 504,344 Rp - Rp 504,344 17 0 0 1768
18 Sarifa Soabangsa TKD/Gimul D3 60 0 19 19 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 441,301 Rp - Rp 441,301 18 0 0 1768
20 Aisyah TKD/UKS D3 60 0 19 19 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 441,301 Rp - Rp 441,301 20 0 0 1768
Hendra Rahman, S. Farm., M.
Apotek
21 Kes., Apt S2 80 0 19 19 80 1 80 Rp 11,146,001 Rp 5,515,700 Rp 504,344 Rp 1 Rp 504,343 21
22 Siti Magfirah Nurdin, A.Md. KL Kesling S1 60 0 19 19 10 70 1 70 Rp 11,146,002 Rp 5,515,700 Rp 441,301 Rp 2 Rp 441,299 22
1768 Rp 11,146,000 Rp 232,632 Rp 10,913,369
Soakonora, 28 Februari 2019
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN Rp 309,779 uang sisa

Nurafni Kudo SKM Iriyani Sartoso, Amd. Keb


NIP. 198006162009032003 Nip.19790320 20032 2 011
Pajak

Rp 59,576 Rp 1,131,937

Rp 28,369 Rp 29,862 Rp 509,155

Rp 36,250 Rp 38,158 Rp 650,587

Rp 50,434 Rp 958,253
Rp 26,793 Rp 28,203 Rp 480,869
Rp 29,945 Rp 31,521 Rp 567,387
Rp 23,641 Rp 24,885 Rp 447,937
Rp 20,489 Rp 21,567 Rp 388,212
Rp 20,489 Rp 21,567 Rp 388,212
Rp 23,641 Rp 24,885 Rp 447,937
Rp 20,489 Rp 21,567 Rp 388,212
Rp 23,641 Rp 24,885 Rp 447,937
Rp 363,758 Rp 267,103 Rp 6,806,635
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN Januari TAHUN 2019
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,789,250
Penerimaan Kapitasi dengan
Kehadiran Jumlah Presentas Jumlah peserta 6.213
Rangk Tanggu Poin e Jumlah Jasa Pelayanan
Jenis ap ng Variabel Kehadiran Total yang diterima
Pendidi Masa Jumlah Jumlah Biaya
No Nama Pegawai Jabatan Ketena Tugas Jawab Ketenagaan (%Pembag Seluruh dengan Peserta Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Hari Admini Progra
Jasa Pelayanan
Operasional
gaan Masuk ian Kolom Point (60 %) ( Klm 9 x klm 10
Kerja stratif m (= klm 3 dibagi (Kolm 8x7) ( 40 %) dibagi jumlah klm 9)
Kerja
1+2+5+6) klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 9 21 21 100 0 189 1 189 Rp 11,146,000 Rp 5,515,700 Rp 1,293,182 Rp 64,659 Rp 1,228,523 1
Sutriyanti Sartoso, SKM Kesling / IIIb S1 80 10 21 21 0 0 90 1 90 Rp 11,146,000 Rp 5,515,700 Rp 615,801 Rp 30,790 Rp 585,011 2
2 Ferderika Lefara , Amd.Keb KB,KTU / IIId D3 60 20 21 21 0 30 110 1 110 Rp 11,146,000 Rp 5,515,700 Rp 752,646 Rp 37,632 Rp 715,014 3
P. SP2TP,, Pneumonia,
Masriati Cein, AMK
3 PTM/IIIb D1 60 25 21 21 30 115 1 115 Rp 11,146,000 Rp 5,515,700 Rp 786,857 Rp 39,343 Rp 747,514 4
4 Iriyani Sartoso , Amd.Keb , Batra, B JKN /IIIc
D3 60 10 21 21 50 40 160 1 160 Rp 11,146,000 Rp 5,515,700 Rp 1,094,758 Rp 54,738 Rp 1,040,020 5
6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 21 21 20 85 1 85 Rp 11,146,000 Rp 5,515,700 Rp 581,590 Rp 29,079 Rp 552,510 7
7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 21 21 30 95 1 95 Rp 11,146,000 Rp 5,515,700 Rp 650,012 Rp - Rp 650,012 8
8 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 21 21 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 513,168 - Rp 513,168 9
9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 21 21 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 444,745 Rp - Rp 444,745 10
10 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 21 21 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 444,745 Rp - Rp 444,745 11
11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS/P Aset D3 60 5 21 21 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 513,168 Rp - Rp 513,168 12
12 Rusni GaertiAmd. Keb CPNS D3 60 5 21 21 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 444,745 Rp - Rp 444,745 13
13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 21 21 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 513,168 Rp - Rp 513,168 14
14 Endah P. W, Amd. Keb Jurim D3 60 5 21 21 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 513,168 Rp - Rp 513,168 15
15 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 21 21 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 478,956 Rp - Rp 478,956 16
16 Nikmat Triandini Pataha TKD/Ispa / Diare D3 60 0 21 21 20 80 1 80 Rp 11,146,000 Rp 5,515,700 Rp 547,379 Rp - Rp 547,379 17
17 Sarifa Soabangsa TKD/Gimul D3 60 0 21 21 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 478,956 Rp - Rp 478,956 18
19 Aisyah TKD/UKS D3 60 0 21 21 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 478,956 Rp - Rp 478,956 20
1629 Rp 11,146,000 Rp 256,242 Rp 10,889,758
Soakonora, 31 Januari 2018
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN

Nurafni Kudo SKM Iriyani Sartoso, Amd. Keb


NIP. 198006162009032003 Nip.19790320 20032 2 011
Pajak

0 0 1629 Rp 64,659 Rp 1,228,523


0 0 1629
0 0 1629 Rp 37,632 Rp 35,840 Rp 679,173

0 0 1629 Rp 39,343 Rp 37,469 Rp 710,045

0 0 1629 Rp 54,738 Rp 1,040,020


0 0 1629 Rp 29,079 Rp 27,695 Rp 524,816
0 0 1629 Rp 32,501 Rp 30,953 Rp 619,059
0 0 1629 Rp 25,658 Rp 24,437 Rp 488,731
0 0 1629 Rp 22,237 Rp 21,178 Rp 423,567
0 0 1629 Rp 22,237 Rp 21,178 Rp 423,567
0 0 1629 Rp 25,658 Rp 24,437 Rp 488,731
0 0 1629 Rp 22,237 Rp 21,178 Rp 423,567
0 0 1629 Rp 25,658 Rp 24,437 Rp 488,731
0 0 1629
0 0 1629
0 0 1629
0 0 1629
0 0 1629
Rp 401,639 Rp 268,802 Rp 7,538,530

Rp 344,745 uang sisa


DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN Januari TAHUN 2019
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,789,250
Penerimaan Kapitasi dengan
Kehadiran Jumlah Presentas Jumlah peserta 6.213
Rangk Tanggu Poin e Jumlah Jasa Pelayanan
Jenis ap ng Variabel Kehadiran Total yang diterima
Pendidi Masa Jumlah Jumlah Biaya
No Nama Pegawai Jabatan Ketena Tugas Jawab Ketenagaan (%Pembag Seluruh dengan Peserta Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Hari Admini Progra
Jasa Pelayanan
Operasional
gaan Masuk ian Kolom Point (60 %) ( Klm 9 x klm 10
Kerja stratif m (= klm 3 dibagi (Kolm 8x7) ( 40 %) dibagi jumlah klm 9)
Kerja
1+2+5+6) klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 9 21 21 100 0 189 1 189 Rp 11,146,000 Rp 5,515,700 Rp 1,184,145 Rp 59,207 Rp 1,124,938 1
Sutriyanti Sartoso, SKM Kesling / IIIb S1 80 10 21 21 0 0 90 1 90 Rp 11,146,000 Rp 5,515,700 Rp 563,879 Rp 28,194 Rp 535,685 2
2 Ferderika Lefara , Amd.Keb KB,KTU / IIId D3 60 20 21 21 0 30 110 1 110 Rp 11,146,000 Rp 5,515,700 Rp 689,185 Rp 34,459 Rp 654,726 3
P. SP2TP, Ispa, Diare,
Masriati Cein, AMK
3 Pneumonia, PTM/IIIb D1 60 25 21 21 30 115 1 115 Rp 11,146,000 Rp 5,515,700 Rp 720,512 Rp 36,026 Rp 684,486 4
4 Iriyani Sartoso , Amd.Keb , Batra, B JKN /IIIc
D3 60 10 21 21 50 40 160 1 160 Rp 11,146,000 Rp 5,515,700 Rp 1,002,451 Rp 50,123 Rp 952,328 5
5 Ida M. Djalil, SKM Kontrak, Kesling S1 80 0 21 21 10 90 1 90 Rp 11,146,000 Rp 5,515,700 Rp 563,879 Rp 28,194 Rp 535,685 6
6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 21 21 20 85 1 85 Rp 11,146,000 Rp 5,515,700 Rp 532,552 Rp 26,628 Rp 505,924 7
7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 21 21 30 95 1 95 Rp 11,146,000 Rp 5,515,700 Rp 595,205 Rp - Rp 595,205 8
8 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 21 21 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 469,899 - Rp 469,899 9
9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 21 21 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 407,246 Rp - Rp 407,246 10
10 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 21 21 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 407,246 Rp - Rp 407,246 11
11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS D3 60 5 21 21 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 407,246 Rp - Rp 407,246 12
12 Rusni GaertiAmd. Keb CPNS D3 60 5 21 21 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 407,246 Rp - Rp 407,246 13
13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 21 21 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 469,899 Rp - Rp 469,899 14
14 Endah P. W, Amd. Keb Jurim D3 60 5 21 21 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 469,899 Rp - Rp 469,899 15
15 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 21 21 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 438,572 Rp - Rp 438,572 16
16 Nikmat Triandini Pataha TKD D3 60 0 21 21 60 1 60 Rp 11,146,000 Rp 5,515,700 Rp 375,919 Rp - Rp 375,919 17
17 Sarifa Soabangsa TKD/Gimul D3 60 0 21 21 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 438,572 Rp - Rp 438,572 18
18 Nurlela TKD/kesling S1 80 0 21 21 10 90 1 90 Rp 11,146,000 Rp 5,515,700 Rp 563,879 Rp - Rp 563,879 19
19 Aisyah TKD/UKS D3 60 0 21 21 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 438,572 Rp - Rp 438,572 20
1779 Rp 11,146,000 Rp 262,830 Rp 10,883,170
Soakonora, 31 Januari 2018
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN

Nurafni Kudo SKM Iriyani Sartoso, Amd. Keb


NIP. 198006162009032003 Nip.19790320 20032 2 011
Pajak

0 0 1779 Rp 59,207 Rp 1,124,938


0 0 1779
0 0 1779 Rp 34,459 Rp 32,818 Rp 621,907

0 0 1779 Rp 36,026 Rp 34,310 Rp 650,176

0 0 1779 Rp 50,123 Rp 952,328


0 0 1779 Rp 28,194 Rp 26,851 Rp 508,833
0 0 1779 Rp 26,628 Rp 25,360 Rp 480,565
0 0 1779 Rp 29,760 Rp 28,343 Rp 566,862
0 0 1779 Rp 23,495 Rp 22,376 Rp 447,523
0 0 1779 Rp 20,362 Rp 19,393 Rp 387,853
0 0 1779 Rp 20,362 Rp 19,393 Rp 387,853
0 0 1779 Rp 20,362 Rp 19,393 Rp 387,853
0 0 1779 Rp 20,362 Rp 19,393 Rp 387,853
0 0 1779 Rp 23,495 Rp 22,376 Rp 447,523
0 0 1779
0 0 1779
0 0 1779
0 0 1779
0 0 3
0 0 1779
Rp 392,835 Rp 270,005 Rp 7,352,067

Rp 510,475 uang sisa


DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN Maret TAHUN 2019
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,789,250
Penerimaan Kapitasi dengan
Kehadiran
Presentas Jumlah peserta 6.213
Rangk Tanggu Jumlah Poin e Jumlah Jasa Pelayanan
Jenis ap ng Variabel Kehadiran Total yang diterima
Pendidi Masa Jumlah Jumlah Biaya
No Nama Pegawai Jabatan Ketena Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan dengan Peserta Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Hari Admini Progra Operasional
gaan Masuk (= ian Kolom Point (60 %) ( Klm 9 x klm 10
Kerja stratif m klm 1+2+5+6) 3 dibagi (Kolm 8x7) ( 40 %) dibagi jumlah klm 9)
Kerja
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 10 19 19 100 0 190 1 190 Rp 11,146,000 Rp 5,515,700 Rp 1,091,619 Rp 54,581 Rp 1,037,038 1 0 0 1940
2 Sutriyanti Sartoso, SKM Kesling / IIIb S1 80 10 19 19 0 0 90 1 90 Rp 11,146,000 Rp 5,515,700 Rp 517,082 Rp 25,854 Rp 491,228 2 0 0 1940
3 Ferderika Lefara , Amd.Keb KB,KTU / IIId D3 60 20 19 19 0 30 110 1 110 Rp 11,146,000 Rp 5,515,700 Rp 631,990 Rp 31,599 Rp 600,390 3 0 0 1940
P. SP2TP, Ispa, Diare,
Masriati Cein, AMK
4 Pneumonia, PTM/IIIb D1 60 25 19 19 30 115 1 115 Rp 11,146,000 Rp 5,515,700 Rp 660,716 Rp 33,036 Rp 627,681 4 0 0 1940
Iriyani Sartoso , Amd.Keb P. Aset, Batra, B JKN /IIIc
5 D3 60 10 19 19 50 50 170 1 170 Rp 11,146,000 Rp 5,515,700 Rp 976,711 Rp 48,836 Rp 927,876 5 0 0 1940
6 Ida M. Djalil, SKM Kontrak, Kesling S1 80 0 19 19 10 90 1 90 Rp 11,146,000 Rp 5,515,700 Rp 517,082 Rp 25,854 Rp 491,228 6 0 0 1940
7 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 19 19 20 85 1 85 Rp 11,146,000 Rp 5,515,700 Rp 488,356 Rp 24,418 Rp 463,938 7 0 0 1940
8 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 19 19 30 95 1 95 Rp 11,146,000 Rp 5,515,700 Rp 545,809 Rp - Rp 545,809 8 0 0 1940
9 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 19 19 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 430,902 - Rp 430,902 9 0 0 1940
10 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 19 19 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 373,448 Rp - Rp 373,448 10 0 0 1940
11 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 19 19 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 373,448 Rp - Rp 373,448 11 0 0 1940
12 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS D3 60 5 19 19 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 373,448 Rp - Rp 373,448 12 0 0 1940
13 Rusni GaertiAmd. Keb CPNS D3 60 5 19 19 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 373,448 Rp - Rp 373,448 13 0 0 1940
14 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 19 19 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 430,902 Rp - Rp 430,902 14 0 0 1940
15 Endah P. W, Amd. Keb Jurim D3 60 5 19 19 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 430,902 Rp - Rp 430,902 15 0 0 1940
16 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 19 19 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 402,175 Rp - Rp 402,175 16 0 0 1940
17 Nikmat Triandini Pataha TKD D3 60 0 19 19 60 1 60 Rp 11,146,000 Rp 5,515,700 Rp 344,722 Rp - Rp 344,722 17 0 0 1940
18 Sarifa Soabangsa TKD/Gimul D3 60 0 19 19 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 402,175 Rp - Rp 402,175 18 0 0 1940
19 Nurlela TKD/kesling S1 80 0 19 19 10 90 1 90 Rp 11,146,000 Rp 5,515,700 Rp 517,082 Rp - Rp 517,082 19 0 0 3
20 Aisyah TKD/UKS D3 60 0 19 19 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 402,175 Rp - Rp 402,175 20 0 0 1940
Hendra Rahman, S. Farm., M.
Apotek
21 Kes., Apt S2 80 0 19 19 10 90 1 90 Rp 11,146,001 Rp 5,515,700 Rp 517,083 Rp 1 Rp 517,082 21

22 Siti Magfirah Nurdin, A.Md. KL Kesling S1 60 0 19 19 0 60 1 60 Rp 11,146,002 Rp 5,515,700 Rp 344,722 Rp 2 Rp 344,720 22

23 Fardaila, Tarate, SKM Kesling S2 80 0 19 19 0 80 1 80 Rp 11,146,003 Rp 5,515,700 Rp 459,629 Rp 3 Rp 459,626 23


1940 Rp 11,146,000 Rp 244,181 Rp 10,901,819
Soakonora, 28 Maret 2019
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN Rp 432,222 uang sisa

Nurafni Kudo SKM Iriyani Sartoso, Amd. Keb


NIP. 198006162009032003 Nip.19790320 20032 2 011
Pajak

Rp 54,581 Rp 1,037,038

Rp 31,599 Rp 33,263 Rp 567,128

Rp 33,036 Rp 34,775 Rp 592,906

Rp 48,836 Rp 927,876
Rp 25,854 Rp 27,215 Rp 464,013
Rp 24,418 Rp 25,703 Rp 438,235
Rp 27,290 Rp 28,727 Rp 517,082
Rp 21,545 Rp 22,679 Rp 408,223
Rp 18,672 Rp 19,655 Rp 353,793
Rp 18,672 Rp 19,655 Rp 353,793
Rp 18,672 Rp 19,655 Rp 353,793
Rp 18,672 Rp 19,655 Rp 353,793
Rp 21,545 Rp 22,679 Rp 408,223
Rp 363,394 Rp 273,661 Rp 6,775,897
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN Februari TAHUN 2019
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,789,250
Penerimaan Kapitasi dengan
Kehadiran
Presentas Jumlah peserta 6.213
Rangk Tanggu Jumlah Poin e Jumlah Jasa Pelayanan
Jenis ap ng Variabel Kehadiran Total yang diterima
Pendidi Masa Jumlah Jumlah Biaya
No Nama Pegawai Jabatan Ketena Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan dengan Peserta Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Hari Admini Progra Operasional
gaan Masuk (= ian Kolom Point (60 %) ( Klm 9 x klm 10
Kerja stratif m klm 1+2+5+6) 3 dibagi (Kolm 8x7) ( 40 %) dibagi jumlah klm 9)
Kerja
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 10 19 19 100 0 190 1 190 Rp 11,146,000 Rp 5,515,700 Rp 1,091,619 Rp 54,581 Rp 1,037,038 1 0 0 1940
2 Sutriyanti Sartoso, SKM Kesling / IIIb S1 80 10 19 19 0 0 90 1 90 Rp 11,146,000 Rp 5,515,700 Rp 517,082 Rp 25,854 Rp 491,228 2 0 0 1940
3 Ferderika Lefara , Amd.Keb KB,KTU / IIId D3 60 20 19 19 0 30 110 1 110 Rp 11,146,000 Rp 5,515,700 Rp 631,990 Rp 31,599 Rp 600,390 3 0 0 1940
P. SP2TP, Ispa, Diare,
Masriati Cein, AMK
4 Pneumonia, PTM/IIIb D1 60 25 19 19 30 115 1 115 Rp 11,146,000 Rp 5,515,700 Rp 660,716 Rp 33,036 Rp 627,681 4 0 0 1940
Iriyani Sartoso , Amd.Keb P. Aset, Batra, B JKN /IIIc
5 D3 60 10 19 19 50 50 170 1 170 Rp 11,146,000 Rp 5,515,700 Rp 976,711 Rp 48,836 Rp 927,876 5 0 0 1940
6 Ida M. Djalil, SKM Kontrak, Kesling S1 80 0 19 19 10 90 1 90 Rp 11,146,000 Rp 5,515,700 Rp 517,082 Rp 25,854 Rp 491,228 6 0 0 1940
7 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 19 19 20 85 1 85 Rp 11,146,000 Rp 5,515,700 Rp 488,356 Rp 24,418 Rp 463,938 7 0 0 1940
8 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 19 19 30 95 1 95 Rp 11,146,000 Rp 5,515,700 Rp 545,809 Rp - Rp 545,809 8 0 0 1940
9 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 19 19 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 430,902 - Rp 430,902 9 0 0 1940
10 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 19 19 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 373,448 Rp - Rp 373,448 10 0 0 1940
11 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 19 19 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 373,448 Rp - Rp 373,448 11 0 0 1940
12 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS D3 60 5 19 19 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 373,448 Rp - Rp 373,448 12 0 0 1940
13 Rusni GaertiAmd. Keb CPNS D3 60 5 19 19 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 373,448 Rp - Rp 373,448 13 0 0 1940
14 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 19 19 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 430,902 Rp - Rp 430,902 14 0 0 1940
15 Endah P. W, Amd. Keb Jurim D3 60 5 19 19 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 430,902 Rp - Rp 430,902 15 0 0 1940
16 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 19 19 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 402,175 Rp - Rp 402,175 16 0 0 1940
17 Nikmat Triandini Pataha TKD D3 60 0 19 19 60 1 60 Rp 11,146,000 Rp 5,515,700 Rp 344,722 Rp - Rp 344,722 17 0 0 1940
18 Sarifa Soabangsa TKD/Gimul D3 60 0 19 19 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 402,175 Rp - Rp 402,175 18 0 0 1940
19 Nurlela TKD/kesling S1 80 0 19 19 10 90 1 90 Rp 11,146,000 Rp 5,515,700 Rp 517,082 Rp - Rp 517,082 19 0 0 3
20 Aisyah TKD/UKS D3 60 0 19 19 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 402,175 Rp - Rp 402,175 20 0 0 1940
Hendra Rahman, S. Farm., M.
Apotek
21 Kes., Apt S2 80 0 19 19 10 90 1 90 Rp 11,146,001 Rp 5,515,700 Rp 517,083 Rp 1 Rp 517,082 21

22 Siti Magfirah Nurdin, A.Md. KL Kesling S1 60 0 19 19 0 60 1 60 Rp 11,146,002 Rp 5,515,700 Rp 344,722 Rp 2 Rp 344,720 22


1940 Rp 11,146,000 Rp 244,181 Rp 10,901,819
Soakonora, 28 Februari 2019
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN Rp 432,222 uang sisa

Nurafni Kudo SKM Iriyani Sartoso, Amd. Keb


NIP. 198006162009032003 Nip.19790320 20032 2 011
Pajak

Rp 54,581 Rp 1,037,038

Rp 31,599 Rp 33,263 Rp 567,128

Rp 33,036 Rp 34,775 Rp 592,906

Rp 48,836 Rp 927,876
Rp 25,854 Rp 27,215 Rp 464,013
Rp 24,418 Rp 25,703 Rp 438,235
Rp 27,290 Rp 28,727 Rp 517,082
Rp 21,545 Rp 22,679 Rp 408,223
Rp 18,672 Rp 19,655 Rp 353,793
Rp 18,672 Rp 19,655 Rp 353,793
Rp 18,672 Rp 19,655 Rp 353,793
Rp 18,672 Rp 19,655 Rp 353,793
Rp 21,545 Rp 22,679 Rp 408,223
Rp 363,394 Rp 273,661 Rp 6,775,897
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN Januari TAHUN 2019
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,789,250
Penerimaan Kapitasi dengan
Kehadiran Jumlah Presentas Jumlah peserta 6.213
Rangk Tanggu Poin e Jumlah Jasa Pelayanan
Jenis ap ng Variabel Kehadiran Total yang diterima
Pendidi Masa Jumlah Jumlah Biaya
No Nama Pegawai Jabatan Ketena Tugas Jawab Ketenagaan (%Pembag Seluruh dengan Peserta Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Hari Admini Progra
Jasa Pelayanan
Operasional
gaan Masuk ian Kolom Point (60 %) ( Klm 9 x klm 10
Kerja stratif m (= klm 3 dibagi (Kolm 8x7) ( 40 %) dibagi jumlah klm 9)
Kerja
1+2+5+6) klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 9 21 21 100 0 189 1 189 Rp 11,146,000 Rp 5,515,700 Rp 1,177,526 Rp 58,876 Rp 1,118,650 1
Sutriyanti Sartoso, SKM Kesling / IIIb S1 80 10 21 21 0 0 90 1 90 Rp 11,146,000 Rp 5,515,700 Rp 560,727 Rp 28,036 Rp 532,690 2
2 Ferderika Lefara , Amd.Keb KB,KTU / IIId D3 60 20 21 21 0 30 110 1 110 Rp 11,146,000 Rp 5,515,700 Rp 685,333 Rp 34,267 Rp 651,066 3
P. SP2TP, Ispa, Diare,
Masriati Cein, AMK
3 Pneumonia, PTM/IIIb D1 60 25 21 21 30 115 1 115 Rp 11,146,000 Rp 5,515,700 Rp 716,484 Rp 35,824 Rp 680,660 4
4 Iriyani Sartoso , Amd.Keb P. Aset, Batra, B JKN /IIIc
D3 60 10 21 21 50 50 170 1 170 Rp 11,146,000 Rp 5,515,700 Rp 1,059,150 Rp 52,958 Rp 1,006,193 5
5 Ida M. Djalil, SKM Kontrak, Kesling S1 80 0 21 21 10 90 1 90 Rp 11,146,000 Rp 5,515,700 Rp 560,727 Rp 28,036 Rp 532,690 6
6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 21 21 20 85 1 85 Rp 11,146,000 Rp 5,515,700 Rp 529,575 Rp 26,479 Rp 503,096 7
7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 21 21 30 95 1 95 Rp 11,146,000 Rp 5,515,700 Rp 591,878 Rp - Rp 591,878 8
8 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 21 21 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 467,272 - Rp 467,272 9
9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 21 21 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 404,969 Rp - Rp 404,969 10
10 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 21 21 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 404,969 Rp - Rp 404,969 11
11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS D3 60 5 21 21 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 404,969 Rp - Rp 404,969 12
12 Rusni GaertiAmd. Keb CPNS D3 60 5 21 21 0 65 1 65 Rp 11,146,000 Rp 5,515,700 Rp 404,969 Rp - Rp 404,969 13
13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 21 21 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 467,272 Rp - Rp 467,272 14
14 Endah P. W, Amd. Keb Jurim D3 60 5 21 21 10 75 1 75 Rp 11,146,000 Rp 5,515,700 Rp 467,272 Rp - Rp 467,272 15
15 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 21 21 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 436,121 Rp - Rp 436,121 16
16 Nikmat Triandini Pataha TKD D3 60 0 21 21 60 1 60 Rp 11,146,000 Rp 5,515,700 Rp 373,818 Rp - Rp 373,818 17
17 Sarifa Soabangsa TKD/Gimul D3 60 0 21 21 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 436,121 Rp - Rp 436,121 18
18 Nurlela TKD/kesling S1 80 0 21 21 10 90 1 90 Rp 11,146,000 Rp 5,515,700 Rp 560,727 Rp - Rp 560,727 19
19 Aisyah TKD/UKS D3 60 0 21 21 10 70 1 70 Rp 11,146,000 Rp 5,515,700 Rp 436,121 Rp - Rp 436,121 20
1789 Rp 11,146,000 Rp 264,476 Rp 10,881,524
Soakonora, 31 Januari 2018
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN

Nurafni Kudo SKM Iriyani Sartoso, Amd. Keb


NIP. 198006162009032003 Nip.19790320 20032 2 011
Pajak

0 0 1789 Rp 58,876 Rp 1,118,650


0 0 1789
0 0 1789 Rp 34,267 Rp 32,635 Rp 618,431

0 0 1789 Rp 35,824 Rp 34,118 Rp 646,542

0 0 1789 Rp 52,958 Rp 1,006,193


0 0 1789 Rp 28,036 Rp 26,701 Rp 505,989
0 0 1789 Rp 26,479 Rp 25,218 Rp 477,879
0 0 1789 Rp 29,594 Rp 28,185 Rp 563,693
0 0 1789 Rp 23,364 Rp 22,251 Rp 445,021
0 0 1789 Rp 20,248 Rp 19,284 Rp 385,685
0 0 1789 Rp 20,248 Rp 19,284 Rp 385,685
0 0 1789 Rp 20,248 Rp 19,284 Rp 385,685
0 0 1789 Rp 20,248 Rp 19,284 Rp 385,685
0 0 1789 Rp 23,364 Rp 22,251 Rp 445,021
0 0 1789
0 0 1789
0 0 1789
0 0 1789
0 0 3
0 0 1789
Rp 393,755 Rp 268,496 Rp 7,370,159

Rp 505,205 uang sisa


DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN MEI TAHUN 2018
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,045,500

Penerimaan Kapitasi dengan


Kehadiran
Presentas Jumlah peserta 6.213 Jasa Pelayanan
Rangk Tanggu Jumlah Poin e Jumlah
Jenis ap ng yang diterima
Variabel Kehadiran Total
Pendidi Masa Jumlah Jumlah Biaya dengan Peserta
No Nama Pegawai Jabatan Ketena Hari Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan Pajak 5 % Sisa Terima Jasa Total Sisa Jasa Yang Paraf
kan Kerja Hari Admini Progra Operasional ( Klm 9 x klm
gaan Masuk (= ian Kolom Point (60 %) Di Terima
Kerja stratif ( 40 %) 10 dibagi jumlah klm
Kerja m klm 1+2+5+6) 3 dibagi (Kolm 8x7)
9)
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 10 24 24 100 0 190 1 190 Rp 32,401,603 Rp 5,218,200 Rp 3,674,492 Rp 183,725 Rp 3,490,767 Rp 3,490,767 1
DR. Gembong Dokter S1 80 10 24 24 100 0 150 1 150 Rp 32,401,603 Rp 5,218,200 Rp 2,900,914 Rp 145,046 Rp 2,755,869 Rp 1,015,050 1
2 Ferderika Lefara , Amd.Keb KB,KTU / IIId D3 60 20 24 24 0 30 110 1 110 Rp 32,401,603 Rp 5,218,200 Rp 2,127,337 Rp 106,367 Rp 2,020,970 Rp 2,020,970 2
P. SP2TP, Ispa, Diare,
Masriati Cein, AMK
3 Pneumonia, PTM/IIIb D1 60 25 24 24 30 115 1 115 Rp 32,401,603 Rp 5,218,200 Rp 2,224,034 Rp 111,202 Rp 2,112,833 Rp 2,112,833 3
4 Iriyani Sartoso , Amd.Keb P. Aset, Batra, B JKN /IIIc
D3 60 10 24 24 50 50 170 1 170 Rp 32,401,603 Rp 5,218,200 Rp 3,287,703 Rp 164,385 Rp 3,123,318 Rp 3,123,318 4
5 Ida M. Djalil, SKM Kontrak, Kesling S1 80 0 21 24 10 90 0.875 78.75 Rp 32,401,603 Rp 5,218,200 Rp 1,522,980 Rp 76,149 Rp 1,446,831 Rp 275,222 5
6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 24 24 20 85 1 85 Rp 32,401,603 Rp 5,218,200 Rp 1,643,852 Rp 82,193 Rp 1,561,659 Rp 1,453,234 6
7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 22 24 30 95 0.916667 87.083333 Rp 32,401,603 Rp 5,218,200 Rp 1,684,142 Rp - Rp 1,684,142 Rp 1,345,672 7
8 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 24 24 10 75 1 75 Rp 32,401,603 Rp 5,218,200 Rp 1,450,457 - Rp 1,450,457 Rp 1,236,435 8
9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 2 24 0 65 0.083333 5.4166667 Rp 32,401,603 Rp 5,218,200 Rp 104,755 Rp - Rp 104,755 Rp 100,000 9
10 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 24 24 0 65 1 65 Rp 32,401,603 Rp 5,218,200 Rp 1,257,063 Rp - Rp 1,257,063 Rp 1,257,063 10
11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS D3 60 5 0 24 0 65 0 0 Rp 32,401,603 Rp 5,218,200 Rp - Rp - Rp - Rp 975,053 11
12 Rusni GaertiAmd. Keb CPNS D3 60 5 22 24 0 65 0.916667 59.583333 Rp 32,401,603 Rp 5,218,200 Rp 1,152,308 Rp - Rp 1,152,308 Rp 1,112,308 12
13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 22 24 10 75 0.916667 68.75 Rp 32,401,603 Rp 5,218,200 Rp 1,329,586 Rp - Rp 1,329,586 Rp 1,150,067 13
14 Endah P. W, Amd. Keb Jurim D3 60 5 24 24 10 75 1 75 Rp 32,401,603 Rp 5,218,200 Rp 1,450,457 Rp - Rp 1,450,457 Rp 1,234,523 14
15 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 23 24 10 70 0.958333 67.083333 Rp 32,401,603 Rp 5,218,200 Rp 1,297,353 Rp - Rp 1,297,353 Rp 650,756 15
16 Nikmat Triandini Pataha TKD D3 60 0 22 24 60 0.916667 55 Rp 32,401,603 Rp 5,218,200 Rp 1,063,669 Rp - Rp 1,063,669 Rp 650,756 16
17 Sarifa Soabangsa TKD/Gimul D3 60 0 24 24 10 70 1 70 Rp 32,401,603 Rp 5,218,200 Rp 1,353,760 Rp - Rp 1,353,760 Rp 650,756 17
18 Nurlela TKD/kesling S1 80 0 21 24 10 90 0.875 78.75 Rp 32,401,603 Rp 5,218,200 Rp 1,522,980 Rp - Rp 1,522,980 Rp 650,756 18
19 Aisyah TKD/UKS D3 60 0 24 24 10 70 1 70 Rp 32,401,603 Rp 5,218,200 Rp 1,353,760 Rp - Rp 1,353,760 Rp 650,756 19
1675.4167 Rp 32,401,603 Rp 869,066 Rp 31,532,537 Rp 25,156,295
Soakonora, 30 Mei 2018
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN

Nurafni Kudo SKM Iriyani Sartoso, Amd. Keb


NIP. 198006162009032003 Nip.19790320 20032 2 011
Pajak

0 0 1675.4166667 Rp 183,725 Rp 3,490,767


0 0 1675.4166667
0 0 1675.4166667 Rp 106,367 Rp 88,639 Rp 1,932,331

0 0 1675.4166667 Rp 111,202 Rp 92,668 Rp 2,020,165

0 0 1675.4166667 Rp 164,385 Rp 3,123,318


3 60,000 1675.4166667 Rp 76,149 Rp 63,458 Rp 1,383,374
0 0 1675.4166667 Rp 82,193 Rp 68,494 Rp 1,493,165
2 40,000 1675.4166667 Rp 84,207 Rp 70,173 Rp 1,613,969
0 0 1675.4166667 Rp 72,523 Rp 60,436 Rp 1,390,022
22 440,000 1675.4166667 Rp 5,238 Rp 4,365 Rp 100,390
0 0 1675.4166667 Rp 62,853 Rp 52,378 Rp 1,204,685
24 480,000 1675.4166667 Rp - Rp - Rp -
2 40,000 1675.4166667 Rp 57,615 Rp 48,013 Rp 1,104,295
2 40,000 1675.4166667 Rp 66,479 Rp 55,399 Rp 1,274,186
0 0 1675.4166667
1 20,000 1675.4166667
2 40,000 1675.4166667
0 0 1675.4166667
3 60,000 3
0 0 1675.4166667
Rp1,072,935 Rp 604,021 Rp 20,130,668

Rp 6,376,243 uang sisa


DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN MEI TAHUN 2018
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,045,500

Penerimaan Kapitasi dengan


Kehadiran
Presentas Jumlah peserta 6.213 Jasa Pelayanan
Rangk Tanggu Jumlah Poin e Jumlah
Jenis ap ng yang diterima
Variabel Kehadiran Total
Pendidi Masa Jumlah Jumlah Biaya dengan Peserta
No Nama Pegawai Jabatan Ketena Hari Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Admini Progra Operasional ( Klm 9 x klm
gaan Masuk (= ian Kolom Point (60 %)
Kerja stratif ( 40 %) 10 dibagi jumlah klm
Kerja m klm 1+2+5+6) 3 dibagi (Kolm 8x7)
9)
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 10 24 24 100 0 190 1 190 Rp 32,401,603 Rp 5,218,200 Rp 3,674,492 Rp 183,725 Rp 3,490,767 1
DR. Gembong Dokter S1 80 10 24 24 100 0 150 1 150 Rp 32,401,603 Rp 5,218,200 Rp 2,900,914 Rp 145,046 Rp 2,755,869 1
2 Ferderika Lefara , Amd.Keb KB,KTU / IIId D3 60 20 24 24 0 30 110 1 110 Rp 32,401,603 Rp 5,218,200 Rp 2,127,337 Rp 106,367 Rp 2,020,970 2
P. SP2TP, Ispa, Diare,
Masriati Cein, AMK
3 Pneumonia, PTM/IIIb D1 60 25 24 24 30 115 1 115 Rp 32,401,603 Rp 5,218,200 Rp 2,224,034 Rp 111,202 Rp 2,112,833 3
4 Iriyani Sartoso , Amd.Keb P. Aset, Batra, B JKN /IIIc
D3 60 10 24 24 50 50 170 1 170 Rp 32,401,603 Rp 5,218,200 Rp 3,287,703 Rp 164,385 Rp 3,123,318 4
5 Ida M. Djalil, SKM Kontrak, Kesling S1 80 0 21 24 10 90 0.875 78.75 Rp 32,401,603 Rp 5,218,200 Rp 1,522,980 Rp 76,149 Rp 1,446,831 5
6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 24 24 20 85 1 85 Rp 32,401,603 Rp 5,218,200 Rp 1,643,852 Rp 82,193 Rp 1,561,659 6
7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 22 24 30 95 0.916667 87.083333 Rp 32,401,603 Rp 5,218,200 Rp 1,684,142 Rp - Rp 1,684,142 7
8 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 24 24 10 75 1 75 Rp 32,401,603 Rp 5,218,200 Rp 1,450,457 - Rp 1,450,457 8
9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 2 24 0 65 0.083333 5.4166667 Rp 32,401,603 Rp 5,218,200 Rp 104,755 Rp - Rp 104,755 9
10 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 24 24 0 65 1 65 Rp 32,401,603 Rp 5,218,200 Rp 1,257,063 Rp - Rp 1,257,063 10
11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS D3 60 5 0 24 0 65 0 0 Rp 32,401,603 Rp 5,218,200 Rp - Rp - Rp - 11
12 Rusni GaertiAmd. Keb CPNS D3 60 5 22 24 0 65 0.916667 59.583333 Rp 32,401,603 Rp 5,218,200 Rp 1,152,308 Rp - Rp 1,152,308 12
13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 22 24 10 75 0.916667 68.75 Rp 32,401,603 Rp 5,218,200 Rp 1,329,586 Rp - Rp 1,329,586 13
14 Endah P. W, Amd. Keb Jurim D3 60 5 24 24 10 75 1 75 Rp 32,401,603 Rp 5,218,200 Rp 1,450,457 Rp - Rp 1,450,457 14
15 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 23 24 10 70 0.958333 67.083333 Rp 32,401,603 Rp 5,218,200 Rp 1,297,353 Rp - Rp 1,297,353 15
16 Nikmat Triandini Pataha TKD D3 60 0 22 24 60 0.916667 55 Rp 32,401,603 Rp 5,218,200 Rp 1,063,669 Rp - Rp 1,063,669 16
17 Sarifa Soabangsa TKD/Gimul D3 60 0 24 24 10 70 1 70 Rp 32,401,603 Rp 5,218,200 Rp 1,353,760 Rp - Rp 1,353,760 17
18 Nurlela TKD/kesling S1 80 0 21 24 10 90 0.875 78.75 Rp 32,401,603 Rp 5,218,200 Rp 1,522,980 Rp - Rp 1,522,980 18
19 Aisyah TKD/UKS D3 60 0 24 24 10 70 1 70 Rp 32,401,603 Rp 5,218,200 Rp 1,353,760 Rp - Rp 1,353,760 19
1675.4167 Rp 32,401,603 Rp 869,066 Rp 31,532,537
Soakonora, 30 Mei 2018
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN #REF!

Nurafni Kudo SKM Iriyani Sartoso, Amd. Keb


NIP. 198006162009032003 Nip.19790320 20032 2 011
Pajak

0 0 1675.4166667 Rp 183,725 Rp 3,490,767


0 0 1675.4166667
0 0 1675.4166667 Rp 106,367 Rp 88,639 Rp 1,932,331

0 0 1675.4166667 Rp 111,202 Rp 92,668 Rp 2,020,165

0 0 1675.4166667 Rp 164,385 Rp 3,123,318


3 60,000 1675.4166667 Rp 76,149 Rp 63,458 Rp 1,383,374
0 0 1675.4166667 Rp 82,193 Rp 68,494 Rp 1,493,165
2 40,000 1675.4166667 Rp 84,207 Rp 70,173 Rp 1,613,969
0 0 1675.4166667 Rp 72,523 Rp 60,436 Rp 1,390,022
22 440,000 1675.4166667 Rp 5,238 Rp 4,365 Rp 100,390
0 0 1675.4166667 Rp 62,853 Rp 52,378 Rp 1,204,685
24 480,000 1675.4166667 Rp - Rp - Rp -
2 40,000 1675.4166667 Rp 57,615 Rp 48,013 Rp 1,104,295
2 40,000 1675.4166667 Rp 66,479 Rp 55,399 Rp 1,274,186
0 0 1675.4166667
1 20,000 1675.4166667
2 40,000 1675.4166667
0 0 1675.4166667
3 60,000 3
0 0 1675.4166667
Rp1,072,935 Rp 604,021 Rp 20,130,668

uang sisa
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN AGUSTUS TAHUN 2018
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi
Rp 25,859,719

Penerimaan Kapitasi dengan


Kehadiran
Presentas Jumlah peserta 6.213 Jasa Pelayanan
Rangk Tanggu Jumlah Poin e Jumlah
Jenis ap ng yang diterima
Variabel Kehadiran Total
Pendidi Masa Jumlah Jumlah Biaya dengan Peserta
No Nama Pegawai Jabatan Ketena Hari Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan Pajak 5 % Sisa Terima Jasa Total Sisa Jasa Yang Paraf
kan Kerja Hari Admini Progra Operasional ( Klm 9 x klm
gaan Masuk (= ian Kolom Point (60 %) Di Terima
Kerja stratif ( 40 %) 10 dibagi jumlah klm
Kerja m klm 1+2+5+6) 3 dibagi (Kolm 8x7)
9)
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 10 24 24 100 0 190 1 190 Rp 32,401,603 Rp 10,343,888 Rp 3,674,492 Rp 183,725 Rp 3,490,767 Rp 3,490,767 1
DR. Gembong Dokter S1 80 10 24 24 100 0 150 1 150 Rp 32,401,603 Rp 10,343,888 Rp 2,900,914 Rp 145,046 Rp 2,755,869 Rp 2,755,869 1
2 Ferderika Lefara , Amd.Keb KB,KTU / IIId D3 60 20 24 24 0 30 110 1 110 Rp 32,401,603 Rp 10,343,888 Rp 2,127,337 Rp 106,367 Rp 2,020,970 Rp 2,020,970 2
P. SP2TP, Ispa, Diare,
Masriati Cein, AMK
3 Pneumonia, PTM/IIIb D1 60 25 24 24 30 115 1 115 Rp 32,401,603 Rp 10,343,888 Rp 2,224,034 Rp 111,202 Rp 2,112,833 Rp 2,112,833 3
4 Iriyani Sartoso , Amd.Keb P. Aset, Batra, B JKN /IIIc
D3 60 10 24 24 50 50 170 1 170 Rp 32,401,603 Rp 10,343,888 Rp 3,287,703 Rp 164,385 Rp 3,123,318 Rp 3,123,318 4
5 Ida M. Djalil, SKM Kontrak, Kesling S1 80 0 21 24 10 90 0.875 78.75 Rp 32,401,603 Rp 10,343,888 Rp 1,522,980 Rp 76,149 Rp 1,446,831 Rp 1,386,831 5
6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 24 24 20 85 1 85 Rp 32,401,603 Rp 10,343,888 Rp 1,643,852 Rp 82,193 Rp 1,561,659 Rp 1,561,659 6
7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 22 24 30 95 0.916667 87.083333 Rp 32,401,603 Rp 10,343,888 Rp 1,684,142 Rp - Rp 1,684,142 Rp 1,644,142 7
8 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 24 24 10 75 1 75 Rp 32,401,603 Rp 10,343,888 Rp 1,450,457 - Rp 1,450,457 Rp 1,450,457 8
9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 2 24 0 65 0.083333 5.4166667 Rp 32,401,603 Rp 10,343,888 Rp 104,755 Rp - Rp 104,755 Rp 100,000 9
10 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 24 24 0 65 1 65 Rp 32,401,603 Rp 10,343,888 Rp 1,257,063 Rp - Rp 1,257,063 Rp 1,257,063 10
11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS D3 60 5 0 24 0 65 0 0 Rp 32,401,603 Rp 10,343,888 Rp - Rp - Rp - Rp - 11
12 Rusni GaertiAmd. Keb CPNS D3 60 5 22 24 0 65 0.916667 59.583333 Rp 32,401,603 Rp 10,343,888 Rp 1,152,308 Rp - Rp 1,152,308 Rp 1,112,308 12
13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 22 24 10 75 0.916667 68.75 Rp 32,401,603 Rp 10,343,888 Rp 1,329,586 Rp - Rp 1,329,586 Rp 1,289,586 13
14 Endah P. W, Amd. Keb Jurim D3 60 5 24 24 10 75 1 75 Rp 32,401,603 Rp 10,343,888 Rp 1,450,457 Rp - Rp 1,450,457 Rp 1,450,457 14
15 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 23 24 10 70 0.958333 67.083333 Rp 32,401,603 Rp 10,343,888 Rp 1,297,353 Rp - Rp 1,297,353 Rp 1,277,353 15
16 Nikmat Triandini Pataha TKD D3 60 0 22 24 60 0.916667 55 Rp 32,401,603 Rp 10,343,888 Rp 1,063,669 Rp - Rp 1,063,669 Rp 1,023,669 16
17 Sarifa Soabangsa TKD/Gimul D3 60 0 24 24 10 70 1 70 Rp 32,401,603 Rp 10,343,888 Rp 1,353,760 Rp - Rp 1,353,760 Rp 1,353,760 17
18 Nurlela TKD/kesling S1 80 0 21 24 10 90 0.875 78.75 Rp 32,401,603 Rp 10,343,888 Rp 1,522,980 Rp - Rp 1,522,980 Rp 1,462,980 18
19 Aisyah TKD/UKS D3 60 0 24 24 10 70 1 70 Rp 32,401,603 Rp 10,343,888 Rp 1,353,760 Rp - Rp 1,353,760 Rp 1,353,760 19
1675.4167 Rp 32,401,603 Rp 869,066 Rp 31,532,537 Rp 31,227,782
Soakonora, 31 Agustus 2018
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN

Nurafni Kudo SKM Iriyani Sartoso, Amd. Keb


NIP. 198006162009032003 Nip.19790320 20032 2 011
Pajak

0 0 1675.4166667 Rp 183,725 Rp 3,490,767


0 0 1675.4166667
0 0 1675.4166667 Rp 106,367 Rp 88,639 Rp 1,932,331

0 0 1675.4166667 Rp 111,202 Rp 92,668 Rp 2,020,165

0 0 1675.4166667 Rp 164,385 Rp 3,123,318


3 60,000 1675.4166667 Rp 76,149 Rp 63,458 Rp 1,383,374
0 0 1675.4166667 Rp 82,193 Rp 68,494 Rp 1,493,165
2 40,000 1675.4166667 Rp 84,207 Rp 70,173 Rp 1,613,969
0 0 1675.4166667 Rp 72,523 Rp 60,436 Rp 1,390,022
22 440,000 1675.4166667 Rp 5,238 Rp 4,365 Rp 100,390
0 0 1675.4166667 Rp 62,853 Rp 52,378 Rp 1,204,685
24 480,000 1675.4166667 Rp - Rp - Rp -
2 40,000 1675.4166667 Rp 57,615 Rp 48,013 Rp 1,104,295
2 40,000 1675.4166667 Rp 66,479 Rp 55,399 Rp 1,274,186
0 0 1675.4166667
1 20,000 1675.4166667
2 40,000 1675.4166667
0 0 1675.4166667
3 60,000 3
0 0 1675.4166667
Rp1,072,935 Rp 604,021 Rp 20,130,668

Rp 304,755 uang sisa


DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN DESEMBER TAHUN 2018
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp -
Rp 25,859,719

Penerimaan Kapitasi dengan


Kehadiran
Presentas Jumlah peserta 6.213 Jasa Pelayanan
Rangk Tanggu e Jumlah
Jenis ap ng yang diterima
Jumlah Poin Variabel Kehadiran Total
Pendidi Masa Jumlah Jumlah Biaya dengan Peserta
No Nama Pegawai Jabatan Ketena Hari Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Admini Progra Operasional ( Klm 9 x klm
gaan Masuk (= klm 1+2+5+6) ian Kolom Point (60 %)
Kerja stratif ( 40 %) 10 dibagi jumlah klm
Kerja m 3 dibagi (Kolm 8x7)
9)
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 10 23 23 100 0 190 1 190 Rp 15,515,831 Rp 10,343,888 Rp 1,811,977 Rp 90,599 Rp 1,721,378 1
SUTRIATI PNS S1 80 10 23 23 100 0 90 1 90 Rp 15,515,831 Rp 10,343,888 Rp 858,305 Rp 42,915 Rp 815,390 1
2 Ferderika Lefara , Amd.Keb KB,KTU / IIId D3 60 20 23 23 0 30 110 1 110 Rp 15,515,831 Rp 10,343,888 Rp 1,049,039 Rp 52,452 Rp 996,587 2
P. SP2TP, Ispa, Diare,
Masriati Cein, AMK
3 Pneumonia, PTM/IIIb D1 60 25 23 23 30 115 1 115 Rp 15,515,831 Rp 10,343,888 Rp 1,096,723 Rp 54,836 Rp 1,041,887 3
4 Iriyani Sartoso , Amd.Keb P. Aset, Batra, B JKN /IIIc
D3 60 10 23 23 50 50 170 1 170 Rp 15,515,831 Rp 10,343,888 Rp 1,621,243 Rp 81,062 Rp 1,540,180 4
5 Ida M. Djalil, SKM Kontrak, Kesling S1 80 0 19 23 10 90 0.826087 74.347826 Rp 15,515,831 Rp 10,343,888 Rp 709,035 Rp 35,452 Rp 673,583 5
6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 23 23 20 85 1 85 Rp 15,515,831 Rp 10,343,888 Rp 810,621 Rp 40,531 Rp 770,090 6
7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 23 23 30 95 1 95 Rp 15,515,831 Rp 10,343,888 Rp 905,989 Rp - Rp 905,989 7
8 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 23 23 10 75 1 75 Rp 15,515,831 Rp 10,343,888 Rp 715,254 - Rp 715,254 8
9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 4 23 0 65 0.173913 11.304348 Rp 15,515,831 Rp 10,343,888 Rp 107,806 Rp - Rp 107,806 9
10 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 23 23 0 65 1 65 Rp 15,515,831 Rp 10,343,888 Rp 619,887 Rp - Rp 619,887 10
11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS D3 60 5 0 23 0 65 0 0 Rp 15,515,831 Rp 10,343,888 Rp - Rp - Rp - 11
12 Rusni GaertiAmd. Keb CPNS D3 60 5 22 23 0 65 0.956522 62.173913 Rp 15,515,831 Rp 10,343,888 Rp 592,935 Rp - Rp 592,935 12
13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 16 23 10 75 0.695652 52.173913 Rp 15,515,831 Rp 10,343,888 Rp 497,568 Rp - Rp 497,568 13
14 Endah P. W, Amd. Keb Jurim D3 60 5 23 23 10 75 1 75 Rp 15,515,831 Rp 10,343,888 Rp 715,254 Rp - Rp 715,254 14
15 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 22 23 10 70 0.956522 66.956522 Rp 15,515,831 Rp 10,343,888 Rp 638,546 Rp - Rp 638,546 15
16 Nikmat Triandini Pataha TKD D3 60 0 23 23 60 1 60 Rp 15,515,831 Rp 10,343,888 Rp 572,203 Rp - Rp 572,203 16
17 Sarifa Soabangsa TKD/Gimul D3 60 0 23 23 10 70 1 70 Rp 15,515,831 Rp 10,343,888 Rp 667,570 Rp - Rp 667,570 17
18 Nurlela TKD/kesling S1 80 0 23 23 10 90 1 90 Rp 15,515,831 Rp 10,343,888 Rp 858,305 Rp - Rp 858,305 18
19 Aisyah TKD/UKS D3 60 0 23 23 10 70 1 70 Rp 15,515,831 Rp 10,343,888 Rp 667,570 Rp - Rp 667,570 19
1626.9565 Rp 15,515,831 Rp 397,847 Rp 15,117,984
Soakonora, 31 Desember 2018
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN

Nurafni Kudo SKM Iriyani Sartoso, Amd. Keb


NIP. 198006162009032003 Nip.19790320 20032 2 011
Pajak

1626.9565217 Rp 90,599 Rp 1,721,378


1626.9565217
1626.9565217 Rp 52,452 Rp 45,610 Rp 950,977

1626.9565217 Rp 54,836 Rp 47,684 Rp 994,203

1626.9565217 Rp 81,062 Rp 1,540,180


1626.9565217 Rp 35,452 Rp 30,828 Rp 642,755
1626.9565217 Rp 40,531 Rp 35,244 Rp 734,846
1626.9565217 Rp 45,299 Rp 39,391 Rp 866,598
1626.9565217 Rp 35,763 Rp 31,098 Rp 684,156
1626.9565217 Rp 5,390 Rp 4,687 Rp 103,119
1626.9565217 Rp 30,994 Rp 26,952 Rp 592,935
1626.9565217 Rp - Rp - Rp -
1626.9565217 Rp 29,647 Rp 25,780 Rp 567,155
1626.9565217 Rp 24,878 Rp 21,633 Rp 475,935
0
0
0
0
1626.9565217
Rp 526,904 Rp 308,907 Rp 9,874,238
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN NOVEMBER TAHUN 2018
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp -
Rp 25,859,719

Penerimaan Kapitasi dengan


Kehadiran
Presentas Jumlah peserta 6.213 Jasa Pelayanan
Rangk Tanggu e Jumlah
Jenis ap ng yang diterima
Jumlah Poin Variabel Kehadiran Total
Pendidi Masa Jumlah Jumlah Biaya dengan Peserta
No Nama Pegawai Jabatan Ketena Hari Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Admini Progra Operasional ( Klm 9 x klm
gaan Masuk (= klm 1+2+5+6) ian Kolom Point (60 %)
Kerja stratif ( 40 %) 10 dibagi jumlah klm
Kerja m 3 dibagi (Kolm 8x7)
9)
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 10 25 25 100 0 190 1 190 Rp 15,515,831 Rp 10,343,888 Rp 1,788,406 Rp 89,420 Rp 1,698,985 1
DR. Gembong Dokter S1 80 10 25 25 100 0 150 1 150 Rp 15,515,831 Rp 10,343,888 Rp 1,411,899 Rp 70,595 Rp 1,341,304 1
2 Ferderika Lefara , Amd.Keb KB,KTU / IIId D3 60 20 25 25 0 30 110 1 110 Rp 15,515,831 Rp 10,343,888 Rp 1,035,393 Rp 51,770 Rp 983,623 2
P. SP2TP, Ispa, Diare,
Masriati Cein, AMK
3 Pneumonia, PTM/IIIb D1 60 25 25 25 30 115 1 115 Rp 15,515,831 Rp 10,343,888 Rp 1,082,456 Rp 54,123 Rp 1,028,333 3
4 Iriyani Sartoso , Amd.Keb P. Aset, Batra, B JKN /IIIc
D3 60 10 25 25 50 50 170 1 170 Rp 15,515,831 Rp 10,343,888 Rp 1,600,152 Rp 80,008 Rp 1,520,145 4
5 Ida M. Djalil, SKM Kontrak, Kesling S1 80 0 19 25 10 90 0.76 68.4 Rp 15,515,831 Rp 10,343,888 Rp 643,826 Rp 32,191 Rp 611,635 5
6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 25 25 20 85 1 85 Rp 15,515,831 Rp 10,343,888 Rp 800,076 Rp 40,004 Rp 760,072 6
7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 26 25 30 95 1.04 98.8 Rp 15,515,831 Rp 10,343,888 Rp 929,971 Rp - Rp 929,971 7
8 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 25 25 10 75 1 75 Rp 15,515,831 Rp 10,343,888 Rp 705,950 - Rp 705,950 8
9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 4 25 0 65 0.16 10.4 Rp 15,515,831 Rp 10,343,888 Rp 97,892 Rp - Rp 97,892 9
10 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 25 25 0 65 1 65 Rp 15,515,831 Rp 10,343,888 Rp 611,823 Rp - Rp 611,823 10
11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS D3 60 5 0 25 0 65 0 0 Rp 15,515,831 Rp 10,343,888 Rp - Rp - Rp - 11
12 Rusni GaertiAmd. Keb CPNS D3 60 5 22 25 0 65 0.88 57.2 Rp 15,515,831 Rp 10,343,888 Rp 538,404 Rp - Rp 538,404 12
13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 16 25 10 75 0.64 48 Rp 15,515,831 Rp 10,343,888 Rp 451,808 Rp - Rp 451,808 13
14 Endah P. W, Amd. Keb Jurim D3 60 5 24 25 10 75 0.96 72 Rp 15,515,831 Rp 10,343,888 Rp 677,712 Rp - Rp 677,712 14
15 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 22 25 10 70 0.88 61.6 Rp 15,515,831 Rp 10,343,888 Rp 579,820 Rp - Rp 579,820 15
16 Nikmat Triandini Pataha TKD D3 60 0 24 25 60 0.96 57.6 Rp 15,515,831 Rp 10,343,888 Rp 542,169 Rp - Rp 542,169 16
17 Sarifa Soabangsa TKD/Gimul D3 60 0 24 25 10 70 0.96 67.2 Rp 15,515,831 Rp 10,343,888 Rp 632,531 Rp - Rp 632,531 17
18 Nurlela TKD/kesling S1 80 0 23 25 10 90 0.92 82.8 Rp 15,515,831 Rp 10,343,888 Rp 779,368 Rp - Rp 779,368 18
19 Aisyah TKD/UKS D3 60 0 23 25 10 70 0.92 64.4 Rp 15,515,831 Rp 10,343,888 Rp 606,175 Rp - Rp 606,175 19
1648.4 Rp 15,515,831 Rp 418,110 Rp 15,097,721
Soakonora, 30 November 2018
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN

Nurafni Kudo SKM Iriyani Sartoso, Amd. Keb


NIP. 198006162009032003 Nip.19790320 20032 2 011
Pajak

1648.4 Rp 89,420 Rp 1,698,985


1648.4
1648.4 Rp 51,770 Rp 41,416 Rp 942,207

1648.4 Rp 54,123 Rp 43,298 Rp 985,035

1648.4 Rp 80,008 Rp 1,520,145


1648.4 Rp 32,191 Rp 25,753 Rp 585,882
1648.4 Rp 40,004 Rp 32,003 Rp 728,069
1648.4 Rp 46,499 Rp 37,199 Rp 892,772
1648.4 Rp 35,297 Rp 28,238 Rp 677,712
1648.4 Rp 4,895 Rp 3,916 Rp 93,976
1648.4 Rp 30,591 Rp 24,473 Rp 587,350
1648.4 Rp - Rp - Rp -
1648.4 Rp 26,920 Rp 21,536 Rp 516,868
1648.4 Rp 22,590 Rp 18,072 Rp 433,735
0
0
0
0
1648.4
Rp 514,308 Rp 275,904 Rp 9,662,737
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN MEI TAHUN 2018
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi
Rp 25,859,719

Penerimaan Kapitasi dengan


Kehadiran
Presentas Jumlah peserta 6.213 Jasa Pelayanan
Rangk Tanggu Jumlah Poin e Jumlah
Jenis ap ng yang diterima
Variabel Kehadiran Total
Pendidi Masa Jumlah Jumlah Biaya dengan Peserta
No Nama Pegawai Jabatan Ketena Hari Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan Pajak 5 % Sisa Terima Jasa Total Sisa Jasa Yang Paraf
kan Kerja Hari Admini Progra Operasional ( Klm 9 x klm
gaan Masuk (= ian Kolom Point (60 %) Di Terima
Kerja stratif ( 40 %) 10 dibagi jumlah klm
Kerja m klm 1+2+5+6) 3 dibagi (Kolm 8x7)
9)
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 10 24 24 100 0 190 1 190 Rp 15,515,831 Rp 10,343,888 Rp 1,759,567 Rp 87,978 Rp 1,671,589 Rp 1,671,589 1
DR. Gembong Dokter S1 80 10 24 24 100 0 150 1 150 Rp 15,515,831 Rp 10,343,888 Rp 1,389,132 Rp 69,457 Rp 1,319,675 Rp 1,319,675 1
2 Ferderika Lefara , Amd.Keb KB,KTU / IIId D3 60 20 24 24 0 30 110 1 110 Rp 15,515,831 Rp 10,343,888 Rp 1,018,697 Rp 50,935 Rp 967,762 Rp 967,762 2
P. SP2TP, Ispa, Diare,
Masriati Cein, AMK
3 Pneumonia, PTM/IIIb D1 60 25 24 24 30 115 1 115 Rp 15,515,831 Rp 10,343,888 Rp 1,065,001 Rp 53,250 Rp 1,011,751 Rp 1,011,751 3
4 Iriyani Sartoso , Amd.Keb P. Aset, Batra, B JKN /IIIc
D3 60 10 24 24 50 50 170 1 170 Rp 15,515,831 Rp 10,343,888 Rp 1,574,349 Rp 78,717 Rp 1,495,632 Rp 1,495,632 4
5 Ida M. Djalil, SKM Kontrak, Kesling S1 80 0 21 24 10 90 0.875 78.75 Rp 15,515,831 Rp 10,343,888 Rp 729,294 Rp 36,465 Rp 692,830 Rp 332,455 5
6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 24 24 20 85 1 85 Rp 15,515,831 Rp 10,343,888 Rp 787,175 Rp 39,359 Rp 747,816 Rp 747,816 6
7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 22 24 30 95 0.916667 87.083333 Rp 15,515,831 Rp 10,343,888 Rp 806,468 Rp - Rp 806,468 Rp 766,468 7
8 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 24 24 10 75 1 75 Rp 15,515,831 Rp 10,343,888 Rp 694,566 - Rp 694,566 Rp 694,566 8
9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 2 24 0 65 0.083333 5.4166667 Rp 15,515,831 Rp 10,343,888 Rp 50,163 Rp - Rp 50,163 Rp 100,000 9
10 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 24 24 0 65 1 65 Rp 15,515,831 Rp 10,343,888 Rp 601,957 Rp - Rp 601,957 Rp 601,957 10
11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS D3 60 5 0 24 0 65 0 0 Rp 15,515,831 Rp 10,343,888 Rp - Rp - Rp - Rp - 11
12 Rusni GaertiAmd. Keb CPNS D3 60 5 22 24 0 65 0.916667 59.583333 Rp 15,515,831 Rp 10,343,888 Rp 551,794 Rp - Rp 551,794 Rp 511,794 12
13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 22 24 10 75 0.916667 68.75 Rp 15,515,831 Rp 10,343,888 Rp 636,685 Rp - Rp 636,685 Rp 596,685 13
14 Endah P. W, Amd. Keb Jurim D3 60 5 24 24 10 75 1 75 Rp 15,515,831 Rp 10,343,888 Rp 694,566 Rp - Rp 694,566 Rp 694,566 14
15 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 23 24 10 70 0.958333 67.083333 Rp 15,515,831 Rp 10,343,888 Rp 621,251 Rp - Rp 621,251 Rp 601,251 15
16 Nikmat Triandini Pataha TKD D3 60 0 22 24 60 0.916667 55 Rp 15,515,831 Rp 10,343,888 Rp 509,348 Rp - Rp 509,348 Rp 469,348 16
17 Sarifa Soabangsa TKD/Gimul D3 60 0 24 24 10 70 1 70 Rp 15,515,831 Rp 10,343,888 Rp 648,262 Rp - Rp 648,262 Rp 648,262 17
18 Nurlela TKD/kesling S1 80 0 21 24 10 90 0.875 78.75 Rp 15,515,831 Rp 10,343,888 Rp 729,294 Rp - Rp 729,294 Rp 669,294 18
19 Aisyah TKD/UKS D3 60 0 24 24 10 70 1 70 Rp 15,515,831 Rp 10,343,888 Rp - #VALUE! #VALUE! 19
1675.4167 Rp 14,867,569 Rp 416,161 #VALUE! #VALUE!
Soakonora, 30 Mei 2018
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN

Nurafni Kudo SKM Iriyani Sartoso, Amd. Keb


NIP. 198006162009032003 Nip.19790320 20032 2 011
Pajak

0 0 1675.4166667 Rp 87,978 Rp 1,671,589


0 0 1675.4166667
0 0 1675.4166667 Rp 50,935 Rp 42,446 Rp 925,316

0 0 1675.4166667 Rp 53,250 Rp 44,375 Rp 967,376

0 0 1675.4166667 Rp 78,717 Rp 1,495,632


3 60,000 1675.4166667 Rp 36,465 Rp 30,387 Rp 662,442
0 0 1675.4166667 Rp 39,359 Rp 32,799 Rp 715,017
2 40,000 1675.4166667 Rp 40,323 Rp 33,603 Rp 772,865
0 0 1675.4166667 Rp 34,728 Rp 28,940 Rp 665,626
22 440,000 1675.4166667 Rp 2,508 Rp 2,090 Rp 48,073
0 0 1675.4166667 Rp 30,098 Rp 25,082 Rp 576,876
24 480,000 1675.4166667 Rp - Rp - Rp -
2 40,000 1675.4166667 Rp 27,590 Rp 22,991 Rp 528,803
2 40,000 1675.4166667 Rp 31,834 Rp 26,529 Rp 610,157
0 0 1675.4166667
1 20,000 1675.4166667
2 40,000 1675.4166667
0 0 1675.4166667
3 60,000 3
0 0 1675.4166667
Rp 513,786 Rp 289,242 Rp 9,639,771

#VALUE! uang sisa


DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN MEI TAHUN 2018
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,045,500

Penerimaan Kapitasi dengan


Kehadiran
Presentas Jumlah peserta 6.213 Jasa Pelayanan
Rangk Tanggu Jumlah Poin e Jumlah
Jenis ap ng yang diterima
Variabel Kehadiran Total
Pendidi Masa Jumlah Jumlah Biaya dengan Peserta
No Nama Pegawai Jabatan Ketena Hari Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan Pajak 5 % Sisa Terima Jasa Total Sisa Jasa Yang Paraf
kan Kerja Hari Admini Progra Operasional ( Klm 9 x klm
gaan Masuk (= ian Kolom Point (60 %) Di Terima
Kerja stratif ( 40 %) 10 dibagi jumlah klm
Kerja m klm 1+2+5+6) 3 dibagi (Kolm 8x7)
9)
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 10 24 24 100 0 190 1 190 Rp 15,515,831 Rp 5,218,200 Rp 1,759,567 Rp 87,978 Rp 1,671,589 Rp 1,671,589 1
DR. Gembong Dokter S1 80 10 24 24 100 0 150 1 150 Rp 15,515,831 Rp 5,218,200 Rp 1,389,132 Rp 69,457 Rp 1,319,675 Rp 1,319,675 1
2 Ferderika Lefara , Amd.Keb KB,KTU / IIId D3 60 20 24 24 0 30 110 1 110 Rp 15,515,831 Rp 5,218,200 Rp 1,018,697 Rp 50,935 Rp 967,762 Rp 967,762 2
P. SP2TP, Ispa, Diare,
Masriati Cein, AMK
3 Pneumonia, PTM/IIIb D1 60 25 24 24 30 115 1 115 Rp 15,515,831 Rp 5,218,200 Rp 1,065,001 Rp 53,250 Rp 1,011,751 Rp 1,011,751 3
4 Iriyani Sartoso , Amd.Keb P. Aset, Batra, B JKN /IIIc
D3 60 10 24 24 50 50 170 1 170 Rp 15,515,831 Rp 5,218,200 Rp 1,574,349 Rp 78,717 Rp 1,495,632 Rp 1,495,632 4
5 Ida M. Djalil, SKM Kontrak, Kesling S1 80 0 21 24 10 90 0.875 78.75 Rp 15,515,831 Rp 5,218,200 Rp 729,294 Rp 36,465 Rp 692,830 Rp 332,455 5
6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 24 24 20 85 1 85 Rp 15,515,831 Rp 5,218,200 Rp 787,175 Rp 39,359 Rp 747,816 Rp 747,816 6
7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 22 24 30 95 0.916667 87.083333 Rp 15,515,831 Rp 5,218,200 Rp 806,468 Rp - Rp 806,468 Rp 766,468 7
8 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 24 24 10 75 1 75 Rp 15,515,831 Rp 5,218,200 Rp 694,566 - Rp 694,566 Rp 694,566 8
9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 2 24 0 65 0.083333 5.4166667 Rp 15,515,831 Rp 5,218,200 Rp 50,163 Rp - Rp 50,163 Rp 100,000 9
10 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 24 24 0 65 1 65 Rp 15,515,831 Rp 5,218,200 Rp 601,957 Rp - Rp 601,957 Rp 601,957 10
11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS D3 60 5 0 24 0 65 0 0 Rp 15,515,831 Rp 5,218,200 Rp - Rp - Rp - Rp - 11
12 Rusni GaertiAmd. Keb CPNS D3 60 5 22 24 0 65 0.916667 59.583333 Rp 15,515,831 Rp 5,218,200 Rp 551,794 Rp - Rp 551,794 Rp 511,794 12
13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 22 24 10 75 0.916667 68.75 Rp 15,515,831 Rp 5,218,200 Rp 636,685 Rp - Rp 636,685 Rp 596,685 13
14 Endah P. W, Amd. Keb Jurim D3 60 5 24 24 10 75 1 75 Rp 15,515,831 Rp 5,218,200 Rp 694,566 Rp - Rp 694,566 Rp 694,566 14
15 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 23 24 10 70 0.958333 67.083333 Rp 15,515,831 Rp 5,218,200 Rp 621,251 Rp - Rp 621,251 Rp 601,251 15
16 Nikmat Triandini Pataha TKD D3 60 0 22 24 60 0.916667 55 Rp 15,515,831 Rp 5,218,200 Rp 509,348 Rp - Rp 509,348 Rp 469,348 16
17 Sarifa Soabangsa TKD/Gimul D3 60 0 24 24 10 70 1 70 Rp 15,515,831 Rp 5,218,200 Rp 648,262 Rp - Rp 648,262 Rp 648,262 17
18 Nurlela TKD/kesling S1 80 0 21 24 10 90 0.875 78.75 Rp 15,515,831 Rp 5,218,200 Rp 729,294 Rp - Rp 729,294 Rp 669,294 18
19 Aisyah TKD/UKS D3 60 0 24 24 10 70 1 70 Rp 15,515,831 Rp 5,218,200 Rp - #VALUE! #VALUE! 19
1675.4167 Rp 14,867,569 Rp 416,161 #VALUE! #VALUE!
Soakonora, 30 Mei 2018
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN

Nurafni Kudo SKM Iriyani Sartoso, Amd. Keb


NIP. 198006162009032003 Nip.19790320 20032 2 011
Pajak

0 0 1675.4166667 Rp 87,978 Rp 1,671,589


0 0 1675.4166667
0 0 1675.4166667 Rp 50,935 Rp 42,446 Rp 925,316

0 0 1675.4166667 Rp 53,250 Rp 44,375 Rp 967,376

0 0 1675.4166667 Rp 78,717 Rp 1,495,632


3 60,000 1675.4166667 Rp 36,465 Rp 30,387 Rp 662,442
0 0 1675.4166667 Rp 39,359 Rp 32,799 Rp 715,017
2 40,000 1675.4166667 Rp 40,323 Rp 33,603 Rp 772,865
0 0 1675.4166667 Rp 34,728 Rp 28,940 Rp 665,626
22 440,000 1675.4166667 Rp 2,508 Rp 2,090 Rp 48,073
0 0 1675.4166667 Rp 30,098 Rp 25,082 Rp 576,876
24 480,000 1675.4166667 Rp - Rp - Rp -
2 40,000 1675.4166667 Rp 27,590 Rp 22,991 Rp 528,803
2 40,000 1675.4166667 Rp 31,834 Rp 26,529 Rp 610,157
0 0 1675.4166667
1 20,000 1675.4166667
2 40,000 1675.4166667
0 0 1675.4166667
3 60,000 3
0 0 1675.4166667
Rp 513,786 Rp 289,242 Rp 9,639,771

#VALUE! uang sisa


DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN OKTOBER TAHUN 2018
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi
Rp 25,859,719

Penerimaan Kapitasi dengan


Kehadiran
Presentas Jumlah peserta 6.213 Jasa Pelayanan
Rangk Tanggu Jumlah Poin e Jumlah
Jenis ap ng yang diterima
Variabel Kehadiran Total
Pendidi Masa Jumlah Jumlah Biaya dengan Peserta
No Nama Pegawai Jabatan Ketena Hari Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Admini Progra Operasional ( Klm 9 x klm
gaan Masuk (= ian Kolom Point (60 %)
Kerja stratif ( 40 %) 10 dibagi jumlah klm
Kerja m klm 1+2+5+6) 3 dibagi (Kolm 8x7)
9)
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 10 27 27 100 0 190 1 190 Rp 15,515,831 Rp 10,343,888 Rp 1,856,039 Rp 92,802 Rp 1,763,237 1
DR. Gembong Dokter S1 80 10 27 27 100 0 150 1 150 Rp 15,515,831 Rp 10,343,888 Rp 1,465,294 Rp 73,265 Rp 1,392,029 1
2 Ferderika Lefara , Amd.Keb KB,KTU / IIId D3 60 20 27 27 0 30 110 1 110 Rp 15,515,831 Rp 10,343,888 Rp 1,074,549 Rp 53,727 Rp 1,020,821 2
P. SP2TP, Ispa, Diare,
Masriati Cein, AMK
3 Pneumonia, PTM/IIIb D1 60 25 27 27 30 115 1 115 Rp 15,515,831 Rp 10,343,888 Rp 1,123,392 Rp 56,170 Rp 1,067,222 3
4 Iriyani Sartoso , Amd.Keb P. Aset, Batra, B JKN /IIIc
D3 60 10 27 27 50 50 170 1 170 Rp 15,515,831 Rp 10,343,888 Rp 1,660,666 Rp 83,033 Rp 1,577,633 4
5 Ida M. Djalil, SKM Kontrak, Kesling S1 80 0 19 27 10 90 0.703704 63.333333 Rp 15,515,831 Rp 10,343,888 Rp 618,680 Rp 30,934 Rp 587,746 5
6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 25 27 20 85 0.925926 78.703704 Rp 15,515,831 Rp 10,343,888 Rp 768,827 Rp 38,441 Rp 730,386 6
7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 26 27 30 95 0.962963 91.481481 Rp 15,515,831 Rp 10,343,888 Rp 893,648 Rp - Rp 893,648 7
8 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 26 27 10 75 0.962963 72.222222 Rp 15,515,831 Rp 10,343,888 Rp 705,512 - Rp 705,512 8
9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 4 27 0 65 0.148148 9.6296296 Rp 15,515,831 Rp 10,343,888 Rp 94,068 Rp - Rp 94,068 9
10 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 27 27 0 65 1 65 Rp 15,515,831 Rp 10,343,888 Rp 634,961 Rp - Rp 634,961 10
11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS D3 60 5 0 27 0 65 0 0 Rp 15,515,831 Rp 10,343,888 Rp - Rp - Rp - 11
12 Rusni GaertiAmd. Keb CPNS D3 60 5 22 27 0 65 0.814815 52.962963 Rp 15,515,831 Rp 10,343,888 Rp 517,375 Rp - Rp 517,375 12
13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 16 27 10 75 0.592593 44.444444 Rp 15,515,831 Rp 10,343,888 Rp 434,161 Rp - Rp 434,161 13
14 Endah P. W, Amd. Keb Jurim D3 60 5 24 27 10 75 0.888889 66.666667 Rp 15,515,831 Rp 10,343,888 Rp 651,242 Rp - Rp 651,242 14
15 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 22 27 10 70 0.814815 57.037037 Rp 15,515,831 Rp 10,343,888 Rp 557,173 Rp - Rp 557,173 15
16 Nikmat Triandini Pataha TKD D3 60 0 24 27 60 0.888889 53.333333 Rp 15,515,831 Rp 10,343,888 Rp 520,993 Rp - Rp 520,993 16
17 Sarifa Soabangsa TKD/Gimul D3 60 0 24 27 10 70 0.888889 62.222222 Rp 15,515,831 Rp 10,343,888 Rp 607,825 Rp - Rp 607,825 17
18 Nurlela TKD/kesling S1 80 0 23 27 10 90 0.851852 76.666667 Rp 15,515,831 Rp 10,343,888 Rp 748,928 Rp - Rp 748,928 18
19 Aisyah TKD/UKS D3 60 0 23 27 10 70 0.851852 59.62963 Rp 15,515,831 Rp 10,343,888 Rp 582,499 Rp - Rp 582,499 19
1588.3333 Rp 15,515,831 Rp 428,372 Rp 15,087,459
Soakonora, 31 Oktober 2018
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN

Nurafni Kudo SKM Iriyani Sartoso, Amd. Keb


NIP. 198006162009032003 Nip.19790320 20032 2 011
Pajak

1588.3333333 Rp 92,802 Rp 1,763,237


1588.3333333
1588.3333333 Rp 53,727 Rp 39,798 Rp 981,023

1588.3333333 Rp 56,170 Rp 41,607 Rp 1,025,615

1588.3333333 Rp 83,033 Rp 1,577,633


1588.3333333 Rp 30,934 Rp 22,914 Rp 564,831
1588.3333333 Rp 38,441 Rp 28,475 Rp 701,910
1588.3333333 Rp 44,682 Rp 33,098 Rp 860,550
1588.3333333 Rp 35,276 Rp 26,130 Rp 679,382
1588.3333333 Rp 4,703 Rp 3,484 Rp 90,584
1588.3333333 Rp 31,748 Rp 23,517 Rp 611,443
1588.3333333 Rp - Rp - Rp -
1588.3333333 Rp 25,869 Rp 19,162 Rp 498,213
1588.3333333 Rp 21,708 Rp 16,080 Rp 418,081
0
0
0
0
1588.3333333
Rp 519,094 Rp 254,266 Rp 9,772,503
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN SEPTEMBER TAHUN 2018
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi
Rp 25,859,719

Penerimaan Kapitasi dengan


Kehadiran
Presentas Jumlah peserta 6.213 Jasa Pelayanan
Rangk Tanggu Jumlah Poin e Jumlah
Jenis ap ng yang diterima
Variabel Kehadiran Total
Pendidi Masa Jumlah Jumlah Biaya dengan Peserta
No Nama Pegawai Jabatan Ketena Hari Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Admini Progra Operasional ( Klm 9 x klm
gaan Masuk (= ian Kolom Point (60 %)
Kerja stratif ( 40 %) 10 dibagi jumlah klm
Kerja m klm 1+2+5+6) 3 dibagi (Kolm 8x7)
9)
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 10 25 24 100 0 190 1.041667 197.91667 Rp 15,515,831 Rp 10,343,888 Rp 1,812,597 Rp 90,630 Rp 1,721,967 1
DR. Gembong Dokter S1 80 10 25 24 100 0 150 1.041667 156.25 Rp 15,515,831 Rp 10,343,888 Rp 1,430,998 Rp 71,550 Rp 1,359,448 1
2 Ferderika Lefara , Amd.Keb KB,KTU / IIId D3 60 20 25 24 0 30 110 1.041667 114.58333 Rp 15,515,831 Rp 10,343,888 Rp 1,049,398 Rp 52,470 Rp 996,928 2
P. SP2TP, Ispa, Diare,
Masriati Cein, AMK
3 Pneumonia, PTM/IIIb D1 60 25 25 24 30 115 1.041667 119.79167 Rp 15,515,831 Rp 10,343,888 Rp 1,097,098 Rp 54,855 Rp 1,042,243 3
4 Iriyani Sartoso , Amd.Keb P. Aset, Batra, B JKN /IIIc
D3 60 10 25 24 50 50 170 1.041667 177.08333 Rp 15,515,831 Rp 10,343,888 Rp 1,621,797 Rp 81,090 Rp 1,540,708 4
5 Ida M. Djalil, SKM Kontrak, Kesling S1 80 0 18 24 10 90 0.75 67.5 Rp 15,515,831 Rp 10,343,888 Rp 618,191 Rp 30,910 Rp 587,281 5
6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 24 24 20 85 1 85 Rp 15,515,831 Rp 10,343,888 Rp 778,463 Rp 38,923 Rp 739,540 6
7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 25 24 30 95 1.041667 98.958333 Rp 15,515,831 Rp 10,343,888 Rp 906,299 Rp - Rp 906,299 7
8 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 23 24 10 75 0.958333 71.875 Rp 15,515,831 Rp 10,343,888 Rp 658,259 - Rp 658,259 8
9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 2 24 0 65 0.083333 5.4166667 Rp 15,515,831 Rp 10,343,888 Rp 49,608 Rp - Rp 49,608 9
10 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 25 24 0 65 1.041667 67.708333 Rp 15,515,831 Rp 10,343,888 Rp 620,099 Rp - Rp 620,099 10
11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS D3 60 5 0 24 0 65 0 0 Rp 15,515,831 Rp 10,343,888 Rp - Rp - Rp - 11
12 Rusni GaertiAmd. Keb CPNS D3 60 5 22 24 0 65 0.916667 59.583333 Rp 15,515,831 Rp 10,343,888 Rp 545,687 Rp - Rp 545,687 12
13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 16 24 10 75 0.666667 50 Rp 15,515,831 Rp 10,343,888 Rp 457,919 Rp - Rp 457,919 13
14 Endah P. W, Amd. Keb Jurim D3 60 5 24 24 10 75 1 75 Rp 15,515,831 Rp 10,343,888 Rp 686,879 Rp - Rp 686,879 14
15 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 22 24 10 70 0.916667 64.166667 Rp 15,515,831 Rp 10,343,888 Rp 587,663 Rp - Rp 587,663 15
16 Nikmat Triandini Pataha TKD D3 60 0 24 24 60 1 60 Rp 15,515,831 Rp 10,343,888 Rp 549,503 Rp - Rp 549,503 16
17 Sarifa Soabangsa TKD/Gimul D3 60 0 24 24 10 70 1 70 Rp 15,515,831 Rp 10,343,888 Rp 641,087 Rp - Rp 641,087 17
18 Nurlela TKD/kesling S1 80 0 23 24 10 90 0.958333 86.25 Rp 15,515,831 Rp 10,343,888 Rp 789,911 Rp - Rp 789,911 18
19 Aisyah TKD/UKS D3 60 0 23 24 10 70 0.958333 67.083333 Rp 15,515,831 Rp 10,343,888 Rp 614,375 Rp - Rp 614,375 19
1694.1667 Rp 15,515,831 Rp 420,427 Rp 15,095,404
Soakonora, 30 September 2018
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN

Nurafni Kudo SKM Iriyani Sartoso, Amd. Keb


NIP. 198006162009032003 Nip.19790320 20032 2 011
Pajak

1694.1666667 Rp 90,630 Rp 1,721,967


1694.1666667
1694.1666667 Rp 52,470 Rp 43,725 Rp 953,203

1694.1666667 Rp 54,855 Rp 45,712 Rp 996,531

1694.1666667 Rp 81,090 Rp 1,540,708


1694.1666667 Rp 30,910 Rp 25,758 Rp 561,523
1694.1666667 Rp 38,923 Rp 32,436 Rp 707,104
1694.1666667 Rp 45,315 Rp 37,762 Rp 868,536
1694.1666667 Rp 32,913 Rp 27,427 Rp 630,831
1694.1666667 Rp 2,480 Rp 2,067 Rp 47,541
1694.1666667 Rp 31,005 Rp 25,837 Rp 594,262
1694.1666667 Rp - Rp - Rp -
1694.1666667 Rp 27,284 Rp 22,737 Rp 522,950
1694.1666667 Rp 22,896 Rp 19,080 Rp 438,839
0
0
0
0
1694.1666667
Rp 510,771 Rp 282,543 Rp 9,583,996
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN MEI TAHUN 2018
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,045,500

Penerimaan Kapitasi dengan


Kehadiran
Presentas Jumlah peserta 6.213 Jasa Pelayanan
Rangk Tanggu Jumlah Poin e Jumlah
Jenis ap ng yang diterima
Variabel Kehadiran Total
Pendidi Masa Jumlah Jumlah Biaya dengan Peserta
No Nama Pegawai Jabatan Ketena Hari Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan Pajak 5 % Sisa Terima Jasa Total Sisa Jasa Yang Paraf
kan Kerja Hari Admini Progra Operasional ( Klm 9 x klm
gaan Masuk (= ian Kolom Point (60 %) Di Terima
Kerja stratif ( 40 %) 10 dibagi jumlah klm
Kerja m klm 1+2+5+6) 3 dibagi (Kolm 8x7)
9)
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 10 24 24 100 0 190 1 190 Rp 15,515,831 Rp 5,218,200 Rp 1,759,567 Rp 87,978 Rp 1,671,589 Rp 1,671,589 1
DR. Gembong Dokter S1 80 10 24 24 100 0 150 1 150 Rp 15,515,831 Rp 5,218,200 Rp 1,389,132 Rp 69,457 Rp 1,319,675 Rp 1,319,675 1
2 Ferderika Lefara , Amd.Keb KB,KTU / IIId D3 60 20 24 24 0 30 110 1 110 Rp 15,515,831 Rp 5,218,200 Rp 1,018,697 Rp 50,935 Rp 967,762 Rp 967,762 2
P. SP2TP, Ispa, Diare,
Masriati Cein, AMK
3 Pneumonia, PTM/IIIb D1 60 25 24 24 30 115 1 115 Rp 15,515,831 Rp 5,218,200 Rp 1,065,001 Rp 53,250 Rp 1,011,751 Rp 1,011,751 3
4 Iriyani Sartoso , Amd.Keb P. Aset, Batra, B JKN /IIIc
D3 60 10 24 24 50 50 170 1 170 Rp 15,515,831 Rp 5,218,200 Rp 1,574,349 Rp 78,717 Rp 1,495,632 Rp 1,495,632 4
5 Ida M. Djalil, SKM Kontrak, Kesling S1 80 0 21 24 10 90 0.875 78.75 Rp 15,515,831 Rp 5,218,200 Rp 729,294 Rp 36,465 Rp 692,830 Rp 332,455 5
6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 24 24 20 85 1 85 Rp 15,515,831 Rp 5,218,200 Rp 787,175 Rp 39,359 Rp 747,816 Rp 747,816 6
7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 22 24 30 95 0.916667 87.083333 Rp 15,515,831 Rp 5,218,200 Rp 806,468 Rp - Rp 806,468 Rp 766,468 7
8 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 24 24 10 75 1 75 Rp 15,515,831 Rp 5,218,200 Rp 694,566 - Rp 694,566 Rp 694,566 8
9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 2 24 0 65 0.083333 5.4166667 Rp 15,515,831 Rp 5,218,200 Rp 50,163 Rp - Rp 50,163 Rp 100,000 9
10 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 24 24 0 65 1 65 Rp 15,515,831 Rp 5,218,200 Rp 601,957 Rp - Rp 601,957 Rp 601,957 10
11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS D3 60 5 0 24 0 65 0 0 Rp 15,515,831 Rp 5,218,200 Rp - Rp - Rp - Rp - 11
12 Rusni GaertiAmd. Keb CPNS D3 60 5 22 24 0 65 0.916667 59.583333 Rp 15,515,831 Rp 5,218,200 Rp 551,794 Rp - Rp 551,794 Rp 511,794 12
13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 22 24 10 75 0.916667 68.75 Rp 15,515,831 Rp 5,218,200 Rp 636,685 Rp - Rp 636,685 Rp 596,685 13
14 Endah P. W, Amd. Keb Jurim D3 60 5 24 24 10 75 1 75 Rp 15,515,831 Rp 5,218,200 Rp 694,566 Rp - Rp 694,566 Rp 694,566 14
15 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 23 24 10 70 0.958333 67.083333 Rp 15,515,831 Rp 5,218,200 Rp 621,251 Rp - Rp 621,251 Rp 601,251 15
16 Nikmat Triandini Pataha TKD D3 60 0 22 24 60 0.916667 55 Rp 15,515,831 Rp 5,218,200 Rp 509,348 Rp - Rp 509,348 Rp 469,348 16
17 Sarifa Soabangsa TKD/Gimul D3 60 0 24 24 10 70 1 70 Rp 15,515,831 Rp 5,218,200 Rp 648,262 Rp - Rp 648,262 Rp 648,262 17
18 Nurlela TKD/kesling S1 80 0 21 24 10 90 0.875 78.75 Rp 15,515,831 Rp 5,218,200 Rp 729,294 Rp - Rp 729,294 Rp 669,294 18
19 Aisyah TKD/UKS D3 60 0 24 24 10 70 1 70 Rp 15,515,831 Rp 5,218,200 Rp - #VALUE! #VALUE! 19
1675.4167 Rp 14,867,569 Rp 416,161 #VALUE! #VALUE!
Soakonora, 30 Mei 2018
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN

Nurafni Kudo SKM Iriyani Sartoso, Amd. Keb


NIP. 198006162009032003 Nip.19790320 20032 2 011
Pajak

0 0 1675.4166667 Rp 87,978 Rp 1,671,589


0 0 1675.4166667
0 0 1675.4166667 Rp 50,935 Rp 42,446 Rp 925,316

0 0 1675.4166667 Rp 53,250 Rp 44,375 Rp 967,376

0 0 1675.4166667 Rp 78,717 Rp 1,495,632


3 60,000 1675.4166667 Rp 36,465 Rp 30,387 Rp 662,442
0 0 1675.4166667 Rp 39,359 Rp 32,799 Rp 715,017
2 40,000 1675.4166667 Rp 40,323 Rp 33,603 Rp 772,865
0 0 1675.4166667 Rp 34,728 Rp 28,940 Rp 665,626
22 440,000 1675.4166667 Rp 2,508 Rp 2,090 Rp 48,073
0 0 1675.4166667 Rp 30,098 Rp 25,082 Rp 576,876
24 480,000 1675.4166667 Rp - Rp - Rp -
2 40,000 1675.4166667 Rp 27,590 Rp 22,991 Rp 528,803
2 40,000 1675.4166667 Rp 31,834 Rp 26,529 Rp 610,157
0 0 1675.4166667
1 20,000 1675.4166667
2 40,000 1675.4166667
0 0 1675.4166667
3 60,000 3
0 0 1675.4166667
Rp 513,786 Rp 289,242 Rp 9,639,771

#VALUE! uang sisa


DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN AGUSTUS TAHUN 2018
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,045,500

Penerimaan Kapitasi dengan


Kehadiran
Presentas Jumlah peserta 6.213 Jasa Pelayanan
Rangk Tanggu Jumlah Poin e Jumlah
Jenis ap ng yang diterima
Variabel Kehadiran Total
Pendidi Masa Jumlah Jumlah Biaya dengan Peserta
No Nama Pegawai Jabatan Ketena Hari Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Admini Progra Operasional ( Klm 9 x klm
gaan Masuk (= ian Kolom Point (60 %)
Kerja stratif ( 40 %) 10 dibagi jumlah klm
Kerja m klm 1+2+5+6) 3 dibagi (Kolm 8x7)
9)
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 10 25 25 100 0 190 1 190 Rp 15,515,831 Rp 5,218,200 Rp 1,812,597 Rp 90,630 Rp 1,721,967 1
DR. Gembong Dokter S1 80 10 25 25 100 0 150 1 150 Rp 15,515,831 Rp 5,218,200 Rp 1,430,998 Rp 71,550 Rp 1,359,448 1
2 Ferderika Lefara , Amd.Keb KB,KTU / IIId D3 60 20 25 25 0 30 110 1 110 Rp 15,515,831 Rp 5,218,200 Rp 1,049,398 Rp 52,470 Rp 996,928 2
P. SP2TP, Ispa, Diare,
Masriati Cein, AMK
3 Pneumonia, PTM/IIIb D1 60 25 25 25 30 115 1 115 Rp 15,515,831 Rp 5,218,200 Rp 1,097,098 Rp 54,855 Rp 1,042,243 3
4 Iriyani Sartoso , Amd.Keb P. Aset, Batra, B JKN /IIIc
D3 60 10 25 25 50 50 170 1 170 Rp 15,515,831 Rp 5,218,200 Rp 1,621,797 Rp 81,090 Rp 1,540,708 4
5 Ida M. Djalil, SKM Kontrak, Kesling S1 80 0 18 25 10 90 0.72 64.8 Rp 15,515,831 Rp 5,218,200 Rp 618,191 Rp 30,910 Rp 587,281 5
6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 24 25 20 85 0.96 81.6 Rp 15,515,831 Rp 5,218,200 Rp 778,463 Rp 38,923 Rp 739,540 6
7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 25 25 30 95 1 95 Rp 15,515,831 Rp 5,218,200 Rp 906,299 Rp - Rp 906,299 7
8 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 23 25 10 75 0.92 69 Rp 15,515,831 Rp 5,218,200 Rp 658,259 - Rp 658,259 8
9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 2 25 0 65 0.08 5.2 Rp 15,515,831 Rp 5,218,200 Rp 49,608 Rp - Rp 49,608 9
10 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 25 25 0 65 1 65 Rp 15,515,831 Rp 5,218,200 Rp 620,099 Rp - Rp 620,099 10
11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS D3 60 5 0 25 0 65 0 0 Rp 15,515,831 Rp 5,218,200 Rp - Rp - Rp - 11
12 Rusni GaertiAmd. Keb CPNS D3 60 5 22 25 0 65 0.88 57.2 Rp 15,515,831 Rp 5,218,200 Rp 545,687 Rp - Rp 545,687 12
13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 16 25 10 75 0.64 48 Rp 15,515,831 Rp 5,218,200 Rp 457,919 Rp - Rp 457,919 13
14 Endah P. W, Amd. Keb Jurim D3 60 5 24 25 10 75 0.96 72 Rp 15,515,831 Rp 5,218,200 Rp 686,879 Rp - Rp 686,879 14
15 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 22 25 10 70 0.88 61.6 Rp 15,515,831 Rp 5,218,200 Rp 587,663 Rp - Rp 587,663 15
16 Nikmat Triandini Pataha TKD D3 60 0 24 25 60 0.96 57.6 Rp 15,515,831 Rp 5,218,200 Rp 549,503 Rp - Rp 549,503 16
17 Sarifa Soabangsa TKD/Gimul D3 60 0 24 25 10 70 0.96 67.2 Rp 15,515,831 Rp 5,218,200 Rp 641,087 Rp - Rp 641,087 17
18 Nurlela TKD/kesling S1 80 0 23 25 10 90 0.92 82.8 Rp 15,515,831 Rp 5,218,200 Rp 789,911 Rp - Rp 789,911 18
19 Aisyah TKD/UKS D3 60 0 23 25 10 70 0.92 64.4 Rp 15,515,831 Rp 5,218,200 Rp 614,375 Rp - Rp 614,375 19
1626.4 Rp 15,515,831 Rp 420,427 Rp 15,095,404
Soakonora, 31 Agustus 2018
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN

Nurafni Kudo SKM Iriyani Sartoso, Amd. Keb


NIP. 198006162009032003 Nip.19790320 20032 2 011
Pajak

1626.4 Rp 90,630 Rp 1,721,967


1626.4
1626.4 Rp 52,470 Rp 41,976 Rp 954,952

1626.4 Rp 54,855 Rp 43,884 Rp 998,359

1626.4 Rp 81,090 Rp 1,540,708


1626.4 Rp 30,910 Rp 24,728 Rp 562,554
1626.4 Rp 38,923 Rp 31,139 Rp 708,401
1626.4 Rp 45,315 Rp 36,252 Rp 870,047
1626.4 Rp 32,913 Rp 26,330 Rp 631,929
1626.4 Rp 2,480 Rp 1,984 Rp 47,624
1626.4 Rp 31,005 Rp 24,804 Rp 595,295
1626.4 Rp - Rp - Rp -
1626.4 Rp 27,284 Rp 21,827 Rp 523,860
1626.4 Rp 22,896 Rp 18,317 Rp 439,602
0
0
0
0
1626.4
Rp 510,771 Rp 271,241 Rp 9,595,297
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN MEI TAHUN 2018
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,045,500

Penerimaan Kapitasi dengan


Kehadiran
Presentas Jumlah peserta 6.213 Jasa Pelayanan
Rangk Tanggu Jumlah Poin e Jumlah
Jenis ap ng yang diterima
Variabel Kehadiran Total
Pendidi Masa Jumlah Jumlah Biaya dengan Peserta
No Nama Pegawai Jabatan Ketena Hari Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan Pajak 5 % Sisa Terima Jasa Total Sisa Jasa Yang Paraf
kan Kerja Hari Admini Progra Operasional ( Klm 9 x klm
gaan Masuk (= ian Kolom Point (60 %) Di Terima
Kerja stratif ( 40 %) 10 dibagi jumlah klm
Kerja m klm 1+2+5+6) 3 dibagi (Kolm 8x7)
9)
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 10 25 25 100 0 190 1 190 Rp 15,515,831 Rp 5,218,200 Rp 1,812,597 Rp 90,630 Rp 1,721,967 Rp 1,721,967 1
DR. Gembong Dokter S1 80 10 25 25 100 0 150 1 150 Rp 15,515,831 Rp 5,218,200 Rp 1,430,998 Rp 71,550 Rp 1,359,448 Rp 1,359,448 1
2 Ferderika Lefara , Amd.Keb KB,KTU / IIId D3 60 20 25 25 0 30 110 1 110 Rp 15,515,831 Rp 5,218,200 Rp 1,049,398 Rp 52,470 Rp 996,928 Rp 996,928 2
P. SP2TP, Ispa, Diare,
Masriati Cein, AMK
3 Pneumonia, PTM/IIIb D1 60 25 25 25 30 115 1 115 Rp 15,515,831 Rp 5,218,200 Rp 1,097,098 Rp 54,855 Rp 1,042,243 Rp 1,042,243 3
4 Iriyani Sartoso , Amd.Keb P. Aset, Batra, B JKN /IIIc
D3 60 10 25 25 50 50 170 1 170 Rp 15,515,831 Rp 5,218,200 Rp 1,621,797 Rp 81,090 Rp 1,540,708 Rp 1,540,708 4
5 Ida M. Djalil, SKM Kontrak, Kesling S1 80 0 18 25 10 90 0.72 64.8 Rp 15,515,831 Rp 5,218,200 Rp 618,191 Rp 30,910 Rp 587,281 Rp 254,632 5
6 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 24 25 20 85 0.96 81.6 Rp 15,515,831 Rp 5,218,200 Rp 778,463 Rp 38,923 Rp 739,540 Rp 724,540 6
7 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 25 25 30 95 1 95 Rp 15,515,831 Rp 5,218,200 Rp 906,299 Rp - Rp 906,299 Rp 906,299 7
8 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 23 25 10 75 0.92 69 Rp 15,515,831 Rp 5,218,200 Rp 658,259 - Rp 658,259 Rp 628,259 8
9 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 2 25 0 65 0.08 5.2 Rp 15,515,831 Rp 5,218,200 Rp 49,608 Rp - Rp 49,608 Rp 100,000 9
10 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 25 25 0 65 1 65 Rp 15,515,831 Rp 5,218,200 Rp 620,099 Rp - Rp 620,099 Rp 620,099 10
11 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS D3 60 5 0 25 0 65 0 0 Rp 15,515,831 Rp 5,218,200 Rp - Rp - Rp - Rp - 11
12 Rusni GaertiAmd. Keb CPNS D3 60 5 22 25 0 65 0.88 57.2 Rp 15,515,831 Rp 5,218,200 Rp 545,687 Rp - Rp 545,687 Rp 500,687 12
13 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 16 25 10 75 0.64 48 Rp 15,515,831 Rp 5,218,200 Rp 457,919 Rp - Rp 457,919 Rp 322,919 13
14 Endah P. W, Amd. Keb Jurim D3 60 5 24 25 10 75 0.96 72 Rp 15,515,831 Rp 5,218,200 Rp 686,879 Rp - Rp 686,879 Rp 671,879 14
15 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 22 25 10 70 0.88 61.6 Rp 15,515,831 Rp 5,218,200 Rp 587,663 Rp - Rp 587,663 Rp 542,663 15
16 Nikmat Triandini Pataha TKD D3 60 0 24 25 60 0.96 57.6 Rp 15,515,831 Rp 5,218,200 Rp 549,503 Rp - Rp 549,503 Rp 534,503 16
17 Sarifa Soabangsa TKD/Gimul D3 60 0 24 25 10 70 0.96 67.2 Rp 15,515,831 Rp 5,218,200 Rp 641,087 Rp - Rp 641,087 Rp 626,087 17
18 Nurlela TKD/kesling S1 80 0 23 25 10 90 0.92 82.8 Rp 15,515,831 Rp 5,218,200 Rp 789,911 Rp - Rp 789,911 Rp 759,911 18
19 Aisyah TKD/UKS D3 60 0 23 25 10 70 0.92 64.4 Rp 15,515,831 Rp 5,218,200 Rp 614,375 Rp - Rp 614,375 Rp 584,375 19
1626.4 Rp 15,515,831 Rp 420,427 Rp 15,095,404 Rp 14,438,147
Soakonora, 30 Mei 2018
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN

Nurafni Kudo SKM Iriyani Sartoso, Amd. Keb


NIP. 198006162009032003 Nip.19790320 20032 2 011
Pajak

0 0 1626.4 Rp 90,630 Rp 1,721,967


0 0 1626.4
0 0 1626.4 Rp 52,470 Rp 41,976 Rp 954,952

0 0 1626.4 Rp 54,855 Rp 43,884 Rp 998,359

0 0 1626.4 Rp 81,090 Rp 1,540,708


7 105,000 1626.4 Rp 30,910 Rp 24,728 Rp 562,554
1 15,000 1626.4 Rp 38,923 Rp 31,139 Rp 708,401
0 0 1626.4 Rp 45,315 Rp 36,252 Rp 870,047
2 30,000 1626.4 Rp 32,913 Rp 26,330 Rp 631,929
23 345,000 1626.4 Rp 2,480 Rp 1,984 Rp 47,624
0 0 1626.4 Rp 31,005 Rp 24,804 Rp 595,295
25 375,000 1626.4 Rp - Rp - Rp -
3 45,000 1626.4 Rp 27,284 Rp 21,827 Rp 523,860
9 135,000 1626.4 Rp 22,896 Rp 18,317 Rp 439,602
1 15,000 1626.4
3 45,000 1626.4
1 15,000 1626.4
1 15,000 1626.4
2 30,000 3
2 30,000 1626.4
Rp 510,771 Rp 271,241 Rp 9,595,297

Rp 657,257 uang sisa


DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN JANUARI TAHUN 2018
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,789,250
Penerimaan Kapitasi dengan
Kehadiran
Presentas Jumlah peserta 6.213 Jasa Pelayanan
Rangk Tanggu Jumlah Poin e Jumlah
Jenis ap ng yang diterima
Variabel Kehadiran Total
Pendidi Masa Jumlah Jumlah Biaya dengan Peserta
No Nama Pegawai Jabatan Ketena Hari Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Admini Progra Operasional ( Klm 9 x klm
gaan Masuk (= ian Kolom Point (60 %)
Kerja stratif ( 40 %) 10 dibagi jumlah klm
Kerja m klm 1+2+5+6) 3 dibagi (Kolm 8x7)
9)
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 dr. Melky Suhendro Dokter PTT S1 150 0 23 23 0 0 150 1 150 Rp 8,273,550 Rp 5,515,700 Rp 686,395 Rp 34,320 Rp 652,076 1
2 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 10 23 23 100 0 190 1 190 Rp 8,273,550 Rp 5,515,700 Rp 869,434 Rp 43,472 Rp 825,962 2
3 Ferderika Lefara , Amd.Keb KB,KTU / IIId D3 60 20 23 23 0 30 110 1 110 Rp 8,273,550 Rp 5,515,700 Rp 503,357 Rp 25,168 Rp 478,189 3
P. SP2TP, Ispa, Diare,
Masriati Cein, AMK
4 Pneumonia, PTM/IIIb D1 60 25 23 23 50 135 1 135 Rp 8,273,550 Rp 5,515,700 Rp 617,756 Rp 30,888 Rp 586,868 4
P. Gizi, Aset, Gimul, Batra,
5 Iriyani Sartoso , Amd.Keb
B JKN /IIIc D3 60 10 23 23 50 50 170 1 170 Rp 8,273,550 Rp 5,515,700 Rp 777,915 Rp 38,896 Rp 739,019 5
6 Rustandi Cein, SKM Kontrak, Kesling S1 80 0 23 23 10 90 1 90 Rp 8,273,550 Rp 5,515,700 Rp 411,837 Rp 20,592 Rp 391,245 6
7 Herto Hamangau P. Uks / IIIa D3 60 10 15 23 10 80 0.652174 52.173913 Rp 8,273,550 Rp 5,515,700 Rp 238,746 Rp 11,937 Rp 226,809 7
8 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 20 23 20 85 0.869565 73.913043 Rp 8,273,550 Rp 5,515,700 Rp 338,224 Rp 16,911 Rp 321,313 8
9 Heridikson Pare, AMK PKPR / IIc D3 60 5 17 23 10 75 0.73913 55.434783 Rp 8,273,550 Rp 5,515,700 Rp 253,668 Rp - Rp 253,668 9
10 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 20 23 30 95 0.869565 82.608696 Rp 8,273,550 Rp 5,515,700 Rp 378,015 Rp - Rp 378,015 10
11 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 22 23 10 75 0.956522 71.73913 Rp 8,273,550 Rp 5,515,700 Rp 328,276 - Rp 328,276 11
12 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 0 0 23 0 60 0 0 Rp 8,273,550 Rp 5,515,700 Rp - Rp - Rp - 12
13 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 22 23 0 65 0.956522 62.173913 Rp 8,273,550 Rp 5,515,700 Rp 284,506 Rp - Rp 284,506 13
20 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS D3 60 5 19 23 0 65 0.826087 53.695652 Rp 8,273,550 Rp 5,515,700 Rp 245,710 Rp - Rp 245,710 14
15 Rusni GaertiAmd. Keb CPNS D3 60 5 23 23 0 65 1 65 Rp 8,273,550 Rp 5,515,700 Rp 297,438 Rp - Rp 297,438 15
16 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 20 23 10 75 0.869565 65.217391 Rp 8,273,550 Rp 5,515,700 Rp 298,433 Rp - Rp 298,433 16
17 Endah P. W, Amd. Keb Jurim D3 60 5 23 23 10 75 1 75 Rp 8,273,550 Rp 5,515,700 Rp 343,198 Rp - Rp 343,198 17
18 Gusti Ulandari D., AMG TKD D3 60 0 22 23 60 0.956522 57.391304 Rp 8,273,550 Rp 5,515,700 Rp 262,621 Rp - Rp 262,621 18
19 Nikmat Triandini Pataha TKD D3 60 0 23 23 60 1 60 Rp 8,273,550 Rp 5,515,700 Rp 274,558 Rp - Rp 274,558 19
20 Sarifa Soabangsa TKD D3 60 0 22 23 60 0.956522 57.391304 Rp 8,273,550 Rp 5,515,700 Rp 262,621 Rp - Rp 262,621 20
21 Reni Dawile TKD S1 80 0 22 23 80 0.956522 76.521739 Rp 8,273,550 Rp 5,515,700 Rp 350,161 Rp - Rp 350,161
22 Aisyah TKD D3 60 0 21 23 60 0.913043 54.782609 Rp 8,273,550 Rp 5,515,700 Rp 250,683 Rp - Rp 250,683 21
1808.0435 Rp 8,273,550 Rp 222,183 Rp 8,051,367
Soakonora, 30 JANUARI 2018
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN

Nurafni Kudo SKM Iriyani Sartoso, Amd. Keb


NIP. 198006162009032003 Nip.19790320 20032 2 011
Pajak

1808.04347826087 Rp 34,320
1808.0434783 Rp 43,472 Rp 825,962
1808.0434783 Rp 25,168 Rp 21,885 Rp 456,304

1808.0434783 Rp 30,888 Rp 26,859 Rp 560,009

1808.0434783 Rp 38,896 Rp 739,019


1808.0434783 Rp 20,592 Rp 17,906 Rp 373,339
1808.0434783 Rp 11,937 Rp 10,380 Rp 216,429
1808.0434783 Rp 16,911 Rp 14,705 Rp 306,607
1808.0434783 Rp 12,683 Rp 11,029 Rp 242,639
1808.0434783 Rp 18,901 Rp 16,435 Rp 361,579
1808.0434783 Rp 16,414 Rp 14,273 Rp 314,003
1808.0434783 Rp - Rp - Rp -
1808.0434783 Rp 14,225 Rp 12,370 Rp 272,136
1808.0434783 Rp 12,285 Rp 10,683 Rp 235,027
1808.0434783 Rp 14,872 Rp 12,932 Rp 284,506
1808.0434783 Rp 14,922 Rp 12,975 Rp 285,457
0
0
0
0

1808.0434783
Rp 292,166 Rp 182,433 Rp 5,473,016
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN MEI TAHUN 2017
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Jumlah Kapitasi Rp 13,045,500
Jumlah
Penerimaan Kapitasi dengan
Kehadiran Poin Jasa
Presentas Jumlah peserta 6.213
Rangk Tangg Variabe Jumlah Pelayanan
e
Jenis ap ung l yang diterima
Pendid Masa Jumlah Jumla Kehadiran Total
No Nama Pegawai Jabatan Ketena Tugas Jawab Ketena Jasa Biaya dengan Pajak 5 % Poin per hari poin per hari kali alpa
ikan Kerja Hari (%Pembag Seluruh Kolom 11 di total yang di
gaan h Hari Admini Progr gaan ian Kolom Point Pelayanan (60 Operasional Peserta
Masuk ( Klm 9 x klm 10 alpa kurang 12 terima
Kerja stratif am 3 dibagi (Kolm 8x7) %) ( 40 %)
Kerja (= klm dibagi jumlah klm
klm 4)
1+2+5+6 9
1 2 3 4 5 6 7) 8 9 10 11 12 13 14 15
1 dr. Melky Suhendro Dokter PTT S1 150 0 23 23 0 0 150 1 150 Rp 7,827,300 Rp 5,218,200 Rp 635,617 Rp 31,781 Rp 27,636 Rp - Rp - Rp 635,617 0
2 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 10 23 23 100 0 190 1 190 Rp 7,827,300 Rp 5,218,200 Rp 805,115 Rp 40,256 Rp 35,005 Rp - Rp - Rp 805,115 0
3 Ferderika Lefara , Amd.Keb KB,KTU / IIId D3 60 20 23 23 0 30 110 1 110 Rp 7,827,300 Rp 5,218,200 Rp 466,119 Rp 23,306 Rp 20,266 Rp - Rp - Rp 466,119 0
P. SP2TP, Ispa, Diare,
Masriati Cein, AMK
4 Pneumonia, PTM/IIIb D1 60 25 23 23 50 135 1 135 Rp 7,827,300 Rp 5,218,200 Rp 572,055 Rp 28,603 Rp 24,872 Rp - Rp - Rp 572,055 0
P. Gizi, Aset, Gimul, Batra,
5 Iriyani Sartoso , Amd.Keb D3 60 10 23 23 50 50 170 1 170 Rp 7,827,300 Rp 5,218,200 Rp 720,366 Rp 36,018 Rp 31,320 Rp - Rp - Rp 720,366 0
B JKN /IIIc
6 Rustandi Cein, SKM Kontrak, Kesling S1 80 0 23 23 10 90 1 90 Rp 7,827,300 Rp 5,218,200 Rp 381,370 Rp - Rp 16,581 Rp - Rp - Rp 381,370 0
7 Herto Hamangau P. Uks / IIIa D3 60 10 18 23 10 80 0.782609 62.608696 Rp 7,827,300 Rp 5,218,200 Rp 265,301 Rp - Rp 11,535 Rp 57,674 Rp 57,674 Rp 207,627 5
8 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 21 23 20 85 0.913043 77.608696 Rp 7,827,300 Rp 5,218,200 Rp 328,863 Rp - Rp 14,298 Rp 28,597 Rp 28,597 Rp 300,266 2
9 Heridikson Pare, AMK PKPR / IIc D3 60 5 17 23 10 75 0.73913 55.434783 Rp 7,827,300 Rp 5,218,200 Rp 234,902 Rp - Rp 10,213 Rp 61,279 Rp 61,279 Rp 173,623 6
10 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 21 23 30 95 0.913043 86.73913 Rp 7,827,300 Rp 5,218,200 Rp 367,552 Rp - Rp 15,981 Rp 31,961 Rp 31,961 Rp 335,591 2
11 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 23 23 10 75 1 75 Rp 7,827,300 Rp 5,218,200 Rp 317,808 Rp - Rp 13,818 Rp - Rp - Rp 317,808 0
12 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 0 0 23 0 60 0 0 Rp 7,827,300 Rp 5,218,200 Rp - Rp - Rp - Rp - Rp - Rp - 23
13 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 23 23 0 65 1 65 Rp 7,827,300 Rp 5,218,200 Rp 275,434 Rp - Rp 11,975 Rp - Rp - Rp 275,434 0
20 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS D3 60 5 20 23 0 65 0.869565 56.521739 Rp 7,827,300 Rp 5,218,200 Rp 239,508 Rp - Rp 10,413 Rp 31,240 Rp 31,240 Rp 208,268 3
15 Rusni GaertiAmd. Keb CPNS D3 60 5 23 23 0 65 1 65 Rp 7,827,300 Rp 5,218,200 Rp 275,434 Rp - Rp 11,975 Rp - Rp - Rp 275,434 0
16 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 21 23 10 75 0.913043 68.478261 Rp 7,827,300 Rp 5,218,200 Rp 290,173 Rp - Rp 12,616 Rp 25,232 Rp 25,232 Rp 264,941 2
17 Endah P. W, Amd. Keb Jurim D3 60 5 23 23 10 75 1 75 Rp 7,827,300 Rp 5,218,200 Rp 317,808 Rp - Rp 13,818 Rp - Rp - Rp 317,808 0
18 Gusti Ulandari D., AMG TKD D3 60 0 23 23 0 60 1 60 Rp 7,827,300 Rp 5,218,200 Rp 254,247 Rp - Rp 11,054 Rp - Rp - Rp 254,247 0
19 Nikmat Triandini Pataha TKD D3 60 0 23 23 0 60 1 60 Rp 7,827,300 Rp 5,218,200 Rp 254,247 Rp - Rp 11,054 Rp - Rp - Rp 254,247 0
20 Sarifa Soabangsa TKD D3 60 0 23 23 0 60 1 60 Rp 7,827,300 Rp 5,218,200 Rp 254,247 Rp - Rp 11,054 Rp - Rp - Rp 254,247 0
21 Reni Dawile TKD S1 80 0 23 23 0 80 1 80 Rp 7,827,300 Rp 5,218,200 338,995.69 Rp - Rp 14,739 Rp - Rp - Rp 338,996 0
22 Aisyah TKD D3 60 0 21 23 0 60 0.913043 54.782609 Rp 7,827,300 Rp 5,218,200 Rp 232,138 Rp - Rp 10,093 Rp 20,186 Rp 20,186 Rp 211,952 2

1847.1739 Rp 7,827,300 Rp 128,183 Rp 340,317 Rp 256,169 Rp 256,169 Rp 7,571,131


Soakonora, 31 Mei 2017
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN
FERDERIKA LEFARA, Amd. Keb Iriyani Sartoso, Amd. Keb
NIP. 19680218 198903 2 008 Nip.19790320 20032 2 011

Sisa Uang Rp 256,169


Pajak

1847.173913 Rp 31,781 Rp 27,636


1847.173913 Rp 40,256 Rp 35,005 Rp -
1847.173913 Rp 23,306 Rp 20,266 Rp -

1847.173913 Rp 28,603 Rp 24,872


1847.173913 Rp 36,018 Rp 31,320 Rp -
1847.173913 Rp 19,069 Rp 16,581 Rp -
1847.173913 Rp 13,265 Rp 11,535 Rp -
1847.173913 Rp 16,443 Rp 14,298 Rp -
1847.173913 Rp 11,745 Rp 10,213 Rp -
1847.173913 Rp 18,378 Rp 15,981 Rp -
1847.173913 Rp 15,890 Rp 13,818 Rp -
1847.173913 Rp - Rp - Rp -
1847.173913 Rp 13,772 Rp 11,975 Rp -
1847.173913 Rp 11,975 Rp 10,413 Rp -
1847.173913 Rp 13,772 Rp 11,975 Rp -
1847.173913 Rp 14,509 Rp 12,616 Rp -
1847.173913 Rp 15,890 Rp 13,818 Rp -
1847.173913 Rp 12,712 Rp 11,054 Rp -
1847.173913 Rp 12,712 Rp 11,054 Rp -
1847.173913 Rp 12,712 Rp 11,054 Rp -
1847.173913 Rp 16,950 Rp 14,739 Rp -
1847.173913 Rp 11,607 Rp 10,093 Rp -
Rp 280,501 Rp 191,406 Rp 52,507
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN JANUARI TAHUN 2018
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,789,250
Penerimaan Kapitasi dengan
Kehadiran
Presentas Jumlah peserta 6.213 Jasa Pelayanan
Rangk Tanggu Jumlah Poin e Jumlah
Jenis ap ng yang diterima
Variabel Kehadiran Total
Pendidi Masa Jumlah Jumlah Biaya dengan Peserta
No Nama Pegawai Jabatan Ketena Hari Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Admini Progra Operasional ( Klm 9 x klm
gaan Masuk (= ian Kolom Point (60 %)
Kerja stratif ( 40 %) 10 dibagi jumlah klm
Kerja m klm 1+2+5+6) 3 dibagi (Kolm 8x7)
9)
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 20 23 21 100 0 200 1.095238 219.04762 Rp 8,273,550 Rp 5,515,700 Rp 990,973 Rp 49,549 Rp 941,425 2
2 Ferderika Lefara , Amd.Keb KB,KTU / IIId D3 60 25 23 21 0 30 115 1.095238 125.95238 Rp 8,273,550 Rp 5,515,700 Rp 569,810 Rp 28,490 Rp 541,319 3
P. SP2TP, Ispa, Diare,
Masriati Cein, AMK
3 Pneumonia, PTM/IIIb D1 60 5 23 21 50 115 1.095238 125.95238 Rp 8,273,550 Rp 5,515,700 Rp 569,810 Rp 28,490 Rp 541,319 4
P. Gizi, Aset, Gimul, Batra,
4 Iriyani Sartoso , Amd.Keb
B JKN /IIIc D3 60 10 23 21 50 50 170 1.095238 186.19048 Rp 8,273,550 Rp 5,515,700 Rp 842,327 Rp 42,116 Rp 800,211 5
5 Sutriyanti Sartoso, SKM Kesling / III b S1 80 20 23 21 10 110 1.095238 120.47619 Rp 8,273,550 Rp 5,515,700 Rp 545,035 Rp 27,252 Rp 517,784 6
7 Herto Hamangau P. Uks / IIIa D3 60 5 15 21 10 75 0.714286 53.571429 Rp 8,273,550 Rp 5,515,700 Rp 242,358 Rp 12,118 Rp 230,240 7
8 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 20 21 20 85 0.952381 80.952381 Rp 8,273,550 Rp 5,515,700 Rp 366,229 Rp 18,311 Rp 347,918 8
9 Heridikson Pare, AMK PKPR / IIc D3 60 5 17 21 10 75 0.809524 60.714286 Rp 8,273,550 Rp 5,515,700 Rp 274,672 Rp - Rp 274,672 9
10 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 20 21 30 95 0.952381 90.47619 Rp 8,273,550 Rp 5,515,700 Rp 409,315 Rp - Rp 409,315 10
11 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 22 21 10 75 1.047619 78.571429 Rp 8,273,550 Rp 5,515,700 Rp 355,458 - Rp 355,458 11
12 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 0 0 21 0 60 0 0 Rp 8,273,550 Rp 5,515,700 Rp - Rp - Rp - 12
13 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 22 21 0 65 1.047619 68.095238 Rp 8,273,550 Rp 5,515,700 Rp 308,063 Rp - Rp 308,063 13
20 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS D3 60 5 19 21 0 65 0.904762 58.809524 Rp 8,273,550 Rp 5,515,700 Rp 266,055 Rp - Rp 266,055 14
15 Rusni GaertiAmd. Keb CPNS D3 60 5 23 21 0 65 1.095238 71.190476 Rp 8,273,550 Rp 5,515,700 Rp 322,066 Rp - Rp 322,066 15
16 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 20 21 10 75 0.952381 71.428571 Rp 8,273,550 Rp 5,515,700 Rp 323,143 Rp - Rp 323,143 16
17 Endah P. W, Amd. Keb Jurim D3 60 5 23 21 10 75 1.095238 82.142857 Rp 8,273,550 Rp 5,515,700 Rp 371,615 Rp - Rp 371,615 17
18 Gusti Ulandari D., AMG TKD D3 60 0 22 21 60 1.047619 62.857143 Rp 8,273,550 Rp 5,515,700 Rp 284,366 Rp - Rp 284,366 18
19 Nikmat Triandini Pataha TKD D3 60 0 23 21 60 1.095238 65.714286 Rp 8,273,550 Rp 5,515,700 Rp 297,292 Rp - Rp 297,292 19
20 Sarifa Soabangsa TKD D3 60 0 22 21 60 1.047619 62.857143 Rp 8,273,550 Rp 5,515,700 Rp 284,366 Rp - Rp 284,366 20
21 Reni Dawile TKD S1 80 0 22 21 80 1.047619 83.809524 Rp 8,273,550 Rp 5,515,700 Rp 379,155 Rp - Rp 379,155
22 Aisyah TKD D3 60 0 21 21 60 1 60 Rp 8,273,550 Rp 5,515,700 Rp 271,441 Rp - Rp 271,441 21
1828.8095 Rp 8,273,550 Rp 206,327 Rp 8,067,223
Soakonora, 30 JANUARI 2018
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN

Nurafni Kudo SKM Iriyani Sartoso, Amd. Keb


NIP. 198006162009032003 Nip.19790320 20032 2 011
Pajak

1828.8095238 Rp 49,549 Rp 941,425


1828.8095238 Rp 28,490 Rp 27,134 Rp 514,185

1828.8095238 Rp 28,490 Rp 27,134 Rp 514,185

1828.8095238 Rp 42,116 Rp 800,211


1828.8095238 Rp 27,252 Rp 25,954 Rp 491,829
1828.8095238 Rp 12,118 Rp 11,541 Rp 218,699
1828.8095238 Rp 18,311 Rp 17,439 Rp 330,478
1828.8095238 Rp 13,734 Rp 13,080 Rp 261,592
1828.8095238 Rp 20,466 Rp 19,491 Rp 389,824
1828.8095238 Rp 17,773 Rp 16,927 Rp 338,531
1828.8095238 Rp - Rp - Rp -
1828.8095238 Rp 15,403 Rp 14,670 Rp 293,394
1828.8095238 Rp 13,303 Rp 12,669 Rp 253,386
1828.8095238 Rp 16,103 Rp 15,336 Rp 306,730
1828.8095238 Rp 16,157 Rp 15,388 Rp 307,756
0
0
0
0

1828.8095238
Rp 319,266 Rp 216,763 Rp 5,962,225
DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN FEBRUARI TAHUN 2018
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,045,500

Penerimaan Kapitasi dengan


Kehadiran
Presentas Jumlah peserta 6.213 Jasa Pelayanan
Rangk Tanggu Jumlah Poin e Jumlah
Jenis ap ng yang diterima
Variabel Kehadiran Total
Pendidi Masa Jumlah Jumlah Biaya dengan Peserta
No Nama Pegawai Jabatan Ketena Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Hari Admini Progra Operasional ( Klm 9 x klm
gaan Masuk (= ian Kolom Point (60 %)
Kerja stratif ( 40 %) 10 dibagi jumlah klm
Kerja m klm 1+2+5+6) 3 dibagi (Kolm 8x7)
9)
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 dr. Melky Suhendro Dokter PTT S1 150 0 23 23 0 0 150 1 150 Rp 7,827,300 Rp 5,218,200 Rp 657,196 Rp 32,860 Rp 624,336 1 1786.52173913043

2 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 10 23 23 100 0 190 1 190 Rp 7,827,300 Rp 5,218,200 Rp 832,448 Rp 41,622 Rp 790,826 2 1786.5217391
3 Ferderika Lefara , Amd.Keb KB,KTU / IIId D3 60 20 23 23 0 30 110 1 110 Rp 7,827,300 Rp 5,218,200 Rp 481,944 Rp 24,097 Rp 457,847 3 1786.5217391
P. SP2TP, Ispa, Diare,
Masriati Cein, AMK
4 Pneumonia, PTM/IIIb D1 60 25 23 23 30 115 1 115 Rp 7,827,300 Rp 5,218,200 Rp 503,850 Rp 25,193 Rp 478,658 4 1786.5217391
5 Iriyani Sartoso , Amd.Keb P. Aset, Batra, B JKN /IIIc
D3 60 10 23 23 50 50 170 1 170 Rp 7,827,300 Rp 5,218,200 Rp 744,822 Rp 37,241 Rp 707,581 5 1786.5217391
6 Rustandi Cein, SKM Kontrak, Kesling S1 80 0 22 23 10 90 0.956522 86.086957 Rp 7,827,300 Rp 5,218,200 Rp 377,173 Rp 18,859 Rp 358,315 6 1786.5217391
7 Herto Hamangau P. Uks / IIIa D3 60 10 17 23 10 80 0.73913 59.130435 Rp 7,827,300 Rp 5,218,200 Rp 259,069 Rp 12,953 Rp 246,115 7 1786.5217391
8 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 20 23 20 85 0.869565 73.913043 Rp 7,827,300 Rp 5,218,200 Rp 323,836 Rp 16,192 Rp 307,644 8 1786.5217391
9 Heridikson Pare, AMK PKPR / IIc D3 60 5 15 23 10 75 0.652174 48.913043 Rp 7,827,300 Rp 5,218,200 Rp 214,303 Rp - Rp 214,303 9 1786.5217391
10 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 21 23 30 95 0.913043 86.73913 Rp 7,827,300 Rp 5,218,200 Rp 380,031 Rp - Rp 380,031 10 1786.5217391
11 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 22 23 10 75 0.956522 71.73913 Rp 7,827,300 Rp 5,218,200 Rp 314,311 - Rp 314,311 11 1786.5217391
12 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 0 23 0 65 0 0 Rp 7,827,300 Rp 5,218,200 Rp - Rp - Rp - 12 1786.5217391
13 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 19 23 0 65 0.826087 53.695652 Rp 7,827,300 Rp 5,218,200 Rp 235,257 Rp - Rp 235,257 13 1786.5217391
14 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS D3 60 5 20 23 0 65 0.869565 56.521739 Rp 7,827,300 Rp 5,218,200 Rp 247,639 Rp - Rp 247,639 14 1786.5217391
15 Rusni GaertiAmd. Keb CPNS D3 60 5 21 23 0 65 0.913043 59.347826 Rp 7,827,300 Rp 5,218,200 Rp 260,021 Rp - Rp 260,021 15 1786.5217391
16 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 20 23 10 75 0.869565 65.217391 Rp 7,827,300 Rp 5,218,200 Rp 285,737 Rp - Rp 285,737 16 1786.5217391
17 Endah P. W, Amd. Keb Jurim D3 60 5 23 23 10 75 1 75 Rp 7,827,300 Rp 5,218,200 Rp 328,598 Rp - Rp 328,598 17 0
18 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 21 23 10 70 0.913043 63.913043 Rp 7,827,300 Rp 5,218,200 Rp 280,023 Rp - Rp 280,023 18 0
19 Nikmat Triandini Pataha TKD D3 60 0 22 23 60 0.956522 57.391304 Rp 7,827,300 Rp 5,218,200 Rp 251,449 Rp - Rp 251,449 19 0
20 Sarifa Soabangsa TKD/Gimul D3 60 0 22 23 10 70 0.956522 66.956522 Rp 7,827,300 Rp 5,218,200 Rp 293,357 Rp - Rp 293,357 20 0
21 Reni Dawile TKD S1 80 0 20 23 80 0.869565 69.565217 Rp 7,827,300 Rp 5,218,200 Rp 304,787 Rp - Rp 304,787
22 Aisyah TKD D3 60 0 22 23 60 0.956522 57.391304 Rp 7,827,300 Rp 5,218,200 Rp 251,449 Rp - Rp 251,449 21 1786.5217391
1786.5217 Rp 7,827,300 Rp 209,017 Rp 7,618,283
Soakonora, 28 Februari 2018
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN

Nurafni Kudo SKM Iriyani Sartoso, Amd. Keb


NIP. 198006162009032003 Nip.19790320 20032 2 011
Pajak

Rp 32,860
Rp 41,622 Rp 790,826
Rp 24,097 Rp 20,954 Rp 436,892

Rp 25,193 Rp 21,907 Rp 456,751

Rp 37,241 Rp 707,581
Rp 18,859 Rp 16,399 Rp 341,916
Rp 12,953 Rp 11,264 Rp 234,851
Rp 16,192 Rp 14,080 Rp 293,564
Rp 10,715 Rp 9,318 Rp 204,986
Rp 19,002 Rp 16,523 Rp 363,508
Rp 15,716 Rp 13,666 Rp 300,645
Rp - Rp - Rp -
Rp 11,763 Rp 10,229 Rp 225,029
Rp 12,382 Rp 10,767 Rp 236,872
Rp 13,001 Rp 11,305 Rp 248,716
Rp 14,287 Rp 12,423 Rp 273,314

Rp 273,022 Rp 168,834 Rp 5,115,451


DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN FEBRUARI TAHUN 2018
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,045,500

Penerimaan Kapitasi dengan


Kehadiran
Presentas Jumlah peserta 6.213 Jasa Pelayanan
Rangk Tanggu Jumlah Poin e Jumlah
Jenis ap ng yang diterima
Variabel Kehadiran Total
Pendidi Masa Jumlah Jumlah Biaya dengan Peserta
No Nama Pegawai Jabatan Ketena Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Hari Admini Progra Operasional ( Klm 9 x klm
gaan Masuk (= ian Kolom Point (60 %)
Kerja stratif ( 40 %) 10 dibagi jumlah klm
Kerja m klm 1+2+5+6) 3 dibagi (Kolm 8x7)
9)
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 dr. Melky Suhendro Dokter PTT S1 150 0 23 23 0 0 150 1 150 Rp 7,827,300 Rp 5,218,200 Rp 591,484 Rp 29,574 Rp 561,909 1 1985

2 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 10 23 23 100 0 190 1 190 Rp 7,827,300 Rp 5,218,200 Rp 749,213 Rp 37,461 Rp 711,752 2 1985
3 Ferderika Lefara , Amd.Keb KB,KTU / IIId D3 60 20 23 23 0 30 110 1 110 Rp 7,827,300 Rp 5,218,200 Rp 433,755 Rp 21,688 Rp 412,067 3 1985
P. SP2TP, Ispa, Diare,
Masriati Cein, AMK
4 Pneumonia, PTM/IIIb D1 60 25 23 23 30 115 1 115 Rp 7,827,300 Rp 5,218,200 Rp 453,471 Rp 22,674 Rp 430,797 4 1985
5 Iriyani Sartoso , Amd.Keb P. Aset, Batra, B JKN /IIIc
D3 60 10 23 23 50 50 170 1 170 Rp 7,827,300 Rp 5,218,200 Rp 670,348 Rp 33,517 Rp 636,831 5 1985
6 Rustandi Cein, SKM Kontrak, Kesling S1 80 0 23 23 10 90 1 90 Rp 7,827,300 Rp 5,218,200 Rp 354,890 Rp 17,745 Rp 337,146 6 1985
7 Herto Hamangau P. Uks / IIIa D3 60 10 23 23 10 80 1 80 Rp 7,827,300 Rp 5,218,200 Rp 315,458 Rp 15,773 Rp 299,685 7 1985
8 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 23 23 20 85 1 85 Rp 7,827,300 Rp 5,218,200 Rp 335,174 Rp 16,759 Rp 318,415 8 1985
9 Heridikson Pare, AMK PKPR / IIc D3 60 5 23 23 10 75 1 75 Rp 7,827,300 Rp 5,218,200 Rp 295,742 Rp - Rp 295,742 9 1985
10 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 23 23 30 95 1 95 Rp 7,827,300 Rp 5,218,200 Rp 374,606 Rp - Rp 374,606 10 1985
11 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 23 23 10 75 1 75 Rp 7,827,300 Rp 5,218,200 Rp 295,742 - Rp 295,742 11 1985
12 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 23 23 0 65 1 65 Rp 7,827,300 Rp 5,218,200 Rp 256,310 Rp - Rp 256,310 12 1985
13 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 23 23 0 65 1 65 Rp 7,827,300 Rp 5,218,200 Rp 256,310 Rp - Rp 256,310 13 1985
14 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS D3 60 5 23 23 0 65 1 65 Rp 7,827,300 Rp 5,218,200 Rp 256,310 Rp - Rp 256,310 14 1985
15 Rusni GaertiAmd. Keb CPNS D3 60 5 23 23 0 65 1 65 Rp 7,827,300 Rp 5,218,200 Rp 256,310 Rp - Rp 256,310 15 1985
16 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 23 23 10 75 1 75 Rp 7,827,300 Rp 5,218,200 Rp 295,742 Rp - Rp 295,742 16 1985
17 Endah P. W, Amd. Keb Jurim D3 60 5 23 23 10 75 1 75 Rp 7,827,300 Rp 5,218,200 Rp 295,742 Rp - Rp 295,742 17 0
18 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 23 23 10 70 1 70 Rp 7,827,300 Rp 5,218,200 Rp 276,026 Rp - Rp 276,026 18 0
19 Nikmat Triandini Pataha TKD D3 60 0 23 23 60 1 60 Rp 7,827,300 Rp 5,218,200 Rp 236,593 Rp - Rp 236,593 19 0
20 Sarifa Soabangsa TKD/Gimul D3 60 0 23 23 10 70 1 70 Rp 7,827,300 Rp 5,218,200 Rp 276,026 Rp - Rp 276,026 20 0
21 Reni Dawile TKD S1 80 0 23 23 80 1 80 Rp 7,827,300 Rp 5,218,200 Rp 315,458 Rp - Rp 315,458
22 Aisyah TKD D3 60 0 23 23 60 1 60 Rp 7,827,300 Rp 5,218,200 Rp 236,593 Rp - Rp 236,593 21 1985
1985 Rp 7,827,300 Rp 195,190 Rp 7,632,110
Soakonora, 28 Februari 2018
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN

Nurafni Kudo SKM Iriyani Sartoso, Amd. Keb


NIP. 198006162009032003 Nip.19790320 20032 2 011
Pajak

Rp 29,574
Rp 37,461 Rp 711,752
Rp 21,688 Rp 18,859 Rp 393,208

Rp 22,674 Rp 19,716 Rp 411,081

Rp 33,517 Rp 636,831
Rp 17,745 Rp 15,430 Rp 321,716
Rp 15,773 Rp 13,716 Rp 285,969
Rp 16,759 Rp 14,573 Rp 303,843
Rp 14,787 Rp 12,858 Rp 282,883
Rp 18,730 Rp 16,287 Rp 358,319
Rp 14,787 Rp 12,858 Rp 282,883
Rp 12,815 Rp 11,144 Rp 245,166
Rp 12,815 Rp 11,144 Rp 245,166
Rp 12,815 Rp 11,144 Rp 245,166
Rp 12,815 Rp 11,144 Rp 245,166
Rp 14,787 Rp 12,858 Rp 282,883

Rp 279,969 Rp 181,731 Rp 5,252,032


DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN MARETTAHUN 2018
PUSKESMAS SOAKONORA, KEC GALELA SELATAN

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,045,500

Penerimaan Kapitasi dengan


Kehadiran
Presentas Jumlah peserta 6.213 Jasa Pelayanan
Rangk Tanggu Jumlah Poin e Jumlah
Jenis ap ng yang diterima
Variabel Kehadiran Total
Pendidi Masa Jumlah Jumlah Biaya dengan Peserta
No Nama Pegawai Jabatan Ketena Hari Tugas Jawab Ketenagaan (%Pembag Seluruh Jasa Pelayanan Pajak 5 % Sisa Terima Jasa Paraf
kan Kerja Hari Admini Progra Operasional ( Klm 9 x klm
gaan Masuk (= ian Kolom Point (60 %)
Kerja stratif ( 40 %) 10 dibagi jumlah klm
Kerja m klm 1+2+5+6) 3 dibagi (Kolm 8x7)
9)
klm 4)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 dr. Melky Suhendro Dokter PTT S1 150 0 23 23 0 0 150 1 150 Rp 7,827,300 Rp 5,218,200 Rp 662,842 Rp 33,142 Rp 629,700 1 1771.30434782609

2 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 10 23 23 100 0 190 1 190 Rp 7,827,300 Rp 5,218,200 Rp 839,600 Rp 41,980 Rp 797,620 2 1771.3043478
3 Ferderika Lefara , Amd.Keb KB,KTU / IIId D3 60 20 23 23 0 30 110 1 110 Rp 7,827,300 Rp 5,218,200 Rp 486,084 Rp 24,304 Rp 461,780 3 1771.3043478
P. SP2TP, Ispa, Diare,
Masriati Cein, AMK
4 Pneumonia, PTM/IIIb D1 60 25 23 23 30 115 1 115 Rp 7,827,300 Rp 5,218,200 Rp 508,179 Rp 25,409 Rp 482,770 4 1771.3043478
5 Iriyani Sartoso , Amd.Keb P. Aset, Batra, B JKN /IIIc
D3 60 10 23 23 50 50 170 1 170 Rp 7,827,300 Rp 5,218,200 Rp 751,221 Rp 37,561 Rp 713,660 5 1771.3043478
6 Rustandi Cein, SKM Kontrak, Kesling S1 80 0 20 23 10 90 0.869565 78.26087 Rp 7,827,300 Rp 5,218,200 Rp 345,831 Rp 17,292 Rp 328,539 6 1771.3043478
7 Herto Hamangau P. Uks / IIIa D3 60 10 15 23 10 80 0.652174 52.173913 Rp 7,827,300 Rp 5,218,200 Rp 230,554 Rp 11,528 Rp 219,026 7 1771.3043478
8 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 22 23 20 85 0.956522 81.304348 Rp 7,827,300 Rp 5,218,200 Rp 359,280 Rp 17,964 Rp 341,316 8 1771.3043478
9 Heridikson Pare, AMK PKPR / IIc D3 60 5 16 23 10 75 0.695652 52.173913 Rp 7,827,300 Rp 5,218,200 Rp 230,554 Rp - Rp 230,554 9 1771.3043478
10 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 19 23 30 95 0.826087 78.478261 Rp 7,827,300 Rp 5,218,200 Rp 346,791 Rp - Rp 346,791 10 1771.3043478
11 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 22 23 10 75 0.956522 71.73913 Rp 7,827,300 Rp 5,218,200 Rp 317,011 - Rp 317,011 11 1771.3043478
12 Azhari Hi. Ahmad, Amd.Keb CPNS, D3 60 5 0 23 0 65 0 0 Rp 7,827,300 Rp 5,218,200 Rp - Rp - Rp - 12 1771.3043478
13 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 20 23 0 65 0.869565 56.521739 Rp 7,827,300 Rp 5,218,200 Rp 249,767 Rp - Rp 249,767 13 1771.3043478
14 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS D3 60 5 19 23 0 65 0.826087 53.695652 Rp 7,827,300 Rp 5,218,200 Rp 237,278 Rp - Rp 237,278 14 1771.3043478
15 Rusni GaertiAmd. Keb CPNS D3 60 5 20 23 0 65 0.869565 56.521739 Rp 7,827,300 Rp 5,218,200 Rp 249,767 Rp - Rp 249,767 15 1771.3043478
16 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 19 23 10 75 0.826087 61.956522 Rp 7,827,300 Rp 5,218,200 Rp 273,783 Rp - Rp 273,783 16 1771.3043478
17 Endah P. W, Amd. Keb Jurim D3 60 5 22 23 10 75 0.956522 71.73913 Rp 7,827,300 Rp 5,218,200 Rp 317,011 Rp - Rp 317,011 17 0
18 Gusti Ulandari D., AMG TKD, P. Gizi D3 60 0 22 23 10 70 0.956522 66.956522 Rp 7,827,300 Rp 5,218,200 Rp 295,877 Rp - Rp 295,877 18 0
19 Nikmat Triandini Pataha TKD D3 60 0 22 23 60 0.956522 57.391304 Rp 7,827,300 Rp 5,218,200 Rp 253,609 Rp - Rp 253,609 19 0
20 Sarifa Soabangsa TKD/Gimul D3 60 0 22 23 10 70 0.956522 66.956522 Rp 7,827,300 Rp 5,218,200 Rp 295,877 Rp - Rp 295,877 20 0
21 Reni Dawile TKD S1 80 0 21 23 80 0.913043 73.043478 Rp 7,827,300 Rp 5,218,200 Rp 322,775 Rp - Rp 322,775
22 Aisyah TKD D3 60 0 22 23 60 0.956522 57.391304 Rp 7,827,300 Rp 5,218,200 Rp 253,609 Rp - Rp 253,609 21 1771.3043478
1771.3043 Rp 7,827,300 Rp 209,180 Rp 7,618,120
Soakonora, 30 Maret 2018
Kepala Puskesmas Soakonora Bendahara Kapitasi JKN

Nurafni Kudo SKM Iriyani Sartoso, Amd. Keb


NIP. 198006162009032003 Nip.19790320 20032 2 011
Pajak

Rp 33,142
Rp 41,980 Rp 797,620
Rp 24,304 Rp 21,134 Rp 440,646

Rp 25,409 Rp 22,095 Rp 460,675

Rp 37,561 Rp 713,660
Rp 17,292 Rp 15,036 Rp 313,503
Rp 11,528 Rp 10,024 Rp 209,002
Rp 17,964 Rp 15,621 Rp 325,695
Rp 11,528 Rp 10,024 Rp 220,530
Rp 17,340 Rp 15,078 Rp 331,713
Rp 15,851 Rp 13,783 Rp 303,228
Rp - Rp - Rp -
Rp 12,488 Rp 10,859 Rp 238,907
Rp 11,864 Rp 10,316 Rp 226,962
Rp 12,488 Rp 10,859 Rp 238,907
Rp 13,689 Rp 11,904 Rp 261,879

Rp 271,285 Rp 166,734 Rp 5,082,927


DAFTAR TERIMA JASA PELAYANAN BPJS
BULAN JANUARI TAHUN 2018
PUSKESMAS SOAKONORA, KEC GALELA SELATA

Nama Puskesmas : SOAKONORA, KEC GALELA SELATAN


Jumlah Peserta JKN :
Jumlah besaran Kapitasi Rp 3,000
Rp 13,045,500

Kehadiran
Presentas
Rangk Tanggu Jumlah Poin e
Jenis ap ng Variabel Kehadiran
Pendidi Masa Jumlah Jumlah
No Nama Pegawai Jabatan Ketena Tugas Jawab Ketenagaan (%Pembag
kan Kerja Hari Hari Admini Progra
gaan Masuk (= ian Kolom
Kerja stratif m klm 1+2+5+6) 3 dibagi
Kerja
klm 4)

1 2 3 4 5 6 7 8
1 dr. Melky Suhendro Dokter PTT S1 150 0 23 23 0 0 150 1
2 Nurafni Kudo,SKM Kepala Puskesmas / IIIc S1 80 20 23 23 100 0 200 1
3 Ferderika Lefara , Amd.Keb KB,KTU / IIId D3 60 25 23 23 0 30 115 1
P. SP2TP, Ispa, Diare,
Masriati Cein, AMK
4 Pneumonia, PTM/IIIb D1 60 5 23 23 50 115 1
P. Gizi, Aset, Gimul, Batra,
5 Iriyani Sartoso , Amd.Keb
B JKN /IIIc D3 60 5 23 23 50 50 165 1
6 Rustandi Cein, SKM Kontrak, Kesling S1 80 0 23 23 10 90 1
7 Herto Hamangau P. Uks / IIIa D3 60 5 23 23 10 75 1
8 Najmi Azzahirah Syair, Amd. Keb P. KIA SDIDTK /IIIa D3 60 5 23 23 20 85 1
9 Heridikson Pare, AMK PKPR / IIc D3 60 5 23 23 10 75 1
10 Muh. Gantian Dabi-Dabi,AMK P. TB, Kusta, Malaria /Iid D3 60 5 23 23 30 95 1
11 Naisa Tauda , Amd. Keb CPNS , Usila D3 60 5 23 23 10 75 1
12 Azhari Hi. Ahmad, Amd.Keb CPNS, KB D3 60 5 23 23 10 75 1
13 Regina Amralia Ali, Amd. Keb CPNS D3 60 5 23 23 0 65 1
14 S. Nila Sari Dabi-Dabi, Amd. Keb CPNS D3 60 5 23 23 0 65 1
15 Rusni GaertiAmd. Keb CPNS D3 60 5 23 23 0 65 1
16 Nurafni M. Jalil, Amd. Keb CPNS, , MTBS D3 60 5 23 23 10 75 1
17 Endah P. W, Amd. Keb Jurim D3 60 5 23 23 10 75 1
18 Gusti Ulandari D., AMG TKD D3 60 0 23 23 60 1
19 Nikmat Triandini Pataha TKD D3 60 0 23 23 60 1
20 Sarifa Soabangsa TKD D3 60 0 23 23 60 1
21 Reni Dawile TKD S1 80 0 23 23 80 1
22 Aisyah TKD D3 60 0 23 23 60 1

Kepala Puskesmas Soakonora

Nurafni Kudo SKM


NIP. 198006162009032003
ASA PELAYANAN BPJS
ARI TAHUN 2018
RA, KEC GALELA SELATAN

Penerimaan Kapitasi dengan


Jumlah peserta 6.213 Jasa Pelayanan
Jumlah
yang diterima
Total
Biaya dengan Peserta Pajak 5 % Sisa Terima Jasa Paraf
Seluruh Jasa Pelayanan
Operasional ( Klm 9 x klm
Point (60 %)
( 40 %) 10 dibagi jumlah klm
(Kolm 8x7)
9)

9 10 11 12 13 14 15

150 Rp 7,827,300 Rp 5,218,200 Rp 592,977 Rp 29,649 Rp 563,328 1


200 Rp 7,827,300 Rp 5,218,200 Rp 790,636 Rp 39,532 Rp 751,105 2
115 Rp 7,827,300 Rp 5,218,200 Rp 454,616 Rp 22,731 Rp 431,885 3

115 Rp 7,827,300 Rp 5,218,200 Rp 454,616 Rp 22,731 Rp 431,885 4

165 Rp 7,827,300 Rp 5,218,200 Rp 652,275 Rp 32,614 Rp 619,661 5


90 Rp 7,827,300 Rp 5,218,200 Rp 355,786 Rp 17,789 Rp 337,997 6
75 Rp 7,827,300 Rp 5,218,200 Rp 296,489 Rp 14,824 Rp 281,664 7
85 Rp 7,827,300 Rp 5,218,200 Rp 336,020 Rp 16,801 Rp 319,219 8
75 Rp 7,827,300 Rp 5,218,200 Rp 296,489 Rp - Rp 296,489 9
95 Rp 7,827,300 Rp 5,218,200 Rp 375,552 Rp - Rp 375,552 10
75 Rp 7,827,300 Rp 5,218,200 Rp 296,489 - Rp 296,489 11
75 Rp 7,827,300 Rp 5,218,200 Rp 296,489 Rp - Rp 296,489 12
65 Rp 7,827,300 Rp 5,218,200 Rp 256,957 Rp - Rp 256,957 13
65 Rp 7,827,300 Rp 5,218,200 Rp 256,957 Rp - Rp 256,957 14
65 Rp 7,827,300 Rp 5,218,200 Rp 256,957 Rp - Rp 256,957 15
75 Rp 7,827,300 Rp 5,218,200 Rp 296,489 Rp - Rp 296,489 16
75 Rp 7,827,300 Rp 5,218,200 Rp 296,489 Rp - Rp 296,489 17
60 Rp 7,827,300 Rp 5,218,200 Rp 237,191 Rp - Rp 237,191 18
60 Rp 7,827,300 Rp 5,218,200 Rp 237,191 Rp - Rp 237,191 19
60 Rp 7,827,300 Rp 5,218,200 Rp 237,191 Rp - Rp 237,191 20
80 Rp 7,827,300 Rp 5,218,200 Rp 316,255 Rp - Rp 316,255
60 Rp 7,827,300 Rp 5,218,200 Rp 237,191 Rp - Rp 237,191 21
1980 Rp 7,827,300 Rp 196,671 Rp 7,630,629
Soakonora, 30 JANUARI 2018
Bendahara Kapitasi JKN

Iriyani Sartoso, Amd. Keb


Nip.19790320 20032 2 011
Pajak

1980 Rp 29,649
1980 Rp 39,532 Rp 751,105
1980 Rp 22,731 Rp 19,766 Rp 412,119

1980 Rp 22,731 Rp 19,766 Rp 412,119

1980 Rp 32,614 Rp 619,661


1980 Rp 17,789 Rp 15,469 Rp 322,528
1980 Rp 14,824 Rp 12,891 Rp 268,773
1980 Rp 16,801 Rp 14,610 Rp 304,610
1980 Rp 14,824 Rp 12,891 Rp 283,598
1980 Rp 18,778 Rp 16,328 Rp 359,224
1980 Rp 14,824 Rp 12,891 Rp 283,598
1980 Rp 14,824 Rp 12,891 Rp 283,598
1980 Rp 12,848 Rp 11,172 Rp 245,785
1980 Rp 12,848 Rp 11,172 Rp 245,785
1980 Rp 12,848 Rp 11,172 Rp 245,785
1980 Rp 14,824 Rp 12,891 Rp 283,598
0
0
0
0

1980
Rp 283,641 Rp 183,909 Rp 5,321,885

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