Rekap Klaim BPJS Kia

Laporan Pengajuan Klem Non Kapitasi dan Realisasi Unit KIA
BULAN
No Tindakan
Januari Realisasi Februari Realisasi Maret Realisasi April Realisasi Mei Realisasi Juni Realisasi Juli Realisasi Agustus Realisasi September Realisasi Oktober Realisasi November Realisasi Desember Realisasi
1 ANC 50 - 32 - 33 32 34 34 28 28 30 30 38 38 41 41 42 40 54 52 45 34
2 INC - - 4 - - 8 3 - 2 2 5 5 10 10 4 4 6 6 4 4 3 3
3 PNC 1 - 1 - - - 3 - 1 1 3 3 12 12 4 4 6 6 8 8 1 -
4 Pra Rujukan 4 - 6 - 3 - 4 4 4 4 4 4 8 8 2 2 1 1 8 8 2 7
5 Ambulan 4 - 5 - 3 - 2 2 3 3 4 4 8 8 2 2 1 1 8 8 1 7
6 rawat inap kia - - 4 - - - 3 - 2 2 6 6 10 10 4 4 6 6 4 4 2 4
7 KB - - - - - - - - - - - - - - 2 2 19 19 2 2 2 0
BULAN
No Tindakan
Januari Realisasi Februari Realisasi Maret Realisasi April Realisasi Mei Realisasi Juni Realisasi Juli Realisasi Agustus Realisasi September Realisasi Oktober Realisasi November Realisasi Desember Realisasi
1 ANC 2,500,000 - 1,600,000 - 1,650,000 1,600,000 1,700,000 1,700,000 1,400,000 1,400,000 1,500,000 1,500,000 1,900,000 1,900,000 2,050,000 2,050,000 2,100,000 2,000,000 2,700,000 2,600,000 2,250,000 - 1,700,000 -
2 INC - - 2,800,000 - - 5,600,000 2,100,000 - 1,400,000 1,400,000 3,500,000 3,500,000 7,000,000 7,000,000 2,800,000 2,800,000 4,200,000 4,200,000 2,800,000 2,800,000 2,100,000 - 2,100,000 -
3 PNC 25,000 - 25,000 - - - 75,000 - 25,000 25,000 75,000 75,000 300,000 300,000 100,000 100,000 150,000 150,000 200,000 200,000 25,000 - - -
4 Pra Rujukan 500,000 - 750,000 - 375,000 - 500,000 500,000 500,000 500,000 500,000 500,000 1,000,000 1,000,000 250,000 250,000 125,000 125,000 1,000,000 1,000,000 250,000 - 875,000 -
5 Ambulan 1,150,000 - 1,437,500 - 862,500 - 575,000 575,000 862,500 862,500 1,150,000 1,150,000 2,300,000 2,300,000 575,000 575,000 287,500 287,500 2,300,000 2,300,000 287,500 - 2,012,500 -
6 rawat inap kia - - 480,000 - - - 360,000 - 240,000 240,000 720,000 720,000 1,200,000 1,200,000 480,000 480,000 720,000 720,000 480,000 480,000 240,000 - 480,000 -
7 KB - - - - - - - - - - - - - - 200,000 200,000 1,900,000 1,900,000 200,000 200,000 200,000 - - -
jumlah 4,175,000 - 7,092,500 - 2,887,500 7,200,000 5,310,000 7,197,100 4,427,500 4,427,500 7,445,000 7,445,000 13,700,000 13,700,000 6,455,000 6,455,000 9,482,500 9,382,500 9,680,000 9,580,000 5,352,500 - 7,167,500 -
BIdan Koordinator CI Ruangan KIA Kepala UPT PKM Cigalontang
Nurzakiah Saripah, STr.Keb Yoyoh, AM.Keb Iwan Setiawan, S.Kep, MSi

Non Kapitasi dan Realisasi Unit KIA
JUMLAH JUMLAH
KLAIM REALISASI
461 295
44 39
40 34
53 31
48 28
45 32
25 23
- -
JUMLAH JUMLAH
KLAIM REALISASI
23,050,000 14,750,000
30,800,000
1,000,000 850,000
6,625,000 3,875,000
13,800,000 8,050,000
5,400,000 3,840,000
2,500,000 2,300,000
83,175,000 65,387,100
1 1/21/2022 1/21/2022 NURHAYATI (0000436043542) Rp. 125.000,-
2 1/21/2022 1/21/2022 IDA PARIDA (0001815361514) Rp. 125.000,-
3 1/9/2022 1/9/2022 TIRNA SUMIATI (0000434396553) Rp. 125.000,-
4 1/2/2022 1/2/2022 UMIN (0000435108609) Rp. 125.000,-
5 1/22/2022 1/22/2022 YANTI ROSMIATI (0000433648675) Rp. 25.000,-
6 1/22/2022 1/22/2022 NURHAYATI (0000436043542) Rp. 287.500,-
7 1/22/2022 1/22/2022 IDA PARIDA (0001815361514) Rp. 287.500,-
8 1/10/2022 1/10/2022 TIRNA SUMIATI (0000434396553) Rp. 287.500,-
9 1/3/2022 1/3/2022 UMIN (0000435108609) Rp. 287.500,-
10 1/28/2022 1/28/2022 IRMAWATI (0000433882449) Rp. 50.000,-
11 1/28/2022 1/28/2022 SANTI YULIANTI (0000434207024) Rp. 50.000,-
12 1/27/2022 1/27/2022 ZAM ZAM NOER AZIZAH (0000070568335) Rp. 50.000,-
13 1/27/2022 1/27/2022 IDA ROYANI (0000434052101) Rp. 50.000,-
14 1/27/2022 1/27/2022 KIKI zakiah (0000434139041) Rp. 50.000,-
15 1/27/2022 1/27/2022 SITI ULFAH (0000434648463) Rp. 50.000,-
16 1/25/2022 1/25/2022 SUSILAWATI (0000434389149) Rp. 50.000,-
17 1/25/2022 1/25/2022 ERTI FERDIANTI (0000434479601) Rp. 50.000,-
18 1/25/2022 1/25/2022 NINING YUNINGSIH (0002794799259) Rp. 50.000,-
19 1/25/2022 1/25/2022 PIPIT NAMATUL FARIHAH (0003103885719) Rp. 50.000,-
20 1/24/2022 1/24/2022 evi (0000434942166) Rp. 50.000,-
21 1/22/2022 1/22/2022 TELI NURAIDAH (0002838620777) Rp. 50.000,-
22 1/22/2022 1/22/2022 NURLaELA (0003129601105) Rp. 50.000,-
23 1/21/2022 1/21/2022 INA (0002869608846) Rp. 50.000,-
24 1/20/2022 1/20/2022 PITRI (0000435241978) Rp. 50.000,-
25 1/20/2022 1/20/2022 NURHAYATI (0000436043542) Rp. 50.000,-
26 1/19/2022 1/19/2022 ERLIYANTI (0002627172887) Rp. 50.000,-
27 1/18/2022 1/18/2022 LINA HURIYAH (0002794795042) Rp. 50.000,-
28 1/17/2022 1/17/2022 MITA PATIMAH (0000433492143) Rp. 50.000,-
29 1/17/2022 1/17/2022 YANTI (0000433711631) Rp. 50.000,-
30 1/17/2022 1/17/2022 ITA ROSITA (0000435044024) Rp. 50.000,-
31 1/17/2022 1/17/2022 SALWA SUPRIATIN (0002838617807) Rp. 50.000,-
32 1/17/2022 1/17/2022 PIPIT NAMATUL FARIHAH (0003103885719) Rp. 50.000,-
33 1/15/2022 1/15/2022 KRISTINA (0000432071199) Rp. 50.000,-
34 1/15/2022 1/15/2022 AMINAH (0000435595836) Rp. 50.000,-
35 1/15/2022 1/15/2022 AAS ASIAH (0002794801869) Rp. 50.000,-
36 1/15/2022 1/15/2022 NENG SITI SAHIDATUL UMAH (0002904690598) Rp. 50.000,-
37 1/15/2022 1/15/2022 LILI WALIAH (0002911660648) Rp. 50.000,-
38 1/15/2022 1/15/2022 risma (0003099205888) Rp. 50.000,-
39 1/14/2022 1/14/2022 REYNITA (0000433386472) Rp. 50.000,-
40 1/14/2022 1/14/2022 NINING (0002594241246) Rp. 50.000,-
41 1/13/2022 1/13/2022 ATIN (0000434292164) Rp. 50.000,-
42 1/13/2022 1/13/2022 NINA NURSAMSI (0000434300455) Rp. 50.000,-
43 1/12/2022 1/12/2022 KOMALaSARI (0000434560937) Rp. 50.000,-
44 1/12/2022 1/12/2022 DILA AGIS AULIA (0000434975231) Rp. 50.000,-
45 1/12/2022 1/12/2022 DESI (0002794822964) Rp. 50.000,-
46 1/11/2022 1/11/2022 SOPI NURCAHYA (0002794793005) Rp. 50.000,-
47 1/10/2022 1/10/2022 HIKMAH SAIDAH (0000435024011) Rp. 50.000,-
48 1/10/2022 1/10/2022 TETI RUSMIATI (0002393206481) Rp. 50.000,-
49 1/8/2022 1/8/2022 OKOY RUKOYAH (0002794819533) Rp. 50.000,-
50 1/6/2022 1/6/2022 TIRNA SUMIATI (0000434396553) Rp. 50.000,-
51 1/6/2022 1/6/2022 NURHAYATI (0000436043542) Rp. 50.000,-
52 1/5/2022 1/5/2022 KOMALASARI (0000435336309) Rp. 50.000,-
53 1/5/2022 1/5/2022 DISKI NURFAUZAN (0002920320369) Rp. 50.000,-
54 1/4/2022 1/4/2022 SRI MULYATI (0000434146138) Rp. 50.000,-
55 1/4/2022 1/4/2022 IDA PARIDA (0001815361514) Rp. 50.000,-
56 1/3/2022 1/3/2022 MIMIN (0000433927732) Rp. 50.000,-
57 1/3/2022 1/3/2022 WINA AGUSTIN (0000434789256) Rp. 50.000,-
58 1/3/2022 1/3/2022 IMA (0000435923381) Rp. 50.000,-
59 1/3/2022 1/3/2022 SITI NURASIYAH (0001005514457) Rp. 50.000,-
CIGALONTANG (10221501) Blm Verif ANC 50
CIGALONTANG (10221501) Blm Verif INC 0
CIGALONTANG (10221501) Blm Verif PNC 1
CIGALONTANG (10221501) Blm Verif Pra Rujuka 4
CIGALONTANG (10221501) Blm Verif Ambulan 4
CIGALONTANG (10221501) Blm Verif rawat inap 0
CIGALONTANG (10221501) Blm Verif
1 2/28/2022 2/28/2022 E SURTINI (0000433882372) Rp. 700.000,-
2 2/8/2022 2/8/2022 PINA SUPIANA (0000435252058) Rp. 700.000,-
3 2/8/2022 2/8/2022 NURLaELA (0003129601105) Rp. 700.000,-
4 2/2/2022 2/2/2022 ernawati (0000435250394) Rp. 700.000,-
5 1/29/2022 2/11/2022 RITA (0000434410097) Rp. 600.000,-
6 2/25/2022 2/25/2022 WIWIS KURNIATI (0000434949142) Rp. 50.000,-
7 2/25/2022 2/25/2022 SILVI ANDINI (0000435229896) Rp. 50.000,-
8 2/21/2022 2/21/2022 ROSA ROSTAFIA (0000434837891) Rp. 50.000,-
9 2/21/2022 2/21/2022 ELLYA NURLATIFAH (0001264408277) Rp. 50.000,-
10 2/19/2022 2/19/2022 NIAWATI (0000433889919) Rp. 50.000,-
11 2/14/2022 2/14/2022 RISNA DESI SUTENA (0003094094733) Rp. 50.000,-
12 2/12/2022 2/12/2022 DINA MAULIDATI (0000435057243) Rp. 50.000,-
13 2/12/2022 2/12/2022 HERTI ISLAMIYATI (0003005388404) Rp. 50.000,-
14 2/11/2022 2/11/2022 RANI (0000434057916) Rp. 50.000,-
15 2/11/2022 2/11/2022 ERNI (0000434384954) Rp. 50.000,-
16 2/11/2022 2/11/2022 IRMAYANTI (0000435531058) Rp. 50.000,-
17 2/10/2022 2/10/2022 ATIN (0000434292164) Rp. 50.000,-
18 2/10/2022 2/10/2022 RENI (0003005653026) Rp. 50.000,-
19 2/9/2022 2/9/2022 AI YULIANTI (0001005522849) Rp. 50.000,-
20 2/8/2022 2/8/2022 MASTOAH (0000433996299) Rp. 50.000,-
21 2/8/2022 2/8/2022 PITRIANI (0000434097202) Rp. 50.000,-
22 2/8/2022 2/8/2022 ROFIATUL FITRI (0001781253606) Rp. 50.000,-
23 2/8/2022 2/8/2022 LAELA SARI (0002633678302) Rp. 50.000,-
24 2/7/2022 2/7/2022 SERLI NUGRAHAWATI (0000433435972) Rp. 50.000,-
25 2/4/2022 2/4/2022 NINA HERLINA (0000435390107) Rp. 50.000,-
26 2/2/2022 2/2/2022 LINA HERLINA (0000428457161) Rp. 50.000,-
27 2/2/2022 2/2/2022 JUARIAH (0000434007911) Rp. 50.000,-
28 2/2/2022 2/2/2022 SANTI (0000434100148) Rp. 50.000,-
29 2/2/2022 2/2/2022 SITI NURJANAH (0000434318894) Rp. 50.000,-
30 2/2/2022 2/2/2022 YAYAT (0000434638732) Rp. 50.000,-
31 2/2/2022 2/2/2022 KAROMAH (0000434692585) Rp. 50.000,-
32 2/2/2022 2/2/2022 SINDI (0000434796153) Rp. 50.000,-
33 2/2/2022 2/2/2022 HERNI (0000434848059) Rp. 50.000,-
34 2/2/2022 2/2/2022 LIA SARI (0002608801828) Rp. 50.000,-
35 2/2/2022 2/2/2022 ALIS WINARTI (0002863679782) Rp. 50.000,-
36 2/2/2022 2/2/2022 IDAWATI (0002863680096) Rp. 50.000,-
37 2/2/2022 2/2/2022 RATNASARI (0002863681964) Rp. 50.000,-
38 1/29/2022 2/2/2022 IIS SOPIAH (0001425466282) Rp. 480.000,-
39 2/13/2022 2/16/2022 ATIH KURNIASIH (0000435126745) Rp. 360.000,-
40 1/31/2022 2/3/2022 MARNA (0000435211593) Rp. 360.000,-
41 1/30/2022 2/2/2022 ITA ROSITA (0000434140356) Rp. 360.000,-
42 2/25/2022 2/25/2022 RINA ANGGRAENI (0000434864744) Rp. 287.500,-
43 2/18/2022 2/18/2022 ROSITA (0000433588498) Rp. 287.500,-
44 2/16/2022 2/16/2022 ANITA (0000435046645) Rp. 287.500,-
45 2/14/2022 2/14/2022 ELA NAPILATULLAILA (0002888063212) Rp. 287.500,-
1 2/7/2022 2/7/2022 SRI ENDANG RESMAWATI (0002794788461) Rp. 287.500,-
2 2/7/2022 2/7/2022 ernawati (0000435250394) Rp. 25.000,-
3 2/21/2022 2/23/2022 INAYAH (0003006279606) Rp. 240.000,-
4 2/19/2022 2/21/2022 ENDANG (0002794792307) Rp. 240.000,-
5 2/14/2022 2/16/2022 SITI MUDRIKAH (0002482719996) Rp. 240.000,-
6 2/13/2022 2/15/2022 LASMINI HATIN (0000163229692) Rp. 240.000,-
7 2/3/2022 2/5/2022 CICI PEBRIANTI (0001269269381) Rp. 240.000,-
8 2/24/2022 2/24/2022 RINA ANGGRAENI (0000434864744) Rp. 125.000,-
9 2/17/2022 2/17/2022 ROSITA (0000433588498) Rp. 125.000,-
10 2/15/2022 2/15/2022 ANITA (0000435046645) Rp. 125.000,-
11 2/13/2022 2/13/2022 ELA NAPILATULLAILA (0002888063212) Rp. 125.000,-
12 2/8/2022 2/8/2022 ALMA FIBRI ANGGRAENI (0002489875986) Rp. 125.000,-
13 2/6/2022 2/6/2022 SRI ENDANG RESMAWATI (0002794788461) Rp. 125.000,-
16 2/27/2022 2/28/2022 E SURTINI (0000433882372) Rp. 120.000,-
17 2/22/2022 2/23/2022 OYOH (0000433967736) Rp. 120.000,-
18 2/9/2022 2/10/2022 PINA SUPIANA (0000435252058) Rp. 120.000,-
19 2/9/2022 2/10/2022 NURLaELA (0003129601105) Rp. 120.000,-
20 2/3/2022 2/4/2022 ernawati (0000435250394) Rp. 120.000,-
CIGALONTANG (10221501) Blm Verif ANC 32
CIGALONTANG (10221501) Blm Verif INC 4
CIGALONTANG (10221501) Blm Verif PNC 1
CIGALONTANG (10221501) Blm Verif Pra Rujukan 6
CIGALONTANG (10221501) Blm Verif Ambulan 5
CIGALONTANG (10221501) Blm Verif rawat inap kia 5
1 3/14/2022 3/14/2022 AMINAH (0000435595836) Rp. 287.500,-
2 3/14/2022 3/14/2022 YULI SRI RAHAYU (0002070982405) Rp. 287.500,-
3 3/13/2022 3/13/2022 YULI SRI RAHAYU (0002070982405) Rp. 125.000,-
4 3/12/2022 3/12/2022 AMINAH (0000435595836) Rp. 125.000,-
5 3/2/2022 3/2/2022 ERLIYANTI (0002627172887) Rp. 287.500,-
6 3/1/2022 3/1/2022 ERLIYANTI (0002627172887) Rp. 125.000,-
1 3/21/2022 435737283 NISA LIDYA Rp. 700.000,-
2 3/21/2022 435327524 PIPIH PARIDAH Rp. 700.000,-
3 3/21/2022 434919036 FARIDAH Rp. 700.000,-
4 3/21/2022 435579298 AI NURKOMALASARI Rp. 700.000,-
5 3/21/2022 433855214 NUR JANAH Rp. 700.000,-
6 3/21/2022 2794813828 HASANAH Rp. 700.000,-
7 3/21/2022 433522912 JAMILLAH Rp. 700.000,-
8 3/21/2022 433705781 DINI NURFADILAH Rp. 700.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Rp. 50.000,-
Blm
CIGALONTANG (10221501) ANC
Verif 32
Blm
CIGALONTANG (10221501) INC
Verif 8
Blm
CIGALONTANG (10221501) PNC
Verif 0
Blm
CIGALONTANG (10221501) Pra Rujuka
Verif 3
Blm
CIGALONTANG (10221501) Ambulan
Verif 3
Blm
CIGALONTANG (10221501) rawat inap
Verif 0
Rp. 700.000,- Layak
Rp. 700.000,- Layak
Rp. 700.000,- Layak
Rp. 700.000,- Layak
Rp. 700.000,- Layak
Rp. 700.000,- Layak
Rp. 700.000,- Layak
Rp. 700.000,- Layak

ANC 0
INC 0
PNC 0
Pra Rujuka 0
Ambulan 0
rawat inap 0
ANC 0
INC 0
PNC 0
Pra Rujuka 0
Ambulan 0
rawat inap 0
ANC 0
INC 0
PNC 0
Pra Rujuka 0
Ambulan 0
rawat inap 0

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Laporan Pengajuan Klem Non Kapitasi dan Realisasi Unit KIA

BIdan Koordinator CI Ruangan KIA Kepala UPT PKM Cigalontang

Nurzakiah Saripah, STr.Keb Yoyoh, AM.Keb Iwan Setiawan, S.Kep, MSi

2 3/14/2022 3/14/2022 YULI SRI RAHAYU (0002070982405) Rp. 287.500,-

3 3/13/2022 3/13/2022 YULI SRI RAHAYU (0002070982405) Rp. 125.000,-

4 3/12/2022 3/12/2022 AMINAH (0000435595836) Rp. 125.000,-

5 3/2/2022 3/2/2022 ERLIYANTI (0002627172887) Rp. 287.500,-

6 3/1/2022 3/1/2022 ERLIYANTI (0002627172887) Rp. 125.000,-

1 3/21/2022 435737283 NISA LIDYA Rp. 700.000,-

2 3/21/2022 435327524 PIPIH PARIDAH Rp. 700.000,-

3 3/21/2022 434919036 FARIDAH Rp. 700.000,-

4 3/21/2022 435579298 AI NURKOMALASARI Rp. 700.000,-

5 3/21/2022 433855214 NUR JANAH Rp. 700.000,-

6 3/21/2022 2794813828 HASANAH Rp. 700.000,-

7 3/21/2022 433522912 JAMILLAH Rp. 700.000,-

8 3/21/2022 433705781 DINI NURFADILAH Rp. 700.000,-

Rp. 700.000,- Layak

Rp. 700.000,- Layak

Rp. 700.000,- Layak

Rp. 700.000,- Layak

Rp. 700.000,- Layak

Rp. 700.000,- Layak

Rp. 700.000,- Layak

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