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  • Rekap Pembayaran Qris - Puskesmas Payangan

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    Arlan Pratama
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    The document is a letter from the head of the Payangan community health center to the head of the BPD Bali regional development bank Gianyar branch. It includes a reimbursement request for QRIS fees collected in February 2023 and a recapitulation table of payments received through BPD Bali's QRIS at the Payangan community health center that month, totaling 896,400 with a difference of 3,600 compared to the Gianyar regulation tariffs. The letter provides details of the reimbursement request according to the referenced regulation and receipts, thanking the bank for their cooperation.

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    REKAP PEMBAYARAN QRIS - PUSKESMAS PAYANGAN

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    The document is a letter from the head of the Payangan community health center to the head of the BPD Bali regional development bank Gianyar branch. It includes a reimbursement request for QRIS fees collected in February 2023 and a recapitulation table of payments received through BPD Bali's QRIS at the Payangan community health center that month, totaling 896,400 with a difference of 3,600 compared to the Gianyar regulation tariffs. The letter provides details of the reimbursement request according to the referenced regulation and receipts, thanking the bank for their cooperation.

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    © All Rights Reserved
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    24 views2 pages

    Rekap Pembayaran Qris - Puskesmas Payangan

    Uploaded by

    Arlan Pratama
    The document is a letter from the head of the Payangan community health center to the head of the BPD Bali regional development bank Gianyar branch. It includes a reimbursement request for QRIS fees collected in February 2023 and a recapitulation table of payments received through BPD Bali's QRIS at the Payangan community health center that month, totaling 896,400 with a difference of 3,600 compared to the Gianyar regulation tariffs. The letter provides details of the reimbursement request according to the referenced regulation and receipts, thanking the bank for their cooperation.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
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    of 2

    Payangan, 27 Februari 2023

    Lamp. : 1 (Satu) Gabung Kepada :


    Nomor : 900/219/Pusk.Py/2023 Yth. Kepala Bank Pembangunan Daerah (BPD) Bali
    Perihal : Pengembalian Biaya MDR QRIS Kantor Cabang Gianyar
    Bulan Februari 2023 di -
    Gianyar

    Dengan hormat,
    Berdasarkan surat dari Plt. Kepala Dinas Kesehatan Kabupaten Gianyar kepada Kepala Bank BPD Bali, PT Bank
    Pembangunan Daerah Bali - Kantor Cabang Gianyar Nomor 900/0416/DIKES/2023 perihal Pengembalian Biaya
    MDR QRIS Puskesmas Se-Kabupaten Gianyar, berikut kami lampirkan rekapitulasi penerimaan pembayaran layanan
    kesehatan melalui QRIS BPD Bali di UPTD Puskesmas Payangan pada bulan Februari 2023.

    Adapun rincian penerimaan pembayaran melalui QRIS BPD Bali kami peroleh dari Rekening Koran Giro (Online)
    BPD Bali periode 01-Feb-2023 s/d 27-Feb-2023 dan tarif pelayanan sesuai dengan Peraturan Bupati Gianyar
    Nomor 134 Tahun 2018 tentang Perubahan Kedua Atas Peraturan Bupati Nomor 48 Tahun 2011 Tentang Tarif
    Pelayanan Kesehatan Pada Unit Pelaksana Teknis Kesehatan Masyarakat di Kabupaten Gianyar.

    Demikian kami sampaikan untuk dapat ditindaklanjuti sesuai kesepakatan. Atas perhatian dan kerjasamanya kami
    ucapkan terima kasih.

    Kepala UPTD Puskesmas Payangan

    dr. Made Arisani


    NIP. 197112282010012012
    REKAPITULASI PEMBAYARAN QRIS BPD BALI
    DI UPTD PUSKESMAS PAYANGAN
    BULAN : Februari 2023

    Pembayaran Sesuai
    Tanggal Pembayaran QRIS Perbup Gianyar Nomor Selisih Ket. Transaksi
    134 Tahun 2018
    QRPAY 0310215001100 MERCHANT: UPTD PUSKESMAS
    16/2/2023 69,720.00 70,000.00 280.00 PAYANGAN(ID.CO.QRIS.WWW) NOREF: MB47452001 TERMINAL:
    A01
    QRPAY 0310215001100 MERCHANT: UPTD PUSKESMAS
    17/2/2023 184,260.00 185,000.00 740.00 PAYANGAN(ID.CO.QRIS.WWW) NOREF: MB47908226 TERMINAL:
    A01
    QRPAY 0310215001333 MERCHANT: UPTD PUSKESMAS
    20/2/2023 134,460.00 135,000.00 540.00 PAYANGAN(ID.CO.QRIS.WWW) NOREF: MB48030644 TERMINAL:
    A01
    QRPAY 0310215001462 MERCHANT: UPTD PUSKESMAS
    20/2/2023 69,720.00 70,000.00 280.00 PAYANGAN(ID.CO.QRIS.WWW) NOREF: MB48230777 TERMINAL:
    A01
    QRPAY 0310215001462 MERCHANT: UPTD PUSKESMAS
    20/2/2023 69,720.00 70,000.00 280.00 PAYANGAN(ID.CO.QRIS.WWW) NOREF: MB48238716 TERMINAL:
    A01
    QRPAY 0310215001100 MERCHANT: UPTD PUSKESMAS
    20/2/2023 34,860.00 35,000.00 140.00 PAYANGAN(ID.CO.QRIS.WWW) NOREF: MB48551797 TERMINAL:
    A01
    QRPAY 0310215001333 MERCHANT: UPTD PUSKESMAS
    21/2/2023 64,740.00 65,000.00 260.00 PAYANGAN(ID.CO.QRIS.WWW) NOREF: MB48856343 TERMINAL:
    A01
    QRPAY 0310215001100 MERCHANT: UPTD PUSKESMAS
    21/2/2023 19,920.00 20,000.00 80.00 PAYANGAN(ID.CO.QRIS.WWW) NOREF: MB49060176 TERMINAL:
    A01
    QRPAY 0310215001100 MERCHANT: UPTD PUSKESMAS
    22/2/2023 39,840.00 40,000.00 160.00 PAYANGAN(ID.CO.QRIS.WWW) NOREF: MB49253760 TERMINAL:
    A01
    QRPAY 0310215001100 MERCHANT: UPTD PUSKESMAS
    23/2/2023 79,680.00 80,000.00 320.00 PAYANGAN(ID.CO.QRIS.WWW) NOREF: MB49567713 TERMINAL:
    A01
    QRPAY 0310215000755 MERCHANT: UPTD PUSKESMAS
    27/2/2023 109,560.00 110,000.00 440.00 PAYANGAN(ID.CO.QRIS.WWW) NOREF: MB50161957 TERMINAL:
    A01
    QRPAY 0310215001100 MERCHANT: UPTD PUSKESMAS
    27/2/2023 19,920.00 20,000.00 80.00 PAYANGAN(ID.CO.QRIS.WWW) NOREF: MB50169454 TERMINAL:
    A01

    TOTAL 896,400.00 900,000.00 3,600.00

    Mengetahui, Payangan, 27 Februari 2023


    Kepala UPTD Puskesmas Payangan Bendahara Penerimaan Pembantu,

    dr. Made Arisani Putri Agung Sri Pramitadewi, A.Md.Kep


    NIP. 197112282010012012 NIP. 199009132015032004

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