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JASA PELAYANAN JAMINAN KESEHATAN NASIONAL

PEGAWAI UPT. PUSKESMAS MENGWI III


BULAN MEI TAHUN 2017
Jenis Masa Kehadiran Rangkap Tanggung
Ketenagaan Kerja Tugas Jawab
No Nama Pegawai Jabatan Pendidikan Jml Hari Masuk Jml Hari Kerja Administratif Program

1 2 3 4 5 6
1 dr. Km Widia Asmawan,S.Ked Kepala Puskesmas S1 150 10 24 24 100 30
2 drg.Made Oka Sukendra Dokter Gigi S1 150 20 24 24 50
3 dr.I Nyoman Kurniawan Dokter Umum S1 150 0 24 24 40
4 dr.Ni Kadek Eka Rusmayant Dokter Umum S1 150 0 24 24 40
5 drg.I A Sulaksmi Sidemen Dokter Gigi S1 150 0 24 24 40
6 drg.Ni Putu Ari Wahyuni Dokter Gigi S1 150 5 24 24 20
7 Ni Made Widhiastut Apoteker S1 100 5 24 24 40
8 Ni Diah Sukmawat Perawat Ners S1 100 5 24 24 30
9 Desak Putu Indiat Promosi Kesehatan S1 80 15 24 24 10
10 Kade Ayu Sulistyawathi Nutrisionis D3 60 15 24 24 40
11 Sri Mulyani Perawat D3 60 20 24 24 50
12 Ni Nyoman Natri Perawat D3 60 20 24 24 50
13 Ni Ketut Sri Martni Perawat D3 60 10 24 24 30
14 Ni Luh Rai Aryawat Perawat D3 60 10 24 24 10
15 Ni Made Winten Perawat SPK 50 25 24 24 10
16 Luh Maharani Bidan D3 60 20 24 24 30
17 Ni Luh Sudani Bidan D3 60 25 24 24 20
18 Ni Ketut Sarinadi Bidan D3 60 15 24 24 40
19 Ni Komang Sri Rejeki Bidan D3 60 15 24 24 20
20 Ni Putu Julitasari Kesuma Bidan D3 60 15 24 24 30
21 Harfiyah Bidan D3 60 15 24 24 20
22 Ni Luh Surasmini Bidan D3 60 20 24 24 10
23 Ni Made Sartni Bidan D3 60 15 24 24 30
24 Putu Susant Perawat D3 60 5 24 24 30
25 Ni Kadek Sumiart Bidan D3 60 15 24 24 30
26 Ni Luh Made Kertasih Bidan D3 60 5 24 24 20
27 Desak Winiasih Bidan P2B 50 25 24 24 30
28 I.G.A. Raka Marheni Kesling SPPH 50 20 24 24 30
29 I Ketut Sujana Kesling D3 60 15 24 24 20
30 Desak Nyoman Wirani Perawat Gigi SPRG 50 25 24 24 30
31 I Gust Agung Kencanawat Perawat Gigi SPRG 50 20 24 24 20
32 Ni Ketut Nelly Indriani Ka. TU Pekarya Kes 25 20 24 24 30 20
33 Ni Made Ratnawat Bendahara Umum Pekarya Kes 25 20 24 24 20
34 Putu Metrisari Bagian Aset SMA 25 15 24 24 20
35 Putu Trisna Suandewi Perawat D3 60 5 24 24 50 30
36 Ni Putu Seniasih Bidan D3 60 15 24 24 30
37 Ni Wayan Putu Sinarwat Bidan D3 60 5 24 24 30
38 Ni Luh Putu Asri Yuliandari Bidan D3 60 5 24 24 30
39 Ketut Arisandi Bidan D1 50 15 24 24 30
40 Ida Ayu Putri Astt Bidan D3 60 5 24 24 30
41 Ni Made Kembarsari Bidan D3 60 5 0 24 30
42 I Wayan Sudarsana Administrasi Umum STM 25 0 24 24 30
43 Kadek Suryaning A.Yuli Asisten Apoteker SMF 50 5 24 24 20
44 Ni Made Wardani Administrasi Umum SMA 25 15 24 24 30
45 I Putu Sudana Sopir Ambulans SMA 25 15 24 24 10
TOTAL

Mengetahui
Kepala FKTP UPT Puskesmas Mengwi III Bendahara JKN

dr. Komang Widia Asmawan, S.Ked Putu Trisna Suandewi,A.Md.Kep


NIP.197912022005011010 NIP. 198410032011012013
JASA PELAYANAN JAMINAN KESEHATAN NASIONAL
NON PEGAWAI UPT. PUSKESMAS MENGWI III
BULAN MARET TAHUN 2017
Jenis Masa Kehadiran Rangkap Tanggung
Ketenagaan Kerja Tugas Jawab
No Nama Pegawai Jabatan Pendidikan Jml Hari Masuk Jml Hari Kerja Administratif Program

1 2 3 4 5 6
1 Gust Ayu Apri Adnyani Bidan PTT D3 60 5 24 24 10
2 Ketut Suarnadi Bidan PTT D3 60 10 24 24 10
3 Ni Nyoman Ayu Erawat Bidan PTT D3 60 5 24 24 10
4 Ni Luh Putu Sri Ernawat Bidan PTT D3 60 5 24 24 10
5 Ni Luh Made Yunjayant R.D Bidan PTT D3 60 5 24 24 10
6 Komang Dwi Payani CS SMA 25 5 24 24 10
7 Kadek Dwi Payant CS SMA 25 5 24 24 10
8 Ni Made Jatni CS SMA 25 5 24 24 10
9 Ni Made Manis Mariasih CS SMP 25 15 24 24 10
10 Ni Nyoman Asmini CS SMA 25 5 24 24 10
11 Rai Ast Arini CS SMA 25 0 24 24 10
TOTAL

Mengetahui
Kepala FKTP UPT Puskesmas Mengwi III Bendahara JKN

dr. Komang Widia Asmawan, S.Ked Putu Trisna Suandewi,A.Md.Kep


NIP.197912022005011010 NIP. 198410032011012013
ANAN JAMINAN KESEHATAN NASIONAL
WAI UPT. PUSKESMAS MENGWI III
BULAN MEI TAHUN 2017
Jumlah Poin Persentase Jumlah Total Penerimaan Kapitasi PPh Jaspel
Variabel Ketenagaan Kehadiran Seluruh Poin Jaspel Operasional Jaspel Diterima (Pasal 21) Bersih
Total Poin

(1+2+5+6) (3:4)% ( 7 x 8) (60%) (40%) (9x11) : 10


7 8 9 10 11 12 13 14 15
290 100% 290 5614 44,641,680 29,761,120 2,377,602 2,377,602
220 100% 220 5614 44,641,680 29,761,120 1,749,407 1,749,407
190 100% 190 5614 44,641,680 29,761,120 1,510,851 1,510,851
190 100% 190 5614 44,641,680 29,761,120 1,510,851 1,510,851
190 100% 190 5614 44,641,680 29,761,120 1,510,851 1,510,851
175 100% 175 5614 44,641,680 29,761,120 1,391,574 1,391,574
145 100% 145 5614 44,641,680 29,761,120 1,153,018 1,153,018
135 100% 135 5614 44,641,680 29,761,120 1,073,500 1,073,500
105 100% 105 5614 44,641,680 29,761,120 834,944 834,944
115 100% 115 5614 44,641,680 29,761,120 914,463 914,463
130 100% 130 5614 44,641,680 29,761,120 1,033,740 1,033,740
130 100% 130 5614 44,641,680 29,761,120 1,033,740 1,033,740
100 100% 100 5614 44,641,680 29,761,120 795,185 795,185
80 100% 80 5614 44,641,680 29,761,120 636,148 636,148
85 100% 85 5614 44,641,680 29,761,120 675,907 675,907
110 100% 110 5614 44,641,680 29,761,120 874,703 874,703
105 100% 105 5614 44,641,680 29,761,120 834,944 834,944
115 100% 115 5614 44,641,680 29,761,120 914,463 914,463
95 100% 95 5614 44,641,680 29,761,120 755,426 755,426
105 100% 105 5614 44,641,680 29,761,120 834,944 834,944
95 100% 95 5614 44,641,680 29,761,120 755,426 755,426
90 100% 90 5614 44,641,680 29,761,120 715,666 715,666
105 100% 105 5614 44,641,680 29,761,120 834,944 834,944
95 100% 95 5614 44,641,680 29,761,120 755,426 755,426
105 100% 105 5614 44,641,680 29,761,120 834,944 834,944
85 100% 85 5614 44,641,680 29,761,120 675,907 675,907
105 100% 105 5614 44,641,680 29,761,120 834,944 834,944
100 100% 100 5614 44,641,680 29,761,120 795,185 795,185
95 100% 95 5614 44,641,680 29,761,120 755,426 755,426
105 100% 105 5614 44,641,680 29,761,120 834,944 834,944
90 100% 90 5614 44,641,680 29,761,120 715,666 715,666
95 100% 95 5614 44,641,680 29,761,120 755,426 755,426
65 100% 65 5614 44,641,680 29,761,120 516,870 516,870
60 100% 60 5614 44,641,680 29,761,120 477,111 477,111
145 100% 145 5614 44,641,680 29,761,120 1,153,018 1,153,018
105 100% 105 5614 44,641,680 29,761,120 834,944 834,944
95 100% 95 5614 44,641,680 29,761,120 755,426 755,426
95 100% 95 5614 44,641,680 29,761,120 755,426 755,426
95 100% 95 5614 44,641,680 29,761,120 755,426 755,426
95 100% 95 5614 44,641,680 29,761,120 755,426 755,426
95 0% 0 5614 44,641,680 29,761,120 0 0
55 100% 55 5614 44,641,680 29,761,120 437,352 437,352
75 100% 75 5614 44,641,680 29,761,120 596,389 596,389
70 100% 70 5614 44,641,680 29,761,120 556,629 556,629
50 100% 50 5614 44,641,680 29,761,120 397,592 397,592
39,671,774 0 39,671,774

Mangupura, 7 Juni 2017


Bendahara JKN Penerima/Pembagi Jaspel JKN

Putu Trisna Suandewi,A.Md.Kep Ni Luh Pt. Asri Yuliandari, A.Md.Keb


NIP. 198410032011012013 NIP. 199107052012122001
ANAN JAMINAN KESEHATAN NASIONAL
AWAI UPT. PUSKESMAS MENGWI III
BULAN MARET TAHUN 2017
Jumlah Poin Persentase Jumlah Total Penerimaan Kapitasi PPh Jaspel
Variabel Ketenagaan Kehadiran Seluruh Poin Jaspel Operasional Jaspel Diterima (Pasal 21) Bersih
Total Poin

(1+2+5+6) (3:4)% ( 7 x 8) (60%) (40%) (9x11) : 10


7 8 9 10 11 12 13 14 15
75 100% 75 5614 44,641,680 29,761,120 596,389 596,389
80 100% 80 5614 44,641,680 29,761,120 636,148 636,148
75 100% 75 5614 44,641,680 29,761,120 596,389 596,389
75 100% 75 5614 44,641,680 29,761,120 596,389 596,389
75 100% 75 5614 44,641,680 29,761,120 596,389 596,389
40 100% 40 5614 44,641,680 29,761,120 318,074 318,074
40 100% 40 5614 44,641,680 29,761,120 318,074 318,074
40 100% 40 5614 44,641,680 29,761,120 318,074 318,074
50 100% 50 5614 44,641,680 29,761,120 397,592 397,592
40 100% 40 5614 44,641,680 29,761,120 318,074 318,074
35 100% 35 5614 44,641,680 29,761,120 278,315 278,315
5614 4,969,906 0 4,969,906

Mangupura, 7 Juni 2017


Penerima/Pembagi Jaspel JKN

Ni Luh Pt. Asri Yuliandari, A.Md.Keb


NIP. 199107052012122001