ALOKASI ANGGARAN KAS KEGIATAN PENYELENGGARAAN PELAYANAN KESEHATAN MASYARAKAT UNTUK PESERTA JKN

TAHUN ANGGARAN 2017 UPTD PUSKESMAS PERUMNAS II

KODE PAGU ALOKASI TRIWULAN

URAIAN
REKENING (Rp) TW 1 TW 2 TW 3
5 . 2 . 1 . 01 . 02 Honorarium Pejabat / Tim Pengadaan Barang dan Jasa 480,000 - 480,000 -
5 . 2 . 1 . 01 . 05 Honorarium Pejabat / Tim Pemeriksa / Penerima Hasil Pekerjaan 420,000.00 - 420,000 -
5 . 2 . 1 . 01 . 06 Uang Saku 300,000 - 60,000 240,000
5 . 2 . 1 . 02 . 02 Uang Saku Non PNS 1,500,000 - 300,000 1,200,000
5 . 2 . 2 . 01 . 01 Belanja Alat Tulis Kantor 35,560,900 1,750,000 8,118,300 25,692,600
5 . 2 . 2 . 01 . 02 Belanja Dokumen Pengadaan Barang / Jasa 350,000 - 350,000 -
5 . 2 . 2 . 01 . 03 Belanja Komponen Alat Listrik dan Elektronik 2,325,000 - - 2,325,000
5 . 2 . 2 . 01 . 04 Belanja Benda Pos 1,200,000 - 480,000 720,000
5 . 2 . 2 . 01 . 05 Belanja Bahan Pembersih 8,700,000 - 455,000 8,245,000
5 . 2 . 2 . 01 . 06 Belanja Bahan Bakar Minyak / Gas dan Pelumas 9,169,500 1,100,000 2,533,900 4,035,600
5 . 2 . 2 . 01 . 11 Belanja Pakai Habis Pelayanan Kesehatan 41,889,000 - 8,965,000 35,744,000
5 . 2 . 2 . 03 . 01 Belanja Cetak 117,580,000 - 8,530,000 108,200,000
5 . 2 . 2 . 03 . 02 Belanja Penggandaan 2,526,000 396,000 792,000 744,000
5 . 2 . 2 . 04 . 01 Belanja Makanan dan Minuman Harian Pegawai 1,020,000 255,000 255,000 255,000
5 . 2 . 2 . 08 . 01 Belanja Barang Inventaris Peralatan / Perlengkapan Kantor 700,000 - - 700,000
5 . 2 . 2 . 08 . 03 Belanja Barang Inventaris Peralatan / Perlengkapan Rumah Tangga 4,000,000 - - 4,000,000
5 . 2 . 2 . 08 . 05 Belanja Barang Inventaris Peralatan / Perlengkapan Kesehatan 800,000 - - 800,000
5 . 2 . 2 . 16 . 03 Belanja Listrik 19,200,000 4,800,000 4,800,000 4,800,000
5 . 2 . 2 . 16 . 06 Belanja Kawat / Faksimili / Internet / TV Kabel 4,800,000 1,200,000 1,200,000 1,200,000
5 . 2 . 2 . 25 . 01 Belanja Kursus-kursus Singkat / Pelatihan 31,500,000 - 10,500,000 21,000,000
5 . 2 . 2 . 29 . 04 Jasa Tenaga Ahli / Instruktur / Narasumber / Juri / Moderator PNS 47,110,000 - - 47,110,000
5 . 2 . 2 . 30 . 03 Belanja Uji Laboratorium 36,000,000 6,000,000 12,000,000 9,000,000
5 . 2 . 2 . 30 . 06 Belanja Jasa Pelayanan Kesehatan 737,478,876 122,913,146 245,826,292 184,369,719
5 . 2 . 2 . 39 . 03 Belanja Pemeliharaan Gedung /Bangunan 89,557,500 - 89,557,500 -
5 . 2 . 2 . 39 . 11 Belanja Pemeliharaan Peralatan Kantor, Perlengkapan Kantor/ Komputer / Peralatan - - 2,000,000
2,000,000
dan Perlengkapan Teknis
5 . 2 . 2 . 39 . 14 Belanja Pemeliharaan Peralatan Kedokteran / Peralatan Kesehatan dan Penyelidikan 1,500,000 - 300,000 1,200,000
5 . 2 . 3 . 16 . 04 Belanja Modal Peralatan dan Mesin - Pengadaan Electric Generating Set 16,720,000 - 70,000 16,650,000
5 . 2 . 3 . 28 . 06 Belanja Modal Peralatan dan Mesin - Pengadaan Alat Rumah Tangga Lainnya (Home - - 7,424,697
Use) 7,424,697

5 . 2 . 3 . 30 . 07 Belanja Modal Peralatan dan Mesin - Pengadaan Lemari dan Arsip Pejabat 4,500,000 - - 4,500,000
JUMLAH 1,229,131,473 138,414,146 395,992,992 492,155,616

Bekasi, 2017
PPK SKPD DINAS KESEHATAN KOTA B

Dra. Sumarsih
 KODE PAGU ALOKASI TRIWULAN
URAIAN
REKENING (Rp) TW 1 TW 2 TW 3
NIP. 19670413 198703 2 004
 AN PELAYANAN KESEHATAN MASYARAKAT UNTUK PESERTA JKN
7 UPTD PUSKESMAS PERUMNAS II

ALOKASI TRIWULAN
TW 4
-
-
-
-
-
-
-
-
-
1,500,000
-
850,000
594,000
255,000
-
-
-
4,800,000
1,200,000
-
-
9,000,000
184,369,719
-
-

-
-
-

-
202,568,719

Bekasi, 2017
PPK SKPD DINAS KESEHATAN KOTA BEKASI

Dra. Sumarsih
ALOKASI TRIWULAN
TW 4
NIP. 19670413 198703 2 004
 RENCANA ANGGARAN BELANJA (RAB)
DANA KAPITASI JKN T.A 2017
PUSKESMAS PERUMNAS II

RINCIAN PERHITUNGAN
KODE PAGU
URAIAN Harga JAN FEB MAR APR MEI JUN JUL AGS SEP OKT NOV DES
REKENING Volume Satuan (Rp)
Satuan
5 BELANJA 1,229,131,473
5.2 BELANJA LANGSUNG 1,229,131,473
5.2.1 Belanja Pegawai 1,800,000
5 . 2 . 1 . 01 Honorarium PNS 300,000
5 . 2 . 1 . 01 . 02 Honorarium Pejabat / Tim Pengadaan 480,000 - 480,000 - -
Barang dan Jasa
Honorarium pejabat pengadaan 1 or/kl 480,000 480,000 480,000
barang dan jasa
5 . 2 . 1 . 01 . 05 Honorarium Pejabat / Tim 420,000.00 - 420,000 - -
Pemeriksa / Penerima Hasil
Pekerjaan
Honorarium pejabat penerima hasil 1 or/kl 420,000 420,000 420,000
pekerjaan
5 . 2 . 1 . 01 . 06 Uang Saku 300,000 - 60,000 240,000 -
Uang Saku PNS 300,000
- Transport petugas monitoring 5 or/lok 60,000 300,000 60,000 120,000 120,000
5 . 2 . 1 . 02 fogging Non PNS
Honorarium 1,500,000
5 . 2 . 1 . 02 . 02 Uang Saku Non PNS 1,500,000 - 300,000 1,200,000 -
Uang saku Non PNS 1,500,000
- Transport petugas fogging 10 or/lok 150,000 1,500,000 300,000 600,000 600,000
5.2.2 Belanja Barang dan Jasa 1,075,949,276
5 . 2 . 2 . 01 Belanja Barang Pakai Habis 98,844,400
5 . 2 . 2 . 01 . 01 Belanja Alat Tulis Kantor 35,560,900 1,750,000 8,118,300 25,692,600 -
Alat Tulis Kantor 35,560,900
- Tinta printer laser jet 6 bh/kl 1,000,000 6,000,000 1,000,000 1,000,000 2,000,000 2,000,000
- Tinta printer 50 bh/kl 150,000 7,500,000 750,000 750,000 750,000 1,500,000 1,500,000 2,250,000
- Kertas HVS A4 60 rim/kl 29,000 1,740,000 290,000 290,000 290,000 290,000 580,000
- Kertas HVS F4 60 rim/bh 36,500 2,190,000 365,000 365,000 365,000 365,000 730,000
- Pulpen 24 lsn/kl 30,000 720,000 120,000 120,000 120,000 120,000 240,000
- Clear holder 70 bh/kl 30,000 2,100,000 300,000 600,000 600,000 600,000
- Odner 90 bh/kl 25,000 2,250,000 500,000 250,000 250,000 250,000 500,000 500,000
- Paper clip 30 pak/kl 18,000 540,000 90,000 90,000 90,000 90,000 180,000
- Isi hecter 12 pak/kl 25,000 300,000 50,000 50,000 50,000 150,000
- Spidol 12 lsn/kl 69,000 828,000 138,000 138,000 138,000 414,000
- Buku folio 200 lembar 24 pak/kl 70,000 1,680,000 280,000 280,000 280,000 280,000 280,000 280,000
- Buku folio 100 lembar 24 pak/kl 60,000 1,440,000 240,000 240,000 240,000 240,000 240,000 240,000
- Plastic pocket 36 pak/kl 19,000 684,000 114,000 114,000 114,000 114,000 228,000
- Buku tulis 2 lsn/kl 24,000 48,000 48,000
- Label sticker 30 pak/kl 18,000 540,000 108,000 108,000 108,000 108,000 108,000
- Buku kas 4 bk/kl 20,000 80,000 80,000
- Stopmap 24 pak/kl 18,500 444,000 74,000 74,000 74,000 74,000 74,000 74,000
- Stopmap snell 20 pak/kl 65,000 1,300,000 260,000 130,000 130,000 260,000 260,000 260,000
- Lem kertas 10 bh/kl 6,000 60,000 60,000
- Amplop kecil 10 dus/kl 19,500 195,000 97,500 97,500
- Amplop besar 6 dus/kl 24,000 144,000 72,000 72,000
- Box file 30 bh/kl 24,500 735,000 245,000 245,000 245,000
- Businnes file folio 36 pak/kl 25,400 914,400 152,400 152,400 152,400 152,400 304,800
- Post it 40 set/kl 20,300 812,000 406,000 406,000
- Buku big boss 2 lsn/kl 35,000 70,000 70,000
- Stabillo 3 pak/kl 70,000 210,000 210,000
- Buku kwitansi 6 bk/kl 9,000 54,000 54,000
- Rak leaflet mika 4 bh/kl 350,000 1,400,000 1,400,000
- Penghapus 1 lsn/kl 30,000 30,000 30,000
- Tip ex 15 bh/kl 23,500 352,500 352,500
- Hecter HD 8 bh/kl 25,000 200,000 200,000
5 . 2 . 2 . 01 . 02 Belanja Dokumen Pengadaan Barang / - 350,000 - -
Jasa
Dokumen belanja pemeliharaan 1 pkt/kl 350,000 350,000 350,000
bangunan Puskesmas
5 . 2 . 2 . 01 . 03 Belanja Komponen Alat Listrik dan 2,325,000 - - 2,325,000 -
Elektronik alat listrik
Komponen 2,325,000
- Batre kotak 30 bh/kl 35,000.00 1,050,000 525,000 525,000
- Kabel roll 6 bh/kl 175,000.00 1,050,000 1,050,000
- Lampu neon panjang 5 bh/kl 45,000.00 225,000 225,000
5 . 2 . 2 . 01 . 04 Belanja Benda Pos 1,200,000 - 480,000 720,000 -
 RINCIAN PERHITUNGAN
KODE PAGU
URAIAN Harga JAN FEB MAR APR MEI JUN JUL AGS SEP OKT NOV DES
REKENING Volume Satuan (Rp)
Satuan
Belanja benda Pos 1,200,000
- Materai 6000 200 lbh/bln 6,000.00 1,200,000 240,000 240,000 240,000 240,000 240,000
5 . 2 . 2 . 01 . 05 Belanja Bahan Pembersih 8,700,000 - 455,000 8,245,000 -
Belanja bahan pembersih 8,700,000
- Kain pel 6 bh/kl 50,000 300,000 150,000 150,000
- Sapu lidi bertangkai 4 bh/kl 70,000 280,000 140,000 140,000
- Sapu ijuk 6 bh/kl 65,000 390,000 195,000 195,000
- Sabun cuci tangan 20 bh/kl 12,500 250,000 125,000 125,000
- Larutan antiseptik 40 bh/kl 35,000 1,400,000 350,000 350,000 700,000
- Tissue 24 bh/kl 30,000 720,000 360,000 360,000
- Tissue gulung 9 pak/kl 20,000 180,000 180,000
- Sabun cuci alat 30 bh/kl 15,000 450,000 150,000 150,000 150,000
- Bahan pembersih porselain 10 bh/kl 19,000 190,000 190,000
- Pengharum ruangan 20 bh/kl 26,000 520,000 260,000 260,000
- Plastik sampah hitam 60 pak/kl 30,000 1,800,000 900,000 900,000
- Sabun pembersih lantai 60 bh/kl 18,000 1,080,000 540,000 540,000
- Cairan pembersih kaca 10 bh/kl 18,000 180,000 180,000
- Plastik sampah kuning 24 pak/kl 40,000 960,000 480,000 480,000
5 . 2 . 2 . 01 . 06 Belanja Bahan Bakar Minyak / Gas 9,169,500 1,100,000 2,533,900 4,035,600 1,500,000
dan
BahanPelumas
bakar kendaraan 6,000,000
- Belanja BBM Ambulance 12 pkt/bln 300,000 3,600,000 600,000 300,000 300,000 300,000 300,000 300,000 300,000 300,000 300,000 300,000 300,000
- belanja BBM mobil eselon IV 12 pkt/bln 200,000 2,400,000 200,000 400,000 400,000 200,000 200,000 200,000 200,000 200,000 200,000 200,000
Bahan bakar mesin Fogging 3,169,500
- Belanja bahan bakar Solar mesin 270 ltr/lok 9,600 2,592,000 518,400 1,036,800 1,036,800
Fogging bahan bakar Bensin mesin
- Belanja 75 ltr/lok 7,700.00 577,500 115,500 231,000 231,000
5 . 2 . 2 . 01 . 11 Fogging
Belanja Pakai Habis Pelayanan 41,889,000 - 8,965,000 35,744,000 -
Kesehatan
BHP Kesehatan 41,889,000
- Strip cek gula darah (isi 25) 60 pak/kl 85,000 5,100,000 1,020,000 1,020,000 1,020,000 2,040,000
- Strip cek kolesterol (isi 10) 90 pak/kl 150,000 13,500,000 2,700,000 2,700,000 2,700,000 5,400,000
- Strip cek asam urat (isi 25) 36 pak/kl 85,000 3,060,000 510,000 510,000 510,000 510,000 1,020,000
- Vagina speculum disposible 100 bh/kl 15,000 1,500,000 1,500,000
- Jarum citoject 3 box/kl 150,000 450,000 450,000
- Cairan anestesi untuk citoject 1 pak/kl 720,000 720,000 720,000
- Plastik obat 60 pak/kl 9,000 540,000 90,000 90,000 90,000 90,000 180,000
- Kantong plastik 40 pak/kl 9,000 360,000 90,000 90,000 90,000 90,000
- Kertas puyer 40 pak/kl 9,000 360,000 90,000 90,000 90,000 90,000
- Plastik 1/2 Kg 6 pak/kl 9,000 54,000 54,000
- Diamond bur 30 bh/kl 30,000 900,000 450,000 450,000
- Gentian violet (PIN) 47 btl/kl 20,000 940,000 940,000
- Freeze tag (PIN) 1 bh/kl 300,000 300,000 300,000
- Cairan sterilisasi sal. akar (gigi) 3 btl/kl 760,000 2,280,000 760,000 760,000 760,000
- Cairan pembersih stain (gigi) 4 btl/kl 200,000 800,000 200,000 200,000 200,000 200,000
- Tumpatan sementara ready made 18 btl/kl 265,000 4,770,000 795,000 795,000 1,590,000 1,590,000
- (gigi)
Cotton roll (gigi) 12 pak/kl 70,000 840,000 420,000 420,000
- Lancet 13 box/kl 25,000 325,000 325,000
- Strip cek Hb (isi 25) 36 pak/kl 140,000 5,040,000 2,520,000 2,520,000
- Methanol 10 btl/kl 20,000 200,000 200,000
- Larutan Giemsa 1 liter 10 btl/kl 20,000 200,000 200,000
- Alkohol swab 2 pak/kl 100,000 200,000 200,000
- Pipa kapiler non heparin (isi 100) 10 btl/kl 40,000 400,000 400,000
- Kaca slide mikroskop 10 pak/kl 49,000 490,000 490,000
- Box slide 9 bh/kl 70,000 630,000 630,000
- Handscoon 15 pak/kl 50,000 750,000 750,000
5 . 2 . 2 . 03 Belanja Cetak dan Penggandaan 120,106,000
5 . 2 . 2 . 03 . 01 Belanja Cetak 117,580,000 - 8,530,000 108,200,000 850,000
Cetak 117,580,000
- Kohort Ibu, Balita dan Bayi 141 bk/kl 30,000.00 4,230,000 4,230,000
- Spanduk 50 bh/kl 200,000.00 10,000,000 1,000,000 3,000,000 3,000,000 3,000,000
- Stiker PHBS 6,500 lbr/kl 1,000.00 6,500,000 6,500,000
- Leaflet 10 rim/kl 850,000.00 8,500,000 1,700,000 1,700,000 2,550,000 1,700,000 850,000
- Tanda pengenal kader jumantik 94 rim/kl 70,000.00 6,580,000 6,580,000
- Kartu jentik 10,000 lbr/kl 600.00 6,000,000 6,000,000
- Buku TB 01 - 06 3 rim/kl 200,000.00 600,000 600,000
 RINCIAN PERHITUNGAN
KODE PAGU
URAIAN Harga JAN FEB MAR APR MEI JUN JUL AGS SEP OKT NOV DES
REKENING Volume Satuan (Rp)
Satuan
- Poster 50 bh/kl 80,000.00 4,000,000 800,000 400,000 400,000 800,000 800,000 800,000
- PIN sign 47 bh/kl 50,000.00 2,350,000 2,350,000
- Spanduk PIN 3 bh/kl 300,000 900,000 900,000
- Kwitansi SPJ 3 rangkap 15 rim/kl 200,000 3,000,000 1,000,000 1,000,000 1,000,000
- Inform Consent 3 rim/kl 200,000 600,000 600,000
- Blanko hasil Lab 10 rim/kl 300,000 3,000,000 1,500,000 1,500,000
- Kartu TB 01 - 02 2 rim/kl 525,000 1,050,000 525,000 525,000
- Surat keterangan sakit 2 rim/kl 200,000 400,000 400,000
- Surat keterangan sehat 4 rim/kl 200,000 800,000 800,000
- Papan data 6 pkt/kl 3,000,000 18,000,000 9,000,000 9,000,000
- Papan informasi 1 pkt/kl 30,000,000 30,000,000 30,000,000
- Rujukan umum 2 rim/kl 200,000 400,000 400,000
- Kop surat Puskesmas 6 rim/kl 200,000 1,200,000 1,200,000
- Odontogram 2 rim/kl 800,000 1,600,000 1,600,000
- Lembar isi odontogram 4 rim/kl 150,000 600,000 600,000
- Buku kegiatan staf 60 bk/kl 7,000 420,000 420,000
- Etiket obat apotek 6 rim/kl 150,000 900,000 900,000
- LPLPO 1 rim/kl 300,000 300,000 300,000
- Kartu stok opnam 2 rim/kl 200,000 400,000 400,000
- Resep luar 25 bk/kl 10,000 250,000 250,000
- Resep dalam 250 bk/kl 5,000 1,250,000 1,250,000
- Buku status pasien+kartu+plastik 500 set/kl 7,500 3,750,000 3,750,000
5 . 2 . 2 . 03 . 02 Belanja Penggandaan 2,526,000 396,000 792,000 744,000 594,000
Foto copy 2,376,000
- Foto copy arsip 12 pkt/bln 198,000 2,376,000 198,000 198,000 198,000 198,000 396,000 198,000 198,000 198,000 198,000 198,000 198,000
Jilid hard cover 150,000
- Jilid hard cover profil 3 bk/kl 25,000 75,000 75,000
- Jilid hard cover (PTP, LSD, 3 bk/kl 25,000 75,000 75,000
5 . 2 . 2 . 04 Akreditasi)
Belanja Makanan dan Minuman 1,020,000
5 . 2 . 2 . 04 . 01 Belanja Makanan dan Minuman 1,020,000 255,000 255,000 255,000 255,000
Harian Pegawai
Belanja Minuman Pegawai 1,020,000
- Galon air mineral 60 gln/bln 17,000 1,020,000 85,000 85,000 85,000 85,000 85,000 85,000 85,000 85,000 85,000 85,000 85,000 85,000
5 . 2 . 2 . 08 Belanja Barang Inventaris Non Aset 5,500,000
5 . 2 . 2 . 08 . 01 Belanja Barang Inventaris 700,000 - - 700,000 -
Peralatan / Perlengkapan Kantor
Inventaris perlengkapan kantor 700,000
- Pembatas antrian 2 bh/kl 350,000 700,000 700,000
5 . 2 . 2 . 08 . 03 Belanja Barang Inventaris 4,000,000 - - 4,000,000 -
Peralatan / Perlengkapan Rumah
Tangga
Perlengkapan rumah tangga 4,000,000
- Handle bantu kamar mandi 8 bh/kl 500,000 4,000,000 4,000,000
5 . 2 . 2 . 08 . 05 Belanja Barang Inventaris 800,000 - - 800,000 -
Peralatan / Perlengkapan Kesehatan
Inventaris alat kesehatan 800,000
- Alat diagnostik standart (gigi) 20 bh/kl 40,000 800,000 800,000
5 . 2 . 2 . 16 Belanja Jasa Kantor 24,000,000
5 . 2 . 2 . 16 . 03 Belanja Listrik 19,200,000 4,800,000 4,800,000 4,800,000 4,800,000
Belanja listrik bulanan 19,200,000
- belanja listrik bulanan 12 kl/bln 1,600,000 19,200,000 3,200,000 1,600,000 1,600,000 1,600,000 1,600,000 1,600,000 1,600,000 1,600,000 1,600,000 1,600,000 1,600,000
5 . 2 . 2 . 16 . 06 Belanja Kawat / Faksimili / Internet / 4,800,000 1,200,000 1,200,000 1,200,000 1,200,000
TV Kabelinternet bulanan
Belanja 4,800,000
- belanja internet bulanan 12 kl/bln 400,000 4,800,000 800,000 400,000 400,000 400,000 400,000 400,000 400,000 400,000 400,000 400,000 400,000
5 . 2 . 2 . 25 Belanja Kursus, Pelatihan, Sosialisasi 31,500,000
5 . 2 . 2 . 25 . 01 dan Bimbingan
Belanja Teknis PNS
Kursus-kursus Singkat / 31,500,000 - 10,500,000 21,000,000 -
Pelatihan
Kursus/pelatihan singkat 31,500,000
- belanja kursus/pelatihan singkat 21 kl/pkt 1,500,000 31,500,000 4,500,000 3,000,000 3,000,000 3,000,000 9,000,000 9,000,000
5 . 2 . 2 . 29 Belanja Jasa Lainnya 47,110,000
5 . 2 . 2 . 29 . 04 Jasa Tenaga Ahli / Instruktur / 47,110,000 - - 47,110,000 -
Narasumber / Juri / Moderator PNS
Jasa tenaga ahli/narasumber PNS 47,110,000
- Narasumber untuk pendampingan 1 pkt/thn 47,110,000 47,110,000 47,110,000
BLUD
 RINCIAN PERHITUNGAN
KODE PAGU
URAIAN Harga JAN FEB MAR APR MEI JUN JUL AGS SEP OKT NOV DES
REKENING Volume Satuan (Rp)
Satuan
5 . 2 . 2 . 30 Belanja Jasa Pihak Ketiga dan 773,478,876
5 . 2 . 2 . 30 . 03 Perorangan
Belanja Uji Laboratorium 36,000,000 6,000,000 12,000,000 9,000,000 9,000,000
Uji laboratorium 36,000,000
- Uji Laboratorium 12 pkt/bln 3,000,000 36,000,000 3,000,000 3,000,000 6,000,000 3,000,000 3,000,000 3,000,000 3,000,000 3,000,000 3,000,000 3,000,000 3,000,000
5 . 2 . 2 . 30 . 06 Belanja Jasa Pelayanan Kesehatan 737,478,876 122,913,146 245,826,292 184,369,719 184,369,719
jasa pelayanan kesehatan 737,478,876
- jasa pelayanan kesehatan 12 kl/bln 61,456,573 737,478,876 61,456,573 61,456,573 122,913,146 61,456,573 61,456,573 61,456,573 61,456,573 61,456,573 61,456,573 61,456,573 61,456,573
5 . 2 . 2 . 39 Belanja Pemeliharaan
5 . 2 . 2 . 39 . 03 Belanja Pemeliharaan Gedung - 89,557,500 - -
/Bangunan
Pemeliharaan bangunan Puskesmas 1 pkt/kl 89,557,500 89,557,500 89,557,500
5 . 2 . 2 . 39 . 11 Belanja Pemeliharaan Peralatan 2,000,000 - - 2,000,000 -
Kantor, Perlengkapan Kantor/
Komputer / Peralatan dan
Perlengkapan Teknis
service AC 2,000,000
- service AC 20 unt/kl 100,000 2,000,000 1,000,000 1,000,000
5 . 2 . 2 . 39 . 14 Belanja Pemeliharaan Peralatan 1,500,000 - 300,000 1,200,000 -
Kedokteran / Peralatan Kesehatan
dan Penyelidikan
service Alat Kesehatan 1,500,000
- service alkes 5 pkt/kl 300,000 1,500,000 300,000 300,000 300,000 600,000
5.2.3 Belanja Modal 151,382,197
5 . 2 . 3 . 16 Belanja Modal Peralatan dan Mesin - 16,600,000
5 . 2 . 3 . 16 . 04 Pengadaan Alat-alat
Belanja Modal Bantudan Mesin -
Peralatan 16,720,000 - 70,000 16,650,000 -
Pengadaan Electric Generating Set
Generator Set 15,000,000
- Generator Set 1 set/kl 15,000,000 15,000,000 15,000,000
Honorarium pejabat 1,100,000
- Honorarium pejabat pengadaan 1 or/kl 480,000 480,000 480,000
barang dan jasa
- Honorarium pejabat penerima 1 or/kl 420,000 420,000 420,000
hasil pekerjaan
Dokumen 350,000
- Dokumen belanja modal 1 pkt/kl 350,000 350,000 350,000
Ongkos kirim
Ongkos kirim Generator Set 1 pkt/kl 400,000 400,000 400,000
Biaya pengiriman dokumen
Biaya pengiriman dokumen 2 pkt/kl 35,000 70,000 70,000
5 . 2 . 3 . 28 Belanja Modal Peralatan dan Mesin -
Pengadaan Alat Rumah Tangga
5 . 2 . 3 . 28 . 06 Belanja Modal Peralatan dan Mesin - - - 7,424,697 -
Pengadaan Alat Rumah Tangga
Lainnya (Home Use)
LED TV 1 unt/kl 7,424,697 7,424,697 7,424,697
5 . 2 . 3 . 30 Belanja Modal Peralatan dan Mesin -
Pengadaan Meja Dan Kursi 6,100,000
Kerja/Rapat Pejabat
5 . 2 . 3 . 30 . 07 Belanja Modal Peralatan dan Mesin - 4,500,000 - - 4,500,000 -
Pengadaan Lemari dan Arsip Pejabat

Lemari arsip 4,500,000

- Lemari arsip 1 bh/kl 4,500,000 4,500,000 4,500,000

Mengetahui,
Kepala UPTD Puskesmas Perumnas II

Drg. Anastasia Happy Sumanti

NIP. 19791023 200501 2 006
 RENCANA ANGGARAN BELANJA (RAB)
DANA KAPITASI JKN T.A 2017
PUSKESMAS PERUMNAS II
11.26 32.22 40.04 16.48
138,414,146 395,992,992 492,155,616
RINCIAN PERHITUNGAN
KODE JUMLAH
URAIAN Harga JAN FEB MAR APR MEI JUN JUL AGS SEP OKT
REKENING Volume Satuan (Rp)
Satuan
5 BELANJA 1,229,131,473
5.2 BELANJA LANGSUNG 1,229,131,473
5.2.1 Belanja Pegawai 1,800,000
5 . 2 . 1 . 01 Honorarium PNS 300,000
5 . 2 . 1 . 01 . 02 Honorarium Pejabat / Tim Pengadaan 480,000 - 480,000 -
Barang dan Jasa
Honorarium pejabat pengadaan barang 1 or/kl 480,000 480,000 480,000
dan jasa
5 . 2 . 1 . 01 . 05 Honorarium Pejabat / Tim Pemeriksa / 420,000.00 - 420,000 -
Penerima Hasil Pekerjaan
Honorarium pejabat penerima hasil 1 or/kl 420,000 420,000 420,000
pekerjaan
5 . 2 . 1 . 01 . 06 Uang Saku 300,000 - 60,000 240,000
Uang Saku PNS 300,000
- Transport petugas monitoring fogging 5 or/lok 60,000 300,000 60,000 120,000 120,000
5 . 2 . 1 . 02 Honorarium Non PNS 1,500,000
5 . 2 . 1 . 02 . 02 Uang Saku Non PNS 1,500,000 - 300,000 1,200,000
Uang saku Non PNS 1,500,000
- Transport petugas fogging 10 or/lok 150,000 1,500,000 300,000 600,000 600,000
5.2.2 Belanja Barang dan Jasa 1,075,949,276
5 . 2 . 2 . 01 Belanja Barang Pakai Habis 98,844,400
5 . 2 . 2 . 01 . 01 Belanja Alat Tulis Kantor 35,560,900 1,750,000 8,118,300 25,692,600
Alat Tulis Kantor 35,560,900
- Tinta printer laser jet 6 bh/kl 1,000,000 6,000,000 1,000,000 1,000,000 2,000,000 2,000,000
- Tinta printer 50 bh/kl 150,000 7,500,000 750,000 750,000 750,000 1,500,000 1,500,000 2,250,000
- Kertas HVS A4 60 rim/kl 29,000 1,740,000 290,000 290,000 290,000 290,000 580,000
- Kertas HVS F4 60 rim/bh 36,500 2,190,000 365,000 365,000 365,000 365,000 730,000
- Pulpen 24 lsn/kl 30,000 720,000 120,000 120,000 120,000 120,000 240,000
- Clear holder 70 bh/kl 30,000 2,100,000 300,000 600,000 600,000 600,000
- Odner 90 bh/kl 25,000 2,250,000 500,000 250,000 250,000 250,000 500,000 500,000
- Paper clip 30 pak/kl 18,000 540,000 90,000 90,000 90,000 90,000 180,000
- Isi hecter 12 pak/kl 25,000 300,000 50,000 50,000 50,000 150,000
- Spidol 12 lsn/kl 69,000 828,000 138,000 138,000 138,000 414,000
- Buku folio 200 lembar 24 pak/kl 70,000 1,680,000 280,000 280,000 280,000 280,000 280,000 280,000
- Buku folio 100 lembar 24 pak/kl 60,000 1,440,000 240,000 240,000 240,000 240,000 240,000 240,000
- Plastic pocket 36 pak/kl 19,000 684,000 114,000 114,000 114,000 114,000 228,000
- Buku tulis 2 lsn/kl 24,000 48,000 48,000
- Label sticker 30 pak/kl 18,000 540,000 108,000 108,000 108,000 108,000 108,000
- Buku kas 4 bk/kl 20,000 80,000 80,000
- Stopmap 24 pak/kl 18,500 444,000 74,000 74,000 74,000 74,000 74,000 74,000
- Stopmap snell 20 pak/kl 65,000 1,300,000 260,000 130,000 130,000 260,000 260,000 260,000
- Lem kertas 10 bh/kl 6,000 60,000 60,000
- Amplop kecil 10 dus/kl 19,500 195,000 97,500 97,500
- Amplop besar 6 dus/kl 24,000 144,000 72,000 72,000
- Box file 30 bh/kl 24,500 735,000 245,000 245,000 245,000
- Businnes file folio 36 pak/kl 25,400 914,400 152,400 152,400 152,400 152,400 304,800
- Post it 40 set/kl 20,300 812,000 406,000 406,000
- Buku big boss 2 lsn/kl 35,000 70,000 70,000
- Stabillo 3 pak/kl 70,000 210,000 210,000
- Buku kwitansi 6 bk/kl 9,000 54,000 54,000
- Rak leaflet mika 4 bh/kl 350,000 1,400,000 1,400,000
- Penghapus 1 lsn/kl 30,000 30,000 30,000
- Tip ex 15 bh/kl 23,500 352,500 352,500
- Hecter HD 8 bh/kl 25,000 200,000 200,000
5 . 2 . 2 . 01 . 02 Belanja Dokumen Pengadaan Barang / - 350,000 -
Jasa
Dokumen belanja pemeliharaan bangunan 1 pkt/kl 350,000 350,000 350,000
Puskesmas
5 . 2 . 2 . 01 . 03 Belanja Komponen Alat Listrik dan 2,325,000 - - 2,325,000
 Komponen alat listrik 2,325,000
- Batre kotak 30 bh/kl 35,000.00 1,050,000 525,000 525,000
- Kabel roll 6 bh/kl 175,000.00 1,050,000 1,050,000
- Lampu neon panjang 5 bh/kl 45,000.00 225,000 225,000
5 . 2 . 2 . 01 . 04 Belanja Benda Pos 1,200,000 - 480,000 720,000
Belanja benda Pos 1,200,000
- Materai 6000 200 lbh/bln 6,000.00 1,200,000 240,000 240,000 240,000 240,000 240,000
5 . 2 . 2 . 01 . 05 Belanja Bahan Pembersih 8,700,000 - 455,000 8,245,000
Belanja bahan pembersih 8,700,000
- Kain pel 6 bh/kl 50,000 300,000 150,000 150,000
- Sapu lidi bertangkai 4 bh/kl 70,000 280,000 140,000 140,000
- Sapu ijuk 6 bh/kl 65,000 390,000 195,000 195,000
- Sabun cuci tangan 20 bh/kl 12,500 250,000 125,000 125,000
- Larutan antiseptik 40 bh/kl 35,000 1,400,000 350,000 350,000 700,000
- Tissue 24 bh/kl 30,000 720,000 360,000 360,000
- Tissue gulung 9 pak/kl 20,000 180,000 180,000
- Sabun cuci alat 30 bh/kl 15,000 450,000 150,000 150,000 150,000
- Bahan pembersih porselain 10 bh/kl 19,000 190,000 190,000
- Pengharum ruangan 20 bh/kl 26,000 520,000 260,000 260,000
- Plastik sampah hitam 60 pak/kl 30,000 1,800,000 900,000 900,000
- Sabun pembersih lantai 60 bh/kl 18,000 1,080,000 540,000 540,000
- Cairan pembersih kaca 10 bh/kl 18,000 180,000 180,000
- Plastik sampah kuning 24 pak/kl 40,000 960,000 480,000 480,000
5 . 2 . 2 . 01 . 06 Belanja Bahan Bakar Minyak / Gas dan 9,169,500 1,100,000 2,533,900 4,035,600
Pelumas
Bahan bakar kendaraan 6,000,000
- Belanja BBM Ambulance 12 pkt/bln 300,000 3,600,000 600,000 300,000 300,000 300,000 300,000 300,000 300,000 300,000 300,000
- belanja BBM mobil eselon IV 12 pkt/bln 200,000 2,400,000 200,000 400,000 400,000 200,000 200,000 200,000 200,000 200,000
Bahan bakar mesin Fogging 3,169,500
- Belanja bahan bakar Solar mesin 270 ltr/lok 9,600 2,592,000 518,400 1,036,800 1,036,800
- Fogging
Belanja bahan bakar Bensin mesin 75 ltr/lok 7,700.00 577,500 115,500 231,000 231,000
5 . 2 . 2 . 01 . 11 Fogging
Belanja Pakai Habis Pelayanan 41,889,000 - 8,965,000 35,744,000
Kesehatan
BHP Kesehatan 41,889,000
- Strip cek gula darah (isi 25) 60 pak/kl 85,000 5,100,000 1,020,000 1,020,000 1,020,000 2,040,000
- Strip cek kolesterol (isi 10) 90 pak/kl 150,000 13,500,000 2,700,000 2,700,000 2,700,000 5,400,000
- Strip cek asam urat (isi 25) 36 pak/kl 85,000 3,060,000 510,000 510,000 510,000 510,000 1,020,000
- Vagina speculum disposible 100 bh/kl 15,000 1,500,000 1,500,000
- Jarum citoject 3 box/kl 150,000 450,000 450,000
- Cairan anestesi untuk citoject 1 pak/kl 720,000 720,000 720,000
- Plastik obat 60 pak/kl 9,000 540,000 90,000 90,000 90,000 90,000 180,000
- Kantong plastik 40 pak/kl 9,000 360,000 90,000 90,000 90,000 90,000
- Kertas puyer 40 pak/kl 9,000 360,000 90,000 90,000 90,000 90,000
- Plastik 1/2 Kg 6 pak/kl 9,000 54,000 54,000
- Diamond bur 30 bh/kl 30,000 900,000 450,000 450,000
- Gentian violet (PIN) 47 btl/kl 20,000 940,000 940,000
- Freeze tag (PIN) 1 bh/kl 300,000 300,000 300,000
- Cairan sterilisasi sal. akar (gigi) 3 btl/kl 760,000 2,280,000 760,000 760,000 760,000
- Cairan pembersih stain (gigi) 4 btl/kl 200,000 800,000 200,000 200,000 200,000 200,000
- Tumpatan sementara ready made 18 btl/kl 265,000 4,770,000 795,000 795,000 1,590,000 1,590,000
(gigi) roll (gigi)
- Cotton 12 pak/kl 70,000 840,000 420,000 420,000
- Lancet 13 box/kl 25,000 325,000 325,000
- Strip cek Hb (isi 25) 36 pak/kl 140,000 5,040,000 2,520,000 2,520,000
- Methanol 10 btl/kl 20,000 200,000 200,000
- Larutan Giemsa 1 liter 10 btl/kl 20,000 200,000 200,000
- Alkohol swab 2 pak/kl 100,000 200,000 200,000
- Pipa kapiler non heparin (isi 100) 10 btl/kl 40,000 400,000 400,000
- Kaca slide mikroskop 10 pak/kl 49,000 490,000 490,000
- Box slide 9 bh/kl 70,000 630,000 630,000
- Handscoon 15 pak/kl 50,000 750,000 750,000
5 . 2 . 2 . 03 Belanja Cetak dan Penggandaan 120,106,000
5 . 2 . 2 . 03 . 01 Belanja Cetak 117,580,000 - 8,530,000 108,200,000
Cetak 117,580,000
- Kohort Ibu, Balita dan Bayi 141 bk/kl 30,000.00 4,230,000 4,230,000
- Spanduk 50 bh/kl 200,000.00 10,000,000 1,000,000 3,000,000 3,000,000 3,000,000
 - Stiker PHBS 6,500 lbr/kl 1,000.00 6,500,000 6,500,000
- Leaflet 10 rim/kl 850,000.00 8,500,000 1,700,000 1,700,000 2,550,000 1,700,000 850,000
- Tanda pengenal kader jumantik 94 rim/kl 70,000.00 6,580,000 6,580,000
- Kartu jentik 10,000 lbr/kl 600.00 6,000,000 6,000,000
- Buku TB 01 - 06 3 rim/kl 200,000.00 600,000 600,000
- Poster 50 bh/kl 80,000.00 4,000,000 800,000 400,000 400,000 800,000 800,000 800,000
- PIN sign 47 bh/kl 50,000.00 2,350,000 2,350,000
- Spanduk PIN 3 bh/kl 300,000 900,000 900,000
- Kwitansi SPJ 3 rangkap 15 rim/kl 200,000 3,000,000 1,000,000 1,000,000 1,000,000
- Inform Consent 3 rim/kl 200,000 600,000 600,000
- Blanko hasil Lab 10 rim/kl 300,000 3,000,000 1,500,000 1,500,000
- Kartu TB 01 - 02 2 rim/kl 525,000 1,050,000 525,000 525,000
- Surat keterangan sakit 2 rim/kl 200,000 400,000 400,000
- Surat keterangan sehat 4 rim/kl 200,000 800,000 800,000
- Papan data 6 pkt/kl 3,000,000 18,000,000 9,000,000 9,000,000
- Papan informasi 1 pkt/kl 30,000,000 30,000,000 30,000,000
- Rujukan umum 2 rim/kl 200,000 400,000 400,000
- Kop surat Puskesmas 6 rim/kl 200,000 1,200,000 1,200,000
- Odontogram 2 rim/kl 800,000 1,600,000 1,600,000
- Lembar isi odontogram 4 rim/kl 150,000 600,000 600,000
- Buku kegiatan staf 60 bk/kl 7,000 420,000 420,000
- Etiket obat apotek 6 rim/kl 150,000 900,000 900,000
- LPLPO 1 rim/kl 300,000 300,000 300,000
- Kartu stok opnam 2 rim/kl 200,000 400,000 400,000
- Resep luar 25 bk/kl 10,000 250,000 250,000
- Resep dalam 250 bk/kl 5,000 1,250,000 1,250,000
- Buku status pasien+kartu+plastik 500 set/kl 7,500 3,750,000 3,750,000
5 . 2 . 2 . 03 . 02 Belanja Penggandaan 2,526,000 396,000 792,000 744,000
Foto copy 2,376,000
- Foto copy arsip 12 pkt/bln 198,000 2,376,000 198,000 198,000 198,000 198,000 396,000 198,000 198,000 198,000 198,000
Jilid hard cover 150,000
- Jilid hard cover profil 3 bk/kl 25,000 75,000 75,000
- Jilid hard cover (PTP, LSD, Akreditasi) 3 bk/kl 25,000 75,000 75,000
5 . 2 . 2 . 04 Belanja Makanan dan Minuman 1,020,000
5 . 2 . 2 . 04 . 01 Belanja Makanan dan Minuman Harian 1,020,000 255,000 255,000 255,000
Pegawai
Belanja Minuman Pegawai 1,020,000
- Galon air mineral 60 gln/bln 17,000 1,020,000 85,000 85,000 85,000 85,000 85,000 85,000 85,000 85,000 85,000 85,000
5 . 2 . 2 . 08 Belanja Barang Inventaris Non Aset 5,500,000
5 . 2 . 2 . 08 . 01 Belanja Barang Inventaris Peralatan / 700,000 - - 700,000
Perlengkapan Kantor
Inventaris perlengkapan kantor 700,000
- Pembatas antrian 2 bh/kl 350,000 700,000 700,000
5 . 2 . 2 . 08 . 03 Belanja Barang Inventaris Peralatan / 4,000,000 - - 4,000,000
Perlengkapan Rumah Tangga
Perlengkapan rumah tangga 4,000,000
- Handle bantu kamar mandi 8 bh/kl 500,000 4,000,000 4,000,000
5 . 2 . 2 . 08 . 05 Belanja Barang Inventaris Peralatan / 800,000 - - 800,000
Perlengkapan Kesehatan
Inventaris alat kesehatan 800,000
- Alat diagnostik standart (gigi) 20 bh/kl 40,000 800,000 800,000
5 . 2 . 2 . 16 Belanja Jasa Kantor 24,000,000
5 . 2 . 2 . 16 . 03 Belanja Listrik 19,200,000 4,800,000 4,800,000 4,800,000
Belanja listrik bulanan 19,200,000
- belanja listrik bulanan 12 kl/bln 1,600,000 19,200,000 3,200,000 1,600,000 1,600,000 1,600,000 1,600,000 1,600,000 1,600,000 1,600,000 1,600,000
5 . 2 . 2 . 16 . 06 Belanja Kawat / Faksimili / Internet / 4,800,000 1,200,000 1,200,000 1,200,000
TV Kabelinternet bulanan
Belanja 4,800,000
- belanja internet bulanan 12 kl/bln 400,000 4,800,000 800,000 400,000 400,000 400,000 400,000 400,000 400,000 400,000 400,000
5 . 2 . 2 . 25 Belanja Kursus, Pelatihan, Sosialisasi dan 31,500,000
5 . 2 . 2 . 25 . 01 Bimbingan Teknis PNS Singkat /
Belanja Kursus-kursus 31,500,000 - 10,500,000 21,000,000
Pelatihan
Kursus/pelatihan singkat 31,500,000
 - belanja kursus/pelatihan singkat 21 kl/pkt 1,500,000 31,500,000 4,500,000 3,000,000 3,000,000 3,000,000 9,000,000 9,000,000
5 . 2 . 2 . 29 Belanja Jasa Lainnya 47,110,000
5 . 2 . 2 . 29 . 04 Jasa Tenaga Ahli / Instruktur / 47,110,000 - - 47,110,000
Narasumber / Juri / Moderator PNS
Jasa tenaga ahli/narasumber PNS 47,110,000
- Narasumber untuk pendampingan 1 pkt/thn 47,110,000 47,110,000 47,110,000
5 . 2 . 2 . 30 BLUDJasa Pihak Ketiga dan
Belanja 773,478,876
5 . 2 . 2 . 30 . 03 Perorangan
Belanja Uji Laboratorium 36,000,000 6,000,000 12,000,000 9,000,000
Uji laboratorium 36,000,000
- Uji Laboratorium 12 pkt/bln 3,000,000 36,000,000 3,000,000 3,000,000 6,000,000 3,000,000 3,000,000 3,000,000 3,000,000 3,000,000 3,000,000
5 . 2 . 2 . 30 . 06 Belanja Jasa Pelayanan Kesehatan 737,478,876 122,913,146 245,826,292 184,369,719
jasa pelayanan kesehatan 737,478,876
- jasa pelayanan kesehatan 12 kl/bln 61,456,573 737,478,876 61,456,573 61,456,573 122,913,146 61,456,573 61,456,573 61,456,573 61,456,573 61,456,573 61,456,573
5 . 2 . 2 . 39 Belanja Pemeliharaan
5 . 2 . 2 . 39 . 03 Belanja Pemeliharaan Gedung - 89,557,500 -
/Bangunan
Pemeliharaan bangunan Puskesmas 1 pkt/kl 89,557,500 89,557,500 89,557,500
5 . 2 . 2 . 39 . 11 Belanja Pemeliharaan Peralatan Kantor, 2,000,000 - - 2,000,000
Perlengkapan Kantor/ Komputer /
Peralatan dan Perlengkapan Teknis

service AC 2,000,000
- service AC 20 unt/kl 100,000 2,000,000 1,000,000 1,000,000
5 . 2 . 2 . 39 . 14 Belanja Pemeliharaan Peralatan 1,500,000 - 300,000 1,200,000
Kedokteran / Peralatan Kesehatan dan
Penyelidikan
service Alat Kesehatan 1,500,000
- service alkes 5 pkt/kl 300,000 1,500,000 300,000 300,000 300,000 600,000
5.2.3 Belanja Modal 151,382,197
5 . 2 . 3 . 16 Belanja Modal Peralatan dan Mesin - 16,600,000
5 . 2 . 3 . 16 . 04 Pengadaan Alat-alat
Belanja Modal Bantudan Mesin -
Peralatan 16,720,000 - 70,000 16,650,000
Pengadaan Electric Generating Set
Generator Set 15,000,000
- Generator Set 1 set/kl 15,000,000 15,000,000 15,000,000
Honorarium pejabat 1,100,000
- Honorarium pejabat pengadaan 1 or/kl 480,000 480,000 480,000
barang dan jasa
- Honorarium pejabat penerima hasil 1 or/kl 420,000 420,000 420,000
pekerjaan
Dokumen 350,000
- Dokumen belanja modal 1 pkt/kl 350,000 350,000 350,000
Ongkos kirim
Ongkos kirim Generator Set 1 pkt/kl 400,000 400,000 400,000
Biaya pengiriman dokumen
Biaya pengiriman dokumen 2 pkt/kl 35,000 70,000 70,000
5 . 2 . 3 . 28 Belanja Modal Peralatan dan Mesin -
Pengadaan Alat Rumah Tangga
5 . 2 . 3 . 28 . 06 Belanja Modal Peralatan dan Mesin - - - 7,424,697
Pengadaan Alat Rumah Tangga Lainnya
(Home Use)
LED TV 1 unt/kl 7,424,697 7,424,697 7,424,697
5 . 2 . 3 . 30 Belanja Modal Peralatan dan Mesin -
Pengadaan Meja Dan Kursi Kerja/Rapat 6,100,000
Pejabat
5 . 2 . 3 . 30 . 07 Belanja Modal Peralatan dan Mesin - 4,500,000 - - 4,500,000
Pengadaan Lemari dan Arsip Pejabat
Lemari arsip 4,500,000
- Lemari arsip 1 bh/kl 4,500,000 4,500,000 4,500,000
16.48
202,568,719 1,229,131,473

NOV DES JUMLAH

- 480,000

480,000

- 420,000

420,000

- 300,000
-
300,000
-
- 1,500,000
-
1,500,000
-
-
- 35,560,900
-
6,000,000
7,500,000
1,740,000
2,190,000
720,000
2,100,000
2,250,000
540,000
300,000
828,000
1,680,000
1,440,000
684,000
48,000
540,000
80,000
444,000
1,300,000
60,000
195,000
144,000
735,000
914,400
812,000
70,000
210,000
54,000
1,400,000
30,000
352,500
200,000
- 350,000

350,000

- 2,325,000
 -
1,050,000
1,050,000
225,000
- 1,200,000
-
1,200,000
- 8,700,000
-
300,000
280,000
390,000
250,000
1,400,000
720,000
180,000
450,000
190,000
520,000
1,800,000
1,080,000
180,000
960,000
1,500,000 9,169,500
-
300,000 300,000 3,600,000
200,000 200,000 2,400,000
-
2,592,000
577,500
- 44,709,000

-
5,100,000
13,500,000
3,060,000
1,500,000
450,000
720,000
540,000
360,000
360,000
54,000
900,000
940,000
300,000
2,280,000
800,000
4,770,000
840,000
325,000
5,040,000
200,000
200,000
200,000
400,000
490,000
630,000
750,000
-
850,000 117,580,000
-
4,230,000
10,000,000
 6,500,000
8,500,000
6,580,000
6,000,000
600,000
4,000,000
2,350,000
900,000
3,000,000
600,000
3,000,000
1,050,000
400,000
800,000
18,000,000
30,000,000
400,000
1,200,000
1,600,000
600,000
420,000
900,000
300,000
400,000
250,000
1,250,000
3,750,000
594,000 2,526,000
-
198,000 198,000 2,376,000
-
75,000
75,000
-
255,000 1,020,000

-
85,000 85,000 1,020,000
-
- 700,000

-
700,000
- 4,000,000

-
4,000,000
- 800,000

-
800,000
-
4,800,000 19,200,000
-
1,600,000 1,600,000 19,200,000
1,200,000 4,800,000
-
400,000 400,000 4,800,000
-
- 31,500,000

-
 31,500,000
-
- 47,110,000

-
47,110,000
-
9,000,000 36,000,000
-
3,000,000 3,000,000 36,000,000
184,369,719 737,478,876
-
61,456,573 61,456,573 737,478,876
-
- 89,557,500

89,557,500
- 2,000,000

-
2,000,000
- 1,500,000

-
1,500,000
-
-
- 16,720,000

-
15,000,000
-
480,000

420,000

-
350,000
-
400,000
-
70,000
-

- 7,424,697

7,424,697
-
-

- 4,500,000

-
4,500,000
1,229,131,473
 RENCANA ANGGARAN BELANJA (RAB)
UPTD PUSKESMAS PERUMNAS II T.A 2017

NO. BARANG/JASA UNIT HARGA JUMLAH

1 LED TV 1 unt Rp 7,424,697 Rp 7,424,697
Jumlah Rp 7,424,697

Bekasi, 9 Desember 2016

Kepala UPTD Puskesmas Perumnas II

Drg. Anastasia Happy Sumant

NIP. 19791023 200501 2 006
 RENCANA ANGGARAN BELANJA (RAB)
UPTD PUSKESMAS PERUMNAS II T.A 2017

NO. BARANG/JASA UNIT SATUAN HARGA JUMLAH

1 Pemeliharaan Bangunan Puskesmas
Bambu 60 batang Rp 15,000 Rp 900,000
Tali ijuk 20 ikat Rp 10,000 Rp 200,000
Paku 5 20 Kg Rp 15,000 Rp 300,000
Paku 7 20 Kg Rp 15,000 Rp 300,000
Kaso 5/7 110 batang Rp 65,000 Rp 7,150,000
Triplek 12 mm 20 lembar Rp 125,000 Rp 2,500,000
Besi 12 mm 30 batang Rp 76,000 Rp 2,280,000
Kawat bendrat 20 Kg Rp 10,000 Rp 200,000
Pasir beton 20 m3 Rp 240,000 Rp 4,800,000
Split 20 m3 Rp 280,000 Rp 5,600,000
Hebel 7,5 cm 120 buah Rp 6,500 Rp 780,000
Semen 50 kg 110 Zak Rp 70,000 Rp 7,700,000
Pasir pasang 30 m3 Rp 250,000 Rp 7,500,000
Cat Vinilex 25 Pail Rp 810,000 Rp 20,250,000
Pipa 3/4" 18 batang Rp 25,000 Rp 450,000
Lem Pipa PVC 10 buah Rp 8,000 Rp 80,000
Keni 3/4" 15 buah Rp 6,000 Rp 90,000
Sok 3/4" 15 buah Rp 6,500 Rp 97,500
2 Pekerja Rp -
Tukang umum 120 oh Rp 65,000 Rp 7,800,000
Tukang kayu kasar (bekisting) 25 oh Rp 100,000 Rp 2,500,000
Tukang besi beton 25 oh Rp 110,000 Rp 2,750,000
Tukang batu kasar (dinding bata) 40 oh Rp 100,000 Rp 4,000,000
Tukang batu halus (plesteran, acian) 50 oh Rp 110,000 Rp 5,500,000
Tukang cat 35 oh Rp 110,000 Rp 3,850,000
Tukang ledeng 18 oh Rp 110,000 Rp 1,980,000
3 Honorarium pejabat pengadaan barang 1 orang Rp 680,000 Rp 680,000
dan jasa
4 Honorarium pejabat penerima hasil 1 orang Rp 420,000 Rp 420,000
pekerjaan
5 Dokumen 1 paket Rp 350,000 Rp 350,000
JUMLAH Rp 91,007,500

Bekasi, 9 Desember 2016

Kepala UPTD Puskesmas Perumnas II

Drg. Anastasia Happy Sumant

NIP. 19791023 200501 2 006
 RENCANA ANGGARAN BELANJA (RAB)
UPTD PUSKESMAS PERUMNAS II T.A 2017

NO. BARANG/JASA UNIT HARGA JUMLAH

1 Lemari Arsip 1 unt Rp 4,500,000 Rp 4,500,000
Jumlah Rp 4,500,000

Bekasi, 9 Desember 2016

Kepala UPTD Puskesmas Perumnas II

Drg. Anastasia Happy Sumant

NIP. 19791023 200501 2 006
O
D RENCANA ANGGARAN BELANJA (RAB)
E DANA KAPITASI JKN T.A 2017
R PUSKESMAS PERUMNAS II
E
K
E RINCIAN PERHITUNGAN
N KODE JUMLAH
URAIAN Harga JAN FEB MAR APR MEI JUN JUL AGS SEP OKT
I REKENING Volume Satuan
Satuan
(Rp)
N
G5 BELANJA 1,229,131,473
5.2 BELANJA LANGSUNG 1,229,131,473
5.2.1 Belanja Pegawai 1,800,000
5 . 2 . 1 . 01 Honorarium PNS 300,000
5 . 2 . 1 . 01 . 02 Honorarium Pejabat / Tim Pengadaan 480,000
Barang dan Jasa
Honorarium pejabat pengadaan barang 1 or/kl 480,000 480,000 480,000
dan jasa
5 . 2 . 1 . 01 . 05 Honorarium Pejabat / Tim Pemeriksa / 420,000.00
Penerima Hasil Pekerjaan
Honorarium pejabat penerima hasil 1 or/kl 420,000 420,000 420,000
pekerjaan
5 . 2 . 1 . 01 . 06 Uang Saku 300,000
Uang Saku PNS 300,000
- Transport petugas monitoring fogging 5 or/lok 60,000 300,000 60,000 120,000
5 . 2 . 1 . 02 Honorarium Non PNS 1,500,000
5 . 2 . 1 . 02 . 02 Uang Saku Non PNS 1,500,000
Uang saku Non PNS 1,500,000
- Transport petugas fogging 10 or/lok 150,000 1,500,000 300,000 600,000
5.2.2 Belanja Barang dan Jasa 1,075,949,276
5 . 2 . 2 . 01 Belanja Barang Pakai Habis 98,844,400
5 . 2 . 2 . 01 . 01 Belanja Alat Tulis Kantor 35,560,900
Alat Tulis Kantor 35,560,900
- Tinta printer laser jet 6 bh/kl 1,000,000 6,000,000 1,000,000 1,000,000 1,000,000 1,000,000
- Tinta printer 50 bh/kl 150,000 7,500,000 750,000 750,000 750,000 750,000 750,000 750,000 750,000 750,000
- Kertas HVS A4 60 rim/kl 29,000 1,740,000 290,000 290,000 290,000 290,000 290,000
- Kertas HVS F4 60 rim/bh 36,500 2,190,000 365,000 365,000 365,000 365,000 365,000
- Pulpen 24 lsn/kl 30,000 720,000 120,000 120,000 120,000 120,000 120,000
- Clear holder 70 bh/kl 30,000 2,100,000 300,000 300,000 300,000 300,000 300,000
- Odner 90 bh/kl 25,000 2,250,000 250,000 250,000 250,000 250,000 250,000 250,000 250,000 250,000
- Paper clip 30 pak/kl 18,000 540,000 90,000 90,000 90,000 90,000 90,000
- Isi hecter 12 pak/kl 25,000 300,000 50,000 50,000 50,000 50,000 50,000
- Spidol 12 lsn/kl 69,000 828,000 138,000 138,000 138,000 138,000 138,000
- Buku folio 200 lembar 24 pak/kl 70,000 1,680,000 140,000 140,000 140,000 140,000 140,000 140,000 140,000 140,000 140,000 140,000
- Buku folio 100 lembar 24 pak/kl 60,000 1,440,000 120,000 120,000 120,000 120,000 120,000 120,000 120,000 120,000 120,000 120,000
- Plastic pocket 36 pak/kl 19,000 684,000 114,000 114,000 114,000 114,000 114,000
- Buku tulis 2 lsn/kl 24,000 48,000 48,000
- Label sticker 30 pak/kl 18,000 540,000 108,000 108,000 108,000 108,000 108,000
- Buku kas 4 bk/kl 20,000 80,000 80,000
- Stopmap 24 pak/kl 18,500 444,000 37,000 37,000 37,000 37,000 37,000 37,000 37,000 37,000 37,000 37,000
- Stopmap snell 20 pak/kl 65,000 1,300,000 130,000 130,000 130,000 130,000 130,000 130,000 130,000 130,000
- Lem kertas 10 bh/kl 6,000 60,000 60,000
- Amplop kecil 10 dus/kl 19,500 195,000 97,500 97,500
- Amplop besar 6 dus/kl 24,000 144,000 72,000 72,000
- Box file 30 bh/kl 24,500 735,000 245,000 245,000 245,000
- Businnes file folio 36 pak/kl 25,400 914,400 152,400 152,400 152,400 152,400 152,400
- Post it 40 set/kl 20,300 812,000 406,000
- Buku big boss 2 lsn/kl 35,000 70,000 70,000
- Stabillo 3 pak/kl 70,000 210,000 210,000
- Buku kwitansi 6 bk/kl 9,000 54,000 54,000
- Rak leaflet mika 4 bh/kl 350,000 1,400,000 1,400,000
- Penghapus 1 lsn/kl 30,000 30,000 30,000
- Tip ex 15 bh/kl 23,500 352,500 352,500
- Hecter HD 8 bh/kl 25,000 200,000 200,000
5 . 2 . 2 . 01 . 02 Belanja Dokumen Pengadaan Barang /
Jasa
Dokumen belanja pemeliharaan bangunan 1 pkt/kl 350,000 350,000 350,000
Puskesmas
5 . 2 . 2 . 01 . 03 Belanja Komponen Alat Listrik dan 2,325,000
Elektronik
Komponen alat listrik 2,325,000
 - Batre kotak 30 bh/kl 35,000.00 1,050,000 525,000 525,000
- Kabel roll 6 bh/kl 175,000.00 1,050,000 1,050,000
- Lampu neon panjang 5 bh/kl 45,000.00 225,000 225,000
5 . 2 . 2 . 01 . 04 Belanja Benda Pos 1,200,000
Belanja benda Pos 1,200,000
- Materai 6000 200 lbh/bln 6,000.00 1,200,000 240,000 240,000 240,000 240,000 240,000
5 . 2 . 2 . 01 . 05 Belanja Bahan Pembersih 8,700,000
Belanja bahan pembersih 8,700,000
- Kain pel 6 bh/kl 50,000 300,000 150,000 150,000
- Sapu lidi bertangkai 4 bh/kl 70,000 280,000 140,000 140,000
- Sapu ijuk 6 bh/kl 65,000 390,000 195,000 195,000
- Sabun cuci tangan 20 bh/kl 12,500 250,000 125,000 125,000
- Larutan antiseptik 40 bh/kl 35,000 1,400,000 350,000 350,000 350,000
- Tissue 24 bh/kl 30,000 720,000 360,000 360,000
- Tissue gulung 9 pak/kl 20,000 180,000 180,000
- Sabun cuci alat 30 bh/kl 15,000 450,000 150,000 150,000 150,000
- Bahan pembersih porselain 10 bh/kl 19,000 190,000 190,000
- Pengharum ruangan 20 bh/kl 26,000 520,000 260,000
- Plastik sampah hitam 60 pak/kl 30,000 1,800,000 900,000
- Sabun pembersih lantai 60 bh/kl 18,000 1,080,000 540,000
- Cairan pembersih kaca 10 bh/kl 18,000 180,000 180,000
- Plastik sampah kuning 24 pak/kl 40,000 960,000 480,000 480,000
5 . 2 . 2 . 01 . 06 Belanja Bahan Bakar Minyak / Gas dan 9,169,500
Pelumas
Bahan bakar kendaraan 6,000,000
- Belanja BBM Ambulance 12 pkt/bln 300,000 3,600,000 300,000 300,000 300,000 300,000 300,000 300,000 300,000 300,000 300,000 300,000
- belanja BBM mobil eselon IV 12 pkt/bln 500,000 6,000,000 500,000 500,000 500,000 500,000 500,000 500,000 500,000 500,000 500,000 500,000
Bahan bakar mesin Fogging 3,169,500
- Belanja bahan bakar Solar mesin 270 ltr/lok 9,600 2,592,000 518,400 1,036,800
Fogging bahan bakar Bensin mesin
- Belanja 75 ltr/lok 7,700.00 577,500 115,500 231,000
5 . 2 . 2 . 01 . 11 Fogging
Belanja Pakai Habis Pelayanan 41,889,000
Kesehatan
BHP Kesehatan 41,889,000
- Strip cek gula darah (isi 25) 60 pak/kl 85,000 5,100,000 1,020,000 1,020,000 1,020,000 1,020,000
- Strip cek kolesterol (isi 10) 90 pak/kl 150,000 13,500,000 2,700,000 2,700,000 2,700,000 2,700,000
- Strip cek asam urat (isi 25) 36 pak/kl 85,000 3,060,000 510,000 510,000 510,000 510,000 510,000
- Vagina speculum disposible 100 bh/kl 15,000 1,500,000 1,500,000
- Jarum citoject 3 box/kl 150,000 450,000 450,000
- Cairan anestesi untuk citoject 1 pak/kl 720,000 720,000 720,000
- Plastik obat 60 pak/kl 9,000 540,000 90,000 90,000 90,000 90,000 90,000
- Kantong plastik 40 pak/kl 9,000 360,000 90,000 90,000 90,000
- Kertas puyer 40 pak/kl 9,000 360,000 90,000 90,000 90,000
- Plastik 1/2 Kg 6 pak/kl 9,000 54,000 54,000
- Diamond bur 30 bh/kl 30,000 900,000 450,000 450,000
-
-
- Cairan sterilisasi sal. akar (gigi) 3 btl/kl 760,000 2,280,000 760,000 760,000 760,000
- Cairan pembersih stain (gigi) 4 btl/kl 200,000 800,000 200,000 200,000 200,000
- Tumpatan sementara ready made 18 btl/kl 265,000 4,770,000 795,000 795,000 795,000 795,000 795,000
- (gigi)
Cotton roll (gigi) 12 pak/kl 70,000 840,000 420,000 420,000
- Lancet 13 box/kl 25,000 325,000 325,000
- Strip cek Hb (isi 25) 36 pak/kl 140,000 5,040,000 2,520,000 2,520,000
- Methanol 10 btl/kl 20,000 200,000 200,000
- Larutan Giemsa 1 liter 10 btl/kl 20,000 200,000 200,000
- Alkohol swab 2 pak/kl 100,000 200,000 200,000
- Pipa kapiler non heparin (isi 100) 10 btl/kl 40,000 400,000 400,000
- Kaca slide mikroskop 10 pak/kl 49,000 490,000 490,000
- Box slide 9 bh/kl 70,000 630,000 630,000
- Handscoon 15 pak/kl 50,000 750,000 750,000
5 . 2 . 2 . 03 Belanja Cetak dan Penggandaan 120,106,000
5 . 2 . 2 . 03 . 01 Belanja Cetak 117,580,000
Cetak 117,580,000
- Kohort Ibu, Balita dan Bayi 141 bk/kl 30,000.00 4,230,000 4,230,000
- Spanduk 50 bh/kl 200,000.00 10,000,000 500,000 1,000,000 500,000 1,000,000 1,000,000 1,000,000 1,000,000 1,000,000 1,000,000 500,000
- Stiker PHBS 6,500 lbr/kl 1,000.00 6,500,000 6,500,000
 - Leaflet 10 rim/kl 850,000.00 8,500,000 850,000 850,000 850,000 850,000 850,000 850,000 850,000 850,000
- Tanda pengenal kader 235 rim/kl 30,000.00 7,050,000 7,050,000
poyandu/posbindu
- Kartu jentik 10,000 lbr/kl 600.00 6,000,000 6,000,000
- Buku TB 01 - 06 3 rim/kl 200,000.00 600,000 600,000
- Poster 30 bh/kl 80,000.00 2,400,000 240,000 240,000 240,000 240,000 240,000 240,000 240,000 240,000
-
-
- Kwitansi SPJ 3 rangkap 15 rim/kl 200,000 3,000,000 1,000,000 1,000,000
- Inform Consent 3 rim/kl 200,000 600,000 600,000
- Blanko hasil Lab 10 rim/kl 300,000 3,000,000 1,500,000 1,500,000
- Kartu TB 01 - 02 2 rim/kl 525,000 1,050,000 525,000
- Surat keterangan sakit 2 rim/kl 200,000 400,000 400,000
- Surat keterangan sehat 4 rim/kl 200,000 800,000 800,000
- Papan data/papan DUK(TAMBAH 1 pkt/kl 10,000,000 10,000,000 10,000,000
- U/DT)
Papan Struktur Organisasi 1 pkt/kl 8,000,000 8,000,000 8,000,000
- Rujukan umum 2 rim/kl 200,000 400,000 400,000
- Kop surat Puskesmas 6 rim/kl 200,000 1,200,000
- Odontogram 2 rim/kl 800,000 1,600,000 1,600,000
- Lembar isi odontogram 4 rim/kl 150,000 600,000 600,000
- Buku kegiatan staf 60 bk/kl 7,000 420,000 420,000
- Etiket obat apotek 6 rim/kl 150,000 900,000 900,000
- LPLPO 1 rim/kl 300,000 300,000 300,000
- Kartu stok opnam 2 rim/kl 200,000 400,000 400,000
- Resep luar 25 bk/kl 10,000 250,000 250,000
- Resep dalam 250 bk/kl 5,000 1,250,000 1,250,000
- Buku status pasien+kartu+plastik 500 set/kl 7,500 3,750,000 3,750,000
5 . 2 . 2 . 03 . 02 Belanja Penggandaan 2,526,000
Foto copy 2,376,000
- Foto copy arsip 12 pkt/bln 198,000 2,376,000 198,000 198,000 198,000 198,000 198,000 198,000 198,000 198,000 198,000 198,000
Jilid hard cover 150,000
- Jilid hard cover profil 3 bk/kl 25,000 75,000 75,000
- Jilid hard cover (PTP, LSD, Akreditasi) 3 bk/kl 25,000 75,000 75,000
5 . 2 . 2 . 04 Belanja Makanan dan Minuman 1,020,000
5 . 2 . 2 . 04 . 01 Belanja Makanan dan Minuman Harian 1,020,000
Pegawai
Belanja Minuman Pegawai 1,020,000
- Galon air mineral 100 gln/bln 20,000 1,020,000 20,000 20,000 20,000 20,000 20,000 20,000 20,000 20,000 20,000 20,000
5 . 2 . 2 . 08 Belanja Barang Inventaris Non Aset 5,500,000
5 . 2 . 2 . 08 . 01 Belanja Barang Inventaris Peralatan / 700,000
Perlengkapan Kantor
Inventaris perlengkapan kantor 700,000
- Pembatas antrian 2 bh/kl 350,000 700,000 700,000
5 . 2 . 2 . 08 . 03 Belanja Barang Inventaris Peralatan / 4,000,000
Perlengkapan Rumah Tangga
Perlengkapan rumah tangga 4,000,000
- Handle bantu pasien 4 bh/kl 1,000,000 4,000,000 4,000,000
5 . 2 . 2 . 08 . 05 Belanja Barang Inventaris Peralatan / 800,000
Perlengkapan Kesehatan
Inventaris alat kesehatan 800,000
- Alat diagnostik standart (gigi) 20 bh/kl 40,000 800,000 800,000
5 . 2 . 2 . 16 Belanja Jasa Kantor 24,000,000
5 . 2 . 2 . 16 . 03 Belanja Listrik 19,200,000
Belanja listrik bulanan 19,200,000
- belanja listrik bulanan 12 kl/bln 1,600,000 19,200,000 1,600,000 1,600,000 1,600,000 1,600,000 1,600,000 1,600,000 1,600,000 1,600,000 1,600,000 1,600,000
5 . 2 . 2 . 16 . 06 Belanja Kawat / Faksimili / Internet / 4,800,000
TV Kabelinternet bulanan
Belanja 4,800,000
- belanja internet bulanan 12 kl/bln 400,000 4,800,000 400,000 400,000 400,000 400,000 400,000 400,000 400,000 400,000 400,000 400,000
5 . 2 . 2 . 25 Belanja Kursus, Pelatihan, Sosialisasi dan 31,500,000
5 . 2 . 2 . 25 . 01 Bimbingan Teknis PNS Singkat /
Belanja Kursus-kursus 31,500,000
Pelatihan
Kursus/pelatihan singkat 31,500,000
- belanja kursus/pelatihan singkat 19 kl/pkt 1,500,000 31,500,000 3,000,000 4,500,000 3,000,000 3,000,000 3,000,000 3,000,000 3,000,000 3,000,000
5 . 2 . 2 . 29 Belanja Jasa Lainnya 27,110,000
5 . 2 . 2 . 29 . 04 Jasa Tenaga Ahli / Instruktur / 27,110,000
Narasumber / Juri / Moderator PNS
?????? Jasa tenaga ahli/narasumber PNS 27,110,000
- Narasumber untuk pendampingan 1 pkt/thn 27,110,000 27,110,000 27,110,000
5 . 2 . 2 . 30 BLUDJasa Pihak Ketiga dan
Belanja 773,478,876
5 . 2 . 2 . 30 . 03 Perorangan
Belanja Uji Laboratorium 36,000,000
Uji laboratorium 36,000,000
- Uji Laboratorium 12 pkt/bln 3,000,000 36,000,000 3,000,000 3,000,000 3,000,000 3,000,000 3,000,000 3,000,000 3,000,000 3,000,000 3,000,000 3,000,000
5 . 2 . 2 . 30 . 06 Belanja Jasa Pelayanan Kesehatan 737,478,876
jasa pelayanan kesehatan 737,478,876
- jasa pelayanan kesehatan 12 kl/bln 61,456,573 737,478,876 61,456,573 61,456,573 61,456,573 61,456,573 61,456,573 61,456,573 61,456,573 61,456,573 61,456,573 61,456,573
5 . 2 . 2 . 39 Belanja Pemeliharaan 3,500,000
5 . 2 . 2 . 39 . 03 Belanja Pemeliharaan Gedung
/Bangunan
Pemeliharaan bangunan Puskesmas 1 pkt/kl 118,000,000 118,000,000 118,000,000
5 . 2 . 2 . 39 . 11 Belanja Pemeliharaan Peralatan Kantor, 2,000,000
Perlengkapan Kantor/ Komputer /
Peralatan dan Perlengkapan Teknis

service AC 2,000,000
- service AC 20 unt/kl 100,000 2,000,000 1,000,000 1,000,000
5 . 2 . 2 . 39 . 14 Belanja Pemeliharaan Peralatan 1,500,000
Kedokteran / Peralatan Kesehatan dan
Penyelidikan
service Alat Kesehatan 1,500,000
- service alkes 5 pkt/kl 300,000 1,500,000 300,000 300,000 300,000
5.2.3 Belanja Modal 151,382,197
5 . 2 . 3 . 16 Belanja Modal Peralatan dan Mesin - 16,600,000
5 . 2 . 3 . 16 . 04 Pengadaan Alat-alat
Belanja Modal Bantudan Mesin -
Peralatan 16,600,000
Pengadaan Electric Generating Set
Mesin Antrian Pasien 15,000,000
- Mesin Antrian Pasien 1 set/kl 23,577,500 23,577,500 15,000,000
Honorarium pejabat 1,100,000
- Honorarium pejabat pengadaan 1 or/kl 480,000 480,000 480,000
barang dan jasa
- Honorarium pejabat penerima hasil 1 or/kl 420,000 420,000 420,000
pekerjaan
Dokumen 350,000
- Dokumen belanja modal 1 pkt/kl 350,000 350,000 350,000
Ongkos kirim
Ongkos kirim Mesin Antrian pasien 1 pkt/kl 400,000 400,000 400,000
Biaya pengiriman dokumen
Biaya pengiriman dokumen 2 pkt/kl 35,000 70,000 70,000
5 . 2 . 3 . 28 Belanja Modal Peralatan dan Mesin -
Pengadaan Alat Rumah Tangga
5 . 2 . 3 . 28 . 06 Belanja Modal Peralatan dan Mesin -
Pengadaan Alat Rumah Tangga Lainnya
(Home Use)
LED TV 1 unt/kl 7,424,697 7,424,697 7,424,697
5 . 2 . 3 . 30 Belanja Modal Peralatan dan Mesin -
Pengadaan Meja Dan Kursi Kerja/Rapat 6,100,000
Pejabat
5 . 2 . 3 . 30 . 07 Belanja Modal Peralatan dan Mesin - 6,100,000
Pengadaan Lemari dan Arsip Pejabat
Lemari arsip 4,500,000
- Lemari arsip/kursi anak u/ tumbang 5 bh/kl 4,500,000 22,500,000 11,250,000 11,250,000
 NOV DES JUMLAH

480,000

480,000

420,000

420,000

300,000
-
120,000 300,000
-
1,500,000
-
600,000 1,500,000
-
-
35,560,900
-
1,000,000 1,000,000 6,000,000
750,000 750,000 7,500,000
290,000 1,740,000
365,000 2,190,000
120,000 720,000
300,000 300,000 2,100,000
250,000 2,250,000
90,000 540,000
50,000 300,000
138,000 828,000
140,000 140,000 1,680,000
120,000 120,000 1,440,000
114,000 684,000
48,000
540,000
80,000
37,000 37,000 444,000
130,000 130,000 1,300,000
60,000
195,000
144,000
735,000
152,400 914,400
406,000 812,000
70,000
210,000
54,000
1,400,000
30,000
352,500
200,000
350,000

350,000

2,325,000
-
 1,050,000
1,050,000
225,000
1,200,000
-
1,200,000
8,700,000
-
300,000
280,000
390,000
250,000
350,000 1,400,000
720,000
180,000
450,000
190,000
260,000 520,000
900,000 1,800,000
540,000 1,080,000
180,000
960,000
12,769,500
-
300,000 300,000 3,600,000
500,000 500,000 6,000,000
-
1,036,800 2,592,000
231,000 577,500
43,469,000

-
1,020,000 5,100,000
2,700,000 13,500,000
510,000 3,060,000
1,500,000
450,000
720,000
90,000 540,000
90,000 360,000
90,000 360,000
54,000
900,000
-
-
2,280,000
200,000 800,000
795,000 4,770,000
840,000
325,000
5,040,000
200,000
200,000
200,000
400,000
490,000
630,000
750,000
-
83,200,000
-
4,230,000
500,000 1,000,000 10,000,000
6,500,000
 850,000 850,000 8,500,000
7,050,000
6,000,000
600,000
240,000 240,000 2,400,000
-
-
1,000,000 3,000,000
600,000
3,000,000
525,000 1,050,000
400,000
800,000
10,000,000
8,000,000
400,000
1,200,000 1,200,000
1,600,000
600,000
420,000
900,000
300,000
400,000
250,000
1,250,000
3,750,000
2,526,000
-
198,000 198,000 2,376,000
-
75,000
75,000
-
1,020,000

-
20,000 20,000 1,020,000
-
700,000

-
700,000
4,000,000

-
4,000,000
800,000

-
800,000
-
19,200,000
-
1,600,000 1,600,000 19,200,000
4,800,000
-
400,000 400,000 4,800,000
-
28,500,000

-
3,000,000 3,000,000 28,500,000
 -
27,110,000

-
27,110,000
-
36,000,000
-
3,000,000 3,000,000 36,000,000
737,478,876
-
61,456,573 61,456,573 737,478,876
-
118,000,000

118,000,000
2,000,000

-
2,000,000
1,500,000

-
300,000 300,000 1,500,000
-
-
25,297,500

-
23,577,500
-
480,000

420,000

-
350,000

400,000

70,000
-

7,424,697

7,424,697
-
-

22,500,000

-
22,500,000
1,229,131,473
 RENCANA ANGGARAN BELANJA (RAB)
UPTD PUSKESMAS PERUMNAS II T.A 2017

NO. BARANG/JASA UNIT HARGA JUMLAH

1 Generator Set 1 set Rp 15,000,000 Rp 15,000,000
2 Honorarium pejabat pengadaan barang dan jasa 1 or Rp 680,000 Rp 680,000
3 Honorarium pejabat penerima hasil pekerjaan 1 or Rp 420,000 Rp 420,000
4 Dokumen 1 pkt Rp 350,000 Rp 350,000
Jumlah Rp 16,450,000

Bekasi, 9 Desember 2016

Kepala UPTD Puskesmas Perumnas II

Drg. Anastasia Happy Sumant

NIP. 19791023 200501 2 006
 DAFTAR RENCANA KEBUTUHAN BARANG UNIT (RKBU)
TAHUN ANGGARAN 2016

SKPD : UPTD Puskesmas Perumnas II

KOTA : Bekasi
PROVINSI : Jawa Barat

HARGA SATUAN JUMLAH BIAYA

No. NAMA JENIS BARANG MERK/TIPE UKARAN JUMLAH BARANG
Rp. Rp.
1 Alat Tulis Kantor
Tinta printer laser jet HP laser jet 1020 6 1,000,000 6,000,000
Tinta printer HP 704, HP 678 50 150,000 7,500,000
Kertas HVS A4 Epaper 60 29,000 1,740,000
Kertas HVS F4 Epaper 60 36,500 2,190,000
Pulpen Joyco 24 30,000 720,000
Clear holder bambi 70 30,000 2,100,000
Odner bambi 90 25,000 2,250,000
Paper clip Joyco 30 18,000 540,000
Isi hecter Joyco 12 25,000 300,000
Spidol snowman 12 69,000 828,000
Buku folio 200 lembar sinar dunia 24 70,000 1,680,000
Buku folio 100 lembar sinar dunia 24 60,000 1,440,000
Plastic pocket joyco 36 19,000 684,000
Buku tulis Kiky 2 24,000 48,000
Label sticker tom & jerry 30 18,000 540,000
Buku kas sinar dunia 4 20,000 80,000
Stopmap Elvins 24 18,500 444,000
Stopmap snell Elvins 20 65,000 1,300,000
Lem kertas Joyco 10 6,000 60,000
Amplop kecil sinar dunia 10 19,500 195,000
Amplop besar sinar dunia 6 24,000 144,000
Box file bambi 30 24,500 735,000
Businnes file folio bambi 36 25,400 914,400
Post it joyco 40 20,300 812,000
Buku big boss Kiky 2 35,000 70,000
Stabillo stabillo 3 70,000 210,000
Buku kwitansi joyco 6 9,000 54,000
Rak leaflet mika 4 350,000 1,400,000
Penghapus fabel castle 1 30,000 30,000
Tip ex pantle 15 23,500 352,500
Hecter HD kenko 8 25,000 200,000
2 Belanja Komponen Alat Listrik dan Elektronik
 Batre kotak ABC 30 35,000.00 1,050,000
Kabel roll 6 175,000.00 1,050,000
Lampu neon panjang Philips 5 45,000.00 225,000
3 Belanja benda Pos
Materai 6000 200 6000 1,200,000
4 Belanja Bahan Pembersih
Kain pel scott bright 6 50,000 300,000
Sapu lidi bertangkai scott bright 4 70,000 280,000
Sapu ijuk scott bright 6 65,000 390,000
Sabun cuci tangan nuvo 20 12,500 250,000
Larutan antiseptik dettol 40 35,000 1,400,000
Tissue nice 24 30,000 720,000
Tissue gulung nice 9 20,000 180,000
Sabun cuci alat sunlight 30 15,000 450,000
Bahan pembersih porselain porstek 10 19,000 190,000
Pengharum ruangan glade 20 26,000 520,000
Plastik sampah hitam 60 30,000 1,800,000
Sabun pembersih lantai SOS 60 18,000 1,080,000
Cairan pembersih kaca clean 10 18,000 180,000
Plastik sampah kuning 24 40,000 960,000
5 Belanja Bahan Bakar Minyak / Gas dan Pelumas
Belanja BBM Ambulance 12 300,000 3,600,000
belanja BBM mobil eselon IV 12 200,000 2,400,000
Belanja bahan bakar Solar mesin Fogging 270 9,600 2,592,000
Belanja bahan bakar Bensin mesin Fogging 75 7,700.00 577,500
6 Belanja Pakai Habis Pelayanan Kesehatan
Strip cek gula darah (isi 25) 60 85,000 5,100,000
Strip cek kolesterol (isi 10) 90 150,000 13,500,000
Strip cek asam urat (isi 25) 36 85,000 3,060,000
Vagina speculum disposible 100 15,000 1,500,000
Jarum citoject 3 150,000 450,000
Cairan anestesi untuk citoject 1 720,000 720,000
Plastik obat 60 9,000 540,000
Kantong plastik 40 9,000 360,000
Kertas puyer 40 9,000 360,000
Plastik 1/2 Kg 6 9,000 54,000
Diamond bur 30 30,000 900,000
Gentian violet (PIN) 47 20,000 940,000
Freeze tag (PIN) 1 300,000 300,000
Cairan sterilisasi sal. akar (gigi) 3 760,000 2,280,000
Cairan pembersih stain (gigi) 4 200,000 800,000
Tumpatan sementara ready made (gigi) 18 265,000 4,770,000
Cotton roll (gigi) 12 70,000 840,000
Lancet 15 25,000 375,000
 Strip cek Hb (isi 25) 36 140,000 5,040,000
7 Belanja Cetak
Kohort Ibu, Balita dan Bayi 141 30,000.00 4,230,000
Spanduk 50 200,000.00 10,000,000
Stiker PHBS 6,500 1,000.00 6,500,000
Leaflet 10 850,000.00 8,500,000
Tanda pengenal kader jumantik 94 70,000.00 6,580,000
Kartu jentik 10,000 600.00 6,000,000
Buku TB 01 - 06 3 200,000.00 600,000
Poster 50 80,000.00 4,000,000
PIN sign 47 50,000.00 2,350,000
Spanduk PIN 3 300,000 900,000
Kwitansi SPJ 3 rangkap 15 200,000 3,000,000
Inform Consent 3 200,000 600,000
Blanko hasil Lab 10 300,000 3,000,000
Kartu TB 01 - 02 2 525,000 1,050,000
Surat keterangan sakit 2 200,000 400,000
Surat keterangan sehat 4 200,000 800,000
Papan data 6 3,000,000 18,000,000
Papan informasi 1 30,000,000 30,000,000
Rujukan umum 2 200,000 400,000
Kop surat Puskesmas 6 200,000 1,200,000
Odontogram 2 800,000 1,600,000
Lembar isi odontogram 4 150,000 600,000
Buku kegiatan staf 60 7,000 420,000
Etiket obat apotek 6 150,000 900,000
LPLPO 1 300,000 300,000
Kartu stok opnam 2 200,000 400,000
Resep luar 25 10,000 250,000
Resep dalam 250 5,000 1,250,000
Buku status pasien+kartu+plastik 500 7,500 3,750,000
8 Belanja Penggandaan
Foto copy arsip 12 198,000 2,376,000
Jilid hard cover profil 3 25,000 75,000
Jilid hard cover (PTP, LSD, Akreditasi) 3 25,000 75,000
9 Belanja Makanan dan Minuman Harian Pegawai

Galon air mineral 60 17,000 1,020,000

10 Belanja Barang Inventaris Peralatan / Perlengkapan Kantor

Pembatas antrian 2 350,000 700,000

11 Belanja Barang Inventaris Peralatan / Perlengkapan Rumah
Tangga
 Handle bantu kamar mandi 8 500,000 4,000,000
12 Belanja Barang Inventaris Peralatan / Perlengkapan Kesehatan

Alat diagnostik standart (gigi) 20 40,000 800,000

13 Belanja Listrik
belanja listrik bulanan 12 1,600,000 19,200,000
14 Belanja Kawat / Faksimili / Internet / TV Kabel
belanja internet bulanan 12 400,000 4,800,000
15 Belanja Kursus-kursus Singkat / Pelatihan
belanja kursus/pelatihan singkat 19 1,500,000 28,500,000
16 Jasa Tenaga Ahli / Instruktur / Narasumber / Juri / Moderator PNS

Narasumber untuk pendampingan BLUD 1 18,000,000 18,000,000

17 Belanja Uji Laboratorium
Uji Laboratorium 12 3,000,000 36,000,000
18 Belanja Jasa Pelayanan Kesehatan
jasa pelayanan kesehatan 12 61,456,573 737,478,876
19 Belanja Pemeliharaan Peralatan Kantor, Perlengkapan Kantor/
Komputer / Peralatan dan Perlengkapan Teknis
service AC 20 100,000 2,000,000
20 Belanja Pemeliharaan Peralatan Kedokteran / Peralatan
Kesehatan dan Penyelidikan
service alkes 5 300000 1,500,000

Bekasi, 9 Desember 2016

Kepala UPTD Puskesmas Perumnas II

Drg. Anastasia Happy Sumant

NIP. 19791023 200501 2 006
 KODE REKENING KET.

5 . 2 . 2 . 01 . 01

5 . 2 . 2 . 01 . 03
5 . 2 . 2 . 01 . 04

5 . 2 . 2 . 01 . 05

5 . 2 . 2 . 01 . 06

5 . 2 . 2 . 01 . 11
5 . 2 . 2 . 03 . 01

5 . 2 . 2 . 03 . 02

5 . 2 . 2 . 04 . 01

5 . 2 . 2 . 08 . 01

5 . 2 . 2 . 08 . 03
 5 . 2 . 2 . 08 . 05

5 . 2 . 2 . 16 . 03

5 . 2 . 2 . 16 . 06

5 . 2 . 2 . 25 . 01

5 . 2 . 2 . 29 . 04

5 . 2 . 2 . 30 . 03

5 . 2 . 2 . 30 . 06

5 . 2 . 2 . 39 . 11

5 . 2 . 2 . 39 . 14

ember 2016
smas Perumnas II

appy Sumant
200501 2 006
 RENCANA UMUM PENGADAAN BARANG/JASA UPTD PUSKESMAS PERUMNAS II
DINAS KESEHATAN KOTA BEKASI
DANA JKN TAHUN ANGGARAN 2017

KPA : drg. Anastasia Happy Sumanti

Kota : Kota Bekasi
SKPD : Dinas Kesehatan
Tahun Anggaran : 2017

PENGADAAN BARANG/JASA
RENCANA JADWAL PEMILIHAN PENYEDIA RENCANA JADWAL PELAKS

PAGU KEGIATAN SUMBER METODE

NO. KODE KEGIATAN NAMA KEGIATAN LOKASI PEKERJAAN PAGU PAKET
(Rp.) DANA NAMA PAKET PEKERJAAN JENIS BELANJA JENIS PENGADAAN PEMILIHAN
(Rp.) JANGKA
PENYEDIA TANGGAL
TAHAP TANGGAL AKHIR WAKTU
AWAL
(HARI)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 1.02.1.02.01.16.79 Penyelenggaraan Pelayanan
Kesehatan Masyarakat Untuk
Peserta Jaminan Kesehatan UPTD Puskesmas
Nasional di Puskesmas 1,229,131,473 JKN Pengadaan Alat Tulis Kantor 35,560,900 Belanja Barang Pengadaan Barang Swakelola TW I-IV 1 Februari 2016 23 Desember 2017 330 hari
Perumnas II
Perumnas II

2 1.02.1.02.01.16.79 Penyelenggaraan Pelayanan

Kesehatan Masyarakat Untuk
Peserta Jaminan Kesehatan UPTD Puskesmas Pengadaan Bahan Habis Pakai
Nasional di Puskesmas 1,229,131,473 JKN 44,709,000 Belanja Barang Pengadaan Barang Swakelola TW I-IV 1 Februari 2016 23 Desember 2017 330 hari
Perumnas II Kesehatan
Perumnas II

3 1.02.1.02.01.16.79 Penyelenggaraan Pelayanan

Kesehatan Masyarakat Untuk
Peserta Jaminan Kesehatan UPTD Puskesmas
Nasional di Puskesmas 1,229,131,473 JKN Pengadaan Cetak 117,580,000 Belanja Barang Pengadaan Barang Swakelola TW I-IV 1 Februari 2016 23 Desember 2017 330 hari
Perumnas II
Perumnas II

4 1.02.1.02.01.16.79 Penyelenggaraan Pelayanan

Kesehatan Masyarakat Untuk
Peserta Jaminan Kesehatan UPTD Puskesmas
Nasional di Puskesmas 1,229,131,473 JKN Pengadaan Listrik 19,200,000 Belanja Jasa Pengadaan Jasa Swakelola TW I-IV 1 Februari 2016 23 Desember 2017 330 hari
Perumnas II
Perumnas II

5 1.02.1.02.01.16.79 Penyelenggaraan Pelayanan

Kesehatan Masyarakat Untuk
Peserta Jaminan Kesehatan UPTD Puskesmas Pengadaan Kursus
Nasional di Puskesmas 1,229,131,473 JKN 31,500,000 Belanja Jasa Pengadaan Jasa Swakelola TW II-IV ### 23 Desember 2017 270 hari
Perumnas II Singkat/Pelatihan
Perumnas II

6 1.02.1.02.01.16.79 Penyelenggaraan Pelayanan

Kesehatan Masyarakat Untuk
Peserta Jaminan Kesehatan UPTD Puskesmas
Nasional di Puskesmas 1,229,131,473 JKN Pengadaan Uji Laboratorium 36,000,000 Belanja Jasa Pengadaan Jasa Swakelola TW I-IV 1 Februari 2016 23 Desember 2017 330 hari
Perumnas II
Perumnas II

7 1.02.1.02.01.16.79 Penyelenggaraan Pelayanan

Kesehatan Masyarakat Untuk
Peserta Jaminan Kesehatan UPTD Puskesmas Pengadaan Tenaga
Nasional di Puskesmas 1,229,131,473 JKN 47,110,000 Belanja Jasa Pengadaan Jasa Swakelola TW II ### ### 30 hari
Perumnas II Ahli/Narasumber PNS
Perumnas II

8 1.02.1.02.01.16.79 Penyelenggaraan Pelayanan

Kesehatan Masyarakat Untuk
Peserta Jaminan Kesehatan UPTD Puskesmas Pengadaan Jasa Pelayanan
Nasional di Puskesmas 1,229,131,473 JKN 737,478,876 Belanja Jasa Pengadaan Jasa Swakelola TW I-IV 1 Februari 2016 23 Desember 2017 330 hari
Perumnas II Kesehatan
Perumnas II

9 1.02.1.02.01.16.79 Penyelenggaraan Pelayanan

Kesehatan Masyarakat Untuk
Peserta Jaminan Kesehatan UPTD Puskesmas Pengadaan Pemeliharaan Pengadaan
Nasional di Puskesmas 1,229,131,473 JKN 89,557,500 Belanja Jasa Pengadaan Jasa TW I 1 Maret 2017 11 Maret 2017 40 hari
Perumnas II Gedung Langsung
Perumnas II

10 1.02.1.02.01.16.79 Penyelenggaraan Pelayanan

Kesehatan Masyarakat Untuk
Peserta Jaminan Kesehatan UPTD Puskesmas Pengadaan Electric Generating
Nasional di Puskesmas 1,229,131,473 JKN 16,720,000 Belanja Modal Pengadaan Barang E-Catalogue TW IV 2 Oktober 2017 14 Oktober 2017 20 hari
Perumnas II Set
Perumnas II
11 1.02.1.02.01.16.79 Penyelenggaraan Pelayanan
Kesehatan Masyarakat Untuk
Peserta Jaminan Kesehatan UPTD Puskesmas
Nasional di Puskesmas 1,229,131,473 JKN Pengadaan LED TV 7,424,697 Belanja Modal Pengadaan Barang Swakelola TW III 1 Agustus 2017 12 Agustus 2017 13 hari
Perumnas II
Perumnas II
 PENGADAAN BARANG/JASA
RENCANA JADWAL PEMILIHAN PENYEDIA RENCANA JADWAL PELAKS

PAGU KEGIATAN SUMBER METODE

NO. KODE KEGIATAN NAMA KEGIATAN LOKASI PEKERJAAN PAGU PAKET
(Rp.) DANA NAMA PAKET PEKERJAAN JENIS BELANJA JENIS PENGADAAN PEMILIHAN
(Rp.) JANGKA
PENYEDIA TANGGAL
TAHAP TANGGAL AKHIR WAKTU
AWAL
(HARI)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
12 1.02.1.02.01.16.79 Penyelenggaraan Pelayanan
Kesehatan Masyarakat Untuk
Peserta Jaminan Kesehatan UPTD Puskesmas
1,229,131,473 JKN Pengadaan Lemari Arsip 4,500,000 Belanja Modal Pengadaan Barang Swakelola TW III 1 Juli 2017 8 Juli 2017 13 hari
Nasional di Puskesmas Perumnas II
Perumnas II

Bekasi, 19 Januar
Kepala UPTD Puskesma

Drg. Anastasia Happ

NIP. 19791023 2005
RENCANA JADWAL PELAKSANAAN PEKERJAAN

KETERANGAN

TANGGAL AWAL TANGGAL AKHIR

16 17 18

1 Februari 2017 23 Desember 2017

1 Februari 2017 23 Desember 2017

1 Februari 2017 23 Desember 2017

1 Februari 2017 23 Desember 2017

### 23 Desember 2017

1 Februari 2017 23 Desember 2017

### 6 Mei 2017

1 Februari 2017 23 Desember 2017

13 Maret 2017 Friday, April 21, 2017

16 Oktober 2017 ###

14 Agustus 2017 26 Agustus 2017
RENCANA JADWAL PELAKSANAAN PEKERJAAN

KETERANGAN

TANGGAL AWAL TANGGAL AKHIR

16 17 18

10 Juli 2017 22 Juli 2017

Bekasi, 19 Januari 2017

Kepala UPTD Puskesmas Perumnas II

Drg. Anastasia Happy Sumant

NIP. 19791023 200501 2 006
 RINCIAN PERHITUNGAN
KODE
URAIAN HARGA
REKENING VOLUME SATUAN
SATUAN

5 Belanja
52 Belanja Langsung
521 Belanja Pegawai

522 Belanja Barang dan Jasa

5 2 2 10 Belanja Sarana/Prasarana Fasilitas Umum Non
Aset
5 2 2 10 1 Belanja Bangunan Fasilitas Umum Non Aset
Loket pendaftaran dan loket apotek sesuai standar 1 pkt/kl 80,000,000
akreditasi
5 2 2 10 2 Belanja Peralatan/Perlengkapan Fasilitas Umum
Non Aset
Kitchen set 1 pkt/kl 20,000,000
523 Belanja Modal
5 2 3 30 Belanja Modal Peralatan dan Mesin - Pengadaan
Meja dan Kursi Kerja/ Rapat Pejabat

5 2 3 30 1 Belanja Modal Peralatan dan Mesin - Pengadaan

Meja Kerja Pejabat
Meja Kerja 3 bh/kl 3,500,000
5 2 3 30 7 Belanja Modal Peralatan dan Mesin - Pengadaan
Lemari dan Arsip Pejabat
Lemari Arsip 4 bh/kl 4,500,000
JUMLAH Rp.

128,500,000

80,000,000

20,000,000
-
-

10,500,000
-

18,000,000
-
-
-
-
-