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••• ~.
BPJSKesehatan
Badan Penyelenggara Jaminan Sosial
Nomar 1502NII-0711117
Jemb€r, 17 November 2017
lampi,s... 1set
Perihal FeedbackPenggunaanP.Cere

Kepada Yth,

1. Kepela Dines Kesehatan Kabupaten Jambe'

2 Kepala Oinas Kesehatan Kabupaten Lumajang
3. Dokle, Prakter Perorangan
4, Dokter Gigi Perorangan
5, Klinik Pratama
di tampa!

Pertama-tama kern; sampaikan tarima kasih alas ke~asama dan dukungan Bapakllbu
yang lalah diberikan kepada BPJS Kesehatan dalam melaksanakan program Jam;nan
Kesehalan Nasional salama ini.

Bersama sural inj kami informasikan feedback penggunaan aplikasi P-Ca,e terulama
input data kuniungan dan penerbitan rujukan (sebagaimanil tar/ampi,) di Fa$il~as Kesehatan
Tingkat Pertama

Sesuai dengsn komitmen dslsm pe~snjian keriasama FKTP bahwa FKTP wajib
melakuksn input semua dsts pelsyansn yang diberik,m terhadsp peserts ke dalsm aplikssi
P-Care secara benar dan rutin, Sehingga kami mahan adanya pemenuhan terhadap
komitmen tersebul.
Demlklan kami sampalkan, atas pertlatian dan kerjasamanya diucapkan terima kaslh,

Kaotor Cabang JembH

J I. !.w" N". 5; Jo", ",", </jIll
r.>p _"1 nl J30 20B ",n'''g:
F" ,,233' 3J:ias,
H,,,,,, ~'''''ce (l@11:J<.78131'
'"'''' OO!,-Io."o"""n.~o,'
Data Kunjungan FKTP Kab Jembcr Bulan OJ<tober 2017

KODE PPK ~AMAPPK

", KUNJUNGAN RUJUK LANJUT

,, 01696001
01896013
6P Or. M. Suherm.n Unmuh (JST)
KLINIK PRATAMA ROlAS MEDIKA
4,397
3.179 '"no
, 0189BOO4 BP KIMIA ~ARMA (JST) 3,149 m

, 01896002
0189B016
BP CAMAR (JST)
KLINIK ODKHRKU TAMAN GAOING """"
2,467
m
",
•, 0189B003 BP DOKTERKU OST 2.389 m
m
, 01896021 Klinik Nu," Medika BondoyudO 1.869

, H2W&Ol TANGGUL 1.773

'"
13291101 SUMBERSARI 1,597
'"
"
n
0189B017
13291701
KliNIK UPT UNIVERSITASJEMBER
PANTI
1.505
1,478 '"
'"
n
n
1329U017
13292501
TRIWIRANTO, OR
ARJASA
1.292
1.291
"
m
.•
13290102 KAUSAT 1,244
" '"
"
"
13292003
13292502
JEMBER KIOUL
JHBUK
1.197
1.152 '"'"
H 01898023 KUNIK NUSA MEOIKA ARJASA 1.137 ;0

" 01898008 KUNIK WIRA SAKTI 1.097

'"
"
"
13292401
13290202
PATRANG
KARANG DUREN
1.050

'"
'""
n
n
13291502
13290901
CURAH NONGKO
AMBULU '"
on
'"m
"
n 13292201 LEOOKOMBO m
m
"
"
13291301
1329U036
MUMBULSARI
YU~I ERMITA DJATMIKO. DR '"
'"m no
"
n
13290501
13292301
WUWHA~
5UMBERJAMBE
'" '"'"
m
" 01898022 Klinik NUl' Mcdik. Ajl)n

n' "
" 13290301 RAMBIPUJI
'"
..-
;0 0189U038 dr. AlFI ¥UDISIANTO m m
n 1329UOO4 MEVIE mRAH DEWI,DR m
n '"
n 01898019
POlRES JEM6ER
Klinik PT,KAJ Perwrol Jemller '"
'"
"
""
dr. ANGGUN PUSPITA DEWt m
" O189L10St
"
"
"
13292701
1890004
5UKORAM61
KUNIK YONlf S09/9/2 KOSTRAD
'"'"
'"n
n PALERAN
13291202
'" '"m
"
"
13291001
0189&014
SUKOWONO
KUNIK PRATAMA TEMU WARAS '"'" "
KEMUNINGSARI m
" 13291902
'"
"
"
13292101
01898012
SUM8ERBARU
BP RAWAT tNAP GRAIJA PUGER SEIJAT '"'"' '"
"
m
"
«
13292001
0189Ul103
KALIWATES
BAMBANG WITARNO, or '"'" "
" 13291601 BANGSALSARI
'",,, '"
"" 0189U020
0189U025
IGNATIUS y.sUGIARTO, dr
SUWINASIS, dr m ""
Data Kunjungan ,KiP Kab. Jember Bulan Oklobcr 2017

KODE PP~ NAMAPP~ KUNJUNGAN RUJU~ LANJUT

" m no
" 13290601 PUGER

"
"
01l!9U039
13290701
dr, fAUZIAft
MAYANG
PRATIWI m

'"
~
.-"
"
"
13291903
1329D401
AJUNG
KENCONG
'"
'"m
" 01898024
13290802
KUNIK IIHAKn PRATAMA MAYANG
S<MBDRD '"'" "
'"m
"
" 1329U032 LlUK lMSMIATI, DR
'"
13292002 MANGU on m
"
"
"
01890001
0189U019
KUNI~ BRIGlf 9f~
SUSllO WARDHANI. dr '"'" "
••
" 13291901 JENGGAWAH
'"n" '"
'"
"
13290404
01119U018
JOMBANG
NURI USMAWATI, dr m ""
m
" 13290602 KASIYAN
n, m"
" 13292601 PAKUSARI
m
"" 189000li WNIK YONIF SlSjK
"
n'
"
13291201
01896011
UMSUlSARI
SP Dokterku Milr. Sehat ""
no
"
" 0189UOO8 TITIS SULISTYOWATI, dr
'" ",
"
"
0189UOI0
0189U022
ADI WIDJAJA, dr
SUNARYQ, dr '"
'" "
m m
'"
n
13290201
0189U021
BAlliNG
WI~E WAHYU WIJAYANTI, dr m
m m"
n 13291S01 TEMPUREJO
n m
n
13291801
13291401
SILO I
GUMUKMAS
'"
m
'CO
.-
"
"
13290302
13290902
NDGOSARI
SABRANG m ""
"" 13292102
01898018
ROWOTENGAH
KlINI~ PRATAMA Al. FURQAN
""m ""
n,
"
w
0189U009 WISNU WIDODO EKA PUTRA, dr
TEMBOKREJO "
",
13291402
1329U01S AKHMAD MULTAZAM, DR '"'
'"
"' 0189BOO9 liP SAKINAH KALiURANG m
"
"'" 01B9U037 dr. AGUS VUDI PRASTAJI no
",
.-"
"
01890007 POSKES 05,10.23 TANGGUL
'" "
OlB9G014
0189U044
dr . SARI VUNIARn
dr. UllL ABSHOR '"'" "
m
"
0189G012 FIlIII EKA RAHMAFUIII, dr
m ",
~
1-1!
0189U049
0189GOO8
dr. CONDRD SUIIVO SAWONO
AlliE WEIIDININGSIH. dr m '"
~
13290903 ANDONGSAIII W
"
i-¥, 1329180, SilO II 'CO
""
" 0189602S KLiNIK HAIIAPAN SEHAT
'"'
"
13291602 SUKOREJO
SALEM Me, <!r
'00
~ '",
" 0189GOO6
Dala Kunjun~an ~l(TP K.b. Jember Bulan Oklaber 2017

WOE PPK NAMAPPK KUNJUNGAN RUJUK LANJUT

'"
"
"
13290803
018!1U043
KLATAKAN
dr, DANI RIANOI "" ""
" B~S0403 CAKRU
•• ;0
,
" 0189G015 dr ,BEAUlY RATNA YULIASARI
"'"
"
'00
0189GOO1
O189U012
KUSHAYATI KUSUMA WARDANI, drg
RITA WAHYUNINGSIH, dr
" .-.-•
'" O189U04S dr. ERLINA HADI
"
'" 13290S0, LDJEJER
dr. ANGGINO GRANDIKA ANDROMEDA "'
;0 "',,
,~
'" 0189U047
O189GOOS SRI ROHIDAFI, drg
"
'0; O189GOOl RUUTA AGUSTIN, dr n 0

"" 01B9UOSO dr, AINUR ROKHMAH

" ",
'"
01B!lU046 dr. HEPPIE NUANSA
"
'" 01B9GOO4
0189BO,0
WAHYU KATMINI, dr
KliNIK PRATAMA INDONESIA SEHAT ", ,
0

'"
"0 0189UOS3 dr. NUR RAKHMAN AHAOI
• 0
m 1329110~ GLADAK PAKEM •, •0
m'" 0189G013
O189G016
drg, Adriyeni Herlidiq Adi
dr . WAHYU SHINTYA VIRGIYANTI
, ,
n. 01B98026 KliNIK KEBUN BANJARSARI 0 0
m 01898027 KliNIK SUMBER SEHAT 0 0
O189G017 drg. OADAN APRINDA EKO TANTIO 0 0
'"
m 0189U052 dr, KOESHAR YUOYARTO 0 0
D.t. Kunjung.n FKTP Kab Jember Bulan Septembe' 2017
KUN)l)NGAN RUJUK lANJUT

,
"
,
KODE PPK
01890001
NAMAPPK
BP Dr. M. SUHERMAN UNMUH (lSII
KUNIK PRATAMA ROLAS MEDIKA
4,146
2,797 '"
••••
01896013

--',,-- 01898004
01898002
liP KIMI'" fARMA (JST)
BP CAMAR I)ST)
2,728
2,4B8 '"
'"'
0189B016 KUNIK OOKTERKU TAMAN GADING l.223
'"m
•, 01898003
13290801
BP DOKTERKU !lST)
TANGGUl
1.863
1,729 m

•, 13291701
13291101
PANT!
SUMBERSARI
1,536
1,504
'"
on

"
n
018geOn
018911017
KLiNIK NUSA MEDIKA BONDOYUOO
KliNIK UPT UNIVERSITASJEMBER
1,489
1,258 '"'"
"
n
1329U017
13292.501
TRIWIRANTO, OR
ARJASA
1,131
1.104 '"
on
13292401 PI\TRANG 1,054 ."
"" 13292502 JElBUK
1,039 n

""
01898023 KlINIK NUSA MEDIKA ARJASA
'"
on "
..
00
13290202 KARANG DUREN
,n m
" 13292003
13290102
JEMBER KIDUl
KAUSAT
, m
" 13190901 AMBUlU ." m
" 01898008 KLlNIK WIRA SAKTI
'" m
"
n 13292301 SUMBERJAMBE m
no
m
n 018ge022
In91502
KlINIK NUSA MEDIKA NONG
CURAH NONGKO m '""
"
" 1329U036 YUNI ERMITA OJATMIKO, OR m
'"
""
0189U038
01890004
dr. ALFI YUDISIANTO
KlINIK YONIF 509/9/2 KOSTRAD
'"00' '""
" 13292201 lEDOKOMBO 00'
'"
""
13290S01
13291301
WULUHAN
MUMBULSARI
'"m '">0.
."
"
"
"
13291001
1329UOO4
13290301
0189U051
SUKOWONO
MEVI!: FlTRAH DEWI,DR
RAM81PUJI
dr. ANGGUN PU5PITA OEWI
..,
00'

'00
'""
m
00

" 0189U003 BAM BANG WITARNO. dr ". ••

"
" 13292101 SUMBERBARU
'" '"••
" 01B9OOO8 POLRESJEMBER
'" "
"
01S9U039
0189B019
dr. FAU21AH PRATlWI
KlINIK PT,KAI (PERSERO) JEMBER '"'" ••
" 13291~2 KEMUNINGSARI
'"". "
"" 13:192001
0189B014
KAUWATES
KLINIK PRATAMA TEMU WARAS ." '""
"
" 23291201 UMBULSARI
'" '"
"
Ol89U025
0189UO.0
SUWINASIS, d,
IGNATIUS Y.SUGIARTD, d,
'"
." ""
" 13290202 SEMBORD
'"
on
"" 13292601 PAKUSARI
'"""
m

" 13290401 KENOONG

'"
" 01896024 WNIK BHAKTI PRATAMA MAYIING
'"." "
'""
13292002 MANGU
'"
13292101 SUKORAMBI
PALEflAN
•••
." '"
m
" 13291202
13290404 JOMBANG ." "
" 13291601 BANGSALSARI ••• m
"" B29U032 ULIK LAKSMIATI. DR
'"."
m

"
01898012 BP RAWAT INAP GRAHA PUGER SEHAT
"
" 13291903 AlLING
'" """
" O189U019
01690001
SUSILD WARDHAN1, dr
KliNIK 8RIGIF 9/K '"
'" ••
"
" 13290701 MAYANG m
"
B'
"
13291901 JENGGAWAH
ANDONGSARI '"
'" ••
" 13290903
13291501 HMPUREJO
'"m '""
"
•• 1890006 KLiNIK YONIF SIS/K
m
"
0189U018 NURI USMAWI\TI, d'
m "
" 13290601 PUGER
""
"
OlB9UOO8 TITIS $ULISTYOWAH dr
'"
"
0189U022
1329060,
SUNARYD, dr
KASIYAN
'"'
m "
••
" O189UOOS WISNU WIDOOD EKA PUTRA, dr
'" "
" 0189U021 WIKE WAHYU WIJAYANH dr
'" "
"" 13290902 SABRANG
'"'"
n

" Ol89ElOll
OlB9UOIO
8P DOKTERKU MITRA SEHAT
ADI WIOJAJA, d, m ",
" 0189U037 dr. AGUS VUDI PRASTAJI m
"
"
" 13291801 SILO I m
m "
n 13291401 GUMUKMAS
""
"" 01898018 KlINIK PRATAM'" Al- ~URQAN
'"
132914Q2 TEMBOKREJO
'" "
W 0189B009
13290302
BP SMINAK
NOGOSARI
KALIURANG
'"'" "
"
" 13290201 BALUNG
'"
m
,,
" MIlMAD MULTAlAM, OR
'"
"'
M
1329U016
01119G014 d,&, SARI YUNI"'Rn
'"
m
"
13291602 SUKOREJO
"
"
~
0189U044
B2H802
dr,UUlABSIlOR
SILO II
'"
no
",
"
•• 01890007 POSUS OS,lO,23 TANGGUl m
0
" 018%012 flT!!1 EKA RAHMAfURI. drg
'" "
W 13292102
13290303
ROWOTENGAH
KLATAKAN '"
'" ,
;;

"
" 0189G008 ARIE WEROIN1NGSIK. d'R '0;

" 13291102 GLADAK PMEM

" ",
"
0189U043
0189GOO1
d'. DANI RIANDI
KUSHAYATI KUSUMA WARDANI. dr
"'
W "
" CAKRU
" ""
"'" 13290403
132905<12 LOJEJER
""
" 0189U012 RITA WAfWUNINGSIH. d,
"
"
OlS9U049 dr. CONDRO 5URYO BAWDi'lO
" "0
'00 0189G015 d,S_ BEAUTY RATNA YULIASARI
" 0
'"
018%006 SALEM MS. dr
"
", O189U045
O189GOOS
dr. [RUNA HADI
SRI RDHIDAFI, drs
~
~
U
0
'" KLiNIK HARAPAN SEHAT
" ",
""
~
OlS98025
D189U047 dr, ANGGIND GRANDIKA ANDROMEDA
dr, HEPPIE NVANSA
"
n ,
0189U046
'"
~ 0189GOO3 RUlITA AGUSTIN, d'g ;0 0

". D189UOSO dl. AINUR ROKHMAH U •

",
WAHYU KATMINI. dT 0
'"
no
0189GOO4
0189G013
"
ADRIYENI HERSIDIQAOI
,, ,
0
m 01890010 KLiNIK PRATAMA INDONESIA SEHAl
0
m 0189UOS2 dr, KOESHAR YUOYARTO
0 0
m 01898026 XUNIK KEBLIN BANJARSIIRI
0 0
n. 01898027 KliNIK SUMBER SEHAT
0 0
m WAHYU SKINTYA VIRGIYANTI
no
0189G016
OIS9G017 "". OAOAN APRINDA EKO TArnlD 0
0
0
0
m O189U053 dr, NliR RAKHMAN AHADI