PROGRAM PEMBAGIAN JASA PELAYANAN JKN SESUAI PERMENKES NO 21 TAHUN 2016

UPTD : PUSKESMAS Martimbang

BULAN : Januari (diisi bulan sesuai jaspel)
DANA : Rp 8,910,000 (diisi angka jaspel yang akan dibagi bulan ini)
PERNILAI : Rp 5,066 (jangan dirubah)

NILAI
NAMA
NO JABATAN PROFESI (diisi sesuai KOREKTOR*) Tanggung TOTAL POINT PERNILAI NAMA REALISASI
Pendidikan Masa Rangkap Tugas TOTAL POINT JLH HARI JUMLAH HARI PERSENTASE
jabatan) jawab
Kerja Administratif program KETENAGAAN MASUK KERJA KERJA KEHADIRAN

(jangan (jangan (bisa (jangan (bisa (jangan (bisa dirubah) (bisa dirubah) (jangan dirubah) (jangan dirubah) (jangan dirubah) (jangan dirubah) (jangan dirubah)
lupa!!!) dirubah) dirubah) dirubah) dirubah) dirubah)
1 Kepala UPTD Puskemas Medis dr.Eva M Tampubolon 1 150 8 100 10 268 26 26 100% 268 Rp 5,066 dr.Eva M Tampubolon Rp 1,357,640
2 Non medis / S1 0 60 0 100 0 160 0 26 0% 0 Rp 5,066 0 Rp -
3 KTU Apt/ Ners 0 100 0 30 0 130 0 26 0% 0 Rp 5,066 0 Rp -
4 S1 / D IV kes 0 80 0 30 0 110 0 26 0% 0 Rp 5,066 0 Rp -
5 D III Kes 0 60 0 30 0 90 0 26 0% 0 Rp 5,066 0 Rp -
7 D III Non Kes /< D III Kes 0 50 0 30 0 80 0 26 0% 0 Rp 5,066 0 Rp -
< D III Non Kes Espita Siburian 1 25 27 30 10 92 25 26 96% 88.4615384615 Rp 5,066 Espita Siburian Rp 448,130
8 Bendahara Apt/ Ners 0 100 0 50 0 150 0 26 0% 0 Rp 5,066 0 Rp -
9 S1 / D IV kes 0 80 5 50 0 135 0 26 0% 0 Rp 5,066 0 Rp -
10 D III Kes 0 60 0 50 0 110 0 26 0% 0 Rp 5,066 0 Rp -
11 D III Non Kes /< D III Kes Ida Riama Sianturi 1 50 18 50 10 128 25 26 96% 123.0769230769 Rp 5,066 Ida Riama Sianturi Rp 623,486
< D III Non Kes 0 25 0 50 0 75 0 26 0% 0 Rp 5,066 Rp -
13 Medis Dokter Umum 150 0 0 0 150 0 26 0% 0 Rp 5,066 0 Rp -
14 Dokter Umum dr Tonggo HS Siagian 1 150 8 0 10 168 26 26 100% 168 Rp 5,066 dr Tonggo HS Siagian Rp 851,058
15 Dokter Umum 0 150 0 0 0 150 0 26 0% 0 Rp 5,066 0 Rp -
16 Dokter Umum 0 150 0 0 0 150 0 26 0% 0 Rp 5,066 0 Rp -
17 Dokter Umum 0 150 0 0 0 150 0 26 0% 0 Rp 5,066 0 Rp -
18 Dokter Umum 0 150 0 0 0 150 0 26 0% 0 Rp 5,066 0 Rp -
19 Dokter Umum 0 150 0 0 0 150 0 26 0% 0 Rp 5,066 0 Rp -
20 Dokter Umum 0 150 0 0 0 150 0 26 0% 0 Rp 5,066 0 Rp -
21 Dokter Gigi 150 0 0 0 150 0 26 0% 0 Rp 5,066 0 Rp -
22 Dokter Gigi 0 150 0 0 0 150 0 26 0% 0 Rp 5,066 0 Rp -
23 Dokter Gigi 0 150 0 0 0 150 0 26 0% 0 Rp 5,066 0 Rp -
24 Dokter Gigi 0 150 0 0 0 150 0 26 0% 0 Rp 5,066 0 Rp -
25 Apt/ Ners Apoteker 0 100 0 0 0 100 0 26 0% 0 Rp 5,066 0 Rp -
26 Apoteker 0 100 0 0 0 100 0 26 0% 0 Rp 5,066 0 Rp -
27 NERS 0 100 0 0 0 100 0 26 0% 0 Rp 5,066 0 Rp -
28 NERS 0 100 0 0 0 100 0 26 0% 0 Rp 5,066 0 Rp -
29 S1 / D IV kes SKM 0 80 0 0 0 80 0 26 0% 0 Rp 5,066 0 Rp -
30 SKM 0 80 0 0 0 80 0 26 0% 0 Rp 5,066 0 Rp -
31 S.Kep 0 80 0 0 0 80 0 26 0% 0 Rp 5,066 0 Rp -
32 S.Kep 0 80 0 0 0 80 0 26 0% 0 Rp 5,066 0 Rp -
33 S.Kep 0 80 0 0 0 80 0 26 0% 0 Rp 5,066 0 Rp -
34 SST 0 80 0 0 0 80 0 26 0% 0 Rp 5,066 0 Rp -
35 SST 0 80 0 0 0 80 0 26 0% 0 Rp 5,066 0 Rp -
36 SST 0 80 0 0 0 80 0 26 0% 0 Rp 5,066 0 Rp -
37 SGz 0 80 0 0 0 80 0 26 0% 0 Rp 5,066 0 Rp -
38 SGz 0 80 0 0 0 80 0 26 0% 0 Rp 5,066 0 Rp -
39 D III Kes Amd. Kep Lisbeth M Samosir 1 60 29 0 10 99 21 26 81% 79.9615384615 Rp 5,066 Lisbeth M Samosir Rp 405,071
40 Amd. Kep Nonorita lumbanraja 1 60 17 0 0 77 24 26 92% 71.0769230769 Rp 5,066 Nonorita lumbanraja Rp 360,063
41 Amd. Kep 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
42 Amd. Kep 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
43 Amd. Kep 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
44 Amd. Kep 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
 45 Amd. Kep 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
46 Amd. Kep 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
47 Amd. Kep 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
48 Amd. Kep 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
49 Amd. Keb. Yanti R Hutahaean 1 60 20 0 10 90 23 26 88% 79.6153846154 Rp 5,066 Yanti R Hutahaean Rp 403,317
50 Amd. Keb. yunita Sijabat 1 60 4 0 10 74 24 26 92% 68.3076923077 Rp 5,066 yunita Sijabat Rp 346,035
51 Amd. Keb. Juni serpicce S 1 60 21 0 10 91 23 26 88% 80.5 Rp 5,066 Juni serpicce S Rp 407,799
52 Amd. Keb. Alfrida OJ Na70 1 60 4 0 10 74 26 26 100% 74 Rp 5,066 Alfrida OJ Na70 Rp 374,871
53 Amd. Keb. Endang Aprianti 1 60 12 0 10 82 24 26 92% 75.6923076923 Rp 5,066 Endang Aprianti Rp 383,444
54 Amd. Keb. 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
55 Amd. Keb. 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
56 Amd. Keb. 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
57 Amd. Keb. 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
58 Amd. Keb. 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
59 Amd. KG Lamria Sinaga 1 60 18 0 10 88 24 26 92% 81.2307692308 Rp 5,066 Lamria Sinaga Rp 411,501
60 Amd. KG 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
61 Amd. G 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
62 Amd. G 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
63 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
64 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
65 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
66 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
67 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
68 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
69 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
70 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
71 0 60 0 0 0 60 0 26 0% 0 Rp 5,066 0 Rp -
72 D III Non Kes /< D III Kes < D III Kes Basaria Sitorus 1 50 23 0 10 83 25 26 96% 79.8076923077 Rp 5,066 Basaria Sitorus Rp 404,291
73 < D III Kes Albine Marpaung 1 50 29 0 0 79 24 26 92% 72.9230769231 Rp 5,066 Albine Marpaung Rp 369,415
74 < D III Kes Sonti Panjaitan 1 50 23 0 10 83 23 26 88% 73.4230769231 Rp 5,066 Sonti Panjaitan Rp 371,948
75 < D III Kes Tienny Sulastri 1 50 18 0 10 78 21 26 81% 63 Rp 5,066 Tienny Sulastri Rp 319,147
76 < D III Kes Damewati 1 50 21 0 10 81 26 26 100% 81 Rp 5,066 Damewati Rp 410,332
77 < D III Kes Rismauli Siboro 1 50 15 0 10 75 26 26 100% 75 Rp 5,066 Rismauli Siboro Rp 379,937
78 D III Non Kes 0 50 0 0 0 50 0 26 0% 0 Rp 5,066 0 Rp -
79 D III Non Kes 0 50 0 0 0 50 0 26 0% 0 Rp 5,066 0 Rp -
80 D III Non Kes 0 50 0 0 0 50 0 26 0% 0 Rp 5,066 0 Rp -
81 D III Non Kes 0 50 0 0 0 50 0 26 0% 0 Rp 5,066 0 Rp -
82 < D III Non Kes Staf Hasiholan S 1 25 23 0 10 58 25 26 96% 55.7692307692 Rp 5,066 Hasiholan S Rp 282,517
83 Staf 0 25 0 0 0 25 0 26 0% 0 Rp 5,066 0 Rp -
84 Staf 0 25 0 0 0 25 0 26 0% 0 Rp 5,066 0 Rp -
85 Staf 0 25 0 0 0 25 0 26 0% 0 Rp 5,066 0 Rp -
86 Staf 0 25 0 0 0 25 0 26 0% 0 Rp 5,066 0 Rp -
87 Staf 0 25 0 0 0 25 0 26 0% 0 Rp 5,066 0 Rp -
88 Staf 0 25 0 0 0 25 0 26 0% 0 Rp 5,066 0 Rp -
89 Staf 0 25 0 0 0 25 0 26 0% 0 Rp 5,066 0 Rp -
90 Staf 0 25 0 0 0 25 0 26 0% 0 Rp 5,066 0 Rp -
91 Staf 0 25 0 0 0 25 0 26 0% 0 Rp 5,066 0 Rp -
92 Staf 0 25 0 0 0 25 0 26 0% 0 Rp 5,066 0 Rp -
93 Staf 0 25 0 0 0 25 0 26 0% 0 Rp 5,066 0 Rp -
0
JUMLAH PEGAWAI 19 TOTAL 1758.8462 Rp 8,910,000
Keterangan :
*) : Korektor, diisi dengan angka 1 bila ADA.
**) : Kehadiran harian tiap bulan, disesuaikan kehadiran pegawai
***) : Nilai tambahan, bisa diberikan atau tidak, disesuaikan dengan kebijakan puskesmas masing-masing
PROGRAM PEMBAGIAN JASA PELAYANAN JKN SESUAI PERMENKES NO 21 TAHUN 2016
UPTD : PUSKESMAS Martimbang
BULAN : Februari (diisi bulan sesuai jaspel)
DANA : Rp 9,005,040 (diisi angka jaspel yang akan dibagi bulan ini)
PERNILAI : Rp 5,183 (jangan dirubah)

NILAI
NAMA
NO JABATAN PROFESI (diisi sesuai KOREKTOR*) Tanggung TOTAL POINT PERNILAI NAMA REALISASI
Pendidikan Masa Rangkap Tugas TOTAL POINT JLH HARI JUMLAH HARI PERSENTASE
jabatan) jawab
Kerja Administratif program KETENAGAAN MASUK KERJA KERJA KEHADIRAN

(jangan (jangan (bisa (jangan (bisa (jangan (bisa dirubah) (bisa dirubah) (jangan dirubah) (jangan dirubah) (jangan dirubah) (jangan dirubah) (jangan dirubah)
lupa!!!) dirubah) dirubah) dirubah) dirubah) dirubah)
1 Kepala UPTD Puskemas Medis dr.Eva M Tampubolon 1 150 8 100 10 268 23 23 100% 268 Rp 5,183 dr.Eva M Tampubolon Rp 1,389,135
2 Non medis / S1 0 60 0 100 0 160 0 23 0% 0 Rp 5,183 0 Rp -
3 KTU Apt/ Ners 0 100 0 30 0 130 0 23 0% 0 Rp 5,183 0 Rp -
4 S1 / D IV kes 0 80 0 30 0 110 0 23 0% 0 Rp 5,183 0 Rp -
5 D III Kes 0 60 0 30 0 90 0 23 0% 0 Rp 5,183 0 Rp -
7 D III Non Kes /< D III Kes 0 50 0 30 0 80 0 23 0% 0 Rp 5,183 0 Rp -
< D III Non Kes Espita Siburian 1 25 27 30 10 92 22 23 96% 88 Rp 5,183 Espita Siburian Rp 456,134
8 Bendahara Apt/ Ners 0 100 0 50 0 150 0 23 0% 0 Rp 5,183 0 Rp -
9 S1 / D IV kes 0 80 5 50 0 135 0 23 0% 0 Rp 5,183 0 Rp -
10 D III Kes 0 60 0 50 0 110 0 23 0% 0 Rp 5,183 0 Rp -
11 D III Non Kes /< D III Kes Ida Riama Sianturi 1 50 18 50 10 128 23 23 100% 128 Rp 5,183 Ida Riama Sianturi Rp 663,468
< D III Non Kes 0 25 0 50 0 75 0 23 0% 0 Rp 5,183 Rp -
13 Medis Dokter Umum 150 0 0 0 150 0 23 0% 0 Rp 5,183 0 Rp -
14 Dokter Umum dr Tonggo HS Siagian 1 150 8 0 10 168 23 23 100% 168 Rp 5,183 dr Tonggo HS Siagian Rp 870,801
15 Dokter Umum 0 150 0 0 0 150 0 23 0% 0 Rp 5,183 0 Rp -
16 Dokter Umum 0 150 0 0 0 150 0 23 0% 0 Rp 5,183 0 Rp -
17 Dokter Umum 0 150 0 0 0 150 0 23 0% 0 Rp 5,183 0 Rp -
18 Dokter Umum 0 150 0 0 0 150 0 23 0% 0 Rp 5,183 0 Rp -
19 Dokter Umum 0 150 0 0 0 150 0 23 0% 0 Rp 5,183 0 Rp -
20 Dokter Umum 0 150 0 0 0 150 0 23 0% 0 Rp 5,183 0 Rp -
21 Dokter Gigi 150 0 0 0 150 0 23 0% 0 Rp 5,183 0 Rp -
22 Dokter Gigi 0 150 0 0 0 150 0 23 0% 0 Rp 5,183 0 Rp -
23 Dokter Gigi 0 150 0 0 0 150 0 23 0% 0 Rp 5,183 0 Rp -
24 Dokter Gigi 0 150 0 0 0 150 0 23 0% 0 Rp 5,183 0 Rp -
25 Apt/ Ners Apoteker 0 100 0 0 0 100 0 23 0% 0 Rp 5,183 0 Rp -
26 Apoteker 0 100 0 0 0 100 0 23 0% 0 Rp 5,183 0 Rp -
27 NERS 0 100 0 0 0 100 0 23 0% 0 Rp 5,183 0 Rp -
28 NERS 0 100 0 0 0 100 0 23 0% 0 Rp 5,183 0 Rp -
29 S1 / D IV kes SKM 0 80 0 0 0 80 0 23 0% 0 Rp 5,183 0 Rp -
30 SKM 0 80 0 0 0 80 0 23 0% 0 Rp 5,183 0 Rp -
31 S.Kep 0 80 0 0 0 80 0 23 0% 0 Rp 5,183 0 Rp -
32 S.Kep 0 80 0 0 0 80 0 23 0% 0 Rp 5,183 0 Rp -
33 S.Kep 0 80 0 0 0 80 0 23 0% 0 Rp 5,183 0 Rp -
34 SST 0 80 0 0 0 80 0 23 0% 0 Rp 5,183 0 Rp -
35 SST 0 80 0 0 0 80 0 23 0% 0 Rp 5,183 0 Rp -
36 SST 0 80 0 0 0 80 0 23 0% 0 Rp 5,183 0 Rp -
37 SGz 0 80 0 0 0 80 0 23 0% 0 Rp 5,183 0 Rp -
38 SGz 0 80 0 0 0 80 0 23 0% 0 Rp 5,183 0 Rp -
39 D III Kes Amd. Kep Lisbeth M Samosir 1 60 29 0 10 99 20 23 87% 86.0869565217 Rp 5,183 Lisbeth M Samosir Rp 446,218
40 Amd. Kep Nonorita lumbanraja 1 60 17 0 0 77 21 23 91% 70.3043478261 Rp 5,183 Nonorita lumbanraja Rp 364,411
41 Amd. Kep 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
42 Amd. Kep 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
43 Amd. Kep 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
44 Amd. Kep 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
 45 Amd. Kep 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
46 Amd. Kep 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
47 Amd. Kep 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
48 Amd. Kep 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
49 Amd. Keb. Yanti R Hutahaean 1 60 20 0 10 90 19 23 83% 74.347826087 Rp 5,183 Yanti R Hutahaean Rp 385,370
50 Amd. Keb. yunita Sijabat 1 60 4 0 10 74 20 23 87% 64.347826087 Rp 5,183 yunita Sijabat Rp 333,537
51 Amd. Keb. Juni serpicce S 1 60 21 0 10 91 20 23 87% 79.1304347826 Rp 5,183 Juni serpicce S Rp 410,160
52 Amd. Keb. Alfrida OJ Na70 1 60 4 0 10 74 22 23 96% 70.7826086957 Rp 5,183 Alfrida OJ Na70 Rp 366,890
53 Amd. Keb. Endang Aprianti 1 60 12 0 10 82 21 23 91% 74.8695652174 Rp 5,183 Endang Aprianti Rp 388,074
54 Amd. Keb. 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
55 Amd. Keb. 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
56 Amd. Keb. 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
57 Amd. Keb. 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
58 Amd. Keb. 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
59 Amd. KG Lamria Sinaga 1 60 18 0 10 88 21 23 91% 80.347826087 Rp 5,183 Lamria Sinaga Rp 416,470
60 Amd. KG 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
61 Amd. G 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
62 Amd. G 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
63 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
64 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
65 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
66 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
67 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
68 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
69 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
70 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
71 0 60 0 0 0 60 0 23 0% 0 Rp 5,183 0 Rp -
72 D III Non Kes /< D III Kes < D III Kes Basaria Sitorus 1 50 23 0 10 83 22 23 96% 79.3913043478 Rp 5,183 Basaria Sitorus Rp 411,512
73 < D III Kes Albine Marpaung 1 50 29 0 0 79 20 23 87% 68.6956521739 Rp 5,183 Albine Marpaung Rp 356,073
74 < D III Kes Sonti Panjaitan 1 50 23 0 10 83 20 23 87% 72.1739130435 Rp 5,183 Sonti Panjaitan Rp 374,102
75 < D III Kes Tienny Sulastri 1 50 18 0 10 78 19 23 83% 64.4347826087 Rp 5,183 Tienny Sulastri Rp 333,987
76 < D III Kes Damewati 1 50 21 0 10 81 22 23 96% 77.4782608696 Rp 5,183 Damewati Rp 401,596
77 < D III Kes Rismauli Siboro 1 50 15 0 10 75 23 23 100% 75 Rp 5,183 Rismauli Siboro Rp 388,751
78 D III Non Kes 0 50 0 0 0 50 0 23 0% 0 Rp 5,183 0 Rp -
79 D III Non Kes 0 50 0 0 0 50 0 23 0% 0 Rp 5,183 0 Rp -
80 D III Non Kes 0 50 0 0 0 50 0 23 0% 0 Rp 5,183 0 Rp -
81 D III Non Kes 0 50 0 0 0 50 0 23 0% 0 Rp 5,183 0 Rp -
82 < D III Non Kes Staf Hasiholan S 1 25 23 0 10 58 19 23 83% 47.9130434783 Rp 5,183 Hasiholan S Rp 248,350
83 Staf 0 25 0 0 0 25 0 23 0% 0 Rp 5,183 0 Rp -
84 Staf 0 25 0 0 0 25 0 23 0% 0 Rp 5,183 0 Rp -
85 Staf 0 25 0 0 0 25 0 23 0% 0 Rp 5,183 0 Rp -
86 Staf 0 25 0 0 0 25 0 23 0% 0 Rp 5,183 0 Rp -
87 Staf 0 25 0 0 0 25 0 23 0% 0 Rp 5,183 0 Rp -
88 Staf 0 25 0 0 0 25 0 23 0% 0 Rp 5,183 0 Rp -
89 2 0 25 0 0 0 25 0 23 0% 0 Rp 5,183 0 Rp -
90 Staf 0 25 0 0 0 25 0 23 0% 0 Rp 5,183 0 Rp -
91 Staf 0 25 0 0 0 25 0 23 0% 0 Rp 5,183 0 Rp -
92 Staf 0 25 0 0 0 25 0 23 0% 0 Rp 5,183 0 Rp -
93 Staf 0 25 0 0 0 25 0 23 0% 0 Rp 5,183 0 Rp -
0
JUMLAH PEGAWAI 19 TOTAL 1737.3043 Rp 9,005,040
Keterangan :
*) : Korektor, diisi dengan angka 1 bila ADA.
**) : Kehadiran harian tiap bulan, disesuaikan kehadiran pegawai
***) : Nilai tambahan, bisa diberikan atau tidak, disesuaikan dengan kebijakan puskesmas masing-masing
PROGRAM PEMBAGIAN JASA PELAYANAN JKN SESUAI PERMENKES NO 21 TAHUN 2016
UPTD : PUSKESMAS Martimbang
BULAN : Maret (diisi bulan sesuai jaspel)
DANA : Rp 8,975,340 (diisi angka jaspel yang akan dibagi bulan ini)
PERNILAI : Rp 5,674 (jangan dirubah)

NILAI
NAMA
NO JABATAN PROFESI (diisi sesuai KOREKTOR*) Tanggung TOTAL POINT PERNILAI NAMA REALISASI
Pendidikan Masa Rangkap Tugas TOTAL POINT JLH HARI JUMLAH HARI PERSENTASE
jabatan) jawab
Kerja Administratif program KETENAGAAN MASUK KERJA KERJA KEHADIRAN

(jangan (jangan (bisa (jangan (bisa (jangan (bisa dirubah) (bisa dirubah) (jangan dirubah) (jangan dirubah) (jangan dirubah) (jangan dirubah) (jangan dirubah)
lupa!!!) dirubah) dirubah) dirubah) dirubah) dirubah)
1 Kepala UPTD Puskemas Medis dr.Eva M Tampubolon 1 150 8 100 10 268 25 25 100% 268 Rp 5,674 dr.Eva M Tampubolon Rp 1,520,629
2 Non medis / S1 0 60 0 100 0 160 0 25 0% 0 Rp 5,674 0 Rp -
3 KTU Apt/ Ners 0 100 0 30 0 130 0 25 0% 0 Rp 5,674 0 Rp -
4 S1 / D IV kes 0 80 0 30 0 110 0 25 0% 0 Rp 5,674 0 Rp -
5 D III Kes 0 60 0 30 0 90 0 25 0% 0 Rp 5,674 0 Rp -
7 D III Non Kes /< D III Kes 0 50 0 30 0 80 0 25 0% 0 Rp 5,674 0 Rp -
< D III Non Kes Espita Siburian 1 25 27 30 10 92 20 25 80% 73.6 Rp 5,674 Espita Siburian Rp 417,605
8 Bendahara Apt/ Ners 0 100 0 50 0 150 0 25 0% 0 Rp 5,674 0 Rp -
9 S1 / D IV kes 0 80 5 50 0 135 0 25 0% 0 Rp 5,674 0 Rp -
10 D III Kes 0 60 0 50 0 110 0 25 0% 0 Rp 5,674 0 Rp -
11 D III Non Kes /< D III Kes Ida Riama Sianturi 1 50 18 50 10 128 23 25 92% 117.76 Rp 5,674 Ida Riama Sianturi Rp 668,169
< D III Non Kes 0 25 0 50 0 75 0 25 0% 0 Rp 5,674 Rp -
13 Medis Dokter Umum 150 0 0 0 150 0 25 0% 0 Rp 5,674 0 Rp -
14 Dokter Umum dr Tonggo HS Siagian 1 150 8 0 10 168 24 25 96% 161.28 Rp 5,674 dr Tonggo HS Siagian Rp 915,101
15 Dokter Umum 0 150 0 0 0 150 0 25 0% 0 Rp 5,674 0 Rp -
16 Dokter Umum 0 150 0 0 0 150 0 25 0% 0 Rp 5,674 0 Rp -
17 Dokter Umum 0 150 0 0 0 150 0 25 0% 0 Rp 5,674 0 Rp -
18 Dokter Umum 0 150 0 0 0 150 0 25 0% 0 Rp 5,674 0 Rp -
19 Dokter Umum 0 150 0 0 0 150 0 25 0% 0 Rp 5,674 0 Rp -
20 Dokter Umum 0 150 0 0 0 150 0 25 0% 0 Rp 5,674 0 Rp -
21 Dokter Gigi 150 0 0 0 150 0 25 0% 0 Rp 5,674 0 Rp -
22 Dokter Gigi 0 150 0 0 0 150 0 25 0% 0 Rp 5,674 0 Rp -
23 Dokter Gigi 0 150 0 0 0 150 0 25 0% 0 Rp 5,674 0 Rp -
24 Dokter Gigi 0 150 0 0 0 150 0 25 0% 0 Rp 5,674 0 Rp -
25 Apt/ Ners Apoteker 0 100 0 0 0 100 0 25 0% 0 Rp 5,674 0 Rp -
26 Apoteker 0 100 0 0 0 100 0 25 0% 0 Rp 5,674 0 Rp -
27 NERS 0 100 0 0 0 100 0 25 0% 0 Rp 5,674 0 Rp -
28 NERS 0 100 0 0 0 100 0 25 0% 0 Rp 5,674 0 Rp -
29 S1 / D IV kes SKM 0 80 0 0 0 80 0 25 0% 0 Rp 5,674 0 Rp -
30 SKM 0 80 0 0 0 80 0 25 0% 0 Rp 5,674 0 Rp -
31 S.Kep 0 80 0 0 0 80 0 25 0% 0 Rp 5,674 0 Rp -
32 S.Kep 0 80 0 0 0 80 0 25 0% 0 Rp 5,674 0 Rp -
33 S.Kep 0 80 0 0 0 80 0 25 0% 0 Rp 5,674 0 Rp -
34 SST 0 80 0 0 0 80 0 25 0% 0 Rp 5,674 0 Rp -
35 SST 0 80 0 0 0 80 0 25 0% 0 Rp 5,674 0 Rp -
36 SST 0 80 0 0 0 80 0 25 0% 0 Rp 5,674 0 Rp -
37 SGz 0 80 0 0 0 80 0 25 0% 0 Rp 5,674 0 Rp -
38 SGz 0 80 0 0 0 80 0 25 0% 0 Rp 5,674 0 Rp -
39 D III Kes Amd. Kep Lisbeth M Samosir 1 60 29 0 10 99 20 25 80% 79.2 Rp 5,674 Lisbeth M Samosir Rp 449,380
40 Amd. Kep Nonorita lumbanraja 1 60 17 0 0 77 21 25 84% 64.68 Rp 5,674 Nonorita lumbanraja Rp 366,993
41 Amd. Kep 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
42 Amd. Kep 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
43 Amd. Kep 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
44 Amd. Kep 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
 45 Amd. Kep 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
46 Amd. Kep 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
47 Amd. Kep 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
48 Amd. Kep 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
49 Amd. Keb. Yanti R Hutahaean 1 60 20 0 10 90 7 25 28% 25.2 Rp 5,674 Yanti R Hutahaean Rp 142,984
50 Amd. Keb. yunita Sijabat 1 60 4 0 10 74 22 25 88% 65.12 Rp 5,674 yunita Sijabat Rp 369,490
51 Amd. Keb. Juni serpicce S 1 60 21 0 10 91 20 25 80% 72.8 Rp 5,674 Juni serpicce S Rp 413,066
52 Amd. Keb. Alfrida OJ Na70 1 60 4 0 10 74 22 25 88% 65.12 Rp 5,674 Alfrida OJ Na70 Rp 369,490
53 Amd. Keb. Endang Aprianti 1 60 12 0 10 82 21 25 84% 68.88 Rp 5,674 Endang Aprianti Rp 390,824
54 Amd. Keb. 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
55 Amd. Keb. 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
56 Amd. Keb. 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
57 Amd. Keb. 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
58 Amd. Keb. 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
59 Amd. KG Lamria Sinaga 1 60 18 0 10 88 21 25 84% 73.92 Rp 5,674 Lamria Sinaga Rp 419,421
60 Amd. KG 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
61 Amd. G 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
62 Amd. G 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
63 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
64 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
65 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
66 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
67 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
68 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
69 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
70 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
71 0 60 0 0 0 60 0 25 0% 0 Rp 5,674 0 Rp -
72 D III Non Kes /< D III Kes < D III Kes Basaria Sitorus 1 50 23 0 10 83 22 25 88% 73.04 Rp 5,674 Basaria Sitorus Rp 414,428
73 < D III Kes Albine Marpaung 1 50 29 0 0 79 20 25 80% 63.2 Rp 5,674 Albine Marpaung Rp 358,596
74 < D III Kes Sonti Panjaitan 1 50 23 0 10 83 20 25 80% 66.4 Rp 5,674 Sonti Panjaitan Rp 376,753
75 < D III Kes Tienny Sulastri 1 50 18 0 10 78 19 25 76% 59.28 Rp 5,674 Tienny Sulastri Rp 336,354
76 < D III Kes Damewati 1 50 21 0 10 81 22 25 88% 71.28 Rp 5,674 Damewati Rp 404,442
77 < D III Kes Rismauli Siboro 1 50 15 0 10 75 23 25 92% 69 Rp 5,674 Rismauli Siboro Rp 391,505
78 D III Non Kes 0 50 0 0 0 50 0 25 0% 0 Rp 5,674 0 Rp -
79 D III Non Kes 0 50 0 0 0 50 0 25 0% 0 Rp 5,674 0 Rp -
80 D III Non Kes 0 50 0 0 0 50 0 25 0% 0 Rp 5,674 0 Rp -
81 D III Non Kes 0 50 0 0 0 50 0 25 0% 0 Rp 5,674 0 Rp -
82 < D III Non Kes Staf Hasiholan S 1 25 23 0 10 58 19 25 76% 44.08 Rp 5,674 Hasiholan S Rp 250,109
83 Staf 0 25 0 0 0 25 0 25 0% 0 Rp 5,674 0 Rp -
84 Staf 0 25 0 0 0 25 0 25 0% 0 Rp 5,674 0 Rp -
85 Staf 0 25 0 0 0 25 0 25 0% 0 Rp 5,674 0 Rp -
86 Staf 0 25 0 0 0 25 0 25 0% 0 Rp 5,674 0 Rp -
87 Staf 0 25 0 0 0 25 0 25 0% 0 Rp 5,674 0 Rp -
88 Staf 0 25 0 0 0 25 0 25 0% 0 Rp 5,674 0 Rp -
89 2 0 25 0 0 0 25 0 25 0% 0 Rp 5,674 0 Rp -
90 Staf 0 25 0 0 0 25 0 25 0% 0 Rp 5,674 0 Rp -
91 Staf 0 25 0 0 0 25 0 25 0% 0 Rp 5,674 0 Rp -
92 Staf 0 25 0 0 0 25 0 25 0% 0 Rp 5,674 0 Rp -
93 Staf 0 25 0 0 0 25 0 25 0% 0 Rp 5,674 0 Rp -
0
JUMLAH PEGAWAI 19 TOTAL 1581.84 Rp 8,975,340
Keterangan :
*) : Korektor, diisi dengan angka 1 bila ADA.
**) : Kehadiran harian tiap bulan, disesuaikan kehadiran pegawai
***) : Nilai tambahan, bisa diberikan atau tidak, disesuaikan dengan kebijakan puskesmas masing-masing