DAFTAR PEMBAYARAN PENGHASILAN PPNPN

BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

1 AGUSTINA LANGI' MASIRRIN 1102 HK.01.07/MENKES/60 8.498.000 158.122 84.980 243.102 8.254.898 179701000660503
7371014408810004 21-11-2017
982958779804000 1. ...............
2 ROKILAH 1103 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000654502
3212026102830004 21-11-2017
000000000063000 2. ...............
3 ROSMIANTA SARAGIH 1102 HK.01.07/MENKES/60 5.123.000 76.000 51.230 127.230 4.995.770 179701000613506
1207235811800002 21-11-2017
459919601113000 3. ...............
4 GURUH WICAKSONO 1000 HK.01.07/MENKES/60 6.729.000 70.082 67.290 137.372 6.591.628 179701000787509
6402140702840001 21-11-2017
166366740728000 4. ...............
5 PUDLAN WAEL 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000515504
8101142007850002 21-11-2017
000000000063000 5. ...............
6 dr. ZALDI 1103 HK.01.07/MENKES/60 14.424.000 450.561 120.000 570.561 13.853.439 179701000840501
7371091108850007 21-11-2017
664782208832000 6. ...............
7 dr. ELISA FITRI SIREGAR 1000 HK.01.07/MENKES/60 11.440.000 31.686 114.400 146.086 11.293.914 179701000601509
1203026404860004 21-11-2017
159831791211000 7. ...............
8 LA ODE ABDUL MAJID 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000832508
7403230805860001 21-11-2017
805002763811000 8. ...............
JUMLAH HALAMAN INI 63.114.000 852.657 606.900 1.459.557 61.654.443

9 LAURENSIUS SAUNOAH 1101 HK.01.07/MENKES/60 6.729.000 25.763 67.290 93.053 6.635.947 179701000783505
5303052107860002 21-11-2017
000000000063000 9. ...............

Halaman 1
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

10 dr. FINA GUNAWATI 1101 HK.01.07/MENKES/60 11.440.000 31.686 0 31.686 11.408.314 179701000507501
1571016911860021 21-11-2017
696830330302000 10. ...............
11 dr. YAYAN KURNIAWAN 1102 HK.01.07/MENKES/60 14.424.000 713.354 120.000 833.354 13.590.646 179701000555504
1571043011860001 21-11-2017
715073797331000 11. ...............
12 SUTEDY 1102 HK.01.07/MENKES/60 8.045.000 69.136 80.450 149.586 7.895.414 179701000763505
3276022012860003 21-11-2017
972811426412000 12. ...............
13 AWALUDDIN K 1101 HK.01.07/MENKES/60 8.498.000 113.803 84.980 198.783 8.299.217 179701000774506
7317040505870002 21-11-2017
000000000063000 13. ...............
14 KHAERIDA 1003 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000849505
7401045309870002 21-11-2017
000000000063000 14. ...............
15 HALENA B LOBAN 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000704501
5305036909870002 21-11-2017
822819066922000 15. ...............
16 VERONIKA SILALAHI 1000 HK.01.07/MENKES/60 6.729.000 90.535 67.290 157.825 6.571.175 179701000616504
1218105910870001 21-11-2017
822517454124000 16. ...............
JUMLAH HALAMAN INI 69.173.000 1.176.689 553.090 1.729.779 67.443.221

17 ROBI PADUNUNAN 1000 HK.01.07/MENKES/60 5.123.000 18.342 51.230 69.572 5.053.428 179701000724501
9206011512870001 21-11-2017
000000000063000 17. ...............
18 FLORIDA SASI 1000 HK.01.07/MENKES/60 10.316.000 185.210 103.160 288.370 10.027.630 179701000810506
5303026704880002 21-11-2017
000000000063000 18. ...............

Halaman 2
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

19 dr. RAHMATUL FADHILAH 1101 HK.01.07/MENKES/60 11.440.000 31.686 114.400 146.086 11.293.914 179701000546505
1305086305880004 21-11-2017
817804917334000 19. ...............
20 dr. M. SYAHREZA 1101 HK.01.07/MENKES/60 11.440.000 0 114.400 114.400 11.325.600 179701000764501
1106061906880001 21-11-2017
827665779104000 20. ...............
21 dr. BAIHAKI 1000 HK.01.07/MENKES/60 11.440.000 11.232 114.400 125.632 11.314.368 179701000768505
1571012706880121 21-11-2017
739763076331000 21. ...............
22 KADEK MELAH 1000 HK.01.07/MENKES/60 6.729.000 70.082 67.290 137.372 6.591.628 179701000676504
7405150507880001 21-11-2017
749923645811000 22. ...............
23 ROSSY KURNIASARI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000777504
5204171707880001 21-11-2017
809194178913000 23. ...............
24 dr. RIZKY AZRIANI 1000 HK.01.07/MENKES/60 11.440.000 31.686 114.400 146.086 11.293.914 179701000517506
1271104209880003 21-11-2017
759758964122000 24. ...............
JUMLAH HALAMAN INI 73.051.000 348.238 730.510 1.078.748 71.972.252

25 WA HABIIBA 1101 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000729501

7471095009880003 21-11-2017
151046455811000 25. ...............
26 HERMINA SIMARMATA 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000670508
1216056909880002 21-11-2017
819236126005000 26. ...............
27 dr. MELATI R SITORUS 1000 HK.01.07/MENKES/60 11.440.000 31.686 114.400 146.086 11.293.914 179701000512506
1871027110880004 21-11-2017
558048369127000 27. ...............

Halaman 3
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

28 HENDRA PANJAITAN 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000706503
6310090811880006 21-11-2017
248700999734000 28. ...............
29 MARAIMAN RAMBE 1000 HK.01.07/MENKES/60 6.654.000 91.067 66.540 157.607 6.496.393 179701000717504
1220020101890002 21-11-2017
809631104118000 29. ...............
30 LIZA 1000 HK.01.07/MENKES/60 8.045.000 156.068 80.450 236.518 7.808.482 179701000575504
1312054101890010 21-11-2017
761469626202000 30. ...............
31 drg. HILYA 1000 HK.01.07/MENKES/60 11.440.000 11.232 114.400 125.632 11.314.368 179701000792504
1171024102890003 21-11-2017
000000000063000 31. ...............
32 MAITIKA BR GINTING 1000 HK.01.07/MENKES/60 6.654.000 91.067 66.540 157.607 6.496.393 179701000716508
1211044702890001 21-11-2017
000000000063000 32. ...............
JUMLAH HALAMAN INI 61.133.000 447.326 611.330 1.058.656 60.074.344

33 LINDAWATI 1000 HK.01.07/MENKES/60 6.729.000 90.535 67.290 157.825 6.571.175 179701000605503

1109085502890002 21-11-2017
754567519106000 33. ...............
34 DEWI ANDRIATI 1000 HK.01.07/MENKES/60 8.045.000 156.068 80.450 236.518 7.808.482 179701000528507
7405074903890001 21-11-2017
822603353811000 34. ...............
35 ROSVITA LADA 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000688501
5308056703890001 21-11-2017
817497670923000 35. ...............
36 BELLYA HERIANCE 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000561505
1304106803890001 21-11-2017
000000000063000 36. ...............

Halaman 4
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

37 VIVID DWI RAHMADI 1000 HK.01.07/MENKES/60 11.440.000 11.232 114.400 125.632 11.314.368 179701000520509
1607051304890003 21-11-2017
726065881314000 37. ...............
38 NUR NIZ AMALIA 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000682505
7373016204890004 21-11-2017
808751960803000 38. ...............
39 RENO YUFENDRI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000582501
1311050905890004 21-11-2017
000000000063000 39. ...............
40 MELKIANUS EDUK 1000 HK.01.07/MENKES/60 8.498.000 158.122 84.980 243.102 8.254.898 179701000812508
5304121505890001 21-11-2017
822814836925000 40. ...............
JUMLAH HALAMAN INI 58.266.000 548.369 582.660 1.131.029 57.134.971

41 drg. NUR IDAWATI RASMA 1000 HK.01.07/MENKES/60 11.440.000 11.232 114.400 125.632 11.314.368 179701000837508
7371115107890001 21-11-2017
800342057831000 41. ...............
42 SAMSUL KAMAR 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000584503
1171040108890003 21-11-2017
705206103104000 42. ...............
43 MAIYANI 1100 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000851502
5315054408890001 21-11-2017
000000000063000 43. ...............
44 drg. HIDAYAT HADIANSYAH 1000 HK.01.07/MENKES/60 11.440.000 11.232 114.400 125.632 11.314.368 179701000788505
1111051308890002 21-11-2017
710956848101000 44. ...............
45 NETTY SEBRIANY SUSANTI FALLO 1000 HK.01.07/MENKES/60 8.498.000 158.122 84.980 243.102 8.254.898 179701000680503
5303025109890001 21-11-2017
000000000063000 45. ...............

Halaman 5
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

46 HENDRI 1000 HK.01.07/MENKES/60 6.654.000 86.660 66.540 153.200 6.500.800 179701000533502

1106032009890002 21-11-2017
827893686101000 46. ...............
47 HESKY ROMBE PADATI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000779506
6408046010890008 21-11-2017
874750615724000 47. ...............
48 IBNU HAJAR 1000 HK.01.07/MENKES/60 6.729.000 70.082 67.290 137.372 6.591.628 179701000652500
1107102510890004 21-11-2017
822420758104000 48. ...............
JUMLAH HALAMAN INI 60.130.000 337.328 601.300 938.628 59.191.372

49 LA JUMRAN 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000848509

7404200311890001 21-11-2017
000000000063000 49. ...............
50 SAYYIDAH 1000 HK.01.07/MENKES/60 10.316.000 185.210 103.160 288.370 10.027.630 179701000725507
6371016002900005 21-11-2017
714188562731000 50. ...............
51 FIRWAN SAPUTRA 1000 HK.01.07/MENKES/60 10.316.000 0 103.160 103.160 10.212.840 179701000703505
6110022702900001 21-11-2017
764337622706000 51. ...............
52 DASWATI BR SEMBIRING 1000 HK.01.07/MENKES/60 6.729.000 0 67.290 67.290 6.661.710 179701000563507
1206084903900002 21-11-2017
769943416128000 52. ...............
53 ELINA SITUMORANG 1000 HK.01.07/MENKES/60 10.316.000 185.210 103.160 288.370 10.027.630 179701000830506
1217066603900001 21-11-2017
820229706405000 53. ...............
54 SARNIA MARTHA SIMAMORA 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000615508
1202096903900001 21-11-2017
883255804118000 54. ...............

Halaman 6
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

55 NITA RAHMADANI HARAHAP 1100 HK.01.07/MENKES/60 8.045.000 156.068 80.450 236.518 7.808.482 179701000620503
1218024904900002 21-11-2017
666908959416000 55. ...............
56 AGUS BASUKI DWI PURNOMO 1000 HK.01.07/MENKES/60 6.729.000 70.082 67.290 137.372 6.591.628 179701000846507
7405121004900004 21-11-2017
000000000063000 56. ...............
JUMLAH HALAMAN INI 64.228.000 662.776 642.280 1.305.056 62.922.944

57 IMAM BUHARI 1000 HK.01.07/MENKES/60 10.316.000 185.210 103.160 288.370 10.027.630 179701000710502
5206111006901004 21-11-2017
811961069912000 57. ...............
58 YOSEP PIRMANSYAH 1000 HK.01.07/MENKES/60 10.316.000 258.690 103.160 361.850 9.954.150 179701000521505
1705021206900003 21-11-2017
703783605311000 58. ...............
59 WASIRO 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000657500
1610166606900002 21-11-2017
768914822309000 59. ...............
60 JULIANTI 1101 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000861507
0721008590790000 21-11-2017
715340741831000 60. ...............
61 SITTI ROSNAWIA 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000727509
7403095907900001 21-11-2017
769818725816000 61. ...............
62 JOKO DARMAWAN 1000 HK.01.07/MENKES/60 6.654.000 86.660 66.540 153.200 6.500.800 179701000536500
1708010108900002 21-11-2017
000000000063000 62. ...............
63 IRMAYANTI 1000 HK.01.07/MENKES/60 10.316.000 0 103.160 103.160 10.212.840 179701000875506
7402104108900006 21-11-2017
822949236811000 63. ...............

Halaman 7
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

64 NURHALIMAH 1102 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000645503

3210015909900021 21-11-2017
804764298702000 64. ...............
JUMLAH HALAMAN INI 58.094.000 530.560 580.940 1.111.500 56.982.500

65 KHAMIRULLAH 1101 HK.01.07/MENKES/60 6.654.000 21.887 66.540 88.427 6.565.573 179701000714506

6106212409900001 21-11-2017
758518641036000 65. ...............
66 drg. NINA ROVIDHAH 1101 HK.01.07/MENKES/60 11.440.000 11.232 114.400 125.632 11.314.368 179701000765507
1171054511900001 21-11-2017
827873233101000 66. ...............
67 CUT MUTIA 1101 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000562501
1101146810900001 21-11-2017
829829639106000 67. ...............
68 NOVIA SAFITRI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000581505
1509015011900004 21-11-2017
642605133332000 68. ...............
69 NURUL QALBI 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000795502
7312055511900001 21-11-2017
821516697802000 69. ...............
70 dr. NAILI RAHMI 1000 HK.01.07/MENKES/60 11.440.000 31.686 114.400 146.086 11.293.914 179701000514508
1171056312900001 21-11-2017
747860138101000 70. ...............
71 ADRA YUDRIKA 1000 HK.01.07/MENKES/60 8.498.000 178.577 84.980 263.557 8.234.443 179701000495500
7471105901910001 21-11-2017
000000000063000 71. ...............
72 DORIANA 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000564503
1506020802910006 21-11-2017
827804279334000 72. ...............

Halaman 8
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

JUMLAH HALAMAN INI 60.055.000 309.588 600.550 910.138 59.144.862

73 ZAINUDIN ZUHRI 1101 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000522501

1602041202910001 21-11-2017
769663014312000 73. ...............
74 ASTI 1000 HK.01.07/MENKES/60 8.045.000 156.068 80.450 236.518 7.808.482 179701000527501
1903056202910001 21-11-2017
000000000063000 74. ...............
75 FITRI MARDIA 1100 HK.01.07/MENKES/60 10.316.000 258.690 103.160 361.850 9.954.150 179701000531500
1771044303910002 21-11-2017
822541405311000 75. ...............
76 dr. SUTAN MUDA MUNTHE 1000 HK.01.07/MENKES/60 11.440.000 31.686 114.400 146.086 11.293.914 179701000586505
1223061303910001 21-11-2017
744979063116000 76. ...............
77 DAMARIS PURA TANYA 1000 HK.01.07/MENKES/60 8.498.000 158.122 84.980 243.102 8.254.898 179701000813504
5311075703910001 21-11-2017
000000000063000 77. ...............
78 AYU CANIAGO 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000632500
3173015104910005 21-11-2017
800832156034000 78. ...............
79 dr. AIDA MAYASARI 1000 HK.01.07/MENKES/60 11.440.000 31.686 114.400 146.086 11.293.914 179701000593502
1223066204910002 21-11-2017
703705533116000 79. ...............
80 ENGELBERTUS MAU 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000641509
5304030305910003 21-11-2017
822417093925000 80. ...............
JUMLAH HALAMAN INI 66.639.000 702.458 666.390 1.368.848 65.270.152

Halaman 9
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

81 KAMISAH 1101 HK.01.07/MENKES/60 6.729.000 70.082 67.290 137.372 6.591.628 179701000790502

1404095005910002 21-11-2017
822868451524000 81. ...............
82 KHAIRUN NIZAR 1000 HK.01.07/MENKES/60 8.498.000 178.577 84.980 263.557 8.234.443 179701000572506
1171061305910001 21-11-2017
720146950101000 82. ...............
83 dr. ZUSANA RAHAKBAUW 1000 HK.01.07/MENKES/60 14.424.000 798.448 120.000 918.448 13.505.552 179701000809505
8108074806910002 21-11-2017
709442933036000 83. ...............
84 NONI ARISMA 1000 HK.01.07/MENKES/60 8.045.000 157.138 80.450 237.588 7.807.412 179701000872508
7312065606910002 21-11-2017
000000000063000 84. ...............
85 drg. SAHRAENI M. SAID 1000 HK.01.07/MENKES/60 14.424.000 798.448 120.000 918.448 13.505.552 179701000850506
7371136906910006 21-11-2017
000000000063000 85. ...............
86 EVA FAHMILA 1100 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000530504
1115015306920004 21-11-2017
000000000063000 86. ...............
87 ARDI WARNANDES 1000 HK.01.07/MENKES/60 10.316.000 258.690 103.160 361.850 9.954.150 179701000526505
1771011307910002 21-11-2017
822413407311000 87. ...............
88 FAKHRIATY 1000 HK.01.07/MENKES/60 6.729.000 90.535 67.290 157.825 6.571.175 179701000608501
1171056207910001 21-11-2017
809436066106000 88. ...............
JUMLAH HALAMAN INI 74.288.000 2.351.918 694.400 3.046.318 71.241.682

89 UCI YULIYANA 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000807503
1804026307910006 21-11-2017
764816872326000 89. ...............

Halaman 10
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

90 FATMAWATI MUCHTAR 1000 HK.01.07/MENKES/60 8.498.000 158.122 84.980 243.102 8.254.898 179701000833504
7471064108910003 21-11-2017
822421426811000 90. ...............
91 A. HAERUL AGUS M 1000 HK.01.07/MENKES/60 10.316.000 258.690 103.160 361.850 9.954.150 179701000523507
7307050208910001 21-11-2017
000000000063000 91. ...............
92 FATMAWATI S 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000505509
1671044408910008 21-11-2017
666595038307000 92. ...............
93 NELSON KURNIAWAN 1000 HK.01.07/MENKES/60 6.654.000 86.660 66.540 153.200 6.500.800 179701000541505
1703070608910001 21-11-2017
000000000063000 93. ...............
94 JUNGJUNG JASA PUTRA 1000 HK.01.07/MENKES/60 6.729.000 70.082 67.290 137.372 6.591.628 179701000781503
1211021508910002 21-11-2017
000000000063000 94. ...............
95 ARNITHA AHMAD 1000 HK.01.07/MENKES/60 6.729.000 70.082 67.290 137.372 6.591.628 179701000696504
7304024209910001 21-11-2017
753227446807000 95. ...............
96 SELLY SILVIANA WIJAYANTI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000793500
3502114909901001 21-11-2017
769456237647000 96. ...............
JUMLAH HALAMAN INI 55.826.000 709.842 558.260 1.268.102 54.557.898

97 TAUFIK RASJID 1000 HK.01.07/MENKES/60 6.729.000 70.082 67.290 137.372 6.591.628 179701000844505
7309012609910003 21-11-2017
752809608809000 97. ...............
98 DARA PUSPITA 1102 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000814500
5272014110910004 21-11-2017
822909008912000 98. ...............

Halaman 11
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

99 IDA FITRIANI MARSUN 1000 HK.01.07/MENKES/60 6.729.000 70.082 67.290 137.372 6.591.628 179701000708505
7302045010910003 21-11-2017
000000000063000 99. ...............
100 ESA MULIYA 1000 HK.01.07/MENKES/60 6.654.000 0 66.540 66.540 6.587.460 179701000606509
1311035710910002 21-11-2017
802526251825000 100. ...............
101 GUSTI AYU PUTU CANDRA DEWI 1000 HK.01.07/MENKES/60 8.045.000 0 80.450 80.450 7.964.550 179701000778500
5104015011910003 21-11-2017
769944737723000 101. ...............
102 dr. RESTI NOVRIANA 1000 HK.01.07/MENKES/60 14.424.000 897.690 120.000 1.017.690 13.406.310 179701000516500
1701115111910001 21-11-2017
750333023311000 102. ...............
103 EKA CINTIA PRAHESTI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000756508
3502015211910002 21-11-2017
769852716647000 103. ...............
104 MARIA VIRGINIA T. KAHA 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000769501
5303056111910001 21-11-2017
679980516925000 104. ...............
JUMLAH HALAMAN INI 59.481.000 1.104.060 570.570 1.674.630 57.806.370

105 EBID GERSON TAUNU 1000 HK.01.07/MENKES/60 6.729.000 0 67.290 67.290 6.661.710 179701000757504
5371020412910001 21-11-2017
764231825922000 105. ...............
106 ALAN ABIDIN 1000 HK.01.07/MENKES/60 6.729.000 70.082 67.290 137.372 6.591.628 179701000661509
7401040412910001 21-11-2017
000000000063000 106. ...............
107 AGNES RUSIANTAMA SINURAT 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000592506
1207285012910002 21-11-2017
749552477125000 107. ...............

Halaman 12
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

108 dr. MIRZA ANANDA PASARIBU 1000 HK.01.07/MENKES/60 11.440.000 11.232 114.400 125.632 11.314.368 179701000785507
3276041012910003 21-11-2017
000000000063000 108. ...............
109 DARMADI 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000775502
1371102712910001 21-11-2017
000000000063000 109. ...............
110 BADARIA 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000870506
7472024101920001 21-11-2017
000000000063000 110. ...............
111 AGUSTIA 1000 HK.01.07/MENKES/60 6.654.000 86.660 66.540 153.200 6.500.800 179701000498508
1101085401920001 21-11-2017
000000000063000 111. ...............
112 JUFRIANTO. TANDI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000711508
7604043101920002 21-11-2017
484326020813000 112. ...............
JUMLAH HALAMAN INI 55.106.000 300.386 551.060 851.446 54.254.554

113 ANDI MUH. HAERUL 1000 HK.01.07/MENKES/60 6.729.000 70.082 67.290 137.372 6.591.628 179701000873504
7302100202920005 21-11-2017
822223178806000 113. ...............
114 YUFITA UBA S LAMEN 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000588507
5371014402920006 21-11-2017
000000000063000 114. ...............
115 ETRI WAHYUNI 1000 HK.01.07/MENKES/60 8.498.000 0 84.980 84.980 8.413.020 179701000644507
6104174402920003 21-11-2017
817494883703000 115. ...............
116 SUSANTY BR SEMBIRING 1000 HK.01.07/MENKES/60 6.654.000 91.067 66.540 157.607 6.496.393 179701000728505
1220036003920001 21-11-2017
000000000063000 116. ...............

Halaman 13
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

117 RAHMAYANTI 1000 HK.01.07/MENKES/60 8.498.000 158.122 84.980 243.102 8.254.898 179701000648501
7471085803860002 21-11-2017
000000000063000 117. ...............
118 YULIANUS MARSELUS NAHAK 1000 HK.01.07/MENKES/60 8.498.000 158.122 84.980 243.102 8.254.898 179701000694502
5304051902920003 21-11-2017
165175951925000 118. ...............
119 LISNA YANTI 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000839500
7322024203920002 21-11-2017
000000000063000 119. ...............
120 IKA KARTIKA 1000 HK.01.07/MENKES/60 8.045.000 0 80.450 80.450 7.964.550 179701000626509
6101155003920003 21-11-2017
769561325702000 120. ...............
JUMLAH HALAMAN INI 58.699.000 543.599 586.990 1.130.589 57.568.411

121 EVI SALFIANI 1101 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000865501
7407055803920002 21-11-2017
829734615816000 121. ...............
122 HARDIANTI SARI 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000705507
7310106303920001 21-11-2017
817799075809000 122. ...............
123 FRISKA BAYA 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000647505
6108141049200002 21-11-2017
800935355705000 123. ...............
124 NURHILALIA RAMADHAN ARSYAD 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000852508
7472024504920001 21-11-2017
664642428816000 124. ...............
125 ESTER APLIHEN TANESAB 1000 HK.01.07/MENKES/60 6.729.000 70.082 67.290 137.372 6.591.628 179701000643501
5302015104920001 21-11-2017
740568795922000 125. ...............

Halaman 14
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

126 PRISCA ANDARINI 1000 HK.01.07/MENKES/60 6.729.000 90.535 67.290 157.825 6.571.175 179701000545509
1604104505920017 21-11-2017
808395776309000 126. ...............
127 MAYA SARI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000577506
1506025605920009 21-11-2017
720022581334000 127. ...............
128 FLORYANA SITORUS 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000811502
1211056805920002 21-11-2017
257299214113000 128. ...............
JUMLAH HALAMAN INI 50.320.000 425.441 503.200 928.641 49.391.359

129 EKO DINA PERMADI 1000 HK.01.07/MENKES/60 10.316.000 185.210 103.160 288.370 10.027.630 179701000701503
6371023105920005 21-11-2017
766757249731000 129. ...............
130 RAHMADANI 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000771508
7410026006920001 21-11-2017
000000000063000 130. ...............
131 LINDA LESTARI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000821507
7271017006920005 21-11-2017
000000000063000 131. ...............
132 M. DIMAS JULIANTINO 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000509503
1871060107920072 21-11-2017
768437154322000 132. ...............
133 JEFRIANA F. LETO 1000 HK.01.07/MENKES/60 8.498.000 178.577 84.980 263.557 8.234.443 179701000602505
5304034707920001 21-11-2017
822814729925000 133. ...............
134 EKA RIAS YULIANTI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000638506
1811025007920001 21-11-2017
000000000063000 134. ...............

Halaman 15
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

135 IDA SOMBOLAYUK 1000 HK.01.07/MENKES/60 10.316.000 185.210 103.160 288.370 10.027.630 179701000874500
7318055907920006 21-11-2017
822686481803000 135. ...............
136 LAILATAM MARDIAH 1000 HK.01.07/MENKES/60 10.316.000 258.690 103.160 361.850 9.954.150 179701000538502
1709026807920002 21-11-2017
000000000063000 136. ...............
JUMLAH HALAMAN INI 61.469.000 873.893 614.690 1.488.583 59.980.417

137 EKO PRANATA 1000 HK.01.07/MENKES/60 6.729.000 0 67.290 67.290 6.661.710 179701000599508
1210143007920001 21-11-2017
801328485116000 137. ...............
138 GERRY GUSTIAWAN 1000 HK.01.07/MENKES/60 10.316.000 258.690 103.160 361.850 9.954.150 179701000532506
1705090208820001 21-11-2017
822486379311000 138. ...............
139 EKA AGUSTIA SARI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000666509
1306024408920002 21-11-2017
810255653202000 139. ...............
140 A MASHURIA 1000 HK.01.07/MENKES/60 5.123.000 18.342 51.230 69.572 5.053.428 179701000695508
7312015208920001 21-11-2017
000000000063000 140. ...............
141 NUR INTAN 1000 HK.01.07/MENKES/60 6.729.000 70.082 67.290 137.372 6.591.628 179701000860501
7471056508920002 21-11-2017
879307395811000 141. ...............
142 MARIA MAYA PANGADONGAN 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000866507
9271027008920002 21-11-2017
769830076951000 142. ...............
143 ADE PETRUS MANDARA YEWANG 1000 HK.01.07/MENKES/60 8.498.000 158.122 84.980 243.102 8.254.898 179701000627505
5371041909920008 21-11-2017
822614384922000 143. ...............

Halaman 16
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

144 MIFTAHUDDIN 1000 HK.01.07/MENKES/60 6.654.000 86.660 66.540 153.200 6.500.800 179701000578502
1101012109920003 21-11-2017
581642493106000 144. ...............
JUMLAH HALAMAN INI 54.295.000 591.896 542.950 1.134.846 53.160.154

145 THURSINA ARMIS 1000 HK.01.07/MENKES/60 8.498.000 158.122 84.980 243.102 8.254.898 179701000869505
1171056409920001 21-11-2017
769789165101000 145. ...............
146 SUSI RAHMAWATI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000786503
7405206409920002 21-11-2017
000000000063000 146. ...............
147 ERWIN SUSANTI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000566505
1401196509920001 21-11-2017
821511995221000 147. ...............
148 RUPIS TOSELA TARIGAN 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000772504
1211066709920001 21-11-2017
822197406128000 148. ...............
149 NURHAYATI NAMIRA 1000 HK.01.07/MENKES/60 6.729.000 70.082 67.290 137.372 6.591.628 179701000784501
7304024311920004 21-11-2017
769218926807000 149. ...............
150 AMRI NURKARTIKA 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000629507
1802054911920001 21-11-2017
809045891321000 150. ...............
151 HAYATI 1000 HK.01.07/MENKES/60 6.654.000 86.660 66.540 153.200 6.500.800 179701000557506
2103084111931002 21-11-2017
809188238214000 151. ...............
152 drg. CUT MANDA MEUTIA 1000 HK.01.07/MENKES/60 11.440.000 31.686 114.400 146.086 11.293.914 179701000598502
1271075611920002 21-11-2017
000000000063000 152. ...............

Halaman 17
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

JUMLAH HALAMAN INI 53.813.000 346.550 538.130 884.680 52.928.320

153 CHRISTOVEL ENOK 1000 HK.01.07/MENKES/60 8.498.000 158.122 84.980 243.102 8.254.898 179701000634502
5371021911920003 21-11-2017
728954504922000 153. ...............
154 PARNO GULTOM 1000 HK0107/MENKES/603/ 6.729.000 90.490 67.290 157.780 6.571.220 179701000621509
1217031303930000 21-11-2017
000000000063000 154. ...............
155 TITI ASRIATI 1000 HK.01.07/MENKES/60 8.498.000 158.122 84.980 243.102 8.254.898 179701000801507
7404085909920003 21-11-2017
822980322816000 155. ...............
156 IKRAN 1000 HK.01.07/MENKES/60 8.498.000 158.122 84.980 243.102 8.254.898 179701000877508
7410012911920001 21-11-2017
000000000063000 156. ...............
157 ANDI RISKA ARSYAD 1101 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000841507
7308274212920001 21-11-2017
830169876808000 157. ...............
158 NATALLIA TIUR MAIDA 1000 HK.01.07/MENKES/60 6.729.000 90.535 67.290 157.825 6.571.175 179701000619502
1409025412910005 21-11-2017
883124683213000 158. ...............
159 IRMA YENI ELINDA 1000 HK.01.07/MENKES/60 6.729.000 90.535 67.290 157.825 6.571.175 179701000618506
1302176701930002 21-11-2017
000000000063000 159. ...............
160 AGUNG PUTRA SANDI 1000 HK.01.07/MENKES/60 8.498.000 178.577 84.980 263.557 8.234.443 179701000560509
1501082801931001 21-11-2017
822435236333000 160. ...............
JUMLAH HALAMAN INI 59.302.000 924.503 593.020 1.517.523 57.784.477

Halaman 18
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

161 HASLINDA 1101 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000569503

1107025202930001 21-11-2017
682647375101000 161. ...............
162 ANNA LIVIANIKA 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000500509
3310066002930001 21-11-2017
768286759525000 162. ...............
163 INTAN PERMAT SARI 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000674502
1374016502930002 21-11-2017
477636260202000 163. ...............
164 PUTRI PUPUT SARI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000722509
3404166602930002 21-11-2017
767690100542000 164. ...............
165 WAHIDA RAMDIYANI SAPATUGA 1000 HK.01.07/MENKES/60 6.654.000 86.660 66.540 153.200 6.500.800 179701000554508
1703134203930001 21-11-2017
809841471328000 165. ...............
166 WINDA WINARTI 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000656504
6106175103930001 21-11-2017
822469391706000 166. ...............
167 RISMAWATI 1000 HK.01.07/MENKES/60 6.654.000 91.067 66.540 157.607 6.496.393 179701000723505
7301016703930002 21-11-2017
813280385806000 167. ...............
168 KASIDI MARKUS 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000633506
6105092803930002 21-11-2017
768845570706000 168. ...............
JUMLAH HALAMAN INI 47.108.000 310.139 471.080 781.219 46.326.781

169 JERI PRINANDO 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000535504
1701053003930001 21-11-2017
822340873331000 169. ...............

Halaman 19
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

170 AFRIZAL HASAN 1000 HK.01.07/MENKES/60 10.316.000 258.690 103.160 361.850 9.954.150 179701000559508
1213040904930001 21-11-2017
822592325118000 170. ...............
171 AFRINA FITRIA 1000 HK.01.07/MENKES/60 6.654.000 86.660 66.540 153.200 6.500.800 179701000496506
1101045704930001 21-11-2017
000000000063000 171. ...............
172 NUR APRIANI DAI 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000871502
7472025804930001 21-11-2017
803016435816000 172. ...............
173 IBNU FAJRI 1101 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000651504
1106043004930002 21-11-2017
830171039101000 173. ...............
174 KIKI RIZKY 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000831502
3205056104930001 21-11-2017
764224200443000 174. ...............
175 CATUR WINDA APRILLIA 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000663501
3323126604930001 21-11-2017
000000000063000 175. ...............
176 MENTARI IRMA DIAFRILIA 1000 HK.01.07/MENKES/60 6.729.000 0 67.290 67.290 6.661.710 179701000513502
7172076604930001 21-11-2017
731667341825000 176. ...............
JUMLAH HALAMAN INI 53.907.000 543.968 539.070 1.083.038 52.823.962

177 DIAN PRATIWI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000665503
7312044805930002 21-11-2017
809155914808000 177. ...............
178 IMELDA IRAWAN SILALAHI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000820501
1211146005930002 21-11-2017
822738258128000 178. ...............

Halaman 20
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

179 ADE LOLYTA SILITONGA 1000 HK.01.07/MENKES/60 6.729.000 70.082 67.290 137.372 6.591.628 179701000760507
1310046205930005 21-11-2017
000000000063000 179. ...............
180 RAFNI MAISARAH 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000612500
1101186305930001 21-11-2017
741031512106000 180. ...............
181 ENDAH WAHYUNINGSIH 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000640503
3311126805930001 21-11-2017
000000000063000 181. ...............
182 FLORENSIANA SIO 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000669507
5303054306930003 21-11-2017
000000000063000 182. ...............
183 YUNI JULITA 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000590504
1406024606930001 21-11-2017
000000000063000 183. ...............
184 JUNI IRMASARI SITUMEANG 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000826507
1202044706930002 21-11-2017
000000000063000 184. ...............
JUMLAH HALAMAN INI 45.652.000 202.494 456.520 659.014 44.992.986

185 ANDI KURNIAWAN 1100 HK.01.07/MENKES/60 6.729.000 70.082 67.290 137.372 6.591.628 179701000525509
1572021306930002 21-11-2017
822486122333000 185. ...............
186 MAWARDIANA 1000 HK0107/MENKES/603/ 5.123.000 0 51.230 51.230 5.071.770 179701000511500
1108195506930000 21-11-2017
799133745102000 186. ...............
187 FALERIA EWITA SISWARNI 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000667505
1214066806930002 21-11-2017
822760062126000 187. ...............

Halaman 21
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

188 ARSADI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000501505

1104101207930003 21-11-2017
000000000063000 188. ...............
189 JULIANGGA SATRIA RAHMAT 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000571500
1171021507930001 21-11-2017
830208138101000 189. ...............
190 NUR AFDALIAH 1000 HK.01.07/MENKES/60 6.729.000 0 67.290 67.290 6.661.710 179701000681509
7371146007930007 21-11-2017
765258405801000 190. ...............
191 ENI ERIKA SURBAKTI 1000 HK.01.07/MENKES/60 6.729.000 70.082 67.290 137.372 6.591.628 179701000868509
1271116797930008 21-11-2017
000000000063000 191. ...............
192 RISKI ILHANI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000842503
7109137007930001 21-11-2017
000000000063000 192. ...............
JUMLAH HALAMAN INI 47.333.000 206.370 473.330 679.700 46.653.300

193 RANI PRATIWI IRMAYANTI 1000 HK.01.07/MENKES/60 8.045.000 156.068 80.450 236.518 7.808.482 179701000548507
1302127107930001 21-11-2017
000000000063000 193. ...............
194 SITI NURHIDAYATI 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000690508
1471125908930041 21-11-2017
822645339211000 194. ...............
195 AFZAL MAULIDI 1000 HK.01.07/MENKES/60 6.654.000 86.660 66.540 153.200 6.500.800 179701000524503
1173022508930001 21-11-2017
822680732102000 195. ...............
196 dr. AGUNG ADI NUGROHO 1000 HK.01.07/MENKES/60 11.440.000 31.686 114.400 146.086 11.293.914 179701000497502
3402163008930001 21-11-2017
759951718543000 196. ...............

Halaman 22
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

197 NURMALITHA P 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000683501
3402087108930006 21-11-2017
000000000063000 197. ...............
198 ABDUL RACHMAN RAZAK 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000789501
7302021409930001 21-11-2017
828115626806000 198. ...............
199 NINING SRI PRIHARYANI 1001 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000542501
1102056009930002 21-11-2017
822486759107000 199. ...............
200 DEDI KURNIAWAN 1000 HK.01.07/MENKES/60 10.316.000 185.210 103.160 288.370 10.027.630 179701000698506
1310011910930003 21-11-2017
822430401203000 200. ...............
JUMLAH HALAMAN INI 60.009.000 592.036 600.090 1.192.126 58.816.874

201 YESI OKFAHMI 1000 HK.01.07/MENKES/60 8.498.000 158.122 84.980 243.102 8.254.898 179701000658506
1301027010930004 21-11-2017
000000000063000 201. ...............
202 NURDIANA 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000802503
7307025311930001 21-11-2017
753335249941000 202. ...............
203 NOVIANTI KRISTIANI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000791508
7371145811930004 21-11-2017
804287001801000 203. ...............
204 SUMITA ERNILA TB 1000 HK.01.07/MENKES/60 6.654.000 86.660 66.540 153.200 6.500.800 179701000552506
1701064612930001 21-11-2017
000000000063000 204. ...............
205 LINDA A 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000715502
6304045212930001 21-11-2017
000000000063000 205. ...............

Halaman 23
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

206 SRI WAHYUNI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000691504
6406025212930003 21-11-2017
822839874727000 206. ...............
207 RIZKI RAHMATIA 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000583507
1108045712930001 21-11-2017
822766580102000 207. ...............
208 HENDRA SYAFI 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000799506
8271021701940001 21-11-2017
000000000063000 208. ...............
JUMLAH HALAMAN INI 48.952.000 377.194 489.520 866.714 48.085.286

209 PRISKA 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000646509

6103216301940002 21-11-2017
821484896705000 209. ...............
210 DEWI SINTA 1000 HK.01.07/MENKES/60 6.729.000 70.082 67.290 137.372 6.591.628 179701000699502
7311055002940002 21-11-2017
822296778802000 210. ...............
211 MSAMSUL HAER 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000679502
8204082802940004 21-11-2017
000000000063000 211. ...............
212 EKA ASTUTI 1000 HK.01.07/MENKES/60 8.045.000 135.612 80.450 216.062 7.828.938 179701000700507
3506064103940002 21-11-2017
768751190655000 212. ...............
213 MERY SINTYA NINGSIH 1000 HK.01.07/MENKES/60 6.729.000 90.535 67.290 157.825 6.571.175 179701000539508
1509035003940009 21-11-2017
000000000063000 213. ...............
214 INDAH WANTI KAUNAR 1000 HK.01.07/MENKES/60 8.498.000 158.122 84.980 243.102 8.254.898 179701000838504
8104035203940001 21-11-2017
981211634941000 214. ...............

Halaman 24
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

215 HERIBERTUS D. LANU 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000803509
5308201603940002 21-11-2017
579945403925000 215. ...............
216 SELLY MARSELA PUTRI 1000 HK.01.07/MENKES/60 6.729.000 90.535 67.290 157.825 6.571.175 179701000551500
1701055803940001 21-11-2017
807347778311000 216. ...............
JUMLAH HALAMAN INI 55.161.000 677.298 551.610 1.228.908 53.932.092

217 MOH. SYAIFUL DJAMAL 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000859500
7204071903940003 21-11-2017
000000000063000 217. ...............
218 RICKY ANDANI HS 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000549503
1277022103940001 21-11-2017
810211441118000 218. ...............
219 MUHAMMAD RAHMAT GEDE 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000639502
5303052403940002 21-11-2017
000000000063000 219. ...............
220 INTAN LORENZA JASRIL 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000673506
1371091404940006 21-11-2017
822955266201000 220. ...............
221 NANIK KOMARIAH 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000642505
6105014404940004 21-11-2017
810079525706000 221. ...............
222 KARLINA 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000713500
6301035604940001 21-11-2017
822648929732000 222. ...............
223 MASYHURI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000719506
6301090604940001 21-11-2017
662176999732000 223. ...............

Halaman 25
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

224 NURUL ANNISA 1000 HK.01.07/MENKES/60 6.729.000 90.535 67.290 157.825 6.571.175 179701000610508
1207386104940002 21-11-2017
000000000063000 224. ...............
JUMLAH HALAMAN INI 45.652.000 222.947 456.520 679.467 44.972.533

225 MARWAH 1000 HK.01.07/MENKES/60 6.729.000 70.082 67.290 137.372 6.591.628 179701000718500
6308066404940001 21-11-2017
830190864735000 225. ...............
226 RANO KURNIAWAN 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000622505
1871033004940003 21-11-2017
000000000063000 226. ...............
227 ELIA SARI SIMBOLON 1000 HK.01.07/MENKES/60 8.498.000 178.577 84.980 263.557 8.234.443 179701000600503
1209164505940004 21-11-2017
000000000063000 227. ...............
228 MEIGA NUR ADZANI SAIN 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000817508
8171026705940006 21-11-2017
000000000063000 228. ...............
229 RIFKI JUNIANDA 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000623501
1106101306940003 21-11-2017
000000000063000 229. ...............
230 NADIA RIZKI YOVANDA 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000819500
1706025806940002 21-11-2017
822439964328000 230. ...............
231 SITI YULAIHA 1000 HK.01.07/MENKES/60 6.729.000 90.535 67.290 157.825 6.571.175 179701000624507
3307046406940003 21-11-2017
000000000063000 231. ...............
232 IKKE ZUKHAIRAH SIMATUPANG 1000 HK.01.07/MENKES/60 6.729.000 90.535 67.290 157.825 6.571.175 179701000595504
1210096906940002 21-11-2017
000000000063000 232. ...............

Halaman 26
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

JUMLAH HALAMAN INI 49.177.000 429.729 491.770 921.499 48.255.501

233 DIAH KUSUMA PRATIWI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000637500
6171017006940008 21-11-2017
822615142701000 233. ...............
234 JUNARDI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000853504
7404110707940002 21-11-2017
830149613816000 234. ...............
235 LIA LIDIAWATI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000573502
1105094907940001 21-11-2017
000000000063000 235. ...............
236 ENGKI JULI RAHMAN 1000 HK.01.07/MENKES/60 6.729.000 90.535 67.290 157.825 6.571.175 179701000565509
1404020705930004 21-11-2017
808972095213000 236. ...............
237 HENDRIKA AGNES YULIANTI 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000649507
6110025307940003 21-11-2017
822422622706000 237. ...............
238 SARA GLORIA 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000689507
3273115807940004 21-11-2017
740560370424000 238. ...............
239 IWAN KURNIAWAN 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000834500
7303072007940002 21-11-2017
823300256807000 239. ...............
240 WA ODE ALAWIAH NURFAIDAH M 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000835506
7407016307940001 21-11-2017
810121251816000 240. ...............
JUMLAH HALAMAN INI 47.183.000 289.153 471.830 760.983 46.422.017

Halaman 27
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

241 YESTI FEBRIANA 1000 HK.01.07/MENKES/60 6.729.000 90.535 67.290 157.825 6.571.175 179701000556500
1771026407940004 21-11-2017
000000000063000 241. ...............
242 SARLIAN 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000805501
7402326407940001 21-11-2017
000000000063000 242. ...............
243 LUSIANA MANURUNG 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000818504
1208186507940002 21-11-2017
822714929117000 243. ...............
244 MUHAMMAD FADLI 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000828509
7315030808940001 21-11-2017
000000000063000 244. ...............
245 AHMAD JURAID 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000816502
8101172608940001 21-11-2017
000000000063000 245. ...............
246 SEPTYANI SAMBO 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000815506
6401065209940001 21-11-2017
000000000063000 246. ...............
247 SUSY AMELIA 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000553502
1312066309940001 21-11-2017
829806116202000 247. ...............
248 SEPTIA ANGGINA 1000 HK.01.07/MENKES/60 6.729.000 90.535 67.290 157.825 6.571.175 179701000585509
1371076309940003 21-11-2017
000000000063000 248. ...............
JUMLAH HALAMAN INI 47.258.000 313.482 472.580 786.062 46.471.938

249 HUSNUL MARDHIAH 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000570504
1403134210940001 21-11-2017
822931481219000 249. ...............

Halaman 28
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

250 LIZA SAFITRI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000576500
1406166010940002 21-11-2017
000000000063000 250. ...............
251 LISRIANI 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000796508
7410054111940001 21-11-2017
000000000063000 251. ...............
252 DIONISIUS F NAINNULE 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000770502
7371100501920012 21-11-2017
828939710925000 252. ...............
253 QUIN DWI JAYANTI PURBA 1000 HK.01.07/MENKES/60 6.729.000 70.082 67.290 137.372 6.591.628 179701000684507
1208296211940001 21-11-2017
000000000063000 253. ...............
254 RIZKY KHOLILA NASUTION 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000687505
1271186811940003 21-11-2017
822419727113000 254. ...............
255 MUHAMMAD HERMAN 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000806507
7471011012940001 21-11-2017
000000000063000 255. ...............
256 RISMAYA JAFAR 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000653506
7316056912940001 21-11-2017
000000000063000 256. ...............
JUMLAH HALAMAN INI 47.183.000 268.700 471.830 740.530 46.442.470

257 DJUMIYATI KADER 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000804505
8271035301950002 21-11-2017
000000000063000 257. ...............
258 LOLA PERMATA SARI 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000677500
1308047101950001 21-11-2017
000000000063000 258. ...............

Halaman 29
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

259 HAMDAN ARBI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000568507
1608010202950001 21-11-2017
821934783302000 259. ...............
260 KARINI RAHMADANI KAHAR 1000 HK.01.07/MENKES/60 8.498.000 158.122 84.980 243.102 8.254.898 179701000823509
7324044702950001 21-11-2017
808754451803000 260. ...............
261 FITRIANI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000668501
7472064802950001 21-11-2017
000000000063000 261. ...............
262 CONY MARIA SIBUEA 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000635508
1472026002950021 21-11-2017
809833718212000 262. ...............
263 AMRIYANI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000836502
8271036402950001 21-11-2017
000000000063000 263. ...............
264 IKA RAHMADANI 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000671504
1509046702950004 21-11-2017
822548244332000 264. ...............
JUMLAH HALAMAN INI 48.952.000 356.740 489.520 846.260 48.105.740

265 LISA FITRIA SARIDIN 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000574508
1112034303950001 21-11-2017
000000000063000 265. ...............
266 ANNISA ROSA RESEDA 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000662505
1371116703950010 21-11-2017
822797130201000 266. ...............
267 PIPE RONIKASARI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000544503
1509064604950002 21-11-2017
000000000063000 267. ...............

Halaman 30
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

268 EMA RAHLYA 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000603501
1106035104950002 21-11-2017
000000000063000 268. ...............
269 RIRIN KARNILA 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000650508
6106195204950001 21-11-2017
822722443706000 269. ...............
270 KHAIRA ILMA 1000 HK.01.07/MENKES/60 6.729.000 90.535 67.290 157.825 6.571.175 179701000508507
1371084605950007 21-11-2017
000000000063000 270. ...............
271 IMAS SEKAR ARUM 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000534508
3319098059500002 21-11-2017
000000000063000 271. ...............
272 WAHYUNI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000858504
7208036805950001 21-11-2017
829880772831000 272. ...............
JUMLAH HALAMAN INI 44.121.000 156.741 441.210 597.951 43.523.049

273 FIFI YANTI 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000800501
8101155006960001 21-11-2017
000000000063000 273. ...............
274 RAINI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000547501
2104055206950003 21-11-2017
822825287224000 274. ...............
275 FAJAR YUNIWATI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000504503
1507045304960001 21-11-2017
000000000063000 275. ...............
276 EVA YUNITA SIAHAAN 1000 HK.01.07/MENKES/60 6.729.000 90.535 67.290 157.825 6.571.175 179701000625503
1271216006950004 21-11-2017
000000000063000 276. ...............

Halaman 31
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

277 ULFARISA 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000692500

1705016006950001 21-11-2017
822814596311000 277. ...............
278 JULIA PUSPA WARDANA 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000675508
6402024107950010 21-11-2017
822431144728000 278. ...............
279 MAMI YUNITA ARMALINDA THONAK 1000 HK.01.07/MENKES/60 8.498.000 158.122 84.980 243.102 8.254.898 179701000678506
5301104707950003 21-11-2017
828523431922000 279. ...............
280 EMELIANA KRISDIANTI MARPAUNG 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000604507
1271015107950003 21-11-2017
000000000063000 280. ...............
JUMLAH HALAMAN INI 49.027.000 381.069 490.270 871.339 48.155.661

281 MAYASTIANA 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000720507

7601035607950002 21-11-2017
000000000063000 281. ...............
282 IRMAYANTI 1000 HK.01.07/MENKES/60 6.654.000 32.247 66.540 98.787 6.555.213 179701000797504
7210016907950001 21-11-2017
822979829831000 282. ...............
283 MISLIA 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000540509
1111054608950001 21-11-2017
000000000063000 283. ...............
284 MARDHA AZIZAH 1000 HK.01.07/MENKES/60 6.729.000 90.535 67.290 157.825 6.571.175 179701000510504
1307025508950002 21-11-2017
000000000063000 284. ...............
285 MUTIA BIN TAHER 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000867503
8101154107880103 21-11-2017
822552659951000 285. ...............

Halaman 32
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

286 SITI MAULIDA 1000 HK.01.07/MENKES/60 6.654.000 86.660 66.540 153.200 6.500.800 179701000617500
1111057108900001 21-11-2017
830069217104000 286. ...............
287 RAFIKA TUL A'LA 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000857508
7315074409950005 21-11-2017
000000000063000 287. ...............
288 SITI NUR FAHMI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000863509
7309024909950001 21-11-2017
000000000063000 288. ...............
JUMLAH HALAMAN INI 45.652.000 209.442 456.520 665.962 44.986.038

289 ANGGELINA BARA RADJA 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000776508
5371045009950004 21-11-2017
817291164922000 289. ...............
290 VINA EKA PUTRI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000693506
1371076009950006 21-11-2017
000000000063000 290. ...............
291 WINDA ASMIDAR 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000876502
7406034610950001 21-11-2017
822266748815000 291. ...............
292 DIAH KRISTIANTI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000664507
6208015710950002 21-11-2017
000000000063000 292. ...............
293 WAHYU CATUR PARAMITA 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000730502
7208076210950002 21-11-2017
822978458831000 293. ...............
294 SHINTA NOVITA AYU GALINGGING 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000655508
1208015011950002 21-11-2017
000000000063000 294. ...............

Halaman 33
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

295 WINDA LESTARI 1000 HK.01.07/MENKES/60 6.654.000 86.660 66.540 153.200 6.500.800 179701000587501
1307095311950003 21-11-2017
830177648204000 295. ...............
296 RINA 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000686509
6271016011950002 21-11-2017
000000000063000 296. ...............
JUMLAH HALAMAN INI 48.639.000 351.484 486.390 837.874 47.801.126

297 AULIA RAHMAH 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000697500
6301065612950004 21-11-2017
822782850732000 297. ...............
298 EMANUEL LEDO 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000762509
5309062512950001 21-11-2017
000000000063000 298. ...............
299 KURNIA AOLIA 1000 HK.01.07/MENKES/60 6.654.000 86.660 66.540 153.200 6.500.800 179701000537506
7309144401960001 21-11-2017
000000000063000 299. ...............
300 MOH. NATSIR 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000636504
7208061602960001 21-11-2017
000000000063000 300. ...............
301 MUTIARA RAHMADINA 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000798500
3276055802960008 21-11-2017
000000000063000 301. ...............
302 ROMDONI 1000 HK.01.07/MENKES/60 6.654.000 86.660 66.540 153.200 6.500.800 179701000550504
1601092802960001 21-11-2017
000000000063000 302. ...............
303 AFIFAH AMANI AZZAHRA 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000659502
1771084203960001 21-11-2017
000000000063000 303. ...............

Halaman 34
 DAFTAR PEMBAYARAN PENGHASILAN PPNPN
BULANAN
No. DPP: 000505
BULAN : NOVEMBER 2019

SATUAN KERJA : BIRO UMUM (465930)

ANAK SATKER : NS INDIVIDU PERIODE 3 TMT DESEMBER 2017(47)
KEMENTERIAN : KEMENTERIAN KESEHATAN (024)

NAMA NOMOR
STATUS JUMLAH IURAN JAMINAN JUMLAH JUMLAH NOMOR REKENING
NO NIK TANGGAL PPh PASAL 21
TK/K1/K2/K3 SK/PERJANJIAN/ PENGHASILAN KESEHATAN POTONGAN BERSIH TANDA TANGAN
NPWP
KONTRAK KERJA

304 SITI FATIMAH 1000 HK.01.07/MENKES/60 6.654.000 66.206 66.540 132.746 6.521.254 179701000726503
1276035703960001 21-11-2017
000000000063000 304. ...............
JUMLAH HALAMAN INI 47.108.000 305.732 471.080 776.812 46.331.188

305 GINANTI AWIN TIANI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000843509
7371116903960005 21-11-2017
000000000063000 305. ...............
306 DESI WULANDARI 1000 HK.01.07/MENKES/60 5.123.000 0 51.230 51.230 5.071.770 179701000502501
1671026807960007 21-11-2017
000000000063000 306. ...............
JUMLAH HALAMAN INI 10.246.000 0 102.460 102.460 10.143.540

JUMLAH TOTAL 2.104.802.000 20.282.795 20.812.420 41.095.215 2.063.706.785

Jakarta, 25-11-2019
Pejabat Pembuat Komitmen

Ferdhy Firdausy, SE, M.AP

NIP. 197705042009121001

Halaman 35