08 JASPEL September 2020 Revisi 2
08 JASPEL September 2020 Revisi 2
Umum
Rawat Jalan 5,352,000 2,515,440
Rawat Inap -
UGD 227,000 106,690
Laboratorium dan penunjang lainnya 2,335,000 1,097,450
Persalinan -
Lainnya 519,892 244,349
57,476,967 27,014,174
Yang Diisi
Mengetahui, Garut,
Kepala UPT Puskesmas Kersamenak Kepala Sub Bagian Tata Usaha
5
TOTAL RATING DAN SKOR
BULAN SEPTEMBER 2020
UPT PUSKESMAS KERSAMENAK
Disiplin Dedikasi
Basic Index Kompetensi Risk Jabatan RAWAT JALAN
dan Loyalitas
Kerja &
No. Nama Kepngkt Lama Ijazah Srtfkt Pnmptn Emerge Rngkp Kepatuh Klinik Klinik Klinik Front
n Kerja Terakhir STR Keahlian Kerja Posisi Jbtn Apel an Umum Gigi KIA Office
ncy
10 100 10 100 100 100 100 100 100 100 100 0.3 0.6 0.4 0.023
1 Hj. Ai Suryati, SKM., MM. 4.20 7.63 30.00 3.85 25.00 2.78 7.87 7.58 0.00 4.78 2.78 0.00 0.00 0.00 0.00
2 Enyang Taufik Hidayat, ST. 3.40 7.63 25.00 0.00 25.00 2.78 4.49 6.06 0.00 4.78 2.78 0.00 0.00 0.00 0.00
3 dr. Dedi Rahmat 3.60 1.58 30.00 3.85 25.00 2.78 3.37 1.52 0.00 0.96 2.78 0.09 0.00 0.00 0.00
4 dr. Giand Elmadahlia Tusara 3.40 0.26 30.00 3.85 25.00 2.78 3.37 4.55 0.00 0.96 2.78 0.05 0.00 0.00 0.00
5 Ani Maryani, SST. 4.20 7.63 25.00 3.85 0.00 2.78 2.25 4.55 0.00 4.31 2.78 0.00 0.00 0.17 0.00
6 H. Hana Kartiwa, AMK., SKM. 3.80 8.42 20.00 0.00 0.00 2.78 2.25 1.52 0.00 0.00 2.78 1.70 0.00 0.00 0.00
7 Lia Rosalia, A.Md.Kep. 3.80 7.89 20.00 3.85 0.00 2.78 2.25 3.03 0.00 3.83 2.78 0.74 0.00 0.00 0.00
8 Poppy Gusdiantini, A.Md.Kep. 3.80 6.84 20.00 3.85 0.00 2.78 2.25 4.55 0.00 2.39 2.78 0.80 0.00 0.00 0.00
9 Risma Fatimah, A.Md.Keb. 3.80 7.11 20.00 3.85 0.00 2.78 2.25 1.52 0.00 0.00 2.78 0.00 0.00 0.28 0.00
10 Raswin, S.Si. 3.60 7.37 25.00 3.85 0.00 2.78 3.37 1.52 0.00 4.31 2.78 0.00 0.00 0.00 0.00
11 Hj. Purwani, A.Md.Kes. 3.60 6.32 20.00 3.85 0.00 2.78 5.62 4.55 0.00 2.39 2.78 0.00 0.49 0.00 0.00
12 Suryati 3.40 8.95 10.00 3.85 0.00 2.78 1.12 1.52 0.00 3.83 2.78 0.00 0.00 0.00 0.00
13 Hj. Aan Warlimah, SKM. 3.20 3.68 25.00 3.85 0.00 2.78 2.25 3.03 0.00 5.26 2.78 0.00 0.00 0.00 0.00
14 Puji Sri Fauzi, A.Md.Keb. 2.60 0.79 20.00 3.85 0.00 2.78 3.37 1.52 0.00 0.96 2.78 0.00 0.00 0.05 0.00
15 Yeni Rachman Khasim, SST. 2.60 0.79 25.00 3.85 0.00 2.78 2.25 3.03 0.00 2.39 2.78 0.00 0.00 0.04 0.00
16 Wawan Gunawan 2.60 6.58 10.00 0.00 0.00 2.78 1.12 1.52 0.00 3.35 2.78 0.00 0.00 0.00 0.00
17 Ani Fitriani, A.Md.Kep. 2.60 0.26 20.00 3.85 0.00 2.78 5.62 1.52 0.00 0.00 2.78 0.25 0.00 0.00 0.00
18 Isti Hasanah, A.Md.AK. 2.00 1.58 20.00 3.85 0.00 2.78 2.25 1.52 0.00 3.35 2.78 0.00 0.00 0.00 0.00
19 Elis Muslimah, AMK. 2.00 0.79 20.00 3.85 0.00 2.78 2.25 3.03 0.00 0.48 2.78 0.12 0.00 0.00 0.00
20 Rohayati 2.00 0.79 10.00 0.00 0.00 2.78 2.25 1.52 0.00 4.78 2.78 0.00 0.00 0.00 0.13
21 Nani Handayani 2.00 0.79 10.00 0.00 0.00 2.78 3.37 1.52 0.00 5.26 2.78 0.00 0.00 0.00 0.40
22 Solihah Wulandari Ningsih, SKM. 2.00 0.79 25.00 0.00 0.00 2.78 3.37 3.03 0.00 0.96 2.78 0.00 0.00 0.00 0.24
23 Amanda Amarwaty, A.Md.Keb. 2.00 0.79 20.00 3.85 0.00 2.78 2.25 3.03 0.00 0.96 2.78 0.00 0.00 0.00 0.00
24 Teli Yulianti, S.Si. 2.00 0.79 25.00 3.85 0.00 2.78 2.25 3.03 0.00 0.96 2.78 0.00 0.00 0.23 0.00
25 Herni Siti Muniroh, A.Md.Keb. 2.00 0.79 20.00 3.85 0.00 2.78 2.25 3.03 0.00 0.96 2.78 0.00 0.00 0.04 0.00
26 Devi Hesti Supriadi, A.Md.Keb. 2.00 0.79 20.00 3.85 0.00 2.78 2.25 3.03 0.00 1.44 2.78 0.29 0.00 0.00 0.00
27 Rizal Cahyadi, A.Md.Kep. 2.00 0.79 20.00 3.85 0.00 2.78 2.25 3.03 0.00 1.44 2.78 0.34 0.00 0.00 0.00
28 Imam Prasetya Hermansah, S.Kep., Ners. 2.00 0.79 30.00 3.85 0.00 2.78 2.25 3.03 0.00 3.83 2.78 0.00 0.00 0.00 0.20
29 Irawati 2.00 0.79 2.00 0.00 0.00 2.78 2.25 1.52 0.00 4.78 2.78 0.00 0.00 0.00 0.00
30 Siti Nur Azijah, A.Md.Gz. 2.00 0.00 20.00 3.85 0.00 2.78 2.25 3.03 0.00 3.35 2.78 0.00 0.00 0.00 0.00
31 Seli Cahyani 2.00 0.00 10.00 0.00 0.00 2.78 1.12 1.52 0.00 1.91 2.78 0.59 0.00 0.00 0.00
32 Dewi Syahadah, A.Md.Kep. 2.00 0.00 20.00 3.85 0.00 2.78 2.25 3.03 0.00 2.87 2.78 0.00 0.00 0.13 0.00
33 Ami Jamiatul, A.Md.Keb. 2.00 0.00 20.00 3.85 0.00 2.78 2.25 3.03 0.00 4.78 2.78 0.00 0.00 0.00 0.20
34 Sindi Audila Arum 2.00 0.00 10.00 0.00 0.00 2.78 2.25 1.52 0.00 4.78 2.78 Err:508 Err:508 Err:508 Err:508
35 Azizah Putri Wibowo, A.Md.Kes. 2.00 0.00 20.00 3.85 0.00 2.78 2.25 3.03 0.00 3.83 2.78 0.00 0.00 0.00 0.00
36 Anwar Muhlis 2.00 0.00 2.00 0.00 0.00 2.78 3.37 1.52 0.00 4.78 2.78 0.00 0.00 0.00 0.00
JUMLAH
RATING DAN SKOR TOTAL RATING DAN SKOR
N SEPTEMBER 2020 BULAN SEPTEMBER 2020
KESMAS KERSAMENAK UPT PUSKESMAS KERSAMENAK
RAWAT JALAN RAWAT INAP DAN UGD RUJUKAN
Askep OBS Persalin
No. Nama Farmasi Front
Lab Visite Askeb GD/ned an office RI Sopir
Tind u/ dr
0.023 0.4 2.2 0.40 1.1 2.3 0.023 0.3
1 Hj. Ai Suryati, SKM., MM. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2 Enyang Taufik Hidayat, ST. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
3 dr. Dedi Rahmat 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
4 dr. Giand Elmadahlia Tusara 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5 Ani Maryani, SST. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
6 H. Hana Kartiwa, AMK., SKM. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
7 Lia Rosalia, A.Md.Kep. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
8 Poppy Gusdiantini, A.Md.Kep. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
9 Risma Fatimah, A.Md.Keb. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 Raswin, S.Si. 0.31 0.00 0.00 0.00 0.00 0.00 0.00 0.00
11 Hj. Purwani, A.Md.Kes. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
12 Suryati 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
13 Hj. Aan Warlimah, SKM. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
14 Puji Sri Fauzi, A.Md.Keb. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
15 Yeni Rachman Khasim, SST. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
16 Wawan Gunawan 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
17 Ani Fitriani, A.Md.Kep. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
18 Isti Hasanah, A.Md.AK. 0.00 1.15 0.00 0.00 0.00 0.00 0.00 0.00
19 Elis Muslimah, AMK. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
20 Rohayati 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
21 Nani Handayani 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22 Solihah Wulandari Ningsih, SKM. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
23 Amanda Amarwaty, A.Md.Keb. 0.30 0.00 0.00 0.00 0.00 0.00 0.00 0.00
24 Teli Yulianti, S.Si. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
25 Herni Siti Muniroh, A.Md.Keb. 0.00 0.09 0.00 0.00 0.00 0.00 0.00 0.00
26 Devi Hesti Supriadi, A.Md.Keb. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
27 Rizal Cahyadi, A.Md.Kep. 0.00 0.01 0.00 0.00 0.00 0.00 0.00 0.00
28 Imam Prasetya Hermansah, S.Kep., Ners. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
29 Irawati 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
30 Siti Nur Azijah, A.Md.Gz. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
31 Seli Cahyani 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
32 Dewi Syahadah, A.Md.Kep. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
33 Ami Jamiatul, A.Md.Keb. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
34 Sindi Audila Arum Err:508 Err:508 0.00 0.00 0.00 0.00 0.00 0.00
35 Azizah Putri Wibowo, A.Md.Kes. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
36 Anwar Muhlis 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
JUMLAH JUMLAH
TOTAL RATING DAN SKOR
BULAN SEPTEMBER 2020
UPT PUSKESMAS KERSAMENAK
RUJUKAN UKM JASA PELAYANAN LANGSUNG
Pendam UKM Jmlh Kehadir Total JASPEL TDK LS Manajemen
No. Nama UKM
ping Esensial Pngmbn Index an Index Rawat Jalan Rawat Inap Persalinan
gn
0.3 0.1 0.1 22,449,711 2,701,417 1,863,046 - -
1 Hj. Ai Suryati, SKM., MM. 0.00 0.83 1.25 98.54 92 90.96 Err:508 810,425 - - -
2 Enyang Taufik Hidayat, ST. 0.00 0.83 1.25 84.01 88 74.32 Err:508 351,184 - - -
3 dr. Dedi Rahmat 0.00 0.00 0.00 75.51 73 55.18 Err:508 189,099 - - -
4 dr. Giand Elmadahlia Tusara 0.00 0.00 0.00 76.99 85 65.14 Err:508 189,099 - - -
5 Ani Maryani, SST. 0.00 1.21 0.00 58.72 88 51.94 Err:508 54,028 - - -
6 H. Hana Kartiwa, AMK., SKM. 0.00 0.00 0.00 43.24 58 24.95 Err:508 - - - -
7 Lia Rosalia, A.Md.Kep. 0.00 0.00 1.76 52.71 81 42.57 Err:508 54,028 - - -
8 Poppy Gusdiantini, A.Md.Kep. 0.00 0.00 0.43 50.46 73 36.87 Err:508 54,028 - - -
9 Risma Fatimah, A.Md.Keb. 0.00 0.00 0.00 44.35 85 37.53 Err:508 - - - -
10 Raswin, S.Si. 0.00 0.00 0.00 54.87 96 52.76 Err:508 - - - -
11 Hj. Purwani, A.Md.Kes. 0.00 0.00 0.79 53.15 88 47.02 Err:508 270,142 - - -
12 Suryati 0.00 0.00 0.00 38.22 92 35.28 Err:508 - - - -
13 Hj. Aan Warlimah, SKM. 0.00 0.77 0.00 52.60 100 52.60 Err:508 - - - -
14 Puji Sri Fauzi, A.Md.Keb. 0.00 0.00 0.00 38.68 69 26.78 Err:508 54,028 - - -
15 Yeni Rachman Khasim, SST. 0.00 1.21 0.00 46.72 85 39.53 Err:508 54,028 - - -
16 Wawan Gunawan 0.00 0.00 0.00 30.72 81 24.81 Err:508 54,028 - - -
17 Ani Fitriani, A.Md.Kep. 0.00 0.00 0.00 39.65 81 32.02 Err:508 324,170 - - -
18 Isti Hasanah, A.Md.AK. 0.00 0.00 0.00 41.24 96 39.66 Err:508 - - - -
19 Elis Muslimah, AMK. 0.00 0.06 0.00 38.13 23 8.80 Err:508 - - - -
20 Rohayati 0.00 0.00 0.00 27.02 92 24.94 Err:508 - - - -
21 Nani Handayani 0.00 0.00 0.00 28.89 100 28.89 Err:508 - - - -
22 Solihah Wulandari Ningsih, SKM. 0.00 0.00 0.75 41.69 88 36.88 Err:508 - - - -
23 Amanda Amarwaty, A.Md.Keb. 0.00 1.21 0.00 39.94 81 32.26 Err:508 - - - -
24 Teli Yulianti, S.Si. 0.00 0.00 0.33 43.99 85 37.22 Err:508 - - - -
25 Herni Siti Muniroh, A.Md.Keb. 0.00 0.35 0.97 39.87 85 33.74 Err:508 54,028 - - -
26 Devi Hesti Supriadi, A.Md.Keb. 0.00 1.21 0.00 40.40 62 24.86 Err:508 - - - -
27 Rizal Cahyadi, A.Md.Kep. 0.00 0.47 2.46 42.19 92 38.95 Err:508 - - - -
28 Imam Prasetya Hermansah, S.Kep., Ners. 0.00 0.48 0.00 51.97 96 49.98 Err:508 94,550 - - -
29 Irawati 0.00 0.00 0.00 18.89 96 18.17 Err:508 - - - -
30 Siti Nur Azijah, A.Md.Gz. 0.00 0.55 0.00 40.58 92 37.46 Err:508 - - - -
31 Seli Cahyani 0.00 0.00 0.00 22.70 81 18.33 Err:508 54,028 - - -
32 Dewi Syahadah, A.Md.Kep. 0.00 0.01 0.00 39.69 77 30.53 Err:508 40,521 - - -
33 Ami Jamiatul, A.Md.Keb. 0.00 0.06 0.00 41.72 88 36.91 Err:508 - - - -
34 Sindi Audila Arum 0.00 0.00 0.00 Err:508 96 Err:508 Err:508 - - - -
35 Azizah Putri Wibowo, A.Md.Kes. 0.00 0.72 0.00 41.23 85 34.89 Err:508 - - - -
36 Anwar Muhlis 0.00 0.00 0.00 19.23 100 19.23 Err:508 - - - -
22,449,711 2,701,417 JUMLAH
- - -
Mengetahui,
Kepala UPT Puskesmas Kersamenak
Jumlah Jasa
No. Nama Jumlah Jasa Pajak PPh Pasal Pelayanan Setelah NO. REKENING
Pelayanan 21
Pajak
1 Hj. Ai Suryati, SKM., MM. 2,304,203 345,630 1,958,572 0173210075976
2 Enyang Taufik Hidayat, ST. 1,571,611 78,581 1,493,031 0009741054100
3 dr. Dedi Rahmat 1,112,337 55,617 1,056,721 0063195820100
4 dr. Giand Elmadahlia Tusara 1,268,469 63,423 1,205,046 0094836778100
5 Ani Maryani, SST. 941,192 141,179 800,013 0173200121761
6 H. Hana Kartiwa, AMK., SKM. 745,687 37,284 708,402 0173110119614
7 Lia Rosalia, A.Md.Kep. 900,384 45,019 855,364 0173110288507
8 Poppy Gusdiantini, A.Md.Kep. 817,419 40,871 776,548 0173200121481
9 Risma Fatimah, A.Md.Keb. 671,738 33,587 638,151 0173200108187
10 Raswin, S.Si. 927,179 46,359 880,820 0084427675101
11 Hj. Purwani, A.Md.Kes. 1,138,251 56,913 1,081,338 0014605037101
12 Suryati 579,301 28,965 550,335 0173110270702
13 Hj. Aan Warlimah, SKM. 863,761 43,188 820,573 0004691709100
14 Puji Sri Fauzi, A.Md.Keb. 503,791 - 503,791 0078297824100
15 Yeni Rachman Khasim, SST. 711,746 - 711,746 0078305932100
16 Wawan Gunawan 461,529 - 461,529 0068158941100
17 Ani Fitriani, A.Md.Kep. 899,106 - 899,106 0077832580100
18 Isti Hasanah, A.Md.AK. 878,828 43,941 834,887 0068768055100
19 Elis Muslimah, AMK. 169,031 8,452 160,579 0086185911100
20 Rohayati 435,388 21,769 413,619 0086108038100
21 Nani Handayani 552,790 27,639 525,150 0086132028100
22 Solihah Wulandari Ningsih, SKM. 652,680 32,634 620,046 0086199483100
23 Amanda Amarwaty, A.Md.Keb. 589,932 29,497 560,435 0086109336100
24 Teli Yulianti, S.Si. 656,770 32,838 623,931 0086099470100
25 Herni Siti Muniroh, A.Md.Keb. 633,702 31,685 602,017 0077361499100
26 Devi Hesti Supriadi, A.Md.Keb. 464,863 23,243 441,620 0086089785100
27 Rizal Cahyadi, A.Md.Kep. 709,674 35,484 674,190 0086186802100
28 Imam Prasetya Hermansah, S.Kep., Ners. 954,429 47,721 906,707 0086187868100
29 I r a w a t i 298,313 14,916 283,397 0086182361100
30 Siti Nur Azijah, A.Md.Gz. 615,096 36,906 578,190 0093614429100
31 Seli Cahyani 471,349 28,281 443,068 0094212049100
32 Dewi Syahadah, A.Md.Kep. 567,486 28,374 539,112 0094226120100
33 Ami Jamiatul, A.Md.Keb. 645,311 32,266 613,046 0094793637100
34 Sindi Audila Arum 412,169 24,730 387,439 0097865264100
35 Azizah Putri Wibowo, A.Md.Kes. 572,928 28,646 544,282 0100517604100
36 Anwar Muhlis 315,732 15,787 299,945 0100315114100
JUMLAH 27,014,174 1,561,426 25,452,749