1 2 3 4 5 6=(3X5)
3 EKUITAS DANA 226,295,253.00
3.1 EKUITAS DANA LANCAR 226,295,253.00
3.1.1 Sisa Lebih Pembiayaan Anggaran (SILPA) 226,295,253.00
3.1.1.01 Sisa Lebih Pembiayaan Anggaran (SILPA) 226,295,253.00
3.1.1.01.01 Sisa Lebih Pembiayaan Anggaran (SILPA) 226,295,253.00
Sisa Lebih Pembiayaan Anggaran ( SILPA) 2022 226,295,253.00
4 PENDAPATAN 1,535,500,000.00
4.1 PENDAPATAN ASLI DAERAH 1,535,500,000.00
4.1.4 LAIN-LAIN PENDAPATAN ASLI DAERAH YANG SAH 1,535,500,000.00
4.1.4.16 PENDAPATAN BADAN LAYANAN UMUM 1,535,500,000.00
4.1.4.16.01 PENDAPATAN BADAN LAYANAN UMUM PUSKESMAS KEBOAN 1,535,500,000.00
Pendapatan Jasa Layanan BLUD 1,530,700,000.00
Jasa Layanan 1 th 198,000,000.00 198,000,000.00
Kapitasi BPJS 1 th 1,170,000,000.00 1,170,000,000.00
Non Kapitasi (Klaim) 1 th 156,000,000.00 156,000,000.00
Prolanis 1 th 6,700,000.00 6,700,000.00
Pendapatan Hibah
Pendapatan Hibah 1 th -
1 2 3 4 5 6=(3X5)
Salmonella OA 2 230,000.00 460,000.00
Salmonella OB 2 230,000.00 460,000.00
Salmonella OD 2 230,000.00 460,000.00
Salmonella HD 2 230,000.00 460,000.00
Golongan darah A 2 230,000.00 460,000.00
Golongan darah B 2 230,000.00 460,000.00
Cholesterol 3 1,700,000.00 5,100,000.00
Trigliserida 2 2,000,000.00 4,000,000.00
Gula Darah 3 1,000,000.00 3,000,000.00
Asam Urat 3 1,700,000.00 5,100,000.00
Diluent 4 3,500,000.00 14,000,000.00
Lythic 3 3,700,000.00 11,100,000.00
Enzymatic Cleaner 5 3,500,000.00 17,500,000.00
Hematology Cleaner 1 1,200,000.00 1,200,000.00
Darah Kontrol 2 1,500,000.00 3,000,000.00
1 2 3 4 5 6=(3X5)
5.1.02.01.01.0025 Belanja Alat/ Bahan untuk Kegiatan Kantor- Kertas dan Cover 5,600,000.00
5.1.02.01.01.0027 Belanja Alat/ Bahan untuk Kegiatan Kantor - Benda Pos 1,000,000.00
1 2 3 4 5 6=(3X5)
5.1.02.01.01.0029 Belanja Alat/Bahan untuk Kegiatan Kantor-Bahan Komputer 500,000.00
5.1.02.01.01.0056 Belanja Makanan dan Minuman pada Fasilitas Pelayanan Urusan 72,000,000.00
Kesehatan
RINCIAN PERHITUNGAN
1 2 3 4 5 6=(3X5)
Belanja Makan Minum Pasien Rawat Inap ( 50 org x 3 hr rwt x 2 kl mkn x 12 3600 org/kali 20,000.00 72,000,000.00
bln)
Remunerasi 865,500,000.00
Jasa Pelayanan Kesehatan 12 bulan 72,125,000.00 865,500,000.00
1 2 3 4 5 6=(3X5)
Belanja Telepon/Internet 10 bulan 1,700,000.00 17,000,000.00
1 2 3 4 5 6=(3X5)
5.2.02.05.02.0006 Belanja Modal Alat Rumah Tangga Lainnya (Home Use) 20,800,000.00
Lemari Dokumen 1 unit 4,000,000.00 4,000,000.00
TV LED 32" 3 unit 5,600,000.00 16,800,000.00
Sesuai Kebutuhan
Sesuai Kebutuhan
Sesuai Kebutuhan
Sesuai Kebutuhan
Sesuai Kebutuhan
Sesuai Kebutuhan
Sesuai Kebutuhan
Keterangan
Sesuai Kebutuhan
Sesuai Kebutuhan
Sesuai Kebutuhan
Keterangan
Sesuai Kebutuhan
Keterangan
Keterangan
sesuai kebutuhan
Keterangan
Sesuai Kebutuhan
Sesuai Kebutuhan
Sesuai Kebutuhan
Sesuai Kebutuhan
Sesuai Kebutuhan
Sesuai Kebutuhan
Sesuai Kebutuhan
Sesuai Kebutuhan
Sesuai Kebutuhan
Sesuai Kebutuhan
Sesuai Kebutuhan
Keterangan
Sesuai Kebutuhan
Sesuai Kebutuhan
PUSKESMAS KEBOAN NGUSIKAN
RINCIAN ANGGARAN PENDAPATAN DAN BELANJA
TAHUN ANGGARAN 2022
5.1.02.01.01.0013
Belanja Suku Cadang Alat Angkutan 3,000,000.00 3,000,000.00 3,000,000.00 3,000,000.00
5.1.02.01.01.0052
Belanja Makanan dan Minuman Rapat 31,012,500.00 31,012,500.00 31,012,500.00 31,012,500.00
5.1.02.01.01.0056 Belanja Makanan dan Minuman pada
Fasilitas Pelayanan Urusan Kesehatan 50,400,000.00 50,400,000.00 50,400,000.00 50,400,000.00
5.1.02.02.01.0026
Belanja Jasa Tenaga Administrasi 21,600,000.00 21,600,000.00 21,600,000.00 21,600,000.00
5.1.02.02.01.0029 Belanja Jasa Tenaga Ahli 8,000,000.00
5.1.02.02.01.0030 Belanja Jasa Tenaga Kebersihan 12,600,000.00 12,600,000.00 12,600,000.00 12,600,000.00
5.1.02.02.01.0033 Belanja Jasa Tenaga Supir 4,800,000.00 4,800,000.00 4,800,000.00 4,800,000.00
Belanja Jasa Pelaksanaan Transaksi
5.1.02.02.01.0042
Keuangan 100,000.00 100,000.00 100,000.00 100,000.00
5.1.02.02.01.0050 Belanja Jasa Kalibrasi 2,170,993.00 2,170,993.00 2,170,993.00 2,170,993.00
Belanja Kawat/Faksimili/Internet/TV
5.1.02.02.01.0063
Berlangganan
18,000,000.00 18,000,000.00 18,000,000.00 18,000,000.00
5.1.02.02.05
Belanja Sewa Gedung dan Bangunan 10,220,000.00 10,220,000.00 10,220,000.00 10,220,000.00
5.1.02.02.05.0043 Belanja Sewa Hotel 10,220,000.00 10,220,000.00 10,220,000.00 10,220,000.00
5.1.2.2.12.0001
Belanja Kursus Singkat/Pelatihan 14,004,000.00 14,004,000.00 14,004,000.00 25,504,000.00
-
5.1.02.03 Belanja Pemeliharaan 28,600,000.00 28,600,000.00 28,600,000.00 28,600,000.00
Belanja Pemeliharaan Peralatan dan
5.1.02.03.02
Mesin 28,600,000.00 28,600,000.00 28,600,000.00 28,600,000.00
226,295,253.00 -
226,295,253.00 -
226,295,253.00 -
226,295,253.00
-
-
2,304,205,000.00 2,304,205,000.00 -
2,304,205,000.00 2,304,205,000.00 -
2,304,205,000.00 2,304,205,000.00 -
2,304,205,000.00 2,304,205,000.00 -
2,304,205,000.00 2,304,205,000.00 -
2,299,500,000.00 2,299,500,000.00 -
- - -
- - -
4,705,000.00 4,705,000.00 -
-
2,530,500,253.00 2,530,500,253.00 -
2,530,500,253.00 2,530,500,253.00 -
23,400,000.00 23,400,000.00 -
23,400,000.00 23,400,000.00 -
18,600,000.00 18,600,000.00 -
16,200,000.00 16,200,000.00 -
2,400,000.00 2,400,000.00 -
- -
4,800,000.00 4,800,000.00 -
4,800,000.00 4,800,000.00 -
-
-
2,067,100,253.00 2,067,100,253.00 -
456,641,500.00 456,641,500.00 -
456,641,500.00 456,641,500.00 -
103,300,000.00 103,300,000.00 -
24,250,000.00 24,250,000.00 -
4,400,000.00 4,400,000.00 -
- - -
39,730,000.00 39,730,000.00 -
15,830,000.00 15,830,000.00 -
1,350,000.00 1,350,000.00 -
3,000,000.00 3,000,000.00 -
4,000,000.00 4,000,000.00 -
19,600,000.00 19,600,000.00 -
37,819,000.00 37,819,000.00 -
6,500,000.00 6,500,000.00 -
4,500,000.00 4,500,000.00 -
1,000,000.00 1,000,000.00 -
500,000.00 500,000.00 -
1,265,000.00 1,265,000.00 -
6,190,000.00 6,190,000.00 -
101,995,000.00 101,995,000.00 -
31,012,500.00 31,012,500.00 -
50,400,000.00 50,400,000.00 -
-
-
1,559,348,753.00 1,559,348,753.00 -
1,503,551,753.00 1,503,551,753.00 -11,500,000.00 Sesuai Kebutuhan
31,000,000.00 31,000,000.00 -
- - -
195,600,000.00 195,600,000.00 -
1,131,680,760.00 1,131,680,760.00 -13,500,000.00 Sesuai Kebutuhan
21,600,000.00 21,600,000.00 -
8,000,000.00 8,000,000.00 8,000,000 Sesuai Kebutuhan
12,600,000.00 12,600,000.00 -
4,800,000.00 4,800,000.00 -
100,000.00 100,000.00 -
2,170,993.00 2,170,993.00 -
12,000,000.00 12,000,000.00 -
1,000,000.00 1,000,000.00 -
60,000,000.00 60,000,000.00 -
18,000,000.00 18,000,000.00 -
4,000,000.00 4,000,000.00 -
1,000,000.00 1,000,000.00 -
-
-
2,073,000.00 2,073,000.00 -
2,073,000.00 2,073,000.00 -
-
10,220,000.00 10,220,000.00 -
10,220,000.00 10,220,000.00 -
-
18,000,000.00 18,000,000.00 -
18,000,000.00 18,000,000.00 -
-
28,600,000.00 28,600,000.00 -
2,000,000.00 2,000,000.00 -
4,800,000.00 4,800,000.00 -
1,500,000.00 1,500,000.00 -
15,000,000.00 15,000,000.00 -
2,800,000.00 2,800,000.00 -
1,000,000.00 1,000,000.00 -
1,000,000.00 1,000,000.00 -
500,000.00 500,000.00 -
-
22,510,000.00 22,510,000.00 -
22,510,000.00 22,510,000.00 -
7,510,000.00 7,510,000.00 -
15,000,000.00 15,000,000.00 -
-
-
440,000,000.00 440,000,000.00 -
440,000,000.00
440,000,000.00 -
172,000,000.00
172,000,000.00 -
172,000,000.00 172,000,000.00 -
31,500,000.00 31,500,000.00 -
31,500,000.00 31,500,000.00 -
-
43,500,000.00 43,500,000.00 -
18,000,000.00 18,000,000.00 -
25,500,000.00 25,500,000.00 -
-
97,000,000.00 97,000,000.00
-
15,000,000.00 15,000,000.00 -
24,000,000.00 24,000,000.00 -
4,000,000.00 4,000,000.00 -
54,000,000.00 54,000,000.00 -
-
16,000,000.00 16,000,000.00
-
16,000,000.00 16,000,000.00 -
8,000,000.00 8,000,000.00 -
8,000,000.00 8,000,000.00 -
-
97,000,000.00 97,000,000.00
-
97,000,000.00 97,000,000.00 -
49,000,000.00
49,000,000.00 -
49,000,000.00 49,000,000.00 -
-
48,000,000.00 48,000,000.00
-
48,000,000.00 48,000,000.00 -
-
-
7,000,000.00 7,000,000.00
-
7,000,000.00 7,000,000.00 -
7,000,000.00 7,000,000.00 -
7,000,000.00 7,000,000.00 -
- -
23,000,000.00
23,000,000.00 -
23,000,000.00
23,000,000.00 -
23,000,000.00
23,000,000.00 -
23,000,000.00 23,000,000.00 -
- -
120,000,000.00 120,000,000.00 -
120,000,000.00 120,000,000.00 -
120,000,000.00 120,000,000.00 -
51,000,000.00 51,000,000.00 -
69,000,000.00 69,000,000.00 -
- -
5,000,000.00
5,000,000.00 -
5,000,000.00 5,000,000.00 -
5,000,000.00 5,000,000.00 -
5,000,000.00 5,000,000.00 -
2,530,500,253.00 2,530,500,253.00 -
Jombang,
a/n Kepala Dinas Kesehatan
Kepala Puskesmas Keboan Ngusikan
BELANJA BELANJA
TIDAK BELANJA LANGSUNG TIDAK
LANGSUNG ANGGARAN LANGSUNG
NO ALOKASI BIAYA ANGGARAN AWAL
PERGESERAN
Belanja Belanja Barang Belanja
Belanja Pegawai Belanja Modal Jumlah
Pegawai dan Jasa Pegawai
1 2 3 4 5 6 7 8 = 4+5+6+7 3 4
A BIAYA OPERASIONAL
I BIAYA LAYANAN
1 Biaya Pegawai 264,000,000 23,400,000 240,600,000 264,000,000 258,000,000.00
Belanja Honorarium
Penanggungjawaban Pengelola
Keuangan 16,200,000 16,200,000 16,200,000 16,200,000.00
Belanja Honorarium Pengadaan
Barang / Jasa 2,400,000 2,400,000 2,400,000 2,400,000.00
Belanja Jasa Pengelolaan BMD
yang Tidak Menghasilkan
Pendapatan 4,800,000 4,800,000 4,800,000 4,800,000.00
Belanja Jasa Tenaga Kesehatan 195,600,000 195,600,000 195,600,000 195,600,000.00
-
5 Biaya Promosi 1,000,000.00 - - 1,000,000.00 - 1,000,000.00 1,000,000.00
Belanja Bahan Spanduk - - - -
Belanja Jasa Publikasi / Iklan 1,000,000.00 1,000,000.00 1,000,000.00 1,000,000.00
-
6 Biaya Umum & Adm lainnya
86,305,500.00 - - 86,305,500.00 - 86,305,500.00 94,305,500.00
Belanja Sewa Sarana Mobil Darat 2,073,000.00 2,073,000.00 2,073,000.00 2,073,000.00
Belanja Honor Narasumber atau
Pembahas, Moderator, Pembawa 31,000,000.00 31,000,000.00 31,000,000.00 31,000,000.00
Acara, dan Panitia
Belanja Jasa Tenaga Ahli 8,000,000.00
Belanja Makanan dan Minuman
Sosialisasi, Penyuluhan, Bimtek &
Pelatihan 31,012,500.00 31,012,500.00 31,012,500.00 31,012,500.00
Belanja Sewa Hotel 10,220,000.00 10,220,000.00 10,220,000.00 10,220,000.00
Belanja Transportasi dan
Akomodasi Non PNS - - - -
Jasa Pemusnahan Sampah Medis 12,000,000.00 12,000,000.00 12,000,000.00 12,000,000.00
-
Jumlah Biaya Umum &
Administrasi 349,393,500.00 - - 349,393,500.00 - 349,393,500.00 368,893,500.00 -
-
III BIAYA LAIN-LAIN - - - - - -
1
Belanja Jasa Transaksi Keuangan 100,000.00 100,000.00 100,000.00 100,000.00
-
Jumlah Biaya lain-Lain 100,000.00 - - 100,000.00 - 100,000.00 100,000.00 -
-
Jumlah Biaya Operasional 2,090,500,253.00 - 23,400,000.00 2,067,100,253.00 - 2,090,500,253.00 2,090,500,253.00 -
-
B INVESTASI -
1 Tanah -
2 Gedung dan Bangunan -
3 Peralatan dan Mesin 440,000,000.00 - 440,000,000.00 440,000,000.00 440,000,000.00
4 Jalan, Irigasi, dan Jaringan -
5 Aset Tetap Lainnya -
Jumlah Biaya Investasi 440,000,000.00 - - - 440,000,000.00 440,000,000.00 440,000,000.00 -
-
16,200,000.00 16,200,000.00 -
2,400,000.00 2,400,000.00 -
4,800,000.00 4,800,000.00 -
195,600,000.00 195,600,000.00 -
21,600,000.00 21,600,000.00 -
12,600,000.00 12,600,000.00 -
4,800,000.00 4,800,000.00 -
245,025,000.00 245,025,000.00 -
101,995,000.00 101,995,000.00 -
103,300,000.00 103,300,000.00 -
39,730,000.00 39,730,000.00 -
34,230,000.00 34,230,000.00 -
6,800,000.00 6,800,000.00 -
7,000,000.00 7,000,000.00 -
3,600,000.00 3,600,000.00 -
1,000,000.00 1,000,000.00 -
15,830,000.00 15,830,000.00 -
- - -
2,170,993.00 2,170,993.00 -
2,170,993.00 2,170,993.00 -
50,400,000.00 50,400,000.00 -
50,400,000.00 50,400,000.00 -
7,510,000.00 7,510,000.00 -
15,000,000.00 15,000,000.00 -
- 49,819,000.00 - 49,819,000.00 -
37,819,000.00 37,819,000.00 -
1,000,000.00 1,000,000.00 -
4,500,000.00 4,500,000.00 -
6,500,000.00 6,500,000.00 -
45,400,000.00 45,400,000.00 -
4,000,000.00 4,000,000.00 -
6,800,000.00 6,800,000.00 -
19,600,000.00 19,600,000.00 -
15,000,000.00 15,000,000.00 -
1,265,000.00 1,265,000.00 -
20,650,000.00 20,650,000.00 -
- - -
4,400,000.00 4,400,000.00 -
500,000.00 500,000.00 -
1,350,000.00 1,350,000.00 -
- - -
- - -
60,000,000.00 60,000,000.00 -
- - -
18,000,000.00 18,000,000.00 -
6,190,000.00 6,190,000.00 -
1,000,000.00 1,000,000.00 -
- - -
1,000,000.00 1,000,000.00 -
31,000,000.00 31,000,000.00 -
31,012,500.00 31,012,500.00 -
10,220,000.00 10,220,000.00 -
- - -
12,000,000.00 12,000,000.00 -
100,000.00 100,000.00 -
- 100,000.00 - 100,000.00 -
- -
- -
440,000,000.00 440,000,000.00 -
- -
- -
- - 440,000,000.00 440,000,000.00 -
Jombang,
a/n Kepala Dinas Kesehatan
Kepala Puskesmas Keboan Ngusikan
SUMBER DANA
ANGGARAN
NO ALOKASI BIAYA ANGGARAN AWAL
FUNGSIONAL APBD APBN Jumlah PERGESERAN
1 2 3 4 5 6 7= 4+5+6 3
A BIAYA OPERASIONAL
I BIAYA LAYANAN
1 Biaya Pegawai 264,000,000.00 264,000,000.00 - - 264,000,000.00 258,000,000.00
Belanja Honorarium
Penanggungjawaban Pengelola
Keuangan 16,200,000.00 16,200,000.00 16,200,000.00 16,200,000.00
Belanja Honorarium Pengadaan
Barang / Jasa 2,400,000.00 2,400,000.00 2,400,000.00 2,400,000.00
Belanja Jasa Pengelolaan BMD
yang Tidak Menghasilkan
Pendapatan 4,800,000.00 4,800,000.00 4,800,000.00 4,800,000.00
Belanja Jasa Tenaga Kesehatan 195,600,000.00 195,600,000.00 195,600,000.00 195,600,000.00
6
Biaya pelayanan Lain-lain 50,400,000.00 50,400,000.00 - - 50,400,000.00 50,400,000.00
Belanja Makanan dan Minuman
pada Fasilitas Pelayanan Urusan
Kesehatan 50,400,000.00 50,400,000.00 50,400,000.00 50,400,000.00
2 Biaya Administrasi
Perkantoran 49,819,000.00 49,819,000.00 - 49,819,000.00 49,819,000.00
Belanja Alat Tulis Kantor 37,819,000.00 37,819,000.00 37,819,000.00 37,819,000.00
Belanja Perangko, Materai dan
Benda Pos 1,000,000.00 1,000,000.00 1,000,000.00 1,000,000.00
Belanja Cetak 4,500,000.00 4,500,000.00 4,500,000.00 4,500,000.00
Belanja Penggandaan 6,500,000.00 6,500,000.00 6,500,000.00 6,500,000.00
B INVESTASI
1 Tanah
2 Gedung dan Bangunan
3 Peralatan dan Mesin 440,000,000.00 440,000,000.00 440,000,000.00 440,000,000.00
4
Jalan, Irigasi, dan Jaringan
5 Aset Tetap Lainnya
Jumlah Biaya Investasi 440,000,000.00 440,000,000.00 440,000,000.00 440,000,000.00
SUMBER DANA
Berkurang /
FUNGSIONAL APBD APBN Jumlah Bertambah
Keterangan
4 5 6 7= 4+5+6
16,200,000.00 16,200,000.00 -
2,400,000.00 2,400,000.00 -
4,800,000.00 4,800,000.00 -
195,600,000.00 195,600,000.00 -
21,600,000.00 21,600,000.00 -
12,600,000.00 12,600,000.00 -
4,800,000.00 4,800,000.00 -
245,025,000.00 245,025,000.00 -
101,995,000.00 101,995,000.00 -
103,300,000.00 103,300,000.00 -
39,730,000.00 39,730,000.00 -
34,230,000.00 34,230,000.00 -
6,800,000.00 6,800,000.00 -
7,000,000.00 7,000,000.00 -
3,600,000.00 3,600,000.00 -
1,000,000.00 1,000,000.00 -
15,830,000.00 15,830,000.00 -
- - -
2,170,993.00 2,170,993.00 -
2,170,993.00 2,170,993.00 -
50,400,000.00 - - 50,400,000.00 -
50,400,000.00 50,400,000.00 -
7,510,000.00 7,510,000.00 -
15,000,000.00 15,000,000.00 -
49,819,000.00 - 49,819,000.00 -
37,819,000.00 37,819,000.00 -
1,000,000.00 1,000,000.00 -
4,500,000.00 4,500,000.00 -
6,500,000.00 6,500,000.00 -
45,400,000.00 - 45,400,000.00 -
4,000,000.00 4,000,000.00 -
6,800,000.00 6,800,000.00 -
19,600,000.00 19,600,000.00 -
15,000,000.00 15,000,000.00 -
130,355,000.00 - - 130,355,000.00 -
1,265,000.00 1,265,000.00 -
20,650,000.00 20,650,000.00 -
- - -
4,400,000.00 4,400,000.00 -
500,000.00 500,000.00 -
1,350,000.00 1,350,000.00 -
- - -
- - -
60,000,000.00 60,000,000.00 -
- - -
18,000,000.00 18,000,000.00 -
6,190,000.00 6,190,000.00 -
18,000,000.00 18,000,000.00 -
-
1,000,000.00 - 1,000,000.00 -
- - -
1,000,000.00 1,000,000.00 -
2,073,000.00 2,073,000.00 -
31,000,000.00 31,000,000.00 -
8,000,000.00
31,012,500.00 31,012,500.00 -
10,220,000.00 10,220,000.00 -
- - -
12,000,000.00 12,000,000.00 -
100,000.00 - 100,000.00 -
100,000.00 100,000.00 -
-
100,000.00 - 100,000.00 -
2,090,500,253.00 - 2,082,500,253.00
-
440,000,000.00 440,000,000.00 -
440,000,000.00 440,000,000.00 -
2,530,500,253.00 - - 2,522,500,253.00 -
Jombang,
a/n Kepala Dinas Kesehatan
Kepala Puskesmas Keboan Ngusikan