PEMBAYARAN JASA LAYANAN NON PELAYANAN RSUD SUMBAWA

     I.        Pendapatan Praktik Klinik Keperawatan dari November 2019 s/d Januari 2020 Sebesar = Rp 2.940.000
–      Jasa Sarana 60 % = Rp 1.764.000
–      Jasa Pelayanan 40% = Rp 1.176.000
Besarnya Pembagian Jasa Layanan Praktik Klinik 40% : Rp 1.176.000
1.      Pembimbing Klinik (CI) : 30 % = Rp 352.800
2.      Kepala Ruangan tempat praktik : 30 % = Rp 352.800
3.      Tim Diklat : 40 % = Rp 470.400
1.      Pembimbing Klinik (CI) : 30 % = Rp 352.800

No Nama Pembimbing Nip/Golongan Ruangan Honor Pajak Potongan Jumlah Terima Paraf

1 2 3 4 5 6 7 8 9
1 ERLIA ROSITHA, A.Md.Keb 19780730 201501 2 014/IIId Ruang Nifas 153,600.00 5% 7680.000 145920.000

2 NUNIEK ASTRI BUANAWATI, A.Md.Keb 19830627 200701 2 003/IIId Poli Kandungan 153,600.00 5% 7680.000 145920.000

3 ZAKIAH, S.Kep. Ners 19830814 201001 2 019/IIId Ruang NICU 153,600.00 5% 7680.000 145920.000

4 NUR RAHMI, A.Md.Keb 19740728 200501 2 012/IIId Ruang Bersalin 153,600.00 5% 7680.000 145920.000

Total 614400.000 30720.000 583680.000

2.      Kepala Ruangan : 30 % = Rp 352.800

No Nama Kepala Ruang Nip/Golongan Ruangan Honor Pajak Potongan Jumlah Terima Paraf
1 2 3 4 5 6 7 8 9
1 Hj. UMMI LATIFAH, S.ST.,M.Kes 19651012 198603 2 015/IVa Ruang Nifas 88.200 15% 13.230 74.970

2 LINDA INDRIYANTI, S.Kep.Ns 19810126 200701 2 007/IIIb Ruang NICU 88.200 5% 4.410 83.790

3 ENDRIANI 19670711 198803 2 011/IIId Poliklinik 88.200 5% 4.410 83.790

4 H. RITA M, A.Md.Keb 19661231 198703 2 135/IIId Ruang Bersalin 88.200 5% 4.410 83.790
Total 352.800 26.460 326.340

3.      Tim Diklat : 40 % = Rp 470.400

No NAMA Nip/Golongan Jabatan Honor Pajak Potongan Jumlah Terima Paraf
1 2 3 4 5 6 7 8 9

1 dr. DEDE HASAN BASRI 19720601 200909 1 001/IVa Pembina 84.672 15% 12.701 71.971

2 ABDUL MALIK, A.Md 19670706 199603 1 004/IVa Ketua 70.560 5% 3.528 67.032

3 ABDURRAKHMAN, S.Kep.Ns 19800505 200501 1 016/IIIc Sekretaris 61.152 5% 3.058 58.094

4 IIN SUSILAWATI, SE 19780927 201001 2 004/IIIa Bendahara 32.928 5% 1.646 31.282

Koordinator Praktik
5 JONI SARJAN, S.ST 19760730 199803 1 002/IIId 221.088 5% 54.000 167.088
Keperawatan/ Kebidanan
Total 470.400 74.933 395.467

Direktur RSUD Sumbawa

dr. DEDE HASAN BASRI

NIP. 19720601 200909 1 001
 PEMBAYARAN JASA LAYANAN NON PELAYANAN RSUD SUMBAWA
     I.        Pendapatan Praktik Klinik Keperawatan dari April 2021 Sebesar = Rp 3.840.000
–      Jasa Sarana 60 % = Rp 2.340.000
–      Jasa Pelayanan 40% = Rp1.536.000
Besarnya Pembagian Jasa Layanan Praktik Klinik 40% : Rp 1.536.000
1. Pembimbing Klinik (CI) 30% = Rp460.800
2. Kepala Ruangan tempat praktik 30 % = Rp 460.800
3. Tim Diklat 40 % = Rp 614.400
1.      Pembimbing Klinik (CI) : 30 % = Rp460.800
No Nama Pembimbing Nip/Golongan Ruangan Honor Pajak Potongan Jumlah Terima Paraf
1 2 3 4 5 6 7 8 9
1 YUDI PERMANSYA, S.Kep.Ns 19850825 201101 1 008/IIId IGD 153,600.00 5% 7,680.00 145,920.00
2 SRI WAHYUNI, A.Md.Kep 19750130 199703 2 003/IIId Zaal Jiwa 153,600.00 5% 7,680.00 145,920.00
YOHANES ENGELBERTUS,
3 Non PNS Poliklinik 153,600.00 5% 7,680.00 145,920.00
A.Md.Kep
Total 460,800.00 23,040.00 437,760.00

2.      Kepala Ruangan : 30 % = Rp 460.800

No Nama Kepala Ruang Nip/Golongan Ruangan Honor Pajak Potongan Jumlah Terima Paraf
1 2 3 4 5 6 7 8 9
1 YUDI PERMANSYA, S.Kep.Ns 19850825 201101 1 008/IIId IGD 153,600.00 5% 7,680.00 145920.000
2 SRI WAHYUNI, A.Md.Kep 19750130 199703 2 003/IIId Zaal Jiwa 153,600.00 5% 7,680.00 145920.000
3 ENDRIANI 19670711 198803 2 011/IIId Poliklinik 153,600.00 5% 7,680.00 145920.000
Total 460,800.00 23,040.00 437,760.00

3.      Tim Diklat : 40 % = Rp 614.400

No NAMA Nip/Golongan Jabatan Honor Pajak Potongan Jumlah Terima Paraf
1 2 3 4 5 6 7 8 9
1 dr. DEDE HASAN BASRI 19720601 200909 1 001/Ivb Pembina 110,592.00 15% 16,588.80 94,003.20
2 ABDUL MALIK, A.Md 19670706 199603 1 004/IIIc Ketua 92,160.00 5% 4,608.00 87,552.00
3 ABDUL MUNIR, S.ST 19730424 199403 1 005/Iva Sekretaris 79,872.00 15% 11,980.80 67,891.20
4 IIN SUSILAWATI, SE 19780927 201001 2 004/IIIa Bendahara 43,008.00 5% 2,150.40 40,857.60
Koordinator Praktik
5 JONI SARJAN, S.ST 19760730 199803 1 002/IIId Keperawatan/ 288,768.00 5% 14,438.40 274,329.60
Kebidanan
Total 614,400.00 49,766.40 564,633.60

Direktur RSUD Sumbawa

dr. DEDE HASAN BASRI

NIP. 19720601 200909 1 001
1,536,000
460800 153600
614400 110,592.00 4,080,000.00
92,160.00 2,340,000.00
79,872.00
43,008.00
288,768.00

4,080,000.00
2,448,000.00
1,632,000.00
489,600.00
652,800.00
489,600.00
1,632,000.00

3,000,000.00
1,800,000.00
1,200,000.00
360,000.00 72,000.00
480,000.00
360,000.00
18,000.00

86,400.00 12,960.00
72,000.00 3,600.00
62,400.00 9,360.00
33,600.00 1,680.00
225,600.00 11,280.00
38,880.00

480,000.00
 568,512 15%
473,760 5%
410,592 15%
221,088 5%
1,484,448 5%
LAB
GIZI

99,878 117,504
93,024 97,920
72,134 84,864
43,411 45,696
291,475 306,816
599922 652800
24,480.00 465,120.00
73,440.00 416,160.00
652796
117,504.00 17,626 99,878 17,625
97,920.00 4,896 93,024 4,896
84,864.00 12,730 72,134 12,729
45,696.00 2,285 43,411 2,284.00
306,816.00 15,341 291,475 15,340
52,877 599,923 52874
652,800.00

3,600.00 68,400.00
18,000.00 342,000.00
360,000.00
342,000.00

73,440.00
68,400.00
53,040.00
31,920.00
214,320.00
441,120.00

186,120 2,182,680 16,589

4,608
2368800 11,981
2,150
 14,438
85,277 483,235 49766
23,688 450,072 614400
61,589 349,003 219,960 2,148,840
11,054 210,034
74,222 1,410,226 2368800
255830 2902570
1484448 3158400
94,003
87,552
67,891
40,858
274,330
564634