Pembukuan April 2021

PEMERINTAH KABUPATEN SUMBA TIMUR
RUMAH SAKIT UMUM DAERAH UMBU RARA MEHA WAINGAPU

Jln. Adam Malik No. 54 - Telp.(0387) 61302 Fax. 62551
BUKU KAS UMUM

Periode 01 April s/d 30 April 2021
NO TANGGAL NO. BUKTI KODE REK URAIAN DEBET KREDIT
01 01-04-2021 Terima dari Rawat Jalan 2,901,125

Setor ke bank 2,901,125
03 03-04-2021 Terima dari Rawat Jalan 827,903
Setor ke bank 827,903
Terima biaya Klaim bpjs Februari 2021 1,061,219,200 1,061,219,200
Terima dari Rawat Inap 4,157,498
Terima biaya Klaim yankes Covid'19 3,290,969,500 3,290,969,500
Terima biaya sewa dapur maret 2021 3,500,000
Terima biaya Klaim Jasa raharja 4 org korban 43,370,863 43,370,863
Terima biaya Klaim Bpjs susuln Nov 2020 384,104,400 384,104,400
Terima biaya UTDRS dari Lindimara 38,695,625 38,695,625
Terima biaya Klaim Jasa raharja 1 org korban 6,294,651 6,294,651
Jasa Bank Bulan April 2021 5,333 5,333
Jasa Bank Bulan April 2021 34,875.03 34,875.03
Terima biaya Visum 135,000
Jasa Bank Bulan April 2021 12,224,837.19 12,224,837.19
Jumlah bulan ini, April 2021 5,002,873,020.22 5,002,873,020.22

Jumlah s/d bulan lalu 10,131,511,718.90 10,131,511,718.90
Jumlah s/d bulan ini, April 2021 15,134,384,739.12 15,134,384,739.12
Saldo - -
Mengetahui : Waingapu, 30 April 2021

Direktur RSUD Umbu Rara Meha, Bendahara Penerimaan,
Dr. Lely Harakai, M.Kes Ester Praing, SE

NIP. 19710901 200112 2 003 NIK . 1218 3 020
Mengetahui :
Direktur RSUD Umbu Rara Meha,
Mengetahui :
Dr. Lely Harakai, M.Kes PLT. Direktur RSUD Umbu Rara Meha,
NIP. 19710901 200112 2 003 Kepala Bagian Tata Usaha
Sonya Rambu Hana Ndima, ST

NIP. 19750916 200112 2 003
SALDO
-
2,901,125
- 2,901,125 - -
1,470,506
- 1,470,506 - -
827,903
- 827,903 - -
270,072
- 270,072 - -
538,700
- 538,700 - -
2,332,018
- 2,332,018 - -
1,484,757
- 1,484,757 - -
1,891,136
- 1,891,136 - -
3,154,075
- 3,154,075 -
8,030,521
- 8,030,521 -
825,590
- 825,590 -
3,970,160
- 3,970,160 -
- 1,061,219,200 -
6,896,585
11,054,083
- 11,054,083 -
4,349,091
6,011,590
- 6,011,590 -
3,363,270
- 3,363,270 -
3,599,467
- 3,599,467 -
- 3,290,969,500 -
7,989,691
11,489,691
- 11,489,691 -
1,901,635
- 1,901,635 -
4,124,120
- 4,124,120 -
4,521,382
- 4,521,382 -
- 43,370,863 -
4,096,218
- 4,096,218 -
- 384,104,400 -
1,395,708
- 1,395,708 -
- 38,695,625 -
1,668,520
- 1,668,520 -
- 6,294,651 -
3,685,100
- 3,685,100 -
401,564
- 401,564 -
- 5,333
5,145,070
- 5,145,070 -
7,477,516
22,303,845
- 22,303,845 -
- 34,875.03
3,257,196
- 3,257,196 -
1,373,470
6,179,865
- 6,179,865 -
2,285,779
43,923,849
44,058,849
- 44,058,849 -
- 12,224,837.19
-
- 5,002,832,812.19 - 34,875.03 5,333.00 5,002,873,020.22 -
- 10,131,511,718.90 bl lalu Home Core B'NTT Home Core B'BRI
-
-
0 April 2021
Penerimaan, bntt
bbri
rek .koran
5,002,832,812.19 TOTAL
aing, SE
18 3 020
jan 2,131,172,300.00
feb 1,854,346,974.60
maret 6,145,992,444.30
april 5,002,873,020.22
15,134,384,739.12 -
135,000,000 1,350,000
3,915,000
66,553,197
32,440,000
5,000,000
2,800,000
12,500,000
1,600,000
256,000
800,000
3,150,000
4,635,803
-
389,530 455,000 lab
257,500 karcis 1,102,030

bri
B'ntt
blud
- ###
34,875.03
5,333.00
5,002,832,812.19
5,002,873,020.22
-
500,000 6,000,000
750,000 9,000,000
3,500,000 42,000,000
400,000
400,000 2,216,000
400,000 (2,216,000)
1,200,000
PENERIMAAN PENDAPATAN RSUD UMBU RARA MEHA WAINGAPU
BULAN : APRIL 2021
JENIS JASA
NO TGL SETORAN JUMLAH SETORAN TGL PENERIMAAN
J. Layanan J. Lain - Lain
1 1 April 2021 2,901,125 2,901,125 1 April 2021

2 2 April 2021 1,470,506 1,470,506 2 April 2021
3 3 April 2021 827,903 827,903 3 April 2021
4 4 April 2021 270,072 270,072 4 April 2021
5 5 April 2021 538,700 538,700 5 April 2021
6 6 April 2021 2,332,018 2,332,018 6 April 2021
7 7 April 2021 1,484,757 1,484,757 7 April 2021
8 8 April 2021 1,891,136 1,891,136 8 April 2021
9 9 April 2021 3,154,075 3,154,075 9 April 2021
10 10 April 2021 8,030,521 8,030,521 10 April 2021
11 11 April 2021 825,590 825,590 11 April 2021
12 12 April 2021 3,970,160 3,970,160 12 April 2021
13 13 April 2021 11,054,083 11,054,083 13 April 2021
14 14 April 2021 6,011,590 6,011,590 14 April 2021
15 15 April 2021 3,363,270 3,363,270 15 April 2021
16 16 April 2021 3,599,467 3,599,467 16 April 2021
17 17 April 2021 7,989,691 3,500,000 11,489,691 17 April 2021
18 18 April 2021 1,901,635 1,901,635 18 April 2021
19 19 April 2021 4,124,120 4,124,120 19 April 2021
20 20 April 2021 4,521,382 4,521,382 20 April 2021
21 21 April 2021 4,096,218 4,096,218 21 April 2021
22 22 April 2021 1,395,708 1,395,708 22 April 2021
23 23 April 2021 1,668,520 1,668,520 23 April 2021
24 24 April 2021 3,685,100 3,685,100 24 April 2021
25 25 April 2021 401,564 401,564 25 April 2021
26 26 April 2021 5,145,070 5,145,070 26 April 2021
27 27 April 2021 22,303,845 22,303,845 27 April 2021
28 28 April 2021 3,257,196 3,257,196 28 April 2021
29 29 April 2021 6,179,865 6,179,865 29 April 2021
30 30 April 2021 43,923,849 135,000 44,058,849 30 April 2021
162,318,736 3,635,000 165,953,736
Terima biaya Klaim Bpjs 1,061,219,200 1,061,219,200
Februari 2021
Terima biaya Klaim covid'19 3,290,969,500 3,290,969,500
Terima biaya Santunan Jasa

Raharja dari 4 korban 43,370,863 43,370,863
Terima biaya Klaim Bpjs

susulan November 2020 384,104,400 384,104,400
Terima biaya dari RSKL (UTDRS) 38,695,625 38,695,625
Terima biaya Santunan Jasa

6,294,651 6,294,651
Raharja dari 1 korban
Jumlah ( 2 ) 4,824,654,239 - 4,824,654,239
Jasa Giro 5,333.00 5,333.00

Jasa Giro 34,875.03 34,875.03
Jasa Giro 12,224,837.19 12,224,837.19
Jumlah ( 3 ) 12,265,045.22 - 12,265,045.22

Jumlah (1+2+3 ) 4,999,238,020.22 3,635,000.00 5,002,873,020.22 -
Waingapu, 30 April 2021
Bendahara Penerimaan
RSUD Umbu Rara Meha
Ester Praing, SE
NIK . 1218 3 020
-
4,999,238,020.22 3,635,000 5,002,873,020 -

5,002,873,020.22 -
-
REGISTER STS
RSUD UMBU RARA MEHA WAINGAPU
BULAN : APRIL 2021
No No. STS Tanggal Kode Rekening Uraian Jumlah Penyetor Keterangan

1 2 3 4 5 6 7 8
1 1 April 2021 Pendapatan Jasa Layanan Umum BLUD 2,901,125
3 3 April 2021 Pendapatan Jasa Layanan Umum BLUD 827,903
Jumlah 165,953,736

Direktur RSUD Umbu Rara Meha, Bendahara Penerimaan
Dr. Lely Harakai, M.Kes Ester Praing,SE
NIP. 19710901 200112 2 003 NIK : 1218 3 020
-
-
LAPORAN PERTANGGUNGJAWABAN BENDAHARA PENERIMAAN
( SPJ PENDAPATAN - FUNGSIONAL )
Urusan Pemerintahan : 1.02 Urusan Wajib Pelayanan Dasar Kesehatan

Unit Organisasi : 1.02.02 RUMAH SAKIT UMUM DAERAH UMBU RARA MEHA
Sub Unit Organisasi : 1.02.02.02 RUMAH SAKIT UMUM DAERAH UMBU RARA MEHA Sebagai BLUD
Pengguna Anggaran : dr. Lely Harakai,M.Kes

Bendahara Penerimaan : Ester Praing,SE
Bulan : APRIL
S/D BULAN LALU BULAN INI S/D BULAN INI SISA ANGGARAN YANG
JUMLAH PENERIMAAN BELUM TEREALISASI

KODE REKENING URAIAN
ANGGARAN PENYETORAN PELAMPAUAN
SISA ANGGARAN
4 PENDAPATAN 45,000,000,000 10,131,511,718.90 5,002,873,020.22 15,134,384,739.12 (29,865,615,260.88)

4.1 PENDAPATAN ASLI DAERAH 45,000,000,000 10,131,511,718.90 5,002,873,020.22 15,134,384,739.12 (29,865,615,260.88)
4.1.4 Lain-lain Pendapatan Asli Daerah yang Sah 45,000,000,000 10,131,511,718.90 5,002,873,020.22 15,134,384,739.12 (29,865,615,260.88)
Pendapatan Jasa Layanan 10,114,876,718.90 4,999,238,020.22 15,114,114,739.12
Rawat Jalan 248,318,808 93,818,845 342,137,653
Kartu Kunjungan - 40,000 40,000
Karcis dr. Ahli 22,357,000 6,150,000 28,507,000
Karcis dr. Umum 3,110,000 3,080,000 6,190,000
Karcis Poli 5,800,000 2,030,000 7,830,000
Karcis IGD 3,150,000 1,125,000 4,275,000
SKS 1,991,000 1,032,000 3,023,000
Kunjungan dr. IGD 3,300,000 1,470,000 4,770,000
Polik Mata 8,181,000 4,311,000 12,492,000
Polik Penyakit Dalam/EKG 372,000 372,000 744,000
Polik Umum/EKG 118,000 - 118,000
Polik Kebidanan(usg) 11,645,000 3,378,000 15,023,000
Polik Bedah 745,000 348,000 1,093,000
Polik Gigi 186,000 - 186,000

Polik Anak - - -
Polik THT,syaraf - - -
Laboratorium 83,610,500 22,490,000 106,100,500
Fisioterapi 617,000 280,000 897,000
Farmasi 84,618,308 33,844,845 118,463,153
IGD/EKG 7,656,000 2,275,000 9,931,000
USG 1,924,000 1,185,000 3,109,000
Radiologi 8,938,000 10,408,000 19,346,000
Home Care - - -
Rawat Nginap 161,400,746 68,499,891 229,900,637
ANGGREK 6,528,928 - 6,528,928
BOUGENVILE 39,390,177 46,444,465 85,834,642
DAHLIA 17,779,702 - 17,779,702
KEMUNING 85,721,602 18,812,676 104,534,278
VIP/UTM - - -
ICU 9,890,745 - 9,890,745
PERINA/NICU 2,089,592 3,242,750 5,332,342
PICU - - -
IGD - - -
Pembayaran Klaim 9,677,792,597 4,824,654,239 14,502,446,836
Jasa Giro 27,364,567.90 12,265,045.22 39,629,613.12
Pendapatan Lain yang Sah 16,635,000 3,635,000 20,270,000
Parkiran - - -
Ambulance - - -
Penelitian /data awal,ijin praktek - - -
Visum 135,000 135,000 270,000
Sewa Gedung(dapur,kantin,atm) 10,500,000 3,500,000 14,000,000
Autopsi - - -
Pemeriksaan Bandara,Pertamina - - -
Pemeriksaan kesehatan BRI - - -
Pemeriksaan kesehatan Specimen Swab 6,000,000 - 6,000,000

NIP. 19710901 200112 2 003 NIK. 1218 3 020
-
Mengetahui :
PLT. Direktur RSUD Umbu Rara Meha,
Kepala Bagian Tata Usaha

NIP. 19750916 200112 2 003
-
Dr. Lely Harakai, M.Kes
NIP. 19710901 200112 2 003
-
-
-
-
1,712,034
3,632,416
1,920,382
(1,782,416)
(70,382)
-
-
-
-
-
-
-
-
-
-
-
Rumah Sakit Umum Daerah Umbu Rara Meha
Realisasi Pendapatan Bulan APRIL 2021
NO ANGGARAN DALAM DPA REALISASI S/D BULAN LALU REALISASI BULAN INI REALISASI S/D BULAN INI LEBIH (KURANG)
4.1.4 Lain - Lain Pendapatan Asli Daerah Yang Sah 45,000,000,000 10,131,511,718.90 5,002,873,020.22 15,134,384,739.12 (29,865,615,260.88)
4.1.4.16 Pendapatan BLUD 45,000,000,000 10,131,511,718.90 5,002,873,020.22 15,134,384,739.12 (29,865,615,260.88)
4.1.4.16.01 Pendapatan BLUD 45,000,000,000 10,131,511,718.90 5,002,873,020.22 15,134,384,739.12 (29,865,615,260.88)
- Pendapatan Jasa Layanan 45,000,000,000 10,114,876,718.90 4,999,238,020.22 15,114,114,739.12
- Pendapatan Hibah
- Pendapatan Hasil Kerjasama
- Pendapatan Lainnya Yang sah 16,635,000 3,635,000 20,270,000


NIP. 19710901 200112 2 003 NIK . 1218 3 020
Pagu Perubahan 45,000,000,000 om Lius baru kshtau pagu
Mengetahui :
PLT. Direktur RSUD Umbu Rara Meha,
Kepala Bagian Tata Usaha

NIP. 19750916 200112 2 003
Mengetahui :

NIP. 19710901 200112 2 003
45,000,000,000
1,262,630,531 35% 441,920,686

Mengetahui :

NIP. 19710901 200112 2 003
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SKS(
sdh
karcis term karcis KARTU
TGL NO PX INAP
polik sk igd KUNJUNGAN
karci
s)
1 tidak ada pasien umum

13 1
14 2
19 3
4
27 5
6
29 7
30 8 40,000
9
10
11
0 0 0 40,000
KARCIS
KARCIS IGD KUNJGN Dr. AHLI
POLI
PAD JP TOTAL TOTAL
60,000 48,750 26,250 75,000 250,000

39,000 21,000 60,000 -
30,000 9,750 5,250 15,000 100,000
9,750 5,250 15,000 -
9,750 5,250 15,000 -
30,000 9,750 5,250 15,000 100,000
40,000 39,000 21,000 60,000 200,000
50,000 39,000 21,000 60,000 150,000
90,000 58,500 31,500 90,000 200,000
70,000 29,250 15,750 45,000 250,000
29,250 15,750 45,000 -
130,000 9,750 5,250 15,000 400,000
130,000 58,500 31,500 90,000 300,000
160,000 19,500 10,500 30,000 500,000
130,000 48,750 26,250 75,000 100,000
70,000 19,500 10,500 30,000 100,000
150,000 58,500 31,500 90,000 150,000
29,250 15,750 45,000 -
130,000 - - 200,000
- - -
90,000 9,750 5,250 15,000 400,000
70,000 9,750 5,250 15,000 300,000
60,000 - - 300,000
80,000 - - 350,000
70,000 19,500 10,500 30,000 300,000
39,000 21,000 60,000 -
80,000 39,000 21,000 60,000 300,000
120,000 19,500 10,500 30,000 450,000
- - -
90,000 - - 400,000
60,000 - - 200,000
40,000 29,250 15,750 45,000 150,000
- - -
- - -
- - -
2,030,000 731,250 393,750 1,125,000 6,150,000
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
dr. MATA (dr.I
dr. MATA (dr.Ni Dr. I GUSTI ASIH dr. KETUT,
Ketut
Luh Nita,Sp.M) (SYARAF) Sp.OG
Aryawan,Sp.M)
100,000
50,000
50,000
50,000 150,000
50,000
100,000
50,000
50,000
50,000 100,000
150,000 100,000
200,000 50,000
200,000
200,000 50,000
50,000
100,000 50,000 50,000

150,000
150,000 50,000
100,000 50,000
50,000
- 1,300,000 800,000 450,000
dr. REEVES, dr. ANRY dr. I MADE dr. PUTU
dr. ANDRY,SPB
Sp.OG (PARU) DEWI,SPA AYUNDA,SPA
100,000
50,000
100,000
50,000 50,000 50,000
50,000 50,000 50,000 100,000
50,000 50,000
100,000
100,000 50,000
100,000 50,000
50,000 50,000
50,000
50,000
200,000 50,000
50,000
150,000 50,000 50,000
50,000
50,000
100,000
500,000 650,000 400,000 - 550,000
POLIK Dr.ANTON dr
Dr DIAH,SPOG Dr.ERIK L.
GERIADRI RIO,SPD JOKO(YOSEP)
50,000
100,000
150,000 50,000
150,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
- - - 350,000 500,000
dr. Desy KUNJUNGAN Dr.Widya R.
dr. Jeni (FISIO) Dr I MADE M
Moekoe dr. UMUM Artonang
TOTAL
20,000 20,000
-
50,000 20,000
-
-
20,000
-
40,000
120,000
40,000
-
100,000 120,000
150,000 180,000
100,000 280,000
520,000
240,000
460,000
-
300,000
-
140,000
140,000
60,000
50,000 80,000
20,000
-
60,000
50,000 60,000
-
150,000 60,000
60,000
40,000
-
-
-
- 650,000 3,080,000 - 20,000
-
-
-
-
-
-
-
-
-
-
Dr Yani Dr. UNTONO Dr.Rambu ITA Dr. STEVIA Dr. SARY
20,000
20,000
40,000
20,000 100,000
40,000
120,000
180,000
80,000 200,000
160,000 360,000
240,000
120,000 340,000
40,000 260,000
80,000 60,000
60,000 80,000
20,000 40,000
40,000 40,000
20,000
20,000 40,000
60,000
20,000 40,000
60,000
40,000
- - 660,000 2,400,000 -
Dr.ERNESTO Dr.ANGGI. Dr.IMANUEL KUNJUNGAN Dr. IGD
PAD JP
58,500 31,500
39,000 21,000
19,500 10,500
19,500 10,500
19,500 10,500
19,500 10,500
78,000 42,000
58,500 31,500
39,000 21,000
58,500 31,500
58,500 31,500
- -
97,500 52,500
39,000 21,000
39,000 21,000
39,000 21,000
39,000 21,000
39,000 21,000
- -
- -
- -
19,500 10,500
- -
- -
19,500 10,500
39,000 21,000
78,000 42,000
- -
- -
- -
- -
39,000 21,000
- -
- -
- -
- - - 955,500 514,500
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
NGAN Dr. IGD SKS POLIK MATA
TOTAL PAD JP JP TOTAL PAD

dr.Stevie dr. Ni Luh
90,000 - - -
60,000 - - -
30,000 7,800 4,200 12,000 21,450
30,000 - - -
30,000 - - -
30,000 - - -
120,000 - - -
90,000 15,600 8,400 24,000 -
60,000 23,400 12,600 36,000 160,550
90,000 - - 69,550
90,000 - - -
- 31,200 16,800 48,000 160,550
150,000 23,400 12,600 36,000 170,300
60,000 70,200 37,800 108,000 195,000
60,000 78,000 42,000 120,000 459,550
60,000 46,800 25,200 72,000 21,450
60,000 46,800 25,200 72,000 671,450
60,000 - - -
70,200 37,800 108,000 180,050
- - -
23,400 12,600 36,000 173,550
30,000 23,400 12,600 36,000 54,600
15,600 8,400 24,000 170,300
39,000 21,000 60,000 100,750
30,000 - - -
60,000 - - -
120,000 15,600 8,400 24,000 21,450
46,800 12,600 12,600 72,000 64,350
- - -
31,200 16,800 48,000 42,900
39,000 12,600 8,400 60,000 42,900
60,000 23,400 8,400 4,200 36,000 21,450
- - -
- - -
- - -
1,470,000 670,800 336,000 25,200 1,032,000 2,802,150
361,200 86
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
RAWAT JALAN APRIL 2020
POLIK MATA RADIOLOGI
JP TOTAL PAD JP Dokter Ahli TOTAL
- - -
- - -
11,550 33,000 - -
- - -
- - -
- - -
- - -
- - -
86,450 247,000 - -
37,450 107,000 - -
- - -
86,450 247,000 195,000 105,000 300,000
91,700 262,000 731,900 394,100 1,126,000
105,000 300,000 97,500 52,500 150,000
247,450 707,000 - -
11,550 33,000 292,500 157,500 450,000
361,550 1,033,000 - -
- - -
96,950 277,000 - -
- - -
93,450 267,000 1,268,800 683,200 1,952,000
29,400 84,000 634,400 341,600 976,000
91,700 262,000 - -
54,250 155,000 54,600 29,400 84,000
- 731,900 394,100 1,126,000
- - -
11,550 33,000 195,000 105,000 300,000
34,650 99,000 2,466,100 1,327,900 3,794,000
- - -
23,100 66,000 97,500 52,500 150,000
23,100 66,000 - -
11,550 33,000 - -
- - -
- - -
- - -
1,508,850 4,311,000 6,765,200 3,642,800 - 10,408,000
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
ALAN APRIL 2020
USG RADIOLOGI FISIOTERAPI
PAD JP TOTAL PAD
- - 91,000
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
154,050 82,950 237,000 -
154,050 82,950 237,000 -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - 91,000
- - -
- - -
154,050 82,950 237,000 -
- - -
308,100 165,900 474,000 -
- - -
- - -
- - -
- - -
- - -
770,250 414,750 1,185,000 182,000
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
FISIOTERAPI POLI ANAK
JP TOTAL PAD JP
49,000 140,000 - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
49,000 140,000 - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
98,000 280,000 - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
ANAK IGD,OUTOPSI
TOTAL PAD JP TOTAL
- -
185,250 99,750 285,000
- -
- -
- -
73,450 39,550 113,000
102,700 55,300 158,000
- -
50,700 27,300 78,000
95,550 51,450 147,000
80,600 43,400 124,000
- - -
486,850 262,150 749,000
114,400 61,600 176,000
14,300 7,700 22,000
- -
- -
7,150 3,850 11,000
- -
- -
- -
- -
- -
- -
- -
- -
119,600 64,400 184,000
- -
- -
- -
- -
87,750 47,250 135,000
- -
- -
- -
- 1,418,300 763,700 2,182,000
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
EKG IGD POLIK UMUM,EKG
PAD JP TOTAL PAD
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
60,450 32,550 93,000 -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
60,450 32,550 93,000 -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
POLIK UMUM,EKG POLIK PENYKT DLM/EKG
JP TOTAL PAD JP
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- 120,900 65,100
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- 60,450 32,550
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- 60,450 32,550
- - -
- - -
- - -
- - -
- - -
- - 241,800 130,200
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
KT DLM/EKG POLIK KEBIDANAN
TOTAL PAD JP TOTAL
- -
- -
- -
- -
- -
- -
20,800 11,200 32,000
- -
16,250 8,750 25,000
16,250 8,750 25,000
- -
48,750 26,250 75,000
186,000 - -
- -
- -
- -
32,500 17,500 50,000
- -
16,250 8,750 25,000
- -
93,000 - -
- -
- -
- -
16,250 8,750 25,000
- -
26,000 14,000 40,000
- -
- -
93,000 - -
- -
- -
- -
- -
- -
372,000 193,050 103,950 297,000
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
USG POLI KEBIDANAN POLIK BEDAH
PAD JP TOTAL PAD
- - 95,550
- - -
- - 26,000
- - -
- - -
- - -
- - -
- - 47,450
154,050 82,950 237,000 36,400
154,050 82,950 237,000 -
- - -
616,200 331,800 948,000 -
- - -
- - -
- - -
- - -
308,100 165,900 474,000 -
- - -
308,100 165,900 474,000 -
- - -
154,050 82,950 237,000 -
- - 20,800
- - -
- - -
308,100 165,900 474,000 -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
2,002,650 1,078,350 3,081,000 226,200
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
POLIK BEDAH POLIK GIGI
JP TOTAL PAD JP
51,450 147,000 - -
- - -
14,000 40,000 - -
- - -
- - -
- - -
- - -
25,550 73,000 - -
19,600 56,000 - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
11,200 32,000 - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
121,800 348,000 - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
K GIGI POLIK THT,SYARAF
TOTAL PAD JP TOTAL
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- - - -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
KONSUL GIZI FARMASI
PAD JP TOTAL PAD
- - 1,657,625
- - 949,606
- - 542,203
- - 218,772
- - 481,500
- - 2,017,718
- - 858,857
- - 630,936
- - 725,075
- - 7,009,721
- - 554,290
- - 265,760
- - 1,833,285
- - 1,000,191
- - 479,120
- - 1,739,367
- - 233,991
- - 167,235
- - 258,220
- -
- - 1,050,882
- - 2,022,418
- - 407,608
- - 413,920
- - 1,040,750
- - 145,564
- - 3,409,570
- - 1,665,916
- -
- - 872,296
- - 311,770
- - 554,379
- -
- -
- -
- - - 33,518,545
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
FARMASI LABORAT
JP TOTAL PAD JP
10,500 1,668,125 293,150 157,850

3,900 953,506 72,800 39,200
5,700 547,903 - -
6,300 225,072 - -
12,200 493,700 - -
6,300 2,024,018 - -
15,900 874,757 - -
16,200 647,136 492,050 264,950
11,000 736,075 766,350 412,650
9,800 7,019,521 - -
12,300 566,590 - -
5,400 271,160 920,400 495,600
21,300 1,854,585 976,950 526,050
12,900 1,013,091 867,750 467,250
8,400 487,520 742,138 399,613
11,100 1,750,467 516,100 277,900
2,700 236,691 3,389,100 1,824,900
5,400 172,635 1,048,450 564,550
4,800 263,020 609,700 328,300
- - -
24,500 1,075,382 140,400 75,600
10,800 2,033,218 247,000 133,000
8,100 415,708 178,100 95,900
6,600 420,520 285,350 153,650
18,600 1,059,350 266,988 143,763
3,000 148,564 86,450 46,550
24,500 3,434,070 331,500 178,500
12,600 1,678,516 609,050 327,950
- - -
12,900 885,196 644,150 346,850
9,700 321,470 393,900 212,100
12,900 567,279 740,675 398,825
- - -
- - -
- - -
326,300 33,844,845 14,618,500 7,871,500
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
ORAT PAD JP BILLING Total
TOTAL -
451,000 2,304,575 596,550 2,901,125

112,000 1,285,656 184,850 1,470,506
- 656,703 171,200 827,903
- 248,022 22,050 270,072
- 510,750 27,950 538,700
- 2,150,418 181,600 2,332,018
- 1,139,357 345,400 1,484,757
757,000 1,333,536 557,600 1,891,136
1,179,000 2,120,275 1,033,800 3,154,075
- 7,502,871 527,650 8,030,521
- 722,640 102,950 825,590
1,416,000 2,377,610 1,592,550 3,970,160
1,503,000 4,844,085 2,052,500 6,896,585
1,335,000 2,717,591 1,631,500 4,349,091
1,141,750 1,990,858 1,372,413 3,363,270
794,000 2,744,717 854,750 3,599,467
5,214,000 4,929,441 3,060,250 7,989,691
1,613,000 1,291,085 610,550 1,901,635
938,000 1,572,520 1,142,500 2,715,020
- - -
216,000 2,971,282 1,550,100 4,521,382
380,000 3,101,868 994,350 4,096,218
274,000 831,608 564,100 1,395,708
439,000 973,620 694,900 1,668,520
410,750 2,563,988 1,121,113 3,685,100
133,000 310,014 91,550 401,564
510,000 4,315,720 829,350 5,145,070
937,000 5,145,766 2,331,750 7,477,516
- - -
991,000 2,146,596 1,110,600 3,257,196
606,000 847,570 525,900 1,373,470
1,139,500 1,575,904 709,875 2,285,779
- - - -
- - -
- - -
22,490,000 67,226,645 26,592,200 93,818,845
49,146,011
48,625,311
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
CROSS CEK
CROSS CEK ( RWT JLN PG+RWT JLN SORE )
2,901,125 -
1,470,506 -
827,903 -
270,072 -
538,700 -
2,332,018 -
1,484,757 -
1,891,136 -
3,154,075 -
8,030,521 -
825,590 -
3,970,160 -
6,896,585 -
4,349,091 -
3,363,270 -
3,599,467 -
7,989,691 -
1,901,635 -
2,715,020 -
-
4,521,382 -
4,096,218 -
1,395,708 -
1,668,520 -
3,685,100 -
401,564 -
5,145,070 -
7,477,516 -
-
3,257,196 -
1,373,470 -
2,285,779 -
-
-
-
93,818,845 - -
-
1,080,000
#REF!
#REF!
#REF!
#REF!
#REF!
#REF!
#REF!
#REF!
#REF!
#REF!
RAWAT INAP : APRIL 2021
NAMA PASIEN RG TOTAL
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
JESSICA VANESSA KWENTINO RK 4,157,498 4,157,498
MERLIS KONGA HAMULY RK 1,662,499 1,662,499
- -
- -
- -
- -
MARAMBA HUTAR RK 327,500
MIRNAWATI RK 1,081,600 1,409,100
-
- -
- -
- -
- -
- -
- -
BY.NY MARLIN RIANA YIWA NICU 3,242,750
MARLIN RIANA YIWA RK 11,583,579 14,826,329
- -
IVAN IRWANSA UMBU DASI RB,PICU 4,806,395 4,806,395
LODOWYK MANZAYN PE RB 9,863,120
GRACIA MAGDALENA RB 10,164,525
NOLAWATI TAMU INA RB 11,631,725
GERHARD LIONEL UMBU RIADA RB 9,978,700 41,638,070
- - 68,499,891 68,499,891
RAWAT INAP 68,499,891 -
RAWAT JALAN 93,818,845 -

LAIN-LAINNYA 4,840,554,284.22 -
BKU 5,002,873,020.22 -
DG+DM(INAP + RJ)
2,901,125 2,901,125 2,901,125 -

1,470,506 1,470,506 1,470,506 -
827,903 827,903 827,903 -
270,072 270,072 270,072 -
538,700 538,700 538,700 -
2,332,018 2,332,018 2,332,018 -
1,484,757 1,484,757 1,484,757 -
1,891,136 1,891,136 1,891,136 -
3,154,075 3,154,075 3,154,075 -
8,030,521 8,030,521 8,030,521 -
825,590 825,590 825,590 -
3,970,160 3,970,160 3,970,160 -
11,054,083 19,369,079 11,054,083 -
6,011,590 9,336,588 6,011,590 -
3,363,270 3,363,270 3,363,270 -
3,599,467 3,599,467 3,599,467 -
7,989,691 7,989,691 7,989,691 -
1,901,635 1,901,635 1,901,635 -
327,500 -
4,124,120 6,614,820 4,124,120 -
- -
4,096,218 4,096,218 4,096,218 -
1,395,708 1,395,708 1,395,708 -
- -
3,685,100 3,685,100 3,685,100 -
401,564 401,564 401,564 -
5,145,070 5,145,070 5,145,070 -
3,242,750 -
22,303,845 48,713,753 22,303,845 -
3,257,196 3,257,196 3,257,196 -
6,179,865 15,792,655 6,179,865 -
9,863,120 -
10,164,525 -
11,631,725 -
43,923,849 95,540,619 43,923,849 -
156,128,834 293,128,616 156,128,834 -
93,818,845
54,595,670
148,414,515.22
266,579,920.22
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
Pemeriksaan
PRAKTEK/pene Pemeriksaan
SPECIMEN
AMBULANCE VISUM litian/Data Lab. Baksos
SWAB (Pjbtn
awal,jasa lahan Mata
presiden RI)
praktek
TOTAL TOTAL
135,000
- 135,000.00 - - -
PT. Peniti
sungai
Pemeriksaan purun,Triloka
Pemeriksaan Rapid Tes
PARKIRAN Pengawai cipta arma,PT.
BRI Wings Air
ASKES Palma Asri
s.PT.Sumber
Cipta M
- - - - -
UTDRS
Dana Covid'19 HOME CARE JASA RAHARJA
RS.LINDIMARA
3,290,969,500
43,370,863
38,695,625
6,294,651
3,290,969,500.00 - 38,695,625.00 49,665,514.00
-
JUMLAH
Pembyrn SEWA
JASA GIRO klaim/denda BPJS GEDUNG,KANTIN,L
2019,TAHUN 2020 AHAN ( ATM )
-
-
-
-
-
-
-
-
-
-
-
1,061,219,200 1,061,219,200.00
-
-
-
3,290,969,500.00
3,500,000 3,500,000.00
-
-
-
43,370,863.00
384,104,400 384,104,400.00
38,695,625.00
6,294,651.00
-
5,333.00 5,333.00
-
34,875.03 34,875.03
-
-
-
12,224,837.19 12,359,837.19
-
-
-
12,265,045.22 1,445,323,600.00 3,500,000.00 4,840,554,284.22
3,635,000
03 JUNI 2020 73,497,100
06 AGUST 2020 #NAME?
#NAME?
-
-
-
-
-
-
-
-
-
-
REKAPAN JASA RAWAT JALAN APRIL 2021
NO KETERANGAN PAD JP PERAWAT
1 KARTU KUNJUNGAN 40,000

2 KARCIS dr. AHLI
Dr.Dessy 650,000
Dr. Anry 400,000
Dr .JOSEP 500,000
Dr .Andry,Sp.B) 650,000
Dr. Ni Lu nita,S.PM 1,325,200
Dr. Putu Ayunda ,Sp.A 550,000
Dr. Ketut,Spog 450,000
Dr. Reeves,Spog 500,000
Dr. Diah.SpoG -
Dr. Jeny (Fisio) -
Dr. Erik,Sp.D 350,000
Dr. Anton,Sp.D -
Dr .Asih Syaraf 800,000
3 KARCIS dr. UMUM( SKS)
dr. Made -
dr. Rambu Ita 660,000
dr. Imanuel -
dr. Stevie 2,710,800
dr. Ervan 47,250
dr. Widya A. 20,000
dr. Yani -
dr. Untono -
dr. Sary -
4 SKS 670,800 -
5 KARCIS Poli 2,030,000 -
6 KARCIS IGD 731,250 393,750
7 KUNJUNGAN dr. IGD 955,500 514,500
8 Poli Mata 2,802,150 1,508,850
9 POLIK PENY DALAM/EKG 241,800 130,200
10 POLIK UMUM/EKG - -
11 POLIK KEBIDANAN/dr.spog 193,050 103,950
12 POLIK BEDAH 226,200 121,800
13 POLIK GIGI - -
14 POLIK THT - -
15 LABORATORIUM 14,618,500 7,871,500
16 Fisioterapi 182,000 98,000
17 Konsul Gizi - -
18 FARMASI 33,518,545 326,300
19 IGD,ekg 1,478,750 749,000
20 USG 2,002,650
Dr . Ketut 663,600
Dr . Reeves 331,800
21 USG 770,250
Dr RUDY 414,750
22 RADIOLOGI 6,765,200
Dr RUDY -
OPERATOR 3,642,800
TOTAL 67,226,645 26,484,050 -
-
93,818,845 93,818,845 -
-
-
3,496,500
2,900
3,493,600
-
JM SATU TAHUN
45,000,000,000 30% 13,500,000,000

RK 4,157,498
RK 1,662,499
RK 327,500
RK 1,081,600
RK 11,583,579
18,812,676
NICU 3,242,750
3,242,750
RB,PICU 4,806,395
RB 9,863,120
RB 10,164,525
RB 11,631,725
RB 9,978,700
46,444,465
68,499,891 68,499,891
-
-
TANGGAL TANGGAL
NO NAMA NO MR RG
MASUK KELUAR
1 JESSICA VANESSA KWENTINO 081923 RK 07-04-2021 11-04-2021
2 MERLIS KONGA HAMULY 01-37-82 RK 11-04-2021 12-04-2021
3 MARAMBA HUTAR RK 19-04-2021 19-04-2021
4 MIRNAWATI RK 19-04-2021 19-04-2021
5 BY.NY MARLIN RIANA YIWA 08-23-44 NICU 24-04-2021 27-04-2021
6 MARLIN RIANA YIWA 08-23-45 RK 23-04-2021 27-04-2021
7 IVAN IRWANSA UMBU DASI 02-12-80 RB,PICU 26-04-2021 29-04-2021
8 LODOWYK MANZAYN PE 081585 RB 16-04-2021 26-04-2021
9 GRACIA MAGDALENA 042089 RB 16-04-2021 26-04-2021
10 NOLAWATI TAMU INA 081470 RB 16-04-2021 26-04-2021
11 GERHARD LIONEL UMBU RIADA 081959 RB 16-04-2021 26-04-2021
TOTAL
IGD
AKOMODASI
TOTAL PAD JP
4,157,498 - -
119,000 15,000 9,750 5,250
327,500 - -
1,081,600 - -
1,650,000 - -
1,600,000 15,000 9,750 5,250
788,000 388,000 252,200 135,800
1,190,000 - -
1,190,000 - -
1,190,000 - -
1,190,000 - -
14,483,598 418,000 271,700 146,300

DAHLIA ANGGREK (UTM)
TOTAL PAD JP TOTAL
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- - - -
ANGGREK (UTM) BOUGENVILLE
PAD JP TOTAL PAD
- - -
- - -
- - -
- - -
- - -
- - -
- - 334,000 217,100
- - 1,021,000 663,650
- - 1,033,000 671,450
- - 1,316,000 855,400
- - 543,000 352,950
- - 4,247,000 2,760,550
TOTAL TARIF
NVILLE VIP/UTM
JP TOTAL PAD JP
- - -
- - -
- - -
- - -
- - -
- - -
116,900 - -
357,350 - -
361,550 - -
460,600 - -
190,050 - -
1,486,450 - - -
KEMUNING PICU
TOTAL PAD JP TOTAL
- -
841,000 546,650 294,350
- -
- -
- -
2,497,000 1,623,050 873,950
- - 542,000
- -
- -
- -
- -
3,338,000 2,169,700 1,168,300 542,000

PICU NICU
PAD JP TOTAL PAD
- - -
- - -
- - -
- - -
- - 926,000 601,900
- - -
352,300 189,700 -
- - -
- - -
- - -
- - -
352,300 189,700 926,000 601,900

CU HEMODELISA
JP TOTAL PAD JP
- - -
- - -
- - -
- - -
324,100 - -
- - -
- - -
- - -
- - -
- - -
- - -
324,100 - - -
ICU
DR .I KETUT
TOTAL PAD JP
ARYAWAN,SPM
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- - - -
JASA OK
DR KETUT DR REEVES DR DESI,SPD DR DIAH,SPOG
820,400
820,400 - - -
JASA OK
DR.JOSEP JUKO DR ANDRY U. L.

DR.DONY.SP.B DR ANASTESI(NUR)
H.SP.B LANDUDJAMA,SPB
382,865
656,250 393,750
656,250 393,750
656,250 393,750
656,250 393,750
2,625,000 - - 1,957,865
PAD
TOTAL PAD+JP
ASISTEN(instrumen) TOTAL JP TOTAL PAD
- -
- -
- -
- -
- -
437,535 1,640,800 3,047,200 4,688,000
- -
262,500 1,312,500 2,437,500 3,750,000
262,500 1,312,500 2,437,500 3,750,000
262,500 1,312,500 2,437,500 3,750,000
262,500 1,312,500 2,437,500 3,750,000
1,487,535 6,890,800 12,797,200 19,688,000

KARCIS LABORAT UTDRS RADIOLOGI
294,000
84,000 150,000
294,000 841,250
463,000 976,000
524,500 150,000
1,024,500 420,625 150,000
524,500 420,625 150,000
524,500 150,000
- 3,733,000 1,682,500 1,726,000

DR KETUT,SPOG
FISIOTERAPI FARMASI
KARCIS USG
263,499
232,750
1,328,329 40,000
985,395
2,727,620
2,046,400
3,780,600
3,271,200
- 14,635,793 40,000 -
T,SPOG DR REEVES,SPOG
VISITE KARCIS/KONSUL USG VISITE
50,000
200,000
250,000 - - -
BULAN A
DR ANRY,Sp.P dr. RUDI
KARCIS/TINDKN VISITE KARCIS/TINDKN USG
- - - -
BULAN APRIL 2021
dr.DESI,Sp.PD DR ANDRY UMBU L.LANDJAWA,SPB
KARCIS/TINDKN VISITE KARCIS/TINDKN/KON VISITE

SUL
130,000
- - - 130,000
DR NUR KUSMAWATI,Sp.An DR I GUSTI AYU K. S,S.P.S
KARCIS/TINDKN VISITE KARCIS/TINDKN VISITE
50,000
50,000
- 100,000 - -
DR.NI MADE DEWI ARYATI,SPA DR.PUTU AYUNDA TRISNIA,SPA
32,500
130,000
65,000
50,000
- - - 277,500
DR.ANTONIUS RIO ADI NUGRAHA,Sp.PD dr.ERIK LIOS,Sp.PD
- - - -
DR JOSEP JOKO H, SPB DR DIAH A. KARTIKA,SPOG
KARCIS/TINDKN VISITE KARCIS/TINDK USG
325,000
325,000
325,000
325,000
- 1,300,000 - -
ARTIKA,SPOG DR JENNY J.C. PANDELELE DR I KETUT ARYAWAN,S.PM
VISITE KARCIS/TINDKN VISITE KARCIS/TINDKN
- - - -
KETUT ARYAWAN,S.PM
DR I MADE M DR YANI
VISITE KARCIS/TINDKN VISITE/USG KARCIS/TINDKN
- - - -
DR YANI DR PANGESTU DR ERNESTO
- - - -
DR ERNESTO DR CHRISTINA DR ERVAN
- - - -
DR ERVAN DR STEVIE DR WIDYA
17,500
17,500 - - -
DOKTER UMUM
DR WIDYA DR TAMU RAMBU I. DR.ARTIKA PASANDE
30,000
30,000
60,000 - - -
DOKTER UMUM
R.ARTIKA PASANDE DR AKTA DR DWIYUNIA A.RAMBU T.I
35,000
175,000
175,000
175,000
175,000
- - 735,000 -
DWIYUNIA A.RAMBU T.I DR KARTIKA DR IRENE
70,000
70,000 - - -
DR IRENE DR BOPI GRISNAWATI HAMADUNA DR RAYVANY ULI
17,500
17,500 - - -
DR RAYVANY ULI DR IMANUEL RUSTON HENDRIK DR AGUNG UTONO K.S. YAPUTRA
52,500
52,500 - - -
UNG UTONO K.S. YAPUTRA DR ADITYA
TOTAL VISITE
VISITE KARCIS/TINDKN VISITE
30,000 130,000
200,000
320,000
330,000
500,000
550,000
500,000
550,000
- - 30,000 3,080,000
TOTAL
PAD JP TOTAL
4,157,498 - 4,157,498 -
1,232,899 429,600 1,662,499 -
327,500 - 327,500 -
1,081,600 - 1,081,600 -
2,718,650 524,100 3,242,750 -
8,743,579 2,840,000 11,583,579 -
4,033,995 772,400 4,806,395 -
7,693,270 2,169,850 9,863,120 -
7,940,475 2,224,050 10,164,525 -
9,358,625 2,273,100 11,631,725 -
7,926,150 2,052,550 9,978,700 -
55,214,241 13,285,650 68,499,891 -
-
JASA UMUM APRIL 2021
PAD JASA
AKOMODASI 14,483,598
TINDAKAN RUANGAN 5,803,850
KARCIS -
OPERASI 12,797,200
LABORAT 3,733,000
TINDAKAN
UTDRS 1,682,500
RADIOLOGI 1,726,000
FISIOTERAPI -
FARMASI 14,635,793
Operasi
VISITE
TOTAL PAD 54,861,941

PAD + JASA 68,147,591 TOTAL JASA
55,214,241
352,300
UMUM APRIL 2021
JASA
IGD 146,300
DAHLIA -
ANGGREK -
BOUGENVILE 1,486,450
VIP -
KEMUNING 1,168,300
NICU 324,100
HEMADELISA -
PICU 189,700
ICU -
dr. Ketut Ananda,Sp.OG 820,400
dr. I Ketut Aryawan,Sp.M -
dr. Reeves,Sp.OG -
dr. Josep ,Sp.B 2,625,000
dr. Dony ,Sp.B -
dr.Andry U.Landujama,Sp.B -
dr. Desi D. Moekoe,Sp.PD -
dr. Anestesi(NUR) 1,957,865
Asisten 1,487,535
290,000
dr. Ketut Ananda,Sp.G
USG -
-
dr. Reeves,Sp.G
USG -
dr. Anry,Sp.P -
dr. Rudy USG -
dr.Andry U.Landujama,Sp.B 130,000
dr. Nur,Sp.AN 100,000
dr. I Gusti Ayu K. S, S.P.S -
dr. I Made Dewi A.S.PA -
dr. Putu Ayunda Trisnia.S.PA 277,500
dr. Antonius Rio Adi Nurgraha,Sp.PD -
dr. Erik,Sp.PD -
dr. Dony ,Sp.B -
-
dr. Diah Kartikaratri ,Sp.G
USG -
dr. Jeny Pandalele -
dr. Made Mekel -
dr. Yani -
dr. Pangestu -
dr. Ernesto -
dr. Christine -
dr. Ervan 17,500
dr. Stevie -
dr. Widya 60,000
dr. Agung Utomo K.S. Yaputra -
dr. Tamu Ina Ita Ining -
dr. Artikasari Pasande -
dr. Aktha Yudistira 735,000
dr. Dwiyunia Hilunggara 70,000
dr. Kartika -
dr. Irene 17,500
dr. Bopi -
dr. Rayvany. 52,500
dr. Imanuel Rostom -
dr. Aditya Y. 30,000
TOTAL JASA 13,285,650

13,285,650 ok
-
237,753,930
250,000,000
12,246,070
68,499,891 -
-
(870,000)
TANGGAL TANGGAL
NO NAMA NO MR RG
MASUK KELUAR
3 MARAMBA HUTAR RK 19-04-2021 19-04-2021
4 MIRNAWATI RK 19-04-2021 19-04-2021
12 ACHMAD DZIKRY RAMADHANI 019753 RB 09-03-2021 27-03-2021
13 RIAN MBORA HORUNG 081790 RB 24-03-2021 28-03-2021
14 MARINTO RATU DJAWA 081636 RB 16-03-2021 17-03-2021
15 SANDI ASHARI NJONGUMARA 081791 RB 24-03-2021 30-03-2021
16 LELYANISALSABILAH 082045 RB 09-04-2021 14-04-2021
TOTAL
IGD
AKOMODASI
TOTAL PAD JP
4,157,498 - -
119,000 15,000 9,750 5,250
327,500 - -
1,081,600 - -
1,650,000 - -
1,600,000 15,000 9,750 5,250
788,000 388,000 252,200 135,800
1,190,000 - -
1,190,000 - -
1,190,000 - -
1,190,000 - -
455,700 455,700 296,205 159,495
476,000 525,000 341,250 183,750
119,000 330,000 214,500 115,500
714,000 835,000 542,750 292,250
1,065,000 637,000 414,050 222,950
17,313,298 3,200,700 2,080,455 1,120,245

TOTAL PAD JP TOTAL
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- - - -
PAD JP TOTAL PAD
- - -
- - -
- - -
- - -
- - -
- - -
- - 334,000 217,100
- - 1,021,000 663,650
- - 1,033,000 671,450
- - 1,316,000 855,400
- - 543,000 352,950
- - 455,701 296,206
- - 513,000 333,450
- - 50,000 32,500
- - 1,015,000 659,750
- - 1,125,000 731,250
- - 7,405,701 4,813,706
TOTAL TARIF
NVILLE VIP/UTM
JP TOTAL PAD JP
- - -
- - -
- - -
- - -
- - -
- - -
116,900 - -
357,350 - -
361,550 - -
460,600 - -
190,050 - -
159,495 - -
179,550 - -
17,500 - -
355,250 - -
393,750 - -
2,591,995 - - -
KEMUNING PICU
TOTAL PAD JP TOTAL
- -
841,000 546,650 294,350
- -
- -
- -
2,497,000 1,623,050 873,950
- - 542,000
- -
- -
- -
- -
- - 455,701
- -
- -
- -
- -
3,338,000 2,169,700 1,168,300 997,701

PICU NICU
PAD JP TOTAL PAD
- - -
- - -
- - -
- - -
- - 926,000 601,900
- - -
352,300 189,700 -
- - -
- - -
- - -
- - -
296,206 159,495 -
- - -
- - -
- - -
- - -
648,506 349,195 926,000 601,900

CU HEMODELISA
JP TOTAL PAD JP
- - -
- - -
- - -
- - -
324,100 - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- 34,000 22,100 11,900
- - -
324,100 34,000 22,100 11,900

ICU
DR .I KETUT
TOTAL PAD JP
ARYAWAN,SPM
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- - - -
JASA OK
820,400
820,400 - - -
JASA OK

382,865
656,250 393,750
656,250 393,750
656,250 393,750
656,250 393,750
656,250 393,750
341,906 205,144
341,906 205,144
2,625,000 - 1,340,062 2,761,903

PAD TOTAL PAD+JP
ASISTEN(instrumen) TOTAL JP
- -
- -
- -
- -
- -
437,535 1,640,800 3,047,200 4,688,000
- -
262,500 1,312,500 2,437,500 3,750,000
262,500 1,312,500 2,437,500 3,750,000
262,500 1,312,500 2,437,500 3,750,000
262,500 1,312,500 2,437,500 3,750,000
262,500 1,312,500 2,437,500 3,750,000
136,763 683,813 1,269,938 1,953,751
- -
136,763 683,813 1,269,938 1,953,751
- -
2,023,561 9,570,926 17,774,576 27,345,502

294,000
84,000 150,000
294,000 841,250
463,000 976,000
524,500 150,000
1,024,500 420,625 150,000
524,500 420,625 150,000
524,500 150,000
902,000 841,250 784,400
250,500 885,600
214,000 300,000
250,500 885,600
81,000 1,119,600
- 5,431,000 2,523,750 5,701,200

DR KETUT,SPOG
FISIOTERAPI FARMASI
KARCIS USG
263,499
232,750
1,328,329 40,000
985,395
2,727,620
2,046,400
3,780,600
3,271,200
10,740,648
3,765,586
414,964
5,540,811
1,596,651
- 36,694,453 40,000 -
50,000
200,000
250,000 - - -
KARCIS/TINDKN VISITE KARCIS/TINDKN USG,CT SCAN
390,400
390,400
390,400
390,400
- - - 1,561,600

SUL
130,000
980,000
130,000
115,000
227,500
- - - 1,582,500
50,000
50,000
- 100,000 - -
32,500
130,000
65,000
50,000
130,000
- - - 407,500
DR.ANTONIUS RIO ADI
dr.ERIK LIOS,Sp.PD
NUGRAHA,Sp.PD
- - - -
325,000
325,000
325,000
325,000
162,500
- 1,462,500 - -
- - - -
KETUT ARYAWAN,S.PM
DR I MADE M DR YANI
30,000
- - - 30,000
30,000
- - - 30,000
- - - -
17,500
30,000
30,000
17,500 - - 60,000
DOKTER UMUM
30,000
- - - 30,000
DOKTER UMUM
35,000
175,000
175,000
175,000
175,000
140,000
30,000
30,000
- 60,000 875,000 -
70,000
227,500
70,000
35,000
122,500
87,500
70,000 - 542,500 -
17,500
17,500 - - -
52,500
52,500 - - -
TOTAL VISITE
30,000 130,000
200,000
320,000
330,000
500,000
550,000
500,000
550,000
35,000 1,932,900
620,400
180,000
770,400
670,400
- 30,000 35,000 7,254,100

TOTAL
PAD JP TOTAL
4,157,498 - 4,157,498 -
1,232,899 429,600 1,662,499 -
327,500 - 327,500 -
1,081,600 - 1,081,600 -
2,718,650 524,100 3,242,750 -
8,743,579 2,840,000 11,583,579 -
4,033,995 772,400 4,806,395 -
7,693,270 2,169,850 9,863,120 -
7,940,475 2,224,050 10,164,525 -
9,358,625 2,273,100 11,631,725 -
7,926,150 2,052,550 9,978,700 -
17,050,114 3,723,886 20,774,000 -
7,322,324 1,667,513 8,989,837 -
1,294,964 313,000 1,607,964 -
9,885,449 2,113,613 11,999,062 -
5,007,551 1,287,100 6,294,651 -
95,774,643 22,390,762 118,165,405

68,499,891 paien umum byr lgsg
49,665,514 pasien dibyr jasa raharja
118,165,405
-
JASA UMUM APRIL 2021
PAD JASA
Kep/Keb IGD
AKOMODASI 17,313,298 IGD 1,120,245 dr. Yani 222,950
TINDAKAN RUANGAN 10,336,366 DAHLIA - dr. Ernesto 115,500
KARCIS - ANGGREK - dr. Dwiyunia 141,050
OPERASI 17,774,576 BOUGENVILE 2,591,995 dr. Artika P. 159,495
LABORAT 5,431,000 VIP - dr. Akta 476,000
TINDAKAN
UTDRS 2,523,750 KEMUNING 1,168,300 dr. Aditya 5,250
RADIOLOGI 5,701,200 PICU 349,195
FISIOTERAPI - NICU 324,100 1,120,245
FARMASI 36,694,453 HEMADELISA 11,900
ICU -
dr. Ketut Ananda,Sp.OG 820,400
dr. Reeves,Sp.OG -
Operasi
dr.Andry U.Landujama,Sp.B 1,340,062
dr. Anestesi(NUR) 2,761,903
dr. Putu Ayunda Trisnia.S.PA -
Asisten 2,023,561
290,000
dr. Ketut Ananda,Sp.G
USG -
-
dr. Reeves,Sp.G
USG -
dr. Anry,Sp.P -
dr. Rudy USG 1,561,600
dr.Andry U.Landujama,Sp.B 1,582,500
dr. Nur,Sp.AN 100,000
dr. I Gusti Ayu K. S, S.P.S -
dr. I Made Dewi A.S.PA -
dr. Putu Ayunda Trisnia.S.PA 407,500
dr. Antonius Rio Adi Nurgraha,Sp.PD -
dr. Erik,Sp.PD -
dr. Made Mekel -
VISITE
dr. Yani 30,000
dr. Pangestu -
dr. Ernesto 30,000
dr. Christine -
dr. Ervan 17,500
dr. Stevie -
dr. Widya 60,000
dr. Agung Utomo K.S. Yaputra -
dr. Artikasari Pasande 30,000
dr. Aktha Yudistira 935,000
dr. Dwiyunia Hilunggara 70,000
dr. Kartika 542,500
dr. Irene 17,500
dr. Bopi -
dr. Rayvany. 52,500
dr. Imanuel Rostom -
dr. Aditya Y. 65,000
TOTAL PAD 95,774,643
PAD + JASA 118,165,405 TOTAL JASA 22,390,762
95,774,643 22,390,762 ok 118,165,405
- -
TANGGAL TANGGAL
NO NAMA NO MR RG
MASUK KELUAR
3 MARAMBA HUTAR RK 19-04-2021 19-04-2021
4 MIRNAWATI RK 19-04-2021 19-04-2021

IGD
AKOMODASI
TOTAL PAD JP
4,157,498 - -
119,000 15,000 9,750 5,250
327,500 - -
1,081,600 - -
1,650,000 - -
1,600,000 15,000 9,750 5,250
788,000 388,000 252,200 135,800
1,190,000 - -
1,190,000 - -
1,190,000 - -
1,190,000 - -
455,700 455,700 296,205 159,495
476,000 525,000 341,250 183,750
119,000 330,000 214,500 115,500
714,000 835,000 542,750 292,250
1,065,000 637,000 414,050 222,950
17,313,298 3,200,700 2,080,455 1,120,245

TOTAL PAD JP TOTAL
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- - - -
PAD JP TOTAL PAD
- - -
- - -
- - -
- - -
- - -
- - -
- - 334,000 217,100
- - 1,021,000 663,650
- - 1,033,000 671,450
- - 1,316,000 855,400
- - 543,000 352,950
- - 455,701 296,206
- - 513,000 333,450
- - 50,000 32,500
- - 1,015,000 659,750
- - 1,125,000 731,250
- - 7,405,701 4,813,706
TOTAL TARIF
NVILLE VIP/UTM
JP TOTAL PAD JP
- - -
- - -
- - -
- - -
- - -
- - -
116,900 - -
357,350 - -
361,550 - -
460,600 - -
190,050 - -
159,495 - -
179,550 - -
17,500 - -
355,250 - -
393,750 - -
2,591,995 - - -
KEMUNING PICU
TOTAL PAD JP TOTAL
- -
841,000 546,650 294,350
- -
- -
- -
2,497,000 1,623,050 873,950
- - 542,000
- -
- -
- -
- -
- - 455,701
- -
- -
- -
- -
3,338,000 2,169,700 1,168,300 997,701

PICU NICU
PAD JP TOTAL PAD
- - -
- - -
- - -
- - -
- - 926,000 601,900
- - -
352,300 189,700 -
- - -
- - -
- - -
- - -
296,206 159,495 -
- - -
- - -
- - -
- - -
648,506 349,195 926,000 601,900

CU HEMODELISA
JP TOTAL PAD JP
- - -
- - -
- - -
- - -
324,100 - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- 34,000 22,100 11,900
- - -
324,100 34,000 22,100 11,900

ICU
DR .I KETUT
TOTAL PAD JP
ARYAWAN,SPM
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- - - -
JASA OK
820,400
820,400 - - -
JASA OK

382,865
656,250 393,750
656,250 393,750
656,250 393,750
656,250 393,750
656,250 393,750
341,906 205,144
341,906 205,144
2,625,000 - 1,340,062 2,761,903

PAD TOTAL PAD+JP
- -
- -
- -
- -
- -
437,535 1,640,800 3,047,200 4,688,000
- -
262,500 1,312,500 2,437,500 3,750,000
262,500 1,312,500 2,437,500 3,750,000
262,500 1,312,500 2,437,500 3,750,000
262,500 1,312,500 2,437,500 3,750,000
262,500 1,312,500 2,437,500 3,750,000
136,763 683,813 1,269,938 1,953,751
- -
136,763 683,813 1,269,938 1,953,751
- -
2,023,561 9,570,926 17,774,576 27,345,502

294,000
84,000 150,000
294,000 841,250
463,000 976,000
524,500 150,000
1,024,500 420,625 150,000
524,500 420,625 150,000
524,500 150,000
902,000 841,250 784,400
250,500 885,600
214,000 300,000
250,500 885,600
81,000 1,119,600
- 5,431,000 2,523,750 5,701,200

DR KETUT,SPOG
FISIOTERAPI FARMASI
KARCIS USG
263,499
232,750
1,328,329 40,000
985,395
2,727,620
2,046,400
3,780,600
3,271,200
10,740,648
3,765,586
414,964
5,540,811
1,596,651
- 36,694,453 40,000 -
50,000
200,000
250,000 - - -
390,400
390,400
390,400
390,400
- - - 1,561,600

SUL
130,000
980,000
130,000
115,000
227,500
- - - 1,582,500
50,000
50,000
- 100,000 - -
32,500
130,000
65,000
50,000
130,000
- - - 407,500
DR.ANTONIUS RIO ADI
dr.ERIK LIOS,Sp.PD
NUGRAHA,Sp.PD
- - - -
325,000
325,000
325,000
325,000
162,500
- 1,462,500 - -
- - - -
KETUT ARYAWAN,S.PM
DR I MADE M DR YANI
30,000
- - - 30,000
30,000
- - - 30,000
- - - -
17,500
30,000
30,000
17,500 - - 60,000
DOKTER UMUM
30,000
- - - 30,000
DOKTER UMUM
35,000
175,000
175,000
175,000
175,000
140,000
30,000
30,000
- 60,000 875,000 -
70,000
227,500
70,000
35,000
122,500
87,500
70,000 - 542,500 -
17,500
17,500 - - -
52,500
52,500 - - -
TOTAL VISITE
30,000 130,000
200,000
320,000
330,000
500,000
550,000
500,000
550,000
35,000 1,932,900
620,400
180,000
770,400
670,400
- 30,000 35,000 7,254,100

TOTAL
PAD JP TOTAL
4,157,498 - 4,157,498 -
1,232,899 429,600 1,662,499 -
327,500 - 327,500 -
1,081,600 - 1,081,600 -
2,718,650 524,100 3,242,750 -
8,743,579 2,840,000 11,583,579 -
4,033,995 772,400 4,806,395 -
7,693,270 2,169,850 9,863,120 -
7,940,475 2,224,050 10,164,525 -
9,358,625 2,273,100 11,631,725 -
7,926,150 2,052,550 9,978,700 -
17,050,114 3,723,886 20,774,000 -
7,322,324 1,667,513 8,989,837 -
1,294,964 313,000 1,607,964 -
9,885,449 2,113,613 11,999,062 -
5,007,551 1,287,100 6,294,651 -
95,774,643 22,390,762 118,165,405

118,165,405
LAPORAN HARIAN RAWAT JALAN APRIL 2021
TANGGAL JUMLAH
1 APRIL 2021 50
2 APRIL 2021 0
3 APRIL 2021 31
4 APRIL 2021 0
5 APRIL 2021 4
6 APRIL 2021 34
7 APRIL 2021 82
8 APRIL 2021 57
9 APRIL 2021 16
10 APRIL 2021 34
11 APRIL 2021 0
12 APRIL 2021 39
13 APRIL 2021 57
14 APRIL 2021 62
15 APRIL 2021 49
16 APRIL 2021 29
17 APRIL 2021 46
18 APRIL 2021 0
19 APRIL 2021 49
20 APRIL 2021 59
21 APRIL 2021 64
22 APRIL 2021 67
23 APRIL 2021 18
24 APRIL 2021 46
25 APRIL 2021 0
26 APRIL 2021 45
27 APRIL 2021 54
28 APRIL 2021 69
29 APRIL 2021 45
30 APRIL 2021 27
TOTAL 1,133
LAPORAN HARIAN RAWAT INAP BULAN APRIL 2021
TANGGAL RUANG JUMLAH
RA 17
RB 55
RD 111
1 - 30 APRIL 2021
RK 117
ICU 2
NICU 28
TOTAL 330
BUKU PEMBANTU
PER RINCIAN OBYEK PENERIMAAN
Urusan Pemerintahan : 1.02 Urusan Wajib Pelayanan Dasar Kese

Bidang Pemerintah : 1.02 RUMAH SAKIT UMUM DAERAH UMB
Unit Organisasi : 1.02.02 RUMAH SAKIT UMUM DAERAH UMB
Sub Unit Organisasi : 1.02.02.02 RUMAH SAKIT UMUM DAERAH UMB
Kode Rekening : 4.1.4.16.01
Nama Rekening : Pendapatan Jasa Layanan Umum ( BLUD )
Target Anggaran : 44,196,806,078
Tahun : 2021
Bulan : FEBRUARI
NO NO. BKU TANGGAL SETOR KETERANGAN

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Jumlah
Jumlah periode ini Rp -

Jumlah sampai periode lalu Rp 2,136,316,017
Jumlah sampai dengan periode ini Rp 2,136,316,017
Mengetahui Waingapu, Mei 202

Direktur RSUD Umbu Rara Meha Waingapu Bendahara Penerimaa

NIP. 19710901 200112 2 003 NIK . 1218 3 020
MUR
yanan Dasar Kesehatan

UM DAERAH UMBU RARA MEHA
00501.05.001279-9
JUMLAH
-
2,136,316,017
Waingapu, Mei 2020 2,136,316,017
Ester Praing, SE
NIK . 1218 3 020
321,250
358,937
680,187
BUKU PEMBANTU
Urusan Pemerintahan : 1.02 Urusan Wajib Pelayanan Dasar Ke

Bidang Pemerintah : 1.02 RUMAH SAKIT UMUM DAERAH UMBU
Unit Organisasi : 1.02.02 RUMAH SAKIT UMUM DAERAH UMBU
Sub Unit Organisasi : 1.02.02.02 RUMAH SAKIT UMUM DAERAH UMBU

Nama Rekening : Pendapatan Jasa Layanan Umum ( Home Care - Bank
Tahun : 2020
Bulan : MEI
1
2
3
4
5 bunga
6 pajak
7
8
9
10
11
Jumlah
Jumlah sampai periode lalu Rp 2,455,060
Jumlah sampai dengan periode ini Rp 2,455,060

Direktur RSUD Umbu Rara Meha Waingapu Bendahara Penerima

NIP. 19710901 200112 2 003 NIK . 1218 3 020
MBA TIMUR
RIMAAN
ajib Pelayanan Dasar Kesehatan

KIT UMUM DAERAH UMBU RARA MEHA
KIT UMUM DAERAH UMBU RARA MEHA
KIT UMUM DAERAH UMBU RARA MEHA Sebagai BLUD
um ( Home Care - Bank NTT ) 005 02.02.0044368-7
KETERANGAN JUMLAH
- -
Waingapu, Mei 2020
Ester Praing, SE
NIK . 1218 3 020
BUKU PEMBANTU
Urusan Pemerintahan : 1.02 Urusan Wajib Pelayanan Dasar Kes

Bidang Pemerintah : 1.02 RUMAH SAKIT UMUM DAERAH UMBU
Unit Organisasi : 1.02.02 RUMAH SAKIT UMUM DAERAH UMBU
Sub Unit Organisasi : 1.02.02.02 RUMAH SAKIT UMUM DAERAH UMBU
Nama Rekening : Pendapatan Jasa Layanan Umum (Home Care - Bank B
Tahun : 2020
Bulan : MEI
1
2
3
4
5
6
7
8
9
10
Jumlah

Jumlah sampai periode lalu Rp 665,485
Jumlah sampai dengan periode ini Rp 665,485
Direktur RSUD Umbu Rara Meha Waingapu Bendahara Penerimaan

NIP. 19710901 200112 2 003 NIK . 1218 3 020
A TIMUR
MAAN
ib Pelayanan Dasar Kesehatan

IT UMUM DAERAH UMBU RARA MEHA
IT UMUM DAERAH UMBU RARA MEHA
IT UMUM DAERAH UMBU RARA MEHA Sebagai BLUD
m (Home Care - Bank BRI) 014101001214301
ETERANGAN JUMLAH
- -
Waingapu, Mei 2020
Ester Praing, SE
NIK . 1218 3 020
-
25,000,000 12% 3,000,000 1,666,667 22,000,000
3,335,000 1
3,335,000 2
3,335,000 3 10,005,000
3,335,000 4
3,335,000 5
3,335,000 6
3,335,000 7
3,335,000 8
3,335,000 9
3,335,000 10
3,335,000 11
3,335,000 12
3,335,000 13 33,350,000
3,335,000 14 36,685,000
3,310,000 15 39,995,000
50,000,000
7,000,000 10% 700,000 700,000 6,300,000
3,000,437
2,400,000
500,000
102,448 34,000,000 2% 680,000
350,000 566,667
550,000
50,000
100,000 1,246,667
1,600,000
1,200,000 (53,333)
1,050,000 100,437
100,000
120,000
50,000
5,272,448 (900,000)
184,558,940 1
128,861,394 2
178,490,340 3
141,176,090 4
139,765,202 5
98,189,107 6
158,283,458 7
1,029,324,531
36,685,000 komini
10,000,000 pengd
13,315,000 3,000,000 I'ida
3,600,000 1,500,000 I'tut
1,400,000 k'R
52,585,000 7,415,000
16,915,000
40,000,000 45,000,000 12% 2,666,667 3,000,000

4,000,000 4,000,000
36,000,000 41,000,000
19,085,000 24,085,000
-
129,389,347
35,570,502
2,325
220
170
170
110
95
150
130
3,370
1,850
5,220
TANGGAL TANGGAL
NO NAMA NO MR RG
MASUK KELUAR
3 MARAMBA HUTAR RK 19-04-2021 19-04-2021
4 MIRNAWATI RK 19-04-2021 19-04-2021
TOTAL
IGD
AKOMODASI
TOTAL PAD JP
1,065,000 637,000 414,050 222,950
4,157,498 - -
119,000 15,000 9,750 5,250
327,500 - -
1,081,600 - -
1,650,000 - -
1,600,000 15,000 9,750 5,250
788,000 388,000 252,200 135,800
1,190,000 - -
1,190,000 - -
1,190,000 - -
1,190,000 - -
455,700 455,700 296,205 159,495
476,000 525,000 341,250 183,750
119,000 330,000 214,500 115,500
714,000 835,000 542,750 292,250
4,144,700 2,145,700 1,394,705 750,995

TOTAL PAD JP TOTAL
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- - - -
PAD JP TOTAL PAD
- - 1,125,000 731,250
- - -
- - -
- - -
- - -
- - -
- - -
- - 334,000 217,100
- - 1,021,000 663,650
- - 1,033,000 671,450
- - 1,316,000 855,400
- - 543,000 352,950
- - 455,701 296,206
- - 513,000 333,450
- - 50,000 32,500
- - 1,015,000 659,750
- - 3,892,701 2,530,256
TOTAL TARIF
NVILLE VIP/UTM
JP TOTAL PAD JP
393,750 - -
- - -
- - -
- - -
- - -
- - -
- - -
116,900 - -
357,350 - -
361,550 - -
460,600 - -
190,050 - -
159,495 - -
179,550 - -
17,500 - -
355,250 - -
1,362,445 - - -
KEMUNING PICU
TOTAL PAD JP TOTAL
- -
- -
841,000 546,650 294,350
- -
- -
- -
2,497,000 1,623,050 873,950
- - 542,000
- -
- -
- -
- -
- - 455,701
- -
- -
- -
- - - 455,701
PICU NICU
PAD JP TOTAL PAD
- - -
- - -
- - -
- - -
- - -
- - 926,000 601,900
- - -
352,300 189,700 -
- - -
- - -
- - -
- - -
296,206 159,495 -
- - -
- - -
- - -
296,206 159,495 - -
CU HEMODELISA
JP TOTAL PAD JP
- - -
- - -
- - -
- - -
- - -
324,100 - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- 34,000 22,100 11,900
- 34,000 22,100 11,900

ICU
DR .I KETUT
TOTAL PAD JP
ARYAWAN,SPM
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- - - -
JASA OK
820,400
- - - -
JASA OK

382,865
656,250 393,750
656,250 393,750
656,250 393,750
656,250 393,750
656,250 393,750
341,906 205,144
341,906 205,144
1,312,500 - 1,340,062 1,591,538

PAD TOTAL PAD+JP
- -
- -
- -
- -
- -
- -
437,535 1,640,800 3,047,200 4,688,000
- -
262,500 1,312,500 2,437,500 3,750,000
262,500 1,312,500 2,437,500 3,750,000
262,500 1,312,500 2,437,500 3,750,000
262,500 1,312,500 2,437,500 3,750,000
262,500 1,312,500 2,437,500 3,750,000
136,763 683,813 1,269,938 1,953,751
- -
136,763 683,813 1,269,938 1,953,751
1,061,026 5,305,126 9,852,376 15,157,502

81,000 1,119,600
294,000
84,000 150,000
294,000 841,250
463,000 976,000
524,500 150,000
1,024,500 420,625 150,000
524,500 420,625 150,000
524,500 150,000
902,000 841,250 784,400
250,500 885,600
214,000 300,000
250,500 885,600
- 2,666,000 1,261,875 3,155,600
585600
DR KETUT,SPOG
FISIOTERAPI FARMASI
KARCIS USG
1,596,651
263,499
232,750
1,328,329 40,000
985,395
2,727,620
2,046,400
3,780,600
3,271,200
10,740,648
3,765,586
414,964
5,540,811
- 27,513,809 - -
50,000
200,000
- - - -
390,400
390,400
390,400
390,400
- - - 1,171,200

SUL
130,000
980,000
130,000
115,000
227,500
- - - 1,452,500
50,000
50,000
- 50,000 - -
32,500
130,000
65,000
50,000
130,000
- - - 130,000
DR.ANTONIUS RIO ADI NUGRAHA,Sp.PD dr.ERIK LIOS,Sp.PD
- - - -
162,500
325,000
325,000
325,000
325,000
- 650,000 - -
- - - -
KETUT ARYAWAN,S.PM
DR I MADE M DR YANI
30,000
- - - -
30,000
- - - 30,000
- - - -
17,500
30,000
30,000
- - - -
DOKTER UMUM
30,000
- - - 30,000
DOKTER UMUM
35,000
175,000
175,000
175,000
175,000
140,000
30,000
30,000
- 60,000 490,000 -
87,500
70,000
227,500
70,000
35,000
122,500
- - 455,000 -
17,500
- - - -
52,500
- - - -
TOTAL VISITE
670,400
30,000 130,000
200,000
320,000
330,000
500,000
550,000
500,000
550,000
35,000 1,932,900
620,400
180,000
770,400
- - 35,000 4,553,700
TOTAL
PAD JP TOTAL
5,007,551 1,287,100 6,294,651 -
4,157,498 - 4,157,498 -
1,232,899 429,600 1,662,499 -
327,500 - 327,500 -
1,081,600 - 1,081,600 -
2,718,650 524,100 3,242,750 -
8,743,579 2,840,000 11,583,579 -
4,033,995 772,400 4,806,395 -
7,693,270 2,169,850 9,863,120 -
7,940,475 2,224,050 10,164,525 -
9,358,625 2,273,100 11,631,725 -
7,926,150 2,052,550 9,978,700 -
17,050,114 3,723,886 20,774,000 -
7,322,324 1,667,513 8,989,837 -
1,294,964 313,000 1,607,964 -
9,885,449 2,113,613 11,999,062 -
52,837,626 12,143,662 64,981,288 -
455,701
6,294,651 2,137,153.00
(49,665,514)
SKS(
sdh
TGL NO PX INAP
karci
s)
1 tidak ada pasien umum 6 0 5

13 1 13 3 6
14 2 16 9 2
19 3 13 9 0
4
27 5 12 6 2
6
29 7 6 5 0
30 8 4 3 3 40,000
9
10
11
203 86 73 40,000
KARCIS
POLI
PAD JP TOTAL TOTAL
60,000 48,750 26,250 75,000 250,000

39,000 21,000 60,000 -
30,000 9,750 5,250 15,000 100,000
9,750 5,250 15,000 -
9,750 5,250 15,000 -
30,000 9,750 5,250 15,000 100,000
40,000 39,000 21,000 60,000 200,000
50,000 39,000 21,000 60,000 150,000
90,000 58,500 31,500 90,000 200,000
70,000 29,250 15,750 45,000 250,000
29,250 15,750 45,000 -
130,000 9,750 5,250 15,000 400,000
130,000 58,500 31,500 90,000 300,000
160,000 19,500 10,500 30,000 500,000
130,000 48,750 26,250 75,000 100,000
70,000 19,500 10,500 30,000 100,000
150,000 58,500 31,500 90,000 150,000
29,250 15,750 45,000 -
130,000 - - 200,000
- - -
90,000 9,750 5,250 15,000 400,000
70,000 9,750 5,250 15,000 300,000
60,000 - - 300,000
80,000 - - 350,000
70,000 19,500 10,500 30,000 300,000
39,000 21,000 60,000 -
80,000 39,000 21,000 60,000 300,000
120,000 19,500 10,500 30,000 450,000
- - -
90,000 - - 400,000
60,000 - - 200,000
40,000 29,250 15,750 45,000 150,000
- - -
- - -
- - -
2,030,000 731,250 393,750 1,125,000 6,150,000
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
dr. MATA (dr.I
Ketut
Aryawan,Sp.M)
100,000
50,000
50,000
50,000 150,000
50,000
100,000
50,000
50,000
50,000 100,000
150,000 100,000
200,000 50,000
200,000
200,000 50,000
50,000
100,000 50,000 50,000

150,000
150,000 50,000
100,000 50,000
50,000
- 1,300,000 800,000 450,000
dr. ANDRY,SPB
100,000
50,000
100,000
50,000 50,000 50,000
50,000 50,000 50,000 100,000
50,000 50,000
100,000
100,000 50,000
100,000 50,000
50,000 50,000
50,000
50,000
200,000 50,000
50,000
150,000 50,000 50,000
50,000
50,000
100,000
500,000 650,000 400,000 - 550,000
POLIK Dr.ANTON dr
50,000
100,000
150,000 50,000
150,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
- - - 350,000 500,000
TOTAL
20,000 20,000
-
50,000 20,000
-
-
20,000
-
40,000
120,000
40,000
-
100,000 120,000
150,000 180,000
100,000 280,000
520,000
240,000
460,000
-
300,000
-
140,000
140,000
60,000
50,000 80,000
20,000
-
60,000
50,000 60,000
-
150,000 60,000
60,000
40,000
-
-
-
- 650,000 3,080,000 - 20,000
-
-
-
-
-
-
-
-
-
-
20,000
20,000
40,000
20,000 100,000
40,000
120,000
180,000
80,000 200,000
160,000 360,000
240,000
120,000 340,000
40,000 260,000
80,000 60,000
60,000 80,000
20,000 40,000
40,000 40,000
20,000
20,000 40,000
60,000
20,000 40,000
60,000
40,000
- - 660,000 2,400,000 -
PAD JP
58,500 31,500
39,000 21,000
19,500 10,500
19,500 10,500
19,500 10,500
19,500 10,500
78,000 42,000
58,500 31,500
39,000 21,000
58,500 31,500
58,500 31,500
- -
97,500 52,500
39,000 21,000
39,000 21,000
39,000 21,000
39,000 21,000
39,000 21,000
- -
- -
- -
19,500 10,500
- -
- -
19,500 10,500
39,000 21,000
78,000 42,000
- -
- -
- -
- -
39,000 21,000
- -
- -
- -
- - - 955,500 514,500
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -

90,000 - - -
60,000 - - -
30,000 7,800 4,200 12,000 21,450
30,000 - - -
30,000 - - -
30,000 - - -
120,000 - - -
90,000 15,600 8,400 24,000 -
60,000 23,400 12,600 36,000 160,550
90,000 - - 69,550
90,000 - - -
- 31,200 16,800 48,000 160,550
150,000 23,400 12,600 36,000 170,300
60,000 70,200 37,800 108,000 195,000
60,000 78,000 42,000 120,000 459,550
60,000 46,800 25,200 72,000 21,450
60,000 46,800 25,200 72,000 671,450
60,000 - - -
70,200 37,800 108,000 180,050
- - -
23,400 12,600 36,000 173,550
30,000 23,400 12,600 36,000 54,600
15,600 8,400 24,000 170,300
39,000 21,000 60,000 100,750
30,000 - - -
60,000 - - -
120,000 15,600 8,400 24,000 21,450
46,800 12,600 12,600 72,000 64,350
- - -
31,200 16,800 48,000 42,900
39,000 12,600 8,400 60,000 42,900
60,000 23,400 8,400 4,200 36,000 21,450
- - -
- - -
- - -
1,470,000 670,800 336,000 25,200 1,032,000 2,802,150
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
11,550 33,000 - -
- - -
- - -
- - -
- - -
- - -
86,450 247,000 - -
37,450 107,000 - -
- - -
86,450 247,000 195,000 105,000 300,000
91,700 262,000 731,900 394,100 1,126,000
105,000 300,000 97,500 52,500 150,000
247,450 707,000 - -
11,550 33,000 292,500 157,500 450,000
361,550 1,033,000 - -
- - -
96,950 277,000 - -
- - -
93,450 267,000 1,268,800 683,200 1,952,000
29,400 84,000 634,400 341,600 976,000
91,700 262,000 - -
54,250 155,000 54,600 29,400 84,000
- 731,900 394,100 1,126,000
- - -
11,550 33,000 195,000 105,000 300,000
34,650 99,000 2,466,100 1,327,900 3,794,000
- - -
23,100 66,000 97,500 52,500 150,000
23,100 66,000 - -
11,550 33,000 - -
- - -
- - -
- - -
1,508,850 4,311,000 6,765,200 3,642,800 - 10,408,000
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
ALAN APRIL 2020
PAD JP TOTAL PAD
- - 91,000
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
154,050 82,950 237,000 -
154,050 82,950 237,000 -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - 91,000
- - -
- - -
154,050 82,950 237,000 -
- - -
308,100 165,900 474,000 -
- - -
- - -
- - -
- - -
- - -
770,250 414,750 1,185,000 182,000
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
JP TOTAL PAD JP
49,000 140,000 - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
49,000 140,000 - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
98,000 280,000 - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
ANAK IGD,OUTOPSI
TOTAL PAD JP TOTAL
- -
185,250 99,750 285,000
- -
- -
- -
73,450 39,550 113,000
102,700 55,300 158,000
- -
50,700 27,300 78,000
95,550 51,450 147,000
80,600 43,400 124,000
- - -
486,850 262,150 749,000
114,400 61,600 176,000
14,300 7,700 22,000
- -
- -
7,150 3,850 11,000
- -
- -
- -
- -
- -
- -
- -
- -
119,600 64,400 184,000
- -
- -
- -
- -
87,750 47,250 135,000
- -
- -
- -
- 1,418,300 763,700 2,182,000
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
PAD JP TOTAL PAD
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
60,450 32,550 93,000 -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
60,450 32,550 93,000 -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
JP TOTAL PAD JP
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- 120,900 65,100
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- 60,450 32,550
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- 60,450 32,550
- - -
- - -
- - -
- - -
- - -
- - 241,800 130,200
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
TOTAL PAD JP TOTAL
- -
- -
- -
- -
- -
- -
20,800 11,200 32,000
- -
16,250 8,750 25,000
16,250 8,750 25,000
- -
48,750 26,250 75,000
186,000 - -
- -
- -
- -
32,500 17,500 50,000
- -
16,250 8,750 25,000
- -
93,000 - -
- -
- -
- -
16,250 8,750 25,000
- -
26,000 14,000 40,000
- -
- -
93,000 - -
- -
- -
- -
- -
- -
372,000 193,050 103,950 297,000
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
PAD JP TOTAL PAD
- - 95,550
- - -
- - 26,000
- - -
- - -
- - -
- - -
- - 47,450
154,050 82,950 237,000 36,400
154,050 82,950 237,000 -
- - -
616,200 331,800 948,000 -
- - -
- - -
- - -
- - -
308,100 165,900 474,000 -
- - -
308,100 165,900 474,000 -
- - -
154,050 82,950 237,000 -
- - 20,800
- - -
- - -
308,100 165,900 474,000 -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
2,002,650 1,078,350 3,081,000 226,200
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
JP TOTAL PAD JP
51,450 147,000 - -
- - -
14,000 40,000 - -
- - -
- - -
- - -
- - -
25,550 73,000 - -
19,600 56,000 - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
11,200 32,000 - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
121,800 348,000 - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
TOTAL PAD JP TOTAL
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- - - -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
KONSUL GIZI FARMASI
PAD JP TOTAL PAD
- - 1,657,625
- - 949,606
- - 542,203
- - 218,772
- - 481,500
- - 2,017,718
- - 858,857
- - 630,936
- - 725,075
- - 7,009,721
- - 554,290
- - 265,760
- - 1,833,285
- - 1,000,191
- - 479,120
- - 1,739,367
- - 233,991
- - 167,235
- - 258,220
- -
- - 1,050,882
- - 2,022,418
- - 407,608
- - 413,920
- - 1,040,750
- - 145,564
- - 3,409,570
- - 1,665,916
- -
- - 872,296
- - 311,770
- - 554,379
- -
- -
- -
- - - 33,518,545
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
FARMASI LABORAT
JP TOTAL PAD JP
10,500 1,668,125 293,150 157,850

3,900 953,506 72,800 39,200
5,700 547,903 - -
6,300 225,072 - -
12,200 493,700 - -
6,300 2,024,018 - -
15,900 874,757 - -
16,200 647,136 492,050 264,950
11,000 736,075 766,350 412,650
9,800 7,019,521 - -
12,300 566,590 - -
5,400 271,160 920,400 495,600
21,300 1,854,585 976,950 526,050
12,900 1,013,091 867,750 467,250
8,400 487,520 742,138 399,613
11,100 1,750,467 516,100 277,900
2,700 236,691 3,389,100 1,824,900
5,400 172,635 1,048,450 564,550
4,800 263,020 609,700 328,300
- - -
24,500 1,075,382 140,400 75,600
10,800 2,033,218 247,000 133,000
8,100 415,708 178,100 95,900
6,600 420,520 285,350 153,650
18,600 1,059,350 266,988 143,763
3,000 148,564 86,450 46,550
24,500 3,434,070 331,500 178,500
12,600 1,678,516 609,050 327,950
- - -
12,900 885,196 644,150 346,850
9,700 321,470 393,900 212,100
12,900 567,279 740,675 398,825
- - -
- - -
- - -
326,300 33,844,845 14,618,500 7,871,500
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
TOTAL -
451,000 2,304,575 596,550 2,901,125

112,000 1,285,656 184,850 1,470,506
- 656,703 171,200 827,903
- 248,022 22,050 270,072
- 510,750 27,950 538,700
- 2,150,418 181,600 2,332,018
- 1,139,357 345,400 1,484,757
757,000 1,333,536 557,600 1,891,136
1,179,000 2,120,275 1,033,800 3,154,075
- 7,502,871 527,650 8,030,521
- 722,640 102,950 825,590
1,416,000 2,377,610 1,592,550 3,970,160
1,503,000 4,844,085 2,052,500 6,896,585
1,335,000 2,717,591 1,631,500 4,349,091
1,141,750 1,990,858 1,372,413 3,363,270
794,000 2,744,717 854,750 3,599,467
5,214,000 4,929,441 3,060,250 7,989,691
1,613,000 1,291,085 610,550 1,901,635
938,000 1,572,520 1,142,500 2,715,020
- - -
216,000 2,971,282 1,550,100 4,521,382
380,000 3,101,868 994,350 4,096,218
274,000 831,608 564,100 1,395,708
439,000 973,620 694,900 1,668,520
410,750 2,563,988 1,121,113 3,685,100
133,000 310,014 91,550 401,564
510,000 4,315,720 829,350 5,145,070
937,000 5,145,766 2,331,750 7,477,516
- - -
991,000 2,146,596 1,110,600 3,257,196
606,000 847,570 525,900 1,373,470
1,139,500 1,575,904 709,875 2,285,779
- - - -
- - -
- - -
22,490,000 67,226,645 26,592,200 93,818,845
49,146,011
48,625,311
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
CROSS CEK
2,901,125 -
1,470,506 -
827,903 -
270,072 -
538,700 -
2,332,018 -
1,484,757 -
1,891,136 -
3,154,075 -
8,030,521 -
825,590 -
3,970,160 -
6,896,585 -
4,349,091 -
3,363,270 -
3,599,467 -
7,989,691 -
1,901,635 -
2,715,020 -
-
4,521,382 -
4,096,218 -
1,395,708 -
1,668,520 -
3,685,100 -
401,564 -
5,145,070 -
7,477,516 -
-
3,257,196 -
1,373,470 -
2,285,779 -
-
-
-
93,818,845 - -
-
1,080,000
#REF!
#REF!
#REF!
#REF!
#REF!
#REF!
#REF!
#REF!
#REF!
#REF!
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
MIRNAWATI RK 1,081,600 1,409,100
-
- -
- -
- -
- -
- -
- -
- -
- - 68,499,891 68,499,891
RAWAT INAP 68,499,891 -

LAIN-LAINNYA 4,840,554,284.22 -
BKU 5,002,873,020.22 -
DG+DM(INAP + RJ)
2,901,125 2,901,125 2,901,125 -

1,470,506 1,470,506 1,470,506 -
827,903 827,903 827,903 -
270,072 270,072 270,072 -
538,700 538,700 538,700 -
2,332,018 2,332,018 2,332,018 -
1,484,757 1,484,757 1,484,757 -
1,891,136 1,891,136 1,891,136 -
3,154,075 3,154,075 3,154,075 -
8,030,521 8,030,521 8,030,521 -
825,590 825,590 825,590 -
3,970,160 3,970,160 3,970,160 -
11,054,083 19,369,079 11,054,083 -
6,011,590 9,336,588 6,011,590 -
3,363,270 3,363,270 3,363,270 -
3,599,467 3,599,467 3,599,467 -
7,989,691 7,989,691 7,989,691 -
1,901,635 1,901,635 1,901,635 -
327,500 -
4,124,120 6,614,820 4,124,120 -
- -
4,096,218 4,096,218 4,096,218 -
1,395,708 1,395,708 1,395,708 -
- -
3,685,100 3,685,100 3,685,100 -
401,564 401,564 401,564 -
5,145,070 5,145,070 5,145,070 -
3,242,750 -
22,303,845 48,713,753 22,303,845 -
3,257,196 3,257,196 3,257,196 -
6,179,865 15,792,655 6,179,865 -
9,863,120 -
10,164,525 -
11,631,725 -
43,923,849 95,540,619 43,923,849 -
156,128,834 293,128,616 156,128,834 -
93,818,845
54,595,670
148,414,515.22
266,579,920.22
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
Pemeriksaan
SPECIMEN
SWAB (Pjbtn
presiden RI)
praktek
TOTAL TOTAL
135,000
- 135,000.00 - - -
PT. Peniti
sungai
BRI Wings Air
ASKES Palma Asri
s.PT.Sumber
Cipta M
- - - - -
UTDRS
RS.LINDIMARA
3,290,969,500
43,370,863
38,695,625
6,294,651
3,290,969,500.00 - 38,695,625.00 49,665,514.00
-
JUMLAH
Pembyrn SEWA
-
-
-
-
-
-
-
-
-
-
-
1,061,219,200 1,061,219,200.00
-
-
-
3,290,969,500.00
3,500,000 3,500,000.00
-
-
-
43,370,863.00
384,104,400 384,104,400.00
38,695,625.00
6,294,651.00
-
5,333.00 5,333.00
-
34,875.03 34,875.03
-
-
-
12,224,837.19 12,359,837.19
-
-
-
12,265,045.22 1,445,323,600.00 3,500,000.00 4,840,554,284.22
3,635,000
03 JUNI 2020 73,497,100
#NAME?

-
-
-
-
-
-
-
-
-
-
TANGGAL NAMA PASIEN
NAMA DOKTER
1 APRIL 2021 AISYAHRI KARTINI

NURHAYATI SIU
MUHAMMAD AZKA ALKHOIR
SIDIQ ABDUL AZIZ DR WIDYA ARITONANG
2 APRIL 2021 FERNANDUS MARA KORO
ANGELA SUBARTI RAMBU MAY
3 APRIL 2021 QUEZYN ANASTA RAME
JESICHA RAMBU MUNI DR STEEVI A
4 APRIL 2021 FREDERIKA A.BUBU
5 APRIL 2021 BINTANG SABANA MAUPANJI
6 APRIL 2021 ANDERIAS SAINGO
ANTON BABU NEKA DR STEEVI A
7 APRIL 2021 BARA HUDA AMAH
RONI IRAWAN
FERDINAND HARU MBALA
LAHMOT MARULY BUTAR BUTAR
8 APRIL 2021 SIGIT PURNOMO
APLIANA LENDE
SYAFRUDDIN
MARIA JESIKA INA DR STEEVI A
LEPIR ATANDEWA DR STEEVI A
9 APRIL 2021 SKOI ASTIKA TRI FINA PINDI
STEPANUS NGONGO
EXON MALINGARA DR STEEVI A
NOFRIANUS NDAWA RAJI DR STEEVI A
UMBU ROY CHRISTIAN KULANDIMA DR STEEVI A
MARGARETHA NGAMBAR HUNGGURUY DR STEEVI A
UMBU ROY CHRISTIAN KULANDIMA DRG TR ITA INING
10 APRIL 2021 HELENA INTAN INDAYANI
VHICRANT MALIK ABDUL AZIZ
GRASIELA MONIKE TAMBALO
PITOYO DR STEEVI A
STEVANUS PAILA DR STEEVI A
11 APRIL 2021 BINTANG NDAKULARAK
DISIYA KAHI LEBA
ANDREAS HESRON
12 APRIL 2021 DINDA RAMBU NABILA DR STEEVI A
DADANG SUDIRMAN DR STEEVI A
RAMBU NOVIA HINGGIRANJA DR STEEVI A
FAIJAH JULIANA DR STEEVI A
POERNOMO TJONDRO DR STEEVI A
13 APRIL 2021 DRS.SUAEB DR STEEVI A
LUSIA NATALIA KEO DR STEEVI A
CHRISTIAN METAYADI DR STEEVI A
SHOPHIE PLORENTINE LAURA DR STEEVI A
JEMY DATU LANGKAY DR STEEVI A
MUTH IM ABUBAKAR
LUSIA NATALIA KEO DR STEEVI A
MUHAMMAD WAFI IZZUDIEN
DAMARIS D. ANATANA
MERLIN NIWA BANJA URU
JOHNY UMBU YOLI DR STEEVI A
ANGGRIANI NEWA LAPUR DR STEEVI A
GALVIN UMBU SOGAR
14 APRIL 2021 HOSANA PUTRI DR STEEVI A
EMILIANUS YEGHO DR STEEVI A
DELIA ANA YUHIN DR STEEVI A
SOFIA BIDA DR STEEVI A
UMBU KANNI PRAING DR STEEVI A
ANGGRIANI NEWA LAPUR DR STEEVI A
ANGGRIANI KARANJA NGANA DR STEEVI A
ANGGRIANI KARANJA NGANA DRG TR ITA INING
HOSANA PUTRI DAU DRG TR ITA INING
DELIA ANA YUHIN DRG TR ITA INING
ANGGRIANI NEWA LAPUR DRG TR ITA INING
SALMAN AMBAR
NANDA TONDA MBITU
15 APRIL 2021 MARO WARTONO
SAMSIA KONGA YULI DR STEEVI A
RONI ROMU REMIDATA RENGGI
STEVI ENGELITA MANU DR STEEVI A
STEVI ENGELITA MANU DRG TR ITA INING
ANGGRENI RAMBU MORA DR STEEVI A
ANGGRENI RAMBU MORA DRG TR ITA INING
RUSTI RAMBU LINGGA DR STEEVI A
RUSTI RAMBU LINGGA DRG TR ITA INING
TIARA FEBRIANA TARI DR STEEVI A
TIARA FEBRIANA TARI DRG TR ITA INING
BOBIYONO DANIEL ANGGUMAY DR STEEVI A
BOBIYONO DANIEL ANGGUMAY DRG TR ITA INING
KEVIN RIANTO DR STEEVI A
KEVIN RIANTO DRG TR ITA INING
DELIA DAVIANTI MARO DR STEEVI A
DELIA DAVIANTI MARO DRG TR ITA INING
GERSON TALUNDIMA DR STEEVI A
KHARISMA ALSYAD NUR AZIZAH DR STEEVI A
KHARISMA ALSYAD NUR AZIZAH DRG TR ITA INING
ANGELIA RAMBU HAMU RATU AMAH DR STEEVI A
16 APRIL 2021 REZANI ADRILIS DIMA
ARIEL KATOGA RETANG
ELEAZAR LU UMARATU DR STEEVI A
ANASTASIA PADU LEMBA DR STEEVI A
MAXWELL JOSHUA ARA DR STEEVI A
ARSI BANGU KAHI DR STEEVI A
GRACE ZABRINA ANGELA DJUKA DR STEEVI A
17 APRIL 2021 ALVANDER BEES
ANANDA KUDU DJERA DR STEEVI A
YUSTINA BANGU DR STEEVI A
DAMIANA JENIVER TANGGU BORE DR STEEVI A
ANA KUDU DJERA UTU H. DR STEEVI A
NIA ATA NDEWA DR STEEVI A
NOVANLI HARABI LODA DR STEEVI A
ADE IRMA D. DR STEEVI A
DAMIANA JENIVER TANGGU BORE DR STEEVI A
YOSEFINA DAIRO TIMBULA DR STEEVI A
MARTINUS UMBU RETANG DR STEEVI A
MARKUS WIE LAY DR STEEVI A
ADE IRMA D. DRG TR ITA INING
DAMIANA JENIVER TANGGU BORE DRG TR ITA INING
ANA KUDU DJERA UTU H. DRG TR ITA INING
YUSTINA BANGU DRG TR ITA INING
NIA ATA NDEWA DRG TR ITA INING
NOVANLI HARABI LODA DRG TR ITA INING
GENOVENA NGANA DR STEEVI A
YENI BULU DR STEEVI A
MARIA KONI GIDI DR STEEVI A
DARIEL KIANO NDENA
18 APRIL 2021 SUKAINA
HENDRIKUS G.W
19 APRIL 2021 JOSHUA KRISTANTO T. DR STEEVI A
MELTARIN HAMAKONDA DR STEEVI A
FIRMANSYAH DR STEEVI A
RAMBU FELYN TAMU APU DR STEEVI A
HENDRA OKYTAVIANUS DR STEEVI A
ADELIN FEBRIANI A. RUNGA DR STEEVI A
RAMBU DEA APLYCARLY DR STEEVI A
ERNALINDA NDAKULARAK DR STEEVI A
I GUSTI AYU KETUT DRG TR ITA INING
RAMBU DEA APLYCARLY DRG TR ITA INING
20 APRIL 2021 ANGGUN PRASTIKA DAY HAMBATI DR STEEVI A
YULIANTO LANGO DODO DR STEEVI A
GERALDA HOLLMAYELA LUDJI DR STEEVI A
YAKOBA MARIA DJARA DRG TR ITA INING
ANGGUN PRASTIKA DAY HAMBATI DRG TR ITA INING
YULIANTO LANGO DODO DRG TR ITA INING
GERALDA HOLLMAYELA LUDJI DRG TR ITA INING
21 APRIL 2021 BERNAD SEMUEL ELIM
BOBIYONO DANIEL ANGGUMAY DR STEEVI A
SURYANI HIDA HAMU DR STEEVI A
CINDY PUSPITASARI DR STEEVI A
NISVINA KONGA ATA DJAWA DR STEEVI A
SURYANI HIDA HAMU DRG TR ITA INING
CINDY PUSPITASARI DRG TR ITA INING
NISVINA KONGA ATA DJAWA DR STEEVI A
22 APRIL 2021 SAMSIA KONGA YULI DR STEEVI A
SAMSIA KONGA YULI DRG TR ITA INING
ERVINA RATU DR STEEVI A
23 APRIL 2021 EMILIA BABANG KIAU DRG TR ITA INING
EMILIA BABANG KIAU DR STEEVI A
RIVALDY ALAM TEGAR B. WUNGA DR STEEVI A
ARITA TENGGA WUASU DR STEEVI A
ARITA TENGGA WUASU DRG TR ITA INING
24 APRIL 2021 YEWA PAKU DUDU DR WIDYA ARITONANG
MATHEUS HORUNG LAKI DJUA
25 APRIL 2021 MARIA VALENDINA GELOLE
RAMBU APRIANI KARITA
26 APRIL 2021 HUSNI MUBAROK NURDIN DRG TR ITA INING
MARIA SELVIANA
SALMAN TOASU
SAUL DJOKKAHO
WILIBRODUS NANI
ANGELA FRISKA RAMBU MAY MAHA LILA DR STEEVI A
SKOLASTIKA GRACIA RAMBU MAY AGUL DR STEEVI A
27 APRIL 2021 SAMMY DAVIS ROHI DR STEEVI A
YUBLINA ROHI DR STEEVI A
JARIAMAN PUAY DR STEEVI A
28 APRIL 2021 CHRISTOFEL RIWU DRG TR ITA INING
WENANG PUTRA PRATAMA PETRUS PANDAHU DR STEEVI A
NADILA SURYANI MALO DR STEEVI A
29 APRIL 2021 ELWADI JACKMARC RATU DR STEEVI A
GREYSDA R.L UET DR STEEVI A
MAZIALFAS UMBU NDJUKA ANDUNG DR STEEVI A
30 APRIL 2021 YUSTINA NONA INA
YANUS MBAKU TARAAMAH
MARIA KEWA LEMBA HOARATAN DR STEEVI A
APREDIS DJAMI DR STEEVI A
DOKTER POLIKLINIK
JASA PEMERIKSAAN SKS TINDAKAN KEP/KEB
20,000
20,000 4,200
20,000
20,000 4,200
20,000 4,200
20,000
20,000 4,200
40,000 8,400
20,000
20,000
20,000
20,000
40,000 8,400
20,000
20,000 4,200
20,000 4,200
20,000
20,000 4,200 1
20,000 4,200 1
40,000 4,200 2
20,000 1
20,000 1
20,000
20,000 1
20,000 1
40,000 8,400
20,000 4,200
40,000 8,400
20,000 4,200
20,000 4,200
20,000 4,200
40,000
20,000
20,000
20,000
20,000 4,200
20,000 1
40,000 4,200 2
20,000
40,000 4,200 2
20,000
40,000 4,200 2
20,000
40,000 4,200 2
20,000
40,000 4,200 2
20,000
40,000 4,200 2
20,000
40,000 4,200 2
20,000
20,000 1
20,000 8,400 1
20,000
20,000 4,200 1
18
40,000 8,400 2
20,000 4,200 1
60,000 4,200 3
60,000 4,200 3
60,000 4,200 3
12
20,000 4,200 1
40,000 4,200 2
20,000 1
20,000 1
40,000 4,200 2
40,000 4,200 2
20,000 4,200 1
20,000 4,200 1
20,000 1
20,000 1
20,000 1
20,000
20,000
20,000
20,000
20,000
20,000
20,000 4,200 1
20,000 1
20,000 1
17
40,000 8,400 2
60,000 4,200 3
20,000 1
60,000 4,200 3
20,000 4,200 1
20,000 4,200 1
20,000 4,200 1
20,000 4,200 1
20,000
20,000 4,200
20,000 4,200 1
20,000 4,200 1
20,000 4,200 1
20,000
20,000
20,000
20,000
20,000
20,000 4,200
20,000 4,200
20,000 4,200
20,000
20,000
20,000
20,000 4,200
20,000
20,000 4,200
20,000
20,000 8,400
20,000 8,400
4,200
20,000
20,000
20,000
20,000
20,000 4,200
20,000 4,200
20,000 4,200
20,000 4,200
20,000
20,000 8,400
20,000 8,400
20,000 4,200
20,000 4,200
20,000 4,200
20,000 4,200
20,000 4,200
DOKTER UGD
NAMA DOKTER JASA PEMERIKSAAN SKS TINDAKAN
DR ANRY WIDITY 30,000

DR RAYVANY UIL 30,000
DR ARTIKASARI PASANDE 30,000
DR KARTIKA RAMBU LEKI S 30,000

DR ADITYA YOGARAMA 30,000
DR AKTHA YUDISTIRA 30,000

DR ERNESTO NJURUMANA 30,000

DR ERVAN 30,000
DR ERVAN 30,000
DR SILVRIYANI NJRUMANA 30,000

DR ERVAN 30,000


DR.ERNESTO 30,000
DR ERVAN 30,000


DR IMANUEL RUSTOM 30,000
DR ERVAN 30,000
DR AGUNG TOMO K.S. YAPUT 30,000
DR WIDYA ARITONANG 30,000
DR KARTIKA 30,000
DR IREN 30,000
DR ERVAN 30,000
DR KARTIKA 30,000
DR YANI 30,000
DR AGUNG 30,000
DR KARTIKA 30,000
DR WIDIA 30,000
DR ERVAN 30,000
1,470,000
1470000
-
TIND KEPERAWATAN
285,000
34,000
124,000
78,000
34,000
113,000
113,000
707,000
135,000
63,000
113,000
22,000
34,000
22,000
113,000
TANGGAL NAMA PASIEN
1 ANGELA SUBARTI RAMBU MAY

2 8 APRIL 2021 SIGIT PURNOMO
3 9 APRIL 2021 SKOI ASTIKA TRI FINA PINDI
4 DISIYA KAHI LEBA
5 SALMAN AMBAR
6 RONI ROMU REMIDATA RENGGI
7 SAUL DJOKKAHO
8 HENDRIKUS G.W
9 3 APRIL 2021 QUEZYN ANASTA RAME
10 5 APRIL 2021 BINTANG SABANA MAUPANJI
11 RONI IRAWAN
12 11 APRIL 2021 BINTANG NDAKULARAK
13 ANDREAS HESRON
14 MUTH IM ABUBAKAR
15 15 APRIL 2021 MARO WARTONO
16 1 APRIL 2021 AISYAHRI KARTINI
17 MUHAMMAD AZKA ALKHOIR
18 4 APRIL 2021 FREDERIKA A.BUBU
19 7 APRIL 2021 BARA HUDA AMAH
20 SYAFRUDDIN
21 10 APRIL 2021 HELENA INTAN INDAYANI
22 GRASIELA MONIKE TAMBALO
23 DAMARIS D. ANATANA
24 MUHAMMAD WAFI IZZUDIEN
25 6 APRIL 2021 ANDERIAS SAINGO
26 VHICRANT MALIK ABDUL AZIZ
27 FERDINAND HARU MBALA
28 LAHMOT MARULY BUTAR BUTAR
29 STEPANUS NGONGO
30 MERLIN NIWA BANJA URU
31 DARIEL KIANO NDENA
32 RAMBU APRIANI KARITA
33 YANUS MBAKU TARAAMAH
34 16 APRIL 2021 REZANI ADRILIS DIMA
35 18 APRIL 2021 SUKAINA
36 25 APRIL 2021 MARIA VALENDINA GELOLE
37 MATHEUS HORUNG LAKI DJUA
38 MARIA SELVIANA
39 WILIBRODUS NANI
40 2 APRIL 2021 FERNANDUS MARA KORO
41 NANDA TONDA MBITU
42 ARIEL KATOGA RETANG
43 NURHAYATI SIU
44 APLIANA LENDE
45 GALVIN UMBU SOGAR
46 17 APRIL 2021 ALVANDER BEES
47 SALMAN TOASU
48 30 APRIL 2021 YUSTINA NONA INA
49 21 APRIL 2021 BERNAD SEMUEL ELIM
NAMA DOKTER
DR ADITYA YOGARAMA
DR AGUNG TOMO K.S. YAPUTRA
DR AKTHA YUDISTIRA
DR ARTIKASARI PASANDE
DR ERNESTO NJURUMANA
DR ERVAN
DR IMANUEL RUSTOM
DR IREN
DR KARTIKA RAMBU LEKI S
DR RAYVANY UIL
DR SILVRIYANI NJRUMANA
DR WIDYA ARITONANG
DOKTER POLIKLINIK DOKTER UGD
TIND KEPERAWATAN
NAMA DOKTER NAMA DOKTER JASA PEMERIKSAAN

###
###
DR AGUNG TOMO K.S. YAPUTRA 30,000
DR AGUNG TOMO K.S. YAPUTRA 30,000
###
###
###
DR ANRY WIDITY 30,000
###
###
DR ERVAN 30,000
###
DR ERVAN 30,000
DR ERVAN 30,000
###
DR ERVAN 30,000
###
DR ERVAN 30,000
DR ERVAN 30,000
DR ERVAN 30,000
###
DR IREN 30,000
###
###
###
DR RAYVANY UIL 30,000
DR WIDIA ARITONANG 30,000
###
DR WIDYA ARITONANG 30,000
1,470,000
1470000
JUMLAH PASIEN JP KARCIS TOTAL
6 30,000 180,000
2 30,000 60,000
7 30,000 210,000
7 30,000 210,000
3 30,000 90,000
7 30,000 210,000
2 30,000 60,000
1 30,000 30,000
6 30,000 180,000
1 30,000 30,000
4 30,000 120,000
2 30,000 60,000
48
TANGGAL TANGGAL
NO NAMA NO MR RG
MASUK KELUAR
3 MARAMBA HUTAR RK 19-04-2021 19-04-2021
4 MIRNAWATI RK 19-04-2021 19-04-2021

IGD
AKOMODASI
TOTAL PAD JP
4,157,498 - -
119,000 15,000 9,750 5,250
327,500 - -
1,081,600 - -
1,650,000 - -
1,600,000 15,000 9,750 5,250
788,000 388,000 252,200 135,800
1,190,000 - -
1,190,000 - -
1,190,000 - -
1,190,000 - -
455,700 455,700 296,205 159,495
476,000 525,000 341,250 183,750
119,000 330,000 214,500 115,500
714,000 835,000 542,750 292,250
1,065,000 637,000 414,050 222,950
17,313,298 3,200,700 2,080,455 1,120,245

TOTAL PAD JP TOTAL
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- - - -
PAD JP TOTAL PAD
- - -
- - -
- - -
- - -
- - -
- - -
- - 334,000 217,100
- - 1,021,000 663,650
- - 1,033,000 671,450
- - 1,316,000 855,400
- - 543,000 352,950
- - 455,701 296,206
- - 513,000 333,450
- - 50,000 32,500
- - 1,015,000 659,750
- - 1,125,000 731,250
- - 7,405,701 4,813,706
TOTAL TARIF
NVILLE VIP/UTM
JP TOTAL PAD JP
- - -
- - -
- - -
- - -
- - -
- - -
116,900 - -
357,350 - -
361,550 - -
460,600 - -
190,050 - -
159,495 - -
179,550 - -
17,500 - -
355,250 - -
393,750 - -
2,591,995 - - -
KEMUNING PICU
TOTAL PAD JP TOTAL
- -
841,000 546,650 294,350
- -
- -
- -
2,497,000 1,623,050 873,950
- - 542,000
- -
- -
- -
- -
- - 455,701
- -
- -
- -
- -
3,338,000 2,169,700 1,168,300 997,701

PICU NICU
PAD JP TOTAL PAD
- - -
- - -
- - -
- - -
- - 926,000 601,900
- - -
352,300 189,700 -
- - -
- - -
- - -
- - -
296,206 159,495 -
- - -
- - -
- - -
- - -
648,506 349,195 926,000 601,900

CU HEMODELISA
JP TOTAL PAD JP
- - -
- - -
- - -
- - -
324,100 - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- 34,000 22,100 11,900
- - -
324,100 34,000 22,100 11,900

ICU
DR .I KETUT
TOTAL PAD JP
ARYAWAN,SPM
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- - - -
JASA OK
820,400
820,400 - - -
JASA OK

382,865
656,250 393,750
656,250 393,750
656,250 393,750
656,250 393,750
656,250 393,750
341,906 205,144
341,906 205,144
2,625,000 - 1,340,062 2,761,903

PAD TOTAL PAD+JP
- -
- -
- -
- -
- -
437,535 1,640,800 3,047,200 4,688,000
- -
262,500 1,312,500 2,437,500 3,750,000
262,500 1,312,500 2,437,500 3,750,000
262,500 1,312,500 2,437,500 3,750,000
262,500 1,312,500 2,437,500 3,750,000
262,500 1,312,500 2,437,500 3,750,000
136,763 683,813 1,269,938 1,953,751
- -
136,763 683,813 1,269,938 1,953,751
- -
2,023,561 9,570,926 17,774,576 27,345,502

294,000
84,000 150,000
294,000 841,250
463,000 976,000
524,500 150,000
1,024,500 420,625 150,000
524,500 420,625 150,000
524,500 150,000
902,000 841,250 784,400
250,500 885,600
214,000 300,000
250,500 885,600
81,000 1,119,600
- 5,431,000 2,523,750 5,701,200

DR KETUT,SPOG
FISIOTERAPI FARMASI
KARCIS USG
263,499
232,750
1,328,329 40,000
985,395
2,727,620
2,046,400
3,780,600
3,271,200
10,740,648
3,765,586
414,964
5,540,811
1,596,651
- 36,694,453 40,000 -
50,000
200,000
250,000 - - -
390,400
390,400
390,400
390,400
- - - 1,561,600

SUL
130,000
980,000
130,000
115,000
227,500
- - - 1,582,500
50,000
50,000
- 100,000 - -
32,500
130,000
65,000
50,000
130,000
- - - 407,500
DR.ANTONIUS RIO ADI
dr.ERIK LIOS,Sp.PD
NUGRAHA,Sp.PD
- - - -
325,000
325,000
325,000
325,000
162,500
- 1,462,500 - -
- - - -
KETUT ARYAWAN,S.PM
DR I MADE M DR YANI
30,000
- - - 30,000
30,000
- - - 30,000
- - - -
17,500
30,000
30,000
17,500 - - 60,000
DOKTER UMUM
30,000
- - - 30,000
DOKTER UMUM
35,000
175,000
175,000
175,000
175,000
140,000
30,000
30,000
- 60,000 875,000 -
70,000
227,500
70,000
35,000
122,500
87,500
70,000 - 542,500 -
17,500
17,500 - - -
52,500
52,500 - - -
TOTAL VISITE
30,000 130,000
200,000
320,000
330,000
500,000
550,000
500,000
550,000
35,000 1,932,900
620,400
180,000
770,400
670,400
- 30,000 35,000 7,254,100

TOTAL
PAD JP TOTAL
4,157,498 - 4,157,498 -
1,232,899 429,600 1,662,499 -
327,500 - 327,500 -
1,081,600 - 1,081,600 -
2,718,650 524,100 3,242,750 -
8,743,579 2,840,000 11,583,579 -
4,033,995 772,400 4,806,395 -
7,693,270 2,169,850 9,863,120 -
7,940,475 2,224,050 10,164,525 -
9,358,625 2,273,100 11,631,725 -
7,926,150 2,052,550 9,978,700 -
17,050,114 3,723,886 20,774,000 -
7,322,324 1,667,513 8,989,837 -
1,294,964 313,000 1,607,964 -
9,885,449 2,113,613 11,999,062 -
5,007,551 1,287,100 6,294,651 -
95,774,643 22,390,762 118,165,405

118,165,405
SKS(
sdh
TGL NO PX INAP
karci
s)

13 1
14 2
19 3
4
27 5
6
29 7
30 8 40,000
9
10
11
0 0 0 40,000
KARCIS
POLI
PAD JP TOTAL TOTAL
60,000 48,750 26,250 75,000 250,000

39,000 21,000 60,000 -
30,000 9,750 5,250 15,000 100,000
9,750 5,250 15,000 -
9,750 5,250 15,000 -
30,000 9,750 5,250 15,000 100,000
40,000 39,000 21,000 60,000 200,000
50,000 39,000 21,000 60,000 150,000
90,000 58,500 31,500 90,000 200,000
70,000 29,250 15,750 45,000 250,000
29,250 15,750 45,000 -
130,000 9,750 5,250 15,000 400,000
130,000 58,500 31,500 90,000 300,000
160,000 19,500 10,500 30,000 500,000
130,000 48,750 26,250 75,000 100,000
70,000 19,500 10,500 30,000 100,000
150,000 58,500 31,500 90,000 150,000
29,250 15,750 45,000 -
130,000 - - 200,000
- - -
90,000 9,750 5,250 15,000 400,000
70,000 9,750 5,250 15,000 300,000
60,000 - - 300,000
80,000 - - 350,000
70,000 19,500 10,500 30,000 300,000
39,000 21,000 60,000 -
80,000 39,000 21,000 60,000 300,000
120,000 19,500 10,500 30,000 450,000
- - -
90,000 - - 400,000
60,000 - - 200,000
40,000 29,250 15,750 45,000 150,000
- - -
- - -
- - -
2,030,000 731,250 393,750 1,125,000 6,150,000
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
dr. MATA (dr.I
Ketut
Aryawan,Sp.M)
100,000
50,000
50,000
50,000 150,000
50,000
100,000
50,000
50,000
50,000 100,000
150,000 100,000
200,000 50,000
200,000
200,000 50,000
50,000
100,000 50,000 50,000

150,000
150,000 50,000
100,000 50,000
50,000
- 1,300,000 800,000 450,000
dr. ANDRY,SPB
100,000
50,000
100,000
50,000 50,000 50,000
50,000 50,000 50,000 100,000
50,000 50,000
100,000
100,000 50,000
100,000 50,000
50,000 50,000
50,000
50,000
200,000 50,000
50,000
150,000 50,000 50,000
50,000
50,000
100,000
500,000 650,000 400,000 - 550,000
POLIK Dr.ANTON dr
50,000
100,000
150,000 50,000
150,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
- - - 350,000 500,000
TOTAL
20,000 20,000
-
50,000 20,000
-
-
20,000
-
40,000
120,000
40,000
-
100,000 120,000
150,000 180,000
100,000 280,000
520,000
240,000
460,000
-
300,000
-
140,000
140,000
60,000
50,000 80,000
20,000
-
60,000
50,000 60,000
-
150,000 60,000
60,000
40,000
-
-
-
- 650,000 3,080,000 - 20,000
-
-
-
-
-
-
-
-
-
-
20,000
20,000
40,000
20,000 100,000
40,000
120,000
180,000
80,000 200,000
160,000 360,000
240,000
120,000 340,000
40,000 260,000
80,000 60,000
60,000 80,000
20,000 40,000
40,000 40,000
20,000
20,000 40,000
60,000
20,000 40,000
60,000
40,000
- - 660,000 2,400,000 -
PAD JP
58,500 31,500
39,000 21,000
19,500 10,500
19,500 10,500
19,500 10,500
19,500 10,500
78,000 42,000
58,500 31,500
39,000 21,000
58,500 31,500
58,500 31,500
- -
97,500 52,500
39,000 21,000
39,000 21,000
39,000 21,000
39,000 21,000
39,000 21,000
- -
- -
- -
19,500 10,500
- -
- -
19,500 10,500
39,000 21,000
78,000 42,000
- -
- -
- -
- -
39,000 21,000
- -
- -
- -
- - - 955,500 514,500
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -

90,000 - - -
60,000 - - -
30,000 7,800 4,200 12,000 21,450
30,000 - - -
30,000 - - -
30,000 - - -
120,000 - - -
90,000 15,600 8,400 24,000 -
60,000 23,400 12,600 36,000 160,550
90,000 - - 69,550
90,000 - - -
- 31,200 16,800 48,000 160,550
150,000 23,400 12,600 36,000 170,300
60,000 70,200 37,800 108,000 195,000
60,000 78,000 42,000 120,000 459,550
60,000 46,800 25,200 72,000 21,450
60,000 46,800 25,200 72,000 671,450
60,000 - - -
70,200 37,800 108,000 180,050
- - -
23,400 12,600 36,000 173,550
30,000 23,400 12,600 36,000 54,600
15,600 8,400 24,000 170,300
39,000 21,000 60,000 100,750
30,000 - - -
60,000 - - -
120,000 15,600 8,400 24,000 21,450
46,800 12,600 12,600 72,000 64,350
- - -
31,200 16,800 48,000 42,900
39,000 12,600 8,400 60,000 42,900
60,000 23,400 8,400 4,200 36,000 21,450
- - -
- - -
- - -
1,470,000 670,800 336,000 25,200 1,032,000 2,802,150
361,200 86
21,000
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
11,550 33,000 - -
- - -
- - -
- - -
- - -
- - -
86,450 247,000 - -
37,450 107,000 - -
- - -
86,450 247,000 195,000 105,000 300,000
91,700 262,000 731,900 394,100 1,126,000
105,000 300,000 97,500 52,500 150,000
247,450 707,000 - -
11,550 33,000 292,500 157,500 450,000
361,550 1,033,000 - -
- - -
96,950 277,000 - -
- - -
93,450 267,000 1,268,800 683,200 1,952,000
29,400 84,000 634,400 341,600 976,000
91,700 262,000 - -
54,250 155,000 54,600 29,400 84,000
- 731,900 394,100 1,126,000
- - -
11,550 33,000 195,000 105,000 300,000
34,650 99,000 2,466,100 1,327,900 3,794,000
- - -
23,100 66,000 97,500 52,500 150,000
23,100 66,000 - -
11,550 33,000 - -
- - -
- - -
- - -
1,508,850 4,311,000 6,765,200 3,642,800 - 10,408,000
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
ALAN APRIL 2020
PAD JP TOTAL PAD
- - 91,000
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
154,050 82,950 237,000 -
154,050 82,950 237,000 -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - 91,000
- - -
- - -
154,050 82,950 237,000 -
- - -
308,100 165,900 474,000 -
- - -
- - -
- - -
- - -
- - -
770,250 414,750 1,185,000 182,000
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
JP TOTAL PAD JP
49,000 140,000 - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
49,000 140,000 - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
98,000 280,000 - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
ANAK IGD,OUTOPSI
TOTAL PAD JP TOTAL
- -
185,250 99,750 285,000
- -
- -
- -
73,450 39,550 113,000
102,700 55,300 158,000
- -
50,700 27,300 78,000
95,550 51,450 147,000
80,600 43,400 124,000
- - -
486,850 262,150 749,000
114,400 61,600 176,000
14,300 7,700 22,000
- -
- -
7,150 3,850 11,000
- -
- -
- -
- -
- -
- -
- -
- -
119,600 64,400 184,000
- -
- -
- -
- -
87,750 47,250 135,000
- -
- -
- -
- 1,418,300 763,700 2,182,000
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
PAD JP TOTAL PAD
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
60,450 32,550 93,000 -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
60,450 32,550 93,000 -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
JP TOTAL PAD JP
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- 120,900 65,100
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- 60,450 32,550
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- 60,450 32,550
- - -
- - -
- - -
- - -
- - -
- - 241,800 130,200
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
TOTAL PAD JP TOTAL
- -
- -
- -
- -
- -
- -
20,800 11,200 32,000
- -
16,250 8,750 25,000
16,250 8,750 25,000
- -
48,750 26,250 75,000
186,000 - -
- -
- -
- -
32,500 17,500 50,000
- -
16,250 8,750 25,000
- -
93,000 - -
- -
- -
- -
16,250 8,750 25,000
- -
26,000 14,000 40,000
- -
- -
93,000 - -
- -
- -
- -
- -
- -
372,000 193,050 103,950 297,000
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
PAD JP TOTAL PAD
- - 95,550
- - -
- - 26,000
- - -
- - -
- - -
- - -
- - 47,450
154,050 82,950 237,000 36,400
154,050 82,950 237,000 -
- - -
616,200 331,800 948,000 -
- - -
- - -
- - -
- - -
308,100 165,900 474,000 -
- - -
308,100 165,900 474,000 -
- - -
154,050 82,950 237,000 -
- - 20,800
- - -
- - -
308,100 165,900 474,000 -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
2,002,650 1,078,350 3,081,000 226,200
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
JP TOTAL PAD JP
51,450 147,000 - -
- - -
14,000 40,000 - -
- - -
- - -
- - -
- - -
25,550 73,000 - -
19,600 56,000 - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
11,200 32,000 - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
121,800 348,000 - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
TOTAL PAD JP TOTAL
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- - - -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
KONSUL GIZI FARMASI
PAD JP TOTAL PAD
- - 1,657,625
- - 949,606
- - 542,203
- - 218,772
- - 481,500
- - 2,017,718
- - 858,857
- - 630,936
- - 725,075
- - 7,009,721
- - 554,290
- - 265,760
- - 1,833,285
- - 1,000,191
- - 479,120
- - 1,739,367
- - 233,991
- - 167,235
- - 258,220
- -
- - 1,050,882
- - 2,022,418
- - 407,608
- - 413,920
- - 1,040,750
- - 145,564
- - 3,409,570
- - 1,665,916
- -
- - 872,296
- - 311,770
- - 554,379
- -
- -
- -
- - - 33,518,545
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
FARMASI LABORAT
JP TOTAL PAD JP
10,500 1,668,125 293,150 157,850

3,900 953,506 72,800 39,200
5,700 547,903 - -
6,300 225,072 - -
12,200 493,700 - -
6,300 2,024,018 - -
15,900 874,757 - -
16,200 647,136 492,050 264,950
11,000 736,075 766,350 412,650
9,800 7,019,521 - -
12,300 566,590 - -
5,400 271,160 920,400 495,600
21,300 1,854,585 976,950 526,050
12,900 1,013,091 867,750 467,250
8,400 487,520 742,138 399,613
11,100 1,750,467 516,100 277,900
2,700 236,691 3,389,100 1,824,900
5,400 172,635 1,048,450 564,550
4,800 263,020 609,700 328,300
- - -
24,500 1,075,382 140,400 75,600
10,800 2,033,218 247,000 133,000
8,100 415,708 178,100 95,900
6,600 420,520 285,350 153,650
18,600 1,059,350 266,988 143,763
3,000 148,564 86,450 46,550
24,500 3,434,070 331,500 178,500
12,600 1,678,516 609,050 327,950
- - -
12,900 885,196 644,150 346,850
9,700 321,470 393,900 212,100
12,900 567,279 740,675 398,825
- - -
- - -
- - -
326,300 33,844,845 14,618,500 7,871,500
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
TOTAL -
451,000 2,304,575 596,550 2,901,125

112,000 1,285,656 184,850 1,470,506
- 656,703 171,200 827,903
- 248,022 22,050 270,072
- 510,750 27,950 538,700
- 2,150,418 181,600 2,332,018
- 1,139,357 345,400 1,484,757
757,000 1,333,536 557,600 1,891,136
1,179,000 2,120,275 1,033,800 3,154,075
- 7,502,871 527,650 8,030,521
- 722,640 102,950 825,590
1,416,000 2,377,610 1,592,550 3,970,160
1,503,000 4,844,085 2,052,500 6,896,585
1,335,000 2,717,591 1,631,500 4,349,091
1,141,750 1,990,858 1,372,413 3,363,270
794,000 2,744,717 854,750 3,599,467
5,214,000 4,929,441 3,060,250 7,989,691
1,613,000 1,291,085 610,550 1,901,635
938,000 1,572,520 1,142,500 2,715,020
- - -
216,000 2,971,282 1,550,100 4,521,382
380,000 3,101,868 994,350 4,096,218
274,000 831,608 564,100 1,395,708
439,000 973,620 694,900 1,668,520
410,750 2,563,988 1,121,113 3,685,100
133,000 310,014 91,550 401,564
510,000 4,315,720 829,350 5,145,070
937,000 5,145,766 2,331,750 7,477,516
- - -
991,000 2,146,596 1,110,600 3,257,196
606,000 847,570 525,900 1,373,470
1,139,500 1,575,904 709,875 2,285,779
- - - -
- - -
- - -
22,490,000 67,226,645 26,592,200 93,818,845
49,146,011
48,625,311
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
CROSS CEK
2,901,125 -
1,470,506 -
827,903 -
270,072 -
538,700 -
2,332,018 -
1,484,757 -
1,891,136 -
3,154,075 -
8,030,521 -
825,590 -
3,970,160 -
6,896,585 -
4,349,091 -
3,363,270 -
3,599,467 -
7,989,691 -
1,901,635 -
2,715,020 -
-
4,521,382 -
4,096,218 -
1,395,708 -
1,668,520 -
3,685,100 -
401,564 -
5,145,070 -
7,477,516 -
-
3,257,196 -
1,373,470 -
2,285,779 -
-
-
-
93,818,845 - -
-
1,080,000
#REF!
#REF!
#REF!
#REF!
#REF!
#REF!
#REF!
#REF!
#REF!
#REF!
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
MIRNAWATI RK 1,081,600 1,409,100
-
- -
- -
- -
- -
- -
- -
- -
- - 68,499,891 68,499,891
RAWAT INAP 68,499,891 -

LAIN-LAINNYA 4,840,554,284.22 -
BKU 5,002,873,020.22 -
DG+DM(INAP + RJ)
2,901,125 2,901,125 2,901,125 -

1,470,506 1,470,506 1,470,506 -
827,903 827,903 827,903 -
270,072 270,072 270,072 -
538,700 538,700 538,700 -
2,332,018 2,332,018 2,332,018 -
1,484,757 1,484,757 1,484,757 -
1,891,136 1,891,136 1,891,136 -
3,154,075 3,154,075 3,154,075 -
8,030,521 8,030,521 8,030,521 -
825,590 825,590 825,590 -
3,970,160 3,970,160 3,970,160 -
11,054,083 19,369,079 11,054,083 -
6,011,590 9,336,588 6,011,590 -
3,363,270 3,363,270 3,363,270 -
3,599,467 3,599,467 3,599,467 -
7,989,691 7,989,691 7,989,691 -
1,901,635 1,901,635 1,901,635 -
327,500 -
4,124,120 6,614,820 4,124,120 -
- -
4,096,218 4,096,218 4,096,218 -
1,395,708 1,395,708 1,395,708 -
- -
3,685,100 3,685,100 3,685,100 -
401,564 401,564 401,564 -
5,145,070 5,145,070 5,145,070 -
3,242,750 -
22,303,845 48,713,753 22,303,845 -
3,257,196 3,257,196 3,257,196 -
6,179,865 15,792,655 6,179,865 -
9,863,120 -
10,164,525 -
11,631,725 -
43,923,849 95,540,619 43,923,849 -
156,128,834 293,128,616 156,128,834 -
93,818,845
54,595,670
148,414,515.22
266,579,920.22
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
Pemeriksaan
SPECIMEN
SWAB (Pjbtn
presiden RI)
praktek
TOTAL TOTAL
135,000
- 135,000.00 - - -
PT. Peniti
sungai
BRI Wings Air
ASKES Palma Asri
s.PT.Sumber
Cipta M
- - - - -
UTDRS
RS.LINDIMARA
3,290,969,500
43,370,863
38,695,625
6,294,651
3,290,969,500.00 - 38,695,625.00 49,665,514.00
-
JUMLAH
Pembyrn SEWA
-
-
-
-
-
-
-
-
-
-
-
1,061,219,200 1,061,219,200.00
-
-
-
3,290,969,500.00
3,500,000 3,500,000.00
-
-
-
43,370,863.00
384,104,400 384,104,400.00
38,695,625.00
6,294,651.00
-
5,333.00 5,333.00
-
34,875.03 34,875.03
-
-
-
12,224,837.19 12,359,837.19
-
-
-
12,265,045.22 1,445,323,600.00 3,500,000.00 4,840,554,284.22
3,635,000
03 JUNI 2020 73,497,100
#NAME?
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-
-
-
-
-
-
-
-
-

Pembukuan April 2021

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PEMERINTAH KABUPATEN SUMBA TIMUR

RUMAH SAKIT UMUM DAERAH UMBU RARA MEHA WAINGAPU

BUKU KAS UMUM

NO TANGGAL NO. BUKTI KODE REK URAIAN DEBET KREDIT

01 01-04-2021 Terima dari Rawat Jalan 2,901,125

Jumlah bulan ini, April 2021 5,002,873,020.22 5,002,873,020.22

Mengetahui : Waingapu, 30 April 2021

Dr. Lely Harakai, M.Kes Ester Praing, SE

Sonya Rambu Hana Ndima, ST

389,530 455,000 lab

257,500 karcis 1,102,030

1 1 April 2021 2,901,125 2,901,125 1 April 2021

Terima biaya Klaim covid'19 3,290,969,500 3,290,969,500

Terima biaya Santunan Jasa

Terima biaya Klaim Bpjs

Terima biaya dari RSKL (UTDRS) 38,695,625 38,695,625

Terima biaya Santunan Jasa

Jasa Giro 5,333.00 5,333.00

Jumlah ( 3 ) 12,265,045.22 - 12,265,045.22

4,999,238,020.22 3,635,000 5,002,873,020 -

No No. STS Tanggal Kode Rekening Uraian Jumlah Penyetor Keterangan

Mengetahui : Waingapu, 30 April 2021

Urusan Pemerintahan : 1.02 Urusan Wajib Pelayanan Dasar Kesehatan

Pengguna Anggaran : dr. Lely Harakai,M.Kes

JUMLAH PENERIMAAN BELUM TEREALISASI

4 PENDAPATAN 45,000,000,000 10,131,511,718.90 5,002,873,020.22 15,134,384,739.12 (29,865,615,260.88)

Kartu Kunjungan - 40,000 40,000

Karcis dr. Ahli 22,357,000 6,150,000 28,507,000

Karcis dr. Umum 3,110,000 3,080,000 6,190,000

Karcis Poli 5,800,000 2,030,000 7,830,000

Karcis IGD 3,150,000 1,125,000 4,275,000

SKS 1,991,000 1,032,000 3,023,000

Kunjungan dr. IGD 3,300,000 1,470,000 4,770,000

Polik Mata 8,181,000 4,311,000 12,492,000

Polik Penyakit Dalam/EKG 372,000 372,000 744,000

Polik Umum/EKG 118,000 - 118,000

Polik Kebidanan(usg) 11,645,000 3,378,000 15,023,000

Polik Bedah 745,000 348,000 1,093,000

Polik Gigi 186,000 - 186,000

Laboratorium 83,610,500 22,490,000 106,100,500

Fisioterapi 617,000 280,000 897,000

Farmasi 84,618,308 33,844,845 118,463,153

IGD/EKG 7,656,000 2,275,000 9,931,000

USG 1,924,000 1,185,000 3,109,000

Radiologi 8,938,000 10,408,000 19,346,000

ANGGREK 6,528,928 - 6,528,928

BOUGENVILE 39,390,177 46,444,465 85,834,642

DAHLIA 17,779,702 - 17,779,702

KEMUNING 85,721,602 18,812,676 104,534,278

ICU 9,890,745 - 9,890,745

PERINA/NICU 2,089,592 3,242,750 5,332,342

Pembayaran Klaim 9,677,792,597 4,824,654,239 14,502,446,836

Jasa Giro 27,364,567.90 12,265,045.22 39,629,613.12

Pendapatan Lain yang Sah 16,635,000 3,635,000 20,270,000

Mengetahui : Waingapu, 30 April 2021

Sonya Rambu Hana Ndima, ST

4.1.4.16 Pendapatan BLUD 45,000,000,000 10,131,511,718.90 5,002,873,020.22 15,134,384,739.12 (29,865,615,260.88)

4.1.4.16.01 Pendapatan BLUD 45,000,000,000 10,131,511,718.90 5,002,873,020.22 15,134,384,739.12 (29,865,615,260.88)

- Pendapatan Jasa Layanan 45,000,000,000 10,114,876,718.90 4,999,238,020.22 15,114,114,739.12

- Pendapatan Hasil Kerjasama

- Pendapatan Lainnya Yang sah 16,635,000 3,635,000 20,270,000

Mengetahui : Waingapu, 30 April 2021

Dr. Lely Harakai, M.Kes Ester Praing, SE