DAFTAR PEMBAYARAN JASA PELAYANAN JAMINAN KESEHATAN NASIONAL {JKN}

UPTD PUSKESMAS LONGKIB BULAN MARET TAHUN 2023

Nama Puskesmas : UPTD Puskesmas Longkib

Jumlah Peserta JKN : 6157 orang
Jumlah Besaran Kapitasi : 5000,-Per jiwa perbulan
Jumlah Kapitasi : Rp34,645,198
Jumlah Pegawai : 20
Jumlah Tenaga Fungsional : 28
Total Kapitasi : Rp34,645,198
Alokasi Jasa Pelayanan sesuai Keputusan Kepala Daerah 65%

PJ.
JABATAN/
KEHADIRAN UPAYA/KOORDINA POTONGAN
RANGKAP TUGAS
TOR KEGIATAN
Masa Kepal
Poin TOTAL
Kerja Poin Bend a PENERIMAAN JASA JUMLAH YANG
NO NAMA PEGAWAI NIP/GOL JENIS TENAGA Masa POIN JASA PELAYANAN (65%) BPJS (1%) PPh 21 ZAKAT INFAQ
(Tahun Tenaga ahara TU/PJ PELAYANAN KAPITASI DITERIMA
Kerja Ka. Nama PEGAWAI
Jumlah ) Dana Penat TANDA TANGAN
Hadir (%) Puske Nilai Program/ JUMLAH
Hari Kerja Kapit ausah
smas Kegiatan
asi aan
JKN Keua (1%) (5%) (15%) (2,5%) (1%)
ngan
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
1

1 Maya Dina 19830108 200803 2 001/IIId Kepala UPTD PKM 25 25 100% 4 2 25 100 0 0 10 Pj. 137 Rp 22,519,379 Rp 796,992 Rp 7,970 Rp 39,850 Rp 749,172 Rp 18,729 Rp 730,443
Longkib Akreditasi

2
2 dr.Marhamah 19930607 202203 2 007/III b 25 25 100% 2 150 0 0 0 10 Ketua UKP 162 Rp 22,519,379 Rp 942,428 Rp 9,424 Rp 47,121 Rp 885,882 Rp 22,147 Rp 863,735

Dokter
3 dr. Muhammad Rizki Afrisa DOKTER UMUM KONTRAK 25 25 100% 150 0 0 0 0 Umum 150 Rp 22,519,379 Rp 872,619 Rp 872,619 Rp 8,726 Rp 863,892
Kontrak

KR.Imunisa
si ,PJ.Imuni
sasi ,Petuga
s
SMILE,ben
4 Bd. Martina Sondang, S.Tr.Keb 19830326 200904 2 005/IIId Bendahara Dana 25 25 100% 0 2 100 0 50 0 50 dahara 202 Rp 22,519,379 Rp 1,175,126 Rp 11,751 Rp 58,756 Rp 1,104,619 Rp 1,104,619
Kapitasi JKN Bok,Pengel
ola Dana
Kapitasi
Jaminan
Kesehatan
Nasional
(JKN)

5
KR Poly
Gigi,Ketua
5 Kollin Saragih.AMKG 19810914 200803 1 001/ IIId 25 25 100% 14 10 60 0 0 50 30 Admin, & 150 Rp 22,519,379 Rp 872,619 Rp 8,726 Rp 43,631 Rp 820,262 Rp 820,262
Kepala Tata Usaha
Petugas
ABK/SISD
MK

6
PJ.Inventari
s dan Aspak
6 Ardinsyah,Amd.Kep 19730327 199604 1 002/IIId 25 25 100% 26 25 60 0 0 0 20 dan Rumah 105 Rp 22,519,379 Rp 610,833 Rp 6,108 Rp 30,542 Rp 574,183 Rp 14,355 Rp 559,828
Tangga &
KR. UGD

Pj. 7
7 Yunarti,Amd.Keb 19840312 200803 2 001/IIId 25 25 100% 14 10 60 0 0 0 10 80 Rp 22,519,379 Rp 465,397 Rp 4,654 Rp 23,270 Rp 437,473 Rp 10,937 Rp 426,536
KESJAOR
 8
KR.Poli
8 Rasta Ginting,AMK 19790101 200904 2 005/IIId 25 25 100% 13 10 60 0 0 0 20 Umum & 90 Rp 22,519,379 Rp 523,571 Rp 5,236 Rp 26,179 Rp 492,157 Rp 12,304 Rp 479,853
PJ.PTM

Staf 9
9 Hermansyah,SKM 19850113 201003 2 002/IIId 25 25 100% 12 10 80 0 0 0 90 Rp 22,519,379 Rp 523,571 Rp 5,236 Rp 26,179 Rp 492,157 Rp 12,304 Rp 479,853
Puskesmas
PJ.Promkes 10
,KARU
10 Siti Makrifah, S.Tr.Keb 19740507 200604 2 004/IIIc 25 25 100% 16 2 80 0 0 0 30 MTBS ,Ket 112 Rp 22,519,379 Rp 651,555 Rp 6,516 Rp 32,578 Rp 612,462 Rp 15,312 Rp 597,150
ua
UKM,Ketu
a Mutu
11
PJ.TBC,KA
RU
11 Alumiati ,Am.Keb 19880925 201705 2 006/IId 25 25 100% 5 5 60 0 0 0 30 KARTU/Re 95 Rp 22,519,379 Rp 552,658 Rp 5,527 Rp 547,132 Rp 13,678 Rp 533,454
kam
medik,Pj
Resepsionis
12
12 Dewi Kurnia Sari,Am.Keb 19840824 201705 2 002/IId 25 25 100% 5 5 60 0 0 0 10 PJ .PKPR 75 Rp 22,519,379 Rp 436,309 Rp 4,363 Rp 431,946 Rp 10,799 Rp 421,148

13
Bidan Desa
13 Desi Arianti,Am.Keb 19891016 201705 2 009 /Iid 25 25 100% 5 5 60 0 0 0 10 Rantau 75 Rp 22,519,379 Rp 436,309 Rp 4,363 Rp 431,946 Rp 10,799 Rp 421,148
Panjang,PJ.
Prolanis

Bidan desa 14
Darul
Aman &
Pengelola
14 Fitraini Tanjung,Am.Keb 19881205 201705 2 009/IId 25 25 100% 5 5 60 0 0 0 10 dana Non 75 Rp 22,519,379 Rp 436,309 Rp 4,363 Rp 431,946 Rp 10,799 Rp 421,148
Kapitasi
JKN,Petuga
s
HFIS/Fakta
Integritas
15

Pj.KIA,Kar
u
15 Lidia Fitrayani,Am.Keb 19850617 201705 2 004/IId 25 25 100% 5 5 60 0 0 0 30 KIA,Ketua 95 Rp 22,519,379 Rp 552,658 Rp 5,527 Rp 547,132 Rp 13,678 Rp 533,454
Tim Audit
Internal

16
16 Septi Khairani,Am.Keb 19870924 201705 2 006 /IId 25 25 100% 5 5 60 0 0 0 0 Bidan Desa 65 Rp 22,519,379 Rp 378,135 Rp 3,781 Rp 374,353 Rp 9,359 Rp 364,995
Bukit Alim

17
17 Kamelia Astuti,Am.Keb 19850414 201705 2 007 /IId 25 25 100% 5 5 60 0 0 0 0 Bidan Desa 65 Rp 22,519,379 Rp 378,135 Rp 3,781 Rp 374,353 Rp 9,359 Rp 364,995
Sepang
18

18
Nelly Handayani 19900921 202203 2 006/IIc 25 25 100% 2 60 0 0 0 10 72
Pj.Gizi Rp 22,519,379 Rp 418,857 Rp 4,189 Rp 414,668 Rp 10,367 Rp 404,302
Banjarnahor,A.Md.Keb

19

19 Pindi Seprilla,AMd.Keb 19950916 202203 2 004/ IIc 25 25 100% 2 60 0 0 0 10 Ketua Mutu 72 Rp 22,519,379 Rp 418,857 Rp 4,189 Rp 414,668 Rp 10,367 Rp 404,302

20
20 Fifit Fransiska,Amd.Kep 19970112 202203 2 004/IIc 25 25 100% 2 60 0 0 0 10 Koordinator 72 Rp 22,519,379 Rp 418,857 Rp 4,189 Rp 414,668 Rp 10,367 Rp 404,302
PIS-PK
21

Pj.Surveila
21 Monarisah,A.Md.Kep 19920428 202203 2 006/IIc 25 25 100% 2 60 0 0 0 20 ns & Pj. 82 Rp 22,519,379 Rp 477,032 Rp 4,770 Rp 472,261 Rp 11,807 Rp 460,455
ISPA /Diare

22
22 Ratna Puspita Widia Sari BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 0 Bidan Desa 60 Rp 22,519,379 Rp 349,047 Rp 349,047 Rp 3,490 Rp 345,557
Darussalam
 Pj.Website/ 23
23 Khoirun Nisa,AMd.Kes Nusantara Sehat 25 25 100% 30 0 0 0 10 Media 40 Rp 22,519,379 Rp 232,698 Rp 232,698 Rp 2,327 Rp 230,371
soaial
puskesmas
24
24 Nurmayanti,Amd.Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 0 Bidan Desa 60 Rp 22,519,379 Rp 349,047 Rp 349,047 Rp 3,490 Rp 345,557
Lae Saga

25
25 Ahlina Wati,Amd.Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 0 Bidan Desa 60 Rp 22,519,379 Rp 349,047 Rp 349,047 Rp 3,490 Rp 345,557
Longkib

26
26 Sanawiyah,Amd.Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 0 Bidan Desa 60 Rp 22,519,379 Rp 349,047 Rp 349,047 Rp 3,490 Rp 345,557
Panji

27
27
Haoni Fahmy Gani Nasution BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 0 Bidan Desa 60 Rp 22,519,379 Rp 349,047 Rp 349,047 Rp 3,490 Rp 345,557
Amd.Keb Sikerabang

Bidan Desa 28
28 Yulia Safitri,Amd.Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 0 Bangun 60 Rp 22,519,379 Rp 349,047 Rp 349,047 Rp 3,490 Rp 345,557
Sari
29
KR.APOTI
K,PJ.Pemba
29 Apt.Fatmah Solin,S.Farm BAKTI FUNGSIONAL 25 25 100% 100 0 0 0 20 ntu 120 Rp 22,519,379 Rp 698,095 Rp 698,095 Rp 6,981 Rp 691,114
bendahara
BOK

30

pj.Picare
30 Helmiati BM,S.E BAKTI FUNGSIONAL 25 25 100% 80 0 0 0 10 Kunjungan 90 Rp 22,519,379 Rp 523,571 Rp 523,571 Rp 5,236 Rp 518,335
Sehat

31

PJ.P-Care
Rawat
31 Lili Suryani,Amd.Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 30 Jalan,Pj. 90 Rp 22,519,379 Rp 523,571 Rp 523,571 Rp 5,236 Rp 518,335
Tanggap
bencana,Ka
ru P-Care

32

32 Asmala ,Amd.Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 10 Pj.Keswa 70 Rp 22,519,379 Rp 407,222 Rp 407,222 Rp 4,072 Rp 403,150

33

33 Siti Rodiah,Amd.Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 10 PJ.Poskestr 70 Rp 22,519,379 Rp 407,222 Rp 407,222 Rp 4,072 Rp 403,150
en

34
34 Rahimah,Am,Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 10 Pj.KB 70 Rp 22,519,379 Rp 407,222 Rp 407,222 Rp 4,072 Rp 403,150

35
Pj Gudang
35
Dian Winarti BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 30 Obat,Pj. 90 Rp 22,519,379 Rp 523,571 Rp 523,571 Rp 5,236 Rp 518,335
Telaumbanua,Amd.Keb Hepatitis,Pj
.HIV/AIDS

36
36 Mirawati,Am.Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 0 60 Rp 22,519,379 Rp 349,047 Rp 349,047 Rp 3,490 Rp 345,557
PJ.Filariasis

Pj.SP2TP 37
37 Yuyun Cahyati,Amd.Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 10 70 Rp 22,519,379 Rp 407,222 Rp 407,222 Rp 4,072 Rp 403,150
dan Pelkes
38
38 Heni Tiara Indriani,Amd..Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 10 Pj.SDIDTK 70 Rp 22,519,379 Rp 407,222 Rp 407,222 Rp 4,072 Rp 403,150

39
39 Nur Hasanah,Amd.Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 60 Rp 22,519,379 Rp 349,047 Rp 349,047 Rp 3,490 Rp 345,557
 Pj.UKS/ 40
40 Betetsi Manalu,AMK BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 10 70 Rp 22,519,379 Rp 407,222 Rp 407,222 Rp 407,222
UKGS
41

Pj .Malaria,
Pj Penyakit
yang
41 Elvi Masnur Jannah,Am.Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 20 disebabkan 80 Rp 22,519,379 Rp 465,397 Rp 465,397 Rp 4,654 Rp 460,743
virus dan
menular(Ra
bies,DHF,dl
l)

42

42 Endang Fatmawati,AMK BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 10 Pj. Lansia 70 Rp 22,519,379 Rp 407,222 Rp 407,222 Rp 4,072 Rp 403,150

43
43 Risno Tinambun,SKM BAKTI FUNGSIONAL 25 25 100% 80 0 0 0 10 Pj.Kesling 90 Rp 22,519,379 Rp 523,571 Rp 523,571 Rp 5,236 Rp 518,335

PJ.Lab,PJ.T 44
44 Erni,A.Md.Ak BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 20 80 Rp 22,519,379 Rp 465,397 Rp 465,397 Rp 4,654 Rp 460,743
BC
45
45 Sakiyah BAKTI FUNGSIONAL 25 25 100% 25 0 0 0 0 Cleaning 25 Rp 22,519,379 Rp 145,436 Rp 145,436 Rp 1,454 Rp 143,982
Service
46
46 Masitah BAKTI FUNGSIONAL 25 25 100% 25 0 0 0 0 Cleaning 25 Rp 22,519,379 Rp 145,436 Rp 145,436 Rp 1,454 Rp 143,982
Service
47
47 Sukat BAKTI FUNGSIONAL 25 25 100% 25 0 0 0 0 Supir 25 Rp 22,519,379 Rp 145,436 Rp 145,436 Rp 1,454 Rp 143,982
Ambulance

Supir 48
48 Bakrin BAKTI FUNGSIONAL 25 25 100% 25 0 0 0 0 25 Rp 22,519,379 Rp 145,436 Rp 145,436 Rp 1,454 Rp 143,982
Pusling Air

JUMLAH TOTAL 116 3015 100 50 50 540 0 3871 Rp 22,519,379 Rp 22,519,379 Rp 114,662 Rp 328,105 Rp - Rp 22,076,612 Rp 227,464 Rp 106,459 Rp 21,742,688
###

Subulussalam, 2023
Kepala Puskesmas Longkib Bendahara JKN
Kuasa Pengguna Anggaran

( Ns.NUR AFNI ,S.Kep) (Bd. Martina Sondang.S.Tr.Keb)

Nip. 19830108 200803 2 001 NIP. 19830326 200904 2 005
Rp 22,519,379

Rp 64,938,048
 DAFTAR PEMBAYARAN JASA PELAYANAN JAMINAN KESEHATAN NASIONAL {JKN}
UPTD PUSKESMAS LONGKIB BULAN MARET TAHUN 2023

Nama Puskesmas : UPTD Puskesmas Longkib

Jumlah Peserta JKN : 6157 orang
Jumlah Besaran Kapitasi : 5000,-Per jiwa perbulan
Jumlah Kapitasi : Rp34,483,291
Jumlah Pegawai : 20
Jumlah Tenaga Fungsional : 28
Total Kapitasi : Rp34,483,291
Alokasi Jasa Pelayanan sesuai Keputusan Kepala Daerah 65%

PJ.
JABATAN/
KEHADIRAN UPAYA/KOORDINA POTONGAN
RANGKAP TUGAS
TOR KEGIATAN
Masa Kepal
Poin TOTAL
Kerja Poin Bend a PENERIMAAN JASA JUMLAH YANG
NO NAMA PEGAWAI NIP/GOL JENIS TENAGA Masa POIN JASA PELAYANAN (65%) BPJS (1%) PPh 21 ZAKAT INFAQ
(Tahun Tenaga ahara TU/PJ PELAYANAN KAPITASI DITERIMA
Kerja Ka. Nama PEGAWAI
Jumlah ) Dana Penat TANDA TANGAN
Hadir (%) Puske Nilai Program/ JUMLAH
Hari Kerja Kapit ausah
smas Kegiatan
asi aan
JKN Keua (1%) (5%) (15%) (2,5%) (1%)
ngan
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
1

1 Maya Dina 19830108 200803 2 001/IIId Kepala UPTD PKM 23 23 100% 4 2 25 100 0 0 10 Pj. 137 Rp 22,414,139 Rp 793,267 Rp 7,933 Rp 39,663 Rp 745,671 Rp 18,642 Rp 727,029
Longkib Akreditasi

2
2 dr.Marhamah 19930607 202203 2 007/III b 23 23 100% 2 150 0 0 0 10 Ketua UKP 162 Rp 22,414,139 Rp 938,024 Rp 9,380 Rp 46,901 Rp 881,742 Rp 22,044 Rp 859,699

Dokter
3 dr. Muhammad Rizki Afrisa DOKTER UMUM 23 23 100% 150 0 0 0 0 Umum 150 Rp 22,414,139 Rp 868,541 Rp 868,541 Rp 8,685 Rp 859,855
Kontrak

KR.Imunisa
si ,PJ.Imuni
4 Bd. Martina Sondang, S.Tr.Keb 19830326 200904 2 005/IIId Bendahara Dana 23 23 100% 0 2 100 0 50 0 40 192 Rp 22,414,139 Rp 1,111,732 Rp 11,117 Rp 55,587 Rp 1,045,028 Rp 1,045,028
sasi ,Petuga
Kapitasi JKN
s
SMILE,ben
dahara Bok

5
KR Poly
Gigi,Ketua
5 Kollin Saragih.AMKG 19810914 200803 1 001/ IIId 23 23 100% 14 10 60 0 0 50 30 Admin, & 150 Rp 22,414,139 Rp 868,541 Rp 8,685 Rp 43,427 Rp 816,428 Rp 816,428
Kepala Tata Usaha
Petugas
ABK/SISD
MK

6
PJ.Inventari
s dan Aspak
6 Ardinsyah,Amd.Kep 19730327 199604 1 002/IIId 23 23 100% 26 25 60 0 0 0 20 dan Rumah 105 Rp 22,414,139 Rp 607,978 Rp 6,080 Rp 30,399 Rp 571,500 Rp 14,287 Rp 557,212
Tangga &
KR. UGD

Pj. 7
7 Yunarti,Amd.Keb 19840312 200803 2 001/IIId 23 23 100% 14 10 60 0 0 0 10 80 Rp 22,414,139 Rp 463,222 Rp 4,632 Rp 23,161 Rp 435,428 Rp 10,886 Rp 424,543
KESJAOR
8
KR.Poli
8 Rasta Ginting,AMK 19790101 200904 2 005/IIId 23 23 100% 13 10 60 0 0 0 20 Umum & 90 Rp 22,414,139 Rp 521,124 Rp 5,211 Rp 26,056 Rp 489,857 Rp 12,246 Rp 477,611
PJ.PTM

Staf 9
9 Hermansyah,SKM 19850113 201003 2 002/IIId 23 23 100% 12 10 80 0 0 0 90 Rp 22,414,139 Rp 521,124 Rp 5,211 Rp 26,056 Rp 489,857 Rp 12,246 Rp 477,611
Puskesmas
 PJ.Promkes 10
,KARU
10 Siti Makrifah, S.Tr.Keb 19740507 200604 2 004/IIIc 23 23 100% 16 2 80 0 0 0 30 MTBS ,Ket 112 Rp 22,414,139 Rp 648,510 Rp 6,485 Rp 32,426 Rp 609,600 Rp 15,240 Rp 594,360
ua
UKM,Ketu
a Mutu
PJ.TBC,KA 11
RU
KARTU/Re
11 Alumiati ,Am.Keb 19880925 201705 2 006/IId 23 23 100% 5 5 60 0 0 0 40 kam 105 Rp 22,414,139 Rp 607,978 Rp 6,080 Rp 601,899 Rp 15,047 Rp 586,851
medik,Pj
Resepsionis
,Cool chain
12
12 Dewi Kurnia Sari,Am.Keb 19840824 201705 2 002/IId 23 23 100% 5 5 60 0 0 0 10 PJ .PKPR 75 Rp 22,414,139 Rp 434,270 Rp 4,343 Rp 429,928 Rp 10,748 Rp 419,179

13
Bidan Desa
13 Desi Arianti,Am.Keb 19891016 201705 2 009 /Iid 23 23 100% 5 5 60 0 0 0 10 Rantau 75 Rp 22,414,139 Rp 434,270 Rp 4,343 Rp 429,928 Rp 10,748 Rp 419,179
Panjang,PJ.
Prolanis

Bidan desa 14
Darul
Aman &
Pengelola
14 Fitraini Tanjung,Am.Keb 19881205 201705 2 009/IId 23 23 100% 5 5 60 0 0 0 10 dana Non 75 Rp 22,414,139 Rp 434,270 Rp 4,343 Rp 429,928 Rp 10,748 Rp 419,179
Kapitasi
JKN,Petuga
s
HFIS/Fakta
Integritas
15

Pj.KIA,Kar
u
15 Lidia Fitrayani,Am.Keb 19850617 201705 2 004/IId 23 23 100% 5 5 60 0 0 0 30 KIA,Ketua 95 Rp 22,414,139 Rp 550,076 Rp 5,501 Rp 544,575 Rp 13,614 Rp 530,961
Tim Audit
Internal

16
16 Septi Khairani,Am.Keb 19870924 201705 2 006 /IId 23 23 100% 5 5 60 0 0 0 0 Bidan Desa 65 Rp 22,414,139 Rp 376,368 Rp 3,764 Rp 372,604 Rp 9,315 Rp 363,289
Bukit Alim

17
17 Kamelia Astuti,Am.Keb 19850414 201705 2 007 /IId 23 23 100% 5 5 60 0 0 0 0 Bidan Desa 65 Rp 22,414,139 Rp 376,368 Rp 3,764 Rp 372,604 Rp 9,315 Rp 363,289
Sepang
18

18
Nelly Handayani 19900921 202203 2 006/IIc 23 23 100% 2 60 0 0 0 10 72 Rp 22,414,139 Rp 416,900 Rp 4,169 Rp 412,731 Rp 10,318 Rp 402,412
Banjarnahor,A.Md.Keb Pj.Gizi

19

19 Pindi Seprilla,AMd.Keb 19950916 202203 2 004/ IIc 23 23 100% 2 60 0 0 0 10 Ketua Mutu 72 Rp 22,414,139 Rp 416,900 Rp 4,169 Rp 412,731 Rp 10,318 Rp 402,412

20
20 Fifit Fransiska,Amd.Kep 19970112 202203 2 004/IIc 23 23 100% 2 60 0 0 0 10 Koordinator 72 Rp 22,414,139 Rp 416,900 Rp 4,169 Rp 412,731 Rp 10,318 Rp 402,412
PIS-PK
21

Pj.Surveila
21 Monarisah,A.Md.Kep 19920428 202203 2 006/IIc 23 23 100% 2 60 0 0 0 20 ns & Pj. 82 Rp 22,414,139 Rp 474,802 Rp 4,748 Rp 470,054 Rp 11,751 Rp 458,303
ISPA /Diare

22
22 Ratna Puspita Widia Sari BAKTI FUNGSIONAL 23 23 100% 60 0 0 0 0 Bidan Desa 60 Rp 22,414,139 Rp 347,416 Rp 347,416 Rp 3,474 Rp 343,942
Darussalam

Pj.Website/ 23
23 Khoirun Nisa,AMd.Kes Nusantara Sehat 23 23 100% 30 0 0 0 10 Media 40 Rp 22,414,139 Rp 231,611 Rp 231,611 Rp 2,316 Rp 229,295
soaial
puskesmas
24
24 Nurmayanti,Amd.Keb BAKTI FUNGSIONAL 23 23 100% 60 0 0 0 0 Bidan Desa 60 Rp 22,414,139 Rp 347,416 Rp 347,416 Rp 3,474 Rp 343,942
Lae Saga
 25
25 Ahlina Wati,Amd.Keb BAKTI FUNGSIONAL 23 23 100% 60 0 0 0 0 Bidan Desa 60 Rp 22,414,139 Rp 347,416 Rp 347,416 Rp 3,474 Rp 343,942
Longkib

26
26 Sanawiyah,Amd.Keb BAKTI FUNGSIONAL 23 23 100% 60 0 0 0 0 Bidan Desa 60 Rp 22,414,139 Rp 347,416 Rp 347,416 Rp 3,474 Rp 343,942
Panji

27
27
Haoni Fahmy Gani Nasution BAKTI FUNGSIONAL 23 23 100% 60 0 0 0 0 Bidan Desa 60 Rp 22,414,139 Rp 347,416 Rp 347,416 Rp 3,474 Rp 343,942
Amd.Keb Sikerabang

Bidan Desa 28
28 Yulia Safitri,Amd.Keb BAKTI FUNGSIONAL 23 23 100% 60 0 0 0 0 Bangun 60 Rp 22,414,139 Rp 347,416 Rp 347,416 Rp 3,474 Rp 343,942
Sari
29
KR.APOTI
K,PJ.Pemba
29 Apt.Fatmah Solin,S.Farm BAKTI FUNGSIONAL 23 23 100% 100 0 0 0 20 ntu 120 Rp 22,414,139 Rp 694,833 Rp 694,833 Rp 6,948 Rp 687,884
bendahara
BOK

30

pj.Picare
30 Helmiati BM,S.E BAKTI FUNGSIONAL 23 23 100% 80 0 0 0 10 Kunjungan 90 Rp 22,414,139 Rp 521,124 Rp 521,124 Rp 5,211 Rp 515,913
Sehat

31

PJ.P-Care
Rawat
31 Lili Suryani,Amd.Keb BAKTI FUNGSIONAL 23 23 100% 60 0 0 0 30 Jalan,Pj. 90 Rp 22,414,139 Rp 521,124 Rp 521,124 Rp 5,211 Rp 515,913
Tanggap
bencana,Ka
ru P-Care

32

32 Asmala ,Amd.Keb BAKTI FUNGSIONAL 23 23 100% 60 0 0 0 10 Pj.Keswa 70 Rp 22,414,139 Rp 405,319 Rp 405,319 Rp 4,053 Rp 401,266

33

33 Siti Rodiah,Amd.Keb BAKTI FUNGSIONAL 23 23 100% 60 0 0 0 10 PJ.Poskestr 70 Rp 22,414,139 Rp 405,319 Rp 405,319 Rp 4,053 Rp 401,266
en

34
34 Rahimah,Am,Keb BAKTI FUNGSIONAL 23 23 100% 60 0 0 0 10 Pj.KB 70 Rp 22,414,139 Rp 405,319 Rp 405,319 Rp 4,053 Rp 401,266

35
Pj Gudang
35
Dian Winarti BAKTI FUNGSIONAL 23 23 100% 60 0 0 0 30 Obat,Pj. 90 Rp 22,414,139 Rp 521,124 Rp 521,124 Rp 5,211 Rp 515,913
Telaumbanua,Amd.Keb Hepatitis,Pj
.HIV/AIDS

36
36 Mirawati,Am.Keb BAKTI FUNGSIONAL 23 23 100% 60 0 0 0 0 60 Rp 22,414,139 Rp 347,416 Rp 347,416 Rp 3,474 Rp 343,942
PJ.Filariasis

Pj.SP2TP 37
37 Yuyun Cahyati,Amd.Keb BAKTI FUNGSIONAL 23 23 100% 60 0 0 0 10 70 Rp 22,414,139 Rp 405,319 Rp 405,319 Rp 4,053 Rp 401,266
dan Pelkes
38
38 Heni Tiara Indriani,Amd..Keb BAKTI FUNGSIONAL 23 23 100% 60 0 0 0 10 Pj.SDIDTK 70 Rp 22,414,139 Rp 405,319 Rp 405,319 Rp 4,053 Rp 401,266

39
39 Nur Hasanah,Amd.Keb BAKTI FUNGSIONAL 23 23 100% 60 0 0 0 60 Rp 22,414,139 Rp 347,416 Rp 347,416 Rp 3,474 Rp 343,942

Pj.UKS/ 40
40 Betetsi Manalu,AMK BAKTI FUNGSIONAL 23 23 100% 60 0 0 0 10 70 Rp 22,414,139 Rp 405,319 Rp 405,319 Rp 405,319
UKGS
 41

Pj .Malaria,
Pj Penyakit
yang
41 Elvi Masnur Jannah,Am.Keb BAKTI FUNGSIONAL 23 23 100% 60 0 0 0 20 disebabkan 80 Rp 22,414,139 Rp 463,222 Rp 463,222 Rp 4,632 Rp 458,589
virus dan
menular(Ra
bies,DHF,dl
l)

42

42 Endang Fatmawati,AMK BAKTI FUNGSIONAL 23 23 100% 60 0 0 0 10 Pj. Lansia 70 Rp 22,414,139 Rp 405,319 Rp 405,319 Rp 4,053 Rp 401,266

43
43 Risno Tinambun,SKM BAKTI FUNGSIONAL 23 23 100% 80 0 0 0 10 Pj.Kesling 90 Rp 22,414,139 Rp 521,124 Rp 521,124 Rp 5,211 Rp 515,913

PJ.Lab,PJ 44
44 Erni,A.Md.Ak BAKTI FUNGSIONAL 23 23 100% 60 0 0 0 20 80 Rp 22,414,139 Rp 463,222 Rp 463,222 Rp 4,632 Rp 458,589
TBC
45
45 Sakiyah BAKTI FUNGSIONAL 23 23 100% 25 0 0 0 0 Cleaning 25 Rp 22,414,139 Rp 144,757 Rp 144,757 Rp 1,448 Rp 143,309
Service
46
46 Masitah BAKTI FUNGSIONAL 23 23 100% 25 0 0 0 0 Cleaning 25 Rp 22,414,139 Rp 144,757 Rp 144,757 Rp 1,448 Rp 143,309
Service
47
47 Sukat BAKTI FUNGSIONAL 23 23 100% 25 0 0 0 0 Supir 25 Rp 22,414,139 Rp 144,757 Rp 144,757 Rp 1,448 Rp 143,309
Ambulance

Supir 48
48 Bakrin BAKTI FUNGSIONAL 23 23 100% 25 0 0 0 0 25 Rp 22,414,139 Rp 144,757 Rp 144,757 Rp 1,448 Rp 143,309
Pusling Air

JUMLAH TOTAL 116 3015 100 50 50 540 0 3871 Rp 22,414,139 Rp 22,414,139 Rp 114,126 Rp 323,676 Rp - Rp 21,976,337 Rp 227,834 Rp 105,962 Rp 21,642,541

Subulussalam, 2023
Kepala Puskesmas Longkib Bendahara JKN
Kuasa Pengguna Anggaran

( Ns.NUR AFNI ,S.Kep) (Bd. Martina Sondang.S.Tr.Keb)

Nip. 19830108 200803 2 001 NIP. 19830326 200904 2 005
Rp 22,414,139
 DAFTAR PEMBAYARAN JASA PELAYANAN JAMINAN KESEHATAN NASIONAL {JKN}
UPTD PUSKESMAS LONGKIB BULAN JANUARI TAHUN 2023

Nama Puskesmas : UPTD Puskesmas Longkib

Jumlah Peserta JKN : 6157 orang
Jumlah Besaran Kapitasi : 5000,-Per jiwa perbulan
Jumlah Kapitasi : Rp30,776,200
Jumlah Pegawai : 20
Jumlah Tenaga Fungsional : 28
Total Kapitasi : Rp30,776,200
Alokasi Jasa Pelayanan sesuai Keputusan Kepala Daerah 65%

PJ.
JABATAN/
KEHADIRAN UPAYA/KOORDINA POTONGAN
RANGKAP TUGAS
TOR KEGIATAN
Masa Kepal
Poin TOTAL
Kerja Poin Bend a PENERIMAAN JASA JUMLAH YANG
NO NAMA PEGAWAI NIP/GOL JENIS TENAGA Masa POIN JASA PELAYANAN (65%) BPJS (1%) PPh 21 ZAKAT INFAQ
(Tahun Tenaga ahara TU/PJ PELAYANAN KAPITASI DITERIMA
Kerja Ka. Nama PEGAWAI
Jumlah ) Dana Penat TANDA TANGAN
Hadir (%) Puske Nilai Program/ JUMLAH
Hari Kerja Kapit ausah
smas Kegiatan
asi aan
JKN Keua (1%) (5%) (15%) (2,5%) (1%)
ngan
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
1

1 Ns.Nur Afni,S.Kep 19830108 200803 2 001/IIId Kepala UPTD PKM 25 25 100% 4 2 100 100 0 0 10 Pj. 212 Rp 20,004,530 Rp 1,077,480 Rp 10,775 Rp 53,874 Rp 1,012,831 Rp 25,321 Rp 987,510
Longkib Akreditasi

2
2 dr.Marhamah 19930607 202203 2 007/III b 25 25 100% 2 150 0 0 0 10 Ketua UKP 162 Rp 20,004,530 Rp 823,357 Rp 8,234 Rp 41,168 Rp 773,956 Rp 19,349 Rp 754,607

Dokter
3 dr. Muhammad Rizki Afrisa DOKTER UMUM KONTRAK 25 25 100% 150 0 0 0 0 Umum 150 Rp 20,004,530 Rp 762,368 Rp 762,368 Rp 7,624 Rp 754,744
Kontrak

KR.Imunisa
si ,PJ.Imuni
Bendahara Dana
4 Bd. Martina Sondang, S.Tr.Keb 19830326 200904 2 005/IIId 25 25 100% 0 2 100 0 50 0 40 sasi ,Petuga 192 Rp 20,004,530 Rp 975,831 Rp 9,758 Rp 48,792 Rp 917,281 Rp 917,281
Kapitasi JKN
s
SMILE,ben
dahara Bok

5
KR Poly
Gigi,Ketua
5 Kollin Saragih.AMKG 19810914 200803 1 001/ IIId 25 25 100% 14 10 60 0 0 50 30 Admin, & 150 Rp 20,004,530 Rp 762,368 Rp 7,624 Rp 38,118 Rp 716,626 Rp 716,626
Kepala Tata Usaha
Petugas
ABK/SISD
MK

6
PJ.Inventari
s dan Aspak
6 Ardinsyah,Amd.Kep 19730327 199604 1 002/IIId 25 25 100% 26 25 60 0 0 0 20 dan Rumah 105 Rp 20,004,530 Rp 533,657 Rp 5,337 Rp 26,683 Rp 501,638 Rp 12,541 Rp 489,097
Tangga &
KR. UGD

Pj. 7
7 Yunarti,Amd.Keb 19840312 200803 2 001/IIId 25 25 100% 14 10 60 0 0 0 10 80 Rp 20,004,530 Rp 406,596 Rp 4,066 Rp 20,330 Rp 382,200 Rp 9,555 Rp 372,645
KESJAOR
8
KR.Poli
8 Rasta Ginting,AMK 19790101 200904 2 005/IIId 25 25 100% 13 10 60 0 0 0 20 Umum & 90 Rp 20,004,530 Rp 457,421 Rp 4,574 Rp 22,871 Rp 429,975 Rp 10,749 Rp 419,226
PJ.PTM

Staf 9
9 Hermansyah,SKM 19850113 201003 2 002/IIId 25 25 100% 12 10 80 0 0 0 90 Rp 20,004,530 Rp 457,421 Rp 4,574 Rp 22,871 Rp 429,975 Rp 10,749 Rp 419,226
Puskesmas
 10
PJ.Promkes
,KARU
10 Siti Makrifah, S.Tr.Keb 19740507 200604 2 004/IIIc 25 25 100% 16 2 80 0 0 0 30 MTBS ,Ket 112 Rp 20,004,530 Rp 569,235 Rp 5,692 Rp 28,462 Rp 535,081 Rp 13,377 Rp 521,704
ua
UKM,Ketu
a Mutu

11
PJ.TBC,KA
RU
11 Alumiati ,Am.Keb 19880925 201705 2 006/IId 25 25 100% 5 5 60 0 0 0 30 KARTU/Re 95 Rp 20,004,530 Rp 482,833 Rp 4,828 Rp 478,005 Rp 11,950 Rp 466,054
kam
medik,Pj
Resepsionis
12
12 Dewi Kurnia Sari,Am.Keb 19840824 201705 2 002/IId 25 25 100% 5 5 60 0 0 0 10 PJ .PKPR 75 Rp 20,004,530 Rp 381,184 Rp 3,812 Rp 377,372 Rp 9,434 Rp 367,938

13
Bidan Desa
13 Desi Arianti,Am.Keb 19891016 201705 2 009 /Iid 25 25 100% 5 5 60 0 0 0 10 Rantau 75 Rp 20,004,530 Rp 381,184 Rp 3,812 Rp 377,372 Rp 9,434 Rp 367,938
Panjang,PJ.
Prolanis

14
Bidan desa
Darul
Aman &
Pengelola
14 Fitraini Tanjung,Am.Keb 19881205 201705 2 009/IId 25 25 100% 5 5 60 0 0 0 20 dana Non 75 Rp 20,004,530 Rp 381,184 Rp 3,812 Rp 377,372 Rp 9,434 Rp 367,938
Kapitasi
JKN,Petuga
s
HFIS/Fakta
Integritas

15

Pj.KIA,Kar
u
15 Lidia Fitrayani,Am.Keb 19850617 201705 2 004/IId 25 25 100% 5 5 60 0 0 0 40 KIA,Ketua 105 Rp 20,004,530 Rp 533,657 Rp 5,337 Rp 528,321 Rp 13,208 Rp 515,113
Mutu,Ketua
Audit

16
16 Septi Khairani,Am.Keb 19870924 201705 2 006 /IId 25 25 100% 5 5 60 0 0 0 0 Bidan Desa 65 Rp 20,004,530 Rp 330,359 Rp 3,304 Rp 327,056 Rp 8,176 Rp 318,879
Bukit Alim

17
17 Kamelia Astuti,Am.Keb 19850414 201705 2 007 /IId 25 25 100% 5 5 60 0 0 0 0 Bidan Desa 65 Rp 20,004,530 Rp 330,359 Rp 3,304 Rp 327,056 Rp 8,176 Rp 318,879
Sepang
18

Nelly Handayani Pj.SP2TP

18 19900921 202203 2 006/IIc 25 25 100% 2 60 0 0 0 20 dan Pelkes, 82 Rp 20,004,530 Rp 416,761 Rp 4,168 Rp 412,593 Rp 10,315 Rp 402,279
Banjarnahor,A.Md.Keb
Yankestrad

19
Pj. Cold
chain,Penge
lola Dana
19 Pindi Seprilla,AMd.Keb 19950916 202203 2 004/ IIc 25 25 100% 2 60 0 0 0 20 Kapitasi 82 Rp 20,004,530 Rp 416,761 Rp 4,168 Rp 412,593 Rp 10,315 Rp 402,279
Jaminan
Kesehatan
Nasional
(JKN)

20
20 Fifit Fransiska,Amd.Kep 19970112 202203 2 004/IIc 25 25 100% 2 60 0 0 0 10 Koordinator 72 Rp 20,004,530 Rp 365,937 Rp 3,659 Rp 362,277 Rp 9,057 Rp 353,220
PIS-PK
21

Pj.Surveila
21 Monarisah,A.Md.Kep 19920428 202203 2 006/IIc 25 25 100% 2 60 0 0 0 20 ns & Pj. 82 Rp 20,004,530 Rp 416,761 Rp 4,168 Rp 412,593 Rp 10,315 Rp 402,279
ISPA /Diare

22
22 Ratna Puspita Widia Sari BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 0 Bidan Desa 60 Rp 20,004,530 Rp 304,947 Rp 304,947 Rp 3,049 Rp 301,898
Darussalam

Pj.Website/ 23
23 Khoirun Nisa,AMd.Kes Nusantara Sehat 25 25 100% 30 0 0 0 10 Media 40 Rp 20,004,530 Rp 203,298 Rp 203,298 Rp 2,033 Rp 201,265
soaial
puskesmas
 24
24 Nurmayanti,Amd.Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 0 Bidan Desa 60 Rp 20,004,530 Rp 304,947 Rp 304,947 Rp 3,049 Rp 301,898
Lae Saga

25
25 Ahlina Wati,Amd.Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 0 Bidan Desa 60 Rp 20,004,530 Rp 304,947 Rp 304,947 Rp 3,049 Rp 301,898
Longkib

26
26 Sanawiyah,Amd.Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 0 Bidan Desa 60 Rp 20,004,530 Rp 304,947 Rp 304,947 Rp 3,049 Rp 301,898
Panji

27
27
Haoni Fahmy Gani Nasution BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 0 Bidan Desa 60 Rp 20,004,530 Rp 304,947 Rp 304,947 Rp 3,049 Rp 301,898
Amd.Keb Sikerabang

Bidan Desa 28
28 Yulia Safitri,Amd.Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 0 Bangun 60 Rp 20,004,530 Rp 304,947 Rp 304,947 Rp 3,049 Rp 301,898
Sari
29
KR.APOTI
K,PJ.Pemba
29 Apt.Fatmah Solin,S.Farm BAKTI FUNGSIONAL 25 25 100% 100 0 0 0 20 ntu 120 Rp 20,004,530 Rp 609,894 Rp 609,894 Rp 6,099 Rp 603,795
bendahara
BOK

30

pj.Picare
30 Helmiati BM,S.E BAKTI FUNGSIONAL 25 25 100% 80 0 0 0 10 Kunjungan 90 Rp 20,004,530 Rp 457,421 Rp 457,421 Rp 4,574 Rp 452,846
Sehat

31

PJ.P-Care
Rawat
31 Lili Suryani,Amd.Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 30 Jalan,Pj. 90 Rp 20,004,530 Rp 457,421 Rp 457,421 Rp 4,574 Rp 452,846
Tanggap
bencana,Ka
ru P-Care

32

32 Asmala ,Amd.Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 10 Pj.Keswa 70 Rp 20,004,530 Rp 355,772 Rp 355,772 Rp 3,558 Rp 352,214

33

33 Siti Rodiah,Amd.Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 10 PJ.Poskestr 70 Rp 20,004,530 Rp 355,772 Rp 355,772 Rp 3,558 Rp 352,214
en

34
34 Rahimah,Am,Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 10 Pj.KB 70 Rp 20,004,530 Rp 355,772 Rp 355,772 Rp 3,558 Rp 352,214

35
Pj Gudang
35
Dian Winarti BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 30 Obat,Pj. 90 Rp 20,004,530 Rp 457,421 Rp 457,421 Rp 4,574 Rp 452,846
Telaumbanua,Amd.Keb Hepatitis,Pj
.HIV/AIDS

36
36 Mirawati,Am.Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 0 60 Rp 20,004,530 Rp 304,947 Rp 304,947 Rp 3,049 Rp 301,898
PJ.Filariasis

37
37 Yuyun Cahyati,Amd.Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 10 Pj.GIZI 70 Rp 20,004,530 Rp 355,772 Rp 355,772 Rp 3,558 Rp 352,214

38
38 Heni Tiara Indriani,Amd..Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 10 Pj.SDIDTK 70 Rp 20,004,530 Rp 355,772 Rp 355,772 Rp 3,558 Rp 352,214

39
39 Nur Hasanah,Amd.Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 60 Rp 20,004,530 Rp 304,947 Rp 304,947 Rp 3,049 Rp 301,898

Pj.UKS/ 40
40 Betetsi Manalu,AMK BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 10 70 Rp 20,004,530 Rp 355,772 Rp 355,772 Rp 355,772
UKGS
 41

41 Elvi Masnur Jannah,Am.Keb BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 10 Pj.MALAR 70 Rp 20,004,530 Rp 355,772 Rp 355,772 Rp 3,558 Rp 352,214
IA,Pj .DBD

42

42 Endang Fatmawati,AMK BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 10 Pj. Lansia 70 Rp 20,004,530 Rp 355,772 Rp 355,772 Rp 3,558 Rp 352,214

43
43 Risno Tinambun,SKM BAKTI FUNGSIONAL 25 25 100% 80 0 0 0 10 Pj.Kesling 90 Rp 20,004,530 Rp 457,421 Rp 457,421 Rp 4,574 Rp 452,846

44
44 Erni,A.Md.Ak BAKTI FUNGSIONAL 25 25 100% 60 0 0 0 0 PJ.Lab 60 Rp 20,004,530 Rp 304,947 Rp 304,947 Rp 3,049 Rp 301,898

45
45 Sakiyah BAKTI FUNGSIONAL 25 25 100% 25 0 0 0 0 Cleaning 25 Rp 20,004,530 Rp 127,061 Rp 127,061 Rp 1,271 Rp 125,791
Service
46
46 Masitah BAKTI FUNGSIONAL 25 25 100% 25 0 0 0 0 Cleaning 25 Rp 20,004,530 Rp 127,061 Rp 127,061 Rp 1,271 Rp 125,791
Service
47
47 Sukat BAKTI FUNGSIONAL 25 25 100% 25 0 0 0 0 Supir 25 Rp 20,004,530 Rp 127,061 Rp 127,061 Rp 1,271 Rp 125,791
Ambulance

Supir 48
48 Bakrin BAKTI FUNGSIONAL 25 25 100% 25 0 0 0 0 25 Rp 20,004,530 Rp 127,061 Rp 127,061 Rp 1,271 Rp 125,791
Pusling Air

JUMLAH TOTAL 116 3090 100 50 50 540 0 3936 Rp 20,004,530 Rp 20,004,530 Rp 105,003 Rp 303,168 Rp - Rp 19,596,358 Rp 211,457 Rp 91,484 Rp 19,293,417

Subulussalam, 2023
Kepala Puskesmas Longkib Bendahara JKN
Kuasa Pengguna Anggaran

( Ns.NUR AFNI ,S.Kep) (Bd. Martina Sondang.S.Tr.Keb)

Nip. 19830108 200803 2 001 NIP. 19830326 200904 2 005
Rp 20,004,530
 JASA PELAYANAN JAMINAN KESEHATAN NASIONAL (JKN)

Bulan : JANUARI S/D MARET 2023

Nama Puskesmas : UPTD PUSKESMAS LONGKIB

No Nama Pegawai Jabatan

JANUARI FEBRUARI MARET TOTAL ADM BANK

Ns.Nur Afni,S.Kep
1 Kepala FKTP PKM Longkib,Pj. Akreditasi Rp 987,510 Rp987,510 Rp1,000
Nip.19830108 200803 2 001

2 Maya Dina Kepala FKTP PKM Longkib,Pj. Akreditasi Rp 727,029 Rp 730,443 Rp1,457,472 Rp1,000

dr.Marhamah Rp 754,607 Rp 859,699 Rp 863,735

3 Ketua UKP Rp2,478,041 Rp1,000
Nip.19930607 202203 2 007

4 dr. Muhammad Rizki Afrisa Dokter Umum Kontrak Rp 754,744 Rp 859,855 Rp 863,892 Rp2,478,492 Rp1,000

Bendahara Dana Kapitasi JKN,

Bd. Martina Sondang,S.Tr.Keb Rp 917,281 Rp 1,045,028 Rp 1,104,619
5 KR.Imunisasi ,PJ.Imunisasi & ,Petugas Rp3,066,928 Rp1,000
Nip.19830326 200904 2 005
SMILE

Kepala Tata Usaha,KR Poly Gigi,Ketua

Kollin Saragih.AMKG Nip.19810914 Rp 716,626 Rp 816,428 Rp 820,262
6 Admin, & Petugas Administrasi Rp2,353,315 Rp1,000
200803 1 001
Kepegawaian&ABK.

Ardinsyah,Amd.Kep Nip. PJ.Inventaris dan Aspak dan Rumah Rp 489,097 Rp 557,212 Rp 559,828
7 Rp1,606,138 Rp1,000
19730327 199604 1 002 Tangga & KR. UGD
Yunarti,Amd.Keb Nip. Rp 372,645 Rp 424,543 Rp 426,536
8 Pj. KESJAOR Rp1,223,724 Rp1,000
19840312 200803 2 001
Rasta Ginting,AMK Nip. Rp 419,226 Rp 477,611 Rp 479,853
9 KR.Poli Umum & PJ.PTM Rp1,376,690 Rp1,000
19790101 200904 2 005

10 Hermansyah,SKM Staf Puskesmas Rp 419,226 Rp 477,611 Rp 479,853 Rp1,376,690 Rp1,000

Siti Makrifah, S.Tr.Keb Nip. Rp 521,704 Rp 594,360 Rp 597,150

11 PJ.Promkes,KARU MTBS ,Ketua UKM Rp1,713,214 Rp1,000
19740507 200604 2 004
Alumiati ,Am.Keb Nip. Rp 466,054 Rp 586,851 Rp 533,454
12 PJ.TB,KARU KARTU Rp1,586,359 Rp1,000
19880925 201705 2 006
Dewi Kurnia Sari,Am.Keb Nip. Rp 367,938 Rp 419,179 Rp 421,148
13 PJ .PKPR Rp1,208,265 Rp1,000
19840824 201705 2 002
Desi Arianti,Am.Keb Nip. Rp 367,938 Rp 419,179 Rp 421,148
14 Bidan Desa Rantau Panjang& Pj. Prolanis Rp1,208,265 Rp1,000
19891016 201705 2 009

Fitraini Tanjung,Am.Keb Bidan desa Darul Aman & Pengelola dana Rp 367,938 Rp 419,179 Rp 421,148
15 Rp1,208,265 Rp1,000
Nip.19881205 201705 2 009 Non Kapitasi JKN/KFIS/Fakta Integritas

Lidia Fitrayani,Am.Keb Rp 515,113 Rp 530,961 Rp 533,454

16 Pj.KIA,Karu KIA/KB,Ketua Mutu Rp1,579,527 Rp1,000
Nip.19850617 201705 2 004
Septi Khairani,Am.Keb Nip. Rp 318,879 Rp 363,289 Rp 364,995
17 Bidan Desa Bukit Alim Rp1,047,163 Rp1,000
19870924 201705 2 006

Kamelia Astuti,Am.Keb Nip. Rp 318,879 Rp 363,289 Rp 364,995

18 Bidan Desa Sepang Rp1,047,163 Rp1,000
19850414 201705 2 007

Nelly Handayani Banjarnahor,A.Md.Keb Rp 402,279 Rp 402,412 Rp 404,302

19 Pj.SP2TP dan Pelkes, Yankestrad Rp1,208,993 Rp1,000
Nip.19900921 202203 2 006

Pindi Seprilla,AMd.Keb
20 Pembantu dana kapitasi JKN, Pj Cold Chain Rp 402,279 Rp 402,412 Rp 404,302 Rp1,208,993 Rp1,000
Nip.19950916 202203 2 004
Fifit Fransiska,Amd.Kep Rp 353,220 Rp 402,412 Rp 404,302
21 Koordinator PIS-PK Rp1,159,934 Rp1,000
Nip.19970112 202203 2 004
Monarisah,A.Md.Kep Pj.Surveilans & Pj. Penyakit yang Rp 402,279 Rp 458,303 Rp 460,455
22 Rp1,321,036 Rp1,000
Nip.19920428 202203 2 2006 disebabkan virus dan menular

23 Ratna Puspita Widia Sari Bidan Desa Darussalam Rp 301,898 Rp 343,942 Rp 345,557 Rp991,397 Rp1,000

24 Khoirun Nisa,AMd.Kes Nusantara Sehat Rp 201,265 Rp 229,295 Rp 230,371 Rp660,931 Rp1,000

25 Nurmayanti,Amd.Keb Bidan Desa Lae Saga Rp 301,898 Rp 343,942 Rp 345,557 Rp991,397 Rp1,000

26 Ahlina Wati,Amd.Keb Bidan Desa Longkib Rp 301,898 Rp 343,942 Rp 345,557 Rp991,397 Rp1,000

27 Sanawiyah,Amd.Keb Bidan Desa Panji Rp 301,898 Rp 343,942 Rp 345,557 Rp991,397 Rp1,000

28 Haoni Fahmy Gani Nasution Amd.Keb Bidan Desa Sikerabang Rp 301,898 Rp 343,942 Rp 345,557 Rp991,397 Rp1,000

29 Yulia Safitri,Amd.Keb Bidan Desa Bangun Sari Rp 301,898 Rp 343,942 Rp 345,557 Rp991,397 Rp1,000

30 Apt.Fatmah Solin,S.Farm KR.APOTIK,PJ.Pengelola BOK Rp 603,795 Rp 687,884 Rp 691,114 Rp1,982,793 Rp1,000

31 Helmiati BM,S.E Petugas P-care Kunjungan Sehat Rp 452,846 Rp 515,913 Rp 518,335 Rp1,487,095 Rp1,000

PJ.P-Care Rawat Jalan, & Pj. Tanggap Rp 452,846 Rp 515,913 Rp 518,335

32 Lili Suryani,Amd.Keb Rp1,487,095 Rp1,000
bencana,Karu P-Care

33 Asmala ,Amd.Keb Pj.KESWA Rp 352,214 Rp 401,266 Rp 403,150 Rp1,156,630 Rp1,000

34 Siti Rodiah,Amd.Keb PJ.Poskestren Rp 352,214 Rp 401,266 Rp 403,150 Rp1,156,630 Rp1,000

35 Rahimah,Am,Keb Pj.KB Rp 352,214 Rp 401,266 Rp 403,150 Rp1,156,630 Rp1,000

Pj Gudang Obat,Pj. Rp 452,846 Rp 515,913 Rp 518,335

36 Dian Winarti Celaumbanua,Amd.Keb Rp1,487,095 Rp1,000
P2M(HIV,SIPILIS,HEPATITIS,DLL)

37 Mirawati,Am.Keb PJ.Filariasis Rp 301,898 Rp 343,942 Rp 345,557 Rp991,397 Rp1,000

38 Yuyun Cahyani Pj. GIZI Rp 352,214 Rp 401,266 Rp 403,150 Rp1,156,630 Rp1,000

39 Heni Tiara Indriani,Amd..Keb Pj.SDIDTK Rp 352,214 Rp 401,266 Rp 403,150 Rp1,156,630 Rp1,000
40 Nur Hasanah,Am.Keb Staf fungsional Rp 301,898 Rp 343,942 Rp 345,557 Rp991,397 Rp1,000
41 Betetsi Manalu,AMK Pj.UKS/UKGS Rp 355,772 Rp 405,319 Rp 407,222 Rp1,168,313 Rp1,000

Pj .Malaria,Pj Penyakit yang disebabkan Rp 352,214 Rp 458,589 Rp 460,743

42 Elvi Masnur Jannah,Am.Keb Rp1,271,546 Rp1,000
virus dan menular(Rabies,DHF,dll)

43 Endang Fatmawati,AMK Pj. Lansia ,Bendahara BOK Rp 352,214 Rp 401,266 Rp 403,150 Rp1,156,630 Rp1,000

44 Risno Tinambun,SKM BAKTI FUNGSIONAL Rp 452,846 Rp 515,913 Rp 518,335 Rp1,487,095 Rp1,000

45 Erni,A.Md.Ak Pj.Lab,Pj TBC Rp 301,898 Rp 458,589 Rp 460,743 Rp1,221,230 Rp1,000

46 Sakiyah Cleaning Service Rp 125,791 Rp 143,309 Rp 143,982 Rp413,082 Rp1,000

47 Masitah Cleaning Service Rp 125,791 Rp 143,309 Rp 143,982 Rp413,082 Rp1,000

48 Sukat Supir Ambulance Rp 125,791 Rp 143,309 Rp 143,982 Rp413,082 Rp1,000

49 Bakrin Supir Pusling Air Rp 125,791 Rp 143,309 Rp 143,982 Rp413,082 Rp1,000

TOTAL Rp19,293,417 Rp21,642,541 Rp21,742,688 Rp62,678,647 Rp49,000

Rp19,293,417 Rp21,642,541 Rp21,742,688 Rp62,678,647

Kepala Puskesmas Longkib
Kuasa Pengguna Anggaran
 ( Ns.NUR AFNI ,S.Kep) Bd. MARTINA SONDANG ,S.Tr.Keb
Nip. 19830108 200803 2 001
JMLH YANG DITERIMA NO .REKENING BSI

Rp986,510 1046235284

Rp1,456,472 7147960534

Rp2,477,041 1059415636

Rp2,477,492 7206818934

Rp3,065,928 7153461265

Rp2,352,315 1046235499

Rp1,605,138 1046235353

Rp1,222,724 1046235716

Rp1,375,690 1046235320

Rp1,375,690 1057963741

Rp1,712,214 1210258160

Rp1,585,359 1122623124

Rp1,207,265 1046235591

Rp1,207,265 1046235488

Rp1,207,265 1046235455

Rp1,578,527 1046235364

Rp1,046,163 1046235557

Rp1,046,163 1046235433

Rp1,207,993 7198550021

Rp1,207,993 7198620507

Rp1,158,934 7198506251

Rp1,320,036 7198624718

Rp990,397 1046235375

Rp659,931 7215860749

Rp990,397 1046235422

Rp990,397 1046235444

Rp990,397 1192826176

Rp990,397

Rp990,397 1190536668

Rp1,981,793 1173841619

Rp1,486,095 7194607991

Rp1,486,095 1046235568

Rp1,155,630 7153462741 JASPEL AGUSTUS 2022

Rp1,155,630 1046235397 jaspel #REF!

Rp1,155,630 1046235400 bpjs #REF!
Rp1,486,095 1046235535 pph25 #REF!

Rp990,397 1046235681 zakat #REF!

Rp1,155,630 1190558264 infaq #REF!
Rp1,155,630 1046235411 #REF!
Rp990,397 1046235670 #REF!
Rp1,167,313 1046235524

Rp1,270,546 1046235580 Rp 78,243,636

Rp1,155,630 1046235705

Rp1,486,095 9897524670

Rp1,220,230 7227464358

Rp412,082 1046235750
Rp412,082 1046235658

Rp412,082 1046235636 jaspel Rp62,678,647

Rp412,082 1119950372 pph 21 Rp 954,949
Rp62,629,647 bpjs Rp 333,792
Rp62,629,647 infag Rp 303,906
zakat Rp 666,755
Bendahara JKN Rp 62,678,647
Rp 64,938,048
 Rp 64,938,048

Bd. MARTINA SONDANG ,S.Tr.Keb

NIP.19830326 200904 2 005
#REF!
#REF!