RINCIAN JASA PELAYANAN PASIEN COVID-19 1

KELOMPOK PARAMEDIK DAN NON MEDIK

BULAN : JANUARI 2023

Index Jasa Tak Langsung Jasa Langsung

No No. Rekening NAMA RUANG Gol Pajak Netto
Tk.Lsg Lsg Bruto Pajak R.Jalan R.Inap Pajak

1 1021 172932 Ns. Feranema Widyanti, S.Kep HD III.B 0.05 - 85 - - - - - - -

2 1022 374440 Iwan Kurniawan, AMK HD HD III.A 0.05 47 70 - 137,188 6,859 - - - 130,328
3 1022 016179 Irfan Khamil, Amd.Kep HD II.D - 47 70 - 137,188 - - - - 137,188
4 1022 016411 Sondang Dame.M, Amd.Kep HD III.B 0.05 47 70 - 137,188 6,859 - - - 130,328
5 1022 024449 Amelia Susanti,Amd.Kep HD III.A 0.05 47 70 - 137,188 6,859 - - - 130,328
6 1022 016004 Aziz Mathori, Amd.Kep HD III.B 0.05 47 70 - 137,188 6,859 - - - 130,328
7 1022 293130 Siti Khairiah, Amd.Kep HD III.D 0.05 47 70 - 137,188 6,859 - - - 130,328
8 1022 010111 Theodora Ira, S.Kep HD III.C 0.05 48 70 - 140,107 7,005 - - - 133,101
9 1022 009857 Andi Putra, Amd.Kep HD III.C 0.05 47 70 - 137,188 6,859 - - - 130,328
10 1022 016527 Teguh Pramono, Amd.Kep HD III.B 0.05 47 70 - 137,188 6,859 - - - 130,328
11 1022 015997 Reny Ocktavia , Amd.Kep HD III.A 0.05 47 70 - 137,188 6,859 - - - 130,328
12 1721 091151 Majadanlipah, S.Kep.Ners HD X 0.05 44 60 - 128,431 6,422 - - - 122,010
13 7025 741549 Ahmad Munir, S.Kep. Ners. HD - - 44 61 - 128,431 - - - - 128,431
14 1021 172908 Agus Salim, Amd.Kep HD - - 44 62 - 128,431 - - - - 128,431
15 - - - - - - - - - - - - - -
16 - - - - - - - - - - - - - -
17 1022 004324 Samsul Hadi HD II.C - 33 49 - 96,323 - - - - 96,323
18 - - - - - - - - - - - - - -

Jumlah 1,856,413 68,302 - - - 1,788,111

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Kepala Ruangan/inst/Unit Kerja Pembuat Daftar

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 RINCIAN JASA PELAYANAN PASIEN COVID-19 1
KELOMPOK PARAMEDIK DAN NON MEDIK
BULAN : PEBRUARI 2023

Index Jasa Tak Langsung Jasa Langsung

No No. Rekening NAMA RUANG Gol Pajak Netto
Tk.Lsg Lsg Bruto Pajak R.Jalan R.Inap Pajak

1 1021 172932 Ns. Feranema Widyanti, S.Kep HD III.B 0.05 - 85 - - - - 13,768 688 13,079
2 1022 374440 Iwan Kurniawan, AMK HD HD III.A 0.05 47 70 - 82,815 4,141 - 11,338 567 89,446
3 1022 016179 Irfan Khamil, Amd.Kep HD II.D - 47 70 - 82,815 - - 11,338 - 94,154
4 1022 016411 Sondang Dame.M, Amd.Kep HD III.B 0.05 47 70 - 82,815 4,141 - 11,338 567 89,446
5 1022 024449 Amelia Susanti,Amd.Kep HD III.A 0.05 47 70 - 82,815 4,141 - 11,338 567 89,446
6 1022 016004 Aziz Mathori, Amd.Kep HD III.B 0.05 47 70 - 82,815 4,141 - 11,338 567 89,446
7 1022 293130 Siti Khairiah, Amd.Kep HD III.D 0.05 47 70 - 82,815 4,141 - 11,338 567 89,446
8 1022 010111 Theodora Ira, S.Kep HD III.C 0.05 48 70 - 84,578 4,229 - 11,338 567 91,120
9 1022 009857 Andi Putra, Amd.Kep HD III.C 0.05 47 70 - 82,815 4,141 - 11,338 567 89,446
10 1022 016527 Teguh Pramono, Amd.Kep HD III.B 0.05 47 70 - 82,815 4,141 - 11,338 567 89,446
11 1022 015997 Reny Ocktavia , Amd.Kep HD III.A 0.05 47 70 - 82,815 4,141 - 11,338 567 89,446
12 1721 091151 Majadanlipah, S.Kep.Ners HD X 0.05 44 60 - 77,529 3,876 - 9,719 486 82,885
13 7025 741549 Ahmad Munir, S.Kep. Ners. HD - - 44 61 - 77,529 - - 9,880 - 87,410
14 1021 172908 Agus Salim, Amd.Kep HD - - 44 62 - 77,529 - - 10,042 - 87,572
15 - - - - - - - - - - - - - -
16 - - - - - - - - - - - - - -
17 1022 004324 Samsul Hadi HD II.C - 33 49 - 58,147 - - 7,937 - 66,084
18 - - - - - - - - - - - - - -

Jumlah 1,120,652 41,232 - 164,729 6,277 1,237,873

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Kepala Ruangan/inst/Unit Kerja Pembuat Daftar

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 RINCIAN JASA PELAYANAN PASIEN COVID-19 1
KELOMPOK PARAMEDIK DAN NON MEDIK
BULAN : MARET 2023

Index Jasa Tak Langsung Jasa Langsung

No No. Rekening NAMA RUANG Gol Pajak Netto
Tk.Lsg Lsg Bruto Pajak HD Double Lumen Pajak

1 1021 172932 Ns. Feranema Widyanti, S.Kep HD III.B 0.05 - 85 - - - - - -

2 1022 374440 Iwan Kurniawan, AMK HD HD III.A 0.05 47 70 85,791 4,290 - - - 81,502
3 1022 016179 Irfan Khamil, Amd.Kep HD II.D - 47 70 85,791 - - - - 85,791
4 1022 016411 Sondang Dame.M, Amd.Kep HD III.B 0.05 47 70 85,791 4,290 - - - 81,502
5 1022 024449 Amelia Susanti,Amd.Kep HD III.A 0.05 47 70 85,791 4,290 - - - 81,502
6 1022 016004 Aziz Mathori, Amd.Kep HD III.B 0.05 47 70 85,791 4,290 - - - 81,502
7 1022 293130 Siti Khairiah, Amd.Kep HD III.D 0.05 47 70 85,791 4,290 - - - 81,502
8 1022 010111 Theodora Ira, S.Kep HD III.C 0.05 47 70 85,791 4,290 - - - 81,502
9 1022 009857 Andi Putra, Amd.Kep HD III.C 0.05 47 70 85,791 4,290 - - - 81,502
10 1022 016527 Teguh Pramono, Amd.Kep HD III.B 0.05 47 70 85,791 4,290 - - - 81,502
11 1022 015997 Reny Ocktavia , Amd.Kep HD III.A 0.05 47 70 85,791 4,290 - - - 81,502
12 1721 091151 Majadanlipah, S.Kep.Ners HD X 0.05 44 60 80,315 4,016 - - - 76,299
13 7025 741549 Ahmad Munir, S.Kep. Ners. HD - - 44 61 80,315 - - - - 80,315
14 1021 172908 Agus Salim, Amd.Kep HD - - 44 62 80,315 - - - - 80,315
15 - - - - - - - - - - - - -
16 1022 004324 Samsul Hadi HD II.C - 34 49 62,062 - - - - 62,062
17 1022 027278 Chotimah HD II.C - 31 46 29,503 - - - - 29,503
18 1022 005738 Farida HD II.C - 31 46 56,586 - - - - 56,586

Jumlah 1,247,008 42,622 - - - 1,204,386

Mengetahui
Kepala Ruangan/inst/Unit Kerja Pembuat Daftar

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