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DAFTAR PESERTA VAKSINASI HEPATITIS B TAHUN 2015

BPJS KESEHATAN CABANG BULUKUMBA


UNTUK FASILITAS KESEHATAN TINGKAT PERTAMA KABUPATEN SELAYAR

NOMOR TENAGA KESEHATAN


NO FKTP NAMA PESERTA ALAMAT NO HP
KARTU PESERTA Dr Drg perawat Bidan Nakes Lain
1 PKM Benteng Dr. Frengki Wiyaya 0000127799651 V Jl. Syarif Al Qadri 081342393000
2 PKM Benteng Dr. Zaenal Abidin 0000127780031 V Jl. Dr Muchtar 081524115165
3 PKM Benteng Drg. Yunda Iswari 0000206784369 V Jl. KH. Hayyung 085299307878
4 PKM Benteng Saribanong 0000127831702 V Jl. Raup Rahman 085299294678
5 PKM Benteng Muh. Ilham Tamrin 0000127779219 V Jl. Hamang DM 081354966756
6 PKM Benteng Petrus Milu. ET.AMK 0000127810653 V Jl. Dr Muchtar 081242583842
7 PKM Benteng Hj. Nur Azizal Hastati,AMK 0000127810372 V Jl. Hamang DM 081342252052
8 PKM Benteng Rahma Yuliana, AMK 0000208962933 V Jl. Kemiri 081355974474
9 PKM Benteng Amsari Parida Amir, AMK 0000198959411 V Jl. Kemiri 081340611613
10 PKM Benteng Elsa Handayani, AMK 0000161594673 V Jl. Dr Muchtar 081343694482
11 PKM Benteng Nadia Sri Damayanti AMK 0001081539358 V Jl. Jend. Sudirma 082188883882
12 PKM Benteng Nur Ariani Amk 0000127272846 V Jl. Siswomiharjo 082187553550
13 PKM Benteng Nurdamayanti, S.Kep 0000210841457 V Jl. Vetran 085396014247
14 PKM Benteng Hj. Rostini AMG 0000127779603 V Jl. Hati Sucu 085256839557
15 PKM Benteng Sri Sulastri AMK 0000207752207 V Jl. Vetran 085341934449
16 PKM Benteng Yurniati, A.Md.AK 0000127805411 V Polebungin 081355308700
17 PKM Benteng Rosdiana 0000127779535 V Jl. Siswomiharjo 085394228113
18 PKM Benteng Normalina A.Md.AK 0001089263248 V Jl. KH. Hayyung 085656606171
19 PKM Benteng Bustan 0000127798841 V Jl. Dr. Wahidin 082195777377
20 PKM Benteng Nur Indah Kurnianti 0000127810405 V Jl. KH. Hayyung 085656238864
21 PKM Benteng Rahmaniar, Amd.KG V Jl. Diponegoro
22 PKM Benteng Muhammad Ali 0000127810091 V Jl. DI Panjaitan 081343669955
23 PKM Benteng St. Rosdiana, B.Sc 0000127804702 V Jl. KH. Hayyung 082193207234
24 PKM Benteng Muhammad Nawir 0000127779221 V Jl. Bonto 085255401765
25 PKM Benteng Agustina Bintang,Amd.Keb 0000127809257 V Jl. Dr. Muctar 081355484409
26 PKM Benteng Nur Rahmawati, A.md.Keb 0000208246959 V Jl. Dr. Wahidin 085230568878
27 PKM Benteng Suriati, A.md.Keb 0000149353626 V Jl. Pieere Tendean 085242331486
28 PKM Benteng Sitti Aminah Anas,Amd.Keb 0000195915306 V Jl. Kartini 085255644488
29 PKM Benteng Sitti Suprihartini,Amd.Keb 0000209002689 V Parappa 082349111168
30 PKM Benteng Andi Jemma, Amd.Keb V Jl S.Parman 085395073972
31 PKM Benteng Ira Muliati Radi.Amd.Keb 0001860597281 V Jl. Yos Sudarso 085696035101
32 PKM Benteng Rosidah, AMKL 0000127810732 V Jl. Bonto 085399049790
33 PKM Benteng Israyana Yulianti AMKL 0000127809821 V Jl. Kihajar Dewantara 081355840480
34 PKM Benteng Rostati, SKM 0000127803881 V Jl. Vetran 081241466460
35 PKM Benteng Armawati, S.Kep 0000127798108 V Jl MT Haryono 081343694704
36 PKM Benteng Anna Marsela,AMK V Jl. Siswomiharjo 085255253585
37 PKM Benteng Andi Rezkiani Amd.Keb 0000976046174 V Jl. AP Pettarani 058299202908
38 PKM Benteng Wa Ode Sinta Kalsum 0000127805321 V Jl. Dr. Muctar 085242288539
39 PKM Benteng Andi Megawati V Matalalang 082188280009
40 PKM Benteng Nur Fauzi, S, Si, Apt 0000127779366 V Jl. Manga 081343728267
41 PKM Benteng Sri Rahmat Yani Nur 0000127110013 V Jl. Pahlawan 082189618873
42 PKM Benteng Santi Hasbullah, AMK 0000127779669 v Jl. Siswomiharjo 085242103014
43 PKM Benteng Mayanti, AMF 0000127800944 V Jl. Dr. Muctar 085242597974
44 PKM Benteng Hj. Syahraeni, AMK 0000129748544 V Parappa 085299403344
45 PKM Benteng Nur Ilma, Amd.Keb 0000127802428 V Jl. MT. Haryono 082191786303
46 PKM Benteng Irmawati, Amd.Keb 0000202140505 V Parappa 085299703743
47 PKM Benteng Ridha Arbiah, Amd.Keb 0000204452234 V Gusung 085299511051
48 PKM Benteng Ramlah, Amd.Keb 0000976047939 V Gusung 085343378979
49 PKM Benteng Hermin Wahida AMK V Jl. Mappatoba 085342936111
50 PKM Benteng Andi Jumrianti, Amd.Keb 0000202140483 V Jl Ahmad Dahlan 082346561144
51 PKM Benteng Yulianti, Amd.Keb V Matalalang 082187610088
52 PKM Benteng Wahyuni, Amd.Keb 0000198245799 V Jl. Pahlawan 081242999901
53 PKM Benteng Andi Salmei, Amd.Keb 0000127794434 V Jl. Bina Karya 085342581891

Benteng, 08 Juni 2015


Kepala UPTD Puskesmas Benteng,

Dr. Frengki Wijaya


Pangkat : Pembina
Nip. 1979092 20004 1 023
DAFTAR PENERIMAAN JASA PELAYANAN KESEHATAN PESERTA JKN BAGI PETUGAS PUSKESMAS PUSTU DAN POSKEDES
BULAN JANUARI TAHUN 2015
PUSKESMAS : BENTENG
JUMLAH PESERTA : 6886 ORANG
JUMLAH PEGAWAI : 89 ORANG
BESARAN KAPITASI : 6000 PERJIWA / BULAN
TOTAL KAPITASI : 41307000 TOTAL JASA PELAYANAN SESUAI SK BUPATI 60 % = 24,784,200.-

GOLO VARIABEL POINT VARIABEL DAERAH POINT JUMLAH PPH JUMLAH


NO NAMA PETUGAS NGAN JABATAN KETENA KEHADIRAN JABA /ORG KINER STATUSMASA /ORG DITERIMA PASAL 21 DIBAYARKAN TANDA TANGAN
GAAN EFEKTIF 1 BLNTDK HADIR TAN /HARI JA KEPEG KERJA BULAN ( Rp ) ( 15% / 5% ) ( Rp )
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

1 Dr. Frengki Wiyaya ( Kepala Pusk) III Dokter Umum 150 24 5 30 6.25 90 30 25 312.8 Rp 428,995 Rp 21,450 Rp 407,545 1

2 Dr. Zaenal Abidin IV Dokter Umum 150 24 6.25 90 30 85 379.0 Rp 519,869 Rp 77,980 Rp 441,889 2

3 Drg. Yunda Iswari III Dokter Gigi 150 24 4 6.25 90 30 0 265.0 Rp 363,497 Rp 18,175 Rp 345,322 3

4 Saribanong III Perawat 40 24 1.67 90 30 100 284.0 Rp 389,559 Rp 19,478 Rp 370,081 4

5 Muh. Ilham Tamrin III Perawat 40 24 7 1.67 90 30 40 205.3 Rp 281,653 Rp 14,083 Rp 267,570 5

6 Petrus Milu. ET.AMK (Bend. Pusk) III Perawat 40 24 30 1.67 90 30 70 284.0 Rp 389,559 Rp 19,478 Rp 370,081 6

7 Hj. Nur Azizal Hastati,AMK III Perawat 40 24 4 1.67 90 30 85 258.3 Rp 354,352 Rp 17,718 Rp 336,635 7

8 Rahma Yuliana, AMK II Perawat 40 24 1.67 90 30 25 209.0 Rp 286,682 Rp - Rp 286,682 8

9 Amsari Parida Amir, AMK II Perawat 40 24 3 1.67 90 30 25 201.0 Rp 275,709 Rp - Rp 275,709 9

10 Elsa Handayani, AMK II Perawat 40 24 3 1.67 90 30 25 201.0 Rp 275,709 Rp - Rp 275,709 10

11 Muhrawati, AMK Perawat 40 24 2 1.67 90 10 10 168.7 Rp 231,358 Rp - Rp 231,358 11

12 Sri Adrianti, AMK Perawat 40 24 1.67 90 10 10 174.0 Rp 238,673 Rp - Rp 238,673 12

13 Nur Wahyuni, AMK Perawat 40 24 2 1.67 90 10 10 168.7 Rp 231,358 Rp - Rp 231,358 13

14 Musfiah Zainuddin, AMK Perawat 40 24 6 1.67 90 20 10 168.0 Rp 230,443 Rp - Rp 230,443 14

15 Andi Armita Dewi, AMK Perawat 40 24 1.67 90 10 10 174.0 Rp 238,673 Rp - Rp 238,673 15

16 Hasmirawati, AMK Perawat 40 24 4 1.67 90 10 25 178.3 Rp 244,617 Rp - Rp 244,617 16

17 Muh. Subhan, AMK Perawat 40 24 1.67 90 10 0 164.0 Rp 224,957 Rp - Rp 224,957 17

18 Musdalifah, MR,AMK Perawat 40 24 6 1.67 90 10 0 148.0 Rp 203,010 Rp - Rp 203,010 18

19 Muhammad Rum, AMK Perawat 40 24 8 1.67 90 10 0 142.7 Rp 195,694 Rp - Rp 195,694 19


20 Agustina, AMK Perawat 40 24 3 1.67 90 10 10 166.0 Rp 227,700 Rp - Rp 227,700 20

21 Risaldi Razak, AMK Perawat 40 24 1.67 90 10 0 164.0 Rp 224,957 Rp - Rp 224,957 21

22 Dewi Ahryani, AMK Perawat 40 24 1.67 90 10 0 164.0 Rp 224,957 Rp - Rp 224,957 22

23 Nurdamayanti, S.Kep III Perawat 40 24 1 1.67 90 30 40 221.3 Rp 303,600 Rp 15,180 Rp 288,420 23

24 Hj. Rostini AMG II Tenaga Penunjang 15 24 0.63 90 30 70 229.0 Rp 314,116 Rp Rp 314,116 24

25 Sri Sulastri AMK II Perawat 40 24 2 1.67 90 30 25 203.7 Rp 279,367 Rp - Rp 279,367 25

26 Agustini Tenaga Penunjang 15 24 0.63 90 20 25 174.0 Rp 238,673 Rp - Rp 238,673 26

27 Yurniati, A.Md.AK II Analis 40 24 1 1.67 90 30 25 206.3 Rp 283,025 Rp - Rp 283,025 27

28 Rosdiana III Analis 40 24 1 1.67 90 30 85 266.3 Rp 365,326 Rp 18,266 Rp 347,060 28

29 Normalina, Amd. Anakes II Analis 40 24 6 1.67 90 30 25 193.0 Rp 264,735 Rp - Rp 264,735 29

30 Yunarsih, AMAK Analis 40 24 1.67 90 10 25 189.0 Rp 259,249 Rp - Rp 259,249 30

31 Bustan II Perawat Gigi 40 24 1.67 90 30 40 224.0 Rp 307,258 Rp 15,363 Rp 291,895 31

32 Nur Indah Kurnianti III Perawat Gigi 40 24 1.67 90 30 40 224.0 Rp 307,258 Rp - Rp 307,258 32

33 Rahmaniar, Amd.KG Perawat Gigi 40 24 1 1.67 90 10 0 161.3 Rp 221,299 Rp 11,065 Rp 210,234 33

34 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 40 24 30 1.67 90 30 70 284.0 Rp 389,559 Rp 19,478 Rp 370,081 34

35 St. Rosdiana, B.Sc III Perawat 40 24 8 1.67 90 30 100 262.7 Rp 360,296 Rp - Rp 360,296 35

36 Muhammad Nawir II Pel. Administrasi 40 24 1.67 90 30 25 209.0 Rp 286,682 Rp 14,334 Rp 272,348 36

37 Agustina Bintang,Amd.Keb III Tenaga Bidan 60 24 2.50 90 30 85 289.0 Rp 396,417 Rp Rp 396,417 37

38 Nur Rahmawati, A.md.Keb II Tenaga Bidan 60 24 2.50 90 30 25 229.0 Rp 314,116 Rp 15,706 Rp 298,410 38

39 Suriati, A.md.Keb III Tenaga Bidan 60 24 2.50 90 30 25 229.0 Rp 314,116 Rp - Rp 314,116 39

40 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 60 24 2.50 90 30 25 229.0 Rp 314,116 Rp - Rp 314,116 40

41 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 60 24 5 2.50 90 30 25 211.5 Rp 290,112 Rp - Rp 290,112 41

42 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 60 24 1 2.50 90 10 0 180.5 Rp 247,589 Rp - Rp 247,589 42

43 Isnayani, Amd. Keb Tenaga Bidan 60 24 2.50 90 10 0 184.0 Rp 252,390 Rp - Rp 252,390 43

44 Andi Jemma, Amd.Keb Tenaga Bidan 60 24 8 2.50 90 30 10 186.0 Rp 255,134 Rp - Rp 255,134 44

45 Dewi Sartika, Amd.Keb Tenaga Bidan 60 24 2.50 90 10 10 194.0 Rp 266,107 Rp - Rp 266,107 45

46 Titin Sumarni, Amd.Keb Tenaga Bidan 60 24 2.50 90 10 10 194.0 Rp 266,107 Rp - Rp 266,107 46


47 Lisdayanti, A.md.Keb Tenaga Bidan 60 24 2.50 90 10 0 184.0 Rp 252,390 Rp - Rp 252,390 47

48 Yul Fitriani, Amd. Keb Tenaga Bidan 60 24 2.50 90 10 10 194.0 Rp 266,107 Rp - Rp 266,107 48

49 Andi Isna, Amd.Keb Tenaga Bidan 60 24 2 2.50 90 10 10 187.0 Rp 256,505 Rp - Rp 256,505 49

50 Citra Pratiwi, Amd.Keb Tenaga Bidan 60 24 4 2.50 90 10 10 180.0 Rp 246,904 Rp - Rp 246,904 50

51 Rosmiati, Amd.Keb Tenaga Bidan 60 24 2.50 90 20 10 204.0 Rp 279,824 Rp - Rp 279,824 51

52 Sri Wahyuni, Amd.Keb Tenaga Bidan 60 24 2.50 90 10 10 194.0 Rp 266,107 Rp - Rp 266,107 52

53 Nurfitra, Amd.Keb Tenaga Bidan 60 24 9 2.50 90 10 0 152.5 Rp 209,182 Rp - Rp 209,182 53

54 Panca Lisma, Amd.Keb Tenaga Bidan 60 24 5 2.50 90 10 10 176.5 Rp 242,103 Rp - Rp 242,103 54

55 Sulastri, Amd.Keb Tenaga Bidan 60 24 2.50 90 10 0 184.0 Rp 252,390 Rp - Rp 252,390 55

56 Sulmiati Bahri Amd.Keb Tenaga Bidan 60 24 15 2.50 90 10 0 131.5 Rp 180,377 Rp - Rp 180,377 56

57 Ira Muliati Radi.Amd.Keb Tenaga Bidan 60 24 2.50 90 30 10 214.0 Rp 293,541 Rp 14,677 Rp 278,864 57

58 Rosidah, AMKL III Sanitarian 40 24 1.67 90 30 40 224.0 Rp 307,258 Rp 15,363 Rp 291,895 58

59 Israyana Yulianti AMKL III Sanitarian 40 24 1.67 90 30 40 224.0 Rp 307,258 Rp 15,363 Rp 291,895 59

60 Rostati, SKM III Tenaga Penunjang 15 24 0.63 90 30 40 199.0 Rp 272,966 Rp 13,648 Rp 259,317 60

61 Armawati, S.Kep III Perawat 40 24 1 1.67 90 30 40 221.3 Rp 303,600 Rp 15,180 Rp 288,420 61

62 Andi Rezki Wardani S.Kep Ns Perawat 100 24 2 4.17 90 10 0 213.7 Rp 293,084 Rp 14,654 Rp 278,429 62

63 Wa Ode Sinta Kalsum II Pelak. Gizi 40 24 1.67 90 30 70 254.0 Rp 348,408 Rp - Rp 348,408 63

64 Andi Megawati, SKM Tenaga Penunjang 15 24 0.63 90 20 25 174.0 Rp 238,673 Rp 11,934 Rp 226,740 64

65 Rosmayanti, SKM Tenaga Penunjang 15 24 0.63 90 10 25 164.0 Rp 224,957 Rp 11,248 Rp 213,709 65

66 Sudirman H Tenaga Penunjang 15 24 0.63 90 20 25 174.0 Rp 238,673 Rp - Rp 238,673 66

67 Nur Fauzi, S, Si, Apt III Tenaga Penunjang 15 24 5 0.63 90 30 25 175.9 Rp 241,245 Rp 12,062 Rp 229,183 67

68 Sri Rahmat Yani Nur III Perawat 40 24 1.67 90 30 70 254.0 Rp 348,408 Rp 17,420 Rp 330,988 68

69 Mayanti, AMF III Tenaga Penunjang 15 24 4 0.63 90 30 25 177.5 Rp 243,474 Rp 12,174 Rp 231,301 69

70 Irdawati, S.Si,Apt Tenaga Penunjang 15 24 11 0.63 90 20 25 156.1 Rp 214,155 Rp 10,708 Rp 203,447 70

71 Hamriana Tenaga Penunjang 15 24 2 0.63 90 10 10 145.8 Rp 199,923 Rp - Rp 199,923 71

72 Sri Wedari Yusuf, AMF Tenaga Penunjang 15 24 2 0.63 90 10 0 135.8 Rp 186,206 Rp - Rp 186,206 72

73 Santi Wardianti Amd.Keb Tenaga Bidan 60 24 2 2.50 90 10 10 187.0 Rp 256,505 Rp - Rp 256,505 73


74 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 60 24 2.50 90 10 0 184.0 Rp 252,390 Rp - Rp 252,390 74

75 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 60 24 2.50 90 10 0 184.0 Rp 252,390 Rp - Rp 252,390 75

76 Desi Asriana, Amd>keb Tenaga Bidan 60 24 2.50 90 10 0 184.0 Rp 252,390 Rp - Rp 252,390 76

77 Hastuti, Amd.Keb Tenaga Bidan 60 24 2.50 90 10 0 184.0 Rp 252,390 Rp - Rp 252,390 77

78 Nur Ilma, Amd.Keb Tenaga Bidan 60 24 2.50 90 30 55 259.0 Rp 355,267 Rp - Rp 355,267 78

79 Irmawati, Amd.Keb Tenaga Bidan 60 24 2.50 90 30 10 214.0 Rp 293,541 Rp - Rp 293,541 79

80 Ridha Arbiah, Amd.Keb II Tenaga Bidan 60 24 2.50 90 30 25 229.0 Rp 314,116 Rp - Rp 314,116 80

81 Ramlah, Amd.Keb Tenaga Bidan 60 24 2.50 90 30 10 214.0 Rp 293,541 Rp - Rp 293,541 81

82 Hermin Wahida III Perawat 40 24 1.67 90 30 55 239.0 Rp 327,833 Rp 16,392 Rp 311,441 82

83 Andi Jumrianti, Amd.Keb Tenaga Bidan 60 24 3 2.50 90 30 10 203.5 Rp 279,138 Rp - Rp 279,138 83

84 Yulianti, Amd.Keb Tenaga Bidan 60 24 2.50 90 30 10 214.0 Rp 293,541 Rp - Rp 293,541 84

85 Israwati Tenaga Penunjang 15 24 0.63 90 20 10 159.0 Rp 218,098 Rp - Rp 218,098 85

86 Andi Mas Muliani Tenaga Penunjang 15 24 0.63 90 10 10 149.0 Rp 204,381 Rp - Rp 204,381 86

87 Wahyuni, Amd.Keb II Tenaga Bidan 60 24 2.50 90 30 25 229.0 Rp 314,116 Rp - Rp 314,116 87

88 Andi Salmei, Amd.Keb Tenaga Bidan 60 24 2.50 90 30 10 214.0 Rp 293,541 Rp - Rp 293,541 88

89 Reski Arisanti Amelia Safitri, AMK Perawat 40 24 1.67 90 10 10 174.0 Rp 238,673 Rp - Rp 238,673 89

JUMLAH 4305 2136 158 90 179.38 8010 1860 2155 18068.417 Rp 24,784,200 Rp 478,576 Rp 24,305,624

Mengetahui / Menyetujui : Benteng, 31 Januari 2015


Kepala UPTD Puskesmas Benteng Bendahara JKN

Dr. FRENGKI WIJAYA PETRUS MILU E.T, AMK


Pangkat : Penata Tk.I Nip 19710704 199103 1 009
NIP. 19790926 200604 1 023
41,307,000 6,885

24,784,200 18068.417

24,784,200 18068.417

24,784,200 18068.417

24,784,200 18068.417 41,307,000 24,784,200

24,784,200 18068.417 41,307,000 16,522,800 6,609,120 9,913,680 16,522,800

24,784,200 18068.417 41,307,000

24,784,200 18068.417 6,609,120 9,913,680 16,522,800

24,784,200 18068.417

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DAFTAR VARIABEL DAERAH SEBAGAI PENILAIAN TAMBAHAN DALAM MELAKUKAN PEMBAGIAN JASA PELAYANAN
JAMINAN KESEHATAN NASIONAL DI PUSKESMAS BENTENG BULAN JANUARI TAHUN 2015

VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK PEGAWAI KERJA
NGAN HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

1 Dr. Frengki Wiyaya ( Kepala Pusk III Dokter Umum 90 30 25 5

2 Dr. Zaenal Abidin IV Dokter Umum 90 30 85

3 Drg. Yunda Iswari III Dokter Gigi 90 30 0 4

4 Saribanong III Perawat 90 30 100

5 Muh. Ilham Tamrin III Perawat 90 30 40 7

6 Petrus Milu. ET.AMK (Bend. Pusk III Perawat 90 30 70

7 Hj. Nur Azizal Hastati,AMK III Perawat 90 30 85 4

8 Rahma Yuliana, AMK II Perawat 90 30 25

9 Amsari Parida Amir, AMK II Perawat 90 30 25 3

10 Elsa Handayani, AMK II Perawat 90 30 25 3

11 Muhrawati, AMK Perawat 90 10 10 2

12 Sri Adrianti, AMK Perawat 90 10 10

13 Nur Wahyuni, AMK Perawat 90 10 10 2

14 Musfiah Zainuddin, AMK Perawat 90 20 10 6

15 Andi Armita Dewi, AMK Perawat 90 10 10

16 Hasmirawati, AMK Perawat 90 10 25 4

17 Muh. Subhan, AMK Perawat 90 10 0

18 Musdalifah, MR,AMK Perawat 90 10 0 6

19 Muhammad Rum, AMK Perawat 90 10 0 8

20 Agustina, AMK Perawat 90 10 10 3

21 Risaldi Razak, AMK Perawat 90 10 0

22 Dewi Ahryani, AMK Perawat 90 10 0

23 Nurdamayanti, S.Kep III Perawat 90 30 40 1

24 Hj. Rostini AMG II Tenaga Penunjang 90 30 70

25 Sri Sulastri AMK II Perawat 90 30 25 2

26 Agustini Tenaga Penunjang 90 20 25

27 Yurniati, A.Md.AK II Analis 90 30 25 1

28 Rosdiana III Analis 90 30 85 1

29 Normalina, Amd. Anakes II Analis 90 30 25 6

30 Yunarsih, AMAK Analis 90 10 25

31 Bustan II Perawat Gigi 90 30 40

32 Nur Indah Kurnianti III Perawat Gigi 90 30 40

33 Rahmaniar, Amd.KG Perawat Gigi 90 10 0 1

34 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 90 30 70

35 St. Rosdiana, B.Sc III Perawat 90 30 100 8

36 Muhammad Nawir II Pel. Administrasi 90 30 25

37 Agustina Bintang,Amd.Keb III Tenaga Bidan 90 30 85

38 Nur Rahmawati, A.md.Keb II Tenaga Bidan 90 30 25

39 Suriati, A.md.Keb III Tenaga Bidan 90 30 25

40 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 90 30 25

41 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 90 30 25 5

42 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 90 10 0 1

43 Isnayani, Amd. Keb Tenaga Bidan 90 10 0

44 Andi Jemma, Amd.Keb Tenaga Bidan 90 30 10 8


VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK PEGAWAI KERJA
NGAN HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

45 Dewi Sartika, Amd.Keb Tenaga Bidan 90 10 10

46 Titin Sumarni, Amd.Keb Tenaga Bidan 90 10 10

47 Lisdayanti, A.md.Keb Tenaga Bidan 90 10 0

48 Yul Fitriani, Amd. Keb Tenaga Bidan 90 10 10

49 Andi Isna, Amd.Keb Tenaga Bidan 90 10 10 2

50 Citra Pratiwi, Amd.Keb Tenaga Bidan 90 10 10 4

51 Rosmiati, Amd.Keb Tenaga Bidan 90 20 10

52 Sri Wahyuni, Amd.Keb Tenaga Bidan 90 10 10

53 Nurfitra, Amd.Keb Tenaga Bidan 90 10 0 9

54 Panca Lisma, Amd.Keb Tenaga Bidan 90 10 10 5

55 Sulastri, Amd.Keb Tenaga Bidan 90 10 0

56 Sulmiati Bahri Amd.Keb Tenaga Bidan 90 10 0 15

57 Ira Muliati Radi.Amd.Keb Tenaga Bidan 90 30 10

58 Rosidah, AMKL III Sanitarian 90 30 40

59 Israyana Yulianti AMKL III Sanitarian 90 30 40

60 Rostati, SKM III Tenaga Penunjang 90 30 40

61 Armawati, S.Kep III Perawat 90 30 40 1

62 Andi Rezki Wardani S.Kep Ns Perawat 90 10 0 2

63 Wa Ode Sinta Kalsum II Pelak. Gizi 90 30 70

64 Andi Megawati, SKM Tenaga Penunjang 90 20 25

65 Rosmayanti, SKM Tenaga Penunjang 90 10 25

66 Sudirman H Tenaga Penunjang 90 20 25

67 Nur Fauzi, S, Si, Apt III Tenaga Penunjang 90 30 25 5

68 Sri Rahmat Yani Nur III Perawat 90 30 70

69 Mayanti, AMF III Tenaga Penunjang 90 30 25 4

70 Irdawati, S.Si,Apt Tenaga Penunjang 90 20 25 11

71 Hamriana Tenaga Penunjang 90 10 10 2

72 Sri Wedari Yusuf, AMF Tenaga Penunjang 90 10 0 2

73 Santi Wardianti Amd.Keb Tenaga Bidan 90 10 10 2

74 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 90 10 0

75 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 90 10 0

76 Desi Asriana, Amd>keb Tenaga Bidan 90 10 0

77 Hastuti, Amd.Keb Tenaga Bidan 90 10 0

78 Nur Ilma, Amd.Keb Tenaga Bidan 90 30 55

79 Irmawati, Amd.Keb Tenaga Bidan 90 30 10

80 Ridha Arbiah, Amd.Keb II Tenaga Bidan 90 30 25

81 Ramlah, Amd.Keb Tenaga Bidan 90 30 10

82 Hermin Wahida III Perawat 90 30 55

83 Andi Jumrianti, Amd.Keb Tenaga Bidan 90 30 10 3

84 Yulianti, Amd.Keb Tenaga Bidan 90 30 10

85 Israwati Tenaga Penunjang 90 20 10

86 Andi Mas Muliani Tenaga Penunjang 90 10 10


VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK PEGAWAI KERJA
NGAN HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

87 Wahyuni, Amd.Keb II Tenaga Bidan 90 30 25

88 Andi Salmei, Amd.Keb Tenaga Bidan 90 30 10

89 Reski Arisanti Amelia Safitri, AMK Perawat 90 10 10

JUMLAH 1860 2155

Mengetahui : Benteng, 31 Januari 2015


Kepala UPTD Puskesmas Benteng, Kasubag Tata Usaha,

Dr. Frengki Wijaya Muhammad Ali


Pangkat : Penata Tk.I Nip. 19641211 198903 1 019
Nip. 1979092 20004 1 023
DAFTAR PENERIMAAN JASA PELAYANAN KESEHATAN PESERTA JKN BAGI PETUGAS PUSKESMAS PUSTU DAN POSKEDES
PADA BULAN PEBRUARI TAHUN 2015
PUSKESMAS : BENTENG
JUMLAH PESERTA : 6923 ORANG
JUMLAH PEGAWAI : 89 ORANG
BESARAN KAPITASI : 6000 PERJIWA / BULAN
TOTAL KAPITASI : 41,541,000 TOTAL JASA PELAYANAN SESUAI SK BUPATI 60 % = 24,924,600.-

GOLO VARIABEL POINT VARIABEL DAERAH POINT JUMLAH PPH JUMLAH


NO NAMA PETUGAS NGAN JABATAN KETENA KEHADIRAN JABA /ORG KINER STATU MASA /ORG DITERIMA PASAL 21 DIBAYARKAN TANDA TANGAN
GAAN EFEK 1 BLN TDK HADIR TAN /HARI JA KEPEG KERJA BULAN ( Rp ) ( 15% / 5% ) ( Rp )
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

1 Dr. Frengki Wiyaya ( Kepala Pusk) III Dokter Umum 150 23 30 6.52 90 30 25 325.0 Rp 498,923 Rp 24,946 Rp 473,977 1

2 Dr. Zaenal Abidin IV Dokter Umum 150 23 6.52 90 30 85 355.0 Rp 544,978 Rp 81,747 Rp 463,231 2

3 Drg. Yunda Iswari III Dokter Gigi 150 23 11 6.52 90 30 0 209.3 Rp 321,246 Rp 16,062 Rp 305,184 3

4 Saribanong III Perawat 40 23 1.74 90 30 100 260.0 Rp 399,139 Rp 19,957 Rp 379,182 4

5 Muh. Ilham Tamrin III Perawat 40 23 1.74 90 30 40 200.0 Rp 307,030 Rp 15,351 Rp 291,678 5

6 Petrus Milu. ET.AMK (Bend. Pusk) III Perawat 40 23 30 1.74 90 30 70 260.0 Rp 399,139 Rp 19,957 Rp 379,182 6

7 Hj. Nur Azizal Hastati,AMK III Perawat 40 23 1 1.74 90 30 85 244.3 Rp 374,977 Rp 18,749 Rp 356,228 7

8 Rahma Yuliana, AMK II Perawat 40 23 1.74 90 30 25 185.0 Rp 284,002 Rp - Rp 284,002 8

9 Amsari Parida Amir, AMK II Perawat 40 23 1.74 90 30 25 185.0 Rp 284,002 Rp - Rp 284,002 9

10 Elsa Handayani, AMK II Perawat 40 23 3 1.74 90 30 25 182.8 Rp 280,598 Rp - Rp 280,598 10

11 Muhrawati, AMK Perawat 40 23 3 1.74 90 10 5 142.8 Rp 219,192 Rp - Rp 219,192 11

12 Sri Adrianti, AMK Perawat 40 23 1.74 90 10 10 150.0 Rp 230,272 Rp - Rp 230,272 12

13 Nur Wahyuni, AMK Perawat 40 23 4 1.74 90 10 10 147.0 Rp 225,734 Rp - Rp 225,734 13

14 Musfiah Zainuddin, AMK Perawat 40 23 10 1.74 90 20 10 152.6 Rp 234,277 Rp - Rp 234,277 14

15 Andi Armita Dewi, AMK Perawat 40 23 1.74 90 10 10 150.0 Rp 230,272 Rp - Rp 230,272 15

16 Hasmirawati, AMK Perawat 40 23 7 1.74 90 10 25 159.8 Rp 245,357 Rp - Rp 245,357 16

17 Muh. Subhan, AMK Perawat 40 23 1.74 90 10 0 140.0 Rp 214,921 Rp - Rp 214,921 17

18 Musdalifah, MR,AMK Perawat 40 23 9 1.74 90 10 0 133.3 Rp 204,709 Rp - Rp 204,709 18

19 Muhammad Rum, AMK Perawat 40 23 1.74 90 10 0 140.0 Rp 214,921 Rp - Rp 214,921 19


20 Agustina, AMK Perawat 40 23 1.74 90 10 10 150.0 Rp 230,272 Rp - Rp 230,272 20

21 Risaldi Razak, AMK Perawat 40 23 1.74 90 10 0 140.0 Rp 214,921 Rp - Rp 214,921 21

22 Dewi Ahryani, AMK Perawat 40 23 1.74 90 10 0 140.0 Rp 214,921 Rp - Rp 214,921 22

23 Nurdamayanti, S.Kep III Perawat 40 23 1.74 90 30 40 200.0 Rp 307,030 Rp 15,351 Rp 291,678 23

24 Hj. Rostini AMG II Tenaga Penunjang 15 23 0.65 90 30 70 205.0 Rp 314,705 Rp Rp 314,705 24

25 Sri Sulastri AMK II Perawat 40 23 3 1.74 90 30 25 182.8 Rp 280,598 Rp - Rp 280,598 25

26 Agustini Tenaga Penunjang 15 23 0.65 90 20 25 150.0 Rp 230,272 Rp - Rp 230,272 26

27 Yurniati, A.Md.AK II Analis 40 23 1.74 90 30 25 185.0 Rp 284,002 Rp - Rp 284,002 27

28 Rosdiana III Analis 40 23 1.74 90 30 85 245.0 Rp 376,111 Rp 18,806 Rp 357,306 28

29 Yunarsih, AMAK Analis 40 23 1.74 90 10 25 165.0 Rp 253,299 Rp - Rp 253,299 29

30 Bustan II Perawat Gigi 40 23 1 1.74 90 30 40 199.3 Rp 305,895 Rp - Rp 305,895 30

31 Nur Indah Kurnianti III Perawat Gigi 40 23 1.74 90 30 40 200.0 Rp 307,030 Rp 15,351 Rp 291,678 31

32 Rahmaniar, Amd.KG Perawat Gigi 40 23 7 1.74 90 10 0 134.8 Rp 206,978 Rp - Rp 206,978 32

33 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 40 23 2 30 1.74 90 30 70 258.5 Rp 396,869 Rp 19,843 Rp 377,026 33

34 St. Rosdiana, B.Sc III Perawat 40 23 1.74 90 30 100 260.0 Rp 399,139 Rp 19,957 Rp 379,182 34

35 Muhammad Nawir II Pel. Administrasi 40 23 1 1.74 90 30 25 184.3 Rp 282,868 Rp - Rp 282,868 35

36 Agustina Bintang,Amd.Keb III Tenaga Bidan 60 23 2.61 90 30 85 265.0 Rp 406,814 Rp 20,341 Rp 386,474 36

37 Nur Rahmawati, A.md.Keb II Tenaga Bidan 60 23 2.61 90 30 25 205.0 Rp 314,705 Rp Rp 314,705 37

38 Suriati, A.md.Keb III Tenaga Bidan 60 23 2.61 90 30 25 205.0 Rp 314,705 Rp 15,735 Rp 298,970 38

39 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 60 23 2.61 90 30 25 205.0 Rp 314,705 Rp - Rp 314,705 39

40 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 60 23 2.61 90 30 25 205.0 Rp 314,705 Rp - Rp 314,705 40

41 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 60 23 11 2.61 90 10 0 142.3 Rp 218,458 Rp - Rp 218,458 41

42 Isnayani, Amd. Keb Tenaga Bidan 60 23 2.61 90 10 0 160.0 Rp 245,624 Rp - Rp 245,624 42

43 Andi Jemma, Amd.Keb Tenaga Bidan 60 23 1 2.61 90 30 10 188.4 Rp 289,209 Rp - Rp 289,209 43

44 Dewi Sartika, Amd.Keb Tenaga Bidan 60 23 2.61 90 10 10 170.0 Rp 260,975 Rp - Rp 260,975 44

45 Titin Sumarni, Amd.Keb Tenaga Bidan 60 23 2.61 90 10 10 170.0 Rp 260,975 Rp - Rp 260,975 45

46 Lisdayanti, A.md.Keb Tenaga Bidan 60 23 2.61 90 10 10 170.0 Rp 260,975 Rp - Rp 260,975 46


47 Yul Fitriani, Amd. Keb Tenaga Bidan 60 23 2.61 90 10 0 160.0 Rp 245,624 Rp - Rp 245,624 47

48 Andi Isna, Amd.Keb Tenaga Bidan 60 23 1 2.61 90 10 10 168.4 Rp 258,506 Rp - Rp 258,506 48

49 Citra Pratiwi, Amd.Keb Tenaga Bidan 60 23 1 2.61 90 10 10 168.4 Rp 258,506 Rp - Rp 258,506 49

50 Rosmiati, Amd.Keb Tenaga Bidan 60 23 2.61 90 20 10 180.0 Rp 276,327 Rp - Rp 276,327 50

51 Sri Wahyuni, Amd.Keb Tenaga Bidan 60 23 3 2.61 90 10 10 165.2 Rp 253,566 Rp - Rp 253,566 51

52 Nurfitra, Amd.Keb Tenaga Bidan 60 23 2.61 90 10 0 160.0 Rp 245,624 Rp - Rp 245,624 52

53 Panca Lisma, Amd.Keb Tenaga Bidan 60 23 2.61 90 10 10 170.0 Rp 260,975 Rp - Rp 260,975 53

54 Sulastri, Amd.Keb Tenaga Bidan 60 23 2.61 90 10 0 160.0 Rp 245,624 Rp - Rp 245,624 54

55 Sulmiati Bahri Amd.Keb Tenaga Bidan 60 23 2.61 90 10 0 160.0 Rp 245,624 Rp - Rp 245,624 55

56 Ira Muliati Radi.Amd.Keb Tenaga Bidan 60 23 2.61 90 30 10 190.0 Rp 291,678 Rp - Rp 291,678 56

57 Rosidah, AMKL III Sanitarian 40 23 1 1.74 90 30 40 199.3 Rp 305,895 Rp 15,295 Rp 290,600 57

58 Israyana Yulianti AMKL III Sanitarian 40 23 1.74 90 30 40 200.0 Rp 307,030 Rp 15,351 Rp 291,678 58

59 Rostati, SKM III Tenaga Penunjang 15 23 0.65 90 30 40 175.0 Rp 268,651 Rp 13,433 Rp 255,218 59

60 Armawati, S.Kep III Perawat 40 23 1.74 90 30 40 200.0 Rp 307,030 Rp 15,351 Rp 291,678 60

61 Andi Rezki Wardani S.Kep Ns Perawat 100 23 4.35 90 10 0 200.0 Rp 307,030 Rp 15,351 Rp 291,678 61

62 Anna Marsela, AMK Perawat 40 23 4 1.74 90 10 0 137.0 Rp 210,382 Rp 10,519 Rp 199,863 62

63 Wa Ode Sinta Kalsum II Pelak. Gizi 40 23 2 1.74 90 30 70 228.5 Rp 350,815 Rp - Rp 350,815 63

64 Andi Megawati, SKM Tenaga Penunjang 15 23 0.65 90 20 25 150.0 Rp 230,272 Rp 11,514 Rp 218,759 64

65 Rosmayanti, SKM Tenaga Penunjang 15 23 11 0.65 90 10 25 143.8 Rp 220,794 Rp 11,040 Rp 209,755 65

66 Sudirman H Tenaga Penunjang 15 23 0.65 90 20 25 150.0 Rp 230,272 Rp - Rp 230,272 66

67 Nur Fauzi, S, Si, Apt III Tenaga Penunjang 15 23 0.65 90 30 25 160.0 Rp 245,624 Rp 12,281 Rp 233,343 67

68 Sri Rahmat Yani Nur III Perawat 40 23 1 1.74 90 30 70 229.3 Rp 351,949 Rp 17,597 Rp 334,352 68

69 Mayanti, AMF III Tenaga Penunjang 15 23 2 0.65 90 30 25 160.7 Rp 246,692 Rp 12,335 Rp 234,357 69

70 Irdawati, S.Si,Apt Tenaga Penunjang 15 23 7 0.65 90 20 25 152.4 Rp 234,010 Rp 11,700 Rp 222,309 70

71 Hamriana Tenaga Penunjang 15 23 1 0.65 90 10 10 125.3 Rp 192,427 Rp - Rp 192,427 71

72 Sri Wedari Yusuf, AMF Tenaga Penunjang 15 23 0.65 90 10 0 115.0 Rp 176,542 Rp - Rp 176,542 72

73 Santi Wardianti Amd.Keb Tenaga Bidan 60 23 4 2.61 90 10 10 163.6 Rp 251,097 Rp - Rp 251,097 73


74 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 60 23 2 2.61 90 10 0 156.8 Rp 240,685 Rp - Rp 240,685 74

75 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 60 23 2.61 90 10 0 160.0 Rp 245,624 Rp - Rp 245,624 75

76 Desi Asriana, Amd>keb Tenaga Bidan 60 23 2.61 90 10 0 160.0 Rp 245,624 Rp - Rp 245,624 76

77 Hastuti, Amd.Keb Tenaga Bidan 60 23 2.61 90 10 0 160.0 Rp 245,624 Rp - Rp 245,624 77

78 Nur Ilma, Amd.Keb Tenaga Bidan 60 23 2.61 90 30 55 235.0 Rp 360,760 Rp - Rp 360,760 78

79 Irmawati, Amd.Keb Tenaga Bidan 60 23 2.61 90 30 10 190.0 Rp 291,678 Rp - Rp 291,678 79

80 Ridha Arbiah, Amd.Keb II Tenaga Bidan 60 23 2.61 90 30 25 205.0 Rp 314,705 Rp - Rp 314,705 80

81 Ramlah, Amd.Keb Tenaga Bidan 60 23 2.61 90 30 10 190.0 Rp 291,678 Rp - Rp 291,678 81

82 Hermin Wahida III Perawat 40 23 1.74 90 30 55 215.0 Rp 330,057 Rp 16,503 Rp 313,554 82

83 Andi Jumrianti, Amd.Keb Tenaga Bidan 60 23 2.61 90 30 10 190.0 Rp 291,678 Rp - Rp 291,678 83

84 Yulianti, Amd.Keb Tenaga Bidan 60 23 2.61 90 30 10 190.0 Rp 291,678 Rp - Rp 291,678 84

85 Israwati Tenaga Penunjang 15 23 0.65 90 20 10 135.0 Rp 207,245 Rp - Rp 207,245 85

86 Andi Mas Muliani Tenaga Penunjang 15 23 0.65 90 10 10 125.0 Rp 191,894 Rp - Rp 191,894 86

87 Wahyuni, Amd.Keb II Tenaga Bidan 60 23 2.61 90 30 25 205.0 Rp 314,705 Rp - Rp 314,705 87

88 Andi Salmei, Amd.Keb Tenaga Bidan 60 23 2.61 90 30 10 190.0 Rp 291,678 Rp - Rp 291,678 88

89 Reski Arisanti Amelia Safitri, AMK Perawat 40 23 1.74 90 10 10 150.0 Rp 230,272 Rp - Rp 230,272 89

JUMLAH 4305 2047 114 90 187.2 8010 1840 2125 ### Rp 24,924,600 Rp 500,425 Rp 24,424,175

Mengetahui / Menyetujui : Benteng, 28 Pebruari 2015


Kepala UPTD Puskesmas Benteng Bendahara JKN

Dr. FRENGKI WIJAYA PETRUS MILU E.T, AMK


Pangkat : Penata Tk.I Nip 19710704 199103 1 009
NIP. 19790926 200604 1 023
41,541,000
6923.5

24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600 41,541,000 24,924,600

16235.9565 24,924,600 41,541,000 16,616,400 6,646,560 9,969,840 16,616,400

16235.9565 24,924,600 41,541,000

16235.9565 24,924,600 6,646,560 9,969,840 16,616,400

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600
16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600
16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600
16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

16235.9565 24,924,600

#VALUE!
DAFTAR VARIABEL DAERAH SEBAGAI PENILAIAN TAMBAHAN DALAM MELAKUKAN PEMBAGIAN JASA PELAYANAN
JAMINAN KESEHATAN NASIONAL DI PUSKESMAS BENTENG BULAN PEBRUARI TAHUN 2015

VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK PEGAWAI KERJA
NGAN HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

1 Dr. Frengki Wiyaya ( Kepala Pusk III Dokter Umum 90 30 25

2 Dr. Zaenal Abidin IV Dokter Umum 90 30 85

3 Drg. Yunda Iswari III Dokter Gigi 90 30 0 11

4 Saribanong III Perawat 90 30 100

5 Muh. Ilham Tamrin III Perawat 90 30 40

6 Petrus Milu. ET.AMK (Bend. Pusk III Perawat 90 30 70

7 Hj. Nur Azizal Hastati,AMK III Perawat 90 30 85 1

8 Rahma Yuliana, AMK II Perawat 90 30 25

9 Amsari Parida Amir, AMK II Perawat 90 30 25

10 Elsa Handayani, AMK II Perawat 90 30 25 3

11 Muhrawati, AMK Perawat 90 10 5 3

12 Sri Adrianti, AMK Perawat 90 10 10

13 Nur Wahyuni, AMK Perawat 90 10 10 4

14 Musfiah Zainuddin, AMK Perawat 90 20 10 10

15 Andi Armita Dewi, AMK Perawat 90 10 10

16 Hasmirawati, AMK Perawat 90 10 25 7

17 Muh. Subhan, AMK Perawat 90 10 0

18 Musdalifah, MR,AMK Perawat 90 10 0 9

19 Muhammad Rum, AMK Perawat 90 10 0

20 Agustina, AMK Perawat 90 10 10

21 Risaldi Razak, AMK Perawat 90 10 0

22 Dewi Ahryani, AMK Perawat 90 10 0

23 Nurdamayanti, S.Kep III Perawat 90 30 40

24 Hj. Rostini AMG II Tenaga Penunjang 90 30 70

25 Sri Sulastri AMK II Perawat 90 30 25 3

26 Agustini Tenaga Penunjang 90 20 25

27 Yurniati, A.Md.AK II Analis 90 30 25

28 Rosdiana III Analis 90 30 85

29 Yunarsih, AMAK Analis 90 10 25

30 Bustan II Perawat Gigi 90 30 40 1

31 Nur Indah Kurnianti III Perawat Gigi 90 30 40

32 Rahmaniar, Amd.KG Perawat Gigi 90 10 0 7

33 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 90 30 70 2

34 St. Rosdiana, B.Sc III Perawat 90 30 100

35 Muhammad Nawir II Pel. Administrasi 90 30 25 1

36 Agustina Bintang,Amd.Keb III Tenaga Bidan 90 30 85

37 Nur Rahmawati, A.md.Keb II Tenaga Bidan 90 30 25

38 Suriati, A.md.Keb III Tenaga Bidan 90 30 25

39 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 90 30 25

40 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 90 30 25

41 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 90 10 0 11

42 Isnayani, Amd. Keb Tenaga Bidan 90 10 0

43 Andi Jemma, Amd.Keb Tenaga Bidan 90 30 10 1

44 Dewi Sartika, Amd.Keb Tenaga Bidan 90 10 10


VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK PEGAWAI KERJA
NGAN HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

45 Titin Sumarni, Amd.Keb Tenaga Bidan 90 10 10

46 Lisdayanti, A.md.Keb Tenaga Bidan 90 10 10

47 Yul Fitriani, Amd. Keb Tenaga Bidan 90 10 0

48 Andi Isna, Amd.Keb Tenaga Bidan 90 10 10 1

49 Citra Pratiwi, Amd.Keb Tenaga Bidan 90 10 10 1

50 Rosmiati, Amd.Keb Tenaga Bidan 90 20 10

51 Sri Wahyuni, Amd.Keb Tenaga Bidan 90 10 10 3

52 Nurfitra, Amd.Keb Tenaga Bidan 90 10 0

53 Panca Lisma, Amd.Keb Tenaga Bidan 90 10 10

54 Sulastri, Amd.Keb Tenaga Bidan 90 10 0

55 Sulmiati Bahri Amd.Keb Tenaga Bidan 90 10 0

56 Ira Muliati Radi.Amd.Keb Tenaga Bidan 90 30 10

57 Rosidah, AMKL III Sanitarian 90 30 40 1

58 Israyana Yulianti AMKL III Sanitarian 90 30 40

59 Rostati, SKM III Tenaga Penunjang 90 30 40

60 Armawati, S.Kep III Perawat 90 30 40

61 Andi Rezki Wardani S.Kep Ns Perawat 90 10 0

62 Anna Marsela, AMK Perawat 90 10 0 4

63 Wa Ode Sinta Kalsum II Pelak. Gizi 90 30 70 2

64 Andi Megawati, SKM Tenaga Penunjang 90 20 25

65 Rosmayanti, SKM Tenaga Penunjang 90 10 25 11

66 Sudirman H Tenaga Penunjang 90 20 25

67 Nur Fauzi, S, Si, Apt III Tenaga Penunjang 90 30 25

68 Sri Rahmat Yani Nur III Perawat 90 30 70 1

69 Mayanti, AMF III Tenaga Penunjang 90 30 25 2

70 Irdawati, S.Si,Apt Tenaga Penunjang 90 20 25 7

71 Hamriana Tenaga Penunjang 90 10 10 1

72 Sri Wedari Yusuf, AMF Tenaga Penunjang 90 10 0

73 Santi Wardianti Amd.Keb Tenaga Bidan 90 10 10 4

74 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 90 10 0 2

75 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 90 10 0

76 Desi Asriana, Amd>keb Tenaga Bidan 90 10 0

77 Hastuti, Amd.Keb Tenaga Bidan 90 10 0

78 Nur Ilma, Amd.Keb Tenaga Bidan 90 30 55

79 Irmawati, Amd.Keb Tenaga Bidan 90 30 10

80 Ridha Arbiah, Amd.Keb II Tenaga Bidan 90 30 25

81 Ramlah, Amd.Keb Tenaga Bidan 90 30 10

82 Hermin Wahida III Perawat 90 30 55

83 Andi Jumrianti, Amd.Keb Tenaga Bidan 90 30 10

84 Yulianti, Amd.Keb Tenaga Bidan 90 30 10

85 Israwati Tenaga Penunjang 90 20 10

86 Andi Mas Muliani Tenaga Penunjang 90 10 10


VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK PEGAWAI KERJA
NGAN HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

87 Wahyuni, Amd.Keb II Tenaga Bidan 90 30 25

88 Andi Salmei, Amd.Keb Tenaga Bidan 90 30 10

89 Reski Arisanti Amelia Safitri, AMK Perawat 90 10 10

JUMLAH 1840 2125

Mengetahui : Benteng, 28 Pebruari 2015


Kepala UPTD Puskesmas Benteng, Kasubag Tata Usaha,

Dr. Frengki Wijaya Muhammad Ali


Pangkat : Penata Tk.I Nip. 19641211 198903 1 019
Nip. 1979092 20004 1 023
DAFTAR PENERIMAAN JASA PELAYANAN KESEHATAN PESERTA JKN BAGI PETUGAS PUSKESMAS PUSTU DAN POSKEDES
BULAN MARET TAHUN 2015
PUSKESMAS : BENTENG
JUMLAH PESERTA : 6928 ORANG
JUMLAH PEGAWAI : 90 ORANG
BESARAN KAPITASI : 6000 PERJIWA / BULAN
TOTAL KAPITASI : 41,565,000 TOTAL JASA PELAYANAN SESUAI SK BUPATI 60 % = 24,939,000.-

GOLO VARIABEL POINT POINT VARIABEL DAERAH POINT POINT JUMLAH PPH JUMLAH
NO NAMA PETUGAS NGAN JABATAN KETENA KEHADIRAN JABA /ORG /ORG KINER STATUS MASA /ORG /ORG DITERIMA PASAL 21 DIBAYARKAN TANDA TANGAN
GAAN EFEKTIF 1 BLNTDK HADIR TAN /HARI BULAN JA KEPEG KERJA HARI BULAN ( Rp ) ( 15% / 5% ) ( Rp )
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

1 Dr. Frengki Wiyaya ( Kepala Pusk) III Dokter Umum 150 25 8 30 7.2 122.4 90 30 25 5.8 98.60 Rp 368,910 Rp 18,446 Rp 350,465 1

2 Dr. Zaenal Abidin IV Dokter Umum 150 25 6.0 150.0 90 30 85 8.2 205.00 Rp 592,593 Rp 88,889 Rp 503,704 2

3 Drg. Yunda Iswari III Dokter Gigi 150 25 6.0 150.0 90 30 0 4.8 120.00 Rp 450,705 Rp 22,535 Rp 428,170 3

4 Saribanong III Perawat 25 25 1.0 25.0 90 30 100 8.8 220.00 Rp 408,973 Rp 20,449 Rp 388,524 4

5 Muh. Ilham Tamrin III Perawat 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 333,855 Rp 16,693 Rp 317,163 5

6 Petrus Milu. ET.AMK (Bend. Pusk) III Perawat 40 25 30 2.8 70.0 90 30 70 7.6 190.00 Rp 434,012 Rp 21,701 Rp 412,311 6

7 Hj. Nur Azizal Hastati,AMK III Perawat 40 25 5 1.6 32.0 90 30 85 8.2 164.00 Rp 327,178 Rp 16,359 Rp 310,819 7

8 Rahma Yuliana, AMK II Perawat 40 25 1 1.6 38.4 90 30 25 5.8 139.20 Rp 296,464 Rp - Rp 296,464 8

9 Amsari Parida Amir, AMK II Perawat 40 25 8 1.6 27.2 90 30 25 5.8 98.60 Rp 209,995 Rp - Rp 209,995 9

10 Elsa Handayani, AMK II Perawat 40 25 7 1.6 28.8 90 30 25 5.8 104.40 Rp 222,348 Rp - Rp 222,348 10

11 Nadia Sri Damayanti AMK II Perawat 40 25 12 1.6 20.8 90 30 25 5.8 75.40 Rp 160,584 Rp - Rp 160,584 11

12 Muhrawati, AMK Perawat 40 25 7 1.6 28.8 90 10 10 4.4 79.20 Rp 180,282 Rp - Rp 180,282 12

13 Sri Adrianti, AMK Perawat 40 25 2 1.6 36.8 90 10 10 4.4 101.20 Rp 230,360 Rp - Rp 230,360 13

14 Nur Wahyuni, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 250,392 Rp - Rp 250,392 14

15 Musfiah Zainuddin, AMK Perawat 40 25 2 1.6 36.8 90 20 10 4.8 110.40 Rp 245,718 Rp - Rp 245,718 15

16 Andi Armita Dewi, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 250,392 Rp - Rp 250,392 16

17 Hasmirawati, AMK Perawat 40 25 7 1.6 28.8 90 10 25 5.0 90.00 Rp 198,310 Rp - Rp 198,310 17

18 Muh. Subhan, AMK Perawat 40 25 7 1.6 28.8 90 10 0 4.0 72.00 Rp 168,263 Rp - Rp 168,263 18

19 Musdalifah, MR,AMK Perawat 40 25 13 1.6 19.2 90 10 0 4.0 48.00 Rp 112,175 Rp - Rp 112,175 19

20 Muhammad Rum, AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 233,699 Rp - Rp 233,699 20
21 Agustina, AMK Perawat 40 25 2 1.6 36.8 90 10 10 4.4 101.20 Rp 230,360 Rp - Rp 230,360 21

22 Risaldi Razak, AMK Perawat 40 25 3 1.6 35.2 90 10 0 4.0 88.00 Rp 205,655 Rp - Rp 205,655 22

23 Dewi Ahryani, AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 233,699 Rp - Rp 233,699 23

24 Nurdamayanti, S.Kep III Perawat 100 25 4 4.0 84.0 90 30 40 6.4 134.40 Rp 364,570 Rp 18,229 Rp 346,342 24

25 Hj. Rostini AMG II Tenaga Penunjang 40 25 1.6 40.0 90 30 70 7.6 190.00 Rp 383,934 Rp Rp 383,934 25

26 Sri Sulastri AMK II Perawat 40 25 2 1.6 36.8 90 30 25 5.8 133.40 Rp 284,111 Rp - Rp 284,111 26

27 Agustini Tenaga Penunjang 15 25 9 0.6 9.6 90 20 25 5.4 86.40 Rp 160,251 Rp - Rp 160,251 27

28 Yurniati, A.Md.AK II Analis 40 25 1 1.6 38.4 90 30 25 5.8 139.20 Rp 296,464 Rp - Rp 296,464 28

29 Rosdiana III Analis 40 25 1.6 40.0 90 30 85 8.2 205.00 Rp 408,973 Rp 20,449 Rp 388,524 29

30 Yunarsih, AMAK Analis 40 25 1 1.6 38.4 90 10 25 5.0 120.00 Rp 264,413 Rp - Rp 264,413 30

31 Bustan II Perawat Gigi 40 25 5 1.6 32.0 90 30 40 6.4 128.00 Rp 267,084 Rp - Rp 267,084 31

32 Nur Indah Kurnianti III Teknik Gigi 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 333,855 Rp 16,693 Rp 317,163 32

33 Rahmaniar, Amd.KG Perawat Gigi 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 233,699 Rp - Rp 233,699 33

34 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 40 25 30 2.8 70.0 90 30 70 7.6 190.00 Rp 434,012 Rp 21,701 Rp 412,311 34

35 St. Rosdiana, B.Sc III Perawat 40 25 1.6 40.0 90 30 100 8.8 220.00 Rp 434,012 Rp 21,701 Rp 412,311 35

36 Muhammad Nawir II Pel. Administrasi 15 25 0.6 15.0 90 30 25 5.8 145.00 Rp 267,084 Rp - Rp 267,084 36

37 Agustina Bintang,Amd.Keb III Tenaga Bidan 40 25 1.6 40.0 90 30 85 8.2 205.00 Rp 408,973 Rp 20,449 Rp 388,524 37

38 Nur Rahmawati, A.md.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 308,816 Rp - Rp 308,816 38

39 Suriati, A.md.Keb III Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 308,816 Rp 15,441 Rp 293,375 39

40 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 308,816 Rp - Rp 308,816 40

41 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 40 25 5 1.6 32.0 75 30 25 5.2 104.00 Rp 227,022 Rp - Rp 227,022 41

42 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 40 25 4 1.6 33.6 90 10 0 4.0 84.00 Rp 196,307 Rp - Rp 196,307 42

43 Isnayani, Amd. Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 233,699 Rp - Rp 233,699 43

44 Andi Jemma, Amd.Keb Tenaga Bidan 40 25 6 1.6 30.4 90 30 10 5.2 98.80 Rp 215,671 Rp - Rp 215,671 44

45 Dewi Sartika, Amd.Keb Tenaga Bidan 40 25 3 1.6 35.2 90 10 10 4.4 96.80 Rp 220,345 Rp - Rp 220,345 45

46 Titin Sumarni, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 233,699 Rp - Rp 233,699 46

47 Lisdayanti, A.md.Keb Tenaga Bidan 40 25 1 1.6 38.4 90 10 10 4.4 105.60 Rp 240,376 Rp - Rp 240,376 47

48 Yul Fitriani, Amd. Keb Tenaga Bidan 40 25 1 1.6 38.4 90 10 0 4.0 96.00 Rp 224,351 Rp - Rp 224,351 48

49 Andi Isna, Amd.Keb Tenaga Bidan 40 25 5 1.6 32.0 90 10 0 4.0 80.00 Rp 186,959 Rp - Rp 186,959 49
50 Citra Pratiwi, Amd.Keb Tenaga Bidan 40 25 1 1.6 38.4 90 10 0 4.0 96.00 Rp 224,351 Rp - Rp 224,351 50

51 Rosmiati, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 20 0 4.4 110.00 Rp 250,392 Rp - Rp 250,392 51

52 Sri Wahyuni, Amd.Keb Tenaga Bidan 40 25 3 1.6 35.2 90 10 0 4.0 88.00 Rp 205,655 Rp - Rp 205,655 52

53 Nurfitra, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 233,699 Rp - Rp 233,699 53

54 Panca Lisma, Amd.Keb Tenaga Bidan 40 25 2 1.6 36.8 90 10 0 4.0 92.00 Rp 215,003 Rp - Rp 215,003 54

55 Sulastri, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 233,699 Rp - Rp 233,699 55

56 Sulmiati Bahri Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 233,699 Rp - Rp 233,699 56

57 Ira Muliati Radi.Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 283,777 Rp - Rp 283,777 57

58 Rosidah, AMKL III Sanitarian 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 333,855 Rp 16,693 Rp 317,163 58

59 Israyana Yulianti AMKL III Sanitarian 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 333,855 Rp 16,693 Rp 317,163 59

60 Rostati, SKM III Tenaga Penunjang 60 25 2.4 60.0 90 30 40 6.4 160.00 Rp 367,241 Rp 18,362 Rp 348,879 60

61 Armawati, S.Kep III Perawat 60 25 2.4 60.0 90 30 40 6.4 160.00 Rp 367,241 Rp 18,362 Rp 348,879 61

62 Andi Rezki Wardani S.Kep Ns Perawat 100 25 4.0 100.0 90 10 0 4.0 100.00 Rp 333,855 Rp 16,693 Rp 317,163 62

63 Anna Marsela, AMK Perawat 40 25 5 1.6 32.0 90 10 0 4.0 80.00 Rp 186,959 Rp - Rp 186,959 63

64 Wa Ode Sinta Kalsum II Pelak. Gizi 40 25 7 1.6 28.8 90 30 70 7.6 136.80 Rp 276,432 Rp - Rp 276,432 64

65 Andi Megawati II Teknik Gigi 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 308,816 Rp - Rp 308,816 65

66 Rosmayanti, SKM Tenaga Penunjang 60 25 2.4 60.0 90 10 25 5.0 125.00 Rp 308,816 Rp 15,441 Rp 293,375 66

67 Sudirman H Tenaga Penunjang 15 25 0.6 15.0 90 20 25 5.4 135.00 Rp 250,392 Rp - Rp 250,392 67

68 Nur Fauzi, S, Si, Apt III Tenaga Penunjang 100 25 4.0 100.0 90 30 25 5.8 145.00 Rp 408,973 Rp 20,449 Rp 388,524 68

69 Sri Rahmat Yani Nur III Perawat 40 25 1.6 40.0 90 30 70 7.6 190.00 Rp 383,934 Rp 19,197 Rp 364,737 69

70 Mayanti, AMF III Tenaga Penunjang 40 25 3 1.6 35.2 90 30 25 5.8 127.60 Rp 271,758 Rp 13,588 Rp 258,170 70

71 Irdawati, S.Si,Apt III Tenaga Penunjang 100 25 6 4.0 76.0 90 20 25 5.4 102.60 Rp 298,133 Rp 14,907 Rp 283,226 71

72 Hamriana Tenaga Penunjang 15 25 14 0.6 6.6 90 10 10 4.4 48.40 Rp 91,810 Rp - Rp 91,810 72

73 Sri Wedari Yusuf, AMF Tenaga Penunjang 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 233,699 Rp - Rp 233,699 73

74 Santi Wardianti Amd.Keb Tenaga Bidan 40 25 5 1.6 32.0 90 10 10 4.4 88.00 Rp 200,313 Rp - Rp 200,313 74

75 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 233,699 Rp - Rp 233,699 75

76 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 233,699 Rp - Rp 233,699 76

77 Desi Asriana, Amd.Keb Tenaga Bidan 40 25 3 1.6 35.2 90 10 0 4.0 88.00 Rp 205,655 Rp - Rp 205,655 77

78 Hastuti, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 233,699 Rp - Rp 233,699 78
79 Nur Ilma, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 55 7.0 175.00 Rp 358,895 Rp - Rp 358,895 79

80 Irmawati, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 283,777 Rp - Rp 283,777 80

81 Ridha Arbiah, Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 308,816 Rp - Rp 308,816 81

82 Ramlah, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 283,777 Rp - Rp 283,777 82

83 Hermin Wahida III Perawat 40 25 1.6 40.0 90 30 55 7.0 175.00 Rp 358,895 Rp 17,945 Rp 340,950 83

84 Andi Jumrianti, Amd.Keb Tenaga Bidan 40 25 3 1.6 35.2 90 30 10 5.2 114.40 Rp 249,724 Rp - Rp 249,724 84

85 Yulianti, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 283,777 Rp - Rp 283,777 85

86 Israwati Tenaga Penunjang 15 25 0.6 15.0 90 20 10 4.8 120.00 Rp 225,352 Rp - Rp 225,352 86

87 Andi Mas Muliani Tenaga Penunjang 15 25 0.6 15.0 90 10 10 4.4 110.00 Rp 208,660 Rp - Rp 208,660 87

88 Wahyuni, Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 308,816 Rp - Rp 308,816 88

89 Andi Salmei, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 283,777 Rp - Rp 283,777 89

90 Reski Arisanti Amelia Safitri, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 250,392 Rp - Rp 250,392 90

JUMLAH 4065 2250 183 90 166 3,816.4 8085 1880 2095 482 11123.6 Rp 24,939,000 Rp 528,059 Rp 24,410,941

Mengetahui / Menyetujui : Benteng, 05 April 2015


Kepala UPTD Puskesmas Benteng Bendahara JKN

Dr. FRENGKI WIJAYA PETRUS MILU E.T, AMK


Pangkat : Penata Tk.I Nip 19710704 199103 1 009
NIP. 19790926 200604 1 023
150 30 24 151.25
41,565,000 6,928 24,939,000

14940.0000 24,939,000 15239.792 150

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792 41,565,000 24,939,000

14940.0000 24,939,000 15239.792 41,565,000 16,626,000 6,650,400 9,975,600 16,626,000

14940.0000 24,939,000 15239.792 41,565,000

14940.0000 24,939,000 15239.792 6,609,120 9,913,680 16,522,800

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792 24,784,200

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792


14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792


14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792


14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 24,939,000 15239.792

14940.0000 14940.000
9975600
DAFTAR VARIABEL DAERAH SEBAGAI PENILAIAN TAMBAHAN DALAM MELAKUKAN PEMBAGIAN JASA PELAYANAN
JAMINAN KESEHATAN NASIONAL DI PUSKESMAS BENTENG BULAN MARET TAHUN 2015

VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK PEGAWAI KERJA
NGAN HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

1 Dr. Frengki Wiyaya ( Kepala Pusk III Dokter Umum 90 30 25 8

2 Dr. Zaenal Abidin IV Dokter Umum 90 30 85

3 Drg. Yunda Iswari III Dokter Gigi 90 30 0

4 Saribanong III Perawat 90 30 100

5 Muh. Ilham Tamrin III Perawat 90 30 40

6 Petrus Milu. ET.AMK (Bend. Pusk III Perawat 90 30 70

7 Hj. Nur Azizal Hastati,AMK III Perawat 90 30 85 5

8 Rahma Yuliana, AMK II Perawat 90 30 25 1

9 Amsari Parida Amir, AMK II Perawat 90 30 25 8

10 Elsa Handayani, AMK II Perawat 90 30 25 7

11 Nadia Sri Damayanti AMK II Perawat 90 30 25 12

12 Muhrawati, AMK Perawat 90 10 10 7

13 Sri Adrianti, AMK Perawat 90 10 10 2

14 Nur Wahyuni, AMK Perawat 90 10 10

15 Musfiah Zainuddin, AMK Perawat 90 20 10 2

16 Andi Armita Dewi, AMK Perawat 90 10 10

17 Hasmirawati, AMK Perawat 90 10 25 7

18 Muh. Subhan, AMK Perawat 90 10 0 7

19 Musdalifah, MR,AMK Perawat 90 10 0 13

20 Muhammad Rum, AMK Perawat 90 10 0

21 Agustina, AMK Perawat 90 10 10 2

22 Risaldi Razak, AMK Perawat 90 10 0 3

23 Dewi Ahryani, AMK Perawat 90 10 0

24 Nurdamayanti, S.Kep III Perawat 90 30 40 4

25 Hj. Rostini AMG II Tenaga Penunjang 90 30 70

26 Sri Sulastri AMK II Perawat 90 30 25 2

27 Agustini Tenaga Penunjang 90 20 25 9

28 Yurniati, A.Md.AK II Analis 90 30 25 1

29 Rosdiana III Analis 90 30 85

30 Yunarsih, AMAK Analis 90 10 25 1

31 Bustan II Perawat Gigi 90 30 40 5

32 Nur Indah Kurnianti III Teknik Gigi 90 30 40

33 Rahmaniar, Amd.KG Perawat Gigi 90 10 0

34 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 90 30 70

35 St. Rosdiana, B.Sc III Perawat 90 30 100

36 Muhammad Nawir II Pel. Administrasi 90 30 25

37 Agustina Bintang,Amd.Keb III Tenaga Bidan 90 30 85

38 Nur Rahmawati, A.md.Keb II Tenaga Bidan 90 30 25

39 Suriati, A.md.Keb III Tenaga Bidan 90 30 25

40 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 90 30 25

41 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 90 30 25 5

42 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 90 10 0 4

43 Isnayani, Amd. Keb Tenaga Bidan 90 10 0

44 Andi Jemma, Amd.Keb Tenaga Bidan 90 30 10 6


VARIABEL
GOLO KEHA
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK PEGAWAI KERJA
NGAN DIRAN
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

45 Dewi Sartika, Amd.Keb Tenaga Bidan 90 10 10 3

46 Titin Sumarni, Amd.Keb Tenaga Bidan 90 10 10

47 Lisdayanti, A.md.Keb Tenaga Bidan 90 10 0 1

48 Yul Fitriani, Amd. Keb Tenaga Bidan 90 10 10 1

49 Andi Isna, Amd.Keb Tenaga Bidan 90 10 10 5

50 Citra Pratiwi, Amd.Keb Tenaga Bidan 90 10 10 1

51 Rosmiati, Amd.Keb Tenaga Bidan 90 20 10

52 Sri Wahyuni, Amd.Keb Tenaga Bidan 90 10 10 3

53 Nurfitra, Amd.Keb Tenaga Bidan 90 10 0

54 Panca Lisma, Amd.Keb Tenaga Bidan 90 10 0 2

55 Sulastri, Amd.Keb Tenaga Bidan 90 10 0

56 Sulmiati Bahri Amd.Keb Tenaga Bidan 90 10 0

57 Ira Muliati Radi.Amd.Keb Tenaga Bidan 90 30 10

58 Rosidah, AMKL III Sanitarian 90 30 40

59 Israyana Yulianti AMKL III Sanitarian 90 30 40

60 Rostati, SKM III Tenaga Penunjang 90 30 40

61 Armawati, S.Kep III Perawat 90 30 40

62 Andi Rezki Wardani S.Kep Ns Perawat 90 10 0

63 Anna Marsela, AMK Perawat 90 10 0 5

64 Wa Ode Sinta Kalsum II Pelak. Gizi 90 30 70 7

65 Andi Megawati II Teknik Gigi 90 30 25

66 Rosmayanti, SKM Tenaga Penunjang 90 10 25

67 Sudirman H Tenaga Penunjang 90 20 25

68 Nur Fauzi, S, Si, Apt III Tenaga Penunjang 90 30 25

69 Sri Rahmat Yani Nur III Perawat 90 30 70

70 Mayanti, AMF III Tenaga Penunjang 90 30 25 3

71 Irdawati, S.Si,Apt Tenaga Penunjang 90 20 25 6

72 Hamriana Tenaga Penunjang 90 10 10 14

73 Sri Wedari Yusuf, AMF Tenaga Penunjang 90 10 0

74 Santi Wardianti Amd.Keb Tenaga Bidan 90 10 10 5

75 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 90 10 0

76 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 90 10 0

77 Desi Asriana, Amd.Keb Tenaga Bidan 90 10 0 3

78 Hastuti, Amd.Keb Tenaga Bidan 90 10 0

79 Nur Ilma, Amd.Keb Tenaga Bidan 90 30 55

80 Irmawati, Amd.Keb Tenaga Bidan 90 30 10

81 Ridha Arbiah, Amd.Keb II Tenaga Bidan 90 30 25

82 Ramlah, Amd.Keb Tenaga Bidan 90 30 10

83 Hermin Wahida III Perawat 90 30 55

84 Andi Jumrianti, Amd.Keb Tenaga Bidan 90 30 10 3

85 Yulianti, Amd.Keb Tenaga Bidan 90 30 10

86 Israwati Tenaga Penunjang 90 20 10


VARIABEL
GOLO KEHA
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK PEGAWAI KERJA
NGAN DIRAN
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

87 Andi Mas Muliani Tenaga Penunjang 90 10 10

88 Wahyuni, Amd.Keb II Tenaga Bidan 90 30 25

89 Andi Salmei, Amd.Keb Tenaga Bidan 90 30 10

90 Reski Arisanti Amelia Safitri, AMK Perawat 90 10 10

JUMLAH 1880 2145

Mengetahui : Benteng,
Kepala UPTD Puskesmas Benteng, Kasubag Tata Usaha,

Dr. Frengki Wijaya Muhammad Ali


Pangkat : Penata Tk.I Nip. 19641211 198903 1 019
Nip. 1979092 20004 1 023
DAFTAR PENERIMAAN JASA PELAYANAN KESEHATAN PESERTA JKN BAGI PETUGAS PUSKESMAS PUSTU DAN POSKEDES
BULAN APRIL TAHUN 2015
PUSKESMAS : BENTENG
JUMLAH PESERTA : 6941 ORANG
JUMLAH PEGAWAI : 90 ORANG
BESARAN KAPITASI : 6000 PERJIWA / BULAN
TOTAL KAPITASI : 41,643,000 TOTAL JASA PELAYANAN SESUAI SK BUPATI 60 % = 24,985,800.-

GOLO VARIABEL POINT POINT VARIABEL DAERAH POINT POINT JUMLAH PPH JUMLAH
NO NAMA PETUGAS NGAN JABATAN KETENA KEHADIRAN JABA /ORG /ORG KINER STATUS MASA /ORG /ORG DITERIMA PASAL 21 DIBAYARKAN TANDA TANGAN
GAAN EFEKTIF 1 BLNTDK HADIR TAN /HARI BULAN JA KEPEG KERJA HARI BULAN ( Rp ) ( 15% / 5% ) ( Rp )
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

1 Dr. Frengki Wiyaya ( Kepala Pusk) IV Dokter Umum 150 25 30 7.2 180.0 90 30 25 5.8 145.00 Rp 528,389 Rp 79,258 Rp 449,130 1

2 Dr. Zaenal Abidin IV Dokter Umum 150 25 6.0 150.0 90 30 85 8.2 205.00 Rp 577,163 Rp 86,574 Rp 490,589 2

3 Drg. Yunda Iswari Dokter Gigi 150 25 6.0 150.0 90 30 0 4.8 120.00 Rp 438,969 Rp 21,948 Rp 417,021 3

4 Saribanong III Perawat 40 25 1.6 40.0 90 30 100 8.8 220.00 Rp 422,711 Rp 21,136 Rp 401,576 4

5 Muh. Ilham Tamrin III Perawat 40 25 3 1.6 35.2 90 30 40 6.4 140.80 Rp 286,143 Rp 14,307 Rp 271,836 5

6 Petrus Milu. ET.AMK (Bend. Pusk) III Perawat 40 25 5 30 2.8 56.0 90 30 70 7.6 152.00 Rp 338,169 Rp 16,908 Rp 321,260 6

7 Hj. Nur Azizal Hastati,AMK III Perawat 40 25 4 1.6 33.6 90 30 85 8.2 172.20 Rp 334,592 Rp 16,730 Rp 317,862 7

8 Rahma Yuliana, AMK II Perawat 40 25 2 1.6 36.8 90 30 25 5.8 133.40 Rp 276,713 Rp - Rp 276,713 8

9 Amsari Parida Amir, AMK II Perawat 40 25 3 1.6 35.2 90 30 25 5.8 127.60 Rp 264,682 Rp - Rp 264,682 9

10 Elsa Handayani, AMK II Perawat 40 25 1 1.6 38.4 90 30 25 5.8 139.20 Rp 288,744 Rp - Rp 288,744 10

11 Nadia Sri Damayanti AMK II Perawat 40 25 4 1.6 33.6 60 30 25 4.6 96.60 Rp 211,681 Rp - Rp 211,681 11

12 Muhrawati, AMK Perawat 40 25 1 1.6 38.4 90 10 10 4.4 105.60 Rp 234,117 Rp - Rp 234,117 12

13 Sri Adrianti, AMK Perawat 40 25 7 1.6 28.8 60 10 10 3.2 57.60 Rp 140,470 Rp - Rp 140,470 13

14 Nur Wahyuni, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 243,872 Rp - Rp 243,872 14

15 Musfiah Zainuddin, AMK Perawat 40 25 5 1.6 32.0 75 20 10 4.2 84.00 Rp 188,594 Rp - Rp 188,594 15

16 Andi Armita Dewi, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 243,872 Rp - Rp 243,872 16

17 Hasmirawati, AMK Perawat 40 25 6 1.6 30.4 75 10 25 4.4 83.60 Rp 185,343 Rp - Rp 185,343 17

18 Muh. Subhan, AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 227,614 Rp - Rp 227,614 18

19 Musdalifah, MR,AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 227,614 Rp - Rp 227,614 19

20 Muhammad Rum, AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 227,614 Rp - Rp 227,614 20
21 Agustina, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 243,872 Rp - Rp 243,872 21

22 Risaldi Razak, AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 227,614 Rp - Rp 227,614 22

23 Dewi Ahryani, AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 227,614 Rp - Rp 227,614 23

24 Nurdamayanti, S.Kep III Perawat 60 25 2.4 60.0 90 30 40 6.4 160.00 Rp 357,679 Rp 17,884 Rp 339,795 24

25 Hj. Rostini AMG II Tenaga Penunjang 40 25 1 1.6 38.4 90 30 70 7.6 182.40 Rp 358,979 Rp Rp 358,979 25

26 Sri Sulastri AMK II Perawat 40 25 1 1.6 38.4 90 30 25 5.8 139.20 Rp 288,744 Rp - Rp 288,744 26

27 Agustini Tenaga Penunjang 15 25 0.6 15.0 90 20 25 5.4 135.00 Rp 243,872 Rp - Rp 243,872 27

28 Yurniati, A.Md.AK II Analis 40 25 1.6 40.0 75 30 25 5.2 130.00 Rp 276,388 Rp - Rp 276,388 28

29 Rosdiana III Analis 40 25 1.6 40.0 90 30 85 8.2 205.00 Rp 398,324 Rp 19,916 Rp 378,408 29

30 Normalina A.Md.AK II Analis 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 300,775 Rp - Rp 300,775 30

31 Yunarsih, AMAK Analis 40 25 4 1.6 33.6 90 10 10 4.4 92.40 Rp 204,852 Rp - Rp 204,852 31

32 Bustan II Perawat Gigi 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 325,162 Rp - Rp 325,162 32

33 Nur Indah Kurnianti III Teknik Gigi 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 325,162 Rp 16,258 Rp 308,904 33

34 Rahmaniar, Amd.KG Perawat Gigi 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 227,614 Rp - Rp 227,614 34

35 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 40 25 30 2.8 70.0 90 30 70 7.6 190.00 Rp 422,711 Rp 21,136 Rp 401,576 35

36 St. Rosdiana, B.Sc III Perawat 40 25 1.6 40.0 90 30 100 8.8 220.00 Rp 422,711 Rp 21,136 Rp 401,576 36

37 Muhammad Nawir II Pel. Administrasi 15 25 0.6 15.0 90 30 25 5.8 145.00 Rp 260,130 Rp - Rp 260,130 37

38 Agustina Bintang,Amd.Keb III Tenaga Bidan 40 25 1.6 40.0 90 30 85 8.2 205.00 Rp 398,324 Rp 19,916 Rp 378,408 38

39 Nur Rahmawati, A.md.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 300,775 Rp - Rp 300,775 39

40 Suriati, A.md.Keb III Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 300,775 Rp 15,039 Rp 285,736 40

41 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 300,775 Rp - Rp 300,775 41

42 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 300,775 Rp - Rp 300,775 42

43 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 227,614 Rp - Rp 227,614 43

44 Isnayani, Amd. Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 227,614 Rp - Rp 227,614 44

45 Andi Jemma, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 276,388 Rp - Rp 276,388 45

46 Dewi Sartika, Amd.Keb Tenaga Bidan 40 25 7 1.6 28.8 60 10 10 3.2 57.60 Rp 140,470 Rp - Rp 140,470 46

47 Titin Sumarni, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 227,614 Rp - Rp 227,614 47

48 Lisdayanti, A.md.Keb Tenaga Bidan 40 25 2 1.6 36.8 90 10 10 4.4 101.20 Rp 224,362 Rp - Rp 224,362 48

49 Yul Fitriani, Amd. Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 227,614 Rp - Rp 227,614 49
50 Andi Isna, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 227,614 Rp - Rp 227,614 50

51 Citra Pratiwi, Amd.Keb Tenaga Bidan 40 25 7 1.6 28.8 75 10 0 3.4 61.20 Rp 146,323 Rp - Rp 146,323 51

52 Rosmiati, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 20 0 4.4 110.00 Rp 243,872 Rp - Rp 243,872 52

53 Sri Wahyuni, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 227,614 Rp - Rp 227,614 53

54 Nurfitra, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 227,614 Rp - Rp 227,614 54

55 Panca Lisma, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 227,614 Rp - Rp 227,614 55

56 Sulastri, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 227,614 Rp - Rp 227,614 56

57 Sulmiati Bahri Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 227,614 Rp - Rp 227,614 57

58 Ira Muliati Radi.Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 276,388 Rp - Rp 276,388 58

59 Rosidah, AMKL III Sanitarian 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 325,162 Rp 16,258 Rp 308,904 59

60 Israyana Yulianti AMKL III Sanitarian 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 325,162 Rp 16,258 Rp 308,904 60

61 Rostati, SKM III Tenaga Penunjang 60 25 10 2.4 36.0 75 30 40 5.8 87.00 Rp 199,975 Rp 9,999 Rp 189,976 61

62 Armawati, S.Kep III Perawat 60 25 2.4 60.0 90 30 40 6.4 160.00 Rp 357,679 Rp 17,884 Rp 339,795 62

63 Andi Rezki Wardani S.Kep Ns Perawat 100 25 4.0 100.0 90 10 0 4.0 100.00 Rp 325,162 Rp 16,258 Rp 308,904 63

64 Anna Marsela, AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 227,614 Rp - Rp 227,614 64

65 Wa Ode Sinta Kalsum III Pelak. Gizi 40 25 1.6 40.0 90 30 70 7.6 190.00 Rp 373,937 Rp 18,697 Rp 355,240 65

66 Andi Megawati II Teknik Gigi 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 300,775 Rp - Rp 300,775 66

67 Rosmayanti, SKM Tenaga Penunjang 60 25 1 2.4 57.6 90 10 25 5.0 120.00 Rp 288,744 Rp 14,437 Rp 274,307 67

68 Sudirman H Tenaga Penunjang 15 25 0.6 15.0 90 20 25 5.4 135.00 Rp 243,872 Rp - Rp 243,872 68

69 Nur Fauzi, S, Si, Apt III Tenaga Penunjang 100 25 5 4.0 80.0 90 30 25 5.8 116.00 Rp 318,659 Rp 15,933 Rp 302,726 69

70 Sri Rahmat Yani Nur III Perawat 40 25 4 1.6 33.6 90 30 70 7.6 159.60 Rp 314,107 Rp 15,705 Rp 298,401 70

71 Mayanti, AMF III Tenaga Penunjang 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 300,775 Rp 15,039 Rp 285,736 71

72 Hj. Syahraeni, AMK II Perawat 25 25 1.0 25.0 90 30 25 5.8 145.00 Rp 276,388 Rp - Rp 276,388 72

73 Sri Wedari Yusuf, AMF Tenaga Penunjang 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 227,614 Rp - Rp 227,614 73

74 Santi Wardianti Amd.Keb Tenaga Bidan 40 25 7 1.6 28.8 75 10 10 3.8 68.40 Rp 158,029 Rp - Rp 158,029 74

75 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 227,614 Rp - Rp 227,614 75

76 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 227,614 Rp - Rp 227,614 76

77 Desi Asriana, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 227,614 Rp - Rp 227,614 77

78 Hastuti, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 227,614 Rp - Rp 227,614 78
79 Nur Ilma, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 55 7.0 175.00 Rp 349,550 Rp - Rp 349,550 79

80 Irmawati, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 276,388 Rp - Rp 276,388 80

81 Ridha Arbiah, Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 300,775 Rp - Rp 300,775 81

82 Ramlah, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 276,388 Rp - Rp 276,388 82

83 Hermin Wahida III Perawat 40 25 1.6 40.0 90 30 55 7.0 175.00 Rp 349,550 Rp 17,477 Rp 332,072 83

84 Andi Jumrianti, Amd.Keb Tenaga Bidan 40 25 2 1.6 36.8 90 30 10 5.2 119.60 Rp 254,277 Rp - Rp 254,277 84

85 Yulianti, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 276,388 Rp - Rp 276,388 85

86 Israwati Tenaga Penunjang 15 25 0.6 15.0 90 20 10 4.8 120.00 Rp 219,485 Rp - Rp 219,485 86

87 Andi Mas Muliani Tenaga Penunjang 15 25 0.6 15.0 90 10 10 4.4 110.00 Rp 203,226 Rp - Rp 203,226 87

88 Wahyuni, Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 300,775 Rp - Rp 300,775 88

89 Andi Salmei, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 276,388 Rp - Rp 276,388 89

90 Reski Arisanti Amelia Safitri, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 243,872 Rp - Rp 243,872 90

JUMLAH 3990 2250 92 90 163 3,906.0 7920 1910 2095 477 11462.2 Rp 24,985,800 Rp 562,092 Rp 24,423,708

Mengetahui / Menyetujui : Benteng, 05 Mei 2015


Kepala UPTD Puskesmas Benteng Bendahara JKN

Dr. FRENGKI WIJAYA PETRUS MILU E.T, AMK


Pangkat : Penata Tk.I Nip 19710704 199103 1 009
NIP. 19790926 200604 1 023
150 30 24 151.25
41,643,000 6,941 24,985,800

15368.2000 24,985,800 15239.792 150

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792 41,565,000 24,939,000

15368.2000 24,985,800 15239.792 41,565,000 16,626,000 6,650,400 9,975,600 16,626,000

15368.2000 24,985,800 15239.792 41,565,000

15368.2000 24,985,800 15239.792 6,609,120 9,913,680 16,522,800

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792 24,784,200

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792


15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792


15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792


15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 24,985,800 15239.792

15368.2000 15368.200
9975600
DAFTAR VARIABEL DAERAH SEBAGAI PENILAIAN TAMBAHAN DALAM MELAKUKAN PEMBAGIAN JASA PELAYANAN
JAMINAN KESEHATAN NASIONAL DI PUSKESMAS BENTENG BULAN APRIL TAHUN 2015

VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK PEGAWAI KERJA
NGAN HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

1 Dr. Frengki Wiyaya ( Kepala Pusk III Dokter Umum 90 30 25

2 Dr. Zaenal Abidin IV Dokter Umum 90 30 85

3 Drg. Yunda Iswari III Dokter Gigi 90 30 0

4 Saribanong III Perawat 90 30 100

5 Muh. Ilham Tamrin III Perawat 90 30 40 3

6 Petrus Milu. ET.AMK (Bend. Pusk III Perawat 90 30 70 5

7 Hj. Nur Azizal Hastati,AMK III Perawat 90 30 85 4

8 Rahma Yuliana, AMK II Perawat 90 30 25 2

9 Amsari Parida Amir, AMK II Perawat 90 30 25 3

10 Elsa Handayani, AMK II Perawat 90 30 25 1

11 Nadia Sri Damayanti AMK II Perawat 60 30 25 4

12 Muhrawati, AMK Perawat 90 10 10 1

13 Sri Adrianti, AMK Perawat 60 10 10 7

14 Nur Wahyuni, AMK Perawat 90 10 10

15 Musfiah Zainuddin, AMK Perawat 75 20 10 5

16 Andi Armita Dewi, AMK Perawat 90 10 10

17 Hasmirawati, AMK Perawat 75 10 25 6

18 Muh. Subhan, AMK Perawat 90 10 0

19 Musdalifah, MR,AMK Perawat 90 10 0

20 Muhammad Rum, AMK Perawat 90 10 0

21 Agustina, AMK Perawat 90 10 10

22 Risaldi Razak, AMK Perawat 90 10 0

23 Dewi Ahryani, AMK Perawat 90 10 0

24 Nurdamayanti, S.Kep III Perawat 90 30 40

25 Hj. Rostini AMG II Tenaga Penunjang 90 30 70 1

26 Sri Sulastri AMK II Perawat 90 30 25 1

27 Agustini Tenaga Penunjang 90 20 25

28 Yurniati, A.Md.AK II Analis 75 30 25

29 Rosdiana III Analis 90 30 85

30 Normalina A.Md.AK II Analis 90 30 85

31 Yunarsih, AMAK Analis 90 10 25 4

32 Bustan II Perawat Gigi 90 30 40

33 Nur Indah Kurnianti III Teknik Gigi 90 30 40

34 Rahmaniar, Amd.KG Perawat Gigi 90 10 0

35 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 90 30 70

36 St. Rosdiana, B.Sc III Perawat 90 30 100

37 Muhammad Nawir II Pel. Administrasi 90 30 25

38 Agustina Bintang,Amd.Keb III Tenaga Bidan 90 30 85

39 Nur Rahmawati, A.md.Keb II Tenaga Bidan 90 30 25

40 Suriati, A.md.Keb III Tenaga Bidan 90 30 25

41 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 90 30 25

42 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 90 30 25

43 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 90 10 0

44 Isnayani, Amd. Keb Tenaga Bidan 90 10 0


VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK PEGAWAI KERJA
NGAN HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

45 Andi Jemma, Amd.Keb Tenaga Bidan 90 30 10

46 Dewi Sartika, Amd.Keb Tenaga Bidan 60 10 10 7

47 Titin Sumarni, Amd.Keb Tenaga Bidan 90 10 0

48 Lisdayanti, A.md.Keb Tenaga Bidan 90 10 10 2

49 Yul Fitriani, Amd. Keb Tenaga Bidan 90 10 0

50 Andi Isna, Amd.Keb Tenaga Bidan 90 10 0

51 Citra Pratiwi, Amd.Keb Tenaga Bidan 75 10 0 7

52 Rosmiati, Amd.Keb Tenaga Bidan 90 20 0

53 Sri Wahyuni, Amd.Keb Tenaga Bidan 90 10 0

54 Nurfitra, Amd.Keb Tenaga Bidan 90 10 0

55 Panca Lisma, Amd.Keb Tenaga Bidan 90 10 0

56 Sulastri, Amd.Keb Tenaga Bidan 90 10 0

57 Sulmiati Bahri Amd.Keb Tenaga Bidan 90 10 0

58 Ira Muliati Radi.Amd.Keb Tenaga Bidan 90 30 10

59 Rosidah, AMKL III Sanitarian 90 30 40

60 Israyana Yulianti AMKL III Sanitarian 90 30 40

61 Rostati, SKM III Tenaga Penunjang 75 30 40 10

62 Armawati, S.Kep III Perawat 90 30 40

63 Andi Rezki Wardani S.Kep Ns Perawat 90 10 0

64 Anna Marsela, AMK Perawat 90 10 0

65 Wa Ode Sinta Kalsum II Pelak. Gizi 90 30 70

66 Andi Megawati II Teknik Gigi 90 30 25

67 Rosmayanti, SKM Tenaga Penunjang 90 10 25 1

68 Sudirman H Tenaga Penunjang 90 20 25

69 Nur Fauzi, S, Si, Apt III Tenaga Penunjang 90 30 25 5

70 Sri Rahmat Yani Nur III Perawat 90 30 70 4

71 Mayanti, AMF III Tenaga Penunjang 90 30 25

72 Hj. Syahraeni, AMK II Perawat 90 30 25

73 Sri Wedari Yusuf, AMF Tenaga Penunjang 75 10 0

74 Santi Wardianti Amd.Keb Tenaga Bidan 90 10 10 7

75 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 90 10 0

76 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 90 10 0

77 Desi Asriana, Amd.Keb Tenaga Bidan 90 10 0

78 Hastuti, Amd.Keb Tenaga Bidan 90 10 0

79 Nur Ilma, Amd.Keb Tenaga Bidan 90 30 55

80 Irmawati, Amd.Keb Tenaga Bidan 90 30 10

81 Ridha Arbiah, Amd.Keb II Tenaga Bidan 90 30 25

82 Ramlah, Amd.Keb Tenaga Bidan 90 30 10

83 Hermin Wahida III Perawat 90 30 55

84 Andi Jumrianti, Amd.Keb Tenaga Bidan 90 30 10 2

85 Yulianti, Amd.Keb Tenaga Bidan 90 30 10

86 Israwati Tenaga Penunjang 90 20 10


VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK PEGAWAI KERJA
NGAN HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

87 Andi Mas Muliani Tenaga Penunjang 90 10 10

88 Wahyuni, Amd.Keb II Tenaga Bidan 90 30 25

89 Andi Salmei, Amd.Keb Tenaga Bidan 90 30 10

90 Reski Arisanti Amelia Safitri, AMK Perawat 90 10 10

JUMLAH 1910 2170

Mengetahui : Benteng, 04 Mei 2015


Kepala UPTD Puskesmas Benteng, Kasubag Tata Usaha,

Dr. Frengki Wijaya Muhammad Ali


Pangkat : Penata Tk.I Nip. 19641211 198903 1 019
Nip. 1979092 20004 1 023
DAFTAR PENERIMAAN JASA PELAYANAN KESEHATAN PESERTA JKN BAGI PETUGAS PUSKESMAS PUSTU DAN POSKEDES
BULAN MEI TAHUN 2015
PUSKESMAS : BENTENG
JUMLAH PESERTA : 6981 ORANG
JUMLAH PEGAWAI : 92 ORANG
BESARAN KAPITASI : 6000 PERJIWA / BULAN
TOTAL KAPITASI : 41,871,000 TOTAL JASA PELAYANAN SESUAI SK BUPATI 60 % = 25,122,600.-

GOLO VARIABEL POINT POINT VARIABEL DAERAH POINT POINT JUMLAH PPH JUMLAH
NO NAMA PETUGAS NGAN JABATAN KETENA KEHADIRAN JABA /ORG /ORG KINER STATUS MASA /ORG /ORG DITERIMA PASAL 21 DIBAYARKAN TANDA TANGAN
GAAN EFEKTIF 1 BLNTDK HADIR TAN /HARI BULAN JA KEPEG KERJA HARI BULAN ( Rp ) ( 15% / 5% ) ( Rp )
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

1 Dr. Frengki Wiyaya ( Kepala Pusk) IV Dokter Umum 150 23 30 7.8 180.0 90 30 25 6.3 145.00 Rp 572,273 Rp 85,841 Rp 486,432 1

2 Dr. Zaenal Abidin IV Dokter Umum 150 23 6.5 150.0 90 30 85 8.9 205.00 Rp 625,098 Rp 93,765 Rp 531,334 2

3 Drg. Yunda Iswari Dokter Gigi 150 23 5 6.5 117.4 60 30 0 3.9 70.43 Rp 330,732 Rp 16,537 Rp 314,195 3

4 Saribanong III Perawat 40 23 1.7 40.0 90 30 100 9.6 220.00 Rp 457,819 Rp 22,891 Rp 434,928 4

5 Muh. Ilham Tamrin III Perawat 40 23 5 1.7 31.3 60 30 40 5.7 101.74 Rp 234,268 Rp 11,713 Rp 222,555 5

6 Petrus Milu. ET.AMK (Bend. Pusk) III Perawat 40 23 30 3.0 70.0 90 30 70 8.3 190.00 Rp 457,819 Rp 22,891 Rp 434,928 6

7 Hj. Nur Azizal Hastati,AMK III Perawat 40 23 3 1.7 34.8 75 30 85 8.3 165.22 Rp 352,168 Rp 17,608 Rp 334,560 7

8 Rahma Yuliana, AMK II Perawat 40 23 7 1.7 27.8 60 30 25 5.0 80.00 Rp 189,865 Rp - Rp 189,865 8

9 Amsari Parida Amir, AMK II Perawat 40 23 1 1.7 38.3 90 30 25 6.3 138.70 Rp 311,592 Rp - Rp 311,592 9

10 Elsa Handayani, AMK II Perawat 40 23 2 1.7 36.5 90 30 25 6.3 132.39 Rp 297,429 Rp - Rp 297,429 10

11 Nadia Sri Damayanti AMK II Perawat 40 23 4 1.7 33.0 90 30 25 6.3 119.78 Rp 269,102 Rp - Rp 269,102 11

12 Muhrawati, AMK Perawat 40 23 7 1.7 27.8 60 10 10 3.5 55.65 Rp 146,992 Rp - Rp 146,992 12

13 Sri Adrianti, AMK Perawat 40 23 1.7 40.0 90 10 10 4.8 110.00 Rp 264,126 Rp - Rp 264,126 13

14 Nur Wahyuni, AMK Perawat 40 23 5 1.7 31.3 60 10 10 3.5 62.61 Rp 165,366 Rp - Rp 165,366 14

15 Musfiah Zainuddin, AMK Perawat 40 23 1.7 40.0 90 20 10 5.2 120.00 Rp 281,734 Rp - Rp 281,734 15

16 Andi Armita Dewi, AMK Perawat 40 23 1.7 40.0 90 10 10 4.8 110.00 Rp 264,126 Rp - Rp 264,126 16

17 Hasmirawati, AMK Perawat 40 23 11 1.7 20.9 50 10 25 3.7 44.35 Rp 114,837 Rp - Rp 114,837 17

18 Muh. Subhan, AMK Perawat 40 23 2 1.7 36.5 90 10 0 4.3 91.30 Rp 225,081 Rp - Rp 225,081 18

19 Musdalifah, MR,AMK Perawat 40 23 2 1.7 36.5 90 10 0 4.3 91.30 Rp 225,081 Rp - Rp 225,081 19

20 Muhammad Rum, AMK Perawat 40 23 1.7 40.0 90 10 0 4.3 100.00 Rp 246,518 Rp - Rp 246,518 20
21 Agustina, AMK Perawat 40 23 6 1.7 29.6 60 10 10 3.5 59.13 Rp 156,179 Rp - Rp 156,179 21

22 Risaldi Razak, AMK Perawat 40 23 3 1.7 34.8 90 10 0 4.3 86.96 Rp 214,363 Rp - Rp 214,363 22

23 Dewi Ahryani, AMK Perawat 40 23 1.7 40.0 90 10 0 4.3 100.00 Rp 246,518 Rp - Rp 246,518 23

24 Nurdamayanti, S.Kep III Perawat 60 23 8 2.6 39.1 60 30 40 5.7 84.78 Rp 218,191 Rp 10,910 Rp 207,282 24

25 Hj. Rostini AMG II Tenaga Penunjang 40 23 1.7 40.0 90 30 70 8.3 190.00 Rp 404,993 Rp Rp 404,993 25

26 Sri Sulastri AMK II Perawat 40 23 7 1.7 27.8 60 30 25 5.0 80.00 Rp 189,865 Rp - Rp 189,865 26

27 Agustini Tenaga Penunjang 15 23 0.7 15.0 90 20 25 5.9 135.00 Rp 264,126 Rp - Rp 264,126 27

28 Yurniati, A.Md.AK II Analis 40 23 1.7 40.0 90 30 25 6.3 145.00 Rp 325,755 Rp - Rp 325,755 28

29 Rosdiana III Analis 40 23 1.7 40.0 90 30 85 8.9 205.00 Rp 431,406 Rp 21,570 Rp 409,836 29

30 Normalina A.Md.AK II Analis 40 23 1.7 40.0 90 30 25 6.3 145.00 Rp 325,755 Rp - Rp 325,755 30

31 Yunarsih, AMAK Analis 40 23 1 1.7 38.3 90 10 10 4.8 105.22 Rp 252,642 Rp - Rp 252,642 31

32 Bustan II Perawat Gigi 40 23 1.7 40.0 90 30 40 7.0 160.00 Rp 352,168 Rp - Rp 352,168 32

33 Nur Indah Kurnianti III Teknik Gigi 40 23 1.7 40.0 90 30 40 7.0 160.00 Rp 352,168 Rp 17,608 Rp 334,560 33

34 Rahmaniar, Amd.KG Perawat Gigi 40 23 1.7 40.0 90 10 0 4.3 100.00 Rp 246,518 Rp - Rp 246,518 34

35 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 40 23 30 3.0 70.0 90 30 70 8.3 190.00 Rp 457,819 Rp 22,891 Rp 434,928 35

36 St. Rosdiana, B.Sc III Perawat 40 23 1 1.7 38.3 90 30 100 9.6 210.43 Rp 437,913 Rp 21,896 Rp 416,018 36

37 Muhammad Nawir II Pel. Administrasi 15 23 3 0.7 13.0 90 30 25 6.3 126.09 Rp 244,987 Rp - Rp 244,987 37

38 Agustina Bintang,Amd.Keb III Tenaga Bidan 40 23 1.7 40.0 90 30 85 8.9 205.00 Rp 431,406 Rp 21,570 Rp 409,836 38

39 Nur Rahmawati, A.md.Keb II Tenaga Bidan 40 23 1.7 40.0 90 30 25 6.3 145.00 Rp 325,755 Rp - Rp 325,755 39

40 Suriati, A.md.Keb III Tenaga Bidan 40 23 1.7 40.0 90 30 25 6.3 145.00 Rp 325,755 Rp 16,288 Rp 309,468 40

41 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 40 23 1.7 40.0 90 30 25 6.3 145.00 Rp 325,755 Rp - Rp 325,755 41

42 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 40 23 1.7 40.0 90 30 25 6.3 145.00 Rp 325,755 Rp - Rp 325,755 42

43 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 40 23 5 1.7 31.3 90 10 0 4.3 78.26 Rp 192,927 Rp - Rp 192,927 43

44 Isnayani, Amd. Keb Tenaga Bidan 40 23 1.7 40.0 90 10 0 4.3 100.00 Rp 246,518 Rp - Rp 246,518 44

45 Andi Jemma, Amd.Keb Tenaga Bidan 40 23 1.7 40.0 90 30 10 5.7 130.00 Rp 299,343 Rp - Rp 299,343 45

46 Dewi Sartika, Amd.Keb Tenaga Bidan 40 23 1.7 40.0 90 10 10 4.8 110.00 Rp 264,126 Rp - Rp 264,126 46

47 Titin Sumarni, Amd.Keb Tenaga Bidan 40 23 1 1.7 38.3 90 10 0 4.3 95.65 Rp 235,800 Rp - Rp 235,800 47

48 Lisdayanti, A.md.Keb Tenaga Bidan 40 23 4 1.7 33.0 90 10 10 4.8 90.87 Rp 218,191 Rp - Rp 218,191 48

49 Yul Fitriani, Amd. Keb Tenaga Bidan 40 23 2 1.7 36.5 90 10 0 4.3 91.30 Rp 225,081 Rp - Rp 225,081 49
50 Andi Isna, Amd.Keb Tenaga Bidan 40 23 3 1.7 34.8 90 10 0 4.3 86.96 Rp 214,363 Rp - Rp 214,363 50

51 Citra Pratiwi, Amd.Keb Tenaga Bidan 40 23 8 1.7 26.1 60 10 0 3.0 45.65 Rp 126,321 Rp - Rp 126,321 51

52 Rosmiati, Amd.Keb Tenaga Bidan 40 23 12 1.7 19.1 60 20 0 3.5 38.26 Rp 101,057 Rp - Rp 101,057 52

53 Sri Wahyuni, Amd.Keb Tenaga Bidan 40 23 13 1.7 17.4 60 10 0 3.0 30.43 Rp 84,214 Rp - Rp 84,214 53

54 Nurfitra, Amd.Keb Tenaga Bidan 40 23 1.7 40.0 90 10 0 4.3 100.00 Rp 246,518 Rp - Rp 246,518 54

55 Sulastri, Amd.Keb Tenaga Bidan 40 23 4 1.7 33.0 90 10 0 4.3 82.61 Rp 203,645 Rp - Rp 203,645 55

56 Sulmiati Bahri Amd.Keb Tenaga Bidan 40 23 1.7 40.0 90 10 0 4.3 100.00 Rp 246,518 Rp - Rp 246,518 56

57 Ira Muliati Radi.Amd.Keb Tenaga Bidan 40 23 1.7 40.0 90 30 10 5.7 130.00 Rp 299,343 Rp - Rp 299,343 57

58 Rosidah, AMKL III Sanitarian 40 23 3 1.7 34.8 90 30 40 7.0 139.13 Rp 306,233 Rp 15,312 Rp 290,921 58

59 Israyana Yulianti AMKL III Sanitarian 40 23 1.7 40.0 90 30 40 7.0 160.00 Rp 352,168 Rp 17,608 Rp 334,560 59

60 Rostati, SKM III Tenaga Penunjang 60 23 8 2.6 39.1 60 30 40 5.7 84.78 Rp 218,191 Rp 10,910 Rp 207,282 60

61 Armawati, S.Kep III Perawat 60 23 2 2.6 54.8 90 30 40 7.0 146.09 Rp 353,699 Rp 17,685 Rp 336,014 61

62 Andi Rezki Wardani S.Kep Ns Perawat 100 23 4.3 100.0 90 10 0 4.3 100.00 Rp 352,168 Rp 17,608 Rp 334,560 62

63 Anna Marsela, AMK Perawat 40 23 1.7 40.0 90 10 0 4.3 100.00 Rp 246,518 Rp - Rp 246,518 63

64 Wa Ode Sinta Kalsum III Pelak. Gizi 40 23 1.7 40.0 90 30 70 8.3 190.00 Rp 404,993 Rp 20,250 Rp 384,744 64

65 Andi Megawati II Teknik Gigi 40 23 1.7 40.0 90 30 25 6.3 145.00 Rp 325,755 Rp - Rp 325,755 65

66 Rosmayanti, SKM Tenaga Penunjang 60 23 2.6 60.0 90 10 25 5.4 125.00 Rp 325,755 Rp 16,288 Rp 309,468 66

67 Sudirman H Tenaga Penunjang 15 23 0.7 15.0 90 20 25 5.9 135.00 Rp 264,126 Rp - Rp 264,126 67

68 Nur Fauzi, S, Si, Apt III Tenaga Penunjang 100 23 21 4.3 8.7 50 30 25 4.6 9.13 Rp 31,389 Rp 1,569 Rp 29,819 68

69 Sri Rahmat Yani Nur III Perawat 40 23 4 1.7 33.0 60 30 70 7.0 132.17 Rp 290,921 Rp 14,546 Rp 276,375 69

70 Mayanti, AMF III Tenaga Penunjang 40 23 1.7 40.0 90 30 25 6.3 145.00 Rp 325,755 Rp 16,288 Rp 309,468 70

71 Hj. Syahraeni, AMK II Perawat 25 23 1.1 25.0 90 30 25 6.3 145.00 Rp 299,343 Rp - Rp 299,343 71

72 Sri Wedari Yusuf, AMF Tenaga Penunjang 40 23 1.7 40.0 90 10 0 4.3 100.00 Rp 246,518 Rp - Rp 246,518 72

73 Hamriana Tenaga Penunjang 15 23 10 0.7 8.5 60 10 10 3.5 45.22 Rp 94,549 Rp - Rp 94,549 73

74 Santi Wardianti Amd.Keb Tenaga Bidan 40 23 22 1.7 1.7 50 10 10 3.0 3.04 Rp 8,421 Rp - Rp 8,421 74

75 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 40 23 1.7 40.0 90 10 0 4.3 100.00 Rp 246,518 Rp - Rp 246,518 75

76 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 40 23 4 1.7 33.0 60 10 0 3.0 57.83 Rp 160,007 Rp - Rp 160,007 76

77 Desi Asriana, Amd.Keb Tenaga Bidan 40 23 6 1.7 29.6 60 10 0 3.0 51.74 Rp 143,164 Rp - Rp 143,164 77

78 Andi Rezkiiani Amd.Keb Tenaga Bidan 40 23 14 1.7 15.7 50 10 0 2.6 23.48 Rp 68,902 Rp - Rp 68,902 78
79 Bau Asni S.ST Tenaga Bidan 40 23 11 1.7 20.9 50 10 0 2.6 31.30 Rp 91,870 Rp - Rp 91,870 79

80 Hastuti, Amd.Keb Tenaga Bidan 40 23 1.7 40.0 90 10 0 4.3 100.00 Rp 246,518 Rp - Rp 246,518 80

81 Nur Ilma, Amd.Keb Tenaga Bidan 40 23 1.7 40.0 90 30 55 7.6 175.00 Rp 378,581 Rp - Rp 378,581 81

82 Irmawati, Amd.Keb Tenaga Bidan 40 23 1.7 40.0 90 30 10 5.7 130.00 Rp 299,343 Rp - Rp 299,343 82

83 Ridha Arbiah, Amd.Keb II Tenaga Bidan 40 23 1.7 40.0 90 30 25 6.3 145.00 Rp 325,755 Rp - Rp 325,755 83

84 Ramlah, Amd.Keb Tenaga Bidan 40 23 1.7 40.0 90 30 10 5.7 130.00 Rp 299,343 Rp - Rp 299,343 84

85 Hermin Wahida III Perawat 40 23 1.7 40.0 90 30 55 7.6 175.00 Rp 378,581 Rp 18,929 Rp 359,652 85

86 Andi Jumrianti, Amd.Keb Tenaga Bidan 40 23 1.7 40.0 90 30 10 5.7 130.00 Rp 299,343 Rp - Rp 299,343 86

87 Yulianti, Amd.Keb Tenaga Bidan 40 23 1.7 40.0 90 30 10 5.7 130.00 Rp 299,343 Rp - Rp 299,343 87

88 Israwati Tenaga Penunjang 15 23 0.7 15.0 90 20 10 5.2 120.00 Rp 237,713 Rp - Rp 237,713 88

89 Andi Mas Muliani Tenaga Penunjang 15 23 0.7 15.0 90 10 10 4.8 110.00 Rp 220,105 Rp - Rp 220,105 89

90 Wahyuni, Amd.Keb II Tenaga Bidan 40 23 1.7 40.0 90 30 25 6.3 145.00 Rp 325,755 Rp - Rp 325,755 90

91 Andi Salmei, Amd.Keb Tenaga Bidan 40 23 1.7 40.0 90 30 10 5.7 130.00 Rp 299,343 Rp - Rp 299,343 91

92 Reski Arisanti Amelia Safitri, AMK Perawat 40 23 1.7 40.0 90 10 10 4.8 110.00 Rp 264,126 Rp - Rp 264,126 92

JUMLAH 4045 2116 240 90 180 3,637.4 7585 1930 2105 505 10630.0 Rp 25,122,600 Rp 570,972 Rp 24,551,628

Mengetahui / Menyetujui : Benteng, 05 Juni 2015


Kepala UPTD Puskesmas Benteng Bendahara JKN

Dr. FRENGKI WIJAYA PETRUS MILU E.T, AMK


Pangkat : Pembina Nip 19710704 199103 1 009
NIP. 19790926 200604 1 023
150 30 24 151.25
41,886,000 6,981
41,871,000 6,979 25,122,600

14267.3913 25,122,600 15239.792 150

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792 41,871,000 25,122,600

14267.3913 25,122,600 15239.792 41,871,000 16,748,400 6,699,360 10,049,040 16,748,400

14267.3913 25,122,600 15239.792 41,871,000

14267.3913 25,122,600 15239.792 6,609,120 9,913,680 16,522,800

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792 24,784,200

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792


14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792


14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792


14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 25,122,600 15239.792

14267.3913 14267.391
9975600
DAFTAR VARIABEL DAERAH SEBAGAI PENILAIAN TAMBAHAN DALAM MELAKUKAN PEMBAGIAN JASA PELAYANAN
JAMINAN KESEHATAN NASIONAL DI PUSKESMAS BENTENG BULAN MEI AHUN 2015

VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK PEGAWAI KERJA
NGAN HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

1 Dr. Frengki Wiyaya ( Kepala Pusk IV Dokter Umum 90 30 25

2 Dr. Zaenal Abidin IV Dokter Umum 90 30 85

3 Drg. Yunda Iswari Dokter Gigi 60 30 0 5

4 Saribanong III Perawat 90 30 100

5 Muh. Ilham Tamrin III Perawat 60 30 40 5

6 Petrus Milu. ET.AMK (Bend. Pusk III Perawat 75 30 70

7 Hj. Nur Azizal Hastati,AMK III Perawat 90 30 85 3

8 Rahma Yuliana, AMK II Perawat 60 30 25 7

9 Amsari Parida Amir, AMK II Perawat 90 30 25 1

10 Elsa Handayani, AMK II Perawat 90 30 25 2

11 Nadia Sri Damayanti AMK II Perawat 90 30 25 4

12 Muhrawati, AMK Perawat 60 10 10 7

13 Sri Adrianti, AMK Perawat 90 10 10

14 Nur Wahyuni, AMK Perawat 60 10 10 5

15 Musfiah Zainuddin, AMK Perawat 90 20 10

16 Andi Armita Dewi, AMK Perawat 90 10 10

17 Hasmirawati, AMK Perawat 50 10 25 11

18 Muh. Subhan, AMK Perawat 90 10 0 2

19 Musdalifah, MR,AMK Perawat 90 10 0 2

20 Muhammad Rum, AMK Perawat 90 10 0

21 Agustina, AMK Perawat 60 10 10 6

22 Risaldi Razak, AMK Perawat 90 10 0 3

23 Dewi Ahryani, AMK Perawat 90 10 0

24 Nurdamayanti, S.Kep III Perawat 60 30 40 8

25 Hj. Rostini AMG II Tenaga Penunjang 90 30 70

26 Sri Sulastri AMK II Perawat 60 30 25 7

27 Agustini Tenaga Penunjang 90 20 25

28 Yurniati, A.Md.AK II Analis 90 30 25

29 Rosdiana III Analis 90 30 85

30 Normalina A.Md.AK II Analis 90 30 25

31 Yunarsih, AMAK Analis 90 10 10 1

32 Bustan II Perawat Gigi 90 30 40

33 Nur Indah Kurnianti III Teknik Gigi 90 30 40

34 Rahmaniar, Amd.KG Perawat Gigi 90 10 0

35 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 90 30 70

36 St. Rosdiana, B.Sc III Perawat 90 30 100 1

37 Muhammad Nawir II Pel. Administrasi 90 30 25 3

38 Agustina Bintang,Amd.Keb III Tenaga Bidan 90 30 85

39 Nur Rahmawati, A.md.Keb II Tenaga Bidan 90 30 25

40 Suriati, A.md.Keb III Tenaga Bidan 90 30 25

41 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 90 30 25

42 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 90 30 25

43 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 90 10 0 5

44 Isnayani, Amd. Keb Tenaga Bidan 90 10 0


VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK PEGAWAI KERJA
NGAN HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

45 Andi Jemma, Amd.Keb Tenaga Bidan 90 30 10

46 Dewi Sartika, Amd.Keb Tenaga Bidan 90 10 10

47 Titin Sumarni, Amd.Keb Tenaga Bidan 90 10 0 1

48 Lisdayanti, A.md.Keb Tenaga Bidan 90 10 10 4

49 Yul Fitriani, Amd. Keb Tenaga Bidan 90 10 0 2

50 Andi Isna, Amd.Keb Tenaga Bidan 90 10 0 3

51 Citra Pratiwi, Amd.Keb Tenaga Bidan 60 10 0 8

52 Rosmiati, Amd.Keb Tenaga Bidan 60 20 0 12

53 Sri Wahyuni, Amd.Keb Tenaga Bidan 60 10 0 13

54 Nurfitra, Amd.Keb Tenaga Bidan 90 10 0

55 Sulastri, Amd.Keb Tenaga Bidan 90 10 0 4

56 Sulmiati Bahri Amd.Keb Tenaga Bidan 90 10 0

57 Ira Muliati Radi.Amd.Keb Tenaga Bidan 90 30 10

58 Rosidah, AMKL III Sanitarian 90 30 40 3

59 Israyana Yulianti AMKL III Sanitarian 90 30 40

60 Rostati, SKM III Tenaga Penunjang 60 30 40 8

61 Armawati, S.Kep III Perawat 90 30 40 2

62 Andi Rezki Wardani S.Kep Ns Perawat 90 10 0

63 Anna Marsela, AMK Perawat 90 10 0

64 Wa Ode Sinta Kalsum III Pelak. Gizi 90 30 70

65 Andi Megawati II Teknik Gigi 90 30 25

66 Rosmayanti, SKM Tenaga Penunjang 90 10 25

67 Sudirman H Tenaga Penunjang 90 20 25

68 Nur Fauzi, S, Si, Apt III Tenaga Penunjang 50 30 25 21

69 Sri Rahmat Yani Nur III Perawat 60 30 70 4

70 Mayanti, AMF III Tenaga Penunjang 90 30 25

71 Hj. Syahraeni, AMK II Perawat 90 30 25

72 Sri Wedari Yusuf, AMF Tenaga Penunjang 90 10 0

73 Hamriana Tenaga Penunjang 60 10 10 10

74 Santi Wardianti Amd.Keb Tenaga Bidan 50 10 10 22

75 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 90 10 0

76 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 60 10 0 4

77 Desi Asriana, Amd.Keb Tenaga Bidan 60 10 0 6

78 Andi Rezkiiani Amd.Keb Tenaga Bidan 90 10 0 14

79 Bau Asni S.ST Tenaga Bidan 10 0 11

80 Hastuti, Amd.Keb Tenaga Bidan 90 10 0

81 Nur Ilma, Amd.Keb Tenaga Bidan 90 30 55

82 Irmawati, Amd.Keb Tenaga Bidan 90 30 10

83 Ridha Arbiah, Amd.Keb II Tenaga Bidan 90 30 25

84 Ramlah, Amd.Keb Tenaga Bidan 90 30 10

85 Hermin Wahida III Perawat 90 30 55

86 Andi Jumrianti, Amd.Keb Tenaga Bidan 90 30 10


VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK PEGAWAI KERJA
NGAN HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

87 Yulianti, Amd.Keb Tenaga Bidan 90 30 10

88 Israwati Tenaga Penunjang 90 20 10

89 Andi Mas Muliani Tenaga Penunjang 90 10 10

90 Wahyuni, Amd.Keb II Tenaga Bidan 90 30 25

91 Andi Salmei, Amd.Keb Tenaga Bidan 90 30 10

92 Reski Arisanti Amelia Safitri, AMK Perawat 90 10 10

JUMLAH 1930 2105

Mengetahui : Benteng, Juni 2015


Kepala UPTD Puskesmas Benteng, Kasubag Tata Usaha,

Dr. Frengki Wijaya Muhammad Ali


Pangkat : Pembina Nip. 19641211 198903 1 019
Nip. 1979092 20004 1 023
DAFTAR PENERIMAAN JASA PELAYANAN KESEHATAN PESERTA JKN BAGI PETUGAS PUSKESMAS PUSTU DAN POSKEDES
BULAN JUNI TAHUN 2015
PUSKESMAS : BENTENG
JUMLAH PESERTA : 7007 ORANG
JUMLAH PEGAWAI : 91 ORANG
BESARAN KAPITASI : 6000 PERJIWA / BULAN
TOTAL KAPITASI : 42,027,000 TOTAL JASA PELAYANAN SESUAI SK BUPATI 60 % = 25,216,200.-

GOLO VARIABEL POINT POINT VARIABEL DAERAH POINT POINT JUMLAH PPH JUMLAH
NO NAMA PETUGAS NGAN JABATAN KETENA KEHADIRAN JABA /ORG /ORG KINER STATUS MASA /ORG /ORG DITERIMA PASAL 21 DIBAYARKAN TANDA TANGAN
GAAN EFEKTIF 1 BLNTDK HADIR TAN /HARI BULAN JA KEPEG KERJA HARI BULAN ( Rp ) ( 15% / 5% ) ( Rp )
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

1 Dr. Frengki Wiyaya ( Kepala Pusk) IV Dokter Umum 150 25 3 30 7.2 158.4 90 30 25 5.8 127.60 Rp 505,632 Rp 75,845 Rp 429,787 1

2 Dr. Zaenal Abidin IV Dokter Umum 150 25 8 6.0 102.0 75 30 85 7.6 129.20 Rp 408,749 Rp 61,312 Rp 347,437 2

3 Drg. Yunda Iswari III Dokter Gigi 150 25 2 6.0 138.0 90 30 0 4.8 110.40 Rp 439,158 Rp 21,958 Rp 417,200 3

4 Saribanong III Perawat 40 25 1.6 40.0 90 30 100 8.8 220.00 Rp 459,666 Rp 22,983 Rp 436,682 4

5 Muh. Ilham Tamrin III Perawat 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 353,589 Rp 17,679 Rp 335,910 5

6 Petrus Milu. ET.AMK (Bend. Pusk) III Perawat 40 25 30 2.8 70.0 90 30 70 7.6 190.00 Rp 459,666 Rp 22,983 Rp 436,682 6

7 Hj. Nur Azizal Hastati,AMK III Perawat 40 25 4 1.6 33.6 90 30 85 8.2 172.20 Rp 363,843 Rp 18,192 Rp 345,651 7

8 Nur Ariani, AMK III Perawat 40 25 14 1.6 17.6 60 30 85 7.0 77.00 Rp 167,248 Rp 8,362 Rp 158,885 8

9 Rahma Yuliana, AMK II Perawat 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 327,070 Rp - Rp 327,070 9

10 Amsari Parida Amir, AMK II Perawat 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 327,070 Rp - Rp 327,070 10

11 Elsa Handayani, AMK II Perawat 40 25 2 1.6 36.8 90 30 25 5.8 133.40 Rp 300,904 Rp - Rp 300,904 11

12 Nadia Sri Damayanti AMK II Perawat 40 25 1 1.6 38.4 90 30 25 5.8 139.20 Rp 313,987 Rp - Rp 313,987 12

13 Muhrawati, AMK Perawat 40 25 3 1.6 35.2 90 10 10 4.4 96.80 Rp 233,369 Rp - Rp 233,369 13

14 Sri Adrianti, AMK Perawat 40 25 3 1.6 35.2 90 10 10 4.4 96.80 Rp 233,369 Rp - Rp 233,369 14

15 Nur Wahyuni, AMK Perawat 40 25 1 1.6 38.4 90 10 10 4.4 105.60 Rp 254,584 Rp - Rp 254,584 15

16 Musfiah Zainuddin, AMK Perawat 40 25 4 1.6 33.6 75 20 10 4.2 88.20 Rp 215,336 Rp - Rp 215,336 16

17 Andi Armita Dewi, AMK Perawat 40 25 3 1.6 35.2 90 10 10 4.4 96.80 Rp 233,369 Rp - Rp 233,369 17

18 Hasmirawati, AMK Perawat 40 25 4 1.6 33.6 90 10 25 5.0 105.00 Rp 245,037 Rp - Rp 245,037 18

19 Muh. Subhan, AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 247,512 Rp - Rp 247,512 19

20 Musdalifah, MR,AMK Perawat 40 25 7 1.6 28.8 75 10 0 3.4 61.20 Rp 159,115 Rp - Rp 159,115 20


21 Muhammad Rum, AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 247,512 Rp - Rp 247,512 21

22 Agustina, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 265,192 Rp - Rp 265,192 22

23 Risaldi Razak, AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 247,512 Rp - Rp 247,512 23

24 Dewi Ahryani, AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 247,512 Rp - Rp 247,512 24

25 Nurdamayanti, S.Kep III Perawat 60 25 4 2.4 50.4 90 30 40 6.4 134.40 Rp 326,716 Rp 16,336 Rp 310,380 25

26 Hj. Rostini AMG II Tenaga Penunjang 40 25 1.6 40.0 90 30 70 7.6 190.00 Rp 406,627 Rp Rp 406,627 26

27 Sri Sulastri AMK II Perawat 40 25 5 1.6 32.0 90 30 25 5.8 116.00 Rp 261,656 Rp - Rp 261,656 27

28 Agustini Tenaga Penunjang 15 25 3 0.6 13.2 90 20 25 5.4 118.80 Rp 233,369 Rp - Rp 233,369 28

29 Yurniati, A.Md.AK II Analis 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 327,070 Rp - Rp 327,070 29

30 Rosdiana III Analis 40 25 24 1.6 1.6 50 30 85 6.6 6.60 Rp 14,497 Rp 725 Rp 13,772 30

31 Normalina A.Md.AK II Analis 40 25 10 1.6 24.0 75 30 25 5.2 78.00 Rp 180,330 Rp - Rp 180,330 31

32 Yunarsih, AMAK Analis 40 25 1.6 40.0 50 10 10 2.8 70.00 Rp 194,474 Rp - Rp 194,474 32

33 Bustan II Perawat Gigi 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 353,589 Rp - Rp 353,589 33

34 Nur Indah Kurnianti III Teknik Gigi 40 25 1 1.6 38.4 90 30 40 6.4 153.60 Rp 339,445 Rp 16,972 Rp 322,473 34

35 Rahmaniar, Amd.KG Perawat Gigi 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 247,512 Rp - Rp 247,512 35

36 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 40 25 30 2.8 70.0 90 30 70 7.6 190.00 Rp 459,666 Rp 22,983 Rp 436,682 36

37 St. Rosdiana, B.Sc III Perawat 40 25 1.6 40.0 90 30 100 8.8 220.00 Rp 459,666 Rp 22,983 Rp 436,682 37

38 Muhammad Nawir II Pel. Administrasi 15 25 0.6 15.0 90 30 25 5.8 145.00 Rp 282,871 Rp - Rp 282,871 38

39 Agustina Bintang,Amd.Keb III Tenaga Bidan 40 25 4 1.6 33.6 90 30 85 8.2 172.20 Rp 363,843 Rp 18,192 Rp 345,651 39

40 Nur Rahmawati, A.md.Keb II Tenaga Bidan 40 25 18 1.6 11.2 50 30 25 4.2 29.40 Rp 71,779 Rp - Rp 71,779 40

41 Suriati, A.md.Keb III Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 327,070 Rp 16,353 Rp 310,716 41

42 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 327,070 Rp - Rp 327,070 42

43 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 327,070 Rp - Rp 327,070 43

44 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 247,512 Rp - Rp 247,512 44

45 Isnayani, Amd. Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 247,512 Rp - Rp 247,512 45

46 Andi Jemma, Amd.Keb Tenaga Bidan 40 25 5 1.6 32.0 90 30 10 5.2 104.00 Rp 240,441 Rp - Rp 240,441 46

47 Dewi Sartika, Amd.Keb Tenaga Bidan 40 25 5 1.6 32.0 90 10 10 4.4 88.00 Rp 212,153 Rp - Rp 212,153 47

48 Titin Sumarni, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 247,512 Rp - Rp 247,512 48

49 Lisdayanti, A.md.Keb Tenaga Bidan 40 25 8 1.6 27.2 75 10 10 3.8 64.60 Rp 162,297 Rp - Rp 162,297 49
50 Yul Fitriani, Amd. Keb Tenaga Bidan 40 25 4 1.6 33.6 90 10 0 4.0 84.00 Rp 207,910 Rp - Rp 207,910 50

51 Andi Isna, Amd.Keb Tenaga Bidan 40 25 4 1.6 33.6 90 10 0 4.0 84.00 Rp 207,910 Rp - Rp 207,910 51

52 Citra Pratiwi, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 247,512 Rp - Rp 247,512 52

53 Rosmiati, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 20 0 4.4 110.00 Rp 265,192 Rp - Rp 265,192 53

54 Sri Wahyuni, Amd.Keb Tenaga Bidan 40 25 4 1.6 33.6 75 10 0 3.4 71.40 Rp 185,634 Rp - Rp 185,634 54

55 Sulastri, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 247,512 Rp - Rp 247,512 55

56 Sulmiati Bahri Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 247,512 Rp - Rp 247,512 56

57 Ira Muliati Radi.Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 300,551 Rp - Rp 300,551 57

58 Rosidah, AMKL III Sanitarian 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 353,589 Rp 17,679 Rp 335,910 58

59 Israyana Yulianti AMKL III Sanitarian 40 25 2 1.6 36.8 90 30 40 6.4 147.20 Rp 325,302 Rp 16,265 Rp 309,037 59

60 Rostati, SKM III Tenaga Penunjang 60 25 2.4 60.0 90 30 40 6.4 160.00 Rp 388,948 Rp 19,447 Rp 369,501 60

61 Armawati, S.Kep III Perawat 60 25 2.4 60.0 90 30 40 6.4 160.00 Rp 388,948 Rp 19,447 Rp 369,501 61

62 Andi Rezki Wardani S.Kep Ns Perawat 100 25 5 4.0 80.0 90 10 0 4.0 80.00 Rp 282,871 Rp 14,144 Rp 268,728 62

63 Anna Marsela, AMK Perawat 40 25 3 1.6 35.2 90 10 0 4.0 88.00 Rp 217,811 Rp - Rp 217,811 63

64 Wa Ode Sinta Kalsum III Pelak. Gizi 40 25 8 1.6 27.2 75 30 70 7.0 119.00 Rp 258,474 Rp 12,924 Rp 245,550 64

65 Andi Megawati II Teknik Gigi 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 327,070 Rp - Rp 327,070 65

66 Rosmayanti, SKM Tenaga Penunjang 60 25 2.4 60.0 90 10 25 5.0 125.00 Rp 327,070 Rp 16,353 Rp 310,716 66

67 Sudirman H Tenaga Penunjang 15 25 0.6 15.0 90 20 25 5.4 135.00 Rp 265,192 Rp - Rp 265,192 67

68 Sri Rahmat Yani Nur III Perawat 40 25 8 1.6 27.2 60 30 70 6.4 108.80 Rp 240,441 Rp 12,022 Rp 228,418 68

69 Hj. Syahraeni, AMK II Perawat 40 25 20 1.6 8.0 50 30 25 4.2 21.00 Rp 51,270 Rp - Rp 51,270 69

70 Sri Wedari Yusuf, AMF Tenaga Penunjang 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 247,512 Rp - Rp 247,512 70

71 Hamriana Tenaga Penunjang 15 25 0.6 15.0 90 10 10 4.4 110.00 Rp 220,993 Rp - Rp 220,993 71

72 Santi Wardianti Amd.Keb Tenaga Bidan 40 25 11 1.6 22.4 90 10 10 4.4 61.60 Rp 148,507 Rp - Rp 148,507 72

73 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 40 25 3 1.6 35.2 75 10 0 3.4 74.80 Rp 194,474 Rp - Rp 194,474 73

74 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 247,512 Rp - Rp 247,512 74

75 Desi Asriana, Amd.Keb Tenaga Bidan 40 25 10 1.6 24.0 75 10 0 3.4 51.00 Rp 132,596 Rp - Rp 132,596 75

76 Andi Rezkiiani Amd.Keb Tenaga Bidan 40 25 4 1.6 33.6 75 10 0 3.4 71.40 Rp 185,634 Rp - Rp 185,634 76

77 Bau Asni S.ST Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 247,512 Rp - Rp 247,512 77

78 Hastuti, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 247,512 Rp - Rp 247,512 78
79 Rosdiana Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 247,512 Rp - Rp 247,512 79

80 Nur Ilma, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 55 7.0 175.00 Rp 380,108 Rp - Rp 380,108 80

81 Irmawati, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 300,551 Rp - Rp 300,551 81

82 Ridha Arbiah, Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 327,070 Rp - Rp 327,070 82

83 Ramlah, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 300,551 Rp - Rp 300,551 83

84 Hermin Wahida III Perawat 40 25 1.6 40.0 90 30 55 7.0 175.00 Rp 380,108 Rp 19,005 Rp 361,103 84

85 Andi Jumrianti, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 300,551 Rp - Rp 300,551 85

86 Yulianti, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 300,551 Rp - Rp 300,551 86

87 Israwati Tenaga Penunjang 15 25 0.6 15.0 90 20 10 4.8 120.00 Rp 238,673 Rp - Rp 238,673 87

88 Andi Mas Muliani Tenaga Penunjang 15 25 0.6 15.0 90 10 10 4.4 110.00 Rp 220,993 Rp - Rp 220,993 88

89 Wahyuni, Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 327,070 Rp - Rp 327,070 89

90 Andi Salmei, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 300,551 Rp - Rp 300,551 90

91 Reski Arisanti Amelia Safitri, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 265,192 Rp - Rp 265,192 91

JUMLAH 3960 2275 232 90 162 3,605.8 7820 1900 2140 474 10657.2 Rp 25,216,200 Rp 511,148 Rp 24,705,052

Mengetahui / Menyetujui : Benteng, 05 Juli 2015


Kepala UPTD Puskesmas Benteng Bendahara JKN

Dr. FRENGKI WIJAYA PETRUS MILU E.T, AMK


Pangkat : Penata Tk.I Nip 19710704 199103 1 009
NIP. 19790926 200604 1 023
150 30 24 151.25
42,042,000 7,007
42,027,000 7,005 25,216,200

14263.0000 25,216,200 15239.792 150

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792 41,871,000 25,122,600

14263.0000 25,216,200 15239.792 41,871,000 16,748,400 6,699,360 10,049,040 16,748,400

14263.0000 25,216,200 15239.792 41,871,000

14263.0000 25,216,200 15239.792 6,609,120 9,913,680 16,522,800

14263.0000 25,216,200

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792 24,784,200

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792


14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792


14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792


14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 25,216,200 15239.792

14263.0000 14263.000
9975600
DAFTAR VARIABEL DAERAH SEBAGAI PENILAIAN TAMBAHAN DALAM MELAKUKAN PEMBAGIAN JASA PELAYANAN
JAMINAN KESEHATAN NASIONAL DI PUSKESMAS BENTENG BULAN JUNI TAHUN 2015

VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK
NGAN PEGAWAI KERJA HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

1 Dr. Frengki Wiyaya ( Kepala Pusk IV Dokter Umum 90 30 25 3

2 Dr. Zaenal Abidin IV Dokter Umum 75 30 85 8

3 Drg. Yunda Iswari Dokter Gigi 90 30 0 2

4 Saribanong III Perawat 90 30 100

5 Muh. Ilham Tamrin III Perawat 90 30 40

6 Petrus Milu. ET.AMK (Bend. Pusk III Perawat 90 30 70

7 Hj. Nur Azizal Hastati,AMK III Perawat 90 30 85 4

8 Nur Ariani, AMK III Perawat 60 30 85 14

9 Rahma Yuliana, AMK II Perawat 90 30 25

10 Amsari Parida Amir, AMK II Perawat 90 30 25

11 Elsa Handayani, AMK II Perawat 90 30 25 2

12 Nadia Sri Damayanti AMK II Perawat 90 30 25 1

13 Muhrawati, AMK Perawat 90 10 10 3

14 Sri Adrianti, AMK Perawat 90 10 10 3

15 Nur Wahyuni, AMK Perawat 90 10 10 1

16 Musfiah Zainuddin, AMK Perawat 75 20 10 4

17 Andi Armita Dewi, AMK Perawat 90 10 10 3

18 Hasmirawati, AMK Perawat 90 10 25 4

19 Muh. Subhan, AMK Perawat 90 10 0

20 Musdalifah, MR,AMK Perawat 75 10 0 7

21 Muhammad Rum, AMK Perawat 90 10 0

22 Agustina, AMK Perawat 90 10 10

23 Risaldi Razak, AMK Perawat 90 10 0

24 Dewi Ahryani, AMK Perawat 90 10 0

25 Nurdamayanti, S.Kep III Perawat 90 30 40 4

26 Hj. Rostini AMG II Tenaga Penunjang 90 30 70

27 Sri Sulastri AMK II Perawat 90 30 25 5

28 Agustini Tenaga Penunjang 90 20 25 3

29 Yurniati, A.Md.AK II Analis 90 30 25

30 Rosdiana III Analis 50 30 85 24

31 Normalina A.Md.AK II Analis 75 30 25 10

32 Yunarsih, AMAK Analis 90 10 10

33 Bustan II Perawat Gigi 90 30 40

34 Nur Indah Kurnianti III Teknik Gigi 90 30 40 1

35 Rahmaniar, Amd.KG Perawat Gigi 90 10 0

36 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 90 30 70

37 St. Rosdiana, B.Sc III Perawat 90 30 100

38 Muhammad Nawir II Pel. Administrasi 90 30 25

39 Agustina Bintang,Amd.Keb III Tenaga Bidan 90 30 85 4

40 Nur Rahmawati, A.md.Keb II Tenaga Bidan 50 30 25 18

41 Suriati, A.md.Keb III Tenaga Bidan 90 30 25

42 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 90 30 25

43 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 90 30 25

44 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 90 10 0


VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK
NGAN PEGAWAI KERJA HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

45 Isnayani, Amd. Keb Tenaga Bidan 90 10 0

46 Andi Jemma, Amd.Keb Tenaga Bidan 90 30 10 5

47 Dewi Sartika, Amd.Keb Tenaga Bidan 90 10 10 5

48 Titin Sumarni, Amd.Keb Tenaga Bidan 90 10 0

49 Lisdayanti, A.md.Keb Tenaga Bidan 75 10 10 8

50 Yul Fitriani, Amd. Keb Tenaga Bidan 90 10 0 4

51 Andi Isna, Amd.Keb Tenaga Bidan 90 10 0 4

52 Citra Pratiwi, Amd.Keb Tenaga Bidan 90 10 0

53 Rosmiati, Amd.Keb Tenaga Bidan 90 20 0

54 Sri Wahyuni, Amd.Keb Tenaga Bidan 75 10 0 4

55 Sulastri, Amd.Keb Tenaga Bidan 90 10 0

56 Sulmiati Bahri Amd.Keb Tenaga Bidan 90 10 0

57 Ira Muliati Radi.Amd.Keb Tenaga Bidan 90 30 10

58 Rosidah, AMKL III Sanitarian 90 30 40

59 Israyana Yulianti AMKL III Sanitarian 90 30 40 2

60 Rostati, SKM III Tenaga Penunjang 90 30 40

61 Armawati, S.Kep III Perawat 90 30 40

62 Andi Rezki Wardani S.Kep Ns Perawat 90 10 0 5

63 Anna Marsela, AMK Perawat 90 10 0 3

64 Wa Ode Sinta Kalsum III Pelak. Gizi 75 30 70 8

65 Andi Megawati II Teknik Gigi 90 30 25

66 Rosmayanti, SKM Tenaga Penunjang 90 10 25

67 Sudirman H Tenaga Penunjang 90 20 25

68 Sri Rahmat Yani Nur III Perawat 60 30 70 8

69 Hj. Syahraeni, AMK II Perawat 50 30 25 20

70 Sri Wedari Yusuf, AMF Tenaga Penunjang 90 10 0

71 Hamriana Tenaga Penunjang 90 10 10

72 Santi Wardianti Amd.Keb Tenaga Bidan 75 10 10 11

73 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 90 10 0 3

74 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 90 10 0

75 Desi Asriana, Amd.Keb Tenaga Bidan 75 10 0 10

76 Andi Rezkiiani Amd.Keb Tenaga Bidan 75 10 0 4

77 Bau Asni S.ST Tenaga Bidan 90 10 0

78 Hastuti, Amd.Keb Tenaga Bidan 90 10 0

79 Rosdiana AMD.Keb Tenaga Bidan 90 30 55

80 Nur Ilma, Amd.Keb Tenaga Bidan 90 30 55

81 Irmawati, Amd.Keb Tenaga Bidan 90 30 10

82 Ridha Arbiah, Amd.Keb II Tenaga Bidan 90 30 25

83 Ramlah, Amd.Keb Tenaga Bidan 90 30 10

84 Hermin Wahida III Perawat 90 30 55

85 Andi Jumrianti, Amd.Keb Tenaga Bidan 90 30 10

86 Yulianti, Amd.Keb Tenaga Bidan 90 30 10


VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK
NGAN PEGAWAI KERJA HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

87 Israwati Tenaga Penunjang 90 20 10

88 Andi Mas Muliani Tenaga Penunjang 90 10 10

89 Wahyuni, Amd.Keb II Tenaga Bidan 90 30 25

90 Andi Salmei, Amd.Keb Tenaga Bidan 90 30 10

91 Reski Arisanti Amelia Safitri, AMK Perawat 90 10 10

JUMLAH 1920 2195

Mengetahui : Benteng, Juli 2015


Kepala UPTD Puskesmas Benteng, Kasubag Tata Usaha,

Dr. Frengki Wijaya Muhammad Ali


Pangkat : Pembina Nip. 19641211 198903 1 019
Nip. 1979092 20004 1 023
DAFTAR PENERIMAAN JASA PELAYANAN KESEHATAN PESERTA JKN BAGI PETUGAS PUSKESMAS PUSTU DAN POSKEDES
BULAN JULI TAHUN 2015
PUSKESMAS : BENTENG
JUMLAH PESERTA : 7037 ORANG
JUMLAH PEGAWAI : 89 ORANG
BESARAN KAPITASI : 6000 PERJIWA / BULAN
TOTAL KAPITASI : 42,207,000 TOTAL JASA PELAYANAN SESUAI SK BUPATI 60 % = 25,324,200.-

GOLO VARIABEL POINT POINT VARIABEL DAERAH POINT POINT JUMLAH PPH JUMLAH
NO NAMA PETUGAS NGAN JABATAN KETENA KEHADIRAN JABA /ORG /ORG KINER STATUS MASA /ORG /ORG DITERIMA PASAL 21 DIBAYARKAN TANDA TANGAN
GAAN EFEKTIF 1 BLNTDK HADIR TAN /HARI BULAN JA KEPEG KERJA HARI BULAN ( Rp ) ( 15% / 5% ) ( Rp )
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

1 Dr. Frengki Wiyaya ( Kepala Pusk) IV Dokter Umum 150 22 30 8.2 180.0 90 30 25 6.6 145.00 Rp 560,123 Rp 84,018 Rp 476,104 1

2 Dr. Zaenal Abidin IV Dokter Umum 150 22 6.8 150.0 90 30 85 9.3 205.00 Rp 611,826 Rp 91,774 Rp 520,052 2

3 Drg. Yunda Iswari III Dokter Gigi 150 22 7 6.8 102.3 75 30 0 4.8 71.59 Rp 299,646 Rp 14,982 Rp 284,664 3

4 Saribanong III Perawat 40 22 1.8 40.0 90 30 100 10.0 220.00 Rp 448,098 Rp 22,405 Rp 425,693 4

5 Muh. Ilham Tamrin III Perawat 40 22 3 1.8 34.5 90 30 40 7.3 138.18 Rp 297,688 Rp 14,884 Rp 282,803 5

6 Petrus Milu. ET.AMK (Bend. Pusk) III Perawat 40 22 30 3.2 70.0 90 30 70 8.6 190.00 Rp 448,098 Rp 22,405 Rp 425,693 6

7 Hj. Nur Azizal Hastati,AMK III Perawat 40 22 6 1.8 29.1 75 30 85 8.6 138.18 Rp 288,287 Rp 14,414 Rp 273,873 7

8 Nur Ariani, AMK III Perawat 40 22 7 1.8 27.3 75 30 85 8.6 129.55 Rp 270,269 Rp 13,513 Rp 256,755 8

9 Rahma Yuliana, AMK II Perawat 40 22 2 1.8 36.4 75 30 25 5.9 118.18 Rp 266,352 Rp - Rp 266,352 9

10 Amsari Parida Amir, AMK II Perawat 40 22 1.8 40.0 90 30 25 6.6 145.00 Rp 318,839 Rp - Rp 318,839 10

11 Elsa Handayani, AMK II Perawat 40 22 8 1.8 25.5 75 30 25 5.9 82.73 Rp 186,446 Rp - Rp 186,446 11

12 Nadia Sri Damayanti AMK II Perawat 40 22 4 1.8 32.7 75 30 25 5.9 106.36 Rp 239,717 Rp - Rp 239,717 12

13 Muhrawati, AMK Perawat 40 22 4 1.8 32.7 75 10 10 4.3 77.73 Rp 190,363 Rp - Rp 190,363 13

14 Sri Adrianti, AMK Perawat 40 22 1.8 40.0 90 10 10 5.0 110.00 Rp 258,518 Rp - Rp 258,518 14

15 Nur Wahyuni, AMK Perawat 40 22 1.8 40.0 90 10 10 5.0 110.00 Rp 258,518 Rp - Rp 258,518 15

16 Musfiah Zainuddin, AMK Perawat 40 22 1.8 40.0 90 20 10 5.5 120.00 Rp 275,753 Rp - Rp 275,753 16

17 Andi Armita Dewi, AMK Perawat 40 22 1.8 40.0 90 10 10 5.0 110.00 Rp 258,518 Rp - Rp 258,518 17

18 Hasmirawati, AMK Perawat 40 22 1.8 40.0 90 10 25 5.7 125.00 Rp 284,370 Rp - Rp 284,370 18

19 Muh. Subhan, AMK Perawat 40 22 1.8 40.0 90 10 0 4.5 100.00 Rp 241,284 Rp - Rp 241,284 19

20 Musdalifah, MR,AMK Perawat 40 22 16 1.8 10.9 60 10 0 3.2 19.09 Rp 51,704 Rp - Rp 51,704 20


21 Muhammad Rum, AMK Perawat 40 22 4 1.8 32.7 75 10 0 3.9 69.55 Rp 176,262 Rp - Rp 176,262 21

22 Agustina, AMK Perawat 40 22 1.8 40.0 90 10 10 5.0 110.00 Rp 258,518 Rp - Rp 258,518 22

23 Risaldi Razak, AMK Perawat 40 22 4 1.8 32.7 75 10 0 3.9 69.55 Rp 176,262 Rp - Rp 176,262 23

24 Dewi Ahryani, AMK Perawat 40 22 1.8 40.0 90 10 0 4.5 100.00 Rp 241,284 Rp - Rp 241,284 24

25 Nurdamayanti, S.Kep III Perawat 60 22 3 2.7 51.8 75 30 40 6.6 125.23 Rp 305,130 Rp 15,256 Rp 289,873 25

26 Hj. Rostini AMG II Tenaga Penunjang 40 22 1.8 40.0 90 30 70 8.6 190.00 Rp 396,394 Rp Rp 396,394 26

27 Sri Sulastri AMK II Perawat 40 22 1.8 40.0 90 30 25 6.6 145.00 Rp 318,839 Rp - Rp 318,839 27

28 Agustini Tenaga Penunjang 15 22 0.7 15.0 90 20 25 6.1 135.00 Rp 258,518 Rp - Rp 258,518 28

29 Yurniati, A.Md.AK II Analis 40 22 1.8 40.0 90 30 25 6.6 145.00 Rp 318,839 Rp - Rp 318,839 29

30 Rosdiana III Analis 40 22 1.8 40.0 90 30 85 9.3 205.00 Rp 422,246 Rp 21,112 Rp 401,134 30

31 Normalina A.Md.AK II Analis 40 22 1.8 40.0 90 30 25 6.6 145.00 Rp 318,839 Rp - Rp 318,839 31

32 Yunarsih, AMAK Analis 40 22 1.8 40.0 90 10 10 5.0 110.00 Rp 258,518 Rp - Rp 258,518 32

33 Bustan II Perawat Gigi 40 22 1.8 40.0 90 30 40 7.3 160.00 Rp 344,691 Rp - Rp 344,691 33

34 Nur Indah Kurnianti III Teknik Gigi 40 22 1 1.8 38.2 90 30 40 7.3 152.73 Rp 329,023 Rp 16,451 Rp 312,572 34

35 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 40 22 30 3.2 70.0 90 30 70 8.6 190.00 Rp 448,098 Rp 22,405 Rp 425,693 35

36 St. Rosdiana, B.Sc III Perawat 40 22 1 1.8 38.2 90 30 100 10.0 210.00 Rp 427,730 Rp 21,386 Rp 406,343 36

37 Muhammad Nawir II Pel. Administrasi 15 22 0.7 15.0 90 30 25 6.6 145.00 Rp 275,753 Rp - Rp 275,753 37

38 Agustina Bintang,Amd.Keb III Tenaga Bidan 40 22 1.8 40.0 90 30 85 9.3 205.00 Rp 422,246 Rp 21,112 Rp 401,134 38

39 Nur Rahmawati, A.md.Keb II Tenaga Bidan 40 22 1.8 40.0 90 30 25 6.6 145.00 Rp 318,839 Rp - Rp 318,839 39

40 Suriati, A.md.Keb III Tenaga Bidan 40 22 1.8 40.0 90 30 25 6.6 145.00 Rp 318,839 Rp 15,942 Rp 302,897 40

41 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 40 22 1.8 40.0 90 30 25 6.6 145.00 Rp 318,839 Rp - Rp 318,839 41

42 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 40 22 1.8 40.0 90 30 25 6.6 145.00 Rp 318,839 Rp - Rp 318,839 42

43 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 40 22 11 1.8 20.0 60 10 0 3.2 35.00 Rp 94,790 Rp - Rp 94,790 43

44 Isnayani, Amd. Keb Tenaga Bidan 40 22 1.8 40.0 90 10 0 4.5 100.00 Rp 241,284 Rp - Rp 241,284 44

45 Andi Jemma, Amd.Keb Tenaga Bidan 40 22 1.8 40.0 90 30 10 5.9 130.00 Rp 292,987 Rp - Rp 292,987 45

46 Dewi Sartika, Amd.Keb Tenaga Bidan 40 22 4 1.8 32.7 75 10 10 4.3 77.73 Rp 190,363 Rp - Rp 190,363 46

47 Titin Sumarni, Amd.Keb Tenaga Bidan 40 22 1.8 40.0 90 10 0 4.5 100.00 Rp 241,284 Rp - Rp 241,284 47

48 Lisdayanti, A.md.Keb Tenaga Bidan 40 22 1.8 40.0 90 10 10 5.0 110.00 Rp 258,518 Rp - Rp 258,518 48

49 Yul Fitriani, Amd. Keb Tenaga Bidan 40 22 1.8 40.0 90 10 0 4.5 100.00 Rp 241,284 Rp - Rp 241,284 49
50 Andi Isna, Amd.Keb Tenaga Bidan 40 22 1.8 40.0 90 10 0 4.5 100.00 Rp 241,284 Rp - Rp 241,284 50

51 Citra Pratiwi, Amd.Keb Tenaga Bidan 40 22 1.8 40.0 90 10 0 4.5 100.00 Rp 241,284 Rp - Rp 241,284 51

52 Rosmiati, Amd.Keb Tenaga Bidan 40 22 7 1.8 27.3 75 20 0 4.3 64.77 Rp 158,636 Rp - Rp 158,636 52

53 Sri Wahyuni, Amd.Keb Tenaga Bidan 40 22 1.8 40.0 90 10 0 4.5 100.00 Rp 241,284 Rp - Rp 241,284 53

54 Sulastri, Amd.Keb Tenaga Bidan 40 22 1.8 40.0 90 10 0 4.5 100.00 Rp 241,284 Rp - Rp 241,284 54

55 Sulmiati Bahri Amd.Keb Tenaga Bidan 40 22 1.8 40.0 90 10 0 4.5 100.00 Rp 241,284 Rp - Rp 241,284 55

56 Ira Muliati Radi.Amd.Keb Tenaga Bidan 40 22 1.8 40.0 90 30 10 5.9 130.00 Rp 292,987 Rp - Rp 292,987 56

57 Rosidah, AMKL III Sanitarian 40 22 1.8 40.0 90 30 40 7.3 160.00 Rp 344,691 Rp 17,235 Rp 327,456 57

58 Israyana Yulianti AMKL III Sanitarian 40 22 1.8 40.0 90 30 40 7.3 160.00 Rp 344,691 Rp 17,235 Rp 327,456 58

59 Rostati, SKM III Tenaga Penunjang 60 22 2.7 60.0 90 30 40 7.3 160.00 Rp 379,160 Rp 18,958 Rp 360,202 59

60 Armawati, S.Kep III Perawat 60 22 2.7 60.0 90 30 40 7.3 160.00 Rp 379,160 Rp 18,958 Rp 360,202 60

61 Andi Rezki Wardani S.Kep Ns Perawat 100 22 4.5 100.0 90 10 0 4.5 100.00 Rp 344,691 Rp 17,235 Rp 327,456 61

62 Anna Marsela, AMK Perawat 40 22 1.8 40.0 90 10 0 4.5 100.00 Rp 241,284 Rp - Rp 241,284 62

63 Wa Ode Sinta Kalsum III Pelak. Gizi 40 22 1.8 40.0 90 30 70 8.6 190.00 Rp 396,394 Rp 19,820 Rp 376,575 63

64 Andi Megawati II Teknik Gigi 40 22 1.8 40.0 90 30 25 6.6 145.00 Rp 318,839 Rp - Rp 318,839 64

65 Rosmayanti, SKM Tenaga Penunjang 60 22 7 2.7 40.9 75 10 25 5.0 75.00 Rp 199,764 Rp 9,988 Rp 189,776 65

66 Sudirman H Tenaga Penunjang 15 22 0.7 15.0 90 20 25 6.1 135.00 Rp 258,518 Rp - Rp 258,518 66

67 Sri Rahmat Yani Nur III Perawat 40 22 1.8 40.0 90 30 70 8.6 190.00 Rp 396,394 Rp 19,820 Rp 376,575 67

68 Sri Wedari Yusuf, AMF Tenaga Penunjang 40 22 1.8 40.0 90 10 0 4.5 100.00 Rp 241,284 Rp - Rp 241,284 68

69 Hamriana Tenaga Penunjang 15 22 0.7 15.0 90 10 10 5.0 110.00 Rp 215,432 Rp - Rp 215,432 69

70 Santi Wardianti Amd.Keb Tenaga Bidan 40 22 22 1.8 - 50 10 10 3.2 0.00 Rp - Rp - Rp - 70

71 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 40 22 1.8 40.0 90 10 0 4.5 100.00 Rp 241,284 Rp - Rp 241,284 71

72 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 40 22 1.8 40.0 90 10 0 4.5 100.00 Rp 241,284 Rp - Rp 241,284 72

73 Desi Asriana, Amd.Keb Tenaga Bidan 40 22 1.8 40.0 90 10 0 4.5 100.00 Rp 241,284 Rp - Rp 241,284 73

74 Andi Rezkiiani Amd.Keb Tenaga Bidan 40 22 1.8 40.0 90 10 0 4.5 100.00 Rp 241,284 Rp - Rp 241,284 74

75 Bau Asni S.ST Tenaga Bidan 40 22 1.8 40.0 90 10 0 4.5 100.00 Rp 241,284 Rp - Rp 241,284 75

76 Hastuti, Amd.Keb Tenaga Bidan 40 22 1.8 40.0 90 10 0 4.5 100.00 Rp 241,284 Rp - Rp 241,284 76

77 Rosdiana Amd.Keb Tenaga Bidan 40 22 3 1.8 34.5 75 10 0 3.9 73.41 Rp 186,055 Rp - Rp 186,055 77

78 Nur Ilma, Amd.Keb Tenaga Bidan 40 22 1.8 40.0 90 30 55 8.0 175.00 Rp 370,543 Rp - Rp 370,543 78
79 Irmawati, Amd.Keb Tenaga Bidan 40 22 1.8 40.0 90 30 10 5.9 130.00 Rp 292,987 Rp - Rp 292,987 79

80 Ridha Arbiah, Amd.Keb II Tenaga Bidan 40 22 1.8 40.0 90 30 25 6.6 145.00 Rp 318,839 Rp - Rp 318,839 80

81 Ramlah, Amd.Keb Tenaga Bidan 40 22 1.8 40.0 90 30 10 5.9 130.00 Rp 292,987 Rp - Rp 292,987 81

82 Hermin Wahida III Perawat 40 22 1.8 40.0 90 30 55 8.0 175.00 Rp 370,543 Rp 18,527 Rp 352,016 82

83 Andi Jumrianti, Amd.Keb Tenaga Bidan 40 22 1.8 40.0 90 30 10 5.9 130.00 Rp 292,987 Rp - Rp 292,987 83

84 Yulianti, Amd.Keb Tenaga Bidan 40 22 5 1.8 30.9 75 30 10 5.2 88.86 Rp 206,423 Rp - Rp 206,423 84

85 Israwati Tenaga Penunjang 15 22 0.7 15.0 90 20 10 5.5 120.00 Rp 232,666 Rp - Rp 232,666 85

86 Andi Mas Muliani Tenaga Penunjang 15 22 0.7 15.0 90 10 10 5.0 110.00 Rp 215,432 Rp - Rp 215,432 86

87 Wahyuni, Amd.Keb II Tenaga Bidan 40 22 4 1.8 32.7 75 30 25 5.9 106.36 Rp 239,717 Rp - Rp 239,717 87

88 Andi Salmei, Amd.Keb Tenaga Bidan 40 22 1.8 40.0 90 30 10 5.9 130.00 Rp 292,987 Rp - Rp 292,987 88

89 Reski Arisanti Amelia Safitri, AMK Perawat 40 22 1.8 40.0 90 10 10 5.0 110.00 Rp 258,518 Rp - Rp 258,518 89

JUMLAH 3880 1958 133 90 180 3,684.1 7670 1860 2115 529 11009.8 Rp 25,324,200 Rp 569,837 Rp 24,754,363

Mengetahui / Menyetujui : Benteng, 05 Agustus 2015


Kepala UPTD Puskesmas Benteng Bendahara JKN

Dr. FRENGKI WIJAYA PETRUS MILU E.T, AMK


Pangkat : Pembina Nip 19710704 199103 1 009
NIP. 19790926 200604 1 023
150 30 24 151.25
25324200

42,207,000 7,035
42,207,000 7,035 25,324,200

325.00 Dr. Frengki Wiyaya ( Kepala Pu 14693.8636 25,324,200 15239.792 150

355.00 Dr. Zaenal Abidin 14693.8636 25,324,200 15239.792

173.86 Drg. Yunda Iswari 14693.8636 25,324,200 15239.792

260.00 Saribanong 14693.8636 25,324,200 15239.792 41,871,000 25,122,600

172.73 Muh. Ilham Tamrin 14693.8636 25,324,200 15239.792 41,871,000 16,748,400 6,699,360 10,049,040

260.00 Petrus Milu. ET.AMK (Bend. Pu 14693.8636 25,324,200 15239.792 41,871,000

167.27 Hj. Nur Azizal Hastati,AMK 14693.8636 25,324,200 15239.792 6,609,120 9,913,680

156.82 Nur Ariani, AMK 14693.8636 25,324,200

154.55 Rahma Yuliana, AMK 14693.8636 25,324,200 15239.792

185.00 Amsari Parida Amir, AMK 14693.8636 25,324,200 15239.792

108.18 Elsa Handayani, AMK 14693.8636 25,324,200 15239.792

139.09 Nadia Sri Damayanti AMK 14693.8636 25,324,200 15239.792

110.45 Muhrawati, AMK 14693.8636 25,324,200 15239.792

150.00 Sri Adrianti, AMK 14693.8636 25,324,200 15239.792 24,784,200

150.00 Nur Wahyuni, AMK 14693.8636 25,324,200 15239.792

160.00 Musfiah Zainuddin, AMK 14693.8636 25,324,200 15239.792

150.00 Andi Armita Dewi, AMK 14693.8636 25,324,200 15239.792

165.00 Hasmirawati, AMK 14693.8636 25,324,200 15239.792

140.00 Muh. Subhan, AMK 14693.8636 25,324,200 15239.792

30.00 Musdalifah, MR,AMK 14693.8636 25,324,200 15239.792


102.27 Muhammad Rum, AMK 14693.8636 25,324,200 15239.792

150.00 Agustina, AMK 14693.8636 25,324,200 15239.792

102.27 Risaldi Razak, AMK 14693.8636 25,324,200 15239.792

140.00 Dewi Ahryani, AMK 14693.8636 25,324,200 15239.792

177.05 Nurdamayanti, S.Kep 14693.8636 25,324,200 15239.792

230.00 Hj. Rostini AMG 14693.8636 25,324,200 15239.792

185.00 Sri Sulastri AMK 14693.8636 25,324,200 15239.792

150.00 Agustini 14693.8636 25,324,200 15239.792

185.00 Yurniati, A.Md.AK 14693.8636 25,324,200 15239.792

245.00 Rosdiana 14693.8636 25,324,200 15239.792

185.00 Normalina A.Md.AK 14693.8636 25,324,200 15239.792

150.00 Yunarsih, AMAK 14693.8636 25,324,200 15239.792

200.00 Bustan 14693.8636 25,324,200 15239.792

190.91 Nur Indah Kurnianti 14693.8636 25,324,200 15239.792

260.00 Muhammad Ali (TU Puskesmas 14693.8636 25,324,200 15239.792

248.18 St. Rosdiana, B.Sc 14693.8636 25,324,200 15239.792

160.00 Muhammad Nawir 14693.8636 25,324,200 15239.792

245.00 Agustina Bintang,Amd.Keb 14693.8636 25,324,200 15239.792

185.00 Nur Rahmawati, A.md.Keb 14693.8636 25,324,200 15239.792

185.00 Suriati, A.md.Keb 14693.8636 25,324,200 15239.792

185.00 Sitti Aminah Anas,Amd.Keb 14693.8636 25,324,200 15239.792

185.00 Sitti Suprihartini,Amd.Keb 14693.8636 25,324,200 15239.792

55.00 Mira Septari. R.S, Amd.Keb. 14693.8636 25,324,200 15239.792

140.00 Isnayani, Amd. Keb 14693.8636 25,324,200 15239.792

170.00 Andi Jemma, Amd.Keb 14693.8636 25,324,200 15239.792

110.45 Dewi Sartika, Amd.Keb 14693.8636 25,324,200 15239.792

140.00 Titin Sumarni, Amd.Keb 14693.8636 25,324,200 15239.792

150.00 Lisdayanti, A.md.Keb 14693.8636 25,324,200 15239.792

140.00 Yul Fitriani, Amd. Keb 14693.8636 25,324,200 15239.792


140.00 Andi Isna, Amd.Keb 14693.8636 25,324,200 15239.792

140.00 Citra Pratiwi, Amd.Keb 14693.8636 25,324,200 15239.792

92.05 Rosmiati, Amd.Keb 14693.8636 25,324,200 15239.792

140.00 Sri Wahyuni, Amd.Keb 14693.8636 25,324,200 15239.792

140.00 Sulastri, Amd.Keb 14693.8636 25,324,200 15239.792

140.00 Sulmiati Bahri Amd.Keb 14693.8636 25,324,200 15239.792

170.00 Ira Muliati Radi.Amd.Keb 14693.8636 25,324,200 15239.792

200.00 Rosidah, AMKL 14693.8636 25,324,200 15239.792

200.00 Israyana Yulianti AMKL 14693.8636 25,324,200 15239.792

220.00 Rostati, SKM 14693.8636 25,324,200 15239.792

220.00 Armawati, S.Kep 14693.8636 25,324,200 15239.792

200.00 Andi Rezki Wardani S.Kep Ns 14693.8636 25,324,200 15239.792

140.00 Anna Marsela, AMK 14693.8636 25,324,200 15239.792

230.00 Wa Ode Sinta Kalsum 14693.8636 25,324,200 15239.792

185.00 Andi Megawati 14693.8636 25,324,200 15239.792

115.91 Rosmayanti, SKM 14693.8636 25,324,200 15239.792

150.00 Sudirman H 14693.8636 25,324,200 15239.792

230.00 Sri Rahmat Yani Nur 14693.8636 25,324,200 15239.792

140.00 Sri Wedari Yusuf, AMF 14693.8636 25,324,200 15239.792

125.00 Hamriana 14693.8636 25,324,200 15239.792

- Santi Wardianti Amd.Keb 14693.8636 25,324,200 15239.792

140.00 Andi Tenri Ellung N, Amd.Keb 14693.8636 25,324,200 15239.792

140.00 Wahyuni Hamsah, Amd.Keb 14693.8636 25,324,200 15239.792

140.00 Desi Asriana, Amd.Keb 14693.8636 25,324,200 15239.792

140.00 Andi Rezkiiani Amd.Keb 14693.8636 25,324,200 15239.792

140.00 Bau Asni S.ST 14693.8636 25,324,200 15239.792

140.00 Hastuti, Amd.Keb 14693.8636 25,324,200 15239.792

107.95 Rosdiana Amd.Keb 14693.8636 25,324,200 15239.792

215.00 Nur Ilma, Amd.Keb 14693.8636 25,324,200 15239.792


170.00 Irmawati, Amd.Keb 14693.8636 25,324,200 15239.792

185.00 Ridha Arbiah, Amd.Keb 14693.8636 25,324,200 15239.792

170.00 Ramlah, Amd.Keb 14693.8636 25,324,200

215.00 Hermin Wahida 14693.8636 25,324,200 15239.792

170.00 Andi Jumrianti, Amd.Keb 14693.8636 25,324,200 15239.792

119.77 Yulianti, Amd.Keb 14693.8636 25,324,200 15239.792

135.00 Israwati 14693.8636 25,324,200 15239.792

125.00 Andi Mas Muliani 14693.8636 25,324,200 15239.792

139.09 Wahyuni, Amd.Keb 14693.8636 25,324,200 15239.792

170.00 Andi Salmei, Amd.Keb 14693.8636 25,324,200 15239.792

150.00 Reski Arisanti Amelia Safitri, 14693.8636 25,324,200 15239.792

14693.8636 14693.864
16,748,400 9975600

16,522,800
DAFTAR VARIABEL DAERAH SEBAGAI PENILAIAN TAMBAHAN DALAM MELAKUKAN PEMBAGIAN JASA PELAYANAN
JAMINAN KESEHATAN NASIONAL DI PUSKESMAS BENTENG BULAN JULI TAHUN 2015

VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK
NGAN PEGAWAI KERJA HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

1 Dr. Frengki Wiyaya ( Kepala Pusk IV Dokter Umum 90 30 25

2 Dr. Zaenal Abidin IV Dokter Umum 90 30 85

3 Drg. Yunda Iswari III Dokter Gigi 75 30 0 7

4 Saribanong III Perawat 90 30 100

5 Muh. Ilham Tamrin III Perawat 90 30 40 3

6 Petrus Milu. ET.AMK (Bend. Pusk III Perawat 90 30 70

7 Hj. Nur Azizal Hastati,AMK III Perawat 75 30 85 6

8 Nur Ariani, AMK III Perawat 75 30 85 7

9 Rahma Yuliana, AMK II Perawat 75 30 25 2

10 Amsari Parida Amir, AMK II Perawat 90 30 25

11 Elsa Handayani, AMK II Perawat 75 30 25 8

12 Nadia Sri Damayanti AMK II Perawat 75 30 25 4

13 Muhrawati, AMK Perawat 75 10 10 4

14 Sri Adrianti, AMK Perawat 90 10 10

15 Nur Wahyuni, AMK Perawat 90 10 10

16 Musfiah Zainuddin, AMK Perawat 90 20 10

17 Andi Armita Dewi, AMK Perawat 90 10 10

18 Hasmirawati, AMK Perawat 90 10 25

19 Muh. Subhan, AMK Perawat 90 10 0

20 Musdalifah, MR,AMK Perawat 60 10 0 16

21 Muhammad Rum, AMK Perawat 75 10 0 4

22 Agustina, AMK Perawat 90 10 10

23 Risaldi Razak, AMK Perawat 75 10 0 4

24 Dewi Ahryani, AMK Perawat 90 10 0

25 Nurdamayanti, S.Kep III Perawat 75 30 40 3

26 Hj. Rostini AMG II Tenaga Penunjang 90 30 70

27 Sri Sulastri AMK II Perawat 90 30 25

28 Agustini Tenaga Penunjang 90 20 25

29 Yurniati, A.Md.AK II Analis 90 30 25

30 Rosdiana III Analis 90 30 85

31 Normalina A.Md.AK II Analis 90 30 25

32 Yunarsih, AMAK Analis 90 10 10

33 Bustan II Perawat Gigi 90 30 40

34 Nur Indah Kurnianti III Teknik Gigi 90 30 40 1

35 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 90 30 70

36 St. Rosdiana, B.Sc III Perawat 90 30 100 1

37 Muhammad Nawir II Pel. Administrasi 90 30 25

38 Agustina Bintang,Amd.Keb III Tenaga Bidan 90 30 85

39 Nur Rahmawati, A.md.Keb II Tenaga Bidan 90 30 25

40 Suriati, A.md.Keb III Tenaga Bidan 90 30 25

41 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 90 30 25

42 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 90 30 25

43 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 60 10 0 11

44 Isnayani, Amd. Keb Tenaga Bidan 90 10 0


VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK
NGAN PEGAWAI KERJA HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

45 Andi Jemma, Amd.Keb Tenaga Bidan 90 30 10

46 Dewi Sartika, Amd.Keb Tenaga Bidan 75 10 10 4

47 Titin Sumarni, Amd.Keb Tenaga Bidan 90 10 0

48 Lisdayanti, A.md.Keb Tenaga Bidan 90 10 10

49 Yul Fitriani, Amd. Keb Tenaga Bidan 90 10 0

50 Andi Isna, Amd.Keb Tenaga Bidan 90 10 0

51 Citra Pratiwi, Amd.Keb Tenaga Bidan 90 10 0

52 Rosmiati, Amd.Keb Tenaga Bidan 75 20 0 7

53 Sri Wahyuni, Amd.Keb Tenaga Bidan 90 10 0

54 Sulastri, Amd.Keb Tenaga Bidan 90 10 0

55 Sulmiati Bahri Amd.Keb Tenaga Bidan 90 10 0

56 Ira Muliati Radi.Amd.Keb Tenaga Bidan 90 30 10

57 Rosidah, AMKL III Sanitarian 90 30 40

58 Israyana Yulianti AMKL III Sanitarian 90 30 40

59 Rostati, SKM III Tenaga Penunjang 90 30 40

60 Armawati, S.Kep III Perawat 90 30 40

61 Andi Rezki Wardani S.Kep Ns Perawat 90 10 0

62 Anna Marsela, AMK Perawat 90 10 0

63 Wa Ode Sinta Kalsum III Pelak. Gizi 90 30 70

64 Andi Megawati II Teknik Gigi 90 30 25

65 Rosmayanti, SKM Tenaga Penunjang 75 10 25 7

66 Sudirman H Tenaga Penunjang 90 20 25

67 Sri Rahmat Yani Nur III Perawat 90 30 70

68 Sri Wedari Yusuf, AMF Tenaga Penunjang 90 10 0

69 Hamriana Tenaga Penunjang 90 10 10

70 Santi Wardianti Amd.Keb Tenaga Bidan 50 10 10 22

71 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 90 10 0

72 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 90 10 0

73 Desi Asriana, Amd.Keb Tenaga Bidan 90 10 0

74 Andi Rezkiiani Amd.Keb Tenaga Bidan 90 10 0

75 Bau Asni S.ST Tenaga Bidan 90 10 0

76 Hastuti, Amd.Keb Tenaga Bidan 90 10 0

77 Rosdiana Amd.Keb Tenaga Bidan 75 10 0 3

78 Nur Ilma, Amd.Keb Tenaga Bidan 90 30 55

79 Irmawati, Amd.Keb Tenaga Bidan 90 30 10

80 Ridha Arbiah, Amd.Keb II Tenaga Bidan 90 30 25

81 Ramlah, Amd.Keb Tenaga Bidan 90 30 10

82 Hermin Wahida III Perawat 90 30 55

83 Andi Jumrianti, Amd.Keb Tenaga Bidan 90 30 10

84 Yulianti, Amd.Keb Tenaga Bidan 75 30 10 5

85 Israwati Tenaga Penunjang 90 20 10

86 Andi Mas Muliani Tenaga Penunjang 90 10 10


VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK
NGAN PEGAWAI KERJA HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

87 Wahyuni, Amd.Keb II Tenaga Bidan 75 30 25 4

88 Andi Salmei, Amd.Keb Tenaga Bidan 90 30 10

89 Reski Arisanti Amelia Safitri, AMK Perawat 90 10 10

JUMLAH 1860 2115

Mengetahui : Benteng, Agustus 2015


Kepala UPTD Puskesmas Benteng, Kasubag Tata Usaha,

Dr. Frengki Wijaya Muhammad Ali


Pangkat : Pembina Nip. 19641211 198903 1 019
Nip. 1979092 20004 1 023
DAFTAR PENERIMAAN JASA PELAYANAN KESEHATAN PESERTA JKN BAGI PETUGAS PUSKESMAS PUSTU DAN POSKEDES
BULAN AGUSTUS TAHUN 2015
PUSKESMAS : BENTENG
JUMLAH PESERTA : 7077 ORANG
JUMLAH PEGAWAI : 89 ORANG
BESARAN KAPITASI : 4.500 PERJIWA / BULAN
TOTAL KAPITASI : 31,846,500 TOTAL JASA PELAYANAN SESUAI SK BUPATI 60 % = 19,098,900.-

GOLO VARIABEL POINT POINT VARIABEL DAERAH POINT POINT JUMLAH PPH JUMLAH
NO NAMA PETUGAS NGAN JABATAN KETENA KEHADIRAN JABA /ORG /ORG KINER STATUS MASA /ORG /ORG DITERIMA PASAL 21 DIBAYARKAN TANDA TANGAN
GAAN EFEKTIF 1 BLNTDK HADIR TAN /HARI BULAN JA KEPEG KERJA HARI BULAN ( Rp ) ( 15% / 5% ) ( Rp )
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

1 Dr. Frengki Wiyaya ( Kepala Pusk) IV Dokter Umum 150 25 3 30 7.2 158.4 90 30 25 5.8 127.60 Rp 369,653 Rp 55,448 Rp 314,205 1

2 Dr. Zaenal Abidin IV Dokter Umum 150 25 6.0 150.0 90 30 85 8.2 205.00 Rp 458,835 Rp 68,825 Rp 390,010 2

3 Drg. Yunda Iswari III Dokter Gigi 150 25 6.0 150.0 90 30 0 4.8 120.00 Rp 348,973 Rp 17,449 Rp 331,524 3

4 Saribanong III Perawat 40 25 1.6 40.0 90 30 100 8.8 220.00 Rp 336,048 Rp 16,802 Rp 319,246 4

5 Muh. Ilham Tamrin III Perawat 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 258,498 Rp 12,925 Rp 245,574 5

6 Petrus Milu. ET.AMK (Bend. Pusk) III Perawat 40 25 30 2.8 70.0 90 30 70 7.6 190.00 Rp 336,048 Rp 16,802 Rp 319,246 6

7 Hj. Nur Azizal Hastati,AMK III Perawat 40 25 1.6 40.0 90 30 85 8.2 205.00 Rp 316,661 Rp 15,833 Rp 300,828 7

8 Nur Ariani, AMK III Perawat 40 25 6 1.6 30.4 75 30 85 7.6 144.40 Rp 225,928 Rp 11,296 Rp 214,631 8

9 Rahma Yuliana, AMK II Perawat 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 239,111 Rp - Rp 239,111 9

10 Amsari Parida Amir, AMK II Perawat 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 239,111 Rp - Rp 239,111 10

11 Elsa Handayani, AMK II Perawat 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 239,111 Rp - Rp 239,111 11

12 Nadia Sri Damayanti AMK II Perawat 40 25 12 1.6 20.8 60 30 25 4.6 59.80 Rp 104,175 Rp - Rp 104,175 12

13 Muhrawati, AMK Perawat 40 25 2 1.6 36.8 90 10 10 4.4 101.20 Rp 178,364 Rp - Rp 178,364 13

14 Sri Adrianti, AMK Perawat 40 25 5 1.6 32.0 60 10 10 3.2 64.00 Rp 124,079 Rp - Rp 124,079 14

15 Nur Wahyuni, AMK Perawat 40 25 1 1.6 38.4 90 10 10 4.4 105.60 Rp 186,119 Rp - Rp 186,119 15

16 Musfiah Zainuddin, AMK Perawat 40 25 1.6 40.0 90 20 10 4.8 120.00 Rp 206,799 Rp - Rp 206,799 16

17 Andi Armita Dewi, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 193,874 Rp - Rp 193,874 17

18 Hasmirawati, AMK Perawat 40 25 11 1.6 22.4 60 10 25 3.8 53.20 Rp 97,712 Rp - Rp 97,712 18

19 Muh. Subhan, AMK Perawat 40 25 8 1.6 27.2 75 10 0 3.4 57.80 Rp 109,862 Rp - Rp 109,862 19

20 Musdalifah, MR,AMK Perawat 40 25 4 1.6 33.6 90 10 0 4.0 84.00 Rp 151,997 Rp - Rp 151,997 20


21 Muhammad Rum, AMK Perawat 40 25 10 1.6 24.0 75 10 0 3.4 51.00 Rp 96,937 Rp - Rp 96,937 21

22 Agustina, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 193,874 Rp - Rp 193,874 22

23 Risaldi Razak, AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 180,949 Rp - Rp 180,949 23

24 Dewi Ahryani, AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 180,949 Rp - Rp 180,949 24

25 Nurdamayanti, S.Kep III Perawat 60 25 4 2.4 50.4 90 30 40 6.4 134.40 Rp 238,853 Rp 11,943 Rp 226,910 25

26 Hj. Rostini AMG II Tenaga Penunjang 40 25 1.6 40.0 90 30 70 7.6 190.00 Rp 297,273 Rp Rp 297,273 26

27 Sri Sulastri AMK II Perawat 40 25 6 1.6 30.4 60 30 25 4.6 87.40 Rp 152,256 Rp - Rp 152,256 27

28 Agustini Tenaga Penunjang 15 25 0.6 15.0 90 20 25 5.4 135.00 Rp 193,874 Rp - Rp 193,874 28

29 Yurniati, A.Md.AK II Analis 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 239,111 Rp - Rp 239,111 29

30 Rosdiana III Analis 40 25 4 1.6 33.6 90 30 85 8.2 172.20 Rp 265,995 Rp 13,300 Rp 252,695 30

31 Normalina A.Md.AK II Analis 40 25 7 1.6 28.8 60 30 25 4.6 82.80 Rp 144,242 Rp - Rp 144,242 31

32 Yunarsih, AMAK Analis 40 25 2 1.6 36.8 90 10 10 4.4 101.20 Rp 178,364 Rp - Rp 178,364 32

33 Bustan II Perawat Gigi 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 258,498 Rp - Rp 258,498 33

34 Nur Indah Kurnianti III Teknik Gigi 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 258,498 Rp 12,925 Rp 245,574 34

35 Rohani III Perawat Gigi 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 258,498 Rp - Rp 258,498 35

36 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 40 25 30 2.8 70.0 90 30 70 7.6 190.00 Rp 336,048 Rp 16,802 Rp 319,246 36

37 St. Rosdiana, B.Sc III Perawat 40 25 1.6 40.0 90 30 100 8.8 220.00 Rp 336,048 Rp 16,802 Rp 319,246 37

38 Muhammad Nawir II Pel. Administrasi 15 25 0.6 15.0 90 30 25 5.8 145.00 Rp 206,799 Rp - Rp 206,799 38

39 Agustina Bintang,Amd.Keb III Tenaga Bidan 40 25 1.6 40.0 90 30 85 8.2 205.00 Rp 316,661 Rp 15,833 Rp 300,828 39

40 Nur Rahmawati, A.md.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 239,111 Rp - Rp 239,111 40

41 Suriati, A.md.Keb III Tenaga Bidan 40 25 6 1.6 30.4 60 30 25 4.6 87.40 Rp 152,256 Rp 7,613 Rp 144,643 41

42 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 239,111 Rp - Rp 239,111 42

43 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 40 25 6 1.6 30.4 60 30 25 4.6 87.40 Rp 152,256 Rp - Rp 152,256 43

44 Andi Yulianti, Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 239,111 Rp - Rp 239,111 44

45 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 40 25 6 1.6 30.4 75 10 0 3.4 64.60 Rp 122,787 Rp - Rp 122,787 45

46 Isnayani, Amd. Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 180,949 Rp - Rp 180,949 46

47 Andi Jemma, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 219,724 Rp - Rp 219,724 47

48 Dewi Sartika, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 193,874 Rp - Rp 193,874 48

49 Titin Sumarni, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 180,949 Rp - Rp 180,949 49
50 Lisdayanti, A.md.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 193,874 Rp - Rp 193,874 50

51 Yul Fitriani, Amd. Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 180,949 Rp - Rp 180,949 51

52 Andi Isna, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 180,949 Rp - Rp 180,949 52

53 Citra Pratiwi, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 180,949 Rp - Rp 180,949 53

54 Rosmiati, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 20 0 4.4 110.00 Rp 193,874 Rp - Rp 193,874 54

55 Sri Wahyuni, Amd.Keb Tenaga Bidan 40 25 7 1.6 28.8 60 10 0 2.8 50.40 Rp 102,365 Rp - Rp 102,365 55

56 Sulastri, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 180,949 Rp - Rp 180,949 56

57 Sulmiati Bahri Amd.Keb Tenaga Bidan 40 25 4 1.6 33.6 60 10 0 2.8 58.80 Rp 119,426 Rp - Rp 119,426 57

58 Ira Muliati Radi.Amd.Keb Tenaga Bidan 40 25 4 1.6 33.6 60 30 10 4.0 84.00 Rp 151,997 Rp - Rp 151,997 58

59 Rosidah, AMKL III Sanitarian 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 258,498 Rp 12,925 Rp 245,574 59

60 Israyana Yulianti AMKL III Sanitarian 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 258,498 Rp 12,925 Rp 245,574 60

61 Armawati, S.Kep III Perawat 60 25 2.4 60.0 90 30 40 6.4 160.00 Rp 284,348 Rp 14,217 Rp 270,131 61

62 Andi Rezki Wardani S.Kep Ns Perawat 100 25 4.0 100.0 90 10 0 4.0 100.00 Rp 258,498 Rp 12,925 Rp 245,574 62

63 Wa Ode Sinta Kalsum III Pelak. Gizi 40 25 1.6 40.0 90 30 70 7.6 190.00 Rp 297,273 Rp 14,864 Rp 282,410 63

64 Andi Megawati II Teknik Gigi 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 239,111 Rp - Rp 239,111 64

65 Rosmayanti, SKM Tenaga Penunjang 60 25 2.4 60.0 90 10 25 5.0 125.00 Rp 239,111 Rp 11,956 Rp 227,156 65

66 Sudirman H Tenaga Penunjang 15 25 0.6 15.0 90 20 25 5.4 135.00 Rp 193,874 Rp - Rp 193,874 66

67 Sri Rahmat Yani Nur III Perawat 40 25 1.6 40.0 90 30 70 7.6 190.00 Rp 297,273 Rp 14,864 Rp 282,410 67

68 Sri Wedari Yusuf, AMF Tenaga Penunjang 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 180,949 Rp - Rp 180,949 68

69 Hamriana Tenaga Penunjang 15 25 0.6 15.0 90 10 10 4.4 110.00 Rp 161,562 Rp - Rp 161,562 69

70 Hj. Syahraeni, AMK II Perawat 40 25 1.6 40.0 60 30 25 4.6 115.00 Rp 200,336 Rp - Rp 200,336 70

71 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 180,949 Rp - Rp 180,949 71

72 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 180,949 Rp - Rp 180,949 72

73 Desi Asriana, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 180,949 Rp - Rp 180,949 73

74 Andi Rezkiiani Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 180,949 Rp - Rp 180,949 74

75 Bau Asni S.ST Tenaga Bidan 40 25 6 1.6 30.4 75 10 0 3.4 64.60 Rp 122,787 Rp - Rp 122,787 75

76 Hastuti, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 180,949 Rp - Rp 180,949 76

77 Rosdiana Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 180,949 Rp - Rp 180,949 77

78 Nur Ilma, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 55 7.0 175.00 Rp 277,886 Rp - Rp 277,886 78
79 Irmawati, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 219,724 Rp - Rp 219,724 79

80 Ridha Arbiah, Amd.Keb II Tenaga Bidan 40 25 5 1.6 32.0 75 30 25 5.2 104.00 Rp 175,779 Rp - Rp 175,779 80

81 Ramlah, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 219,724 Rp - Rp 219,724 81

82 Hermin Wahida III Perawat 40 25 1.6 40.0 90 30 55 7.0 175.00 Rp 277,886 Rp 13,894 Rp 263,992 82

83 Andi Jumrianti, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 219,724 Rp - Rp 219,724 83

84 Yulianti, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 219,724 Rp - Rp 219,724 84

85 Israwati Tenaga Penunjang 15 25 0.6 15.0 90 20 10 4.8 120.00 Rp 174,486 Rp - Rp 174,486 85

86 Andi Mas Muliani Tenaga Penunjang 15 25 0.6 15.0 90 10 10 4.4 110.00 Rp 161,562 Rp - Rp 161,562 86

87 Wahyuni, Amd.Keb II Tenaga Bidan 40 25 4 1.6 33.6 90 30 25 5.8 121.80 Rp 200,853 Rp - Rp 200,853 87

88 Andi Salmei, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 219,724 Rp - Rp 219,724 88

89 Reski Arisanti Amelia Safitri, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 193,874 Rp - Rp 193,874 89

JUMLAH 3860 2225 133 90 158 3,717.2 7590 1900 2155 466 11059.6 Rp 19,098,900 Rp 419,168 Rp 18,679,732

Mengetahui / Menyetujui : Benteng, 05 September 2015


Kepala UPTD Puskesmas Benteng Bendahara JKN

Dr. FRENGKI WIJAYA PETRUS MILU E.T, AMK


Pangkat : Pembina Nip 19710704 199103 1 009
NIP. 19790926 200604 1 023
150 30 24 151.25
25324200

31,831,500 5,305
31,831,500 5,305 19,098,900

286.00 Dr. Frengki Wiyaya ( Kepala Pus 14776.8000 19,098,900 15239.792 150

355.00 Dr. Zaenal Abidin 14776.8000 19,098,900 15239.792

270.00 Drg. Yunda Iswari 14776.8000 19,098,900 15239.792

260.00 Saribanong 14776.8000 19,098,900 15239.792 41,871,000 25,122,600

200.00 Muh. Ilham Tamrin 14776.8000 19,098,900 15239.792 41,871,000 16,748,400 6,699,360

260.00 Petrus Milu. ET.AMK (Bend. Pus 14776.8000 19,098,900 15239.792 41,871,000

245.00 Hj. Nur Azizal Hastati,AMK 14776.8000 19,098,900 15239.792 6,609,120

174.80 Nur Ariani, AMK 14776.8000 19,098,900

185.00 Rahma Yuliana, AMK 14776.8000 19,098,900 15239.792

185.00 Amsari Parida Amir, AMK 14776.8000 19,098,900 15239.792

185.00 Elsa Handayani, AMK 14776.8000 19,098,900 15239.792

80.60 Nadia Sri Damayanti AMK 14776.8000 19,098,900 15239.792

138.00 Muhrawati, AMK 14776.8000 19,098,900 15239.792

96.00 Sri Adrianti, AMK 14776.8000 19,098,900 15239.792 24,784,200

144.00 Nur Wahyuni, AMK 14776.8000 19,098,900 15239.792

160.00 Musfiah Zainuddin, AMK 14776.8000 19,098,900 15239.792

150.00 Andi Armita Dewi, AMK 14776.8000 19,098,900 15239.792

75.60 Hasmirawati, AMK 14776.8000 19,098,900 15239.792

85.00 Muh. Subhan, AMK 14776.8000 19,098,900 15239.792

117.60 Musdalifah, MR,AMK 14776.8000 19,098,900 15239.792


75.00 Muhammad Rum, AMK 14776.8000 19,098,900 15239.792

150.00 Agustina, AMK 14776.8000 19,098,900 15239.792

140.00 Risaldi Razak, AMK 14776.8000 19,098,900 15239.792

140.00 Dewi Ahryani, AMK 14776.8000 19,098,900 15239.792

184.80 Nurdamayanti, S.Kep 14776.8000 19,098,900 15239.792

230.00 Hj. Rostini AMG 14776.8000 19,098,900 15239.792

117.80 Sri Sulastri AMK 14776.8000 19,098,900 15239.792

150.00 Agustini 14776.8000 19,098,900 15239.792

185.00 Yurniati, A.Md.AK 14776.8000 19,098,900 15239.792

205.80 Rosdiana 14776.8000 19,098,900 15239.792

111.60 Normalina A.Md.AK 14776.8000 19,098,900 15239.792

138.00 Yunarsih, AMAK 14776.8000 19,098,900 15239.792

200.00 Bustan 14776.8000 19,098,900 15239.792

200.00 Nur Indah Kurnianti 14776.8000 19,098,900 15239.792

200.00 Rohani 14776.8000 19,098,900

260.00 Muhammad Ali (TU Puskesmas) 14776.8000 19,098,900 15239.792

260.00 St. Rosdiana, B.Sc 14776.8000 19,098,900 15239.792

160.00 Muhammad Nawir 14776.8000 19,098,900 15239.792

245.00 Agustina Bintang,Amd.Keb 14776.8000 19,098,900 15239.792

185.00 Nur Rahmawati, A.md.Keb 14776.8000 19,098,900 15239.792

117.80 Suriati, A.md.Keb 14776.8000 19,098,900 15239.792

185.00 Sitti Aminah Anas,Amd.Keb 14776.8000 19,098,900 15239.792

117.80 Sitti Suprihartini,Amd.Keb 14776.8000 19,098,900 15239.792

185.00 Andi Yulianti, Amd.Keb 14776.8000 19,098,900

95.00 Mira Septari. R.S, Amd.Keb. 14776.8000 19,098,900 15239.792

140.00 Isnayani, Amd. Keb 14776.8000 19,098,900 15239.792

170.00 Andi Jemma, Amd.Keb 14776.8000 19,098,900 15239.792

150.00 Dewi Sartika, Amd.Keb 14776.8000 19,098,900 15239.792

140.00 Titin Sumarni, Amd.Keb 14776.8000 19,098,900 15239.792


150.00 Lisdayanti, A.md.Keb 14776.8000 19,098,900 15239.792

140.00 Yul Fitriani, Amd. Keb 14776.8000 19,098,900 15239.792

140.00 Andi Isna, Amd.Keb 14776.8000 19,098,900 15239.792

140.00 Citra Pratiwi, Amd.Keb 14776.8000 19,098,900 15239.792

150.00 Rosmiati, Amd.Keb 14776.8000 19,098,900 15239.792

79.20 Sri Wahyuni, Amd.Keb 14776.8000 19,098,900 15239.792

140.00 Sulastri, Amd.Keb 14776.8000 19,098,900 15239.792

92.40 Sulmiati Bahri Amd.Keb 14776.8000 19,098,900 15239.792

117.60 Ira Muliati Radi.Amd.Keb 14776.8000 19,098,900 15239.792

200.00 Rosidah, AMKL 14776.8000 19,098,900 15239.792

200.00 Israyana Yulianti AMKL 14776.8000 19,098,900 15239.792

220.00 Armawati, S.Kep 14776.8000 19,098,900 15239.792

200.00 Andi Rezki Wardani S.Kep Ns 14776.8000 19,098,900 15239.792

230.00 Wa Ode Sinta Kalsum 14776.8000 19,098,900 15239.792

185.00 Andi Megawati 14776.8000 19,098,900 15239.792

185.00 Rosmayanti, SKM 14776.8000 19,098,900 15239.792

150.00 Sudirman H 14776.8000 19,098,900 15239.792

230.00 Sri Rahmat Yani Nur 14776.8000 19,098,900 15239.792

140.00 Sri Wedari Yusuf, AMF 14776.8000 19,098,900 15239.792

125.00 Hamriana 14776.8000 19,098,900 15239.792

155.00 Hj. Syahraeni, AMK 14776.8000 19,098,900 15239.792

140.00 Andi Tenri Ellung N, Amd.Keb 14776.8000 19,098,900 15239.792

140.00 Wahyuni Hamsah, Amd.Keb 14776.8000 19,098,900 15239.792

140.00 Desi Asriana, Amd.Keb 14776.8000 19,098,900 15239.792

140.00 Andi Rezkiiani Amd.Keb 14776.8000 19,098,900 15239.792

95.00 Bau Asni S.ST 14776.8000 19,098,900 15239.792

140.00 Hastuti, Amd.Keb 14776.8000 19,098,900 15239.792

140.00 Rosdiana Amd.Keb 14776.8000 19,098,900 15239.792

215.00 Nur Ilma, Amd.Keb 14776.8000 19,098,900 15239.792


170.00 Irmawati, Amd.Keb 14776.8000 19,098,900 15239.792

136.00 Ridha Arbiah, Amd.Keb 14776.8000 19,098,900 15239.792

170.00 Ramlah, Amd.Keb 14776.8000 19,098,900 15239.792

215.00 Hermin Wahida 14776.8000 19,098,900 15239.792

170.00 Andi Jumrianti, Amd.Keb 14776.8000 19,098,900

170.00 Yulianti, Amd.Keb 14776.8000 19,098,900 15239.792

135.00 Israwati 14776.8000 19,098,900 15239.792

125.00 Andi Mas Muliani 14776.8000 19,098,900 15239.792

155.40 Wahyuni, Amd.Keb 14776.8000 19,098,900 15239.792

170.00 Andi Salmei, Amd.Keb 14776.8000 19,098,900 15239.792

150.00 Reski Arisanti Amelia Safitri, AM 14776.8000 19,098,900 15239.792

14776.8000 14776.800
10,049,040 16,748,400 9975600

9,913,680 16,522,800
DAFTAR VARIABEL DAERAH SEBAGAI PENILAIAN TAMBAHAN DALAM MELAKUKAN PEMBAGIAN JASA PELAYANAN
JAMINAN KESEHATAN NASIONAL DI PUSKESMAS BENTENG BULAN AGUSTUS TAHUN 2015

VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK
NGAN PEGAWAI KERJA HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

1 Dr. Frengki Wiyaya ( Kepala Pusk IV Dokter Umum 90 30 25 3

2 Dr. Zaenal Abidin IV Dokter Umum 90 30 85

3 Drg. Yunda Iswari III Dokter Gigi 90 30 0

4 Saribanong III Perawat 90 30 100

5 Muh. Ilham Tamrin III Perawat 90 30 40

6 Petrus Milu. ET.AMK (Bend. Pusk III Perawat 90 30 70

7 Hj. Nur Azizal Hastati,AMK III Perawat 90 30 85

8 Nur Ariani, AMK III Perawat 75 30 85 6

9 Rahma Yuliana, AMK II Perawat 90 30 25

10 Amsari Parida Amir, AMK II Perawat 90 30 25

11 Elsa Handayani, AMK II Perawat 90 30 25

12 Nadia Sri Damayanti AMK II Perawat 60 30 25 12

13 Muhrawati, AMK Perawat 90 10 10 2

14 Sri Adrianti, AMK Perawat 60 10 10 5

15 Nur Wahyuni, AMK Perawat 90 10 10 1

16 Musfiah Zainuddin, AMK Perawat 90 20 10

17 Andi Armita Dewi, AMK Perawat 90 10 10

18 Hasmirawati, AMK Perawat 60 10 25 11

19 Muh. Subhan, AMK Perawat 75 10 0 8

20 Musdalifah, MR,AMK Perawat 90 10 0 4

21 Muhammad Rum, AMK Perawat 75 10 0 10

22 Agustina, AMK Perawat 90 10 10

23 Risaldi Razak, AMK Perawat 90 10 0

24 Dewi Ahryani, AMK Perawat 90 10 0

25 Nurdamayanti, S.Kep III Perawat 90 30 40 4

26 Hj. Rostini AMG II Tenaga Penunjang 90 30 70

27 Sri Sulastri AMK II Perawat 60 30 25 6

28 Agustini Tenaga Penunjang 90 20 25

29 Yurniati, A.Md.AK II Analis 90 30 25

30 Rosdiana III Analis 90 30 85 4

31 Normalina A.Md.AK II Analis 60 30 25 7

32 Yunarsih, AMAK Analis 90 10 10 2

33 Bustan II Perawat Gigi 90 30 40

34 Nur Indah Kurnianti III Teknik Gigi 90 30 40

35 Rohani III Perawat Gigi 90 30 40

36 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 90 30 70

37 St. Rosdiana, B.Sc III Perawat 90 30 100

38 Muhammad Nawir II Pel. Administrasi 90 30 25

39 Agustina Bintang,Amd.Keb III Tenaga Bidan 90 30 85

40 Nur Rahmawati, A.md.Keb II Tenaga Bidan 90 30 25

41 Suriati, A.md.Keb III Tenaga Bidan 60 30 25 6

42 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 90 30 25

43 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 60 30 25 6

44 Andi Yulianti, Amd.Keb II Tenaga Bidan 90 30 25


VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK
NGAN PEGAWAI KERJA HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

45 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 75 10 0 6

46 Isnayani, Amd. Keb Tenaga Bidan 90 10 0

47 Andi Jemma, Amd.Keb Tenaga Bidan 90 30 10

48 Dewi Sartika, Amd.Keb Tenaga Bidan 90 10 10

49 Titin Sumarni, Amd.Keb Tenaga Bidan 90 10 0

50 Lisdayanti, A.md.Keb Tenaga Bidan 90 10 10

51 Yul Fitriani, Amd. Keb Tenaga Bidan 90 10 0

52 Andi Isna, Amd.Keb Tenaga Bidan 90 10 0

53 Citra Pratiwi, Amd.Keb Tenaga Bidan 90 10 0

54 Rosmiati, Amd.Keb Tenaga Bidan 90 20 0

55 Sri Wahyuni, Amd.Keb Tenaga Bidan 60 10 0 7

56 Sulastri, Amd.Keb Tenaga Bidan 90 10 0

57 Sulmiati Bahri Amd.Keb Tenaga Bidan 60 10 0 4

58 Ira Muliati Radi.Amd.Keb Tenaga Bidan 60 30 10 4

59 Rosidah, AMKL III Sanitarian 90 30 40

60 Israyana Yulianti AMKL III Sanitarian 90 30 40

61 Armawati, S.Kep III Perawat 90 30 40

62 Andi Rezki Wardani S.Kep Ns Perawat 90 10 0

63 Wa Ode Sinta Kalsum III Pelak. Gizi 90 30 70

64 Andi Megawati II Teknik Gigi 90 30 25

65 Rosmayanti, SKM Tenaga Penunjang 90 10 25

66 Sudirman H Tenaga Penunjang 90 20 25

67 Sri Rahmat Yani Nur III Perawat 90 30 70

68 Sri Wedari Yusuf, AMF Tenaga Penunjang 90 10 0

69 Hamriana Tenaga Penunjang 90 10 10

70 Hj. Syahraeni, AMK II Perawat 60 30 25

71 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 90 10 0

72 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 90 10 0

73 Desi Asriana, Amd.Keb Tenaga Bidan 90 10 0

74 Andi Rezkiiani Amd.Keb Tenaga Bidan 90 10 0

75 Bau Asni S.ST Tenaga Bidan 75 10 0 6

76 Hastuti, Amd.Keb Tenaga Bidan 90 10 0

77 Rosdiana Amd.Keb Tenaga Bidan 90 10 0

78 Nur Ilma, Amd.Keb Tenaga Bidan 90 30 55

79 Irmawati, Amd.Keb Tenaga Bidan 90 30 10

80 Ridha Arbiah, Amd.Keb II Tenaga Bidan 75 30 25 5

81 Ramlah, Amd.Keb Tenaga Bidan 90 30 10

82 Hermin Wahida III Perawat 90 30 55

83 Andi Jumrianti, Amd.Keb Tenaga Bidan 90 30 10

84 Yulianti, Amd.Keb Tenaga Bidan 90 30 10

85 Israwati Tenaga Penunjang 90 20 10

86 Andi Mas Muliani Tenaga Penunjang 90 10 10


VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK
NGAN PEGAWAI KERJA HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

87 Wahyuni, Amd.Keb II Tenaga Bidan 90 30 25

88 Andi Salmei, Amd.Keb Tenaga Bidan 90 30 10

89 Reski Arisanti Amelia Safitri, AMK Perawat 90 10 10

JUMLAH 1900 2155

Mengetahui : Benteng, 05 September 2015


Kepala UPTD Puskesmas Benteng, Kasubag Tata Usaha,

Dr. Frengki Wijaya Muhammad Ali


Pangkat : Pembina Nip. 19641211 198903 1 019
Nip. 1979092 20004 1 023
DAFTAR PENERIMAAN JASA PELAYANAN KESEHATAN PESERTA JKN BAGI PETUGAS PUSKESMAS PUSTU DAN POSKEDES
BULAN SEPTEMBER TAHUN 2015
PUSKESMAS : BENTENG
JUMLAH PESERTA : 7147 ORANG
JUMLAH PEGAWAI : 85 ORANG
BESARAN KAPITASI : 4.500 PERJIWA / BULAN
TOTAL KAPITASI : 32,119,500 TOTAL JASA PELAYANAN SESUAI SK BUPATI 60 % = 19,271,700.-

GOLO VARIABEL POINT POINT VARIABEL DAERAH POINT POINT JUMLAH PPH JUMLAH
NO NAMA PETUGAS NGAN JABATAN KETENA KEHADIRAN JABA /ORG /ORG KINER STATUS MASA /ORG /ORG DITERIMA PASAL 21 DIBAYARKAN TANDA TANGAN
GAAN EFEKTIF 1 BLNTDK HADIR TAN /HARI BULAN JA KEPEG KERJA HARI BULAN ( Rp ) ( 15% / 5% ) ( Rp )
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

1 Dr. Frengki Wiyaya ( Kepala Pusk) IV Dokter Umum 150 25 4 30 7.2 151.2 90 30 25 5.8 121.80 Rp 360,854 Rp 54,128 Rp 306,726 1

2 Dr. Zaenal Abidin IV Dokter Umum 150 25 6.0 150.0 90 30 85 8.2 205.00 Rp 469,242 Rp 70,386 Rp 398,856 2

3 Drg. Yunda Iswari III Dokter Gigi 150 25 7 6.0 108.0 75 30 0 4.2 75.60 Rp 242,684 Rp 12,134 Rp 230,550 3

4 Saribanong III Perawat 40 25 1.6 40.0 90 30 100 8.8 220.00 Rp 343,670 Rp 17,184 Rp 326,487 4

5 Muh. Ilham Tamrin III Perawat 40 25 5 1.6 32.0 90 30 40 6.4 128.00 Rp 211,489 Rp 10,574 Rp 200,915 5

6 Petrus Milu. ET.AMK (Bend. Pusk) III Perawat 40 25 30 2.8 70.0 90 30 70 7.6 190.00 Rp 343,670 Rp 17,184 Rp 326,487 6

7 Hj. Nur Azizal Hastati,AMK III Perawat 40 25 1.6 40.0 90 30 85 8.2 205.00 Rp 323,843 Rp 16,192 Rp 307,651 7

8 Nur Ariani, AMK III Perawat 40 25 5 1.6 32.0 90 30 85 8.2 164.00 Rp 259,074 Rp 12,954 Rp 246,121 8

9 Rahma Yuliana, AMK II Perawat 40 25 3 1.6 35.2 90 30 25 5.8 127.60 Rp 215,190 Rp - Rp 215,190 9

10 Amsari Parida Amir, AMK II Perawat 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 244,535 Rp - Rp 244,535 10

11 Elsa Handayani, AMK II Perawat 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 244,535 Rp - Rp 244,535 11

12 Nadia Sri Damayanti AMK II Perawat 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 244,535 Rp - Rp 244,535 12

13 Muhrawati, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 198,271 Rp - Rp 198,271 13

14 Sri Adrianti, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 198,271 Rp - Rp 198,271 14

15 Nur Wahyuni, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 198,271 Rp - Rp 198,271 15

16 Musfiah Zainuddin, AMK Perawat 40 25 4 1.6 33.6 90 20 10 4.8 100.80 Rp 177,651 Rp - Rp 177,651 16

17 Andi Armita Dewi, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 198,271 Rp - Rp 198,271 17

18 Hasmirawati, AMK Perawat 40 25 1.6 40.0 90 10 25 5.0 125.00 Rp 218,098 Rp - Rp 218,098 18

19 Muh. Subhan, AMK Perawat 40 25 4 1.6 33.6 90 10 0 4.0 84.00 Rp 155,445 Rp - Rp 155,445 19

20 Musdalifah, MR,AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 185,053 Rp - Rp 185,053 20


21 Muhammad Rum, AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 185,053 Rp - Rp 185,053 21

22 Agustina, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 198,271 Rp - Rp 198,271 22

23 Risaldi Razak, AMK Perawat 40 25 3 1.6 35.2 90 10 0 4.0 88.00 Rp 162,847 Rp - Rp 162,847 23

24 Dewi Ahryani, AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 185,053 Rp - Rp 185,053 24

25 Hj. Rostini AMG II Tenaga Penunjang 40 25 1.6 40.0 90 30 70 7.6 190.00 Rp 304,016 Rp Rp 304,016 25

26 Agustini Tenaga Penunjang 15 25 0.6 15.0 90 20 25 5.4 135.00 Rp 198,271 Rp - Rp 198,271 26

27 Yurniati, A.Md.AK II Analis 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 244,535 Rp - Rp 244,535 27

28 Rosdiana III Analis 40 25 1.6 40.0 90 30 85 8.2 205.00 Rp 323,843 Rp 16,192 Rp 307,651 28

29 Yunarsih, AMAK Analis 40 25 6 1.6 30.4 90 10 10 4.4 83.60 Rp 150,686 Rp - Rp 150,686 29

30 Bustan II Perawat Gigi 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 264,362 Rp - Rp 264,362 30

31 Nur Indah Kurnianti III Teknik Gigi 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 264,362 Rp 13,218 Rp 251,144 31

32 Rohani III Perawat Gigi 40 25 1 1.6 38.4 90 30 40 6.4 153.60 Rp 253,787 Rp 12,689 Rp 241,098 32

33 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 40 25 30 2.8 70.0 90 30 70 7.6 190.00 Rp 343,670 Rp 17,184 Rp 326,487 33

34 St. Rosdiana, B.Sc III Perawat 40 25 1.6 40.0 90 30 100 8.8 220.00 Rp 343,670 Rp 17,184 Rp 326,487 34

35 Muhammad Nawir II Pel. Administrasi 15 25 0.6 15.0 90 30 25 5.8 145.00 Rp 211,489 Rp - Rp 211,489 35

36 Agustina Bintang,Amd.Keb III Tenaga Bidan 40 25 1.6 40.0 90 30 85 8.2 205.00 Rp 323,843 Rp 16,192 Rp 307,651 36

37 Nur Rahmawati, A.md.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 244,535 Rp - Rp 244,535 37

38 Suriati, A.md.Keb III Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 244,535 Rp 12,227 Rp 232,308 38

39 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 244,535 Rp - Rp 244,535 39

40 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 244,535 Rp - Rp 244,535 40

41 Andi Yulianti, Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 244,535 Rp - Rp 244,535 41

42 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 40 25 3 1.6 35.2 90 10 0 4.0 88.00 Rp 162,847 Rp - Rp 162,847 42

43 Isnayani, Amd. Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 185,053 Rp - Rp 185,053 43

44 Andi Jemma, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 224,707 Rp - Rp 224,707 44

45 Dewi Sartika, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 198,271 Rp - Rp 198,271 45

46 Titin Sumarni, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 185,053 Rp - Rp 185,053 46

47 Lisdayanti, A.md.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 198,271 Rp - Rp 198,271 47

48 Yul Fitriani, Amd. Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 185,053 Rp - Rp 185,053 48

49 Andi Isna, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 185,053 Rp - Rp 185,053 49
50 Rosmiati, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 20 0 4.4 110.00 Rp 198,271 Rp - Rp 198,271 50

51 Sri Wahyuni, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 185,053 Rp - Rp 185,053 51

52 Sulastri, Amd.Keb Tenaga Bidan 40 25 2 1.6 36.8 90 10 0 4.0 92.00 Rp 170,249 Rp - Rp 170,249 52

53 Sulmiati Bahri Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 185,053 Rp - Rp 185,053 53

54 Ira Muliati Radi.Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 224,707 Rp - Rp 224,707 54

55 Rosidah, AMKL III Sanitarian 40 25 2 1.6 36.8 90 30 40 6.4 147.20 Rp 243,213 Rp 12,161 Rp 231,052 55

56 Israyana Yulianti AMKL III Sanitarian 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 264,362 Rp 13,218 Rp 251,144 56

57 Armawati, S.Kep III Perawat 60 25 9 2.4 38.4 75 30 40 5.8 92.80 Rp 173,421 Rp 8,671 Rp 164,750 57

58 Andi Rezki Wardani S.Kep Ns Perawat 100 25 4.0 100.0 90 10 0 4.0 100.00 Rp 264,362 Rp 13,218 Rp 251,144 58

59 Wa Ode Sinta Kalsum III Pelak. Gizi 40 25 1.6 40.0 90 30 70 7.6 190.00 Rp 304,016 Rp 15,201 Rp 288,815 59

60 Andi Megawati II Teknik Gigi 40 25 6 1.6 30.4 90 30 25 5.8 110.20 Rp 185,846 Rp - Rp 185,846 60

61 Rosmayanti, SKM Tenaga Penunjang 60 25 2.4 60.0 90 10 25 5.0 125.00 Rp 244,535 Rp 12,227 Rp 232,308 61

62 Sudirman H Tenaga Penunjang 15 25 0.6 15.0 90 20 25 5.4 135.00 Rp 198,271 Rp - Rp 198,271 62

63 Sri Rahmat Yani Nur III Perawat 40 25 3 1.6 35.2 90 30 70 7.6 167.20 Rp 267,534 Rp 13,377 Rp 254,157 63

64 Mayanti, AMF III Tenaga Penunjang 40 23 1.7 40.0 90 30 25 6.3 145.00 Rp 244,535 Rp 12,227 Rp 232,308 64

65 Sri Wedari Yusuf, AMF Tenaga Penunjang 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 185,053 Rp - Rp 185,053 65

66 Hamriana Tenaga Penunjang 15 25 0.6 15.0 90 10 10 4.4 110.00 Rp 165,226 Rp - Rp 165,226 66

67 Hj. Syahraeni, AMK II Perawat 40 25 5 1.6 32.0 90 30 25 5.8 116.00 Rp 195,628 Rp - Rp 195,628 67

68 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 40 25 4 1.6 33.6 90 10 0 4.0 84.00 Rp 155,445 Rp - Rp 155,445 68

69 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 40 25 7 1.6 28.8 90 10 0 4.0 72.00 Rp 133,238 Rp - Rp 133,238 69

70 Desi Asriana, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 185,053 Rp - Rp 185,053 70

71 Andi Rezkiiani Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 185,053 Rp - Rp 185,053 71

72 Hastuti, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 185,053 Rp - Rp 185,053 72

73 Rosdiana Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 185,053 Rp - Rp 185,053 73

74 Nur Ilma, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 55 7.0 175.00 Rp 284,189 Rp - Rp 284,189 74

75 Irmawati, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 224,707 Rp - Rp 224,707 75

76 Ridha Arbiah, Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 244,535 Rp - Rp 244,535 76

77 Ramlah, Amd.Keb Tenaga Bidan 40 25 5 1.6 32.0 90 30 10 5.2 104.00 Rp 179,766 Rp - Rp 179,766 77

78 Hermin Wahida III Perawat 40 25 1.6 40.0 90 30 55 7.0 175.00 Rp 284,189 Rp 14,209 Rp 269,979 78
79 Andi Jumrianti, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 224,707 Rp - Rp 224,707 79

80 Yulianti, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 224,707 Rp - Rp 224,707 80

81 Israwati Tenaga Penunjang 15 25 0.6 15.0 90 20 10 4.8 120.00 Rp 178,444 Rp - Rp 178,444 81

82 Andi Mas Muliani Tenaga Penunjang 15 25 0.6 15.0 90 10 10 4.4 110.00 Rp 165,226 Rp - Rp 165,226 82

83 Wahyuni, Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 244,535 Rp - Rp 244,535 83

84 Andi Salmei, Amd.Keb Tenaga Bidan 40 25 8 1.6 27.2 90 30 10 5.2 88.40 Rp 152,801 Rp - Rp 152,801 84

85 Reski Arisanti Amelia Safitri, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 198,271 Rp - Rp 198,271 85

JUMLAH 3680 2123 96 90 151 3,556.0 7620 1820 2090 462 11023.8 Rp 19,271,700 Rp 430,130 Rp 18,841,570

Mengetahui / Menyetujui : Benteng, 30 September 2015


Kepala UPTD Puskesmas Benteng Bendahara JKN

Dr. FRENGKI WIJAYA PETRUS MILU E.T, AMK


Pangkat : Pembina Nip 19710704 199103 1 009
NIP. 19790926 200604 1 023
150 30 24 151.25
15000 32,119,500 32134500 7141
25324200

32,119,500 5,353
32,119,500 5,353 19,271,700

273.00 Dr. Frengki Wiyaya ( Ke 14579.8000 19,271,700 15239.792 150

355.00 Dr. Zaenal Abidin 14579.8000 19,271,700 15239.792

183.60 Drg. Yunda Iswari 14579.8000 19,271,700 15239.792

260.00 Saribanong 14579.8000 19,271,700 15239.792 41,871,000 25,122,600

160.00 Muh. Ilham Tamrin 14579.8000 19,271,700 15239.792 41,871,000 16,748,400 6,699,360 10,049,040

260.00 Petrus Milu. ET.AMK (B 14579.8000 19,271,700 15239.792 41,871,000

245.00 Hj. Nur Azizal Hastati, 14579.8000 19,271,700 15239.792 6,609,120 9,913,680

196.00 Nur Ariani, AMK 14579.8000 19,271,700

162.80 Rahma Yuliana, AMK 14579.8000 19,271,700 15239.792

185.00 Amsari Parida Amir, A 14579.8000 19,271,700 15239.792

185.00 Elsa Handayani, AMK 14579.8000 19,271,700 15239.792

185.00 Nadia Sri Damayanti A 14579.8000 19,271,700 15239.792

150.00 Muhrawati, AMK 14579.8000 19,271,700 15239.792

150.00 Sri Adrianti, AMK 14579.8000 19,271,700 15239.792 24,784,200

150.00 Nur Wahyuni, AMK 14579.8000 19,271,700 15239.792

134.40 Musfiah Zainuddin, AM 14579.8000 19,271,700 15239.792

150.00 Andi Armita Dewi, AMK 14579.8000 19,271,700 15239.792

165.00 Hasmirawati, AMK 14579.8000 19,271,700 15239.792

117.60 Muh. Subhan, AMK 14579.8000 19,271,700 15239.792

140.00 Musdalifah, MR,AMK 14579.8000 19,271,700 15239.792


140.00 Muhammad Rum, AMK 14579.8000 19,271,700 15239.792

150.00 Agustina, AMK 14579.8000 19,271,700 15239.792

123.20 Risaldi Razak, AMK 14579.8000 19,271,700 15239.792

140.00 Dewi Ahryani, AMK 14579.8000 19,271,700 15239.792

230.00 Hj. Rostini AMG 14579.8000 19,271,700 15239.792

150.00 Agustini 14579.8000 19,271,700 15239.792

185.00 Yurniati, A.Md.AK 14579.8000 19,271,700 15239.792

245.00 Rosdiana 14579.8000 19,271,700 15239.792

114.00 Yunarsih, AMAK 14579.8000 19,271,700 15239.792

200.00 Bustan 14579.8000 19,271,700 15239.792

200.00 Nur Indah Kurnianti 14579.8000 19,271,700 15239.792

192.00 Rohani 14579.8000 19,271,700 15239.792

260.00 Muhammad Ali (TU Pus 14579.8000 19,271,700 15239.792

260.00 St. Rosdiana, B.Sc 14579.8000 19,271,700 15239.792

160.00 Muhammad Nawir 14579.8000 19,271,700

245.00 Agustina Bintang,Amd. 14579.8000 19,271,700 15239.792

185.00 Nur Rahmawati, A.md.K 14579.8000 19,271,700 15239.792

185.00 Suriati, A.md.Keb 14579.8000 19,271,700 15239.792

185.00 Sitti Aminah Anas,Amd 14579.8000 19,271,700 15239.792

185.00 Sitti Suprihartini,Amd.K 14579.8000 19,271,700 15239.792

185.00 Andi Yulianti, Amd.Keb 14579.8000 19,271,700 15239.792

123.20 Mira Septari. R.S, Amd. 14579.8000 19,271,700 15239.792

140.00 Isnayani, Amd. Keb 14579.8000 19,271,700 15239.792

170.00 Andi Jemma, Amd.Keb 14579.8000 19,271,700

150.00 Dewi Sartika, Amd.Keb 14579.8000 19,271,700 15239.792

140.00 Titin Sumarni, Amd.Keb 14579.8000 19,271,700 15239.792

150.00 Lisdayanti, A.md.Keb 14579.8000 19,271,700 15239.792

140.00 Yul Fitriani, Amd. Keb 14579.8000 19,271,700 15239.792

140.00 Andi Isna, Amd.Keb 14579.8000 19,271,700 15239.792


150.00 Rosmiati, Amd.Keb 14579.8000 19,271,700 15239.792

140.00 Sri Wahyuni, Amd.Keb 14579.8000 19,271,700 15239.792

128.80 Sulastri, Amd.Keb 14579.8000 19,271,700 15239.792

140.00 Sulmiati Bahri Amd.Keb 14579.8000 19,271,700 15239.792

170.00 Ira Muliati Radi.Amd.Ke 14579.8000 19,271,700 15239.792

184.00 Rosidah, AMKL 14579.8000 19,271,700 15239.792

200.00 Israyana Yulianti AMKL 14579.8000 19,271,700 15239.792

131.20 Armawati, S.Kep 14579.8000 19,271,700 15239.792

200.00 Andi Rezki Wardani S. 14579.8000 19,271,700 15239.792

230.00 Wa Ode Sinta Kalsum 14579.8000 19,271,700 15239.792

140.60 Andi Megawati 14579.8000 19,271,700 15239.792

185.00 Rosmayanti, SKM 14579.8000 19,271,700 15239.792

150.00 Sudirman H 14579.8000 19,271,700 15239.792

202.40 Sri Rahmat Yani Nur 14579.8000 19,271,700 15239.792

185.00 Mayanti, AMF 14579.8000 19,271,700 15239.792

140.00 Sri Wedari Yusuf, AMF 14579.8000 19,271,700 15239.792

125.00 Hamriana 14579.8000 19,271,700 15239.792

148.00 Hj. Syahraeni, AMK 14579.8000 19,271,700 15239.792

117.60 Andi Tenri Ellung N, A 14579.8000 19,271,700 15239.792

100.80 Wahyuni Hamsah, Amd 14579.8000 19,271,700 15239.792

140.00 Desi Asriana, Amd.Keb 14579.8000 19,271,700 15239.792

140.00 Andi Rezkiiani Amd.Keb 14579.8000 19,271,700 15239.792

140.00 Hastuti, Amd.Keb 14579.8000 19,271,700 15239.792

140.00 Rosdiana Amd.Keb 14579.8000 19,271,700 15239.792

215.00 Nur Ilma, Amd.Keb 14579.8000 19,271,700 15239.792

170.00 Irmawati, Amd.Keb 14579.8000 19,271,700 15239.792

185.00 Ridha Arbiah, Amd.Keb 14579.8000 19,271,700 15239.792

136.00 Ramlah, Amd.Keb 14579.8000 19,271,700 15239.792

215.00 Hermin Wahida 14579.8000 19,271,700 15239.792


170.00 Andi Jumrianti, Amd.Ke 14579.8000 19,271,700 15239.792

170.00 Yulianti, Amd.Keb 14579.8000 19,271,700 15239.792

135.00 Israwati 14579.8000 19,271,700 15239.792

125.00 Andi Mas Muliani 14579.8000 19,271,700 15239.792

185.00 Wahyuni, Amd.Keb 14579.8000 19,271,700

115.60 Andi Salmei, Amd.Keb 14579.8000 19,271,700 15239.792

150.00 Reski Arisanti Amelia Sa 14579.8000 19,271,700 15239.792

14579.8000 14579.800
16,748,400 9975600

16,522,800
DAFTAR VARIABEL DAERAH SEBAGAI PENILAIAN TAMBAHAN DALAM MELAKUKAN PEMBAGIAN JASA PELAYANAN
JAMINAN KESEHATAN NASIONAL DI PUSKESMAS BENTENG BULAN SEPTEMBER TAHUN 2015

VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK
NGAN PEGAWAI KERJA HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

1 Dr. Frengki Wiyaya ( Kepala Pusk IV Dokter Umum 90 30 25 4

2 Dr. Zaenal Abidin IV Dokter Umum 90 30 85

3 Drg. Yunda Iswari III Dokter Gigi 75 30 0 7

4 Saribanong III Perawat 90 30 100

5 Muh. Ilham Tamrin III Perawat 90 30 40 5

6 Petrus Milu. ET.AMK (Bend. Pusk III Perawat 90 30 70

7 Hj. Nur Azizal Hastati,AMK III Perawat 90 30 85

8 Nur Ariani, AMK III Perawat 90 30 85 5

9 Rahma Yuliana, AMK II Perawat 90 30 25 3

10 Amsari Parida Amir, AMK II Perawat 90 30 25

11 Elsa Handayani, AMK II Perawat 90 30 25

12 Nadia Sri Damayanti AMK II Perawat 90 30 25

13 Muhrawati, AMK Perawat 90 10 10

14 Sri Adrianti, AMK Perawat 90 10 10

15 Nur Wahyuni, AMK Perawat 90 10 10

16 Musfiah Zainuddin, AMK Perawat 90 20 10 4

17 Andi Armita Dewi, AMK Perawat 90 10 10

18 Hasmirawati, AMK Perawat 90 10 25

19 Muh. Subhan, AMK Perawat 90 10 0 4

20 Musdalifah, MR,AMK Perawat 90 10 0

21 Muhammad Rum, AMK Perawat 90 10 0

22 Agustina, AMK Perawat 90 10 10

23 Risaldi Razak, AMK Perawat 90 10 0 3

24 Dewi Ahryani, AMK Perawat 90 10 0

25 Hj. Rostini AMG II Tenaga Penunjang 90 30 70

26 Agustini Tenaga Penunjang 90 20 25

27 Yurniati, A.Md.AK II Analis 90 30 25

28 Rosdiana III Analis 90 30 85

29 Yunarsih, AMAK Analis 90 10 10 6

30 Bustan II Perawat Gigi 90 30 40

31 Nur Indah Kurnianti III Teknik Gigi 90 30 40

32 Rohani III Perawat Gigi 90 30 40 1

33 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 90 30 70

34 St. Rosdiana, B.Sc III Perawat 90 30 100

35 Muhammad Nawir II Pel. Administrasi 90 30 25

36 Agustina Bintang,Amd.Keb III Tenaga Bidan 90 30 85

37 Nur Rahmawati, A.md.Keb II Tenaga Bidan 90 30 25

38 Suriati, A.md.Keb III Tenaga Bidan 90 30 25

39 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 90 30 25

40 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 90 30 25

41 Andi Yulianti, Amd.Keb II Tenaga Bidan 90 30 25

42 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 90 10 0 3

43 Isnayani, Amd. Keb Tenaga Bidan 90 10 0

44 Andi Jemma, Amd.Keb Tenaga Bidan 90 30 10

45 Dewi Sartika, Amd.Keb Tenaga Bidan 90 10 10

46 Titin Sumarni, Amd.Keb Tenaga Bidan 90 10 0

47 Lisdayanti, A.md.Keb Tenaga Bidan 90 10 10


VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK
NGAN PEGAWAI KERJA HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

48 Yul Fitriani, Amd. Keb Tenaga Bidan 90 10 0

49 Andi Isna, Amd.Keb Tenaga Bidan 90 10 0

50 Rosmiati, Amd.Keb Tenaga Bidan 90 20 0

51 Sri Wahyuni, Amd.Keb Tenaga Bidan 90 10 0

52 Sulastri, Amd.Keb Tenaga Bidan 90 10 0 2

53 Sulmiati Bahri Amd.Keb Tenaga Bidan 90 10 0

54 Ira Muliati Radi.Amd.Keb Tenaga Bidan 90 30 10

55 Rosidah, AMKL III Sanitarian 90 30 40 2

56 Israyana Yulianti AMKL III Sanitarian 90 30 40

57 Armawati, S.Kep III Perawat 75 30 40 9

58 Andi Rezki Wardani S.Kep Ns Perawat 90 10 0

59 Wa Ode Sinta Kalsum III Pelak. Gizi 90 30 70

60 Andi Megawati II Teknik Gigi 90 30 25 6

61 Rosmayanti, SKM Tenaga Penunjang 90 10 25

62 Sudirman H Tenaga Penunjang 90 20 25

63 Sri Rahmat Yani Nur III Perawat 90 30 70 3

64 Mayanti, AMF III Tenaga Penunjang 90 30 25

65 Sri Wedari Yusuf, AMF Tenaga Penunjang 90 10 0

66 Hamriana Tenaga Penunjang 90 10 10

67 Hj. Syahraeni, AMK II Perawat 90 30 25 5

68 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 90 10 0 4

69 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 90 10 0 7

70 Desi Asriana, Amd.Keb Tenaga Bidan 90 10 0

71 Andi Rezkiiani Amd.Keb Tenaga Bidan 90 10 0

72 Hastuti, Amd.Keb Tenaga Bidan 90 10 0

73 Rosdiana Amd.Keb Tenaga Bidan 90 10 0

74 Nur Ilma, Amd.Keb Tenaga Bidan 90 30 55

75 Irmawati, Amd.Keb Tenaga Bidan 90 30 10

76 Ridha Arbiah, Amd.Keb II Tenaga Bidan 90 30 25

77 Ramlah, Amd.Keb Tenaga Bidan 90 30 10 5

78 Hermin Wahida III Perawat 90 30 55

79 Andi Jumrianti, Amd.Keb Tenaga Bidan 90 30 10

80 Yulianti, Amd.Keb Tenaga Bidan 90 30 10

81 Israwati Tenaga Penunjang 90 20 10

82 Andi Mas Muliani Tenaga Penunjang 90 10 10

83 Wahyuni, Amd.Keb II Tenaga Bidan 90 30 25

84 Andi Salmei, Amd.Keb Tenaga Bidan 90 30 10 8

85 Reski Arisanti Amelia Safitri, AMK Perawat 90 10 10

Mengetahui : Benteng, 30 September 2015


Kepala UPTD Puskesmas Benteng, Kasubag Tata Usaha,

Dr. Frengki Wijaya Muhammad Ali


Pangkat : Pembina Nip. 19641211 198903 1 019
Nip. 1979092 20004 1 023
VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK
NGAN PEGAWAI KERJA HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

87 Wahyuni, Amd.Keb II Tenaga Bidan

88 Andi Salmei, Amd.Keb Tenaga Bidan

89 Reski Arisanti Amelia Safitri, AMK Perawat

JUMLAH 1820 2090

Mengetahui : Benteng, 05 September 2015


Kepala UPTD Puskesmas Benteng, Kasubag Tata Usaha,

Dr. Frengki Wijaya Muhammad Ali


Pangkat : Pembina Nip. 19641211 198903 1 019
Nip. 1979092 20004 1 023
DAFTAR PENERIMAAN JASA PELAYANAN KESEHATAN PESERTA JKN BAGI PETUGAS PUSKESMAS PUSTU DAN POSKEDES
BULAN OKTOBER TAHUN 2015
PUSKESMAS : BENTENG
JUMLAH PESERTA : 7245 ORANG
JUMLAH PEGAWAI : 84 ORANG
BESARAN KAPITASI : 6000 PERJIWA / BULAN
TOTAL KAPITASI : 66,915,000 TOTAL JASA PELAYANAN SESUAI SK BUPATI 60 % = 40.149.000.-

GOLO VARIABEL POINT POINT VARIABEL DAERAH POINT POINT JUMLAH PPH JUMLAH
NO NAMA PETUGAS NGAN JABATAN KETENA KEHADIRAN JABA /ORG /ORG KINER STATUS MASA /ORG /ORG DITERIMA PASAL 21 DIBAYARKAN TANDA TANGAN
GAAN EFEKTIF 1 BLNTDK HADIR TAN /HARI BULAN JA KEPEG KERJA HARI BULAN ( Rp ) ( 15% / 5% ) ( Rp )
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

1 Dr. Frengki Wiyaya ( Kepala Pusk) IV Dokter Umum 150 25 30 7.2 180.0 90 30 25 5.8 145.00 Rp 975,499 Rp 146,325 Rp 829,174 1

2 Dr. Zaenal Abidin IV Dokter Umum 150 25 8 6.0 102.0 90 30 85 8.2 139.40 Rp 724,571 Rp 108,686 Rp 615,885 2

3 Drg. Yunda Iswari III Dokter Gigi 150 25 21 6.0 24.0 60 30 0 3.6 14.40 Rp 115,259 Rp 5,763 Rp 109,496 3

4 Saribanong III Perawat 40 25 1.6 40.0 90 30 100 8.8 220.00 Rp 780,399 Rp 39,020 Rp 741,379 4

5 Muh. Ilham Thamrin III Perawat 40 25 9 1.6 25.6 90 30 40 6.4 102.40 Rp 384,196 Rp 19,210 Rp 364,987 5

6 Petrus Milu. ET.AMK (Bend. Pusk) III Perawat 40 25 30 2.8 70.0 90 30 70 7.6 190.00 Rp 780,399 Rp 39,020 Rp 741,379 6

7 Hj. Nur Azizal Hastati,AMK III Perawat 40 25 4 1.6 33.6 90 30 85 8.2 172.20 Rp 617,716 Rp 30,886 Rp 586,830 7

8 Nur Ariani, AMK III Perawat 40 25 11 1.6 22.4 75 30 85 7.6 106.40 Rp 386,598 Rp 19,330 Rp 367,268 8

9 Rahma Yuliana, AMK II Perawat 40 25 4 1.6 33.6 90 30 25 5.8 121.80 Rp 466,439 Rp - Rp 466,439 9

10 Amsari Parida Amir, AMK II Perawat 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 555,284 Rp - Rp 555,284 10

11 Elsa Handayani, AMK II Perawat 40 25 1 1.6 38.4 90 30 25 5.8 139.20 Rp 533,073 Rp - Rp 533,073 11

12 Nadia Sri Damayanti AMK II Perawat 40 25 6 1.6 30.4 90 30 25 5.8 110.20 Rp 422,016 Rp - Rp 422,016 12

13 Muhrawati, AMK Perawat 40 25 3 1.6 35.2 90 10 10 4.4 96.80 Rp 396,203 Rp - Rp 396,203 13

14 Sri Adrianti, AMK Perawat 40 25 1 1.6 38.4 90 10 10 4.4 105.60 Rp 432,221 Rp - Rp 432,221 14

15 Nur Wahyuni, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 450,230 Rp - Rp 450,230 15

16 Musfiah Zainuddin, AMK Perawat 40 25 2 1.6 36.8 90 20 10 4.8 110.40 Rp 441,826 Rp - Rp 441,826 16

17 Andi Armita Dewi, AMK Perawat 40 25 3 1.6 35.2 90 10 10 4.4 96.80 Rp 396,203 Rp - Rp 396,203 17

18 Hasmirawati, AMK Perawat 40 25 7 1.6 28.8 90 10 25 5.0 90.00 Rp 356,582 Rp - Rp 356,582 18

19 Muh. Subhan, AMK Perawat 40 25 2 1.6 36.8 90 10 0 4.0 92.00 Rp 386,598 Rp - Rp 386,598 19

20 Musdalifah, MR,AMK Perawat 40 25 7 1.6 28.8 90 10 0 4.0 72.00 Rp 302,555 Rp - Rp 302,555 20


21 Muhammad Rum, AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 420,215 Rp - Rp 420,215 21

22 Agustina, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 450,230 Rp - Rp 450,230 22

23 Risaldi Razak, AMK Perawat 40 25 9 1.6 25.6 90 10 0 4.0 64.00 Rp 268,938 Rp - Rp 268,938 23

24 Dewi Ahryani, AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 420,215 Rp - Rp 420,215 24

25 Hj. Rostini AMG II Tenaga Penunjang 40 25 1.6 40.0 90 30 70 7.6 190.00 Rp 690,353 Rp Rp 690,353 25

26 Agustini Tenaga Penunjang 15 25 3 0.6 13.2 90 20 25 5.4 118.80 Rp 396,203 Rp - Rp 396,203 26

27 Yurniati, A.Md.AK II Analis 40 25 1 1.6 38.4 90 30 25 5.8 139.20 Rp 533,073 Rp - Rp 533,073 27

28 Rosdiana III Analis 40 25 1 1.6 38.4 90 30 85 8.2 196.80 Rp 705,961 Rp 35,298 Rp 670,663 28

29 Yunarsih, AMAK Analis 40 25 9 1.6 25.6 90 10 10 4.4 70.40 Rp 288,147 Rp - Rp 288,147 29

30 Bustan II Perawat Gigi 40 25 2 1.6 36.8 90 30 40 6.4 147.20 Rp 552,282 Rp - Rp 552,282 30

31 Nur Indah Kurnianti III Teknik Gigi 40 25 6 1.6 30.4 90 30 40 6.4 121.60 Rp 456,233 Rp 22,812 Rp 433,422 31

32 Rohani III Perawat Gigi 40 25 2 1.6 36.8 90 30 40 6.4 147.20 Rp 552,282 Rp 27,614 Rp 524,668 32

33 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 40 25 4 30 2.8 58.8 90 30 70 7.6 159.60 Rp 655,535 Rp 32,777 Rp 622,758 33

34 St. Rosdiana, B.Sc III Perawat 40 25 6 1.6 30.4 90 30 100 8.8 167.20 Rp 593,103 Rp 29,655 Rp 563,448 34

35 Muhammad Nawir II Pel. Administrasi 15 25 0.6 15.0 90 30 25 5.8 145.00 Rp 480,246 Rp - Rp 480,246 35

36 Agustina Bintang,Amd.Keb III Tenaga Bidan 40 25 1.6 40.0 90 30 85 8.2 205.00 Rp 735,376 Rp 36,769 Rp 698,607 36

37 Nur Rahmawati, A.md.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 555,284 Rp - Rp 555,284 37

38 Suriati, A.md.Keb III Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 555,284 Rp 27,764 Rp 527,520 38

39 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 555,284 Rp - Rp 555,284 39

40 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 555,284 Rp - Rp 555,284 40

41 Andi Yulianti, Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 555,284 Rp - Rp 555,284 41

42 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 40 25 4 1.6 33.6 90 10 0 4.0 84.00 Rp 352,980 Rp - Rp 352,980 42

43 Isnayani, Amd. Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 420,215 Rp - Rp 420,215 43

44 Andi Jemma, Amd.Keb Tenaga Bidan 40 25 5 1.6 32.0 90 30 10 5.2 104.00 Rp 408,209 Rp - Rp 408,209 44

45 Dewi Sartika, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 450,230 Rp - Rp 450,230 45

46 Titin Sumarni, Amd.Keb Tenaga Bidan 40 25 17 1.6 12.8 60 10 0 2.8 22.40 Rp 105,654 Rp - Rp 105,654 46

47 Lisdayanti, A.md.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 450,230 Rp - Rp 450,230 47

48 Yul Fitriani, Amd. Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 420,215 Rp - Rp 420,215 48

49 Andi Isna, Amd.Keb Tenaga Bidan 40 25 5 1.6 32.0 90 10 0 4.0 80.00 Rp 336,172 Rp - Rp 336,172 49
50 Rosmiati, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 20 0 4.4 110.00 Rp 450,230 Rp - Rp 450,230 50

51 Sri Wahyuni, Amd.Keb Tenaga Bidan 40 25 7 1.6 28.8 90 10 0 4.0 72.00 Rp 302,555 Rp - Rp 302,555 51

52 Sulastri, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 420,215 Rp - Rp 420,215 52

53 Sulmiati Bahri Amd.Keb Tenaga Bidan 40 25 14 1.6 17.6 75 10 0 3.4 37.40 Rp 165,084 Rp - Rp 165,084 53

54 Ira Muliati Radi.Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 510,261 Rp - Rp 510,261 54

55 Rosidah, AMKL III Sanitarian 40 25 5 1.6 32.0 90 30 40 6.4 128.00 Rp 480,246 Rp 24,012 Rp 456,233 55

56 Israyana Yulianti AMKL III Sanitarian 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 600,307 Rp 30,015 Rp 570,292 56

57 Armawati, S.Kep III Perawat 60 25 13 2.4 28.8 75 30 40 5.8 69.60 Rp 295,351 Rp 14,768 Rp 280,583 57

58 Andi Rezti Wardani S.Kep Ns Perawat 100 25 1 4.0 96.0 90 10 0 4.0 96.00 Rp 576,295 Rp 28,815 Rp 547,480 58

59 Wa Ode Sinta Kalsum III Pelak. Gizi 40 25 6 1.6 30.4 90 30 70 7.6 144.40 Rp 524,668 Rp 26,233 Rp 498,435 59

60 Andi Megawati II Teknik Gigi 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 555,284 Rp - Rp 555,284 60

61 Rosmayanti, SKM Tenaga Penunjang 60 25 7 2.4 43.2 90 10 25 5.0 90.00 Rp 399,804 Rp 19,990 Rp 379,814 61

62 Sudirman H Tenaga Penunjang 15 25 0.6 15.0 90 20 25 5.4 135.00 Rp 450,230 Rp - Rp 450,230 62

63 Sri Rahmat Yani Nur III Perawat 40 25 1.6 40.0 90 30 70 7.6 190.00 Rp 690,353 Rp 34,518 Rp 655,835 63

64 Mayanti, AMF III Tenaga Penunjang 40 23 1 1.7 38.3 90 30 25 6.3 138.70 Rp 531,141 Rp 26,557 Rp 504,584 64

65 Sri Wedari Yusuf, AMF Tenaga Penunjang 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 420,215 Rp - Rp 420,215 65

66 Hj. Syahraeni, AMK II Perawat 40 25 1 1.6 38.4 90 30 25 5.8 139.20 Rp 533,073 Rp - Rp 533,073 66

67 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 420,215 Rp - Rp 420,215 67

68 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 40 25 5 1.6 32.0 90 10 0 4.0 80.00 Rp 336,172 Rp - Rp 336,172 68

69 Desi Asriana, Amd.Keb Tenaga Bidan 40 25 3 1.6 35.2 90 10 0 4.0 88.00 Rp 369,789 Rp - Rp 369,789 69

70 Andi Rezkiiani Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 420,215 Rp - Rp 420,215 70

71 Hastuti, Amd.Keb Tenaga Bidan 40 25 2 1.6 36.8 90 10 0 4.0 92.00 Rp 386,598 Rp - Rp 386,598 71

72 Rosdiana Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 420,215 Rp - Rp 420,215 72

73 Nur Ilma, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 55 7.0 175.00 Rp 645,330 Rp - Rp 645,330 73

74 Irmawati, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 510,261 Rp - Rp 510,261 74

75 Ridha Arbiah, Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 555,284 Rp - Rp 555,284 75

76 Ramlah, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 510,261 Rp - Rp 510,261 76

77 Ermin Wahida. N III Perawat 40 25 1.6 40.0 90 30 55 7.0 175.00 Rp 645,330 Rp 32,266 Rp 613,063 77

78 Andi Jumrianti, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 510,261 Rp - Rp 510,261 78
79 Yulianti, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 510,261 Rp - Rp 510,261 79

80 Israwati Tenaga Penunjang 15 25 0.6 15.0 90 20 10 4.8 120.00 Rp 405,207 Rp - Rp 405,207 80

81 Andi Mas Muliani Tenaga Penunjang 15 25 0.6 15.0 90 10 10 4.4 110.00 Rp 375,192 Rp - Rp 375,192 81

82 Wahyuni, Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 555,284 Rp - Rp 555,284 82

83 Andi Salmei, Amd.Keb Tenaga Bidan 40 25 3 1.6 35.2 90 30 10 5.2 114.40 Rp 449,030 Rp - Rp 449,030 83

84 Reski Arisanti Amelia Safitri, AMK Perawat 40 25 3 1.6 35.2 90 10 10 4.4 96.80 Rp 396,203 Rp - Rp 396,203 84

JUMLAH 3665 2098 234 90 150 3,232.7 7455 1810 2080 454 10143.5 Rp 40,149,000 Rp 858,102 Rp 39,290,898

Mengetahui / Menyetujui : Benteng, 31 Oktober 2015


Kepala UPTD Puskesmas Benteng Bendahara JKN

Dr. FRENGKI WIJAYA PETRUS MILU E.T, AMK


Pangkat : Pembina Nip 19710704 199103 1 009
NIP. 19790926 200604 1 023
150 30 24 151.25
519,000
43,467,000 7,245
1,245,000 10,696,500
387,000 10,600,500
1,632,000 65,283,000 66,915,000 40,149,000 26,766,000 10,706,400 16,059,600

10,700,000 16,066,000 ###


66,915,000

325.00 Dr. Frengki Wiyaya ( Kepala 13376.1565 40,149,000 15239.792 150

241.40 Dr. Zaenal Abidin 13376.1565 40,149,000 15239.792

38.40 Drg. Yunda Iswari 13376.1565 40,149,000 15239.792

260.00 Saribanong 13376.1565 40,149,000 15239.792 41,871,000 25,122,600

128.00 Muh. Ilham Thamrin 13376.1565 40,149,000 15239.792 41,871,000 16,748,400 6,699,360

260.00 Petrus Milu. ET.AMK (Bend. 13376.1565 40,149,000 15239.792 41,871,000

205.80 Hj. Nur Azizal Hastati,AMK 13376.1565 40,149,000 15239.792 6,609,120

128.80 Nur Ariani, AMK 13376.1565 40,149,000

155.40 Rahma Yuliana, AMK 13376.1565 40,149,000 15239.792

185.00 Amsari Parida Amir, AMK 13376.1565 40,149,000 15239.792

177.60 Elsa Handayani, AMK 13376.1565 40,149,000 15239.792

140.60 Nadia Sri Damayanti AMK 13376.1565 40,149,000 15239.792

132.00 Muhrawati, AMK 13376.1565 40,149,000 15239.792

144.00 Sri Adrianti, AMK 13376.1565 40,149,000 15239.792 24,784,200

150.00 Nur Wahyuni, AMK 13376.1565 40,149,000 15239.792

147.20 Musfiah Zainuddin, AMK 13376.1565 40,149,000 15239.792

132.00 Andi Armita Dewi, AMK 13376.1565 40,149,000 15239.792

118.80 Hasmirawati, AMK 13376.1565 40,149,000 15239.792

128.80 Muh. Subhan, AMK 13376.1565 40,149,000 15239.792

100.80 Musdalifah, MR,AMK 13376.1565 40,149,000 15239.792


140.00 Muhammad Rum, AMK 13376.1565 40,149,000 15239.792

150.00 Agustina, AMK 13376.1565 40,149,000 15239.792

89.60 Risaldi Razak, AMK 13376.1565 40,149,000 15239.792

140.00 Dewi Ahryani, AMK 13376.1565 40,149,000 15239.792

230.00 Hj. Rostini AMG 13376.1565 40,149,000 15239.792

132.00 Agustini 13376.1565 40,149,000 15239.792

177.60 Yurniati, A.Md.AK 13376.1565 40,149,000 15239.792

235.20 Rosdiana 13376.1565 40,149,000 15239.792

96.00 Yunarsih, AMAK 13376.1565 40,149,000 15239.792

184.00 Bustan 13376.1565 40,149,000 15239.792

152.00 Nur Indah Kurnianti 13376.1565 40,149,000 15239.792

184.00 Rohani 13376.1565 40,149,000 15239.792

218.40 Muhammad Ali (TU Puskesm 13376.1565 40,149,000 15239.792

197.60 St. Rosdiana, B.Sc 13376.1565 40,149,000 15239.792

160.00 Muhammad Nawir 13376.1565 40,149,000

245.00 Agustina Bintang,Amd.Keb 13376.1565 40,149,000 15239.792

185.00 Nur Rahmawati, A.md.Keb 13376.1565 40,149,000 15239.792

185.00 Suriati, A.md.Keb 13376.1565 40,149,000 15239.792

185.00 Sitti Aminah Anas,Amd.Keb 13376.1565 40,149,000 15239.792

185.00 Sitti Suprihartini,Amd.Keb 13376.1565 40,149,000 15239.792

185.00 Andi Yulianti, Amd.Keb 13376.1565 40,149,000 15239.792

117.60 Mira Septari. R.S, Amd.Keb. 13376.1565 40,149,000 15239.792

140.00 Isnayani, Amd. Keb 13376.1565 40,149,000 15239.792

136.00 Andi Jemma, Amd.Keb 13376.1565 40,149,000

150.00 Dewi Sartika, Amd.Keb 13376.1565 40,149,000 15239.792

35.20 Titin Sumarni, Amd.Keb 13376.1565 40,149,000 15239.792

150.00 Lisdayanti, A.md.Keb 13376.1565 40,149,000 15239.792

140.00 Yul Fitriani, Amd. Keb 13376.1565 40,149,000 15239.792

112.00 Andi Isna, Amd.Keb 13376.1565 40,149,000 15239.792


150.00 Rosmiati, Amd.Keb 13376.1565 40,149,000 15239.792

100.80 Sri Wahyuni, Amd.Keb 13376.1565 40,149,000 15239.792

140.00 Sulastri, Amd.Keb 13376.1565 40,149,000 15239.792

55.00 Sulmiati Bahri Amd.Keb 13376.1565 40,149,000 15239.792

170.00 Ira Muliati Radi.Amd.Keb 13376.1565 40,149,000 15239.792

160.00 Rosidah, AMKL 13376.1565 40,149,000 15239.792

200.00 Israyana Yulianti AMKL 13376.1565 40,149,000 15239.792

98.40 Armawati, S.Kep 13376.1565 40,149,000 15239.792

192.00 Andi Rezti Wardani S.Kep N 13376.1565 40,149,000 15239.792

174.80 Wa Ode Sinta Kalsum 13376.1565 40,149,000 15239.792

185.00 Andi Megawati 13376.1565 40,149,000 15239.792

133.20 Rosmayanti, SKM 13376.1565 40,149,000 15239.792

150.00 Sudirman H 13376.1565 40,149,000 15239.792

230.00 Sri Rahmat Yani Nur 13376.1565 40,149,000 15239.792

176.96 Mayanti, AMF 13376.1565 40,149,000 15239.792

140.00 Sri Wedari Yusuf, AMF 13376.1565 40,149,000 15239.792

177.60 Hj. Syahraeni, AMK 13376.1565 40,149,000 15239.792

140.00 Andi Tenri Ellung N, Amd.Ke 13376.1565 40,149,000 15239.792

112.00 Wahyuni Hamsah, Amd.Keb 13376.1565 40,149,000 15239.792

123.20 Desi Asriana, Amd.Keb 13376.1565 40,149,000 15239.792

140.00 Andi Rezkiiani Amd.Keb 13376.1565 40,149,000 15239.792

128.80 Hastuti, Amd.Keb 13376.1565 40,149,000 15239.792

140.00 Rosdiana Amd.Keb 13376.1565 40,149,000 15239.792

215.00 Nur Ilma, Amd.Keb 13376.1565 40,149,000 15239.792

170.00 Irmawati, Amd.Keb 13376.1565 40,149,000 15239.792

185.00 Ridha Arbiah, Amd.Keb 13376.1565 40,149,000 15239.792

170.00 Ramlah, Amd.Keb 13376.1565 40,149,000 15239.792

215.00 Ermin Wahida. N 13376.1565 40,149,000 15239.792

170.00 Andi Jumrianti, Amd.Keb 13376.1565 40,149,000 15239.792


170.00 Yulianti, Amd.Keb 13376.1565 40,149,000 15239.792

135.00 Israwati 13376.1565 40,149,000 15239.792

125.00 Andi Mas Muliani 13376.1565 40,149,000 15239.792

185.00 Wahyuni, Amd.Keb 13376.1565 40,149,000 15239.792

149.60 Andi Salmei, Amd.Keb 13376.1565 40,149,000

132.00 Reski Arisanti Amelia Safitri 13376.1565 40,149,000 15239.792

13376.1565 13376.157
10,049,040 16,748,400 9975600

9,913,680 16,522,800
DAFTAR VARIABEL DAERAH SEBAGAI PENILAIAN TAMBAHAN DALAM MELAKUKAN PEMBAGIAN JASA PELAYANAN
JAMINAN KESEHATAN NASIONAL DI PUSKESMAS BENTENG BULAN OKTOBER TAHUN 2015

VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK
NGAN PEGAWAI KERJA HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

1 Dr. Frengki Wiyaya ( Kepala Pusk IV Dokter Umum 90

2 Dr. Zaenal Abidin IV Dokter Umum 90 8

3 Drg. Yunda Iswari III Dokter Gigi 60 21

4 Saribanong III Perawat 90

5 Muh. Ilham Tamrin III Perawat 90 9

6 Petrus Milu. ET.AMK (Bend. Pusk III Perawat 90

7 Hj. Nur Azizal Hastati,AMK III Perawat 90 4

8 Nur Ariani, AMK III Perawat 75 11

9 Rahma Yuliana, AMK II Perawat 90 4

10 Amsari Parida Amir, AMK II Perawat 90

11 Elsa Handayani, AMK II Perawat 90 1

12 Nadia Sri Damayanti AMK II Perawat 90 6

13 Muhrawati, AMK Perawat 90 3

14 Sri Adrianti, AMK Perawat 90 1

15 Nur Wahyuni, AMK Perawat 90

16 Musfiah Zainuddin, AMK Perawat 90 2

17 Andi Armita Dewi, AMK Perawat 90 3

18 Hasmirawati, AMK Perawat 90 7

19 Muh. Subhan, AMK Perawat 90 2

20 Musdalifah, MR,AMK Perawat 90 7

21 Muhammad Rum, AMK Perawat 90

22 Agustina, AMK Perawat 90

23 Risaldi Razak, AMK Perawat 90 9

24 Dewi Ahryani, AMK Perawat 90

25 Hj. Rostini AMG II Tenaga Penunjang 90

26 Agustini Tenaga Penunjang 90 3

27 Yurniati, A.Md.AK II Analis 90 1

28 Rosdiana III Analis 90 1

29 Yunarsih, AMAK Analis 90 9

30 Bustan II Perawat Gigi 90 2

31 Nur Indah Kurnianti III Teknik Gigi 90 6

32 Rohani III Perawat Gigi 90 2

33 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 90 4

34 St. Rosdiana, B.Sc III Perawat 90 6

35 Muhammad Nawir II Pel. Administrasi 90

36 Agustina Bintang,Amd.Keb III Tenaga Bidan 90

37 Nur Rahmawati, A.md.Keb II Tenaga Bidan 90

38 Suriati, A.md.Keb III Tenaga Bidan 90

39 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 90

40 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 90

41 Andi Yulianti, Amd.Keb II Tenaga Bidan 90

42 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 90 4

43 Isnayani, Amd. Keb Tenaga Bidan 90

44 Andi Jemma, Amd.Keb Tenaga Bidan 90 5

45 Dewi Sartika, Amd.Keb Tenaga Bidan 90

46 Titin Sumarni, Amd.Keb Tenaga Bidan 60 17

47 Lisdayanti, A.md.Keb Tenaga Bidan 90


VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK
NGAN PEGAWAI KERJA HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

48 Yul Fitriani, Amd. Keb Tenaga Bidan 90

49 Andi Isna, Amd.Keb Tenaga Bidan 90 5

50 Rosmiati, Amd.Keb Tenaga Bidan 90

51 Sri Wahyuni, Amd.Keb Tenaga Bidan 90 7

52 Sulastri, Amd.Keb Tenaga Bidan 90

53 Sulmiati Bahri Amd.Keb Tenaga Bidan 75 14

54 Ira Muliati Radi.Amd.Keb Tenaga Bidan 90

55 Rosidah, AMKL III Sanitarian 90 5

56 Israyana Yulianti AMKL III Sanitarian 90

57 Armawati, S.Kep III Perawat 75 13

58 Andi Rezti Wardani S.Kep Ns Perawat 90 1

59 Wa Ode Sinta Kalsum III Pelak. Gizi 90 6

60 Andi Megawati II Teknik Gigi 90

61 Rosmayanti, SKM Tenaga Penunjang 90 7

62 Sudirman H Tenaga Penunjang 90

63 Sri Rahmat Yani Nur III Perawat 90

64 Mayanti, AMF III Tenaga Penunjang 90 1

65 Sri Wedari Yusuf, AMF Tenaga Penunjang 90

66 Hj. Syahraeni, AMK II Perawat 90 1

67 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 90

68 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 90 5

69 Desi Asriana, Amd.Keb Tenaga Bidan 90 3

70 Andi Rezkiiani Amd.Keb Tenaga Bidan 90

71 Hastuti, Amd.Keb Tenaga Bidan 90 2

72 Rosdiana Amd.Keb Tenaga Bidan 90

73 Nur Ilma, Amd.Keb Tenaga Bidan 90

74 Irmawati, Amd.Keb Tenaga Bidan 90

75 Ridha Arbiah, Amd.Keb II Tenaga Bidan 90

76 Ramlah, Amd.Keb Tenaga Bidan 90

77 Ermin Wahida. N III Perawat 90

78 Andi Jumrianti, Amd.Keb Tenaga Bidan 90

79 Yulianti, Amd.Keb Tenaga Bidan 90

80 Israwati Tenaga Penunjang 90

81 Andi Mas Muliani Tenaga Penunjang 90

82 Wahyuni, Amd.Keb II Tenaga Bidan 90

83 Andi Salmei, Amd.Keb Tenaga Bidan 90 3

84 Reski Arisanti Amelia Safitri, AMK Perawat 90 3

Mengetahui : Benteng, 31 Oktober 2015


Kepala UPTD Puskesmas Benteng, Kasubag Tata Usaha,

Dr. Frengki Wijaya Muhammad Ali


Pangkat : Pembina Nip. 19641211 198903 1 019
Nip. 1979092 20004 1 023
VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK
NGAN PEGAWAI KERJA HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

87 Wahyuni, Amd.Keb II Tenaga Bidan

88 Andi Salmei, Amd.Keb Tenaga Bidan

89 Reski Arisanti Amelia Safitri, AMK Perawat

JUMLAH 0 0

Mengetahui : Benteng, 05 September 2015


Kepala UPTD Puskesmas Benteng, Kasubag Tata Usaha,

Dr. Frengki Wijaya Muhammad Ali


Pangkat : Pembina Nip. 19641211 198903 1 019
Nip. 1979092 20004 1 023
DAFTAR VARIABEL DAERAH SEBAGAI PENILAIAN TAMBAHAN DALAM MELAKUKAN PEMBAGIAN JASA PELAYANAN
JAMINAN KESEHATAN NASIONAL DI PUSKESMAS BENTENG BULAN NOPEMBER TAHUN 2015

VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK
NGAN PEGAWAI KERJA HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

1 Dr. Frengki Wiyaya ( Kepala Pusk IV Dokter Umum 90 30 25 5

2 Dr. Zaenal Abidin IV Dokter Umum 90 30 85 6

3 Drg. Yunda Iswari III Dokter Gigi 75 30 0 11

4 Saribanong III Perawat 90 30 100

5 Muh. Ilham Thamrin III Perawat 90 30 40

6 Petrus Milu. ET.AMK (Bend. Pusk III Perawat 90 30 70

7 Hj. Nur Azizal Hastati,AMK III Perawat 90 30 85

8 Nur Ariani, AMK III Perawat 90 30 85

9 Rahma Yuliana, AMK II Perawat 90 30 25

10 Amsari Parida Amir, AMK II Perawat 90 30 25

11 Elsa Handayani, AMK II Perawat 90 30 25

12 Nadia Sri Damayanti AMK II Perawat 90 30 25 3

13 Muhrawati, AMK Perawat 90 10 10

14 Sri Adrianti, AMK Perawat 90 10 10

15 Nur Wahyuni, AMK Perawat 90 10 10

16 Musfiah Zainuddin, AMK Perawat 90 20 10

17 Andi Armita Dewi, AMK Perawat 90 10 10

18 Hasmirawati, AMK Perawat 90 10 25 6

19 Muh. Subhan, AMK Perawat 90 10 0

20 Musdalifah, MR,AMK Perawat 90 10 0 3

21 Muhammad Rum, AMK Perawat 90 10 0

22 Agustina, AMK Perawat 90 10 10

23 Risaldi Razak, AMK Perawat 90 10 0

24 Dewi Ahryani, AMK Perawat 90 10 0

25 Hj. Rostini AMG II Tenaga Penunjang 90 30 70 3

26 Agustini Tenaga Penunjang 90 20 25

27 Yurniati, A.Md.AK II Analis 90 30 25

28 Rosdiana III Analis 90 30 85

29 Yunarsih, AMAK Analis 90 10 10

30 Bustan II Perawat Gigi 90 30 40

31 Nur Indah Kurnianti III Teknik Gigi 90 30 40

32 Rohani III Perawat Gigi 90 30 40

33 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 90 30 70

34 St. Rosdiana, B.Sc III Perawat 90 30 100

35 Muhammad Nawir II Pel. Administrasi 90 30 25 3

36 Agustina Bintang,Amd.Keb III Tenaga Bidan 90 30 85

37 Nur Rahmawati, A.md.Keb II Tenaga Bidan 90 30 25

38 Suriati, A.md.Keb III Tenaga Bidan 90 30 25

39 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 90 30 25

40 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 90 30 25

41 Andi Yulianti, Amd.Keb II Tenaga Bidan 90 30 25

42 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 90 10 0

43 Isnayani, Amd. Keb Tenaga Bidan 90 10 0

44 Andi Jemma, Amd.Keb Tenaga Bidan 90 30 10

45 Dewi Sartika, Amd.Keb Tenaga Bidan 90 10 10

46 Titin Sumarni, Amd.Keb Tenaga Bidan 90 10 0

47 Lisdayanti, A.md.Keb Tenaga Bidan 90 10 10


VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK
NGAN PEGAWAI KERJA HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

48 Yul Fitriani, Amd. Keb Tenaga Bidan 90 10 0

49 Andi Isna, Amd.Keb Tenaga Bidan 90 10 0

50 Rosmiati, Amd.Keb Tenaga Bidan 90 20 0

51 Sri Wahyuni, Amd.Keb Tenaga Bidan 90 10 0

52 Sulastri, Amd.Keb Tenaga Bidan 90 10 0

53 Sulmiati Bahri Amd.Keb Tenaga Bidan 90 10 0

54 Ira Muliati Radi.Amd.Keb Tenaga Bidan 90 30 10

55 Rosidah, AMKL III Sanitarian 90 30 40

56 Israyana Yulianti AMKL III Sanitarian 90 30 40

57 Armawati, S.Kep III Perawat 90 30 40

58 Andi Rezti Wardani S.Kep Ns Perawat 90 10 0

59 Wa Ode Sinta Kalsum III Pelak. Gizi 90 30 70

60 Andi Megawati II Teknik Gigi 90 30 25

61 Rosmayanti, SKM Tenaga Penunjang 90 10 25

62 Sudirman H Tenaga Penunjang 90 20 25

63 Sri Rahmat Yani Nur III Perawat 90 30 70

64 Mayanti, AMF III Tenaga Penunjang 90 30 25

65 Sri Wedari Yusuf, AMF Tenaga Penunjang 90 10 0

66 Hj. Syahraeni, AMK II Perawat 90 30 25

67 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 90 10 0

68 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 90 10 0 4

69 Desi Asriana, Amd.Keb Tenaga Bidan 90 10 0

70 Andi Rezkiiani Amd.Keb Tenaga Bidan 90 10 0

71 Hastuti, Amd.Keb Tenaga Bidan 60 10 0 12

72 Rosdiana Amd.Keb Tenaga Bidan 90 10 0 5

73 Nur Ilma, Amd.Keb Tenaga Bidan 90 30 55

74 Irmawati, Amd.Keb Tenaga Bidan 90 30 10

75 Ridha Arbiah, Amd.Keb II Tenaga Bidan 90 30 25

76 Ramlah, Amd.Keb Tenaga Bidan 90 30 10

77 Ermin Wahida. N III Perawat 90 30 55

78 Andi Jumrianti, Amd.Keb Tenaga Bidan 90 30 10

79 Yulianti, Amd.Keb Tenaga Bidan 90 30 10

80 Israwati Tenaga Penunjang 90 20 10

81 Andi Mas Muliani Tenaga Penunjang 90 10 10

82 Wahyuni, Amd.Keb II Tenaga Bidan 90 30 25

83 Andi Salmei, Amd.Keb Tenaga Bidan 90 30 10

84 Reski Arisanti Amelia Safitri, AMK Perawat 90 10 10

Mengetahui : Benteng, 30 Nopember 2015


Kepala UPTD Puskesmas Benteng, Kasubag Tata Usaha,

Dr. Frengki Wijaya Muhammad Ali


Pangkat : Pembina Nip. 19641211 198903 1 019
Nip. 1979092 20004 1 023
VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK
NGAN PEGAWAI KERJA HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

87 Wahyuni, Amd.Keb II Tenaga Bidan

88 Andi Salmei, Amd.Keb Tenaga Bidan

89 Reski Arisanti Amelia Safitri, AMK Perawat

JUMLAH 1810 2080

Mengetahui : Benteng, 05 September 2015


Kepala UPTD Puskesmas Benteng, Kasubag Tata Usaha,

Dr. Frengki Wijaya Muhammad Ali


Pangkat : Pembina Nip. 19641211 198903 1 019
Nip. 1979092 20004 1 023
DAFTAR PENERIMAAN JASA PELAYANAN KESEHATAN PESERTA JKN BAGI PETUGAS PUSKESMAS PUSTU DAN POSKEDES
BULAN NOPEMBER TAHUN 2015
PUSKESMAS : BENTENG
JUMLAH PESERTA : 7245 ORANG
JUMLAH PEGAWAI : 84 ORANG
BESARAN KAPITASI : 6000 PERJIWA / BULAN
TOTAL KAPITASI : 44,013,000 TOTAL JASA PELAYANAN SESUAI SK BUPATI 60 % = 26,407,800.-

GOLO VARIABEL POINT POINT VARIABEL DAERAH POINT POINT JUMLAH PPH JUMLAH
NO NAMA PETUGAS NGAN JABATAN KETENA KEHADIRAN JABA /ORG /ORG KINER STATUS MASA /ORG /ORG DITERIMA PASAL 21 DIBAYARKAN TANDA TANGAN
GAAN EFEKTIF 1 BLNTDK HADIR TAN /HARI BULAN JA KEPEG KERJA HARI BULAN ( Rp ) ( 15% / 5% ) ( Rp )
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

1 Dr. Frengki Wiyaya ( Kepala Pusk) IV Dokter Umum 150 25 5 30 7.2 144.0 90 30 25 5.8 116.00 Rp 468,064 Rp 70,210 Rp 397,854 1

2 Dr. Zaenal Abidin IV Dokter Umum 150 25 6 6.0 114.0 90 30 85 8.2 155.80 Rp 485,706 Rp 72,856 Rp 412,850 2

3 Drg. Yunda Iswari III Dokter Gigi 150 25 11 6.0 84.0 75 30 0 4.2 58.80 Rp 257,075 Rp 12,854 Rp 244,221 3

4 Saribanong III Perawat 40 25 1.6 40.0 90 30 100 8.8 220.00 Rp 468,064 Rp 23,403 Rp 444,661 4

5 Muh. Ilham Thamrin III Perawat 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 360,049 Rp 18,002 Rp 342,047 5

6 Petrus Milu. ET.AMK (Bend. Pusk) III Perawat 40 25 30 2.8 70.0 90 30 70 7.6 190.00 Rp 468,064 Rp 23,403 Rp 444,661 6

7 Hj. Nur Azizal Hastati,AMK III Perawat 40 25 1.6 40.0 90 30 85 8.2 205.00 Rp 441,060 Rp 22,053 Rp 419,007 7

8 Nur Ariani, AMK III Perawat 40 25 1.6 40.0 90 30 85 8.2 205.00 Rp 441,060 Rp 22,053 Rp 419,007 8

9 Rahma Yuliana, AMK II Perawat 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 333,045 Rp - Rp 333,045 9

10 Amsari Parida Amir, AMK II Perawat 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 333,045 Rp - Rp 333,045 10

11 Elsa Handayani, AMK II Perawat 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 333,045 Rp - Rp 333,045 11

12 Nadia Sri Damayanti AMK II Perawat 40 25 3 1.6 35.2 90 30 25 5.8 127.60 Rp 293,080 Rp - Rp 293,080 12

13 Muhrawati, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 270,037 Rp - Rp 270,037 13

14 Sri Adrianti, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 270,037 Rp - Rp 270,037 14

15 Nur Wahyuni, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 270,037 Rp - Rp 270,037 15

16 Musfiah Zainuddin, AMK Perawat 40 25 1.6 40.0 90 20 10 4.8 120.00 Rp 288,039 Rp - Rp 288,039 16

17 Andi Armita Dewi, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 270,037 Rp - Rp 270,037 17

18 Hasmirawati, AMK Perawat 40 25 6 1.6 30.4 90 10 25 5.0 95.00 Rp 225,751 Rp - Rp 225,751 18

19 Muh. Subhan, AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 252,034 Rp - Rp 252,034 19

20 Musdalifah, MR,AMK Perawat 40 25 3 1.6 35.2 90 10 0 4.0 88.00 Rp 221,790 Rp - Rp 221,790 20


21 Muhammad Rum, AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 252,034 Rp - Rp 252,034 21

22 Agustina, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 270,037 Rp - Rp 270,037 22

23 Risaldi Razak, AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 252,034 Rp - Rp 252,034 23

24 Dewi Ahryani, AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 252,034 Rp - Rp 252,034 24

25 Hj. Rostini AMG II Tenaga Penunjang 40 25 3 1.6 35.2 90 30 70 7.6 167.20 Rp 364,370 Rp Rp 364,370 25

26 Agustini Tenaga Penunjang 15 25 0.6 15.0 90 20 25 5.4 135.00 Rp 270,037 Rp - Rp 270,037 26

27 Yurniati, A.Md.AK II Analis 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 333,045 Rp - Rp 333,045 27

28 Rosdiana III Analis 40 25 1.6 40.0 90 30 85 8.2 205.00 Rp 441,060 Rp 22,053 Rp 419,007 28

29 Yunarsih, AMAK Analis 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 270,037 Rp - Rp 270,037 29

30 Bustan II Perawat Gigi 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 360,049 Rp - Rp 360,049 30

31 Nur Indah Kurnianti III Teknik Gigi 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 360,049 Rp 18,002 Rp 342,047 31

32 Rohani III Perawat Gigi 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 360,049 Rp 18,002 Rp 342,047 32

33 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 40 25 30 2.8 70.0 90 30 70 7.6 190.00 Rp 468,064 Rp 23,403 Rp 444,661 33

34 St. Rosdiana, B.Sc III Perawat 40 25 1.6 40.0 90 30 100 8.8 220.00 Rp 468,064 Rp 23,403 Rp 444,661 34

35 Muhammad Nawir II Pel. Administrasi 15 25 3 0.6 13.2 90 30 25 5.8 127.60 Rp 253,475 Rp - Rp 253,475 35

36 Agustina Bintang,Amd.Keb III Tenaga Bidan 40 25 1.6 40.0 90 30 85 8.2 205.00 Rp 441,060 Rp 22,053 Rp 419,007 36

37 Nur Rahmawati, A.md.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 333,045 Rp - Rp 333,045 37

38 Suriati, A.md.Keb III Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 333,045 Rp 16,652 Rp 316,393 38

39 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 333,045 Rp - Rp 333,045 39

40 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 333,045 Rp - Rp 333,045 40

41 Andi Yulianti, Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 333,045 Rp - Rp 333,045 41

42 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 252,034 Rp - Rp 252,034 42

43 Isnayani, Amd. Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 252,034 Rp - Rp 252,034 43

44 Andi Jemma, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 306,042 Rp - Rp 306,042 44

45 Dewi Sartika, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 270,037 Rp - Rp 270,037 45

46 Titin Sumarni, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 252,034 Rp - Rp 252,034 46

47 Lisdayanti, A.md.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 270,037 Rp - Rp 270,037 47

48 Yul Fitriani, Amd. Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 252,034 Rp - Rp 252,034 48

49 Andi Isna, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 252,034 Rp - Rp 252,034 49
50 Rosmiati, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 20 0 4.4 110.00 Rp 270,037 Rp - Rp 270,037 50

51 Sri Wahyuni, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 252,034 Rp - Rp 252,034 51

52 Sulastri, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 252,034 Rp - Rp 252,034 52

53 Sulmiati Bahri Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 252,034 Rp - Rp 252,034 53

54 Ira Muliati Radi.Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 306,042 Rp - Rp 306,042 54

55 Rosidah, AMKL III Sanitarian 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 360,049 Rp 18,002 Rp 342,047 55

56 Israyana Yulianti AMKL III Sanitarian 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 360,049 Rp 18,002 Rp 342,047 56

57 Armawati, S.Kep III Perawat 60 25 2.4 60.0 90 30 40 6.4 160.00 Rp 396,054 Rp 19,803 Rp 376,251 57

58 Andi Rezti Wardani S.Kep Ns Perawat 100 25 4.0 100.0 90 10 0 4.0 100.00 Rp 360,049 Rp 18,002 Rp 342,047 58

59 Wa Ode Sinta Kalsum III Pelak. Gizi 40 25 1.6 40.0 90 30 70 7.6 190.00 Rp 414,056 Rp 20,703 Rp 393,354 59

60 Andi Megawati II Teknik Gigi 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 333,045 Rp - Rp 333,045 60

61 Rosmayanti, SKM Tenaga Penunjang 60 25 2.4 60.0 90 10 25 5.0 125.00 Rp 333,045 Rp 16,652 Rp 316,393 61

62 Sudirman H Tenaga Penunjang 15 25 0.6 15.0 90 20 25 5.4 135.00 Rp 270,037 Rp - Rp 270,037 62

63 Sri Rahmat Yani Nur III Perawat 40 25 1.6 40.0 90 30 70 7.6 190.00 Rp 414,056 Rp 20,703 Rp 393,354 63

64 Mayanti, AMF III Tenaga Penunjang 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 333,045 Rp 16,652 Rp 316,393 64

65 Sri Wedari Yusuf, AMF Tenaga Penunjang 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 252,034 Rp - Rp 252,034 65

66 Hj. Syahraeni, AMK II Perawat 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 333,045 Rp - Rp 333,045 66

67 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 252,034 Rp - Rp 252,034 67

68 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 40 25 4 1.6 33.6 90 10 0 4.0 84.00 Rp 211,709 Rp - Rp 211,709 68

69 Desi Asriana, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 252,034 Rp - Rp 252,034 69

70 Andi Rezkiiani Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 252,034 Rp - Rp 252,034 70

71 Hastuti, Amd.Keb Tenaga Bidan 40 25 12 1.6 20.8 60 10 0 2.8 36.40 Rp 102,974 Rp - Rp 102,974 71

72 Rosdiana Amd.Keb Tenaga Bidan 40 25 5 1.6 32.0 90 10 0 4.0 80.00 Rp 201,627 Rp - Rp 201,627 72

73 Nur Ilma, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 55 7.0 175.00 Rp 387,053 Rp - Rp 387,053 73

74 Irmawati, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 306,042 Rp - Rp 306,042 74

75 Ridha Arbiah, Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 333,045 Rp - Rp 333,045 75

76 Ramlah, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 306,042 Rp - Rp 306,042 76

77 Ermin Wahida. N III Perawat 40 25 1.6 40.0 90 30 55 7.0 175.00 Rp 387,053 Rp 19,353 Rp 367,700 77

78 Andi Jumrianti, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 306,042 Rp - Rp 306,042 78
79 Yulianti, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 306,042 Rp - Rp 306,042 79

80 Israwati Tenaga Penunjang 15 25 0.6 15.0 90 20 10 4.8 120.00 Rp 243,033 Rp - Rp 243,033 80

81 Andi Mas Muliani Tenaga Penunjang 15 25 0.6 15.0 90 10 10 4.4 110.00 Rp 225,031 Rp - Rp 225,031 81

82 Wahyuni, Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 333,045 Rp - Rp 333,045 82

83 Andi Salmei, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 306,042 Rp - Rp 306,042 83

84 Reski Arisanti Amelia Safitri, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 270,037 Rp - Rp 270,037 84

JUMLAH 3665 2100 61 90 150 3,557.6 7515 1810 2080 456 11111.4 Rp 26,407,800 Rp 576,277 Rp 25,831,523

Mengetahui / Menyetujui : Benteng, 30 Nopember 2015


Kepala UPTD Puskesmas Benteng Bendahara JKN

Dr. FRENGKI WIJAYA PETRUS MILU E.T, AMK


Pangkat : Pembina Nip 19710704 199103 1 009
NIP. 19790926 200604 1 023
150 30 24 151.25
-

44,013,000
44,013,000 44,013,000 26,407,800 17,605,200 7,042,080 10,563,120

10,700,000 16,066,000 ###


66,915,000

260.00 Dr. Frengki Wiyaya ( 14669.0000 26,407,800 15239.792 150

269.80 Dr. Zaenal Abidin 14669.0000 26,407,800 15239.792

142.80 Drg. Yunda Iswari 14669.0000 26,407,800 15239.792

260.00 Saribanong 14669.0000 26,407,800 15239.792 41,871,000 25,122,600

200.00 Muh. Ilham Thamrin 14669.0000 26,407,800 15239.792 41,871,000 16,748,400 6,699,360 10,049,040

260.00 Petrus Milu. ET.AMK 14669.0000 26,407,800 15239.792 41,871,000

245.00 Hj. Nur Azizal Hasta 14669.0000 26,407,800 15239.792 6,609,120 9,913,680

245.00 Nur Ariani, AMK 14669.0000 26,407,800

185.00 Rahma Yuliana, AM 14669.0000 26,407,800 15239.792

185.00 Amsari Parida Amir, 14669.0000 26,407,800 15239.792

185.00 Elsa Handayani, AM 14669.0000 26,407,800 15239.792

162.80 Nadia Sri Damayant 14669.0000 26,407,800 15239.792

150.00 Muhrawati, AMK 14669.0000 26,407,800 15239.792

150.00 Sri Adrianti, AMK 14669.0000 26,407,800 15239.792 24,784,200

150.00 Nur Wahyuni, AMK 14669.0000 26,407,800 15239.792

160.00 Musfiah Zainuddin, 14669.0000 26,407,800 15239.792

150.00 Andi Armita Dewi, 14669.0000 26,407,800 15239.792

125.40 Hasmirawati, AMK 14669.0000 26,407,800 15239.792

140.00 Muh. Subhan, AMK 14669.0000 26,407,800 15239.792

123.20 Musdalifah, MR,AMK 14669.0000 26,407,800 15239.792


140.00 Muhammad Rum, A 14669.0000 26,407,800 15239.792

150.00 Agustina, AMK 14669.0000 26,407,800 15239.792

140.00 Risaldi Razak, AMK 14669.0000 26,407,800 15239.792

140.00 Dewi Ahryani, AMK 14669.0000 26,407,800 15239.792

202.40 Hj. Rostini AMG 14669.0000 26,407,800 15239.792

150.00 Agustini 14669.0000 26,407,800 15239.792

185.00 Yurniati, A.Md.AK 14669.0000 26,407,800 15239.792

245.00 Rosdiana 14669.0000 26,407,800 15239.792

150.00 Yunarsih, AMAK 14669.0000 26,407,800 15239.792

200.00 Bustan 14669.0000 26,407,800 15239.792

200.00 Nur Indah Kurnianti 14669.0000 26,407,800 15239.792

200.00 Rohani 14669.0000 26,407,800 15239.792

260.00 Muhammad Ali (TU 14669.0000 26,407,800 15239.792

260.00 St. Rosdiana, B.Sc 14669.0000 26,407,800 15239.792

140.80 Muhammad Nawir 14669.0000 26,407,800

245.00 Agustina Bintang,A 14669.0000 26,407,800 15239.792

185.00 Nur Rahmawati, A.m 14669.0000 26,407,800 15239.792

185.00 Suriati, A.md.Keb 14669.0000 26,407,800 15239.792

185.00 Sitti Aminah Anas,A 14669.0000 26,407,800 15239.792

185.00 Sitti Suprihartini,Am 14669.0000 26,407,800 15239.792

185.00 Andi Yulianti, Amd.K 14669.0000 26,407,800 15239.792

140.00 Mira Septari. R.S, A 14669.0000 26,407,800 15239.792

140.00 Isnayani, Amd. Keb 14669.0000 26,407,800 15239.792

170.00 Andi Jemma, Amd.K 14669.0000 26,407,800

150.00 Dewi Sartika, Amd.K 14669.0000 26,407,800 15239.792

140.00 Titin Sumarni, Amd. 14669.0000 26,407,800 15239.792

150.00 Lisdayanti, A.md.Ke 14669.0000 26,407,800 15239.792

140.00 Yul Fitriani, Amd. Ke 14669.0000 26,407,800 15239.792

140.00 Andi Isna, Amd.Keb 14669.0000 26,407,800 15239.792


150.00 Rosmiati, Amd.Keb 14669.0000 26,407,800 15239.792

140.00 Sri Wahyuni, Amd.K 14669.0000 26,407,800 15239.792

140.00 Sulastri, Amd.Keb 14669.0000 26,407,800 15239.792

140.00 Sulmiati Bahri Amd. 14669.0000 26,407,800 15239.792

170.00 Ira Muliati Radi.Amd 14669.0000 26,407,800 15239.792

200.00 Rosidah, AMKL 14669.0000 26,407,800 15239.792

200.00 Israyana Yulianti A 14669.0000 26,407,800 15239.792

220.00 Armawati, S.Kep 14669.0000 26,407,800 15239.792

200.00 Andi Rezti Wardani 14669.0000 26,407,800 15239.792

230.00 Wa Ode Sinta Kalsu 14669.0000 26,407,800 15239.792

185.00 Andi Megawati 14669.0000 26,407,800 15239.792

185.00 Rosmayanti, SKM 14669.0000 26,407,800 15239.792

150.00 Sudirman H 14669.0000 26,407,800 15239.792

230.00 Sri Rahmat Yani Nur 14669.0000 26,407,800 15239.792

185.00 Mayanti, AMF 14669.0000 26,407,800 15239.792

140.00 Sri Wedari Yusuf, A 14669.0000 26,407,800 15239.792

185.00 Hj. Syahraeni, AMK 14669.0000 26,407,800 15239.792

140.00 Andi Tenri Ellung N 14669.0000 26,407,800 15239.792

117.60 Wahyuni Hamsah, A 14669.0000 26,407,800 15239.792

140.00 Desi Asriana, Amd.K 14669.0000 26,407,800 15239.792

140.00 Andi Rezkiiani Amd. 14669.0000 26,407,800 15239.792

57.20 Hastuti, Amd.Keb 14669.0000 26,407,800 15239.792

112.00 Rosdiana Amd.Keb 14669.0000 26,407,800 15239.792

215.00 Nur Ilma, Amd.Keb 14669.0000 26,407,800 15239.792

170.00 Irmawati, Amd.Keb 14669.0000 26,407,800 15239.792

185.00 Ridha Arbiah, Amd. 14669.0000 26,407,800 15239.792

170.00 Ramlah, Amd.Keb 14669.0000 26,407,800 15239.792

215.00 Ermin Wahida. N 14669.0000 26,407,800 15239.792

170.00 Andi Jumrianti, Amd 14669.0000 26,407,800 15239.792


170.00 Yulianti, Amd.Keb 14669.0000 26,407,800 15239.792

135.00 Israwati 14669.0000 26,407,800 15239.792

125.00 Andi Mas Muliani 14669.0000 26,407,800 15239.792

185.00 Wahyuni, Amd.Keb 14669.0000 26,407,800 15239.792

170.00 Andi Salmei, Amd.K 14669.0000 26,407,800

150.00 Reski Arisanti Amelia 14669.0000 26,407,800 15239.792

14669.0000 14669.000
16,748,400 9975600

16,522,800
DAFTAR VARIABEL DAERAH SEBAGAI PENILAIAN TAMBAHAN DALAM MELAKUKAN PEMBAGIAN JASA PELAYANAN
JAMINAN KESEHATAN NASIONAL DI PUSKESMAS BENTENG BULAN DESEMBER TAHUN 2015

VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK
NGAN PEGAWAI KERJA HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

1 Dr. Frengki Wiyaya ( Kepala Pusk IV Dokter Umum 90 3

2 Dr. Zaenal Abidin IV Dokter Umum 90 1

3 Drg. Yunda Iswari III Dokter Gigi 90

4 Saribanong III Perawat 90

5 Muh. Ilham Thamrin III Perawat 90

6 Petrus Milu. ET.AMK (Bend. Pusk III Perawat 90

7 Hj. Nur Azizal Hastati,AMK III Perawat 90 1

8 Nur Ariani, AMK III Perawat 50 20

9 Rahma Yuliana, AMK II Perawat 90 1

10 Amsari Parida Amir, AMK II Perawat 90 3

11 Elsa Handayani, AMK II Perawat 90

12 Nadia Sri Damayanti AMK II Perawat 90

13 Sri Sulastri AMK II Perawat 60 13

14 Muhrawati, AMK Perawat 90

15 Sri Adrianti, AMK Perawat 90

16 Nur Wahyuni, AMK Perawat 90 1

17 Musfiah Zainuddin, AMK Perawat 60 10

18 Andi Armita Dewi, AMK Perawat 90

19 Hasmirawati, AMK Perawat 90 1

20 Muh. Subhan, AMK Perawat 90 5

21 Musdalifah, MR,AMK Perawat 90 1

22 Muhammad Rum, AMK Perawat 90 2

23 Agustina, AMK Perawat 90 4

24 Risaldi Razak, AMK Perawat 90 5

25 Dewi Ahryani, AMK Perawat 90

26 Hj. Rostini AMG II Tenaga Penunjang 90 2

27 Agustini Tenaga Penunjang 90 4

28 Yurniati, A.Md.AK II Analis 90 3

29 Rosdiana III Analis 90 2

30 Normalina A.Md.AK II Analis 60 16

31 Yunarsih, AMAK Analis 90 2

32 Bustan II Perawat Gigi 90

33 Nur Indah Kurnianti III Teknik Gigi 90

34 Rohani III Perawat Gigi 90 3

35 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 90

36 St. Rosdiana, B.Sc III Perawat 90 1

37 Muhammad Nawir II Pel. Administrasi 90

38 Agustina Bintang,Amd.Keb III Tenaga Bidan 90

39 Nur Rahmawati, A.md.Keb II Tenaga Bidan 90

40 Suriati, A.md.Keb III Tenaga Bidan 90

41 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 90

42 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 90

43 Andi Yulianti, Amd.Keb II Tenaga Bidan 90

44 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 75 6

45 Isnayani, Amd. Keb Tenaga Bidan 90 1

46 Andi Jemma, Amd.Keb Tenaga Bidan 75 4

47 Dewi Sartika, Amd.Keb Tenaga Bidan 60 5


VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK
NGAN PEGAWAI KERJA HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

48 Titin Sumarni, Amd.Keb Tenaga Bidan 90 1

49 Lisdayanti, A.md.Keb Tenaga Bidan 90

50 Yul Fitriani, Amd. Keb Tenaga Bidan 90

51 Andi Isna, Amd.Keb Tenaga Bidan 90 2

52 Rosmiati, Amd.Keb Tenaga Bidan 90

53 Sri Wahyuni, Amd.Keb Tenaga Bidan 90

54 Sulastri, Amd.Keb Tenaga Bidan 90

55 Sulmiati Bahri Amd.Keb Tenaga Bidan 90

56 Ira Muliati Radi.Amd.Keb Tenaga Bidan 90 3

57 Rosidah, AMKL III Sanitarian 90

58 Israyana Yulianti AMKL III Sanitarian 90

59 Armawati, S.Kep III Perawat 90

60 Andi Rezti Wardani S.Kep Ns Perawat 90

61 Wa Ode Sinta Kalsum III Pelak. Gizi 90

62 Andi Megawati II Teknik Gigi 90

63 Rosmayanti, SKM Tenaga Penunjang 50 13

64 Sudirman H Tenaga Penunjang 90

65 Sri Rahmat Yani Nur III Perawat 90

66 Mayanti, AMF III Tenaga Penunjang 90

67 Sri Wedari Yusuf, AMF Tenaga Penunjang 90

68 Hj. Syahraeni, AMK II Perawat 60 9

69 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 90

70 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 90

71 Desi Asriana, Amd.Keb Tenaga Bidan 90

72 Andi Rezkiiani Amd.Keb Tenaga Bidan 90

73 Hastuti, Amd.Keb Tenaga Bidan 90

74 Rosdiana Amd.Keb Tenaga Bidan 90

75 Nur Ilma, Amd.Keb Tenaga Bidan 90 2

76 Irmawati, Amd.Keb Tenaga Bidan 90

77 Ridha Arbiah, Amd.Keb II Tenaga Bidan 90

78 Ramlah, Amd.Keb Tenaga Bidan 90

79 Ermin Wahida. N III Perawat 90

80 Andi Jumrianti, Amd.Keb Tenaga Bidan 90

81 Yulianti, Amd.Keb Tenaga Bidan 90

82 Israwati Tenaga Penunjang 90

83 Andi Mas Muliani Tenaga Penunjang 90

84 Wahyuni, Amd.Keb II Tenaga Bidan 90

85 Andi Salmei, Amd.Keb Tenaga Bidan 90

86 Reski Arisanti Amelia Safitri, AMK Perawat 90

Mengetahui : Benteng, 31 Desember 2015


Kepala UPTD Puskesmas Benteng, Kasubag Tata Usaha,

Dr. Frengki Wijaya Muhammad Ali


Pangkat : Pembina Nip. 19641211 198903 1 019
Nip. 1979092 20004 1 023
VARIABEL
GOLO TIDAK
KINERJA STATUS MASA
NO NAMA/ NIP / NR.PTT JABATAN
AMAT BAIK BAIK CUKUP KURANG BURUK
NGAN PEGAWAI KERJA HADIR
91 S/D 100 76 S/D 90 61 S/D 75 51 S/D 60 0 S/D 50

87 Wahyuni, Amd.Keb II Tenaga Bidan

88 Andi Salmei, Amd.Keb Tenaga Bidan

89 Reski Arisanti Amelia Safitri, AMK Perawat

JUMLAH 0 0

Mengetahui : Benteng, 05 September 2015


Kepala UPTD Puskesmas Benteng, Kasubag Tata Usaha,

Dr. Frengki Wijaya Muhammad Ali


Pangkat : Pembina Nip. 19641211 198903 1 019
Nip. 1979092 20004 1 023
DAFTAR PENERIMAAN JASA PELAYANAN KESEHATAN PESERTA JKN BAGI PETUGAS PUSKESMAS PUSTU DAN POSKEDES
BULAN DESEMBER TAHUN 2015
PUSKESMAS : BENTENG
JUMLAH PESERTA : 7.441 ORANG
JUMLAH PEGAWAI : 86 ORANG
BESARAN KAPITASI : 6000 PERJIWA / BULAN
TOTAL KAPITASI : 44,643,000 TOTAL JASA PELAYANAN SESUAI SK BUPATI 60 % = 26,785,800.-

GOLO VARIABEL POINT POINT VARIABEL DAERAH POINT POINT JUMLAH PPH JUMLAH
NO NAMA PETUGAS NGAN JABATAN KETENA KEHADIRAN JABA /ORG /ORG KINER STATUS MASA /ORG /ORG DITERIMA PASAL 21 DIBAYARKAN TANDA TANGAN
GAAN EFEKTIF 1 BLNTDK HADIR TAN /HARI BULAN JA KEPEG KERJA HARI BULAN ( Rp ) ( 15% / 5% ) ( Rp )
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

1 Dr. Frengki Wiyaya ( Kepala Pusk) IV Dokter Umum 150 25 3 30 7.2 158.4 90 30 25 5.8 127.60 Rp 536,013 Rp 80,402 Rp 455,611 1

2 Dr. Zaenal Abidin IV Dokter Umum 150 25 1 6.0 144.0 90 30 85 8.2 196.80 Rp 638,717 Rp 95,808 Rp 542,910 2

3 Drg. Yunda Iswari III Dokter Gigi 150 25 6.0 150.0 90 30 0 4.8 120.00 Rp 506,026 Rp 25,301 Rp 480,725 3

4 Saribanong III Perawat 40 25 1.6 40.0 90 30 100 8.8 220.00 Rp 487,284 Rp 24,364 Rp 462,920 4

5 Muh. Ilham Thamrin III Perawat 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 374,834 Rp 18,742 Rp 356,092 5

6 Petrus Milu. ET.AMK (Bend. Pusk) III Perawat 40 25 30 2.8 70.0 90 30 70 7.6 190.00 Rp 487,284 Rp 24,364 Rp 462,920 6

7 Hj. Nur Azizal Hastati,AMK III Perawat 40 25 1 1.6 38.4 90 30 85 8.2 196.80 Rp 440,805 Rp 22,040 Rp 418,765 7

8 Nur Ariani, AMK III Perawat 40 25 20 1.6 8.0 50 30 85 6.6 33.00 Rp 76,841 Rp 3,842 Rp 72,999 8

9 Rahma Yuliana, AMK II Perawat 40 25 1 1.6 38.4 90 30 25 5.8 139.20 Rp 332,853 Rp - Rp 332,853 9

10 Amsari Parida Amir, AMK III Perawat 40 25 3 1.6 35.2 90 30 25 5.8 127.60 Rp 305,115 Rp 15,256 Rp 289,859 10

11 Elsa Handayani, AMK II Perawat 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 346,722 Rp - Rp 346,722 11

12 Nadia Sri Damayanti AMK III Perawat 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 346,722 Rp 17,336 Rp 329,385 12

13 Sri Sulastri AMK II Perawat 40 22 13 1.8 16.4 60 30 25 5.2 47.05 Rp 118,839 Rp - Rp 118,839 13

14 Muhrawati, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 281,126 Rp - Rp 281,126 14

15 Sri Adrianti, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 281,126 Rp - Rp 281,126 15

16 Nur Wahyuni, AMK Perawat 40 25 1 1.6 38.4 90 10 10 4.4 105.60 Rp 269,881 Rp - Rp 269,881 16

17 Musfiah Zainuddin, AMK Perawat 40 25 10 1.6 24.0 60 20 10 3.6 54.00 Rp 146,185 Rp - Rp 146,185 17

18 Andi Armita Dewi, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 281,126 Rp - Rp 281,126 18

19 Hasmirawati, AMK Perawat 40 25 1 1.6 38.4 90 10 25 5.0 120.00 Rp 296,869 Rp - Rp 296,869 19

20 Muh. Subhan, AMK Perawat 40 25 5 1.6 32.0 90 10 0 4.0 80.00 Rp 209,907 Rp - Rp 209,907 20
21 Musdalifah, MR,AMK Perawat 40 25 1 1.6 38.4 90 10 0 4.0 96.00 Rp 251,889 Rp - Rp 251,889 21

22 Muhammad Rum, AMK Perawat 40 25 2 1.6 36.8 90 10 0 4.0 92.00 Rp 241,393 Rp - Rp 241,393 22

23 Agustina, AMK Perawat 40 25 4 1.6 33.6 90 10 10 4.4 92.40 Rp 236,145 Rp - Rp 236,145 23

24 Risaldi Razak, AMK Perawat 40 25 5 1.6 32.0 90 10 0 4.0 80.00 Rp 209,907 Rp - Rp 209,907 24

25 Dewi Ahryani, AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 262,384 Rp - Rp 262,384 25

26 Hj. Rostini AMG II Tenaga Penunjang 40 25 2 1.6 36.8 90 30 70 7.6 174.80 Rp 396,575 Rp Rp 396,575 26

27 Agustini Tenaga Penunjang 15 25 4 0.6 12.6 90 20 25 5.4 113.40 Rp 236,145 Rp - Rp 236,145 27

28 Yurniati, A.Md.AK II Analis 40 25 3 1.6 35.2 90 30 25 5.8 127.60 Rp 305,115 Rp - Rp 305,115 28

29 Rosdiana III Analis 40 25 2 1.6 36.8 90 30 85 8.2 188.60 Rp 422,438 Rp 21,122 Rp 401,316 29

30 Normalina A.Md.AK II Analis 40 22 16 1.8 10.9 60 30 25 5.2 31.36 Rp 79,226 Rp - Rp 79,226 30

31 Yunarsih, AMAK Analis 40 25 2 1.6 36.8 90 10 10 4.4 101.20 Rp 258,636 Rp - Rp 258,636 31

32 Bustan II Perawat Gigi 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 374,834 Rp - Rp 374,834 32

33 Nur Indah Kurnianti III Teknik Gigi 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 374,834 Rp 18,742 Rp 356,092 33

34 Rohani III Perawat Gigi 40 25 3 1.6 35.2 90 30 40 6.4 140.80 Rp 329,854 Rp 16,493 Rp 313,361 34

35 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 40 25 30 2.8 70.0 90 30 70 7.6 190.00 Rp 487,284 Rp 24,364 Rp 462,920 35

36 St. Rosdiana, B.Sc III Perawat 40 25 1 1.6 38.4 90 30 100 8.8 211.20 Rp 467,793 Rp 23,390 Rp 444,403 36

37 Muhammad Nawir II Pel. Administrasi 15 25 0.6 15.0 90 30 25 5.8 145.00 Rp 299,867 Rp - Rp 299,867 37

38 Agustina Bintang,Amd.Keb III Tenaga Bidan 40 25 1.6 40.0 90 30 85 8.2 205.00 Rp 459,172 Rp 22,959 Rp 436,213 38

39 Nur Rahmawati, A.md.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 346,722 Rp - Rp 346,722 39

40 Suriati, A.md.Keb III Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 346,722 Rp 17,336 Rp 329,385 40

41 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 346,722 Rp - Rp 346,722 41

42 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 346,722 Rp - Rp 346,722 42

43 Andi Yulianti, Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 346,722 Rp - Rp 346,722 43

44 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 40 25 6 1.6 30.4 75 10 0 3.4 64.60 Rp 178,046 Rp - Rp 178,046 44

45 Isnayani, Amd. Keb Tenaga Bidan 40 25 1 1.6 38.4 90 10 0 4.0 96.00 Rp 251,889 Rp - Rp 251,889 45

46 Andi Jemma, Amd.Keb Tenaga Bidan 40 25 4 1.6 33.6 75 30 10 4.6 96.60 Rp 244,017 Rp - Rp 244,017 46

47 Dewi Sartika, Amd.Keb Tenaga Bidan 40 25 5 1.6 32.0 60 10 10 3.2 64.00 Rp 179,920 Rp - Rp 179,920 47

48 Titin Sumarni, Amd.Keb Tenaga Bidan 40 25 1 1.6 38.4 90 10 0 4.0 96.00 Rp 251,889 Rp - Rp 251,889 48

49 Lisdayanti, A.md.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 281,126 Rp - Rp 281,126 49
50 Yul Fitriani, Amd. Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 262,384 Rp - Rp 262,384 50

51 Andi Isna, Amd.Keb Tenaga Bidan 40 25 2 1.6 36.8 90 10 0 4.0 92.00 Rp 241,393 Rp - Rp 241,393 51

52 Rosmiati, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 20 0 4.4 110.00 Rp 281,126 Rp - Rp 281,126 52

53 Sri Wahyuni, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 262,384 Rp - Rp 262,384 53

54 Sulastri, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 262,384 Rp - Rp 262,384 54

55 Sulmiati Bahri Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 262,384 Rp - Rp 262,384 55

56 Ira Muliati Radi.Amd.Keb Tenaga Bidan 40 25 3 1.6 35.2 90 30 10 5.2 114.40 Rp 280,376 Rp - Rp 280,376 56

57 Rosidah, AMKL III Sanitarian 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 374,834 Rp 18,742 Rp 356,092 57

58 Israyana Yulianti AMKL III Sanitarian 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 374,834 Rp 18,742 Rp 356,092 58

59 Armawati, S.Kep III Perawat 60 25 2.4 60.0 90 30 40 6.4 160.00 Rp 412,318 Rp 20,616 Rp 391,702 59

60 Andi Rezti Wardani S.Kep Ns Perawat 100 25 4.0 100.0 90 10 0 4.0 100.00 Rp 374,834 Rp 18,742 Rp 356,092 60

61 Wa Ode Sinta Kalsum III Pelak. Gizi 40 25 1.6 40.0 90 30 70 7.6 190.00 Rp 431,059 Rp 21,553 Rp 409,506 61

62 Andi Megawati II Teknik Gigi 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 346,722 Rp - Rp 346,722 62

63 Rosmayanti, SKM Tenaga Penunjang 60 25 13 2.4 28.8 50 10 25 3.4 40.80 Rp 130,442 Rp 6,522 Rp 123,920 63

64 Sudirman H Tenaga Penunjang 15 25 0.6 15.0 90 20 25 5.4 135.00 Rp 281,126 Rp - Rp 281,126 64

65 Sri Rahmat Yani Nur III Perawat 40 25 1.6 40.0 90 30 70 7.6 190.00 Rp 431,059 Rp 21,553 Rp 409,506 65

66 Mayanti, AMF III Tenaga Penunjang 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 346,722 Rp 17,336 Rp 329,385 66

67 Sri Wedari Yusuf, AMF Tenaga Penunjang 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 262,384 Rp - Rp 262,384 67

68 Hj. Syahraeni, AMK III Perawat 40 25 9 1.6 25.6 60 30 25 4.6 73.60 Rp 185,918 Rp 9,296 Rp 176,622 68

69 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 262,384 Rp - Rp 262,384 69

70 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 262,384 Rp - Rp 262,384 70

71 Desi Asriana, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 262,384 Rp - Rp 262,384 71

72 Andi Rezkiiani Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 262,384 Rp - Rp 262,384 72

73 Hastuti, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 262,384 Rp - Rp 262,384 73

74 Rosdiana Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 262,384 Rp - Rp 262,384 74

75 Nur Ilma, Amd.Keb Tenaga Bidan 40 25 2 1.6 36.8 90 30 55 7.0 161.00 Rp 370,711 Rp - Rp 370,711 75

76 Irmawati, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 318,609 Rp - Rp 318,609 76

77 Ridha Arbiah, Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 346,722 Rp - Rp 346,722 77

78 Ramlah, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 318,609 Rp - Rp 318,609 78
79 Ermin Wahida. N III Perawat 40 25 1.6 40.0 90 30 55 7.0 175.00 Rp 402,947 Rp 20,147 Rp 382,799 79

80 Andi Jumrianti, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 318,609 Rp - Rp 318,609 80

81 Yulianti, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 318,609 Rp - Rp 318,609 81

82 Israwati Tenaga Penunjang 15 25 0.6 15.0 90 20 10 4.8 120.00 Rp 253,013 Rp - Rp 253,013 82

83 Andi Mas Muliani Tenaga Penunjang 15 25 0.6 15.0 90 10 10 4.4 110.00 Rp 234,271 Rp - Rp 234,271 83

84 Wahyuni, Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 346,722 Rp - Rp 346,722 84

85 Andi Salmei, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 318,609 Rp - Rp 318,609 85

86 Reski Arisanti Amelia Safitri, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 281,126 Rp - Rp 281,126 86

JUMLAH 3745 2144 150 90 154 3,561.1 7480 1870 2130 460 10731.0 Rp 26,785,800 Rp 645,108 Rp 26,140,692

Mengetahui / Menyetujui : Benteng, 31 Desember 2015


Kepala UPTD Puskesmas Benteng Bendahara JKN

Dr. FRENGKI WIJAYA PETRUS MILU E.T, AMK


Pangkat : Pembina Nip 19710704 199103 1 009
NIP. 19790926 200604 1 023
150 30 24 151.25
-

44,643,000 7,441
44,643,000 44,643,000 26,785,800 17,857,200 7,142,880 10,714,320

10,700,000 16,066,000 ###


66,915,000

286.00 Dr. Frengki Wiyaya ( Kepala Pu 14292.0818 26,785,800 15239.792 150

340.80 Dr. Zaenal Abidin 14292.0818 26,785,800 15239.792

270.00 Drg. Yunda Iswari 14292.0818 26,785,800 15239.792

260.00 Saribanong 14292.0818 26,785,800 15239.792 41,871,000 25,122,600

200.00 Muh. Ilham Thamrin 14292.0818 26,785,800 15239.792 41,871,000 16,748,400 6,699,360

260.00 Petrus Milu. ET.AMK (Bend. Pu 14292.0818 26,785,800 15239.792 41,871,000

235.20 Hj. Nur Azizal Hastati,AMK 14292.0818 26,785,800 15239.792 6,609,120

41.00 Nur Ariani, AMK 14292.0818 26,785,800

177.60 Rahma Yuliana, AMK 14292.0818 26,785,800 15239.792

162.80 Amsari Parida Amir, AMK 14292.0818 26,785,800 15239.792

185.00 Elsa Handayani, AMK 14292.0818 26,785,800 15239.792

185.00 Nadia Sri Damayanti AMK 14292.0818 26,785,800 15239.792

63.41 Sri Sulastri AMK 14292.0818 26,785,800

150.00 Muhrawati, AMK 14292.0818 26,785,800 15239.792

150.00 Sri Adrianti, AMK 14292.0818 26,785,800 15239.792 24,784,200

144.00 Nur Wahyuni, AMK 14292.0818 26,785,800 15239.792

78.00 Musfiah Zainuddin, AMK 14292.0818 26,785,800 15239.792

150.00 Andi Armita Dewi, AMK 14292.0818 26,785,800 15239.792

158.40 Hasmirawati, AMK 14292.0818 26,785,800 15239.792

112.00 Muh. Subhan, AMK 14292.0818 26,785,800 15239.792


134.40 Musdalifah, MR,AMK 14292.0818 26,785,800 15239.792

128.80 Muhammad Rum, AMK 14292.0818 26,785,800 15239.792

126.00 Agustina, AMK 14292.0818 26,785,800 15239.792

112.00 Risaldi Razak, AMK 14292.0818 26,785,800 15239.792

140.00 Dewi Ahryani, AMK 14292.0818 26,785,800 15239.792

211.60 Hj. Rostini AMG 14292.0818 26,785,800 15239.792

126.00 Agustini 14292.0818 26,785,800 15239.792

162.80 Yurniati, A.Md.AK 14292.0818 26,785,800 15239.792

225.40 Rosdiana 14292.0818 26,785,800 15239.792

42.27 Normalina A.Md.AK 14292.0818 26,785,800

138.00 Yunarsih, AMAK 14292.0818 26,785,800 15239.792

200.00 Bustan 14292.0818 26,785,800 15239.792

200.00 Nur Indah Kurnianti 14292.0818 26,785,800 15239.792

176.00 Rohani 14292.0818 26,785,800 15239.792

260.00 Muhammad Ali (TU Puskesmas 14292.0818 26,785,800 15239.792

249.60 St. Rosdiana, B.Sc 14292.0818 26,785,800 15239.792

160.00 Muhammad Nawir 14292.0818 26,785,800

245.00 Agustina Bintang,Amd.Keb 14292.0818 26,785,800 15239.792

185.00 Nur Rahmawati, A.md.Keb 14292.0818 26,785,800 15239.792

185.00 Suriati, A.md.Keb 14292.0818 26,785,800 15239.792

185.00 Sitti Aminah Anas,Amd.Keb 14292.0818 26,785,800 15239.792

185.00 Sitti Suprihartini,Amd.Keb 14292.0818 26,785,800 15239.792

185.00 Andi Yulianti, Amd.Keb 14292.0818 26,785,800 15239.792

95.00 Mira Septari. R.S, Amd.Keb. 14292.0818 26,785,800 15239.792

134.40 Isnayani, Amd. Keb 14292.0818 26,785,800 15239.792

130.20 Andi Jemma, Amd.Keb 14292.0818 26,785,800

96.00 Dewi Sartika, Amd.Keb 14292.0818 26,785,800 15239.792

134.40 Titin Sumarni, Amd.Keb 14292.0818 26,785,800 15239.792

150.00 Lisdayanti, A.md.Keb 14292.0818 26,785,800 15239.792


140.00 Yul Fitriani, Amd. Keb 14292.0818 26,785,800 15239.792

128.80 Andi Isna, Amd.Keb 14292.0818 26,785,800 15239.792

150.00 Rosmiati, Amd.Keb 14292.0818 26,785,800 15239.792

140.00 Sri Wahyuni, Amd.Keb 14292.0818 26,785,800 15239.792

140.00 Sulastri, Amd.Keb 14292.0818 26,785,800 15239.792

140.00 Sulmiati Bahri Amd.Keb 14292.0818 26,785,800 15239.792

149.60 Ira Muliati Radi.Amd.Keb 14292.0818 26,785,800 15239.792

200.00 Rosidah, AMKL 14292.0818 26,785,800 15239.792

200.00 Israyana Yulianti AMKL 14292.0818 26,785,800 15239.792

220.00 Armawati, S.Kep 14292.0818 26,785,800 15239.792

200.00 Andi Rezti Wardani S.Kep Ns 14292.0818 26,785,800 15239.792

230.00 Wa Ode Sinta Kalsum 14292.0818 26,785,800 15239.792

185.00 Andi Megawati 14292.0818 26,785,800 15239.792

69.60 Rosmayanti, SKM 14292.0818 26,785,800 15239.792

150.00 Sudirman H 14292.0818 26,785,800 15239.792

230.00 Sri Rahmat Yani Nur 14292.0818 26,785,800 15239.792

185.00 Mayanti, AMF 14292.0818 26,785,800 15239.792

140.00 Sri Wedari Yusuf, AMF 14292.0818 26,785,800 15239.792

99.20 Hj. Syahraeni, AMK 14292.0818 26,785,800 15239.792

140.00 Andi Tenri Ellung N, Amd.Keb 14292.0818 26,785,800 15239.792

140.00 Wahyuni Hamsah, Amd.Keb 14292.0818 26,785,800 15239.792

140.00 Desi Asriana, Amd.Keb 14292.0818 26,785,800 15239.792

140.00 Andi Rezkiiani Amd.Keb 14292.0818 26,785,800 15239.792

140.00 Hastuti, Amd.Keb 14292.0818 26,785,800 15239.792

140.00 Rosdiana Amd.Keb 14292.0818 26,785,800 15239.792

197.80 Nur Ilma, Amd.Keb 14292.0818 26,785,800 15239.792

170.00 Irmawati, Amd.Keb 14292.0818 26,785,800 15239.792

185.00 Ridha Arbiah, Amd.Keb 14292.0818 26,785,800 15239.792

170.00 Ramlah, Amd.Keb 14292.0818 26,785,800 15239.792


215.00 Ermin Wahida. N 14292.0818 26,785,800 15239.792

170.00 Andi Jumrianti, Amd.Keb 14292.0818 26,785,800 15239.792

170.00 Yulianti, Amd.Keb 14292.0818 26,785,800 15239.792

135.00 Israwati 14292.0818 26,785,800 15239.792

125.00 Andi Mas Muliani 14292.0818 26,785,800 15239.792

185.00 Wahyuni, Amd.Keb 14292.0818 26,785,800 15239.792

170.00 Andi Salmei, Amd.Keb 14292.0818 26,785,800

150.00 Reski Arisanti Amelia Safitri, 14292.0818 26,785,800 15239.792

14292.0818 14292.082
10,049,040 16,748,400 9975600

9,913,680 16,522,800
DAFTAR PENERIMAAN JASA PELAYANAN KESEHATAN PESERTA JKN BAGI PETUGAS PUSKESMAS PUSTU DAN POSKEDES
BULAN DESEMBER TAHUN 2015
PUSKESMAS : BENTENG
JUMLAH PESERTA : 7.441 ORANG
JUMLAH PEGAWAI : 86 ORANG
BESARAN KAPITASI : 6000 PERJIWA / BULAN
TOTAL KAPITASI : 44,643,000 TOTAL JASA PELAYANAN SESUAI SK BUPATI 60 % = 29,297,400.-

GOLO VARIABEL POINT POINT VARIABEL DAERAH POINT POINT JUMLAH PPH JUMLAH
NO NAMA PETUGAS NGAN JABATAN KETENA KEHADIRAN JABA /ORG /ORG KINER STATUS MASA /ORG /ORG DITERIMA PASAL 21 DIBAYARKAN TANDA TANGAN
GAAN EFEKTIF 1 BLNTDK HADIR TAN /HARI BULAN JA KEPEG KERJA HARI BULAN ( Rp ) ( 15% / 5% ) ( Rp )
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

1 Dr. Frengki Wiyaya ( Kepala Pusk) IV Dokter Umum 150 25 3 30 7.2 158.4 90 30 25 5.8 127.60 Rp 536,013 Rp 80,402 Rp 455,611 1

2 Dr. Zaenal Abidin IV Dokter Umum 150 25 1 6.0 144.0 90 30 85 8.2 196.80 Rp 638,717 Rp 95,808 Rp 542,910 2

3 Drg. Yunda Iswari III Dokter Gigi 150 25 6.0 150.0 90 30 0 4.8 120.00 Rp 506,026 Rp 25,301 Rp 480,725 3

4 Saribanong III Perawat 40 25 1.6 40.0 90 30 100 8.8 220.00 Rp 487,284 Rp 24,364 Rp 462,920 4

5 Muh. Ilham Thamrin III Perawat 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 374,834 Rp 18,742 Rp 356,092 5

6 Petrus Milu. ET.AMK (Bend. Pusk) III Perawat 40 25 30 2.8 70.0 90 30 70 7.6 190.00 Rp 487,284 Rp 24,364 Rp 462,920 6

7 Hj. Nur Azizal Hastati,AMK III Perawat 40 25 1 1.6 38.4 90 30 85 8.2 196.80 Rp 440,805 Rp 22,040 Rp 418,765 7

8 Nur Ariani, AMK III Perawat 40 25 20 1.6 8.0 50 30 85 6.6 33.00 Rp 76,841 Rp 3,842 Rp 72,999 8

9 Rahma Yuliana, AMK II Perawat 40 25 1 1.6 38.4 90 30 25 5.8 139.20 Rp 332,853 Rp - Rp 332,853 9

10 Amsari Parida Amir, AMK III Perawat 40 25 3 1.6 35.2 90 30 25 5.8 127.60 Rp 305,115 Rp 15,256 Rp 289,859 10

11 Elsa Handayani, AMK II Perawat 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 346,722 Rp - Rp 346,722 11

12 Nadia Sri Damayanti AMK III Perawat 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 346,722 Rp 17,336 Rp 329,385 12

13 Sri Sulastri AMK II Perawat 40 22 13 1.8 16.4 60 30 25 5.2 47.05 Rp 118,839 Rp - Rp 118,839 13

14 Muhrawati, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 281,126 Rp - Rp 281,126 14

15 Sri Adrianti, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 281,126 Rp - Rp 281,126 15

16 Nur Wahyuni, AMK Perawat 40 25 1 1.6 38.4 90 10 10 4.4 105.60 Rp 269,881 Rp - Rp 269,881 16

17 Musfiah Zainuddin, AMK Perawat 40 25 10 1.6 24.0 60 20 10 3.6 54.00 Rp 146,185 Rp - Rp 146,185 17

18 Andi Armita Dewi, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 281,126 Rp - Rp 281,126 18

19 Hasmirawati, AMK Perawat 40 25 1 1.6 38.4 90 10 25 5.0 120.00 Rp 296,869 Rp - Rp 296,869 19

20 Muh. Subhan, AMK Perawat 40 25 5 1.6 32.0 90 10 0 4.0 80.00 Rp 209,907 Rp - Rp 209,907 20
21 Musdalifah, MR,AMK Perawat 40 25 1 1.6 38.4 90 10 0 4.0 96.00 Rp 251,889 Rp - Rp 251,889 21

22 Muhammad Rum, AMK Perawat 40 25 2 1.6 36.8 90 10 0 4.0 92.00 Rp 241,393 Rp - Rp 241,393 22

23 Agustina, AMK Perawat 40 25 4 1.6 33.6 90 10 10 4.4 92.40 Rp 236,145 Rp - Rp 236,145 23

24 Risaldi Razak, AMK Perawat 40 25 5 1.6 32.0 90 10 0 4.0 80.00 Rp 209,907 Rp - Rp 209,907 24

25 Dewi Ahryani, AMK Perawat 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 262,384 Rp - Rp 262,384 25

26 Hj. Rostini AMG II Tenaga Penunjang 40 25 2 1.6 36.8 90 30 70 7.6 174.80 Rp 396,575 Rp Rp 396,575 26

27 Agustini Tenaga Penunjang 15 25 4 0.6 12.6 90 20 25 5.4 113.40 Rp 236,145 Rp - Rp 236,145 27

28 Yurniati, A.Md.AK II Analis 40 25 3 1.6 35.2 90 30 25 5.8 127.60 Rp 305,115 Rp - Rp 305,115 28

29 Rosdiana III Analis 40 25 2 1.6 36.8 90 30 85 8.2 188.60 Rp 422,438 Rp 21,122 Rp 401,316 29

30 Normalina A.Md.AK II Analis 40 22 16 1.8 10.9 60 30 25 5.2 31.36 Rp 79,226 Rp - Rp 79,226 30

31 Yunarsih, AMAK Analis 40 25 2 1.6 36.8 90 10 10 4.4 101.20 Rp 258,636 Rp - Rp 258,636 31

32 Bustan II Perawat Gigi 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 374,834 Rp - Rp 374,834 32

33 Nur Indah Kurnianti III Teknik Gigi 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 374,834 Rp 18,742 Rp 356,092 33

34 Rohani III Perawat Gigi 40 25 3 1.6 35.2 90 30 40 6.4 140.80 Rp 329,854 Rp 16,493 Rp 313,361 34

35 Muhammad Ali (TU Puskesmas) III Pel. Administrasi 40 25 30 2.8 70.0 90 30 70 7.6 190.00 Rp 487,284 Rp 24,364 Rp 462,920 35

36 St. Rosdiana, B.Sc III Perawat 40 25 1 1.6 38.4 90 30 100 8.8 211.20 Rp 467,793 Rp 23,390 Rp 444,403 36

37 Muhammad Nawir II Pel. Administrasi 15 25 0.6 15.0 90 30 25 5.8 145.00 Rp 299,867 Rp - Rp 299,867 37

38 Agustina Bintang,Amd.Keb III Tenaga Bidan 40 25 1.6 40.0 90 30 85 8.2 205.00 Rp 459,172 Rp 22,959 Rp 436,213 38

39 Nur Rahmawati, A.md.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 346,722 Rp - Rp 346,722 39

40 Suriati, A.md.Keb III Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 346,722 Rp 17,336 Rp 329,385 40

41 Sitti Aminah Anas,Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 346,722 Rp - Rp 346,722 41

42 Sitti Suprihartini,Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 346,722 Rp - Rp 346,722 42

43 Andi Yulianti, Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 346,722 Rp - Rp 346,722 43

44 Mira Septari. R.S, Amd.Keb. Tenaga Bidan 40 25 6 1.6 30.4 75 10 0 3.4 64.60 Rp 178,046 Rp - Rp 178,046 44

45 Isnayani, Amd. Keb Tenaga Bidan 40 25 1 1.6 38.4 90 10 0 4.0 96.00 Rp 251,889 Rp - Rp 251,889 45

46 Andi Jemma, Amd.Keb Tenaga Bidan 40 25 4 1.6 33.6 75 30 10 4.6 96.60 Rp 244,017 Rp - Rp 244,017 46

47 Dewi Sartika, Amd.Keb Tenaga Bidan 40 25 5 1.6 32.0 60 10 10 3.2 64.00 Rp 179,920 Rp - Rp 179,920 47

48 Titin Sumarni, Amd.Keb Tenaga Bidan 40 25 1 1.6 38.4 90 10 0 4.0 96.00 Rp 251,889 Rp - Rp 251,889 48

49 Lisdayanti, A.md.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 281,126 Rp - Rp 281,126 49
50 Yul Fitriani, Amd. Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 262,384 Rp - Rp 262,384 50

51 Andi Isna, Amd.Keb Tenaga Bidan 40 25 2 1.6 36.8 90 10 0 4.0 92.00 Rp 241,393 Rp - Rp 241,393 51

52 Rosmiati, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 20 0 4.4 110.00 Rp 281,126 Rp - Rp 281,126 52

53 Sri Wahyuni, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 262,384 Rp - Rp 262,384 53

54 Sulastri, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 262,384 Rp - Rp 262,384 54

55 Sulmiati Bahri Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 262,384 Rp - Rp 262,384 55

56 Ira Muliati Radi.Amd.Keb Tenaga Bidan 40 25 3 1.6 35.2 90 30 10 5.2 114.40 Rp 280,376 Rp - Rp 280,376 56

57 Rosidah, AMKL III Sanitarian 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 374,834 Rp 18,742 Rp 356,092 57

58 Israyana Yulianti AMKL III Sanitarian 40 25 1.6 40.0 90 30 40 6.4 160.00 Rp 374,834 Rp 18,742 Rp 356,092 58

59 Armawati, S.Kep III Perawat 60 25 2.4 60.0 90 30 40 6.4 160.00 Rp 412,318 Rp 20,616 Rp 391,702 59

60 Andi Rezti Wardani S.Kep Ns Perawat 100 25 4.0 100.0 90 10 0 4.0 100.00 Rp 374,834 Rp 18,742 Rp 356,092 60

61 Wa Ode Sinta Kalsum III Pelak. Gizi 40 25 1.6 40.0 90 30 70 7.6 190.00 Rp 431,059 Rp 21,553 Rp 409,506 61

62 Andi Megawati II Teknik Gigi 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 346,722 Rp - Rp 346,722 62

63 Rosmayanti, SKM Tenaga Penunjang 60 25 13 2.4 28.8 50 10 25 3.4 40.80 Rp 130,442 Rp 6,522 Rp 123,920 63

64 Sudirman H Tenaga Penunjang 15 25 0.6 15.0 90 20 25 5.4 135.00 Rp 281,126 Rp - Rp 281,126 64

65 Sri Rahmat Yani Nur III Perawat 40 25 1.6 40.0 90 30 70 7.6 190.00 Rp 431,059 Rp 21,553 Rp 409,506 65

66 Mayanti, AMF III Tenaga Penunjang 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 346,722 Rp 17,336 Rp 329,385 66

67 Sri Wedari Yusuf, AMF Tenaga Penunjang 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 262,384 Rp - Rp 262,384 67

68 Hj. Syahraeni, AMK III Perawat 40 25 9 1.6 25.6 60 30 25 4.6 73.60 Rp 185,918 Rp 9,296 Rp 176,622 68

69 Andi Tenri Ellung N, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 262,384 Rp - Rp 262,384 69

70 Wahyuni Hamsah, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 262,384 Rp - Rp 262,384 70

71 Desi Asriana, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 262,384 Rp - Rp 262,384 71

72 Andi Rezkiiani Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 262,384 Rp - Rp 262,384 72

73 Hastuti, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 262,384 Rp - Rp 262,384 73

74 Rosdiana Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 10 0 4.0 100.00 Rp 262,384 Rp - Rp 262,384 74

75 Nur Ilma, Amd.Keb Tenaga Bidan 40 25 2 1.6 36.8 90 30 55 7.0 161.00 Rp 370,711 Rp - Rp 370,711 75

76 Irmawati, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 318,609 Rp - Rp 318,609 76

77 Ridha Arbiah, Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 346,722 Rp - Rp 346,722 77

78 Ramlah, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 318,609 Rp - Rp 318,609 78
79 Ermin Wahida. N III Perawat 40 25 1.6 40.0 90 30 55 7.0 175.00 Rp 402,947 Rp 20,147 Rp 382,799 79

80 Andi Jumrianti, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 318,609 Rp - Rp 318,609 80

81 Yulianti, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 318,609 Rp - Rp 318,609 81

82 Israwati Tenaga Penunjang 15 25 0.6 15.0 90 20 10 4.8 120.00 Rp 253,013 Rp - Rp 253,013 82

83 Andi Mas Muliani Tenaga Penunjang 15 25 0.6 15.0 90 10 10 4.4 110.00 Rp 234,271 Rp - Rp 234,271 83

84 Wahyuni, Amd.Keb II Tenaga Bidan 40 25 1.6 40.0 90 30 25 5.8 145.00 Rp 346,722 Rp - Rp 346,722 84

85 Andi Salmei, Amd.Keb Tenaga Bidan 40 25 1.6 40.0 90 30 10 5.2 130.00 Rp 318,609 Rp - Rp 318,609 85

86 Reski Arisanti Amelia Safitri, AMK Perawat 40 25 1.6 40.0 90 10 10 4.4 110.00 Rp 281,126 Rp - Rp 281,126 86

JUMLAH 3745 2144 150 90 154 3,561.1 7480 1870 2130 460 10731.0 Rp 26,785,800 Rp 645,108 Rp 26,140,692

Mengetahui / Menyetujui : Benteng, 31 Desember 2015


Kepala UPTD Puskesmas Benteng Bendahara JKN

Dr. FRENGKI WIJAYA PETRUS MILU E.T, AMK


Pangkat : Pembina Nip 19710704 199103 1 009
NIP. 19790926 200604 1 023
150 30 24 151.25
-

48,829,000
48,829,000 48,829,000 29,297,400 19,531,600 7,812,640 11,718,960

10,700,000 16,066,000 ###


66,915,000

14292.0818 26,785,800 15239.792 150

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792 41,871,000 25,122,600

14292.0818 26,785,800 15239.792 41,871,000 16,748,400 6,699,360 10,049,040 16,748,400

14292.0818 26,785,800 15239.792 41,871,000

14292.0818 26,785,800 15239.792 6,609,120 9,913,680 16,522,800

14292.0818 26,785,800

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792 24,784,200

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792


14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792


14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792


14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800 15239.792

14292.0818 26,785,800

14292.0818 26,785,800 15239.792

14292.0818 14292.082
9975600

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