Jaspel RAPEL Non Pns

JASA PELAYANAN KAPITA
UPTD PU
BU
Rp 39,600,000
No. PETUGAS PUSKESMAS NIP GOL JABATAN
1 2 3 4 5
1 dr.Hj.Sri Cahyatiningsih 196810062002122001 IV.b 0

2 Lenia Ratna Susanti 196705131989022006 III.c Ka.Tu
3 Yanyan Supriatna,AMD,S.IP 196902172007011010 III.a Bendahara JKN
4 dr.Hj.Sisca Risya Fujiarti 198001012010012008 III.c dr.Fungsional
5 dr.Khania Puspitasari,MARS 197803012007012008 III.d dr.Fungsional Gigi
6 Momoh Rohanah, AMK 196407311987032004 III.d Pel.Perawat
7 Hj.Iis Susilawati, AMK 196712261988032003 III.d Pel.Perawat
8 Hj.Neneng Kurniasih, Am.Keb 195906191981072001 III.d Bidan Koordinator
9 Wartinah, AMK 196704211989022001 III.d Pel.Perawat
10 Hj.Hasanah, S.Kep 196809281995032003 IV.a Pel.Perawat
11 Hj.Elis Supyeni, Am.Keb 196712011989032003 III.d Bidan Fungsional
12 Euis Sukmawati, M.Kes 197501301995032001 III.d Sanitarian
13 Sri Rahmawati, Am.Keb 196509191991032005 III.d Bides Sukagalih
14 Tati Sudaryati, AMKG 197206251994022006 III.c Pel.Perawat Gigi
15 Hj.Lina Zenab,SP 197204161992022001 III.c TPG
16 Mietta Pursitawati,S.Si.Apt 197711152006042005 III.c Apoteker
17 Ai Neti Srihartati,SKM 197009101991032004 III.c Promkes
18 Heriawanto, AMKG III.c Pel.Perawat Gigi
19 Yoseph Ferry, AMK 197803162006041016 III.b Pel.Perawat
20 Wheni Puspitawati, AMK 198305172005012006 III.b Pel.Perawat
21 Gungun Nurdiansyah,S.Kep 198209272010011018 III.a Pel.Perawat
22 Hj.Husnul Khotimah,S.ST 197501242007012006 III.a Bides Sukakarya
23 Hj.Rini Lestari, Am.Keb, SE 197509202007012009 III.a Bend.Penerima
24 Ema Asgaritta,S.ST 197710282008012008 III.a Bidan Fungsional
25 Iis Fatimah,SKM 197904162006042004 II.d Analis / Lab
26 Nenden Nuraeni , S.ST 197905142008012024 II.d Bides Sukajaya
27 Reni Hidayat, Am.Keb 198402152010012012 II.c Bides Mekargalih
28 Ratna Nurhasanah, AMK 198503242011012002 II.c Pel.Perawat
29 Yeni Rella 196110232007012001 II.b Pel.Administrasi
30 Fitri Dwiyani, Am.Keb 198207282014112001 II.a Pel.Perawat
31 Sipa Nurasvia, AMKG TKK Pel.Perawat Gigi
32 Ricka Rikmasari, AMK TKK Pel.Perawat
33 Dewi Yulianti, AMK TKK Pel.Perawat
34 Nina Widianty TKK Pel.Perawat
35 Niki Sesbania TKK Pel.Perawat
36 Irma Nurma Diana, AM.Keb PTT Bides Sukakarya
37 Rina Kurnia Aprianti, Am.Keb PTT Bides Sukagalih
38 Dian Pramesti, Am.Keb PTT Bides Sukajaya
39 Elis Supriyanti, AMKG TKS Pel.Perawat Gigi
40 M Faisal Ali, S.IP TKS Pel.Administrasi
41 Fatmawati, Am.Keb TKS Bides Mekargalih
42 Hasan Alvian, AMK TKS Pel.Perawat
43 Risna D Yulianti, S.ST TKS Pel.Bidan
44 H. Subagja Eska Hidayat,SE TKS Operator JKN
45 Neneng Wulan TKS Pel.Harian Obat
46 Dadan Nurdiansyah,ST TKS Pel.Administrasi
Pel.Perawat /
47 Tira Febrianti DJ, AMK Magang Operator
JKN
48 Empon Rukmini TKS Cleaning Service
49 Indra Sukmana Magang Admin/sopir
50 Delyan Magang Pel.Lab
JUMLAH TOTAL
Kepala Puskesmas / FKTP Puskesmas Pembangunan

Kecamatan Tarogong Kidul Kabupaten Garut
dr.HJ.SRI CAHYATININGSIH
NIP. 19681006 200212 2 001
estimasi 2016
35%
0
JASA PELAYANAN KAPITASI JAMINAN KESEHATAN NASIONAL (JKN)
UPTD PUSKESMAS PEMBANGUNAN
BULAN JANUARI 2016
VARIABEL VARIABEL DAERAH
POIN PER ORG

PERHARI VAR
KEHADIRAN
KETENAGAAN
KETENAGAAN
POIN ORANG
KEPEGAWAIA
MASA KERJA
DAERAH
PERHARI
JMLH
KINERJA
JABATAN
EFEKTIF
STATUS
TDK HADIR
NPWP VARIABEL
DAERAH
N
1 BL
9 14
13
6 7 8 10 11 12 (10+11+12)
(6/7) (13/7)
69.460.927.2-443.000 150 25 0 30 6.00 40 25 40 105 4.20
89.256.644.9-443.000 15 25 0 30 0.60 40 40 20 100 4.00
70.629.580.5-443.000 40 25 0 30 1.60 40 40 20 100 4.00
79.506.558.0-443.000 150 25 0 0 6.00 40 15 20 75 3.00
66.788.118.9-443.000 150 25 0 0 6.00 40 15 15 70 2.80
78.737.531.0-443.000 40 25 0 0 1.60 40 40 5 85 3.40
25.682.985.4-443.000 40 25 0 0 1.60 40 40 5 85 3.40
87.705.648.1-443.000 40 25 0 0 1.60 40 40 5 85 3.40
26.012.366.6-443.000 40 25 0 0 1.60 40 40 5 85 3.40
97,211,140,5-443,000 60 25 0 0 2.40 40 35 5 80 3.20
89,319,886,1-443,000 40 25 0 0 1.60 40 40 5 85 3.40
69,909,571,7-443,000 40 25 0 0 1.60 40 35 5 80 3.20
87,705645,7-443,000 60 25 0 0 2.40 40 35 5 80 3.20
66.803.020.8-443.000 40 25 0 0 1.60 40 35 5 80 3.20
72,429,5951-443,000 60 25 0 0 2.40 40 35 5 80 3.20
25.312.825.0-443.000 100 25 0 0 4.00 40 25 5 70 2.80
77,798,116,8-443,000 60 25 0 0 2.40 40 35 5 80 3.20
40 25 0 0 1.60 40 15 5 60 2.40
24.326.102.1-443.000 40 25 0 0 1.60 40 15 5 60 2.40
46.888.684.1-443.000 40 25 0 0 1.60 40 15 5 60 2.40
97.211.139.7-443.000 60 25 0 0 2.40 40 15 5 60 2.40
78.737.497.4-443.000 60 25 0 0 2.40 40 15 5 60 2.40
89.873.618.6-443.000 40 25 0 0 1.58 40 30 10 80 3.20
89.873.620.2-443.000 60 25 0 0 2.40 40 30 0 70 2.80
79.970.844.1-443.000 40 25 0 0 1.60 40 30 5 75 3.00
89.879.033.2-443.000 60 25 0 0 2.40 40 15 5 60 2.40
71,608,236,7-443,000 60 25 0 0 2.40 40 15 5 60 2.40
97,326,108,4-443,000 40 25 0 0 1.58 40 10 5 55 2.20
25.699.804.8-443.000 15 25 0 0 0.60 40 40 5 85 3.40
71.701.953.0-443.000 25 25 0 0 1.00 40 10 5 55 2.20
71,473,013,2,2-443,000 40 25 0 0 1.60 10 25 0 35 1.40
0 40 25 0 0 1.60 10 25 0 35 1.40
72,583,144,0-443,000 40 25 0 0 1.60 10 25 0 35 1.40
71.472.994.4-443.000 25 25 0 0 1.00 10 25 0 35 1.40
72,473,372,0-443,000 40 25 0 0 1.60 10 25 0 35 1.40
57.951.523.0-443.000 40 25 0 0 1.60 15 15 5 35 1.40
57,951,524,8-443,000 60 25 0 0 2.40 15 15 5 35 1.40
57.951.522.2-443.000 40 25 0 0 1.60 15 15 5 35 1.40
71,466,061,0-443,000 40 25 0 0 1.60 5 5 0 10 0.40
40 25 0 0 1.60 5 5 0 10 0.40
54,886,528,6-443,000 40 25 0 0 1.60 5 5 5 15 0.60
72.465.874.5-443.000 40 25 0 0 1.60 5 5 5 15 0.60
36.646.908.8-443.000 60 25 0 0 2.40 5 5 5 15 0.60
35.135.706.6-443.000 40 25 0 0 1.60 5 5 5 15 0.60
71.473.004.1-443.000 25 25 0 0 1.00 5 5 5 15 0.60
71.466.360.6-443.000 40 25 0 0 1.60 5 5 0 10 0.40
72.463.801.0-443.000 25 25 0 0 1.00 5 5 5 15 0.60
72.465.795.2-443.000 15 25 0 0 0.60 5 5 0 10 0.40

15 25 0 0 0.60 5 5 5 15 0.60
15 25 0 0 0.60 5 5 0 10 0.40
JUMLAH TOTAL
unan
t
99,145,000
34,700,750
N)
PERHITUNGAN
JASPEL
POINT PER DITERIMA
ORANG JUMLAH
PAJAK PPh
(K15)/TOTA Psl 21 JASPEL TANDA TANGAN
(K6)-(K8 x K9) + L POIN X DITERIMA
(K7-K8)+(K13)-
(K8XK14) TOTAL
JASPEL
15 16 17 18 19
310 1,899,128 284,869 1,614,259 1

170 1,041,457 52,073 989,384 2
195 1,194,613 59,731 1,134,882 3
250 1,531,555 76,578 1,454,977 4
245 1,500,924 75,046 1,425,877 5
150 918,933 45,947 872,986 6
150 918,933 45,947 872,986 7
150 918,933 45,947 872,986 8
150 918,933 45,947 872,986 9
165 1,010,826 151,624 859,202 10
150 918,933 45,947 872,986 11
145 888,302 44,415 843,887 12
165 1,010,826 50,541 960,285 13
145 888,302 44,415 843,887 14
165 1,010,826 50,541 960,285 15
195 1,194,613 59,731 1,134,882 16
165 1,010,826 50,541 960,285 17
125 765,777 38,289 727,488
125 765,777 38,289 727,488 18
125 765,777 38,289 727,488 19
145 888,302 44,415 843,887 20
145 888,302 44,415 843,887 21
145 885,300 44,265 841,035 22
155 949,564 47,478 902,086 23
140 857,671 857,671 24
145 888,302 - 888,302 25
145 888,302 - 888,302 26
120 732,144 - 732,144 27
125 765,777 - 765,777 28
105 643,253 - 643,253 29
100 612,622 30,631 581,991 30
100 612,622 30,631 581,991 31
100 612,622 30,631 581,991 32
85 520,729 26,036 494,692 33
100 612,622 30,631 581,991 34
100 612,622 30,631 581,991 35
120 735,146 36,757 698,389 36
100 612,622 30,631 581,991 37
75 459,466 22,973 436,493 38
75 459,466 22,973 436,493 39
80 490,097 24,505 465,593 40
80 490,097 24,505 465,593 41
100 612,622 30,631 581,991 42
80 490,097 24,505 465,593 43
65 398,204 19,910 378,294 44
75 459,466 22,973 436,493 45
65 398,204 19,910 378,294 46
50 306,311 15,316 290,995 47

55 336,942 16,847 320,095 48
50 306,311 15,316 290,995 49
6,464 39,600,000 2,032,223 37,567,777
Garut, 31 Maret 2016

Bendahara JKN FKTP Puskesmas Pembangunan
YANYAN SUPRIATNA, AMD,S.IP

NIP. 19690217 200701 1 010
Rp 34,700,000
1 2 3 4 5
1 dr.Hj.Sri Cahyatiningsih 196810062002122001 IV.b Kepala Puskesmas

17 Ai Neti Srihartati,SKM 197009101991032004 III.d Promkes
18 Heriawanto, AMKG III.c Pel.Perawat Gigi
47 Tira Febrianti DJ, AMK Magang Pel.Perawat /
JUMLAH TOTAL

NIP. 19681006 200212 2 001
Rp 39,600,000
1 2 3 4 5
17 Ai Neti Srihartati,SKM 197009101991032004 III.d Promkes
18 Heriawanto, AMKG 0 III.c Pel.Perawat Gigi
47 Tira Febrianti DJ, AMK Magang Pel.Perawat /
JUMLAH TOTAL

NIP. 19681006 200212 2 001
0
JASA PELAYANAN KAPITASI JAMINAN KESEHATAN NASIONAL (JK
BULAN JANUARI 2016
POIN ORANG PERHARI

KEHADIRAN KINERJA
KEPEGAWAIAN
KETENAGAAN
KETENAGAAN
MASA KERJA
EFEKTIF
VISUM DALAM
PENANGGUNG
JABATAN
VISUM LUAR
STATUS
TDK HADIR
NPWP
GEDUNG
GEDUNG
JAWAB
1 BL
9
6 7 8 10 11 12
(6/7)
69.460.927.2-443.000 150 25 0 30 6.00 40 25 40 0 0
89.256.644.9-443.000 15 25 0 30 0.60 40 40 20 0 0
70.629.580.5-443.000 40 25 0 30 1.60 40 40 20 0 0
79.506.558.0-443.000 150 25 0 0 6.00 40 15 15 0 0
66.788.118.9-443.000 150 25 0 0 6.00 40 15 6 0 0
78.737.531.0-443.000 40 25 0 0 1.60 40 40 6 0 0
25.682.985.4-443.000 40 25 0 0 1.60 40 40 3 0 0
87.705.648.1-443.000 40 25 0 0 1.60 40 40 3 0 0
26.012.366.6-443.000 40 25 0 0 1.60 40 40 6 0 0
97,211,140,5-443,000 60 25 0 0 2.40 40 35 3 0 0
89,319,886,1-443,000 40 25 0 0 1.60 40 40 3 0 0
69,909,571,7-443,000 40 25 0 0 1.60 40 35 3 0 0
87,705645,7-443,000 60 25 0 0 2.40 40 35 3 0 0
66.803.020.8-443.000 40 25 0 0 1.60 40 35 3 0 0
72,429,5951-443,000 60 25 0 0 2.40 40 35 3 0 0
25.312.825.0-443.000 100 25 0 0 4.00 40 25 3 0 0
77,798,116,8-443,000 60 25 0 0 2.40 40 35 3 0 0
40 25 0 0 1.60 40 15 3 0 0
24.326.102.1-443.000 40 25 0 0 1.60 40 15 3 0 0
46.888.684.1-443.000 40 25 0 0 1.60 40 15 6 0 0
97.211.139.7-443.000 60 25 0 0 2.40 40 15 3 0 0
78.737.497.4-443.000 60 25 0 0 2.40 40 15 3 0 0
89.873.618.6-443.000 40 25 0 0 1.58 40 30 10 0 0
89.873.620.2-443.000 60 25 0 0 2.40 40 30 3 0 0
79.970.844.1-443.000 40 25 0 0 1.60 40 30 6 0 0
89.879.033.2-443.000 60 25 0 0 2.40 40 15 3 0 0
71,608,236,7-443,000 60 25 0 0 2.40 40 15 3 0 0
97,326,108,4-443,000 40 25 0 0 1.58 40 10 3 0 0
25.699.804.8-443.000 15 25 0 0 0.60 40 40 3 0 0
71.701.953.0-443.000 25 25 0 0 1.00 40 10 6 0 0
71,473,013,2,2-443,000 40 25 0 0 1.60 10 25 0 0 0
0 40 25 0 0 1.60 10 25 0 0 0
72,583,144,0-443,000 40 25 0 0 1.60 10 25 0 0 0
71.472.994.4-443.000 25 25 0 0 1.00 10 25 3 0 0
72,473,372,0-443,000 40 25 0 0 1.60 10 25 0 0 0
57.951.523.0-443.000 40 25 0 0 1.60 15 15 3 0 0
57,951,524,8-443,000 60 25 0 0 2.40 15 15 3 0 0
57.951.522.2-443.000 40 25 0 0 1.60 15 15 3 0 0
71,466,061,0-443,000 40 25 0 0 1.60 5 5 0 0 0
40 25 0 0 1.60 5 5 5 0 0
54,886,528,6-443,000 40 25 0 0 1.60 5 5 3 0 0
72.465.874.5-443.000 40 25 0 0 1.60 5 5 3 0 0
36.646.908.8-443.000 60 25 0 0 2.40 5 5 0 0 0
35.135.706.6-443.000 40 25 0 0 1.60 5 5 5 0 0
71.473.004.1-443.000 25 25 0 0 1.00 5 5 0 0 0
71.466.360.6-443.000 40 25 0 0 1.60 5 5 3 0 0
72.463.801.0-443.000 25 25 0 0 1.00 5 5 5 0 0
72.465.795.2-443.000 15 25 0 0 0.60 5 5 3 0 0
15 25 0 0 0.60 5 5 5 0 0
15 25 0 0 0.60 5 5 0 0 0
JUMLAH TOTAL
unan
t
0
JASA PELAYANAN KAPITASI JAMINAN KESEHATAN NASIONAL (JK
BULAN JANUARI 2016

POIN ORANG PERHARI
KEHADIRAN KINERJA
KEPEGAWAIAN
KETENAGAAN
KETENAGAAN
MASA KERJA
EFEKTIF
VISUM DALAM
PENANGGUNG
JABATAN
VISUM LUAR
STATUS
TDK HADIR
NPWP
GEDUNG
GEDUNG
JAWAB
1 BL
9
6 7 8 10 11 12
(6/7)
69.460.927.2-443.000 150 25 0 30 6.00 40 25 40 0 0
89.256.644.9-443.000 15 25 0 30 0.60 40 40 20 0 0
70.629.580.5-443.000 40 25 0 30 1.60 40 40 20 0 0
79.506.558.0-443.000 150 25 0 0 6.00 40 15 15 0 0
66.788.118.9-443.000 150 25 0 0 6.00 40 15 6 0 0
78.737.531.0-443.000 40 25 0 0 1.60 40 40 6 0 0
25.682.985.4-443.000 40 25 0 0 1.60 40 40 3 0 0
87.705.648.1-443.000 40 25 0 0 1.60 40 40 3 0 0
26.012.366.6-443.000 40 25 0 0 1.60 40 40 6 0 0
97,211,140,5-443,000 60 25 0 0 2.40 40 35 3 0 0
89,319,886,1-443,000 40 25 0 0 1.60 40 40 3 0 0
69,909,571,7-443,000 40 25 0 0 1.60 40 35 3 0 0
87,705645,7-443,000 60 25 0 0 2.40 40 35 3 0 0
66.803.020.8-443.000 40 25 0 0 1.60 40 35 3 0 0
72,429,5951-443,000 60 25 0 0 2.40 40 35 3 0 0
25.312.825.0-443.000 100 25 0 0 4.00 40 25 3 0 0
77,798,116,8-443,000 60 25 0 0 2.40 40 35 3 0 0
0 40 25 0 0 1.60 40 15 3 0 0
24.326.102.1-443.000 40 25 0 0 1.60 40 15 3 0 0
46.888.684.1-443.000 40 25 0 0 1.60 40 15 6 0 0
97.211.139.7-443.000 60 25 0 0 2.40 40 15 3 0 0
78.737.497.4-443.000 60 25 0 0 2.40 40 15 3 0 0
89.873.618.6-443.000 40 25 0 0 1.58 40 30 10 0 0
89.873.620.2-443.000 60 25 0 0 2.40 40 30 3 0 0
79.970.844.1-443.000 40 25 0 0 1.60 40 30 6 0 0
89.879.033.2-443.000 60 25 0 0 2.40 40 15 3 0 0
71,608,236,7-443,000 60 25 0 0 2.40 40 15 3 0 0
97,326,108,4-443,000 40 25 0 0 1.58 40 10 3 0 0
25.699.804.8-443.000 15 25 0 0 0.60 40 40 3 0 0
71.701.953.0-443.000 25 25 0 0 1.00 40 10 6 0 0
71,473,013,2,2-443,000 40 25 0 0 1.60 10 25 0 0 0
0 40 25 0 0 1.60 10 25 0 0 0
72,583,144,0-443,000 40 25 0 0 1.60 10 25 0 0 0
71.472.994.4-443.000 25 25 0 0 1.00 10 25 3 0 0
72,473,372,0-443,000 40 25 0 0 1.60 10 25 0 0 0
57.951.523.0-443.000 40 25 0 0 1.60 15 15 3 0 0
57,951,524,8-443,000 60 25 0 0 2.40 15 15 3 0 0
57.951.522.2-443.000 40 25 0 0 1.60 15 15 3 0 0
71,466,061,0-443,000 40 25 0 0 1.60 5 5 0 0 0
0 40 25 0 0 1.60 5 5 5 0 0
54,886,528,6-443,000 40 25 0 0 1.60 5 5 3 0 0
72.465.874.5-443.000 40 25 0 0 1.60 5 5 3 0 0
36.646.908.8-443.000 60 25 0 0 2.40 5 5 0 0 0
35.135.706.6-443.000 40 25 0 0 1.60 5 5 5 0 0
71.473.004.1-443.000 25 25 0 0 1.00 5 5 0 0 0
71.466.360.6-443.000 40 25 0 0 1.60 5 5 3 0 0
72.463.801.0-443.000 25 25 0 0 1.00 5 5 5 0 0
72.465.795.2-443.000 15 25 0 0 0.60 5 5 3 0 0
0 15 25 0 0 0.60 5 5 5 0 0
0 15 25 0 0 0.60 5 5 0 0 0
JUMLAH TOTAL
unan
t
ATAN NASIONAL (JKN)
GUNAN
PERHITUNGAN JASPEL
POINT POTONGAN TIDAK APEL
DITERIMA
POIN PER ORG
PERHARI VAR
PER ORANG
DAERAH
JMLH JUMLAH
PAJAK PPh
VARIABEL (K15)/TOTAL JASPEL
DAERAH (K6)-(K8 x K9) + Psl 21 DITERIMA
POIN X JML TDK
(K7-K8)+(K13)- 5,000
(K8XK14) TOTAL APEL
JASPEL
14
13
(10+11+12) 15 16 17 18
(13/7)
105 4.20 310 1,676,585 251,488 1,425,097 - -
100 4.00 170 919,417 45,971 873,446 - -
100 4.00 195 1,054,626 52,731 1,001,894 - -
70 2.80 245 1,325,043 66,252 1,258,790 - -
61 2.44 236 1,276,368 63,818 1,212,549 - -
86 3.44 151 816,659 40,833 775,826 - -
83 3.32 148 800,434 40,022 760,412 - -
83 3.32 148 800,434 40,022 760,412 - -
86 3.44 151 816,659 40,833 775,826 - -
78 3.12 163 881,559 132,234 749,325 - -
83 3.32 148 800,434 40,022 760,412 - -
78 3.12 143 773,392 38,670 734,723 - -
78 3.12 163 881,559 44,078 837,481 - -
78 3.12 143 773,392 38,670 734,723 - -
78 3.12 163 881,559 44,078 837,481 - -
68 2.72 193 1,043,809 52,190 991,619 - -
78 3.12 163 881,559 44,078 837,481 - -
58 2.32 123 665,225 33,261 631,964 - -
58 2.32 123 665,225 33,261 631,964 - -
61 2.44 126 681,450 34,073 647,378 - -
58 2.32 143 773,392 38,670 734,723 - -
58 2.32 143 773,392 38,670 734,723 - -
80 3.20 145 781,559 39,078 742,481 - -
73 2.92 158 854,517 42,726 811,791 - -
76 3.04 141 762,576 762,576 - -
58 2.32 143 773,392 - 773,392 - -
58 2.32 143 773,392 - 773,392 - -
53 2.12 118 635,534 - 635,534 - -
83 3.32 123 665,225 - 665,225 - -
56 2.24 106 573,284 - 573,284 - -
35 1.40 100 540,834 27,042 513,792 - -
35 1.40 100 540,834 27,042 513,792 - -
35 1.40 100 540,834 27,042 513,792 - -
38 1.52 88 475,934 23,797 452,137 - -
35 1.40 100 540,834 27,042 513,792 - -
33 1.32 98 530,017 26,501 503,516 - -
33 1.32 118 638,184 31,909 606,275 - -
33 1.32 98 530,017 26,501 503,516 - -
10 0.40 75 405,625 20,281 385,344 - -
15 0.60 80 432,667 21,633 411,034 - -
13 0.52 78 421,850 21,093 400,758 - -
13 0.52 78 421,850 21,093 400,758 - -
10 0.40 95 513,792 25,690 488,102 - -
15 0.60 80 432,667 21,633 411,034 - -
10 0.40 60 324,500 16,225 308,275 - -
13 0.52 78 421,850 21,093 400,758 - -
15 0.60 65 351,542 17,577 333,965 - -
13 0.52 53 286,642 14,332 272,310 - -
15 0.60 55 297,459 14,873 282,586 - -
10 0.40 50 270,417 13,521 256,896 - -
6,416 34,700,000 1,781,644 32,918,356 - -
Garut, 31 Desember 2015


NIP. 19690217 200701 1 010
ATAN NASIONAL (JKN)

GUNAN
PERHITUNGAN JASPEL
POINT POTONGAN TIDAK APEL
DITERIMA
POIN PER ORG
PERHARI VAR
PER ORANG
DAERAH
JMLH JUMLAH
PAJAK PPh
VARIABEL (K15)/TOTAL JASPEL
DAERAH (K6)-(K8 x K9) + Psl 21
POIN X DITERIMA JML TDK
(K7-K8)+(K13)- 5,000
(K8XK14) TOTAL APEL
JASPEL
14
13
(10+11+12) 15 16 17 18
(13/7)
105 4.20 310 1,913,043 286,957 1,626,087 - -
100 4.00 170 1,049,088 52,454 996,634 - -
100 4.00 195 1,203,366 60,168 1,143,198 - -
70 2.80 245 1,511,921 75,596 1,436,325 - -
61 2.44 236 1,456,381 72,819 1,383,562 - -
86 3.44 151 931,837 46,592 885,245 - -
83 3.32 148 913,324 45,666 867,658 - -
83 3.32 148 913,324 45,666 867,658 - -
86 3.44 151 931,837 46,592 885,245 - -
78 3.12 163 1,005,891 150,884 855,007 - -
83 3.32 148 913,324 45,666 867,658 - -
78 3.12 143 882,468 44,123 838,345 - -
78 3.12 163 1,005,891 50,295 955,596 - -
78 3.12 143 882,468 44,123 838,345 - -
78 3.12 163 1,005,891 50,295 955,596 - -
68 2.72 193 1,191,024 59,551 1,131,473 - -
78 3.12 163 1,005,891 50,295 955,596 - -
58 2.32 123 759,046 37,952 721,094 - -
58 2.32 123 759,046 37,952 721,094 - -
61 2.44 126 777,560 38,878 738,682 - -
58 2.32 143 882,468 44,123 838,345 - -
58 2.32 143 882,468 44,123 838,345 - -
80 3.20 145 894,811 44,741 850,070 - -
73 2.92 158 975,035 48,752 926,283 - -
76 3.04 141 870,126 870,126 - -
58 2.32 143 882,468 - 882,468 - -
58 2.32 143 882,468 - 882,468 - -
53 2.12 118 728,191 - 728,191 - -
83 3.32 123 759,046 - 759,046 - -
56 2.24 106 654,137 - 654,137 - -
35 1.40 100 617,111 30,856 586,255 - -
35 1.40 100 617,111 30,856 586,255 - -
35 1.40 100 617,111 30,856 586,255 - -
38 1.52 88 543,058 27,153 515,905 - -
35 1.40 100 617,111 30,856 586,255 - -
33 1.32 98 604,769 30,238 574,530 - -
33 1.32 118 728,191 36,410 691,781 - -
33 1.32 98 604,769 30,238 574,530 - -
10 0.40 75 462,833 23,142 439,691 - -
15 0.60 80 493,689 24,684 469,004 - -
13 0.52 78 481,346 24,067 457,279 - -
13 0.52 78 481,346 24,067 457,279 - -
10 0.40 95 586,255 29,313 556,942 - -
15 0.60 80 493,689 24,684 469,004 - -
10 0.40 60 370,266 18,513 351,753 - -
13 0.52 78 481,346 24,067 457,279 - -
15 0.60 65 401,122 20,056 381,066 - -
13 0.52 53 327,069 16,353 310,715 - -
15 0.60 55 339,411 16,971 322,440 - -
10 0.40 50 308,555 15,428 293,128 - -
6,417 39,600,000 2,033,072 37,566,928 - -


NIP. 19690217 200701 1 010
POTONGAN TIDAK APEL
JUMLAH YANG
TANDA TANGAN
DITERIMA
(Rp)
19
1,425,097 1
873,446 2
1,001,894 3
1,258,790 4
1,212,549 5
775,826 6
760,412 7
760,412 8
775,826 9
749,325 10
760,412 11
734,723 12
837,481 13
734,723 14
837,481 15
991,619 16
837,481 17
631,964 18
631,964 19
647,378 20
734,723 21
734,723 22
742,481 23
811,791 24
762,576 25
773,392 26
773,392 27
635,534 28
665,225 29
573,284 30
513,792 31
513,792 32
513,792 33
452,137 34
513,792 35
503,516 36
606,275 37
503,516 38
385,344 39
411,034 40
400,758 41
400,758 42
488,102 43
411,034 44
308,275 45
400,758 46
333,965 47
272,310 48
282,586 49
256,896 50
32,918,356
POTONGAN TIDAK APEL
JUMLAH YANG TANDA TANGAN

DITERIMA
(Rp)
19
1,626,087 1
996,634 2
1,143,198 3
1,436,325 4
1,383,562 5
885,245 6
867,658 7
867,658 8
885,245 9
855,007 10
867,658 11
838,345 12
955,596 13
838,345 14
955,596 15
1,131,473 16
955,596 17
721,094 18
721,094 19
738,682 20
838,345 21
838,345 22
850,070 23
926,283 24
870,126 25
882,468 26
882,468 27
728,191 28
759,046 29
654,137 30
586,255 31
586,255 32
586,255 33
515,905 34
586,255 35
574,530 36
691,781 37
574,530 38
439,691 39
469,004 40
457,279 41
457,279 42
556,942 43
469,004 44
351,753 45
457,279 46
381,066 47
310,715 48
322,440 49
293,128 50
37,566,928
4,169,200 34,702,500 38,871,700

7,599,900 34,765,900 42,365,800
8,251,775 34,935,660 43,187,435
124,424,935
VARIABEL PERHITUNGAN SESUAI PERATURAN BUPATI
NOMOR ; 900 / / I / 2016
TANGGAL : 01 JANUARI 2016
1. VARIABEL KETENAGAAN/PENDIDIKAN 2. VARIABEL STATUS KEPEGAWAIAN

DOKTER 150 PNS
APOTEKER/NERS 100 NON PNS
S2 100
S1/D4 90 3. VARIABEL PANGKAT GOLONGAN R
D3 80 IV
D1 70 III
SMA 60 II
SMP 50 I
SD 40
4. VARIABEL KINERJA 6. VARIABVEL BEBAN KERJA

PIMPINAN BLUD 70 DOKTER UMUM
PEjabat KEUANGAN 40 DOKTER GIGI
PENGELOLA KEPEGWAIAN 15 PERAWAT
PENGELOLA ASET 15 PERAWAT GIGI
PENANGGUNGJAWAB UKM ESENSIAL 25 BIDAN
PENANGGUNGJAWAB UKM PENGEMBANGAN 25 ANALIS
PENANGGUNGJAWAB UKP FARMASI,LAB 25 APOTEKER
PENANGGUNGJAWAB TEKNIS JEJARING PUSKESMAS 25 TENAGA KESEHATAN LAINNYA
DOKTER UMUM 100 SOPIR
DOKTER GIGI 50 OFICE BOY/OB/PRAMUSAJI
PUSTU 15 TIM MANAJEMEN
KORDINATOR RUANGAN,BP,KIA,IGD,gigi 15
PENANGGUNGJAWAB PROGRAM PKM 5 PIMPINAN BLUD
PETUGAS RANGKAP MIN 3 KEG PEjabat KEUANGAN
BENDAHARA 25 PENANGGUNGJAWAB TEKNIS
TEKNIS BOK,JKN 15
OPERATOR /P-care keseluruhan 15
5. VARIABEL RESIKO KERJA BENDAHARA
PEGAWAI KONTAK LANGSUNG DG PASIEN 60 TENAGA ADMINISTRASI LAINYA
PEGAWAI TIDAK KONTAK LANGSUNG DG PASIEN 40
CATATAN :
UNTUK PEMBAGIAN JASA PELAYANAN DARI 40%
a. Dikurangi 5% untuk THR Puskesmas
b. sisa 35% untuk pembagian 35% untuk jasa pelayanan puskesmas
c. Seluruh Pegawai Puskesmas hrs disertai STR,SIP/SIK,SIK,SIPA
d. Seluruh Pegawai Non PNS Puskesmaspenilaian ketenagaan maksimal sampai D3
BEL STATUS KEPEGAWAIAN
70
30
BEL PANGKAT GOLONGAN RUANG

125
75
50
25
BVEL BEBAN KERJA

150
75
40
30
30
40
40
KESEHATAN LAINNYA 20
25
Y/OB/PRAMUSAJI 15
50
30
GUNGJAWAB TEKNIS 30
30
ADMINISTRASI LAINYA 20
JASA P
1. KAPITASI JKN 35% : Rp 40,000,000.00

2. JASA LAYANAN BLUD : 9,000,000
Rp 49,000,000
No. PETUGAS PUSKESMAS NIP GOL JABATAN NPWP
1 2 3 4 5 6
1 dr.Hj.Sri Cahyatiningsih 196810062002122001 IV.b Kepala. Puskesmas 69.460.927.2-443.000

2 Lenia Ratna Susanti 196705131989022006 III.c Ka.Tu 89.256.644.9-443.000
3 dr.Hj.Sisca Risya Fujiarti 198001012010012008 III.c dr.Fungsional 79.506.558.0-443.000
4 Momoh Rohanah, AMK 196407311987032004 III.d Pel.Perawat 78.737.531.0-443.000
5 Hj.Iis Susilawati, AMK 196712261988032003 III.d Pel.Perawat 25.682.985.4-443.000
6 Hj.Neneng Kurniasih, Am.Keb 195906191981072001 III.d Bidan Koordinator 87.705.648.1-443.000
7 Wartinah, AMK 196704211989022001 III.d Pel.Perawat 26.012.366.6-443.000
8 Hj.Hasanah, S.Kep 196809281995032003 IV.a Pel.Perawat 97,211,140,5-443,000
9 Hj.Elis Supyeni, Am.Keb 196712011989032003 III.d Bidan Fungsional 89,319,886,1-443,000
10 Sri Rahmawati, S.ST 196509191991032005 III.d Bides Sukagalih 87,705645,7-443,000
11 Tati Sudaryati, AMKG 197206251994022006 III.c Pel.Perawat Gigi 66.803.020.8-443.000
12 Hj.Lina Zenab,SP 197204161997022001 III.c TPG 72,429,5951-443,000
13 Dewi Darojah 197004101991032004 III.c Pel.Lab 54.996.514.3-443.000
14 Mietta Pursitawati,S.Si.Apt 197711152006042005 III.d Apoteker 25.312.825.0-443.000
15 Ai Neti Srihartati,SKM 197009101991032004 III.d Promkes 77,798,116,8-443,000
16 Yoseph Ferry, AMK 197803162006041016 III.b Pel.Perawat 24.326.102.1-443.000
17 Wheni Puspitawati, AMK 198305172005012006 III.b Pel.Perawat 46.888.684.1-443.000
18 Gungun Nurdiansyah,S.Kep 198209272010011018 III.b Pel.Perawat 97.211.139.7-443.000
19 Hj.Husnul Khotimah,S.ST 197501242007012006 III.a Bides Sukakarya 78.737.497.4-443.000
20 Hj.Rini Lestari, Am.Keb, SE 197509202007012009 III.a Bend.Penerima 89.873.618.6-443.000
21 Ema Asgaritta,S.ST 197710282008012008 III.a Bidan Fungsional 89.873.620.2-443.000
22 Nenden Nuraeni , S.ST 197905142008012024 III.a Bides Sukajaya 89.879.033.2-443.000
23 Reni Hidayat, S.ST 198402152010012012 III.a Bides Mekargalih 71,608,236,7-443,000
24 Rudiana 198007052007011010 III.a Pel.Perawat 98.634.740.9-443.000
25 Ratna Nurhasanah, AMK 198503242011012002 II.c Pel.Perawat 97,326,108,4-443,000
26 Yeni Rella 196110232007012001 II.c Pel.Administrasi 25.699.804.8-443.000
27 Fitri Dwiyani, S.ST 198207282014112001 II.a Pel.Perawat 71.701.953.0-443.000
28 Sipa Nurasvia, AMKG TKK Pel.Perawat Gigi 71,473,013,2,2-443,000
29 Dewi Yulianti, AMK, SE TKK Pel.Perawat 72,583,144,0-443,000
30 Nina Widianty TKK Pel.Perawat 71.472.994.4-443.000
31 Niki Sesbania, SE TKK Pel.Perawat 72,473,372,0-443,000
32 Irma Nurma Diana, AM.Keb PTT Bides Sukakarya 57.951.523.0-443.000
33 Rina Kurnia Aprianti, S.ST PTT Bides Sukagalih 57,951,524,8-443,000
34 Dian Pramesti, Am.Keb PTT Bides Sukajaya 57.951.522.2-443.000
35 Elis Supriyanti, AMKG TKS Pel.Perawat Gigi 71,466,061,0-443,000
36 M Faisal Ali, S.IP TKS Pel.Administrasi 75.510.159.9-443.000
37 Fatmawati, Am.Keb TKS Bides Mekargalih 54,886,528,6-443,000
38 Hasan Alvian, AMK TKS Pel.Perawat 72.465.874.5-443.000
39 Risna D Yulianti, S.ST TKS Pel.Bidan 36.646.908.8-443.000
40 H. Subagja Eska Hidayat,SE TKS Operator JKN 35.135.706.6-443.000
41 Neneng Wulan TKS Pel.Harian Obat 71.473.004.1-443.000
42 Dadan Nurdiansyah,ST TKS Pel.Administrasi 71.466.360.6-443.000
43 Tira Febrianti DJ, AMK MagangPel.Perawat / 72.463.801.0-443.000
44 Empon Rukmini TKS Cleaning Service 72.465.795.2-443.000
45 Indra Sukmana MagangAdmin/sopir 75.510.199.5-443.000
46 Delyan MagangPel.Lab -
47 Dudi Tutuarima MagangTeknis JKN -

NIP 19681006 200212 2 001
DAPTAR PENERIMAAN
JASA PELAYANAN PPK - BADAN LAYANAN UMUM DAERAH (BLUD)
BULAN DESEMBER 2016
PERHITUNGAN
VARIABEL VARIABEL DAERAH VARIABEL INTEREN
JMLH VARIABEL
POIN PER ORG

PERHARI VAR
POINT PER
KETENAGAAN
( DAERAH +
POIN ORANG
KEHADIRAN
KEPEGAWAIA
GOLONGAN /
INTEREN )
KETENAGAA
MASA KERJA
VISUM LUAR
DAERAH
ORANG
PERHARI
KINERJA
JABATAN
RESIKO
STATUS
DALAM
RUANG
BEBAN
REKENING BANK
VISUM
EFEKTIF
KERJA
KERJA
(K6)-(K10 x
HADIR
N
N
K12) + (K9-
TDK
K10)+(K21)-
1 BL
(K10XK22)
12 22
7 8 9 10 11 13 14 15 16 17 18 19 20 21 23
(8/9) (21/9)
-0173110172813 150 25 0 30 6.00 40 25 40 40 125 125 2 0 397 15.88 602
-0173200121663 40 25 0 30 1.60 40 40 20 40 100 75 2 0 317 12.68 412
-0009399399100 150 25 0 0 6.00 40 25 20 50 70 75 3 1 284 11.36 459
-0173110220209 40 25 0 0 1.60 40 40 10 50 40 75 1 1 257 10.28 322
-0173210080098 40 25 7 0 1.60 40 40 5 40 40 75 1 0 241 9.64 220
-0173110074702 40 25 1 0 1.60 40 40 10 40 40 75 1 1 247 9.88 300
-0173110288450 40 25 1 0 1.60 40 40 10 40 70 75 1 3 279 11.16 330
-0173210076042 60 25 1 0 2.40 40 40 5 40 40 75 2 0 242 9.68 314
-0173110270876 40 25 4 0 1.60 40 40 5 40 40 75 1 1 242 9.68 258
-0173200117167 60 25 4 0 2.40 40 40 5 40 20 75 0 2 222 8.88 258
-0005473845100 40 25 1 0 1.60 40 35 15 45 50 75 2 0 262 10.48 314
-0173200180203 60 25 1 0 2.40 40 30 5 40 40 75 0 3 233 9.32 305
-0173200095266 40 25 1 0 1.60 40 40 5 45 40 75 2 0 247 9.88 300
-0013338681101 100 25 2 0 4.00 40 25 5 45 40 75 3 0 233 9.32 329
-0001394428100 60 25 1 30 2.40 40 40 35 45 75 75 2 3 315 12.60 414
-0009980733100 40 25 1 0 1.60 40 25 5 40 40 75 1 0 226 9.04 279
-0021419801100 40 25 0 0 1.60 40 25 10 40 70 75 2 2 264 10.56 329
-0173100135663 60 25 1 0 2.40 40 15 5 40 40 75 3 0 218 8.72 291
-0064912992101 60 25 3 0 2.40 40 15 5 40 40 75 0 2 217 8.68 266
-0066203281102 40 25 1 0 1.60 40 15 15 40 70 75 2 0 257 10.28 309
-0004585437100 60 25 1 0 2.40 40 15 5 40 40 75 1 0 216 8.64 289
-0068246105100 60 25 3 0 2.40 40 15 5 40 40 75 0 3 218 8.72 267
-0069281737100 60 25 1 0 2.40 40 15 5 40 20 75 0 2 197 7.88 271
-0068964970100 40 25 3 0 1.60 40 15 5 40 20 75 1 0 196 7.84 230
-0013576645100 40 25 4 0 1.60 40 15 5 40 40 50 3 0 193 7.72 217
-0069791298100 25 25 2 0 1.00 40 40 5 40 20 50 2 0 197 7.88 227
-0063777943100 25 25 2 0 1.00 40 10 5 40 40 50 2 0 187 7.48 218
-0069890733100 40 25 2 0 1.60 10 25 5 45 40 0 1 1 127 5.08 177
-0069793568100 40 25 2 0 1.60 10 25 10 40 40 0 3 0 128 5.12 178
-0069710281100 25 25 0 0 1.00 10 25 5 40 20 0 1 1 102 4.08 152
-0069793274100 40 25 1 0 1.60 10 25 10 40 20 0 3 0 108 4.32 166
-0069793096100 40 25 6 0 1.60 15 25 5 40 20 0 0 2 107 4.28 131
-0069792571100 60 25 0 0 2.40 15 15 5 40 20 0 0 2 97 3.88 182
-0069911382100 40 25 1 0 1.60 15 15 5 40 20 0 0 2 97 3.88 156
-0069894666100 40 25 0 0 1.60 5 15 5 45 40 0 2 1 113 4.52 178
-0069655459100 40 25 1 0 1.60 5 15 10 40 40 0 3 0 113 4.52 171
-0069900429100 40 25 4 0 1.60 5 15 5 40 20 0 0 2 87 3.48 128
-0058904864100 40 25 0 0 1.60 5 15 10 45 45 0 2 2 124 4.96 189
-0069910866100 60 25 0 0 2.40 5 15 5 40 20 0 0 2 87 3.48 172
-0064981323101 25 25 1 0 1.00 5 10 10 40 40 0 3 0 108 4.32 152
-0069654916100 25 25 12 0 1.00 5 15 5 40 20 0 2 0 87 3.48 71
-0069687563100 40 25 1 0 1.60 5 15 5 40 20 0 2 0 87 3.48 146
-0069910645100 40 25 6 0 1.60 5 15 5 40 20 0 1 0 86 3.44 115
-0069895905100 0 25 0 0 - 5 40 5 40 20 0 1 0 111 4.44 136
-0069652298100 25 25 1 0 1.00 5 10 10 45 45 0 3 0 118 4.72 161
-0069911854100 25 25 1 0 1.00 5 10 5 45 40 0 2 0 107 4.28 151
15 25 1 0 0.60 5 10 10 45 45 0 3 0 118 4.72 152
11,390
Be
JASPEL
DITERIMA
PAJAK PPh JUMLAH JASPEL
(K15)/TOTAL Psl 21 DITERIMA TANDA TANGAN
POIN X TOTAL
JASPEL
24 25 26 27
2,589,743 388,461 2,201,281 1

1,772,382 88,619 1,683,763 2
1,974,571 98,729 1,875,843 3
1,385,211 69,261 1,315,951 4
947,794 47,390 900,405 5
1,288,505 64,425 1,224,079 6
1,420,659 71,033 1,349,626 7
1,350,452 67,523 1,282,929 8
1,109,374 55,469 1,053,905 9
1,109,374 55,469 1,053,905 10
1,350,452 67,523 1,282,929 11
1,313,284 65,664 1,247,619 12
1,288,505 64,425 1,224,079 13
1,416,873 70,844 1,346,030 14
1,780,986 89,049 1,691,937 15
1,201,778 60,089 1,141,689 16
1,415,325 70,766 1,344,558 17
1,251,336 62,567 1,188,769 18
1,143,273 57,164 1,086,109 19
1,329,803 66,490 1,263,313 20
1,243,077 62,154 1,180,923 21
1,147,058 57,353 1,089,705 22
1,164,610 58,230 1,106,379 23
988,060 49,403 938,657 24
932,307 - 932,307 25
977,563 - 977,563 26
937,986 - 937,986 27
759,887 37,994 721,893 28
763,845 38,192 725,653 29
653,889 32,694 621,194 30
714,459 35,723 678,736 31
562,344 28,117 534,227 32
782,946 39,147 743,798 33
669,031 33,452 635,580 34
765,738 38,287 727,451 35
735,108 36,755 698,353 36
549,266 27,463 521,803 37
813,059 40,653 772,406 38
739,927 36,996 702,930 39
652,512 32,626 619,886 40
306,467 15,323 291,144 41
627,733 31,387 596,346 42
493,686 24,684 469,002 43
585,058 29,253 555,805 44
693,810 34,691 659,120 45
648,382 32,419 615,963 46
652,512 32,626 619,886 47
49,000,000 2,566,581 46,433,419

AI NETI SRIHARTATI, SKM

NIP. 19700910 199103 2 004
1 2 3 4 5
3 Yanyan Supriatna, AMD, S.IP 196902172007011010 III.a Bendahara JKN
4 Hj. Hasanah, S.Kep ,Ners 198001012010012008 III.c dr.Fungsional
5 Hj.Iis Susilawati, S.Kep 197803012007012008 III.d dr.Fungsional Gigi
6 HJ. Neneng Kurniasih,Am.Keb 196407311987032004 III.d Pel.Perawat
7 Momoh Rohanah, S.Kep 196712261988032003 III.d Pel.Perawat
8 Wartinah, AMK 195906191981072001 III.d Bidan Koordinator
9 Elis Supyeni, Am. Keb 196704211989022001 III.d Pel.Perawat
10 Sri Rahmawati, S.Tr.Keb 196809281995032003 IV.a Pel.Perawat
11 Mietta Pursitawati,S.Si.Apt 196712011989032003 III.d Bidan Fungsional
12 Ai Neti Srihartati,SKM 197501301995032001 III.d Sanitarian
13 dr.Hj.Sisca Risya Fujiarti 196509191991032005 III.d Bides Sukagalih
14 Tati Sudaryati,AMKG 197206251994022006 III.c Pel.Perawat Gigi
15 Lina Zenab, AMG 197204161992022001 III.c TPG
16 Hj.Dewi Darojah 197711152006042005 III.c Apoteker
17 Wheni Puspitawati ,S.Kep 197009101991032004 III.d Promkes
18 Yoseph Ferry,S.Kep III.c Pel.Perawat Gigi
19 Gun Gun Nurdiansyah,S.Kep, Ne 197803162006041016 III.b Pel.Perawat
20 Rudiana, Am.Kep 198305172005012006 III.b Pel.Perawat
21 Hj.Rini Lestari, Am.Keb, SE 198209272010011018 III.a Pel.Perawat
23 Ema Asgaritta,S.ST 197509202007012009 III.a Bend.Penerima
24 Nenden Nuraeni , S.ST, MH.Kes 197710282008012008 III.a Bidan Fungsional
25 Reni Hidayat, S.ST 197904162006042004 II.d Analis / Lab
26 Yeni Rella 197905142008012024 II.d Bides Sukajaya
27 Fitri Dwiyani, S.Tr.Keb 198402152010012012 II.c Bides Mekargalih
28 Sipa Nurasvia, AMKG 198503242011012002 II.c Pel.Perawat
29 Dewi Yulianti, AMK, SE 196110232007012001 II.b Pel.Administrasi
30 Nina Widianty 198207282014112001 II.a Pel.Perawat
31 Niki Sesbania, SE TKK Pel.Perawat Gigi
32 Rina Kurnia Aprianti, S.Tr.Keb TKK Pel.Perawat
33 Dian Pramesti, Am.Keb TKK Pel.Perawat
34 Irma Nurma Diana, AM.Keb TKK Pel.Perawat
35 Elis Supriyanti, AMKG TKK Pel.Perawat
36 M Faisal Ali, S.IP PTT Bides Sukakarya
37 Fatmawati, Am.Keb PTT Bides Sukagalih
38 Hasan Alvian, S.Kep PTT Bides Sukajaya
39 Risna D Yulianti, S.ST TKS Pel.Perawat Gigi
40 H. Subagja Eska Hidayat, SE TKS Pel.Administrasi
41 Neneng Wulan TKS Bides Mekargalih
42 Dadan Nurdiansyah,ST TKS Pel.Perawat
43 Tira Febrianti DJ, Am.Kep TKS Pel.Bidan
44 Indra TKS Operator JKN
45 Delyan TKS Pel.Harian Obat
46 DudiTutuarima TKS Pel.Administrasi
Pel.Perawat /
47 Magang Operator
Ajeng Pratiwi, AMD JKN
48 Wulan Sari Purwanti TKS Cleaning Service
49 Empon Rukmini Magang Admin/sopir
NPWP KETENAGAAN
6 7
69.460.927.2-443.000 150
70.629.580.5-443.000 90
79.506.558.0-443.000 150
66.788.118.9-443.000 150
78.737.531.0-443.000 80
25.682.985.4-443.000 80
87.705.648.1-443.000 80
26.012.366.6-443.000 80
97,211,140,5-443,000 90
89,319,886,1-443,000 80
69,909,571,7-443,000 100
87,705645,7-443,000 90
66.803.020.8-443.000 80
72,429,5951-443,000 90
25.312.825.0-443.000 100
77,798,116,8-443,000 90
80
24.326.102.1-443.000 80
46.888.684.1-443.000 80
97.211.139.7-443.000 90
78.737.497.4-443.000 90
89.873.618.6-443.000 90
89.873.620.2-443.000 90
79.970.844.1-443.000 90
89.879.033.2-443.000 90
71,608,236,7-443,000 90
97,326,108,4-443,000 80
25.699.804.8-443.000 60
71.701.953.0-443.000 80
71,473,013,2,2-443,000 80
0 80
72,583,144,0-443,000 80
71.472.994.4-443.000 60
72,473,372,0-443,000 80
57.951.523.0-443.000 80
57,951,524,8-443,000 80
57.951.522.2-443.000 80
0 80
80
54,886,528,6-443,000 80
72.465.874.5-443.000 80
36.646.908.8-443.000 80
35.135.706.6-443.000 80
71.473.004.1-443.000 70
71.466.360.6-443.000 80
72.463.801.0-443.000 80
72.465.795.2-443.000 40
60
1 2 3 4 5
2 Yanyan Supriatna, AMD, S.IP 196705131989022006 III.c Ka.Tu
3 Hj. Hasanah, S.Kep ,Ners 196902172007011010 III.a Bendahara JKN
4 Hj.Iis Susilawati, S.Kep 198001012010012008 III.c dr.Fungsional
5 HJ. Neneng Kurniasih,Am.Keb 197803012007012008 III.d dr.Fungsional Gigi
8 Elis Supyeni, Am. Keb 195906191981072001 III.d Bidan Koordinator
9 Sri Rahmawati, S.Tr.Keb 196704211989022001 III.d Pel.Perawat
10 Mietta Pursitawati,S.Si.Apt 196809281995032003 IV.a Pel.Perawat
11 Ai Neti Srihartati,SKM 196712011989032003 III.d Bidan Fungsional
12 dr.Hj.Sisca Risya Fujiarti 197501301995032001 III.d Sanitarian
13 Tati Sudaryati,AMKG 196509191991032005 III.d Bides Sukagalih
14 Lina Zenab, AMG 197206251994022006 III.c Pel.Perawat Gigi
15 Hj.Dewi Darojah 197204161992022001 III.c TPG
16 Wheni Puspitawati ,S.Kep 197711152006042005 III.c Apoteker
17 Yoseph Ferry,S.Kep 197009101991032004 III.d Promkes
18 Gun Gun Nurdiansyah,S.Kep, Ners III.c Pel.Perawat Gigi
20 Hj.Rini Lestari, Am.Keb, SE 198305172005012006 III.b Pel.Perawat
21 Hj.Husnul Khotimah,S.ST 198209272010011018 III.a Pel.Perawat
22 Ema Asgaritta,S.ST 197501242007012006 III.a Bides Sukakarya
23 Nenden Nuraeni , S.ST, MH.Kes 197509202007012009 III.a Bend.Penerima
24 Reni Hidayat, S.ST 197710282008012008 III.a Bidan Fungsional
25 Yeni Rella 197904162006042004 II.d Analis / Lab
26 Fitri Dwiyani, S.Tr.Keb 197905142008012024 II.d Bides Sukajaya
27 Sipa Nurasvia, AMKG 198402152010012012 II.c Bides Mekargalih
28 Dewi Yulianti, AMK, SE 198503242011012002 II.c Pel.Perawat
29 Nina Widianty 196110232007012001 II.b Pel.Administrasi
30 Niki Sesbania, SE 198207282014112001 II.a Pel.Perawat
31 Rina Kurnia Aprianti, S.Tr.Keb TKK Pel.Perawat Gigi
35 M Faisal Ali, S.IP TKK Pel.Perawat
36 Fatmawati, Am.Keb PTT Bides Sukakarya
37 Hasan Alvian, S.Kep PTT Bides Sukagalih
38 Risna D Yulianti, S.ST PTT Bides Sukajaya
39 H. Subagja Eska Hidayat, SE TKS Pel.Perawat Gigi
40 Neneng Wulan TKS Pel.Administrasi
41 Dadan Nurdiansyah,ST TKS Bides Mekargalih
42 Tira Febrianti DJ, Am.Kep TKS Pel.Perawat
43 Indra TKS Pel.Bidan
44 Delyan TKS Operator JKN
45 DudiTutuarima TKS Pel.Harian Obat
46 Ajeng Pratiwi, AMD TKS Pel.Administrasi
Magang Pel.Perawat /
47
Wulan Sari Purwanti Operator JKN
NPWP KEHADIRAN
6 7
69.460.927.2-443.000
89.256.644.9-443.000
70.629.580.5-443.000
79.506.558.0-443.000
66.788.118.9-443.000
78.737.531.0-443.000
25.682.985.4-443.000
87.705.648.1-443.000
26.012.366.6-443.000
97,211,140,5-443,000
89,319,886,1-443,000
69,909,571,7-443,000
87,705645,7-443,000
66.803.020.8-443.000
72,429,5951-443,000
25.312.825.0-443.000
77,798,116,8-443,000
24.326.102.1-443.000
46.888.684.1-443.000
97.211.139.7-443.000
78.737.497.4-443.000
89.873.618.6-443.000
89.873.620.2-443.000
79.970.844.1-443.000
89.879.033.2-443.000
71,608,236,7-443,000
97,326,108,4-443,000
25.699.804.8-443.000
71.701.953.0-443.000
71,473,013,2,2-443,000
0
72,583,144,0-443,000
71.472.994.4-443.000
72,473,372,0-443,000
57.951.523.0-443.000
57,951,524,8-443,000
57.951.522.2-443.000
0
54,886,528,6-443,000
72.465.874.5-443.000
36.646.908.8-443.000
35.135.706.6-443.000
71.473.004.1-443.000
71.466.360.6-443.000
72.463.801.0-443.000
72.465.795.2-443.000
1 2 3 4 5
Pel.Perawat /
47 Magang Operator
Wulan Sari Purwanti JKN
STATUS
NPWP KEPEGAWAIAN
6 7
69.460.927.2-443.000 70
89.256.644.9-443.000 70
70.629.580.5-443.000 70
79.506.558.0-443.000 70
66.788.118.9-443.000 70
78.737.531.0-443.000 70
25.682.985.4-443.000 70
87.705.648.1-443.000 70
26.012.366.6-443.000 70
97,211,140,5-443,000 70
89,319,886,1-443,000 70
69,909,571,7-443,000 70
87,705645,7-443,000 70
66.803.020.8-443.000 70
72,429,5951-443,000 70
25.312.825.0-443.000 70
77,798,116,8-443,000 70
70
24.326.102.1-443.000 70
46.888.684.1-443.000 70
97.211.139.7-443.000 70
78.737.497.4-443.000 70
89.873.618.6-443.000 70
89.873.620.2-443.000 70
79.970.844.1-443.000 70
89.879.033.2-443.000 70
71,608,236,7-443,000 70
97,326,108,4-443,000 70
25.699.804.8-443.000 70
71.701.953.0-443.000 70
71,473,013,2,2-443,000 30
0 30
72,583,144,0-443,000 30
71.472.994.4-443.000 30
72,473,372,0-443,000 30
57.951.523.0-443.000 30
57,951,524,8-443,000 30
57.951.522.2-443.000 30
0 30
30
54,886,528,6-443,000 30
72.465.874.5-443.000 30
36.646.908.8-443.000 30
35.135.706.6-443.000 30
71.473.004.1-443.000 30
71.466.360.6-443.000 30
72.463.801.0-443.000 30
72.465.795.2-443.000 30
30
30
1 2 3 4 5
47
NPWP MASA KERJA
6 7
69.460.927.2-443.000 25
89.256.644.9-443.000 40
70.629.580.5-443.000 40
79.506.558.0-443.000 15
66.788.118.9-443.000 15
78.737.531.0-443.000 40
25.682.985.4-443.000 40
87.705.648.1-443.000 40
26.012.366.6-443.000 40
97,211,140,5-443,000 35
89,319,886,1-443,000 40
69,909,571,7-443,000 31
87,705645,7-443,000 35
66.803.020.8-443.000 35
72,429,5951-443,000 35
25.312.825.0-443.000 25
77,798,116,8-443,000 35
15
24.326.102.1-443.000 15
46.888.684.1-443.000 15
97.211.139.7-443.000 15
78.737.497.4-443.000 15
89.873.618.6-443.000 30
89.873.620.2-443.000 30
79.970.844.1-443.000 30
89.879.033.2-443.000 15
71,608,236,7-443,000 15
97,326,108,4-443,000 10
25.699.804.8-443.000 40
71.701.953.0-443.000 10
71,473,013,2,2-443,000 25
0 25
72,583,144,0-443,000 25
71.472.994.4-443.000 25
72,473,372,0-443,000 25
57.951.523.0-443.000 15
57,951,524,8-443,000 15
57.951.522.2-443.000 15
0 5
5
54,886,528,6-443,000 5
72.465.874.5-443.000 5
36.646.908.8-443.000 5
35.135.706.6-443.000 5
71.473.004.1-443.000 5
71.466.360.6-443.000 5
72.463.801.0-443.000 5
72.465.795.2-443.000 5
5
5
1 2 3 4 5
47
NPWP KINERJA
6 7
69.460.927.2-443.000 70 + Ketenagaan dokter umum
89.256.644.9-443.000 40
70.629.580.5-443.000 5
79.506.558.0-443.000 5 + Penanggungjawab UKP
66.788.118.9-443.000 5
78.737.531.0-443.000 5 + kordinator BP
25.682.985.4-443.000 25
87.705.648.1-443.000 5 + kordinator KIA
26.012.366.6-443.000 5
97,211,140,5-443,000 5
89,319,886,1-443,000 25
69,909,571,7-443,000 25
87,705645,7-443,000 5
66.803.020.8-443.000 5 + kordinator GIGI+teknis BOK
72,429,5951-443,000 5
25.312.825.0-443.000 5
77,798,116,8-443,000 5
5
24.326.102.1-443.000 25 + kordinator IGD
46.888.684.1-443.000 25 2 program
97.211.139.7-443.000 15
78.737.497.4-443.000 5
89.873.618.6-443.000 25
89.873.620.2-443.000 5
79.970.844.1-443.000 15
89.879.033.2-443.000 5
71,608,236,7-443,000 5
97,326,108,4-443,000 15
25.699.804.8-443.000 5
71.701.953.0-443.000 10 2 program
71,473,013,2,2-443,000 0
0 0
72,583,144,0-443,000 0
71.472.994.4-443.000 0
72,473,372,0-443,000 0
57.951.523.0-443.000 5
57,951,524,8-443,000 5
57.951.522.2-443.000 5
0 0
20 + pcare
54,886,528,6-443,000 5
72.465.874.5-443.000 10 2 Program
36.646.908.8-443.000 5
35.135.706.6-443.000 0
71.473.004.1-443.000 5
71.466.360.6-443.000 0
72.463.801.0-443.000 5
72.465.795.2-443.000 0
5
0
1 2 3 4 5
47 Wulan Sari Purwanti Magang Pel.Perawat /
NPWP RESIKO KERJA
6 7
69.460.927.2-443.000 60
89.256.644.9-443.000 40
70.629.580.5-443.000 40
79.506.558.0-443.000 60
66.788.118.9-443.000 40
78.737.531.0-443.000 60
25.682.985.4-443.000 60
87.705.648.1-443.000 40
26.012.366.6-443.000 60
97,211,140,5-443,000 40
89,319,886,1-443,000 40
69,909,571,7-443,000 40
87,705645,7-443,000 60
66.803.020.8-443.000 60
72,429,5951-443,000 40
25.312.825.0-443.000 40
77,798,116,8-443,000 40
40
24.326.102.1-443.000 60
46.888.684.1-443.000 60
97.211.139.7-443.000 60
78.737.497.4-443.000 60
89.873.618.6-443.000 40
89.873.620.2-443.000 60
79.970.844.1-443.000 60
89.879.033.2-443.000 60
71,608,236,7-443,000 60
97,326,108,4-443,000 60
25.699.804.8-443.000 40
71.701.953.0-443.000 60
71,473,013,2,2-443,000 60
60
72,583,144,0-443,000 40
71.472.994.4-443.000 60
72,473,372,0-443,000 40
57.951.523.0-443.000 60
57,951,524,8-443,000 60
57.951.522.2-443.000 60
60
40
54,886,528,6-443,000 60
72.465.874.5-443.000 40
36.646.908.8-443.000 40
35.135.706.6-443.000 40
71.473.004.1-443.000 40
71.466.360.6-443.000 40
72.463.801.0-443.000 40
72.465.795.2-443.000 40
40
40
1 2 3 4 5
23 Nenden Nuraeni , S.ST, MH.Ke 197509202007012009 III.a Bend.Penerima
Pel.Perawat /
47 Magang Operator
Wulan Sari Purwanti JKN
NPWP BEBAN KERJA
6 7
69.460.927.2-443.000 150
89.256.644.9-443.000 30
70.629.580.5-443.000 40
79.506.558.0-443.000 150
66.788.118.9-443.000 75
78.737.531.0-443.000 40
25.682.985.4-443.000 40
87.705.648.1-443.000 30
26.012.366.6-443.000 40
97,211,140,5-443,000 40
89,319,886,1-443,000 30
69,909,571,7-443,000 20
87,705645,7-443,000 30
66.803.020.8-443.000 30
72,429,5951-443,000 20
25.312.825.0-443.000 40
77,798,116,8-443,000 20
30
24.326.102.1-443.000 40
46.888.684.1-443.000 40
97.211.139.7-443.000 40
78.737.497.4-443.000 30
89.873.618.6-443.000 20
89.873.620.2-443.000 30
79.970.844.1-443.000 40
89.879.033.2-443.000 30
71,608,236,7-443,000 30
97,326,108,4-443,000 40
25.699.804.8-443.000 20
71.701.953.0-443.000 40
71,473,013,2,2-443,000 30
0 40
72,583,144,0-443,000 20
71.472.994.4-443.000 40
72,473,372,0-443,000 20
57.951.523.0-443.000 30
57,951,524,8-443,000 30
57.951.522.2-443.000 30
0 30
20
54,886,528,6-443,000 30
72.465.874.5-443.000 40
36.646.908.8-443.000 30
35.135.706.6-443.000 20
71.473.004.1-443.000 20
71.466.360.6-443.000 20
72.463.801.0-443.000 40
72.465.795.2-443.000 15
25
20
1 2 3 4 5
47
GOLONGAN
NPWP RUANG
6 7
69.460.927.2-443.000 125
89.256.644.9-443.000 75
70.629.580.5-443.000 75
79.506.558.0-443.000 75
66.788.118.9-443.000 75
78.737.531.0-443.000 75
25.682.985.4-443.000 75
87.705.648.1-443.000 75
26.012.366.6-443.000 75
97,211,140,5-443,000 125
89,319,886,1-443,000 75
69,909,571,7-443,000 75
87,705645,7-443,000 75
66.803.020.8-443.000 75
72,429,5951-443,000 75
25.312.825.0-443.000 75
77,798,116,8-443,000 75
75
24.326.102.1-443.000 75
46.888.684.1-443.000 75
97.211.139.7-443.000 75
78.737.497.4-443.000 75
89.873.618.6-443.000 75
89.873.620.2-443.000 75
79.970.844.1-443.000 50
89.879.033.2-443.000 50
71,608,236,7-443,000 50
97,326,108,4-443,000 50
25.699.804.8-443.000 50
71.701.953.0-443.000 50
71,473,013,2,2-443,000 15
0 15
72,583,144,0-443,000 15
71.472.994.4-443.000 15
72,473,372,0-443,000 15
57.951.523.0-443.000 15
57,951,524,8-443,000 15
57.951.522.2-443.000 15
0 15
15
54,886,528,6-443,000 15
72.465.874.5-443.000 15
36.646.908.8-443.000 15
35.135.706.6-443.000 15
71.473.004.1-443.000 15
71.466.360.6-443.000 15
72.463.801.0-443.000 15
72.465.795.2-443.000 15
15
15
1 2 3 4 5
47
NPWP VISUM DALAM
6 7
69.460.927.2-443.000 0
89.256.644.9-443.000 0
70.629.580.5-443.000 0
79.506.558.0-443.000 10
66.788.118.9-443.000 3
78.737.531.0-443.000 3
25.682.985.4-443.000 5
87.705.648.1-443.000 3
26.012.366.6-443.000 5
97,211,140,5-443,000 3
89,319,886,1-443,000 2
69,909,571,7-443,000 0
87,705645,7-443,000 0
66.803.020.8-443.000 3
72,429,5951-443,000 0
25.312.825.0-443.000 3
77,798,116,8-443,000 0
3
24.326.102.1-443.000 5
46.888.684.1-443.000 5
97.211.139.7-443.000 5
78.737.497.4-443.000 0
89.873.618.6-443.000 0
89.873.620.2-443.000 3
79.970.844.1-443.000 3
89.879.033.2-443.000 0
71,608,236,7-443,000 0
97,326,108,4-443,000 5
25.699.804.8-443.000 2
71.701.953.0-443.000 5
71,473,013,2,2-443,000 3
0 3
72,583,144,0-443,000 2
71.472.994.4-443.000 3
72,473,372,0-443,000 0
57.951.523.0-443.000 0
57,951,524,8-443,000 0
57.951.522.2-443.000 0
0 3
3
54,886,528,6-443,000 0
72.465.874.5-443.000 3
36.646.908.8-443.000 0
35.135.706.6-443.000 2
71.473.004.1-443.000 3
71.466.360.6-443.000 2
72.463.801.0-443.000 2
72.465.795.2-443.000 0
0
2
1 2 3 4 5
47
NPWP VISUM LUAR
6 7
69.460.927.2-443.000 0
89.256.644.9-443.000 0
70.629.580.5-443.000 0
79.506.558.0-443.000 5
66.788.118.9-443.000 0
78.737.531.0-443.000 2
25.682.985.4-443.000 0
87.705.648.1-443.000 0
26.012.366.6-443.000 5
97,211,140,5-443,000 0
89,319,886,1-443,000 0
69,909,571,7-443,000 5
87,705645,7-443,000 5
66.803.020.8-443.000 3
72,429,5951-443,000 3
25.312.825.0-443.000 0
77,798,116,8-443,000 5
0
24.326.102.1-443.000 0
46.888.684.1-443.000 3
97.211.139.7-443.000 0
78.737.497.4-443.000 5
89.873.618.6-443.000 0
89.873.620.2-443.000 0
79.970.844.1-443.000 3
89.879.033.2-443.000 5
71,608,236,7-443,000 5
97,326,108,4-443,000 0
25.699.804.8-443.000 0
71.701.953.0-443.000 3
71,473,013,2,2-443,000 3
0 3
72,583,144,0-443,000 2
71.472.994.4-443.000 3
72,473,372,0-443,000 0
57.951.523.0-443.000 5
57,951,524,8-443,000 5
57.951.522.2-443.000 5
0 3
0
54,886,528,6-443,000 5
72.465.874.5-443.000 2
36.646.908.8-443.000 5
35.135.706.6-443.000 2
71.473.004.1-443.000 0
71.466.360.6-443.000 0
72.463.801.0-443.000 0
72.465.795.2-443.000 0
3
2

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JASA PELAYANAN KAPITA

No. PETUGAS PUSKESMAS NIP GOL JABATAN

1 dr.Hj.Sri Cahyatiningsih 196810062002122001 IV.b 0

Kepala Puskesmas / FKTP Puskesmas Pembangunan

VARIABEL VARIABEL DAERAH

POIN PER ORG

72.463.801.0-443.000 25 25 0 0 1.00 5 5 5 15 0.60

72.465.795.2-443.000 15 25 0 0 0.60 5 5 0 10 0.40

310 1,899,128 284,869 1,614,259 1

65 398,204 19,910 378,294 46

50 306,311 15,316 290,995 47

Garut, 31 Maret 2016

YANYAN SUPRIATNA, AMD,S.IP

No. PETUGAS PUSKESMAS NIP GOL JABATAN

1 dr.Hj.Sri Cahyatiningsih 196810062002122001 IV.b Kepala Puskesmas

Kepala Puskesmas / FKTP Puskesmas Pembangunan

No. PETUGAS PUSKESMAS NIP GOL JABATAN

Kepala Puskesmas / FKTP Puskesmas Pembangunan

VARIABEL VARIABEL DAERAH

POIN ORANG PERHARI

VARIABEL VARIABEL DAERAH

6,416 34,700,000 1,781,644 32,918,356 - -

Garut, 31 Desember 2015

YANYAN SUPRIATNA, AMD,S.IP

ATAN NASIONAL (JKN)

Garut, 31 Desember 2015

YANYAN SUPRIATNA, AMD,S.IP

POTONGAN TIDAK APEL

JUMLAH YANG TANDA TANGAN

4,169,200 34,702,500 38,871,700

1. VARIABEL KETENAGAAN/PENDIDIKAN 2. VARIABEL STATUS KEPEGAWAIAN

4. VARIABEL KINERJA 6. VARIABVEL BEBAN KERJA

BEL PANGKAT GOLONGAN RUANG

BVEL BEBAN KERJA

1. KAPITASI JKN 35% : Rp 40,000,000.00

No. PETUGAS PUSKESMAS NIP GOL JABATAN NPWP

1 dr.Hj.Sri Cahyatiningsih 196810062002122001 IV.b Kepala. Puskesmas 69.460.927.2-443.000

Kepala Puskesmas / FKTP Puskesmas Pembangunan

POIN PER ORG

2,589,743 388,461 2,201,281 1

Garut, 28 Desember 2016

AI NETI SRIHARTATI, SKM

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