PUSKESMAS TENGA

Penerimaan Dana Kapitasi

No. Bulan Saldo Audited 2019
2020

1 2 3 4
1 JANUARI Rp 40,336,326.00 Rp 37,550.00
2 FEBRUARI Rp 40,373,876.00 Rp -
3 MARET Rp 40,373,876.00 Rp -
4 APRIL Rp 40,373,876.00 Rp -
5 MEI Rp 40,373,876.00 Rp 266,807,550.00
6 JUNI Rp 178,896,324.62 Rp 55,706,450.00
7 JULI Rp 146,915,371.12 Rp 58,453,700.00
8 AGUSTUS Rp 181,355,999.56 Rp 58,728,850.00
9 SEPTEMBER Rp 155,320,294.77 Rp 59,704,000.00
10 OKTOBER Rp 164,738,268.43 Rp 59,708,950.00
11 NOVEMBER Rp 153,435,237.22 Rp 59,322,850.00
12 DESEMBER Rp 212,847,479.00 Rp 59,006,050.00
JUMLAH Rp 40,336,326.00 Rp 677,475,950.00
 RINCIAN PENERI

Bunga - Pajak - Administrasi -

Total Penerimaan 2020 Jasa 60%
Meterai
Bruto
5 6 7
Rp - Rp 40,373,876.00 Rp -
Rp - Rp 40,373,876.00 Rp -
Rp - Rp 40,373,876.00 Rp -
Rp - Rp 40,373,876.00 Rp -
Rp 57,473.62 Rp 307,238,899.62 Rp 97,521,840.00
Rp 89,358.50 Rp 234,692,133.12 Rp 62,562,690.00
Rp 76,873.44 Rp 205,445,944.56 Rp -
Rp 66,116.21 Rp 240,150,965.77 Rp 68,496,090.00
Rp 73,755.66 Rp 215,098,050.43
Rp 45,728.79 Rp 224,492,947.22 Rp 71,057,710.00
Rp 89,391.78 Rp 212,847,479.00
Rp 65,775.36 Rp 271,919,304.36 Rp 106,804,710.00
Rp 564,473.36 Rp 718,376,749.36 Rp 406,443,040.00

Mengetahui,
Kepala Dinas Kesehatan

Dr. Erwin Schouten

NIP 19700227 201001 1 007
 RINCIAN PENERIMAAN DAN PENGELUARAN DANA KAPITASI JKN PUSKESMAS TAHU

Pengeluaran
Jasa 60% 40%
Pajak (5% dan 15 %) Netto Operasional
8 9=7-8 10
Rp - Rp - Rp -
Rp - Rp - Rp -
Rp - Rp - Rp -
Rp - Rp - Rp -
Rp 4,366,124.00 Rp 93,155,716.00 Rp -
Rp 2,752,374.00 Rp 59,810,316.00 Rp 15,915,072.00
Rp - Rp -
Rp 3,027,503.00 Rp 65,468,587.00 Rp 6,374,081.00
Rp - Rp - Rp -
Rp 3,175,327.00 Rp 67,882,383.00 Rp -
Rp - Rp - Rp -
Rp 4,761,441.00 Rp 102,043,269.00 Rp 24,380,214.00
Rp 18,082,769.00 Rp 388,360,271.00 Rp 46,669,367.00

Mengetahui,
Kepala Puskesmas Tenga

Harrol A. Tumanduk, S.ST

NIP 19820406 200501 1 009
NA KAPITASI JKN PUSKESMAS TAHUN 2020

Pengeluaran
40%
Belanja Modal BMHP/Alkes/Obat Total 40%
11 12 13 = 10 + 11 + 12
Rp - Rp - Rp -
Rp - Rp - Rp -
Rp - Rp - Rp -
Rp - Rp - Rp -
Rp 30,820,735.00 Rp - Rp 30,820,735.00
Rp - Rp 9,299,000.00 Rp 25,214,072.00
Rp - Rp 24,089,945.00 Rp 24,089,945.00
Rp 9,960,500.00 Rp - Rp 16,334,581.00
Rp 40,363,000.00 Rp 9,996,782.00 Rp 50,359,782.00
Rp - Rp - Rp -
Rp - Rp - Rp -
Rp 62,019,000.00 Rp 4,910,000.00 Rp 91,309,214.00
Rp 143,163,235.00 Rp 48,295,727.00 Rp 238,128,329.00
 Saldo Fisik Kas 2020
Saldo Kas 2020 Seharusnya
Tunai Bank
Total 100%
14 = 7 + 13 15 = 6 - 14 16 17
Rp - Rp 40,373,876.00 Rp - Rp 40,373,876.00
Rp - Rp 40,373,876.00 Rp - Rp 40,373,876.00
Rp - Rp 40,373,876.00 Rp - Rp 40,373,876.00
Rp - Rp 40,373,876.00 Rp - Rp 40,373,876.00
Rp 128,342,575.00 Rp 178,896,324.62 Rp - Rp 178,896,324.62
Rp 87,776,762.00 Rp 146,915,371.12 Rp - Rp 146,915,371.12
Rp 24,089,945.00 Rp 181,355,999.56 Rp - Rp 181,355,999.56
Rp 84,830,671.00 Rp 155,320,294.77 Rp - Rp 155,320,294.77
Rp 50,359,782.00 Rp 164,738,268.43 Rp - Rp 164,738,268.43
Rp 71,057,710.00 Rp 153,435,237.22 Rp - Rp 153,435,237.22
Rp - Rp 212,847,479.00 Rp - Rp 212,847,479.00
Rp 198,113,924.00 Rp 73,805,380.36 Rp - Rp 73,805,380.36
Rp 644,571,369.00 Rp 73,805,380.36 Rp - Rp 73,805,380.36

Pakuweru, 22 Januari 2021

Bendahara JKN Puskesmas Tenga

Stely J. Wowor, Amd.Kep

NIP 19880906 201102 2 001
o Fisik Kas 2020
Selisih
Jumlah
Saldo Kas
18 = 16 + 17 19 = 15 - 18
Rp 40,373,876.00 Rp -
Rp 40,373,876.00 Rp -
Rp 40,373,876.00 Rp -
Rp 40,373,876.00 Rp -
Rp 178,896,324.62 Rp -
Rp 146,915,371.12 Rp -
Rp 181,355,999.56 Rp -
Rp 155,320,294.77 Rp -
Rp 164,738,268.43 Rp -
Rp 153,435,237.22 Rp -
Rp 212,847,479.00 Rp -
Rp 73,805,380.36 Rp -
Rp 73,805,380.36 Rp -