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DAFTAR PENDISTRIBUSIAN JASA PENGIRIMAN JKN (LABORATORIUM) MARET 2016 DAFTAR PEN
NAMA GOL./ PAJAK NILAI PAJAK DITERIMA TANDA TANGAN NO.
dr. Taufiq Sp.PD IV/ 15% 203592.5 30538.88 173053.6 1 1
dr. Luthfi Sp.PD III/ 5% 203592.5 10179.63 193412.9 2 2
dr. Irene Sp.PD 2.5% 203592.5 5089.813 198502.7 3 3
dr. Iskandar Sp.B IV/ 15% 81437 12215.55 69221.45 4 4
dr. Dini Sp.B III/ 5% 81437 4071.85 77365.15 5 5
dr. Irman Sp.A III/ 5% 81437 4071.85 77365.15 6 6
dr. Ineu Sp.A III/ 5% 81437 4071.85 77365.15 7 7
dr. Tatan Sp.A III/ 5% 81437 4071.85 77365.15 8 8
dr. Hervan Sp.OG III/ 5% 81437 4071.85 77365.15 9 9
dr. Bogie Sp.OG III/ 5% 81437 4071.85 77365.15 10 10
dr. Deni Sp.OG III/ 5% 81437 4071.85 77365.15 11 11
dr. Nunung Sp. OG III/ 5% 81437 4071.85 77365.15 12 12
dr. Binto Sp.M III/ 5% 81437 4071.85 77365.15 13 13
dr. Widi Sp.M III/ 5% 81437 4071.85 77365.15 14 14
dr. Edy Sp.THT IV/ 15% 81437 12215.55 69221.45 15 15
dr. Ismi Sp. THT III/ 5% 81437 4071.85 77365.15 16 16
dr. Aris Sp.An III/ 5% 81437 4071.85 77365.15 17 17
dr. Widyatmiko Sp.OT III/ 5% 81437 4071.85 77365.15 18 18
dr. R. Haryo Sp. BS III/ 5% 81437 4071.85 77365.15 19 19
dr. Juhaeriyah IV/ 15% 162874 24431.1 138442.9 20 20
dr. Nurzaman III/ 5% 162874 8143.7 154730.3 21 21
dr. Hari Mukt III/ 5% 162874 8143.7 154730.3 22 22
dr. Amaludin III/ 5% 162874 8143.7 154730.3 23 23
dr. Aji Prasetyo III/ 5% 162874 8143.7 154730.3 24 24
dr. Dyan Fakhry III/ 5% 162874 8143.7 154730.3 25 25
dr. Sedayu III/ 5% 162874 8143.7 154730.3 26 26
dr. Eva R III/ 5% 162874 8143.7 154730.3 27 27
dr. Aulia III/ 5% 162874 8143.7 154730.3 28 28
dr. Riany III/ 5% 162874 8143.7 154730.3 29 29
dr.Rendy III/ 5% 162874 8143.7 154730.3 30 30
dr. Trisy III/ 5% 162874 8143.7 154730.3 31 31
dr.Gisda 2.5% 162874 4071.85 158802.2 32 32
dr. Denok 2.5% 162874 4071.85 158802.2 33 33
dr. Novy 2.5% 162874 4071.85 158802.2 34 34
dr. Dian R. 2.5% 162874 4071.85 158802.2 35 35
dr. Ivan 2.5% 162874 4071.85 158802.2 36 36
dr. Nihayatul 2.5% 162874 4071.85 158802.2 37 37
drg. Yuyum III/ 5% 40718.5 2035.925 38682.58 38 38
4886220 267724.1 4618496
Radiologi 662378
DAFTAR PENDISTRIBUSIAN JASA PENGIRIMAN JKN (RADIOLOGI) APRIL 2016 DAFTAR PEN
NAMA GOL./ PAJAK NILAI PAJAK DITERIMA TANDA TANGAN NO.
dr. Taufiq Sp.PD IV/ 15% 17431 2614.65 14816.35 1 1
dr. Luthfi Sp.PD III/ 5% 17431 871.55 16559.45 2 2
dr. Irene Sp.PD 2.5% 17431 435.775 16995.23 3 3
dr. Iskandar Sp.B IV/ 15% 17431 2614.65 14816.35 4 4
dr. Dini Sp.B III/ 5% 17431 871.55 16559.45 5 5
dr. Irman Sp.A III/ 5% 17431 871.55 16559.45 6 6
dr. Ineu Sp.A III/ 5% 17431 871.55 16559.45 7 7
dr. Tatan Sp.A III/ 5% 17431 871.55 16559.45 8 8
dr. Hervan Sp.OG III/ 5% 17431 871.55 16559.45 9 9
dr. Bogie Sp.OG III/ 5% 17431 871.55 16559.45 10 10
dr. Deni Sp.OG III/ 5% 17431 871.55 16559.45 11 11
dr. Nunung Sp. OG III/ 5% 17431 871.55 16559.45 12 12
dr. Binto Sp.M III/ 5% 17431 871.55 16559.45 13 13
dr. Widi Sp.M III/ 5% 17431 871.55 16559.45 14 14
dr. Edy Sp.THT IV/ 15% 17431 2614.65 14816.35 15 15
dr. Ismi Sp. THT III/ 5% 17431 871.55 16559.45 16 16
dr. Aris Sp.An III/ 5% 17431 871.55 16559.45 17 17
dr. Widyatmiko Sp.OT III/ 5% 17431 871.55 16559.45 18 18
dr. R. Haryo Sp. BS III/ 5% 17431 871.55 16559.45 19 19
dr. Juhaeriyah IV/ 15% 17431 871.55 16559.45 20 20
dr. Nurzaman III/ 5% 17431 871.55 16559.45 21 21
dr. Hari Mukt III/ 5% 17431 871.55 16559.45 22 22
dr. Amaludin III/ 5% 17431 871.55 16559.45 23 23
dr. Aji Prasetyo III/ 5% 17431 871.55 16559.45 24 24
dr. Dyan Fakhry III/ 5% 17431 871.55 16559.45 25 25
dr. Sedayu III/ 5% 17431 871.55 16559.45 26 26
dr. Eva R III/ 5% 17431 871.55 16559.45 27 27
dr. Aulia III/ 5% 17431 871.55 16559.45 28 28
dr. Riany III/ 5% 17431 871.55 16559.45 29 29
dr.Rendy III/ 5% 17431 871.55 16559.45 30 30
dr. Trisy III/ 5% 17431 871.55 16559.45 31 31
dr.Gisda 2.5% 17431 435.775 16995.23 32 32
dr. Denok 2.5% 17431 435.775 16995.23 33 33
dr. Novy 2.5% 17431 435.775 16995.23 34 34
dr. Dian R. 2.5% 17431 435.775 16995.23 35 35
dr. Ivan 2.5% 17431 435.775 16995.23 36 36
dr. Nihayatul 2.5% 17431 435.775 16995.23 37 37
drg. Yuyum III/ 5% 17431 871.55 16559.45 38 38
662378 35297.78 627080.2 39
40
USG April 1602237
DAFTAR PENDISTRIBUSIAN JASA PENGIRIMAN JKN (LABORATORIUM) APRIL 2016 DAFTAR PENDI
NAMA GOL./ PAJAK NILAI PAJAK DITERIMA TANDA TANGAN NO.
dr. Taufiq Sp.PD IV/ 15% 220335.5 33050.33 187285.2 1 1
dr. Luthfi Sp.PD III/ 5% 220335.5 11016.78 209318.8 2 2
dr. Irene Sp.PD 2.5% 220335.5 5508.389 214827.2 3 3
dr. Iskandar Sp.B IV/ 15% 88134.22 13220.13 74914.08 4 4
dr. Dini Sp.B III/ 5% 88134.22 4406.711 83727.51 5 5
dr. Irman Sp.A III/ 5% 88134.22 4406.711 83727.51 6 6
dr. Ineu Sp.A III/ 5% 88134.22 4406.711 83727.51 7 7
dr. Tatan Sp.A III/ 5% 88134.22 4406.711 83727.51 8 8
dr. Hervan Sp.OG III/ 5% 88134.22 4406.711 83727.51 9 9
dr. Bogie Sp.OG III/ 5% 88134.22 4406.711 83727.51 10 10
dr. Deni Sp.OG III/ 5% 88134.22 4406.711 83727.51 11 11
dr. Nunung Sp. OG III/ 5% 88134.22 4406.711 83727.51 12 12
dr. Binto Sp.M III/ 5% 88134.22 4406.711 83727.51 13 13
dr. Widi Sp.M III/ 5% 88134.22 4406.711 83727.51 14 14
dr. Edy Sp.THT IV/ 15% 88134.22 13220.13 74914.08 15 15
dr. Ismi Sp. THT III/ 5% 88134.22 4406.711 83727.51 16 16
dr. Aris Sp.An III/ 5% 88134.22 4406.711 83727.51 17 17
dr. Widyatmiko Sp.OT III/ 5% 88134.22 4406.711 83727.51 18 18
dr. R. Haryo Sp. BS III/ 5% 88134.22 4406.711 83727.51 19 19
dr. Juhaeriyah IV/ 15% 176268.4 26440.27 149828.2 20 20
dr. Nurzaman III/ 5% 176268.4 8813.422 167455 21 21
dr. Hari Mukt III/ 5% 176268.4 8813.422 167455 22 22
dr. Amaludin III/ 5% 176268.4 8813.422 167455 23 23
dr. Aji Prasetyo III/ 5% 176268.4 8813.422 167455 24 24
dr. Dyan Fakhry III/ 5% 176268.4 8813.422 167455 25 25
dr. Sedayu III/ 5% 176268.4 8813.422 167455 26 26
dr. Eva R III/ 5% 176268.4 8813.422 167455 27 27
dr. Aulia III/ 5% 176268.4 8813.422 167455 28 28
dr. Riany III/ 5% 176268.4 8813.422 167455 29 29
dr.Rendy III/ 5% 176268.4 8813.422 167455 30 30
dr. Trisy III/ 5% 176268.4 8813.422 167455 31 31
dr.Gisda 2.5% 176268.4 4406.711 171861.7 32 32
dr. Denok 2.5% 176268.4 4406.711 171861.7 33 33
dr. Novy 2.5% 176268.4 4406.711 171861.7 34 34
dr. Dian R. 2.5% 176268.4 4406.711 171861.7 35 35
dr. Ivan 2.5% 176268.4 4406.711 171861.7 36 36
dr. Nihayatul 2.5% 176268.4 4406.711 171861.7 37 37
drg. Yuyum III/ 5% 44067.11 2203.355 41863.75 38 38
5288053 289741.2 4998312 39
40
Radiologi 879636
DAFTAR PENDISTRIBUSIAN JASA PENGIRIMAN JKN (RADIOLOGI) MEI 2016 DAFTAR PEN
NAMA GOL./ PAJAK NILAI PAJAK DITERIMA TANDA TANGAN NO.
dr. Taufiq Sp.PD IV/ 15% 21990.9 3298.635 18692.27 1 1
dr. Luthfi Sp.PD III/ 5% 21990.9 1099.545 20891.36 2 2
dr. Irene Sp.PD 2.5% 21990.9 549.7725 21441.13 3 3
dr. Fariz Sp. PD III/ 5% 21990.9 1099.545 20891.36 4 4
dr. Iskandar Sp.B IV/ 15% 21990.9 3298.635 18692.27 5 5
dr. Dini Sp.B III/ 5% 21990.9 1099.545 20891.36 6 6
dr. Irman Sp.A III/ 5% 21990.9 1099.545 20891.36 7 7
dr. Ineu Sp.A III/ 5% 21990.9 1099.545 20891.36 8 8
dr. Tatan Sp.A III/ 5% 21990.9 1099.545 20891.36 9 9
dr. Hervan Sp.OG III/ 5% 21990.9 1099.545 20891.36 10 10
dr. Bogie Sp.OG III/ 5% 21990.9 1099.545 20891.36 11 11
dr. Deni Sp.OG III/ 5% 21990.9 1099.545 20891.36 12 12
dr. Nunung Sp. OG III/ 5% 21990.9 1099.545 20891.36 13 13
dr. Binto Sp.M III/ 5% 21990.9 1099.545 20891.36 14 14
dr. Widi Sp.M III/ 5% 21990.9 1099.545 20891.36 15 15
dr. Edy Sp.THT IV/ 15% 21990.9 3298.635 18692.27 16 16
dr. Ismi Sp. THT III/ 5% 21990.9 1099.545 20891.36 17 17
dr. Aris Sp.An III/ 5% 21990.9 1099.545 20891.36 18 18
dr. Widyatmiko Sp.OT III/ 5% 21990.9 1099.545 20891.36 19 19
dr. R. Haryo Sp. BS III/ 5% 21990.9 1099.545 20891.36 20 20
dr. Juhaeriyah IV/ 15% 21990.9 1099.545 20891.36 21 21
dr. Nurzaman III/ 5% 21990.9 1099.545 20891.36 22 22
dr. Hari Mukt III/ 5% 21990.9 1099.545 20891.36 23 23
dr. Amaludin III/ 5% 21990.9 1099.545 20891.36 24 24
dr. Aji Prasetyo III/ 5% 21990.9 1099.545 20891.36 25 25
dr. Dyan Fakhry III/ 5% 21990.9 1099.545 20891.36 26 26
dr. Sedayu III/ 5% 21990.9 1099.545 20891.36 27 27
dr. Eva R III/ 5% 21990.9 1099.545 20891.36 28 28
dr. Aulia III/ 5% 21990.9 1099.545 20891.36 29 29
dr. Riany III/ 5% 21990.9 1099.545 20891.36 30 30
dr.Rendy III/ 5% 21990.9 1099.545 20891.36 31 31
dr. Trisy III/ 5% 21990.9 1099.545 20891.36 32 32
dr.Gisda 2.5% 21990.9 549.7725 21441.13 33 33
dr. Denok 2.5% 21990.9 549.7725 21441.13 34 34
dr. Novy 2.5% 21990.9 549.7725 21441.13 35 35
dr. Dian R. 2.5% 21990.9 549.7725 21441.13 36 36
dr. Ivan 2.5% 21990.9 549.7725 21441.13 37 37
dr. Nihayatul 2.5% 21990.9 549.7725 21441.13 38 38
dr. Heni Diana 2.5% 21990.9 549.7725 21441.13 39 39
drg. Yuyum III/ 5% 21990.9 1099.545 20891.36 40 40
879636 46180.89 833455.1
DAFTAR PENDISTRIBUSIAN JASA PENGIRIMAN JKN (LABORATORIUM) MEI 2016 DAFTAR PENDIS
NAMA GOL./ PAJAK NILAI PAJAK DITERIMA TANDA TANGAN NO.
dr. Taufiq Sp.PD IV/ 15% 204592.5 30688.87 173903.6 1 1
dr. Luthfi Sp.PD III/ 5% 204592.5 10229.62 194362.9 2 2
dr. Irene Sp.PD 2.5% 204592.5 5114.812 199477.7 3 3
dr. Fariz Sp. PD III/ 5% 204592.5 10229.62 194362.9 4 4
dr. Iskandar Sp.B IV/ 15% 81836.99 12275.55 69561.44 5 5
dr. Dini Sp.B III/ 5% 81836.99 4091.85 77745.14 6 6
dr. Irman Sp.A III/ 5% 81836.99 4091.85 77745.14 7 7
dr. Ineu Sp.A III/ 5% 81836.99 4091.85 77745.14 8 8
dr. Tatan Sp.A III/ 5% 81836.99 4091.85 77745.14 9 9
dr. Hervan Sp.OG III/ 5% 81836.99 4091.85 77745.14 10 10
dr. Bogie Sp.OG III/ 5% 81836.99 4091.85 77745.14 11 11
dr. Deni Sp.OG III/ 5% 81836.99 4091.85 77745.14 12 12
dr. Nunung Sp. OG III/ 5% 81836.99 4091.85 77745.14 13 13
dr. Binto Sp.M III/ 5% 81836.99 4091.85 77745.14 14 14
dr. Widi Sp.M III/ 5% 81836.99 4091.85 77745.14 15 15
dr. Edy Sp.THT IV/ 15% 81836.99 12275.55 69561.44 16 16
dr. Ismi Sp. THT III/ 5% 81836.99 4091.85 77745.14 17 17
dr. Aris Sp.An III/ 5% 81836.99 4091.85 77745.14 18 18
dr. Widyatmiko Sp.OT III/ 5% 81836.99 4091.85 77745.14 19 19
dr. R. Haryo Sp. BS III/ 5% 81836.99 4091.85 77745.14 20 20
dr. Juhaeriyah IV/ 15% 163674 24551.1 139122.9 21 21
dr. Nurzaman III/ 5% 163674 8183.699 155490.3 22 22
dr. Hari Mukt III/ 5% 163674 8183.699 155490.3 23 23
dr. Amaludin III/ 5% 163674 8183.699 155490.3 24 24
dr. Aji Prasetyo III/ 5% 163674 8183.699 155490.3 25 25
dr. Dyan Fakhry III/ 5% 163674 8183.699 155490.3 26 26
dr. Sedayu III/ 5% 163674 8183.699 155490.3 27 27
dr. Eva R III/ 5% 163674 8183.699 155490.3 28 28
dr. Aulia III/ 5% 163674 8183.699 155490.3 29 29
dr. Riany III/ 5% 163674 8183.699 155490.3 30 30
dr.Rendy III/ 5% 163674 8183.699 155490.3 31 31
dr. Trisy III/ 5% 163674 8183.699 155490.3 32 32
dr.Gisda 2.5% 163674 4091.85 159582.1 33 33
dr. Denok 2.5% 163674 4091.85 159582.1 34 34
dr. Novy 2.5% 163674 4091.85 159582.1 35 35
dr. Dian R. 2.5% 163674 4091.85 159582.1 36 36
dr. Ivan 2.5% 163674 4091.85 159582.1 37 37
dr. Nihayatul 2.5% 163674 4091.85 159582.1 38 38
dr. Heni Diana 2.5% 163674 4091.85 159582.1 39 39
drg. Yuyum III/ 5% 40918.5 2045.925 38872.57 40 40
5278486 283360.6 4995125
Radiologi 681895
DAFTAR PENDISTRIBUSIAN JASA PENGIRIMAN JKN (RADIOLOGI) JUNI 2016 DAFTAR PEN
NAMA GOL./ PAJAK NILAI PAJAK DITERIMA TANDA TANGAN NO.
dr. Taufiq Sp.PD IV/ 15% 17047.38 2557.106 14490.27 1 1
dr. Luthfi Sp.PD III/ 5% 17047.38 852.3688 16195.01 2 2
dr. Irene Sp.PD 2.5% 17047.38 426.1844 16621.19 3 3
dr. Fariz Sp. PD III/ 5% 17047.38 852.3688 16195.01 4 4
dr. Iskandar Sp.B IV/ 15% 17047.38 2557.106 14490.27 5 5
dr. Dini Sp.B III/ 5% 17047.38 852.3688 16195.01 6 6
dr. Irman Sp.A III/ 5% 17047.38 852.3688 16195.01 7 7
dr. Ineu Sp.A III/ 5% 17047.38 852.3688 16195.01 8 8
dr. Tatan Sp.A III/ 5% 17047.38 852.3688 16195.01 9 9
dr. Hervan Sp.OG III/ 5% 17047.38 852.3688 16195.01 10 10
dr. Bogie Sp.OG III/ 5% 17047.38 852.3688 16195.01 11 11
dr. Deni Sp.OG III/ 5% 17047.38 852.3688 16195.01 12 12
dr. Nunung Sp. OG III/ 5% 17047.38 852.3688 16195.01 13 13
dr. Binto Sp.M III/ 5% 17047.38 852.3688 16195.01 14 14
dr. Widi Sp.M III/ 5% 17047.38 852.3688 16195.01 15 15
dr. Edy Sp.THT IV/ 15% 17047.38 2557.106 14490.27 16 16
dr. Ismi Sp. THT III/ 5% 17047.38 852.3688 16195.01 17 17
dr. Aris Sp.An III/ 5% 17047.38 852.3688 16195.01 18 18
dr. Widyatmiko Sp.OT III/ 5% 17047.38 852.3688 16195.01 19 19
dr. R. Haryo Sp. BS III/ 5% 17047.38 852.3688 16195.01 20 20
dr. Juhaeriyah IV/ 15% 17047.38 852.3688 16195.01 21 21
dr. Nurzaman III/ 5% 17047.38 852.3688 16195.01 22 22
dr. Hari Mukt III/ 5% 17047.38 852.3688 16195.01 23 23
dr. Amaludin III/ 5% 17047.38 852.3688 16195.01 24 24
dr. Aji Prasetyo III/ 5% 17047.38 852.3688 16195.01 25 25
dr. Dyan Fakhry III/ 5% 17047.38 852.3688 16195.01 26 26
dr. Sedayu III/ 5% 17047.38 852.3688 16195.01 27 27
dr. Eva R III/ 5% 17047.38 852.3688 16195.01 28 28
dr. Aulia III/ 5% 17047.38 852.3688 16195.01 29 29
dr. Riany III/ 5% 17047.38 852.3688 16195.01 30 30
dr.Rendy III/ 5% 17047.38 852.3688 16195.01 31 31
dr. Trisy III/ 5% 17047.38 852.3688 16195.01 32 32
dr.Gisda 2.5% 17047.38 426.1844 16621.19 33 33
dr. Denok 2.5% 17047.38 426.1844 16621.19 34 34
dr. Novy 2.5% 17047.38 426.1844 16621.19 35 35
dr. Dian R. 2.5% 17047.38 426.1844 16621.19 36 36
dr. Ivan 2.5% 17047.38 426.1844 16621.19 37 37
dr. Nihayatul 2.5% 17047.38 426.1844 16621.19 38 38
dr. Heni Diana 2.5% 17047.38 426.1844 16621.19 39 39
drg. Yuyum III/ 5% 17047.38 852.3688 16195.01 40 40
681895 35799.49 646095.5
DAFTAR PENDISTRIBUSIAN JASA PENGIRIMAN JKN (LABORATORIUM) JUNI 2016 DAFTAR PENDI
NAMA GOL./ PAJAK NILAI PAJAK DITERIMA TANDA TANGAN NO.
dr. Taufiq Sp.PD IV/ 15% 194633.1 29194.97 165438.2 1 1
dr. Luthfi Sp.PD III/ 5% 194633.1 9731.657 184901.5 2 2
dr. Irene Sp.PD 2.5% 194633.1 4865.828 189767.3 3 3
dr. Fariz Sp. PD III/ 5% 194633.1 9731.657 184901.5 4 4
dr. Iskandar Sp.B IV/ 15% 77853.26 11677.99 66175.27 5 5
dr. Dini Sp.B III/ 5% 77853.26 3892.663 73960.59 6 6
dr. Irman Sp.A III/ 5% 77853.26 3892.663 73960.59 7 7
dr. Ineu Sp.A III/ 5% 77853.26 3892.663 73960.59 8 8
dr. Tatan Sp.A III/ 5% 77853.26 3892.663 73960.59 9 9
dr. Hervan Sp.OG III/ 5% 77853.26 3892.663 73960.59 10 10
dr. Bogie Sp.OG III/ 5% 77853.26 3892.663 73960.59 11 11
dr. Deni Sp.OG III/ 5% 77853.26 3892.663 73960.59 12 12
dr. Nunung Sp. OG III/ 5% 77853.26 3892.663 73960.59 13 13
dr. Binto Sp.M III/ 5% 77853.26 3892.663 73960.59 14 14
dr. Widi Sp.M III/ 5% 77853.26 3892.663 73960.59 15 15
dr. Edy Sp.THT IV/ 15% 77853.26 11677.99 66175.27 16 16
dr. Ismi Sp. THT III/ 5% 77853.26 3892.663 73960.59 17 17
dr. Aris Sp.An III/ 5% 77853.26 3892.663 73960.59 18 18
dr. Widyatmiko Sp.OT III/ 5% 77853.26 3892.663 73960.59 19 19
dr. R. Haryo Sp. BS III/ 5% 77853.26 3892.663 73960.59 20 20
dr. Juhaeriyah IV/ 15% 155706.5 23355.98 132350.5 21 21
dr. Nurzaman III/ 5% 155706.5 7785.326 147921.2 22 22
dr. Hari Mukt III/ 5% 155706.5 7785.326 147921.2 23 23
dr. Amaludin III/ 5% 155706.5 7785.326 147921.2 24 24
dr. Aji Prasetyo III/ 5% 155706.5 7785.326 147921.2 25 25
dr. Dyan Fakhry III/ 5% 155706.5 7785.326 147921.2 26 26
dr. Sedayu III/ 5% 155706.5 7785.326 147921.2 27 27
dr. Eva R III/ 5% 155706.5 7785.326 147921.2 28 28
dr. Aulia III/ 5% 155706.5 7785.326 147921.2 29 29
dr. Riany III/ 5% 155706.5 7785.326 147921.2 30 30
dr.Rendy III/ 5% 155706.5 7785.326 147921.2 31 31
dr. Trisy III/ 5% 155706.5 7785.326 147921.2 32 32
dr.Gisda 2.5% 155706.5 3892.663 151813.8 33 33
dr. Denok 2.5% 155706.5 3892.663 151813.8 34 34
dr. Novy 2.5% 155706.5 3892.663 151813.8 35 35
dr. Dian R. 2.5% 155706.5 3892.663 151813.8 36 36
dr. Ivan 2.5% 155706.5 3892.663 151813.8 37 37
dr. Nihayatul 2.5% 155706.5 3892.663 151813.8 38 38
dr. Heni Diana 2.5% 155706.5 3892.663 151813.8 39 39
drg. Yuyum III/ 5% 38926.63 1946.331 36980.3 40 40
5021535 269566.9 4751968
Radiologi 852929
DAFTAR PENDISTRIBUSIAN JASA PENGIRIMAN JKN (RADIOLOGI) JULI 2016 DAFTAR PENDI
NAMA GOL./ PAJAK NILAI PAJAK DITERIMA TANDA TANGAN NO.
dr. Taufiq Sp.PD IV/ 15% 21323.23 3198.484 18124.74 1 1
dr. Luthfi Sp.PD III/ 5% 21323.23 1066.161 20257.06 2 2
dr. Irene Sp.PD 2.5% 21323.23 533.0806 20790.14 3 3
dr. Fariz Sp. PD III/ 5% 21323.23 1066.161 20257.06 4 4
dr. Iskandar Sp.B IV/ 15% 21323.23 3198.484 18124.74 5 5
dr. Dini Sp.B III/ 5% 21323.23 1066.161 20257.06 6 6
dr. Irman Sp.A III/ 5% 21323.23 1066.161 20257.06 7 7
dr. Ineu Sp.A III/ 5% 21323.23 1066.161 20257.06 8 8
dr. Tatan Sp.A III/ 5% 21323.23 1066.161 20257.06 9 9
dr. Hervan Sp.OG III/ 5% 21323.23 1066.161 20257.06 10 10
dr. Bogie Sp.OG III/ 5% 21323.23 1066.161 20257.06 11 11
dr. Deni Sp.OG III/ 5% 21323.23 1066.161 20257.06 12 12
dr. Nunung Sp. OG III/ 5% 21323.23 1066.161 20257.06 13 13
dr. Binto Sp.M III/ 5% 21323.23 1066.161 20257.06 14 14
dr. Widi Sp.M III/ 5% 21323.23 1066.161 20257.06 15 15
dr. Edy Sp.THT IV/ 15% 21323.23 3198.484 18124.74 16 16
dr. Ismi Sp. THT III/ 5% 21323.23 1066.161 20257.06 17 17
dr. Aris Sp.An III/ 5% 21323.23 1066.161 20257.06 18 18
dr. Widyatmiko Sp.OT III/ 5% 21323.23 1066.161 20257.06 19 19
dr. R. Haryo Sp. BS III/ 5% 21323.23 1066.161 20257.06 20 20
dr. Juhaeriyah IV/ 15% 21323.23 1066.161 20257.06 21 21
dr. Nurzaman III/ 5% 21323.23 1066.161 20257.06 22 22
dr. Hari Mukt III/ 5% 21323.23 1066.161 20257.06 23 23
dr. Amaludin III/ 5% 21323.23 1066.161 20257.06 24 24
dr. Aji Prasetyo III/ 5% 21323.23 1066.161 20257.06 25 25
dr. Dyan Fakhry III/ 5% 21323.23 1066.161 20257.06 26 26
dr. Sedayu III/ 5% 21323.23 1066.161 20257.06 27 27
dr. Eva R III/ 5% 21323.23 1066.161 20257.06 28 28
dr. Aulia III/ 5% 21323.23 1066.161 20257.06 29 29
dr. Riany III/ 5% 21323.23 1066.161 20257.06 30 30
dr.Rendy III/ 5% 21323.23 1066.161 20257.06 31 31
dr. Trisy III/ 5% 21323.23 1066.161 20257.06 32 32
dr.Gisda 2.5% 21323.23 533.0806 20790.14 33 33
dr. Denok 2.5% 21323.23 533.0806 20790.14 34 34
dr. Novy 2.5% 21323.23 533.0806 20790.14 35 35
dr. Dian R. 2.5% 21323.23 533.0806 20790.14 36 36
dr. Ivan 2.5% 21323.23 533.0806 20790.14 37 37
dr. Nihayatul 2.5% 21323.23 533.0806 20790.14 38 38
dr. Heni Diana 2.5% 21323.23 533.0806 20790.14 39 39
drg. Yuyum III/ 5% 21323.23 1066.161 20257.06 40 40
852929 44778.77 808150.2
DAFTAR PENDISTRIBUSIAN JASA PENGIRIMAN JKN (USG) JULI 2016 DAFTAR PEN
NAMA GOL./ PAJAK NILAI PAJAK DITERIMA TANDA TANGAN NO.
dr. Taufiq Sp.PD IV/ 15% 27789.03 4168.354 23620.67 1 1
dr. Luthfi Sp.PD III/ 5% 27789.03 1389.451 26399.57 2 2
dr. Irene Sp.PD 2.5% 27789.03 694.7256 27094.3 3 3
dr. Fariz Sp. PD III/ 5% 27789.03 1389.451 26399.57 4 4
dr. Iskandar Sp.B IV/ 15% 27789.03 4168.354 23620.67 5 5
dr. Dini Sp.B III/ 5% 27789.03 1389.451 26399.57 6 6
dr. Irman Sp.A III/ 5% 27789.03 1389.451 26399.57 7 7
dr. Ineu Sp.A III/ 5% 27789.03 1389.451 26399.57 8 8
dr. Tatan Sp.A III/ 5% 27789.03 1389.451 26399.57 9 9
dr. Hervan Sp.OG III/ 5% 27789.03 1389.451 26399.57 10 10
dr. Bogie Sp.OG III/ 5% 27789.03 1389.451 26399.57 11 11
dr. Deni Sp.OG III/ 5% 27789.03 1389.451 26399.57 12 12
dr. Nunung Sp. OG III/ 5% 27789.03 1389.451 26399.57 13 13
dr. Binto Sp.M III/ 5% 27789.03 1389.451 26399.57 14 14
dr. Widi Sp.M III/ 5% 27789.03 1389.451 26399.57 15 15
dr. Edy Sp.THT IV/ 15% 27789.03 4168.354 23620.67 16 16
dr. Ismi Sp. THT III/ 5% 27789.03 1389.451 26399.57 17 17
dr. Aris Sp.An III/ 5% 27789.03 1389.451 26399.57 18 18
dr. Widyatmiko Sp.OT III/ 5% 27789.03 1389.451 26399.57 19 19
dr. R. Haryo Sp. BS III/ 5% 27789.03 1389.451 26399.57 20 20
dr. Juhaeriyah IV/ 15% 27789.03 1389.451 26399.57 21 21
dr. Nurzaman III/ 5% 27789.03 1389.451 26399.57 22 22
dr. Hari Mukt III/ 5% 27789.03 1389.451 26399.57 23 23
dr. Amaludin III/ 5% 27789.03 1389.451 26399.57 24 24
dr. Aji Prasetyo III/ 5% 27789.03 1389.451 26399.57 25 25
dr. Dyan Fakhry III/ 5% 27789.03 1389.451 26399.57 26 26
dr. Sedayu III/ 5% 27789.03 1389.451 26399.57 27 27
dr. Eva R III/ 5% 27789.03 1389.451 26399.57 28 28
dr. Aulia III/ 5% 27789.03 1389.451 26399.57 29 29
dr. Riany III/ 5% 27789.03 1389.451 26399.57 30 30
dr.Rendy III/ 5% 27789.03 1389.451 26399.57 31 31
dr. Trisy III/ 5% 27789.03 1389.451 26399.57 32 32
dr.Gisda 2.5% 27789.03 694.7256 27094.3 33 33
dr. Denok 2.5% 27789.03 694.7256 27094.3 34 34
dr. Novy 2.5% 27789.03 694.7256 27094.3 35 35
dr. Dian R. 2.5% 27789.03 694.7256 27094.3 36 36
dr. Ivan 2.5% 27789.03 694.7256 27094.3 37 37
dr. Nihayatul 2.5% 27789.03 694.7256 27094.3 38 38
dr. Heni Diana 2.5% 27789.03 694.7256 27094.3 39 39
drg. Yuyum III/ 5% 27789.03 1389.451 26399.57 40 40
1111561 58356.95 1053204
DAFTAR PENDISTRIBUSIAN JASA PENGIRIMAN JKN (LABORATORIUM) JULI 2016 DAFTAR PENDISTR
NAMA GOL./ PAJAK NILAI PAJAK DITERIMA TANDA TANGAN NO.
dr. Taufiq Sp.PD IV/ 15% 173254 25988.09 147265.9 1 1
dr. Luthfi Sp.PD III/ 5% 173254 8662.698 164591.3 2 2
dr. Irene Sp.PD 2.5% 173254 4331.349 168922.6 3 3
dr. Fariz Sp. PD III/ 5% 173254 8662.698 164591.3 4 4
dr. Iskandar Sp.B IV/ 15% 69301.58 10395.24 58906.34 5 5
dr. Dini Sp.B III/ 5% 69301.58 3465.079 65836.5 6 6
dr. Irman Sp.A III/ 5% 69301.58 3465.079 65836.5 7 7
dr. Ineu Sp.A III/ 5% 69301.58 3465.079 65836.5 8 8
dr. Tatan Sp.A III/ 5% 69301.58 3465.079 65836.5 9 9
dr. Hervan Sp.OG III/ 5% 69301.58 3465.079 65836.5 10 10
dr. Bogie Sp.OG III/ 5% 69301.58 3465.079 65836.5 11 11
dr. Deni Sp.OG III/ 5% 69301.58 3465.079 65836.5 12 12
dr. Nunung Sp. OG III/ 5% 69301.58 3465.079 65836.5 13 13
dr. Binto Sp.M III/ 5% 69301.58 3465.079 65836.5 14 14
dr. Widi Sp.M III/ 5% 69301.58 3465.079 65836.5 15 15
dr. Edy Sp.THT IV/ 15% 69301.58 10395.24 58906.34 16 16
dr. Ismi Sp. THT III/ 5% 69301.58 3465.079 65836.5 17 17
dr. Aris Sp.An III/ 5% 69301.58 3465.079 65836.5 18 18
dr. Widyatmiko Sp.OT III/ 5% 69301.58 3465.079 65836.5 19 19
dr. R. Haryo Sp. BS III/ 5% 69301.58 3465.079 65836.5 20 20
dr. Juhaeriyah IV/ 15% 138603.2 20790.47 117812.7 21 21
dr. Nurzaman III/ 5% 138603.2 6930.158 131673 22 22
dr. Hari Mukt III/ 5% 138603.2 6930.158 131673 23 23
dr. Amaludin III/ 5% 138603.2 6930.158 131673 24 24
dr. Aji Prasetyo III/ 5% 138603.2 6930.158 131673 25 25
dr. Dyan Fakhry III/ 5% 138603.2 6930.158 131673 26 26
dr. Sedayu III/ 5% 138603.2 6930.158 131673 27 27
dr. Eva R III/ 5% 138603.2 6930.158 131673 28 28
dr. Aulia III/ 5% 138603.2 6930.158 131673 29 29
dr. Riany III/ 5% 138603.2 6930.158 131673 30 30
dr.Rendy III/ 5% 138603.2 6930.158 131673 31 31
dr. Trisy III/ 5% 138603.2 6930.158 131673 32 32
dr.Gisda 2.5% 138603.2 3465.079 135138.1 33 33
dr. Denok 2.5% 138603.2 3465.079 135138.1 34 34
dr. Novy 2.5% 138603.2 3465.079 135138.1 35 35
dr. Dian R. 2.5% 138603.2 3465.079 135138.1 36 36
dr. Ivan 2.5% 138603.2 3465.079 135138.1 37 37
dr. Nihayatul 2.5% 138603.2 3465.079 135138.1 38 38
dr. Heni Diana 2.5% 138603.2 3465.079 135138.1 39 39
drg. Yuyum III/ 5% 34650.79 1732.54 32918.25 40 40
4469952 239956.7 4229995
Radiologi Agust 701566
DAFTAR PENDISTRIBUSIAN JASA PENGIRIMAN JKN (RADIOLOGI) AGUSTUS 2016 DAFTAR PENDIST
NAMA GOL./ PAJAK NILAI PAJAK DITERIMA TANDA TANGAN NO.
dr. Taufiq Sp.PD IV/ 15% 17539.15 2630.873 14908.28 1 1
dr. Luthfi Sp.PD III/ 5% 17539.15 876.9575 16662.19 2 2
dr. Irene Sp.PD 2.5% 17539.15 438.4788 17100.67 3 3
dr. Fariz Sp. PD III/ 5% 17539.15 876.9575 16662.19 4 4
dr. Iskandar Sp.B IV/ 15% 17539.15 2630.873 14908.28 5 5
dr. Dini Sp.B III/ 5% 17539.15 876.9575 16662.19 6 6
dr. Irman Sp.A III/ 5% 17539.15 876.9575 16662.19 7 7
dr. Ineu Sp.A III/ 5% 17539.15 876.9575 16662.19 8 8
dr. Tatan Sp.A III/ 5% 17539.15 876.9575 16662.19 9 9
dr. Hervan Sp.OG III/ 5% 17539.15 876.9575 16662.19 10 10
dr. Bogie Sp.OG III/ 5% 17539.15 876.9575 16662.19 11 11
dr. Deni Sp.OG III/ 5% 17539.15 876.9575 16662.19 12 12
dr. Nunung Sp. OG III/ 5% 17539.15 876.9575 16662.19 13 13
dr. Binto Sp.M III/ 5% 17539.15 876.9575 16662.19 14 14
dr. Widi Sp.M III/ 5% 17539.15 876.9575 16662.19 15 15
dr. Edy Sp.THT IV/ 15% 17539.15 2630.873 14908.28 16 16
dr. Ismi Sp. THT III/ 5% 17539.15 876.9575 16662.19 17 17
dr. Aris Sp.An III/ 5% 17539.15 876.9575 16662.19 18 18
dr. Widyatmiko Sp.OT III/ 5% 17539.15 876.9575 16662.19 19 19
dr. R. Haryo Sp. BS III/ 5% 17539.15 876.9575 16662.19 20 20
dr. Juhaeriyah IV/ 15% 17539.15 876.9575 16662.19 21 21
dr. Nurzaman III/ 5% 17539.15 876.9575 16662.19 22 22
dr. Hari Mukt III/ 5% 17539.15 876.9575 16662.19 23 23
dr. Amaludin III/ 5% 17539.15 876.9575 16662.19 24 24
dr. Aji Prasetyo III/ 5% 17539.15 876.9575 16662.19 25 25
dr. Dyan Fakhry III/ 5% 17539.15 876.9575 16662.19 26 26
dr. Sedayu III/ 5% 17539.15 876.9575 16662.19 27 27
dr. Eva R III/ 5% 17539.15 876.9575 16662.19 28 28
dr. Aulia III/ 5% 17539.15 876.9575 16662.19 29 29
dr. Riany III/ 5% 17539.15 876.9575 16662.19 30 30
dr.Rendy III/ 5% 17539.15 876.9575 16662.19 31 31
dr. Trisy III/ 5% 17539.15 876.9575 16662.19 32 32
dr.Gisda 2.5% 17539.15 438.4788 17100.67 33 33
dr. Denok 2.5% 17539.15 438.4788 17100.67 34 34
dr. Novy 2.5% 17539.15 438.4788 17100.67 35 35
dr. Dian R. 2.5% 17539.15 438.4788 17100.67 36 36
dr. Ivan 2.5% 17539.15 438.4788 17100.67 37 37
dr. Nihayatul 2.5% 17539.15 438.4788 17100.67 38 38
dr. Heni Diana 2.5% 17539.15 438.4788 17100.67 39 39
drg. Yuyum III/ 5% 17539.15 876.9575 16662.19 40 40
701566 36832.22 664733.8
DAFTAR PENDISTRIBUSIAN JASA PENGIRIMAN JKN (USG) AGUSTUS 2016 DAFTAR PEN
NAMA GOL./ PAJAK NILAI PAJAK DITERIMA TANDA TANGAN NO.
dr. Taufiq Sp.PD IV/ 15% 40563.1 6084.465 34478.64 1 1
dr. Luthfi Sp.PD III/ 5% 40563.1 2028.155 38534.95 2 2
dr. Irene Sp.PD 2.5% 40563.1 1014.078 39549.02 3 3
dr. Fariz Sp. PD III/ 5% 40563.1 2028.155 38534.95 4 4
dr. Iskandar Sp.B IV/ 15% 40563.1 6084.465 34478.64 5 5
dr. Dini Sp.B III/ 5% 40563.1 2028.155 38534.95 6 6
dr. Irman Sp.A III/ 5% 40563.1 2028.155 38534.95 7 7
dr. Ineu Sp.A III/ 5% 40563.1 2028.155 38534.95 8 8
dr. Tatan Sp.A III/ 5% 40563.1 2028.155 38534.95 9 9
dr. Hervan Sp.OG III/ 5% 40563.1 2028.155 38534.95 10 10
dr. Bogie Sp.OG III/ 5% 40563.1 2028.155 38534.95 11 11
dr. Deni Sp.OG III/ 5% 40563.1 2028.155 38534.95 12 12
dr. Nunung Sp. OG III/ 5% 40563.1 2028.155 38534.95 13 13
dr. Binto Sp.M III/ 5% 40563.1 2028.155 38534.95 14 14
dr. Widi Sp.M III/ 5% 40563.1 2028.155 38534.95 15 15
dr. Edy Sp.THT IV/ 15% 40563.1 6084.465 34478.64 16 16
dr. Ismi Sp. THT III/ 5% 40563.1 2028.155 38534.95 17 17
dr. Aris Sp.An III/ 5% 40563.1 2028.155 38534.95 18 18
dr. Widyatmiko Sp.OT III/ 5% 40563.1 2028.155 38534.95 19 19
dr. R. Haryo Sp. BS III/ 5% 40563.1 2028.155 38534.95 20 20
dr. Juhaeriyah IV/ 15% 40563.1 2028.155 38534.95 21 21
dr. Nurzaman III/ 5% 40563.1 2028.155 38534.95 22 22
dr. Hari Mukt III/ 5% 40563.1 2028.155 38534.95 23 23
dr. Amaludin III/ 5% 40563.1 2028.155 38534.95 24 24
dr. Aji Prasetyo III/ 5% 40563.1 2028.155 38534.95 25 25
dr. Dyan Fakhry III/ 5% 40563.1 2028.155 38534.95 26 26
dr. Sedayu III/ 5% 40563.1 2028.155 38534.95 27 27
dr. Eva R III/ 5% 40563.1 2028.155 38534.95 28 28
dr. Aulia III/ 5% 40563.1 2028.155 38534.95 29 29
dr. Riany III/ 5% 40563.1 2028.155 38534.95 30 30
dr.Rendy III/ 5% 40563.1 2028.155 38534.95 31 31
dr. Trisy III/ 5% 40563.1 2028.155 38534.95 32 32
dr.Gisda 2.5% 40563.1 1014.078 39549.02 33 33
dr. Denok 2.5% 40563.1 1014.078 39549.02 34 34
dr. Novy 2.5% 40563.1 1014.078 39549.02 35 35
dr. Dian R. 2.5% 40563.1 1014.078 39549.02 36 36
dr. Ivan 2.5% 40563.1 1014.078 39549.02 37 37
dr. Nihayatul 2.5% 40563.1 1014.078 39549.02 38 38
dr. Heni Diana 2.5% 40563.1 1014.078 39549.02 39 39
drg. Yuyum III/ 5% 40563.1 2028.155 38534.95 40 40
1622524 85182.51 1537341
DAFTAR PENDISTRIBUSIAN JASA PENGIRIMAN JKN (EKG) AGUSTUS 2016 DAFTAR PEN
NAMA GOL./ PAJAK NILAI PAJAK DITERIMA TANDA TANGAN NO.
dr. Taufiq Sp.PD IV/ 15% 797538.6 119630.8 677907.8 1 1
dr. Luthfi Sp.PD III/ 5% 797538.6 39876.93 757661.7 2 2
dr. Irene Sp.PD 2.5% 797538.6 19938.46 777600.1 3 3
dr. Fariz Sp. PD III/ 5% 797538.6 39876.93 757661.7 4 4
dr. Juhaeriyah IV/ 15% 398769.3 59815.39 338953.9 5 5
dr. Nurzaman III/ 5% 398769.3 19938.46 378830.8 6 6
dr. Hari Mukt III/ 5% 398769.3 19938.46 378830.8 7 7
dr. Amaludin III/ 5% 398769.3 19938.46 378830.8 8 8
dr. Aji Prasetyo III/ 5% 398769.3 19938.46 378830.8 9 9
dr. Dyan Fakhry III/ 5% 398769.3 19938.46 378830.8 10 10
dr. Sedayu III/ 5% 398769.3 19938.46 378830.8 11 11
dr. Eva R III/ 5% 398769.3 19938.46 378830.8 12 12
dr. Aulia III/ 5% 398769.3 19938.46 378830.8 13 13
dr. Riany III/ 5% 398769.3 19938.46 378830.8 14 14
dr.Rendy III/ 5% 398769.3 19938.46 378830.8 15 15
dr. Trisy III/ 5% 398769.3 19938.46 378830.8 16 16
dr.Gisda 2.5% 398769.3 9969.232 388800.1 17 17
dr. Denok 2.5% 398769.3 9969.232 388800.1 18 18
dr. Novy 2.5% 398769.3 9969.232 388800.1 19 19
dr. Dian R. 2.5% 398769.3 9969.232 388800.1 20 20
dr. Ivan 2.5% 398769.3 9969.232 388800.1 21 21
dr. Nihayatul 2.5% 398769.3 9969.232 388800.1 22 22
dr. Heni Diana 2.5% 398769.3 9969.232 388800.1 23 23
10766771 568246.2 10198525
DAFTAR PENDISTRIBUSIAN JASA PENGIRIMAN JKN (LABORATORIUM) AGUSTUS 2016 DAFTAR PENDISTRI
NAMA GOL./ PAJAK NILAI PAJAK DITERIMA TANDA TANGAN NO.
dr. Taufiq Sp.PD IV/ 15% 197794.5 29669.18 168125.4 1 1
dr. Luthfi Sp.PD III/ 5% 197794.5 9889.727 187904.8 2 2
dr. Irene Sp.PD 2.5% 197794.5 4944.863 192849.7 3 3
dr. Fariz Sp. PD III/ 5% 197794.5 9889.727 187904.8 4 4
dr. Iskandar Sp.B IV/ 15% 79117.81 11867.67 67250.14 5 5
dr. Dini Sp.B III/ 5% 79117.81 3955.891 75161.92 6 6
dr. Irman Sp.A III/ 5% 79117.81 3955.891 75161.92 7 7
dr. Ineu Sp.A III/ 5% 79117.81 3955.891 75161.92 8 8
dr. Tatan Sp.A III/ 5% 79117.81 3955.891 75161.92 9 9
dr. Hervan Sp.OG III/ 5% 79117.81 3955.891 75161.92 10 10
dr. Bogie Sp.OG III/ 5% 79117.81 3955.891 75161.92 11 11
dr. Deni Sp.OG III/ 5% 79117.81 3955.891 75161.92 12 12
dr. Nunung Sp. OG III/ 5% 79117.81 3955.891 75161.92 13 13
dr. Binto Sp.M III/ 5% 79117.81 3955.891 75161.92 14 14
dr. Widi Sp.M III/ 5% 79117.81 3955.891 75161.92 15 15
dr. Edy Sp.THT IV/ 15% 79117.81 11867.67 67250.14 16 16
dr. Ismi Sp. THT III/ 5% 79117.81 3955.891 75161.92 17 17
dr. Aris Sp.An III/ 5% 79117.81 3955.891 75161.92 18 18
dr. Widyatmiko Sp.OT III/ 5% 79117.81 3955.891 75161.92 19 19
dr. R. Haryo Sp. BS III/ 5% 79117.81 3955.891 75161.92 20 20
dr. Juhaeriyah IV/ 15% 158235.6 23735.34 134500.3 21 21
dr. Nurzaman III/ 5% 158235.6 7911.781 150323.8 22 22
dr. Hari Mukt III/ 5% 158235.6 7911.781 150323.8 23 23
dr. Amaludin III/ 5% 158235.6 7911.781 150323.8 24 24
dr. Aji Prasetyo III/ 5% 158235.6 7911.781 150323.8 25 25
dr. Dyan Fakhry III/ 5% 158235.6 7911.781 150323.8 26 26
dr. Sedayu III/ 5% 158235.6 7911.781 150323.8 27 27
dr. Eva R III/ 5% 158235.6 7911.781 150323.8 28 28
dr. Aulia III/ 5% 158235.6 7911.781 150323.8 29 29
dr. Riany III/ 5% 158235.6 7911.781 150323.8 30 30
dr.Rendy III/ 5% 158235.6 7911.781 150323.8 31 31
dr. Trisy III/ 5% 158235.6 7911.781 150323.8 32 32
dr.Gisda 2.5% 158235.6 3955.891 154279.7 33 33
dr. Denok 2.5% 158235.6 3955.891 154279.7 34 34
dr. Novy 2.5% 158235.6 3955.891 154279.7 35 35
dr. Dian R. 2.5% 158235.6 3955.891 154279.7 36 36
dr. Ivan 2.5% 158235.6 3955.891 154279.7 37 37
dr. Nihayatul 2.5% 158235.6 3955.891 154279.7 38 38
dr. Heni Diana 2.5% 158235.6 3955.891 154279.7 39 39
drg. Yuyum III/ 5% 39558.91 1977.945 37580.96 40 40
5103099 273945.4 4829154
Radiologi Sept 967500
DAFTAR PENDISTRIBUSIAN JASA PENGIRIMAN JKN (RADIOLOGI) SEPTEMBER 2016 DAFTAR PEND
NAMA GOL./ PAJAK NILAI PAJAK DITERIMA TANDA TANGAN NO.
dr. Taufiq Sp.PD IV/ 15% 24187.5 3628.125 20559.38 1 1
dr. Luthfi Sp.PD III/ 5% 24187.5 1209.375 22978.13 2 2
dr. Irene Sp.PD 2.5% 24187.5 604.6875 23582.81 3 3
dr. Fariz Sp. PD III/ 5% 24187.5 1209.375 22978.13 4 4
dr. Iskandar Sp.B IV/ 15% 24187.5 3628.125 20559.38 5 5
dr. Dini Sp.B III/ 5% 24187.5 1209.375 22978.13 6 6
dr. Irman Sp.A III/ 5% 24187.5 1209.375 22978.13 7 7
dr. Ineu Sp.A III/ 5% 24187.5 1209.375 22978.13 8 8
dr. Tatan Sp.A III/ 5% 24187.5 1209.375 22978.13 9 9
dr. Hervan Sp.OG III/ 5% 24187.5 1209.375 22978.13 10 10
dr. Bogie Sp.OG III/ 5% 24187.5 1209.375 22978.13 11 11
dr. Deni Sp.OG III/ 5% 24187.5 1209.375 22978.13 12 12
dr. Nunung Sp. OG III/ 5% 24187.5 1209.375 22978.13 13 13
dr. Binto Sp.M III/ 5% 24187.5 1209.375 22978.13 14 14
dr. Widi Sp.M III/ 5% 24187.5 1209.375 22978.13 15 15
dr. Edy Sp.THT IV/ 15% 24187.5 3628.125 20559.38 16 16
dr. Ismi Sp. THT III/ 5% 24187.5 1209.375 22978.13 17 17
dr. Aris Sp.An III/ 5% 24187.5 1209.375 22978.13 18 18
dr. Widyatmiko Sp.OT III/ 5% 24187.5 1209.375 22978.13 19 19
dr. R. Haryo Sp. BS III/ 5% 24187.5 1209.375 22978.13 20 20
dr. Juhaeriyah IV/ 15% 24187.5 1209.375 22978.13 21 21
dr. Nurzaman III/ 5% 24187.5 1209.375 22978.13 22 22
dr. Hari Mukt III/ 5% 24187.5 1209.375 22978.13 23 23
dr. Amaludin III/ 5% 24187.5 1209.375 22978.13 24 24
dr. Aji Prasetyo III/ 5% 24187.5 1209.375 22978.13 25 25
dr. Dyan Fakhry III/ 5% 24187.5 1209.375 22978.13 26 26
dr. Sedayu III/ 5% 24187.5 1209.375 22978.13 27 27
dr. Eva R III/ 5% 24187.5 1209.375 22978.13 28 28
dr. Aulia III/ 5% 24187.5 1209.375 22978.13 29 29
dr. Riany III/ 5% 24187.5 1209.375 22978.13 30 30
dr.Rendy III/ 5% 24187.5 1209.375 22978.13 31 31
dr. Trisy III/ 5% 24187.5 1209.375 22978.13 32 32
dr.Gisda 2.5% 24187.5 604.6875 23582.81 33 33
dr. Denok 2.5% 24187.5 604.6875 23582.81 34 34
dr. Novy 2.5% 24187.5 604.6875 23582.81 35 35
dr. Dian R. 2.5% 24187.5 604.6875 23582.81 36 36
dr. Ivan 2.5% 24187.5 604.6875 23582.81 37 37
dr. Nihayatul 2.5% 24187.5 604.6875 23582.81 38 38
dr. Heni Diana 2.5% 24187.5 604.6875 23582.81 39 39
drg. Yuyum III/ 5% 24187.5 1209.375 22978.13 40 40
967500 50793.75 916706.3
DAFTAR PENDISTRIBUSIAN JASA PENGIRIMAN JKN (LABORATORIUM) SEPTEMBER 2016 DAFTAR PENDIS
NAMA GOL./ PAJAK NILAI PAJAK DITERIMA TANDA TANGAN NO.
dr. Taufiq Sp.PD IV/ 15% 177254.8 26588.23 150666.6 1 1
dr. Luthfi Sp.PD III/ 5% 177254.8 8862.742 168392.1 2 2
dr. Irene Sp.PD 2.5% 177254.8 4431.371 172823.5 3 3
dr. Fariz Sp. PD III/ 5% 177254.8 8862.742 168392.1 4 4
dr. Iskandar Sp.B IV/ 15% 70901.94 10635.29 60266.65 5 5
dr. Dini Sp.B III/ 5% 70901.94 3545.097 67356.84 6 6
dr. Irman Sp.A III/ 5% 70901.94 3545.097 67356.84 7 7
dr. Ineu Sp.A III/ 5% 70901.94 3545.097 67356.84 8 8
dr. Tatan Sp.A III/ 5% 70901.94 3545.097 67356.84 9 9
dr. Hervan Sp.OG III/ 5% 70901.94 3545.097 67356.84 10 10
dr. Bogie Sp.OG III/ 5% 70901.94 3545.097 67356.84 11 11
dr. Deni Sp.OG III/ 5% 70901.94 3545.097 67356.84 12 12
dr. Nunung Sp. OG III/ 5% 70901.94 3545.097 67356.84 13 13
dr. Binto Sp.M III/ 5% 70901.94 3545.097 67356.84 14 14
dr. Widi Sp.M III/ 5% 70901.94 3545.097 67356.84 15 15
dr. Edy Sp.THT IV/ 15% 70901.94 10635.29 60266.65 16 16
dr. Ismi Sp. THT III/ 5% 70901.94 3545.097 67356.84 17 17
dr. Aris Sp.An III/ 5% 70901.94 3545.097 67356.84 18 18
dr. Widyatmiko Sp.OT III/ 5% 70901.94 3545.097 67356.84 19 19
dr. R. Haryo Sp. BS III/ 5% 70901.94 3545.097 67356.84 20 20
dr. Juhaeriyah IV/ 15% 141803.9 21270.58 120533.3 21 21
dr. Nurzaman III/ 5% 141803.9 7090.194 134713.7 22 22
dr. Hari Mukt III/ 5% 141803.9 7090.194 134713.7 23 23
dr. Amaludin III/ 5% 141803.9 7090.194 134713.7 24 24
dr. Aji Prasetyo III/ 5% 141803.9 7090.194 134713.7 25 25
dr. Dyan Fakhry III/ 5% 141803.9 7090.194 134713.7 26 26
dr. Sedayu III/ 5% 141803.9 7090.194 134713.7 27 27
dr. Eva R III/ 5% 141803.9 7090.194 134713.7 28 28
dr. Aulia III/ 5% 141803.9 7090.194 134713.7 29 29
dr. Riany III/ 5% 141803.9 7090.194 134713.7 30 30
dr.Rendy III/ 5% 141803.9 7090.194 134713.7 31 31
dr. Trisy III/ 5% 141803.9 7090.194 134713.7 32 32
dr.Gisda 2.5% 141803.9 3545.097 138258.8 33 33
dr. Denok 2.5% 141803.9 3545.097 138258.8 34 34
dr. Novy 2.5% 141803.9 3545.097 138258.8 35 35
dr. Dian R. 2.5% 141803.9 3545.097 138258.8 36 36
dr. Ivan 2.5% 141803.9 3545.097 138258.8 37 37
dr. Nihayatul 2.5% 141803.9 3545.097 138258.8 38 38
dr. Heni Diana 2.5% 141803.9 3545.097 138258.8 39 39
drg. Yuyum III/ 5% 35450.97 1772.548 33678.42 40 40
4573175 245498 4327677
Radiologi Okt 1598901
DAFTAR PENDISTRIBUSIAN JASA PENGIRIMAN JKN (RADIOLOGI) OKTOBER 2016 DAFTAR PEND
NAMA GOL./ PAJAK NILAI PAJAK DITERIMA TANDA TANGAN NO.
dr. Taufiq Sp.PD IV/ 15% 39972.53 5995.879 33976.65 1 1
dr. Luthfi Sp.PD III/ 5% 39972.53 1998.626 37973.9 2 2
dr. Irene Sp.PD 2.5% 39972.53 999.3131 38973.21 3 3
dr. Fariz Sp. PD III/ 5% 39972.53 1998.626 37973.9 4 4
dr. Iskandar Sp.B IV/ 15% 39972.53 5995.879 33976.65 5 5
dr. Dini Sp.B III/ 5% 39972.53 1998.626 37973.9 6 6
dr. Irman Sp.A III/ 5% 39972.53 1998.626 37973.9 7 7
dr. Ineu Sp.A III/ 5% 39972.53 1998.626 37973.9 8 8
dr. Tatan Sp.A III/ 5% 39972.53 1998.626 37973.9 9 9
dr. Hervan Sp.OG III/ 5% 39972.53 1998.626 37973.9 10 10
dr. Bogie Sp.OG III/ 5% 39972.53 1998.626 37973.9 11 11
dr. Deni Sp.OG III/ 5% 39972.53 1998.626 37973.9 12 12
dr. Nunung Sp. OG III/ 5% 39972.53 1998.626 37973.9 13 13
dr. Binto Sp.M III/ 5% 39972.53 1998.626 37973.9 14 14
dr. Widi Sp.M III/ 5% 39972.53 1998.626 37973.9 15 15
dr. Edy Sp.THT IV/ 15% 39972.53 5995.879 33976.65 16 16
dr. Ismi Sp. THT III/ 5% 39972.53 1998.626 37973.9 17 17
dr. Aris Sp.An III/ 5% 39972.53 1998.626 37973.9 18 18
dr. Widyatmiko Sp.OT III/ 5% 39972.53 1998.626 37973.9 19 19
dr. R. Haryo Sp. BS III/ 5% 39972.53 1998.626 37973.9 20 20
dr. Juhaeriyah IV/ 15% 39972.53 1998.626 37973.9 21 21
dr. Nurzaman III/ 5% 39972.53 1998.626 37973.9 22 22
dr. Hari Mukt III/ 5% 39972.53 1998.626 37973.9 23 23
dr. Amaludin III/ 5% 39972.53 1998.626 37973.9 24 24
dr. Aji Prasetyo III/ 5% 39972.53 1998.626 37973.9 25 25
dr. Dyan Fakhry III/ 5% 39972.53 1998.626 37973.9 26 26
dr. Sedayu III/ 5% 39972.53 1998.626 37973.9 27 27
dr. Eva R III/ 5% 39972.53 1998.626 37973.9 28 28
dr. Aulia III/ 5% 39972.53 1998.626 37973.9 29 29
dr. Riany III/ 5% 39972.53 1998.626 37973.9 30 30
dr.Rendy III/ 5% 39972.53 1998.626 37973.9 31 31
dr. Trisy III/ 5% 39972.53 1998.626 37973.9 32 32
dr.Gisda 2.5% 39972.53 999.3131 38973.21 33 33
dr. Denok 2.5% 39972.53 999.3131 38973.21 34 34
dr. Novy 2.5% 39972.53 999.3131 38973.21 35 35
dr. Dian R. 2.5% 39972.53 999.3131 38973.21 36 36
dr. Ivan 2.5% 39972.53 999.3131 38973.21 37 37
dr. Nihayatul 2.5% 39972.53 999.3131 38973.21 38 38
dr. Heni Diana 2.5% 39972.53 999.3131 38973.21 39 39
drg. Yuyum III/ 5% 39972.53 1998.626 37973.9 40 40
1598901 83942.3 1514959
DAFTAR PENDISTRIBUSIAN JASA PENGIRIMAN JKN (LABORATORIUM) OKTOBER 2016 DAFTAR PENDIST
NAMA GOL./ PAJAK NILAI PAJAK DITERIMA TANDA TANGAN NO.
dr. Taufiq Sp.PD IV/ 15% 193029.7 28954.45 164075.2 1 1
dr. Luthfi Sp.PD III/ 5% 193029.7 9651.484 183378.2 2 2
dr. Irene Sp.PD 2.5% 193029.7 4825.742 188203.9 3 3
dr. Fariz Sp. PD III/ 5% 193029.7 9651.484 183378.2 4 4
dr. Iskandar Sp.B IV/ 15% 77211.88 11581.78 65630.09 5 5
dr. Dini Sp.B III/ 5% 77211.88 3860.594 73351.28 6 6
dr. Irman Sp.A III/ 5% 77211.88 3860.594 73351.28 7 7
dr. Ineu Sp.A III/ 5% 77211.88 3860.594 73351.28 8 8
dr. Tatan Sp.A III/ 5% 77211.88 3860.594 73351.28 9 9
dr. Hervan Sp.OG III/ 5% 77211.88 3860.594 73351.28 10 10
dr. Bogie Sp.OG III/ 5% 77211.88 3860.594 73351.28 11 11
dr. Deni Sp.OG III/ 5% 77211.88 3860.594 73351.28 12 12
dr. Nunung Sp. OG III/ 5% 77211.88 3860.594 73351.28 13 13
dr. Binto Sp.M III/ 5% 77211.88 3860.594 73351.28 14 14
dr. Widi Sp.M III/ 5% 77211.88 3860.594 73351.28 15 15
dr. Edy Sp.THT IV/ 15% 77211.88 11581.78 65630.09 16 16
dr. Ismi Sp. THT III/ 5% 77211.88 3860.594 73351.28 17 17
dr. Aris Sp.An III/ 5% 77211.88 3860.594 73351.28 18 18
dr. Widyatmiko Sp.OT III/ 5% 77211.88 3860.594 73351.28 19 19
dr. R. Haryo Sp. BS III/ 5% 77211.88 3860.594 73351.28 20 20
dr. Juhaeriyah IV/ 15% 154423.8 23163.56 131260.2 21 21
dr. Nurzaman III/ 5% 154423.8 7721.188 146702.6 22 22
dr. Hari Mukt III/ 5% 154423.8 7721.188 146702.6 23 23
dr. Amaludin III/ 5% 154423.8 7721.188 146702.6 24 24
dr. Aji Prasetyo III/ 5% 154423.8 7721.188 146702.6 25 25
dr. Dyan Fakhry III/ 5% 154423.8 7721.188 146702.6 26 26
dr. Sedayu III/ 5% 154423.8 7721.188 146702.6 27 27
dr. Eva R III/ 5% 154423.8 7721.188 146702.6 28 28
dr. Aulia III/ 5% 154423.8 7721.188 146702.6 29 29
dr. Riany III/ 5% 154423.8 7721.188 146702.6 30 30
dr.Rendy III/ 5% 154423.8 7721.188 146702.6 31 31
dr. Trisy III/ 5% 154423.8 7721.188 146702.6 32 32
dr.Gisda 2.5% 154423.8 3860.594 150563.2 33 33
dr. Denok 2.5% 154423.8 3860.594 150563.2 34 34
dr. Novy 2.5% 154423.8 3860.594 150563.2 35 35
dr. Dian R. 2.5% 154423.8 3860.594 150563.2 36 36
dr. Ivan 2.5% 154423.8 3860.594 150563.2 37 37
dr. Nihayatul 2.5% 154423.8 3860.594 150563.2 38 38
dr. Heni Diana 2.5% 154423.8 3860.594 150563.2 39 39
drg. Yuyum III/ 5% 38605.94 1930.297 36675.64 40 40
4980166 267346.1 4712820
Radiologi Nop 1052620
DAFTAR PENDISTRIBUSIAN JASA PENGIRIMAN JKN (LABORATORIUM) NOVEMBER 2016 DAFTAR PENDISTR
NAMA GOL./ PAJAK NILAI PAJAK DITERIMA TANDA TANGAN NO.
dr. Taufiq Sp.PD IV/ 15% 172665.3 25899.8 146765.5 1 1
dr. Luthfi Sp.PD III/ 5% 172665.3 8633.266 164032 2 2
dr. Irene Sp.PD 2.5% 172665.3 4316.633 168348.7 3 3
dr. Fariz Sp. PD III/ 5% 172665.3 8633.266 164032 4 4
dr. Iskandar Sp.B IV/ 15% 69066.12 10359.92 58706.21 5 5
dr. Dini Sp.B III/ 5% 69066.12 3453.306 65612.82 6 6
dr. Irman Sp.A III/ 5% 69066.12 3453.306 65612.82 7 7
dr. Ineu Sp.A III/ 5% 69066.12 3453.306 65612.82 8 8
dr. Tatan Sp.A III/ 5% 69066.12 3453.306 65612.82 9 9
dr. Hervan Sp.OG III/ 5% 69066.12 3453.306 65612.82 10 10
dr. Bogie Sp.OG III/ 5% 69066.12 3453.306 65612.82 11 11
dr. Deni Sp.OG III/ 5% 69066.12 3453.306 65612.82 12 12
dr. Nunung Sp. OG III/ 5% 69066.12 3453.306 65612.82 13 13
dr. Binto Sp.M III/ 5% 69066.12 3453.306 65612.82 14 14
dr. Widi Sp.M III/ 5% 69066.12 3453.306 65612.82 15 15
dr. Edy Sp.THT IV/ 15% 69066.12 10359.92 58706.21 16 16
dr. Ismi Sp. THT III/ 5% 69066.12 3453.306 65612.82 17 17
dr. Aris Sp.An III/ 5% 69066.12 3453.306 65612.82 18 18
dr. Widyatmiko Sp.OT III/ 5% 69066.12 3453.306 65612.82 19 19
dr. R. Haryo Sp. BS III/ 5% 69066.12 3453.306 65612.82 20 20
dr. Juhaeriyah IV/ 15% 138132.2 20719.84 117412.4 21 21
dr. Nurzaman III/ 5% 138132.2 6906.612 131225.6 22 22
dr. Hari Mukt III/ 5% 138132.2 6906.612 131225.6 23 23
dr. Amaludin III/ 5% 138132.2 6906.612 131225.6 24 24
dr. Aji Prasetyo III/ 5% 138132.2 6906.612 131225.6 25 25
dr. Dyan Fakhry III/ 5% 138132.2 6906.612 131225.6 26 26
dr. Sedayu III/ 5% 138132.2 6906.612 131225.6 27 27
dr. Eva R III/ 5% 138132.2 6906.612 131225.6 28 28
dr. Aulia III/ 5% 138132.2 6906.612 131225.6 29 29
dr. Riany III/ 5% 138132.2 6906.612 131225.6 30 30
dr.Rendy III/ 5% 138132.2 6906.612 131225.6 31 31
dr. Trisy III/ 5% 138132.2 6906.612 131225.6 32 32
dr.Gisda 2.5% 138132.2 3453.306 134678.9 33 33
dr. Denok 2.5% 138132.2 3453.306 134678.9 34 34
dr. Novy 2.5% 138132.2 3453.306 134678.9 35 35
dr. Dian R. 2.5% 138132.2 3453.306 134678.9 36 36
dr. Ivan 2.5% 138132.2 3453.306 134678.9 37 37
dr. Nihayatul 2.5% 138132.2 3453.306 134678.9 38 38
dr. Heni Diana 2.5% 138132.2 3453.306 134678.9 39 39
drg. Yuyum III/ 5% 34533.06 1726.653 32806.41 40 40
4454765 239141.5 4215624
Jamkesda 47416
NO.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
APATAN USG
SEPT OKTOBER NOV TOTAL TANDA TANGAN
34980.11 26887.99 39029.96 348394.4 1
39095.42 30051.28 43621.72 389381.9 2
40124.25 30842.1 44769.66 399628.8 3
39095.42 30051.28 43621.72 243696.3 4
34980.11 26887.99 39029.96 348394.4 5
39095.42 30051.28 43621.72 389381.9 6
39095.42 30051.28 43621.72 389381.9 7
39095.42 30051.28 43621.72 389381.9 8
39095.42 30051.28 43621.72 389381.9 9
39095.42 30051.28 43621.72 389381.9 10
39095.42 30051.28 43621.72 389381.9 11
39095.42 30051.28 43621.72 389381.9 12
39095.42 30051.28 43621.72 389381.9 13
39095.42 30051.28 43621.72 389381.9 14
39095.42 30051.28 43621.72 389381.9 15
34980.11 26887.99 39029.96 348394.4 16
39095.42 30051.28 43621.72 327402.7 17
39095.42 30051.28 43621.72 389381.9 18
39095.42 30051.28 43621.72 389381.9 19
39095.42 30051.28 43621.72 389381.9 20
34980.11 26887.99 39029.96 348394.4 21
39095.42 30051.28 43621.72 389381.9 22
39095.42 30051.28 43621.72 389381.9 23
39095.42 30051.28 43621.72 389381.9 24
39095.42 30051.28 43621.72 389381.9 25
39095.42 30051.28 43621.72 389381.9 26
39095.42 30051.28 43621.72 389381.9 27
39095.42 30051.28 43621.72 389381.9 28
39095.42 30051.28 43621.72 389381.9 29
39095.42 30051.28 43621.72 389381.9 30
39095.42 30051.28 43621.72 389381.9 31
39095.42 30051.28 43621.72 389381.9 32
40124.25 30842.1 44769.66 399628.8 33
40124.25 30842.1 44769.66 399628.8 34
40124.25 30842.1 44769.66 399628.8 35
40124.25 30842.1 44769.66 399628.8 36
40124.25 30842.1 44769.66 399628.8 37
40124.25 30842.1 44769.66 399628.8 38
40124.25 30842.1 44769.66 250109.4 39
39095.42 30051.28 43621.72 389381.9 40
1555586 1195725 1735685 15136118
PENDAPATAN EKG
SEPT OKTOBER NOV JAKESDA TOTAL TANDA TANGAN
59223.53 60717.83 55836.81 489.15 1441117 1
66191 67861.1 62405.85 546.7 1610660 2
67932.87 69646.92 64048.11 561.09 1653046 3
66191 67861.1 62405.85 546.7 1214870 4
29611.76 30358.91 27918.41 244.57 720558.5 5
33095.5 33930.55 31202.93 273.35 805330 6
33095.5 33930.55 31202.93 273.35 805330 7
33095.5 33930.55 31202.93 273.35 805330 8
33095.5 33930.55 31202.93 273.35 805330 9
33095.5 33930.55 31202.93 273.35 805330 10
33095.5 33930.55 31202.93 273.35 805330 11
33095.5 33930.55 31202.93 273.35 805330 12
33095.5 33930.55 31202.93 273.35 805330 13
33095.5 33930.55 31202.93 273.35 805330 14
33095.5 33930.55 31202.93 273.35 805330 15
33095.5 33930.55 31202.93 273.35 805330 16
33966.44 34823.46 32024.06 280.54 826523 17
33966.44 34823.46 32024.06 280.54 826523 18
33966.44 34823.46 32024.06 280.54 826523 19
33966.44 34823.46 32024.06 280.54 826523 20
33966.44 34823.46 32024.06 280.54 826523 21
33966.44 34823.46 32024.06 280.54 826523 22
33966.44 34823.46 32024.06 280.54 623420.2 23
890965.7 913446.1 840015.7 7358.84 21081441
APATAN LABORATORIUM
SEPT OKTOBER NOV JAKESDA TOTAL TANDA TANGAN
150666.6 164075.2 146765.5 35037.46 1673251 1
168392.1 183378.2 164032 39159.52 1870104 2
172823.5 188203.9 168348.7 40190.03 1919318 3
168392.1 183378.2 164032 39159.52 1286722 4
60266.65 65630.09 58706.21 14014.48 669299.9 5
67356.84 73351.28 65612.82 15663.81 748041.7 6
67356.84 73351.28 65612.82 15663.81 748041.7 7
67356.84 73351.28 65612.82 15663.81 748041.7 8
67356.84 73351.28 65612.82 15663.81 748041.7 9
67356.84 73351.28 65612.82 15663.81 748041.7 10
67356.84 73351.28 65612.82 15663.81 748041.7 11
67356.84 73351.28 65612.82 15663.81 748041.7 12
67356.84 73351.28 65612.82 15663.81 748041.7 13
67356.84 73351.28 65612.82 15663.81 748041.7 14
67356.84 73351.28 65612.82 15663.81 748041.7 15
60266.65 73351.28 58706.21 14014.48 677021.1 16
67356.84 73351.28 65612.82 15663.81 598416.4 17
67356.84 73351.28 65612.82 15663.81 748041.7 18
67356.84 73351.28 65612.82 15663.81 748041.7 19
67356.84 73351.28 65612.82 15663.81 748041.7 20
120533.3 131260.2 117412.4 28029.97 1339201 21
134713.7 146702.6 131225.6 31327.61 1496083 22
134713.7 146702.6 131225.6 31327.61 1496083 23
134713.7 146702.6 131225.6 31327.61 1496083 24
134713.7 146702.6 131225.6 31327.61 1496083 25
134713.7 146702.6 131225.6 31327.61 1496083 26
134713.7 146702.6 131225.6 31327.61 1496083 27
134713.7 146702.6 131225.6 31327.61 1496083 28
134713.7 146702.6 131225.6 31327.61 1496083 29
134713.7 146702.6 131225.6 31327.61 1496083 30
134713.7 146702.6 131225.6 31327.61 1496083 31
134713.7 146702.6 131225.6 31327.61 1496083 32
138258.8 150563.2 134678.9 32152.02 1535454 33
138258.8 150563.2 134678.9 32152.02 1535454 34
138258.8 150563.2 134678.9 32152.02 1535454 35
138258.8 150563.2 134678.9 32152.02 1535454 36
138258.8 150563.2 134678.9 32152.02 1535454 37
138258.8 150563.2 134678.9 32152.02 1535454 38
138258.8 150563.2 134678.9 32152.02 1056467 39
33678.42 36675.64 32806.41 7831.903 374020.8 40
4327677 4720542 4215623 1006399 46858002
DAFTAR JUMLAH PENDISTRIBUSIAN PENDAPATAN JKN
NAMA RADIOLOGI USG EKG LAB TOTAL TANDA TANGAN
dr. Taufiq Sp.PD 248340.8 348394.4 1441117 1673251 3711103.2 1
dr. Luthfi Sp.PD 277557.3 389381.9 1610660 1870104 4147703.2 2
dr. Irene Sp.PD 284861 399628.8 1653046 1919318 4256853.8 3
dr. Fariz Sp. PD 190950.4 243696.3 1214870 1286722 2936238.7 4
dr. Iskandar Sp.B 248340.8 348394.4 - 669299.2 1266034.4 5
dr. Dini Sp.B 277557.3 389381.9 - 748041.7 1414980.9 6
dr. Irman Sp.A 277557.3 389381.9 - 748041.7 1414980.9 7
dr. Ineu Sp.A 277557.3 389381.9 - 748041.7 1414980.9 8
dr. Tatan Sp.A 277557.3 389381.9 - 748041.7 1414980.9 9
dr. Hervan Sp.OG 277557.3 389381.9 - 748041.7 1414980.9 10
dr. Bogie Sp.OG 277557.3 389381.9 - 748041.7 1414980.9 11
dr. Deni Sp.OG 277557.3 389381.9 - 748041.7 1414980.9 12
dr. Nunung Sp. OG 277557.3 389381.9 - 748041.7 1414980.9 13
dr. Binto Sp.M 277557.3 389381.9 - 748041.7 1414980.9 14
dr. Widi Sp.M 277557.3 389381.9 - 748041.7 1414980.9 15
dr. Edy Sp.THT 248340.8 348394.4 - 677021.1 1273756.3 16
dr. Ismi Sp. THT 237332.9 327402.7 - 598416.4 1163152 17
dr. Aris Sp.An 277557.3 389381.9 - 748041.7 1414980.9 18
dr. Widyatmiko Sp.OT 277557.3 389381.9 - 748041.7 1414980.9 19
dr. R. Haryo Sp. BS 277557.3 389381.9 - 748041.7 1414980.9 20
dr. Juhaeriyah 248340.8 348394.4 720558.5 1339201 2656494.7 21
dr. Nurzaman 277557.3 389381.9 805330 1496083 2968352.2 22
dr. Hari Mukt 277557.3 389381.9 805330 1496083 2968352.2 23
dr. Amaludin 277557.3 389381.9 805330 1496083 2968352.2 24
dr. Aji Prasetyo 277557.3 389381.9 805330 1496083 2968352.2 25
dr. Dyan Fakhry 277557.3 389381.9 805330 1496083 2968352.2 26
dr. Sedayu 277557.3 389381.9 805330 1496083 2968352.2 27
dr. Eva R 277557.3 389381.9 805330 1496083 2968352.2 28
dr. Aulia 277557.3 389381.9 805330 1496083 2968352.2 29
dr. Riany 277557.3 389381.9 805330 1496083 2968352.2 30
dr.Rendy 277557.3 389381.9 805330 1496083 2968352.2 31
dr. Trisy 277557.3 389381.9 805330 1496083 2968352.2 32
dr.Gisda 284861 399628.8 826523 1535454 3046466.8 33
dr. Denok 284861 399628.8 826523 1535454 3046466.8 34
dr. Novy 284861 399628.8 826523 1535454 3046466.8 35
dr. Dian R. 284861 399628.8 826523 1535454 3046466.8 36
dr. Ivan 284861 399628.8 826523 1535454 3046466.8 37
dr. Nihayatul 284861 399628.8 826523 1535454 3046466.8 38
dr. Heni Diana 195975 250109.4 623420.2 1056467 2125971.6 39
drg. Yuyum 277557.3 389381.9 - 374020.8 1040960 40
10828138.3 15136117 21081440 46858000 93903695
DAFTAR JUMLAH PEN
NO. NAMA JANUARI FEBRUARI MARET APRIL
1 dr. Taufiq Sp.PD 22460.8
2 dr. Luthfi 17450.81 22773.63 21279.2 25103.25
3 dr. Irene S 17910.04 23372.94 21839.18 25763.86
4 dr. Fariz Sp- - - -
5 dr. Iskanda 15613.88 20376.41 19039.28 22460.8
6 dr. Dini Sp 17450.81 22773.63 21279.2 25103.25
7 dr. Irman S 17450.81 22773.63 21279.2 25103.25
8 dr. Ineu Sp 17450.81 22773.63 21279.2 25103.25
9 dr. Tatan 17450.81 22773.63 21279.2 25103.25
10 dr. Hervan 17450.81 22773.63 21279.2 25103.25
11 dr. Bogie 17450.81 22773.63 21279.2 25103.25
12 dr. Deni S 17450.81 22773.63 21279.2 25103.25
13 dr. Nunung 17450.81 22773.63 21279.2 25103.25
14 dr. Binto S 17450.81 22773.63 21279.2 25103.25
15 dr. Widi S 17450.81 22773.63 21279.2 25103.25
16 dr. Edy Sp. 15613.88 20376.41 19039.28 22460.8
17 dr. Ismi Sp - - 21279.2 25103.25
18 dr. Aris Sp 17450.81 22773.63 21279.2 25103.25
19 dr. Widyat 17450.81 22773.63 21279.2 25103.25
20 dr. R. Hary 17450.81 22773.63 21279.2 25103.25
21 dr. Juhaeri 15613.88 20376.41 19039.28 22460.8
22 dr. Nurzam 17450.81 22773.63 21279.2 25103.25
23 dr. Hari Mu17450.81 22773.63 21279.2 25103.25
24 dr. Amalud 17450.81 22773.63 21279.2 25103.25
25 dr. Aji Pra 17450.81 22773.63 21279.2 25103.25
26 dr. Dyan F 17450.81 22773.63 21279.2 25103.25
27 dr. Sedayu 17450.81 22773.63 21279.2 25103.25
28 dr. Eva R 17450.81 22773.63 21279.2 25103.25
29 dr. Aulia 17450.81 22773.63 21279.2 25103.25
30 dr. Riany 17450.81 22773.63 21279.2 25103.25
31 dr.Rendy 17450.81 22773.63 21279.2 25103.25
32 dr. Trisy 17450.81 22773.63 21279.2 25103.25
33 dr.Gisda 17910.04 23372.94 21839.18 25763.86
34 dr. Denok 17910.04 23372.94 21839.18 25763.86
35 dr. Novy 17910.04 23372.94 21839.18 25763.86
36 dr. Dian R. 17910.04 23372.94 21839.18 25763.86
37 dr. Ivan 17910.04 23372.94 21839.18 25763.86
38 dr. Nihayat 17910.04 23372.94 21839.18 25763.86
39 dr. Heni Di- - - -
40 drg. Yuyum17450.81 22773.63 21279.2 25103.25
625933 816854.2 784530.5 947978
DAFTAR JUMLAH PENDISTRIBUSIAN PENDAPATAN USG
MEI JUNI JULI AGUSTUS SEPT OKTOBER NOV JAKESDA TOTAL TANDA TANGAN
23389.88 22706.9 22535.63 24306.18 20559.38 33976.65 22368.18 1007.59 193311.2 1
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3
26829.56 26046.15 25849.69 27880.16 23582.81 38973.21 25657.61 1155.765 284861 3
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 190950.4
23389.88 22706.9 22535.63 24306.18 20559.38 33976.65 22368.18 1007.59 248340.8 5
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3 7
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3 9
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3 11
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3 13
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3 15
23389.88 22706.9 22535.63 24306.18 20559.38 33976.65 22368.18 1007.59 248340.8
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 237332.9 17
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3 19
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3
23389.88 22706.9 22535.63 24306.18 20559.38 33976.65 22368.18 1007.59 248340.8 21
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3 23
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3 25
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3 27
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3 29
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3 31
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3
26829.56 26046.15 25849.69 27880.16 23582.81 38973.21 25657.61 1155.765 284861 33
26829.56 26046.15 25849.69 27880.16 23582.81 38973.21 25657.61 1155.765 284861
26829.56 26046.15 25849.69 27880.16 23582.81 38973.21 25657.61 1155.765 284861 35
26829.56 26046.15 25849.69 27880.16 23582.81 38973.21 25657.61 1155.765 284861
26829.56 26046.15 25849.69 27880.16 23582.81 38973.21 25657.61 1155.765 284861 37
26829.56 26046.15 25849.69 27880.16 23582.81 38973.21 25657.61 1155.765 284861
26829.56 26046.15 25849.69 27880.16 23582.81 38973.21 25657.61 1155.765 195975 39
26141.63 25378.3 25186.88 27165.73 22978.13 37973.9 24999.73 1126.13 277557.3
1040162 1009789 1002173 1080906 914287.6 1510961 994726 44808.12 10773109
TANDA TANGAN
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12
14
16
18
20
22
24
26
28
30
32
34
36
38
40