Data Sip Dokter

(1)

K

KO

ON

NF

FIIR

RM

MA

AS

SI

I T

TA

A

N

NO

O

N

NO

OT

TIIS

SI

I

A

AU

UD

DIIT

T

3

4

4 elengkapan administrasi

elengkapan administrasi Rumah Sakit

Rumah Sakit belum dipenuhi

belum dipenuhi

oleh

oleh Fasilitas

Fasilitas esehatan

esehatan Rujukan

Rujukan Tingkat

Tingkat Lanjutan

Lanjutan di

di

wilayah

wilayah BPJS

BPJS esehatan

esehatan Cabang

Cabang Singaraja

Singaraja

Te

Terdapat penagihan klaim Rawat Jalan

rdapat penagihan klaim Rawat Jalan yang dilanjutkan

yang dilanjutkan

dengan Rawat nap sebanyak !! kasus atau

mengakibatkan e"isiensi sebesar Rp #$%&'$(()*+ di

BPJS

(2)

(3)

GGAPAN

GGAPAN NOTISI

NOTISI SPI

SPI UNIT

UNIT MPKR

MPKR

KONFIRMASI TANGGAPAN

- Terlampir dafar Dokter Spesialis/umum/gigi RSU

- Terlampir dafar Dokter Spesialis/umum/gigi RSU Parama Sidhi

Parama Sidhi

- Secara Lisa Rumah

- Secara Lisa Rumah Sakit !ersedia megem!alika atas hasil pemeriksaa

Sakit !ersedia megem!alika atas hasil pemeriksaa

- Terlampir sura

- Terlampir surat (omor )

t (omor ) **4+/,.0/0*41 "al)Pem!eritahua "asil

**4+/,.0/0*41 "al)Pem!eritahua "asil

2egiata Pemeriksaa teral

'P

'PS 2esehata #a!ag Sigar

S 2esehata #a!ag Sigaraa Periode Septem!er +*4 taggal ++

aa Periode Septem!er +*4 taggal ++

Septem!er +*4

- Terlampir 2eputusa etri 2esehata Repu!lik doesia (omor )

53/(2S/S2/,/+*

53/(2S/S2/,/+* tetag P

tetag Peetapa 2elas Ru

eetapa 2elas Rumah Sakit Umum

mah Sakit Umum

Parama Sidhi di Sigaraa ilik PT. Parama Sidhi Pro7isi 'ali

- Terlampir Sura

- Terlampir Surat RSU

t RSU 'uda (omor)43/0/RSU 'uda/+4

'uda (omor)43/0/RSU 'uda/+4 Prihal)

Prihal)

Per%

Per%ataa $kaa elaksaaka $kreditasi taggal *5 Septem!er +

ataa $kaa elaksaaka $kreditasi taggal 5 Septem!er + 4

*4

- Terlampir sura

- Terlampir surat (omor )

t (omor ) **4+/,.0/0*41 "al)Pem!eritahua "asil

**4+/,.0/0*41 "al)Pem!eritahua "asil

2egiata Pemeriksaa teral

'P

'PS 2esehata #a!ag Sigar

S 2esehata #a!ag Sigaraa Periode Septem!er +*4 taggal ++

aa Periode Septem!er +*4 taggal ++

Septem!er +*4

- Terlampir sura

- Terlampir surat (omor )

t (omor ) **4+/,.0/0*41 "al)Pem!eritahua "asil

**4+/,.0/0*41 "al)Pem!eritahua "asil

2egiata Pemeriksaa teral

(4)

REKAPAN SDM

RSU PARAMA SIDHI

N

NO

O

N

NA

AM

MA

A

N

NO

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4

(5)

BERLAKU SIP

TEMPAT PRAKEK

3//+6

RSU P$R$$ SD"

/5/+>

RSU P$R$$ SD"

8/5/++

RSU P$R$$ SD"

3//+6

RSU P$R$$ SD"

8/8/+>

RSU P$R$$ SD"

8/3/+0

RSU P$R$$ SD"

5//+6

RSU P$R$$ SD"

4/>/+*6

RSU P$R$$ SD"

+8/4/+*0

RSU P$R$$ SD"

+/*+/++

RSU P$R$$ SD"

+/5/+*>

RSU P$R$$ SD"

3//+6

RSU P$R$$ SD"

+/>/+>

RSU P$R$$ SD"

6/+/+8

RSU P$R$$ SD"

+/**/+*6

RSU P$R$$ SD"

+/**/+*6

RSU P$R$$ SD"

(6)

R2$P$( SD

RSUD 'ULL(=

NO

NAMA

NO

SIP

A

DOKTER UMUM

*

dr.2omag Sea $dis:ra $rtha

44/5.+/DU-/Dikes/+*6

+

dr.De;a Putu Suheri 'o;o

44/5./DU-/Dikes/+6

3 dr.(i 2etut Suriai

44/3>/DU -/Dikes/+**

4 dr.(i ade ardai

44/3045/DU-/Dikes/+**

5 dr. @a%a ksasila1.2es

44/*6.**/DU-/Dikes/+*4

6 dr.Luh @idias::

44/3808/DU-/Dikes/+**

8 dr.ade Sulasmi

44/38*4/DU /Dikes/+**

>

dr.=ede uli Suas:ka

44/86.8/DU-/Dikes/+4

0 dr.Putu $%u @ida @irastu: =iri

44/6>/DU-/Dikes/+*6

B

D#"$er Gii

*

drg."ad% Sucita

44/0.3/D=-/Dikes/+*5

+

drg.Putu =ede @ira;a

44/4638/D=-/Dikes/+**

3 drg.La:Bah

44/348/D=-/Dikes/+*+

4 drg.Putu =ia Puspa;a:

44/>/D=-/Dikes/+*+

D

Penunjan Me!i"

*

dr. =ede (o7a @irahasa1Sp.$

44/48.+3/DS-/Dikes/+4

+

dr. De;a =ede (gurah a%a (egara1Sp.$

44/046/DS-/Dikes/+*+

3 dr.(i 2omag Darmias:i1Sp.Rad

44/6+./DS-/Dikes/+*6

4 dr.(i ade De;i $rimas1Sp.P2

44/30+4/DS-/Dikes/+**

5 dr  ade a: Luhur Sp P$

44/03 5/DS-/Dikes/+4

(7)

G

Spesialis Lain

*

dr. 2etut S.2epakisa T.Sp.S

44/46*>/DS-/Dikes/+**

+

dr.Putu Ra:h Dia Pardai.Sp.U

44/0.+/DS-/Dikes/+*5

3 dr. sari dah1Sp.T"T-2L

44/>6.6/DS-/Dikes/+*4

4 dr.da 'agus 9udi aha%aa1Sp.T"T.2L

44/+.**/DS-/Dikes/+*5

5 dr. =st (gura" $om Suprad%a1Sp.

44/6./DS-/Dikes/+*4

6 dr.(i (%oma Sekarsari1Sp.

44/8>.0/DS-/Dikes/+*6

8 dr. 2omag =ua;a L1Sp.2

44/+8>/DS-/Dikes/++

>

dr.2etut Sutea @i!a;a1Sp.22..2es

44/0/5/DS-/Dikes/+4

(8)

MASA BERLAKU

TEMPAT PRAKTEK

*>/**/++

RSUD 'ULL(=

5//++

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3//+6

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RSUD 'ULL(=

(9)

3//+6

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0/+/+0

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$potek Sadha $gug1l.Dipoegoro

//+*0

RSUD 'ULL(=

(10)

R2$

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dr. 2TUT 'UD S$DPUTR$

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+

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4 dr. =UST '$=US =T$ TR$RT$1Sp.'

5 dr.

 $D

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8 dr.$D $=US SUPR$T$$1Sp.&=

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dr S@$R$ S&$D($ DU$RS$ Sp &=

(11)

$( SD RSU (=$R$

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53/0/SP.D.+/2es/2PPT//+3

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*3/**/+*6

RSU (=$R$

53/50/SP.D.6/kes/2PPT/?/+3

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*3/**/+*6

RSU (=$R$

(12)

R2$P$( SD 2L(2 UT$$ D$R$ ($T"$

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44/++/SP$/Dikes/+5

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44/+5/S2TT2/Dikes/+3

(13)

'RL$2U SP

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(14)

REKAPAN SDM RSU KAR%A DHARMA HUSADA

NO NAMA NOSIP BERLAKUSIP TEMPATPRAKTEK

A Spesialis Penunjan

* dr.2etut (gurah =uapri%a1Sp.$ 44/+>0/DS-/Dikes/+*+ 3/3/+*8 RSU 2$R9$ D"$R$ "US$D$ + dr.=ede Darma%asa Saputra1Sp.$ 44/>5.*/DS-/Dikes/+*4 +3/0/+*> RSU 2$R9$ D"$R$ "US$D$ 3 dr. De;a =de (gurah Daa (egara1Sp.$ 44/04>/DS-/Dikes/+*+ >/**/+*6 RSU 2$R9$ D"$R$ "US$D$ 4 dr. =ede (o7a @irahasa1Sp.$ 44/*3+.*/DS-/Dikes/+*4 +5/6/+*0 RSU 2$R9$ D"$R$ "US$D$ 5 dr. =ede Sur%a;a1Sp.$ 44/48.*/DS-/Dikes/+**5 >/*+/+*0 RSU 2$R9$ D"$R$ "US$D$ B Spesialis Dasar

* dr. ade Suas:ka1Sp.&= 44/**/DS-/Dikes/+*3 +>/*+/+*6 RSUD 'ULL(=

+ dr.ade 'agiad%a1S.' 44/5.8/DS-/Dikes/+*4 *+/>/+*6 RSU 2$R9$ D"$R$ "US$D$ 3 dr.ade 2etut Sukarta1Sp.&= 44/*.3/DS-/Dikes/+*5 *6/4/+*8 RSU 2$R9$ D"$R$ "US$D$ 4 dr.&ka Udra%aa1Sp.' 44/*.*/DS-/Dikes/+*6 6/*+/+*8 RSU 2$R9$ D"$R$ "US$D$ 5 dr. 2etut (gurah $lit @idiada1Sp.$ 44/5.4/DS-/Dikes/+*6 +/**/+*6 RSU 2$R9$ D"$R$ "US$D$ C Spesialis Lain

* dr. (%oma (ama Putra1Sp.P 44/>0.+4/DS-/Dikes/+*6 *>/6/+++ PRU =R$ P$( $SR 'L&2 D + dr. 2etut S.2epakisa T1Sp.S 44/*85.3*/DS-/Dikes/+*6 *6/4/+++ RSU 2$R9$ D"$R$ "US$D$ D Sub Spesialis

* dr. 2etut Susila1Sp.P1A"$ 44/58*/'PPC SUR$T TU=$S 3/*/+*6 RSU 2$R9$ D"$R$ "US$D$ E& D#"$er U'u'

* dr.2adek $gus Suhardiatha Putra 44/05.4/DU-/Dikes/+*5 >/*+/+*6 RSU 2$R9$ D"$R$ "US$D$ + dr.(i ade (o7a $dri 2luiari 44/+36.4/DU-/Dikes/+*5 *5/*/++ RSU 2$R9$ D"$R$ "US$D$

(15)

NO

NAMA

A

Dokter Umum

1 dr.I Wayan Parna Arianta

2 dr.Luh Putu Laksmi Antari

3 dr.Luh Komang Enggi Lindayani

4 dr.Andika Metrisiaan

!

dr.Ni Made Ita Pur"a #ani

$

dr.Ni Made %indri Astuti

&

dr.Ni Luh Putu Ayu Maha Isari

'

dr. I Wayan Ari (umardika

)

dr.I *ede Agus A+riyanta

1,

dr.Perina Enri Lisniaan

11 dr.I *st Ayu Nym (ri Ariani Putri

12 dr.Luh (umiari

13 dr.Ni Putu Kusumadei-(.Ked

14 dr.Ni Komang ristiana /ei

B

Dokter Gigi

1 drg.heresia Indriyani

C

Spesialis Dasar

1 dr.I Nyoman 0eteng-(+.0

2 dr.I usti Ngurah Ait-(+.O

3 dr Putu (udarsana (+ O* K

(16)

1 dr.(umiati (unarko-(+.%

2 dr.I Ketut(-Ke+akisan .(+.(

3 dr.I Nyoman Nama Putra-(+.P

4 dr.I *st Ngurah Anom (u+radnya-(+.M

!

dr.I Komang *unaan L-(+.K8

(17)

NOMO5 (IP

MA(A

0E5LAK<

44,=22&.&=/<>I=/ikes=2,1!

1&=11=2,2,

44,=112.1=/<>II=/ikes=2,1$

&=!=2,2,

44,=12,=/<>II=/ikes=2,1!

1=!=2,1'

44,=2'.1=/<>I=/ikes=2,1$

2=12=2,2,

44,=2'.2=/<>I='/ikes=2,1$

2=12=2,2,

44,=12&.13=/<>I=/ikes=2,14

22=!=2,1)

44,=12&.1,=/<>I=/ikes=2,14

22=!=2,1)

44,=12&.14=/<>I=/ikes=2,14

22=!=2,1)

44,=241)=/<>I=/ikes=2,13

1=!=2,1'

44,=241'==/<>I=/ikes=2,13

1=!=2,1'

44,=2!,&=/<>III=/ikes=2,13

$=2=2,1&

44,=1$).2=/<>I=/ikes=2,14

1)=2=2,1)

44,=1!.4=/<>II=/ikes=2,14

2=!=2,1'

44,=12&.11=/<>I=/ikes=2,14

22=!=2,1)

44,=2,4.3$=/*>I=/ikes=2,1$

&=4=2,22

44,=2333=/(>I=/ikes=2,13

12='=2,1'

44,=12!1=/(>II=/ikes=2,12

1!=11=2,1$

44,=2)$=/(>II=/ikes=2,13

1&=,1=2,1&

(18)

44,=1),1=/(>III=/ikes=2,12

3,=4=2,1&

44,=1&!.32=/(>III=/ikes=2,1$

1$=4=2,22

44,=').23=/(>II=/ikes=2,1$

1'=$=2,22

44,=1!.3=/(>II=/ikes=2,14

1)=2=2,1)

44,=2&',=/(>II=/ikes=2,11

3,=1,=2,1$

(19)

EMPA P5AKEK (E(<AI (IP

5(< KE5%A <(A/A

(20)

5(< KE5%A <(A/A

(21)

R2$P$( D$T$ SD RSU S"$(T =R$"$

(&

($$

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D&2TR UU

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dr.LU" PUTU SU$RT( 2

44/0./DU-/Dikes/+*5

+

dr.2$D2 (DR$( $D@T9$

44/+>5>/DU-/Dikes/+*3

3 dr.9ULUS $R$D

44/44.+>/DU-/Dikes/+*6

4 dr.RA$( R&"&T UL $(2

44/+.38/DU-/Dikes/+*6

5 dr1?? S$?TR "$D

44/**4.3/DU-/Dikes/+*5

'

SPS$LS D$S$R

*

dr. (9&$( 'T(=1Sp.'

44/+34/DS-/Dikes/+*3

+

dr. ((=$" D$($ SUS$D1Sp.PD

44/3>8+/DS-/Dikes/+*+

3 dr.2TUT SU$RD$($1Sp.&=

44/363/DS-/Dikes/+**

4 dr. 2TUT $(DR9$S$1Sp.PD

44/+.3/DS-/Dikes/+4

5 dr.S$(TR P$(=$R'U$(1Sp.$

44/++.+/DS-/Dikes/+5

#.

SPS$LS P(U($(=

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dr.=D D$R$9$S$ S$PUTR$1Sp.$

44/>.3/DS-/Dikes/+*4

+

dr. =D SUR9$@$(1Sp.$

44/+.3/DS-/Dikes/+5

(22)

$S$ 'RL$2U

TP$T PR$2T2

3//+6

RSU S"$(T =R$"$

0/+/+*8 RSU S"$(T =R$"$

4/3/++* RSU S"$(T =R$"$

+/0/+*0 RSU S"$(T =R$"$

+5/>/+*0

RSU S"$(T =R$"$

+/>/+> RSU S"$(T =R$"$

+/0/+*6

RSU S"$(T =R$"$

6//+*6

RSU S"$(T =R$"$

+>/**/+*6

RSU S"$(T =R$"$

+//+*8 RSU S"$(T =R$"$

+3/0/+*>

RSU S"$(T =R$"$

>/+/+0 RSU S"$(T =R$"$

(23)

SURAT I(IN PRAKTEK DOKTER

RST TK I) SINGARA(A

NO

NAMA

/OKE5

(PE(IALI(

NO.

(IP

0E5AK%I5

(IP

7AM

P5AKEK

1 dr. A"du %aris /rake-(+.O

44,='',=/(>II=/ikes=2,13

??? ,'.,,>14.3,

2 dr. *ede /armayasa (a+utra-(+.An

44,='!.=/(>I=/ikes=2,14

??? ,'.,,>14.,,

3 dr. Ketut Putra (edana-(+.O*

44,=2!.$=/(>II=/ikes=2,1!

,' 7uni 2,1$

13.,,>1$.,,

4 dr. 0agiadnya-(+.0

44,=2!.!=/(>I=/ikes=2,1!

12 Agustus 2,1'

13.,,>1$.,,

NO

NAMA

/OKE5

<M<M

NO.

(IP

0E5AK%I5

(IP

7AM

P5AKEK

1 dr. Luh Putu (uartini Kusumaati

44,=4,)1=/< I=/inkes=2,11

3, Okto"er 2,1$

Menyusaikan 8ada 8

2 dr. *ede Prasada

44,=2).&=/<>II=/ikes=2,12

31 Okto"er 2,1$

,'.,,>1!.,,

3 dr. 5e9inda A9isantia

44,='4.2=/<>I=/ikes=2,1!

13 7uni 2,1)

>

NO

NAMA

/OKE5

II

NO.

(IP

0E5AK%I5

(IP

7AM

P5AKEK

1 drg. Primandita Nugraha

44,=1,$.3=/*>I=/ikes=2,1!

13 /esem"er 2,1$

>

(24)

5( K I: NI A/ (ingara8a

EMPA P5AKEK (E(<AI

(IP

EMPA P5AKEK (E(<AI

(IP

EMPA P5AKEK (E(<AI

(IP

(25)

R2$P$( SD

Rekredesialig 3*

NO SDM NO&SIP BERAKHIRSIP

I& DOKTER UMUM

* dr. De;a =ede Sida $rdhaa 53/8/SPD.3/2es/2PP9//+*5 GGG

+ dr. Putu Dia Purama Sari 53/*4+/SP.D.6+/2es/2PPT/,/+*3 +8 $gustus +*> 3 dr.  ade Ded% 2usa;a1 S.2ed 53/*+0/D.40/2es/2PPT/?/+*+ 3 Ae!ruari +*8

4 dr. Suri%oo 53/*43/SP.D.63/2es/2PPT/,/+*3 *3 Ae!ruari +*8

5 dr. (i ade ?ia Sep:ai 53/**/SP.D.+0/2es/2PPT/?/+*5 ++ ei +*0 6 dr. Putu 9uliai @idiasari1 S.2ed 53/*+4/D.44/2es/2PPT/?/+*+ 3 Ae!ruari +*8 8 dr.  @a%a Suaa1 .2es 53/4*/SPD.0/2es/2PPT/?/+*5 GGG

> dr.  =us: $u Lakshmi Damaa: 53/40/SP.D.*4/2es/2TTP/?/+*3 GGG

0 dr. da a%u Putu Raga Diatari 53/3+/SP.D.0/2es/2TTP//+*4 0 Ae!ruari +*8 * dr.  Putu $gus Sur%a;a 53/*5/SP.D.+4/2es/2ppT/,/+*4 + ei +*>

II& DOKTER GIGI

* drg. (i Putu $ri 2umalasai 53/*>*/SPD.44/2es/2PPT/,/+*5 +4 aret +*0 + drg.  =us: $%u ade D;i Resturii 53/*3/d.5/2es/2PPT/?/+*+ GGG

III& PELA%ANAN MEDIK SPESIALIS DASAR III&A& PEN%AKIT DALAM

* dr. =ede Sukra;a1 .'iomed1Sp.PD 53/>/SPD.++/2es/2TTP/?/+*5 +* desem!er +*0 + dr. (egah Susup $ra;a1Sp.PD 53/4*/SP.D.*/2es/2PPT//+*3 GGG

3 dr. (i Luh ta:k Sri;ah%ui1Sp.PD 53/4/SPD.>/2es/2TTP/?/+*5 *0 ei +*>

III&B& KESEHATAN ANAK

* dr. R%aa "arlist%a:1Sp.$ 53/*0/D.55/2es/2PPT/,/+** GGG

+ dr. (i Putu Sucita @ah%u De;i1 .Sc1Sp.$ +3/06/D.+3/2es/2TTP//+*+ *4 Desem!er +*6

III&C& BEDAH

* dr.  =us: 'agus =ita Triarta1Sp.' 53/+8/D.**/2es/2TTP/?/+** GGG

+ dr.  ade Liggih $r%aa1Sp.' 53/***/D.58/2es/2TTP/,/+** oda%1 $pril **1 +*6

III&D& OBSTETRI DAN GINEKOLOGI

(26)

+ dr.  2etut Rai @i;a (egara1Sp.&= 53/*83/D.83/2es/2PPT/,/+*+ Suda%1 $pril *01 +*5

I)& PELA%ANAN MEDIK SPESIALIS PENUN(ANG I)&A& ANESTESIOLOGI

* dr.  =ede ka $ri @ira;a1Sp.$ 53/**/D.+4/2ep/2PPT//+*+ +> Ae!ruari +*8

I)&B& RADIOLOGI

* dr. (%oma Sat%a1Sp.Rad 53/*86/D.86/2es/2PPT/,/+*+ 4 uli +*8

)&C& PATOLOGI KLINIK

* dr. 2etut merta dra;a:1Sp.P2 53/*54/SPD.3>/2es/2PPT/?/+*5 oda%1 $pril **1 +*6

)I& DOKTER GIGI SPESIALIS

)II& PELA%ANAN MEDIK LAINN%A

* dr.  =us: Putu $rdaa1Sp.S 53/*85/D.85/2es/2PPT/,/+*+ *3 (opem!er +*6 + dr. (i ade Tirta Sai;ai1Sp.T"T-2L 53/3/SP.D.8/2es/2PPT//+*4 *0 Ae!ruari +*0 3 dr.  gus: (gurah $om Suprad%aa1Sp. Surat Tugas) 44/4+880/'PP GGG

4 dr. De;a =ede Satria $m!ara Putra1.'iomed1Sp.&t 53/3/SPD.38/2es/2PPT/?/+*5 3 ui ++

)III& TENAGA KEFARMASIAN

* @id% Tri Reto Sari1S.Aarm.$pt 53/*45+/9akes.Dikes/?/+*5 GGG

+ (i Putu 9uliasih1S.Aarm.$pt 53/+0>5/9akes.Dikes/,/+*5 * ui ++ 3 (i ade $%u Pra:;i Praa 53/+>>/9akes.Dikes/?/+*5 *5 $gustus +*0 4 2adek $ri Puspa%a:.1 $.d.Aarm 53/+33>/9akes.Dikes/,/+*5 Arida%1 $pril 51 +*0 5 (i ade $%u Puspita Sari 53/+>6/9akes. Dikes/?/+*5 > ei +*0

I*& TENAGA KEPERA+ATAN

* (s.  Putu &las arta;a1S.2ep 53/*0>/S2.P.56/2es/2PPT/,/+*5 *3 aret ++ + (i ade "aria:i 53/*08/S2.P.55/2es/2PPT/,/+*5 *4 aret ++ 3 =utsi $%u Putu Dia Aera%a:1$.d12ep 53/*04/S2.P.5+/2es/2PPT/,/+*5 ++ $gustus ++ 4 $ris Lipa%a:1$.d12ep. 53/*03/S2.P.5*/2es/2PPT/,/+*5 Arida%1 $pril 31 ++ 5 $ggraei Tri a%a Sari1$.d12ep 53/*0+/S2.P.5/2es/2PPT/,/+*5 * aret +*0 6 Ria Pura;a:1$.d12ep 53/*0*/S2.P.40/2es/2PPT/,/+*5 *> ei ++ 8 l% Raha%u SaHtri1$md12ep 53/*0/S2.P.4>/2es/2PPT/,/+*5 5 mei +*> > (i 2etut Sri @idiai1$.d12ep 53/*06/S2.P.54/2es/2PPT/,/+*5 *8 Desem!er ++ 0 (i Luh made @ir%ai1$.d12ep 53/*05/S2.P.53/2es/2PPT/,/+*5 *6 Desem!er ++ * Diaa Sari1$.d12ep 53/*>0/S2.P.48/2es/2PPT/,/+*5 +3 aret ++ ** (s.Aema $rgadiata1S.2ep 53/8+/S2.P.+6/2es/2PPT/?/+*5 GGG

(27)

*+ (s. Putu $rdia 2ariata1S.2ep 53/8*/S2.P.+5/2es/2PPT/?/+*5 *5 Ae!ruari +*8 *3 (s. (i @a%a Sri Raha%ui Utami1 S.2ep 53/6>/S2.P.++/2es/2PPT/?/+*5 5 uli ++ *4 Dei Susi%a:1S.2ep.(s 53/>8/S2.P.+>/2es/2PPT/?/+*5 + $gustus ++ *5 (o7iaa sari (ugroho1S.2ep.(s 53/>6/S2.P.+8/2es/2PPT/?/+*5 GGG

*6 da 'agus 2ade 2uria Saputra1S.2ep.(s 53/0+/S2.P.2es/2PPT/?/+*5 ** $gustus ++ *8  Putu 9oga Semadhi1S.2ep.(s 53/>0/S2.P.3/2es/2PPT/?/+*5 ** Ae!ruari ++ *> (i Luh Dia eiliatariasih1S.2ep.(s 53/*/S2/P.35/2es/2PPT/?/+*5 *0 ei +*8 *0 (s. 2ade D;i $d%aa1S.2ep 53/8/S2.P.+4/2es/2PPT/?/+*5 +0 Desem!er ++ + (s.  ade $r%sta Sur%a;a1S.2ep 53/*3/S2.P.*/2es/2PPT//+*5 Saturda%1 $pril +51 ++ +* Putu $gus $di Pratama1S.2ep.(ers. 53/*4/S2.P.4/2es/2PPT/?/+*5 * aret ++ ++ 9uli $dri @ia%a1S.2ep.(s 53/>>/S2.P.+0/2es/2PPT/?/+*5 3 uli ++ +3 (i ade $%u ra 2usuma De;i1$.d.2ep 53/*6/S2.P.3/2es/2PPT/?/+*+ +6 ei +*8 +4 (i (%oma Suari:1$.d.2ep 53/63/S2.P.*8/2es/2PPT/?/+*5 +4 ui ++ +5  2omag =ede @ira%a =ua $rtha1$.d.2ep 53/6+/S2.P.*6/ 2es/2PPT/?/+*5 GGG +6 (i Putu Dia Utari1$.d.2ep 53/0/S2.P.3*/2es/2PPT/?/+*5 GGG

+8 (i 2etut Ratasih1 $.d12ep 53/+*/S2.P.+/2es/2PPT//+*5 * $gustus ++ +> (ue @ahida1$.d12ep 53/00/S2.P.34/2es/2PPT/?/+*5 Arida%1 $pril +41 ++

+0 Suparto1 SST 53/*3/S2.P$.3/2es/2PPT//+*4 3* Desem!er +*8

*& TENAGA KEBIDANAN

* Putu 'udiar:i1$.d.2e! 53/*43/S2.'.40/2es/2PPT/?/+*5 * auari +*3 + (i ade Umie "ardai1$.d12ed 53/03/S2.'/*8/2es/2PPT/?/+*5 + auari +*0 3 (i 2omag Sri da%a:1$.d.2e! 53/*4+/S2.'.4>/2es/2PPT/?/+*5 +6 aret +*8 4 (i ade (ia D;i 2arlie1$.d.2e! 53/*4>/S2.'.5*/2es/2PPT/?/+*5 *3 $gustus +*0 5 Putu $%u $stri Puspita1$md.2e! 53/*4/S2.'.4>/2es/2PPT/?/+*+ Suda%1 $pril 31 +*8 6 2aria $Brilia1$.d.2e! 53/*48/S2.'.5/2es/2PPT/?/+*5 Arida%1 $pril +41 ++ 8 (i 2adek Sriari aha%oi1$.d.2e! 53/*4*/S2.'.48/2es/2PPT/?/+*5 3 ui +*8 > (i Putu ega Sari De;i 446/*8>/9akes.Dikes +* Ae!ruari +*6 0 Putu $%u Sari De;i1$.d.2e! 53/*30/S2.'.48/2es/2PPT/?/+*+ Suda%1 $pril 31 +*8 * @i;it @idhiarsa:1 $md.2e! 53/*+/S2.'.3/2es/2PPT//+*5 *4 Ae!ruari +*> ** #hrist% Raha%u De;i .$md.2e! 53/*/S2.'.*/2es/2PPT//+*5 GGG

STR Proses Pera;at $estesi

(28)

SU 'U(D$

$gustus +*6

(AM PRAKTEK

KESESUAIAN (UMLAH DENGAN PMK ,- TAHUN ./01

Se2arusn3a Ken3a$aan Kesesuaian

RSU 'uda

0 0 Sesuai

RS 2husus !u da $ak I'U(D$I RS 2husus !u da $ak I'U(D$I RSU 'uda

RSU 'uda

RS 2husus !u da $aka I'U(D$I RSU 'uda

RSU 'uda RSU 'uda

ala Ra%a Depasar -=ilimauk1 desa 'a%u'iru

RSU 'uda + + Sesuai RSU 'uda RSUD (egara + * Sesuai RSU 'uda RSU 'uda

RS 2husus !u da $ak I'U(D$I

+ * Tidak Sesuai

RS' 2erta%asa

+ * Tidak Sesuai

(29)

RS 2husus !u da $ak I'U(D$I * * Sesuai

RSU 'uda * * Sesuai

*  Tidak Sesuai

RS 2husus !u da $ak I'U(D$I RSU 'uda

RSU 'uda (egara RSU 'uda

ARS Umum 'uda ₊ _{Tidak Sesuai}

ARS Umum 'uda ARS Umum 'uda

*+ Cmiimal 3 Tidak Sesuai

RSU 'uda + Pera;at utuk 3 TT umLah TT *>* RSU 'uda RSU 'uda RSU 'uda RSU 'uda RSU 'uda RSU 'uda RSU 'uda RSU 'uda RSU 'uda RSU 'uda > C * 2epala stalasi1 + RTL1 4 RTL1 * 2oordiator peerimaa1distri!usi da Produksi umlah Pera;at +>

(30)

RSU 'uda *)6 Tidak Sesuai RSU 'uda RSU 'uda RSU 'uda +)3 RSU 'uda RSU 'uda RSU 'uda RSU 'uda RSU 'uda RSU 'uda RSU 'uda RSU 'uda RSU 'uda RSU 'uda RSU 'uda RSU 'uda RSU 'uda RSU 'uda RSU 'uda RSU 'uda RSU 'uda RSU 'uda RSU 'uda RSU 'uda RSU 'uda Seluruh doesia

(31)

R2$P$( SD

Rekredesialig 3*

NO SDM NO&SIP BERAKHIRSIP

I& DOKTER UMUM

* dr. De;a Putu ka uli $tara 53/*/SPD.*/2es/2PPT//+*6 + Desem!er ++ + dr. Putu Dia Purama Sari 53/*4+/SP.D.6+/2es/2PPT/,/+*3 +8 $gustus +*> 3 dr.  ade Ded% 2usa;a1 S.2ed 53/*+0/D.40/2es/2PPT/?/+*+ 3 Ae!ruari +*8

4 dr. Suri%oo 53/*43/SP.D.63/2es/2PPT/,/+*3 *3 Ae!ruari +*8

5 dr. (i ade ?ia Sep:ai 53/**/SP.D.+0/2es/2PPT/?/+*5 ++ ei +*0 6 dr.  =us: $u Lakshmi Damaa: 53/40/SP.D.*4/2es/2TTP/?/+*3 GGG

8 dr. da a%u Putu Raga Diatari 53/3+/SP.D.0/2es/2TTP//+*4 0 Ae!ruari +*8 > dr.  Putu $gus Sur%a;a 53/*5/SP.D.+4/2es/2ppT/,/+*4 + ei +*>

II& DOKTER GIGI

* drg. (i Putu $ri 2umalasai 53/*>*/SPD.44/2es/2PPT/,/+*5 +4 aret +*0 + drg.  =us: $%u ade D;i Resturii 53/*3/d.5/2es/2PPT/?/+*+ GGG

III& PELA%ANAN MEDIK SPESIALIS DASAR III&A& PEN%AKIT DALAM

* dr. =ede Sukra;a1 .'iomed1Sp.PD 53/>/SPD.++/2es/2TTP/?/+*5 +* Desem!er +*0 + dr. (egah Susup $ra;a1Sp.PD 53/4*/SP.D.*/2es/2PPT//+*3 GGG

3 dr. (i Luh ta:k Sri;ah%ui1Sp.PD 53/4/SPD.>/2es/2TTP/?/+*5 *0 ei +*>

III&B& KESEHATAN ANAK

* dr. R%aa "arlist%a:1Sp.$ 53/*0/D.55/2es/2PPT/,/+** GGG

+ dr. (i Putu Sucita @ah%u De;i1 .Sc1Sp.$ +3/06/D.+3/2es/2TTP//+*+ *4 Desem!er +*6

III&C& BEDAH

* dr.  =us: 'agus =ita Triarta1Sp.' 53/*+8/D.48/2es/2TTP/?/+*+ GGG + dr.  ade Liggih $r%aa1Sp.' 53/+8/SP.D.+/2es/2PPT/?/+*6 GGG

III&D& OBSTETRI DAN GINEKOLOGI

* dr.  =de ade Saraa1Sp.&= 53/*84/D.84/2es/2PPT/,/+*+ GGG

+ dr.  2etut Rai @i;a (egara1Sp.&= 53/46/SPD.*3/2es/2PPT/?/+*5 Suda%1 $pril *01 ++

(32)

I)&A& ANESTESIOLOGI

* dr.  =ede ka $ri @ira;a1Sp.$ 53/**/D.+4/2ep/2PPT//+*+ +> Ae!ruari +*8

I)&B& RADIOLOGI

* dr. (%oma Sat%a1Sp.Rad 53/*86/D.86/2es/2PPT/,/+*+ 4 ui +*8

)&C& PATOLOGI KLINIK

* dr. 2etut merta dra;a:1Sp.P2 53/+36/SP.D.+5/2es/kppt/7/+*6 +5 auari ++*

)I& DOKTER GIGI SPESIALIS

)II& PELA%ANAN MEDIK LAINN%A

* dr.  =us: Putu $rdaa1Sp.S 53/*85/D.85/2es/2PPT/,/+*+ *3 (opem!er +*6 + dr. (i ade Tirta Sai;ai1Sp.T"T-2L 53/3/SP.D.8/2es/2PPT//+*4 *0 Ae!ruari +*0 3 dr.  gus: (gurah $om Suprad%aa1Sp. Surat Tugas) 44/4+880/'PP GGG

4 dr. De;a =ede Satria $m!ara Putra1.'iomed1Sp.&t 53/3/SPD.38/2es/2PPT/?/+*5 3 ui ++

)III& TENAGA KEFARMASIAN

* @id% Tri Reto Sari1S.Aarm.$pt 53/*45+/9akes.Dikes/?/+*5 GGG

+ (i Putu 9uliasih1S.Aarm.$pt 53/+0>5/9akes.Dikes/,/+*5 * ui ++ 3 (i ade $%u Pra:;i Praa 53/+>>/9akes.Dikes/?/+*5 *5 $gustus +*0 4 2adek $ri Puspa%a:.1 $.d.Aarm 53/+33>/9akes.Dikes/,/+*5 Arida%1 $pril 51 +*0 5 (i ade $%u Puspita Sari 53/+>6/9akes. Dikes/?/+*5 > ei +*0

I*& TENAGA KEPERA+ATAN

* (s.  Putu &las arta;a1S.2ep 53/*0>/S2.P.56/2es/2PPT/,/+*5 *3 aret ++ + (i ade "aria:i 53/*08/S2.P.55/2es/2PPT/,/+*5 *4 aret ++ 3 =utsi $%u Putu Dia Aera%a:1$.d12ep 53/*04/S2.P.5+/2es/2PPT/,/+*5 ++ $gustus ++ 4 $ris Lipa%a:1$.d12ep. 53/*03/S2.P.5*/2es/2PPT/,/+*5 Arida%1 $pril 31 ++ 5 $ggraei Tri a%a Sari1$.d12ep 53/*0+/S2.P.5/2es/2PPT/,/+*5 * aret +*0 6 Ria Pura;a:1$.d12ep 53/*0*/S2.P.40/2es/2PPT/,/+*5 *> ei ++ 8 l% Raha%u SaHtri1$md12ep 53/*0/S2.P.4>/2es/2PPT/,/+*5 5 mei +*> > (i 2etut Sri @idiai1$.d12ep 53/*06/S2.P.54/2es/2PPT/,/+*5 *8 Desem!er ++ 0 (i Luh made @ir%ai1$.d12ep 53/*05/S2.P.53/2es/2PPT/,/+*5 *6 Desem!er ++ * Diaa Sari1$.d12ep 53/*>0/S2.P.48/2es/2PPT/,/+*5 +3 aret ++ ** (s.Aema $rgadiata1S.2ep 53/8+/S2.P.+6/2es/2PPT/?/+*5 GGG

*+ (s. Putu $rdia 2ariata1S.2ep 53/8*/S2.P.+5/2es/2PPT/?/+*5 *5 Ae!ruari +*8 *3 (s. (i @a%a Sri Raha%ui Utami1 S.2ep 53/6>/S2.P.++/2es/2PPT/?/+*5 5 uli ++

(33)

*4 Dei Susi%a:1S.2ep.(s 53/>8/S2.P.+>/2es/2PPT/?/+*5 + $gustus ++ *5 (o7iaa sari (ugroho1S.2ep.(s 53/>6/S2.P.+8/2es/2PPT/?/+*5 GGG

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