| C0001 | SIGIT HERIYANTO | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| B0001 | TJHANG JOEIJ MOIJ | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0002 | PRICHILA RAHMADINI | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| C0002 | SAINA BOENARDI | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| B0003 | MIMIE HARTINI | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0004 | FEBI ANDRIANTO | dr. GOKLASH APRYANTO, Sp.B | BPJS | |
| B0005 | WIDYA ADRIATI | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| D0001 | SILAWATI | dr. MELFIA NAVRATILOVA, Sp. P, M. Kes | BPJS | |
| C0003 | RINA | dr. CARLES, Sp. KJ, M, Sc | BPJS | |
| C0004 | QELVIN PRADIPTA | dr. LINGGAWATI, Sp. THT | BPJS | |
| C0005 | QOIRUL ANAM | dr. LINGGAWATI, Sp. THT | BPJS | |
| A0001 | JESSEN DOMINIC EVANS | dr. RATNA SETIA ASIH, Sp.A.,MM.Kes | BPJS | |
| B0006 | ANATASIA AMANDA | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0007 | WANSIKA SUHERMAN | dr. GOKLASH APRYANTO, Sp.B | BPJS | |
| C0006 | PHANG SUI SIAM | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| C0007 | WANTI HUSEN | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| C0008 | RENDI ARDIANSYAH | dr. RISMAN SARAGIH, Sp.S | BPJS | |
| B0008 | VITA CHRISTIANI | dr. YUDI YUSRIZAL, Sp.PD | BPJS | |
| B0009 | VITA ROYANI SIMATUPANG | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| C0009 | SUPAINO | dr. ESA FREDIGUSTA, Sp.JP | BPJS | |
| B0010 | TIARA MEIRINDA | drg. MUTIA AULIANY, Sp. B. M | BPJS | |
| B0011 | PAUSA | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| B0012 | ROFA AMILIA | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0013 | FERRIE | drg. MUTIA AULIANY, Sp. B. M | BPJS | |
| B0014 | YOLANDA AVITA PUTRI | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0015 | JESICA LUVIANA | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0016 | LIDYA MUSTA LELA | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0017 | SRI WAHYUNI | dr. YUDI YUSRIZAL, Sp.PD | BPJS | |
| A0002 | RACHEL KANISYA HAFLANI | dr. REGGY AMBARDY DWI PUTRA, Sp. A | BPJS | |
| B0018 | YULIARATNA | dr. YUDI YUSRIZAL, Sp.PD | BPJS | |
| B0019 | FINI FURTIKA | drg. MUTIA AULIANY, Sp. B. M | BPJS | |
| B0020 | KABSAH | dr. GOKLASH APRYANTO, Sp.B | BPJS | |
| D0002 | SUPITRA | dr. MELFIA NAVRATILOVA, Sp. P, M. Kes | BPJS | |
| C0010 | DIDIN | dr. RISMAN SARAGIH, Sp.S | BPJS | |
| B0021 | MUHAMMAD ALVARO | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| B0022 | OMPI ELARDA HYGIANITA | dr. GOKLASH APRYANTO, Sp.B | BPJS | |
| B0023 | JENNIFER BOEN | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0024 | SUPARTO | dr. NOVIA NASIR, Sp. M | BPJS | |
| C0011 | SUMIATI | dr. RISMAN SARAGIH, Sp.S | BPJS | |
| B0025 | DERA MONICA | dr. ARINAL PAHLEVI, Sp.D.V. | BPJS | |
| D0003 | CUN CUN | dr. MELFIA NAVRATILOVA, Sp. P, M. Kes | BPJS | |
| B0026 | TANYONO | dr. MEILANO ROBINSYAH, Sp. PD | BPJS | |
| B0027 | GALANG HADIANTO | drg. MUTIA AULIANY, Sp. B. M | BPJS | |
| A0003 | RIZKY GILANG RAMADHAN | dr. REGGY AMBARDY DWI PUTRA, Sp. A | BPJS | |
| C0012 | TJOE NGIAM LEW | dr. ESA FREDIGUSTA, Sp.JP | BPJS | |
| B0028 | TJEN WE YING | dr. YUDI YUSRIZAL, Sp.PD | BPJS | |
| A0004 | NAURA AZKIYA HAFIZAH | dr. RATNA SETIA ASIH, Sp.A.,MM.Kes | BPJS | |
| D0004 | ANDREAS RAY | dr. MELFIA NAVRATILOVA, Sp. P, M. Kes | BPJS | |
| C0013 | FAUZAN | dr. ESA FREDIGUSTA, Sp.JP | BPJS | |