| C0001 | AGUSTARA DWI JUWITA | dr. LINGGAWATI, Sp. THT | BPJS | |
| B0001 | LIONG MIE YUN | dr. GOKLASH APRYANTO, Sp.B | BPJS | |
| B0002 | H.MUHAMMAD YAMIN YAMAN | dr. YUDI YUSRIZAL, Sp.PD | BPJS | |
| C0002 | ISKANDAR | dr. SHENY AGMA, Sp. N | BPJS | |
| B0003 | TJHANG JOEIJ MOIJ | dr. NOVIA NASIR, Sp. M | BPJS | |
| C0003 | MULYONO | dr. SHENY AGMA, Sp. N | BPJS | |
| B0004 | SARAH | drg. MUTIA AULIANY, Sp. B. M | BPJS | |
| B0005 | MUJIONO | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0006 | IWAN DANI | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| C0004 | A. RUSLI | dr. SHENY AGMA, Sp. N | BPJS | |
| B0007 | R E N D R A | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0008 | INDRI | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0009 | WIRNA OKTARINA | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0010 | NUNNIAWATI | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0011 | RIEZKY PRATAMA | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| C0005 | YUSBAIDAR | dr. SHENY AGMA, Sp. N | BPJS | |
| B0012 | SATIWEN | dr. NOVIA NASIR, Sp. M | BPJS | |
| C0006 | DEA DEKRISNAWATI | dr. CARLES, Sp. KJ, M, Sc | BPJS | |
| C0007 | BOEN TJIT MOIJ | dr. RISMAN SARAGIH, Sp.S | BPJS | |
| B0013 | JULIATI | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0014 | SUKIATI SAMSUDIN | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| B0015 | NELLI | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| C0008 | SIU HO | dr. SHENY AGMA, Sp. N | BPJS | |
| C0009 | SUMANTRI | dr. ESA FREDIGUSTA, Sp.JP | BPJS | |
| D0001 | DJUNG FU | dr. MELFIA NAVRATILOVA, Sp. P, M. Kes | BPJS | |
| B0016 | YAHUZ ARIFIN | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0017 | SALMIWATI | dr. NOVIA NASIR, Sp. M | BPJS | |
| C0010 | TRIANA KURNIASIH | dr. SHENY AGMA, Sp. N | BPJS | |
| B0018 | TEBI MULIA ANASTASYA | dr. GOKLASH APRYANTO, Sp.B | BPJS | |
| C0011 | ANDRIAN | dr. LINGGAWATI, Sp. THT | BPJS | |
| C0012 | ANITA ELISABETH LUMENTUT | dr. LINGGAWATI, Sp. THT | BPJS | |
| C0013 | YULI YANTI | dr. LINGGAWATI, Sp. THT | BPJS | |
| C0014 | SHANUM AZRI MAULANA | dr. LINGGAWATI, Sp. THT | BPJS | |
| B0019 | DASTIN | dr ARINAL PAHLEVI, SP.D.V. | BPJS | |
| C0015 | HENDRAWAN FERNANDO NG | dr. SHENY AGMA, Sp. N | BPJS | |
| D0002 | TAHMID | dr. MELFIA NAVRATILOVA, Sp. P, M. Kes | BPJS | |
| B0020 | DERITA PRAPTI RAHAYU | dr. MEILANO ROBINSYAH, Sp. PD | BPJS | |
| B0021 | DERITA PRAPTI RAHAYU | dr. MEILANO ROBINSYAH, Sp. PD | BPJS | |
| C0016 | HIAN PIN | dr. RISMAN SARAGIH, Sp.S | BPJS | |
| B0022 | A NIE | dr. NOVIA NASIR, Sp. M | BPJS | |
| C0017 | SITI ZULAIHA | dr. ENDANG KUSRENI,, Sp. JP | BPJS | |
| C0018 | YANTO | dr. SHENY AGMA, Sp. N | BPJS | |
| C0019 | MARYANI | dr. SHENY AGMA, Sp. N | BPJS | |
| B0023 | SUMARNI | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| D0003 | YENNI NATALIA | dr. MELFIA NAVRATILOVA, Sp. P, M. Kes | BPJS | |
| B0024 | RISMALA | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| C0020 | ROKIAH | dr. ENDANG KUSRENI,, Sp. JP | BPJS | |
| B0025 | LIE NAM KHOEN | dr. GOKLASH APRYANTO, Sp.B | BPJS | |
| B0026 | JUNIYATI | dr. NOVIA NASIR, Sp. M | BPJS | |
| C0021 | JASARI BAKI | dr. ESA FREDIGUSTA, Sp.JP | BPJS | |
| B0027 | SHANUM KHADIJAH RAZIB | dr ARINAL PAHLEVI, SP.D.V. | BPJS | |
| C0022 | SAWATI | dr. ENDANG KUSRENI,, Sp. JP | BPJS | |
| C0023 | ROSITA | dr. ESA FREDIGUSTA, Sp.JP | BPJS | |
| C0024 | MIDJAH | dr. ESA FREDIGUSTA, Sp.JP | BPJS | |
| C0025 | ELIAGUSFATMI | dr. RISMAN SARAGIH, Sp.S | BPJS | |
| C0026 | JONI SULIATNO | dr. RISMAN SARAGIH, Sp.S | BPJS | |
| C0027 | SARNITA | dr. SHENY AGMA, Sp. N | BPJS | |
| B0028 | SYIFA ALFIFI ZELSYA | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0029 | VIORIN NATALIE | drg. F.X. DODDY SETIAWAN, Sp. Perio | BPJS | |
| C0028 | NGUI NGIT THIN | dr. ENDANG KUSRENI,, Sp. JP | BPJS | |
| C0029 | DEKI PURNA IRWANDA | dr. ENDANG KUSRENI,, Sp. JP | BPJS | |
| B0030 | SODIK | dr. GOKLASH APRYANTO, Sp.B | BPJS | |
| B0031 | KIKI RIZKI AMELLYA | dr. MEILANO ROBINSYAH, Sp. PD | BPJS | |
| B0032 | SUPARTI | dr. YUDI YUSRIZAL, Sp.PD | BPJS | |
| B0033 | RUSDIANA | dr. DAMERIA HASTARI, Sp. PD | BPJS | |
| B0034 | KIKI RIZKI AMELLYA | dr. MEILANO ROBINSYAH, Sp. PD | BPJS | |
| C0030 | EDI SUSANTO | dr. ENDANG KUSRENI,, Sp. JP | BPJS | |
| B0035 | EKA USTIATY | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| B0036 | JU AIJ | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0037 | MESTI UDDANI | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| B0038 | TENRI UNGKE | drg. ANDI DAHNIAR, Sp, KG | BPJS | |