| D0001 | SOLAHUDIN | dr. MELFIA NAVRATILOVA, Sp. P, M. Kes | BPJS | |
| B0001 | MUSTARIH | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0002 | WIDIASTUTI | dr. YUDI YUSRIZAL, Sp.PD | BPJS | |
| B0003 | ERNIJANTY THERISITHA | dr. YUDI YUSRIZAL, Sp.PD | BPJS | |
| B0004 | NURLENI | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0005 | AL ZEIN KEMAIL | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0006 | NURUL AJIZAH | drg. MUTIA AULIANY, Sp. B. M | BPJS | |
| B0007 | TJHANG JOEIJ MOIJ | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0008 | RASYA INDRIA | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0009 | YUDI OKTRIADI | dr. MEILANO ROBINSYAH, Sp. PD | BPJS | |
| B0010 | MUHAMMAD MURI RIZKI | dr. DAMERIA HASTARI, Sp. PD | BPJS | |
| D0002 | SUPITRA | dr. MELFIA NAVRATILOVA, Sp. P, M. Kes | BPJS | |
| C0001 | DJAUW ASOET | dr. CARLES, Sp. KJ, M, Sc | BPJS | |
| C0002 | SIU HO | dr. CARLES, Sp. KJ, M, Sc | BPJS | |
| C0003 | TJIA SUI NUN | dr. CARLES, Sp. KJ, M, Sc | BPJS | |
| B0011 | ARIES PRAYOGA IKBAR | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0012 | SUYANTO | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0013 | HADI SATYA | dr. YUDI YUSRIZAL, Sp.PD | BPJS | |
| B0014 | BONG SOEI SIN | dr. MEILANO ROBINSYAH, Sp. PD | BPJS | |
| C0004 | ROKIAH | dr. CARLES, Sp. KJ, M, Sc | BPJS | |
| B0015 | DIANA | dr. GOKLASH APRYANTO, Sp.B | BPJS | |
| B0016 | JAP BUN MEN | dr. YUDI YUSRIZAL, Sp.PD | BPJS | |
| C0005 | HERDA ANDRYANI LIDYA | dr. LINGGAWATI, Sp. THT | BPJS | |
| B0017 | CEPRINA PERDINA PUTRI | dr. GOKLASH APRYANTO, Sp.B | BPJS | |
| C0006 | RINCE | dr. CARLES, Sp. KJ, M, Sc | BPJS | |
| B0018 | SARKIYEM | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| C0007 | LINDA | dr. SHENY AGMA, Sp. N | BPJS | |
| B0019 | NAZAR RAFIANSYAH | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0020 | RUSTAM | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0021 | TRI FENTY PRAMUNINGRUM | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0022 | ISMAYNA ALIMBAR | dr. YUDI YUSRIZAL, Sp.PD | BPJS | |
| B0023 | SRI WANTI PERJANUKI | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0024 | SARKIYEM | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| B0025 | ROMIDA | drg. MUTIA AULIANY, Sp. B. M | BPJS | |
| B0026 | YOLANDA AVITA PUTRI | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0027 | MEGA PERMATASARI CHANDRA | dr. MEILANO ROBINSYAH, Sp. PD | BPJS | |
| B0028 | RUSMANILA | dr. YUDI YUSRIZAL, Sp.PD | BPJS | |
| B0029 | SUSANA | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| D0003 | IKHSAN MASYA FITRAH | dr. MELFIA NAVRATILOVA, Sp. P, M. Kes | BPJS | |
| B0030 | TJEN A KIM | dr. YUDI YUSRIZAL, Sp.PD | BPJS | |
| B0031 | HENI ASMARA | drg. MUTIA AULIANY, Sp. B. M | BPJS | |
| D0004 | HILDAYANTI | dr. MELFIA NAVRATILOVA, Sp. P, M. Kes | BPJS | |
| B0032 | NGIAT NON | dr. GOKLASH APRYANTO, Sp.B | BPJS | |
| B0033 | YANNI | drg. MUTIA AULIANY, Sp. B. M | BPJS | |
| D0005 | K. NURKHOLIS FITHRI | dr. MELFIA NAVRATILOVA, Sp. P, M. Kes | BPJS | |
| B0034 | YULIA DAMAYANTI | dr. ARINAL PAHLEVI, Sp.D.V. | BPJS | |
| B0035 | SAKHA ARKAN WIRATAMA | dr. ARINAL PAHLEVI, Sp.D.V. | BPJS | |
| B0036 | RAHMAN | dr. YUDI YUSRIZAL, Sp.PD | BPJS | |
| B0037 | SANTIKA WALIDAYA | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0038 | DANDI PRATAMA SAHRI | drg. MUTIA AULIANY, Sp. B. M | BPJS | |
| C0008 | RUSDIANA | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| D0006 | ROSMIATI | dr. MELFIA NAVRATILOVA, Sp. P, M. Kes | BPJS | |
| C0009 | TOIPAH | dr. SHENY AGMA, Sp. N | BPJS | |
| D0007 | ISHAK | dr. MELFIA NAVRATILOVA, Sp. P, M. Kes | BPJS | |
| C0010 | ALMI | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| B0039 | HECHDIMA SIMAMORA | dr. NOVIA NASIR, Sp. M | BPJS | |
| C0011 | BONG KHUN NON | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| B0040 | ANWAR SALEH SIMAMORA | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0041 | ODI RAMADHAN | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| B0042 | MUHIDIN | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0043 | ULTRA TISTAWATI | dr. DAMERIA HASTARI, Sp. PD | BPJS | |
| B0044 | THAM SAN TJIN | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| D0008 | WALIYEM | dr. MELFIA NAVRATILOVA, Sp. P, M. Kes | BPJS | |
| D0009 | DZABYAN VIRGA PRATAMA | dr. MELFIA NAVRATILOVA, Sp. P, M. Kes | BPJS | |
| C0012 | RISMUDIANTO | dr. LINGGAWATI, Sp. THT | BPJS | |
| B0045 | SOFIAN | drg. MUTIA AULIANY, Sp. B. M | BPJS | |