| B0001 | SJAFRI ARDIAN | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0002 | LAY KOEIFA | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0003 | GLADYS AUDREY FLORENCIA | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| A0001 | WAHYUNI SAFITRI | dr.H. SUANDI, Sp.OG,M.Kes | BPJS | |
| B0004 | MOHAMMADONG | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| C0001 | YESSICA MANALU | dr. SHENY AGMA, Sp. N | BPJS | |
| B0005 | LIZAM AL AHZA | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0006 | IMAN JAYA | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0007 | MILDA UTAMI DEWI LUBIS | dr. YUDI YUSRIZAL, Sp.PD | BPJS | |
| B0008 | SITI NURHAYATI | dr. YUDI YUSRIZAL, Sp.PD | BPJS | |
| C0002 | WAHYUNI | dr. SHENY AGMA, Sp. N | BPJS | |
| C0003 | SOPINA | dr. SHENY AGMA, Sp. N | BPJS | |
| B0009 | M. FIKRI NOFRIYANSYAH | dr. GOKLASH APRYANTO, Sp.B | BPJS | |
| B0010 | JUNAIDI AMAN | dr. NOVIA NASIR, Sp. M | BPJS | |
| D0001 | ANDREAS RAY | dr. MELFIA NAVRATILOVA, Sp. P, M. Kes | BPJS | |
| B0011 | ALVARIO KURNIAWAN | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| C0004 | RAHIB NAILU RIDHO | dr. LINGGAWATI, Sp. THT | BPJS | |
| B0012 | JULAIHO | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| D0002 | MANSURSYAH | dr. MELFIA NAVRATILOVA, Sp. P, M. Kes | BPJS | |
| B0013 | HASMULYANI | drg. MUTIA AULIANY, Sp. B. M | BPJS | |
| B0014 | DWI NORIKA WULANDARI | dr. GOKLASH APRYANTO, Sp.B | BPJS | |
| B0015 | NURAHMAN | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| B0016 | MAGGY SUSANTI | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0017 | ROZIANA | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0018 | ANGGUN MURNIATI SIREGAR | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0019 | BUDJANG MASRI | dr. YUDI YUSRIZAL, Sp.PD | BPJS | |
| B0020 | FEBI ANDRIANTO | dr. GOKLASH APRYANTO, Sp.B | BPJS | |
| D0003 | DESTI RIZKINARTI | dr. MELFIA NAVRATILOVA, Sp. P, M. Kes | BPJS | |
| C0005 | PUJI LESTARI | dr. LINGGAWATI, Sp. THT | BPJS | |
| B0021 | LO DJOENG KHO | dr. MEILANO ROBINSYAH, Sp. PD | BPJS | |
| B0022 | LIANA | dr. MEILANO ROBINSYAH, Sp. PD | BPJS | |
| B0023 | ROKIAH | dr. NOVIA NASIR, Sp. M | BPJS | |
| C0006 | CHAIRIL ANWAR | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| B0024 | NURSIAH | dr. MEILANO ROBINSYAH, Sp. PD | BPJS | |
| B0025 | AGUSTINUS BINSAR PRAYOGI | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0026 | TIARA RADHA SUKMA | dr. NOVIA NASIR, Sp. M | BPJS | |
| C0149 | IZAM RAMADHAN | dr. CARLES, Sp. KJ, M, Sc | BPJS | |
| C0007 | M. NADIP HAMDI | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| B0027 | ELY SUNARYA GINTING | dr. DAMERIA HASTARI, Sp. PD | BPJS | |
| B0028 | ASMAWATI | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0029 | TRIS ERAWATI YULIANA | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| C0008 | PAUZIAH | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| C0009 | AHMAD MAHFUDIN | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| D0004 | JENNY SERIANI | dr. MELFIA NAVRATILOVA, Sp. P, M. Kes | BPJS | |
| C0010 | FITRI NINGSIH | dr. ESA FREDIGUSTA, Sp.JP | BPJS | |
| B0030 | ABIZAR FABIANDI PRADIDAYA | dr. NOVIA NASIR, Sp. M | BPJS | |
| A0010 | ARUMI NASYA RAZETA | dr. REGGY AMBARDY DWI PUTRA, Sp. A | BPJS | |
| B0031 | HAFIPA RISDA MAWARNI | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0032 | JENNAIRA HAYFA | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0033 | RIKA | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| C0011 | MASHUN | dr. RISMAN SARAGIH, Sp.S | BPJS | |
| B0034 | ELVIRANDA RIZQI FEBRIANTI | dr. GOKLASH APRYANTO, Sp.B | BPJS | |
| D0005 | SUPITRA | dr. MELFIA NAVRATILOVA, Sp. P, M. Kes | BPJS | |
| B0035 | RUSTAM | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| A0011 | MUHAMMAD KHAN ZAYN AL SAKHA | dr. REGGY AMBARDY DWI PUTRA, Sp. A | BPJS | |