| B0001 | SUTIRI | dr. MEILANO ROBINSYAH, Sp. PD | BPJS | |
| B0002 | DELVIRA ANGGRAINI | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0003 | YULISTARI | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| C0001 | SAKILA | dr. SHENY AGMA, Sp. N | BPJS | |
| B0004 | JUN YING | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0005 | TJHANG JOEIJ MOIJ | dr. NOVIA NASIR, Sp. M | BPJS | |
| C0002 | DERRICK YUEN KHO | dr. LINGGAWATI, Sp. THT | BPJS | |
| C0003 | ZURFIKA | dr. SHENY AGMA, Sp. N | BPJS | |
| B0006 | ROSLA | dr. GOKLASH APRYANTO, Sp.B | BPJS | |
| B0007 | SUANNA | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0008 | OKTA SAKTIYANI | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0009 | REVIRA INDIRASARI | dr. GOKLASH APRYANTO, Sp.B | BPJS | |
| C0004 | RADI | dr. ESA FREDIGUSTA, Sp.JP | BPJS | |
| B0010 | RODAINI | dr. MEILANO ROBINSYAH, Sp. PD | BPJS | |
| C0005 | RODAINI | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| C0006 | NO'U LUKITASARI | dr. ESA FREDIGUSTA, Sp.JP | BPJS | |
| D0001 | ABIDIN | dr. MELFIA NAVRATILOVA, Sp. P, M. Kes | BPJS | |
| B0011 | TJHIN A SIANG | dr. DAMERIA HASTARI, Sp. PD | BPJS | |
| B0012 | JUWITA | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0013 | AZWARI | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0014 | ENI | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0015 | PUTRA PANGESTU | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0016 | AGUSTINA | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0017 | IQBAL RAMADHAN | dr. GOKLASH APRYANTO, Sp.B | BPJS | |
| B0018 | M. MUSLIMIN | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| C0007 | RINCE | dr. CARLES, Sp. KJ, M, Sc | BPJS | |
| B0019 | RAFIZI | dr. ARINAL PAHLEVI, Sp.D.V. | BPJS | |
| B0020 | YOLANDA AVITA PUTRI | dr. NOVIA NASIR, Sp. M | BPJS | |
| C0008 | MULSIWAN | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| C0009 | NGUI NGIT THIN | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| B0021 | AZIAH | dr. NOVIA NASIR, Sp. M | BPJS | |
| C0010 | HAWATI | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| C0011 | MISRO | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| C0012 | SWARI ZALIANDO | dr. SHENY AGMA, Sp. N | BPJS | |
| C0013 | MULYADI | dr. SHENY AGMA, Sp. N | BPJS | |
| B0022 | DIDI YUDHA | dr. NOVIA NASIR, Sp. M | BPJS | |
| C0014 | MARIYANI.BR.HUTAPEA | dr. SHENY AGMA, Sp. N | BPJS | |
| C0015 | ORLIN WINEBERNITA | dr. SHENY AGMA, Sp. N | BPJS | |
| C0016 | DEKI PURNA IRWANDA | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| C0017 | PILIH KARINI | dr. SHENY AGMA, Sp. N | BPJS | |
| B0023 | FADHLURRAHMAN FAJARI | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| B0024 | SANELY RISTI | dr. GOKLASH APRYANTO, Sp.B | BPJS | |
| C0018 | SITI ZULAIHA | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| A0001 | RINI FITRIANI | dr.H. SUANDI, Sp.OG,M.Kes | BPJS | |
| B0025 | SUMARTINI | dr. GOKLASH APRYANTO, Sp.B | BPJS | |
| B0026 | MEISYAH FHALIZIA | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0027 | SHINTA RAMA YANTI | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| B0028 | ALDRIAN GEOFANY | drg. MUTIA AULIANY, Sp. B. M | BPJS | |
| C0019 | MIDJAH | dr. ESA FREDIGUSTA, Sp.JP | BPJS | |
| B0029 | SULASTRI | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0030 | CLARA ANGGITA LESTARI | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0031 | SYLVIA MOLINA | drg. MUTIA AULIANY, Sp. B. M | BPJS | |
| D0002 | AMOI | dr. MELFIA NAVRATILOVA, Sp. P, M. Kes | BPJS | |
| D0003 | AMOI | dr. MELFIA NAVRATILOVA, Sp. P, M. Kes | BPJS | |
| B0032 | SITI FATIMAH | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0033 | BIMO HARI BOWO | dr. DAMERIA HASTARI, Sp. PD | BPJS | |
| B0034 | DEWI DAMAYANTI | dr. DAMERIA HASTARI, Sp. PD | BPJS | |
| C0020 | TOIPAH | dr. SHENY AGMA, Sp. N | BPJS | |
| B0035 | DINA BUDIARTI | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| C0021 | LIA MANDASARI | dr. SHENY AGMA, Sp. N | BPJS | |
| C0022 | NUR AZIZAH | dr. LINGGAWATI, Sp. THT | BPJS | |
| B0036 | MINA | dr. NOVIA NASIR, Sp. M | BPJS | |