| PACITAN | RS Umum Daerah dr. Darsono | | 3 | 0 | 3 | 2 | 0 | 2 | 2 | 0 | 2 | 3 | 0 | 3 | 1 | 0 | 1 | 2 | 0 | 2 | 2 | 0 | 2 |
| PONOROGO | RS Umum Daerah Dr. Harjono S. Kabupaten Ponorogo | | 3 | 0 | 3 | 3 | 0 | 3 | 3 | 0 | 3 | 2 | 0 | 2 | 3 | 0 | 3 | 1 | 1 | 2 | 2 | 0 | 2 |
| PONOROGO | RS Umum Daerah Bantarangin | | 0 | 1 | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 0 | 0 | 1 | 0 | 1 |
| TRENGGALEK | RS Umum Daerah dr. Soedomo Trenggalek | | 2 | 1 | 3 | 2 | 0 | 2 | 3 | 0 | 3 | 2 | 2 | 4 | 1 | 2 | 3 | 2 | 0 | 2 | 2 | 0 | 2 |
| TRENGGALEK | RS Umum Daerah Panggul | | 1 | 1 | 2 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 1 | 1 | 0 | 0 | 0 |
| TULUNGAGUNG | RS Umum Daerah Campurdarat | | 0 | 2 | 2 | 0 | 1 | 1 | 1 | 0 | 1 | 1 | 1 | 2 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 1 | 1 |
| BLITAR | RS Umum Daerah Ngudi Waluyo Wlingi | | 2 | 0 | 2 | 2 | 1 | 3 | 2 | 0 | 2 | 4 | 1 | 5 | 2 | 0 | 2 | 2 | 0 | 2 | 1 | 1 | 2 |
| BLITAR | RS Umum Daerah Srengat Kab. Blitar | | 1 | 0 | 1 | 1 | 1 | 2 | 1 | 0 | 1 | 2 | 1 | 3 | 2 | 0 | 2 | 0 | 2 | 2 | 1 | 0 | 1 |
| KEDIRI | RS Umum Daerah Kabupaten Kediri | | 2 | 0 | 2 | 2 | 1 | 3 | 3 | 0 | 3 | 2 | 2 | 4 | 2 | 1 | 3 | 1 | 0 | 1 | 0 | 1 | 1 |
| KEDIRI | RS Umum Daerah Simpang Lima Gumul Kediri | | 3 | 0 | 3 | 1 | 1 | 2 | 3 | 1 | 4 | 2 | 0 | 2 | 2 | 0 | 2 | 1 | 0 | 1 | 1 | 0 | 1 |
| MALANG | RS Umum Daerah Kanjuruhan Kepanjen Kab. Malang | | 3 | 0 | 3 | 2 | 1 | 3 | 4 | 0 | 4 | 5 | 0 | 5 | 4 | 0 | 4 | 3 | 0 | 3 | 2 | 0 | 2 |
| MALANG | RS Umum Daerah Lawang | | 1 | 1 | 2 | 1 | 1 | 2 | 2 | 0 | 2 | 2 | 0 | 2 | 1 | 1 | 2 | 0 | 1 | 1 | 1 | 0 | 1 |
| LUMAJANG | RSUD Dr. HARYOTO KABUPATEN LUMAJANG | | 3 | 1 | 4 | 3 | 0 | 3 | 2 | 0 | 2 | 4 | 1 | 5 | 2 | 0 | 2 | 1 | 1 | 2 | 1 | 1 | 2 |
| LUMAJANG | RS UMUM DAERAH PASIRIAN KABUPATEN LUMAJANG | | 1 | 1 | 2 | 1 | 1 | 2 | 0 | 2 | 2 | 2 | 0 | 2 | 1 | 1 | 2 | 1 | 0 | 1 | 0 | 1 | 1 |
| JEMBER | RS Umum Daerah Dr. Soebandi Jember | | 1 | 3 | 4 | 3 | 3 | 6 | 3 | 3 | 6 | 1 | 6 | 7 | 4 | 1 | 5 | 1 | 3 | 4 | 0 | 2 | 2 |
| JEMBER | RS Daerah Kalisat Jember | | 0 | 1 | 1 | 0 | 2 | 2 | 1 | 1 | 2 | 0 | 2 | 2 | 0 | 2 | 2 | 0 | 0 | 0 | 1 | 0 | 1 |
| JEMBER | RS Daerah Balung Jember | | 2 | 0 | 2 | 0 | 3 | 3 | 0 | 1 | 1 | 3 | 2 | 5 | 0 | 2 | 2 | 0 | 1 | 1 | 1 | 0 | 1 |
| BANYUWANGI | RS Umum Daerah Blambangan | | 2 | 1 | 3 | 2 | 1 | 3 | 2 | 1 | 3 | 1 | 2 | 3 | 2 | 1 | 3 | 0 | 1 | 1 | 1 | 0 | 1 |
| BANYUWANGI | RS Umum Daerah Genteng | | 2 | 0 | 2 | 1 | 2 | 3 | 1 | 2 | 3 | 2 | 0 | 2 | 5 | 0 | 5 | 1 | 0 | 1 | 1 | 0 | 1 |
| BONDOWOSO | RS Umum dr. H.Koesnadi Bondowoso | | 1 | 2 | 3 | 2 | 1 | 3 | 3 | 1 | 4 | 3 | 0 | 3 | 0 | 2 | 2 | 2 | 1 | 3 | 1 | 0 | 1 |
| SITUBONDO | RS Umum Daerah dr. Abdoer Rahem Situbondo | | 1 | 1 | 2 | 2 | 1 | 3 | 2 | 0 | 2 | 0 | 2 | 2 | 2 | 0 | 2 | 1 | 0 | 1 | 1 | 0 | 1 |
| SITUBONDO | RS Umum Daerah Besuki Kabupaten Situbondo | | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2 | 2 | 0 | 2 | 2 | 0 | 1 | 1 | 0 | 1 | 1 |
| SITUBONDO | RS Umum Daerah Asembagus Kabupaten Situbondo | | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 2 | 2 | 0 | 2 | 2 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 |
| PROBOLINGGO | RS Umum Daerah Waluyo Jati Kraksaan | | 2 | 0 | 2 | 2 | 0 | 2 | 3 | 0 | 3 | 2 | 1 | 3 | 1 | 2 | 3 | 2 | 0 | 2 | 1 | 1 | 2 |
| PROBOLINGGO | RS Umum Daerah Tongas | | 1 | 0 | 1 | 0 | 2 | 2 | 1 | 1 | 2 | 2 | 1 | 3 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 |
| PASURUAN | RS Umum Daerah Bangil | | 1 | 2 | 3 | 1 | 2 | 3 | 3 | 2 | 5 | 4 | 2 | 6 | 2 | 1 | 3 | 1 | 4 | 5 | 2 | 0 | 2 |
| PASURUAN | RS Umum Daerah Grati | | 1 | 2 | 3 | 0 | 3 | 3 | 3 | 0 | 3 | 3 | 1 | 4 | 0 | 3 | 3 | 0 | 2 | 2 | 0 | 1 | 1 |
| SIDOARJO | RS Umum Daerah Sidoarjo Barat | | 1 | 1 | 2 | 1 | 1 | 2 | 2 | 0 | 2 | 2 | 1 | 3 | 2 | 0 | 2 | 1 | 0 | 1 | 1 | 0 | 1 |
| MOJOKERTO | RS Umum Daerah Prof. Dr. Soekandar | | 2 | 1 | 3 | 2 | 0 | 2 | 2 | 3 | 5 | 3 | 1 | 4 | 2 | 0 | 2 | 1 | 0 | 1 | 1 | 1 | 2 |
| MOJOKERTO | RS Umum Daerah Raden Achmad Basoeni | | 2 | 0 | 2 | 1 | 1 | 2 | 3 | 1 | 4 | 1 | 1 | 2 | 1 | 1 | 2 | 1 | 0 | 1 | 1 | 0 | 1 |
| JOMBANG | RS Umum Daerah Kab. Jombang | | 3 | 3 | 6 | 2 | 1 | 3 | 2 | 1 | 3 | 1 | 5 | 6 | 2 | 3 | 5 | 2 | 1 | 3 | 1 | 1 | 2 |
| JOMBANG | RS Umum Daerah Ploso | | 1 | 1 | 2 | 0 | 2 | 2 | 2 | 0 | 2 | 0 | 2 | 2 | 1 | 1 | 2 | 0 | 1 | 1 | 0 | 2 | 2 |
| NGANJUK | RS Umum Daerah Nganjuk | | 2 | 1 | 3 | 3 | 0 | 3 | 3 | 0 | 3 | 5 | 0 | 5 | 2 | 0 | 2 | 2 | 0 | 2 | 1 | 1 | 2 |
| NGANJUK | RS Daerah Kertosono | | 3 | 0 | 3 | 1 | 2 | 3 | 1 | 1 | 2 | 1 | 1 | 2 | 0 | 2 | 2 | 0 | 2 | 2 | 1 | 0 | 1 |
| MADIUN | RS Umum Daerah Caruban | | 3 | 0 | 3 | 2 | 0 | 2 | 1 | 1 | 2 | 2 | 1 | 3 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 |
| MADIUN | RS Umum Daerah Dolopo | | 1 | 0 | 1 | 0 | 0 | 0 | 1 | 0 | 1 | 2 | 0 | 2 | 2 | 0 | 2 | 1 | 0 | 1 | 1 | 0 | 1 |
| MAGETAN | RS Umum Daerah dr. Sayidiman Magetan | | 3 | 0 | 3 | 2 | 1 | 3 | 3 | 0 | 3 | 3 | 1 | 4 | 2 | 0 | 2 | 1 | 1 | 2 | 2 | 0 | 2 |
| NGAWI | RS Umum Daerah Dr. Soeroto Ngawi | | 2 | 0 | 2 | 1 | 2 | 3 | 3 | 0 | 3 | 4 | 0 | 4 | 2 | 0 | 2 | 1 | 0 | 1 | 1 | 0 | 1 |
| NGAWI | RS Umum Daerah Geneng | | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 |
| NGAWI | RS Umum Daerah Mantingan | Kelas D | 1 | 0 | 1 | 0 | 1 | 1 | 0 | 2 | 2 | 0 | 2 | 2 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 1 | 1 |
| BOJONEGORO | RS Umum Daerah Dr. R. Sosodoro Djatikoesoemo | | 3 | 0 | 3 | 3 | 0 | 3 | 1 | 0 | 1 | 4 | 2 | 6 | 3 | 0 | 3 | 2 | 1 | 3 | 0 | 2 | 2 |
| BOJONEGORO | RS Umum Daerah Sumberrejo | | 2 | 0 | 2 | 1 | 1 | 2 | 1 | 0 | 1 | 1 | 0 | 1 | 2 | 0 | 2 | 0 | 1 | 1 | 1 | 0 | 1 |
| BOJONEGORO | RS umum Daerah Padangan | | 2 | 0 | 2 | 1 | 1 | 2 | 1 | 1 | 2 | 2 | 0 | 2 | 0 | 2 | 2 | 1 | 0 | 1 | 1 | 0 | 1 |
| BOJONEGORO | RS Umum Daerah Kepohbaru | | 1 | 0 | 1 | 0 | 1 | 1 | 0 | 3 | 3 | 1 | 0 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 |
| BOJONEGORO | RS Umum Daerah Temayang | | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| BOJONEGORO | RS Khusus Onkologi Bojonegoro | | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| TUBAN | RS Umum Daerah Dr. R. Koesma Tuban | | 3 | 1 | 4 | 2 | 1 | 3 | 4 | 1 | 5 | 3 | 1 | 4 | 3 | 1 | 4 | 2 | 0 | 2 | 1 | 1 | 2 |
| TUBAN | RS Umum Daerah R. Ali Manshur | | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 1 | 2 | 3 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 |
| LAMONGAN | RS Umum Daerah Dr. Soegiri Lamongan | | 3 | 0 | 3 | 2 | 1 | 3 | 4 | 1 | 5 | 2 | 1 | 3 | 3 | 0 | 3 | 1 | 1 | 2 | 1 | 0 | 1 |
| LAMONGAN | RS Umum Daerah Ngimbang | | 0 | 1 | 1 | 1 | 1 | 2 | 0 | 2 | 2 | 1 | 1 | 2 | 2 | 0 | 2 | 0 | 1 | 1 | 1 | 0 | 1 |
| LAMONGAN | RS Umum Daerah Karangkembang | | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 2 | 2 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 |
| LAMONGAN | RS Umum Daerah Ki Ageng Brondong | | 0 | 0 | 0 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 1 | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 |
| GRESIK | RS Umum Daerah Ibnu Sina Kab. Gresik | | 4 | 0 | 4 | 2 | 0 | 2 | 1 | 2 | 3 | 6 | 2 | 8 | 3 | 0 | 3 | 2 | 1 | 3 | 2 | 0 | 2 |
| GRESIK | RS Umum Daerah Umar Mas'ud Bawean | | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 0 |
| GRESIK | RS Umum Daerah Gresik Sehati | | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 0 |
| BANGKALAN | RS Umum Daerah Syarifah Ambami Rato Ebu | | 2 | 1 | 3 | 3 | 0 | 3 | 2 | 2 | 4 | 3 | 1 | 4 | 3 | 0 | 3 | 1 | 2 | 3 | 3 | 0 | 3 |
| SAMPANG | RS Umum Daerah dr. Mohammad Zyn Kab. Sampang | | 1 | 0 | 1 | 3 | 1 | 4 | 4 | 0 | 4 | 2 | 0 | 2 | 0 | 3 | 3 | 2 | 0 | 2 | 1 | 0 | 1 |
| SAMPANG | RS Umum Daerah Ketapang | | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 1 | 0 | 1 | 0 | 1 | 1 | 0 | 0 | 0 |
| PAMEKASAN | RS Umum Daerah Dr. H. Slamet Martodirdjo Pamekasan | | 0 | 1 | 1 | 3 | 1 | 4 | 2 | 1 | 3 | 2 | 1 | 3 | 1 | 1 | 2 | 2 | 0 | 2 | 2 | 0 | 2 |
| PAMEKASAN | RS Umum Daerah Waru Pamekasan | | 0 | 1 | 1 | 1 | 0 | 1 | 0 | 1 | 1 | 0 | 2 | 2 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 0 | 0 |
| SUMENEP | RS Umum Daerah dr. H. Moh. Anwar | | 3 | 1 | 4 | 1 | 1 | 2 | 3 | 0 | 3 | 2 | 2 | 4 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 |
| SUMENEP | RS Umum Daerah Abuya Kangean | | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 1 | 0 | 1 |
| KOTA KEDIRI | RS Umum Daerah Gambiran | | 1 | 2 | 3 | 1 | 1 | 2 | 0 | 4 | 4 | 3 | 2 | 5 | 2 | 1 | 3 | 3 | 0 | 3 | 2 | 0 | 2 |
| KOTA KEDIRI | RS Umum Daerah Kilisuci | | 0 | 1 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 3 | 1 | 4 | 1 | 0 | 1 | 1 | 0 | 1 | 0 | 1 | 1 |
| KOTA BLITAR | RS Umum Daerah Mardi Waluyo | | 3 | 0 | 3 | 2 | 1 | 3 | 4 | 0 | 4 | 4 | 0 | 4 | 2 | 0 | 2 | 2 | 0 | 2 | 2 | 0 | 2 |
| KOTA MALANG | RS Umum Daerah Kota Malang | | 2 | 0 | 2 | 0 | 1 | 1 | 1 | 0 | 1 | 3 | 0 | 3 | 1 | 1 | 2 | 2 | 0 | 2 | 1 | 0 | 1 |
| KOTA PROBOLINGGO | RS Umum Daerah dr. Mohamad Saleh Kota Probolinggo | | 1 | 2 | 3 | 2 | 1 | 3 | 0 | 3 | 3 | 3 | 1 | 4 | 2 | 0 | 2 | 0 | 2 | 2 | 0 | 1 | 1 |
| KOTA PROBOLINGGO | RS Umum Daerah Ar Rozy | | 0 | 0 | 0 | 2 | 0 | 2 | 0 | 0 | 0 | 2 | 0 | 2 | 1 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 |
| KOTA PASURUAN | RS Umum Daerah Dr. R. Soedarsono Kota Pasuruan | | 3 | 0 | 3 | 1 | 4 | 5 | 1 | 2 | 3 | 3 | 2 | 5 | 1 | 1 | 2 | 2 | 0 | 2 | 1 | 0 | 1 |
| KOTA MOJOKERTO | RSUD dr. Wahidin Sudiro Husodo Kota Mojokerto | | 2 | 1 | 3 | 3 | 1 | 4 | 3 | 1 | 4 | 4 | 1 | 5 | 2 | 1 | 3 | 1 | 1 | 2 | 2 | 0 | 2 |
| KOTA MADIUN | RS Umum Daerah Kota Madiun | | 2 | 0 | 2 | 3 | 0 | 3 | 1 | 0 | 1 | 1 | 1 | 2 | 1 | 1 | 2 | 1 | 0 | 1 | 1 | 0 | 1 |
| KOTA SURABAYA | RS Umum Daerah Bhakti Dharma Husada | | 2 | 0 | 2 | 1 | 0 | 1 | 4 | 0 | 4 | 4 | 1 | 5 | 4 | 0 | 4 | 2 | 0 | 2 | 1 | 1 | 2 |
| KOTA SURABAYA | RS Umum Daerah dr. Mohamad Soewandhie | | 4 | 3 | 7 | 4 | 1 | 5 | 4 | 1 | 5 | 8 | 2 | 10 | 4 | 1 | 5 | 2 | 1 | 3 | 2 | 0 | 2 |
| KOTA SURABAYA | RSUD EKA CANDRARINI | | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 1 | 0 | 1 | 1 |