| PACITAN | RS Umum Daerah dr. Darsono | Kelas C | 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 | Kelas B | 3 | 0 | 3 | 4 | 0 | 4 | 3 | 0 | 3 | 1 | 1 | 2 | 3 | 0 | 3 | 1 | 1 | 2 | 2 | 0 | 2 |
| PONOROGO | RS Umum Daerah Bantarangin | Kelas D | 0 | 1 | 1 | 1 | 0 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 1 | 1 |
| TRENGGALEK | RS Umum Daerah dr. Soedomo Trenggalek | Kelas C | 2 | 1 | 3 | 2 | 0 | 2 | 3 | 0 | 3 | 2 | 2 | 4 | 1 | 2 | 3 | 3 | 0 | 3 | 2 | 0 | 2 |
| TRENGGALEK | RS Umum Daerah Panggul | Kelas D | 1 | 1 | 2 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 0 | 0 |
| TULUNGAGUNG | RS Umum Daerah Campurdarat | Kelas C | 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 | Kelas B | 2 | 0 | 2 | 1 | 1 | 2 | 2 | 0 | 2 | 4 | 1 | 5 | 2 | 0 | 2 | 2 | 0 | 2 | 1 | 1 | 2 |
| BLITAR | RS Umum Daerah Srengat Kab. Blitar | Kelas C | 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 | Kelas B | 2 | 0 | 2 | 3 | 0 | 3 | 3 | 0 | 3 | 2 | 2 | 4 | 3 | 0 | 3 | 1 | 0 | 1 | 1 | 1 | 2 |
| KEDIRI | RS Umum Daerah Simpang Lima Gumul Kediri | Kelas C | 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 | Kelas B | 3 | 1 | 4 | 2 | 1 | 3 | 4 | 0 | 4 | 5 | 0 | 5 | 4 | 0 | 4 | 3 | 0 | 3 | 2 | 0 | 2 |
| MALANG | RS Umum Daerah Lawang | Kelas C | 1 | 0 | 1 | 1 | 1 | 2 | 2 | 0 | 2 | 2 | 0 | 2 | 1 | 1 | 2 | 0 | 1 | 1 | 1 | 0 | 1 |
| MALANG | RS Umum Daerah Ngantang | Kelas D | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| LUMAJANG | RS Daerah Dr. Haryoto Kabupaten Lumajang | Kelas B | 2 | 2 | 4 | 3 | 0 | 3 | 2 | 0 | 2 | 4 | 2 | 6 | 2 | 0 | 2 | 1 | 1 | 2 | 1 | 1 | 2 |
| LUMAJANG | RS Umum Daerah Pasirian Kabupaten Lumajang | Kelas C | 2 | 0 | 2 | 1 | 1 | 2 | 0 | 2 | 2 | 2 | 0 | 2 | 1 | 1 | 2 | 1 | 0 | 1 | 1 | 0 | 1 |
| JEMBER | RS Umum Daerah Dr. Soebandi Jember | Kelas B | 0 | 4 | 4 | 2 | 3 | 5 | 3 | 3 | 6 | 1 | 6 | 7 | 2 | 1 | 3 | 2 | 2 | 4 | 2 | 1 | 3 |
| JEMBER | RS Daerah Kalisat Jember | Kelas C | 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 | Kelas C | 2 | 0 | 2 | 0 | 3 | 3 | 0 | 2 | 2 | 3 | 2 | 5 | 0 | 2 | 2 | 0 | 1 | 1 | 1 | 0 | 1 |
| BANYUWANGI | RS Umum Daerah Blambangan | Kelas B | 2 | 1 | 3 | 2 | 1 | 3 | 2 | 1 | 3 | 1 | 2 | 3 | 1 | 1 | 2 | 0 | 1 | 1 | 1 | 0 | 1 |
| BANYUWANGI | RS Umum Daerah Genteng | Kelas C | 2 | 0 | 2 | 1 | 2 | 3 | 1 | 1 | 2 | 1 | 1 | 2 | 4 | 0 | 4 | 1 | 0 | 1 | 1 | 0 | 1 |
| BONDOWOSO | RS Umum dr. H.Koesnadi Bondowoso | Kelas B | 1 | 2 | 3 | 2 | 1 | 3 | 2 | 1 | 3 | 3 | 0 | 3 | 0 | 2 | 2 | 2 | 1 | 3 | 1 | 0 | 1 |
| SITUBONDO | RS Umum Daerah dr. Abdoer Rahem Situbondo | Kelas C | 1 | 1 | 2 | 2 | 0 | 2 | 2 | 0 | 2 | 0 | 3 | 3 | 2 | 0 | 2 | 1 | 0 | 1 | 1 | 0 | 1 |
| SITUBONDO | RS Umum Daerah Besuki Kabupaten Situbondo | Kelas D | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 2 | 2 | 0 | 2 | 2 | 0 | 1 | 1 | 0 | 1 | 1 |
| SITUBONDO | RS Umum Daerah Asembagus Kabupaten Situbondo | Kelas D | 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 | Kelas B | 1 | 1 | 2 | 2 | 1 | 3 | 3 | 0 | 3 | 2 | 1 | 3 | 1 | 2 | 3 | 2 | 0 | 2 | 1 | 1 | 2 |
| PROBOLINGGO | RS Umum Daerah Tongas | Kelas C | 2 | 0 | 2 | 0 | 1 | 1 | 1 | 1 | 2 | 2 | 1 | 3 | 1 | 2 | 3 | 0 | 1 | 1 | 0 | 1 | 1 |
| PASURUAN | RS Umum Daerah Bangil | Kelas B | 1 | 3 | 4 | 0 | 2 | 2 | 4 | 1 | 5 | 3 | 4 | 7 | 2 | 1 | 3 | 1 | 4 | 5 | 1 | 0 | 1 |
| PASURUAN | RS Umum Daerah Grati | Kelas C | 1 | 2 | 3 | 0 | 3 | 3 | 3 | 0 | 3 | 3 | 0 | 3 | 0 | 3 | 3 | 0 | 2 | 2 | 0 | 1 | 1 |
| SIDOARJO | RS Umum Daerah Sidoarjo Barat | Kelas C | 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 | Kelas B | 2 | 1 | 3 | 2 | 0 | 2 | 1 | 3 | 4 | 3 | 2 | 5 | 2 | 0 | 2 | 1 | 0 | 1 | 1 | 1 | 2 |
| MOJOKERTO | RS Umum Daerah Raden Achmad Basoeni | Kelas C | 2 | 0 | 2 | 1 | 1 | 2 | 1 | 1 | 2 | 1 | 1 | 2 | 1 | 1 | 2 | 1 | 0 | 1 | 1 | 0 | 1 |
| JOMBANG | RS Umum Daerah Kab. Jombang | Kelas B | 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 | Kelas C | 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 | Kelas B | 1 | 1 | 2 | 2 | 0 | 2 | 3 | 0 | 3 | 4 | 1 | 5 | 2 | 0 | 2 | 2 | 0 | 2 | 1 | 0 | 1 |
| NGANJUK | RS Daerah Kertosono | Kelas C | 3 | 0 | 3 | 1 | 2 | 3 | 1 | 1 | 2 | 1 | 0 | 1 | 0 | 2 | 2 | 0 | 2 | 2 | 1 | 0 | 1 |
| MADIUN | RS Umum Daerah Caruban | Kelas C | 3 | 0 | 3 | 2 | 0 | 2 | 1 | 1 | 2 | 3 | 1 | 4 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 |
| MADIUN | RS Umum Daerah Dolopo | Kelas C | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 2 | 0 | 2 | 2 | 0 | 2 | 1 | 0 | 1 | 1 | 0 | 1 |
| MAGETAN | RS Umum Daerah dr. Sayidiman Magetan | Kelas C | 3 | 0 | 3 | 2 | 0 | 2 | 3 | 1 | 4 | 3 | 2 | 5 | 2 | 0 | 2 | 1 | 1 | 2 | 2 | 0 | 2 |
| NGAWI | RS Umum Daerah Dr. Soeroto Ngawi | Kelas C | 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 | Kelas D | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 2 | 2 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 2 |
| NGAWI | RS Umum Daerah Mantingan | Kelas D | 1 | 0 | 1 | 0 | 1 | 1 | 1 | 1 | 2 | 0 | 2 | 2 | 0 | 2 | 2 | 0 | 1 | 1 | 0 | 1 | 1 |
| BOJONEGORO | RS Umum Daerah Dr. R. Sosodoro Djatikoesoemo | Kelas B | 3 | 0 | 3 | 3 | 0 | 3 | 1 | 1 | 2 | 5 | 1 | 6 | 3 | 0 | 3 | 2 | 1 | 3 | 0 | 2 | 2 |
| BOJONEGORO | RS Umum Daerah Sumberrejo | Kelas C | 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 | Kelas C | 1 | 0 | 1 | 1 | 1 | 2 | 1 | 1 | 2 | 2 | 0 | 2 | 0 | 3 | 3 | 1 | 0 | 1 | 1 | 0 | 1 |
| BOJONEGORO | RS Umum Daerah Kepohbaru | Kelas D | 1 | 0 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 1 | 0 | 1 | 0 | 2 | 2 | 0 | 1 | 1 | 0 | 1 | 1 |
| BOJONEGORO | RS Umum Daerah Temayang | Kelas D | 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 | Kelas B | 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 | Kelas B | 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 | Kelas C | 0 | 2 | 2 | 0 | 1 | 1 | 0 | 1 | 1 | 1 | 2 | 3 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 2 | 2 |
| LAMONGAN | RS Umum Daerah Dr. Soegiri Lamongan | Kelas B | 3 | 1 | 4 | 2 | 1 | 3 | 3 | 0 | 3 | 2 | 1 | 3 | 3 | 0 | 3 | 1 | 1 | 2 | 2 | 0 | 2 |
| LAMONGAN | RS Umum Daerah Ngimbang | Kelas C | 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 | Kelas D | 0 | 1 | 1 | 0 | 1 | 1 | 1 | 0 | 1 | 0 | 2 | 2 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 |
| LAMONGAN | RS Umum Daerah Ki Ageng Brondong | Kelas D | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 0 | 1 | 1 |
| GRESIK | RS Umum Daerah Ibnu Sina Kab. Gresik | Kelas B | 3 | 0 | 3 | 2 | 0 | 2 | 1 | 2 | 3 | 6 | 2 | 8 | 3 | 0 | 3 | 3 | 1 | 4 | 2 | 0 | 2 |
| GRESIK | RS Umum Daerah Umar Mas'ud Bawean | Kelas D | 0 | 1 | 1 | 0 | 2 | 2 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 0 |
| GRESIK | RS Umum Daerah Gresik Sehati | Kelas C | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 1 | 1 |
| BANGKALAN | RS Umum Daerah Syarifah Ambami Rato Ebu | Kelas B | 3 | 1 | 4 | 3 | 0 | 3 | 2 | 2 | 4 | 3 | 1 | 4 | 3 | 1 | 4 | 1 | 2 | 3 | 3 | 0 | 3 |
| SAMPANG | RS Umum Daerah dr. Mohammad Zyn Kab. Sampang | Kelas B | 1 | 0 | 1 | 3 | 0 | 3 | 3 | 0 | 3 | 2 | 0 | 2 | 0 | 2 | 2 | 2 | 0 | 2 | 1 | 0 | 1 |
| SAMPANG | RS Umum Daerah Ketapang | Kelas D | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 2 | 2 | 0 | 1 | 1 | 1 | 1 | 2 | 0 | 1 | 1 | 0 | 0 | 0 |
| PAMEKASAN | RS Umum Daerah Dr. H. Slamet Martodirdjo Pamekasan | Kelas B | 0 | 1 | 1 | 4 | 0 | 4 | 2 | 1 | 3 | 2 | 1 | 3 | 1 | 1 | 2 | 2 | 0 | 2 | 3 | 0 | 3 |
| PAMEKASAN | RS Umum Daerah Waru Pamekasan | Kelas D | 0 | 1 | 1 | 1 | 1 | 2 | 0 | 1 | 1 | 0 | 2 | 2 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 |
| SUMENEP | RS Umum Daerah dr. H. Moh. Anwar | Kelas B | 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 | Kelas D | 0 | 2 | 2 | 0 | 3 | 3 | 0 | 1 | 1 | 0 | 2 | 2 | 0 | 1 | 1 | 0 | 1 | 1 | 1 | 0 | 1 |
| KOTA KEDIRI | RS Umum Daerah Gambiran | Kelas B | 2 | 1 | 3 | 1 | 1 | 2 | 0 | 4 | 4 | 3 | 2 | 5 | 3 | 0 | 3 | 3 | 0 | 3 | 1 | 0 | 1 |
| KOTA KEDIRI | RS Umum Daerah Kilisuci | Kelas C | 0 | 1 | 1 | 1 | 1 | 2 | 1 | 0 | 1 | 2 | 1 | 3 | 1 | 0 | 1 | 1 | 0 | 1 | 0 | 1 | 1 |
| KOTA BLITAR | RS Umum Daerah Mardi Waluyo | Kelas B | 3 | 0 | 3 | 2 | 1 | 3 | 3 | 0 | 3 | 4 | 0 | 4 | 2 | 0 | 2 | 2 | 0 | 2 | 2 | 0 | 2 |
| KOTA MALANG | RS Umum Daerah Kota Malang | Kelas C | 3 | 0 | 3 | 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 | Kelas B | 1 | 2 | 3 | 2 | 1 | 3 | 0 | 3 | 3 | 4 | 1 | 5 | 2 | 0 | 2 | 0 | 2 | 2 | 0 | 2 | 2 |
| KOTA PROBOLINGGO | RS Umum Daerah Ar Rozy | Kelas C | 1 | 0 | 1 | 2 | 0 | 2 | 0 | 0 | 0 | 2 | 0 | 2 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 |
| KOTA PASURUAN | RS Umum Daerah Dr. R. Soedarsono Kota Pasuruan | Kelas C | 3 | 0 | 3 | 1 | 2 | 3 | 1 | 2 | 3 | 2 | 1 | 3 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 |
| KOTA MOJOKERTO | RSUD dr. Wahidin Sudiro Husodo Kota Mojokerto | Kelas B | 2 | 1 | 3 | 3 | 1 | 4 | 3 | 0 | 3 | 4 | 1 | 5 | 2 | 1 | 3 | 1 | 1 | 2 | 2 | 0 | 2 |
| KOTA MADIUN | RS Umum Daerah Kota Madiun | Kelas C | 3 | 0 | 3 | 3 | 0 | 3 | 2 | 0 | 2 | 2 | 0 | 2 | 2 | 0 | 2 | 1 | 0 | 1 | 1 | 0 | 1 |
| KOTA SURABAYA | RS Umum Daerah Bhakti Dharma Husada | Kelas B | 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 | Kelas B | 3 | 3 | 6 | 4 | 2 | 6 | 3 | 1 | 4 | 9 | 2 | 11 | 4 | 1 | 5 | 2 | 1 | 3 | 2 | 0 | 2 |
| KOTA SURABAYA | RS Umum Daerah Eka Candrarini | Kelas C | 2 | 1 | 3 | 3 | 2 | 5 | 2 | 1 | 3 | 3 | 2 | 5 | 3 | 2 | 5 | 1 | 1 | 2 | 2 | 1 | 3 |