AdMedika list of nationwide healthcare provider network

File Version : 01 Date: August 2009

No

Code

Hospital Name

0179
0867
0864
1146
0220
0226
0438
1150
0140
1463
0221
1073
1151

Status

Coverage

Total Active
Terminal

BALI

DENPASAR
001
002
003
004
005
006
007
008
009
010
011
012
013

Address

RSU. KASIH IBU BALI

KIMIA FARMA HEALTHCARE - DENPASAR
APOTIK KIMIA FARMA DENPASAR
RSU. BHAKTI RAHAYU DENPASAR
RS. PRIMA MEDIKA
KLINIK SIMPANG ENAM
RS DHARMA USADHA
RS.
RSIA. PURI BUNDA
RS. MANUABA
KLINIK PENTA MEDIKA
RS. PURI RAHARJA
KASIH IBU MEDICAL CENTER BELITON
KLINIK QUANTUM SARANA MEDIK

JL.TEUKU UMAR, NO.120

JL.DIPENOGORO NO.125, DENPASAR
JL. DIPONEGORO, NO.125
Jl.GATOT SUBROTO II, NO.11
JL.PULAU SERANGAN, 9X
JL. TEUKU UMAR, NO.148, DENPASAR
JL P.B.SUDIRMAN,
P B SUDIRMAN NO.50
NO 50
JL.
JL. GATOT SUBROTO VI, NO.19
JL. HOS. COKROAMINOTO, NO.28
JL.TEUKU UMAR BARAT-MARLBORO,NO.88
JL. WR.SUPRATMAN, NO.14-19, DENPASAR
JL.BELITON NO.1
JL. RAYA SESETAN, NO.20

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

5
4
1
1
3
1
1
1
2
1
1
1
1

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

KUTA
014
015

1138
0996

RSU. KASIH IBU KEDONGANAN

KASIH IBU MEDICAL CENTRE JIMBARAN

016
017

1246
0875

KLINIK KIMIA FARMA HEALTH CARE

KLINIK MANUABA

JL. ULUWATU, NO.69A, KEDONGANAN

JL.BY PASS I GUSTI NGURAH RAI, NO.13-14, KOMPLEK CITRA BALI,
JIMBARAN
JL.KARTIKA PLAZA 67, KUTA
JL. RAYA KUTA - TUBAN

KLINIK KIMIA FARMA - NUSADUA

KLINIK PRIMA MEDIKA

JL.BY PASS NGURAH RAI, NO.890

JL. BY PASS NGURAH RAI, PERTOKOAN NIAGA, NO.9

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

RSU. PARAMA SIDHI

RSU. KERTHA USADA

JL.A.YANI NO.171A
JL.CENDRAWASIH, NO57, SINGARAJA

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

UBUD CLINIC
KLINIK PRIMA MEDIKA NYUH KUNING

JL. TJAMPUHAN, NO.36, P.O.BOX 10, UBUD, GIANYAR

JL.BANJAR NYUH KUNING,UBUD - DENPASAR

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

KLINIK & APOTIK WARINGIN

RB NURFADILAH
KLINIK AMALIA
KLINIK & RB AFINA
KLINIK KELUARGA PULO AMPEL
KLINIK & APOTIK PRIMA SEHAT
KLINIK ANANDA CILEGON
KLINIK BONA MEDIKA
APOTIK SEHAT
APOTIK & KLINIK 24 JAM PRIMA HUSADA CILEGON
APOTIK LABORA FARMA
RSIA KURNIA
APOTIK & KLINIK KIMIA FARMA - CILEGON
KLINIK AL FALAH
RSIA MUTIARA BUNDA
KLINIK ALFINA
RS. KRAKATAU MEDIKA

JL.RAYA WARINGIN KURUNG SERDANG CILEGON

JL.RAYA ANYER NO.92 SAMANG RAYA
JL.S.A TIRTAYASA NO.7
JL. RAMBUTAN 12, PAGEBANGAN - CILEGON
JL.SALIRA INDAH DS.SUMURANJA PULOAMPEL
JL.S.A. TIRTAYASA NO.96
JL. R. SUPRAPTO KM.8
FESTIVAL RUKO, BLOK B10-11, BONAKARTA
RUKO MATAHARI PLAZA, BLOK C, NO.11-16-17-18 (JL.BOJONEGARA)
JL. RAYA MERAK, NO.36
JL. ALUN-ALUN UTARA, NO.23
Jl. JOMBANG MASJID No.4
JL. RAYA MERAK, NO.79
RUKO SUKMAJAYA BLOK.B NO.20 SUKMAJAYA
Jl.SA TIRTAYASA NO.86
RUKO PONDOK CILEGON INDAH, BLOK KK1, NO.7-8
JL. SEMANG RAYA - CILEGON 42435

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1
1
2
1
1
1
1
1
2
1
2
1
2

NUSA DUA
018
019

0866
0222

SINGARAJA
020
021

1451
0870

UBUD
022
023

0224
1464

BANTEN

CILEGON
024
025
026
027
028
029
030
031
032
033
034
035
036
037
038
039
040

0995
0583
0121
1254
1403
1097
0302
0320
0701
0595
0129
0985
0951
0940
0939
0057
0915

PANDEGLANG
041

0997

JL.RAYA LABUAN KM.12

ACTIVE

ALL COVERAGE

RS MISI LEBAK

KLINIK DIFFA

JL.MULTATULI NO.41

ACTIVE

ALL COVERAGE

RANGKASBITUNG
042

1084

SERANG
043
044
045
046

1272
0941
1489
0115

RS. SARI ASIH SERANG

KLINIK MODERN MEDIKA KRAGILAN
KLINIK & RB CITRA MEDIKA
KLINIK SERANG MEDIKA

JL.JEND.SUDIRMAN, NO.38, PENANCANGAN, CIPOCOK

JL.RAYA SERANG KM15 RUKO D9 KRAGILAN
JL.RAYA SERANG KM.9 DS.RANJENG - CIRUAS
JL. RAYA SERANG CILEGON RUKO LEGOK SUKMAJAYA BLOK 5C NO.1

ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1

047
048
049
050
051
052
053
054
055

0716
0717
1009
1008
1004
1003
0984
1126
0937

RSIA. BUDI ASIH

APOTIK RATU FARMA
KLINIK IKHLAS MEDIKA 2
KLINIK IKHLAS MEDIKA 1
KLINIK WISATA MEDIKA
KLINIK RULIANDA
KLINIK CIJAWA MEDIKA
KRAKATAU MEDIKA HEALTHCARE
KLINIK MODERN MEDIKA CIKANDE

JL. K.H. SOHARI, NO.39

JL. MAULANA YUSUF, NO.17
JL.RAYA SERANG - JAKARTA (DEPAN KAMPUS UNTIRTA)
KOMPLEK BUMI AGUNG PERMAI 1,NO. DI/6
JL.RAYA ANYER NO.9
JL.RAYA WARINGIN KURUNG NO.205
Jl. KH. A. FATAH HASAN No.8
JL.A.YANI NO.114
JL. RAYA SERANG KM.68 RUKO B6 CIKANDE SERANG

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
2
1
1
1
1
1

IRIAN JAYA

SORONG
056

1452

RS. KARTINI SORONG

JL.MASJID RAYA,NO.10 SORONG

ACTIVE

ALL COVERAGE

RS. MITRA MASYARAKAT

JL. CHARITAS NO. 1 PO BOX 235, TIMIKA

ACTIVE

ALL COVERAGE

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1
1
1
1
1

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
3
1
1
2

ACTIVE
ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE
ALL COVERAGE

1
1
1

TIMIKA
057

1476

JABOTABEK

BEKASI
058
059
060
061
062
063
064
065
066

0873
0887
0891
0161
0715
0588
0036
0324
1051

APOTIK & KLINIK LEGENDA SEHAT

KLINIK MULYA MEDIKA II
RS MEDIKA GALAXI
RS. MITRA KELUARGA BEKASI TIMUR
KLINIK MUTIARA I (CITRA HUSADA I)
KLINIK MELVIANA
RS. SENTOSA
RS. GRAHA JUANDA
KLINIK & RB ANGELIKA (RB DEBORAH)

067
068
069
070
071

0010
0016
0178
0384
0735

RS. MITRA KELUARGA BEKASI BARAT

RS. KARYA MEDIKA CIBITUNG
RSIA. HERMINA BEKASI
RS. MEKAR SARI
RSU KARTIKA HUSADA
RSU.

072
073
074

0250
0188
0173

KLINIK KARYA MEDIKA I

KLINIK FAJAR MEDIKA
RS. SETO HASBADI

JL ZAMRUD UTARA BLOK U16 NO.100

JL.ZAMRUD
NO 100 KOTA LEGENDA
JL. PERUMAHAN GRAMA PURI, BLOK D1, NO.5, CIBITUNG
JL.GARDENIA RAYA SELATAN BLOK BA1 NO.11
JL.PENGASINAN RAWA SEMUT MARGAHAYU, BEKASI TIMUR
JL. SULTAN HASANUDIN, NO.14, RUKO PLAZA METROPOLITAN,TAMBUN
JL. SAPARUA RAYA NO.239 - 240 PERUMNAS III BEKASI
JL. PAHLAWAN, NO.60 DUREN JAYA, BEKASI TIMUR
JL. IR. H. JUANDA, NO.326
PERUMAHAN PONDOK TANAH MAS JL.BOSIH RAYA BLOK E15 NO.12-13
CIBITUNG
JL. JEND. A.YANI, BEKASI BARAT
JL. RAYA IMAM BONJOL, NO.9B, CIKARANG BARAT, CIBITUNG
JL. KEMAKMURAN, NO.39, MARGAJAYA
JL. MEKAR SARI, NO.1
JL MANGUN JAYA RAYA KP.RUKEM
JL.MANGUN
KP RUKEM RT.003/013,
RT 003/013 DESA MANGUN JAYA,
JAYA
TAMBUN - BEKASI
JL. IR H JUANDA NO.38 C
RUKO KAWASAN INDUSTRI MM2100, CIBITUNG
JL. RAYA SEROJA NO.19 BEKASI

No

Code

Hospital Name

Address

Status

Coverage
GP,SP,OP,DENTA
L,LAB,PHAR,RMRJ,RM-RG,RMKM,RM-RI,RM-RB
ALL COVERAGE
ALL COVERAGE
ALL COVERAGE
ALL COVERAGE
ALL COVERAGE
ALL COVERAGE
ALL COVERAGE
ALL COVERAGE
ALL COVERAGE
ALL COVERAGE
ALL COVERAGE
ALL COVERAGE
ALL COVERAGE
ALL COVERAGE

Total Active
Terminal
1

075

0147

KLINIK KARYA MEDIKA IV

JL. NAROGONG RAYA, KM.11, BANTAR GEBANG

PARTIAL

076
077
078
079
080
081
082
083
084
085
086
087
088
089

0151
0409
0063
0185
0768
0766
1417
1244
1259
1261
1277
1293
1296
1530

KLINIK MULYA MEDIKA (APOTIK MURNI)

KLINIK DHARMA MEDIKA
RS.
RS AL-MULTAZAM
AL MULTAZAM MEDIKA
RS. BHAKTI KARTINI
KLINIK & RB JATIMULYA MEDICAL CENTRE
RS. ANANDA BEKASI
KLINIK & RB RINOVA INTAN
RSIA. MASMITRA
KLINIK WIJAYA KESUMA
RS HOSANA MEDIKA BEKASI
KLINIK & RB GUCI MEDIKA
KLINIK YAKESTI BEKASI
RSB. TAMAN HARAPAN BARU
KLINIK SAPTA MITRA BEKASI

JL. RAYA JATI MULYA, NO.1, BEKASI TIMUR

JL. PEMUDA, NO.33, KRANJI
JL.RAYA
JL RAYA PERUM JATIMULYA,
JATIMULYA PENGKALAN KOASI,
KOASI K-19,
K 19 TAMBUN
JL. KARTINI, NO.11
JL.JATIMULYA RAYA NO.14 BEKASI
JL.SULTAN AGUNG NO.17, MEDAN SATRIA BEKASI
JL.RAYA SEROJA NO.101
JL. KELURAHAN JATIMAKMUR, NO.40, PONDOK GEDE
JL.NAROGONG SAKTI RAYA BLOK A 20 NO.1
JL.PRAMUKA NO.12 RAWA LUMBU
JL.PRAMUKA NO.79 RAWA LUMBU
JL.RAYA NAROGONG KM.7 NO.45 BOJONG MENTENG
JL.TAMAN HARAPAN BARU RAYA BLOK R-I NO.20,PEJUANG MEDAN
JL. KH. M.TABRANI BLOK I NO. 1 A-1B, MARGAMULIA, BEKASI UTARA

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

090
091
092
093
094
095
096
097

1532
1541
1514
1553
1486
1493
1053
0945

KLINIK SAPTA MITRA BEKASI TIMUR

RS. PERMATA BEKASI
KLINIK SUMBER WARAS
RS HERMINA GRAND WISATA
RS. GLOBAL AWAL BROS
KLINIK JATI ASIH
RS ST.ELISABETH - BEKASI
KLINIK HERANI

JL.RAYA PONDOK TIMUR, RUKO GADING MAS

JL. LEGENDA RAYA, NO. 9, MUSTIKA JAYA
JL. RAYA CIBARUSAH, KAMPUNG CIJAMBE, SUKADAMI, CIKARANG
JL. FESTIVAL BOULEVARD BLOK JA NO. I, GRAND WISATA,
JL.KH.NOER ALI KAV.17-18 KALIMALANG
JL. JATI ASIH RAYA, NO.8, PONDOK GEDE
JL.RAYA NAROGONG NO.202 KEMANG PRATAMA
JL.PERUM MUTIARA BEKASI JAYA,BLOK H4 NO.16 - SINDANG MULIA

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1
1
1
1

098
099
100
101
102
103
104
105
106

0949
0950
0974
0982
0987
0988
1120
1122
1123

KLINIK HOSANA MEDIKA III

KLINIK HOSANA MEDIKA IV
KLINIK MITRA MEDIKA
RS.BUDI LESTARI
KLINIK HARAPAN SEHAT
RS. PERMATA BUNDA BEKASI
KLINIK PURI NUSAPHALA
RSIA. JATI SAMPURNA
RS. CITRA HARAPAN

JL.TEUKU UMAR NO.19 CIBITUNG

Jl.MANGUN JAYA I BLOK A NO.6 TAMBUN-BEKASI
JL.AGUS SALIM 52F BEKASI
JL.KH.NOER ALIE, NO.2 DEPAN PERUMNAS II, KALIMALANG
JL.TEUKU UMAR NO.33 CIBITUNG
PERUM GRAMAPURI TAMANSARI C1/8-10 CIBITUNG
JL.CITRA INDAH A/14 PERUM PURI NUSAPALA JATI ASIH
JL. STUDIO ANTV KRANGGAN
JL. RAYA HARAPAN INDAH KAW.SENTRA NIAGA NO.3-5 MEDAN SATRIA

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
2
4
1
1
1

107

1205

KLINIK SADRINA MEDIKA I

ALL COVERAGE

1206

KLINIK SADRINA MEDIKA II

ACTIVE

ALL COVERAGE

109
110
111
112
113

1207
1208
1215
1216
1136

KLINIK DIPONEGORO
KLINIK Dr. ROCKY
APOTIK NAROGONG
RSB. JUWITA
KLINIK PERMATA BUNDA BEKASI

Jl. PERUM MUTIARA GADING TIMUR BLOK.A7 NO.5 Kel.MUSTIKA JAYA BEKASI TIMUR
Jl. PERUM BEKASI TIMUR REGENSI BLOK.H2 NO.12, KEL.CIMUNING,
BEKASI TIMUR
Jl. DIPONEGORO No.26 Tambun
Jl. PONDOK PEKAYON INDAH BLOK.DD38 NO.11 - BEKASI
Jl. TAMAN NAROGONG INDAH BLOK.TA NO.27 BEKASI
Jl. M. HASIBUAN NO.78 - BEKASI
JL. BOSIH RAYA RUKO KARTIKA WANASARI Blok.C1/4 CIBITUNG

ACTIVE

108

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
2

114
115
116
117

1140
1203
1204
1060

RS. RAWA LUMBU

KLINIK SEHAT SEJAHTERA I
KLINIK SEHAT SEJAHTERA II
KLINIK TAMBUN SEHAT

JL.DASA DARMA, NO.20-23, RAWA LUMBU

Jl. RAYA NUSANTARA No.2 PERUMNAS III BEKASI TIMUR
PERUM REGENSI - BEKASI TIMUR
RUKO NIAGA KALIMAS II BLOK A2 JL.INSPEKSI KALIMALANG KM.37

ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
2
1
1

118
119
120
121
122
123
124

1062
0410
0767
0620
0294
0819
0843

RS.CITRA MEDIKA
RS. BELLA BEKASI TIMUR
KLINIK MHT BEKASI
RSIA. KARYA MEDIKA II
KLINIK KARYA MEDIKA III (APOTIK MEKAR ASRI)
KLINIK & RB PERMATA BUNDA SETU
KLINIK DHARMA BHAKTI

JL.RAYA H.BOSIH NO.117 DS.WANASARI,CIBITUNG-BEKASI

JL. IR. JUANDA, NO.141
JL.H.M JOYO MARTONO NO.31B BEKASI TIMUR
JL. SULTAN HASANUDIN NO.63 TAMBUN
JL. PERJUANGAN, NO.30C, TELUK BUYUNG
PERUM GRAHA MUSTIKA MEDIA, BLOK A2, NO.15, SETU
JL.RAYA BOSIH BLOK A4 NO.23 PONDOK TANAH MAS, CIBITUNG -

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

2
2
1
1
1
1
1

125
126

0845
0847

KLINIK & RB SETIA

RSIA. ANNA

JL.RAYA SERANG - CIBARUSAH NO.41 BEKASI

JL. PEKAYON RAYA NO.36, BEKASI SELATAN

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

POLIKLINIK CIBULUH
RS FAMILY MEDICAL CENTRE BOGOR
RS PMI.
RS.
PMI BOGOR
RS. MARY CILEUNGSI HIJAU
RSIA. CITRA INSANI
RS. KARYA BHAKTI
RSIA. HERMINA BOGOR
KLINIK DR.SUSILO
KLINIK PT CORINTHIAN INDUSTRIES
KLINIK & RB CITAMA
KLINIK INSANI CIBINONG
KLINIK & RB. INSANI
KLINIK BUKIT JAYA MEDIKA
EMMA MEDICAL CENTER 1
EMMA MEDICAL CENTER 2
KLINIK & RB TRIMITRA
KLINIK MHT CIPAYUNG
KLINIK MEDISTIRA II
RS BOGOR MEDICAL CENTER
RS TRIMITRA CIBINONG
KLINIK & RB HARAPAN IBU
KLINIK ZAHRA MEDIKA
RS. AZRA
RS BINA HUSADA
RS ISLAM BOGOR
RS. MHT. CILEUNGSI

JL. KEDUNG HALANG TALANG, NO.148

JL.RAYA BOGOR KM.51 CIMANDALA-SUKARAJA
JL RAYA PAJAJARAN,
JL.
PAJAJARAN NO.80
NO 80
JL. RAYA NAROGONG, KM.21, CILEUNGSI
JL. RAYA PARUNG NO.242, LEBAKWANGI PEMAGARSARI
JL. DR. SEMERU NO.120
JL. RING ROAD-1, KAV.23,25,27, PERUM. TMN. YASMIN
Jl. GRIYA BUKIT JAYA, F1 NO. 8, GUNUNG PUTRI
Jl. MERCEDES, CISADAS, GUNUNG PUTRI
JL.BOJONG GEDE-BOGOR
JL.MAYOR OKING, NO.01/02, CIRIUNG, CIBINONG
JL.PAHLAWAN NO.73B CITEUREUP
GRIYA BUKIT JAYA RUKO FORTUNA C.I NO. 2, GUNUNG PUTRI
KOMP.VILLA NUSA INDAH II, HH2, NO.12, BOJONG KULUR, GUNUNG
JL.RAYA CICADAS, KM.9, NO.21, GUNUNG PUTRI
JL. RAYA GUNUNG PUTRI KM 117, GUNUNG PUTRI
JL RAYA PUNCAK CIPAYUNG
JL.RAYA
JL.GUNUNG PUTRI DESA CICADAS,RT31/10, GUNUNG PUTRI
JL.PAJAJARAN INDAH V/97 BOGOR
JL.RAYA CIBINONG KM.43
JL. RAYA CIKABON NO.108 PARUNG PANJANG
JL. MERCEDES, NO.97, CICADAS, GUNUNG PUTERI
JL. RAYA PAJAJARAN, NO.219
Jl. MAYOR O KING NO.101, CIBINONG - BOGOR
JL. PERDANA RAYA NO.22, BUDI AGUNG - KEDUNG BADAK
JL. RAYA NAROGONG, KM.16, LIMUS NUNGGAL, CILEUNGSI

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
3
1
1
1
2
1
1
1
2
1
2
1
1
1
1
1
1
2
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1

BOGOR
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152

0706
0835
0468
0290
0720
0067
0133
1410
1411
1419
1251
1297
1509
1524
1525
1484
0932
0986
0992
1103
1134
1166
0411
0755
0190
0389

CIKARANG
153
154
155

1404
0263
1234

KLINIK BIO MEDI CENTRE

KLINIK BINA MEDIKA
RS HOSANA MEDICA PILAR

RUKO UNION BLOK D 12-15 LIPPO CIKARANG

KP. KONGSI, CIKARANG
JL.K.H.DEWANTARA NO.33,DS KARANG ASIH,CIKARANG UTARA

ACTIVE
ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE
ALL COVERAGE

1
1
1

156
157
158
159
160
161
162

1308
1494
0916
0929
0850
0709
0960

RB. RIDHOKA SALMA

KLINIK & RB ANNISA IV
KLINIK & RB GRAHA BINA HUSADA
KLINIK RENNICHA PUTRA
KLINIK HOSANA MEDIKA II
RSIA HOSANA MEDIKA
RSB. MEKAR MULIA

JL.IMAM BONJOL NO.7 GARDU SAWAH

JL.RAYA CIBARUSAH NO.63 SERANG BARU
JL. INDUSTRI SELATAN NO.1A, BLOK NN 3A, INDUSTRI JABABEKA II
JL.RAYA CIKARANG CIBARUSAH
JL.KAWASAN INDUSTRI I, JABABEKA B8, CIKARANG UTARA
RUKO THAMRIN, BLOK C3, LIPPO CIKARANG
JL.KASUARI IV, SEKTOR MEKAR ALAM,PASIMAL - CIKARANG BARU

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1
6
1

163
164
165
166

0967
1119
1218
1064

CITRA ARDHITA MEDIFARMA

KLINIK SAPTA MITRA CIKARANG
KLINIK CIKARANG MEDIKA JAYA
KLINIK & RB HOSANA MEDIKA CIBARUSAH

ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1

167
168
169
170

1067
0155
0306
1034

RS. MEDIROSSA
KLINIK KARYA MEDIKA V
RS. ANNISA CIKARANG
KLINIK HARAPAN SEHAT II

ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
4
1

171

1041

RS HARAPAN INTERNASIONAL

CAPITOL BUSINESS PARK, BLOK B2, JL. NIAGA RAYA

JL.RAYA CIKARANG - CIBARUSAH, NO.39A, SUKARESMI
Jl. YOS SUDARSO NO.27 CIKARANG
JL.RAYA SERANG-CIBARUSAH KP.BUNISARI RT.07/04 DS.SUKARAGAM
SERANG BARU
JL.INDUSTRI TEGAL GEDE - CIKARANG SELATAN
RUKO HARKO
HARKO, JABABEKA
JABABEKA, CIKARANG
JL. CIKARANG BARU, NO.31, LEMAHABANG
RUKO TELAGA HARAPAN BLOK F NO.16, PERUMAHAN TELAGA HARAPAN,
CIKARANG BARAT
JL.KASUARI RAYA KAV.1A-1B

ACTIVE

ALL COVERAGE

No

Code

Hospital Name

Address

Status

Coverage

Total Active
Terminal

172
173
174
175
176
177
178

1050
0275
0385
0391
0406
0738
0407

RSIA. AMANDA
RS. MEDIKA CIKARANG
RS. BHAKTI HUSADA
SILOAM HOSPITALS LIPPO CIKARANG
KLINIK ANNISA II (CIKARANG)
RSIA AMANDA
KLINIK ANNISA III (CIKARANG)

JL.RAYA INDUSTRI NO.36,CIKARANG UTARA

JL. RAYA INDUSTRI PASIR GOMBONG JABABEKA, CIKARANG
JL. RE. MARTADINATA
JL. MH. THAMRIN, KAV.105, LIPPO CIKARANG
JL.CIBARUSAH RUKO POIN, NO.31 R
JL.RAYA SERANG NO.38 CIKARANG SELATAN
JL.
JL RAYA CIBARUSAH - RUKO CENTRAL CIKARANG,
CIKARANG BLOK A5,
A5 CIKARANG

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1
3
1

179

1231

RB.KARTIKA HUSADA

JL.UTAMA BII NO.1 CIBARUSAH SERANG RT07/01 DESA RESMI

KEC.CIKARANG SELATAN

ACTIVE

ALL COVERAGE

DEPOK
180
181
182
183
184
185
186
187
188
189

1094
1098
1485
0983
1194
1056
0470
0778
0776
0107

KLINIK KARDIOVASKULAR HOSPITAL CINERE

RSIA GRAHA PERMATA IBU
RS. MITRA KELUARGA DEPOK
KLINIK ABADI JAYA
RSIA HASANAH GRAHA AFIAH
RS BUNDA MARGONDA
RS. SENTRA MEDIKA
KLINIK DEPOK 2000
HOSPITAL CINERE
RS SIMPANGAN DEPOK

JL.MARIBAYA NO.1 PURI CINERE

JL.KH.M.USMAN 168,KUKUSAN BEJI - DEPOK
JL. MARGONDA RAYA, PANCORAN MAS - DEPOK
JL.KEADILAN NO.4 BLOK.II DEPOK TIMUR
JL. RADEN SALEH NO.42 DEPOK
JL.MARGONDA RAYA NO.28 PONDOK CINA-DEPOK 16424
JL. RAYA BOGOR KM.33 CISALAK - DEPOK
JL. MARGONDA RAYA, NO.45, PESONA ESTATE, BLOK A-1
JL. MARIBAYA BLOK F2, NO.10, PURI CINERE - DEPOK
JL. RAYA BOGOR, KM.36, SIDAMUKTI SUKMAJAYA, CIMANGGIS - DEPOK

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1
1
1
1
1
1

190
191
192
193
194
195

1007
0009
0346
0777
0265
0279

RS HARAPAN DEPOK
RSU. BHAKTI YUDHA
RS. TUGU IBU
RSIA TUMBUH KEMBANG
RSIA. HERMINA DEPOK
KLINIK ANNIE NENTO

JL.PEMUDA NO.10
JL. RAYA SAWANGAN-DEPOK
JL. RAYA BOGOR, KM29, CIMANGGIS-DEPOK
JL. RAYA BOGOR, KM.31, NO.23, CIMANGGIS
JL. RAYA SILIWANGI, NO.50, PANCORAN DEPOK
PERUMAHAN LEMBAH HIJAU GOBEL, BLOK C6, NO.1A, MEKARSARI,
CIMANGGIS

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1
1

JL. PETA SELATAN, NO.50

HOTEL MENARA PANINSULA JL.LETJEN S PARMAN KAV.78 LT.7
JL.PURI INDAH RAYA BLOK S2, KEMBANGAN SELATAN
JL.KAMAL RAYA BLOK A7 NO.7-11 TEGAL ALUR
JL. TUBAGUS ANGKE NO.27. TAMAN DUTA MAS BLOK D-9B NO.2-3
JL. RAYA PERJUANGAN, KAV.8, KEBUN JERUK
JL.DAAN MOGOT NO.34 GROGOL
JL.AIP II K.S. TUBUN, NO.92-94
BUMI CENGKARENG INDAH, CENGKARENG TIMUR
JL. KINTAMANI RAYA, NO.2, KAW. DAAN MOGOT BARU
PERUM.TAMAN SURYA III BLOK F/63 CENGKARENG
JL.RAYA KEDOYA NO.2 KEBON JERUK
JL. RAYA KEBAYORAN LAMA, NO.64,
JL. AIPDA K.S.TUBUN, NO.79
JL. DAAN MOGOT, KM.17
JL.TANJUNG DUREN RAYA NO.2
JL. JEND S.PARMAN, KAV.87, SLIPI
JL.CENDRAWASIH NO.1 KOMP DEPHAN/MABES TNI
JL. PETA SELATAN RAYA-KALIDERES INDAH I BLOK A NO.12
JL.RAYA PERJUANGAN, KEBUN JERUK
JL.RAYA MANGGA BESAR 137-139

ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
PARTIAL RM-RJ,RM-RG,RM-K
ACTIVE
ALL COVERAGE

1
1
1
1
1
1
1
1
1
1
1
1
2
1
1
1
1
1
1
1
1

JAKARTA BARAT
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216

0695
0931
1479
0771
0782
0101
0836
0018
0736
0390
1127
1256
0204
1102
0381
0956
0109
0952
0783
0752
1054

KLINIK KUSUMA I
KLINIK HOTEL MENARA PENINSULA
RS PURI INDAH
KLINIK YADIKA TEGAL ALUR
KLINIK MHT ANGKE
SILOAM HOSPITALS KEBUN JERUK
RS ROYAL TARUMA
RS. PELNI PETAMBURAN
RSUD. CENGKARENG
RSIA. HERMINA DAAN MOGOT
JESSLYN MEDICAL CENTER
RS. PURI MANDIRI KEDOYA
RS. MEDIKA PERMATA HIJAU
RS BHAKTI MULIA
RS. MHT CENGKARENG
KLINIK TOMANG
RSAB. HARAPAN KITA
RS PATRIA IKKT
KLINIK MHT KALIDERES
IN-HOUSE CLINIC RCTI
RS HUSADA

JAKARTA PUSAT
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240

0788
0953
0970
1115
1121
1197
1066
1069
1078
0790
0600
0397
1477
1544
1495
1358
1250
1406
1405
0787
0029
0398
0789
0793

RSPAD GATOT SUBROTO (PAV.KARTIKA)

RS ISLAM JAKARTA (CEMPAKA PUTIH)
RSAL DR MINTOHARDJO
RSPAD GATOT SUBROTO (PAV.IKA)
RS. BEDAH THT PANTI RAHARJA (YPR Hospital)
RSPAD GATOT SUBROTO (Non. Pav)
SEMANGGI SPECIALIST CLINIC
RSPAD GATOT SUBROTO(P.IMAM SUJUDI)
RSB BUDI KEMULIAAN
RSIA. BUNDA JAKARTA
RS. ST. CAROLUS
KLINIK BARUNA
BUNDA INTERNASIONAL CLINIC
KLINIK HOTEL SARI PAN PACIFIC
KLINIK KIMIA FARMA (INDOSAT)
RB. YPK (YAYASAN PEMERIKSAAN KESEHATAN)
CITRA HEALTH CARE CLINIC
APOTIK FARMARIN I
KLINIK YKK BI KEBON SIRIH
RS. KHUSUS THT-BEDAH PROKLAMASI
RSIA. EVASARI
RS. MH. THAMRIN INTERNASIONAL
KLINIK MHT SERDANG
KLINIK YES CARE

JL. ABDUL RACHMAN SALEH NO.24

JL.CEMPAKA PUTIH TENGAH I/1
JL.BENDUNGAN HILIR NO.17
JL.ABDUL RACHMAN SALEH NO.24
JL. SAWO NO.56-60
Jl. ABDUL RACHMAN SALEH NO.24
PLAZA SEMANGGI LT7, JL JEND SUDIRMAN KAV 50
JL.ABDUL RAHMAN SALEH NO.24
JL.BUDI KEMULIAAN NO.25
JL. TEUKU CIK DITIRO NO.28, MENTENG
JL. SALEMBA RAYA, NO.41
JL. CIKINI RAYA, NO.60 R/S
JL.TEUKU CIK DITIRO NO.12, MENTENG
HOTEL SARI PAN PACIFIC, LT.1, JL.MH.THAMRIN
GD.INDOSAT, LT.23, JL.MEDAN MERDEKA BARAT, NO.21,
JL.GEREJA THERESIA 22
MENARA KEBON SIRIH PODIUM I KAV 17-19
GEDUNG BI, JL.KEBON SIRIH KAV 82-84
JL.KEBON SIRIH NO.94
JL. PROKLAMASI NO.43
JL. RAWAMANGUN NO.47
JL. SALEMBA TENGAH, NO.26-28
JL. H. UNG E - 71/2 KEMAYORAN
PLAZA KEBON SIRIH PODIUM I P1- P13B Jl.KEBON SIRIH Kav.17-19

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

3
1
1
1
1
1
1
1
1
1
3
2
1
1
1
1
1
2
2
1
1
1
1
1

241
242
243
244
245
246
247
248
249

0135
0013
0042
0180
0084
1026
0599
0998
1019

RS. ABDI WALUYO

RS PGI.
RS.
PGI CIKINI
RS. PERTAMINA JAYA
RSU. MENTENG MITRA AFIA
RS. JAKARTA
RSIA TAMBAK
RS. KRAMAT 128
APOTIK MALINA
RSPAD GATOT SUBROTO (P.DARMAWAN)

JL. H.O.S. COKROAMINOTO, NO.31-33

JL RADEN SALEH,
JL.
SALEH NO.40
NO 40
JL. A. YANI NO.2
JL. KALI PASIR, NO.9
JL. JEND. SUDIRMAN, KAV.49
JL.TAMBAK,NO.18 MANGGARAI
JL. KRAMAT RAYA, NO.128
Jl.BENDUNGAN HILIR RAYA No.1A
JL. ABDUL RACHMAN SALEH NO.24

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1
1
1
1
1

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1
1
1
1
2
1
1
1
1
1
1

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL

1
1
1
1
1

JAKARTA SELATAN
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264

0593
0999
0112
0193
0110
0001
0034
0041
0043
0801
0795
0401
0198
0597
0199

RS. SETIA MITRA

RSIA MUHAMMADIYAH TAMAN PURING
SUDIRMAN MEDICAL CENTER
RSIA. BUDHI JAYA
RS. TRIA DIPA
KLINIK FOUR SEASONS HOTEL
ADITYA MEDICAL CENTER
RS. AGUNG
RS. JAKARTA MEDICAL CENTER
KLINIK MEDICAL CARE
RS. PUSAT PERTAMINA
APOTIK-KLINIK SPESIALIS-RSB ESTI
APOTIK SATRIO
KLINIK JMC DHARMA BHAKTI
MEDICARE CLINIC

265
266

0797
1402

RS. MEDISTRA
KLINIK RITZ CARLTON PASIFIC PLACE

JL. RS. FATMAWATI, NO.80-82

JL.GANDARIA I NO.20 KEBAYORAN BARU
JL. JEND. SUDIRMAN, KAV.25
JL. DR. SAHARJO, NO.120
JL.RAYA PASAR MINGGU, NO.3A, PANCORAN
FOUR SEASONS HOTEL,
HOTEL JL.
JL SETIABUDI,
SETIABUDI KUNINGAN
JL. ADITYAWARMAN I, NO.14, KEBAYORAN BARU
JL. SULTAN AGUNG, NO.67, PASAR RUMPUT
JL. BUNCIT RAYA, NO.15
GD.BEJ TOWER 1- LL TOWER JL.JEND.SUDIRMAN KAV.52-53
JL. KYAI MAJA 43, KEBAYORAN BARU
JL. BANGKA RAYA, NO.28-30, PELA MAMPANG
JL. PROF. DR. SATRIO, NO.21E
JL. CILANDAK KKO RAYA NO.45
MENARA KADIN INDONESIA, 27TH FLOOR, JL. H.R. RASUNA SAID, BLOK
X-5, KAV.2-3
JL. GATOT SUBROTO KAV.49
KAWASAN NIAGA TERPADU SUDIRMAN. JL.JEND.SUDIRMAN KAV.52-53

267
268
269
270
271

1408
1412
1546
1554
1461

KLINIK YKK BI RASAMALA

APOTIK FARMARIN III
KLINIK NDH
H2E DENTAL CLINIC
ALL CARE DENTAL CENTRE

WISMA PPBI,JL.RASAMALA RAYA NO.2

Jl GATOT SOEBROTO KAV.
Jl.
KAV 71 - 73 JAKARTA
JL.RADIO DALAM RAYA, NO.54A
JL. HR. RASUNA SAID BLOCK X-7 LT1. UNIT I, KUNINGAN
PLAZA 5 BLOK B NO.15 JL.MARGAGUNA PONDOK INDAH

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

No

Code

Hospital Name

Address

Status

Coverage

Total Active
Terminal

272
273
274
275
276

1488
0923
1111
1112
1076

RS. ASRI
PERTAMEDIKA MEDICAL CENTRE
KLINIK RITZ CARLTON HOTEL JAKARTA
KLINIK J.W MARRIOT HOTEL JAKARTA
KLINIK YADIKA PETUKANGAN

JL.DUREN TIGA RAYA, NO.20

JL. PAKUBUWONO, NO. 1
JL.LINGKAR MEGA KUNINGAN KAV.E.1.1 NO.1 MEGA KUNINGAN
JL.MEGA KUNINGAN KAV.E.1.2 NO1&2 MEGA KUNINGAN
JL.DAMAI RAYA NO.1 PETUKANGAN SELATAN - JAKARTA SELATAN

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1

277
278
279
280
281
282
283

1083
1089
0799
0804
0800
0794
0758

RS. MATA AINI

RS KHUSUS THT & BEDAH CIRANJANG
RS. GANDARIA
KLINIK HOTEL DHARMAWANGSA
KLINIK TRIAZ PERSADA
RS. SIAGA RAYA
DE BLITZR DENTAL CARE

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
3
1
1
1
1

284
285
286
287
288
289
290
291
292
293
294
295
296

0049
0003
0842
0853
0854
0857
0860
0879
0892
0911
0395
0400
0674

RS. PONDOK INDAH

RS. TEBET
BRAWIJAYA WOMEN & CHILDREN HOSPITAL
KLINIK & RB. PRIMA HUSADA CINERE
RSIA ZAHIRAH
TIRTA MEDICAL CENTER
KLINIK SENAYAN CITY
RSIA YADIKA CIPUTAT
KLINIK FAMILY DENTISTRY
KLINIK MEDIKA PLAZA
RS. PRIKASIH
MEDIKALOKA HEALTHCARE CENTER
NUSANTARA STROKE & MEDICAL CENTER

JL.H.R.RASUNA SAID (KUNINGAN) JAKARTA 12920

JL.CIRANJANG
JL
CIRANJANG NO.20-22
NO 20 22 KEB.BARU
KEB BARU
JL. GANDARIA TENGAH II, NO.12-14, KEBAYORAN BARU
JL.BRAWIJAYA RAYA NO.26, KEBAYORAN BARU
GRAHA NIAGA TOWER LT.B1, JL. JEND. SUDIRMAN NO.58
JL. PEJATEN BARAT KAV.4-8, PASAR MINGGU
BELLEZZA SHOPPING ARCADE UNIT 230-231ARTERI PERMATA
HIJAU,JL.LETJEND SOEPENO NO.34
JL. METRO DUTA, KAV. UE, PONDOK INDAH
JL. M.T. HARYONO, NO.8, PANCORAN
JL. TAMAN BRAWIJAYA NO.1 CIPETE UTARA
JL.CINERE RAYA BLOK F1 NO.1 CINERE JAKSEL
JL.SIRSAK NO.21, JAGAKARSA
BELLAGIO MALL O UG 17-20,KAWASAN MEGA KUNINGAN BARAT,KAV.E
JL.ASIA AFRIKA LOT 19
JL CIPUTAT RAYA,
RAYA NO.5,
NO 5 KEBAYORAN LAMA
JL.
JL.PANGLIMA POLIM II/2
KARTIKA CHANDRA HOTEL, JL.JEND GATOT SOEBROTO KAV 18-20
JL. RS.FATMAWATI, NO.74, PONDOK LABU - CILANDAK
JL. HR. RASUNA SAID, BI X-1, KUNINGAN
GRANADI BUILDING, 3RD FLOOR, JL. HR. RASUNA SAID, BLOCK X-1,

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1
1
1
1
1
1
1
2
1

JAKARTA TIMUR
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332

0012
0289
0122
0102
0024
0060
0382
0032
0258
0292
0286
0806
0805
0807
0779
0744
0652
0749
0826
0888
0386
1001
1012
0099
0944
0948
0962
0990
1212
1139
1192
1080
1085
1090
1096
1425

RS. MITRA INTERNASIONAL

RS. OMNI MEDICAL CENTER
RS. MEDIROS
RS ISLAM JAKARTA TIMUR (PONDOK KOPI)
KLINIK PRIMA HUSADA CIBUBUR
RS. HARAPAN BUNDA
RS. MHT PONDOK GEDE
RB BUNDA AUNI
KLINIK DEVITA
KLINIK PONDOK GEDE AGUNG
RS. KARTIKA PULO MAS
RS. HAJI
RS. FK-UKI
KLINIK MHT TEGALAN
RUSPAU DR.ESNAWAN ANTARIKSA
IN-HOUSE CLINIC TPI
RB & KLINIK AL - FAUZAN
RS HARUM
KLINIK SEJAHTERA CIRACAS
RS YADIKA PONDOK BAMBU
RSIA. HERMINA JATINEGARA
RS DHARMA NUGRAHA
KLINIK & RB IBIN SINA
RS. HARAPAN JAYAKARTA
RS POLRI
KLINIK SAPTA MITRA
KLINIK CONDET JAYA
RS. JANTUNG BINA WALUYA CARDIAC CENTER
KLINIK BINA HUSADA BHAKTI
KLINIK TJAKRA
KLINIK & APOTEK PUTEWA
RS KESDAM CIJANTUNG
RS MEILIA
RSIA PERMATA CIBUBUR
KLINIK YADIKA CIBUBUR
APOTEK HALIM FARMA

JL. RAYA JATINEGARA TIMUR, NO.85-87

JL. PULO MAS BARAT VI, NO.20
JL. PERINTIS KEMERDEKAAN, KAV.149
JL. RAYA PONDOK KOPI
JL. LAP. TEMBAK, NO.2A, CIBUBUR
JL. RAYA BOGOR, KM22, NO.44
JL. RAYA PONDOK GEDE,, NO. 23-25,, KRAMAT JATI
VILLA NUSA INDAH, BLOK D5, NO.19
JL. JATINEGARA TIMUR NO.57 JATINEGARA
JL. RAYA HANKAM, NO.58C-D, PONDOK GEDE
JL. PULO MAS TIMUR K BLOK G-H-C/1
JL. RAYA PONDOK GEDE
JL. MAYJEN SOETOYO, CAWANG
JL. TEGALAN NO. 30
JL.MERPATI NO.2 LANUD HALIM PERDANAKUSUMA
JL. PINTU II, TAMAN MINI, LUBANG BUAYA - PONDOK GEDE
JL. RAYA CONDET NO.13, BALEKAMBANG CONDET
JL.TARUM BARAT, KALIMALANG JAKTIM
JL.RAYA CIRACAS NO.7
JL. PAHLAWAN REVOLUSI NO.47 PONDOK BAMBU - JAKARTA TIMUR
JL. RAYA JATINEGARA BARAT,, NO.126
JL.BALAI PUSTAKA BARU NO.19 RAWAMANGUN
JL.PENDIDIKAN RAYA NO.33 DUREN SAWIT
JL. BEKASI TIMUR RAYA, NO.6 KM.18, PULO GADUNG
JL.RAYA KRAMAT JATI
JL.PONDOK KELAPA RAYA BLOK C4 NO.2E MALAKA JAYA - DUREN SAWIT
JL.CONDET JAYA NO.18 BATU AMPAR
JL.TB SIMATUPANG NO.71
JL. PENGGILINGAN RAYA NO.1 Rt.01/07 CAKUNG
Jl. RAYA BOGOR, KM.24, NO.35, SUSUKAN CIRACAS
JL.NUSA INDAH RAYA BLOK 40 NO.17H
JL.MAHONI NO.2 CIJANGTUNG
JL.ALTERNATIF CIBUBUR KM.1
JL ALTERNATIF CIBUBUR NO.6A CILUENGSI
JL.LAPANGAN TEMBAK NO.9 PEKAYON
PEKAYON-CIBUBUR
CIBUBUR
JL.RAYA KOMODOR NO.47 KEBUN PALA, KOMP HALIM PERDANA KUSUMA

ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
PARTIAL RJ,RM-RG,RM-KM,R
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE
ACTIVE
ALL COVERAGE

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
5
1
1
2
1
1
1
1
1
1
1

333
334
335
336
337
338

1258
1257
1262
1501
1473
1490

KLINIK SUCI HUSADA

KLINIK SPESIALIS MEDIKA
RS.RAWAMANGUN
KLINIK & RB PULO GEBANG
BKM CAROLUS & RB ST. ANNA
RSIA. BUNDA ALIYAH

JL.SUCI NO.21 RT.08/06 SUSUKAN - CIRACAS

JL. BATU AMPAR III, NO.5, CONDET
JL. BALAI PUSTAKA RAYA, NO.29-31
JL. RAYA PULO GEBANG NO. 41, CAKUNG
JL.RAYA BOGOR KM.24,6 CIJANTUNG
JL.PAHLAWAN REVOLUSI NO.100 PONDOK BAMBU

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

2
2
1
1
1
1

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
C
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
CO
COVERAGE
G
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1
1
1
1
1
1
1

ACTIVE
ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE
ALL COVERAGE

1
1
1

JAKARTA UTARA
339
340
341
342
343
3
344
345
346
347
348
349

0812
0186
1416
1422
1263
0 8
0587
1033
0811
0170
0011
0876

RS. ATMA JAYA

RS. MITRA KELUARGA KELAPA GADING
KLINIK DELAROSA
ROYAL PROGRESS INT HOSPITAL
KLINIK SEMPER SISMA MEDIKA
RS.
S SATYA
S
NEGARA
G
(SUNTER
(S
AGUNG)
G G)
RS. PORT MEDICAL CENTER
RS. SUKMUL
RS. PLUIT
RS. MITRA KELUARGA KEMAYORAN
RSIA. FAMILY

350
351
352

0882
0910
0392

RS ISLAM JAKARTA UTARA

KLINIK GADING UTAMA
RSIA. HERMINA PODOMORO

JL. PLUIT RAYA NO.2

JL. BUKIT GADING RAYA KAV.2 KELAPA GADING PERMAI
APARTEMEN GADING RESORT RESIDENCES CLUB HOUSE LT.1
JL.DANAU SUNTER UTARA, SUNTER PARADISE I
JL. KESEMEK, NO.3-5, SEMPER BARAT, CILINCING
JL. AGUNG
G G UTARA RAYA, BLOK
O A, NO.1
O
JL. ENGGANO NO.10 TANJUNG PRIOK
JL. TAWES NO.18 - 20, TANJUNG PRIOK
JL. RAYA PLUIT SELATAN, NO. 2
JL. LANDAS PACU TIMUR, KEMAYORAN
JL. PLUIT MAS I BLOK A NO.2A-5A, KOMPLEK PERUMAHAN PLUIT MAS,
JAKARTA UTARA
Jl.TIPAR CAKUNG NO.5 JAKARTA UTARA
JL.KELAPA GADING BOULEVARD CN 2/25
JL. DANAU AGUNG 2, BLOK E3, NO.28-30, SUNTER AGUNG, PODOMORO

353

0748

RS GADING PLUIT

JL.BOULEVARD TIMUR RAYA, KELAPA GADING. JAKARTA UTARA

ACTIVE

ALL COVERAGE

SERPONG
354

0610

RSIA. PUTRA DALIMA

GRIYA LOKA, SEKTOR 1.2, BLOK UA/26-27, BUMI SERPONG DAMAI

ACTIVE

ALL COVERAGE

355
356

1552
1049

BUNDA DALIMA HOSPITAL

KLINIK SELARAS

BUMI SERPONG DAMAI, SEKTOR XIV, BLOK J11, NO.1

JL.RAYA SERPONG BSD SEKTOR IV,RUKO E.NO.43-45 SERPONG-

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

357
358
359

1223
0064
0733

EKA HOSPITAL
KLINIK SPESIALIS DR. DIANA
OMNI INTERNASIONAL HOSPITAL

CENTRAL BUSINESS DISTRICT, LOT IX, BSD CITY

JL. MH. THAMRIN, NO.87C
JL.ALAM SUTERA BOULEVARD KAV.25 SERPONG - TANGERANG

ACTIVE
ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE
ALL COVERAGE

1
1
1

TANGERANG
360
361
362
363
364
365
366
367

0412
0702
0007
0017
0021
0337
0571
0062

RS. INTERNASIONAL BINTARO

KLINIK MAHARANI
RS UIN SYARIF HIDAYATULLAH
RS. AN-NISA TANGERANG
SILOAM HOSPITALS LIPPO KARAWACI
RS. BHINEKA BAKTI HUSADA
KLINIK & RB METTA MEDIKA
KLINIK SARANA MEDIKA BARU

JL. MH THAMRIN NO.1, SEKTOR 7, BINTARO JAYA

JL. PRAMBANAN RAYA NO. 31 PERUMNAS II
JL. IR. H. JUANDA, NO.95, CIPUTAT
JL. GATOT SOEBROTO, NO.96, KM.3, CIBODAS
JL. SILOAM NO.6, LIPPO KARAWACI
JL. CABE RAYA NO.17 PONDOK CABE PAMULANG
JL.LIO BARU NO.1 BATUJAYA , BATU CEPER
JL. RAYA PERUMAHAN KOTA BUMI KP.TERITI DS.KARET.SEPATAN

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1
1
1
1

368
369

0291
1455

RS ICHSAN MEDICAL CENTER (IMC)

KLINIK PRADHANA

JL. RAYA JOMBANG NO.56 BINTARO SEKTOR IX, TANGERANG

RUKO PANORAMA NIAGA NO.14-15 JURUMUDI BARU BENDA

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

No

Code

Hospital Name

Address

Status

Coverage

Total Active
Terminal

370

1459

KLINIK KARUNIA SEHAT II

JL.PAHLAWAN SERIBU RAYA RUKO TOL BOULEVARD BLOK B NO.18.BSD

ACTIVE

ALL COVERAGE

371
372
373
374
375
376
377
378
379
380
381
382
383
384

1467
1480
1487
1491
1077
1081
1086
1426
1322
1496
1531
1527
1528
1547

RS. MUTIARA BUNDA

KLINIK BONA SARANA MEDIKA
RS. MULYA
RS.HERMINA TANGERANG
KLINIK CITRA SEHAT TIGARAKSA
KLINIK&RB KELUARGA SEHAT
RSIA SARI ASIH SANGIANG
APOTEK BANDARA SOEKARNO-HATTA
RB. KARUNIA BUNDA
MEDIPRO CLINIC CIMONE
KLINIK SAPTA MITRA TANGERANG
RSIA.TIARA
KLINIK & RB.ILANUR
KLINIK AMIRA

JL.DR.CIPTO MANGUNKUSUMO, NO.3, CILEDUG

JL.MH. THAMRIN NO.43 KEBON NANAS - CIKOKOL
JL.KH.HASYIM ASHARI NO.18 SUDIMARA PINANG
JL.KS.TUBUN, NO.10, PASAR BARU
JL.ARYA WANGSA KARYA NO.168-169 KEC.TIGARAKSA - TANGERANG
VILLA REGENSI II BLOK.AD
BLOK AD NO.1-2
NO 1 2 PASAR KEMIS
JL.RAYA MAUK.KM.3,5 SIMPANG TIGA SANGIANG
JL.TERMINAL 2 D BANDAR SOEKARNO-HATTA
JL.ARIA SANTIKA NO.28 KEL.MARGASARI
Jl.Raya Merdeka No.325 -326 Ruko Kayamas II Cimone
JL.PANDAN RAYA, NO.21, PERUMNAS 1
JL.RAYA SERANG, NO.1, KM.4.5, CIKUPA
JL.RAYA SERANG, NO.1, BALARAJA
RUKO GOLDEN MADRID II, BLOK G06, NO.8, JL.LETJEND.SOETOPO, BSD

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1
1
1
1
1
1
1
1
1
1

385
386
387
388

1014
1020
1025
0572

RB PERMATA (DR JAMILAH)

RSIA SELARAS CIKUPA
RS. ARIYA MEDIKA
KLINIK KUTA JAYA

JL.NUSA INDAH I, BLOK A7 NO.1, PERUM. CIBODAS

JL.RAYA SERANG KM.18,5 DS BOJONG, CIKUPA
JL.INDUSTRI RAYA 1, BLOK A, NO.1-6, JATAKE
JL.RAYA PASAR KEMIS, RUKO BONA SUBUR REGENSI, BLOK A, NO.9

ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1

389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408

0737
0878
0936
0942
0955
0971
0981
1113
1116
1168
0344
0696
0750
0285
0108
0091
0022
0844
0851
0859

RS USADA INSANI
KLINIK DR. HARYOKO
RS SARI ASIH CILEDUG
RB MURNI ASIH
DENTAL INTERNASIONAL BINTARO
RS ISLAM ASSHOBIRIN
KLINIK CITRA SEHAT
MEDIPRO CLINIC
RS GLOBAL MEDIKA
RSU. BHAKTI ASIH
RS. QADR
KLINIK KARYA MEDICA
KLINIK & RB MEDIKA SILIWANGI
RSIA. MELATI
KLINIK PROVITA
MAYAPADA HOSPITAL (d/h RS.HONORIS)
RS. SARI ASIH KARAWACI
RSIA BUNDA SEJATI
RB MULYA RAHAYU
RS AMINAH

JL.KH HASYIM ASHARI NO.24 TANGERANG

JL. M. TOHA NO.18, PARUNG PANJANG
JL.HOS COKROAMINOTO NO.38 CILEDUG
JL.RAYA BOJONGNANGKA LEGOK
Jl. MH TAHAMRIN NO1, SEKTOR 7, BINTARO JAYA
JL.RAYA SERPONG KM.11 PONDOK JAGUNG
RUKO CITRA RAYA BLOK G1 NO.17R, CIKUPA
RUKO CITRA RAYA BLOK.L NO.7 R CIKUPA
JL.MH.THAMRIN NO.3 KEBON NANAS -CIKOKOL
JL.RADEN SALEH, NO.10, KARANG TENGAH
KOMPLEK ISLAMIC VILLAGE, KELAPA DUA
JL. KARET RAYA, BLOK 7/69, PERUMNAS TANGERANG
JL.SILIWANGI BLOK D - 2 NO.2 PAMULANG TANGERANG
JL. MERDEKA NO.92 TANGERANG
JL. IR.H.JUANDA NO.125 CIPUTAT
JL. HONORIS RAYA, KAV.6, KOTA MODERN/KODYA DATI II
JL. IMAM BONJOL, NO.38
JL.PRABU SILIWANGI NO.11, JATIUWUNG
JL.RAYA PLP CURUG -TANGERANG
Jl.HOS COKROAMINOTO (CILEDUG RAYA) NO.4A KREO SELATAN-

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

409
410
411
412

0872
0902
0907
0912

RB & KLINIK MUTIARA OBBINI MEDIKA

KLINIK & RB BUNDA MULIA (H UPEN)
KLINIK KARUNA MEDIKA
KLINIK KARUNIA SEHAT

JL.RAYA KRESEK NO.27, DS.MERAK, BALARAJA

JL. SUMANTRI NO. 11 MEKAR MULYA PARUNG PANJANG
JL. IMAM BONJOL KAV.19-20
RUKO CIKUPA BLOK B NO.21-23, DEPAN PERUM CITRA RAYA- CIKUPA

ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
2

413

0308

PAMULANG MEDICAL CENTER

JL. RAYA PAMULANG BLOK D II/2, PAMULANG

ACTIVE

ALL COVERAGE

JAWA BARAT

BANDUNG
414
415
416
417
418
419
420
421
422
423
424
425
426
427

0303
1087
0144
0268
0145
0880
0044
1171
1169
1125
1211
0959
0958
1088

RS. ADVENT BANDUNG

RS BUNGSU
RS. IMMANUEL BANDUNG
RS. MITRA KASIH
RS. MUHAMMADIYAH BANDUNG
RS AL ISLAM BANDUNG
RSIA. HERMINA PASTEUR
SANTOSA BANDUNG INTERNASIONAL HOSPITAL
RS. AMC (Annisa Medical Center)
RS. CAHYA KAWALUYAN
KLINIK ASRI HUSADA II
KLINIK ASRI HUSADA I
KLINIK AN-NUR
RS RAJAWALI

JL. CIHAMPELAS, NO.161

JL.VETERAN, NO.6
JL. KOPPO, NO.161
JL. RAYA CIBABAT NO. 341. CIMAHI
JL. KH. AHMAD DAHLAN NO.53
Jl.SOEKARNO-HATTA No.644
JL. DR. DJUNDJUNAN, NO.107, PASTEUR
Jl. KEBONJATI, NO.38
JL.RAYA CILEUNYI RANCAEKEK
JL. PARAHYANGAN KM.3 KAV.HOS PADALARANG
JL. TITIRAN NO.16
JL.BEKAMIN NO.18
JL.DR SETIA BUDI NO.63
JL.RAJAWALI NO.38

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1
1
1
1
1
1
2
2
1
1

RS. PERMATA BUNDA CIAMIS

JL.MR.IWA KUSUMASOMANTRI NO.1

ACTIVE

ALL COVERAGE

RSUD CIANJUR

JL.RUMAH SAKIT NO.1 CIANJUR

ACTIVE

ALL COVERAGE

JL. STASIUN, NO.93

JL.IR.H.JUANDA NO.14
JL. PAWARENGAN NO. 37, DESA DAWUAN TIMUR
JL. ACHMAD YANI NO. 51
JL.RAYA JATISARI NO.3 PASAR JATISARI
JL. AHMAD YANI NO.100, DAWUAN BARAT
JL.IR.H.JUANDA NO.17
JL. JEND. SUDIRMAN No. 10 DESA SARIMULYA, KEC. KOTABARU

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
2
4
1
1
1

CIAMIS
428

1104

CIANJUR
429

0852

CIKAMPEK
AQMA CIKAMPEK
PUTRA MEDIKA
SEHAT
KELUARGA GRAHA MEDIS
PURI ASIH JATISARI
BAKTI MEDIKA
ANDINA CIKAMPEK
24 JAM & RB. FATIMA AZZAHRA

430
431
432
433
434
435
436
437

0093
1172
1497
0908
1409
1423
1300
1301

KLINIK
KLINIK
KLINIK
KLINIK
KLINIK
KLINIK
KLINIK
KLINIK

438
439
440
441

0540
0375
1516
1302

RS. SARASWATI
RS. KARYA HUSADA
KLINIK MADANIA
KLINIK PURI ASIH CIKAMPEK

JL. JEND. A.YANI, NO.92, DAWUAN, CIKAMPEK-KARAWANG

JL. JEND. A.YANI, NO.98, CIKAMPEK-KARAWANG
JL. JEND.A.YANI, NO.12, DAUWAN BARAT
JL.STASIUN NO.2 CIKAMPEK KOTA

ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1

RS. PELABUHAN CIREBON

RS PUTERA BAHAGIA
KLINIK SATELIT (RS.PERTAMINA KLAYAN
APOTIK GARUDA
RSIA. SUMBER KASIH
RS. PERTAMINA KLAYAN

JL. SISINGAMANGARAJA, NO.45

JL.CIREMAI RAYANO.114 ,PERUMNAS
JL.TUPAREV, NO.51A
JL.SILIWANGI, NO.5
JL.SILIWANGI NO.135
JL. PATRA RAYA, KLAYAN

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1
2

CIREBON
442
443
444
445
446
447

0293
1091
1095
1436
1174
0602

KARAWANG
448
449
450
451
452
453
454
455
456
457
458
459

0690
0691
0200
1418
1239
1310
1311
1314
1500
1510
1543
1006

KLINIK YAKESTI
KLINIK PURWAMEDIKA
KLINIK CENTRAL MEDIKA
KLINIK PURI MEDIKA RENGAS DENGKLOK
RSU.AQMA CIKAMPEK
KLINIK ANDINA KARAWANG
KLINIK PURI MEDIKA KOSAMBI
RSB. DR. DJOKO PRAMONO
APOTIK PINDO DELI I
KLINIK & RB ZAHIRA
KLINIK PINDO DELI II
RS.CITRA SARI HUSADA (d/h Klinik Intan Barokah)

JL. RAYA KLARI, Rt. 04 / 01, GINTUNGKERTA KLARI

JL. RAYA TAMELANG NO.53, KERAWANG
JL. RAYA BADAMIN, KARAWANG BARAT
JL.RAYA RENGAS DENGKLOK, KARAWANG
JL.Kp.CISELAN Ds.CIKAMPEK UTARA.KARAWANG
JL.PANCAWATI, NO.5A, KLARI
JL.RAYA KOSAMBI NO.40 PASAR KOSAMBI
JL.PANATAYUDA NO.35
JL.PROF.DR.IR.H.SOETAMI, NO.88
KL. RAYA KLARI, SASAK MISRAN
JL. DESA KUTA MEKAR, KARAWANG
JL.RAYA KOSAMBI-TELAGASARI, KM.3, KLARI, KARAWANG TIMUR

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

3
1
1
1
7
2
1
1
1
1
1
1

460
461
462

1022
1023
1035

RSU. FIKRI MEDIKA

RS. ISLAM KARAWANG
KLINIK MITRA GEMPOL

JL.RAYA KOSAMBI- TELAGASARI, DS BLENDUNG , KLARI

JL.PANGKAL PERJUANGAN KM.2
JL.RAYA PROKLAMASI NO.89, DS KALANGSARI, RENGAS DENGKLOK

ACTIVE
ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE
ALL COVERAGE

1
3
1

463
464

1133
1058

RS. CITO KARAWANG

KLINIK NAFILA MEDIKA

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

465

0689

KLINIK MITRA SEHAT

Jl. ARTERI TOL KARAWANG BARAT TELUK JAMBE

JL.PRINGGODANI BLOK J-47 PERUMNAS TELUK JAMBE,KARAWANG
BARAT
JL.
KOSAMBI CURUG, NO.28, KLARI

ACTIVE

ALL COVERAGE

No
466
467
468
469
470
471

Code
0197
0869
0255
0083
0095
0704

Hospital Name
KLINIK GEMPOL
RS DELIMA ASIH SISMA MEDIKA
RS. BAYUKARTA
RS. DEWI SRI
KLINIK GRAHA MEDIS
KLINIK CITO KARAWANG

Address

Status

Coverage

Total Active
Terminal

JL. RANGGAGEDE, NO.25 KARAWANG BARAT

JL.WIRASABA NO.54 JOHAR - KARAWANG
JL. KERTABUMI, NO.44
JL. ARIF RAHMAN HAKIM, NO.1
JL. RAYA KOSAMBI, NO.23, DUREN KLARI, KARAWANG TIMUR
JL. KERTABUMI, NO.29

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

3
1
4
1
1
1

KLINIK MIRACLE GROUP

RS.AMIRA
RS.MH.THAMRIN PURWAKARTA
RS. EFARINA ETAHAM
KLINIK KOPINDOSAT
KLINIK AQMA PLERED
RSIA. ASRI MEDICAL CENTER
KLINIK AQMA PURWAKARTA

KOMP. ANEKA JASA BLOK AII NO.9-10 KOTA BUKIT INDAH

JL.IPIK GANDA MANAN, RT35/03, MUNJUL JAYA
JL.BUNGURSARI, NO.36
JL.BUNGURSARI NO.1 PO.BOX 167 - Purwakarta
JL.RE MARTADINATA, NO.39
JL.ANJUN NO.96 PLERED
JL.VETERAN CIHIDEUNG NO.15 PURWAKARTA
JL. IBRAHIM SINGADILAGA, NO.14

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

2
1
1
1
1
1
1
2

RS. PERKEBUNAN NUSANTARA 8 SUBANG

JL. OTISTA, NO.1

ACTIVE

ALL COVERAGE

KARTIKA MEDICAL CENTER

RS. BHAKTI MEDICARE
RS ISLAM ASSYIFA
RS HERMINA SUKABUMI
KLINIK & RB. PERMATA BUNDA

JL. JEND. A.YANI, NO.18

JL.RAYA SILIWANGI, CICURUG
JL. JEND. SUDIRMAN, NO. 27
JL.RAYA SUKARAJA RT.003/03,SUKARAJA
JL. SILIWANGI, NO.64, PARUNG KUDA

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1

RS. PAKUWON SUMEDANG

JL.RD.DEWI SARTIKA NO.17 SUMEDANG 45311

ACTIVE

ALL COVERAGE

RS. JASA KARTINI

RSI. HJ. SITI MUNIROH TASIKMALAYA

JL. SARIANINGRAT, NO.2

JL. TAMAN SARI, GOBRAS, NO.208

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

KLINIK DR TUTUK
KLINIK& APOTIK KIMIA FARMA CILACAP
RS PERTAMINA CILACAP
RS. ISLAM FATIMAH CILACAP

JL.PERINTIS KEMERDEKAAN 21
JL.GATOT SUBROTO, NO.59
JL.SETIA BUDI,, TEGAL MULYA
JL.H JUANDA NO.20

ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1

RS. ISLAM NU DEMAK

JL. JOGOLOYO NO.9

ACTIVE

ALL COVERAGE

RS PALANG BIRU

JL.KARTINI, NO.37

ACTIVE

ALL COVERAGE

RS ISLAM KLATEN
RS.ISLAM MUHAMMADIYAH DELANGGU

JL.RAYA SOLO KM.4

JL.DELANGGU UTARA, NO.19

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

PURWAKARTA
472
473
474
475
476
477
478
479

1315
1526
1545
1043
1044
1175
1057
0189

SUBANG
480

0191

SUKABUMI
481
482
483
484
485

1506
1507
0056
0832
0227

SUMEDANG
486

1128

TASIKMALAYA
487
488

0253
0256

JAWA TENGAH

CILACAP
489
490
491
492

1005
0884
0926
0975

DEMAK
493

1221

GOMBONG
494

1243

KLATEN
495
496

0754
1519

KUDUS
497

RS. MARDI RAHAYU

JL. AKBP.R. AGIL KUSUMADYA, NO.110

ACTIVE

ALL COVERAGE

1132
0335

RS. LESTARI RAHARJA

S HARAPAN MAGELANG
G
G
RS.

JL. MAYJEN SUTOPO NO.5

JJL. P. S
O
, NO.11
O
SENOPATI,

ACTIVE
C
ACTIVE

ALL COVERAGE
G
ALL CO
COVERAGE

1
1

1299
1534

KELUARGA SEHAT HOSPITAL

RS.MITRA BANGSA

JL.P.SUDIRMAN NO.9 MARGOREJO

JL.KOL.SUGIYONO, NO.75

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

RS. BUDI RAHAYU PEKALONGAN

RS. SITI KHODIJAH PEKALONGAN

JL. BARITO, NO.5

JL. BANDUNG, NO.39-47

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

RSU. SANTA MARIA PEMALANG

JL. PEMUDA NO.24

ACTIVE

ALL COVERAGE

JL. LETJEND. SUPRAPTO NO.6

ACTIVE

ALL COVERAGE

RSU. ANANDA PURWOKERTO

RSU. BUNDA PURWOKERTO
RS. ST. ELISABETH - PURWOKERTO

JL.PEMUDA, NO.30
JL. PRAMUKA, NO.249
JL.JEND GATOT SUBROTO NO.44 - PURWOKERTO

ACTIVE
ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE
ALL COVERAGE

1
1
1

RS ISLAM SULTAN AGUNG

RSIA. HERMINA PANDANARAN
RS. ST. ELISABETH - SEMARANG
RS. PANTI WILASA DR. CIPTO
RS. PERMATA MEDIKA
RS. ROEMANI MUHAMMADIYAH
RS. TELOGOREJO
RS BANYUMANIK
RS. PANTI WILASA CITARUM

JL. KALIGAWE KM.4

JL. PANDANARAN NO.24
JL. KAWI NO. 1
JL. DR. CIPTO, NO.50
JL.MR.MOCH. ICHSAN, NO.93-97, NGALIYAN
JL. WONDRI, NO.22
JL. KH. AHMAD DAHLAN
JL.BINA REMAJA NO.61
JL. CITARUM, NO. 98

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1
1
1
1
1

RS ISLAM KUSTATI
RS DR.
RS.
DR OEN SOLO BARU
RS. DR. OEN SURAKARTA(KANDANG SAPI)
RSU. KASIH IBU SOLO
RS ISLAM SURAKARTA
RS PKU MUHAMMADIYAH SOLO
RS. PANTI WALUYO SURAKARTA
RS BRAYAT MINULYA
KLINIK BUDI SEHAT

JL. KAPTEN MULYADI NO.249

KOMP. PERUM
KOMP
PERUM. SOLO BARU
BARU, GROGOL
GROGOL, SUKOHARJO
JL. BRIGJEN KATAMSO NO.55, KANDANG SAPI
JL. BRIGJEND SLAMET RIYADI NO.404
JL.A YANI PABELAN KARTASURA, SOLO
JL.RONGGOWARSITO NO130, SOLO
JL.JEND.A.YANI NO.1
Jl. Dr.SETIABUDI NO.106 SURAKARTA
JL.S.PARMAN 131 PASAR LEGI

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1
1
1
1
1

RS.MITRA KELUARGA TEGAL

RS ISLAM HARAPAN ANDA

JL.SIPELEM, NO.4, KEMANDUNGAN, TEGAL BARAT

JL.ABABIL NO.42

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

0146

MAGELANG
498
99
499

PATI
500
501

PEKALONGAN
502
503

1220
0120

PEMALANG
504

1219

PURWODADI
505

1226

RS. PANTI RAHAYU

PURWOKERTO
506
507
508

1447
0201
0825

SEMARANG
509
510
511
512
513
514
515
516
517

0182
0299
0160
0050
1450
0053
0377
0901
0379

SOLO
518
519
520
521
522
523
524
525
526

0212
0118
0214
0119
0745
0746
1483
1179
1180

TEGAL
527
528

1540
0753

TEMANGGUNG
529

1144

RS. NGESTI WALUYO

JL. PAHLAWAN-PARAKAN

ACTIVE

ALL COVERAGE

JL.RING ROAD UTARA NO.160 CONDONG CATUR SLEMAN

JL. IPDA TUT HARSONO NO. 53, TIMOHO
JL. K.H. ACHMAD DAHLAN, NO.20
JL.HAYAM WURUK NO.6
JL. JEND.SUDIRMAN NO.70
JL. WIRATAMA NO.4 TEGALREJO 55244
Jl. JEND. SUDIRMAN 124-126

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1
1
1

YOGYAKARTA
530
531
532
533
534
535
536

1229
1286
0606
1400
0077
0604
1437

JOGJA INTERNATIONAL HOSPITAL

RS HAPPYLAND MEDICAL CENTER
RS. PKU MUHAMMADIYAH YOGYAKARTA
RSU. BETHESDA LEMPUYANGWANGI
RS. BETHESDA
RS. LUDIRA HUSADA TAMA
RS. PKU MUHAMMADIYAH BANTUL

BANYUWANGI
537
538
539

0726
0724
1429

JAWA TIMUR

RS ISLAM FATIMAH BANYUWANGI

RS. AL-HUDA
RS. YASMIN BANYUWANGI

JL. JEMBER, NO.25

JL. DIPONEGORO, NO.65, GENTENG
JL.LETKOL ISTIQLAL NO.80-84

ACTIVE
ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE
ALL COVERAGE

1
1
1

RS. BUDI RAHAYU BLITAR

JL. A.YANI BLITAR

ACTIVE

ALL COVERAGE

JL. HASHIM ASHAARI, NO.17

ACTIVE

ALL COVERAGE

BLITAR
540

0269

BOJONEGORO
541

0731

RS. AISYIYAH BOJONEGORO

No

Code

Hospital Name

Address

Status

Coverage

Total Active
Terminal

GRESIK
542
543

0596
1427

RS. SEMEN GRESIK

RS. PETROKIMIA

JL. RA. KARTINI, NO.280 GRESIK

JL. JEND. A.YANI NO.69

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

RS. BINA SEHAT

RS. PERKEBUNAN (PTPN) X JEMBER

JL.JAYANEGARA NO.7
JL. BEDADUNG, NO.2

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

JEMBER
544
545

1428
0725

JOMBANG
546

0978

RS KRISTEN MOJOWARNO

JL.MERDEKA NO.59

ACTIVE

ALL COVERAGE

RS. HVA TOELOENGREDJO

RS BAPTIS KEDIRI
RSIA. AURA SYIFA

JL. A. YANI NO. 25 PARE

JL.BRIDJEN POLLBH PRANOTO NO.1
JL. JOYOBOYO NO.42 DLOPO

ACTIVE
ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE
ALL COVERAGE

1
1
1

RS. SANTA CLARA

JL. BILITON, NO.15

ACTIVE

ALL COVERAGE

RS. LARASATI

JL. MANDILARAS, NO.74, PAMEKASAN

ACTIVE

ALL COVERAGE

RS. WAVA HUSADA KEPANJEN

RS. MARSUDI WALUYO
RS. ISLAM MALANG
APOTIK & KLINIK 24 JAM GRIYA BROMO
RS ISLAM AISYIYAH MALANG
RSIA. HERMINA TANGKUBANPRAHU
RS. MELATI HUSADA
RS. PANTI WALUYA SAWAHAN
RS. PANTI NIRMALA
RS. LAVALETTE
RS. BAPTIS BATU

JL.PANGLIMA SUDIRMAN NO.99A KEPANJEN

JL.RAYA MONDOROKO KM.9 SINGOSARI
JL. MAYJEND HARYONO NO. 139
JL.BROMO NO.7
JL. SULAWESI, NO.16
JL. TANGKUBAN PRAHU, NO.33
JL. KAWI, NO.32
JL. NUSAKAMBANGANNO.5
JL. KEBALEN WETAN, NO.2-8
JL. W.R. SUPRATMAN, NO.10
JL. RAYA TLEKUNG NO.1 JUNREJO, BATU

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1
1
1
1
1
1
1

RS.EMMA
RS. KARTINI MOJOKERTO
RS. REKSA WALUYA
RS GATOEL MOJOKERTO

JL.RAYA IJEN WATES NO.67

JL. ERLANGGA, NO.137, MOJOSARI
JL. MOJOPAHIT, NO.422
JL.R.WIJAYA NO.56

ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1

RS. PANCA DHARMA

RS ISLAM MASYITHO

JL.RAYA NO.14A SUKOREJO

JL. A. YANI, NO.6

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

0
1

KEDIRI
547
548
549

0248
0977
1430

MADIUN
550

0722

MADURA
551

0113

MALANG
552
553
554
555
556
557
558
559
560
561
562

1326
1325
1252
1482
0252
0094
0125
0815
0609
0708
0192

MOJOKERTO
563
564
565
566

0785
0088
0164
0928

PASURUAN
567
568

1329
0700

PONOROGO
569

0823

RSU.AISYIYAH PONOROGO

JL.DR SUTOMO NO.18-24

ACTIVE

ALL COVERAGE

RSU. WONOLANGAN
RS. DHARMA HUSADA

JL.RAYA DRINGU NO.118

JL. SOEKARNO HATTA NO.10

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

RS. DELTA SURYA

RS ANWAR MEDIKA
RSU SITI KHODIJAH SIDOARJO
KLINIK GRAHA MEDICA
KLINIK CITRA GADING MEDIKA
KLINIK D DOTHE
RS ISLAM SITI HAJAR SIDOARJO

JL. PAHLAWAN NO.9

JL.DUSUN SEMAWUT, KEC BALONG BENDA
JL. PAHLAWAN, NO.260, SEPANJANG
JL.BRIGJEN KATAMSO NO.7 WARU
JL.BRIGJEN KATAMSO BLOK A 408-409 REWIN WARU
JL. MONGINSIDI NO.86-88
JL. RADEN PATAH NO.70

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1
1
1

PROBOLINGGO
570
571

1330
0309

SIDOARJO
572
573
574
575
576
577
578

0249
0927
0545
1339
1336
1413
0271

SURABAYA
579
580
581
582
583
584
585
586

1548
0546
0544
0547
0548
0980
0829
1453

KLINIK MEDIS PUSURA 5 (BALONGSARI)

KLINIK MEDIS PUSURA 1 (YOS SUDARSO)
RS. ST.VINCENTIUS A.PAULO (RS. RKZ)
KLINIK MEDIS PUSURA 2 (RUNGKUT)
KLINIK MEDIS PUSURA 3 (SUNGKONO)
RS ISLAM SURABAYA
RS. SURABAYA INTERNASIONAL
RS. ONKOLOGI

JL. BALONGSARI TAMA, BLOK B, NO.8-9

JL. KOM ( L) YOS SUDARSO, 9A
JL. DIPONEGORO NO.51
JL. RUNGKUT ASRI TENGAH NO.2
JL. MAYJEN, SUNGKONO, NO.64
JL.JEND A YANI NO.2-4
JL.NGINDEN INTAN BARAT, BLOK B
ARAYA GALAXI BUMI PERMAI BLOK A2/7 JL.ARIEF RAHMAN HAKIM 182

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
6
1
1
1
1
1
1

587
588
589
590
591
592
593
594
595
596
597
598
599
600
601
602

0917
0809
1201
1018
1052
1361
1362
1363
1364
0163
0136
0897
0896
0895
0830
0081

RS WILLIAM BOOTH
RS SPESIALIS HUSADA UTAMA
RS. ADI HUSADA KAPASARI
KLINIK SENTRA MEDIKA SURABAYA
KLINIK MEDIS PUSURA 4 (TEGAL SARI)
RS. AL IRSYAD SURABAYA
RS. BHAKTI RAHAYU SURABAYA
RS. BUNDA SURABAYA
RS. ISLAM SURABAYA JEMURSARI
RS. DARMO
RS. MITRA KELUARGA SURABAYA
KLINIK BENOWO
KLINIK KEBRAON
RS PELABUHAN SURABAYA (PHC SURABAYA)
RS. ADI HUSADA UNDAAN WETAN
SILOAM HOSPITALS SURABAYA

JL. DIPENOGORO NO.34

JL.PROF
JL
PROF DR MOESTOPO 31-35
31 35
Jl. KAPASARI NO.97-101
JL.RAYA TENGGILIS, NO.91-93
JL.TEGAL SARI NO.59
JL.KH.MAS MANSYUR 210-214
JL.KETINTANG MADYA I/16
JL.RAYA KANDANGAN NO.23-24 BENOWO
JL.JEMURSARI NO.51-57
JL. RAYA DARMO, NO.90
JL. SATELIT INDAH II, DARMO SATELIT
PONDOK BENOWO INDAH, BLOK PP/22
JL.GRIYA KEBRAON BLOK FA NO.37
JL.PRAPAT KURUNG SELATAN NO.1 TANJUNG PERAK
JL.UNDAAN WETAN NO40-44 SURABAYA
JL RAYA GUBENG NO.
JL.
NO 70

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

2
1
1
1
1
1
1
1
1
1
1
1
1
3
1
1

RS. MEDIKA MULIA

JL. MOJOPAHIT, NO.699

ACTIVE

ALL COVERAGE

JL.KH.R.ABDUL FATAH

ACTIVE

ALL COVERAGE

TUBAN
603

1198

TULUNG AGUNG
604

0813

RS.ISLAM ORPEHA

BALIKPAPAN

KALIMANTAN

605
606
607

1213
1109
0686

RS. BALIKPAPAN BARU

RS KHUSUS BEDAH HARAPAN MULIA
PANACEA CLINIC

KOMP.BALIKPAPAN BARU Jl. MT.HARYONO Blok.A-A3

JL.WILUYO PUSPOYUDO NO.26-30
KOMP MAL FANTASI BLOK AB2 NO.18-20 BALIKPAPAN BARU 76114

ACTIVE
ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE
ALL COVERAGE

1
1
1

608
609
610
611

0633
0692
1374
0672

RS. PERTAMINA BALIKPAPAN

APOTIK KANIDA FARMA II
RS BALIKPAPAN HUSADA
RS.
RSIA. PERMATA HATI BALIKPAPAN

JL. JEND SUDIRMAN NO.1

JL. JEND. SUDIRMAN, NO. 23
JL.MT.HARYONO
JL
MT HARYONO NO
NO.9
9 RING ROAD
JL. IMAM BONJOL NO.1

ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1

JL. PANGERAN ANTASARI NO. 139B

JL. LET JEN S PARMAN GG.PURNAMA NO.1 BANJARMASIN

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

BANJARMASIN
612
613

0631
0849

RS. SARI MULIA

RS ISLAM BANJARMASIN

BONTANG
614

1214

RS. PUPUK KALTIM

Jl. OKSIGEN NO.1, KOMP.PUPUK KALTIM

ACTIVE

ALL COVERAGE

JL.MOH. HATTA, HANDIL 3, MUARA JAWA

ACTIVE

ALL COVERAGE

JL.KH. WAHID HASYIM NO.249

JL. A.R. SALEH (BLKI), KOMP. TAMAN PERMATA INDAH, NO.A5
JL. AHMAD YANI NO. 5-7

ACTIVE
ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE
ALL COVERAGE

1
1
1

JL. GURAMI, NO.18

JL. DAHLIA, NO.4
JL.GN. MERBABU, NO. 62

ACTIVE
ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE
ALL COVERAGE

1
1
1

KUTAI KERTANEGARA
615

1074

KLINIK MAJU SEJAHTERA

PONTIANAK
616
617
618

1106
0096
1431

RS. SANTO ANTONIUS

KLINIK ROSYE JAYA MEDIKA
RSIA ANUGERAH BUNDA KHATULISTIWA

SAMARINDA
619
620
621

0635
0230
0636

RS ISLAM SAMARINDA
RS. H. DARJAD
RS. DIRGAHAYU

No

Code

Hospital Name

Address

Status

Coverage

Total Active
Terminal

ALL COVERAGE

SANGATTA
622

1376

RS. PRIMA SANGATTA

JL.YOS SUDARSOI NO.1 SANGATA

ACTIVE

SINGKAWANG
623

1368

RS. SANTO VINCENTIUS SINGKAWANG

JL.P.DIPONEGORO NO.5

ACTIVE

ALL COVERAGE

KLINIK AZKA MEDIKA

JL. JEND. AHMAD YANI, NO.85

ACTIVE

ALL COVERAGE

RS PERTAMINA TARAKAN

JL. MULAWARMAN NO. 14, TARAKAN

ACTIVE

ALL COVERAGE

TANAH GROGOT
624

1456

TARAKAN
625

1529

MALUKU

AMBON
626

1439

RS BHAKTI RAHAYU AMBON

JL. BATU KERBAU, BELAKANG RRI

ACTIVE

ALL COVERAGE

RS.MEDIKA HARIFALM

JL. ZAINAL ABIDINSYAH, NO.25, KOMPLEX POHON PALA

ACTIVE

ALL COVERAGE

JL.JEND.SUDIRMAN NO.27-29

ACTIVE

ALL COVERAGE

JL. MERDEKA NO.17 SIMPANGAN KUTA BLANG

JL.MERDEKA BARAT NO.25 CUNDA

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

ACTIVE

ALL COVERAGE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

2
1
1
1
1
1
1
1

TERNATE
627

1503

NAD

BANDA ACEH
628

1100

RS.TEUNGKU FAKINAH

LHOKSEUMAWE
629
630

1253
0769

RS. KASIH IBU LHOKSEUMAWE

RS ISLAM LHOKSEUMAWE

NTB

MATARAM
631
632

1124
1539

RSB. EXONERO
RS.RISA SENTRA MEDIKA

JL. PEMUDA NO.16

JL. PEJANGGIK, NO.115, CAKRANEGARA

NTT

KUPANG
633

1380

KLINIK & APOTIK KARTINI

RIAU

BATAM
634
635
636
637
638
639
640
641

0484
0485
0764
0483
1241
0584
1240
1010

JL.ELTARI I NO.2

KLINIK BUDI ROSARI

GENTA MEDICAL CENTER
RS. HARAPAN BUNDA BATAM
BATAM MEDICAL CENTER
KLINIK BERSALIN ERNES
RS. AWAL BROS BATAM
KLINIK TIARA MEDIKA
RS ST. ELISABETH - BATAM

JL. MAHKOTA SIMPANG, NO.1, BENGKONG MAHKOTA

MUKA KUNING INDAH, BLOK F, NO.10
JL.SERAYA NO.1
LIBRA CENTRE, JL. RADEN PATAH
JL.PERMAISURI NO.8 TANJUNG UBAN
JL.GAJAH MADA KAV.1 BALOI
KAPLING TELUK SASAH
JL.ANGGREK BLOK II, BALOI

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

RS. PERMATA HATI DURI

RSU THURSINA
KLINIK THURSINA

JL.JEND SUDIRMAN NO.37 SIMPANG PADANG

JL.HANGTUAH NO.93
JL.JEND SUDIRMAN NO.65 SIMPANG PADANG

ACTIVE
ACTIVE
PARTIAL

ALL COVERAGE
ALL COVERAGE
PHAR,RM-RJ,RM-R

1
1
2

JL.SUNGAI SELAN, KM.4, NO.180

ACTIVE

ALL COVERAGE

JL.
JL RONGGOWARSITO UJUNG,
UJUNG NO.5A,
NO 5A
JL. KH. AHMAD DAHLAN, NO.163
JL.RONGGOWARSITO I NO.1
JL. MELATI, NO.60
JL.SOEKARNO HATTA, KM.6,5
JL. A. YANI, NO.68
JL. LEMBAGA PEMASYARAKATAN NO.25,GOBAH

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL

1
1
1
1
1
1
1

DURI
642
643
644

0921
0930
0922

PANGKAL PINANG
645

1443

RS. KHATOLIK BHAKTI WARA

PEKAN BARU
646
647
648
649
650
651
652

1444
0663
0841
0664
1535
0625
0791

RS.
RS LANCANG KUNING
RB. ERIA BUNDA
RSIA ZAINAB
RS ISLAM IBNU SINA PEKANBARU
EKA HOSPITAL PEKAN BARU
RS. SANTA MARIA PEKANBARU
RS. PEKAN BARU MEDICAL CENTER

SULAWESI

BITUNG
653

1421

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

JL. SAM RATULANGI, BLOK X/9A

ACTIVE

ALL COVERAGE

RSB. SITTI KHODIJAH GORONTALO

JL. AHMAD YANI, NO.101

ACTIVE

ALL COVERAGE

RS HIKMAH
RS.
RS AKADEMIS JAURY YUSUF PUTERA
RS. STELLA MARIS
RS. GRESTELINA
RATULANGI MEDICAL CENTRE

JL.YOSEF
JL
YOSEF LATUMAHINA NO.1
NO 1
JL.GN BULUSARAUNG NO.57 A
JL.SOMBA OPU NO.273, PO.BOX 122
JL.LETJEN HERTASNING RAYA NO.51
JL.SAM RATULANGI NO.28

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1

RS PANCARAN KASIH
RS. ADVENT MANADO

JL.SAM RATULANGI XIII TITIWUNGEN

JL. 14 FEBRUARI, NO.1, TELING ATAS

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

RSU. WOODWARD (BALA KESELAMATAN)

JL. LH. WOODWARD NO.1

ACTIVE

ALL COVERAGE

RS. FATIMA PARE-PARE

JL.ILHAMV KOTAK POS 12

ACTIVE

ALL COVERAGE

RS BUDI MULIA

GORONTALO
654

1420

MAKASAR
655
656
657
658
659

0644
1190
0641
1389
1388

MANADO
660
661

0640
1502

PALU
662

0639

PARE-PARE
663

1394

BUKIT TINGGI
664
665

0687
1398

SUMATERA

RS ISLAM IBNU SINA BUKIT TINGGI

RSU. MADINA

JL. BATANG AGAM, BELAKANG BALOK

JL.GURU HAMZAH NO.17

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

ACTIVE

ALL COVERAGE

JAMBI
666
667

0575
1260

APOTIK ANAK IBU

KLINIK & APOTIK MANDIAH

668

0792

BALAI PENGOBATAN & RB SEJAHTERA

JL. DR. SUTOMO

JL.PUSKESMAS RT.06 NO.67,DS TEBING TINGGI,TUNGKAL ULU KAB.TJG
JABUNG BRT
DESA TEBING TINGGI,KEC TUNGKAL ULU,KAB TANJUNG JABUNG BARAT

669
670
671
672
673
674
675

1303
0730
0894
0573
0621
0553
0665

OPTIK CEMERLANG
OPTIK CITRA (MH.Thamrin)
RS ASIA MEDIKA
KLINIK MAYANG MEDICAL CENTER
APOTIK PERMATA HATI JAMBI
OPTIK INTERNASIONAL
APOTIK SEJAHTERA

JL.KOL ABUNJANI NO.59 SIPIN UJUNG

JL. MH. THAMRIN, NO.60
JL.SOEKARNO - HATTA, PALMERAH
JL.JUANDA RAYA
JL. AGUNG NO.86
JL. HUSNI THAMRIN, NO.110
DESA TEBING TINGGI,KEC TUNGKAL ULU,TANJUNG JABUNG BARAT

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1
1
1

676
677

0550
0623

RS. ST.THERESIA
OPTIK CITRA (Gatot Soebroto)

JL. SUTOMO, NO.19

JL. GATOT SUBROTO, NO.31

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
2

ACTIVE
ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE
ALL COVERAGE

1
1
1

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL

1
1
1
1
1

LAMPUNG
678
679
680

0487
1378
0751

RS. ADVENT LAMPUNG

RS. URIP SUMOHARJO
MEDICAL CENTRE CPB

681
682

1228
0486

RS. BUMI WARAS

RS. IMMANUEL WAY HALIM

JL. TEUKU UMAR, NO.48

JL.URIP SUMOHARJO NO.200 SUKARAME
DESA BRATASENA ADIWARNA, KEC.DENTE TELADAN, KAB.TULANG
BAWANG
JL.WOLTER MONGINSIDI, NO.235
JL. SOEKARNO-HATTA, WAY HALIM

RS NUR SAADAH
RS.
RSU MARTHA FRISKA
RS. ADVENT MEDAN
GLENI INTERNASIONAL HOSPITAL
RS ISLAM MALAHAYATI

JL RAYA MEDAN-TANJUNG
JL.
MEDAN TANJUNG MORAWA KM.12
KM 12
JL.KOL YOS SUDARSO KM.6, NO.91, PULO BRAYAN
JL. GATOT SUBROTO, KM. 4
JL. LISTRIK 2A Medan 20112
JL.DIPENOGORO NO.2-4, MEDAN

MEDAN
683
684
685
686
687

1141
0742
0523
0590
0741

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

No
688
689
690
691
692
693
694
695
696

Code
0418
0740
0739
0322
0626
0416
1399
1061
1193

Hospital Name

Address

Status

Coverage

Total Active
Terminal

KLINIK SPESIALIS BUNDA

RS HERNA
MEDAN MEDICAL CENTRE
RSU PERMATA BUNDA MEDAN
RS. SARI MUTIARA
RS MATERNA
KLINIK METTA HEALTHCARE CENTRE
RS. ESTOMIHI
RS SARAH

JL. SISINGAMANGARAJA NO.17

JL.MAJAPAHIT NO.118A, MEDAN
JL.KOMPLEK MULTATULI INDAH BLOK BB NO.56-57
JL. SISINGAMANGARAJA, NO.7
JL. KAPTEN MUSLIM, NO.79
JL. TEUKU UMAR, NO.11
JL.WAHIDIN
JL WAHIDIN NO.323
NO 323
JL.SISINGAMANGARAJA NO.235 MEDAN
JL. BAJA RAYA NO. 10 PETISAH

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1
1
1
1
1
1

RS SELAGURI
RSU BUNDA MEDICAL CENTER (RS. RESTU IBU)
RS SELASIH
RS. YOS SUDARSO

JL. A.YANI, NO.26

JL. PROKLAMASI NO.37
JL.KHATIB SULAIMAN, NO.2
JL. SITUJUH, NO.1

ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
1

JL.JEND.SUDIRMAN NO.25
JL.ANGKATAN 45, PRABUMULIH
JL.KESEHATAN, NO.100, KOMPLEK PERTAMINA PRABUMULIH
JL.DEMANG LEBAR DAUN, PALEMBANG
JL. DEMANG LEBAR DAUN, LORONG PAKJO
JL. MAYOR ZEN
JL. JEND. SUDIRMAN NO.1054

ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE

ALL
ALL
ALL
ALL
ALL
ALL
ALL

COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE
COVERAGE

1
1
1
2
1
1
1

JL. MERDEKA, NO.329

JL.MEDAN KM2,5 PEMATANG SIANTAR

ACTIVE
ACTIVE

ALL COVERAGE
ALL COVERAGE

1
1

PADANG
697
698
699
700

0304
0423
0734
0616

PALEMBANG
701
702
703
704
705
706
707

1114
1449
0824
0883
0688
0627
0817

KLINIK GRAHA BUNDA

RS. AR BUNDA PRABUMULIH
RS. PERTAMINA PRABUMULIH
RSAB BUNDA PALEMBANG
RS ISLAM SITI KHADIJAH PALEMBANG
RS. PT. PUSRI
RS. RK. CHARITAS

PEMATANG SIANTAR
708
709

0719
0924

RS. VITA INSANI

RS HORAS INSANI