LIST PROVIDER PT. ASURANSI AXA INDONESIA - ADMEDIKA 8 …sdm.mercubuana.ac.id/download/Surat Edaran/ASURANSI-LIST... · 2017-12-13 · No Code Hospital Name Address Tel Number Fax

No Code Hospital Name Address Tel Number Fax Number RI RJ Allowed

BALI

BADUNG

001 5783 RS. KHUSUS BEDAH BIMC NUSA DUA BALI BLOK D KAWASAN BTDC NUSA DUA 0361-3000911| - Y Y ALL COVERAGE

BANGLI

002 4898 RS. BANGLI MEDIKA CANTI JL. TIRTA GIRI KUTRI LCSUBAK AYA BEBALANG, BANGLI, BALI 0366-91555/93444| - Y Y ALL COVERAGE

BULELENG

003 1451 RSU. PARAMASIDHI JL. A.YANI NO.171A 0362-29787, 32701,22426,| 0362-29787 Y Y ALL COVERAGE

004 3422 LAB. PRODIA SINGARAJA JL. NGURAH RAI NO. 67 SINGARAJA 0362-24516| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

005 0870 RSU. KERTHA USADA JL. CENDRAWASIH, NO.5-7, SINGARAJA 0362-26277/8| 0362-22741 Y Y ALL COVERAGE

DENPASAR

006 2598 KLINIK & APOTEK KF 232 JL. RAYA KEROBOKAN 140, SEMINYAK, KUTA 0361 736163| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

007 2600 KLINIK & APOTEK KF 236 JL. DANAU BATUR RAYA, TM GRIYA, JIMBARAN 0361 8479785| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

008 1825 LAB. PRODIA WIDYA HUSADHA JL. DIPONEGORO NO. 192 DENPASAR (0361) 261001| (0361) 236349 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

009 1245 RSU. SURYA HUSADHA UBUNG JL. COKROAMINOTO, NO.356, DENPASAR 0361-425744| 0361-430557 Y Y ALL COVERAGE

010 1202 KLINIK MERDEKA MEDICAL CENTER (MMC) MERDEKA VIII/2 TANJUNG BUNGKAK-DENPASAR 0361-233790| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

011 1273 RS. SURYA HUSADHA JL. PULAU SERANGAN,NO.7, DENPASAR 0361-233787| 0361-231177 Y Y ALL COVERAGE

012 1309 BALI ROYAL HOSPITAL ( BROS ) JL. TANTULAR NO 6 RENON DENPASAR 0361- 247499/222588/228054| 0361-226051/226052 Y Y ALL COVERAGE

013 1146 RS. BHAKTI RAHAYU DENPASAR JL. GATOT SUBROTO II, NO.110361-430270 / 430245 / 428287 /

7420673|0361-263371 Y Y ALL COVERAGE

014 1463 KLINIK PENTA MEDIKA JL. TEUKU UMAR BARAT-MARLBORO,NO.88 0361-7446144/490709| 0361 - 490708 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

015 0220 RS. PRIMA MEDIKA JL. PULAU SERANGAN, 9X 0361 - 236225/257445/235318| 0361-236203/262535 Y Y ALL COVERAGE

016 0179 RSU. KASIH IBU DENPASAR JL. TEUKU UMAR, NO.120 0361-223036/3003030/082146806677| 0361-238690 Y Y ALL COVERAGE

017 0140 RS. MANUABA JL. HOS. COKROAMINOTO, NO.28 0361-426393| 0361-285183/429447 Y Y ALL COVERAGE

018 0221 RS. PURI RAHARJA JL. WR.SUPRATMAN, NO.14-19, DENPASAR 0361-222013| 0361-242537 Y Y ALL COVERAGE

019 0867 KLINIK&APOTEK KF 34 DENPASAR JL. DIPONEGORO NO.125, DENPASAR 0361-255914-|- 0361-255914 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

020 1047 RS. BALIMED (d/h RS BALI MEDISTRA) JL. MAHENDRADATTA, NO.57X, DENPASAR 0361-484748, 482281,8450771, 8450772| 0361-8450773,8450770 Y Y ALL COVERAGE

021 1147 RS. DHARMA YADNYA JL. WR.SUPRATMAN NO. 256, TOHPATI 0361-462488 / 462629| 0361-464526 Y Y ALL COVERAGE

022 1150 RSIA. PURI BUNDA JL. GATOT SUBROTO VI, NO.19 0361-437999| 0361-433988 Y Y ALL COVERAGE

023 1151 KLINIK QUANTUM SARANA MEDIK JL. RAYA SESETAN, NO.20 0361-228835| 0361-245274 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

024 3455 APOTIK KIMIA FARMA NO.66 PATIMURA JL. PATIMURA NO.59 DENPASAR 0361-234797| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

025 2599 KLINIK & APOTEK KF 82 JL. KARTIKA PLAZA, NO.67, KUTA-BALI 0361 757196| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

026 4438 KLINIK UTAMA DHARMA SIDHI JL. SERMA KAWI NO. 13-17, DAUH PURI KELOD, DENPASAR BARAT (0361) 242717; 241013| 361241013 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

027 2602 KLINIK & APOTEK KF 108 JL. T.UMAR 246, DENPASAR 0361 245768| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

GIANYAR

028 1761 RS. ARI CANTI GIANYAR JL. RAYA MAS UBUD GIANYAR 0361-974573| 0361-974573 Y Y ALL COVERAGE

029 4834 RS. KASIH IBU SABA GIANYAR JL. RAYA PANTAI SABA NO 9 DESA SABA, GIANYAR BALI 0361) 3003333| - Y Y ALL COVERAGE

030 3549 RSU. SANJIWANI GIANYAR JL. CIUNG WANARA N0.2 GIANYAR 0361-943049/0361-943020| Y Y ALL COVERAGE

031 4075 RSU. PREMAGANAJL. HAYANG SANGSI NO.2 PERUM CHANDRA AYU, BANJAR TUBUH, BATU

BULAN - SUKAWATI0361-8461955/ 296389 / 082144049401| 0361-295246 Y Y ALL COVERAGE

032 4666 RS. FAMILI HUSADA JL. ASTINA TIMUR, SAMPLANGAN, KEC.GIANYAR, KAB. GIANYAR (0361) 849 3344| (0361) 8493040 Y Y ALL COVERAGE

JEMBRANA

033 6026 RS. BALIMED NEGARAJl. Hayam Wuruk No. 23 Ds. Dangintukadaya, Kec. Jembrana, Kab.

Jembrana0365-4501452| - Y Y ALL COVERAGE

034 3558 RSU. BUNDA JL. RAJAWALI NO. 36, PENDEM, 0365-40251 / 087863229569| 0365-40089 Y Y ALL COVERAGE

KARANGASEM

035 2301 KLINIK PENTA MEDICA CANDIDASA JL. RAYA MANGGIS NO. 88, KAB. KARANGASEM, BALI 0363-41909| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

036 4252 RS. BALIMED KARANGASEM JL. NENAS KECICANG BEBANDEM, KARANGASEM, BALI (0363) 4301618| Y Y ALL COVERAGE

KUTA

037 1138 RSU. KASIH IBU KEDONGANAN JL. ULUWATU, NO.69A, KEDONGANAN 0361-703270| 0361-703329 Y Y ALL COVERAGE

038 1909 SILOAM HOSPITALS BALI JL. SUNSET ROAD NO. 818, KUTA 0361-779900| 0361-779933 Y Y ALL COVERAGE

039 1492 KLINIK KASIH IBU KOMPLEKS PERUM BUMI DALUNG PERMAI, BLOK C1-C4 0361-422150/3700616| 0361-422179 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

NUSA DUA

040 0222 KLINIK PRIMA MEDIKA JL. BY PASS NGURAH RAI, PERTOKOAN NIAGA, NO.81 0361-770509| 0361-770509 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

041 2603 KLINIK & APOTEK KF 126 JL. BY PASS NGURAH RAI NO 890,NUSA DUA 0361 778555| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

042 1359 RSU. SURYA HUSADHA NUSA DUA JL. SILIGITA, BLOK 1, NO.14 0361-775827| 0361-771388 Y Y ALL COVERAGE

SANUR

043 2604 KLINIK & APOTEK KF 173 JL. BY PASS NGURAHRAI 232,SANUR 0361 283395| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

044 1248 KLINIK REMEDIUM CARE JL. BY PASS NGURAH RAI NO.243 0361-288860| 0361-287970 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

TABANAN

045 4520 PRODIA TABANAN JL. NGURAH RAI NO. 43 KEDIRI TABANAN 0361-812758| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

046 1714 RS. WISMA PRASANTI JL. YAH GANGGA NO. 9 TABANAN , BALI 0361-8043219/810555| 0361-812454 Y Y ALL COVERAGE

047 3456 APOTIK & KLINIK KIMIA FARMA.102 TABANAN JL. NGURAH RAI NO.74 A TABANAN 0361-810524| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

048 2133 RSU. KASIH IBU TABANAN JL. FLAMBOYAN NO. 9 ( KAMPUNG KODOK ) TEGAL BELODAN TABANAN 0361-3005757| 0361-3005758 Y Y ALL COVERAGE

UBUD

049 0224 UBUD CLINIC JL. TJAMPUHAN, NO.36, P.O.BOX 10, UBUD, GIANYAR 0361-974911| 0361-974910 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

BANGKA BELITUNG

BANGKA INDUK

050 2148 RS. ARSANI JL. RAYA AIR KENANGA KEC. SUNGAI LIAT KAB. BANGKA BLITUNG 0717-4297825, 4297834| 0717-4297824 Y Y ALL COVERAGE

BANGKA TENGAH

051 6122 SILOAM HOSPITALS BANGKA BELITUNG JL. SOEKARNO HATTA KM.5 0710-9190900| - Y Y ALL COVERAGE

BELITUNG

052 4769 KLINIK BAKTI TIMAH TANJUNG PANDAN JL. MELATI NO. 32 TANJUNG PENDAM 33416 0719-21865| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

053 2370 RS. ALMAH TANJUNG PANDAN JL. JEND. SUDIRMAN KM. 11 NO. 1 KODE POS 33144 0719-9225666| 0719-9225333 Y Y ALL COVERAGE

054 4842 RS. UTAMA TANJUNG PANDANJL. JENDERAL SUDIRMAN KM. 3 RT.019 RW. 008 KEL. DESA LESUNG

BATANG, KEC. TANJUNG PANDAN, KAB. BELITUNG0719-9222211| 0719-9222212 Y Y ALL COVERAGE

055 1928 KLINIK UTAMA BELITUNG JL. MERDEKA NO. 27 TANJUNGPANDAN BELITUNG 0719-25526| 71925600 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

PANGKAL PINANG

056 5045 RSIA. MUHAYAJL. JEND SUDIRMAN NO. 18, TAMAN BUNGA, GERUNGGANG, KEP BANGKA

BLITUNG0717-436997| Y Y ALL COVERAGE

057 2605 KLINIK & APOTEK KF 118 JL. A.YANI, P.PINANG 0717 436762| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

058 0900 SUN CLINIC EL-JOHN PLAZA, JL. SUKARNO HATTA, NO.208 0717-4297888-|- 0717-439488 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

059 1508 RS. MEDIKA STANNIA JL. JEND.SUDIRMAN, NO.3, SUNGAI LIAT 0717-95837/93335| 0717-953335 Y Y ALL COVERAGE

060 1443 RS. KHATOLIK BHAKTI WARA JL. SUNGAI SELAN, KM.4, NO.180 0717-422605| 0717-424314 Y Y ALL COVERAGE

LIST PROVIDER PT. ASURANSI AXA INDONESIA - ADMEDIKA8-Nov-17

Page 1 of 28

NOV-08-2017



061 1230 RS. BAKTI TIMAH PANGKAL PINANG JL. BUKIT BARU NO.1 PANGKAL PINANG 0717-421091| 0717-424212 Y Y ALL COVERAGE

062 5063 PRODIA PANGKAL PINANG JL. KH. ABDURRAHMAN SIDDIQ NO. 176, PANGKAL PINANG 0717-438232| - N Y GP,LAB,PHAR

BANTEN

CILEGON

063 0985 RS. KURNIA CILEGON JL. JOMBANG MASJID NO.4 0254-391161 / 087885829059|- 0254-396489,397023 Y Y ALL COVERAGE

064 2389 KLINIK & RB CIGADING MEDIKA JL. RAYA ANYER KM.7 KUBANGSARI CIWANDAN CILEGON BANTEN 0254-311323| 0254-310568 Y YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

065 3158 KLINIK KELUARGA SURALAYA JL. CIRATA NOM 12 KOMPLEK PLTU SURALAYA (0254) 572100| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

066 4327 KLINIK ISNA MEDIKAJL. RAYA MERAK KM.8 KESERANGAN KEL. RAWA ARUM KEC. GROGOL,

CILEGON, BANTEN0254-573756| - N Y

GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

067 0057 KLINIK ALFINA JL. RAYA SERANG RUKO PCI BLOK KK I NO 7-8 CILEGON 0254-383116| 0254-377377 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

068 3156 LAB. PRODIA CILEGON JL. SULTAN AGENG TIRTAYASA NO. 8, CILEGON - BANTEN 42414 0254-381990/398969| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

069 2780 KLINIK GRIYA SEHATPERUMAHAN GRIYA CILEGON BLOK D6-7 KEL.WARINGIN KURUNGI,

KEC.KRAMATWATU 421610254-388501| 0254-388501 N Y


RB,PHAR

070 1254 RB & KLINIK AFINA JL. RAMBUTAN 12, PAGEBANGAN - CILEGON 0254-392568| 0254-392568 Y Y ALL COVERAGE

071 0129 APOTIK LABORA FARMA JL. ALUN-ALUN UTARA, NO.23 0254-391695| 0254-374278 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

072 0320 KLINIK BONA MEDIKA FESTIVAL RUKO BONA KARTA BLOK A31-32 CILEGON 0254-387684 / 0818769386| 0254-386699 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

073 0951 KLINIK & APOTEK KF 140 JL. S.A. TIRTAYASA NO 12 0254-399174 / 392278|- 0254-399174 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

074 0939 RSIA. MUTIARA BUNDA CILEGON JL. SA TIRTAYASA RUKO MAISONETTE BLOK B 1-2 SIMPANG TIGA CILEGON 0254- 399988/376888/399968-|- 0254-376454 Y Y ALL COVERAGE

075 1403 KLINIK KELUARGA PULO AMPEL JL. SALIRA INDAH DS.SUMURANJA PULOAMPEL 0254-5751100 / 0254 - 572100| 0254-5751100 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

076 0595APOTIK & KLINIK ANNISA SEHAT(D/H PRIMA

HUSADA)RUKO CILEGON CITY SQUARE ( SAMPING GIANT-PCI) BLOK B3;5 E3;5

0254 - 399933/3998560254 -

391677|0254 - 3916770254-399928 N Y


RB,PHAR

077 0302 KLINIK ANANDA CILEGON JL. R. SUPRAPTO KM.8 0254-310609| 0254-310821 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

078 1298 KLINIK IKHLAS MEDIKA IV KOMPLEK PONDOK CILEGON INDAH ( PCI ) BLOK A 19 NO.10 0254-395900/7061935/284937| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

079 0915 RS. KRAKATAU MEDIKA JL. SEMANG RAYA - CILEGON0254-396333; 0254-372180; 0254-

372123|0254-3721230254-391972/374010 Y Y ALL COVERAGE

080 1713KLINIK & APOTEK KF 268 PCI CILEGON (GROUP

140)PONDOK CILEGON INDAH BLOK A4 NO.01CILEGON - BANTEN 0254-394827| 0254-376501 N Y


RB,PHAR

081 1815 KLINIK INSAN PRIMA RUKO CILEGON CITY SQUARE BLOK I-8, CILEGON 0254-393 197| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

082 1943 KLINIK MUTIARA BUNDA JL. S.A TIRTAYASA NO. 86, CILEGON 0254-399968| 0254-399989/376454 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

PANDEGLANG

083 1764 KLINIK ALFURQON JL. RAYA LABUAN KM 2 TOROGONG MARGASANA - PANDEGLANG 0253-5808100| 0253-501313 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

084 0997 KLINIK DIFFA JL. RAYA LABUAN KM.12 CIPUTRI MENES 0253-502161-|- 0253-502160 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

RANGKASBITUNG

085 1084 RS. MISI LEBAK JL. MULTATULI NO.41 0252-201014-|- 0252-203390 Y Y ALL COVERAGE

086 3141 KLINIK DAN APOTEK MEDIKA JL. AHMAD YANI RANCASEMA - RANGKASBITUNG 0252-209975| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

087 0658 KLINIK SEHAT RABINZA JL. HADIWINANGUN, PERTOKOAN RABINZA, BLOK B1-2 0252-280023| 0252-280023 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

SERANG

088 0984 KLINIK CIJAWA MEDIKA JL. KH. A. FATAH HASAN NO.8 0254-204735 / 08128521336-|- 0254-204735 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

089 1009 KLINIK IKHLAS MEDIKA 2 JL. RAYA SERANG - JAKARTA KM.04 PAKUPATAN (DEPAN KAMPUS UNTIRTA) 0254-284937-|- - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

090 5285 RSIA. PERMATA SERDANGJALAN WARINGIN KURUNG RT 001/003 DESA SERDANG, KECAMATAN

KRAMATWATU KABUPATEN SERANG, BANTEN 421610254- 387515| 0254-387494 Y Y ALL COVERAGE

091 3993 RS. KURNIA SERANG JL. RAYA CILEGON KM.8, DESA KRAMATWATU SERANG - BANTEN 0254-232648| 0254-8235050 Y Y ALL COVERAGE

092 0716 RS. BUDI ASIH JL. K.H. SOHARI, NO.39 0254-212484/218666| 0254-208583 Y Y ALL COVERAGE

093 3985 KLINIK & APOTEK MURASAKI MEDIKA KOMP.PEJATEN MAS BLOK C/1 PEJATEN KEC.WATU-BANTEN 0254233317| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

094 2413 KLINIK ANDRI MEDISTRA JL. N. RAYA SERANG JAKARTA KM 8 CIRUAS, SERANG - BANTEN -| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

095 2392 KLINIK & APOTIK BONA MEDIKA SERANG JL. RAYA SERANG - CILEGON, LEGOK SUKMAJAYA RUKO NO.5A1 0254-228005/ 387684| 0254-205906/386699 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

096 2608KLINIK & APOTEK KF 472 SERANG BARU

(GROUP 140)JL. AHMAD YANI NO. 57,SERANG 0254 211065| - N Y


RB,PHAR

097 2726 KLINIK & APOTEK KF 253 (GROUP 140) JL. YUSUF MARTADILAGA NO. 114 SERANG- BANTEN 0254-211447| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

098 4236 KLINIK ALTISJL. RAYA CILEGON KM.2 SABRNG RT.01/05, SERDANG KEC. KRAMATWATU,

SERANG(0254) 386325| - N Y


RB,PHAR

099 2414 KLINIK JANNAH JL. KH.ABDUL HADI NO.13 KEBUN JAHE SERANG, KAB.BANTEN 0254-209321| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

100 1414 RSIA. PURI GARCIAJL. GRIYA PURNAMA NO 99 TEGAL PADANG LEGOK, SERANG BANTEN

421620254-223333| 0254-223786; Y Y ALL COVERAGE

101 1272 RS. SARI ASIH SERANG JL. JEND.SUDIRMAN, NO.38, PENANCANGAN, CIPOCOK 0254-220022| 0254-220345 Y Y ALL COVERAGE

102 1489RS. HERMINA CIRUAS (D/H RS. CITRA MEDIKA

CIRUASJL. RAYA SERANG KM.9 DS.RANJENG - CIRUAS 0254-281829/ 0254-280555| 0254-281845 Y Y ALL COVERAGE

103 0115 KLINIK SERANG MEDIKA JL. RAYA SERANG CILEGON RUKO LEGOK SUKMAJAYA BLOK 5C NO.1 0254-223992| 0254-223992 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

104 1004 KLINIK WISATA MEDIKA JL. RAYA ANYER NO.9 0254-600933/605141/ 081905180805-|- 0254-605141 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

105 1008 KLINIK IKHLAS MEDIKA 1 KOMPLEK BUMI AGUNG PERMAI 1,NO. DI/6 0254-207918-|- 0254-281676 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

106 0937 KLINIK MODERN MEDIKA CIKANDE JL. RAYA SERANG KM.68 RUKO B6 CIKANDE SERANG 0254-400554-|- 0254-400556 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

107 0941 KLINIK MODERN MEDIKA KRAGILAN JL. RAYA SERANG KM15 RUKO D9 KRAGILAN 0254-281720-|- 0254-281720 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

108 1126 KLINIK KRAKATAU MEDIKA SERANG JL. TB SUWANDI, KAV KEMUNING NO. 1 LINGKAR SELATAN KEC SERANG 0254-204407| 0254-221397 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

TANGERANG

109 1555 RSIA. DHIA JL. CENDRAWASIH NO.90, SAWAH LAMA CIPUTAT, TANGERANG SELATAN 021-7494550/ 70310242| 021-7494551 Y Y ALL COVERAGE

110 1949 KLINIK & APOTEK KF 78 JL. A YANI NO 135 TANGERANG 021-5518433| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

111 0308 PAMULANG MEDICAL CENTER JL. RAYA PAMULANG BLOK D II NO.2, PAMULANG 021-740 5317| 021-7497624/7429156 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

112 0610 RSIA. PUTRA DALIMA GRIYA LOKA, SEKTOR 1.2, BLOK UA/26-27, BUMI SERPONG DAMAI021-5380375/5388279021-5388279 /

53741|021-5388279 / 53741021-5381220 Y Y ALL COVERAGE

113 0007 RS. UIN SYARIF HIDAYATULLAH JL. IR. H. JUANDA, NO.95, CIPUTAT 021-30010100/7402718/7499129| 021-7493532 Y Y ALL COVERAGE

114 0062 KLINIK SARANA MEDIKA BARU JL. RAYA PERUMAHAN KOTA BUMI KP.TERITI DS.KARET.SEPATAN 021-5921153 / 02159372781| 021-59308529 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

115 0291 RS. ICHSAN MEDICAL CENTER (IMC) JL. RAYA JOMBANG NO.56 BINTARO SEKTOR IX 021-7456379/ 021-7456386|021-7456386 021-7450819 Y Y ALL COVERAGE

116 0696 KLINIK DOKTER KELUARGA MAWAR JL. KARET RAYA, BLOK 7/69, PERUMNAS TANGERANG 021-5525633; 021-5913616|021-5913616 021-5913616 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

117 0344 RS. QADR KOMPLEK ISLAMIC VILLAGE, KELAPA DUA 021-546 4466; 5463107; 5463106| 021-547 0775 Y Y ALL COVERAGE

118 0064 RB & KLINIK 24 JAM DIANA PERMATA MEDIKA JL. MH. THAMRIN, NO.87C021-5397314/ 53124105021-

5395312|021-5395312021-5394105/5312410 N Y

GP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

119 0337 RS. BHINEKA BAKTI HUSADA JL. CABE RAYA NO.17 PONDOK CABE PAMULANG 021-7490018/7490829| 021-7403535 Y Y ALL COVERAGE

120 0902 RB & KLINIK BUNDA MULYA (H UPEN) JL. SUMANTRI NO. 11 MEKAR MULYA PARUNG PANJANG 021-5978058-|- 021-5978058 Y YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

121 0912 KLINIK KARUNIA SEHAT RUKO CIKUPA BLOK B NO.21-23, DEPAN PERUM CITRA RAYA- CIKUPA 021-5963001-|- 021- 59408388 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

122 0702 KLINIK MAHARANIJLN. BOROBUDUR RAYA NO 152 PERUMNAS II BENCONGAN KELAPA DUA,

TANGERANG021-55654096/5919953| - N Y


RB,PHAR

123 0285 RS. MELATI JL. MERDEKA, NO.92 TANGERANG 021-5523945/55776739| 021-55769914/5520028 Y Y ALL COVERAGE

124 0108 KLINIK PROVITA JL. IR.H.JUANDA NO.125 CIPUTAT 021-749 2619| 021-744 0085 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

125 0091 MAYAPADA HOSPITAL TANGERANG JL. HONORIS RAYA, KAV.6, KOTA MODERN/KODYA DATI II 021-5529035/55781999| 021-5529465/5529495 Y Y ALL COVERAGE

126 0022 RS. SARI ASIH KARAWACI JL. IMAM BONJOL NO.38021-552 2794; 021-5523239|021-

5523239021-5525214 Y Y ALL COVERAGE

127 0833 RSIA. BUNDA SEJAHTERA JL. RAYA PURI AGUNG NO 3, KOTA BARU- PASAR KEMIS 021-5925889| 021-5925876 Y Y ALL COVERAGE

128 0844 RSIA. BUNDA SEJATI JL. PRABU SILIWANGI NO.11, JATIUWUNG 021-5900136 / 59315850| 021-5900056 Y Y ALL COVERAGE

129 0859 RS. AMINAH TANGERANGJL. HOS COKROAMINOTO (CILEDUG RAYA) NO.4A KREO SELATAN-

LARANGAN021-7371919/021-7371818|021-7371818 021-7371333 Y Y ALL COVERAGE

130 0872 RB & KLINIK MUTIARA OBBINI MEDIKA JL. RAYA KRESEK NO.27, DS.MERAK, BALARAJA 021- 59431110-|- 021-59430131 Y YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

131 1014 RB & KLINIK PERMATA - DR JAMILAH JL. NUSA INDAH I, BLOK A7 NO.1, PERUM. CIBODAS 021-5533314| 021-5533314 Y YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

132 1025 RS. ARIYA MEDIKA JL. INDUSTRI RAYA 1, BLOK A, NO.1-6, JATAKE 021-5902229/5902232-|- 021-5902223/5904951 Y Y ALL COVERAGE

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133 0942 RSIA. MURNI ASIH JL. RAYA BOJONGNANGKA NO 86, MEDANG, PAGEDANGAN TANGERANG021-

36868757/5470263/54200982/546367202021-54204504 Y Y ALL COVERAGE

134 1046 RSIA. PRATIWI JL. RHM NOERADJI, NO.42, KARAWACI021-5520692/71342783021-

43933978|021-43933978021-5224139 Y Y ALL COVERAGE

135 1049 KLINIK SELARASJL. RAYA SERPONG BSD SEKTOR IV,RUKO E.NO.43-45 SERPONG-

TANGERANG021-5370311-|- 021-5377842 N Y


RB,PHAR

136 1168 RSU. BHAKTI ASIH JL. RADEN SALEH, NO.10, KARANG TENGAH 021-7305662/63/021-32575495| 021-73449491/7305652 Y Y ALL COVERAGE

137 0971 RS. ISLAM ASSHOBIRIN JL. RAYA SERPONG KM.11 PONDOK JAGUNG - SERPONG 021-5384314; 021-5374293|021-5374293 021-5374392/5374294 Y Y ALL COVERAGE

138 1116RS. AWAL BROS TANGERANG (D/H RS. GLOBAL

MEDIKAJL. MH.THAMRIN NO.3 KEBON NANAS -CIKOKOL 021-55758888/55780888/55781234| 02155780480/55781545 Y Y ALL COVERAGE

139 2440 LAB. PRODIA TANGERANGSUTERA NIAGA I NO. 21, RUKO ALAM SUTERA, SERPONG, TANGGERANG

15325021-539 9961| 021-5312 2589 N Y


RB,PHAR

140 2347 RS. PERMATA PAMULANG JL. RAYA SILIWANGI NO. 1 A, PAMULANG TANGERANG 021-74704999/74709079| 021 - 74709073 Y Y ALL COVERAGE

141 2609 KLINIK & APOTEK KF BERINGIN JL. BERINGIN RAYA NO.45, KARAWACI, TANGERANG 021 55763538| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

142 2469 KLINIK PRATAMA JL. CIRARAB RAYA NO.61 KEC. LEGOK TANGERANG - BANTEN 021- 54260359| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

143 1646 KLINIK JATI ELOKKOMP. BUMI JATI ELOK BLOK A I NO 7, JL. RAYA LEGOK-PARUNG

PANJANG KM. 3,MALANGNENGAH, PAGEDANGAN, TANGERANG, BANTEN021-98496234| 021-5977529 N Y


RB,PHAR

144 2774 RSIA. INSAN PERMATAJL. BHAYANGKARA 1 NO.68 KEL. PAKUJAYA, KEC. SERONG UTARA -

TANGERANG SELATAN021-53121344| 021-5396733 Y Y ALL COVERAGE

145 2744 RSIA. AQIDAH JL. RADEN FATAH NO.40 PARUNG SERAB, CILEDUG, TANGERANG 021 73450244, 7319025| 7310851 EXT.222 Y Y ALL COVERAGE

146 2807 KLINIK PERTAMEDIKA PONDOK RANJI JL. WR SUPRATMAN NO. 43 (KAMP UTAN) TANGERANG SELATAN 021-7355253| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

147 3982 KLINIK & APOTEK KF PALEM SEMIJL. RUKO BARCELONA NO.23 PERUMAHAN PALEM SEMI KARAWACI

TANGGERANG02129662588| N Y


RB,PHAR

148 3983 KLINIK & APOTEK KF CITRARUKO TAMAN PALMA JL. RAYA BOULEVARD BLOK G1 NO.25R CITRA RAYA-

CIKUPA02159409460| - N Y


RB,PHAR

149 0021SILOAM HOSPITALS LIPPO VILLAGE

(KARAWACI)JL. SILOAM NO.6, LIPPO KARAWACI 1600 021-80646900| 021-5460921/546008 Y Y ALL COVERAGE

150 1020 RSIA. SELARAS CIKUPA JL. RAYA SERANG KM.18,5 DS BOJONG, KEC CIKUPA KAB. TANGERANG 021-5969145/59401289/021-59401277| 021-59401277 Y Y ALL COVERAGE

151 2504 RS. HERMINA SERPONG JL. RAYA PUSPITEK KM.8 NO.99, SERPONG, TANGERANG SELATAN (021) 7588 4999| 021 - 75883704 Y Y ALL COVERAGE

152 1082 KLINIK TIGA MANDIRI JL. CABE RAYA NO 68D PONDOK CABE, TANGERANG SELATAN 021-7426366-|- 021-7426414 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

153 1552 BUNDA DALIMA HOSPITAL BUMI SERPONG DAMAI, SEKTOR XIV, BLOK J.11, NO.1 021-53154447/8/9| 021-5385062 Y Y ALL COVERAGE

154 1564 RSB. PERMATA SARANA HUSADA PAMULANG PERMAI, BLOK D3, NO.1-2, PAMULANG 021-7407421/22| 021-7496346/7407421 Y Y ALL COVERAGE

155 1527 RSIA. TIARA TANGERANG JL. RAYA SERANG, NO.1, KM.4.5, CIKUPA 021-59401999| 021-5960699 Y Y ALL COVERAGE

156 1528 RSIA ILANUR JL. RAYA SERANG, NO.1, BALARAJA 021-59450898/5953241| 021-5954473 Y Y ALL COVERAGE

157 1547 KLINIK AMIRA GRIYA LOKA SEK 1.6 BLOK A1 NO.3 BSD, TANGERANG SELATAN 021-5384219| 021-53164795 N YGP,SP,OP,DENTAL,MAT,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

158 1324 RSIA. CINTA KASIH JL. CIPUTAT BARU RAYA NO.10 CIPUTAT 021 - 74706020 / 7424639| 021 - 74707986 Y Y ALL COVERAGE

159 1366 KLINIK KARTIKAJL. WR SUPRATMAN NO.51 RENGAS CIPUTAT TIMUR, TANGERANG

SELATAN021-29053555,29053553| 021-73692937 N Y


RB,PHAR

160 1455 KLINIK PRADHANA RUKO PANORAMA NIAGA NO.14-15 JURUMUDI BARU BENDA 021-55767587| 2159308529 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

161 1459 KLINIK KARUNIA SEHAT IIJL. PAHLAWAN SERIBU RAYA RUKO TOL BOULEVARD BLOK B NO.18.BSD

CITY021-53158045| 021-53158046 N Y


RB,PHAR

162 1471 KLINIK MELIA MEDIKA KOMP. RUKO DUTA GARDEN SQUARE BLOK C NO 2, TANGERANG 021-51488219/54370568| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

163 1575 MOM & CHILD CARE CLINIC JL.RAYA KELAPA DUA RUKO PDA KAV.25-29 GADING SERPONG 021-54214848 / 083804104440| 021-54209393 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

164 1491 RS. HERMINA TANGERANG JL. KS.TUBUN NO.10 PASAR BARU 021-55772525| 021-5582705 Y Y ALL COVERAGE

165 1594 RSU. DINDA JL. GALUH NO.2 JATIUWUNG, TANGERANG 021-55650577| 021-55652149 Y Y ALL COVERAGE

166 1598 RS. KARANG TENGAH MEDIKA (GROUP YADIKA) JL. KARYAWAN IV, KARANG TENGAH TANGERANG 021-7336699/7335599| 021-7333598 Y Y ALL COVERAGE

167 1340 RSIA. KELUARGA KITA JL. RAYA PLP CURUG KM. 4 NO. 8, DS SUKABAKTI CURUG 021 - 59491011 / 021 - 5986572| 021-5984991/5982788 Y Y ALL COVERAGE

168 1292 RS. MEDIKA BSD JL. LETNAN SOETOPO KAV. KOM. III A NO 7, BSD TANGERANG 021 - 5372296| 021 - 5382296 Y Y ALL COVERAGE

169 0017 RS. AN-NISA TANGERANG JL. GATOT SOEBROTO, NO.96, KM.3, CIBODAS021-5525564/021-557 91563|021-557

91563021-55791563 Y Y ALL COVERAGE

170 0412RS. PREMIER BINTARO (d/h

RS.INTERNASIONAL BINTARO)JL. MH THAMRIN NO.1, SEKTOR 7, BINTARO JAYA 021-745 5500/27625500| 021-748 64854/745 58 Y Y ALL COVERAGE

171 1637 RS. MULIA INSANI JL. RAYA SERANG KM 16.8 CIKUPA TANGERANG 021-5962790/5962998/5962996| 021-5963099 Y Y ALL COVERAGE

172 1487 RS. MULYA JL. KH.HASYIM ASHARI NO.18 SUDIMARA PINANG 021-7322443; 7322445| 021-7310721/7322445 Y Y ALL COVERAGE

173 1669 RSIA. BUAH HATI CIPUTAT JL. ARIA PUTRA NO 399 SERUA INDAH CIPUTAT - TANGERANG 021-74632222| 021-74638568 Y Y ALL COVERAGE

174 1670 CIPUTRA HOSPITAL JL. CITRA RAYA BOULEVARD BLOK V 00/08 SEKTOR 3,4 KEC PANONGAN 021-59405555| 021-59405678 Y Y ALL COVERAGE

175 1812 SMILE N SHINE DENTAL CARE CENTER ALAM SUTERA TOWN CENTER (ASTC) BLOK 10D NO.6 0816869191 / 021-29008540| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

176 1866 KLINIK SATELIT GSM BINTARO JL. BINTARO JAYA SEKTOR IX RUKO ELANG RAYA KAV.1 NO.10-11 021-7450818| 021-7450642 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

177 1947 KLINIK & APOTEK KF 219 JL. IR H JUANDA NO 111 SITUGINTUNG, CIPUTAT 021-7401868| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

178 1810 RS. KHUSUS BEDAH THT PROKLAMASI BSDCOMMERCIAL PARK CENTRAL BUSINESS OF DISTRICT BSD KAV.7

TANGERANG SELATAN021-29002929| 021-29002930 Y Y ALL COVERAGE

179 1935 APOTIK FARMARIN IV BINTARO BINTARO UTAMA SEKTOR 3 BLOK AM, BINTARO JAYA 021-7357077| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

180 1948 KLINIK & APOTEK KF 115 JL. PAMULANG PERMAI RAYA NO D2/1A TANGERANG 021-7498708| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

181 1467 RSIA. MUTIARA BUNDA TANGERANG JL. DR. CIPTO MANGUNKUSUMO, NO.3, CILEDUG 021-7301365/73454951| 021-73454952 Y Y ALL COVERAGE

182 1608 RS. SARI ASIH CIPUTAT JL. OTISTA RAYA NO. 3 SASAK TINGGI CIPUTAT, TANGERANG SELATAN 021-7410808| 021-7424445 Y Y ALL COVERAGE

183 1086 RSU. SARI ASIH SANGIANG JL. RAYA MAUK.KM.3,5 SIMPANG TIGA SANGIANG 021-5582732|- 021-55791307 Y Y ALL COVERAGE

184 1768 KLINIK SATELIT GSM TANGERANGJL. KH. HASYIM ASHARI BABAKAN TANGERANG, RUKO MODERNLAND BLOK

AR NO 19-20021-55748000| 021-4254816 N Y


RB,PHAR

185 1985 RS. MEDIKA LESTARIJL. HOS COKROAMINOTO PERUM PONDOK LESTARI BLOK C.1 NO.1-2

CILEDUG021-5854858| 021-7304150/021-7320 Y Y ALL COVERAGE

186 1223 EKA HOSPITAL BSD CENTRAL BUSINESS DISTRICT, LOT IX, BSD CITY 021-25655555| 021-25655544 Y Y ALL COVERAGE

187 1682 RSU. ST CAROLUS SUMMARECON JL. GADING GOLF BOULEVARD KAV. 08 GADING SERPONG 021-54220811| 021-54220810/5422008 Y Y ALL COVERAGE

188 1659 RS. HERMINA CIPUTAT JL. CIPUTAT RAYA NO.2 KERTAMUKTI, CIPUTAT 021-74702525/30492525/30492524| 021-74700999 Y Y ALL COVERAGE

189 6387 AUDY DENTAL BINTARORUKAN VICTORIAN BINTARO BLOK AA NO.03, JL. BINTARO UTAMA SEKTOR

3A, PONDOK AREN, TANGERANG SELATAN(021) 22734928 / 081382154488| - N Y


RB,PHAR

190 6389 J & J DENTAL CARE TANGERANGJL. RAYA KELAPA DUA PARAMOUNT SPARKS BLOK A NO. 18 KEC. KELAPA

DUA TANGERANG-| - N Y


RB,PHAR

191 0955DENTAL PREMIER BINTARO ( D/H DENTAL

INTERNASIONALJL. MH THAMRIN NO.1, SEKTOR 7, BINTARO JAYA 021-745 5500; 021-27625500 ext 1680|- 021-748 64854/745 58 N Y DENTAL

192 0737 RS. USADA INSANI JL. KH HASYIM ASHARI NO.24 CIPONDOH, TANGERANG021-55752575/5521270021-

55755665/5521272|021-021-55754335 Y Y ALL COVERAGE

193 1619 RSIA. BUAH HATI PAMULANG JL. RAYA SILIWANGI NO 189 PONDOK BENDA PAMULANG 021-7421149 / 7414488| 021-7420322 Y Y ALL COVERAGE

194 0733 RS. OMNI ALAM SUTERA JL. ALAM SUTERA BOULEVARD KAV.25 SERPONG021-29779999/85550711 - 353438|0711 -

353438021-5312 8666 Y Y ALL COVERAGE

195 2819 LAB. PRODIA BUMI SERPONG DAMAI (BSD)JL. LETNAN SUTOPO, RUKO GOLDEN MADRID BLOK B NO.1-2, BUMI

SERPONG DAMAI021-53160403/4| 021-53160406 N Y


RB,PHAR

196 3791 RSIA. CITRA ANANDA JL. RE MARTADINATA NO. 30, CIPUTAT (021) 7401347/ 0852 1795 1795| (021) 7491701 Y YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

197 2081 RS ARIA SENTRA MEDIKA JL. ARIA PUTRA NO. 9 KEDAUNG PAMULANG, TANGERANG SELATAN 15431 021-7499199/ 7401376| 021-7495864/7400956 Y Y ALL COVERAGE

198 1867 KLINIK SATELIT GSO CENGKARENGAREA PERKANTORAN GARUDA SENTRA OPERASI (GSO) GEDUNG

POLIKLINIK GSM BANDARA SOEKARNO-HATTA CENGKARENG021-25601565| 021-5501801 N Y


RB,PHAR

199 6002 KLINIK & LAB BETH RAPHA AGAVE INSANIJL. MAULANA HASANUDIN Gg.AMPERA II NO.7-8, PORIS GAGA, BATU

CEPER021-5445855 / 68800855| 021-5445855 N Y


RB,PHAR

200 3978 KLINIK & APOTEK KF 447 CIRENDEU JL. CIRENDEU RAYA NO.27C CIPUTAT 021-7415997| -021-7415997 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

201 3999 KLINIK PESONA LEGOKJL. RAYA LEGOK KM 7 DESA CIJANTRA KEC. LEGOK, KARAWACI,

TANGERANG, BANTEN021-54220281| - N Y


RB,PHAR

202 2337 KLINIK TUMBUR JL.PAHLAWAN NO.4 SITUGINTUNG REMPOA CIPUTAT TIMUR 0217492818| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

203 6457 KLINIK DARMA NUSANTARA JL. RAYA SERANG KM 9 BITUNG KADU CURUG 021- 5566316| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

204 4697 KLINIK ICHSAN BINTAROKEBAYORAN ARCADE III BLOK KA/E 1-22, JL. BOULEVARD BINTARO JAYA

SEKTOR 7/ BINTARO JAYA - TANGERANG SELATAN 15229(021) 29521655| (021) 2952 1655 N Y


RB,PHAR

205 0936 RS. SARI ASIH CILEDUG JL. HOS COKROAMINOTO NO.38 CILEDUG021-7333430/ 33553359021-

7332758|021-7332758021-7333441 Y Y ALL COVERAGE

206 1968 BETHSAIDA HOSPITALDISTRICT TIVOLLI NO.1 PARAMOUNT SERPONG, JL. BOULEVARD RAYA

GADING SERPONG KAV.29021-29309999| 021-29542637 / 39 Y Y ALL COVERAGE

207 4695 RS. TIARA TANGERANGJL. BRINGIN RAYA NO. 3-4-5, KEL. NUSAJAYA, KEC. KARAWACI,

TANGERANG(021) 29238000| (021) 29237999 Y Y ALL COVERAGE

208 3532 CLINIC ICON 8 JL. HORISON BROADWAY BLOK M2 NO. 3 BSD CITY , TANGERANG (021) 33438000/ 021 94588000| (021) 68538820 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

209 4747 RS. HERMINA BITUNGJL. RAYA SERANG KM. 10 RT 001/RW 004 KEL. CURUNG DESA KADU. KAB.

TANGERANG021-59497525| 021-59497690 Y Y ALL COVERAGE

210 4657 RSIA. BUNJL. RAYA KOSAMBI TIMUR RAYA NO. 2, RT. 011/ RW. 004, KEL. KOSAMBI

TIMUR, KEC. KOSAMBI, TANGERANG, BANTEN(021) 70610735; 29031299| - Y Y ALL COVERAGE

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211 4684 KLINIK ALFAKOMP. RUKO W.S FAMILY, JL. GARUDA NO.10/3, KEL. BATU CEPER,

TANGERANG(021) 95000408| - N Y


RB,PHAR

212 3979 KLINIK & APOTEK KF 267 BINTARO JL. BINTARO UTAMA V BLOK EA 2 NO.35 BINTARO 021-7371018| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

213 2863 LAB. PRODIA BINTAROJL. RUKO KEBAYORAN ARCADE 2 SEKTOR 7, BLOK 33-35, BINTARO-

TANGERANG021-7370185; 29511799| 021-29511798 N Y


RB,PHAR

214 3701 PRODIA GADING SERPONGRUKO PARAMOUNT CENTER 1A/ 32 JL. KELAPA DUA, GADING SERPONG,

TANGERANG(021) 29014884, 29014885| - N Y


RB,PHAR

215 1774 RS. DR. SUYOTO PUSREHAB KEMHAN JL. RC VETERAN NO. 178 BINTARO 021-7342012 / 73884000| 021-7342581, 7369156 Y Y ALL COVERAGE

216 4321 JAKARTA BOUTIQUE DENTAL CENTER (JBDC)JL. MALEO RAYA BLOK . JE 8/9 BINTARO, PONDOK PUCUNG, PONDOK

AREN, TANGERANG SELATAN021 745 8195| - N Y


RB,PHAR

217 0772 MEDIPRO CLINIC PASAR KEMIS PERUM WISMA MAS, BLOK A1, NO.30-31, PASAR KEMIS, KUTA JAYA 021-59318964| 021-59318965 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

218 2360 RS. PERMATA IBU TANGERANG JL. KH. MAS MANSYUR NO.2 KUNCIRAN TANGERANG 021-7334343/ 7300883| - Y Y ALL COVERAGE

TANGERANG SELATAN

219 5550 FRIENDLY DENTAL CARE BSD RUKO BIDEX B16, BSD CITY, SERPONG 021-531164571, 08158939191| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

220 5640 RS. PONDOK INDAH BINTARO JAYA CBC EMERALD BLOK CE/C NO. 01, BOULEVARD BINTARO JAYA 021-80828888| 021-8082 8877 Y Y ALL COVERAGE

221 3047 RSIA. VITALAYA JL. RAYA SILIWANGI NO.1 PERUM PONDOK BENDA INDAH NO.1, PAMULANG 021-7470 3313| 021-74701453 Y Y ALL COVERAGE

BENGKULU

BENGKULU

222 2109 APOTEK KIMIA FARMA 220 BENGKULU JL. S. PARMAN BENGKULU -| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

223 5415 KLINIK RAWAT INAP RAFAELA KENCANAJL. FLAMBOYAN DESA GIRI KENCANA NO. 104 KETAHUN BENGKULU UTARA,

BENTONG(085268347777)| - N Y ALL COVERAGE

224 0848 RS. TIARA SELLA JL. S PARMAN NO. 61 PADANG JATI, BENGKULU 0736-20350 021-8221574|021-8221574 0736-20626 Y Y ALL COVERAGE

225 1551 RS. BHAYANGKARA BENGKULU JL. VETERAN, NO.2 0736-341086/21553| 0736-349050 Y Y ALL COVERAGE

226 2108 APOTEK KIMIA FARMA 72 BENGKULU JL. SUPRAPTO NO. 48 BENGKULU 0736-20601| 0736-20601 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

227 1021 RS. RAFFLESIA BENGKULU JL. MAHONI NO.10, PADANG JATI 0736-21710|- 0736-342677/21954 Y Y ALL COVERAGE

DAERAH ISTIMEWA YOGJAKARTA

BANTUL

228 1437 RS. PKU MUHAMMADIYAH BANTUL JL. JEND. SUDIRMAN 124-126 0274-368587| 0274-368586 Y Y ALL COVERAGE

SLEMAN

229 4334 RS. HERMINA YOGYAJL. MATARAMAN HERMINA RT 06 RW 50 GONDANGAN RINGINSARI

MAGUWOHARJO, DEPOK0274-2800808/2800909| 0274-2800909 Y Y ALL COVERAGE

230 2974 RSI. YOGYAKARTA PDHI JL. SOLO KM. 12,5 KALASAN, SLEMAN, YOGYAKARTA (0274) 498000| (0274) 498464 Y Y ALL COVERAGE

231 1674 RS. PKU MUHAMMADIYAH UNIT II JL. WATES KM 5,5 GAMPING SLEMAN YOGYAKARTA 0274-6499704/6499706| 0274-6499727 Y Y ALL COVERAGE

232 3088 RSU. QUEEN LATIFA JL. RING ROAD BARAT NO. 118 MLANGI NOGOTIRTO GAMPING SLEMAN 0274-581402| 0274-626309 Y Y ALL COVERAGE

233 4170 KLINIK PRATAMA DKJL. RING ROAD UTARA NO. 17 A KARANGNANGKA RT 07 RW 13,

MAGUWOHARJO DEPOK SLEMAN0274-4333679| 0274-4333679 N Y


RB,PHAR

234 1229 JOGJA INTERNATIONAL HOSPITAL (JIH) JL. RING ROAD UTARA NO.160 CONDONG CATUR 0274-4463535/4463190| 0274-4463444 Y Y ALL COVERAGE

YOGYAKARTA

235 3986 KLINIK THC TIMOHO YOGYAKARTA JL. TIMOHO NO. 86 YOGYAKARTA 0274-5305079| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

236 1255 RS. MATA DR.YAP JL. TEUKU CIK DITIRO, NO.5 0274-562054| - Y Y ALL COVERAGE

237 0747 RS. PANTI RAPIH JL. CIK DITIRO, NO.30 0274-514014/514845/563333| 0274-564583 Y Y ALL COVERAGE

238 3297 LAB. CITO YOGYAKARTA JL. ATMOSUKARTO NO. 4 KOTABARU YOGYAKARTA 0274 563656| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

239 2864 RS. AN NUR JL. N.COLOMBO, NO. 14, YOGYAKARTA 0274-585848/0274-514784| 0271-564110 Y Y ALL COVERAGE

240 2768 KIMIA FARMA 21 JL. MALIOBORO - YOGYA 0274 514980| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

241 2170 APOTEK FARMARIN YOGYAKARTA JL. P. MANGKUBUMI NO.73 YOGYAKARTA 0274-7822198| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

242 0077 RS. BETHESDA YOGYAKARTA JL. JEND.SUDIRMAN NO.700274-586688/5622460274 -586688|0274 -

5866880274-563312,521251 Y Y ALL COVERAGE

243 2616 KIMIA FARMA 401 JL. SETURAN,C 3/B, JOGJA 0274 4332880| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

244 2617 KLINIK & APOTEK KF 275 JL. KALIURANG KM.6 NO.48 0274-886981/885220| 0274-886981 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

245 2618 KLINIK & APOTEK KF 70 JL. ADISUCIPTO 63A, JOGJAKARTA 0274 489135| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

246 2619 KLINIK & APOTEK KF 316 JL. PALAGAN, JOGJA 0274 869944| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

247 0991 SILOAM HOSPITALS YOGYAKARTAJL. LAKSDA ADISUCIPTO N0. 32-34 DEMANGAN GONDOKUSUMAN

YOGYAKARTA(0274) 4600 900|- (0274) 4600 922 Y Y ALL COVERAGE

248 1400 RSU. BETHESDA LEMPUYANGWANGI JL. HAYAM WURUK NO.6 0274-512257/588002| 0274-547253 Y Y ALL COVERAGE

249 1286 RS. HAPPYLAND MEDICAL CENTER JL. IPDA TUT HARS. ONO NO. 53, TIMOHO 0274-550060/58| 0274-550061 Y Y ALL COVERAGE

250 0604 RS. LUDIRA HUSADA TAMA JL. WIRATAMA NO.4 TEGALREJO 552440274 2871840/ 620333/620373/0274-

620091|0274-6200910274-589087 Y Y ALL COVERAGE

251 2909 LAB. PRODIA BINTARAN YOGYAKARTA JL. BINTARAN KULON NO. 28 YOGYAKARTA 55151 0274-373271/375273| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

252 2908 LAB. PRODIA MANGKUBUMI YOGYAKARTA JL. PANGERAN MANGKUBUMI NO. 50 YOGYAKARTA 55232 0274-580675/515818| 0274-584911 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

253 4036 KLINIK KHADIJAH JL. PURWANGGAN NO. 45 0274-513357| 0274-513357 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

254 0606 RS. PKU MUHAMMADIYAH YOGYAKARTA JL. K.H. ACHMAD DAHLAN, NO.20 0274-512653-|- 0274-566129 Y Y ALL COVERAGE

DKI JAKARTA

JAKARTA BARAT

255 6428 TOOTH AND TEETH DENTAL CLINICRUKAN PURI BOTANICAL RESIDENCE BLOK I 10 JL. JOGLO RAYA NO.51

KEMBANGAN021-58900413 - 414| - N Y


RB,PHAR

256 6249 RSUD TAMAN SARI JL. MADU NO.10 KEL MANGGA DUA KEC TAMANSARI JAKARTA BARAT 021-26564276| - Y Y ALL COVERAGE

257 0204 RS. MEDIKA PERMATA HIJAU JL. RAYA KEBAYORAN LAMA, NO.64021 - 530 5288, 534 7411,021 - 534

741|021 - 534 741021-53652856/5305291 Y Y ALL COVERAGE

258 0782 KLINIK MHT ANGKE JL. TUBAGUS ANGKE NO.27. TAMAN DUTA MAS BLOK D-9B NO.2-3 021- 5675259/5679165| 021-5679165 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

259 0771 KLINIK YADIKA TEGAL ALUR JL. KAMAL RAYA BLOK A7 NO.7-11 TEGAL ALUR 021-70605247 / 55351876| 021-55963484 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

260 0846 RS. JANTUNG HARAPAN KITA JL. LETJEN S PARMAN KAV.87 SLIPI 021-5684093 / 5684085| 021-5601816 Y Y ALL COVERAGE

261 0943 KLINIK MATA NUSANTARA (KEBON JERUK) JL.ARJUNA UTARA NO.50, KEBON JERUK 11510 (021) 564 6688|- (021) 564 2072 N Y GP,OP

262 0695 KLINIK KUSUMA I JL. PETA SELATAN, NO.50 kalideres 021-541 9747| 021-54360626 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

263 2294 RS. JAKARTA EYE CENTER KEDOYA JL. TERUSAN ARJUNA UTARA NO. 1 KEDOYA, JAKARTA BARAT 11520 021-29221000| - Y Y ALL COVERAGE

264 2640 KLINIK & APOTEK KF 254 JL. RAYA POS PENGUMBEN NO.11 JAKARTA BARAT 021 5349063| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

265 1102 RS. BHAKTI MULIA JL. AIPDA K.S.TUBUN, NO.79 021-5481625-|- 021-5331544 Y Y ALL COVERAGE

266 1127 JESSLYN MEDICAL CENTER PERUM.TAMAN SURYA III BLOK F/63 CENGKARENG 021-54365638| 021-54365638 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

267 1479 RS. PONDOK INDAH PURI INDAH JL. PURI INDAH RAYA BLOK S2, KEMBANGAN SELATAN 021-25695222/25695200| 021-25695265 Y Y ALL COVERAGE

268 0736 RSUD. CENGKARENG JL. N. KAMAL RAYA, BUMI CENGKARENG INDAH, CENGKARENG TIMUR 021-54372874/5/6 / 54372882| 021-54374579 Y Y ALL COVERAGE

269 0390 RS. HERMINA DAAN MOGOT JL. KINTAMANI RAYA, NO.2, PERUMAHAN DAAN MOGOT BARU 021-5408989| 021-5449869 Y Y ALL COVERAGE

270 0643 RS. GRHA KEDOYA JL. PANJANG NO 26, KEDOYA UTARA 021-56982222/29910999| 02129910987/56982233 Y Y ALL COVERAGE

271 0381 KLINIK MHT CENGKARENG JL. DAAN MOGOT, KM.17 021-54396298/6194581| 021-6194581 N Y ALL COVERAGE

272 0109 RSAB. HARAPAN KITA JL. JEND S.PARMAN, KAV.87, SLIPI021-5668284/5686404/5683053021-566

8284|021-566 8284021-5601816,5668285 Y Y ALL COVERAGE

273 0836 RS. ROYAL TARUMA JL. DAAN MOGOT NO.34 GROGOL 021-56967788/56958338|- 02156967756/56958589 Y Y ALL COVERAGE

274 0783 KLINIK MHT KALIDERES JL. PETA SELATAN A/2 KALIDERES, JAKARTA BARAT 021- 545602708| 021- 5456027 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

275 3977 KLINIK & APOTEK KF 282 JL. AIPDA KS TUBUN NO.84 B-C JAKARTA 081372756593| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

276 3166 LAB. PRODIA PURI INDAHKOMPLEK SENTRA NIAGA PURI INDAH BLOK T/6 NO.28, JL. PURI LINGKAR

DALAM JAKARTA BARAT021-58304501| N Y GP,LAB

277 4353 MITRA KELUARGA KALIDERES JL. PETA SELATAN NO. 1 RT 007/011 KALIDERES 021-22523700| 021-22523702 Y Y ALL COVERAGE

278 3211 GETHEALTHY CLINICRUKAN SIXTH AVENUE J01 A NO. 20-22, CITRA 6, KALIDERES, JAKARTA

BARAT021-29030041/42| 021-29030045 N Y


RB,PHAR

279 1945 KLINIK & APOTEK KF 96 JL. LET JEND S PARMAN KAV G/12, SLIPI, JAKARTA BARAT 021-5303347/57| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

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280 4770 KLINIK CIPUTRA CITRA GARDEN CITYJL. CITRA 2 BLOK J 2 CITRA GARDEN CITY RT. 002/RW. 012 KEL.

PEGADUNGAN KEC. KALIDERES, JAKARTA BARAT021-29038871-3| - N Y


RB,PHAR

281 0101 SILOAM HOSPITALS KEBON JERUK JL. RAYA PERJUANGAN, KAV.8, KEBON JERUK021- 25677888/021-5300889|021-

5300889021-5321766 Y Y ALL COVERAGE

282 4492 KLINIK VIVA MEDIKA CENTRO CITYJL. MACAN KAV. 4-5 BLOK S16-S20, RT 010/001, KEL. KEDOYA UTARA KEC.

KEBON JERUK, JAKARTA BARAT(021) 29666764 / 50200730| - N Y


RB,PHAR

283 4678 KLINIK BAMEDJL. PENYELESAIAN TOMANG IV KAVLING. DKI BLOK 95 NO. 1, MERUYA

UTARA - KEMBANGAN021 - 584 3456 / 584 46512| (021) 5867004 N Y


RB,PHAR

284 3735 PRODIA KEDOYA-JL. KEDOYA AGAVE RAYA, PERKANTORAN TOMANG TOL RAYA BLOK A

II/22, JAKARTA BARAT 11520(021) 5803066, 5812941| - N Y


RB,PHAR

285 4679 KLINIK KLJL. ARIES UTAMA BLOK E.1 NO. 1 N-M, KEL. MERUYA UTARA, KEC.

KEMBANGAN, JAKARTA BARAT(021) 29415300| 021-29319150 N Y


RB,PHAR

286 3601 PRODIA CIDENG JL. CIDENG BARAT NO. 36 A, JAKARTA PUSAT 10150 (021) 6321820| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

287 4514 PRODIA DAAN MOGOT BARU JL. TAMPAK SIRING BLOK KJG NO. 10 JAKARTA 021-54392150-29038204| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

288 4822 KLINIK MAYAPADA CENTRAL PARKJL. TANJUNG DUREN RAYA GRAND SHOPPING ARCADE BEAUFORT 8 NO.

AC, KEL. TANJUNG DUREN SELATAN, KEC. GROGOL PETAMBURAN, JAKARTA (021) 29859901| - Y Y


RB,PHAR

289 0018 RS. PELNI JL. AIP II K.S. TUBUN, NO.92-94, PETAMBURAN021-5306901-

9/5349475/5460608/5484809021-0215483145/5306904/7 Y Y ALL COVERAGE

290 5539 KLINIK TERATAI KEBON JERUKJL. KEBON JERUK RAYA NO. 68 RT. 001 RW. 011 KEL. KEBON JERUK KEC.

KEBON JERUK, JAKARTA BARAT(021) 22534039| - N Y


RB,PHAR

291 0952 RS. PATRIA IKKT JL. CENDRAWASIH NO.1 KOMP DEPHAN/MABES TNI 021-5308981-84-|- 021-5346387 Y Y ALL COVERAGE

292 5078 RSIA. BINA SEHAT MANDIRIJL. DURI RAYA NO. 22 KEL. DURI KEPA KEC. KEBON JERUK, JAKARTA

BARAT(021) 5669411/12 / 5658870| 021 5603531/5658870 Y Y ALL COVERAGE

293 4686 RS. CIPUTRA CITRA GARDEN CITYJL. BOULEVARD BLOK G-01/01 5 CITRA GERDEN CITY, KRL. PEGADUNGAN

KEC. KALIDERES JAKARTA BARAT 11830(021) 2255 7888| - Y Y ALL COVERAGE

294 6382 AUDY DENTAL GREENVILLE JL RATU KEMUNING BLOK BK NO.6 GREENVILLE (021) 29401060 / 082211700082| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

JAKARTA PUSAT

295 2637 KLINIK & APOTEK KF 2 JL. RAYA SENEN NO. 66 021 384-4788; 384-0742| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

296 4238 MP DENTAL CENTERHOTEL INTERCONTINENTAL LG FLOOR R27-28, JL. JEND SUDIRMAN KAV.10-

11, KEL. KARET TENGSIN, KEC. TANAH ABANG(021) 5735336| - N Y


RB,PHAR

297 2507 MITRASANA IHC KALBE CEMPAKA PUTIH JL. LETJEN SUPRAPTO KAV 4 CEMPAKA PUTIH, JAKARTA PUSAT 021-42873888 EXT : 1451| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

298 4228 RS. LADOKGI JL. FARMASI NO.1, TANAH ABANG, JAKARTA PUSAT (021) 573 3026| - Y Y ALL COVERAGE

299 0788 RSPAD GATOT SUBROTO (PAV.KARTIKA) JL. ABDUL RACHMAN SALEH NO.24021-384 0484, 3441008021-376134|021-

376134021-3859460,3501308 Y Y ALL COVERAGE

300 4375 KLINIK MATA NUSANTARA (Kemayoran)GEDUNG DATA SCRIPT LT.6 KAWASAN NIAGA SELATAN BLOK B-15,

KEMAYORAN(021) 654 6688| (021) 654 5208 N Y GP,OP

301 1837 E-LAB. S PERCETAKAN NEGARA JL. PERCETAKAN NEGARA NO 17 JAKARTA PUSAT -| - N YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

302 4662 KLINIK & APOTEK KF PPBM BANK MANDIRI JL. RP.SOEROSO NO.2-4 CIKINI 021-2300 181| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

303 0397 KLINIK BARUNA JL. CIKINI RAYA NO.60 R/S 021-3141040-059| 021-3151065 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

304 1914 RSUD. TARAKAN JAKARTA JL. KIYAI CARINGIN NO 7, JAKARTA PUSAT 021- 3503150, 3503003, 3842934| 021-3810149, 3503412 Y Y ALL COVERAGE

305 0599 RS. KRAMAT 128 JL. KRAMAT RAYA, NO.128 021-3909814/3918287/3909514| 021-3909125 Y Y ALL COVERAGE

306 1387 BRAWIJAYA CLINIC UOBJL. MH THAMRIN NO.8-9, ANZ SQUARE (UOB PLAZA) BASEMENT 1 UNIT C

1-3021-29261880| 021-29261890 N Y


RB,PHAR

307 0600 RS. ST. CAROLUS JL. SALEMBA RAYA, NO.41 021-3904441| 021-3922831/3154183 Y Y ALL COVERAGE

308 0029 RSU. EVASARI JL. RAWAMANGUN NO.47 - PRAMUKA 021-4202851/52| 021-4209725 Y Y ALL COVERAGE

309 0787 RS. KHUSUS THT-BEDAH PROKLAMASI JL. PROKLAMASI NO.43021-

3900002/3906893/3144795/3909783|021- 3900947/3152548 Y Y ALL COVERAGE

310 0790 RSIA. BUNDA JAKARTA JL. TEUKU CIK DITIRO NO.28, MENTENG(021) 31922005 / 3143215|(021)

31922005021- 3928583,3928585 Y Y ALL COVERAGE

311 1115 RSPAD GATOT SUBROTO (PAV.IKA) JL. ABDUL RACHMAN SALEH NO.24 021-3504614| 021-3520643 Y N ALL COVERAGE

312 0802 SAHID SAHIRMAN MEMORIAL HOSPITAL JL. JEND.SUDIRMAN, NO.86 021- 57853911|021- 5727210 021- 57853922 Y YH&S,GP,SP,OP,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

313 0398 RS. MH. THAMRIN INTERNASIONAL JL. SALEMBA TENGAH, NO.26-28 021-3904422| 021-3926934,3926931 Y Y ALL COVERAGE

314 0705 KLINIK SWA INDOMEDIKA JL. JEND SUDIRMAN KAV 1, GD BNI 46 LANTAI BASEMENT 1 021-5728987| 021-5728990 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

315 0011 RS. MITRA KELUARGA KEMAYORAN JL. HBR MOTIK LANDAS PACU TIMUR, KEMAYORAN JAKPUS 021-6545555/888| 021-6545959 Y Y ALL COVERAGE

316 1019 RSPAD GATOT SUBROTO (P.DARMAWAN) JL. ABDUL RACHMAN SALEH NO.24021-3840484/3500004/021-376134|021-

376134021-3441903/3859460 Y Y ALL COVERAGE

317 0392RS. HERMINA KEMAYORAN (d/h RSIA HERMINA

PODOMORO)

JL. SELANGIT BLOK B.10, KAV. 4 KEL GUNUNG SAHARI, KEMAYORAN,

JAKARTA PUSAT021-22602525 WA 085694155353| - Y Y ALL COVERAGE

318 2406 HENDRA HIDAYAT DENTAL CENTER (HHDC)THAMRIN CITY - OFFICE SUITE FLOOR 3 UNIT 2, JL. KH. MAS MASYUR

JAKARTA021-3199 7482| - N Y


RB,PHAR

319 2636 KLINIK & APOTEK KF 1 JL. GARUDA NO.47, JAKPUS 021 424-5572| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

320 2794 KLINIK PERTAMEDIKA KANTOR PUSAT JL. PERWIRA 2 - 4 JAKARTA PUSAT 021-3816104/3815970/3815687| -- N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

321 1406 APOTIK FARMARIN I KEBON SIRIHGEDUNG BANK INDONESIA JL. KEBON SIRIH NO 82 DAN 84 GEDUNG

KEBON SIRIH LT 1021-29810000 / 29815268| 021-2311940 N Y


RB,PHAR

322 1069 RSPAD GATOT SUBROTO(P.IMAM SUJUDI) JL. ABDUL RAHMAN SALEH NO.24 021-3441008-|- 021-3859460 Y N ALL COVERAGE

323 1078 RSIA. BUDI KEMULIAAN JL. BUDI KEMULIAAN NO.25 021-3842828-|- 021-3501012 Y Y ALL COVERAGE

324 1358 RSIA. YPK MANDIRI JL. GEREJA THERESIA, NO. 22 021-3909725| 021-3909806 Y Y ALL COVERAGE

325 1477 BUNDA INTERNASIONAL CLINIC JL. TEUKU CIK DITIRO NO.12, MENTENG 021-29186133.| 021-3926494 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

326 0013 RS. PGI. CIKINI JL. RADEN SALEH, NO.40 021-38997777| 021-324663/ 3910277 Y Y ALL COVERAGE

327 1590 RS. BEDAH THT PROF. NIZAR JL. KESEHATAN NO.9 021- 3503435/34834982| 021-34834982 Y Y ALL COVERAGE

328 1612 LAB. KLINIK BIOTEST MENTENG JL. SUMATERA RT. 002 / 04, MENTENG 021-31937784| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

329 1577 KLINIK MIRACLE ( GD INDOFOOD )INDOFOOD TOWER - PLAZA SUDIRMAN LT 8, JL. JEND SUDIRMAN KAV 76-

78021-57954537/38| 021-57954541 N Y


RB,PHAR

330 0953 RS. ISLAM JAKARTA (CEMPAKA PUTIH) JL. CEMPAKA PUTIH TENGAH I/1021-4250451/42801567021-

42801567|021-42801567021-4266546 Y Y ALL COVERAGE

331 1105 RS. JAKARTA EYE CENTER MENTENG JL. CIK DI TIRO 46, MENTENG 021-29221000/31935600|021-31935600 021-3904601 Y Y ALL COVERAGE

332 1709 KLINIK WISMA PT YPK MANDIRI WISMA MANDIRI LT I, JL. MH THAMRIN NO 5 021-39832805| 021-39832806 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

333 0042 RS. PERTAMINA JAYA JL. A. YANI NO.2 021-4204056/4211911|021-4211911 021-4211913 Y Y ALL COVERAGE

334 0135 RS. ABDI WALUYO JL. H.O.S. COKROAMINOTO, NO.31-33 021-3144989| 021-31930866 Y Y ALL COVERAGE

335 0793 KLINIK YES CARE JL. WAHID HASYIM NO. 31C 021-3915487| 021-3146659 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

336 0789 KLINIK MHT SERDANG JL. H. UNG E - 71/2 KEMAYORAN 021-4249519| 021- 4249519 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

337 2733 KINAN MEDICAL CENTERKOMPLEK RUKO RAWASARI MAS NO.B10 JL. PERCETAKAN NEGARA,

CEMPAKA PUTIH JAKARTA PUSAT-| - N Y


RB,PHAR

338 2735 THOMSON SPECIALIST CENTER JL. IMAM BONJOL NO.72, MENTENG JAKARTA PUSAT 10310 021-3910030| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

339 1633 KLINIK GARUDA SENTRA MEDIKA ( GSM ) JL. ANGKASA BLOK B.15 KAVLING 1, KEMAYORAN 021-4241000| 021-4254816 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

340 1232 KLINIK PRODIA HEALTH CARE KRAMAT JL. KRAMAT RAYA NO.150 021 - 3906709| 021- 3922721 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

341 2405 HENDRA HIDAYAT IMPLANT CENTERSAHID SUDIRMAN RESIDENCE LT. 1 UNIT 1, JL. JEND. SUDIRMAN NO. 86

JAKARTA PUSAT021-52970102/104| 021-52970205 N Y


RB,PHAR

342 1954 RS. UPN CIPTO MANGUNKUSUMO (KENCANA) JL. DIPONEGORO NO. 71 JAKARTA PUSAT 1500135 , 021 - 92005164| - Y Y ALL COVERAGE

343 1054 RS. HUSADA JL. RAYA MANGGA BESAR 137-139, JAKARTA PUSAT BAG UTARA 021-6260108/021-6490090|021-6490090 021-6497494 Y Y ALL COVERAGE

344 1700 FHL DENTAL CLINIC GEDUNG BRI II LT.15 SUITE 1509 JL. JEND SUDIRMAN NO 44-46 021-57851127/ 57930552| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

345 1702 RS. KHUSUS BEDAH SS MEDIKA JL. SALEMBA I NO 11 JAKARTA PUSAT 021-3913336/3926689| 021-3926687 Y Y ALL COVERAGE

346 1820 RSU. BUNDA JAKARTA JL. TEUKU CIK DITIRO NO.21, MENTENG 021-31923344/ 31922005| 021-31905546 Y Y ALL COVERAGE

347 1495 APOTEK & KLINIK KF INDOSAT GD. INDOSAT LT.23 JL. MEDAN MERDEKA BARAT NO. 1 JAKARTA PUSAT 021-30003750| 021-30003750 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

348 3972 KLINIK MIRACLE GRAND INDONESIA MENARA BCA LT.9 JL. MH. THAMRIN, JAKARTA PUSAT (021) 23587188 EXT.10511| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

349 1026 RSIA. TAMBAK JL. TAMBAK,NO.18 MANGGARAI021-

2303444/087878218215/087880676072|-021-3902550 Y Y ALL COVERAGE

350 1197 RSPAD GATOT SUBROTO (NON. PAV) JL. ABDUL RACHMAN SALEH NO.24 021-3448929| 021-3448929 Y N ALL COVERAGE

351 4804 KLINIK ASHA JL. JOHAR NO. 1A MENTENG, JAKARTA PUSAT (021) 3905035 / 3905037/ 2305326| (021) 3928907 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

352 4058 KLINIK GRAHA PT YPK MANDIRI GEDUNG GRAHA MANDIRI LT.1 LOBBY SELATAN,JL. IMAM BONJOL NO.61 021 - 39838556| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

353 0084 RS. JAKARTA JL. GARNISUN NO.1 JEND. SUDIRMAN, KAV.49021-5732241/5741828021-5741828|021-

5741828021-5719870 Y Y ALL COVERAGE

354 2793 KLINIK PERTAMEDIKA KWARNAS JL. MEDAN MERDEKA TIMUR NO. 6 JAKARTA PUSAT 021-3502150 EXT 1998| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

JAKARTA SELATAN

355 0775 RSIA. DUREN TIGA JL. DUREN TIGA RAYA, NO.5, PANCORAN 021- 794 1843 / 7993817 /7948696| 021- 790 1050 Y Y H&S,GP,SP,OP,DENTAL,MAT,LAB,PHAR

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356 0401 KLINIK SPESIALIS & APOTIK, RSB. ESTI JL. BANGKA RAYA, NO.28-30, PELA MAMPANG 021-7194434-35| 021-71791917 Y YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

357 0892 KLINIK FAMILY DENTISTRY JL. PANGLIMA POLIM II/2 021-7267267-021 7221266|- 021 7264365 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

358 0911 KLINIK MEDIKA PLAZA KARTIKA CANDRA KARTIKA CHANDRA HOTEL, JL. JEND GATOT SOEBROTO KAV 18-20021-5251207 / 021-5205000|021-

5205000021-5265921 N Y


RB,PHAR

359 0400 MEDIKALOKA HEALTHCARE CENTERRDTX TOWER GROUND & 2 ND FLOOR. JL. PROF.DR.SATRIO KAV. E IV NO.6

MEGA KUNINGAN, JAKARTA SELATAN021-5261118| 021-5261119 N Y


RB,PHAR

360 2138 KLINIK PERTAMEDIKA PATRA JASA PATRA JASA OFFICE TOWER, JL. JEND. GATOT SUBROTO KAV.32-34 021-5228026/ 5217318| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

361 2139 KLINIK PERTAMEDIKA SINABUNGJL. SINABUNG II NO. 32 AF KEL. GUNUNG KEC. KEB. BARU JAKARTA

SELATAN021-7243262/7243282| 021-72800985 N Y


RB,PHAR

362 2229BRAWIJAYA CLINIC & LIFE STYLE @ OKTROI

KEMANG

OKTROI PLAZA, MEDICAL MEZZANINE LT. 3 JL. KEMANG UTARA RAYA NO.

1 JAKARTA SELATAN021 - 7197580/ 71792101| 021 - 71792074 N Y


RB,PHAR

363 2443 BALI DENTAL CARE JL. PAKUBUWONO VI NO.111 JAKARTA SELATAN (021) 7223391/ 7223391| - N Y DENTAL

364 2341 KLINIK AJI WARAS CILANDAKJL. CILANDAK KKO NO.45A, RAGUNAN, PASAR MINGGU, JAKARTA SELATAN

12550(021) 78836308; 78835703| - N Y


RB,PHAR

365 2641 KLINIK & APOTEK KF 42 JL. ST. HASANUDDIN NO.1 KEBAYORAN BARU JAKARTA SELATAN 021 7220292| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

366 0957 RSU. PETUKANGAN JL. CILEDUG RAYA NO.8A 021-7340906-|- 021-73889956 Y Y ALL COVERAGE

367 0972 RSU. AULIA JL. JERUK RAYA NO 15 JAGAKARS. A, JAKARTA SELATAN 021-7270208-|- 021-7866057 Y Y ALL COVERAGE

368 1412 APOTIK FARMARIN III BIDAKARAGED. BINASENTRA KOMP. BIDAKARA JL. GATOT SOEBROTO KAV. 71 - 73

JAKARTA021 - 83785219| 021 - 83793006 N Y


RB,PHAR

369 1424 RSIA. ASIH JL. PANGLIMA POLIM I NO.34 JAKARTA SELATAN 12160 021-2700609-10| 021-7255181 Y Y ALL COVERAGE

370 1083 RS. MATA AINI JL. H.R.RASUNA SAID (KUNINGAN) JAKARTA021-5256228/5203866021-5203866|021-

5203866021-5224288/52964781 Y Y ALL COVERAGE

371 1546 KLINIK NDH (RAJA SERVICE) JL. RADIO DALAM RAYA, NO.54A 021-7257244| 021-7257244 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

372 1461 ALL CARE DENTAL CENTRE PLAZA 5 BLOK B NO.15 JL. MARGAGUNA PONDOK INDAH 72788688| 72788687 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

373 1089 RS. KHUSUS THT & BEDAH CIRANJANG JL. CIRANJANG NO.20-22 KEBAYORAN BARU021-7243366/7208192/7208192|021-

7208192021-7264038 Y Y ALL COVERAGE

374 1554 H2E DENTAL CLINICMENARA KUNINGAN,JL. HR. RASUNA SAID BLOCK X-7 LT1. UNIT I,

KUNINGAN021-30040151/152| 021-30040152 N Y


RB,PHAR

375 1458 MULIA HEALTH AND DENTAL CARE (MHDC)GEDUNG MENARA MULIA, LG-SUITE 018, JL. JEND.GATOT SUBROTO KAV.9-

11021-5223838| 021-52901073 N Y


RB,PHAR

376 0799 RS. GANDARIA JL. GANDARIA TENGAH II, NO.12-14, KEBAYORAN BARU 021- 7250718/ 7203311| 021- 7222038 Y Y ALL COVERAGE

377 0800 KLINIK TRIAZ PERSADA GRAHA CIMB NIAGA TOWER LT.B1, JL. JEND. SUDIRMAN KAV.58 021- 2505770 / 2505250| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

378 0193 RSIA. BUDHI JAYA JL. DR. SAHARJO, NO.120021-8292672/8311722021-8311722|021-

8311722021-8301901 Y Y ALL COVERAGE

379 0890 KLINIK INTERMED HEALTH & BEAUTY JL. KEBAGUSAN 1 NO. 8 JAKARTA SELATAN 021-7823501| 021-7823502 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

380 1744 PARAHITA DIAGNOSTIC CENTER MAMPANG JL. WARUNG BUNCIT RAYA NO 150 MAMPANG JAKSEL 021-7949624| 021-7992719 N Y LAB

381 1708 KLINIK PLAZA PT YPK MANDIRI PLAZA MANDIRI LT. BASEMENT I, JL. JEND GATOT SUBROTO KAV 36-38 021-5245351, 5245351| 021-5245351 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

383 0041 RS. AGUNG JL. SULTAN AGUNG, NO.67, PASAR RUMPUT0218294955,8305768/9,8282795,837942

07|021-8305791 Y Y ALL COVERAGE

384 0043 RS. JAKARTA MEDICAL CENTER JL. BUNCIT RAYA, NO.15 021-7980888/7985177 - 7940836/37| 021-7940838 Y Y ALL COVERAGE

385 0199 MEDICARE CLINICMENARA KADIN INDONESIA, 27TH FLOOR, JL. H.R. RASUNA SAID, BLOK X-

5, KAV.2-3021-57903905| 021-5274754 N Y


RB,PHAR

386 2800 KLINIK PERTAMEDIKA JAKARTA LAND (WTC)GED. WTC II LOWER GROUND FLOURJL. JEND SUDIRMAN KAV. 29

JAKARTA SELATAN021-29522610| 021-29522611 N Y


RB,PHAR

387 2954 KLINIK AJI WARAS KARANG TENGAHJL. KARANG TENGAH RAYA NO.60, LEBAK BULUS, CILANDAK, JAKARTA

SELATAN 12440(021) 75909473| - N Y


RB,PHAR

388 3326 KLINIK PERMATA MEDIKAJL. RAYA TANJUNG BARAT NO. 111 RT/RW 007/004, KEL. TANJUNG BARAT,

KEC. JAGAKARSA, JAKARTA SELATAN021-7821817| 021-7828489 N Y


RB,PHAR

389 2140KLINIK PERTAMEDIKA TUGU (pmc dental spa &

clinic)WISMA TUGU JL. HR. RASUNA SAID KAV. C8-9. 021-5200340| - N Y


RB,PHAR

390 1712 KLINIK SUNFLOWER DENTAL & HEALTH CARE KOMP. BUMI KARANG INDAH JL.KARANG INDAH BLOK A2/4, LOEBAK BULUS 021-29203542/085100106511| 021-29203541 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

391 3710 THOMSON EXECUTIVE HEALTH CENTER TALAVERA SUITE, JL. TB.SIMATUPANG KAV. 22-26 JAKARTA SELATAN (021) 7592 5268| (021) 7592 5269 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

392 1488 RS. ASRI JL. DUREN TIGA RAYA, NO.20 021 27837900 / 021-7995566,7992211| 02179198118/79198733 Y Y ALL COVERAGE

393 2874 LAB. PRODIA KEBAYORAN JL. GUNAWARMAN NO. 77, KEBAYORAN BARU 021-7220203| 021-7226450 N YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

394 2797 KLINIK PERTAMEDIKA PHE PHE TOWER LT. 2 JL. TB SIMATUPANG KAV. 99 021-29547300| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

395 4340 KLINIK EPICENTRUM MEDICAL CENTEREPIWALK OFFICE SUITES LT. 3 UNIT B 316-317 KOMPLEK RASUNA

EPICENTRUM, JL. H.R RASUNA SAID KEL. KARET KUNINGAN KEC. (021) 2991 2383| (021) 2991 2393 N Y


RB,PHAR

396 4413 KLINIK UTAMA CIPUTRA MEDICAL CENTERLOTTE SHOPPING AVENUE FLOOR 5 CIPUTRA WORLD 1, JL. PROF. DR.

SATRIO KAV. 3-5, KEL. KARET KEC. SETIABUDI, JAKARTA SELATAN021-29888137| - N Y


RB,PHAR

397 4414 AIC - MEDICAL IMAGING DIAGNOSTIC CENTERKUNINGAN CITY MALL B-C -D, JL. PROF SATRIO KAV. 18, JAKARTA

SELATAN 12940(021) 3005 1801/02| (021) 30051803 N Y


RB,PHAR

398 1066MRCCC-SILOAM HOSPITALS SEMANGGI (D/H

SPECIALIST C

JL. GARNISUN 2-3 KARET, SEMANGGI SETIABUDI (BELAKANG UNIV.

ATMAJAYA ) JAK- SEL021-29962888/800/788| 021-29962778 Y Y ALL COVERAGE

399 1752 LAB. KLINIK BIOTEST WIJAYA JL. WIJAYA I NO 58, KEBAYORAN BARU, JAK-SEL 021-7232445| 021-7268711 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

400 1872 KLINIK TRIHATI PLUS RUKAN ROYAL PALACE BLOK A5, JL. PROF DR SOEPOMO SH NO 1 021-829 9119| 021-8299113 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

401 1838 E-LAB. S JL. GATOT SUBROTO JL. GATOT SUBROTO KAV 52 JAKARTA SELATAN -| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

402 1942 KLINIK & APOTEK KF 47 JL. RADIO DALAM RAYA 1-5, JAKARTA SELATAN 021-7208735| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

403 1944 KLINIK & APOTEK KF 152 JL. RAYA PASAR MINGGU KM 18 JAKARTA SELATAN 0217943222| 021-7943223 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

404 1936 APOTIK FARMARIN VI RASAMALA WISMA PPBI JL. RASAMALA NO.2 PANCORAN 021-8290073| 021-83794460 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

405 2033 KLINIK NAMIRA JL. JATIPADANG RAYA NO. 62 PASAR MINGGU 021-7820645/78830676| 021-7820645 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

406 0228 RSIA. KEMANG MEDICAL CARE JL. AMPERA RAYA, NO.34,KEMANG021-27545454/27545400/021-

6317288|021-6317288021-78843548 Y Y ALL COVERAGE

407 4210 RSIA. ANDHIKAJL. WARUNG SILA no. 8 RT. 006 RW. 04 GUDANG BARU, CIGANJUR,

JAGAKARSA, JAKARTA SELATAN

(021)7874612; 7863408; 78887087;

7863408|(021) 7874612 Y Y ALL COVERAGE

408 3711 THOMSON MEDICAL CLINICPASIFC PLACE MALL, B1-01, JL. JEND SUDIRMAN KAV 52-53 SCBD,

JAKARTA SELATAN(021) 5797 3497| (021) 5797 3496 N Y


RB,PHAR

409 0999 RSU. MUHAMMADIYAH TAMAN PURING JL. GANDARIA I NO.20 KEBAYORAN BARU021-7229623/7250243/7208358|021-

7208358021-7234823/7210516 Y Y ALL COVERAGE

410 0797 RS. MEDISTRA JL. GATOT SUBROTO KAV.49 021-5210200 /| 021-5210184/5 Y Y ALL COVERAGE

411 3974 LAB. CITO JAKARTAJL. RS. FATMAWATI NO. 27 A, RT.001 RW.006 KEL. GANDARIA SELATAN,

CILANDAK, JAKSEL(021) 766 4036| (021) 766 3640 N Y


RB,PHAR

412 1836 AIS HEALTHCAREGEDUNG CITY PLAZA LT P9, JL. GATOT SUBROTO 42 (KAWASAN WISMA

MULIA)021-29305480| - N Y


RB,PHAR

413 4525 ALEA DENTAL CLINICJL. CIPETE RAYA NO. 16 BLOK A-7 RT.006/RW.004, KEL. CIPETE SELATAN,

CILANDAK, JAKARTA SELATAN(021) 75915723| - N Y DENTAL

414 2931 APOTEK KIMIA FARMA DUREN TIGA PLN PUSLITBANG JL. DUREN TIGA NO 102 JAKARTA 12760 -| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

415 0049 RS. PONDOK INDAH JL. METRO DUTA, KAV. UE, PONDOK INDAH 021-7657525| 021-7502324 Y Y ALL COVERAGE

416 2379 KLINIK PRATAMA PALAPA DENTISTSJL. PALAPA I NO. 4 KOMPLEK PERTANIAN PASAR MINGGU JAKARTA

SELATAN 12520021-7806291| 021- 7806291 N Y DENTAL

417 3736 PRODIA KAMPUNG MELAYUJL. KH ABDULLAH SYAFEI NO. 28KEBON BARU, TEBET JAKARTA SELATAN,

12830(021) 8308055, 8304268| - N Y


RB,PHAR

418 4820 TIDI DENTAL CLINICJL. TEBET BARAT VII NO. 49 RT. 004 RW. 004, KEL. TEBET BARAT KEC.

TEBET, JAKARTA SELATAN(021) 8300050| - N Y


RB,PHAR

419 4858 KLINIK YEMIMA MEDICAL CENTER JL. RAYA LENTENG AGUNG KEC. JAGAKARSA, JAKARTA SELATAN (021) 29050669| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

420 3571 PRODIA BONA INDAHRUKO BONA INDAH BLOK A2/ KAV. C7, JL. KARANG TENGAH RAYA LEBAK

BULUS, JAKARTA 12440021-7506715| N Y


RB,PHAR

421 2919 LAB. PRODIA PASAR MINGGU JL. RAYA PASAR MINGGU/ 98E, JAKARTA SELATAN 021-7986247/7901922/79184723| 021-7901922 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

422 2932 APOTEK KF55 CINEREPLN P3B JB KRUKUT-LIMO, CINERE 16514, KOTAK POS 159 CINERE

JAKARTA SELATAN021 7220292| N Y


RB,PHAR

423 6431 TEBET DENTAL CLINIC JL. TEBET BARAT 8/18 KEL. TEBET BARAT, KEC. TEBET, JAKARTA SELATAN (021) 8308221/ 8306244| (021) 8202983 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

424 6081 RSIA. KARTINI CILEDUGJL. CILEDUG RAYA NO. 94-96, KEL. CIPULIR KEC. KEBAYORAN LAMA,

JAKARTA SELATAN(021) 7245646/ 7207828| (021) 72792194 Y Y ALL COVERAGE

425 5592 KLINIK THAMRIN TAMAN SARIAPARTEMEN TAMAN SARI SEMANGGI TOWER A UNIT GF.15 JL.AKRI NO.134

RT.008/002, KARET SEMANGGI, SETIABUDI(021) 29888506| N Y


RB,PHAR

426 2356MAYAPADA HOSPITAL JAKARTA SELATAN

(MHJS)JL. LEBAK BULUS I KAV.29 021-29536660 / 29208505 / 29217777| 021-29216666 Y Y ALL COVERAGE

427 5413 KLINIK ROYAL HEALTH CARE JL. BUNCIT RAYA NO.99 KALIBATA, PANCORAN 021-7940015 / 0811935249| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

428 0796 RS. METROPOLITAN MEDICAL CENTRE (MMC) JL. HR. RASUNA SAID, KAV. C21, KUNINGAN021-

5203435/0811865958/081617106696|021-5226070/5227060 Y Y ALL COVERAGE

429 4234 RAYS INTERNATIONAL DENTAL CLINIC JL. BRAWIJAYA VIII NO. 2, JAKARTA SELATAN 021-7262347| 021-7225844 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

430 3989 KLINIK & APOTEK KF NO. 55 KEBAYORAN JL. KEBAYORAN LAMA NO. 34K JAKARTA SELATAN 021-7226444/7203563| 021-7203563 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

431 4640 KLINIK MOESLICHANJL. CIPETE NO. 3 RT/RW 014/003, KEL. CIPETE SELATAN, KEC. CILANDAK,

JAKARTA SELATAN(021) 7657861| (021) 75904535 N Y


RB,PHAR

432 4488 KLINIK UTAMA CIPUTRA SMG EYE CLINICLOTTE SHOPPING AVENUE FLOOR 5 CIPUTRA WORLD 1, JL. PROF. DR.

SATRIO KAV. 3-5, KEL. KARET KEC. SETIABUDI, JAKARTA SELATAN(021) 29888138| - N Y


RB,PHAR

433 2798 INHOUSE KLINIK PERTAMEDIKA GARDA OTOKAWASAN PERKANTORAN ASS. ASTRA, JL. TB SIMATUPANG KAV.15

JAKSEL021-75918577| - N Y


RB,PHAR

434 0597 KLINIK JMC DHARMA BHAKTI JL. CILANDAK KKO RAYA NO.45 021-781 9848 / 0217989123| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

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NOV-08-2017



435 0758 DE BLITZR DENTAL CAREBellezza Shopping Arcade Lt.2 Unit 30&31 Jl.Letjen Soepeno No.34 Arteri

Permata Hijau JKT SELATAN 12210021-25675742| 021-25675743 N Y


RB,PHAR

436 2820 LAB. PRODIA ARTERIARTERI PONDOK INDAH, JL. SULTAN ISKANDAR MUDA NO. 31 C,

KEBAYORAN LAMA, JAKARTA SELATAN 12240(021) 7227728, 7226655, 7291710| - N Y


RB,PHAR

437 5904 BIC CLINIC BUNDA PACIFIC PLACE PACIFIC PLACE, LEVEL B1 - 17A, JL. JEND.SUDIRMAN KAV.52-53 021-57973781/93| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

438 2174 SILOAM HOSPITALS SIMATUPANG JL. RA KARTINI NO.8 CILANDAK 021 2953 1900 EXT 22601| 021 759 16997 Y Y ALL COVERAGE

439 2086 KLINIK GLOBAL DOCTOR JLN. WARUNG JATI BARAT NO. 98, LOT 7-9, PEJATEN 021-7194565/ 7980183| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

440 1076 KLINIK YADIKA PETUKANGAN JL. DAMAI RAYA NO.1 PETUKANGAN SELATAN - JAKARTA SELATAN 021-7370881|- 021-73887810 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

441 0110 RS. TRIA DIPA JL. RAYA PASAR MINGGU, NO.3A, PANCORAN 021-7993058,7974071-73| 021-7974074 Y Y ALL COVERAGE

442 4374 KLINIK MATA NUSANTARA (Lebak Bulus) JL. R.A. KARTINI NO. 99 LEBAK BULUS, JAKARTA 12440 (021) 751 6688| (021) 7519344 N Y GP,OP

443 3540 FHL DENTAL CLINIC EPPIWALK OFFICEEPPIWALK OFFICE SUITES LT. 6 UNIT B 629, JL. H.R. RASUNA SAID KEL.

KARET KUNINGAN KEC. SETIABUDI021-29912232| - N Y


RB,PHAR

444 0842 BRAWIJAYA WOMEN & CHILDREN HOSPITAL JL. TAMAN BRAWIJAYA NO.1 CIPETE UTARA 021 - 7211337/ 021-7247181| 021 - 7211364 Y Y ALL COVERAGE

445 4707 KLINIK MAYAPADAGD. MAYAPADA TOWER II LT.2, JL.JEND.SUDIRMAN KAV.27, KARET,

SETIABUDI(021) 29859988 / 29859999 ext. 806| - N Y


RB,PHAR

446 5428 GOOD DOCTORS MEDICAL CENTERKOMP.EPICENTRUM RASUNA, EPICENTRUM WALK OFFICE SUITE LT.3 UNIT

A 310-311021-29912131 - 32 / 29941137| 021-29941137 N Y


RB,PHAR

447 5429 KLINIK UTAMA INDO MEDIKA INTERNATIONALPLAZA OLEOS, JL.TB SIMATUPANG KAV.53A LG UNIT B, KEL.KEBAGUSAN,

KEC.PASAR MINGGU021-22780121 / 19| 021-22780120 N Y


RB,PHAR

448 6380 AUDY DENTAL KEMANG JL BANGKA RAYA NO.40E KEMANG (021) 71794428 / 082122324969| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

449 6388 J & J DENTAL CARE RADIO DALAMJL. RADIO DALAM RAYA NO. 9A RT/RW 008/002 KEL GANDARIA KEC.

KEABYORAN BARU JAKARTA SELATAN021-7207877| - N Y


RB,PHAR

450 6227 MEDIKA PLAZA WTC 2 CLINIC WTC 2 LOWER GROUND FLOOR JL. JEND. SUDIRMAN KAV 29 021-29522611| 021-29522610 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

451 6483 KLINIK MEDIKA PLAZA BELTWAYBELTWAY OFFICE PARK , GD ANNEX LT. 1 JL. AMPERA RAYA NO. 9-10,

RAGUNAN PASAR MINGGU(021) 30027070| - N Y


RB,PHAR

452 0003 RS. TEBET JL. LETJEND MT. HARYONO NO.8 KAV.13, PANCORAN 021-8307542/43/44| 021-8311760 Y Y ALL COVERAGE

453 5789 KLINIK UTAMA CONFIDENTA CLINICJL.KEBAGUSAN I NO.4, RT002/01 (KOPINDOSAT), KEBAGUSAN, PASAR

MINGGU021-22780426| N Y


RB,PHAR

454 6381 AUDY DENTAL CIPETE JL. CIPETE RAYA NO.55, CIPETE (021) 29124856 / 085775006872| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

455 0593 RS. SETIA MITRA JL. RS. FATMAWATI, NO.80-82, CILANDAK, JAKARTA SELATAN 021-7656000/7651021/7654676| 021-7656880/7656875 Y Y ALL COVERAGE

456 5808 CLINIC 18 GEDUNG 18 OFFICE PARK KAV.18 LANTAI MEZZANINE.M2, KEBAGUSAN 083871523455| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

457 0854 RS. ZAHIRAH JL. SIRSAK NO.21, JAGAKARSA021-78888723/7872210/78888721021-

78888723|021-78888723021-7270013/7872210 Y Y ALL COVERAGE

458 0112 SUDIRMAN MEDICAL CENTER JL. SETIABUDI TENGAH NO.18 021-5203467| 021-5203468 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

459 0795 RS. PUSAT PERTAMINA JL. KYAI MAJA 43, KEBAYORAN BARU (021) 7219555; 7219800| (021) 7203540, Y Y ALL COVERAGE

460 0395 RS. PRIKASIH JL. RS. FATMAWATI, NO.74, PONDOK LAB. U - CILANDAK021-7501192/7504669/75901174021 -

7504669|021 - 7504669021-7505148 Y Y ALL COVERAGE

461 0879 RSU. YADIKA CIPUTAT JL. CIPUTAT RAYA, NO.5, KEBAYORAN LAMA 021-7291074| 021-72895046 Y Y ALL COVERAGE

462 1408 BIDAKARA MEDICAL CENTER (BIMC)GEDUNG BINA SENTRA, LT.DASAR, KOMP.BIDAKARA, KAV.71-73,

PANCORAN021-83783535/83783636| 021-83785349 N Y


RB,PHAR

463 6231 OMDC DENTAL CLINIC JL. WARUNG BUNCIT RAYA NO.6A 021-79196767| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

JAKARTA TIMUR

464 3531RS. KHUSUS MATA SMEC (SUMATERA EYE

CENTER) JAKARTAJL. PEMUDA NO.36, RAWAMANGUN (021) 4714848| (021) 4755703 N Y


RB,PHAR

465 5899 KLINIK UTAMA ASSHOMADIYAH JL. AL.BAIDHO RAYA NO.2A KEL.LUBANG BUAYA, KEC.CIPAYUNG 021-8779 6464| 021-8779 1956 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

466 6011 KLINIK ZAFIRA MEDIKA KAYUMANIS JL. KAYUMANIS TIMUR NO.37 RT 014 RW 002, KAYUMANIS, MATRAMAN 021-85911696| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

467 1843 RSIA. SAYYIDAH JL. TAMAN MALAKA SELATAN NO. 6 PONDOK KELAPA, JAKARTA TIMUR (021) 8690 2950| (021) 864 9886 Y Y ALL COVERAGE

468 6385 AUDY DENTAL PONDOK BAMBU JL. PAHLAWAN REVOLUSI NO.15 PONDOK BAMBU (021) 29622453 / 081298813800| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

469 0749 RS. HARUM SISMA MEDIKA JL. TARUM BARAT, KALIMALANG JAKTIM021-8617212/3 ; 021-8617213|021-

8617213021-8601030 Y Y ALL COVERAGE

470 1706 RSU. PUSAT PERSAHABATAN JL. PERSAHABATAN RAYA NO. 1 021-4891708, 4891745| 2,147,112,224,890,770 Y Y ALL COVERAGE

471 2826 RS. COLUMBIA ASIA PULOMAS JL. KAYU PUTIH RAYA, PULOMAS - JAKARTA TIMUR 13210 (021) 29459999/29559400| (021) 2955 9477 Y Y ALL COVERAGE

472 0652 RB & KLINIK AL - FAUZAN JL. RAYA CONDET NO.13, BALEKAMBANG CONDET 021-80886224| 021-8096968 Y YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

473 1139 KLINIK TJAKRA JL. RAYA BOGOR, KM.24, NO.35, SUSUKAN CIRACAS 021-8779 4539 / 8401677| 021-87794558/8401677 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

474 5540 KLINIK TERATAI PONDOK BAMBUJL. PONDOK BAMBU BATAS NO. 14 RT. 003 RW. 02, KEL.PONDOK BAMBU,

KEC. DUREN SAWIT, JAKARTA TIMUR(021) 29361827| - N Y


RB,PHAR

475 1933 APOTIK FARMARIN II PENGGILINGAN PERUM TAMAN PULO INDAH BLOK I NO.7-8 PENGGILINGAN CAKUNG 021-4800688| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

476 0060 RS. HARAPAN BUNDA JL. RAYA BOGOR KM.22 NO.44 021-8400257| 021-8412977/87780201 Y Y ALL COVERAGE

477 4157 KLINIK CEMPAKA JL. RAYA PULAU GEBANG NO. 86 RT 06 RW 06, CAKUNG 021- 480 1980| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

478 2142 KLINIK PERTAMEDIKA RAWAMANGUN JL. MUNDU RAYA NO.1 JAKARTA TIMUR 021-4894150| 021-4894278 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

479 1244 RS. MASMITRA JL. KELURAHAN JATIMAKMUR, NO.40, PONDOK GEDE 021-84971766| 021-8483047 Y Y ALL COVERAGE

480 3533 KLINIK MEDIKA PRAKARSA (MEDSA) JL. RADEN INTEN II NO.31 DUREN SAWIT (021) 86908103| 021-86908105 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

481 1217 RSIA. RESTU KASIH JL. RAYA BOGOR, KM.19, NO.3A, KRAMAT JATI 021-8002166/8001177| 021-80882753 Y Y ALL COVERAGE

482 0102 RS. ISLAM JAKARTA TIMUR (PONDOK KOPI) JL. RAYA PONDOK KOPI021-

8630654/29809000/8610471/8610471|02021-8611101/86604256 Y Y ALL COVERAGE

483 4376 KLINIK MATA NUSANTARA (DEWI SARTIKA)GD. ALHIJAZ, JL. DEWI SARTIKA 293A, CAWANG, KEC. KRAMAT JATI,

JAKARTA TIMUR(021) 8087 8833| (021) 8087 7474 N Y GP,OP

484 2464 MITRASANA PT JL. PULOGADUNG RAYA KAV.23 RT.010/09, JATINEGARA, CAKUNG 021-29634912 / 89835394| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

485 4431 RS. PUSAT OTAK NASIONAL JL. M.T HARYONO, CAWANG, JAKARTA TIMUR 13630 (021) 2937 3377| (021) 2937 3445; 293 Y Y ALL COVERAGE

486 1080 RS. KESDAM CIJANTUNG JL. MAHONI NO.1, CIJANGTUNG II PASAR REBO 021-8407886/8400535/87793332-|- 021-87793332 Y Y ALL COVERAGE

487 2643 KLINIK & APOTEK KF 49 JL. P. REVOLUSI 53, PD. BAMBU, JAKARTA TIMUR 021 861-5154| 021-8612721 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

488 3980 KLINIK & APOTEK KF 48 JL. MATRAMAN RAYA NO 55 JAKARTA TIMUR 0818810414| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

489 3981 KLINIK & APOTEK KF LAP.TEMBAK JL. LAWU B1 NO.1 CIBUBUR LAPANGAN TEMBAK CIBUBUR 08128737346| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

490 4356 KLINIK BUDHI PRATAMABPRI CENTER GED. B, JL. RAYA TENGAH NO.26 GEDONG, PASAR REBO,

JAKARTA TIMUR(021) 87783668| (021) 87782670 N Y


RB,PHAR

491 1868RSIA. AL-FAUZAN (JAKARTA ISLAMIC

HOSPITAL)JL. PEDATI NO 3 RT 5 RW 7, KAMPUNG TENGAH KRAMAT JATI 021-87780318| - Y Y ALL COVERAGE

492 1907 RSIA. SAMMARIE BASRA JL. BASUKI RACHMAT NO. 31, PONDOK BAMBU, DUREN SAWIT 021-86613145| 021-86613147 Y Y ALL COVERAGE

493 1932 APOTEK KIMIA FARMA 193 JL. UTAN KAYU NO 105 P JAKARTA TIMUR 021-8520808| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

494 2251 RS. ANTAM MEDIKA JL. PEMUDA RAYA NO 1A PULOGADUNG JAKARTA TIMUR 021- 29378939/40/43/44| 021- 29385160 Y Y ALL COVERAGE

495 2141 KLINIK PERTAMEDIKA MEDAN SATRIA JL. ARUN IX NO. 2 MEDAN SATRIA CAKUNG JAKARTA TIMUR 17132 021-4604944| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

496 2391 RS. JANTUNG JAKARTA JL. MATRAMAN RAYA NO.23, JAKARTA TIMUR 021-29361158/29361160/29360698| 2129361158 Y Y ALL COVERAGE

497 2375 KLINIK NAMIERA JL. KELAPA DUA WETAN PERUM PTB BLOK 2C NO 10 021-8725774| 021-8725774 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

498 2620 KLINIK & APOTEK KF 4 JL. PERSERIKATAN 7-8, RAWAMANGUN 021 471-8059| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

499 2638 KLINIK & APOTEK KF 147 JL. DUREN SAWIT 021 861-5458| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

500 0962 KLINIK CONDET JAYA JL. CONDET JAYA NO.18 BATU AMPAR 021-8090712|- 021-80881275 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

501 0990 RS. JANTUNG BINA WALUYA CARDIAC CENTER JL. TB SIMATUPANG NO.71021-87781605-06021-87781606|021-

87781606021-8403869 Y Y ALL COVERAGE

502 1110 RSIA. RESTI MULYA JL. PAHLAWAN KOMARUDIN RAYA NO. 5 PENGGILINGAN CAKUNG 021-4803936-4802192-4803707| 021-48701488 Y Y ALL COVERAGE

503 1096 KLINIK YADIKA CIBUBUR JL. LAPANGAN TEMBAK NO.9 PEKAYON-CIBUBUR 021-8711515-|- 021-8711515 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

504 1258 KLINIK SUCI HUSADA JL. SUCI NO.21 RT.08/06 SUSUKAN - CIRACAS 021- 87798796| 021- 87798796 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

505 1257 KLINIK PRATAMA MEDIKA KRAMAT JATI JL. BATU AMPAR III NO.55 , RT.011/002 BATU AMPAR, KRAMAT JATI 021-80886446| 021-8016254 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

506 1262 RS. RAWAMANGUN JL. BALAI PUSTAKA RAYA, NO.29-31 021-4893531| 021-4710918 Y Y ALL COVERAGE

507 1538 KLINIK MITRASANA (DANKOS FARMA) JL. RAWA GATEL, BLOK IIIS, KAV.37-38, KAW.INDUSTRI PULO GADUNG 4600158/4600157| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

508 1499 RB & KLINIK ANNISA CIRACAS JL. CIRACAS NO.18 021-87720807/87717636| 021-87717636 Y Y ALL COVERAGE

509 1490 RSIA. BUNDA ALIYAH JL. PAHLAWAN REVOLUSI NO.100 PONDOK BAMBU 021-86602525| 021-86600712 Y Y ALL COVERAGE

510 0888 RS. YADIKA PONDOK BAMBU JL. PAHLAWAN REVOLUSI NO.47 PONDOK BAMBU - JAKARTA TIMUR021-8615754 / 021-8610756|021-

8610756021-8613332 Y Y ALL COVERAGE

511 0289 RS. OMNI MEDICAL CENTER JL. PULO MAS BARAT VI, NO.20 021- 2977 9999| 021-4718081,4708180 Y Y ALL COVERAGE

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512 0012RS. PREMIER JATINEGARA ( RS MITRA

INTERNASIONAL)JL. RAYA JATINEGARA TIMUR, NO.85-87 021-2800666/2800888|021-2800777 021-2800755 Y Y ALL COVERAGE

513 0122 RS. MEDIROS JL. PERINTIS KEMERDEKAAN, KAV.149021-

4750042/4897415/4893036/4895817/472021-4891937 Y Y ALL COVERAGE

514 0024 KLINIK PRIMA HUSADA CIBUBUR JL. LAPANGAN TEMBAK NO.2A CIBUBUR 021-87707503|021-9111938 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

515 0258 KLINIK DEVITA JL. JATINEGARA TIMUR NO.57 JATINEGARA 0218501134/0218516274|021-819 6041 021-85906901/8516274 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

516 0292 KLINIK PONDOK GEDE AGUNG JL. RAYA HANKAM, NO.58C-D, PONDOK GEDE 021-8464030| 021-8463803 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

517 0286 RS. KARTIKA PULO MAS JL. PULO MAS TIMUR K BLOK G-H-C/1 021-4703333|021-470 3333 021-4723402 Y Y ALL COVERAGE

518 0806 RS. HAJI JAKARTA JL. RAYA PONDOK GEDE(021) 8000693-95(021) 8000695|(021)

8000695021-80876175/8000152 Y Y ALL COVERAGE

519 0805 RSU. UKI JL. MAYJEN SOETOYO, CAWANG 021-8092317,8010526,8092831,8010523| 021-8092445/8005595 Y Y ALL COVERAGE

520 0807 KLINIK MHT TEGALAN JL. TEGALAN NO. 30 021-8581344| 021-8581344 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

521 0779 RS. AU DR.ESNAWAN ANTARIKSA JL. MERPATI NO.2 LANUD HALIM PERDANAKUSUMA (021) 8007027| (021) 8098 665 Y Y ALL COVERAGE

522 0382RB & KLINIK 24 JAM MHT PONDOK GEDE D/H

RS PONDOK GJL. RAYA PONDOK GEDE, NO. 23-25, KRAMAT JATI

021-8093602/80887175/74|021-

80887175021-80887174 Y Y ALL COVERAGE

523 0826 RB & KLINIK SEJAHTERA CIRACAS JL. RAYA CIRACAS NO.7 021- 87717635/87712710/87712711-|- 021-87720232 Y Y ALL COVERAGE

524 1012 KLINIK IBIN SINA JL.PENDIDIKAN RAYA NO.33 DUREN SAWIT021- 86603270/8661669/86603270|021-

86603270021-86601611 N Y


RB,PHAR

525 0944RS. BHAYANGKARA TK.1 R.SAID SUKANTO

(POLRI)JL. RAYA BOGOR KRAMAT JATI RS POLRI 021-8093288|- 021-8095310 Y Y ALL COVERAGE

526 0948 KLINIK SAPTA MITRA JALAN TAMAN MALAKA UTARA BLOK A12, MALAKAJAYA021-86906363/021-5844330|021-

5844330021-86906363 N Y


RB,PHAR

527 0099 RS. HARAPAN JAYAKARTA JL. BEKASI TIMUR RAYA, NO.6 KM.18, PULO GADUNG021-4603916/4601371/021-

46822879|021-46822879021-4608863 Y Y ALL COVERAGE

528 0386 RS. HERMINA JATINEGARA JL. RAYA JATINEGARA BARAT, NO.126 021-8513838 / 8191223|021-8504371 021-8190111/8196157 Y Y ALL COVERAGE

529 1001 RS. DHARMA NUGRAHA JL. BALAI PUSTAKA BARU NO.19 RAWAMANGUN021-4707433-37021-4707437|021-

4707437021-4707429/8 Y Y ALL COVERAGE

530 1192 KLINIK & APOTEK PUTEWA JL. NUSA INDAH RAYA BLOK 40 NO.17H 021-8622207/70302043| 021-8622207 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

JAKARTA UTARA

531 1033 RS. PORT MEDICAL CENTER JL. ENGGANO NO.10 TANJUNG PRIOK 021-43902350/43902351-|- 021-43902302 Y Y ALL COVERAGE

532 0919 RS. PELABUHAN JAKARTA JL. KRAMAT JAYA, TANJUNG PRIOK 021-4403026|021-4403026 021-4403551/4406886 Y Y ALL COVERAGE

533 0587 RS. SATYA NEGARA JL. AGUNG UTARA RAYA, BLOK A, NO.1021-64715200/021-687813-14/6|021-

687813-14/6021-6877813 Y Y ALL COVERAGE

534 2458 RSIA. GRAND FAMILYJL. PANTAI INDAH SELATAN 1, KOMP.ELANG LAUT BOULEVARD KAV.1 NO.1,

PENJARINGAN021-29673737/29678062/296333777| 021-29673747 Y Y ALL COVERAGE

535 6384 AUDY DENTAL PANTAI INDAH KAPUK JL. PANTAI INDAH SELATAN 1, RUKO ELANG LAUT BLOK NO.20 (021) 29219170 / 081291303052| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

536 1644 KLINIK SYIFA MEDICAL CENTRE JL. LONTAR LUAR NO.7 RT 004/04 TUGU UTARA KOJA KEC. KOJA 021-43935260| 021-43935375 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

537 0170 RS. PLUIT JL. RAYA PLUIT SELATAN, NO. 2 021-6685006; 021-668507|021-668507 021-6684878 Y Y ALL COVERAGE

538 3998 KLINIK PESONA TANAH PASIRJL. TANAH PASIR RUSUN PENJARINGAN BLOK MAWAR I A

KEL.PENJARINGAN,KEC.PENJARINGAN, JAKARTA UTARA021-66675691/085101280470| - N Y


RB,PHAR

539 2143 KLINIK PERTAMEDIKA DELI JL. DELI NO. 22 JAKARTA UTARA - 1-628 021-43923390 / 3389| 021-4353461 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

540 4377KLINIK MATA NUSANTARA (PANTAI INDAH

KAPUK)

RS. PANTAI INDAH KAPUK LT.8, JL. PANTAI INDAH UTARA NO. 3, KEL.

KAPUK MUARA, PENJARINGAN, JAKARTA UTARA(021) 5595 8236| (021) 5595 8393 N Y GP,OP

541 6383 AUDY DENTAL KELAPA GADING RUKO MAL OF INDONESIA BLOK K NO.3 KELAPA GADING (021) 45869153 / 082298757541| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

542 6390 J & J DENTAL CARE PENJARINGANRUKO CORDOBA BLOK G NO. 16 JL. MARINA RAYA INDAH GOLF NO.2

KEL.KAMAL MUARA KEC. PENJARINGAN JAKARTA UTARA-| - N Y


RB,PHAR

543 0882 RS. ISLAM JAKARTA UTARA ( SUKAPURA ) JL. TIPAR CAKUNG NO.5 JAKARTA UTARA021-4400781,4400778021-4400778|021-

4400778021-44832228,4400782 Y Y ALL COVERAGE

544 4733 CLINIC PROTERA KIRANA BOUTIQUE OFFICE F2 NO. 1-2, KELAPA GADING, JAKARTA 14240 (021) 29365237| (021) 2936 5242 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

545 4079 RS. DUTA INDAHJL. TELUK GONG RAYA NO 12 RT.007/007 KEC. PENJARINGAN

KEL.PENJAGALAN JAKARTA UTARA(021) 6667 6188| (021) 6667 6190 Y Y ALL COVERAGE

546 4513 PRODIA PANTAI INDAH KAPUK RUKAN GOLD COAST B3-B3 021-29032788-99| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

547 3732 KLINIK PRODIA SUNTERJL. DANAU SUNTER UTARA BLOK C1 NO. 14, SUNTER AGUNG - JAKARTA

UTARA 14350-| - N Y


RB,PHAR

548 3733 PRODIA PLUIT-KOMP. RUKO SENTRA BISNIS PLUIT, JL. PLUIT SAKTI RAYA NO. 28 A

BLOK A-6, JAKARTA UTARA 14440(021) 66603561, 66600571| - N Y


RB,PHAR

549 3734 PRODIA KELAPA GADINGJL. BOULEVARD RAYA BLOK H 4 NO. 15, KELAPA GADING PERMAI,

JAKARTA UTARA 14240(021) 4522148| - N Y


RB,PHAR

550 0748 RS. GADING PLUIT JL. BOULEVARD TIMUR RAYA, KELAPA GADING. JAKARTA UTARA021-4521001/4520201021-4520201|021-

4520201021-4520390 Y Y ALL COVERAGE

551 1746 LAB. KLINIK BIOTEST PLUIT JL. PLUIT SAKTI RAYA NO 25 JAKARTA UTARA 021-6622611| 021-6628166 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

552 1813 FRIENDLY DENTAL CARE JL. DANAU SUNTER UTARA BLOK C1 / 4 B JAKARTA UTARA 021-65836485| 021-65836484 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

553 1946 APOTEK KIMIA FARMA 46 JL. RAWA BADAK NO. 3, KOJA, JAKARTA UTARA 021-4393397| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

554 2144 KLINIK PERTAMEDIKA YOS SUDARSO JL. YOS SUDARS. O NO. 34 JAKARTA UTARA - 1-628 021-43928260| 021-43908706 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

555 2412 KLINIK BERSALIN LESTARIJL. MANGGAR NO.141 KEL.LAGOA, KEC.KOJA TANJUNG PRIOK JAKARTA

UTARA021 43922950| - N Y


RB,PHAR

556 2506 MITRASANA KELAPA GADINGJL. BOULEVARD TIMUR RAYA BLOK NB I NO 36 KELURAHAN PEGANGSAAN

DUA, KELAPA GADING JAKARTA UTARA021-36464908/4585455| - N Y


RB,PHAR

557 1263 KLINIK SEMPER SISMA MEDIKA JL. KESEMEK, NO.3-5, SEMPER BARAT, CILINCING 021- 4400902/4403101| 021-4403101 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

558 1269 RS. MULYASARI JL. RAYA PLUMPANG SEMPER NO. 19 JAKARTA UTARA 021-43931111-43936666-43939999| 021-43934369/8888 Y Y ALL COVERAGE

559 1422 ROYAL PROGRESS INT HOSPITAL JL. DANAU SUNTER UTARA, SUNTER PARADISE I 021- 6400261; 6459877| 021-6519534 Y Y ALL COVERAGE

560 1677 KLINIK SOLA GRACIA MEDICAL CENTER JL. SUNTER AGUNG UTARA BLOK A 17 D NO 1 021-6459530/6452041| 021-6459530; 6451274 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

561 0186 RS. MITRA KELUARGA KELAPA GADING JL. BUKIT GADING RAYA KAV.2 KELAPA GADING PERMAI 021-45852700| 021-45852727/4585404 Y Y ALL COVERAGE

562 0812 RS. ATMA JAYA JL. PLUIT RAYA NO.2 (021) 6606127| (021) 6606122 Y Y ALL COVERAGE

563 0811 RS. SUKMUL JL. TAWES NO.18 - 20, TANJUNG PRIOK 021- 4301269| 021- 4301272 Y Y ALL COVERAGE

564 0396 RS. PANTAI INDAH KAPUK JL. PANTAI INDAH UTARA 3, PANTAI INDAH KAPUK 021-5885066; 5885065| 021-5880910/5881091 Y Y ALL COVERAGE

565 0910 KLINIK GADING UTAMA JL. KELAPA GADING BOULEVARD CN 2/25021-4532493/021-4532494021-

4532494|021-4532494021-4521933 N Y


RB,PHAR

566 0876 RSIA. FAMILYJL. PLUIT MAS I BLOK A NO.2A-5A, KOMPLEK PERUMAHAN PLUIT MAS,

JAKARTA UTARA

021-6695066/6694990021-6694990|021-

6694990021-6615563/66607254 Y Y ALL COVERAGE

GORONTALO

GORONTALO

567 3731 PRODIA GORONTALOJL. NANI WARTABONE, GORONTALO (EKS JL. DI PANJAITAN NO. 27,

GORONTALO 96115)(0435) 826246| - N Y


RB,PHAR

568 1420 RSIA. SITTI KHODIJAH GORONTALO JL. NANI WARTABONE NO. 101 d/h JL. AHMAD YANI 0435-822130/0435-821253/0435-824410| 0435-824410 Y N ALL COVERAGE

569 1513 RSU. BUNDA GORONTALO JL. HB.JASSIN, NO.269, KOTA GORONTALO0435-829255/ UGD

830600/827573/829290|0435-827573 Y N H&S,MAT

Page 8 of 28

NOV-08-2017



JAMBI

JAMBI

570 0894SILOAM HOSPITALS JAMBI (D/H RS. ASIA

MEDIKA)JL. SOEKARNO - HATTA, PAALMERAH JAMBI 0741-5919000-|- 0741-573271/573238 Y Y ALL COVERAGE

571 0550 RS. ST.THERESIA JL. SUTOMO, NO.19 0741 - 23119 / 7553811| 0741-20832 Y Y ALL COVERAGE

572 2207 RSU. BAITURRAHIM JAMBI JL. PROF. M. YAMIN SH NO. 30 LEBAK BANDUNG - JAMBI 0741-35165/0741-5911096/97/98| 0741-5911099/97 Y Y ALL COVERAGE

573 2184 APOTEK KIMIA FARMA 208 JL. SOEMANTRI BROJONEGORO NO. 108877800501/082146383275/074170785

71|- N Y


RB,PHAR

574 3570 PRODIA JAMBI JL. URIP SUMOHARDJO 2-3, TELANAI PURA, JAMBI 0741) 64688,| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

575 2047 RSIA. ANNISA JAMBI JL. KABIA NO 04 RT 01 KEL. KEBUN HANDIL KEC JELUTUNG KOTA JAMBI (0741) 445226| - Y Y ALL COVERAGE

576 2644 KLINIK & APOTEK KF 299 JL. R.MATTAHER NO.40, RAWASARI, JAMBI 0741 25635| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

577 2372 RS. KAMBANG JAMBI JL. KOL. AMIR HAMZAH N0 53, KEL SELAMAT KEC.JELUTUNG JAMBI 36129 0741-61714| - Y Y ALL COVERAGE

MUARA BUNGO

578 1926 RS. SENTRAL MEDIKA MUARA BUNGO JL. RANGKAYO HITAM, CADIKA MUARA BUNGO, JAMBI 0747-22207/22209| 0747-22209 Y Y ALL COVERAGE

579 5615 RSIA. PERMATA HATI MUARA BUNGOJL. LEBAI HASAN RT. 06 RW. 02 KEL. SUNGAI PINANG, KEC. BUNGO DANI,

KAB. BUNGO

(0747) 7331122/ 7331123, Hp. 0821 8461

2206|(0747) 7331123 Y Y ALL COVERAGE

JAWA BARAT

BANDUNG

580 1087 RS. BUNGSU JL. VETERAN, NO.6 022-4231550-|- 022-4231582 Y Y ALL COVERAGE

581 1088 RS. RAJAWALI JL. RAJAWALI NO.38022-6031087, 6011913,

6079143,6051087-|-022-6032077 Y Y ALL COVERAGE

582 1093 RS. KHUSUS BEDAH HALMAHERA SIAGA JL. LL.RE MARTADINATA NO.28 022-4206061/70858254/4216436-|- 022-4236920 Y Y ALL COVERAGE

583 1515 RSIA. MELINDA JL. PAJAJARAN, NO.46 022-4222788,4222388,4209088,4266700| 022-4215700 Y Y ALL COVERAGE

584 1211 KLINIK ASRI HUSADA II JL. TITIRAN NO.16 022-2507293| 022-2507293 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

585 4123 LAB. PRODIA MTC METRO INDAH MALL BLOK B NO.5, JL. SOEKARNO HATTA, BANDUNG 022-7536256| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

586 4124 LAB. PRODIA PASIRKALIKI JL. PASIRKALIKI NO. 225, BANDUNG 022-2034685| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

587 3001 LAB. KLINIK BIOTEST NARIPAN JL. NARIPAN NO. 41 BANDUNG (022) 4205544| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

588 4682 KLINIK UTAMA BANDUNG EYE CENTER JL. SUMATERA KEBON PISANG, KEC. SUMUR BANDUNG, BANDUNG (022) 4214390| - N Y ALL COVERAGE

589 1578 RS. HERMINA ARCAMANIK JL. AH.NASUTION, KM.7, NO.50 ARCAMANIK 022-87242525| 022-7271771 Y Y ALL COVERAGE

590 2625 KLINIK & APOTEK KF 12 JL. IR H JUANDA NO1 BANDUNG 022 4205421| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

591 2626 KLINIK & APOTEK KF 14 JL. CIAMPELAS 7, BANDUNG 022-4201596| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

592 2622 KLINIK UTAMA AL-ISLAM JL. AWIBITUNG NO.29 CICADAS BANDUNG 40121 (022) 7208284| (022) 7276149 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

593 2734 RSU. PINDAD JL. JEND. GATOT SUBROTO NO.517 (PAPANGGUNAN) BANDUNG 40285 022-7322877/7309807| 022-7322468 Y Y ALL COVERAGE

594 4237 RSIA. GRHA BUNDA JL. TERUSAN JAKARTA NO. 15-17 BANDUNG, JAWA BARAT 022-872 56789| 022-872 56000 Y Y ALL COVERAGE

595 2730 KLINIK & APOTIK K-24 JL. LASWI NO.1A,BANDUNG (022) 7821700/7215992| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

596 2704 KLINIK & APOTEK KF 43 JL. BUAH BATU, BANDUNG 022 7305019| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

597 2705 KLINIK & APOTEK KF 320 JL. CINUNUK NO.192, BANDUNG 022 7801875| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

598 2719 KLINIK JAYA SENTOSA JL. SUNDA NO.75, BANDUNG 022 426 4258| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

599 2720 KLINIK JAYA ABADI ( GROUP JAYA SENTOSA) JL. BUAHBATU NO.245 , BANDUNG (022) 7317779| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

600 0303 RS. ADVENT BANDUNG JL. CIHAMPELAS, NO.161 022 -2034386-9/2034388| 022-2043167/2041109 Y Y ALL COVERAGE

601 1900 TELEMEDIKA HEALTH CENTER (THC) SENTOT JL. SENTOT ALIBASYAH NO 4 BANDUNG 022-61115555| . N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

602 1568 KLINIK UTAMA MONALISA JL. MOCH. RAMDHAN NO.32 022-5211311| 022-5200162 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

603 1170 RS. SANTO YUSUP JL. CIKUTRA 7 BANDUNG022-7208172,022-7217097, 022-

7217103, 022-7231721|022-7202419 Y Y ALL COVERAGE

604 2163 LAB. PRODIA BANDUNG JL. WASTUKENCANA NO.38 BANDUNG 022-4222541| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

605 2167 APOTEK FARMARIN BANDUNG 2 TUBISJL. TUBAGUS ISMAIL NO.79 RT/RW 004/012 KEL.SEKELOA KEC. COBLONG

BANDUNG022-2500387| 022-2517116 N Y


RB,PHAR

606 2213 TELEMEDIKA FARMA 2 BB JL. TERUSAN BUAH BATU NO 33 022-70348587| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

607 1687 RS. IMC BANDUNGJL.RAYA CIMAREME NO.170-173 NGAMPRAH, PADALARANG, BANDUNG

BARAT022-6620923/6620965| 022 - 6620964 Y Y ALL COVERAGE

608 0886 RSUD. AL IHSAN JL. KIASTRAMANGALA, BALEENDAH,022-

5940872/5941719/5941729/5940770/877022-5941709 Y Y ALL COVERAGE

609 1169 RS. AMC (ANNISA MEDICAL CENTER) JL. RAYA CILEUNYI RANCAEKEK 022-7781630,70804777,70805777| 022-70804777/7781629 Y Y ALL COVERAGE

610 1171 SANTOSA BANDUNG INTERNASIONAL HOSPITAL JL. KEBON JATI, NO.38 022-4248333| 022-4211086/84468598 Y Y ALL COVERAGE

611 0958 KLINIK AN-NUR JL. DR. SETIA BUDI NO.63 022-2031922; 022 2042213|- 022-2031922/2042213 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

612 0959 KLINIK ASRI HUSADA I JL. BEKAMIN NO.18 022-7230425-87245792|- 022-2507293 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

613 0145 RS. MUHAMMADIYAH BANDUNG JL. KH. AHMAD DAHLAN NO.53022-

7301062,7312167,7323549,7306935,7323022-7306458 Y Y ALL COVERAGE

614 0761 RS. SANTO BORROMEUS BANDUNG JL. IR.H.JUANDA NO.100 LEBAK GEDE COBLONG022-2552041/82558000/022-2552083/95;

022-2552003.|022-2552003022-2504235 Y Y ALL COVERAGE

615 6364 RS. KARISMA CIMAREME Jl. RAYA CIMAREME NO.235 NGAMPRAH, BANDUNG BARAT 022-6866221| 022-6867821 Y Y ALL COVERAGE

616 5900 RSU. BINA SEHAT JL. RAYA DAYEUH KOLOT NO.325 (022)5207963-65| 022-5207964 Y Y ALL COVERAGE

617 4986 RSGM. MARANATHAJL. PROF. DRG. SURYA SOEMANTRI NO. 65, RT. 01, RW. 04, KEL.

SUKAWARNA, KEC. SUKAJADI(022) 2005936| (022) 2019571 N Y ALL COVERAGE

618 3678 PRODIA KOPO JL. KOPO PERMAI I BLOK 55 A / 6, BANDUNG 40227 (022) 5404291| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

619 6391 RS MATA BANDUNG EYE CENTER JL. BUAH BATU NO.147 RT.007/006 LENGKONG, TURANGGA (022) 7351 4683/84| (022) 7351 4682 Y Y ALL COVERAGE

620 0044 RSU. HERMINA PASTEUR JL. DR. DJUNDJUNAN, NO.107, PASTEUR 022-6072525| 022-6037815 Y Y ALL COVERAGE

621 0144 RS. IMMANUEL BANDUNG JL. KOPPO, NO.161022-5201051/5201672/5201656|022-

5224216022-5224219 Y Y ALL COVERAGE

622 1265 APOTEK & KLINIK KIMIA FARMA SULAJANA 4 JL. SULAJANA NO.4 022-85880430/91512935| 022-4261088 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

623 3588 KIMIA FARMA SINDANGLAYA JL. AH.NASUTION NO.126 B BANDUNG 022-7278664| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

624 3560 LAB. PRODIA BUAH BATU JL. BUAH BATU NO. 160, BANDUNG 40265 (022) 7310128| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

625 4116 LAB. PRODIA KURDI JL. MOH TOHA NO. 126 BANDUNG (022) 5206492| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

626 2950 RS. KB. MELINDA IIJL. CIPTO NO. 1 RT 05/02, KEL. PASIRKALI KEC. CICENDO, KOTA

BANDUNG022-4267888/4233777| 022-4247888 Y Y ALL COVERAGE

627 5119 KLINIK BRAWIJAYA BANDUNG JL. KH. ACHMAD DAHLAN NO. 40, BUAH BATU, BANDUNG 022- 7308104| (022) 7311484 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

628 1125 RS. CAHYA KAWALUYAN JL. PARAHYANGAN KM.3 KAV.HOS PADALARANG 022-6803700| 022-6803711/6803730 Y Y ALL COVERAGE

629 0880 RS. AL ISLAM BANDUNG JL. SOEKARNO-HATTA NO.644022-7562046 / 022-7563231|022-

7563231022-7563233/7500109 Y Y ALL COVERAGE

630 4967 RSKIA. HARAPAN BUNDA BANDUNGJL. PLUTO RAYA BLOK C RT. 01 RW. 02, KEL. MARGASARI KEC. BUAHBATU,

BANDUNG 40286(022) 7506490| (022) 7514712 Y Y ALL COVERAGE

631 6374 KLINIK JASMINE MQ MEDIKA JL. DAYANG SUMBI NO.10 RT.03/03 LEBAK SILIWANGI, COBLONG 022-20454500 / 20454502| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

632 3589 KIMIA FARMA 319 METRO JL. VENUS RAYA NO 27 0227564623| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

633 3591 APOTEK KIMIA FARMA 381 KOPO JL. KOPO CIRANGRANG NO.638 BANDUNG 022-5436596 / 085721647451| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

634 3592 KIMIA FARMA SETIABUDI JL. DR.SETIABUDHI NO 36, BANDUNG 022-2038048 / 0821200770017| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

635 1829 RSIA. LIMIJATI JL. LAKS L RE MARTADINATA 33-39 022-4207770/022-84281333/84469472| 0224-4260956 Y Y ALL COVERAGE

636 4517 PRODIA MAJALAYA JL. BABAKAN NO.60 MAJALAYA 022-5952724| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

637 4518 PRODIA BANJARAN JL. PAJAGALAN NO. 10 BANJARAN 022-5946190| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

638 2936 LAB. PRODIA BUMI MAS KENCANA RUKO BUMI MAS KENCANA, JL. AH. NASUTION 928 B CIKADUT BANDUNG 022-7236559| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

639 3366 SANTOSA HOSPITAL BANDUNG KOPO JL. K.H. WAHID HASYIM (KOPO), NO.461-463 BANDUNG 022-54280333| 022-5402242/54280365 Y Y ALL COVERAGE

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BANJAR

640 4122 LAB. PRODIA BANJAR JL. STADION PATROMAN KAV III NO. 3 0265-2732534| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

BEKASI

641 2508 MITRASANA TAMAN HARAPAN BARUJL. TAMAN HARAPAN BARU BLOK E7 NO 9, PEJUANG, MEDAN SATRIA,

BEKASI BARAT88870793 / 08891259038| - N Y


RB,PHAR

642 2461KLINIK 24 JAM & RB. PERMATA BUNDA

CIBITUNGJL. RAYA WANAJAYA - CIBITUNG, BEKASI 021 - 88322064, 88323062| - Y Y


RB,PHAR

643 6386 AUDY DENTAL BEKASI RUKO GRAND GALAXY CITY BLOK RGG NO.26 (021) 82733123 / 081212026161| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

644 6069 KLINIK CIPTO 2JL. RAYA CIKARANG SUKATANI NO. 3 DESA KARANG SENTOSA KEC.

KARANG BAHAGIA KAB. BEKASI(021) 89161455| (021) 89161455 N Y


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645 5614 KLINIK MATA UTAMA JEC CIBUBURJL. ALTERNATIF CIBUBUR -CILUENGSI RT.001/011, KEL. JATIKARYA KEC.

JATISAMPURNA, BEKASI(021) 29221000| - N Y


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646 2821 LAB. PRODIA BEKASI JL. KH NOER ALI NO.90 RT.01 RW.25 KAYURINGIN JAYA, BEKASI SELATAN. (021) 8840480, 8844911| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

647 2513 MITRASANA MEGA REGENCY 2"Jl.Perum Mega regency Blok A09 Desa Sukasari Kec. Serang baru kab.

Bekasi0815101487758| - N Y


RB,PHAR

648 1989 RSIA. KARUNIA KASIH (KARUNIA BUNDA) JL. RAYA JATI WARINGIN NO. 133 PONDOK GEDE KOTA BEKASI 021-8461970| 021- 8460991 Y Y ALL COVERAGE

649 5795 KLINIK PRATAMA IMANI MEDIKAJL. RAYA TAMAN NAROGONG INDAH BLOK A10 NO.3, PENGASINAN,

RAWALUMBU(021) 82731078| - N Y


RB,PHAR

650 6010 RS. TARUMAJAYA JL. RAYA TARUMAJAYA NO.1B KP.BALI, PANTAI MAKMUR, TARUMAJAYA 021-88992337 / 88992338| Y Y ALL COVERAGE

651 6068 PRESIDENT MEDICAL CENTERJL. KI HAJAR DEWANTARA NO.81-83, KAWASAN PENDIDIKAN JABABEKA

RUKO INFO PLAZA CIKARANG BARU021-29469400 / 29082423| - N Y


RB,PHAR

652 2036 RSU. DR. IQBALI TAUFANVILA MUTIARA CIKARANG 2 BLOK E3 NO.16-20 SUKASEJATI, CIKARANG

SELATAN - BEKASI021-8971769/89902361| 021-89902361 Y Y ALL COVERAGE

653 0151 KLINIK MULYA MEDIKA (APOTIK MURNI) JL. RAYA JATI MULYA, NO.1, BEKASI TIMUR 021-8203272| 021-8203272 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

654 1296 RSB. TAMAN HARAPAN BARUJL. TAMAN HARAPAN BARU RAYA, BLOK R-I NO.20, PEJUANG - MEDAN

SATRIA021-88871202| 021- 88871203 Y Y ALL COVERAGE

655 0847 RS. ANNA PEKAYON JL. PEKAYON RAYA NO.36, BEKASI SELATAN 021-82432211| 021-82419079 Y Y ALL COVERAGE

656 1261 RS. HOSANA MEDICA BEKASI JL. PRAMUKA NO.12 RAWA LUMBU 021-8221570/73| 021-8224604/8221574 Y Y ALL COVERAGE

657 5902 RS. SATRIA MEDIKA JL. RAYA BANTAR GEBANG - SETU NO.119, PADURENAN, MUSTIKAJAYA 021-22105678| - N Y ALL COVERAGE

658 1062 RS. CIBITUNG MEDIKA JL. RAYA H.BOSIH NO.117 DS.WANASARI,CIBITUNG 021-88323444/88393181-|- 02188323449/88372866 Y Y ALL COVERAGE

659 1333 RSU. KARTIKA HUSADA JATIASIH JL. SWANTARA NO 72 JATI ASIH, BEKASI 021-82435585-82435587| 021-82435586 Y Y ALL COVERAGE

660 0178 RS. HERMINA BEKASI JL. KEMAKMURAN, NO.39, MARGAJAYA 021-8842121/30| 02188865121/88952275 Y Y ALL COVERAGE

661 6250 RS. AWAL BROS BEKASI TIMUR JL. H.M JOYOMARTONO, MARGAHAYU, BEKASI TIMUR (021) 8267 9999| (021) 8267 8989 Y Y ALL COVERAGE

662 1951 KLINIK & APOTEK KF 387 JL. JATIWARINGIN NO 5 PONDOK GEDE BEKASI 021-8461980| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

663 1053 RS. ST. ELISABETH - BEKASI JL. RAYA NAROGONG NO.202 KEMANG PRATAMA021-82430101/82400186/8229767021-

82432082|021-82432082021-82432083 Y Y ALL COVERAGE

664 5422 KLINIK MUSTIKA HUSADAJL. RAYA BURANGKENG PERUM MUSTIKA GRANDE BLOK J NO. 5 DESA

BURANGKENG KEC. SETU, BEKASI(021) 88326109/087880880370| - N Y


RB,PHAR

665 1304 RS. PUSPA HUSADAJL. RAYA PONDOK TIMUR KM. 1, NO 27 JATIMULYA TAMBUN SELATAN-

BEKASI021-82618978/82618979| 021-82618977 Y Y ALL COVERAGE

666 4726 KLINIK CAHAYA AMALIAJL. KH. MUHTAR THABRANI NO. 3-5 KEL. PERWIRA, KEC. BEKASI UTARA,

BEKASI(021) 88879888| (021) 88881747 N Y


RB,PHAR

667 5220 VIVA MEDIKA BEKASI TIMURJL. CUT MUTIA BLOK D NO. 9 RT. 008/ 008 KEL. MARGAHAYU, KEC. BEKASI

TIMUR, BEKASI(021) 8834 8228| - N Y


RB,PHAR

668 5221 RS SILOAM BEKASI TIMUR d/h BLU PLAZAJL. CHAIRIL ANWAR BLU PLAZA NO. 27 RT.004/009 KEL. MARGAHAYU KEC.

BEKASI TIMUR, BEKASI(021) 806 11 900| (021) 806 11 911 Y Y ALL COVERAGE

669 5222 VIVA MEDIKA TAMBUNRUKO TAMBUN CITY BLOK RB NO. 16, JL. SULTAN HASANUDDIN KEC.

TAMBUN SELATAN088888553853| - N Y


RB,PHAR

670 5223 VIVA MEDIKA CIKARANGRUKO CIKARANG CENTRAL CITY BLOK F NO. 23, JL. CIKARANG CIBARUSAH

DESA CIANTRA KEC. CIKARANG SELATAN, BEKASI(021) 2961 9212| - N Y


RB,PHAR

671 4385 KLINIK & APOTEK KF 340 JL.KEDASIH RAYA NO.112 CIKARANG -| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

672 3702 PRODIA HARAPAN INDAHRUKO SENTRA NIAGA, BOULEVARD HIJAU BLOK C5/41 HARAPAN INDAH,

BEKASI(021) 29465476| - N Y


RB,PHAR

673 0010 RS. MITRA KELUARGA BEKASI BARAT JL. JEND. A.YANI, BEKASI BARAT 021-8853333| 021-8842550/8855000 Y Y ALL COVERAGE

674 2544 MITRASANA TAMAN CENTURYJL. RAYA LASKAR NO.59 RT.004/02, KEL.PEKAYON JAYA, KEC.BEKASI

SELATAN085100487742| - N Y


RB,PHAR

675 0766 RS. ANANDA BEKASI JL. SULTAN AGUNG NO.173, MEDAN SATRIA 021-8854338| 021- 88950141 Y Y ALL COVERAGE

676 0843 KLINIK DHARMA BHAKTI JL. RAYA BOSIH BLOK A4 NO.23 PONDOK TANAH MAS, CIBITUNG - BEKASI 021-8831441-|- 021-8831441/8830246 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

677 4515 PRODIA SUMMARECON BEKASI JL. BULEVAR SELATAN SUMMARECON BEKASI RUKO SINPASA BLOK SA 021-8840480| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

678 1350 RS. MITRA KELUARGA CIBUBUR JL. ALTERNATIF TRANSYOGI, CIBUBUR 021-84311771/84311777| 021-84311661 Y Y ALL COVERAGE

679 3382 KHARISMA MEDICAL CENTER JL. CAMAN RAYA NO.54 BEKASI 021-84991671| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

680 1204 KLINIK SEHAT SEJAHTERA II PERUM REGENSI - BEKASI TIMUR 021-88367194| 88349427 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

681 4814 KLINIK MULTAZAMJL. RAYA CIBARUSAH NO. 33KEL. SUKARESMI, KEC. CIKARANG SELATAN,

BEKASI(021) 9874929| - N Y ALL COVERAGE

682 1558 KLINIK ASYIFA HUSADA PERUM. VILLA MUTIARA JAYA BLOK N. 78 /11-12, WANAJAYA, CIBITUNG 021-88338235| 021-88338235 N YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

683 0735 RS. KARTIKA HUSADA TAMBUNJL. MANGUN JAYA RAYA KP.RUKEM RT.003/013, DESA MANGUN JAYA,

TAMBUN - BEKASI

021-88338346/88327281/021-

9172736|021-9172736021-88322529 Y Y ALL COVERAGE

684 4693 RS. CIKUNIR JL. RAYA CIKUNIR GG. HJ NAPSIAH RT.06/03 , JAKAMULYA (021) 82437322| (021) 82437323 Y Y ALL COVERAGE

685 3956 APOTEK KIMIA FARMA CAHAYA AMALIA JL. KH.MUCHTAR TABRANI NO.3-4, KEL.PERWIRA BEKASI UTARA 02188879888| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

686 4484 KLINIK & RB KARUNIA MEDIKA CENTER JL. GATOT SUBROTO NO. 37 RT.003/002 KEL. CIKARANG - BEKASI 021-89104266| - N YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

687 4811 RSU. AS-SHOFWANJL. RAYA KARAWANG BEKASI KM 30 DS. BOJONGSARI KEDUNGWARINGIN

KAB. BEKASI(021) 89141890| (021) 89141754 Y Y ALL COVERAGE

688 1123 RS. CITRA HARAPAN JL. RAYA HARAPAN INDAH KAW.SENTRA NIAGA NO.3-5 MEDAN SATRIA 021-88870606/88870909/88865792-93| 021-88975555 Y Y ALL COVERAGE

689 2511 MITRASANA DUKUH ZAMRUD JL. ZAMRUD UTARA RUKO BLOK S.1 NO. 18 KOTA LEGENDA,BEKASI TIMUR 08891258897/ 82602911| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

690 4815 RS. PERMATA KELUARGA JABABEKA JL. DR.CIPTO MANGUNKUSUMO BLOK A NO.1A, MEDICAL CITY JABABEKA ( 021 ) 29083399| (021) 8990 1860 Y Y ALL COVERAGE

691 0891 RS. HERMINA GALAXY JL. GARDENIA RAYA SELATAN BLOK BA1 NO.11 021-8222525/82417777| 021-82414087 Y Y ALL COVERAGE

692 2433 KLINIK TAMAN FIRDAUS MEDIKA PERUM TAMAN FIRDAUS RESIDENCE BLOK A 06 NO.17 CIBARUSA BEKASI 021 - 89950047| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

693 2573 MITRASANA BUMYAGARA TAMAN BUMYAGARA A.04 KEL MUSTIKA JAYA 085100464921| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

694 2611 KLINIK AMELIAVILA MUTIARA GADING 2 KOMPLEK RUKO ROXY BLOK DD.10 NO.1 KARANG

SATRIA BEKASI021-88376985| - N Y


RB,PHAR

695 2560 MITRASANA MOCHTAR TABRANIJL. KH MUCHTAR TABRANI RT 003 RW 03 KEL. PERWIRA KEC. BEKASI

UTARA KOTA BEKASI36822504/ 08891259008| - N Y


RB,PHAR

696 2585 MITRASANA WIBAWA MUKTI JL. WIBAWA MUKTI RT.01/11 KP.PEDURENAN, JATIASIH 021-36487743| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

697 2515 MITRASANA KALIABANG"RUKO FITRA JAYA, JL. KALIABANG RT 01/06 NO. 7 KEL PERWIRA KEC

BEKASI UTARA021-88974206| - N Y


RB,PHAR

698 2520 MITRASANA UJUNG HARAPAN"KAMPUNG UJUNG HARAPAN RT 02/ RW 15 KEL. BAHAGIA KEC. BABELAN

KAB. BEKASI021-29258727/ 70874627| - N Y


RB,PHAR

699 2539 MITRASANA PONDOK TIMURPONDOK TIMUR INDAH BLOK G NO 1 PONDOK TIMURKEL JATIMULYA KEC

TAMBUN SELATAN KAB BEKASI085100822510| - N Y


RB,PHAR

700 2545 MITRASANA TITIAN INDAHJL. PERUM TITIAN INDAH BLOK I NO 9 RT 07 RW 10 KEL. KALIBARU KEC

MEDAN SATRIA KOTA BEKASI021-94178815| - N Y


RB,PHAR

701 2613 KLINIK & APOTIK MAHADINA MEDIKA JL. KH. BOSIH NO.9 CIBITUNG -| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

702 3367 KLINIK CENTRAL MEDIKA2JL. KH. FUDHOLI (KEBON KPI) DESA KARANG ASIH, KEC. CIKARANG

UTARA KAB. BEKASI021-89100879| 021-89100877 N Y


RB,PHAR

703 3447 KLINIK RAWAT INAP PEDULI SEHATJL. RAYA PILAR SUKATANI KP. SUKAMANTRI NO 62 RT 03/03 DS SUKARAYA

KEC KARANG BAHAGIA021-8903208| 021-89100139 N Y


RB,PHAR

704 0161 RS. MITRA KELUARGA BEKASI TIMUR JL. PENGASINAN RAWA SEMUT MARGAHAYU, BEKASI TIMUR 021-8817777/89999222| 8820707/89999286 Y Y ALL COVERAGE

705 2802 KLINIK PERTAMEDIKA BEKASIRUKO KALIMALANG SQUARE BLOK J NO. 17, JL. KALIMALANG RAYA -

BEKASI BARAT021-88962946| - N Y


RB,PHAR

706 2803 KLINIK PERTAMEDIKA JATIWARINGIN ASRI JL. SANGATTA NO. 1 JATIWARINGIN PONDOK GEDE 17411 021-84990644| 021-84970944 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

707 2689 KLINIK & APOTEK KF 367 JL. JATIMEKAR NO. 33 JATIASIH 021 8473403| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

708 1971 RB. WIJAYANTIJL. PERUM GRIYA BEKASI PERMAI BLOK H6 NO 17, TELAJUNG-CIKARANG

BARAT021-29371856/97958619| 021-82602243 Y Y ALL COVERAGE

709 4378 KLINIK MATA NUSANTARA (BEKASI)RUKO SENTRA NIAGA KALIMALANG, JL. A.YANI BLOK A9 NO. 16, KEL.

MARGA JAYA, KEC. BEKASI SELATAN(021) 2925 7761| (021) 2925 7762 N Y GP,OP

710 0147RS KARYA MEDIKA BANTAR GEBANG(d/h KARYA

MEDIKA IV)JL. NAROGONG RAYA, KM.11, BANTAR GEBANG 021-8254629/8254630|021-8254630 021-8254629 Y Y ALL COVERAGE

711 4743 KLINIK TRAYAJL. KH. NOER ALI NO. 1D RT. 001 RW.016, JAKA SAMPURNA, BEKASI

BARAT BEKASI 17137(021) 21286002| - N Y


RB,PHAR

712 1293 KLINIK YAKESTI BEKASI JL. RAYA NAROGONG KM.7 NO.45 BOJONG MENTENG -021 8253516| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

713 1807 RS. TIARA BEKASI JL. RAYA BABELAN NO. 63 KEL. KEBALEN KEC. BABELAN KAB. BEKASI 021-89131111/021-89133333| 021-89132039 Y Y ALL COVERAGE

714 1486RS. AWAL BROS BEKASI (D/H RS. GLOBAL

AWAL BROS )JL. KH.NOER ALI KAV.17-18 KALIMALANG 021-8868888/88855333| 02188855222/88855210 Y Y ALL COVERAGE

715 1816 RS. HARAPAN MULIA JL. RAYA CIBARUSAH NO. 5 KB. KOPI, CIBARUSAH JAYA KAB. BEKASI 021-89952340| 021-89952460 Y Y ALL COVERAGE

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716 1830 RB & KLINIK AMIRA CIKARANG JL. RAYA BY PASS LEMAH ABANG, CIKARANG TIMUR 021-8914 2719| 021-89142719 Y YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

717 1937 APOTIK FARMARIN VII BEKASIJL. GURAME RAYA PERTOKOAN KAV.29 PERUMNAS KAV.29 PERUMNAS II

KEL, KAYU RINGIN RAYA KEC BEKASI SELATAN.02188968419| - N Y


RB,PHAR

718 1924 KLINIK MANDIRI PERUM VILLA MUTIARA CIKARANG BLOK R 26-27 CIKARANG SELATAN 021-897 4883| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

719 1530 KLINIK SIERRA MITRA JL. KH. M.TABRANI BLOK I NO. 1 A-1B, MARGAMULIA, BEKASI UTARA 021-70266392/8868129| 021-8868129 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

720 1541 RS. PERMATA BEKASI JL. LEGENDA RAYA, NO. 9, MUSTIKA JAYA 021-8251919/8254748| 021-82609705 Y Y ALL COVERAGE

721 1559 RB & KLINIK TIARA BUNDA JL. RAYA PERJUANGAN NO. 1, PERTIGAAN TELUK PUCUNG 021-89131010| 021-89131010 Y YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

722 1122 RS. JATI SAMPURNA JL. STUDIO ANTV KRANGGAN 021-8451457/8455874| 021- 8455712/8459464 Y Y ALL COVERAGE

723 1576RS TAMAN HARAPAN BARU (d/h praktek

bersama dokter)JL KALIABANG TENGAH RT 04/23 KEL. PEJUANG KEC. MEDAN SATRIA 021-88981055| 021-88981055 Y Y ALL COVERAGE

724 0063 RS. MULTAZAM MEDIKA JL. PERUMAHAN JATIMULYA NO.1 TAMBUN SELATAN021-8215101/8215102021-8215102|021-

8215102021-82416678 Y Y ALL COVERAGE

725 1553 RS. HERMINA GRAND WISATA JL. FESTIVAL BOULEVARD BLOK JA NO. I, GRAND WISATA 021-8265 1212| 021-825 2963 Y Y ALL COVERAGE

726 0016 RS. KARYA MEDIKA CIBITUNG JL. RAYA IMAM BONJOL, NO.9B, CIKARANG BARAT, CIBITUNG021-8900190-1& 8903003-4/ 8900190-1

(ext:181)|021-89107753-4 Y Y ALL COVERAGE

727 1588 RB. ASYIFA HUSADA MEDICAL CENTER PERUM. BEKASI REGENCY I BLOK K I NO. 1, CIBITUNG 021-88332152| 021-88332152 Y Y ALL COVERAGE

728 1595 KLINIK VNV MEDIESTETIKOMPLEK PEMDA BLOK C KAV 60 B, JL WARUNG BUAH KOMSEN JATI ASIH

BEKASI021-824 15167/ 82435767| 021-82435767 N Y


RB,PHAR

729 2057 KLINIK BATARA SATU MEDIKAJL. KH. NOER ALI NO. 10 KP. IRIAN RT. 03/04 TELUK PUCUNG, BEKASI

UTARA021-89133229/085100589090| 021-82589090 N Y


RB,PHAR

730 2091 KLINIK SITI ZAHROH PERUMAHAN GRAND RESIDENT RR 100 SETU - BEKASI 021-8261.8362| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

731 1586 RS. BUNDA MULIA (d/h) RSIA SRITINA JL. IMAM BONJOL NO.80A CIKARANG BARAT, BEKASI 021-8900579-89106317| 021-89106633 Y Y ALL COVERAGE

732 1640 RS. JATI RAHAYU JL. RAYA HANKAM NO 17 PONDOK MELATI BEKASI 021-8462566,8462565,84972578| 021-84992723 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

733 1769 KLINIK SATELIT GSM BEKASIBEKASI SQUARE NO 65-66 JL. AHMAD YANI PEKAYON JAYA BEKASI

SELATAN021-82425408| - N Y


RB,PHAR

734 1771 RS. KARTIKA HUSADA SETU JL. BURANGKENG RT 01/06 DESA BURANGKENG SETU BEKASI 021-82610003/4/5| 021- 82610005 Y Y ALL COVERAGE

735 0032 RB. BUNDA AUNI VILLA NUSA INDAH, BLOK D5, NO.19 021-82402286/82420366/82403873| 021-82410136 Y Y ALL COVERAGE

736 0409 KLINIK DHARMA MEDIKA JL. PEMUDA, NO.33, KRANJI 021-8855173,8866711| 021-8866711 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

737 0185 RS. BHAKTI KARTINI JL. KARTINI, NO.11 021-8801954/88348492| 021-8824228 Y Y ALL COVERAGE

738 0767 KLINIK MHT BEKASI JL. H.M JOYO MARTONO NO.31B BEKASI TIMUR 021-8814262| 021-8814262 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

739 0620 RS. KARYA MEDIKA II (D/H RSIA. ) JL. SULTAN HASANUDIN NO.63 TAMBUN021-883 24366; 70934766/ 021-

88361980|021-88361980021-88327514 Y Y ALL COVERAGE

740 0410 RS. BELLA JL. IR. H. JUANDA, NO.141 BEKASI021-880 1775/ 880177/8819377021-

880177|021- 88017702188342438/88352506 Y Y ALL COVERAGE

741 0384 RS. MEKAR SARI JL. MEKAR SARI, NO.1021-8802641,8813787021-8813787|021-

8813787021-8810055/88350908 Y Y ALL COVERAGE

742 0250 KLINIK KARYA MEDIKA I JL. IR H JUANDA NO.38 C 021-8801293021-8800381|021-8800381 021-8816137 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

743 0188KLINIK FAJAR MEDIKA ( GROUP KARYA MEDIKA

)RUKO KAWASAN INDUSTRI MM2100, CIBITUNG 021-8981162| 021-8981162 N Y


RB,PHAR

744 0715 KLINIK MUTIARA I (CITRA HUSADA I) PERUM METLAND JL. KALIMAYA 6 BLOK L2 / 1 BEKASI 021-29487893| 021-88337919 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

745 0294KLINIK KARYA MEDIKA III (APOTIK MEKAR

ASRI)JL. PERJUANGAN, NO.30C, TELUK BUYUNG 021-8851152| 021-8851152 N Y


RB,PHAR

746 0819 RB & KLINIK PERMATA BUNDA SETU PERUM GRAHA MUSTIKA MEDIA, BLOK A5, NO.15, SETU 82611729 / 88328001| 82611729 Y YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

747 0873 APOTIK & KLINIK LEGENDA SEHAT JL. ZAMRUD UTARA BLOK U16 NO.100 KOTA LEGENDA 021-82600148| 021-82606179 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

748 1013 RSIA SELASIH MEDIKA JL. RAYA BINTARA NO 5, BEKASI BARAT 021-8850155| 021-8844667 Y Y ALL COVERAGE

749 1038 KLINIK HARAPAN SEHAT III PERUMAHAN VILLA MUTIARA JAYA, BLOK MB 16/7, CIBITUNG 021- 68295994/88393875-|- - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

750 0947 RS. APRILIA MEDIKA JL. RAYA SETU NO.99 DESA LUBANG BUAYA, KEC SETU BEKASI 021 - 82611565/82603851|021-5901312 021 - 82611565 Y Y ALL COVERAGE

751 0949BP DR. SANDER B(D/H KLINIK HOSANA MEDICA

CIBITUNG)JL. TEUKU UMAR NO.19 CIBITUNG 021-8833 8414-|- 021-8833 8413 N Y


RB,PHAR

752 0950KLINIK HOSANA MEDICA MANGUN JAYA

(HOSANA MEDIKA IVJL. MANGUN JAYA INDAH II BLOK G10 NO. 3 TAMBUN BEKASI 17510 (021) 8832-0349-|- (021) 8832-0349 N Y


RB,PHAR

753 0622 RSU. MITRA MEDIKAJL. DESA JATIWANGI-CIKEDOKAN/SEBELAH SELATAN KAWASAN MM 2100

KP KAMURANG RT 1/1 CIKEDOKAN, CIKARANG BARAT021-8998 3741/71691709/98213879| 021-89983575 Y Y ALL COVERAGE

754 0588 KLINIK MELVIANA JL. SAPARUA RAYA NO.239 - 240 PERUMNAS III BEKASI 082213067595; 021 - 8807610| 021-88341291 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

755 0036 RS. SENTOSA BEKASI ( Group Siloam ) JL. PAHLAWAN, NO.60 DUREN JAYA, BEKASI TIMUR 021-880 6140| 021-881 4950 Y Y ALL COVERAGE

756 0324 RS. GRAHA JUANDA JL. IR. H. JUANDA, NO.326021- 8811832, 8821004,

8811832,88346880|021- 8811832021 - 88346880 Y Y ALL COVERAGE

757 1140 RS. RAWA LUMBU JL. DASA DARMA, NO.20-23, RAWA LUMBU 021-82422511| 021-82432958 Y Y ALL COVERAGE

758 0960 RSB. MEKAR MULIAJL. KASUARI IV NO. 1-2, SEKTOR MEKAR ALAM, PASIMAL - CIKARANG

BARU021-8936940/66/|- 021-89830523 Y Y ALL COVERAGE

759 1334 RS. ANNA MEDIKA JL. RAYA PERJUANGAN NO 45, HARAPAN BARU, BEKASI UTARA 021 - 88882211| 021 - 88973042 Y Y ALL COVERAGE

760 0982 RS. BUDI LESTARI JL. KH.NOER ALIE, NO.2 DEPAN PERUMNAS II, KALIMALANG021-8842336/8893486021-8893486|021-

8893486021-8893487 Y Y ALL COVERAGE

761 0987 RB & KLINIK HARAPAN SEHAT CIBITUNG JL. TEUKU UMAR NO.33 CIBITUNG 021-88336674-|- 021-8901126 Y Y ALL COVERAGE

762 0988 RS. PERMATA BUNDA BEKASI PERUM GRAMAPURI TAMANSARI C1/8-10 CIBITUNG 021-88328001/88392537-|- 88328002 Y Y ALL COVERAGE

763 1120 KLINIK PURI NUSAPHALA JL. CITRA INDAH A/14 PERUM PURI NUSAPALA JATI ASIH 021-82440368/7| 021-82440368 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

764 1207 KLINIK DIPONEGORO JL. DIPONEGORO NO.26 TAMBUN 021 - 8817062| 021-88346743 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

765 1216 RS. JUWITA JL. M. HASIBUAN NO.78 - BEKASI 021 -8829590/1| 021-8829592 Y Y ALL COVERAGE

766 1136 KLINIK PERMATA BUNDA BEKASI JL. BOSIH RAYA RUKO KARTIKA WANASARI BLOK.C1/4 CIBITUNG021- 88373158 / 021-88328001/

88392537|- N Y


RB,PHAR

767 1090 RS. PERMATA CIBUBUR JL. ALTERNATIF CIBUBUR - CILEUNGSI NO.6A 021-8458806|- 021-84594263 Y Y ALL COVERAGE

768 1259 KLINIK WIJAYA KESUMA JL. NAROGONG SAKTI RAYA BLOK A 20 NO.1 021 - 8210779| 021 - 8226455 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

769 1417 RSIA. RINOVA INTAN JL. RAYA SEROJA NO.101 021-8849401| 021-8848739 Y Y ALL COVERAGE

770 1203 KLINIK SEHAT SEJAHTERA I JL. NUSANTARA RAYA NO.2 PERUMNAS III BEKASI TIMUR 021-88349427| 88349427 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

771 1517 RSU. DR. ADAM TALIB JL. TEUKU UMAR, NO.25, CIBITUNG 021-88332305/06| 021-88332308 Y Y ALL COVERAGE

772 1277 RB & KLINIK GUCI MEDIKA JL. PRAMUKA NO.79 RAWA LUMBU 021-82433158| 021-8221921 Y Y ALL COVERAGE

BOGOR

773 1913 KLINIK PURI MEDIKAJL. RAYA CIKARET NO. 12 RT.03 RW.10 KAMPUNG POS PAKANSARI

CIBINONG, BOGOR021-87903120| - N Y


RB,PHAR

774 1353 RS. CITAMA JL. RAYA PABUARAN NO.52 BOJONGGEDE 021-87985555| 021-87986666 Y Y ALL COVERAGE

775 1533 KLINIK DR.BETTY JL. RAYA NAROGONG, PERUMAHAN PT.SEMEN CIBINONG, CILEUNGSI 021-82493032| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

776 0133 RS. HERMINA BOGOR JL. RING ROAD-1, KAV.23,25,27, PERUM. TMN. YASMIN 0251-8382525| 0251-8328252 Y Y ALL COVERAGE

777 0755 RS. BINA HUSADA CIBINONG JL. MAYOR OKING NO.101, CIBINONG021-8758441; 87911000021- 8753422-

|021- 8753422-021-8752463 Y Y ALL COVERAGE

778 0720 RSIA. CITRA INSANI JL. RAYA PARUNG NO.242, LEBAKWANGI PEMAGARSARI, PARUNG0251 - 8611507/86177270251-

611507|0251-6115070251 - 8617493 Y Y ALL COVERAGE

779 1952 KLINIK & APOTEK KF 50 JL. MERDEKA NO 24 BOGOR 0251-8384247 / 8321525| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

780 1734 TELKOMEDIKA HEALTH CENTER (THC)BOGOR JL. PENGADILAN NO. 14 BOGOR 0251 - 8380134| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

781 1679 RS. ANNISA CITEUREUP JL. KARANGGAN NO 02 PUSPASARI CITEUREUP - BOGOR 021-8756780; 8752628| 021-8752628 Y Y ALL COVERAGE

782 1680 RSIA. SENTOSA JL. RAYA KEMANG NO 18 BOGOR 0251-7541900| 0251-7541900 Y Y ALL COVERAGE

783 0992 RS. BOGOR MEDICAL CENTER JL. PAJAJARAN INDAH V/97 BOGOR0251-

8307900/8390435/8346002/83797430251-0251-8313987/8353419 Y Y ALL COVERAGE

784 0706 POLIKLINIK CIBULUH JL. KEDUNG HALANG TALANG, NO.148 0251-8661947| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

785 0673 RSU. MELANIA JL. RAYA PAHLAWAN NO.91 BONDONGAN - BOGOR0251- 8321196021-4506389|021-

45063890251-8331777 Y Y ALL COVERAGE

786 0190 RS. ISLAM BOGOR JL. PERDANA RAYA NO.22, BUDI AGUNG - KEDUNG BADAK 0251 - 8316822 / 7558159| 0251 -8347139 Y Y ALL COVERAGE

787 0835 RS. FAMILY MEDICAL CENTRE BOGOR JL. RAYA BOGOR KM.51 CIMANDALA-SUKARAJA (0251) 8652391| 0251-8661 605 Y Y ALL COVERAGE

788 0932 KLINIK MHT CIPAYUNG JL. RAYA PUNCAK CIPAYUNG, KM 75 0251-8256172-|- 0251-8257648 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

789 0290 RS. MARY CILEUNGSI HIJAU JL. RAYA NAROGONG, KM.21, CILEUNGSI 021-82492222| 021-82493902 Y Y ALL COVERAGE

790 1103 RS. TRIMITRA CIBINONG JL. RAYA CIBINONG KM.43021-8763055-56021-8765993|021-

8765993021-8758038 Y Y ALL COVERAGE

791 1419RB & KLINIK CITAMA KEDUNG WARINGIN

GAVERIJL. BOJONG GEDE-BOGOR 021-87983434| Y Y


RB,PHAR

792 1525 EMMA MEDICAL CENTER 2 JL. RAYA CICADAS, KM.9, NO.21, GUNUNG PUTRI 021-86860577/91304486| 021-86860578 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

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793 6123 SILOAM HOSPITALS BOGOR JL. PAJAJARAN NO.27, BABAKAN, BOGOR TENGAH 0251-8303900| - Y Y ALL COVERAGE

794 2759 RS. KARYA BHAKTI PRATIWI JL. RAYA DRAMAGA KM. 7, DRAMAGA, BOGOR (0251) 8626868| (0251) 8626969 Y Y ALL COVERAGE

795 1251 KLINIK INSANI CIBINONG JL. MAYOR OKING JAYAATMAJA NO.58A, CIRIUNG, CIBINONG 021-8757567| 021-8757567 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

796 3709 RS. VANIA JL. SILIWANGI NO.11 SUKASARI BOGOR TIMUR 0251-8380601/8380605| 0251-8380612 Y Y ALL COVERAGE

797 3000 RSUD. KOTA BOGOR JL. DR. SUMERU NO. 120 MENTENG, BOGOR BARAT 16111 0251-8312292| 0251-8371001 Y Y ALL COVERAGE

798 2824 LAB. PRODIA BOGOR JL. JEND. SUDIRMAN NO.38 B, BOGOR 16143 (0251) 8351612, 8351614| 0251-8351614 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

799 2624 IZI CLINIC JL. ACHMAD ADNAWIJAYA NO.115 (0251) 8359111| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

800 2116 RS. HERMINA MEKARSARI JL. RAYA CILEUNGSI - JONGGOL KM 1 KABUPATEN BOGOR 16820 021-29232525| 021-2923770 Y Y ALL COVERAGE

801 2393 RS. UMMI JL. EMPANG II NO.2 BOGOR RT.004/002 BOGOR SELATAN 0251-8341600| 0251-8341606 Y Y ALL COVERAGE

802 1385 RS. SENTRA MEDIKA CIBINONG JL. MAYOR OKING JAYA ATMAJA NO.9 CIBINONG021-87909999/87911212/(021)

80635969.|021-87909377 Y Y ALL COVERAGE

803 1662 RSIA. KENARI GRAHA MEDIKA GRIYA KENARI MAS BLOK B2 CILEUNGSI 021-8230426/82499885/96684076| 021-8231829 Y Y ALL COVERAGE

804 2191 RS. MEDIKA DRAMAGA JL. RAYA DRAMAGA KM. 7.3 MARGAJAYA BOGOR 0251- 8308900; 081319310610| 0251- 862577 Y Y ALL COVERAGE

805 1833 KLINIK PELITA SEHAT TAMAN KENARI RUKO PERUMAHAN TAMAN KENARI BLOK E3 NO 4, TANAH BARU BOGOR 0251-8664767| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

806 1831 KLINIK PELITA SEHAT CIBINONG CENTRAL RUKO CIBINONG BLOK B No 1-2 JL. MAYOR OKING No 63 021-87910241/08998513939| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

807 2718 KLINIK PELITA SEHAT CIOMAS JL. RAYA TAMAN PAGELARAN BLOK C1 NO.5, PADASUKA, CIOMAS, BOGOR (0251) 7522167| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

808 5813 KLINIK PRATAMA RAWAT INAP BUKAKAJL.RAYA NARONGONG BEKASI KM. 19,5 RT. 003 RW. 002 DESA LIMUS,

NUNGGAL, KEC. CILEUNGSI, KAB. BOGOR(021) 8231764| (021) 8231717 N Y


RB,PHAR

809 2753 KLINIK ARABBANIJL. RAYA KARET VILLA TELAGA CIBINONG NO.07-08, HARAPAN JAYA

CIBINONG, BOGOR(021) 87910118;| (021) 87910118 N Y


RB,PHAR

810 1235 KLINIK & APOTEK KF 7 BOGOR JL. IR. H JUANDA NO. 30 0251-8363473 / 8319030 (Lab)| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

811 0389 RS. MH THAMRIN CILEUNGSI JL. RAYA NAROGONG, KM.16, LIMUS NUNGGAL, CILEUNGSI021-8235052 / 82491332021-

82491332|021-82491332021-82491331 Y Y ALL COVERAGE

812 4983 KLINIK GRACIA JL. RAYA NAROGONG KM. 17 (PANGKALAN 9) CILEUNGSI, (021) 82486305| (021) 82486305 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

813 3990 RSIA. BUNDA SURYATNI JL. KH. SOLEH ISKANDAR NO. 21, CIBADAK, TANAH SAREAL, BOGOR 16161 (0251) 754 3892/7543891| (0251) 754 3893 Y Y ALL COVERAGE

814 4694 RSB. PASUTRI JL. MERAK NO. 3 TANAH SAREAL, BOGOR (0251) 8349707| (0251) 8331938 Y Y ALL COVERAGE

815 2172 KLINIK BHAKTI RAHAYU LEUWILIANG JL. RAYA GALUGA NO. 120 CIBUNGBULANG, BOGOR 0251-8648201| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

816 0411 RS. AZRA JL. RAYA PAJAJARAN, NO.219 0251-8318456|- 0251-8331773/8324093 Y Y ALL COVERAGE

817 2955 RS. PERMATA JONGGOLJL. RAYA JONGGOL NO.1 A RT.008 RW.03, KEL.SUKAMANAH, JONGGOL,

BOGOR021 - 89931222/3| 021- 8993 1836 Y Y ALL COVERAGE

818 3420 RS. MULIA PAJAJARAN JL. RAYA PAJAJARAN NO. 98, BOGOR 0251-8379898 / 081288015174| 0251-8378800 Y Y ALL COVERAGE

819 2441 KLINIK NADYA MH THAMRINJL. KH ABDULLAH BIN NUH RT. 005/ RW. 01 KEL. SINDANG BARNAG, KEC.

BOGOR BARAT(0251) 8624629| - N Y


RB,PHAR

820 2388 RS. PERTAMEDIKA SENTUL CITY JL. MH.THAMRIN KAV.57 SENTUL CITY 021-29672977/29672990| 021-29672978 Y Y ALL COVERAGE

821 2456 RSIA. JULIANA JL. RAYA TAJUR NO 75A - BOGOR 0251 - 8339593| 0251-8339591 Y Y ALL COVERAGE

822 2772 KLINIK SHIFA MEDIKA JL. BRANTA MULIA RT.002/07 KARANG ASEM TIMUR, CITEUREUP - BOGOR (021) 8760357| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

823 2809 KLINIK PERTAMEDIKA BOGOR JL. PANDAWA BLOK A-1 NO 14-15 BANTAR JATI II BUMI INDAH PRASTA I 0251-8363994| 0251-8363993 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

824 2788 RSIA. ASSALAM JL. RAYA BOGOR KM 46, NANGGEWER MEKAR, CIBINONG (021) 8753724| - Y Y ALL COVERAGE

825 2703 KIMIA FARMA 362 JL. MAYOR OKING 112 C, CIBINONG 021 87914400| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

826 2979 LAB. KLINIK KIMIA FARMA BOGOR JL. IR. H. JUANDA NO. 30, BOGOR 0251 - 8319030/8363473| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

827 1297 RB & KLINIK INSANI JL. PAHLAWAN NO.73B DESA KARANG ASEM TIMUR, CITEUREUP 021- 87942723/70247742| 021-87942570 Y YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

828 1673 RB. PELITA SEHAT POMAD JL. RAYA CIBULUH RUKO NO 9 SIMPANG POMAD KEC BOGOR UTARA 0251-8658811| 0251-8652628; Y Y ALL COVERAGE

829 0468 RS. PMI BOGOR JL. RAYA PAJAJARAN, NO.80 0251-8324080-8393030-0817101934|- 0251-8382936/8324709 Y Y ALL COVERAGE

830 1832 KLINIK PELITA SEHAT BANGBARUNG JL. ACHMAD SOBANA/ BANGBARUNG 77 BOGOR 0251-8362525 / 089637057022| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

831 1823 KLINIK SALSABILA MEDICAL CENTREJL. KSR DADI KUSMAYADI RUKO LAMPU MERAH CIKARET NO. 70

CIBINONG-BOGOR021-87905768| - N Y


RB,PHAR

CIAMIS

832 1104 RS. PERMATA BUNDA CIAMIS JL. MR.IWA KUSUMASOMANTRI NO.10265-771650/7767450711-356173|0711-

3561730265-777658 Y Y ALL COVERAGE

833 4125 LAB. PRODIA CIAMIS JL. JEND. SUDIRMAN NO. 99, CIAMIS 0265-2750977| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

CIANJUR

834 2123 KLINIK PADJADJARAN SUKANAGARA JL. RAYA SUKANEGARA KM.45 SUKANEGARA - CIANJUR 0263-340189/ 085794056664| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

835 2121 KLINIK ASSALAM CIKALONG JL. RAYA CIKALONG KULON NO. 61 A KAB. CIANJUR 0263-318222| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

836 4107 RS. DR.HAFIZ JL. PRAMUKA NO. 15 SUKAMULYA, KARANG TENGAH, CIANJUR 0263-2910000| (0263) 2910010 Y Y ALL COVERAGE

CIKAMPEK

837 1497 KLINIK SEHAT JL. PAWARENGAN NO. 37, DESA DAWUAN TIMUR 0264-8385103| 0264-8385103 N YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

838 2472 RB & KLINIK NAURAH MEDIKA JL. A. YANI NO.02 RT.03 RW. 06 DS. CIKAMPEK SELATAN, CIKAMPEK (0264) 8389999| - Y YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

839 0908 KLINIK KELUARGA GRAHA MEDIS JL. ACHMAD YANI NO. 51 0264-310101| 0264-310101 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

840 0093 KLINIK AQMA CIKAMPEK JL. STASIUN, NO.93 0264 - 310 524| 0264 - 319307 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

841 0540 RS. SARASWATI JL. JEND. A.YANI, NO.92, DAWUAN, CIKAMPEK-KARAWANG0264-311531/316101/ 311514/

3115270264-316391|0264-3163910264-311531 Y Y ALL COVERAGE

842 0375 RS. KARYA HUSADA JL. JEND. A.YANI, NO.98, CIKAMPEK-KARAWANG 0264-316188-89| 0264-312834/301626 Y Y ALL COVERAGE

843 1172 KLINIK PUTRA MEDIKA ( GROUP AQMA PUSAT ) JL. IR. H. JUANDA NO.14-19 SUKASEURI 0264-301652 / 8387129| 0264-8387129 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

844 1239 RUMAH SAKIT IZZA JL. KP.CISELAN DS.CIKAMPEK UTARA.KARAWANG 0264-319307/8386830-32| 0264-8386829 Y Y ALL COVERAGE

845 1300 KLINIK ANDINA CIKAMPEK JL. IR.H.JUANDA NO.17 0264-303759| 0264-8387680 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

846 2445 RS. TITIAN BUNDA JL. IR. H. JUANDA NO.123 CIKAMPEK (0264) 8385999/8386222| (0264) 8388936 Y Y ALL COVERAGE

847 1302 KLINIK PURI ASIH CIKAMPEK JL. STASIUN NO.2 CIKAMPEK KOTA 0264-303558| 0264-303558 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

848 1749 APOTEK NAGASARI JL. JEND A. YANI NO.177 CIKAMPEK 0264-316203| 0264-316203 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

CIKARANG

849 1523 RSIA. NURUL ANNISAJL. RAYA CIKARANG CIBARUSA NO 88 DS. SUKARESMI CIKARANG

SELATAN, BEKASI021-897 4854/55| 021 - 8971122 Y Y ALL COVERAGE

850 0306 RS. ANNISA CIKARANG JL. RAYA CIKARANG BARU, NO.31, LEMAH ABANG, CIKARANG UTARA021-8904165/8901962/8904503021 -

8904503|021 - 8904503021-8903350/89113827 Y Y ALL COVERAGE

851 0385 RS. BHAKTI HUSADA JL. RE. MARTADINATA021-8900530/1021-890 0531|021-890

0531021-8900570 Y Y ALL COVERAGE

852 2087 KLINIK JB MEDICAL CENTER SHOP HOUSE PERMATA JUNCTION BLOK B A-15 JABABEKA 1 CIKARANG 021-89846023/24| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

853 2034 RSIA. CIKARANG MEDIKA JL. KH. FUHDOLI NO.78 KAMPUNG KAUM CIKARANG UTARA, BEKASI 021-8902210| 021-82607637 Y Y ALL COVERAGE

854 1962 KLINIK & APOTEK KEMALA JL. TARUM BARAT 2, RUKO GRAND ARTHA NIAGA 2 BLOK O2 NO. 23 - 23A 021-29083377 - 29083376| 021- N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

855 0574 KLINIK BUDI LUHURJL. RAYA IMAM BONJOL, NO.74, RT.07/04, DESA SUKADANAU,CIKARANG

BARAT021- 88327226/88320116| 021-88327226 Y Y ALL COVERAGE

856 1795 KLINIK KHANZA MEDIKA PERUM KOTA SERANG BARU BLOK B 72 NO 25-26, CIKARANG 021-89953361/081212565880| 021-89953117 Y Y ALL COVERAGE

857 2454 RS. HOSANA MEDIKA CIKARANG BARU JL. ANGGREK I B2/2 RT.01/11 DS. MEKARMUKTI - CIKARANG (021) 89831626; 89835418; 89835223| 021-89830442 Y Y ALL COVERAGE

858 2510 MITRASANA TAMAN ASTER RUKO TAMAN ASTER KAV. A3 NO. 41 TELAGA ASIH CIKARANG BARAT 88333364| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

859 0263 RB & KLINIK YAYASAN BINA MEDIKA KP. KONGSI, CIKARANG 021-8900050; 021-8900051|021-8900051 021-8900051 Y YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

860 0406 KLINIK ANNISA II (CIKARANG) JL. CIBARUSAH RUKO POIN, NO.31 R 021-8976189| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

861 0738 RS. AMANDA CIKARANG SELATAN JL. RAYA SERANG NO.83 CIKARANG SELATAN021-8971643021-89110011|021-

89110011021-8970808 Y Y ALL COVERAGE

862 0660RS. PERMATA KELUARGA LIPPO CIKARANG d/h

RS HarapanJL. MH.THAMRIN KAVLING 129 LIPPO CIKARANG 021-8990 5588/ 8990 1927| 02189901860/89901902 Y Y ALL COVERAGE

863 1041RS HARAPAN KELUARGA (d/h RS.HARAPAN

INTERNASIONAL)JL.KASUARI RAYA KAV.1A-1B, KOTA JABABEKA, CIKARANG BARU 021-89840745|- 021-89835839 Y Y ALL COVERAGE

864 0850KLINIK BERKAT MELIMPAH JABABEKA (HOSANA

MEDIKA II)JL. KAWASAN INDUSTRI I, JABABEKA B8, CIKARANG UTARA 021-8937941021-8937942|021-8937942 021-8937942,89833055 N Y


RB,PHAR

865 1050 RS. AMANDA CIKARANG UTARA JL. RAYA INDUSTRI NO.36,CIKARANG UTARA 021- 8900277 / 89110011|021-8900277 021-89110011 Y Y ALL COVERAGE

866 0913 RS. ASRI MEDIKA JL. CITANDUY RAYA BLOK L II NO.1 CIKARANG UTARA 021-89142968, 89142969-|- 02189143860/89143036 Y Y ALL COVERAGE

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867 0929 KLINIK RENNICHA PUTRA JL. RAYA CIKARANG CIBARUSAH NO 89 LIPPO CIKARANG 021-8971852021-8971658|021-8971658 021-8971852 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

868 0966 RB & KLINIK CENTRAL MEDIKA JL. PILAR - SUKATANI, DS SUKARAYA NO 84, KARANG BAHAGIA 021- 89111103-|- 021-89119714 N YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

869 0967 CITRA ARDHITA MEDIFARMA CAPITOL BUSINESS PARK, BLOK B2, JL. NIAGA RAYA021-89831945/7004236021-

89831946|021-8983194602189831946/89833385 N Y


RB,PHAR

870 1119 KLINIK SAPTA MITRA CIKARANGRUKO CIKARANG CENTRAL CITY, BLOK H 29-30 KEL.CIANTRA

KEC.CIKARANG SELATAN KAB.BEKASI021-8975369| 021-8975369 N Y


RB,PHAR

871 1218 KLINIK CIKARANG MEDIKA JAYA JL. YOS SUDARSO NO.27 CIKARANG 021-8900129; 8901318| 021-8901318 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

872 1415 RB & KLINIK PERMATA BUNDA FUDHOLI JL. KH.FUDHOLY NO 11 KARANG ASIH, CIKARANG UTARA 021-89106080| - Y YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

873 1064KLINIK KASIH ANUGERAH SERANG BARU

(HOSANA MEDIKA C

JL. RAYA SERANG-CIBARUSAH KP.BUNISARI RT.07/04 DS.SUKARAGAM

SERANG BARU

021-89952605,89952612021-

89952612|021-89952612021-89951205 N Y


RB,PHAR

874 1067 RS. MEDIROSSA JL. INDUSTRI TEGAL GEDE - CIKARANG SELATAN 021-89833216| 021-8934979 Y Y ALL COVERAGE

875 1514 KLINIK SUMBER WARASJL. RAYA CIBARUSAH, KAMPUNG CIJAMBE, SUKADAMI, CIKARANG

SELATAN021-8970524| 021-8970524 N Y


RB,PHAR

876 1567 RB & KLINIK PUTRA MEDIKAJL. N. PERUM VILA MUTIARA, KAMPUNG KUKUN CIKARANG NO.115

RT.012/06 DS.CIANTAR021-89677215; 02189677628| 021-89677216 Y Y


RB,PHAR

877 4759 KLINIK PUTRA MEDIKA 2JL. RAYA CIKARANG CIBARUSAH KM. 28 RT. 012/006 DESA CIANTRA KEC.

CIKARANG SELATAN(021)8971612| - N Y


RB,PHAR

878 0275 RS. SENTRA MEDIKA CIKARANG JL. RAYA INDUSTRI PASIR GOMBONG JABABEKA, CIKARANG021 8904160-64 / EXT

225/081297102702|021-8904159,89111112 Y Y ALL COVERAGE

879 0916 RB & KLINIK GRAHA BINA HUSADA JL. INDUSTRI SELATAN NO.1A, BLOK NN 3A, INDUSTRI JABABEKA II 021-89836243-|- 021-89836244 Y YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

880 1842 RS. MEDIROSSA 2 JL. RAYA CIBARUSAH DESA SINDANGMULYA KEC. CIBARUSAH BEKASI 021-89955555| 021-89952355 Y Y ALL COVERAGE

881 1462 RS. MITRA KELUARGA CIKARANG JL. INDUSTRI RAYA, NO.100 LEMAH ABANG, CIKARANG 021-89840500/89840900| 021-89845489 Y Y ALL COVERAGE

882 6474 KLINIK ALFARMA KP.KAUM LEBAK NO.101 RT 04/02 SIMPANGAN, CIKARANG UTARA (021) 89323270| (021) 8905376 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

883 1719 CMC CLINIC ( CIKARANG MEDICAL CENTER )SHOPHOUSE BLOK A NO.14-15, 28-29 JABABEKA I KAWASAN INDUSTRI

CIKARANG021-8934371| 021-8934035 N Y


RB,PHAR

884 4670 RS. OMNI CIKARANGOASIS KAV.1 JL. RAYA CIBARUSAH KEL. SUKARESMI, KEC. CIKARANG

SELATAN, BEKASI(021) 2977 9999| 021-2977 9911 Y Y ALL COVERAGE

885 3992 KLINIK CENTRAL MEDIKA 3JL. RAYA RENGAS BANDUNG NO.20 001/003,KARANG SAMBUNG,KEDUNG

WARINGIN,BEKASI021-89142220| 021-89142221 N Y


RB,PHAR

886 1308 RS. RIDHOKA SALMA JL. IMAM BONJOL NO.7 GARDU SAWAH 021-89116527| 021-89116528 Y Y ALL COVERAGE

887 2742 KLINIK SUMBER SEHAT CIKARANGJL. KH. FUDHOLI NO.50 RT.01/04 DS. KARANG ASIH KEC. CIKARANG

UTARA 17530(021) 8900566 / 89106020| (021) 8900566 N Y


RB,PHAR

888 1287 RB & KLINIK NIZA ASYIFA BERSAMA 1 PERUMAHAN TELAGA HARAPAN BLOK E1 NO.1 CIKARANG BARAT 021-89109638| 021-89109638 Y YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

889 4032 RB & KLINIK RIA PILAR JL. GATOT SUBROTO NO. 67(021) 89105057 / 087717188000 /

085669228852|(021) 8900487 Y Y


RB,PHAR

890 5118KLINIK 24 JAM & HARAPAN SEHAT MEGA

REGENCYJL. RAYA MEGA REGENCY PERUM MEGA REGENCY BLOK I NO 3 021-29370936| 021-883366721 N Y


RB,PHAR

891 1034 KLINIK HARAPAN SEHAT IIRUKO TELAGA HARAPAN BLOK F NO.16, PERUMAHAN TELAGA HARAPAN,

CIKARANG BARAT021-8904519-|- - N Y


RB,PHAR

892 2462KLINIK 24 JAM & RB. PERMATA BUNDA

CIKARANGRUKO GRAMA NIAGA H2 NO. 15/15A, KARANG ASIH - CIKARANG UTARA 021 - 2928 2165, 021 - 2928 2166| - Y Y


RB,PHAR

893 2058 RSIA. GIZARJL. VILA MUTIARA CIKARANG, RUKO PASADENA BLOK RA NO. 3, 5, 6

CIANTRA, CIKARANG SELATAN021-89677240 / 89677204| 021-89677239 Y Y ALL COVERAGE

894 0709 RS. HOSANA MEDICA LIPPO JL. UTAMA BIIE NO 01 LIPPO CIKARANG 021-8972472| 021-89900769 Y Y ALL COVERAGE

895 0391 SILOAM HOSPITALS LIPPO CIKARANG JL. MH. THAMRIN, KAV.105, LIPPO CIKARANG 021- 29636900| 021-89900022/8972470 Y Y ALL COVERAGE

896 2975 KLINIK PUTRA MEDIKA 3JL. PERUM KOTA SERANG BARU, KP. GEBANG DS. SUKARAGAM KEC.

SERANG BARU, BEKASI(021) 89950333| - N Y


RB,PHAR

897 1824 KLINIK BUNDA AULIA JL. HAJI RATIM NO. 143 DS JATIWANGI CIKARANG BARAT - BEKASI 021-8998 3742 / 2897 3209| 021-8998 3742 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

898 2061 RS. BUDI ASIH CIKARANGJL. RAYA SERANG - CIBARUSAH RT 01/ RW 01 SERANG KEC.CIKARANG

SELATAN,BEKASI021 - 89677795| 021-89677402 Y Y ALL COVERAGE

899 1494 RB & KLINIK ANNISA IV JL. RAYA CIBARUSAH NO.63 SERANG BARU 021-89954434| 021-89954434 Y Y ALL COVERAGE

CIMAHI

900 0268 RS. MITRA KASIH JL. RAYA CIBABAT NO.341, CIMAHI 022-6654852,6652774,6654397| 022-6654875/6642349 Y Y ALL COVERAGE

901 2467 RSU. KASIH BUNDA JL. MAHAR MARTANEGARA NO.166 LEUWIGAJAH - CIMAHI 40521 022- 6614221/ 6630585| 022- 6630583 Y Y ALL COVERAGE

902 2221 RS. AVISENA CIMAHI JL. MELONGASIH NO. 170 CIJERAH - CIMAHI 022 - 6000830| 022-6000830 Y Y ALL COVERAGE

903 3610 PRODIA CIMAHI JL. JEND. AMIR MAHMUD NO. 523, CIMAHI 40523 (022) 6658125| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

904 5610 RSAD. TK II DUSTIRA JL DUSTIRA NO. 1 BAROS, KOTA CIMAHI 022-6652207| - Y Y ALL COVERAGE

CIREBON

905 5784 RSUD. GUNUNG JATI JL. KESAMBI NO. 56, KOTA CIREBON 0231-206330| - Y Y ALL COVERAGE

906 1174 RS. SUMBER KASIH JL. SILIWANGI NO.135 0231-203815| 0231-210040 Y Y ALL COVERAGE

907 1091 RS. PUTERA BAHAGIA JL. CIREMAI RAYA NO.114 ,PERUMNAS0231-207351, 4856540231-485654|0231-

4856540231-486356/482328 Y Y ALL COVERAGE

908 1029 RS. SUMBER WARAS CIWARINGIN JL. URIP SUMOHARJO, NO.5, CIWARINGIN 0231-342297/341079,3300888,341079-|- 0231-342112 Y Y ALL COVERAGE

909 3677 PRODIA CIREBON JL. R.A. KARTINI NO. 32, CIREBON 45122 (0231) 208989| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

910 2690 KIMIA FARMA 40 (BM CIREBON) JL. PARUJAKAN NO.12 , 0231-208954| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

911 4677 RS. PERMATA CIREBON JL. TUPAREV NO. 117 KEDAWUNG, KAB. CIREBON (0231) 883 8877; 833 8899| 0231-8293698 Y Y ALL COVERAGE

912 0602 RS. PERTAMINA CIREBON JL. PATRA RAYA, KLAYAN0231-224646; 25121730231-

224646|0231-2246460231-224795; 209328 Y Y ALL COVERAGE

913 1316 RS. MITRA PLUMBON JL. RAYA PLUMBON, KM.11 0231-324483/323100| 0231-322355/322066 Y Y ALL COVERAGE

914 0293 RS. PELABUHAN CIREBON JL. SISINGAMANGARAJA, NO.450231-208948/208680 / 0231-2056570231-

205657|0231-2056570231-234670 Y Y ALL COVERAGE

915 2378 RS. KHUSUS JANTUNG HASNA MEDIKA JL. RD GILAP NO. 8 PALIMANAN TIMUR, KABUPATEN CIREBON 0231-343405; 343645| 0231-342224 Y Y ALL COVERAGE

916 2422 RSIA. KHALISAH JL. DR. SETIABUDI NO. 8 PEGAGAN PALIMANAN CIREBON 0231-342440/342441| 0231-343362 Y Y ALL COVERAGE

917 2180 APOTEK FARMARIN CIREBON JL. KESAMBI RAYA NO. 92 A 08179416709| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

918 3882 RSIA. CAHAYA BUNDA JL. RAYA PERJUANGAN NO.8 KESAMBI CIREBON 0231-8333388 / 99| 0231-482121 Y Y ALL COVERAGE

DEPOK

919 2825 LAB. PRODIA CIBUBURJL. ALTERNATIF CIBUBUR CILEUNGSI NO. 8 C-D, DEPOK, JAWA BARAT

16954(021) 84598650, 84590656| (021) 84598651 N Y


RB,PHAR

920 1194 RS. HASANAH GRAHA AFIAH JL. RADEN SALEH NO.42 DEPOK 021-77826267/ 77826276| 021-77833796 Y Y ALL COVERAGE

921 2630 KLINIK & APOTEK KF 202 JL. KEJAYAAN BLOK IX NO. 2, DEPOK 0217704044| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

922 1737 TELKOMEDIKA HEALTH CENTER (THC) DEPOK JL. RAYA KARTINI NO. 17RT. 02 RW.09 DEPOK PANCORAN MAS 021-77219925| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

923 0346 RS. TUGU IBU JL. RAYA BOGOR, KM.29, CIMANGGIS - DEPOK021-8710870/021-8718634/33|021-

8718634/33021-8708266 Y Y ALL COVERAGE

924 6453 RSIA. CITRA ARAFIQ JL. PERINDUSTRIAN RT/RW:006/025, KEL.BAKTIJAYA, KEC.SUKMAJAYA 021-87708400| 021-87708400 Y Y ALL COVERAGE

925 2722 RS. PERMATA DEPOK JL. RAYA MUCHTAR NO. 22 SAWANGAN DEPOK 021-29669000| 021-29668897 Y Y ALL COVERAGE

926 4489 KLINIK PERMATA HATIRUKO PERMATA DEPOK BLOK A,5-6 SEKTOR MUTIARA KEL. PONDOK JAYA,

CIPAYUNG, DEPOK(021) 77200935| - N Y


RB,PHAR

927 0777 RSIA. TUMBUH KEMBANG JL. RAYA BOGOR, KM.31, NO.23, CIMANGGIS021-8701873-74 / 021-8712300|021-

8712300021-8701872 Y Y ALL COVERAGE

928 0107 RS. SIMPANGAN DEPOK JL. RAYA BOGOR, KM.36, SIDAMUKTI SUKMAJAYA, CIMANGGIS - DEPOK 021-8741549| 021-8741574 Y Y ALL COVERAGE

929 1485 RS. MITRA KELUARGA DEPOK JL. MARGONDA RAYA, PANCORAN MAS - DEPOK 021-77210700| 021-77212155 Y Y ALL COVERAGE

930 2791 LAB. PRODIA DEPOKRUKO PESONA KHAYANGAN NO.9, JL. MARGONDA RAYA NO.45, DEPOK

16411(021) 7751178, 7751826| - N Y


RB,PHAR

931 2760 RS. CITRA MEDIKA DEPOK JL. RAYA KALI MULYA NO.68 KOTA KEMBANG, CILODONG 021-29671000/5000/7000/8000| 021-29678000 Y Y ALL COVERAGE

932 2806 KLINIK PERTAMEDIKA CINERE JL. CINERE RAYA NO. 11B 021-7535022| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

933 2808 KLINIK PERTAMEDIKA DEPOK ( MARGONDA) JL. MARGONDA RAYA NO. 270, DEPOK 021-77219363| 021-77219364 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

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934 4007 KLINIK UTAMA RAWAT INAP LIMO MEDICARE JL. MERUYUNG RAYA NO. 70, PANCORAN MAS, DEPOK (021) 77888674; 77888675| (021) 77888675 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

935 4383 KLINIK TUMBUH KEMBANGJL. ALTERNATIF KM 1 RUKO CIBUBUR POINT BLOK A6-8 HARJAMUKTI,

CIMANGGIS DEPOK021-8443316, 8443004| 021-8443018 N Y


RB,PHAR

936 3329 KLINIK AL-ZAMZAM JL. ABDUL GANI NO. 53, CILODONG, DEPOK (021) 77841431; 87904855| (021) 87904855 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

937 1056 RS. BUNDA MARGONDA JL. MARGONDA RAYA NO.28 PONDOK CINA-DEPOK 16424 021-78890551|- 021-78889958 Y Y ALL COVERAGE

938 1318 RB & KLINIK CITAMA CIPAYUNG JL. RAYA CIPAYUNG NO.27 PANCORAN MAS DEPOK 021-87989203/5-021-87982268| 02187986666/8282869 Y YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

939 2090 KLINIK QITA JL. SEDAP MALAM RAYA NO. 5 KOMP. PERTANIAN DEPOK, CITAYAM 021-87989096| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

940 2078 APOTIK FARMARIN V DEPOKJL. ARIF RAHMAN HAKIM SIMPANG 3 MARGONDA NO. 7 KEL DEPOK, KEC

PANCORAN MAS DEPOK021-7757117| 021-29402214 N Y


RB,PHAR

941 1950 KLINIK & APOTEK KF 143 JL. MARGONDA DEPOK 021-7522997| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

942 1736 KJP MEDICAL CENTER JL. KEJAYAAN BLOK IX NO 4 SUKMAJAYA, DEPOK TIMUR 021-7703925, 7714605| 021-7703927 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

943 1776 KLINIK UTAMA RAWAT INAP NAURA MEDIKA JL. KEMAKMURAN RAYA NO 37 DEPOK II 021-77827515| 021-77824756 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

944 2219 KLINIK CITRA INSANI JL. RAYA PENGASINAN NO. 5 SAWANGAN DEPOK 0251-8604733/8611507| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

945 2629 KIMIA FARMA BEJI JL. RAYA NUSANTARA - DEPOK 02177207404| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

946 2627 KLINIK & APOTEK KF 352 JL. MARGONDA RAYA, DEPOK 02178884611| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

947 2628 KLINIK & APOTEK KF 394 JL. SILIWANGI NO.35, DEPOK 02177214567| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

948 2460 KLINIK UTAMA TUGU SAWANGAN JL. RAYA MUCHTAR NO. 20 RT.002/007 SAWANGAN - DEPOK 16511 0251-8613433/021-29420173| 0251-8613433 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

949 0776 RS. PURI CINERE JL. MARIBAYA BLOK F2, NO.10, PURI CINERE - DEPOK 021-7545488| 021-7545486 Y Y ALL COVERAGE

950 0470 RS. SENTRA MEDIKA DEPOK JL. RAYA BOGOR KM.33 CISALAK - DEPOK 021-874 3790| 0218743230/87741666 Y Y ALL COVERAGE

951 1007 RS. HARAPAN DEPOK JL. PEMUDA NO.10 021-7520009,7773817,77200005-|- 021-7765883 Y Y ALL COVERAGE

952 0009 RSU. BHAKTI YUDHA JL. RAYA SAWANGAN NO.24, DEPOK 021-7520082| 021-7775862/7762880 Y Y ALL COVERAGE

953 1615 RSIA. ASYIFA DEPOK JL. CINERE DEPOK NO 9 RANGKAPAN JAYA BARU PANCORAN MAS, DEPOK 021-77883905/77885454| 021-77885454 Y Y ALL COVERAGE

954 0265 RS. HERMINA DEPOK JL. RAYA SILIWANGI, NO.50, PANCORAN MAS 021-77202525| 021-7763309 Y Y ALL COVERAGE

955 1085 RS. MEILIA JL. ALTERNATIF CIBUBUR KM.1 CIMANGGIS DEPOK 021-8444444,84598954-|- 021-84598952 Y Y ALL COVERAGE

956 1098 RS. GRHA PERMATA IBU JL. KH. M. USMAN NO.168 KUKUSAN BEJI 021-7778899-|- 021-7778998 Y Y ALL COVERAGE

957 1266 RB & KLINIK EL RAPHA JL. RAYA BOGOR KM 30 CIMANGGIS - DEPOK 021-8715082/87720327| 021-8715082 Y YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

GARUT

958 2358 KLINIK MAHESA JL. CIMANUK NO.8 0262-233238| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

959 4039 RS. NURHAYATI JL. SUDIRMAN NO. 6 GARUT 0262-238966| 0262-231824 Y Y ALL COVERAGE

960 2994 LAB. KIMIA FARMA GARUT JL. CIMANUK 11A PAMINGGIR (0262) 540077| (0262) 540077 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

961 2934 LAB. PRODIA GARUT JL. RAYA SAMARANG NO. 104, TAROGONG GARUT 0262-2246204| (0262) 2245204 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

962 2120 KLINIK PADJAJARAN LELES JL. RAYA LELES KEC.LELES KAB GARUT 0262-2458083| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

963 1627 BETHESDA MEDICAL CENTER GARUT JL. CIWALEN NO 43 GARUT 0262-242663,238735| 0262-242663 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

964 2699 KLINIK & APOTEK KF 377 JL. CIMANUK NO. 11A, GARUT 0262 233237| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

INDRAMAYU

965 4126 LAB. PRODIA INDRAMAYU JL. RAYA PAKANDANGAN ( DEPAN GRIYA ASRI I ) BUNDERAN MANGGA 0234-275065| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

KARAWANG

966 5434 KLINIK AR-RAHMAN JL. RAYA PERURI NO. 07, TELUK JAMBE TIMUR, KARAWANG (0267) 8458155| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

967 2731 RS. ROSELAJL. INTERCHANGE TOL KARAWANG BARAT NO.3 DS WADAS KEC. TELUK

JAMBE(0267) 8637207/8637205| 0267 8367205 Y Y ALL COVERAGE

968 1006RS. CITRA SARI HUSADA (D/H KLINIK INTAN

BAROKAH)JL. RAYA KOSAMBI-TELAGASARI, KM.3, KLARI, KARAWANG TIMUR 0267-437507/8617972| 0267-438681 Y Y ALL COVERAGE

969 1022 RSU. FIKRI MEDIKA JL. RAYA KOSAMBI- TELAGASARI, DS BLENDUNG , KLARI0267-433636/435527 - 0267-

8615555/8615566 (KLINIK):|-0267-8615577/88 Y Y ALL COVERAGE

970 1409 RSU. PURI ASIH JATISARI JL. RAYA JATISARI NO.3 PASAR JATISARI 0264-361459/361466| 0264-8375276 Y Y ALL COVERAGE

971 0899 KLINIK AULIA KARAWANG JL. PURWASARI KM 6, PURWASARI - KARAWANG 0264-8286755/ 0811 1889279|- 0264-8286756 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

972 4699 RSIA. SENTUL CIKAMPEK JL. A. YANI NO.16 SENTUL, CIKAMPEK SELATAN (0264) 8386671/ 8389060| (0264) 316096 Y Y ALL COVERAGE

973 1133 RS. MANDAYA(D/H RS.CITO KARAWANG) JL. ARTERI TOL KARAWANG BARAT TELUK JAMBE0267-8643000/8641414/414245 / 414264

/ 8643002|0267-414306 Y Y ALL COVERAGE

974 6017 KLINIK LAMARANJL. SYECH QURO NO. 4 KEL. PALUMBONSARI KEC. KARAWANG TIMUR KAB.

KARAWANG 413510267-8453951| 0267-8453951 N Y


RB,PHAR

975 4658 KLINIK INTERNA MEDIKAJL. MELATI NO. 9A RT. 001/ 010, GURO II, KEL. KARAWANG WETAN, KEC.

KARAWANG TIMUR, KARAWANG(0267) 845 2733 / 0812-8586 4765| 2678452733 N Y


RB,PHAR

976 4683 KLINIK SEHAT BAHAGIA JL. PANATAYUDHA I NO. 57 A RT. 02 RW. 03 NAGASARI, KARAWANG (0267) 414 283| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

977 4320 KLINIK SETYA MEDIKAJL. BELAKANG PASAR RT. 02/09 KEL. NAGASARI KEC. KARAWANG BARAT,

KARAWANG(0267) 402025| (0267) 402025 N Y


RB,PHAR

978 1310 KLINIK ANDINA KARAWANG JL. PANCAWATI, NO.5A, KLARI 0267-436568| 0267-438406 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

979 2823 RS. LIRA MEDIKA JL. SYECH QURO NO.14 LAMARAN, KARAWANG - JAWA BARAT (0267) 8452555 / 405 752| (0267) 405 752 Y Y ALL COVERAGE

980 0255 RS. BAYUKARTA JL. KERTABUMI, NO.440267-401817/401818/4003510267-

801818|0267-8018180267-404472/401202 Y Y ALL COVERAGE

981 4319 KLINIK & RB NUR ANNISA JL. MANUNGGAL VII NO. 38 PALUMBONSARI, KARAWANG (0267) 405201| - Y YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

982 4509 KLINIK KYOAI MEDICAL CENTERGEDUNG THE MANOR LT. 2, JL. SURYA UTAMA KAV.C-1, KAWASAN

INDUSTRI SURYA CIPTA(021) 30424007/8/9| 021-30424010 N Y


RB,PHAR

983 2993 KLINIK & APOTEK KF 79 KARAWANG JL. DEWI SARTIKA II NO.30 KARAWANG 0267-405748| 0267-405748 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

984 2801 LAB. PRODIA KARAWANG JL. KERTABUMI NO. 67 A, KARAWANG 41311. 0267- 403644; 412640| 0267-412640 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

985 3400 KLINIK GRAHA MEDIS CILAMAYA JL. CILAMAYA DS CILAMAYA KEC CILAMAYA WETAN 0264-340202| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

986 3369 APOTIK KIMIA FARMA 343 JL. KERTABUMI NO 12A KARAWANG JAWA BARAT 0267-8453321| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

987 1835 KLINIK GRIYA MEDIKAPERUM GRIYA KONDANG ASRI BLOK T NO. 01 DESA KONDANG JAYA KEC.

KLARI - KARAWANG TIMUR0267-8619999; 082112039999| 0267-8615309 N Y


RB,PHAR

988 1572 DHARMA DENTAL CLINIC (DDC) JL. KERTABUMI NO 62 KARAWANG 0267-8453633| 0267-403962 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

989 0083 RS. DEWI SRI JL. ARIF RAHMAN HAKIM, NO.10267-401475, 402855, 406445,

402147|0267-4021470267-404010 Y Y ALL COVERAGE

990 1635 KLINIK MITRA KONDANG UTAMA JL. PENGAIRAN CITRA KEBUN MAS KONDANG KARAWANG 0267-8402700/0267-8616923| 0267-8450001 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

991 2741 RSIA. MITRA FAMILY-KARAWANGJL. RONGGOWALUYO RT.02/05 DESA SUKAHARJA KEC. TELUKJAMBE

TIMUR, KARAWANG0267 - 8458327 , 8458328, 8458329| - Y Y ALL COVERAGE

992 0690 KLINIK YAKESTI KARAWANG JL. RAYA KLARI, RT. 04 / 01, GINTUNGKERTA KLARI 0267-432416| 0267-432416 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

993 0691 KLINIK PURWA MEDIKA JL. RAYA TAMELANG NO.12 DESA MEKARJAYA, PURWASARI 0267-433653| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

994 0689 KLINIK MITRA SEHAT JL. KOSAMBI - CURUG NO.28, DUREN, KLARI 0267-8402061/433930| 0267-8402061 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

995 0704 KLINIK CITO KARAWANG JL. KERTABUMI, NO.29 0267-410173/415957| 0267-415957 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

996 0197 KLINIK GEMPOL JL. RANGGA GEDE NO.29, GEMPOL, TANJUNG PURA 0267-412117/8453903| 0267-8453903 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

997 0869 RS. DELIMA ASIH SISMA MEDIKA JL. WIRASABA NO.54 JOHAR 0267-403073/8454248|- 0267-405598 Y Y ALL COVERAGE

998 1023 RS. ISLAM KARAWANG JL. PANGKAL PERJUANGAN KM.20267-414520, 0267 - 414524,

4145210267-414524|0267-4145240267-413277 Y Y ALL COVERAGE

999 1027 KLINIK BINA MEDIKA KARAWANG JL. RAYA TELUK JAMBE NO 8, SUKA GALIH, TELUK JAMBE TIMUR 0267-641968 / 08121918055-412117|- 0267 - 641968 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1000 1035 KLINIK MITRA GEMPOLJL. PROKLAMASI NO. 15 KW 8 RT 003 RW. 005 KEL. TUNGGAKJATI KEC

KARAWANG BARAT KAB. KARAWANG,0267- 8451114-|- - N Y


RB,PHAR

1001 0095 KLINIK GRAHA MEDIS JL. RAYA KOSAMBI, NO.23, DUREN KLARI, KARAWANG TIMUR 0267-435527| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1002 1058 KLINIK NAFILA MEDIKA JL. PRINGGODANI BLOK J-47 PERUMNAS TELUK JAMBE, KARAWANG BARAT 0267-640020|- 0267-8456419 N Y ALL COVERAGE

1003 1059 KLINIK PURI ASIH TELUKJAMBE JL. PERURI NO. 99 PINAYUNGAN, TELUK JAMBE, KARAWANG TIMUR 0267-646845|- 0267-646845 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1004 1314 RSIA. DR. DJOKO PRAMONO JL. PANATAYUDA 1, NO.35, KARAWANG BARAT 0267-403009/418818/403744| 0267-411744/8454710 Y Y ALL COVERAGE

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KUNINGAN

1005 3763 PRODIA KUNINGAN JL. ACHMAD YANI NO. 39, KUNINGAN 45511 (0232) 876839| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1006 1704 RS. SEKAR KAMULYAN JL. RUMAH SAKIT NO 28, CIGUGUR KUNINGAN 0232-873206| 0232-875516 Y Y ALL COVERAGE

1007 1345 RS. JUANDA KUNINGAN JL. IR. H. JUANDA NO.207 KUNINGAN 0232-876433/875871| 0232-876433/875871 Y Y ALL COVERAGE

MAJALENGKA

1008 3658 PRODIA CIDERESJL. RAYA JOMBOL-DAWUAN RT. 01/05, KECAMATAN DAWUAN,

MAJALENGKA 45452(0233)6645488| - N Y


RB,PHAR

PURWAKARTA

1009 3765 PRODIA PURWAKARTA JL. VETERAN NO.96, PURWAKARTA (0264) 8222 633| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1010 1526 RS. AMIRA JL. IPIK GANDAMANAH RT.035 RW.003 MUNJUL JAYA 0264-8221191/92| 0264-8221193/95 Y Y ALL COVERAGE

1011 5986 KLINIK ANNISAJL. RAYA INDUSTRI KP. MARACANG RT. 07/02 DESA MARACANG KEC.

BABAKANCIKAO, PURWAKARTA(0264) 822 2596| N Y


RB,PHAR

1012 5987 KLINIK ANNISA 2 JL. PRAMUKA NO. 107 DESA BUNDER KEC. JATILUHUR PURWAKARTA (0264) 822 0201| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1013 1718 RS. KHUSUS BEDAH RAMA HADI JL. RAYA SADANG - SUBANG , DS CIWANGI BUNGUR SARI PURWAKARTA 0264 - 202136 / 8282295| 0264-8225679 Y Y ALL COVERAGE

1014 4763 KLINIK SPESIALIS SILOAM PURWAKARTAJL VETERAN RT. 031/004, KEL. NAGRI KALER, KEC.PURWAKARTA, JAWA

BARAT0264-8628901| - N Y


RB,PHAR

1015 4044 RSU. HOLISTIC PURWAKARTA JL. TERUSAN KAPTEN HALIM KM.09 SALAMULYA, PONDOK SALAM 0264-8223434 / 0811129434| 0264-8223432 Y Y ALL COVERAGE

1016 4443 KLINIK MITRA MEDIKA PURWAKARTA JL. MR. DR. KUSUMAATMAJA NO. 13, KEL. CIPAISAN, PURWAKARTA (0264) 8624195| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1017 2698 KLINIK & APOTEK KF PURWAKARTAJL. VETERAN NO 152 KEL NAGRI KALER PURWAKARTA ( DEPAN

INSPECTORAT )0264 8227437| - N Y


RB,PHAR

1018 1545 RS. MH THAMRIN PURWAKARTA JL. BUNGURSARI, NO.36 0264-8222222| 0264-8222223 Y Y ALL COVERAGE

1019 1315 KLINIK MIRACLE GROUP KOMP. ANEKA JASA BLOK AII NO.9-10 KOTA BUKIT INDAH 0264-35166, 351377| 0264-351355 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1020 1057 RSIA. ASRI PURWAKARTA JL. VETERAN CIHIDEUNG NO.15 PURWAKARTA 0264-211680; 8223161; 0811117031|- 0264-219047 Y Y ALL COVERAGE

1021 0759 KLINIK MEDIKA SEHAT JL. IPIK GANDAMANAH SUKAMULYA 0264-8225017| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1022 0189 KLINIK AQMA PURWAKARTA JL. IBRAHIM SINGADILAGA, NO.14 0264-200377| 0264-200377 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1023 1043 SILOAM HOSPITAL PURWAKARTA JL. BUNGURSARI NO.1 PO.BOX 167 - Purwakarta 0264-8628900/8628911|0264-231273 0264-212674 Y Y ALL COVERAGE

1024 1175 KLINIK AQMA PLERED JL. ANJUN NO.96 PLERED 0264-270830| 0264-270830 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1025 1620 RS. BHAKTI HUSADA II PURWAKARTAJL. RAYA SADANG SUBANG, KM 5, KP. KIARA DUA, DS. CIKUMPAY, KEC.

CAMPAKA0264-8225344/8225345/081373360783| 0264-8225255 Y Y ALL COVERAGE

1026 4054RS. KARINA MEDIKA PURWAKARTA D/H

MASITHOHKP.KRAJAN RT. 01/01 MARACANG, BABAKAN CIKAO (0264) 8220544| (0264) 8623240 Y Y ALL COVERAGE

SUBANG

1027 2752 KLINIK MITRA ABADI JL. KAPTEN HANAFIAH NO.3 RT. 98 RW. 27 KEL. KARANGANYAR, SUBANG 0260-418247| 0260-418237 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1028 4325INHOUSE CLINIC PT. DAHANA (KLINIK MITRA

ABADI)JL. RAYA SUBANG, CIKAMURANG KM.12 CIBOGO -SUBANG (0260) 742 3333| (0260) 742 3888 N Y


RB,PHAR

1029 0191 RS. PERKEBUNAN NUSANTARA 8 SUBANG JL. OTTO ISKANDAR, NO.1, SUBANG0260-

420406,411632,420306,420436|0260-0260-420391 Y Y ALL COVERAGE

SUKABUMI

1030 1506RS. KARTIKA KASIH (D/H RS.KARTIKA MEDICAL

CENTER)JL. JEND. A.YANI, NO.18 0266-6250902/6250905/6250904| 0266-6250901 Y Y ALL COVERAGE

1031 3448 RS. RIDOGALIH JL. GUDANG NO. 24 SUKABUMI 0266-221983| 0266-216161 Y Y ALL COVERAGE

1032 0056 RS. ISLAM ASSYIFA JL. JEND. SUDIRMAN, NO. 270266-

222663/218672/241463/223742/22374200266 - 213433/22350 Y Y ALL COVERAGE

1033 0832 RS. HERMINA SUKABUMI JL. RAYA SUKARAJA RT.003/03, SUKARAJA 0266-6252525/6249292| 0266-235020 Y Y ALL COVERAGE

1034 6016 KLINIK PERMATA SUKABUMI JL. RA. KOSASIH NO.112 RT.02/16 CISARUA, CIKOLE (0266) 219188/6245414| (0266) 6247781 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1035 1507 RS. BHAKTI MEDICARE JL. RAYA SILIWANGI, CICURUG 0266-731555| 0266-731899 Y Y ALL COVERAGE

1036 2892 RS. KARTIKA CIBADAK JL. SILIWANGI NO.139, CIBADAK, SUKABUMI (0266) 7160071| (0266) 535586 Y Y ALL COVERAGE

1037 1107 RS. BETHA MEDIKA JL. RAYA CISAAT NO.595 SUKABUMI 0266-216422,224128-|- - Y Y ALL COVERAGE

SUMEDANG

1038 2122 KLINIK PADJADJARAN JATINANGORJL. KOLONEL AHMAD SYAM RT 04 RW 02 DESA SAYANG KEC. JATINANGOR -

BANDUNG022 -7781900| - N Y


RB,PHAR

1039 1128 RS. PAKUWON SUMEDANG JL. RD.DEWI SARTIKA NO.17 SUMEDANG 45311 0261-210834/2797773/201132| 0261-210834 Y Y ALL COVERAGE

1040 3786 PRODIA SUMEDANG JL. P. GEUSANULUN NO. 111, SUMEDANG 45312 (0261) 201259| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

TASIKMALAYA

1041 2106 KLINIK & APOTEK KF 404 JL. R.A MARTADINATA NO. 87 TASIKMALAYA 0265-340515| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1042 4798 RSIA. BUNDA AISYAH JL. R. E. MARTADINATA NO. 200B TASIKMALAYA (0265) 7297400; 7297401| - Y Y ALL COVERAGE

1043 3203 RSIA. UMMI TASIKMALAYA JL. PASEH NO.10 - TASIKMALAYA 0265-329126| - Y Y ALL COVERAGE

1044 0253 RS. JASA KARTINI JL. OTTO ISKANDARDINATA NO 15 0265-331808/331641;|0265-3318641 0265-331808/331114 Y Y ALL COVERAGE

1045 2096 KLINIK & APOTEK KF 195 JL. SUTISNA SENJAYA NO. 191 TASIKMALAYA 0265-311225/311224| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1046 1625 RS. TASIK MEDIKA CITRATAMA (TMC) JL. HZ MUSTOFA NO 310 TASIKMALAYA 0265-322333| 0265-326767 Y Y ALL COVERAGE

1047 2773 RSB. SAYANG BUNDA JL. N. SUKALAYA I NO.22 0265330841| 0265-330841 Y Y ALL COVERAGE

1048 2390 RS. PRASETYA BUNDA TASIKMALAYA JL. IR. H. JUANDA NO. 1 (SIMPANG JATI) 0265344477/0265320100/| - Y Y ALL COVERAGE

1049 2466 RS. PERMATA BUNDA TASIKMALAYA JL. BRIGJEND HR. WASITA KUSUSMAH NO.1 TASIKMALAYA, JAWA BARAT 0265-345650| - Y Y ALL COVERAGE

1050 0256 RSI. HJ. SITI MUNIROH TASIKMALAYA JL. TAMAN SARI, GOBRAS, NO.208 0265-323868,327630|0265-327630 0265-327630 Y Y ALL COVERAGE

1051 2935 LAB. PRODIA TASIKMALAYA JL. RE MARTADINATA NO 9 0265-2353080| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

JAWA TENGAH

BANYUMAS

1052 3171 RSU. WIRADADI HUSADA JL. MENTERI SUPENO NO. 25 SOKARAJA BANYUMAS 0281-6846225| 0281-6846371 Y Y ALL COVERAGE

BATANG

1053 3360 RS. QOLBU INSAN MULYA (QIM) JL. URIP SUMOHARDJO SAMBONG-BATANG, JAWA TENGAH 0285-4495222| 0285-4495224 Y Y ALL COVERAGE

BOYOLALI

1054 3276 LAB. PRODIA BOYOLALI JL. PANDANARAN NO. 252, BOYOLALI 08122895310| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1055 1661 RS. PKU AISYIYAH BOYOLALI JL. PASAR SAPI BARU SINGKIL 0276-322898/3293400| 0726-3293400 Y Y ALL COVERAGE

BREBES

1056 2292 RS. BHAKTI ASIH BREBES JL. PANGERAN DIPONEGORO NO 125 PESANTUNAN, BREBES 0283-673481/671279| 0283-671391 Y Y ALL COVERAGE

1057 1664 RS. DEDY JAYA JL. A. YANI NO 57 BREBES 0283-672145| 0283-672525 Y Y ALL COVERAGE

1058 4057 RS. DERA AS-SYIFA JL. MERDEKA NO. 191, BANJARHARJO, BREBES (0283) 889588| (0283) 889583 Y Y ALL COVERAGE

BUMIAYU

1059 3173 RSU. ALLAM MEDICA BUMIAYU JL. DIPONEGORO NO. 609, JATISAWIT BUMIAYU 0289-430822| - Y Y ALL COVERAGE

1060 1889 RS. MUHAMMADIYAH SITI AMINAH JL. DIPONEGORO, BUMIAYU 0289-432209/430683| 0289-430683 Y Y ALL COVERAGE

CEPU

1061 3268 LAB. PRODIA CEPU JL. PEMUDA NO. 41 B, CEPU 082331833027| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1062 1438 RS. MUHAMMADIYAH CEPU JL. RONGOLAWE, NO.137 0296-421727| 0296424678/424569 Y Y ALL COVERAGE

CILACAP

1063 3526 KLINIK PRATAMA KIMIA FARMA CILACAP JL. GATOT SUBROTIO NO. 59 CILACAP 0282-535293| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1064 0975 RS. ISLAM FATIMAH CILACAP JL. H JUANDA NO.20 0282-542396|- 0282-541065/5452151 Y Y ALL COVERAGE

1065 2866 RSUD. CILACAP JL. JEND GATOT SUBROTO NO. 28 CILACAP 0282-533010| 0282-520755 Y Y ALL COVERAGE

1066 2696 KLINIK & APOTEK KF 89 JL. GATOT SUBROTO NO.59, CILACAP 0282 535293| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1067 4165 RS. APRILLIA JL. JEND GATOT SUBROTO NO.95 CILACAP 0282-536307| 0282-521144 Y Y ALL COVERAGE

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1068 1005 KLINIK DR TUTUK JL. PERINTIS KEMERDEKAAN 21 0282-545921-|- - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1069 1152 RS. SANTA MARIA CILACAP JL. JEND.A.YANI NO.38 CILACAP (0282) 534859, 521725| (0282) 531296 Y Y ALL COVERAGE

1070 3278 LAB. PRODIA CILACAP JL. S. PARMAN NO. 33 CILACAP 0282-5253314| - N Y GP,LAB

DEMAK

1071 2205 RSU. PELITA ANUGERAH JL. RAYA BANDUNG REJO KM 11.5 (SMG-PURWODADI) 024-6725555| 024-6725550 Y Y ALL COVERAGE

GOMBONG

1072 3327 RS. PKU MUHAMMADIYAH GOMBONG JL. YOS SUDARSO NO.461,GOMBONG 0287-471780| - Y Y ALL COVERAGE

1073 1243 RS. PALANG BIRU JL. KARTINI, NO.37 0287-471290/471762| 0287-473221/471762 Y Y ALL COVERAGE

JEPARA

1074 3269 LAB. PRODIA JEPARA JL. MH. THAMRIM NO. 14 JEPARA 0291598808| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1075 3368 RSUD. KARTINI JEPARA JL. KH. WAHID HASYIM NO. 175 BAPANGAN, JEPARA, JAWA TENGAH 0291-598180/591175| 0291-591145 Y Y ALL COVERAGE

KENDAL

1076 1666 RSI. MUHAMMADIYAH KENDAL JL. AR RAHMAH NO 17 WELERI 0294-641870 / 0294-643756| 0294-644150 Y Y ALL COVERAGE

KLATEN

1077 0754 RS. ISLAM KLATEN JL. RAYA SOLO KM.4 0272-322252|- 0272-332422 Y Y ALL COVERAGE

1078 1519 RSU. PKU MUHAMMADIYAH DELANGGU JL. DELANGGU UTARA, NO.19 0272-551051| 0272-554041 Y Y ALL COVERAGE

1079 1441 RS. CAKRA HUSADA KLATEN JL. MERBABU, NO.7 0272-321123-322386-322394| 0272-329029 Y Y ALL COVERAGE

1080 3273 LAB. PRODIA KLATEN JL. PEMUDA SELATAN NO. 85 KLATEN 081931783130| - N Y GP,LAB

KUDUS

1081 3163 LAB. PRODIA KUDUS JL. WAHID HASYIM NO.75, KUDUS -| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1082 0146 RS. MARDI RAHAYU KUDUS JL. AKBP.R. AGIL KUSUMADYA, NO.110 0291-434707-12/435582/443581| 0291-438398,434711 Y Y ALL COVERAGE

1083 3259 LAB. CITO (JL. AKBP AGIL KUSUMADYA NO. 7 ) JL. AKBP AGIL KUSUMADYA NO. 7 0291-4251979| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

MAGELANG

1084 3286 LAB. CITO MAGELANG JL. TENTARA PELAJAR NO 126 MAGELANG 0293 363763| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1085 3161 LAB. PRODIA MAGELANG JL. AHMAD YANI NO.36 A, MAGELANG 0293-364323| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1086 1165 RSIA. GLADIOOL JL. KENANGA, NO.4-6 0293-362702| - Y Y ALL COVERAGE

1087 0335 RS. HARAPAN MAGELANG JL. P. SENOPATI, NO.11 0293-364033-35| 0293-364036-37 Y Y ALL COVERAGE

1088 1132 RS. LESTARI RAHARJA JL. MAYJEN SUTOPO NO.5 0293-362225| 0293-362649/311512 Y Y ALL COVERAGE

PATI

1089 1534 RS. MITRA BANGSA JL. KOLONEL SUGIYONO, NO.75 PATI 0295-382555| 0295-4191994 Y Y ALL COVERAGE

1090 1299 KELUARGA SEHAT HOSPITAL JL. P.SUDIRMAN NO.9 MARGOREJO 0295-386111| 0295-384422 Y Y ALL COVERAGE

1091 4455 RSU FASTABIQ SEHAT JL. RAYA PATI - TAYU KM.3 TAMBAHARJO, PATI, JAWA TENGAH (0295) 4199008| - Y Y ALL COVERAGE

PEKALONGAN

1092 3227 LAB. CITO PEKALONGAN JL. K.H. MANSYUR NO.33 PEKALONGAN 0285-422458| 0285-422458 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1093 2694 KLINIK & APOTEK KF 16 JL. IMAM BONJOL, NO.16 A, PEKALONGAN 0285-421402| 0285-423322 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1094 5665 RSU. H.A DJUNAIDJL.PELITA II RT.05/RW.02, BUARAN KRADENAN KEL. BUARAN KRADENAN

KEC. PEKALONGAN SELATAN(0285) 436325/ 4410660| (0285) 436326 Y Y ALL COVERAGE

1095 1220 RS. BUDI RAHAYU PEKALONGAN JL. BARITO, NO.5 PEKALONGAN 0285 - 423491/424340| 0285-423002 Y Y ALL COVERAGE

1096 0120 RS. SITI KHODIJAH PEKALONGAN JL. BANDUNG, NO.39-47 KOTA PEKALONGAN 0285-422845,425138,423590,424919| 0285-425138 Y Y ALL COVERAGE

PEMALANG

1097 4093 RS. PRIMA MEDIKA PEMALANG JL. SLAMET RIYADI NO. 321 MULYOHARJO 0284 - 324221 / 322448| - Y Y ALL COVERAGE

1098 1219 RSU. SANTA MARIA PEMALANG JL. PEMUDA NO.24 0284 - 321251/321426| 0284 - 322335 Y Y ALL COVERAGE

PURBALINGGA

1099 3277 LAB. PRODIA PURBALINGGA JL. LETJEND SUPRAPTO NO. 17 B, PURBALINGGA 08112616123| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1100 1888 RSU. HARAPAN IBU PURBALINGGA JL. MAYJEND SOENGKONO NO. 1 0281-892222/982277| - Y Y ALL COVERAGE

PURWODADI

1101 1226 RS. PANTI RAHAYU JL. LETJEND. SUPRAPTO NO.6 0292 - 421087-422325| 0292-421370/425095 Y Y ALL COVERAGE

PURWOKERTO

1102 1447 RSU. ANANDA PURWOKERTO JL. PEMUDA, NO.30 0281-631435-636417| 0281-640226/632146 Y Y ALL COVERAGE

1103 0201 RSU. BUNDA PURWOKERTO JL. PRAMUKA, NO.249 0281-635424/0281-632514|0281-632514 0281-632514 Y Y ALL COVERAGE

1104 4665 RSKB. JATIWINANGUN JL. JATIWINANGUN NO. 54, PURWOKERTO (0281) 638169| 081-623938 Y Y ALL COVERAGE

1105 3131 LAB. CITO PURWOKERTO JL. PRAMUKA 798 RT 7/1 PURWOKERTO 0281-637362; 637538| 0281-637583 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1106 2095 KLINIK & APOTEK KF FAJAR SEHAT JL. R.A WIRIATMAJA NO. 37 PURWOKERTO 0281-637247| 0281-640760 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1107 3250 RS. ISLAM PURWOKERTO JL. HAJI MANSYURI NO.39 PURWOKERTO 0281-630019| -0281-635394 Y Y ALL COVERAGE

1108 2094 APOTEK KIMIA FARMA 133 PURWOKERTO JL. JEND. SUDIRMAN TIMUR NO. 435 0281-638546| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1109 2204 LAB. PRODIA PURWOKERTO JL. LETJEN S.PARMAN NO:946 A, PURWOKERTO 0281-642448| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1110 1351 RS. ORTHOPAEDI PURWOKERTO JL. SOEPARDJO ROESTAM NO. 99 PURWOKERTO 0281-6844166| 0281-6844188 Y Y ALL COVERAGE

1111 1448 RSIA. BUNDA ARIF PURWOKERTO JL. JATIWINANGUN, NO.16 PURWOKERTO 0281-636555| - Y Y ALL COVERAGE

PURWOREJO

1112 1908 RS. PALANG BIRU KUTOARJO JL. MADITOMO 17, KUTOARJO-PURWOREJO 0275-641425| - Y Y ALL COVERAGE

1113 4971 RS. ISLAM PURWOREJO JL. MAGELANG KM.2, LOANO (0275) 3255470| (0275) 325 570 Y Y ALL COVERAGE

1114 3272 LAB. PRODIA PURWOREJO JL. JENDRAL AHMAD YANI NO. 22 B PURWOREJO 081914336261| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

SALATIGA

1115 3350 APOTEK KIMIA FARMA SALATIGA JL. BRIGJEN SUDIARTO NO. 30 SALATIGA 0298-325350| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1116 3160 LAB. PRODIA SALATIGA JL. BRIGJEND.SUDIARTO NO.18 A, SALATIGA 50721 0298311371| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1117 1145 RS. PURI ASIH JL. JEND. SUDIRMAN NO.169 0298-323209/0298-312049| 0298-322898/311466 Y Y ALL COVERAGE

SEMARANG

1118 2693 KLINIK & APOTEK KF 71 JL. DR.SOETOMO NO.3 , SEMARANG 024 3520763| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1119 4379 KLINIK MATA NUSANTARA (SEMARANG) JL. AHMAD YANI NO. 164, KEL. KARANG KIDUL, KEC. SEMARANG TENGAH (024) 8645 6688| (024) 841 7770 N Y GP,OP

1120 3261 KIMIA FARMA 153 (JL. JATI RAYA BANYUMANIK) JL. JATI RAYA BANYUMANIK, SEMARANG 024-7464268| 024-7464268 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1121 3262 KIMIA FARMA 259 (JL. FATMAWATI) JL. FATMAWATI NO. 42, SEMARANG 024-76928544| 024-76928544 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1122 3264 KIMIA FARMA 271 MEDITAMA (JL. AHMAD) JL. KH. AHMAD DAHLAN NO. 9, KEL. BENDUNGAN, KEC. GAJAHMUNGKUR 024-8455323| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1123 3265 KLINIK & APOTEK 324 (JL. RAYA NGALIAN) JL. RAYA NGALIYAN , KEL. TAMBAK AJI, KEC.NGALIYAN SEMARANG 024-7612049| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1124 0182 RS. ISLAM SULTAN AGUNG JL. KALIGAWE KM.4 024-6580019| 024-6581928 Y Y ALL COVERAGE

1125 0901 RS. BANYUMANIK JL. BINA REMAJA NO.61 024-7471519/ 7462181|024-7462181 024-7462181 Y Y ALL COVERAGE

Page 16 of 28

NOV-08-2017



1126 0053 RS. ROEMANI MUHAMMADIYAH JL. WONODRI, NO.22 024 - 8444623| 024-8415752 Y Y ALL COVERAGE

1127 0050 RS. PANTI WILASA DR. CIPTO JL. DR. CIPTO, NO.50 024 - 3546040, 3557428| 024-3546042 Y Y ALL COVERAGE

1128 0299 RSU. HERMINA PANDANARAN SEMARANG JL. PANDANARAN NO.24 024-8411112/8442525| 024-8449077 Y Y ALL COVERAGE

1129 0160 RS. ST. ELISABETH - SEMARANG JL. KAWI NO. 1 024-8310076/ 8310035| 024-8413373 Y Y ALL COVERAGE

1130 1806 RSUP. DR KARIADI JL. DR SUTOMO NO.16 SEMARANG, JAWA TENGAH 024-8413476/8413993| 024-8318617 Y Y ALL COVERAGE

1131 2246 APOTEK KIMIA FARMA 17 JL. TENTARA PELAJAR NO. 16 A, SEMARANG 024-8447245| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1132 2168 APOTEK FARMARIN SEMARANG JL. KALIGARANG NO. 2D 024-8450558| 024-8450558 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1133 1450 RS. PERMATA MEDIKA JL. MR.MOCH. ICHSAN, NO.93-97, NGALIYAN 024-7625005/7618800/7626571| 024-7621733 Y Y ALL COVERAGE

1134 0377 RS. TELOGOREJO JL. KH. AHMAD DAHLAN 024 - 8446000/8448448|024-8446000 024 - 8449660 Y Y ALL COVERAGE

1135 4457 RSIA GUNUNG SAWOJL. GUNUNG SAWO NO. 21 RT.08 RW. 04, KEL. PETOMPON, KEC.

GAJAHMUNGKUR, SEMARANG024-8315171| (024) 8412320; Y Y ALL COVERAGE

1136 3267 KIMIA FARMA 374 (JL. TELOGO SARI)JL. TLOGOSARI RAYA NO. 1 KAV. 2, KEL. TLOGOSARI KULON, KEC.

PEDURUNGAN, SEMARANG024-6709192| - N Y


RB,PHAR

1137 3349 APOTEK KIMIA FARMA 203 UNGARAN JL. DIPENOGORO 212 UNGARAN 024-76914353| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1138 3260 KIMIA FARMA 19 (JL. SULTAN AGUNG) JL. SULTAN AGUNG KOMPL. PERTOKOAN R A/15 SEMARANG 024-8315248| 024-8315795 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1139 3162 LAB. PRODIA SEMARANG (JL. JEND SUDIRMAN ) JL. JENDRAL SUDIRMAN NO.121 SEMARANG 024-7621757| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1140 3215 RS. WILLIAM BOOTH SEMARANG JL. S. PARMAN NO. 5 SEMARANG 024-8411800| Y Y ALL COVERAGE

1141 2692 KIMIA FARMA 178 JL. BRIG.SUDIARTO,462 E (MAJAPAHIT LAMA) 024 6716235| -- N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1142 5913 RSIA. BUNDA SEMARANG JL. BRIGJEND KATAMSO NO. 8, SEMARANG (024) 8413060| 024 - 8416037 Y Y ALL COVERAGE

1143 5430 RSIA ANUGERAH SEMARANG JL. KALISARI BARU NO.5-7 024-8313543| 024-8443016 Y Y ALL COVERAGE

1144 2822 RS. COLUMBIA ASIA SEMARANG JL. SILIWANGI NO. 143 SEMARANG (024) 762 9999/86462020| (024) 7667 4228 Y Y ALL COVERAGE

1145 3217 KLINIK KITA TEMBALANG (DR MOEZ) JL. NGESREP TIMUR 5/36 BANYUMANIK, SEMARANG 024-7472220 / 085640398938| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1146 2238 KLINIK & APOTEK KF 18 JL. PEMUDA NO. 135 SEMARANG 024-3545101/3541510/3518913| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1147 2239 LAB. PRODIA SEMARANG JL. MT. HARYONO NO:882 SEMARANG 024-8444331| 024-8414308 N Y GP,LAB

1148 2969 RS. HERMINA BANYUMANIK JL. JENDRAL POLISI ANTON SOEDJARWO NO. 195 A, SEMARANG 50263 (024) 7648 8989| (024) 7647 9080 Y Y ALL COVERAGE

1149 1663 RS. KEN SARAS JL. SOEKARNO HATTA KM 029 024-6922269| 0298-522706 Y Y ALL COVERAGE

1150 3218 KLINIK KITA KALIPANCUR (DR MOEZ) JL. ABDULRAHMAN SALEH KAV. 783 KALIPANCUR, SEMARANG 024-7624455/ 085641869731| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1151 3243 LAB.PRODIA SETIABUDI SEMARANG RUKO SETIABUDI NO.8 JL. SETIABUDI 119 D 024-7479369/081390967979| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1152 3245 LAB. CITO (JL. INDRAPRASTA NO. 81 A) JL. INDRAPRASTA NO. 81 A SEMARANG 024-3556853| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1153 3246 LAB. CITO ( JL. SETIABUDI ) JL. SETIABUDI NO.120 A 024-7461645| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1154 3247 LABORATORIUM KLINIK CITO ( JL. DR. CIPTO ) JL. DR.CIPTO NO.14 A 024-3515374| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1155 4373 KLINIK RAFAEL JL. PLAMPITAN NO.33, SEMARANG (024) 3513888| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1156 3230 KLINIK KITA KEDUNGMUNDU (DR MOEZ) JL. KEDUNGMUNDU RUKO GRAHA WAHID NO. 7, SEMARANG -| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1157 3231 KLINIK IBNU SIENA PUSPONJOLO JL. PUSPONJOLO TENGAH RAYA NO.65 024-7609338| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1158 3232 KLINIK IBNU SIENA NGALIYAN JL. PROF HAMKA RUKO SEGITIGA EMAS B-7 024-76674346| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

SLAWI

1159 1665 RSU. ADELLA JL. PROF MOH YAMIN NO. 77 SLAWI 0283-491154/491773| 0283-491354 Y Y ALL COVERAGE

SOLO

1160 3307 KLINIK & APOTEK KF 63 SOLO JL. ADISUCIPTO NO. 70 SURAKARTA 0271-718014| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1161 3279 LAB. CITO SOLO JL. YOSODIPURO NO.64 SURAKARTA 0271-2500055| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1162 5911 RS. INDRIATI SOLO JL. PALEM RAYA LANGENHARJO, GROGOL, SOLO BARU, SUKOHARJO (0271) 5722 000| (0271) 5722 888 Y Y ALL COVERAGE

1163 0212 RS. ISLAM KUSTATI JL. KAPTEN MULYADI NO.249 0271 - 643013| 0271-634823 Y Y ALL COVERAGE

1164 3354 APOTEK KIMIA FARMA YOSODIPURO 252 JL. NO.111B, SOLO -| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1165 3280 LAB. KLINIK KIMIA FARMA SURAKARTA JL. ADISUCIPTO NO. 70 SURAKARTA 0271-727886| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1166 0745 RS. ISLAM SURAKARTA JL. A YANI PABELAN KARTASURA, SOLO 0271-7105710271-725134|0271-725134 0271-710572 Y Y ALL COVERAGE

1167 0746 RS. PKU MUHAMMADIYAH SURAKARTA JL. RONGGOWARSITO NO130, SURAKARTA 0271-714578| 0271-717012 Y Y ALL COVERAGE

1168 1179 RS. BRAYAT MINULYA JL. DR.SETIABUDI NO.106 SURAKARTA 0271-716646,710170| 0271-727309/712181 Y Y ALL COVERAGE

1169 0214 RS. DR. OEN SURAKARTA(KANDANG SAPI) JL. BRIGJEN KATAMSO NO.55, KANDANG SAPI 0271-643139| 0271-642026 Y Y ALL COVERAGE

1170 1483 RS. PANTI WALUYO SURAKARTA JL. JEND.A.YANI NO.1 0271-712077| 0271-729125 Y Y ALL COVERAGE

1171 2181 APOTEK FARMARIN SOLO JL. GREMET NO.3 RT 007/11 MANAHAN 085727427423| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1172 0118 RS. DR. OEN SOLO BARU KOMP. PERUMAHAN SOLO BARU, GROGOL, SUKOHARJO 0271-620220| 0271-622555/660935 Y Y ALL COVERAGE

1173 2373 KLINIK PRODIA SOLO JL. RONGGOWARSI. TO NO. 143 SOLO 57131 0271-646378| 0271-638779 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1174 2907 RS. HERMINA SOLO JL. KOL SUTARTO NO. 16 JEBRES SOLO 0271-638989| 271 Y Y ALL COVERAGE

SRAGEN

1175 3275 LAB. PRODIA SRAGEN JL. KOLONEL SUGIYONO NO. 8, WIDORO, SRAGEN 0271-890263| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1176 3353 APOTEK KIMIA FARMA 212 - SRAGEN JL. SUKOWATI NO.440A, SRAGEN MANGGIS 0271-892209| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

SUKOHARJO

1177 3355 APOTEK KIMIA FARMA SUKOHARJO JL. VETERAN NO.11 SUKOHARJO 0271-590411| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1178 1178 RS. NIRMALA SURI JL. RAYA SOLO KM 9 SUKOHARJO 0271-592192| - Y Y ALL COVERAGE

TEGAL

1179 3359 RSIA. PALA RAYA JL. PALA RAYA NO. 11 A MEJASEM 0283-356009| - Y Y ALL COVERAGE

1180 3219 LAB. PRODIA TEGAL JL. KAPTEN SUDIBYO NO. 136 TEGAL 0283-358673| 0283-353664 N Y GP,LAB

1181 3220 LAB. CITO TEGAL JL. GAJAH MADA NO. 79 TEGAL 0283-353402| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1182 2093 APOTEK KIMIA FARMA 97 TEGAL JL. MAYJEN SUTOYO NO. 44 TEGAL 0283-35473| 0283-3355765 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1183 1540 RS. MITRA KELUARGA TEGAL JL. SIPELEM, NO.4, KEMANDUNGAN, TEGAL BARAT 0283-340399/ 340999| 0283-340902 Y Y ALL COVERAGE

1184 0753 RS. ISLAM HARAPAN ANDA JL. ABABIL NO.420283-355717 /0283-359900 / 0283-

358244|0283-351263 Y Y ALL COVERAGE

TEMANGGUNG

1185 4519 PRODIA TEMANGGUNG RUKO PANDEAN, JL MT. HARYONO - TEMANGGUNG 0293-4960160| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1186 1144 RS. NGESTI WALUYO JL. PAHLAWAN-PARAKAN 0293-596008| 0293-596410 Y Y ALL COVERAGE

1187 4508 RS. MUHAMMADIYAH TEMANGGUNG JL. RAYA KEDU KM.2 KALISAT TEMANGGUNG 56253 (0293) 596704, 596700, 4909900| (0293) 598700 Y Y ALL COVERAGE

WONOGIRI

1188 3274 LAB. PRODIA WONOGIRI JL. JEND. ACHMAD YANI NO. 58 WONOGIRI 08122583522| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

WONOSOBO

1189 4127 LAB. PRODIA WONOSOBO JL. KAUMAN NO. 15, WONOSOBO ( PERTIGAAN MANGLI ) 0286-325275| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

Page 17 of 28

NOV-08-2017



JAWA TIMUR

BANGIL

1190 0700 RS. ISLAM MASYITHOH JL. A. YANI, NO.6 0343-741018| 0343-742425 Y Y ALL COVERAGE

BANGKALAN

1191 3595 RS. LUKAS JL. KH.MOH.KHOLIL 36A 031-3095148| 031-3061367 Y Y ALL COVERAGE

1192 3841 APOTEK KIMIA FARMA TRUNOJOYO 419 JL. TRUNOJOYO NO.75A BANGKALAN 0313095459| 313095459 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1193 3840 APOTEK KIMIA FARMA 163 JL. JOKOTOLE NO.5 BANGKALAN 0313091016| 313091016 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

BANYUWANGI

1194 1429 RS. YASMIN BANYUWANGI JL. LETKOL ISTIQLAL NO.80-84 0333-424671| -0333-418219 Y Y ALL COVERAGE

1195 0726 RS. ISLAM FATIMAH BANYUWANGI JL. JEMBER, NO.25 0333-421451| 0333-423204/417929 Y Y ALL COVERAGE

1196 0724 RS. AL-HUDA JL. DIPONEGORO, NO.65, GENTENG 0333-842033/844682/845248/842118| 0333-842036/38 Y Y ALL COVERAGE

1197 4065 RS. NAHDLATUL ULAMA BANYUWANGI JL. RAYA MANGIR NO. 09 KEC. ROGOJAMPI KAB. BANYUWANGI 0333-632965| 0333-632965 Y Y ALL COVERAGE

1198 4130 RSIA. PKU MUHAMMADIYAH ROGOJAMPI JL. PANGERAN DIPONEGORO NO. 20, ROGOJAMPI 0333-631149| - Y Y ALL COVERAGE

BLITAR

1199 3807 RS. UMUM AMINAH BLITAR JL. VETERAN NO. 39, KEPANJEN, KIDUL 0342-816304/816305| 0342-816527 Y Y ALL COVERAGE

1200 0269 RS. KATOLIK BUDI RAHAYU BLITAR JL. JEND. A.YANI NO. 18 BLITAR 0342-801066/802316/807802| 0342-806509/804284 Y Y ALL COVERAGE

1201 5908 LAB. PRODIA BLITAR JL MAWAR NO 82/74 KEL/KEC. SUKOREJO KOTA BLITAR 0342-803179| 0342-803179 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

BOJONEGORO

1202 1032 RS. PKU MUHAMMADIYAH KALITIDU JL. RAYA KALITIDU, NO.266, KALITIDU 0353-511731/512066-|- 0353-511678/512066 Y Y ALL COVERAGE

1203 0731 RS. AISYIYAH BOJONEGORO JL. HASYIM ASHAARI, NO.17 0353-881748/885978| 0353-885978 Y Y ALL COVERAGE

BONDOWOSO

1204 3892 RS. MITRA MEDIKA BONDOWOSO JL. HOS COKROAMINOTO 98, BONDOWOSO 0332-421981; 423800| 0332 429601 Y Y ALL COVERAGE

GRESIK

1205 0596 RS. SEMEN GRESIK JL. RA. KARTINI, NO.280 GRESIK 031 - 3987840,3989478,3975847| 031-3987842 Y Y ALL COVERAGE

1206 3842 KLINIK & APOTEK KF 164 (BM GRESIK) JL. R.A KARTINI NO.150-152 0313984783| 313984783 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1207 3648 RSUD. IBNU SINA KAB. GRESIK JL. DR. WAHIDIN SH NO.243B, GRESIK 031-3951239| - Y N H&S,MAT

1208 1427 RS. PETROKIMIA GRESIK (JL JEND SUDIRMAN) JL. JEND. A.YANI NO.69031-

3988877/3990994/3978658/3977666|031-3980008/3981232 Y Y ALL COVERAGE

1209 1923 RS. PETROKIMIA GRESIK GRHA HUSADA JL. PADI NO. 3 KOMPLEK PT PETROKIMIA GRESIK 031-3984465,3973400,3793401| 031-3972623 Y Y ALL COVERAGE

1210 4522 RS. SURYA MEDIKA JL. LABAN KULON NO. 58 MENGANTI GRESIK 61174, JAWA TIMUR (031) 7914025| 031-7911889 Y Y ALL COVERAGE

1211 4235 RS. FATHMA MEDIKA GRESIK JL. PENDOPO NO. 45, SEMBAYAT, MANYAR, GRESIK (031) 394 3500| - Y Y ALL COVERAGE

1212 4966 KLINIK MEDIS PUSURA MENGANTI RUKO MENGANTI MAS BLOK U-2, JL RAYA BRINGKANG, MENGANTI, GRESIK 031-5471707| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1213 4053 RS. PETROKIMIA GRESIK DRIYOREJO JL. RAYA LEGUNDI KM 5 031-8986701, 8981779, 8981778| 031-8986700 Y Y ALL COVERAGE

1214 4078 LAB. PARAHITA GRESIK JL. R.A KARTINI NO 120 031-3981455| 031-3991820 N Y LAB

1215 2610 RS. WATES HUSADA JL. RAYA WATES UTARA KEDUNGPRING, BALONGPANGGGANG - GRESIK (031) 7922351| - Y Y ALL COVERAGE

JEMBER

1216 0725 RS. PERKEBUNAN (PTPN) X JEMBER JL. BEDADUNG, NO.20331-

487104,485415,426873,485912,410748030331-485912 Y Y ALL COVERAGE

1217 2077 KLINIK & APOTEK KF 241 JEMBER JL. PANGLIMA SUDIRMAN NO. 46 JEMBER 0331-489885| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1218 1685RSU. KALIWATES PT PERKEBUNAN NUSANTARA

XIIJL. DIAH PITALOKA NO 1 JEMBER

0331-

3137525/483567/488964/485967/4891000331-489100 Y Y ALL COVERAGE

1219 2342 THC JEMBER JALAN LETJEN SUPRAPTO NO. 65 JEMBER 0331-339725| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1220 3530 RS. CITRA HUSADA JL. TERATAI NO.22 JEMBER (0331) 486200| (0331) 427088 Y Y ALL COVERAGE

1221 1428 RS. BINA SEHAT JL. JAYANEGARA NO.7 0331-422701/424304/421713| 0331-428390 Y Y ALL COVERAGE

1222 2076 KLINIK & APOTEK KF 62 JEMBER JL. GAJAH MADA 171 JEMBER 0331-489020| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

JOMBANG

1223 1849 RSIA. MUSLIMAT JOMBANG JL. URIP SUMOHARJO NO 34 JOMBANG 0321-872200/877600/869434| 0321-854991 Y Y ALL COVERAGE

1224 0978 RS. KRISTEN MOJOWARNO JL. MERDEKA NO.59, MOJOWARNO 0321-495093-|- 0321-492200/495440 Y Y ALL COVERAGE

1225 1880 RS. AIRLANGGA JOMBANG JL. AIRLANGGA NO 50 C JELAKOMBO, JOMBANG 0321-861577| 0321-862194 Y Y ALL COVERAGE

1226 1966 RS. PELENGKAP MEDICAL CENTER JL. JUANDA NO. 03 JOMBANG 0321-877945 / 869826| - Y Y ALL COVERAGE

1227 0810 RS. DR. MOEDJITO DWIDJOSISWOJO JL. HAYAM WURUK, NO.9 JOMBANG 0321-864308,6977788,855555| 0321-877276 Y Y ALL COVERAGE

1228 5425 RS. NAHDLATUL ULAMA JOMBANG JL. KH. HASYIM ASHARI NO.211 0321-878700| 0321-878700 Y Y ALL COVERAGE

KEDIRI

1229 1998 KLINIK & APOTEK KF 75 KEDIRI JL. JAKSA AGUNG SUPRAPTO NO. 25 KEDIRI 0354-773384/ 694913| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1230 0977 RS. BAPTIS KEDIRI JL. BRIDJEN POLLBH PRANOTO NO.1 0354-682170, 683578, 684172-|- 0354-681173 Y Y ALL COVERAGE

1231 1430 RS. AURA SYIFA JL. JOYOBOYO NO.42 DLOPO 0354-671939 / 682316| 0354-696033/641939 Y Y ALL COVERAGE

1232 3828 APOTEK KIMIA FARMA SMAN II PARE JL. PAHLAWAN KUSUMA BANGSA 28 PARE 0354-390006| 0354-390006 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1233 4680 RS. MUHAMMADIYAH SITI KHODIJAH KEDIRI JL. DR. SOETOMO 322 SUKOREJO, KEC. GURAH, KAB. KEDIRI, JAWA TIMUR (0354) 545481; 546593| (0354) 548838 Y Y ALL COVERAGE

1234 3612 PRODIA KEDIRI JL. KARTINI NO. 18, KEDIRI 64123 (0354) 698960| (0354) 698961 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1235 0248 RS. HVA TOELOENGREDJO JL. A. YANI NO. 25 PARE 0354-391047,391145| 0354-392883 Y Y ALL COVERAGE

1236 1599 RS. MUHAMMADIYAH AHMAD DAHLAN KEDIRI JL. GATOT SUBROTO NO 84 KEDIRI 0354-773115/770182| 0354-776318/773736 Y Y ALL COVERAGE

1237 6376 KLINIK SURYA KEDIRI JL. TUNGGUL WULUNG NO.15 KARANGREJO, NGASEM 085216577778| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1238 2075 KLINIK & APOTEK KF 151 KEDIRI JL. STASIUN NO. 47 KEDIRI 0354-694913| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

LAMONGAN

1239 1199 RS. MUHAMMADIYAH LAMONGAN JL. JAKSA AGUNG SUPRAPTO 0322-322834| 0322-314048 Y Y ALL COVERAGE

1240 4782 RS. ISLAM NASHRUL UMMAH JL. MERPATI NO.62 0322-321522| - Y Y ALL COVERAGE

1241 4765 RS. KH. ABDURRAHMAN SYAMSURI (ARSY) JL. RAYA DEANDLES KM. 74 PACIRAN LAMONGAN (0322) 666626 / 081232870229| (0322) 666626 Y Y ALL COVERAGE

LUMAJANG

1242 2724 RS. ISLAM LUMAJANG JL. KYAI MUKSIN 19 LUMAJANG 0334-887999/893535| (0334) 887778 Y Y ALL COVERAGE

1243 1247 RS. WIJAYA KUSUMA JL. A. YANI, NO.149, LUMAJANG 0334-891325| 0334-888844 Y Y ALL COVERAGE

MADIUN

1244 1183 RS. SITI AISYAH MADIUN JL. MAYJEN SUNGKONO, NO.38 0351-464822/451843/452010| 0351-464009 Y Y H&S,MAT

1245 3425 KLINIK & APOTEK KF 76 JL. JAWA NO.14 0351-453381| 0351-453381 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1246 3200 RS. GRIYA HUSADA MADIUN JL. MAYJEND PANJAITAN NO.22 MADIUN 0351 - 472801 / 472802 / 472803| 0351 475900 Y Y ALL COVERAGE

1247 0722 RS. SANTA CLARA JL. BILITON, NO.15 0351-462688/452770/464571| 0351-455780/466509 Y Y ALL COVERAGE

1248 3421 LAB. PRODIA MADIUN JL. SULAWESI NO.9 MADIUN 0351453344| - N Y GP,LAB

1249 2345 THC MADIUN JALAN MANGGIS NO.9, MADIUN 0351-77542120| 0351-476697 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

Page 18 of 28

NOV-08-2017



MALANG

1250 0815 RS. PANTI WALUYA SAWAHAN JL. NUSAKAMBANGAN NO.5 0341-362017,366033,361507| 0341-354068 Y Y ALL COVERAGE

1251 0708 RS. LAVALETTE JL. W.R. SUPRATMAN, NO.10 0341-470805/482612| 0341-470804 Y Y ALL COVERAGE

1252 2790 RSIA. GALERI CANDRA JL. BUNGA ANDONG NO.3 MALANG 65141 (0341) 478571| (0341) 478571 Y Y ALL COVERAGE

1253 1327 RSIA. HUSADA BUNDA JL. PAHLAWAN TRIP NO. 2, ORO-ORO DOWO (0341) 569634; 566972;569799; 580169| 0341-580169/569799 Y Y ALL COVERAGE

1254 2068 RS. LAWANG MEDIKA JL. DR CIPTO NO.8, KEL.BEDALI, KEC.LAWANG 0341-7057623/420888| - Y Y ALL COVERAGE

1255 2048 RS. PRIMA HUSADA MALANG JL. BANJARARUM SELATAN NO. 3, MONDOROKO SINGOSARI-MALANG 0341-458679| 0341-441874 Y Y ALL COVERAGE

1256 2274 KLINIK & APOTEK KF 53 JL. KAWI NO.22 A MALANG 0341 362 301/ 364 056| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1257 1326 RS. WAVA HUSADA KEPANJEN JL. PANGLIMA SUDIRMAN NO.99A KEPANJEN 0341-393000| 0341-398398 Y Y ALL COVERAGE

1258 1325 RS. MARSUDI WALUYO JL. RAYA MONDOROKO KM.9 SINGOSARI 0341-458974| 0341-451579 Y Y ALL COVERAGE

1259 1252 RS. ISLAM MALANG ( UNISMA ) JL. MAYJEND HARYONO NO. 139 0341-551356,580798,565448| 0341-551257 Y Y ALL COVERAGE

1260 0252 RS. ISLAM AISYIYAH MALANG JL. SULAWESI, NO.16 0341-326773| 0341-368883 Y Y ALL COVERAGE

1261 3815 KIMIA FARMA NO.245 BATU JL. DIPONEGORO NO. 93 BATU MALANG -| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1262 3816 KIMIA FARMA NO. 210 MALANG JL. TUMENGGUNG SURYO NO. 25 MALANG 0341423930| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1263 3817 KIMIA FARMA NO. 187 MALANG JL. M.T. HARYONO NO. 110 MALANG 0341553283| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1264 3818 KIMIA FARMA NO. 150 MALANG JL. SELAT SUNDA 1 D NO. 25 MALANG 0341713091| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1265 3820 KIMIA FARMA NO. 36 MALANG JL. IJEN NO. 88 MALANG 0341359677| 341359678 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1266 3164 LAB. PRODIA MALANG JL. MERBABU NO.10, MALANG 0341-366042| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1267 2680 KIMIA FARMA 116 JL. LA SUCIPTO /148,MALANG 0341-489539| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1268 4089 RS. ISLAM GONDANGLEGI JL. HAYAM WURUK NO 66, GONDANGLEGI 0341 - 879047| - Y Y ALL COVERAGE

1269 2967 PERSADA HOSPITAL JL. PANJI SUROSO ARAYA BUSINESS CENTER KAV.II-IV 0341-2996333| 0341-2993773 Y Y ALL COVERAGE

1270 4524 RS. PRASETYA HUSADA JL. RAYA NGIJO NO. 25 KARANGPLOSO KAB. MALANG JAWA TIMUR (0341) 460558| (0341) 463404 Y Y ALL COVERAGE

1271 3437 RSB. MARDI WALOEJA RAMPAL JL. WR. SUPRATMAN NO.01 MALANG (0341) 364756| - Y Y ALL COVERAGE

1272 3814 KIMIA FARMA 453 SUTOYO MALANG JL. LETJEN SUTOYO NO. 107 MALANG 0341478382| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1273 0609 RS. PANTI NIRMALA JL. KEBALEN WETAN, NO.2-8 0341-362459| 0341-327930 Y Y ALL COVERAGE

1274 0125 RSIA. MELATI HUSADA JL. KAWI, NO.320341-325249 / 3570341 / 341357|0341-

3413570341-365094/341357 Y Y ALL COVERAGE

1275 4740 MALANG EYE CENTER JL. DR. CIPTO NO. 3 (0341) 341666| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1276 0192 RS. BAPTIS BATU JL. RAYA TLEKUNG NO.1 JUNREJO, BATU0341-594161 /0341-598192/5|0341-

598192/50341-598911 Y Y ALL COVERAGE

1277 3620 APOTIK KIMIA FARMA 77 JL. SUKARJO WIRYOPRANOTO 2K MALANG 0341-365298| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1278 4172 RSU UNIVERSITAS MUHAMMADIYAH MALANG JL. TLOGOMAS NO. 45 MALANG 0341 561666| 0341 561627 Y Y ALL COVERAGE

1279 3611 RSI. MADINAH KASEMBON JL. RAYA SUKOSARI NO. 32 KASEMBON MALANG 0354-326688/ 393000| 0354-328144 Y Y ALL COVERAGE

1280 2789 RSIA. PURI MALANG JL. TAMAN SLAMET NO.20 MALANG 0341-325329| (0341) 342322 Y Y ALL COVERAGE

1281 0094 RSU. HERMINA TANGKUBANPRAHU MALANG JL. TANGKUBAN PRAHU, NO.33 MALANG0341-325082 - 354844 - 354845/460341-

354844/8|0341-354844/80341-354843 Y Y ALL COVERAGE

1282 1561 RS. PERMATA BUNDA MALANG JL. SOEKARNO HATTA NO. 75, LOWOKWARU 0341-487487/407462| 0341-474242 Y Y ALL COVERAGE

1283 1978 RS. MUTIARA BUNDA MALANG JL. CIUJUNG NO.19 (0341) 400403; 400722| - Y N ALL COVERAGE

1284 2171 APOTEK FARMARIN MALANG JL. W. R.SUPRATMAN C2 KAV.9 MALANG 0341-334163/4| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

MOJOKERTO

1285 0088 RS. KARTINI MOJOKERTO JL. ERLANGGA, NO.137, MOJOSARI 0321-592261| 0321-595569 Y Y ALL COVERAGE

1286 0785 RS. EMMA JL. RAYA IJEN WATES NO.67 0321-396747|- 0321-334021 Y Y ALL COVERAGE

1287 1980 RS. SIDO WARAS JL. RAYA PASAR SAWAHAN KM. 10 BANGSAL KAB. MOJOKERTO 0321-598621| 0321-598624 Y Y ALL COVERAGE

1288 1997 RS. ISLAM HASANAH MUHAMMADIYAHJL. HOS. COKROAMINOTO NO.26 - 28, MAGERS. ARI,MOJOKERTO, JAWA

TIMUR 613130321-321635| - Y Y ALL COVERAGE

1289 3825 RSI. SAKINAH JL. RA BASUNI NO.12 MOJOKERTO 0321-321922| 0321-329670 Y Y ALL COVERAGE

1290 0928 RS. GATOEL MOJOKERTO JL. RADEN WIJAYA NO.56 0321-321681,322329,399772-|- 0321-321684 Y Y ALL COVERAGE

1291 0164 RS. REKSA WALUYA JL. MOJOPAHIT, NO.4220321-322170/3221710321-

322171/3937|0321-322171/39370321-322511 Y Y ALL COVERAGE

1292 2818 RS. MUTIARA HATI JL. RAYA KEMANTREN WETAN 49, TERUSAN,GEDEG, MOJOKERTO (0321) 7223400, 363442| - Y Y ALL COVERAGE

NGAWI

1293 3872 RS. AT-TIN HUSADA JL. RAYA NGAWI-SOLO KM 4 0351747888| 351747666 Y Y ALL COVERAGE

PACITAN

1294 3770 PRODIA PACITAN JL. BASUKI RAHMAT NO. 14, PACITAN 63518 (0357) 884222| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

PAMEKASAN

1295 3811 APOTEK KIMIA FARMA 274 JL. DIPONEGORO No 4, PAMEKASAN 0324611332| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1296 0113 RS. LARASATI JL. MANDILARAS, NO.74, PAMEKASAN 0324-328305| 0324-322080 Y Y ALL COVERAGE

PASURUAN

1297 1347 RS. MITRA SEHAT MEDIKA JL. BY PASS NO.6 PANDAAN 0343-636064| 0343-636083 Y Y ALL COVERAGE

1298 3626 KIMIA FARMA 165 JL. WAHIDIN SUDIRO HUSODO NO 59 PASURUAN 0343-426342| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

PONOROGO

1299 3869 RS. DARMAYU PONOROGO JL. Dr. Soetomo No.44 - 50 0352-481320| 0352-461253 Y Y ALL COVERAGE

1300 0823 RSU. AISYIYAH PONOROGO JL. DR SUTOMO NO.18-24 0352-481784,461560,485093| 0352-484218 Y Y ALL COVERAGE

PROBOLINGGO

1301 0309 RS. DHARMA HUSADA JL. SOEKARNO HATTA NO.10 0335-422176| 0335-422698 Y N H&S,MAT

1302 4081 RS. RIZANI JL. RAYA SURABAYA SITUBONDO KM 135, KEL SUMBEREJO, KEC PAITON 0335 773444| - Y Y ALL COVERAGE

1303 1330 RSU. WONOLANGAN JL. RAYA DRINGU NO.118 0335-424007| 0335-431937 Y Y ALL COVERAGE

SIDOARJO

1304 1040 RS. MITRA KELUARGA WARU JL. RAYA LETJEN. S.PARMAN, NO.8 031-8543111/8542111-|- 031-8534333 Y Y ALL COVERAGE

1305 4077 LAB. PARAHITA DARMO PERMAI JL. RAYA DARMO PERMAI 1/56 031-7326650| 031-7328511 N Y LAB

1306 6375 RS. RAHMAN RAHIM JL. RAYA SAIMBANG RT/RW:10/03 KEBON AGUNG, SUKODONO 031-8830010| - Y Y ALL COVERAGE

1307 2755 RSU. BUNDA SIDOARJO JL. KUNDI NO.70 KEPUH KIRIMAN, WARU SIDOARJO (031) 8668880| (031) 8688218 Y Y ALL COVERAGE

1308 3847 APOTEK KIMIA FARMA 261 JL. MAJAPAHIT NO.35 SIDOARJO 0318956674| 318956674 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1309 3839 APOTEK KIMIA FARMA 119 PERUM DELTASARI BLOK AN NO 11 0318556411| 318556411 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1310 1108 RSAB. SOERYA JL. RAYA KALIJATEN, NO.11-15, TAMAN SEPANJANG 031-7885011-|- 031-7873633 Y Y ALL COVERAGE

1311 0927 RS. ANWAR MEDIKAJL. DUSUN SEMAWUT, RT.10/RW.04, KEC. BALONGBENDO / JL. RAYA BY

PASS KRIAN KM.33031-8972052, 8974943-|- 031-8988313 Y Y ALL COVERAGE

1312 0249 RS. DELTA SURYA JL. PAHLAWAN NO.9031-8962531-8961271031-8961271|031-

8961271031-8961281/8944977 Y Y ALL COVERAGE

1313 1346 RS. CITRA MEDIKA SIDOARJO JL. RAYA SURABAYA, KM.44, KRAMAT TUMENGGUNG 0321-361000| 0321-361666/362956 Y Y ALL COVERAGE

1314 1339 KLINIK GRAHA MEDIKA JL. BRIGJEN KATAMSO NO.7 WARU 031 - 8554910| 031-8554911 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1315 3857 APOTEK KIMIA FARMA KAHURIPAN JL. KAHURIPAN NO.57 SIDOARJO 03151517736| 3151517736 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1316 3614 PRODIA SIDOARJO JL. PAHLAWAN 12A SIDOARJO (031) 8961010| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1317 3845 APOTEK KIMIA FARMA 180 JL. PAHLAWAN NO.10 SIDOARJO 0318947116| 318947116 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1318 3199 RSIA. KIRANA SIDOARJO JL. RAYA NGELOM 87 TAMAN - SIDOARJO 031-7881623| 031-7873010 Y Y ALL COVERAGE

Page 19 of 28

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1319 4706 KLINIK IBU & ANAK PONDOK JATI JL. PONDOK JATI AK 9-13 PAGERWOJO BUDURAN (031) 8052062| (031) 8052037 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1320 1342 KLINIK MEDIS GELORA PERUM TAMAN PINANG INDAH, BLOK B7, NO.3-3A 031-8929139| 031-8929123 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1321 0545 RS.SITI KHODIJAH SIDOARJO JL. PAHLAWAN, NO.260, SEPANJANG031-

7881130,7882123,7872081,60134373|031-7876066 Y Y ALL COVERAGE

1322 0271 RS. ISLAM SITI HAJAR SIDOARJO JL. RADEN PATAH NO.70 031-8921233/8961570| 031-8944438/8944990 Y Y ALL COVERAGE

1323 2054 RSIA. ARAFAH ANWAR MEDIKA SUKODONO JL. SAWO NO. 2 DUNGUS, SUKODONO, SIDOARJO 031-8830989| 031-8831089 Y Y ALL COVERAGE

1324 2273 KLINIK & APOTEK KF 124 JL. RAYA SEDATI GEDE NO. 59 SIDOARJO 031 866 7929| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1325 1846 KLINIK MEDIS PUSURA SIDOARJO JL. RAYA CANDI NO. 49 SIDOARJO 031-8966345| 031-8075917 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1326 1336 KLINIK CITRA GADING MEDIKA JL. BRIGJEN KATAMSO BLOK A 408-409 REWIN WARU 031-8679727| 031-8683181 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

SITUBONDO

1327 3096 RS. ELIZABETH PTP NUSANTARA XI JL. WR SUPRATMAN 2A SITUBONDO 0338-671174| 0338-678061 Y Y ALL COVERAGE

SURABAYA

1328 0809 RS. SPESIALIS HUSADA UTAMA JL. PROF DR MOESTOPO 31-35031- 5017975/5018335(021)

9100682|(021) 9100682031-5010777 Y Y ALL COVERAGE

1329 0081 SILOAM HOSPITALS SURABAYA JL. RAYA GUBENG NO. 70, SURABAYA 031-5031333/5031821| 031-5031533/5039313 Y Y ALL COVERAGE

1330 5398 KLINIK KENCANA MEDIKA JL. RAYA KENDANGSARI NO. 78 SURABAYA (031) 8498880| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1331 3853 APOTEK KIMIA FARMA WIYUNG RUKO TPI BLOK A 17 RAYA MEGANTI SURABAYA 0317668267| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1332 1052 RSIA. PUSURA TEGALSARI (MEDIS PUSURA 4) JL. TEGAL SARI NO.59 031-5473462-|- 031-5462033 Y Y ALL COVERAGE

1333 2001 RS. WIYUNG SEJAHTERA JL. KARANGAN PDAM NO.1-3 WIYUNG SURABAYA (031) 7532653| (031) 7533726 Y Y ALL COVERAGE

1334 3833 APOTEK KIMIA FARMA 24 JL. DHARMAWANGSA NO.24 0315032775| 315037664 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1335 0828 RS. AL. DR.RAMELAN SURABAYA JL. GEDUNG NO.1 SURABAYA (031) 8438153 / 031-8438154| (031) 8437511 Y Y ALL COVERAGE

1336 4076 LAB. PARAHITA DIPONEGORO JL. DIPONEGORO 161-163 031-5610011| - N Y LAB

1337 3851 APOTEK KIMIA FARMA 432 PANDUGO JL. PANDUGO MERR NO.2 SURABAYA 0318709962| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1338 3852 APOTEK KIMIA FARMA G-WALK RUKO TAMAN GAPURO B.2, G-WALK SURABAYA 0317411121| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1339 3855 APOTEK KIMIA FARMA CILIWUNG JL. CILIWUNG NO.76 SURABAYA 0315633156| 315633156 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1340 3856 APOTEK KIMIA FARMA KLAMPIS JL. KLAMPIS JAYA BLOK A NO.30 SURABAYA 0315926293| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1341 3858 APOTEK KIMIA FARMA RUNGKUT JL. RUNGKUT MADYA NO.97 SURABAYA 0318721059| 318721059 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1342 2925 RS. MITRA KELUARGA KENJERAN JL. KENJERAN 506 (031) 99000880| (031) 99000885 Y Y ALL COVERAGE

1343 3613 PRODIA DARMO PERMAI JL. RAYA DARMO PERMAI SELATAN 1F, SURABAYA 60226 (031) 7328866| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1344 4446 RSIA KENDANGSARI MERR JL. DR. IR. H. SOEKARNO NO. 2, SURABAYA (031) 3814388| (031) 3813488 Y Y ALL COVERAGE

1345 0829RS. PREMIER SURABAYA (RS. SURABAYA

INTERNASIONAL)JL. NGINDEN INTAN BARAT, BLOK B 031- 5993211|031-5993211 031- 5993214 Y Y ALL COVERAGE

1346 4209 RS. WIJAYA SURABAYA JL. MENGANTI 398 WIYUNG SURABAYA 031-7523087/031-7523282| Y Y ALL COVERAGE

1347 4231 RSIA NUR UMMI NUMBI (NUN) SURABAYA JL. MANUKAN TENGAH BLOK 51J/4-6 (031) 740 4391 ; 741 5313| - Y Y ALL COVERAGE

1348 3538 LAB. PARAHITA DHARMAWANGSA JL. DHARMAWANGSA 66 SURABAYA 031-5020552,5020081,5013705-6| 031-5032676, 5023551 N Y LAB

1349 4799 RSIA. CEMPAKA PUTIH PERMATA SURABAYA JL. JAMBANGAN KEBON AGUNG NO. 8, SURABAYA (031) 8282350| (031) 8297578 Y Y ALL COVERAGE

1350 3197 RS. SURABAYA MEDICAL SERVICE JL. KAPUAS NO. 2 SURABAYA 031-5686161| - Y Y ALL COVERAGE

1351 4653 LAB KLINIK UTAMA BIOTEST SURABAYA JL KERTAJAYA INDAH F-304 SURABAYA 031-5929159/5929150| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1352 4128 LAB. PRODIA BOGOWONTO JL. BOGOWONTO NO.14 ( PUSAT GMC ) 031-5631818| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1353 3002 LAB. KLINIK BIOTEST SURABAYA JL. RA. KARTINI NO.78, SURABAYA, JAWA TIMUR (031) 5678736| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1354 1365 RS. MATA UNDAAN JL. UNDAAN KULON, NO.19 031-5343806/531619| 031-5317503 Y Y ALL COVERAGE

1355 3769 PRODIA MEGA GALAXI (UNDAAN) SBYRUKO MEGA GALAXI, JL. KERTAJAYA INDAH TIMUR 14 C NO. 6, SURABAYA

60282(031) 5991010| - N Y


RB,PHAR

1356 4082 RS. ISLAM DARUS SYIFA JL. RAYA BENOWO NO. 5 SURABAYA 0317406293| - Y Y ALL COVERAGE

1357 0548 KLINIK MEDIS PUSURA 3 (SUNGKONO) JL. MAYJEN, SUNGKONO, NO.64 031-5612120/22| 031-5668763 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1358 0830 RS. ADI HUSADA UNDAAN WETAN JL. UNDAAN WETAN NO40-44 dan 50 031-5321256/031-5318000|031-5318000 031- 5321081 Y Y ALL COVERAGE

1359 0136 RS. MITRA KELUARGA SURABAYA JL. SATELIT INDAH II, DARMO SATELIT 031-7345333| 031-7345955 Y Y ALL COVERAGE

1360 1548 KLINIK MEDIS PUSURA 5 (BALONGSARI) JL. BALONGSARI TAMA, BLOK B, NO.8-9 031-7416234| 031-7416234 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1361 0546 MEDIS PUSURA JL. KOM ( L) YOS SUDARSO, 9A 031-5340604 / 031-5471707/5328920| 031-5327095 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1362 1000 RS. MUJI RAHAYU JL. RAYA MANUKAN WETAN 68 A, SURABAYA 031-7404132/709837250000000|0000000 - Y Y ALL COVERAGE

1363 0163 RS. DARMO JL. RAYA DARMO, NO.90 031 - 567 6253/54/55/56| 031-5620690 Y Y ALL COVERAGE

1364 0547 KLINIK MEDIS PUSURA 2 (RUNGKUT) JL. RUNGKUT ASRI TENGAH NO.2 031- 8705210| 031-8793028 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1365 0544 RS. ST.VINCENTIUS A.PAULO (RS. RKZ) JL. DIPONEGORO NO.51031-

5677562/5687846/5663895031/5687846|031-5674748/5651057 Y Y ALL COVERAGE

1366 0895 RS. PHC SURABAYA JL. PRAPAT KURUNG SELATAN NO.1 TANJUNG PERAK 031-3294801/2/3|- 031-3294804 Y Y ALL COVERAGE

1367 0896 KLINIK KEBRAON JL. GRIYA KEBRAON BLOK FA NO.37 031-7663816-|- 031-7663816 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1368 0897 KLINIK BENOWO PONDOK BENOWO INDAH, BLOK PP/22 031-70547492-|- - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1369 2315 NATIONAL HOSPITAL SURABAYA BOULEVARD FAMILI SEL KAV 1 GRAHA FAMILI, SURABAYA 031-2975777| 031-297799 Y Y ALL COVERAGE

1370 2639 LAB. PRODIA SURABAYA JL. DIPONEGORO NO.107 SURABAYA 60241 031-28953900| 031-5675476 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1371 2476 RS. ROYAL SURABAYA JL. RUNGKUT INDUSTRI I/ 1 SURABAYA 031-8476111| 031-8476211 Y Y ALL COVERAGE

1372 2272 APOTEK KIMIA FARMA 35 JL. NGAGEL JAYA SELATAN NO. 107 SURABAYA 60258 031 504 1276, 504 9098| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1373 2212 APOTEK FARMARIN SURABAYA JL. JEMUR ANDAYANI II/1 031-8418190| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1374 1690 RS. BEDAH SURABAYA JL. RAYA MANYAR NO 9 SURABAYA 031-5999369,5999339| 031-5995284 Y Y ALL COVERAGE

1375 1364 RS. ISLAM SURABAYA JEMURSARI JL. JEMURSARI NO.51-57 031 - 8471877/8471878/8471889| 031-8437784 Y Y ALL COVERAGE

1376 1362 RS. BHAKTI RAHAYU SURABAYA JL. KETINTANG MADYA I/16 031-8295922/8291799/8299217/23| 031-8293839 Y Y ALL COVERAGE

1377 1363 RS. BUNDA SURABAYA JL. RAYA KANDANGAN NO.23-24 BENOWO 031 - 7442220/7440077/7400694| 031 - 7442133 Y Y ALL COVERAGE

1378 1453 RS. ONKOLOGI ARAYA GALAXI BUMI PERMAI BLOK A2/7 JL. ARIEF RAHMAN HAKIM 182 031-5914855| 031-5914860 Y Y ALL COVERAGE

1379 1454RSIA. PUTRI ( RS. KHUSUS OBSTETRI &

GINEKOLOGI )JL. ARIF RAHMAN HAKIM, NO.122 031-5999987| 031-5997215 Y Y ALL COVERAGE

1380 1201 RS. ADI HUSADA KAPASARI JL. KAPASARI NO.97-101 031-3764555| 031-3764666 Y Y ALL COVERAGE

1381 0980 RS. ISLAM SURABAYA JL. JEND A YANI NO.2-4 031-8284505;8284506;8284507|- 031-8291805 Y Y ALL COVERAGE

1382 3831 APOTEK KIMIA FARMA 22 JL. BRATANG GEDE NO.100 A Surabaya 0315016713| 315016713 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1383 3832 APOTEK KIMIA FARMA 23 JL. KENDANGSARI BLOK J NO.7 0318414215| 318419345 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1384 3834 APOTEK KIMIA FARMA 25 JL. RAYA DARMO NO.2-4 0315677777| 315666454 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1385 3835 APOTEK KIMIA FARMA 26 JL. DIPONEGORO NO.94 0315677007| 315664420 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1386 3836 APOTEK KIMIA FARMA 45 JL. RAYA DARMO NO.94 0315676301| 315678819 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1387 3837 APOTEK KIMIA FARMA 52 JL. DUKUH KUPANG NO.54 0315671773| 315665755 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1388 3843 APOTEK KIMIA FARMA 166 JL. A.YANI 228 SURABAYA 0318291785| 318291785 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1389 3844 APOTEK KIMIA FARMA 175 JL. KARANG MENJANGAN NO.9 SURABAYA 0315991991| 315991991 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1390 3846 APOTEK KIMIA FARMA 243 JL. RAYA ARJUNO NO.151 SURABAYA 0315345031| 315459789 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1391 3165 LAB. PRODIA JEMURSARI JL. RAYA JEMURSARI NO.39, SURABAYA 031-8421010| 031-8438111 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1392 3848 APOTEK KIMIA FARMA 304 JL. PERAK TIMUR NO.166 SURABAYA 0313550007| 313550007 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1393 3850 APOTEK KIMIA FARMA 407 JL. MULYOSARI NO.288 SURABAYA 0315937994| 315937994 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1394 2785 RS. ORTHOPEDI DAN TRAUMATOLOGY JL. EMERALD MANSION TX 10 CITRALAND, SURABAYA (031) 57431299| (031) 57431255 Y Y ALL COVERAGE

Page 20 of 28

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1395 2786 RS. PURA RAHARJA JL.PUNCANG ADI 12-14 (031) 5019898/ 5022151/ 5024591| - Y Y ALL COVERAGE

1396 2217 RS. KENDANG SARI SURABAYA JL. RAYA KENDANGSARI NO.38 SURABAYA 031-8436200/8437200| 031-8494484 Y Y ALL COVERAGE

1397 3390 RSIA. LOMBOK DUA DUA ( JL. FLORES) JL. FLORES NO. 12 SURABAYA 031- 5022044| - Y Y ALL COVERAGE

TUBAN

1398 1198 RS. MEDIKA MULIA TUBAN JL. MOJOPAHIT, NO.699 TUBAN 0356-322744/324618| 0356-322666 Y Y ALL COVERAGE

1399 2002 RS. NAHDLATUL ULAMA TUBAN JL. LETDA SUCIPTO NO 211 TUBAN 0356-328244/(0356) 328299| (0356) 712072 Y Y ALL COVERAGE

TULUNG AGUNG

1400 3655 PRODIA TULUNGAGUNG JL. SUPRIADI NO.45 BLOK A.14, RUKO NIRWANA (0355) 336989| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1401 3826 RS. ERA MEDIKA JL. RAYA PULOSARI, NGUNUT, TULUNGAGUNG, JAWA TIMUR 0355-398706/396566/ 08155199111| 0355-398706 Y Y ALL COVERAGE

1402 0813 RS. ISLAM ORPEHA JL. KH. R. ABDUL FATAH 0355-323186| 0355-327691 Y Y ALL COVERAGE

1403 3708 APOTEK KIMIA FARMA 392 JL. I GUSTI NGURAH RAI NO. 10 TULUNGAGUNG 0355-322308| 0355-322308 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

KALIMANTAN BARAT

KETAPANG

1404 1800 RS. FATIMA KETAPANG JL. JEND SUDIRMAN NO. 27 KETAPANG 0534-32814| 0534-31649 Y Y ALL COVERAGE

MELAWI

1405 5633 RS. KASIH BUNDA JAYAJL. JUANG KM.1 NANGA PINOH, TANAH TINGGI RT.003/004 DESA TANJUNG

NIAGA0568-22885| Y Y ALL COVERAGE

1406 5627 RS. CITRA HUSADA MELAWIJL.DHARMA BAKTI NO.45C DUSUN TANAH TINGGI DESA TANJUNG NIAGA

KEC.NANGA PINOH KAB.MELAWI0568-22355| 0568-21645 Y Y ALL COVERAGE

PONTIANAK

1407 2729 RS. MITRA MEDIKA PONTIANAK JL. SULTAN ABDURRAHMAN NO.25, PONTIANAK, KALBAR (0561) 584888| - Y Y ALL COVERAGE

1408 2679 KIMIA FARMA SERDAM (SUNGAI RAYA DALAM) JL. SUNGAI RAYA DALAM RUKO B1 0561-737797| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1409 2253 KLINIK & APOTEK KF 32 PONTIANAK JL. TANJUNG PURA NO. 419 0561-731658| 0591-735802 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1410 2255 KIMIA FARMA 333 PONTIANAK JL. WAHID HASYIM NO.60 0561-768140| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1411 2254 APOTEK KIMIA FARMA 371 PONTIANAK JL. AHMAD YANI NO.5 0561-713988| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1412 1431 RSIA. ANUGERAH BUNDA KHATULISTIWA JL. AHMAD YANI NO. 5-7 0561-581818/085249922000| 0561-584100 Y Y ALL COVERAGE

1413 1106 RS. SANTO ANTONIUS JL. KH. WAHID HASYIM NO.249 0561-732101-|- 0561-742242/733623 Y Y ALL COVERAGE

1414 3574 PRODIA PONTIANAK JL. AHMAD YANI NO.6C PONTIANAK 0561-736177| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

SANGGAU

1415 4108 RS. SENTRA MEDIKA SANGGAU JL. CEMPAKA KEL. ILIR KOTA RT.013/RW.OO3, KEC. KAPUAS 78513 (0564) 24240| (0564) 24248 Y Y ALL COVERAGE

SINGKAWANG

1416 1368 RS. SANTO VINCENTIUS SINGKAWANG JL. P. DIPONEGORO NO.5 0562-631008/636768| 0562-633881 Y Y ALL COVERAGE

1417 2621 RSU. HARAPAN BERSAMA JL. N. P. BELITUNG NO. 61) SINGKAWANG 0562-631791| 0562-633359 Y Y ALL COVERAGE

KALIMANTAN SELATAN

BANJARBARU

1418 5424 CIPUTRA MITRA HOSPITAL JL. A. YANI KM. 7.8 BANJARMASIN, KALIMANTAN SELATAN 05116743999| - Y Y ALL COVERAGE

1419 2709 RSIA. LEMBAYUNG HUSADA JL. A. YANI KM 36 SIMPANG EMPAT (0511) 4777115| Y Y ALL COVERAGE

1420 5781 RS. SYIFA MEDIKA BANJARBARU JL. R.O ULIN NO. 93, BANJARBARU, KALIMANTAN SELATAN 70712 0511-5910889| Y Y ALL COVERAGE

1421 4393 KLINIK & APOTEK KF 111 JL. JEND. A.YANI NO.10 RT.10/001 0511-6749027 / 4772141| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

BANJARMASIN

1422 3572 PRODIA BANJARMASIN JL. JEND. ACHMAD YANI KM 3.5 NO. 131 - 133 BANJARMASIN 70235 0511-3273500| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1423 0631 RS. SARI MULIA JL. PANGERAN ANTASARI NO. 139B0511 - 3252570/3274447/3261491/0511-

266960|0511-2669600511 - 3257889 Y Y ALL COVERAGE

1424 0849 RS. ISLAM BANJARMASIN JL. LET JEN S PARMAN GG.PURNAMA NO.88 BANJARMASIN0511-3350332, 3354896, 3350335|0511-

3350332/350511-3351690 Y Y ALL COVERAGE

1425 1758 KLINIK SPESIALIS SARI MULIA JL. PANGERAN ANTASARI NO. 139 B 0511-3254341/3266960/3252570| 0511-3266960 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1426 2236 APOTEK KIMIA FARMA 217 JL.A.YANI KM 2 NO.136 0511-3252250/3251369| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1427 2237 KLINK & APOTEK KF 188 JL. LETJEN S. PARMAN NO. 42 0511-3354020| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1428 2235 KLINIK & APOTEK KF 61 JL. VETERAN NO. 51 0511-3250682/3252779| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1429 2677 KLINIK & APOTEK KF 265 JL. A.YANI 49, KUALA KAPUAS 0513-21406| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

BATU LICIN

1430 2471 KLINIK MEDIKA BATULICIN JL.RAYA BATULICIN - SERONGGO KM.1 SEI KECIL, TANAH BUMBU 0518-71570| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

KANDANGAN

1431 1799 RS. PAHLAWAN MEDIKA CENTER JL. PAHLAWAN NO. 15 KANDANGAN KAB. HULU SUNGAI SELATAN 0517-23191| 0517-23678 Y Y ALL COVERAGE

MARTAPURA

1432 4392 KLINIK & APOTEK KF 179 JL. JEND. A YANI KM.39.5 NO.47 0511-4722654| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1433 1797 RSIA. MUTIARA BUNDA MARTAPURA JL. TAISIR NO. 2, MARTAPURA O511- 4721901| 0511- 4720664 Y Y ALL COVERAGE

1434 2721 RS. PELITA INSANI JL. SEKUMPUL NO.66 MARTAPURA 70614, KALIMANTAN SELATAN (0511) 4722210/ 4722220| (0511) 4722230 Y Y ALL COVERAGE

TABALONG

1435 2707 RS. PERTAMINA TANJUNGJL. GAS, KOMPERTA MURUNG PUDAK TANJUNG, KALIMANTAN SELATAN

71571(0526) 2022550/2023068| (0526) 2027678 Y Y ALL COVERAGE

TANAH BUMBU

1436 3996 KLINIK SIMPANG TANAH BUMBUJL. GAWE SABUMI RT 08 NO. 083, DESA BERSU. JUD,KEC. SIMPANG

EMPAT, KAB. TANAH BUMBU, KALIMANTAN SELATAN 72200(081258339911 / 081953230699)| - N Y


RB,PHAR

1437 1011 KLINIK SURYA MEDIKA SATUI (SMS) JL. PROPINSI NO 11, RT 17 SUNGAI DANAU SATUI 0512-61717|0778-322122 0512-61312 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

KALIMANTAN TENGAH

MUARA TEWEH

1438 2675 KLINIK & APOTEK KF 156 JL. Y.SINSENG NO.1 M.TEWEH, KALTENG 0519-21698| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

PALANGKARAYA

1439 2673 KLINIK & APOTEK KF 112 (BM PALANGKARAYA) JL. DIPONEGORO NO.8, PAHANDUT 0536 -3221952| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1440 3764 PRODIA PALANGKARAYA JL. DIPONEGORO NO. 20 A-B, PALANGKARAYA (0536) 3235399| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1441 2889RS. ISLAM PKU MUHAMMADIYAH

PALANGKARAYAJL. RTA MILONO KM .2,5 MENTENG, JEKAN RAYA 0536-3244801-4803| 0536-3239444 Y Y ALL COVERAGE

PANGKALAN BUN

1442 3529 KLINIK KESUMA JL. ISKANDAR NO.12 A, PANGKALAN BUN 0532-2065244 / (0532) 23935| (0532) 23935 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1443 4676 RS. CITRA HUSADA PANGKALAN BUNJL. MALIJO, MADUREJO, ARUT SELATN, KOTAWARINGIN BARAT,

KALIMANTAN TENGAH(0532) 2070777| (0523) 2070789 Y Y ALL COVERAGE

SAMPIT

1444 4085 KLINIK SARI MEDIKA SAMPIT JL. P.ANATASARI NO 5 SAMPIT 0531-25288; 0531-24396| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1445 2672 KLINIK & APOTEK KF 103 JL. H.M ARS. YAD, NO.120, SAMPIT 0531-24828| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

KALIMANTAN TIMUR

BALIKPAPAN

1446 1520 APOTEK KIMIA FARMA 56 JL. A.YANI, NO.95 0542-412244, 424187,7031852| 0542-731560 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1447 3459 SUMATERA EYE CENTRE BALIKPAPAN RUKO SENTRA EROPA BLOK AA 2B NO.16 BALIKPAPAN BARU (0542) 876732/876941| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1448 0686 PANACEA CLINIC KOMP MAL FANTASI BLOK AB2 NO.18-20 BALIKPAPAN BARU 761140542-877898,72040460751-

444712/5|0751-444712/50542-877641/7031819 N Y


RB,PHAR

1449 0692 APOTIK KANIDA FARMA II JL. JEND. SUDIRMAN, NO. 239 0542-424309,0542 420496|0542-420496 0542-424031 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

Page 21 of 28

NOV-08-2017



1450 1457 KLINIK & APOTEK KF 136 BALIKPAPAN JL. MT. HARYONO NO. 72 0542-763962| 0542-761629 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1451 0672 RSIA. PERMATA HATI BALIKPAPAN JL. IMAM BONJOL NO.1 0542-413932/413928| 0542 - 413928 Y Y ALL COVERAGE

1452 2073 KLINIK MEDIKA UTAMA ( KMU SETIARA )JL. MULAWARMAN NO. 24 RT 7 MANGGAR BARU BALIKPAPAN,

KALIMANTAN TIMUR0542-770846| 0542-770847 N Y


RB,PHAR

1453 2632 KLINIK & APOTEK KF 293 JL. A. YANI NO.45 KARANG JATI 0542 792420| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1454 2633 KLINIK & APOTEK KF 68 JL. JEND.SUDIRMAN NO.2-3 PERTOKOAN KLANDASAN 0542 422691| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1455 2635 KLINIK & APOTEK KF 329 JL. SOEKARNO HATTA KM 5 / 86, BPN 0542 860024| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1456 1213 RS. BALIKPAPAN BARU KOMP. BALIKPAPAN BARU JL. MT.HARYONO BLOK. A-A3 0542-877330| 0542-877331 Y Y ALL COVERAGE

1457 1374SILOAM HOSPITALS BALIKPAPAN (RS

BALIKPAPAN HUSADA)JL. MT.HARYONO NO.9 RINGROAD 0542 - 8862 999| 0542-7206517 Y Y ALL COVERAGE

1458 2634 KLINIK & APOTEK KF 425 SEPINGGAN JL. MARS. MA ISWAHYUDI NO. 702 0542 7210391| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1459 5912 RS. HERMINA BALIKPAPAN JL. MT.HARYONO NO.45, SEPINGGAN BARU, BALIKPAPAN SELATAN 0542 - 8532525| 0542 - 8508989 Y Y ALL COVERAGE

1460 0633 RS. PERTAMINA BALIKPAPAN JL. JEND SUDIRMAN NO.1 0542-7517485/734020/21| 0542-7517493 Y Y ALL COVERAGE

1461 3573 PRODIA BALIKPAPANKOMP. PERTOKOAN BANDAR KLANDASAN BLOK D-11, JL. JEND.

SUDIRMAN, BALIKPAPAN 761130542-739337| - N Y


RB,PHAR

1462 0632 RS. RESTU IBU BALIKPAPAN JL. JEND. A. YANI, NO.120542-427342/3/40542-427342|0542-

4273420542-441494/417290 Y Y ALL COVERAGE

BATU KAJANG

1463 1767 KUSUMA MEDICAL CENTER BATUKAJANG JL. NEGARA KM.141 RT 09C PASER 0543-5230262| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

BONTANG

1464 3189 RSI. BONTANG ( YABIS ) JL. BRIGJEN KATAMSO NO. 40 BONTANG 0548 - 20003| 0548-22644 Y Y ALL COVERAGE

1465 2118 RS. AMALIA BONTANG JL. R. SOEPRAPTO NO. 22 BONTANG BARU, KOTA BONTANG KALTIM 0548-25050| 0548-23275 Y Y ALL COVERAGE

1466 1214 RS. PUPUK KALTIM BONTANG JL. OKSIGEN NO.1, KOMP.PUPUK KALTIM 0548-41118/41444| 0548-41555 Y Y ALL COVERAGE

1467 3874 KLINIK SATELIT 3 RS. PKT BONTANG JL. LETJEN S PARMAN NO. 5 BONTANG 0548-23388| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1468 2474 KLINIK RS. PKT 1 JL. IMAM BONJOL BONTANG-KALTIM 0548-24800| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

KUTAI KARTANEGARA

1469 3707 KLINIK QICAJL. RA. KARTINI RT. 21, DESA GAS ALAM MUARA BADAK, KUTAI

KARTANEGARA082227276911| - N Y


RB,PHAR

1470 1074 KLINIK MAJU SEJAHTERA JL. MOH. HATTA, HANDIL 3, MUARA JAWA 0541-691891/ 081333001836-|- 0541-691892 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

PASER

1471 5520 KLINIK ATHIRAHJL. NEGARA KM. 140 NO. 09 RT. 009 KEC BATU SOPANG KAB PASER

KALTIM081257436633 / 081255578967| - N Y


RB,PHAR

SAMARINDA

1472 1794 RSIA. THAHA BAKRIE JL. PANGERAN HIDAYATULLAH NO 11 SAMARINDA 0541-742191| 0541-200075 Y Y ALL COVERAGE

1473 1656 KLINIK MELATI HUSADAJL. CIPTO MANGUN KUSUMO RT 12 NO 52 KEL SENGKOTEK LOA JUAN

SAMARINDA0541-260721| 0541-241752 N Y


RB,PHAR

1474 2104 KLINIK & APOTEK KF 105 JL. DR. SUTOMO NO 36-37 SAMARINDA 0541-741639| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1475 2105 KLINIK & APOTEK KF 138 KARTIKA JL. KH AGUS SALIM NO. 30 SAMARINDA 75121 0541-737447| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1476 2453 RS. SAMARINDA MEDIKA CITRA JL. KADRIE OENING NO.81 RT.35 SAMARINDA 75124 (0541) 7273000| (0541) 7272888 Y Y ALL COVERAGE

1477 0230 RS. H. DARJAD JL. DAHLIA, NO.4 0541-732698,734123,732609| 0541-732562 Y Y ALL COVERAGE

1478 3813 KLINIK & APOTEK KF 385 (PPO) JL. P.M.I NO.25 SAMARINDA 0541-734334| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1479 4795 KLINIK SILOAM SAMARINDAJL. A. YANI (PEMUDA II) NO.3, RT. 10 - KEL. TEMINDUNG PERMAI KEC.

SUNGAI PINANG, SAMARINDA(0541) 2090 900| - N Y


RB,PHAR

1480 3575 PRODIA SAMARINDA JL. A. YANI KOMP. CENDRAWASIH TRADE CENTER BLOK A-6, SAMARINDA (0541) 736198| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1481 3460 SUMATERA EYE CENTRE SAMARINDA JL. A. YANI NO. 6 A-B SAMARINDA (0541) 200257, 200258| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1482 0636 RS. DIRGAHAYU JL. GN. MERB. ABU, NO. 620541-742161/748309/7483100541-

748309/10/11|0541-748309/10/110541-748308/744636 Y Y ALL COVERAGE

1483 2631 KLINIK & APOTEK KF 114 SAMARINDA JL. P.HIDAYATULLAH NO.63, SAMARINDA 0541 742198| 0541 742198 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1484 5666 KLINIK KUMALA JL. P. ANTASARI NO. 33 B RT. 02 SAMARINDA 75124 (0541) 735602/ 769357| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1485 2473 RS. SIAGA RAMANIA JL. RAMANIA 3 ( JL. JEND. SOEPARTO) SAMARINDA, KALTIM 0541-739772| 0541-749131 Y Y ALL COVERAGE

SANGATTA

1486 1376RS. PKT PRIMA SANGATTA (RS. PUPUK KALTIM

)JL. YOS SUDARSO I NO.1 SANGATTA 0549-24555 / 085828779475| 0549-24524; 25927 Y Y ALL COVERAGE

1487 1801 RS. SOHC JL. YOS SUDARSO IV, NO. 1, TELUK LINGGA 0549-23417| 0549-23417 Y Y ALL COVERAGE

1488 1556 RS. MELOY SANGATTA JL. YOS SUDARSO II NO.101 0549-2026258| 0549-24222 Y Y H&S,MAT

KALIMANTAN UTARA

BULUNGAN

1489 4681 KLINIK BUNYU MEDIKA JL. EMPLASMEN RT. 07 DESA BUNYU TIMUR, KAB. BULUNGAN (0511) 2055374| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

TARAKAN

1490 4731 RSUD. TARAKAN (KALIMANTAN UTARA) Jl. PULAU IRIAN NO.1, KAMPUNG SKIP (0551) 21720/21166| (0551) 21720 Y Y ALL COVERAGE

1491 1972 RUMKITAL ILYAS TARAKAN JL. MARTADINATA NO 29 0551-24320 / 21353| - Y Y ALL COVERAGE

1492 1529 RS. PERTAMINA TARAKAN JL. MULAWARMAN NO. 14, TARAKAN 0551-31403/31665| 0551-33310 Y Y ALL COVERAGE

LAMPUNG

BANDAR LAMPUNG

1493 5605 RSIA BELLEZA KEDATON JL.SULTAN HAJI LABUHAN RATU 0721-773333| 0721-773338 Y Y ALL COVERAGE

1494 1092 RS. MITRA HUSADA PRINGSEWU JL. JEND A. YANI NO.14 PRINGSEWU, LAMPUNG 0729-23792-|- 0729-23836 Y Y ALL COVERAGE

1495 1228 RS. BUMI WARAS JL. WOLTER MONGINSIDI, NO.235 0721-254589/261122/257925/267855| 0721-257926 Y Y ALL COVERAGE

1496 1692 RS. HARAPAN BUNDA LAMPUNG JL. RAYA LINTAS SUMATERA NO.30 SEPUTIH JAYA LAMPUNG TENGAH 0725-26766| 0725-25091 Y Y ALL COVERAGE

1497 1693 RSIA. MUTIARA PUTRI JL. HOS COKROAMINOTO NO 76 ENGGAL LAMPUNG 0721-252579/254999| 0721-254282 Y Y ALL COVERAGE

1498 0486 RS. IMMANUEL WAY HALIM JL. SOEKARNO-HATTA, WAY HALIM 0721-704900,704630/628| 0721-704807/784897 Y Y ALL COVERAGE

1499 1970 RSIA. BUNDA ASY-SYIFA JL. DR.SUSILO NO. 54 PAHOMAN TELUK BETUNG UTARA BANDAR LAMPUNG 0721-259259/256256| 0721-266800 Y Y ALL COVERAGE

1500 1871 RS. PERTAMINA BINTANG AMIN JL. PRAMUKA NO 27, LAMPUNG 0721-273601| 0721-273597 Y Y ALL COVERAGE

1501 1378 RS. URIP SUMOHARJO JL. URIP SUMOHARJO NO.200 SUKARAME 0721-771322/23/24| 0721-771321/707990 Y Y ALL COVERAGE

1502 0487 RS. ADVENT LAMPUNG JL. TEUKU UMAR, NO.48 KEDATON BANDAR LAMPUNG 0721-703459| 0721-786349/770717 Y Y ALL COVERAGE

1503 5124 LAB. PRODIA TELUK BETUNG Jl. Ikan Hiu Teluk Betung 085768958661| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1504 2110 KLINIK & APOTEK KF 131 BANDAR LAMPUNG JL. KARTINI NO. 44-45 BANDAR LAMPUNG 0721240291| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1505 2112 KLINIK & APOTEK KF 327 BANDAR LAMPUNG JL. JEND. SUDIRMAN NO. 88 BANDAR LAMPUNG 0721- 5600608| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1506 2176 RSIA. RESTU BUNDAJL. K.H. HASYIM ASHARI NO. 73, TELUK BETUNG SELATAN - BANDAR

LAMPUNG0721-484158/484185| 0721-482832 Y Y ALL COVERAGE

1507 2465 RSIA. PURI BETIK HATI JL. PAJAJARAN NO.109, JAGABAYA, BANDAR LAMPUNG, LAMPUNG 0721-787799| - Y Y ALL COVERAGE

1508 2767 RS. ISLAM ASY-SYIFAAJL. NEGARA LINTAS SUMATERA KM.65 YUKUM JAYA - BANDAR JAYA, KEC.

TERB. ANGGI BESAR, LAMPUNG TENGAH 34162(0725) 25264| (0752) 527476 Y Y ALL COVERAGE

Page 22 of 28

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1509 2725 THC TELKOM MEDIKA LAMPUNG EX. GEDUNG PLASA TELKOM JL. SULTAN AGUNG NO. 1 BANDAR LAMPUNG 0721703044/ 704999| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1510 1352 RS. GRAHA HUSADA LAMPUNG JL. GAJAH MADA, NO. 6 GH, TANJUNG AGUNG, BANDAR LAMPUNG 0721-240000| 0721-263181/268417 Y Y ALL COVERAGE

1511 4394 KLINIK & APOTEK KF 222 JL. GAJAH MADA NO.58B BANDAR LAMPUNG 0721 5601300| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1512 2901 LAB. PRODIA PAHOMAN LAMPUNG JL. JEND. SUDIRMAN NO. 120 PAHOMAN LAMPUNG 0721-8017700/1| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

LAMPUNG SELATAN

1513 3170 KLINIK DUA PUTRI JAYAJL. IR. SUTAMI KM.30 DESA MALANG SARI, TANJUNG SARI-LAMPUNNG

SELATAN085366797190| - N Y


RB,PHAR

1514 4523 KLINIK LEMATANG MEDICAL CENTERJL. IR. SUTAMI NO. 153, DESA LEMATANG, KEC. TANJUNG BINTANG, KAB.

LAMPUNG SELATAN 35361(0721) 350145; 0823 0607 2345| - N Y


RB,PHAR

METRO

1515 4516 PRODIA METRO JL. JEND SUDIRMAN NO. 37 LAMPUNG 0725-7855205| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

NATAR

1516 1632 RS. NATAR MEDIKA (YADIKA GROUP) JL. RAYA NATAR NO. 04 MUARA PUTIH, KEC NATAR LAMPUNG SELATAN 0721-92521/92519| 0721-92519 Y Y ALL COVERAGE

TANJUNG HARAPAN

1517 2921 RSU. HANDAYANIJL. N. SOEKARNO - HATTA NO : 94, TANJUNG HARAPAN, KOTABUMI,

LAMPUNG UTARA0724328399| Y Y ALL COVERAGE

MALUKU

AMBON

1518 2265 APOTEK KIMIA FARMA PEL.26 AMBON,MALUKUJL. DR. KAYADOE, KEL. KUDAMATI, AMBON-MALUKU(DI DALAM RS.

HALAUSSY)0911-351677| - N Y


RB,PHAR

1519 2911 RS. T TK.II DR.J.A. LATUMETEN JL. DR. TAMAELA N0. 2 AMBON 0911-353555| 0911-354763 Y Y ALL COVERAGE

1520 1439 RS. BHAKTI RAHAYU AMBON JL. BATU KERB. AU, BELAKANG RRI 0911-342746| - Y Y ALL COVERAGE

1521 2912 RS. SUMBER HIDUP JL. ANTHONY RHEBOK, HONIPOPU, SIRIMAU, AMBON, MALUKU (0911) 352373, 351654| 0911-352401 Y N H&S,MAT

1522 2264 LAB. PRODIA AMBON JL. ANTHONY RHEBOK NO: 1 B-C 0911-314296| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

MALUKU UTARA

TERNATE

1523 2259 LAB. KLINIK PRODIA TERNATE JL. A. MONONUTU NO:21 TERNATE, MALUKU UTARA 0921-3111246| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1524 2260 KLINIK & APOTEK KF 168 TAKOMA TERNATE JL. HASAN ESA 151 TERNATE, MALUKU UTARA 0921-3121037/3123076| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1525 2012 RS. ISLAM TERNATE JL. PEMUDA NO. 131 KEL.TOBELEU 0921-3121623| - Y N ALL COVERAGE

1526 1503 RS. MEDIKA HARIFALM JL. ZAINAL ABIDINSYAH, NO.25, KOMPLEX POHON PALA 0921-3126087| 0921-3126198 Y N H&S,MAT

NAD

BANDA ACEH

1527 4836 RS. PERTAMEDIKA UMMI ROSNATIJL. SEKOLAH MO. 5 GAMPONG ATEUK PAHLAAWN KEC. BAITURRAHMAN

KOTA BANDA ACEH(0651) 35092| - Y Y ALL COVERAGE

1528 2962 KLINIK PRODIA BANDA ACEH JL. T.H.M. DAUD BEUREUH NO. 45 B-C, BANDA ACEH 23126 (0651) 23823, 637807| (0651) 22387 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1529 1790 RS. CEMPAKA AZ ZAHRA JL. POCUT BAREN NO 36-38-40 BANDA ACEH 0651-31066| 0651-25281 Y N ALL COVERAGE

1530 2187 APOTEK KIMIA FARMA 402 LAMPRIET JL. TEUKU DAUD BEUREUEH NO. 167-171 0651-637008| 0651-635 669 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1531 2186 APOTEK KIMIA FARMA ACEH (37) JL. DIPONOGORO NO 8 0651-21559| 0651-635 669 N Y GP,SP,OP,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-RB,PHAR

1532 4816 RS. MEUTIA JL. CUT MEUTIA NO. 55 KP. BARU, BANDA ACEH (0651) 33149| Y Y ALL COVERAGE

1533 1789 KLINIK SPECIALIS CEMPAKA LIMA JL. TENGKU M. DAUD BEUREUEH NO 156 0651-33345 / 08126922264| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1534 1100 RS. TEUNGKU FAKINAH JL. JEND. SUDIRMAN NO.27-29 0651-41454 / 081377028888-|- 0651-47646/49454 Y N H&S,MAT

BIREUN

1535 6082 RSU. JEUMPA HOSPITALJL. BANDA ACEH-MEDAN KM. 220 NO. 102 DUSUN TERATAI GAMPONG

GEULANGGANG BARO, KEC. KOTA JUANG, KAB. BIREUEN, ACEH(0644) 324150| - Y Y ALL COVERAGE

1536 1694 RS. TELAGA BUNDA BIERUN JL. PEUTUA BANTA NO.7, GP BIREUN 0644-324433| 0644-324433 Y Y ALL COVERAGE

LANGSA

1537 2667 KLINIK & APOTEK KF 81 JL. TM.ZEIN NO.1E ,LANGSA,ACEHTIMUR 0641-21020| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1538 2711 RS. CUT MEUTIA JL. GARUDA NO. 1 KEL. KEBON BARU (0641) 425314 / 4811339| (0641) 426285 Y Y ALL COVERAGE

LHOKSEUMAWE

1539 1892 RSU. SAKINAH LHOKSEUMAWE JL. ANTARA NO.30 0645-45534/42158| - Y N H&S,MAT

1540 2903 LAB. PRODIA LHOKSEUMAWE JL. MERDEKA NO. 18 LHOKSEUMAWE ( DEPAN TELKOM ) 0645-47205| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1541 1975 KLINIK VINCA ROSEAJL. DARUSSALAM NO. 36 KP JAWA BARU, KOTA LHOKSEUMAWE - ACEH

UTARA0645-7011117 / 46725/ 085338437373| 0645-630218 N Y


RB,PHAR

1542 2119 KLINIK & APOTEK KF 60 JL. MERDEKA NO. 47 B -C LHOKSEUMAWE BANDA ACEH 0645-41152| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

MEULABOH

1543 4212 KLINIK CEMPAKA LIMA MEULABOH JL. SWADAYA NO 39 F/39 G MEULABOH082361103699/08116822077/081269802

42|N Y


RB,PHAR

1544 3686 RS. SWASTA MONTELLA JL. BERINGIN JAYA SAMPING MESJID AGUNG, MEULABOH, ACEH BARAT (0655) 7551974; 085277358711| - Y Y ALL COVERAGE

PIDIE

1545 4106 KLINIK MUTIARA SIGLI JL. PROF A. MADJID IBRAHIM NO. 10, SIGLI, PIDIE, ACEH 24151 0653-21529| 0653-24565 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

SIGLI

1546 3958 KLINIK & APOTEK KF 397 SIGLI JL. PERDAGANGAN NO.1 SIGLI - ACEH 065321536 / 085265313030| 65321536 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

NTB

BIMA

1547 3506 KIMIA FARMA NO. 263 BIMA JL. SOEKARNO - HATTA NO. 3 BIMA 0374-42910| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1548 3453 LAB. PRODIA BIMA JL. SOEKARNO HATTA NO. 39 D BIMA 0374-646910| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

LOMBOK TIMUR

1549 1894 RS. ISLAM NAMIRA SELONG JL. KH AHMAD DAHLAN NO 7. KEC SELONG KOTA SELONG 0376-22693/21004/| - Y Y ALL COVERAGE

1550 3503 KIMIA FARMA NO. 55 SELONG JL. M. YAMIN NO. 77 SELONG - LOMBOK TIMUR -| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1551 1783 RS. RISA SENTRA MEDIKA LOTIM JL. PEJANGGIK NO.78 A RAKAM, SELONG 0376-23888| 0376-23999 Y Y ALL COVERAGE

MATARAM

1552 3452 LAB. PRODIA MATARAM JL. PEJANGGIK NO. 107 MATARAM 0370-635248; 635010| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1553 3504KIMIA FARMA NO. 231 MATARAM (Group KF

189)JL. SALEH SUNGKAR NO. 33 AMPENAN -| - N Y


RB,PHAR

1554 3507KIMIA FARMA 458 CATUR WARGA (Group KF

189)JL. CATUR WARGA NO. 17 MATARAM -| - N Y


RB,PHAR

1555 3505KIMIA FARMA NO. 234 MATARAM (Group KF

189)JL. SELAPARANG NO. 53 MATARAM -| - N Y


RB,PHAR

1556 4358 RS. GRHA ULTIMA MEDIKA (Group Siloam) JL. MAJAPAHIT NO. 10, MATARAM (0370) 623999; 628111| +62370 - 635955 Y Y ALL COVERAGE

1557 1957 RSIA. PERMATA HATI MATARAM JL. MAJAPAHIT NO 10 0370-631999| 0370-632999 Y Y ALL COVERAGE

1558 1956 RSI. SITI HAJAR MATARAM JL. CATUR WARGA NO. 6 MATARAM 0370-623498| - Y Y ALL COVERAGE

1559 2258 KLINIK & APOTEK KF NO. 189 JL. SRIWIJAYA NO. 295 MATARAM 0370-633211| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1560 1645 RS. HARAPAN KELUARGA MATARAMJL. AHMAD YANI NO. 9 SELAGALAS, SANDUBAYA, MATARAM - LOMBOK

(NTB)0370-670000,6177027,6177000| 0370-673666 Y Y ALL COVERAGE

1561 4688 KLINIK PRATAMA ASY-SYIFA JL. PANJI TILAR NEGARA NO. 136 MATARAM -| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1562 1124 RSB. EXONERO JL. PEMUDA NO.16, DASAN AGUNG 0370-636454,644440| 0370-647023/636454 Y Y ALL COVERAGE

1563 1539 RS. RISA SENTRA MEDIKA JL. PEJANGGIK, NO.115, CAKRANEGARA0370-632117/0370) 632117 / 0878 651

29354 / 089 7090 1005/06/56/0370-0370-625559 Y Y ALL COVERAGE

1564 1827 RS. BIOMEDIKA JL. BUNG KARNO NO 143 MATARAM 0370-645137| 0370-645138 Y Y ALL COVERAGE

Page 23 of 28

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SUMBAWA

1565 3482 KIMIA FARMA NO. 303 SUMBAWA JL. CENDRAWASIH SUMBAWA BESAR 0371 - 24029| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

NTT

ENDE

1566 3500 APOTEK KF KELIMUTU ENDE JALAN KELIMUTU ENDE (0381)-2627456| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

KUPANG

1567 2972 RS. KARTINI KUPANG JL. FRANS SEDA NO.17,KELURAHAN TUAK DAUN MERAH, KUPANG-85228 0380-80265111/0380 - 831 270| (0380) 831270 Y Y ALL COVERAGE

1568 4099 RSIA. LEONA JL. SOEVARDI NO. 20 OEBUFU, KUPANG 0380-840212 - 0811 3818 622| 0380-840212 Y Y ALL COVERAGE

1569 3464 RS. WIRASAKTI JL. MOH. HATTA KUPANG (0380)-821131 / 0380-824735| - Y Y ALL COVERAGE

1570 2240 RS. ST CAROLUS BORROMEUS JL. HR. KOROH KM. 08 BELLO KUPANG 0380 - 8030530, 085100030530| - Y Y ALL COVERAGE

1571 3494 LAB. PRODIA KUPANG JL. CAKDOKO NO. 52 KUPANG (0380)-824566, 821010, 8080020| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1572 3975 SILOAM HOSPITALS KUPANG JL. RW MONGINSIDI RT. 014 RW. 004 FATUTULI 0380-8530900/8530911| 0380-8530933 Y Y ALL COVERAGE

1573 2666 KLINIK & APOTEK KF LALAMENTIK JL. WJ.LALAMENTIK,95 D-E, KUPANG 0380-840362| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1574 1380 KLINIK & APOTIK KARTINI JL. ELTARI I NO.2 0380-833010| 0380-820660 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1575 1647 RSIA. DEDARI JL. RANTAI DAMAI 69 D TDM OEBUFU KUPANG-NTT 0380-8553914/826774| 0380-830041/8553914 Y Y ALL COVERAGE

1576 2242 KLINIK & APOTEK KF 135 KUPANG Jl. M.Hatta 46 Kupang 0380- 830944/820541/831296| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1577 2245 KLINIK & APOTEK KF 101 KUPANG JL. HEREWILA NO. 38 KUPANG 0380- 827270| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

LABUHAN BAJO

1578 4762 SILOAM HOSPITALS LABUAN BAJOJL. GABRIEL GAMPUR RT.013. RW.005, DUSUN V, KEC. KOMODO, KAB.

MANGGARAI BARAT, LABUHAN BAJO(0385) 238 1900 EXT. 22001| (0385) 238 1911 EXT. Y Y ALL COVERAGE

SIKKA

1579 3616 LAB. KLINIK PRODIA MAUMERE JL. EL TARI, KEL. MADAWAT, KEC. ALOK, MAUMERE FLORES (0382) 21146| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

PAPUA

JAYAPURA

1580 4203 LAB. KLINIK CITO JL. ARGAPURA NO. 11 E, JAYAPURA 0967-522080 / 085244202002| 0967-522082 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1581 1469 RS. DIAN HARAPAN JL. TARUNA BHAKTI KEL YABANSAI DISTRIK HERANG - JAYAPURA0967-573479/ 572325; 0852 4400

4655;0813 44100 432|0967-573362/573979 Y Y ALL COVERAGE

1582 2188 KLINIK & APOTEK KF 172 JAYAPURA JL. AHMAD YANI NO. 67,JAYAPURA 0967-534921/533 322| 0967-534921 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

MERAUKE

1583 4213 LAB. KLINIK CITO MERAUKE JL. RAYA MANDALA 293, MERAUKE PAPUA 0971-325367| 0971-325368 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

TIMIKA

1584 2732 KLINIK PURI HUSADA JL. BUDI UTOMO UJUNG, TIMIKA PAPUA (0901) 3126661/081240760444| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1585 2716 RS. KASIH HERLINA TIMIKA JL. A.YANI NO. 37 (0901) 321433/321443 / 082398124027| (0901) 324310 Y Y ALL COVERAGE

PAPUA BARAT

MANOKWARI

1586 4181RS. ANGKATAN LAUT DR AZHAR ZAHIR

MANOKWARIJL. SERMA SUWANDI NO. 1 0986-211758; 0822-38980-504| - Y Y ALL COVERAGE

SORONG

1587 6454 RS. KASIH HERLINA SORONG JL. SELAT MAKASAR NO.7 REMU, SORONG 0951-321424| - Y Y ALL COVERAGE

1588 1475 RS. PERTAMINA SORONG JL. AHMAD YANI NO. 13 0951-321362, 321581| 0951-326110 Y Y ALL COVERAGE

RIAU

DUMAI

1589 2766 KLINIK IGA DUMAI JL. SUTAN SYARIF KASIM NO.221, DUMAI - RIAU 0765-4397481/ 085264881796| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1590 1621 KLINIK RAWAT INAP & BERSALIN PADU SERASI JL. JEND. SUDIRMAN NO. 188 DUMAI, RIAU 0765-438189 / 438289| 0765-438008 Y Y ALL COVERAGE

1591 4169 KLINIK CITRA MEDIKA JL. M. YAMIN SH NO. 58, DUMAI (0765) 38508; 4300044| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

DURI

1592 0624 RSIA. MUTIA SARI JL. BATHIN BETUAH, NO.1-A, SIMPANG PADANG 0765-93635/92080| 0765-597972/55979 Y Y ALL COVERAGE

1593 0922 KLINIK THURSINA JL. JEND SUDIRMAN NO.65 SIMPANG PADANG 0765-595573|0765-595573 0765-595573 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1594 0921 RS. PERMATA HATI DURI JL. JEND SUDIRMAN NO.37 SIMPANG PADANG0765-94902/95799, GIGI913670765-0765-

596899|0765-0765-5968990765-595799 Y Y ALL COVERAGE

1595 0930 RSU. THURSINA JL. HANGTUAH NO.93 0765-597782 / 595573|0765-595573 0765-597773 Y Y ALL COVERAGE

1596 4121 LAB. PRODIA DURI JL. HANG TUAH 105 D, DURI 0765-93008| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

PANGKALAN KERINCI

1597 1369 RS. EFARINA PANGKALAN KERINCI JL. LINTAS TIMUR NO 1, PANGKALAN KERINCI, KAB PELALAWAN 0761-494500/493980| 0761- 493981 Y Y ALL COVERAGE

PEKANBARU

1598 4853 RS. PRIMA PEKANBARUJL. BIMA NO. 1 NANGKA UJUNG, KEL. DELIMA KEC. TAMPAN, PEKANBARU,

RIAU(0761) 8419007| (0761) 8419006 Y Y ALL COVERAGE

1599 4689 PRODIA PEKANBARU(PHC) JL. JENDRAL SUDIRMAN NO. 203 L-M PEKANBARU (0761) 8403383, 856739| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1600 4511 RS. A. YANI PEKANBARU JL. JEND. A. YANI NO. 73, PEKANBARU (0761) 856370| - Y Y ALL COVERAGE

1601 4739 AULIA HOSPITAL PEKANBARU JL. HR.SUBRANTAS No. 63, PANAM 0761-6700 000| (0761) 854815 Y Y ALL COVERAGE

1602 2926 RSIA. ANDINI JL. TUANKU TAMBUSAI NO.55, PEKANBARU (0761) 33612 / 33850| (0761) 33649 Y Y ALL COVERAGE

1603 0625 RS. SANTA MARIA PEKANBARU JL. A. YANI, NO.68 0761-28800,20235,20166,22213| 0761-26071 Y Y ALL COVERAGE

1604 0664 RS. ISLAM IBNU SINA PEKANBARU JL. MELATI, NO.60 0761-24242/26011| 0761-35698 Y Y ALL COVERAGE

1605 0841 RSIA. ZAINAB JL. RONGGOWARSITO I NO.1 0761-24000| 0761-859448 Y Y ALL COVERAGE

1606 5205 RS. MATA PEKANBARU EYE CENTERJL. SOEKARNO HATTA NO.236 KEL.SIDOMULYO TIMUR, KEC MARPOYAN

DAMAI07617875191-92| 0761-7875195 Y Y ALL COVERAGE

1607 3568 PRODIA PEKANBARU JL. CEMPAKA NO. 80 B-C, PEKANBARU, RIAU 28156 0761-45542| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1608 0920 RS. AWAL BROS PEKANBARU JL. JEND. SUDIRMAN NO.117 0761-47333-|- 0761-47222 Y Y ALL COVERAGE

1609 2837KLINIK MATA SUMATERA EYE CENTER

PEKANBARUJL. ARIFIN AHMAD NO. 58 PEKANBARU 0761-565686| 0761-565786 N Y


RB,PHAR

1610 0663 RSIA. ERIA BUNDA JL. KH. AHMAD DAHLAN, NO.163 0761-23100/23600| 0761-47235 Y Y ALL COVERAGE

1611 2101 APOTEK KIMIA FARMA 229 JL. SUDIRMAN 724 0761 29186| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1612 2102 APOTEK KIMIA FARMA 93 JL. JEND. SUDIRMAN NO 175 0761-32796| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1613 1596 RS. KHUSUS BEDAH & KEBIDANAN SYAFIRA JL. JEND.SUDIRMAN NO.134 PEKANBARU 0761-856517,35360| 0761-41887 Y Y ALL COVERAGE

1614 2409 RSIA. BUDHI MULIA JL.SOEKARNO HATTA NO.226-228 ARENGKA, PEKANBARU 0761-3069900/8417200| 0761-8417255 Y Y ALL COVERAGE

1615 2590 RSB. ANNISA TANGKERANGJL. GARUDA NO. 66 TASKURUN UNJUNG TANGKERANG TENGAH,

PEKANBARU(0761) 848 652| (0761) 848 652 Y Y ALL COVERAGE

1616 2468 RS. AWAL BROS PANAMJL. HR. SOEBRANTAS RT. 01/RW. 03 NO 88 KEL. TUAH KARYA KEC.

TAMPAN PANAM, PEKANBARU0761-586 888| 0761 586111 Y Y ALL COVERAGE

1617 3003 PRAKTEK DRG. TENSY A. T JL. AHMAD YANI 111C ( APOTEK PANGEAN ) PEKANBARU 081365910510 ; 081364223894| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1618 1535 EKA HOSPITAL PEKANBARU JL. SOEKARNO HATTA, KM.6,5 0761-6989999| 0761-6989944 Y Y ALL COVERAGE

ROKAN HILIR

1619 2199 KLINIK AGUNG JL. JEND. SUDIRMAN KM. 8, BAGAN BATU 0765-552459| 0765-552459 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1620 4136 KLINIK UTAMA CAHAYA JL. LINTAS RIAU UJUNG TANJUNG KAB. ROKAN HILIR 081-266818300| - Y Y ALL COVERAGE

Page 24 of 28

NOV-08-2017



ROKAN HULU

1621 1878 RS. AWAL BROS UJUNG BATU JL. JEND. SUDIRMAN NO. 314 UJUNG BATU ROKAN HULU RIAU 0762-7363329| 0762-7363334 Y Y ALL COVERAGE

RIAU KEPULAUAN

BATAM

1622 2503 RS. GRAHA HERMINE KOMP. RUKO ASIH RAYA NO.9-15, BATU AJI (0778) 363318, 363127| (0778) 363164 Y Y ALL COVERAGE

1623 3608 PRODIA BATAMJL. ENGKU PUTRI, KOMPLEKS MAHKOTA RAYA BLOK E NO. 12A-12B,

BATAM CENTRE - BATAM 29432(0778) 7495735| N Y


RB,PHAR

1624 4336 KLINIK DUNIA MEDICAL CENTRE RUKO PERUMNAS FANINDO BLOK B NO. 7-10, BATAM 29432, KEP. RIAU (0778) 7432 899| (0778) 3581209 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1625 4150 KLINIK & APOTEK KF NO. 230 PANBIL MALL BLOK A NO. 5 0778-371149| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1626 6018 KLINIK MUTIARA AISYAFA KOMPLEK RUKO TAMAN CARINA BLOK 3 NO.5 BATU AJI 0778-7432804 / 081374682228| 0778-7432804 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1627 1010 RS. ST. ELISABETH - BATAM JL. ANGGREK BLOK II, BALOI 0778 - 457357-|- 0778-457710/422473 Y Y ALL COVERAGE

1628 0485 GENTA MEDICAL CENTER MUKA KUNING INDAH, BLOK F, NO.10 0778-361909| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1629 0484 RB. BUDI ROSARI JL. MAHKOTA SIMPANG, NO.1, BENGKONG MAHKOTA 0778-427854| 0778-432833 Y Y ALL COVERAGE

1630 0582 RS. BUDI KEMULIAAN BATAM JL. BUDI KEMULIAAN, NO.1 0778-426865, 454044|0778-454044 0778-454055 Y Y ALL COVERAGE

1631 2448 YAHYA MEDICAL CENTER & APOTIK ZAHRUNIKOMPLEK RUKO SAGULUNG PERMAI BLOK B14-15, SAGULUNG KOTA,

BATAM(0778) 392748| (0778) 392749 N Y


RB,PHAR

1632 2479 KLINIK & APOTEK KF 413 KOMP. RUKO BOTANIA GARDEN BLOK A 1 NO. 1 C - BATAM 0778 7431199| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1633 2480 KLINIK & APOTEK KF 128 KOMP. PERTOKOAN WIJAYA BLOK A NO. 4 SEI HARAPAN - BATAM 0778 323697| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1634 2482 KLINIK & APOTEK KF 269 JL. JEND SUDIRMAN, BATAM CENTRE, BATAM 0778 461482; 363375| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1635 2486 KLINIK & APOTEK KF 137 KOMP.SAGULUNG MAS INDAH B3, BATAM 0778 392146| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1636 2487 KLINIK & APOTEK KF 224 KOMP MUKA KUNING INDAH II B2.3, BATAM 0778 363375| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1637 0584 RS. AWAL BROS BATAM JL. GAJAH MADA KAV.1 BALOI 0778 - 431777| 0778-430777 Y Y ALL COVERAGE

1638 4838 RSIA. FRISDHY ANGEL JL. RADEN PATAH BLOK B NO. 1-3, LUBUK BAJA, BALOI, BATAM 0778-424 901/ 425134| Y Y ALL COVERAGE

BINTAN

1639 1240 RB. & BP TIARA MEDIKA JL. KAMPUNG HARAPAN RT 01/01 TELUK SASAH, TANJUNG UBAN 0771-484427| 0771-484427 Y Y ALL COVERAGE

1640 1241 KLINIK BERSALIN ERNES JL. PERMAISURI NO.8 TANJUNG UBAN 0771-483212| 0771-482738 Y YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

BINTAN UTARA

1641 2457 RSUD. TANJUNG UBAN JL. INDUN SURI SIMPANG BUSUNG NO.1 TANJUNG UBAN 29152 (0771) 482655/ 082324421982| - Y Y ALL COVERAGE

KARIMUN

1642 1271 RS. BAKTI TIMAH KARIMUNJL. CANGGAI PUTRI TELUK UMA KABUPATEN KARIMUN PROVINSI

KEPULAUAN RIAU 296610777-7367085| 0777-7333251 Y Y ALL COVERAGE

1643 5782 KLINIK NAYA MEDIKAJL. RAJA OESMAN RUKO TAMAN ANGGREK NO.5 BATU LIPAI RT.002 /001,

KEL.BARAN TIMUR, KEC. MERAL0777-327842| - N Y


RB,PHAR

1644 0874 RSB. GRAHA RAP JL. R.USMAN, BATU LIPAI, TANJUNG BALAI 0777-326097| 0777-323857 Y YH&S,GP,SP,OP,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1645 1208 MEDIC CENTRE CLINICJL. AHMAD YANI, KOMPLEK KARIMUN INDAH, BLOK B, NO.1, TANJUNG

BALAI0777- 325 561| 0777- 325561 N Y


RB,PHAR

1646 1237 KLINIK SAYANG IBU JL. AHMAD YANI, NO.20, BARAN SATU, MERAL, TANJUNG BALAI 0777- 216 76| 0777- 222 52 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1647 1291 APOTIK DEVI FARMA JL. AHMAD YANI, SEI PASIR, MERAL, TANJUNG BALAI 0777-21388| 0777-368974/21388 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

TANJUNG PINANG

1648 2483 KLINIK & APOTEK KF 31 JL. BINTAN 656-658,TG.PINANG 0771 22879, 21091| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1649 4397 KLINIK & APOTEK KF 297 JL. BANTAR CETEK KM.9 TANJUNG PINANG 0771 441619| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1650 4416 KLINIK & APOTEK KF 169 JL. BRIGJEND. KATAMSO, TG.PINANG(JL. RAJA ALI HAJI KM 4 NO. 3) 0771 - 317631| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1651 3766 PRODIA TANJUNG PINANG JL. IR. SUTAMI, RUKO VILLA AKASIA NO. 20 (0771) 25305| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1652 4396 KLINIK & APOTEK KF 109 JL. MT.HARYONO KM.3,5 TANJUNG PINANG 0771 313590| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

SULAWESI BARAT

MAMUJU

1653 4521 PRODIA MAMUJU JL. ABD WAHAB AZASI NO. 43 MAMUJU 081513905286| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1654 4087 RSUD. MAMUJU JL. RE. MARTADINATA MAMUJU - SULBAR 0426-21107| - Y Y ALL COVERAGE

SULAWESI SELATAN

BONE

1655 4819 RS. HAPSAH JL. URIP SUMOHARJO, NO. X BONE 92731 (0481) 2911811| - Y Y ALL COVERAGE

MAKASSAR

1656 2717 KLINIK & APOTEK KF 38 JL. HASANUDDIN, NO.46, MAKASSAR 0411- 3617110| - N YGP,SP,OP,DENTAL,MAT,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1657 2904 KLINIK PRODIA MAKASSAR (SADDANG) JALAN SUNGAI SADDANG NO.40 MAKASSAR (0411) 872727/446666| (0411) 873110 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1658 2905 KLINIK PRODIA MAKASSAR (JOKO WIDODO)JL. BOULEVARD RUKO RUBY I NO. 7-8, PANAKKUKANG MAS, MAKASSAR

90222 (PUSAT GMC - PPS PANAKKUKANG)(0411) 446666| (0411) 457000 N Y


RB,PHAR

1659 4161 KLINIK & APOTEK KF GOWA JL. SULTAN HASANUDDIN NO. 8 GOWA 0411-869842|- - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1660 4163 KLINIK & APOTEK KF MAROS JL. POROS MAROS MACCOPA 0411-372020|- - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1661 1388 RATULANGI MEDICAL CENTRE JL. SAM RATULANGI NO.28 0411-878605/06/88| 0411-878587 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1662 1389 RS. GRESTELINA JL. LETJEN HERTASNING RAYA NO.51 0411-448855/448852| 0411-448854 Y Y ALL COVERAGE

1663 1390 RS. IBNU SINA YBW-UMI JL. URIP SUMOHARJO, KM.5, NO.264 0411-452958/5781595/452917| 0411-425397 Y Y ALL COVERAGE

1664 1393 RSIA. SITI KHADIJAH 1 MAKASSAR JL. KARTINI NO.15-17 MAKASSAR 0411-3624554/8614661| 0411-3627119 Y Y ALL COVERAGE

1665 0641 RS. STELLA MARIS MAKASSAR JL. SOMBA OPU NO.273, PO.BOX 122 0411-871391/873346| 0411 - 859545 Y Y ALL COVERAGE

1666 4415KLINIK & APOTEK IMEDICAL SPECIALIST

CENTREJL. RACING CENTRE NO. 17 MAKASSAR (0411) 4668835| (0411) 4668834 N Y


RB,PHAR

1667 4817KLINIK TELKOMEDIKA MAKASSAR (THC

MAKASSAR)Jl. DR. RATULANGI NO. 126 MAKASSAR 0411 8122283 / 081355551600| - N Y


RB,PHAR

1668 1630 RS. AWAL BROS MAKASSAR JL. JEND. URIP SUMOHARJO NO.43 MAKASSAR 0411-454567/455558| 0411-455123 Y Y ALL COVERAGE

1669 1190 RS. AKADEMIS JAURY YUSUF PUTERA JL. JEND. M YUSUF NO. 47A, PATTUNUANG0411-

3617343/3613054/3613071/3617344|0411-313914 Y Y ALL COVERAGE

1670 2291 KLINIK & APOTEK KF 199 ERLINA JL. URIP SUMOHARJO NO. 32 MAKASSAR 0411 449 936| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1671 2657 KLINIK & APOTEK KF HERTASNING JL. HERTASNING NO 11 - MAKASSAR 0411- 442945| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1672 2658 KLINIK & APOTEK KF 33 JL. AHMAD YANI, NO.17 - 19, MAKASSAR 0411-3616722| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1673 2659 KLINIK & APOTEK KF PETTARANI JL. PETTARANI 18, MAKASSAR 0411-857210 / 857215| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1674 2660 KLINIK & APOTEK KF DAENG TATA JL. DAENG TATA 69, MAKASSAR 0411-880685| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1675 2661 KLINIK & APOTEK KF 250 JL. DR.RATULANGI 59, MAKASSAR 0411- 582895| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1676 1847 SILOAM HOSPITALS MAKASSAR JL. METRO TANJUNG BUNGA KAV.9 PANAMBUNGAN, MARISSO0411-

3662900/8117555/8117430/5290000|0411-8117911 Y Y ALL COVERAGE

1677 3085 RS. UNIVERSITAS HASANUDDIN JL. PERINTIS KEMERDEKAAN KM.11 MAKASSAR 90245 0411 - 591331| - Y Y ALL COVERAGE

1678 3065 RSB. SENTOSA MAKASSAR JL. JEND. SUDIRMAN 52, 0411-3612720| (0411) 3619711 Y Y ALL COVERAGE

1679 5129 PARAHITA DIAGNOSTIC CENTER JL. GUNUNG LATIMOJONG NO.123 0411-3623573| N Y LAB

1680 5237 CEREBELLUM CLINIC JL. SWADAYA NO. 4, MAKASSAR (0411) 427184| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1681 2178 APOTEK FARMARIN MAKASSAR JL. LANDAK LAMA NO 27, KEL LABUANG BAJI KEC MAMAJANG 0411-870397| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1682 5593 RS. HERMINA MAKASSARJL. TODDOPULI RAYA TIMYUR LORONG MAKASSAR BORONG KEC.

MANGGALA(0411) 4091817| (0411) 4091775 Y Y ALL COVERAGE

1683 5414 RSIA. PERMATA HATI MAKASSAR JL. TAMALANREA RAYA POROS BTP BLOK 10M NO.9-10 0411-4774085 / 582278| Y Y ALL COVERAGE

1684 6437 RSIA. PARAMOUNT MAKASSAR JL. ANDI PANGERAN PETTARANI NO.82 0411-4671666| 0411-4671999 Y Y ALL COVERAGE

Page 25 of 28

NOV-08-2017



1685 4985 RSU. WISATA UNIVERSITAS INDONESIA TIMUR JL. ABDUL KADIR NO. 70, MAKASSAR, 90224 (0411) 888444, 888666| (0411) 8115656 Y Y ALL COVERAGE

1686 5145 PRODIA-BATU PUTIH JL. G. BATU PUTIH NO. 25, MAKASSAR -| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

PALOPO

1687 3772 LAB. PRODIA PALOPO JL. ANDI DJEMMA NO. 53, PALOPO 91921 (0471) 327467| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1688 0914 RS. AT MEDIKA JL. ANDI JEMMA, NO.09 0471-21596-|- 0471-23008 Y Y ALL COVERAGE

PARE PARE

1689 3773 LAB. PRODIA PARE PARE JL. ANDI MAPPATOLA NO. 7, PARE-PARE 91114 (0421) 22265 / 7007433| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1690 1394 RS. FATIMA PARE-PARE JL. ILHAMV KOTAK POS 12 0421-21847| 0421-21328 Y Y ALL COVERAGE

SENGKANG

1691 4129 LAB. PRODIA SENGKANG JL. AP PETTARANI NO.18, SENGKANG 0485-323409| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

SULAWESI TENGAH

PALU

1692 3577 KLINIK PRODIA PALU JL. S. PARMAN NO. 16, PALU 94111 0451-451639| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1693 2288 KLINIK & APOTEK KF 390 PALU JL. SETIABUDI NO. 65 D PALU SULTENG 0451-425132| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1694 2287 APOTEK KIMIA FARMA 449 TATURA JL. WOLTER MONGINSIDI NO. 145 PALU, SULTENG 0451-429832| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1695 0639 RSU. WOODWARD (BALA KESELAMATAN) JL. LH. WOODWARD NO.1 0451 - 421769, 423744| 0451 - 423744 Y Y ALL COVERAGE

SULAWESI TENGGARA

BAU BAU

1696 4761 SILOAM HOSPITALS BUTONJL. SULTAN HASANUDDIN No. 58, KEL.BATULO, KEC.WOLIO KOTA BAUBAU,

SULAWESI TENGGARA0402-2825555| (0402) 2823020 Y Y ALL COVERAGE

1697 2300 RS. MURHUMJL. SULTAN MURHUM NO. 69 KEL. WAJO KEC. MURHUM SULTENG, BAU

BAU0402-2822650| 0402-2823919 Y Y ALL COVERAGE

KENDARI

1698 1537 RS. ST. ANNA JL. DR. MOH.HATTA, NO.65A 0401-3123092| 0401-3124872 Y Y ALL COVERAGE

1699 2286 KLINIK & APOTEK KF 288 JL. A. YANI NO. 84 KENDARI 0401 319 6186| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1700 2285KLINIK & APOTEK KIMIA FARMA 104 (BM

KENDARI)JL. HOMAMMAD HATTA NO.77, KENDARI BARAT 0401 -3127182| - N Y


RB,PHAR

1701 3576 PRODIA KENDARI JL. SAOSAO NO. 207 KENDARI 0401-3121789| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1702 6229 KLINIK DIAGNOSTIK RAPHA KENDARI JL. MALAKA NO. 25 ANDUONOHU, KENDARI 0401-3081484| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

SULAWESI UTARA

KOTAMOBAGU

1703 3762 PRODIA KOTAMOBAGU JL. D.I. PANJAITAN NO. 13, KOTAMOBAGU 95176 (0434) 2629104| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

MANADO

1704 4245 KLINIK & APOTEK KF TUMINTING MANADO JL. HASANUDIN NO 137 MANADO 0431 855420| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1705 4244 KLINIK & APOTEK KF 290 MANADO JL. MARTHADINATA RAYA NO. 38 0431 861878| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1706 1502 RS. ADVENT MANADO JL. 14 FEBRUARI, NO.1, TELING ATAS 0431-847950/858429| 0431-850012 Y Y ALL COVERAGE

1707 1798 SILOAM HOSPITALS MANADO JL. SAM RATULANGI NO 22 MANADO 0431-7290900| 0431-8883133 Y Y ALL COVERAGE

1708 2875 POLIKLINIK PERTAMINA MANADO JL. SAM RATULANGI N0.8 MANADO -| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1709 2805 RSIA. KASIH IBU MANADOKOMPLEKS BAHU MALL BLOCK. C NO. 23) JL. N. WOLTER MONGINSIDI NO.

10431 834780/834667| 0431 834721 Y Y ALL COVERAGE

1710 2296 THC MANADO JALAN WR SUPRATMAN NO. 5 MANADO 0431- 843363| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1711 2230 KLINIK & APOTEK KF NO. 74 JL. SAM RATULANGI NO.31 MANADO 93117 0431-864012| 0431-850838 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1712 2232 KLINIK & APOTEK KF WENANG 309 JL. LIMIMUNT NO. 12 A KEL. TIKALA KUMARAKA, KEC. WENANG, MANADO 0431-867163/840087| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1713 2233 LAB. PRODIA MANADO JL. SAM RATULANGI NO. 72 MANADO 95111 0431-874567| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1714 2231 APOTEK KIMIA FARMA MALALAYANG KP. REL NO. 5 RS. VP MALALAYANG 0431-838278| 0431-838277 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1715 2656 KLINIK & APOTEK KF 129 JL. A.YANI, SARIO, MANADO 0431- 861571| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1716 2650 KLINIK & APOTEK KF 331, BAHU JL. W.MONGINSIDI 29 A,MANADO 0431-842786| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1717 2654 KLINIK & APOTEK KF 332 JL. SAM RATULANGI NO.338,, WANEA 0431- 843002| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1718 5427 RS. MANADO MEDICAL CENTER JL. RAJAWALI NO.8, PAAL 2 0431-866641 / 082190285345| 0431-866641 Y Y ALL COVERAGE

SUMATERA BARAT

BUKIT TINGGI

1719 2114 KLINIK & APOTEK KF 146 BUKIT TINGGI JL. JEND. SUDIRMAN NO 14 BUKIT TINGGI 0752-35700| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1720 1398 RSU. MADINA JL. GURU HAMZAH NO.17 0752-21388 EXT 228| 0752-626677 Y Y ALL COVERAGE

1721 3602 PRODIA BUKIT TINGGI JL. A. RIVAI 23, BUKIT TINGGI 26116 (0752) 23348| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

PADANG

1722 1320 RSI. SITI RAHMAH PADANG JL. RAYA BY PASS KM 15 AIE PACAH, PADANG 0751-463059| 0751-463531 Y Y ALL COVERAGE

1723 0423 RSU. BUNDA MEDICAL CENTER (RSU. C-BMC) JL. PROKLAMASI NO.31-33-37 PADANG 0751-23164/29536/21151/24750| 0751-23200 Y Y ALL COVERAGE

1724 0616 RS. YOS SUDARSO JL. SITUJUH, NO.1 0751-33230/33231| 0751-31811 Y Y ALL COVERAGE

1725 2060 KLINIK & APOTEK KF 94 PADANG JL. PROKLAMASI N. 24 PADANG 0751-891195| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1726 2113 KLINIK & APOTEK KF 238 PADANG JL. PATIMURA NO 18 PADANG 0751-23620| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1727 1569 RSIA. CICIK JL. DR. SUTOMO NO.94 MARAPALAM PADANG 25125 (0751) 38846; 38866| (0751) 841286 Y Y ALL COVERAGE

1728 0304 RS. SELAGURI JL. A.YANI, NO.26 0751 -33010/21953| 0751-840051 Y Y ALL COVERAGE

1729 4840 RSB. MUTIARA BUNDA JL. S. PARMAN NO. 142 PADANG, SUMATERA BARAT 0751-7054076| - Y Y ALL COVERAGE

1730 6420 RSIA. RESTU IBU PADANG JL TERAMDAN NO. 5-7 PADANG 0751-810756| 0751-31743 Y Y ALL COVERAGE

1731 4070 RSIA. ANNISA PADANG JL. PEMUDA NO. 18, PADANG (0751) 31906| (0751) 31905 Y Y ALL COVERAGE

1732 2369 RS. MATA PADANG EYE CENTER (PEC) JL. PEMUDA NO. 53 PADANG - SUMBAR 0751-30094| 0751-30098 Y Y ALL COVERAGE

1733 2714 SEMEN PADANG HOSPITAL JL. BY PASS KM 7 KEL. PISANG, KEC. PAUH (0751) 777888, 4782999., 4782997| (0751) 4782990 Y Y ALL COVERAGE

1734 4805 ZIRCONIC DENTAL CLINIC JL. H. AGUS SALIM NO. 57 B PADANG (0751) 841917; (0811666310)| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1735 3569 PRODIA PADANG (JL. PATTIMURA) JL. PATTIMURA NO. 3 A, PADANG 25113 0751-38795| N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1736 4051 RSIA. SITI HAWA JL. PARAK GADANG RAYA NO.35 0751-841251| - Y Y ALL COVERAGE

1737 4794 RS. NAILI DBSJL. RATULANGI NO. 24 RT. 001 RW. 008, KEL. KAMPUNG JAO, KEC.

PADANG BARAT(0751) 8951900 ; 8951901| (0751) 8951902 Y Y ALL COVERAGE

1738 4195 RS. KHUSUS BEDAH ROPANASURI JL. ALUR NO.8 PADANG 0751-31938,33854| 0751-25735 Y Y ALL COVERAGE

PAYAKUMBUH

1739 1720 RSI. IBNU SINA PAYAKUMBUH JL. PEMUDA NO.14 0752-92222/90555| 0752-796744 Y Y ALL COVERAGE

1740 2115 KLINIK & APOTEK KF 372 PAYAKUMBUH JL. JEND. SUDIRMAN PAYAKUMBUH -| KF_ N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

SUMATERA SELATAN

BATU RAJA

1741 1284 RS. SANTO ANTONIO JL. KOMISARIS UMAR NO. 33, BATURAJA 0735-320395/322418/324700| 0735-320201 Y Y ALL COVERAGE

Page 26 of 28

NOV-08-2017



LUBUK LINGGAU

1742 1869 KLINIK SEKATA JL. YOS SUDARS. O NO. 230 TABAH JEMEKEH, LUBUK LINGGAU 0733-321357| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1743 2715 RS. AR BUNDA LUBUK LINGGAU JL. GARUDA NO 245 RT 03 KEL. BANDUNG KIRI, KEC. LINGGAU BARAT 1 (0733) 324955/324963| (0733) 321892 Y Y ALL COVERAGE

MUARA ENIM

1744 5778KLINIK BERSALIN KARUNIA INDAH MEDIKA

(KIM)JL. MAYOR TJI AGUS KIEMAS LINTAS KEPUR - MUARA ENIM 081273373378| N Y


RB,PHAR

1745 4372 RS. BUKIT ASAM JL. Raya Bukit Asam No 118, Tanjung Enim Sumatera Selatan 0734-451096| - Y Y ALL COVERAGE

PALEMBANG

1746 1622 RS. HERMINA PALEMBANG JL. BASUKI RAHMAT NO.897 RT.011/003 KEL.20 ILIR II KEC.KEMUNING 0711-352525| 0711-366945 Y Y ALL COVERAGE

1747 1884 SILOAM SRIWIJAYA PALEMBANG JL. POM IX KEL. LOROK PAKJO KEC. ILIR BARAT 1 0711-5229100| 0711-5649100 Y Y ALL COVERAGE

1748 3965 RS. SRIWIJAYA EYE CENTER JL. JEND.SUDIRMAN KM. 4,5 NO.502 KEL. 20 ILIR, KEC. IT I (0711) 5611976/419680| Y Y ALL COVERAGE

1749 6116 RSIA. BUNDA NONI Jl. SRIJAYA NEGARA, RT.072 / 011 Kel. Bukit Lama Kec. Ilir Barat I (0711) 441952| - Y Y ALL COVERAGE

1750 4034 RSIA. SITI MIRZAJL. DEMANG LEBAR DAUN RT 035 RW 010, KELURAHAN DEMANG LEBAR

DAUN, KECAMATAN ILIR BARAT I0711-446272| 0711-441345 Y Y ALL COVERAGE

1751 0883 RS. BUNDA PALEMBANG JL. DEMANG LEBAR DAUN, PALEMBANG0711-312866,3118660711-311866|0711-

3118660711-355553 Y Y ALL COVERAGE

1752 0688 RS. ISLAM SITI KHADIJAH PALEMBANG JL. DEMANG LEBAR DAUN, LORONG PAKJO 0711-356008/374440-2/310407| 0711-311884 Y Y ALL COVERAGE

1753 0627 RS. PUSRI JL. MAYOR ZEN, KOMPLEK PUSRI NO. 1 0711 -712222-712111| 0711-712071 Y Y ALL COVERAGE

1754 0885 RSIA. YK. MADIRA JL. JEND SUDIRMAN NO.1051 C-D PALEMBANG0711-364954,362766, 374802,

3747850711-356173|0711-356173(0711) 356173 Y Y ALL COVERAGE

1755 0803 RS. MYRIA JL. KOL. H. BURLIAN KM. 7 NO 228 PALEMBANG 0711-411610/412433/421914| 0711-414052 Y Y ALL COVERAGE

1756 0817 RS. RK. CHARITAS JL. JEND. SUDIRMAN NO.10540711-350426/3533750711-

353374/5|0711-353374/50711-362205/377088 Y Y ALL COVERAGE

1757 2394 KIMIA FARMA 239 JL. MP. MANGKUNEGARA 0711 - 823503| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1758 2423 RSIA. AZZAHRA PALEMBANG JL. BRIGJEN HASAN KASIM NO.1-2 BUKIT SANGKAL PALEMBANG 0711-822723| 0711-826044 Y Y ALL COVERAGE

1759 2442 KLINIK PRODIA PALEMBANG JL. BASUKI RAHMAT NO.801 PALEMBANG 30113 0711-411304| 0711-5610294 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1760 2185 KLINIK & APOTEK KF 209 JL. LETKOL ISKANDAR NO. 222 0711354717/0711362245| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1761 2787 RS. PERTAMINA PLAJU PERTAMEDIKAJL. PENGANTINGAN NO.1 KOMPLEK PERTAMINA PLAJU SUMATERA

SELATAN 30268(0711) 597401/597442| (0711) 542388 Y Y ALL COVERAGE

1762 4132 LAB. PRODIA VETERAN JL. VETERAN 930/C2, 9 ILIR, PALEMBANG 0711-377239/362487| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1763 2839 POLIKLINIK PERTAMINA PALEMBANG JL. JEND. AHMAD YANI NO. 1247. 1 PALEMBANG -| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

PENUKAL ABAB LEMATANG ILIR

1764 2152 RSUD. TALANG UBIJL. TAMAN SISWA KELURAHAN PASAR BHAYANGKARA ,KEC TALANG UBI,

KAB PENUKAL ABAB LEMATANG ILIR0713-390487/0713-390566-391111| 0713-391456/390487 Y Y ALL COVERAGE

PRABUMULIH

1765 3953 RS. FADHILAH JL. JENDRAL SUDIRMAN NO. 01 PATIH GALUNG PRABUMULIH (0713) 3300032; 323939;| (0713) 3300032 Y Y ALL COVERAGE

1766 0824 RS. PERTAMINA PRABUMULIH JL. KESEHATAN, NO.100, KOMPLEK PERTAMINA PRABUMULIH0713-

383333/382749/322069/382742/382731(0713-321903/325181 Y Y ALL COVERAGE

1767 1449 RS. AR BUNDA PRABUMULIH JL. ANGKATAN 45, KEL GUNUNG IBUL PRABUMULIH TIMUR 0713-322954, 7003330| 0713-325980/322954 Y Y ALL COVERAGE

SUMATERA UTARA

ASAHAN

1768 2351 RS. SETIO HUSODO JL. S. M. RAJA N0 67 KISARAN, ASAHAN SUMATERA UTARA 0623-44999| 0623-43394 Y Y ALL COVERAGE

BINJAI

1769 1624 RSU. ARTHA MEDICA JL. SAMANHUDI NO. 22 BINJAI 061-8820387/8828167| 061-8830757 Y Y ALL COVERAGE

1770 6461 RSU. RATU MAS JL. TENGKU AMIR HAMZAH NO.281A BINJAI UTARA 061-8829404/8828173| - Y Y ALL COVERAGE

1771 2776 RSU. SYLVANI JL. N.PERINTIS KEMERDEKAAN.NO. 21 BINJAI (061) 80045925| (061) 80045923 Y Y ALL COVERAGE

1772 3722 PRODIA BINJAI JL. SUDIRMAN NO. 25, BINJAI 20714 (061) 8828269| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1773 1811 RS. BIDADARI BINJAI PERINTIS KEMERDEKAAN NO 174 A KEBUN LADA KOTA BIJAI 061- 8830003| 061 - 8826004 Y Y ALL COVERAGE

1774 1652 RS. LATERSIA JL. SOEKARNO HATTA, KM.18 NO.451, BINJAI 061-8829588/8829788| 061-8822565 Y Y ALL COVERAGE

BRASTAGI

1775 1542 RS. EFARINA ETAHAM BRASTAGI JL. JAMIN GINTING, NO.1, DESA RAYA, 0628-323716/17| 0628-213718 Y Y ALL COVERAGE

DELI SERDANG

1776 2348 RS. PATAR ASIH LUBUK PAKAMJL. BAKARAN BATU DESA TEMPATAN KEC. BERINGIN, NO. 45 KAB. DELI

SERDANG061-7950449,50| 061-7950313 Y Y ALL COVERAGE

1777 4359 RS. THEOTOKOSJL.BESAR NAMORAMBE NO. 10 -15, KEC. NAMORAMBE DESA DELI TUA

MEDAN 20355(061) 7032854; 7032694;| (061) 7032806 Y Y ALL COVERAGE

KARO

1778 4118 LAB. PRODIA KABANJAHE JL. VETERAN NO. 21 ( RSU ESTER ) KABANJAHE, KARO 0628-323321| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

KISARAN

1779 3730 PRODIA KISARAN JL. IMAM BONJOL NO. 177, KISARAN 21222 (0623) 348599| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

LANGKAT

1780 1653 RS. PERTAMINA PANGKALAN BRANDAN JL. WAHIDIN NO.01 PANGKALAN BRANDAN LANGKAT-SUMUT 0620-322612,322455| 0620-323392 Y Y ALL COVERAGE

LUBUK PAKAM

1781 4119 LAB. PRODIA LUBUK PAKAM JL. AHMAD DAHLAN NO. 69, LUBUK PAKAM 061-7952030| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1782 2023 RS. GRAND MEDISTRA LUBUK PAKAM JL. RAYA MEDAN-LUBUK PAKAM KM 25 NO. 66 061-7955114| 061-7950114 Y Y ALL COVERAGE

MEDAN

1783 0523 RS. ADVENT MEDAN JL. GATOT SUBROTO, KM. 4 061 - 4524875/4574025| 061-4154839 Y Y ALL COVERAGE

1784 0816 RS. METHODIST JL. MH. THAMRIN, NO.105 (061) 7369000| (061) 7363779 Y Y ALL COVERAGE

1785 0925 RS. ST ELISABETH - MEDAN JL. H. MISBAH NO.7, MEDAN 061-4144737/4522010/4144240| 061 - 4143168 Y Y ALL COVERAGE

1786 0742 RSU. MARTHA FRISKA JL. KOL. YOS SUDARSO KM.6, NO.91, PULO BRAYAN 061-6610910| 061-6612005 Y Y ALL COVERAGE

1787 1193 RSU. SARAH JL. BAJA RAYA NO. 10 PETISAH 061-4528044| 061-4529454 Y Y ALL COVERAGE

1788 1061 RS. ESTOMIHI JL. SISINGAMANGARAJA NO.235 MEDAN061-7861771,7864656061-7864656|061-

7864656061-7866660 Y Y ALL COVERAGE

1789 0741 RS. ISLAM MALAHAYATI JL. DIPENOGORO NO.2-4, MEDAN 061 - 4518766| 061-4519474 Y Y ALL COVERAGE

1790 0740 RS. HERNA JL. MAJAPAHIT NO.118A, MEDAN 061 -451 0766|IBU HENI/DR LIMENTA 061-415 3955 Y Y ALL COVERAGE

1791 1592 RSIA. STELLA MARIS MEDAN JL. SAMANHUDI NO.20 MEDAN 061-4158383| 061-4157088 Y Y ALL COVERAGE

1792 0626 RS. SARI MUTIARA JL. KAPTEN MUSLIM, NO.79 061-8451812| 061-8452134 Y Y ALL COVERAGE

1793 1649 RS. IMELDA PEKERJA INDONESIA JL. BILAL NO 24 PULO BRAYAN DARAT I MEDAN TIMUR 061-6610072-6631380| 061-6618457 Y Y ALL COVERAGE

1794 2028 RS. MITRA SEJATI MEDAN JL. AH. NASUTION PANGKALAN MAHSYUR NO.7, MEDAN 061-7875967/ 7881682| 061-7850261 Y Y ALL COVERAGE

1795 2053 MURNI TEGUH MEMORIAL HOSPITAL JL. JAWA NO. 2 SIMPANG JL. VETERAN 061-80501888/777| 061 - 80501800 Y Y ALL COVERAGE

1796 1651 RS. BUNDA THAMRIN MEDAN JL. SEI BATANG HARI NO. 28/30 MEDAN SUNGGAL

061-

4553928,88813615,4557318,4557218,455

3918|

061-4558218 Y Y ALL COVERAGE

1797 3957 RS. ROYAL PRIMA MEDAN JL. AYAHANDA NO. 68 A, MEDAN - SUMATERA UTARA (061) 8881 3182; 8881 3183| (061) 8001 3181 Y Y ALL COVERAGE

1798 0322 RSU. PERMATA BUNDA MEDAN JL. SISINGAMANGARAJA, NO.7061-7362777 / 7360120 / 7367980 EXT.

141|061-7320222 Y N ALL COVERAGE

Page 27 of 28

NOV-08-2017



1799 0590RS. COLUMBIA ASIA MEDAN (D/H GLENI

MEDAN)JL. LISTRIK 2A MEDAN 061-4566368| 061-4566585/4515453 Y Y ALL COVERAGE

1800 4092 RSIA. SRI RATU JL. NIBUNG RAYA NO 204-212 MEDAN 061-4521074| 061-4539236 Y Y ALL COVERAGE

1801 4001 RS. MADANI MEDANJL. A.R. HAKIM NO. 168, KEL. SUKA RAMAI I, KEC. MEDAN AREA, KOTA

MEDAN061-7345911, 061 - 7361357| Y Y ALL COVERAGE

1802 2900 LAB. PRODIA JL. ASIA MEDAN JL. ASIA NO. 115B MEDAN 061-7321260| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1803 1650 RS. MARTHA FRISKA MULTATULI JL. MULTATULI KOMP. MULTATULI INDAH NO 1 MEDAN 061-4149666 / 08286103148| 061-4154761 Y Y ALL COVERAGE

1804 4168 RS. KHUSUS BEDAH SETIA BUDI JL. MESJID NO. 3 TANJUNG REJO, MEDAN (061) 8220995 ; 8220996| (061) 8220955 Y Y ALL COVERAGE

1805 2876 KLINIK PRODIA MEDAN S PARMAN JL. LETJEND S PARMAN NO. 17/223 G LT LI 20153 MEDAN 061-4535731 / 4534903| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1806 4091 RSU. SUNDARI JL. TB SIMATUPANG NO 31 MEDAN 061-8452536-|- 061-8452536 Y Y ALL COVERAGE

1807 3779 RS. SILOAM DHIRGA SURYA JL. IMAM BONJOL NO. 6, KEL. PETISAH - MEDAN 20112 (061) 8888 1900 EXT. 22601| (061) 8888 1933 Y Y ALL COVERAGE

1808 3767 PRODIA MEDAN SETIA BUDI KOMPLEKS RUKO MILALA MAS BLOK A NO. 8, SETIA BUDI, MEDAN (061) 8224129| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1809 3768 PRODIA MEDAN (GATSU) JL. JEND. GATOT SUBROTO NO.129, MEDAN 20112 (061) 4157459| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1810 2182 KLINIK & APOTEK KF 27 JL. PALANG MERAH NO. 32 061-4576023/4515513| 061-451551 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1811 2179 APOTEK FARMARIN MEDAN JL. GATOT SUBROTO KM 4,2 NO. 311 MEDAN PETISAN 061- 4528454| 061- 4528464 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1812 2183 KLINIK & APOTEK KF 39 JL. GATOT SOEBROTO NO 37 A/C 061-4529909| 061-4532717 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1813 2438 E-LABS MEDAN JL. SENA NO.10 MEDAN 061-4101293| 061-4530850 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1814 2395 SUMATERA EYE CENTER JL. ISKANDAR NO. 278 - 280, MEDAN 061-4525058 ; 4518222| 061-4510978 Y Y ALL COVERAGE

1815 2754 RS. DELI JL. MERBABU NO.18-20, MEDAN (061) 4565229| (061) 4552361 Y Y ALL COVERAGE

1816 0416 RS. MATERNA JL. TEUKU UMAR NO.11 061 -4514222| 061-4155392 Y Y ALL COVERAGE

1817 0773 RSU. PROF.DR.BOLONI JL. W. MONGINSIDI NO. 11 MEDAN (061) 4512687; 4556879; 4154637| (061) 4154621 Y Y ALL COVERAGE

1818 0418 KLINIK SPESIALIS BUNDA JL. SISINGAMANGARAJA NO.17 061 -7321666| 061-7344786 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1819 6482 RSU. HERMINA MEDAN JL. ASRAMA/AMPERA II SEI SIKAMBING C-II MEDAN HELVETIA (061) 80862525/80867690| Y Y ALL COVERAGE

PADANG LAWAS

1820 4861 RSU. PERMATA MADINA SIBUHUANJL. KH. DEWANTARA SIHUBUAN KEC. BARUMUN KAB. PADANG LAWAS,

SUMUT(0636) 421211| (0636) 421311 Y Y ALL COVERAGE

PADANG SIDEMPUAN

1821 3771 PRODIA PADANG SIDEMPUAN JL. MERDEKA NO 52 PADANG SIDEMPUAN 22718 (0634) 7366622| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

PEMATANG SIANTAR

1822 2208 KIMIA FARMA 29 SOETOMO JL. SUTOMO NO.63 PEMATANG SIANTAR 0622-22447| 0622-25527 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1823 2209 APOTEK & KLINIK KIMIA FARMA KARTINI JL. KARTINI NO. 19 PEMATANG SIANTAR 0622-22448| 0622-25527 N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1824 0719 RS. VITA INSANI JL. MERDEKA, NO.329 0622-22520| 0622-24521/29133 Y Y ALL COVERAGE

1825 2984 RS. HARAPAN PEMATANG SIANTAR JL. FAREL PASARIBU NO : 21 PEMATANG SIANTAR, SUMATERA UTARA 0622-21162, 21612| 0622-435301 Y Y ALL COVERAGE

1826 4418 KLINIK & APOTEK KF 162 JL. KARTINI PEMATANG SIANTAR 0622-22448| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1827 2898 LAB. PRODIA PEMATANG SIANTAR JL. MERDEKA NO 37 PEMATANG SIANTAR 0622-22437| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

RANTAU PRAPAT

1828 3785 LAB. PRODIA RANTAU PRAPAT JL. AHMAD YANI NO. 197, RANTAU PRAPAT 21415 (0624) 25368| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

SIBOLGA

1829 3566 LAB. PRODIA WIDYAHUSADA SIBOLGA JL. S.M. RAJA NO.74B 0631-22539| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1830 2249 RS. METTA MEDIKA SIBOLGA JL. SUTOYO SISWOMIHARJO NO.34 / JL. DIPENOGORO 6-8 SIBOLGA 0631-25007/25008/24001/24002| 0631-25006 Y Y ALL COVERAGE

TANJUNG BALAI

1831 4120 LAB. PRODIA TANJUNG BALAI JL. SUDIRMAN NO. 23, TANJUNG BALAI - KARIMUN 0623-596227| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

TEBING TINGGI

1832 3787 LAB. PRODIA TEBING TINGGI JL. SUDIRMAN NO. 257 D, TEBING TINGGI 26014 (0621) 22494| - N YGP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM-

RB,PHAR

1833 6460 RS CHEVANI JLN. PROF M. YAMIN NO. 17 TEBING TINGGI 0621-3950222| 0621-3950221 Y Y ALL COVERAGE

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