| Rank | Club Information | Gold | Silver | Bronze |
|---|---|---|---|---|
| 1 |
KAB SIDOARJO, , |
2 | 1 | 0 |
| 2 |
KAB JEMBER, , |
2 | 0 | 0 |
| 3 |
KOTA MALANG, , |
0 | 1 | 3 |
| 4 |
KOTA SURABAYA, , |
0 | 1 | 1 |
| 5 |
KOTA MOJOKERTO, , |
0 | 1 | 0 |