Subtotal Subtotal

Code Deskripsi Jumlah ALOS

RS INA-CBG
1 Z09.8^K04.0 Pulpitis 45 - 12,027,000 12,888,000
2 K04.1 Necrosis of pulp 20 - 4,040,000 5,494,300
3 Z09.8^K04.1 Necrosis of pulp 13 - 2,884,998 3,723,200
Pain localized to upper
4 R10.1 9 - 3,352,000 3,233,200
abdomen
5 K04.0 Pulpitis 6 - 1,105,000 1,640,500
6 Z09.8^K02.8 Other dental caries 6 - 1,790,000 1,718,400
Tuberculosis of lung, confirmed
7 A15.3 5 - 660,000 936,500
by unspecified means
Non-insulin-dependent diabetes
8 E11.4 mellitus with neurological 3 - 405,000 561,900
complications
Pain localized to upper
9 Z09.8^R10.1 3 - 1,257,000 1,267,300
abdomen
10 D24 Benign neoplasm of breast 2 - 896,000 1,080,000
11 I50.0 Congestive heart failure 2 - 716,000 1,051,400
12 K00.6 Disturbances in tooth eruption 2 - 213,000 572,800
13 K01.1 Impacted teeth 2 - 270,000 494,900
Calculus of gallbladder without
14 K80.2 2 - 1,261,000 1,080,000
cholecystitis
Pain localized to other parts of
15 R10.3 2 - 315,000 266,600
lower abdomen
16 Z09.8^E04.2 Nontoxic multinodular goitre 2 - 300,000 374,600
17 Z09.8^E06.9 Thyroiditis, unspecified 2 - 280,000 374,600
18 Z09.8^I50.0 Congestive heart failure 2 - 495,000 374,600
Benign lipomatous neoplasm of
19 D17.7 1 - 532,000 540,000
other sites
20 E05.9 Thyrotoxicosis, unspecified 1 - 0 187,300

November 2018