DATAFIKASI · BENEFIT & ITEM DETAIL
Benefit & Item Details
Breakdown by benefit category and claim line item
Benefit Summary
10 indicators
Total Datafikasi Payment
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Total Claims
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Total Items
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Average Readability Score
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Mismatched Items
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Mismatched Items %
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Overcharged Items
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Overcharged Items %
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Total Datafikasi Overcharge
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Total Datafikasi Excess
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Diagnosis & Disease Distribution
Top 10 ICD-10
DIAGNOSIS DISTRIBUTION
Top 10 ICD10 — anchor for FWA benchmarking
| ICD10 | Diagnosis | Claims | % Total |
|---|---|---|---|
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BENEFIT COVERAGE
Claims per Benefit Category
RJTP & RJTL = 84% of volume. Maternity benefit is in the long tail.
Benefit Analytics
5 independent rankings
BENEFIT
Benefit by Total Claims
SUB-BENEFIT
Sub-Benefit by Total Claims
BENEFIT
Benefit by Total PICA Payment
BENEFIT
Benefit by Total Datafikasi Payment
SUB-BENEFIT
Sub-Benefit by Total Datafikasi Payment
Diagnostic & Laboratory Support Table
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DIAGNOSTIC DETAIL
Diagnostic & Lab Support — tests performed per claim
| Claim No. | Provider | Doctor | Diagnosis | Test/Lab Name | Datafikasi Payment |
|---|---|---|---|---|---|
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Medical Procedures Table
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PROCEDURE DETAIL
Medical Procedures — procedures performed per claim, sorted by highest value
*A single claim can have multiple line items — duplicate Claim No. values are normal.
| Claim No. | Provider | Doctor | Diagnosis | Procedure Name | Datafikasi Payment |
|---|---|---|---|---|---|
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