TABLE 5.
List of Top 10 most frequent service details (in TZS)
| Servicedetail | Service type | Number of claim [% total] | Mean claim value (in TZS) | Total claim value (in million TZS) [% total] |
|---|---|---|---|---|
| Top 10 service details: Sorted by number of claims | ||||
| Ibuprofen + paracetamol (pain) | Medicine | 1,859,265 [7.1%] | 444 | 826 [0.5%] |
| Dispensing bag | Consumables | 1,535,436 [5.8%] | 38 | 58 [0%] |
| Urine analysis | Diagnostic | 1,503,470 [5.7%] | 1680 | 2527 [1.4%] |
| Malaria blood smear (B/S) | Diagnostic | 1,352,523 [5.1%] | 1701 | 2301 [1.3%] |
| Amoxycillin (antibiotics) | Medicine | 638,543 [2.4%] | 2466 | 1575 [0.9%] |
| Stool analysis | Diagnostic | 604,499 [2.3%] | 1588 | 960 [0.5%] |
| Full blood picture (FBP) | Diagnostic | 412,369 [1.6%] | 6220 | 2565 [1.4%] |
| Artemether + Lumefantrine (malaria) | Medicine | 397,579 [1.5%] | 1739 | 691 [0.4%] |
| Metronidazole (antibiotics) | Medicine | 382,269 [1.5%] | 1588 | 607 [0.3%] |
| Ciprofloxacin (eye drops) | Medicine | 340,153 [1.3%] | 2589 | 881 [0.5%] |
| Top 10 service details: Sorted by mean claim value | ||||
| CABG ‐ coronary artery bypass graft | Procedural | 1 [0%] | 15,450,000 | 15 [0%] |
| Mitral valve replacement | Procedural | 4 [0%] | 10,780,000 | 43 [0%] |
| Mitral valve replacement + tricuspid valve repair ‐ devega's | Procedural | 1 [0%] | 10,780,000 | 11 [0%] |
| Dual chamber pace maker insertion (incl. Pace maker device) | Procedural | 3 [0%] | 10,500,000 | 32 [0%] |
| Trastuzumab/Herceptin (cancer) | Medicine | 224 [0%] | 9,836,429 | 2203 [1.2%] |
| Mitral valve repair | Procedural | 4 [0%] | 9,650,000 | 39 [0%] |
| Ventral septal defect (VSD) closure | Procedural | 11 [0%] | 8,850,000 | 97 [0.1%] |
| Tetralogy of fallot (TOF) repair | Procedural | 7 [0%] | 8,850,000 | 62 [0%] |
| Atrial septal defect (ASD) closure | Procedural | 1 [0%] | 8,850,000 | 9 [0%] |
| Atrio‐ventricular canal repair | Procedural | 1 [0%] | 8,850,000 | 9 [0%] |
| Top 10 service details per service type: sorted by total claim value | ||||
| Hemodialysis per session | Procedural | 16,434 [0.1%] | 384,005 | 6311 [3.5%] |
| Amoxycillin + Clavulanic acid (antibiotics) | Medicine | 169,797 [0.6%] | 19,743 | 3352 [1.9%] |
| Caesarian section (C/S) | Surgical | 8189 [0%] | 392,593 | 3215 [1.8%] |
| Full blood picture (FBP) | Diagnostic | 412,369 [1.6%] | 6220 | 2565 [1.4%] |
| Urine analysis | Diagnostic | 1,503,470 [5.7%] | 1680 | 2527 [1.4%] |
| Malaria blood smear (B/S) | Diagnostic | 1,352,523 [5.1%] | 1701 | 2301 [1.3%] |
| Trastuzumab/Herceptin (cancer) | Medicine | 224 [0.0%] | 9,836,429 | 2203 [1.2%] |
| Hydrochlorthiazide + Losartan (blood pressure) | Medicine | 100,859 [0.4%] | 21,823 | 2201 [1.2%] |
| Gabapectin/Gabatin‐300 (neuropathic pain related diseases) | Medicine | 52,036 [0.2%] | 37,893 | 1972 [1.1%] |
| Raberprazole/Rabeloc (stomache acid related diseases) | Medicine | 58,081 [0.2%] | 32,520 | 1889 [1.1%] |
Note: Registration and consultation charges included registration and consultation fees; Inpatient charges included accommodation fees or intensitive care unit service charges. Both categories are not included in the table. Total number of claims in 2016 is 26,299,491 and total claim value is 178,400 million TZS.
Abbreviation: TZS, Tanzanian shilling.