A = Prix (TVAc) - Prijs (incl.

BTW)
B = Remboursement Bén. ordin./Prestataire conventionné - Remboursement V.I.P.O. / Prestataire avec ou sans convention
Terugbetaling Gew. recht. / Verstr. met overeenkomst - Terugbetaling W.I.G.W. / Verstr. met of zonder overeenkomst
C = Supplément patient Bén. ordin. / Prestataire conventionné - Supplément patient V.I.P.O. / Prestataire avec ou sans convention
Supplement patiënt Gew. recht. / Verstr. met overeenkomst - Supplement patiënt W.I.G.W. / Verstr. met of zonder overeenkomst
D = Remboursement Bén. ordin. / Prestataire non conventionné
Terugbetaling Gew. recht. / Verstr. zonder overeenkomst
E = Supplément patient Bén. ordin. / Prestataire non conventionné
Supplement patiënt / Verstr. zonder overeenkomst
F = Marge de délivrance
Afleveringsmarge

700011-700022
Tige longitudinale pour fixation à la colonne vertébrale par vis et/ou crochets
Longitudinale staaf voor fixatie aan de wervelkolom via schroeven en/of haken

Valeur de U - U waarde : U 230
Remboursement - Terugbetaling :

Marge de sécurité - Veiligheidsgrens :
237,55 €

Prix plafond - Plafondprijs : 285,06 €

Distributeur
Verdeler

Code d'identification
Identificatiecode

20%

Les montants de la marge de délivrance sont donnés à titre
indicatif : le plafond de 148,74 € est d'application sur l'ensemble
des éléments des implants de la colonne vertébrale - De bedragen
voor de afleveringsmarge worden slechts ter informatie vermeld :
het grensbedrag van 148,74 € is van toepassing op het geheel van
de wervelkolomimplantaten.

Nom du produit
Productnaam

Numéros de référence
Referentienummers

A

B

C

D

E

F

A partir de Jusqu'au
Vanaf
Tot

157001000012

B Braun Medical

Macs rod

SX11xT / SX120T

265,85 237,55

28,30

178,17

87,68

26,58

01-02-2011

157001000021

B Braun Medical

S4 Spinal system rod

SW65xT / SW66xT / SW67xT /
SW68xT

250,69 237,55

13,14

178,17

72,52

25,06

01-02-2011

157001000037

B Braun Medical

S4 Spinal system rod hex tip

SW55xT / SW56xT / SW57xT /
SW58xT / SW59xT

250,69 237,55

13,14

178,17

72,52

25,06

01-02-2011

157001000046

B Braun Medical

S4C Rod

SW19xT

252,30 237,55

14,75

178,17

74,13

25,23

01-02-2011

157001000055

B Braun Medical

Socon rod

FG68xT/ FG71xT / FG72xT

265,65 237,55

28,10

178,17

87,48

26,56

01-02-2011

157001000064

Biomet

Altius Rod

1200-00xx

255,25 237,55

17,70

178,17

77,08

25,52

01-02-2011

157001000073

Biomet

Array Rod

940x9

265,73 237,55

28,18

178,17

87,56

26,57

01-02-2011

157001000082

Biomet

Array Rod

9441x

265,73 237,55

28,18

178,17

87,56

26,57

01-02-2011

157001000091

Biomet

Ballista Rod

14-5004xx

285,06 237,55

47,51

178,17

106,89

28,50

01-02-2011

157001000107

Biomet

Omega Rod

12xx-xx / 1272-xxx

255,25 237,55

17,70

178,17

77,08

25,52

01-02-2011

Mise à jour 01-08-2013 - Bijwerking 01-08-2013

Page 1

(700011-700022)

157001000116

Biomet

Polaris Rod

2000-51xx / 2000-5405 / 642x /
60xx

285,06 237,55

47,51

178,17

106,89

28,50

01-02-2011

157001000125

Cormed

DCR Dynamic composite rod

DCR 00.xxx / DCR 09.xxx /
DCR 18.xxx

285,06 237,55

47,51

178,17

106,89

28,50

01-02-2011

157001000134

Cormed

Evos

62.xxx

258,20 237,55

20,65

178,17

80,03

25,82

01-02-2011

157001000143

Cormed

Odalys Rod

ODPBR6xxx / ODRR6xxx

258,20 237,55

20,65

178,17

80,03

25,82

01-02-2011

157001000152

Cormed

PASS LP Rod

B0217xxxx / B0212xxxx

258,20 237,55

20,65

178,17

80,03

25,82

01-02-2011

157001000161

Cormed

Saxxo Rod

SRS1TTxx(x)

258,20 237,55

20,65

178,17

80,03

25,82

01-02-2011

157001000177

Cormed

Slick's Spinal Rod

S11/TX.6xx

258,20 237,55

20,65

178,17

80,03

25,82

01-02-2011

157001000186

Cormed

Solas

SRxxxx

258,20 237,55

20,65

178,17

80,03

25,82

01-02-2011

157001000195

Cormed

Solas RS Deg Bent Rod

SR16xxBx0 / SR16xx.5Bx0

258,20 237,55

20,65

178,17

80,03

25,82

01-02-2011

157001000204

Globus Medical Belgium

3.7mm Straight Rod, 40mm-240mm

115.8xx

265,00 237,55

27,45

178,17

86,83

26,50

01-02-2011

157001000213

Globus Medical Belgium

5.5mm Curved Rod, 35mm-150mm

124.6xx

265,00 237,55

27,45

178,17

86,83

26,50

01-02-2011

157001000222

Globus Medical Belgium

5.5mm Stainless Steel Curved Rod, 35mm-150mm

224.6xx

265,00 237,55

27,45

178,17

86,83

26,50

01-02-2011

157001000231

Globus Medical Belgium

5.5mm Stainless Steel Straight Rod

224.5xx / 224.0xx

265,00 237,55

27,45

178,17

86,83

26,50

01-02-2011

157001000247

Globus Medical Belgium

5.5mm Stainless Steel Straight Rod, Hex End 300-500mm

424.5xx

265,00 237,55

27,45

178,17

86,83

26,50

01-02-2011

157001000256

Globus Medical Belgium

5.5mm Straight Rod, 30mm-150mm

124.5xx

265,00 237,55

27,45

178,17

86,83

26,50

01-02-2011

157001000265

Globus Medical Belgium

5.5mm Straight Rod, CP, 250mm-500mm

124.00x

265,00 237,55

27,45

178,17

86,83

26,50

01-02-2011

157001000274

Globus Medical Belgium

5.5mm Straight Rod, CP2, 250mm-500mm

124.00x

265,00 237,55

27,45

178,17

86,83

26,50

01-02-2011

157001000283

Globus Medical Belgium

5.5mm Straight Rod, Hex-End

524.00x / 524.5xx

265,00 237,55

27,45

178,17

86,83

26,50

01-02-2011

157001000292

Globus Medical Belgium

Ellipse 3,5mm Occipital Rod, 240mm, 100 deg - 130 deg

182.95x

285,06 237,55

47,51

178,17

106,89

28,50

01-02-2011

157001000301

Globus Medical Belgium

Ellipse 3,5mm Rod 80mm - 240mm

182.80x

285,06 237,55

47,51

178,17

106,89

28,50

01-02-2011

157001000317

Globus Medical Belgium

Ellipse Tapered Rod 3,5 to 6,5mm, 350mm - 500mm

182.98x

285,06 237,55

47,51

178,17

106,89

28,50

01-02-2011

157001000326

Globus Medical Belgium

Revolve 5,5mm Curved Rod, Cone Tip, 40mm - 95mm

132.1xx

285,06 237,55

47,51

178,17

106,89

28,50

01-02-2011

157001000335

Globus Medical Belgium

Revolve 5,5mm Rod, 100mm - 190mm

185.3xx

285,06 237,55

47,51

178,17

106,89

28,50

01-02-2011

157001000344

Globus Medical Belgium

Revolve 5,5mm Rod, 200mm - 240mm

185.4xx

285,06 237,55

47,51

178,17

106,89

28,50

01-02-2011

157001000353

Globus Medical Belgium

Revolve 5,5mm Rod, 300mm

185.5xx

285,06 237,55

47,51

178,17

106,89

28,50

01-02-2011

157001000362

Globus Medical Belgium

Revolve 5,5mm Rod, 80mm - 90mm

185.2xx

285,06 237,55

47,51

178,17

106,89

28,50

01-02-2011

157001000371

Globus Medical Belgium

Tapered Rod, 3.7mm to 6.5mm, 240mm-500mm

115.98x

265,00 237,55

27,45

178,17

86,83

26,50

01-02-2011

Mise à jour 01-08-2013 - Bijwerking 01-08-2013

Page 2

(700011-700022)

157001000387

Hospithera

Alphatec CP TI STRAIGHT ROD x.x DIA x XCM FEMALE HEX

620xx-xx(x)

265,00 237,55

27,45

178,17

86,83

26,50

01-02-2011

157001000396

Hospithera

Alphatec PRE-CONTOURED / C.P. TI ROD x.xMM X xCM

736xx-xxx

285,00 237,55

47,45

178,17

106,83

28,50

01-02-2011

157001000405

Hospithera

Alphatec TI 3.3MM - 5.5MM TRANSITIONAL ROD - 500MM

63002-500

280,00 237,55

42,45

178,17

101,83

28,00

01-02-2011

157001000414

Hospithera

Alphatec TI CERVICAL ROD - 3.3MM

63001-xxx

265,00 237,55

27,45

178,17

86,83

26,50

01-02-2011

157001000423

Hospithera

Alphatec ZODIAC TI ALLOY STRAIGHT ROD x.x X 50CM

62001-50

280,00 237,55

42,45

178,17

101,83

28,00

01-02-2011

157001000432

Hospithera

Romeo PRE BEND TIGE NON-STERILE Ø 5.4 - (30MM à 90 MM)

ELL-RD00xx-N

238,50 237,55

0,95

178,17

60,33

23,85

01-02-2011

157001000441

Hospithera

Romeo PRE BEND TIGE STERILE Ø 5.4 - (30MM à 90 MM)

ELL-RD00xx-S

265,00 237,55

27,45

178,17

86,83

26,50

01-02-2011

157001000457

Hospithera

Romeo TIGE NON STERILE Ø 5.4 - (100MM à 350MM)

ELL-RD0xxx-N

238,50 237,55

0,95

178,17

60,33

23,85

01-02-2011

157001000466

Hospithera

Romeo TIGE STERILE Ø 5.4 - (100MM à 180 MM)

ELL-RD0xxx-S

265,00 237,55

27,45

178,17

86,83

26,50

01-02-2011

157001000475

InSpine Belgium

LDR Rod - M

ES5xxT

285,06 237,55

47,51

178,17

106,89

28,50

01-02-2011

157001000484

InSpine Belgium

LDR Rod - R

ES6xxT

285,06 237,55

47,51

178,17

106,89

28,50

01-02-2011

157001000493

InSpine Belgium

LDR Rod - S

ES40xT

285,06 237,55

47,51

178,17

106,89

28,50

01-02-2011

157001000502

InSpine Belgium

Pioneer Rod Hex Head XXX

10-55-RH-xxx

285,06 237,55

47,51

178,17

106,89

28,50

01-02-2011

157001000511

InSpine Belgium

Pioneer Rod Prebend XX(X)

10-55-PR-xx(x)

285,06 237,55

47,51

178,17

106,89

28,50

01-02-2011

157001000527

InSpine Belgium

Pioneer Rod Straight XX(X)

10-55-RR-xx(x)

285,06 237,55

47,51

178,17

106,89

28,50

01-02-2011

157001000536

ISKRA

Tige Lisse 3K Chrome-Cobalt

3KTCC55x00

285,00 237,55

47,45

178,17

106,83

28,50

01-02-2011

157001000545

ISKRA

Tige Lisse 3K T.40

3KTL16xx(x)

285,00 237,55

47,45

178,17

106,83

28,50

01-02-2011

157001000554

ISKRA

Tige Lisse 3K TA6V

3KTR26xxx / 3 KTS36500/
3KTP46500 / /3KTF56250

285,00 237,55

47,45

178,17

106,83

28,50

01-02-2011

157001000563

ISKRA

Tige T.40 3K Ø1 L300

3KTSL66300

285,00 237,55

47,45

178,17

106,83

28,50

01-02-2011

157001000572

Johnson & Johnson MedicalDepuy

Expedium 4.5 mm rod

1861 61 4xx

265,00 237,55

27,45

178,17

86,83

26,50

01-02-2011

157001000581

Johnson & Johnson MedicalDepuy

Expedium 5.5 SS

1881 63 xxx

280,05 237,55

42,50

178,17

101,88

28,00

01-02-2011

157001000597

Johnson & Johnson MedicalDepuy

Expedium Anterior Rod

1877 03 xxx

257,99 237,55

20,44

178,17

79,82

25,79

01-02-2011

157001000606

Johnson & Johnson MedicalDepuy

Expedium Cr Co rod

1861 78 xxx / 1861 62 551 /
1967 89 xxx / 1797 78 xxx

280,06 237,55

42,51

178,17

101,89

28,00

01-02-2011

157001000615

Johnson & Johnson MedicalDepuy

Expedium LIS rod

1867 xx xxx

280,06 237,55

42,51

178,17

101,89

28,00

01-02-2011

157001000624

Johnson & Johnson MedicalDepuy

Expedium Offset rod pre lordosed SS 5.5

1896 72 0xx

285,00 237,55

47,45

178,17

106,83

28,50

01-02-2011

157001000633

Johnson & Johnson MedicalDepuy

Expedium Offset rod pre lordosed SS 6.35

1899 72 0xx

285,00 237,55

47,45

178,17

106,83

28,50

01-02-2011

157001000642

Johnson & Johnson MedicalDepuy

Expedium Offset rod pre lordosed Ti 6.35

1799 72 0xx

285,00 237,55

47,45

178,17

106,83

28,50

01-02-2011

Mise à jour 01-08-2013 - Bijwerking 01-08-2013

Page 3

(700011-700022)

88 28.89 28.44 178. L=20 848012 283.17 106.55 20.35 01-02-2011 157001000886 Medtronic Antares Pre-cut Rod 5.5mm Ti.25 237.45 178.Bijwerking 01-08-2013 Page 4 (700011-700022) .17 101.55 47.83 28.82 25.35 1899 6x xxx 285.06 237.55 20.17 106.83 28.99 237.35 1797 92 xxx 179793xxx / 17744xxxx / 179797xxx / 179798xxx 1770 70 xxx 280.5 1896 62 xxx 285.45 178.55 45.00 237.55 47.55 42.06 237.06 237.55 47.51 178.51 178.51 178.17 106.51 178.95 178.5 1797 72 0xx 285.51 178.55 20.55 47.50 01-02-2011 157001000834 MEDIANN SCS Tige 2T46-Txxx 285.50 01-02-2011 157001000676 Johnson & Johnson MedicalDepuy Expedium Offset rod straight Ti 6.82 25.82 25.44 178.79 01-02-2011 157001000791 Johnson & Johnson MedicalDepuy Summit Rod Dual 1746 63 xxx 280..51 178.55 42.89 28.44 178.89 28.50 01-02-2011 157001000685 Johnson & Johnson MedicalDepuy Expedium Peek rod 1867 82 xxx 280.5 1797 62 xxx 285.55 42.08 25.50 01-02-2011 157001000861 MEDIANN TWINFLEX II Tige Elf en U 1T40-xxxX 285.35mm Super Flex rod L51cm 808-088 283.50 01-02-2011 157001000712 Johnson & Johnson MedicalDepuy Expedium Sacral extender 285.35 01-02-2011 157001000904 Medtronic CD Eclipse 4.33 28.89 28.89 28.17 106.35 01-02-2011 157001000895 Medtronic Antares Rod Ti 855-012 283.50 237.55 42.51 178.17 105.35 1770 10 0xx 280.51 178.89 28.17 106.50 01-02-2011 157001000852 MEDIANN TWINFLEX I Tige Elf en U 1T40-Xxxx 285.17 79.55 47.17 106.33 28.17 101.50 237.06 237.99 237.06 237.89 28.55 42.95 178.55 45.70 178.50 01-02-2011 157001000703 Johnson & Johnson MedicalDepuy Expedium Rod Prebent 5.83 28.55 17.06 237.17 101.35 1799 63 xxx 285.33 28.00 237.50 01-02-2011 157001000877 Medtronic 6.17 106.00 237.17 106.52 01-02-2011 157001000816 MEDIANN ORIA ALIS Tige GT40-Txxx 285.50 01-02-2011 157001000843 MEDIANN TLS Tige CT40-Cxxx 285.50 01-02-2011 157001000667 Johnson & Johnson MedicalDepuy Expedium Offset rod straight SS 6.50 237.99 237.05 237.06 237.17 105.00 01-02-2011 157001000746 Johnson & Johnson MedicalDepuy Mountaineer Rod 1883 16 xxx / 1883 10 xxx 257.79 01-02-2011 157001000764 Johnson & Johnson MedicalDepuy Mountaineer Rod Dual 1883 11 0xx / 1883 10 0xx 280.55 47.89 28.17 79.55 47.50 178.00 01-02-2011 157001000773 Johnson & Johnson MedicalDepuy Mountaineer Rod Prebent 1883 63 xxx 257.17 106.17 106.06 237.99 237.55 45.89 28.79 01-02-2011 157001000782 Johnson & Johnson MedicalDepuy Summit Rod 1746 xx xxx 257.06 237.45 178.17 77.06 237.79 01-02-2011 157001000755 Johnson & Johnson MedicalDepuy Mountaineer Rod Adjustable 1883 64 x00 257.50 01-02-2011 157001000825 MEDIANN ORIA CLARIS Tige 7T40-Hxxx 285.17 79.35 01-02-2011 Mise à jour 01-08-2013 .06 237.51 178.55 20.17 105.51 178.00 01-02-2011 157001000694 Johnson & Johnson MedicalDepuy Expedium Rod 5.17 101.89 28.17 106.82 25.45 178.00 01-02-2011 157001000737 Johnson & Johnson MedicalDepuy Monarch Rod Prebent 6. L-X 8698xxx 283.5 mm CP ROD.00 01-02-2011 157001000807 Johnson & Johnson MedicalDepuy 'VSP / Isola Stainless Steel Rod 50001xxx/5000xx 255.44 178.55 47.33 28.83 28.50 237.95 178.17 79.50 01-02-2011 157001000721 Johnson & Johnson MedicalDepuy Monarch Rod 6.55 47.55 47.17 106.45 178.55 45.55 47.83 28.55 47.95 178.157001000651 Johnson & Johnson MedicalDepuy Expedium Offset rod straight SS 5.51 178.89 28.17 105.17 101.00 237.00 237.

33 28.17 106.50 237.50 237.89 28.33 28.35 X xxxmm PREBENT ROD.95 178.06 237.95 178.33 28.5 mm 855-011 283.17 105.95 178.35 Sea Foam Green CP Rod w Line 969-022 283.6 L-X 8313xxx 283.95 178.5 x 508mm SS X1199100 283.33 28.95 178.06 237.35 01-02-2011 157001001062 Medtronic Legacy Rod Ti 3.17 105.50 237.17 105.5mm lined 500mm 869-xxx 283.95 178.35 01-02-2011 157001001132 Medtronic ROD EXTENSION 4X15MM SS X110615 283.95 178.17 105.33 28.55 45.55 45.55 45.17 105.95 178.33 28.17 105. TI CP 969xxxx 283.5 L-X 8690xxx / G8690xxx 283.33 28.Bijwerking 01-08-2013 Page 5 (700011-700022) .17 105.95 178.35 01-02-2011 157001001001 Medtronic Legacy 6.TI CP 8690xxx 283.55 45.50 01-02-2011 Mise à jour 01-08-2013 .35 01-02-2011 157001001026 Medtronic Legacy Anterior Rod xxxmm 8699xxx 283.50 237.55 45.5 DIA HEX END SS 868-011 283.5 mm 845-011 283.33 28.17 106.35 01-02-2011 157001001175 Medtronic Rod Percutaneous Peek 757xxxx 285.55 47.55 45.50 237.17 105.55 45.95 178.33 28.17 105.17 105.5 DIA LINED HEX END SS 868-021 283.33 28.35 01-02-2011 157001000965 Medtronic CDH Longitude staaf Ti L-X 7571xxx 285.50 237.95 178.50 237.33 28.55 45.35 01-02-2011 157001001035 Medtronic Legacy Peek Rod 7893xxx 285.95 178.33 28.55 47.17 105.55 45.50 237.6 MM XB103303351 283.35 01-02-2011 157001001017 Medtronic Legacy Anterior Rod 5.50 01-02-2011 157001000974 Medtronic Colorado2 Inox staaf D5mm L-X 86135xx 285.50 237.5 DIA HEX END TI 869-012 283.33 28.35 01-02-2011 157001000931 Medtronic CD Pediatrisch M7 Ti Staaf 4.35 01-02-2011 157001000947 Medtronic CDH 5.55 45.35 01-02-2011 157001001105 Medtronic Legacy Ti.17 105.55 45.33 28.5mm 838-012 283.95 178.50 237.55 45.89 28.157001000913 Medtronic CD Horizon Inox Staaf 5.50 237.51 178.17 105.51 178.33 28.5mm 8643480 283.55 45.17 105.5mm 7360xxx 283.35 01-02-2011 157001001053 Medtronic Legacy Rod SS 4.55 45.06 237.33 28.33 28.5mm Hex End 848-011 283.95 178.35 01-02-2011 157001001071 Medtronic Legacy Rod Ti 4. Rod 5.89 28.17 105.35 01-02-2011 157001001141 Medtronic ROD LEG 5.35 01-02-2011 157001001123 Medtronic Rod CDH Leg 4.55 45.17 105.50 237.50 01-02-2011 157001000983 Medtronic Equation Staaf 3.51 178.5mm 7340xxx 283.95 178.50 237.95 178.33 28.33 28.55 45.35 01-02-2011 157001000956 Medtronic CDH 6.50 237.55 47.50 237.17 105.17 106.35 01-02-2011 157001001096 Medtronic Legacy Ti.50 237.55 45.35 01-02-2011 157001001166 Medtronic ROD LEG 5. Prebent Rod 5.95 178.35 Sea Foam Green CP Rod 969-012 283.35 01-02-2011 157001000992 Medtronic Legacy 6.50 237.17 105.89 28.55 45.35 01-02-2011 157001001087 Medtronic Legacy Ti Mini Rod xxxmm 734xxxxINT 283.06 237.55 45.17 105.95 178.95 178.35 01-02-2011 157001001157 Medtronic ROD LEG 5.35 01-02-2011 157001000922 Medtronic CD Horizon Ti.35 01-02-2011 157001001114 Medtronic ROD 3.17 105. Staaf 5.50 237.95 178.5x500mm 869-011 283.33 28.50 237.95 178.55 45.50 237.5Xxxxmm STRAIGHT ROD.17 105.17 105.55 45.51 178.33 28.95 178.55 45.50 237.55 45.50 237.50 01-02-2011 157001001044 Medtronic Legacy Rod SS 3.95 178.55 47.33 28.17 105.33 28.17 106.50 237.

55 47.38 23.55 45.95 178.50 01-02-2011 157001001315 NEW2DM Tige Lisse 3K TA6V 3KTR26xxx / 3 KTS36500/ 3KTP46500 / 3KTF56250 285.55 237.5mm 837-125 283.51 178.51 178.35 01-02-2011 157001001263 Medtronic TSRH-3D Ti.17 106.55 237.17 105.55 47.xxXxx / ATR410x.95 178.33 28.IR600L 285.50 01-02-2011 157001001351 Orthogèse BJR Tige Ø 5.50 01-02-2011 157001001437 SDI Belgium Tige iliaque gauche U1 .06 237.17 105.0 mm x xx0 mm PLUS™ Titane U1 .95 178.17 106.83 28.55 32.0 mm x xx mm Ti LUMIS™ MS1-RB6xxT/ MS1-RB6xxST 285.55 45.89 28.50 01-02-2011 157001001324 NEW2DM Tige T.33 28.35 01-02-2011 157001001245 Medtronic Tenor Staaf D=5.17 106.50 237.35 01-02-2011 157001001281 Medtronic Vertex Ti Rod xxmm x xxmm 695xxxx 283.55 237.95 178.55 45.75 01-02-2011 157001001421 SDI Belgium Tige iliaque droite U1 .95 178.51 178.83 28.5mm Staaf L-X 8370xxx 283.55 45. L-X 6900xxx 283.51 178.06 237.17 105.00 178.55 47.17 92.95 178.89 28.83 28.40 3K Ø1 L300 3KTSL66300 285.0 mm x xx0 mm Ti Uni-Thread™ L2-R6xxHT 237.50 01-02-2011 157001001446 SDI Belgium Tige pré-cintrée 6.17 106.17 105.50 01-02-2011 157001001376 OSTEON RODS PFR05xx(x) / PFR06xx(x) 237.17 106.Rod 22409-40 / 22630-40 270.55 45.R6xxH 237.00 237.55 47.06 237.03 01-02-2011 157001001342 Orthogèse BJR Tige ceintrée Ø 5.55 45.IR600R 285.06 237.0 mm x xx mm Ti LUMIS™ avec double butées MS1-RA6xxST 285.50 01-02-2011 157001001306 NEW2DM Tige Lisse 3K T.35mm 968-021 283.75 01-02-2011 157001001385 SDI Belgium Tige à butée unique 6.55 0.51 178.55 45.33 28.50 01-02-2011 157001001254 Medtronic TSRH-3D Ti.75 CCM NS CURV xxMM 147500xxxx/1476000500 / 1475501xxx 285.5 et Ø 7 MUN410x.55 47.17 105. L-X 8672xxx 283.55 47.55 47.17 59.51 178.17 106.89 28.00 178.35 01-02-2011 157001001202 Medtronic SOLERA ROD 4.17 105.06 237.17 106.89 28.45 178.75 178.55 45.xxXxx 285.50 237.35 01-02-2011 157001001272 Medtronic Vertex 3.R6xxHT 237.00 237.50 237.95 178.13 27.55 47.45 178.33 28.50 237.5 12TGxx. 5.89 28.45 178.06 237.33 28.50 01-02-2011 157001001211 Medtronic SS Rod with line .50 01-02-2011 157001001333 Ortho Team WSI .00 178.83 28. 25cm staaf.17 106.89 28.51 178.55 47.00 237.55 47.Legacy Rod SS 6.89 28.89 28.95 178.17 106.50 237.Bijwerking 01-08-2013 Page 6 31-03-2011 (700011-700022) .17 59.50 237.17 105.55 47.50 237.5 ATR4600. 5.55 0.xxXxx 285.75 01-02-2011 157001001403 SDI Belgium Tige avec hexagone 6.33 28.38 23.00 178.95 178.33 28.157001001184 Medtronic ROD SMOOTH 4X180MM SS X110580 283.50 237.50 01-02-2011 Mise à jour 01-08-2013 .89 28.17 59.0 mm x xx0 mm PLUS™ U1 .55 0.50 01-02-2011 157001001367 Orthogèse Scient'x Rod 5.17 106.17 106. diam.38 23.50 237.38 23.35 01-02-2011 157001001227 Medtronic T2D Pcut bent rod 8371xxx 283.06 237.55 45.17 106.55 47.55 237.40 3KTL16xx(x) 285.35 01-02-2011 157001001297 NEW2DM Tige Lisse 3K Chrome-Cobalt 3KTCC55x00 285.30 237.55 0.50 01-02-2011 157001001394 SDI Belgium Tige avec hexagone 6.35 01-02-2011 157001001193 Medtronic Sextant Staaf Ti.5mm L-X 806TS55LxxxT 285.55 47.xxx 285.35 01-02-2011 157001001236 Medtronic T3D 25cm PCUT 6.51 178.33 28.06 237.35 837-135 283.2mm Titanium Rod.75 01-02-2011 157001001412 SDI Belgium Tige avec hexagone 6.17 105.17 59.06 237.00 237.33 28.51 178.17 106.45 178.17 105.

55 47.06 237.55 47.45 178.19 237.75 01-02-2011 157001001491 SHARK MEDICAL Tige Lisse 3K Chrome-Cobalt 3KTCC55x00 285.50 01-02-2011 157001001604 STRYKER Ø 4.17 106.50 01-02-2011 Mise à jour 01-08-2013 .R660HS 237.45 178.Bijwerking 01-08-2013 Page 7 (700011-700022) .75 01-02-2011 157001001482 SDI Belgium Tige rigide 6.17 80.06 237.45 178.51 178.64 178.89 28.02 25.50 01-02-2011 157001001622 STRYKER ROD 1XXmm 6651xx 258.17 106.81 01-02-2011 157001001647 STRYKER ROD 3XX 6653xx 285.5 x XXXmm TA6V ROD 48133xxx 262.17 80.5 x XXXmm ROD 48552xxx / 48551xxx 259.55 0.83 28.06 237.00 237.55 47.02 25.51 178.55 27.00 237.37 0.00 75.70 237.17 106.17 81.50 01-02-2011 157001001586 STRYKER MANTIS STRAIGHT ROD 48288xxx 285.55 47.37 0.17 106.89 28.53 01-02-2011 157001001543 STRYKER 3.89 28.06 237.53 25.19 237.55 20.0 mm x xx0 mm Ti Uni-Thread™ L2-R6xxCHT 285.55 47.15 178.81 01-02-2011 157001001577 STRYKER DYNAMIC ROD 671xxx 285.89 28.55 22.5X480 48222000 / 48222001 258.17 106.17 59.55 47.06 237.40 3KTL16xx(x) 285.51 178.38 23.17 106.97 01-02-2011 157001001552 STRYKER 5.17 106.17 80.17 59.19 237.37 75.02 25.51 178.06 237.17 106.45 178.50 01-02-2011 157001001701 STRYKER VITALLIUM ROD 4.55 20.64 178.89 28.17 106.88 237.64 178.17 106.81 01-02-2011 157001001692 STRYKER SR 90 ROD 1924xxx / 812xx 285.19 237.50 01-02-2011 157001001595 STRYKER MaX Rods Radius 486615xxx 265.17 106.50 01-02-2011 157001001665 STRYKER ROD 5.55 237.00 178.51 178.17 106.75 01-02-2011 157001001473 SDI Belgium Tige rigide 6.0 mm x 600 PLUS™ U1 .17 86.28 01-02-2011 157001001613 STRYKER RADIUS ROD 48551xxx / 4866130xx 285.06 237.19 237.50 01-02-2011 157001001507 SHARK MEDICAL Tige Lisse 3K T.89 28.R650HS 237.17 80.50 01-02-2011 157001001717 STRYKER VITALLIUM ROD 6 MM 600MM 03822601 285.17 84.50 01-02-2011 157001001683 STRYKER ROD XXmm 6650xx 258.81 01-02-2011 157001001631 STRYKER ROD 2XXmm 6652xx 258.38 23.55 25.55 20.51 178.89 28.71 26.0 mm x 500 PLUS™ U1 .55 0.5 MM 600 MM 48132601 285.00 7.40 3K Ø1 L300 3KTSL66300 285.00 178.17 59.00 178.55 47.00 237.55 47.45 178.17 80.89 28.55 237.02 25.50 01-02-2011 157001001534 Spineway MONT BLANC BABY TIGE BB1R4xxx 75.55 47.17 106.00 237.83 28.64 178.83 26.06 237.89 28.64 178.00 237.06 237.33 178.83 28.51 178.50 01-02-2011 157001001561 STRYKER ATLROD6x XXXmm 03802xxx 258.17 106.02 25.55 0.55 47.0 mm x 420 PLUS™ U1 .R642HS 237.51 178.51 178.83 28.55 47.157001001455 SDI Belgium Tige pré-cintrée 6.55 47.17 106.55 20.06 237.38 23.51 178.89 28.51 178.5 TI ROD 486613600 285.06 237.55 237.50 01-02-2011 157001001464 SDI Belgium Tige rigide 6.89 28.50 01-02-2011 157001001656 STRYKER ROD 4XX 6654xx 285.50 01-02-2011 157001001516 SHARK MEDICAL Tige Lisse 3K TA6V 3KTR26xxx / 3 KTS36500/ 3KTP46500 / 3KTF56250 285.81 01-02-2011 157001001674 STRYKER ROD 5XX 6655xx 285.55 20.50 01-02-2011 157001001525 SHARK MEDICAL Tige T.55 47.55 47.55 47.

11 01-02-2011 157001001927 Synthes USS fractuur inox 100mm 298.032 285.06 237.61 01-02-2011 157001001963 Synthes USS fractuur inox 50mm 298.631.50 01-02-2011 157001001841 Synthes PANGEA gebogen staaf 04.13x / 498.627.89 28.957(S) 285.400 285.22 01-02-2011 157001001884 Synthes USS deg inox 150mm 298.51 178.00 57.74 47.89 28.13 0.11 0.0 x XXX MM 48286xxx 285.55 47.94 01-02-2011 157001001911 Synthes USS deg inox 75mm 298.06 237.102 46.00 8.76 01-02-2011 157001001893 Synthes USS deg inox 200mm 298.17 106.17 106.51 178.17 84.95 49.55 47.50 01-02-2011 157001001787 STRYKER XIA ROD 6.06 237.11 0.89 28.89 28.17 106.89 28.09 135.00 5.55 25.33 178.06 237.55 47.00 55.06 237.17 106.28 0.50 01-02-2011 157001001832 Synthes Clampfix Staaf met klem 04.1xx / 498.55 47.06 237.0 X 200 MM 48287200 258.06 237.28 112.81 01-02-2011 157001001796 Synthes AXON 498.00 4.114 106.51 178.28 01-02-2011 157001001735 STRYKER XIA MAX RAD ROD 48219xxx 285.02 25.61 01-02-2011 157001001875 Synthes USS deg inox 125mm 298.17 106.51 178.51 178.50 01-02-2011 157001001945 Synthes USS fractuur inox 150mm 298.00 112.76 01-02-2011 157001001954 Synthes USS fractuur inox 200mm 298.xxx(S) 285.89 28.50 01-02-2011 157001001823 Synthes Clampfix Staaf 04.60 127.51 178.66 57.74 0.66 0.0 MM 480 MM 48232480 262.17 106.00 4.00 10.60 0.00 5.13 106.161.627.50 01-02-2011 157001001771 STRYKER XIA ROD 4823xxxx 285.00 4.60 01-02-2011 157001001972 Synthes USS fractuur inox 75mm 298.74 0.51 178.89 28.631.51 178.50 01-02-2011 157001001857 Synthes SPIRIT staaf 04.28 0.55 47.89 28.07 0.89 28.89 28.17 106.51 178.10x 285.55 47.00 127.620.10 0.00 12.09 0.17 106.110 89.00 106.17 106.17 80.06 237.64 178.99 01-02-2011 157001001936 Synthes USS fractuur inox 125mm 298.00 13.07 46.00 11.89 28.50 01-02-2011 157001001814 Synthes Clampfix percutane staaf 04.88 237.00 47.50 01-02-2011 157001001762 STRYKER XIA RAD ROD 6.103 47.065 285.50 01-02-2011 157001001744 STRYKER XIA MAX RAD ROD 6.50 01-02-2011 157001001866 Synthes USS deg inox 100mm 298.50 01-02-2011 Mise à jour 01-08-2013 .118 127.116 112.050 285.09 0.00 86.89 28.17 106.14x 285.48 89.10 86.03 0.00 89.119 135.06 237.108 86.66 0.95 0.17 106.51 178.00 49.17 106.00 135.659.50 01-02-2011 157001001753 STRYKER XIA RAD ROD 482180xx 285.51 178.06 237.112 101.71 26.06 237.00 101.00 10.10 0.11 101.07 0.50 01-02-2011 157001001805 Synthes AXON gebogen 04.0 x XXX MM 48287xxx 285.00 8.50 01-02-2011 157001001902 Synthes USS deg inox 50 mm 298.89 28.157001001726 STRYKER XIA III TIT ROD 6.03 0.51 178.06 237.48 0.104 49.119 / (0)4.00 46.77 01-02-2011 157001001981 Synthes USS fractuur titanium 498.105 55.95 0.55 47.19 237.55 47.03 55.102 -> 498.60 0.55 47.55 47.17 106.55 47.48 0.55 20.51 178.55 47.13 0.06 237.Bijwerking 01-08-2013 Page 8 30-06-2011 (700011-700022) .106 57.55 47.

06 237.50 01-02-2011 157001002042 Synthes Verbindingsstaaf SYNAPSE 04.2xx 285.25 mm.00 11.00 165.45 178.45 01-02-2011 31-08-2012 157001002164 MSH krypton rod.67 0. (length 30 mm to 40 mm) CS 2808-30T -> CS 2808-40T 49.00 74.00 4.76 0.43 50.15x / 498.89 28.55 47. (length 120 mm to 140mm) CS 1408-120T -> CS 1408140T 116.04 01-02-2011 31-08-2012 157001002234 MSH neon rod.5 mm/6.00 116.00 82.06 237.55 47.45 178.06 237. length 375 mm CS 2808-375T 285.45 0.98 0.83 24. Ø 6.25 mm.17 106.00 9.98 82.00 8.25 mm CS 1428 T 267. length 400 mm CS 3013-400 285.17 106.00 237.58 98. Ø 4.29 01-02-2011 31-08-2012 157001002252 MSH neon rod.97 01-02-2011 31-08-2012 157001002121 MSH krypton rod.00 131.00 98.02 66.36 0. Ø 6.00 13.55 47.18 01-02-2011 31-08-2012 157001002112 MSH krypton rod. Ø 6.00 24. Ø 4.76 149.78 0. Ø 6.50 01-02-2011 157001002051 MSH Hybrid rod krypton/tangoRS/cosmic Ø 6.50 0.45 0. (length 50 mm to 60mm) CS 1408-50T -> CS 1408-60T 50. Ø 4.50 01-02-2011 157001002024 Synthes USS zachte staaf 498.34 0.43 0.39 0.00 57.31 33.157001001997 Synthes USS harde staaf 498. (length 60 mm to 70mm) CS 2808-60T -> CS 2808-70T 66.00 6.0 mm/ 6.51 178.83 28. (length 65 mm to 75mm) CS 1408-65T -> CS 1408-75T 66.95 26.39 0. Ø 6.83 28.98 0. (length 90 mm to 95mm) CS 2808-90T -> CS 2808-95T 82.00 33.00 14.64 01-02-2011 31-08-2012 157001002207 MSH neon rod.29 01-02-2011 31-08-2012 157001002173 MSH krypton rod.58 0.25 mm.25 mm.00 9.64 01-02-2011 31-08-2012 157001002103 MSH krypton rod.50 01-02-2011 31-08-2012 157001002076 MSH Hybridstab neon/krypton ø 4. Ø 6.89 28.00 5. Ø 4.89 28.25 mm.25 mm.73 01-02-2011 31-08-2012 157001002146 MSH krypton rod.67 0.00 237.50 01-02-2011 31-08-2012 157001002067 MSH Hybrid rod neon/tangoRS Ø 4.5 mm.93x 285.5 mm.00 66.83 0.17 106.78 0. Ø 4.00 49.50 01-02-2011 31-08-2012 157001002191 MSH neon rod. length 450 mm CS 3014-450 285.50 01-02-2011 157001002015 Synthes USS paediatric 498. Ø 6.31 0.39 57.0 mm.17 88.00 237.96 01-02-2011 31-08-2012 157001002137 MSH krypton rod.50 01-02-2011 157001002033 Synthes Verbindingsstaaf 498.MAB.67 49.02 0.55 47.55 47.25 mm. (length 100 mm to 108mm) CS 2808-100T -> CS 2808108T 98.50 01-02-2011 157001002006 Synthes USS paediatric 498.78 66.58 0.89 0.00 6.00 149.45 0.34 99.89 0.25 mm. Ø 4.5 mm. (length 80 mm to 90mm) CS 1408-80T -> CS 1408-90T 82.12 237. (length 156 mm to 168mm) CS 2808-156T -> CS 2808168T 131. Ø 6. Ø 4.55 29.76 0.93 01-02-2011 31-08-2012 Mise à jour 01-08-2013 .83 28.17 106.55 47. (length 180 mm to 192mm) CS 2808-180T -> CS 2808192T 149.5 mm.5 mm.51 178.67 01-02-2011 31-08-2012 157001002155 MSH krypton rod.51 178.06 237.00 3.89 28.98 82.45 0.50 74. Ø 6.00 16.89 28.00 66.00 8.49x 285.00 99.89 28.17 106.17 106.00 7.57 178. Ø 6.5xx (S) 285.60 01-02-2011 31-08-2012 157001002243 MSH neon rod.25 mm.17 106. (length 120 mm to 144mm) CS 2808-120T -> CS 2808144T 116.25 mm.06 237. length 204 mm CS 2808-204T 165.51 178. Ø 6. (length 45 mm to 55mm) CS 2808-45T -> CS 2808-55T 57.55 47.614.5 mm.00 116.43 0.00 5.25 mm.98 0.55 47.00 2.45 116.00 50.25 mm.45 178.89 131.45 116. (length 20 mm to 30mm) CS 1408-20T -> CS 1408-30T 24.85 01-02-2011 31-08-2012 157001002094 MSH krypton rod.02 0.55 47.50 0. (length 35 mm to 45 mm ) CS 1408-35T -> CS 1408-45T 33.51895 285.34 0.48 01-02-2011 31-08-2012 157001002216 MSH neon rod. (length 75 mm to 85 mm) CS 2808-75T -> CS 2808-85T 74.98 0.36 0.36 165.5mm/ 6.71 01-02-2011 31-08-2012 157001002085 MSH krypton rod.17 106.Bijwerking 01-08-2013 Page 9 (700011-700022) .33 01-02-2011 31-08-2012 157001002225 MSH neon rod.00 82.06 237.51 178.83 0. (length 95 mm to 100mm) CS 1408-95 -> CS-100T 99.53 01-02-2011 31-08-2012 157001002182 MSH krypton rod.31 0.5 mm.17 106.51 178.10x 285.00 11.

67 198. Ø 6.45 178.00 178. 6.12 0.06 237.55 0.89 28.55 47.89 28.50 01-02-2011 157001002374 Zimmer Nexlink Titanium Rod 4.50 01-02-2011 157001002356 Zimmer Java Precontoured rod length SN2023-0-xx051 285.5 rod SN2030-0-x0055 285.17 106.89 28. Ti.06 237.61 0.86 01-02-2011 31-08-2012 157001002295 MSH tangoRS connection rod CS 3006-03 267.45 178.83 28.55 42.61 01-02-2011 31-08-2012 157001002286 MSH neon rod.5mm 7500-560x-00 285.51 178. length 230 mm CS 1408-230T 198.5mm Ti 9203-55-X 285.51 178. Ø 6.89 28. blue.17 106.5mm 7500-55xx-00 285.06 237.83 28.00 237.51 178.5 mm.17 106.17 106.45 178.55 47.50 01-02-2011 157001002462 Zimmer SILH/ST360 Rod Curved 5.45 0.61 171.51 178.55 47. Ø 4.50 01-02-2011 31-08-2012 157001002331 Zimmer Java diam.17 106.51 178.35 07.80 01-02-2011 157001002383 Zimmer Optima Curved Rod SG19xx 280.06 237.06 237. blue.51 178.51 178.06 237.00 15.55 47.55 47.06 237.50 01-02-2011 157001002453 Zimmer Sequoia Straight Rod 3311-510 285.06 237.55 47.71 01-02-2011 31-08-2012 157001002304 MSH tangoRS rod.5mm 9205-xxx 285.17 106.00x 285.44 01-02-2011 31-08-2012 157001002313 MSH 'tangoRS rod.00 132.06 237. Ø 4. 5.0 mm (length 100 mm to 192 mm / length 204 mm) CS 3008-1xx / CS 3008-2xx 171.00 237. 5.89 28.61 0.55 47.06 237.50 01-02-2011 157001002487 Zimmer SILH/ST360 Rod Standard 5.83 28.50 01-02-2011 157001002505 Zimmer ST360 Top Loading Rod 07.89 28.51 178.17 101.51 178.65 0.157001002261 MSH neon rod.00 237.50 01-02-2011 157001002417 Zimmer Pathfinder Sterile Bent Rod Ti 9205-xxx-S 285.55 47.00 237.0 mm SG16xx 280.26 01-02-2011 31-08-2012 157001002277 MSH neon rod.51 178.06 237.0 mm (length 30 mm to 95 mm) CS 3008-0xx 154.17 106.00x 285.50 01-02-2011 Mise à jour 01-08-2013 .06 237.17 106.83 23.89 28.00 01-02-2011 157001002392 Zimmer Otpima Straight Rod 6.5 mm.45 0.57 178. length 375 mm CS 3008-375 285.00x 285.50 19.5mm 07.50 01-02-2011 157001002471 Zimmer SILH/ST360 Rod Hex End 5.00 237.95 26.89 28.83 28.50 01-02-2011 157001002496 Zimmer ST360 Rod Standard 6.12 237.17 106.17 106.06 237.50 01-02-2011 157001002514 Cormed Serengeti rod 1001.45 178.45 154.12 166.89 28.0mm Ti 9204-55-X 285.17 88.17 106.00 16. blue.45 178.12 0.51 178.5 mm.55 47.00 13.55 47.45 178.17 59.55 47.0 mm.55 29.00292.55 42.00 17.17 106.89 28.06 237.50 01-02-2011 157001002444 Zimmer Sequoia Pre Bent Rod Ti 3313-xxxx 285.51 178.16 01-02-2011 31-08-2012 157001002322 MSH tangoRS rod.17 20.65 0.50 01-02-2011 157001002435 Zimmer S Bend Sacral Rods.00 01-02-2011 157001002401 Zimmer Pathfinder Spinal Pre-Bent Rod.17 106.67 0.50 01-02-2011 157001002365 Zimmer Java Straight Rod SN2023-0-xx050 285. 5. length 200 mm CS 1408-200T 166.51 178. Ø 6.50 01-02-2011 157001002347 Zimmer Java Ductile Rod SN2023-0-xx055 285.55 47.17 106.55 47.17 101.55 47.55 47.89 28.17 106.0 mm 724-xx0 238. length 160 mm CS 1408-160T 132.65 132.55 47.Bijwerking 01-08-2013 Page 10 (700011-700022) .00 154.0085x.50 01-02-2011 157001002426 Zimmer S Bend Sacral Rods.00 237.55 47.00 166.00 171.51 178.89 28.83 28.17 106.E55xx(x) 285.00320.89 28.17 106. Ø 4.89 28.

50 01-02-2011 157001002645 LDR MEDICAL Barre LDR Easyspine ES 4xx T / ES 5xx T / ES 6xx T 285.17 106.17 101.17 106.17 106.06 237.00 01-07-2011 157001002681 Johnson & Johnson MedicalDepuy Expedium Z-Rod Ti/SS 285. 484861xx(S) 285.89 28.48 237.51 178.89 28.89 28.50 01-09-2011 157001002751 Zimmer Percutaneous Pre-Bent Rod 3510-030 -> 3510-100 284.50 01-02-2011 157001002532 Cormed Fixpine rod 285.50 01-02-2011 157001002654 LDR MEDICAL Barre Précintrée Spine Tune ST54xxT-S / ST55xxT-S 285.2200 285.xxx(S) 273.51 178.xxx(S) 273.17 106.xxx(S) 273.92x(S) 285.89 28.31 27.06 237.xxx OSM313x /OSM313X / OSM320x / OSM321x 285.06 237.51 178.xxx / 84.17 106.89 28. curved 186298300 / 186782x25 280.50 01-02-2011 157001002557 MSH Hybrid rod CS 711x-x00 285.44 178.55 47.51 178.48 237.89 28.06 237.55 42.51 178.06 237.50 01-02-2011 157001002541 Cormed Ascent Rod 65.17 106.17 106.55 47.17 95.17 106.631.50 01-09-2011 157001002776 STRYKER Mantis Hex Rad Rod 484850xx(S).51 178.89 28.51 178.xxx / 59.50 01-02-2011 157001002566 Zimmer Instinct Java Pre-Contoured rod 046W0AN51xxx 285.55 47.51 178.2xx/ 04.633.51 178.55 47.17 106.51 178.17 106.651.50 01-02-2011 157001002663 Johnson & Johnson MedicalDepuy Expedium Hex Rod 188163xx0 280.636.31 27.89 28.06 237.17 95.48 237.55 47.51 178.631.89 28.17 106.06 237.06 237.51 178.3xx 285.55 47.50 01-07-2011 157001002706 Synthes SPIRIT .636.06 237.93 178.55 47.50 01-07-2011 157001002715 Synthes Synapse Rod Prebent 498. 484851xx(S).55 47.51 178.13x(S) 285.xxx / 58.06 237.50 01-02-2011 157001002627 SHARK MEDICAL Barre LDR Easyspine ES 4xx T / ES 5xx T / ES 6xx T 285.157001002523 Cormed Flexstaas Rod 48.631.06 237.xxx / 46.xxx / 64.89 28.xxx(S) / 09.17 106.1xx/ 04.06 237.50 01-07-2011 157001002697 Johnson & Johnson MedicalDepuy Expedium Connector inline with integrated Rod Ti/SS 186198xx0 / 186298xx0 / 179x98xx0 / 188198xx0 / 189698xx0 179x7x55x / 18967x555 / 18817x55x 285.34 01-02-2011 157001002593 Synthes Rod 04.637.51 178.17 106.50 01-08-2011 157001002724 Synthes Synapse Rod Ti 498.06 237.89 28.82 28.89 28.Bijwerking 01-08-2013 Page 11 31-08-2012 (700011-700022) .55 47.55 42.17 106.125(S) 285.89 28.5 CRCO Rod 510 mm 14-500585 285.99 237.55 35.49 01-09-2011 157001002767 Zimmer Percutaneous Straight Rod 3512-100 -> 3512-240 285.89 28.55 35.17 101.34 01-02-2011 157001002611 Biomet Polaris 5.06 237.17 106.2070 / 65.xxx / 81.631.MIS staaf 6 radius 200 genormaliseerd L 04.55 47.34 01-02-2011 157001002602 Synthes MIS ROD 04.55 47.55 47.06 237.xxx / 49.50 01-08-2011 157001002742 Zimmer Straight Rod 3311-100 285.17 106.06 237.51 178.55 47.06 237.06 237.55 47.50 01-02-2011 157001002584 Synthes Headed Rod 04.55 35.51 178.06 237.89 28.51 178.93 178.17 95.17 106.55 47.51 178.51 178.17 106.89 28. 484860xx(S).06 237.55 47.50 01-02-2011 157001002575 Zimmer Instinct Java Straight Rod 046W0AN50xxx 285.2120 / 65.50 01-12-2011 Mise à jour 01-08-2013 .55 47.50 01-02-2011 157001002636 SHARK MEDICAL Barre Précintrée Spine Tune ST54xxT-S / ST55xxT-S 285.89 28.50 01-08-2011 157001002733 Synthes Synapse Rod TAN 498.89 28.xxx(S) / 04.55 47.93 178.17 106.89 28.31 27.06 237.89 28.06 237.51 178.55 47.17 106.0xx/ 04.55 47.51 178.89 28.51 178.89 28.55 47.00 01-07-2011 157001002672 Johnson & Johnson MedicalDepuy Expedium PEEK Rod W/BaSO4.17 106.

51 178.06 237.00 237.17 106.11 178.26 01-03-2012 157001002891 InSpine Belgium MIS Rod 51-55-PR-xx(x) 285.50 01-09-2012 157001003013 Hospithera Hybrid rod neon/tangoRS Ø 4.57 178.4xx / 03.50 01-01-2012 157001002864 Medtronic Solera Rod Sextant 14750050xx / 14750051xx 283.17 106.4 MIS-RT 10 xx-S / MIS-RT 01 xx.45 178.STERILE ELL-RD2xxxS 265.17 652.00 237. length 400 mm CS 3013-400 285.5mm Mantis Hex Vitallium Straight Rod 48484xxx(S) 285.51 178.55 45.49 237.205 + 452.17 106.00 237. 48488xxx(S) 285.89 28.07xS + 452.55 35.55 47.26 01-03-2012 157001002882 Medtronic Rod sagittal SS + set screw SS standard 77826x0x5 + 778270001 272.45 178.13 178.56 01-09-2012 157001002952 Globus Medical Belgium Transition End spool with cord + spacer + spool + bumper + set screw 285.11 178.94 178.00 237.17 87.89 28.0xxS + 152.50.55 47.07 01-09-2012 157001002943 Aceemed MPM staaf TH55Txxx 265.205 + 452.51 178.55 S / MIS-RT 02 00-S 47.33 23.17 106.50 01-12-2011 157001002846 Hospithera Low profile semi-rigid rod diam 5.89 28.55 47.17 106.285.17 94.95 178.55 47.50 01-12-2011 157001002794 STRYKER 6.06 237.89 28.50 01-09-2012 157001002961 Globus Medical Belgium Transition rod with cord + spacer + spool + bumper + set screw 285.55 592.34 01-01-2012 157001002873 Medtronic Rod sagittal TI + set screw TI standard 77816x0x5 + 779170005 272.50 01-12-2011 157001002803 STRYKER 5.150S + 152.50 01-09-2012 157001002986 Globus Medical Belgium Transition 1 or 2 level implant straight 152.83 178.17 106.210 152.4 – (100 mm à 220 mm) .17 94.83 26.45 178.06 237.55 28.55 47.85 01-06-2012 157001002916 Hospithera Romeo 2 rod straight Ø 5.21 83.55 3.55 47.17 106.17 652.06 237.0 mm.51 178.150S + 152.50 237.71 01-09-2012 Mise à jour 01-08-2013 .06 237.50 01-09-2012 157001002977 Globus Medical Belgium Transition 1 or 2 level implant lordosed 152.55 47.20 178.38 237. length 450 mm CS 3014-450 285.38 237.1xxS 285.157001002785 STRYKER Mantis Hex Straight Rod 48487xxx(S).06 237.83 178.50.89 28.51 178.55 47.6xxS 285.51 178.0 Rod 285.00 237.83 28.06 237.0xxS + 152.5 mm/6.50 01-09-2012 157001002934 Medacta Must Rod 155320xxxx / 1554200500 / 1555000500 / 15555xxxxx / 1606000500 / 1556000500 03.55 47.50 01-09-2012 157001003004 Hospithera Hybrid rod krypton/tangoRS/cosmic Ø 6.5 mm 12TGN55-xx / 12TGN55-1xx 285.200/152.06 237.09xS + 452.17 106.03 01-12-2011 1-12-2011 157001002821 Hospithera SupStance Corporectomy Cage 830.83 28.66 237.200/152.83 28.89 28.66 237.45 178.50 01-09-2012 157001002995 Globus Medical Belgium Transition 2 level implant X lordotic 152.55 47.17 62.95 26.75 237.50 01-09-2012 157001003022 Hospithera Hybridstab neon/krypton ø 4.03 01-12-2011 1-12-2011 157001002837 InSpine Belgium DSS Fusion Coupler 100119xxx / 100120xxx / 100122xxx / 100125xxx / 100128xxx DAI700xx 285.51 178.55 0.12 237.08xS/152.17 105.50 01-05-2012 157001002907 Hospithera Romeo 2 rod straight Ø 5.25 mm.17 88.17 106.55 47.NON STERILE ELL-RD2xxxN 238.55 29.210 152.17 106.55 592.55 47.45 178.50 01-12-2011 157001002812 Hospithera SupStance Small Vertebral Body Replacement Cage 100112xxx / 100114xxx 830.89 28.51 178.17 106.89 28.55 47.06 237.55 27.50 01-06-2012 157001002925 Medtronic CD Horizon Solera 5.58 24.0xxS 285.51 178.49 27.17 106.51 178.06 237.49 27.51 178.25 mm CS 1428 T 267.55 35.4 – (100 mm à 550 mm) .5xx 240.55 47.0mm Mantis Hex Vitallium Straight Rod 48489xxx 285.0 mm/ 6.Bijwerking 01-08-2013 Page 12 (700011-700022) .17 60.51 26.21 83.50 01-01-2012 157001002855 Hospithera Percutaneous rod diam 5.17 86.17 106.5mm/ 6.89 28.89 28.83 28.89 28.06 237.68 237.17 106.32 28.5/6.17 106.

25 mm.78 0.45 116.25 mm.02 66. Ø 4.61 171.57 178. Ø 6.00 16.83 28.65 0.36 0.00 5.00 9.17 106.0 mm (length 100 mm to 192 mm / length 204 mm) CS 3008-1xx / CS 3008-2xx 171.25 mm.00 154.00 165. (length 60 mm to 70mm) CS 2808-60T -> CS 2808-70T 66.5 mm.Bijwerking 01-08-2013 Page 13 (700011-700022) .29 01-09-2012 157001003205 Hospithera neon rod.98 82.02 0.71 01-09-2012 157001003257 Hospithera tangoRS rod. (length 120 mm to 144mm) CS 2808-120T -> CS 2808144T 116.83 28. Ø 6. blue.02 0.93 01-09-2012 157001003214 Hospithera neon rod. Ø 4.00 66.67 0. length 375 mm CS 3008-375 285. Ø 6.43 50.83 0.5 mm.12 166.50 01-09-2012 157001003284 Hospithera Hybrid rod CS 711x-x00 285.00 178.29 01-09-2012 157001003126 Hospithera krypton rod.25 mm.17 88.12 0.58 98.86 01-09-2012 157001003241 Hospithera tangoRS connection rod CS 3006-03 267. (length 100 mm to 108mm) CS 2808-100T -> CS 2808108T 98.96 01-09-2012 157001003083 Hospithera krypton rod.45 178. Ø 6.98 0.00 6.43 0.55 47. Ø 6.65 132.25 mm. (length 30 mm to 40 mm) CS 2808-30T -> CS 2808-40T 49. Ø 6.36 165.43 0.00 82.55 47. length 230 mm CS 1408-230T 198.25 mm.95 26.5 mm.5 mm.00 132.00 57. Ø 4.34 99.25 mm. Ø 6.25 mm.48 01-09-2012 157001003162 Hospithera neon rod.55 29.97 01-09-2012 157001003074 Hospithera krypton rod.45 178.50 0.50 19.89 131.00 16.64 01-09-2012 157001003153 Hospithera neon rod. Ø 6.00 50.45 0. (length 65 mm to 75mm) CS 1408-65T -> CS 1408-75T 66.17 106.00 149.00 11.98 82.50 0.00 6.12 237. Ø 4.65 0.00 11.00 98.0 mm (length 30 mm to 95 mm) CS 3008-0xx 154.67 0.89 28.17 106.00 17.50 74. (length 75 mm to 85 mm) CS 2808-75T -> CS 2808-85T 74. length 375 mm CS 2808-375T 285.00 7.31 0.620. length 204 mm CS 2808-204T 165.50 01-09-2012 157001003144 Hospithera neon rod.00 14.5 mm. (length 45 mm to 55mm) CS 2808-45T -> CS 2808-55T 57. Ø 4.00 8.00 49. (length 95 mm to 100mm) CS 1408-95 -> CS-100T 99.620.39 0.83 24.25 mm.26 01-09-2012 157001003223 Hospithera neon rod.00 33.45 154.45 0.5 mm.39 57.55 47.61 0.04 01-09-2012 157001003187 Hospithera neon rod.60 01-09-2012 157001003196 Hospithera neon rod. length 200 mm CS 1408-200T 166.00 15.06 237. (length 50 mm to 60mm) CS 1408-50T -> CS 1408-60T 50. Ø 6.78 0.67 01-09-2012 157001003101 Hospithera krypton rod.76 149.67 0.030S -> 08.25 mm.00 5. (length 180 mm to 192mm) CS 2808-180T -> CS 2808192T 149.58 0. Ø 4. Ø 6.100S 285.89 0. (length 156 mm to 168mm) CS 2808-156T -> CS 2808168T 131.00 131.85 01-09-2012 157001003047 Hospithera krypton rod. Ø 6.17 20.34 0.00 116.45 0. length 160 mm CS 1408-160T 132. blue.00 13.83 0.5 mm. Ø 4.00 99. Ø 6.00 3. Ø 4. Ø 6.73 01-09-2012 157001003092 Hospithera krypton rod.17 106.45 0. (length 35 mm to 45 mm ) CS 1408-35T -> CS 1408-45T 33. (length 90 mm to 95mm) CS 2808-90T -> CS 2808-95T 82.00 74.51 178.16 01-09-2012 157001003275 Hospithera tangoRS rod.31 0.00 2.06 237.00 237.67 49.89 28.00 8.78 66. (length 20 mm to 30mm) CS 1408-20T -> CS 1408-30T 24.45 0.00 66.44 01-09-2012 157001003266 Hospithera 'tangoRS rod.64 01-09-2012 157001003056 Hospithera krypton rod.00 237.45 01-09-2012 157001003117 Hospithera krypton rod.5 mm.33 01-09-2012 157001003171 Hospithera neon rod.50 01-09-2012 157001003293 Synthes PEEK rod 08.98 0.67 198.00 4.89 0.18 01-09-2012 157001003065 Hospithera krypton rod.00 116.55 47. (length 120 mm to 140mm) CS 1408-120T -> CS 1408140T 116.76 0.00 166.58 0. (length 80 mm to 90mm) CS 1408-80T -> CS 1408-90T 82.5 mm.00 13.12 0.61 0.31 33.5 mm.76 0.50 01-02-2013 Mise à jour 01-08-2013 .51 178.45 0.36 0. Ø 4.25 mm. Ø 4.157001003031 Hospithera krypton rod.00 24.00 82.98 0. Ø 6.61 01-09-2012 157001003232 Hospithera neon rod.00 9. blue.00 171.45 116.34 0.0 mm.53 01-09-2012 157001003135 Hospithera krypton rod.39 0.98 0.

17 106.55 47.50 01-03-2013 157001003311 Spinaxis Kit de tiges Sterispine PS (réf.45 178.83 28.17 0.51 178.55 47.17 106.55 47.Spine – Tige A25101xxx / A251020xx 285.50 01-03-2013 157001003327 Eurospine MPM tige TH55Txxx 265.06 237.00 18.17 87.68 237.06 237.56 01-05-2013 157001003336 Biomet Lineum Rod 14-5240xx 181.17 181. par 2 tiges) KITRODxxx / KITRMIxxx 285.00 178.157001003302 Spinaxis Tige Sterispine PS PSRODxxx / PSRMIxxx 285.55 47.06 237.51 178.51 178.11 01-06-2013 157001003345 Spinaxis E.55 28.89 28.51 26.17 3.50 01-08-2013 Mise à jour 01-08-2013 .89 28.Bijwerking 01-08-2013 Page 14 (700011-700022) .40 3KTL16xx(x) 285.50 01-06-2013 157001003354 SpineConcept Tige Lisse 3K T.13 178.89 28.17 106.17 106.00 237.

22 94.Prijs (incl.72 353.19 01-02-2011 157002000032 Medtronic Unit Rod Staaf L-X 830-0xx 941.O.10 01-02-2011 157002000075 Zimmer Unit Rods .0mm Ilium Extensions.28 90. / Prestataire non conventionné Supplement patiënt / Verstr. recht.I.Plafondprijs : 941.95 116.94 784.Terugbetaling : Marge de sécurité .6.U waarde : U 760 Remboursement . / Verstr. met of zonder overeenkomst C = Supplément patient Bén.99 588. ordin. / Prestataire non conventionné Terugbetaling Gew.I. / Verstr.72 312. / Verstr.72 353.72 312.6. met overeenkomst .95 156.95 116. verankerd aan beide zijden van de posterieure wervelkolom Valeur de U .05 588.Supplement patiënt W.94 € Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157002000014 Medtronic Unit Rod 830-5xx 941.A = Prix (TVAc) . Ti 928-xx 901.6.19 01-02-2011 157002000057 Zimmer SS Unit Rods.W.35mm Diameter Rod with 3/16" (4.95 116.G.28 90.35mm Ilium Extensions 819-xx 901.0mm Diameter Rod with 6. met of zonder overeenkomst D = Remboursement Bén.00 784.00 784. zonder overeenkomst E = Supplément patient Bén.I.Terugbetaling W. BTW) B = Remboursement Bén. fixée des deux côtés à la colonne vertébrale postérieure U-staaf uit één stuk.10 01-02-2011 157002000084 Zimmer Unit Rods.95 156.72 353.05 588.00 784.0mm Ilium Extensions.72 312.22 94.22 94. met overeenkomst .35mm DIA with 6.95 156.10 01-02-2011 157002000066 Zimmer Unit Rods .8xx 941.94 784.99 588. SS 818-xx 901. ordin. recht.00 784. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700033-700044 Tige en U et en une pièce.19 01-02-2011 157002000041 Orthogèse Olerud U rod 120.99 588.Supplément patient V.P. / Verstr.72 312. Ti 929-xx 901.95 116.95 156.28 90.28 90.99 588.72 353.05 588.05 588.74 € is van toepassing op het geheel van de wervelkolomimplantaten.95 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.I.22 94. / Verstr.94 784. ordin.P. / Prestataire conventionné . ordin.Veiligheidsgrens : 784. / Prestataire avec ou sans convention Terugbetaling Gew.Bijwerking 01-08-2013 Page 1 31-03-2011 (700033-700044) .O.W./Prestataire conventionné .Remboursement V.19 01-02-2011 157002000023 Medtronic Unit Rod Staaf 3/16" L-X X1091-xxx 941.0mm Diameter Rod with 5.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .G. Prix plafond .De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148. / Prestataire avec ou sans convention Supplement patiënt Gew.8mm) Illium Extensions.10 01-02-2011 Mise à jour 01-08-2013 . recht.94 784. 6.

48 1325.55 € 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.20xx + 65. veuillez facturer le nombre de vis réellement utilisé lors de l'intervention.5x0.G.81 SW206T -> SW216T / SW126T -> SW136T + SW19xT + SW002T/SW003T SW202T -> SW205T + 1750.2002 1908.9xx 1908.55 318.5x0. M4.204x + 65.56 30xx + 1200-2601 132.98x + 115. zonder overeenkomst E = Supplément patient Bén.U waarde : U 1540 Remboursement . / Verstr.I.55 114. (x2) + Protex Occipital Clamp (x2) + Protex Set Screw.55 159. Het aantal schroeven kan volgens het type van de gemaakte constructie variëren. Le nombre de vis pouvant varier selon le type de construction réalisée.590.P.W.92 511.66 1590. Prix plafond .92 557.11 1192.59 SW206T -> SW216T / SW126T -> SW136T + SW200T + SW002T/SW003T 1200-32xx + 1200-00xx + 1200.8xx / 110.11 1192.17 1192.Prijs (incl.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .92 715.8xx / 110.Supplement patiënt W.95x + 110.8xx / 110.80x + 115.74 148.74 01-02-2011 157003000086 Globus Medical Belgium Protex Tapered Rod.O.51 1590.9xx 1908. inclusief de occiput-schroeven Valeur de U .74 01-02-2011 157003000061 Globus Medical Belgium Protex Straight Rod (x2) + Protex Occipital Clamp (x2) + Protex Set Screw.54 01-02-2011 Cormed Ascent occipital ancher plate + Ascent Rod (2x) + Ascent occipital bone screw (4x) + Ascent locking screw (2x) 65. ordin.O.96 1192. / Prestataire conventionné .98x / 182.55 318. M4.Terugbetaling : Marge de sécurité . y compris les vis occiptitales Twee staven met alle bijkomende elementen voor verankering aan het occiput.74 01-02-2011 157003000052 Globus Medical Belgium Ellipse Occipital plate./Prestataire conventionné . recht.66 1590. BTW) B = Remboursement Bén.72 1590.Plafondprijs : 1.9xx 115.74 148.1325.00 1192.73 1590. / Prestataire non conventionné Supplement patiënt / Verstr.Veiligheidsgrens : 1.11 1192.Remboursement V.66 1590.Large (1x) + Ellipse Locking Cap (2x) + Ellipse Rod (2x)+ Standard screw self tapping (5x) 1899. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700055-700066 Deux tiges y compris tous les éléments supplémentaires pour fixation à l'occiput.952 + 110.908.I. Distributeur Verdeler Code d'identification Identificatiecode Nom du produit Productnaam 157003000016 B Braun Medical S4C Occiput plate + S4C Occiput plate screw (5 screws) + S4C Rod for Occiput plate + S4C Set Screw 157003000025 B Braun Medical S4C Occiput plate + S4C Occiput plate screw (5 screws) + S4C Rod prebent for Occiput plate + S4C Set Screw 157003000034 Biomet 157003000043 Numéros de référence Referentienummers A B C D E A partir de Jusqu'au Vanaf Tot F 148.8xx / 110.74 € is van toepassing op het geheel van de wervelkolomimplantaten. Self-Tapping (6 screws) 115.95x + 115. le prix qui figure sur la liste se base sur une construction maximaliste.74 01-02-2011 Mise à jour 01-08-2013 .952 + 110.48 0.500 + 182. / Prestataire avec ou sans convention Supplement patiënt Gew. recht.74 148.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.74 01-02-2011 148. ordin.Bijwerking 01-08-2013 Page 1 (700055-700066) .80 148.Terugbetaling W.A = Prix (TVAc) .18 1192.92 715. / Prestataire non conventionné Terugbetaling Gew. is de prijs die op de lijst vermeld wordt op een maximalistische constructie gebaseerd. met overeenkomst . met of zonder overeenkomst D = Remboursement Bén.2060 + 65.I. Self-Tapping (6 screws) 115. / Verstr.74 148.66 € Voor de implantaten van deze verstrekking.75 + Protex Standard Screw. / Verstr.74 01-02-2011 157003000077 Globus Medical Belgium Protex Occipital Rod (x2) + Protex Occipital Clamp (x2) + Protex Set Screw. met of zonder overeenkomst C = Supplément patient Bén. / Verstr.55 318. / Verstr. / Prestataire avec ou sans convention Terugbetaling Gew.I.Supplément patient V.11 1192. Small . Self-Tapping (6 screws) 182.P.66 1590.75 + Protex Standard Screw.92 132.55 309. Pour les implants de cette prestation.G.95x + 115.75 + Protex Standard Screw.5x0.952 + 110.92 715. M4.95x + 182.95x + 115. ordin.74 01-02-2011 Altius Occipital Plate + Altius Occipital Rod (2) + Altius Occipital Bone screw (2) + Helical Flange Plug (2) SW202T -> SW205T + 1704.9xx 1908.95x + 115. ordin.W.80x / 182.55 318. Het aantal schroeven dat werkelijk gebruikt werd tijdens de ingreep moet gefactureerd worden.92 706. met overeenkomst . recht.92 715.

74 01-02-2011 31-08-2012 157003000253 MSH neon M plate for OC-stabilization (1x) + Neon toggle (6x) + Hex nut for Neon toggle (6x) + Locking plate for Neon toggle (6x) 1653.26 1488.00 1192.11 0. length 10 mm (1x) 1565.74 148.0xx + 04.66 1590.12 1399.92 715. Ø 3.11 1192.157003000095 Johnson & Johnson MedicalDepuy Mountaineer Rod (x2) + Mountaineer OC Plate (x2)+ nut + Mountaineer OC Lateral Washer + Mountaineer OC screws (5 screws) 1908.07 147.68 0.92 206.00 1192.11 1192. length 10 mm (2x) 1477. Ø 3.71 1565.79 01-02-2011 31-08-2012 157003000244 MSH neon M plate for OC-stabilization (1x) + Neon toggle (5x) + Hex nut for Neon toggle (5x) + Locking plate for Neon toggle (5x)+ Neon Cortical screw.92 715.11 1192.5 mm.43 1590.5 mm.601.104 1883.48 01-02-2011 31-08-2012 157003000217 MSH neon M plate for OC-stabilization (1x) + Neon toggle (2x) + Hex nut for Neon toggle (2x) + Locking plate for Neon toggle (2x)+ Neon Cortical screw.74 01-02-2011 157003000174 Synthes Cervicale staaf (x2) + Occiput schroef diam 3.92 295.99 0.92 715.92 285.71 01-02-2011 31-08-2012 157003000201 MSH neon M plate for OC-stabilization (1x) + Neon toggle (1x) + Hex nut for Neon toggle (1x) + Locking plate for Neon toggle (1x)+ Neon Cortical screw.26 0.00 1127.55 293. length 10 mm (6x) CS 1407T (2x) + CS 1417-1T (1x) + CS 1417-2T (1x) + CS 1417-3T (1x) + CS 1404-xxT (7x) CS 1407T (2x) + CS 1417-1T (2x) + CS 1417-2T (2x) + CS 1417-3T (2x) + CS 1404-xxT (6x) 1399.5 (8 screws) 485510xx(X) / 485710xx(X) + 48552xxx / 48573xxx + 48551000 + 48554xxx 498.92 21.74 01-02-2011 1488.92 197.5 mm.032 + 04.00 1192.91 01-02-2011 31-08-2012 Mise à jour 01-08-2013 .51 148.66 1590.00 112.74 01-02-2011 ORIA ALIS plaques occipitales (x2) + ORIA ALIS vis occipitales (x2) + ORIA ALIS Tiges (x2) 1883 63 xxx / 1883 64 x00 + 1883 62 0xx + 1883 62 025 + 1883 65 000 + 1883 62 xxx 1883 63 xxx /1883 64 x00 + 1883 62 0xx + 1883 62 025 + 1883 62 xxx 1746 60 xxx / 1746 61 xxx + 1746 11 xxx + 1746 62 100 + 1746 41 000 GT40-POxX + FT10-40xx + GT40-Txxx 157003000104 Johnson & Johnson MedicalDepuy Mountaineer Rod (x2) + Mountaineer OC Plate + nut (x2) + Mountaineer OC screws (3 screws) 157003000113 Johnson & Johnson MedicalDepuy Summit T-Plate + occiput screws (x3) + Summit rods (x2) + nuts (x2) 157003000122 MEDIANN 1634.55 318. Ø 3.74 148.31x 1883. Ø 3.74 01-02-2011 1488.88 1192.161.92 118.76 122.27 1390.74 148.55 43.55 0.11 1192.55 318.74 01-02-2011 31-08-2012 157003000262 MSH neon OC rod (2x) + Neon Cortical screw.5 mm.66 1590. length 10 mm (4x) 1302.74 148.35 139. length 10 mm (5x) 1214.97 1192.5 x XXXmm ROD (2x)+ BLOCKER (2x) + PLATE SCREWS 1908.xxx + 406.55 318. Ti (x2) + occipital screws (6 screws) 6900271 / 6900281 + 690xxxx 1908.91 121.74 01-02-2011 157003000156 Orthogèse Olerud occiput rod + occiput screws (3 screws) 120.55 318.34 148.956 + 404.5 mm.11 1192.91x 1908.55 1302.26 0. Ø 3.02 01-02-2011 31-08-2012 157003000235 MSH neon M plate for OC-stabilization (1x) + Neon toggle (4x) + Hex nut for Neon toggle (4x) + Locking plate for Neon toggle (4x)+ Neon Cortical screw.14 01-02-2011 31-08-2012 157003000287 MSH neon OC rod (2x) + Neon toggle (2x) + Hex nut for Neon toggle (2x) + Locking plate for Neon toggle (2x) + Neon Cortical screw.40 1311.92 109.74 01-02-2011 157003000183 Synthes OC-plaat + Cervicale staaf (x2) + OC-schroeven (4 screws) + Axon innie (2x) 04.55 318.11 1192. Ø 3.68 1223.74 148.00 1192.00 1192. length 10 mm (7x) 1311.91x + 120.74 01-02-2011 157003000131 Medtronic Vertex Occipital Midline Plate + Vertex Ti Rod (x2)+ Vertex Occipital Bone Screws (4 screws) +set screw 69552xx + 695xxxx + 695xxxx + 6950315 1908.00 1192.00 1192.20 139.55 293. Ø 3.00 1192.52 1590.63 130.92 372.92 715.27 0.92 441.40 0. length 10 mm (6x) CS 1406T (1x) + CS 1404-xxT (6x) 1127. Ø 3. Ø 3.74 148.5 mm.92 295.66 1590.5 mm.92 690.66 1590.25 01-02-2011 31-08-2012 157003000226 MSH neon M plate for OC-stabilization (1x) + Neon toggle (3x) + Hex nut for Neon toggle (3x) + Locking plate for Neon toggle (3x)+ Neon Cortical screw.99 1477.74 01-02-2011 157003000192 MSH neon M plate for OC-stabilization (1x) + Neon Cortical screw.66 1590.71 0.92 30.36 01-02-2011 31-08-2012 157003000271 MSH neon OC rod (2x) + Neon toggle (1x) + Hex nut for Neon toggle (1x) + Locking plate for Neon toggle (1x) + Neon Cortical screw.83 1214.161. length 10 mm (3x) 1390.48 131.92 460.00 1192.60 148.Bijwerking 01-08-2013 Page 2 31-03-2011 (700055-700066) .11 1192.74 148.11 1127.11 0.66 1590.34 148.26 1488.5 mm.5 mm.74 01-02-2011 157003000147 Medtronic Vertex Pre-Curved Occipital Plate/Rod.92 715.74 01-02-2011 157003000165 STRYKER OASYS OCCIPUT PLATE (2x) + 3.92 690. length 10 mm (8x) CS 1406T (1x) + CS 1417-1T (1x) + CS 1417-2T (1x) + CS 1417-3T (1x) + CS 1404-xxT (5x) CS 1406T (1x) + CS 1417-1T (2x) + CS 1417-2T (2x) + CS 1417-3T (2x) + CS 1404-xxT (4x) CS 1406T (1x) + CS 1417-1T (3x) + CS 1417-2T (3x) + CS 1417-3T (3x) + CS 1404-xxT (3x) CS 1406T (1x) + CS 1417-1T (4x) + CS 1417-2T (4x) + CS 1417-3T (4x) + CS 1404-xxT (2x) CS 1406T (1x) + CS 1417-1T (5x) + CS 1417-2T (5x) + CS 1417-3T (5x) + CS 1404-xxT (1x) CS 1406T (1x) + CS 1417-1T (6x) + CS 1417-2T (6x) + CS 1417-3T (6x) CS 1407T (2x) + CS 1404-xxT (8x) 1223.12 0.00 1192.55 62.79 148.83 0.

84 1486.92 395.74 01-06-2011 ROD Precurved OC Ti (2) + LP OC Keel Plate + OC BONE Screw (6) 6955270 + 695997x + 77505xx / 77506xx 1844.69 1590.157003000296 MSH neon OC rod (2x) + Neon toggle (3x) + Hex nut for Neon toggle (3x) + Locking plate for Neon toggle (3x) + Neon Cortical screw.74 01-02-2011 148.99 0.92 413.83 1214. length 10 mm (3x) 1390.73 1192.Bijwerking 01-08-2013 CS 1407T (2x) + CS 1417-1T (3x) + CS 1417-2T (3x) + CS 1417-3T (3x) + CS 1404-xxT (5x) CS 1407T (2x) + CS 1417-1T (4x) + CS 1417-2T (4x) + CS 1417-3T (4x) + CS 1404-xxT (4x) CS 1407T (2x) + CS 1417-1T (5x) + CS 1417-2T (5x) + CS 1417-3T (5x) + CS 1404-xxT (3x) CS 1407T (2x) + CS 1417-1T (6x) + CS 1417-2T (6x) + CS 1417-3T (6x) + CS 1404-xxT (2x) 7003-xx0 + 7001-01 + 7002-1 + 7004-xxxx + 707-01 Page 3 (700055-700066) .11 0.5 mm.55 1192.11 1127.35 139.10 1590.08 + (7004 xxxx / 7005 xxxx) + 70701 6955270 + 775532x + 77505xx 1886.25 01-09-2012 157003000454 Hospithera neon M plate for OC-stabilization (1x) + Neon toggle (3x) + Hex nut for Neon toggle (3x) + Locking plate for Neon toggle (3x)+ Neon Cortical screw.69 1588.92 21.07 148.0 mm precontoured occipital rod (2x) + Octa II plate + Octa II Connector (2x) + occipital screw (5x) + 4. length 10 mm (2x) 157003000332 Zimmer 157003000341 Zimmer Nexlink 4.5 mm.5 mm.07 147.74 01-06-2011 Medtronic ROD Precurved OC Ti (2) + LP OC M Plate + OC BONE Screw (6) 6955270 + 775997x + 77505xx / 77506xx 1881.92 634.74 01-06-2011 157003000427 Hospithera neon M plate for OC-stabilization (1x) + Neon Cortical screw.00 1590.68 01-02-2011 31-08-2012 1574.92 652.74 01-02-2011 01-02-2011 7003-xx0 + 7001 01 + 7002 01 1772. Ø 3.27 1192.92 293.56 1574.07 148.5 mm.00 1192.00 1192. length 10 mm (3x) 157003000323 MSH neon OC rod (2x) + Neon toggle (6x) + Hex nut for Neon toggle (6x) + Locking plate for Neon toggle (6x) + Neon Cortical screw.00 1127.74 01-06-2011 157003000411 Medtronic Adjustable ROD (2) + Adjustable OC Plate + OC BONE Screw (6) 775512x + 7755278 + 77505xx / 77506xx 1588.92 469.0 mm open connector 157003000357 Medtronic Rod Precurved OC Ti (2) + Screw Connector (6) + OC BONE Screw (6) 157003000366 Medtronic 157003000375 1486.55 1302.5 mm.00 112.92 285.08 148.60 148.74 01-06-2011 157003000402 Medtronic Adjustable ROD (2) + LP OC M Plate + OC BONE Screw (6) 775512x + 775997x + 77505xx / 77506xx 1643.08 148.00 1192.79 148.45 1192.92 372.00 1590.90 148.92 381.5 mm.00 1192. Ø 3.00 1590.11 0.18 / 77506xx 148. length 10 mm (5x) 1214. length 10 mm (4x) 1302.92 693.48 01-09-2012 157003000445 Hospithera neon M plate for OC-stabilization (1x) + Neon toggle (2x) + Hex nut for Neon toggle (2x) + Locking plate for Neon toggle (2x)+ Neon Cortical screw.79 01-09-2012 157003000472 Hospithera neon M plate for OC-stabilization (1x) + Neon toggle (5x) + Hex nut for Neon toggle (5x) + Locking plate for Neon toggle (5x)+ Neon Cortical screw.00 1192.71 01-09-2012 157003000436 Hospithera neon M plate for OC-stabilization (1x) + Neon toggle (1x) + Hex nut for Neon toggle (1x) + Locking plate for Neon toggle (1x)+ Neon Cortical screw.27 1390.55 159.45 1192.36 148.00 1192.55 254.74 01-06-2011 157003000384 Medtronic ROD Precurved OC Ti (2) + Adjustable OC plate + OC BONE Screw (6) 6955270 + 7755278 + 77505xx / 77506xx 1826.5 mm.92 109. Ø 3. length 10 mm (6x) CS 1406T (1x) + CS 1404-xxT (6x) 1127.55 291.71 0. Ø 3.55 0.63 130. length 10 mm (2x) 1477.92 450.77 148.99 1477.74 01-02-2011 31-08-2012 1662.77 148.82 1590. Ø 3.52 1590.55 181.55 71.5 mm.92 197.55 16.55 295.92 148. length 10 mm (4x) 157003000314 MSH neon OC rod (2x) + Neon toggle (5x) + Hex nut for Neon toggle (5x) + Locking plate for Neon toggle (5x) + Neon Cortical screw.92 579.45 1192.55 181.02 01-09-2012 157003000463 Hospithera neon M plate for OC-stabilization (1x) + Neon toggle (4x) + Hex nut for Neon toggle (4x) + Locking plate for Neon toggle (4x)+ Neon Cortical screw.14 1192.55 236.44 1192.99 1590.0 mm precontoured occipital rod (2x) + Octa II plate + Octa II connector (2x) + occipital cancellous screw (5x) + 4.83 0.84 0.99 1590. Ø 3.55 52.74 01-02-2011 31-08-2012 1772.0 mm open connector closure top (2x) Nexlink 4.56 0. Ø 3.44 1192.71 1565.27 0.92 688.91 121.64 148.92 579.97 1192.92 557.74 01-09-2012 Mise à jour 01-08-2013 .00 1192.00 1192. Ø 3. length 10 mm (1x) CS 1406T (1x) + CS 1417-1T (1x) + CS 1417-2T (1x) + CS 1417-3T (1x) + CS 1404-xxT (5x) CS 1406T (1x) + CS 1417-1T (2x) + CS 1417-2T (2x) + CS 1417-3T (2x) + CS 1404-xxT (4x) CS 1406T (1x) + CS 1417-1T (3x) + CS 1417-2T (3x) + CS 1417-3T (3x) + CS 1404-xxT (3x) CS 1406T (1x) + CS 1417-1T (4x) + CS 1417-2T (4x) + CS 1417-3T (4x) + CS 1404-xxT (2x) CS 1406T (1x) + CS 1417-1T (5x) + CS 1417-2T (5x) + CS 1417-3T (5x) + CS 1404-xxT (1x) 1565. Ø 3.74 01-02-2011 31-08-2012 1750.74 01-06-2011 157003000393 Medtronic Adjustable ROD (2) + LP OC Keel Plate + OC BONE Screw (6) 775512x + 695997x + 77505xx / 77506xx 1606. length 10 mm (5x) 157003000305 MSH neon OC rod (2x) + Neon toggle (4x) + Hex nut for Neon toggle (4x) + Locking plate for Neon toggle (4x) + Neon Cortical screw.5 mm.69 0.28 1590.5 mm. Ø 3.

84 0.55 62.20 139.92 381.5 mm.5 mm.84 1486.12 0.92 557.40 1311.00 1192.00 1192.74 01-09-2012 1750.28 1590.Bijwerking 01-08-2013 CS 1406T (1x) + CS 1417-1T (6x) + CS 1417-2T (6x) + CS 1417-3T (6x) CS 1407T (2x) + CS 1417-1T (1x) + CS 1417-2T (1x) + CS 1417-3T (1x) + CS 1404-xxT (7x) CS 1407T (2x) + CS 1404-xxT (8x) 1653.36 148.00 1192.51 148.40 0. length 10 mm (2x) Mise à jour 01-08-2013 .14 01-09-2012 1223.73 1192.43 1590.157003000481 Hospithera neon M plate for OC-stabilization (1x) + Neon toggle (6x) + Hex nut for Neon toggle (6x) + Locking plate for Neon toggle (6x) 157003000497 Hospithera neon OC rod (2x) + Neon toggle (1x) + Hex nut for Neon toggle (1x) + Locking plate for Neon toggle (1x) + Neon Cortical screw.45 1192. length 10 mm (6x) 157003000524 Hospithera neon OC rod (2x) + Neon toggle (3x) + Hex nut for Neon toggle (3x) + Locking plate for Neon toggle (3x) + Neon Cortical screw. length 10 mm (3x) 157003000551 Hospithera neon OC rod (2x) + Neon toggle (6x) + Hex nut for Neon toggle (6x) + Locking plate for Neon toggle (6x) + Neon Cortical screw.88 1192.56 1574.48 131.5 mm.92 30.91 01-09-2012 1486. Ø 3. Ø 3. Ø 3.00 1590.00 1192. Ø 3.74 01-09-2012 Page 4 (700055-700066) . Ø 3.92 460.36 01-09-2012 CS 1407T (2x) + CS 1417-1T (2x) + CS 1417-2T (2x) + CS 1417-3T (2x) + CS 1404-xxT (6x) CS 1407T (2x) + CS 1417-1T (3x) + CS 1417-2T (3x) + CS 1417-3T (3x) + CS 1404-xxT (5x) CS 1407T (2x) + CS 1417-1T (4x) + CS 1417-2T (4x) + CS 1417-3T (4x) + CS 1404-xxT (4x) CS 1407T (2x) + CS 1417-1T (5x) + CS 1417-2T (5x) + CS 1417-3T (5x) + CS 1404-xxT (3x) CS 1407T (2x) + CS 1417-1T (6x) + CS 1417-2T (6x) + CS 1417-3T (6x) + CS 1404-xxT (2x) 1399.64 148. Ø 3.92 293.92 206.5 mm. length 10 mm (7x) 157003000506 Hospithera neon OC rod (2x) + Neon Cortical screw.92 469. length 10 mm (5x) 157003000533 Hospithera neon OC rod (2x) + Neon toggle (4x) + Hex nut for Neon toggle (4x) + Locking plate for Neon toggle (4x) + Neon Cortical screw.92 148.08 148.68 1223.5 mm.55 159.00 1192. Ø 3. length 10 mm (8x) 157003000515 Hospithera neon OC rod (2x) + Neon toggle (2x) + Hex nut for Neon toggle (2x) + Locking plate for Neon toggle (2x) + Neon Cortical screw.56 0.76 122.68 01-09-2012 1574.74 01-09-2012 1662.68 0.12 1399.55 71.92 118.5 mm.74 01-09-2012 1311.5 mm. length 10 mm (4x) 157003000542 Hospithera neon OC rod (2x) + Neon toggle (5x) + Hex nut for Neon toggle (5x) + Locking plate for Neon toggle (5x) + Neon Cortical screw.

O.18 201.I.Prijs (incl.33 201. / Prestataire avec ou sans convention Terugbetaling Gew.W.Bijwerking 01-08-2013 Page 1 (700070-700081) .40 108. met of zonder overeenkomst C = Supplément patient Bén.23 268.Veiligheidsgrens : 268.46 30.23 268.22 01-02-2011 157004000106 Cormed Slick's monoaxial screw + nut S11/Maxxx 322./Prestataire conventionné . ordin.31 30. / Prestataire conventionné .24 268.98 01-02-2011 157004000072 Biomet Polaris Monoaxial screw + nut 2000-4xxx + 2000-1005 / 67xx + 6451 / 63xx + 6451 322.40 108.33 201.U waarde : U 260 Remboursement .70 201.40 120.G.53 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.G.18 201.53 34.53 41. ordin.O. ordin. / Verstr. / Prestataire non conventionné Terugbetaling Gew. recht.Terugbetaling : Marge de sécurité .40 118.40 103.53 51.84 32.23 268.22 01-02-2011 157004000097 Cormed Odalys monaxial screw + vis de blocage ODMS64xx / ODMS65xx + ODLS 322.71 268. avec tête de vis ouverte pour fixation de la tige dans la tête de vis. ordin. / Verstr.P.36 201.53 36.83 32.53 41.22 01-02-2011 Mise à jour 01-08-2013 .83 32.40 103. recht. / Prestataire non conventionné Supplement patiënt / Verstr. recht.40 120.71 268.W. met overeenkomst . / Prestataire avec ou sans convention Supplement patiënt Gew. / Verstr.70 201.70 201.53 53.40 120. Prix plafond .40 120.I.I.22 01-02-2011 157004000081 Cormed DTPS monoaxial screw + nut SH61xxxx 322.46 30.47 01-02-2011 157004000036 B Braun Medical S4 Spinal system monoaxial trauma screw+set screw SW50xT -> SW52xT + SW790T 304.Remboursement V.83 32.53 53.89 268.40 101.Supplément patient V.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .70 201.53 36.49 30.83 32.47 01-02-2011 157004000045 Biomet Array Fixed Screw + nut 94xxx + 94950 302. met of zonder overeenkomst D = Remboursement Bén.74 € is van toepassing op het geheel van de wervelkolomimplantaten. y compris toutes les pièces de fixation et d'attache Monoaxiale verankeringsschroef met open schroefkop. BTW) B = Remboursement Bén.A = Prix (TVAc) . zonder overeenkomst E = Supplément patient Bén.Plafondprijs : 322.02 01-02-2011 157004000027 B Braun Medical S4 Spinal system monoaxial screw+set screw SW70xT -> SW74xT + SW790T 304.53 53.53 53.Supplement patiënt W. / Verstr.23 268.Terugbetaling W.71 201.98 01-02-2011 157004000063 Biomet Omega Monoaxiale schroef 124x-xx 309.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.I. / Verstr. inclusief alle toebehoren voor fixatie en blokkering Valeur de U .28 01-02-2011 157004000054 Biomet Omega Monoaxiale expansive schroef 135x-xx 309. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700070-700081 Vis d'ancrage mono-axiale.31 30. waarbij de staaf in de schroefkop wordt gefixeerd.23 € Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157004000011 B Braun Medical S4 Spinal system monoaxial screw cannulated + set screw cannulated SW42xT / SW43xT / SW44xT / SW46xT / SW47xT + SW375T 320. met overeenkomst .86 268.86 268.P.

53 53.22 01-02-2011 157004000167 Globus Medical Belgium Stainless Steel REVERE Monoaxial Screw + SS Revere™ locking cap 224.50 01-02-2011 31-08-2012 157004000185 Hospithera Romeo ELLI MONO SCREW NON STER Ø6 ELL-MS06xx-N 265.83 32.23 268.70 201.0xx + 224.23 268.53 18.70 201.60 26.70 201.40 104.53 53.47 201.20 01-02-2011 157004000291 ISKRA Vis Monoaxiale 3K+ vis de blocage std 3KVX (X)(X) xxx .83 32.53 43.000 / 524.22 01-02-2011 157004000273 ISKRA Vis Antérieure 3K + vis de blocage moyenne 3KVAX1xxx-A + 3KDCV602 322.40 120.53 37.23 268.40 85.47 201.53 53.40 120.60 32.40 120.00 0.22 01-02-2011 157004000246 InSpine Belgium Pedicular Screw Alpha ES1xxT 322.91 30.60 32.53 53.70 201.23 268.23 268.22 01-02-2011 157004000325 Johnson & Johnson MedicalDepuy Expedium Anterior screw +innie 1877 02 xxx + 1877 01 015 322.47 201.A + 3KVBB1005 322.23 268.2xx + 124.83 32.23 268.40 120.22 01-02-2011 157004000151 Globus Medical Belgium SS REVERE Monoaxial Reduction Screw 30mm-65mm + SS Revere™ locking cap 224.85x + 124.70 201.22 01-02-2011 Mise à jour 01-08-2013 .22 01-02-2011 157004000133 Globus Medical Belgium REVERE Monoaxial Reduction Screw + Revere™ locking cap 524.23 268.53 53.40 120.53 37.000 / 224.40 120.70 201.70 201.50 01-02-2011 31-08-2012 157004000194 Hospithera Romeo ELLI MONO SCREW NON STER Ø7 ELL-MS07xx-N 265.47 201.5 + single innie 1861 02 xxx +1861 00 001 322.23 268.53 53.40 120.70 201.20 01-02-2011 157004000282 ISKRA Vis Fermée 3K + vis de blocage moyenne 3KVXF(X)xxx-A + 3KDCV602 322.22 01-02-2011 157004000377 Medtronic CD Eclipse screw + set screw 848-xxx / 848xxxx + 848-855 322.TI MONOAXIAL PEDICLE SCREW x.53 53.00 265.40 63.60 28.63 01-02-2011 157004000343 Johnson & Johnson MedicalDepuy Isola Anterior Open screw 5011xxxx 306.50 01-02-2011 31-08-2012 157004000203 Hospithera Vis Romeo Monoaxiale non-sterile + nut ELL-MS xx xx-N + ELLSC0000-X 267.00 268.83 32.8xx + 224.40 110.20 01-02-2011 157004000316 Johnson & Johnson MedicalDepuy Expedium 4.78 201.83 32.47 201.8xx + 124.Bijwerking 01-08-2013 Page 2 (700070-700081) .000 322.20 01-02-2011 157004000307 ISKRA Vis Pédiatrique 3K + vis de blocage std péd 3KVP430-A + 3KVAP1006 322.53 53.22 01-02-2011 157004000176 Hospithera Romeo ELLI MONO SCREW NON STER Ø5 ELL-MS05xx-N 265.00 268.70 01-02-2011 157004000221 Hospithera ZODIAC .83 32.53 53.40 63.000 / 224.70 201.47 201.00 268.xMMXxMM + hexalobe set screw 622xx-xx + 22015 312.2xx + 124.22 01-02-2011 157004000361 MEDIANN SCS Vis sacrée + clip 2T10-Xxxx + 2T60-CVxx 322.83 32.23 268.91 30.60 26.00 201.53 53.7xx + 224.000 / 124.40 120.00 265.00 201.40 65.83 32.00 267.23 268.40 120.53 53.000 322.23 268.22 01-02-2011 157004000255 InSpine Belgium Pedicular Screw standard ES0xxT 322.40 120.00 0.157004000115 Cormed Solas monoaxial screw + nut MASxxxx 322.53 53.40 120.70 201.40 120.83 32.40 120.60 26.20 01-02-2011 157004000237 InSpine Belgium Long LP Multiaxial Pedicle Screw ES82xT / ES83xT 322.40 120.70 201.53 53.31 268.31 268.60 31.23 268.40 120.00 201.00 0.53 53.70 01-02-2011 157004000212 Hospithera Vis Romeo Monoaxiale Sterile + nut ELL-MSxx xx-S + ELL-SC0000X 287.23 268.00 201.00 268.40 120.40 120.70 201.53 53.00 265.40 120.00 268.83 32.70 201.70 201.60 32.83 32.00 268.83 32.22 01-02-2011 157004000334 Johnson & Johnson MedicalDepuy Isola Anterior Closed screw 5010xxxx 306.22 01-02-2011 157004000124 Cormed Solas RS monoaxial screw + set screw SAMxxxx + PSS3050 322.53 53.78 201.000 322.40 63.53 53.22 01-02-2011 157004000142 Globus Medical Belgium Revere™ Monoaxial Pedicle Screw 25mm-55mm + Revere™ locking cap 124.60 32.00 0.2xx + 224.53 53.40 120.53 53.22 01-02-2011 157004000264 InSpine Belgium Standard LP Multiaxial Pedicle Screw ES86xT 322.000 322.60 26.83 32.70 201.83 32.40 104.23 268.63 01-02-2011 157004000352 MEDIANN SCS Vis pédiculaire + clip 2T10-X(X)xxx + 2T60-CVxx 322.83 32.

40 120.70 201.40 120.22 01-02-2011 157004000395 Medtronic CDH Legacy Peek non cannulated screw xxmm + set screw 789xxxx + 722xxxx 322.23 268.83 32.70 201.22 01-02-2011 157004000404 Medtronic Equation screw + set screw 8311xxx + 83151xx 322.53 53.23 268.70 201.40 120.22 01-02-2011 157004000422 Medtronic Legacy Anterior Screw xx X xxmm + set screw 654xxxx + 7440020 322.23 268.85 01-02-2011 157004000614 OSTEON TLFUSION SCREW incl.00 268.23 268.F7xx 322.70 201.22 01-02-2011 157004000587 Orthogèse BJR Vis en U mono-axiale + BJR Boulon vis en U ATR43MU.23 268.47 201.40 120.23 268.Grub Screw 226xx-xx/1 + 22650-30-02 322.23 268.53 53.53 268.20 01-02-2011 157004000553 NEW2DM Vis Monoaxiale 3K+ vis de blocage std 3KVX (X)(X) xxx .157004000386 Medtronic CDH Legacy Peek MAS xxmm + set screw 722xxxx + 722xxxx 322.22 01-02-2011 157004000596 Orthogèse Vis en U + Ecrou de serrage 12VUHXxx.22 01-02-2011 157004000623 SDI Belgium Vis iliaque diamètre 7.70 201.23 268.22 01-02-2011 157004000447 Medtronic legacy Iliac inox + Legacy set screw breakoff inox 7442xxx + 7440020 / 746xxxx + 7460020 / 7443xxx + 7440020 / 734xxxx + 7340000 / 736xxxx + 7360000 702xxxx + 702xxxx 322.22 01-02-2011 157004000501 Medtronic Legacy Ti mini xx X xxmm + set screw 734xxxxINT + 734xxxxINT 322.83 32.22 01-02-2011 157004000456 Medtronic Legacy Screw Fixed Angle + Legacy Set Screw breakoff ss 7563xxx/7562xxx + 7560000 / 7560020 322.70 201.53 53.22 01-02-2011 157004000431 Medtronic Legacy bone screw Fxd Angle + Legacy Set Screw breakoff ti 322.53 53.53 53.cap 83xPTD(x)1xLxx 322.83 32.83 32.22 01-02-2011 157004000492 Medtronic Legacy Ti fixed angled screw + Legacy set screw breakoff Ti X43502xxxx + 7440030 322.70 201.60 32.40 120.53 53.00 268.40 120.40 120.40 120.40 120.22 01-02-2011 Mise à jour 01-08-2013 .23 268.23 268.53 53.53 53.40 120.40 120.40 120.20 01-02-2011 157004000571 Ortho Team WSI .70 201.xx + 12VUE01 322.22 01-02-2011 157004000483 Medtronic Legacy Ti Fixed angle screw + Legacy Set Screw breakoff ti G7543xxx+ G7540020 322.5 mm Longueur xx mm U1 .40 120.MX.xxXxx + ATR480U.40 120.70 201.5 mm Longueur xx mm Titane U1 .53 53.47 201.70 201.20 01-02-2011 157004000544 NEW2DM Vis Fermée 3K + vis de blocage moyenne 3KVXF(X)xxx-A + 3KDCV602 322.83 32.53 53.40 120.22 01-02-2011 157004000632 SDI Belgium Vis iliaque diamètre 7.23 268.83 32.53 53.20 01-02-2011 157004000562 NEW2DM Vis Pédiatrique 3K + vis de blocage std péd 3KVP430-A + 3KVAP1006 322.83 32.00 268.40 120.13 26.22 01-02-2011 157004000465 Medtronic Legacy Screw Fixed Angle + Legacy Set Screw breakoff ti 766xxxx + 7660020 / 764xxxx + 7640020 322.83 32.83 32.83 32.40 120.47 201.70 201.22 01-02-2011 157004000526 Medtronic SOLERA SCREW FAS xxXxx TI + SET SCREW BREAK OFF 5441000xxxx + 5440020 / 5440030 322.53 53.Monoaxial Pedicle Screw + WSI .83 32.23 268.40 120.40 120.53 53.70 201.40 67.40 120.23 268.00 201.40 120.22 01-02-2011 157004000413 Medtronic Iliac Ti + Legacy set screw breakoff ti 704xxxx + 704xxxx 322.22 01-02-2011 157004000474 Medtronic Legacy Ti Fixed angle screw + Legacy Set Screw breakoff ti 7543xxx/7542xxx + 7540000 / 7540020 322.23 268.70 201.70 201.60 32.00000 322.53 53.23 268.23 268.83 32.23 268.40 120.A + 3KVBB1005 322.40 120.53 0.83 32.23 268.83 32.MX .70 201.70 201.53 53.70 201.53 53.60 32.22 01-02-2011 157004000517 Medtronic Longitude screw FAS + set screw 757xxxx + 7570955 322.Bijwerking 01-08-2013 Page 3 31-08-2011 (700070-700081) .53 53.22 01-02-2011 157004000535 NEW2DM Vis Antérieure 3K + vis de blocage moyenne 3KVAX1xxx-A + 3KDCV602 322.00 268.53 53.F7xxT 322.53 53.60 32.83 32.70 201.70 201.83 32.47 201.53 53.83 32.23 268.23 268. Nut PSFH0xxx 268.83 32.70 201.83 32.83 32.53 53.53 53.53 53.40 120.70 201.53 53.22 01-02-2011 157004000605 OSTEON PEDICULAR SCREW FIXED HEAD incl.40 120.53 53.83 32.23 268.

70 201.81 01-02-2011 157004000736 STRYKER ATLSPINALSCR.5xx 322.53 53.70 201.60 32.00 268.23 268.X x Yymm + blocker 4848xxxx(XL) + 48482001 / (48482010 + 48482020) 311.37 31.23 268.98 01-02-2011 157004000745 STRYKER MA SCREW RADIUS x.22 01-02-2011 157004000666 SDI Belgium Vis ilio-sacrée diamètre 7 mm Longueur xx mm U1 .23 268.40 120.36 268.83 32.I7xx 322.15 0.75 21.40 120.5 x Yymm + BLOCKER 03800xxx + 03756230 309.23 268.40 32.53 53.83 32.5 + BLOCKER 48140xxxx + 48130000 322.53 51.1xx 322.22 01-02-2011 157004000842 STRYKER XIA III REDUCT MA SCREW X.40 120.60 32.53 53.20 01-02-2011 157004000727 Spineway MONT BLANC BABY VIS PEDICULAIRE FERMEE + VIS DE VERROUILLAGE BB1MS35xx / BB1MS40xx + BB1LS 218.83 201.00 268.00 201.70 201.40 120.70 201.70 201.83 32.5 XIA SS + BLOCKER 48220xxx + 48220000 322.53 53.53 53.23 268.70 201.70 201.40 120.53 53.40 16.22 01-02-2011 157004000763 STRYKER MONO SCREW X.2 + USS LP huls + USS LP moer 499.SxxxT + U1L100T / U1 Sxxx + U1L100 322.5 x YY MM 03828xxx + 48230000 322.03 01-02-2011 157004000833 STRYKER XIA III PED SCR MA X MM x YY MM 48230xxxx + 48230000 322.40 120.00 268.70 201.70 201.40 120.83 32.24 201.23 268.22 01-02-2011 157004000772 STRYKER MONO SCREW X.83 32.75 + BLOCKER 486610xxx + 486610000 321.83 32.53 53. 5mm 298.83 32.70 201. 7mm 298.40 120.83 32.83 32.86 268.40 120.46 30.22 01-02-2011 157004000851 Synthes CLAMPFIX posterieure schroef 04.53 53.23 268.887 322.53 53.40 120. 6mm 298.MA X.70 201.53 43.53 41.83 32.83 32.96 32.40 120.23 268.23 268.40 120.23 268.70 201.40 108.23 268.40 120.70 201.40 120.22 01-02-2011 157004000876 Synthes USS INOX.22 01-02-2011 157004000867 Synthes CLAMPFIX schanzschroef 04./LUMB.20 01-02-2011 157004000702 SHARK MEDICAL Vis Monoaxiale 3K+ vis de blocage std 3KVX (X)(X) xxx .40 120.23 268.15 218.70 201.5 PED SCR MA 4 x XX + BLOCKER 4813xxxx(x) + 48130000 320.22 01-02-2011 157004000797 STRYKER THOR.40 120.47 201.47 201.53 53.23 268.40 120.53 53.40 118.23 268.22 01-02-2011 157004000903 Synthes USS LP diam 4.40 110.70 201.83 32.22 01-02-2011 157004000675 SDI Belgium Vis PLUS™ + (clip + vis de blocage M6) U1 .40 120.53 53.157004000641 SDI Belgium Vis iliaque diamètre 8.53 53.6xx 322.23 268.22 01-02-2011 157004000684 SHARK MEDICAL Vis Antérieure 3K + vis de blocage moyenne 3KVAX1xxx-A + 3KDCV602 322.83 32.7xx 322.60 32.83 32.53 53.23 268.27 201.A + 3KVBB1005 322.70 201.5 + BLOCKER 48239xxxx + (48230000 / 03756230) 322.SCREW X.23 268.627.F8xx 322.70 201.22 01-02-2011 157004000885 Synthes USS INOX.70 201.40 120.17 01-02-2011 157004000806 STRYKER XIA 3 TIT MA SCREW CLOSED HEAD x.53 53.F8xxT 322.22 01-02-2011 157004000657 SDI Belgium Vis iliaque diamètre 8.20 01-02-2011 157004000711 SHARK MEDICAL Vis Pédiatrique 3K + vis de blocage std péd 3KVP430-A + 3KVAP1006 322.00 268.53 53.40 120.627.53 53.60 32.83 32.83 32.5 x YY + BLOCKER 03828xxx + 03756230 322.22 01-02-2011 157004000894 Synthes USS INOX./SACR.15x + 499.20 01-02-2011 157004000693 SHARK MEDICAL Vis Fermée 3K + vis de blocage moyenne 3KVXF(X)xxx-A + 3KDCV602 322.47 201.53 53.53 53.5 mm Longueur xx mm Titane U1 .77 268.5 mm Longueur xx mm U1 .23 268.5 48232xxx 322.53 53.22 01-02-2011 157004000815 STRYKER XIA 3 TIT MA SCREW x.5 XIA TIT + BLOCKER 03820xxx + 03756230 322.888 + 499.53 53.47 201.53 53.80 268.83 32.40 120.83 32.22 01-02-2011 157004000824 STRYKER XIA 4.Bijwerking 01-08-2013 Page 4 (700070-700081) .33 201.22 01-02-2011 157004000781 STRYKER REDXIATIMA SCR X.40 120.3xx 322.22 01-02-2011 Mise à jour 01-08-2013 .18 01-02-2011 157004000754 STRYKER MA SCREW REDUCTION x.53 53.40 120.

22 01-02-2011 157004001007 Synthes Pedicle Screw Matrix 5.22 01-02-2011 157004001043 LDR MEDICAL Vis monoaxiale Spine Tune ST3xxxT-S 322.66 268.22 01-02-2011 157004000982 Cormed Fixspine monoaxial screw + set screw OSM11xx / OSM12xx + OSM4153 322.4xx 306.76 0.Bijwerking 01-08-2013 Page 5 31-08-2012 (700070-700081) .000(S) / 04.70 201.53 37.53 53.78 201.70 201.632.40 120.53 53.53 53.67 201.32 01-02-2011 157004000955 Zimmer Java Monoaxial Pedicle screw + nut SN2036-0-2xxxx + SN2023-000002 322.83 32.40 113.83 32.59 01-06-2011 157004001061 B Braun Medical S4 Spinal system monoaxial screw cannulated + set screw SW42xT / SW43xT / SW44xT / SW46xT / SW47xT + SW790T 314.22 01-09-2012 157004001104 Hospithera tangoRS screw monoaxial + tangoRS locking screw CS 3065-x-xx + CS 3001 303.23 268.23 268.40 120.40 101.099(S) / 09.40 120.40 120.5/6.40 104.887 322.157004000912 Synthes USS LP diam 5 .53 53.83 32.23 268.40 120.70 201.23 268.40 120.23 268. 02x + 498.40 120.7 + USS LP huls + USS LP moer 499.32 01-09-2012 157004001113 SpineConcept Vis mono-axiale 3K 3KVX(X)(X)xxx-A+3KVBB1005 322. B021572xx 149.47 201.53 27.00 14.40 120.22 01-02-2011 157004000973 Zimmer Optima MS screw SMxxxx + SP30x0 322.83 32.83 32.76 0.632.96 268.23 268.23 268.1xx + 499.22 01-02-2011 157004001034 LDR MEDICAL Vis pédiculaire standard Easyspine ES 0xx T 322.70 201.67 201.632.40 94.70 201.53 46.83 32.23 268.5 x D (4.633.70 201.53 34.83 32.53 53.53 53.35-10mm) x L (20-100mm) 1797-02-xxx / 186717xxx 295.050(S) / 04.70 201.83 32.70 201.53 53.53 53.76 149.40 120.70 201.56 29.53 53.23 268.40 120.23 268.70 201.70 201.43 201.20 268.91 30.0 Fixed Screw 5541000xxxx + 5540030 / 5540230 322.60 32.40 101. B021565xx.83 32.31 268.22 01-02-2011 157004000921 Synthes USS paediatric + USS paediatric huls + USS paediatric moer 498.23 268.13 201.40 120.83 32.53 34.xxx(S) + 04.23 268.53 53.22 01-02-2011 157004000964 Zimmer Optima MS reduction screw SMx1x0 + SP30x0 322.22 01-02-2011 157004001052 Johnson & Johnson MedicalDepuy Expedium Monoaxial screw 5.23 268.83 32.53 53.53 53.22 01-02-2011 157004000937 Synthes USS Ti 498.40 120.00 268.53 53.70 201.22 01-03-2012 157004001086 Cormed PASS LP anterior screw B021555xx.40 120.80 30.022 322.83 32.22 01-02-2011 157004000991 Zimmer Instinct Java Monoaxial Pedicle screw + blocker 046W0AN3xxxx + 046W0AN00002 322.23 268.20 01-08-2013 Mise à jour 01-08-2013 .099(S) ES 0xx T 322.4xx + 498.26 31.22 01-02-2011 157004001025 SHARK MEDICAL Vis monoaxiale Spine Tune ST3xxxT-S 322.00 149.70 201.97 01-07-2012 157004001095 Medtronic CD Horizon SOLERA 5.83 32.53 53.46 01-07-2011 157004001077 InSpine Belgium Quantum Fixed screw 10-x75-FX-xx 322.40 120.80 30.888 + 499.40 120.83 32.22 01-02-2011 157004001016 SHARK MEDICAL Vis pédiculaire standard Easyspine 04.53 53.20 268.70 201.632.63 01-02-2011 157004000946 MSH tangoRS screw monoaxial + tangoRS locking screw CS 3065-x-xx + CS 3001 303.5 Monoaxial + Locking Cap 322.

64 78.O. / Verstr.22 30./Prestataire conventionné . recht. ordin.07 30.76 224. / Verstr. met of zonder overeenkomst C = Supplément patient Bén.64 31.25 30.I.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.42 01-02-2011 157005000056 B Braun Medical S4C Smooth shank screw + set screw SW061T -> SW088T+ SW002T / SW003T 314.28 299.86 299. ordin. / Prestataire non conventionné Supplement patiënt / Verstr. met of zonder overeenkomst D = Remboursement Bén.42 01-02-2011 157005000065 Biomet Altius Polyaxiale schroef 1200-2xxx 309. ordin. met overeenkomst .Terugbetaling W. ordin.O.52 10. / Verstr.52 3.Prijs (incl.I.28 01-02-2011 157005000083 Biomet Ballista Cannulated screw + nut 2000-3xxx + 2000-1005 359.Plafondprijs : 359. / Verstr. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700092-700103 Vis d'ancrage poly-axiale.19 224. zonder overeenkomst E = Supplément patient Bén.64 89.64 89.34 224.78 35.Supplément patient V. inclusief alle toebehoren voor fixatie en blokkering Valeur de U .71 299.64 134. Prix plafond .52 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148. y compris toutes les pièces de fixation et d'attache Polyaxiale verankeringsschroef met open schroefkop.I.76 224.64 85.G.Supplement patiënt W.52 59. / Prestataire avec ou sans convention Supplement patiënt Gew.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .64 85.22 30.90 224.64 95.U waarde : U 290 Remboursement .52 20.02 01-02-2011 157005000031 B Braun Medical S4C Favored angle screw + set screw 14.42 299.37 224.52 10.24 299.28 299.94 01-02-2011 157005000092 Biomet Omega Polyaxiale reductieschroef 123x-xx 309. recht.64 31.98 01-02-2011 157005000074 Biomet Array polyaxial screw + nut 94xxx + 94950 302.74 € is van toepassing op het geheel van de wervelkolomimplantaten.G. / Prestataire non conventionné Terugbetaling Gew.W.52 SW002T / SW003T 14.98 01-02-2011 Mise à jour 01-08-2013 . / Prestataire avec ou sans convention Terugbetaling Gew.64 80.A = Prix (TVAc) .64 31.Remboursement V.86 299.Veiligheidsgrens : 299.52 14. recht.I.Terugbetaling : Marge de sécurité .89 299. BTW) B = Remboursement Bén.W.P.72 224.P.64 89.47 01-02-2011 157005000022 B Braun Medical S4 Spinal system polyaxial screw canulated + S4 Spinal system set screw canulated SW32xT -> SW37xT + SW375T 320. / Prestataire conventionné .28 299.42 € Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157005000013 B Braun Medical S4 Spinal system polyaxial screw + set screw SW75xT -> SW79xT / SW80xT -> SW81xT+ SW790T 304. avec tête de vis ouverte pour fixation de la tige dans la tête de vis.52 5.52 SW002T / SW003T / SW121T > SW124T + SW002T / SW003T SW161T -> SW182T+ 314.42 01-02-2011 157005000047 B Braun Medical S4C Polyaxial screw + set screw SW141T -> SW160T + 314.34 224. waarbij de staaf in de schroefkop wordt gefixeerd.60 32. / Verstr.76 224. met overeenkomst .Bijwerking 01-08-2013 Page 1 (700092-700103) .

00 299.94 01-02-2011 157005000162 Cormed Odalys polyaxial screw + vis de blocage ODPS6xxx / ODSS6xxx + ODLS 359.61 01-02-2011 157005000354 Hospithera Alphatec TI CANNULATED POLYAXIAL PEDICLE SCREW x.52 59.48 224.90 224.78 35.002 359.000 359.64 134.64 224.42 299.157005000101 Biomet Omega Polyaxiale schroef 126x-xx 309.64 134.000 359.1xx + 124.90 01-02-2011 157005000232 Globus Medical Belgium PROTEX™ CT Polyaxial Screw + PROTEX™ CT Locking cap 115.42 299.52 29.61 01-02-2011 157005000327 Hospithera Alphatec MA HIGH-TOP POLYAXIAL SCREW.16 299.94 01-02-2011 157005000171 Cormed Saxxo polyaxial screw + nut SEO1VPx.64 103.78 35.64 134.36 33.4xxS + 152.4xx + 224.78 35.64 134.64 103.94 01-02-2011 157005000205 Cormed Solas RS polyaxial screw +nut PRSxxxx 359.52 56.000 328.52 59.61 01-02-2011 157005000336 Hospithera Alphatec Ø3. xxMM + ZODIAC TI HEXALOBE SET SCREW 627xx-xx + 22015 / 63020 356.33xx/65.94 01-02-2011 157005000266 Globus Medical Belgium Revere Uniplanar Screw + Revere Locking Cap 524.0xx + 224.2002 359.48 224.52 59.00 299.46 224.0xx + 124.29 01-02-2011 157005000345 Hospithera Alphatec SACRAL CANNULATED POLYAXIAL SCREW x.16 299.1 / NUT9.36 35.98 01-02-2011 157005000117 Biomet Polaris Polyaxial Reduction screw + nut 2000-7xxx + 2000-1005 / 536xxxMP + 6451 359.52 59.0xx + 124.90 01-02-2011 Mise à jour 01-08-2013 .90 224.64 131.5MM POLYAXIAL SMOOTH SHANK SCREW.78 35.34 35.00 299.4xx / 182.64 131.94 01-02-2011 157005000257 Globus Medical Belgium REVERE Reduction Screw + Revere™ Locking cap 524.42 299.78 35.000 359.64 224.94 01-02-2011 157005000214 Cormed Solas SAS modular polyaxial screw+ nut + seat SASxxxx+ SAP1x00 359.48 224.48 224.64 134.64 134.000 / 224.52 59.90 224.500 359.90 224.94 01-02-2011 157005000223 Globus Medical Belgium Ellipse Polyaxial Screw + Ellipse Locking Cap 182.52 56.78 35.5xx + 182.64 114.000 / 124.42 299.1 359.90 01-02-2011 157005000275 Globus Medical Belgium Revere™ Pedicle Screw + Revere™ Locking cap 124.000 / 124.94 01-02-2011 157005000126 Biomet Polaris Polyaxial screw + nut 359.42 299.52 59.94 01-02-2011 157005000241 Globus Medical Belgium REVERE Dual Outer Diameter Polyaxial Screw + Revere™ Locking cap 124.42 299.64 85.xxx + 78.78 35.08 224. S11/PRxxxx +S11/ST3030 PASxxxx 359.94 01-02-2011 157005000153 Cormed FlexStaas polyaxial screw + set screw 78.2xx / 182.52 59.94 01-02-2011 157005000135 Cormed Ascent polyaxial screw + Ascent locking screw 14-500xxx + 2000-1005 / 20002xxx + 2000-1005 / 50-6xxxMP + 6451 / 14-512xxx(R) + 20001005 65.64 134.52 59.7xx + 124.34 224.xMM X xxMM + ZODIAC TI HEXALOBE SET SCREW 626xx-xx / 627xx-xx / 628xx-xx + 22015 339.78 35.4xx + 185.48 224.52 59.52 59.64 224.52 35.52 35.94 01-02-2011 157005000144 Cormed DTPS polyaxial screw + nut SH61xxxx 359.00 299.42 299.xx + NUT8.52 59.000 328.90 224.90 01-02-2011 157005000293 Globus Medical Belgium Stainless Steel REVERE Solid Pedicle Screw + Stainless Steel REVERE Locking cap 224.3xx / 182.90 224.64 134.64 134.42 299.42 299.000 359.4xx + 124.94 01-02-2011 157005000187 Cormed Slick's polyaxial screw + nut 359.86 299.52 56.78 35.64 134.64 128.52 59.78 35.78 35.42 299.64 134.08 224.78 35.90 224.90 01-02-2011 157005000311 Hospithera Alphatec CANNULATED POLYAXIAL SCREW x.64 131.64 134.500 / 185.08x + 182.90 224.000 / 524.000 359.52 29.90 224.xxx + S11/ST3020.42 299.Bijwerking 01-08-2013 Page 2 (700092-700103) .90 224.16 299.64 134.86 01-02-2011 157005000302 Globus Medical Belgium TRANSITION™ HA Polyaxial Pedicle Screw + TRANSITION Locking Cap 152.78 35.52 59. S11/RSxxxx + S11/ST3020.22 30.98 299.xMM X xxMM + ZODIAC TI HEXALOBE SET SCREW 739xx-xx + 22015 / 63020 356.52 59.78 35.42 299.64 134.36 35.42 299.52 35.xxx + 115.90 224.90 224.52 10.90 224.42 299.96 32.00 299.xMM X xxMM + ZODIAC TI HEXALOBE SET SCREW 73xxx-xx + 22015 / 63020 356.6xx + 124.4xx + 124.64 134. xxMM L + ZODIAC TI HEXALOBE SET SCREW 63xxx-xx + 22015 / 63020 352.36 35.52 53.64 134.52 39.52 59.86 01-02-2011 157005000284 Globus Medical Belgium Revolve Polyaxial Pedicle Screw + Revolve Locking Cap 185.36 35.64 134.60 299.60 299.52 59.94 01-02-2011 157005000196 Cormed Solas polyaxial screw + nut S11/PO.64 134.52 59.500 359.52 59.90 224.96 32.34xx + 65.

90 01-02-2011 157005000397 Hospithera Alphatec TI SACRAL POLYAXIAL SCREW ASSY.64 132.90 01-02-2011 157005000476 Johnson & Johnson MedicalDepuy Expedium 4.95 35.90 224.73 35.90 224.52 57.73 224.36 299.36 29.90 01-02-2011 157005000406 Hospithera Spineart Romeo Sterile Polyaxial screw + nut Øx X xx ELL-PS xx xx.64 132.00 0.52 57.00 299.64 132.52 59.84 224.36 34.90 224.73 01-02-2011 157005000582 Johnson & Johnson MedicalDepuy Expedium Viper SC screws + Peek Innie 1797 12 xxx / 1867 19 xxx + 1797 02 000 / 1867 82 000 / (1797 61 000) 1797 3x xxx + 1867 82 000 359.64 134.34 35.78 35.75 01-02-2011 157005000494 Johnson & Johnson MedicalDepuy Expedium DI Favored Angle Reduction screw + Expedium Dual-innie Setscrew 1797 99 xxx +1797 22 0x0 / 1799 82 000 357.52 X 47.64 132.94 01-02-2011 157005000451 ISKRA Vis Adaptable 3K + vis de blocage std 3KVX(X)A xxx-A + 3KVBB1005 359.52 39.48 224.98 224.50 299.84 224.78 35.xMMXxxMM + ZODIAC TI HEXALOBE SET SCREW 620xx-xx + 22015 339.42 299.xMM x xxMM + ZODIAC TI HEXALOBE SET SCREW 623xx-xx + 22015 339.90 01-02-2011 157005000467 ISKRA Vis Pédiculaire de Rappel 3K + vis de blocage std 3KVR650-A + 3KVBB1005 359.52 27.xMM X xxMM + ZODIAC TI HEXALOBE SET SCREW 621xx-xx + 22015 342.64 134.64 122.52 57.36 32.29 01-02-2011 157005000372 Hospithera Alphatec TI HIGH TOP POLYAXIAL PEDICLE SCREW x.00 299.70 01-02-2011 157005000424 Hospithera Vis Romeo MIS Polyaxiale non-sterile + nut MIS-PS xx xx-N + ELL SC 0000-X 327.59 299.36 35.59 299.64 117.37 299.64 132.36 33.5 mm + innie 1861 12 xxx + 1861 00 001 357.00 297.94 01-02-2011 157005000564 Johnson & Johnson MedicalDepuy Expedium SI Screw +innie SS 1725 13 4xx + 1797 02 000 / 1797 26 xxx + 1797 02 000 / 1797 26 xxx + 1867 82 000 / 1797 26 xxx + 1867 15 000 1881 12 xxx + 1881 02 000 357.73 01-02-2011 157005000503 Johnson & Johnson MedicalDepuy Expedium DI Favored Angle Reduction screw + Expedium Dual-innie Unitized Setscrew 1797 99 xxx +1797 22 0x0 / 1799 82 000 357.Bijwerking 01-08-2013 Page 3 (700092-700103) .52 59.36 35.00 297.64 132.00 299.347.37 299.48 224.48 224.64 134.73 01-02-2011 157005000512 Johnson & Johnson MedicalDepuy Expedium DI Screw + innie 1797 22 xxx +1797 22 0x0 357.36 29.73 01-02-2011 157005000537 Johnson & Johnson MedicalDepuy Expedium LIS Extended Tab + innie 359.46 224.00 299.78 35.20 01-02-2011 157005000381 Hospithera Alphatec TI POLYAXIAL PEDICLE SCREW -x.75 01-02-2011 157005000485 Johnson & Johnson MedicalDepuy Expedium 4.73 35.157005000363 Hospithera Alphatec TI POLYAXIAL PEDICLE SCREW .64 128.00 0.52 57.70 01-02-2011 157005000415 Hospithera vis de réduction Romeo spondylo ELL-SS0xxx-N / ELL-SS0xxx-S 297.72 35.72 35.70 01-02-2011 157005000433 Hospithera Vis Romeo MIS Polyaxiale sterile + nut MIS-PS xx xx-S + ELL SC 0000.52 53.00 224.72 01-02-2011 157005000573 Johnson & Johnson MedicalDepuy Expedium SI Screw +innie titanium 357.x.70 01-02-2011 157005000442 InSpine Belgium pedicular Screw Standard Pioneer + cap 10-x75-PA-xx 359.42 299.85 224.94 01-02-2011 157005000546 Johnson & Johnson MedicalDepuy Expedium LIS Screw SI + innie 1867 50 0xx / 1867 60 0xx /1867 70 0xx /1867 75 0xxx + 1867 15 000 / 1867 82 000 186715xxx + 186715000 / 1867 82 000 357.52 59.64 132.52 58.00 299.36 33.73 01-02-2011 157005000521 Johnson & Johnson MedicalDepuy Expedium Extended Tab Screw+ Expendium Single Innie Setscrew 1797 32 xxx + 1797 02 000 / 1867 82 000 357.48 224.85 224.48 224.5 mm Extended Tab + innie 1861 32 xxx + 1861 00 001 357.64 114.72 35.52 57.64 134.48 224.52 42.36 35.52 59.36 299.00 299.64 72.07 224.84 224.86 32.64 134.52 57.37 299.64 114.42 299.85 224.64 132.37 299.00 299.73 35.73 01-02-2011 157005000607 Johnson & Johnson MedicalDepuy Mountaineer Favored Angled screws + innie 1883 18 xxx + 1883 42 200 321.85 224.00 224.95 35.48 224.73 35.36 34.52 59.61 35.52 58.X + ELL SC 0000-X 297.52 21.25 299.64 102.xxMM X xxMM + ZODIAC TI HEXALOBE SET SCREW 63xxx-xx + 22015 / 63020 352.00 299.64 132.36 299.90 01-02-2011 157005000591 Johnson & Johnson MedicalDepuy Monarch Poly screw + cap 1770 3x xxx x + 1770 91 060 357.52 57.98 299.64 132.52 39.48 224.73 01-02-2011 157005000555 Johnson & Johnson MedicalDepuy Expedium osteoporosis + innie 359.07 224.64 96.15 01-02-2011 Mise à jour 01-08-2013 .64 72.52 57.x.64 134.52 59.

57 34.21 299. Multi Axial Screw + Legacy Ss set screw break off 340.52 59.21 299.21 299.64 134.64 134.02 01-02-2011 157005000731 Medtronic Legacy Multi Axial screw + set screw 764xxxxx + 7640020 340.52 21.15 01-02-2011 157005000634 Johnson & Johnson MedicalDepuy Summit MFA Screw + innie 1746 18 xxx / 1746 20 xxx + 1746 42 200 321.21 299.21 299.52 40.57 34.64 96.21 299.VExx + 1020-CFxx 359.15 01-02-2011 157005000643 MEDIANN TLS Vis pédiculaire polyaxiale + TLS clip CT10-BPxxx + CT60-TLxx 359.86 32.69 224.50 299.69 224.42 299.52 59.64 134.02 01-02-2011 157005000695 Medtronic Legacy FNS + set screw 7462xxx/7463xxx + 7460020 Y755xxxx + 7540020 359.02 01-02-2011 157005000765 Medtronic Legacy SAS Ti screws + Legacy Set Screw breakoff inox 7545xxxx + 7540020 340.90 224. set screw break off 7544xxxx + 7540000 / 7540020 340.21 299.52 59. Multi Axial Screw + Legacy Ti.64 134.94 01-02-2011 157005000677 Medtronic BONE SCREW SAGITL ADJ xx X xx SS + set screw 7565xxxx +7560020/75601xx/75602x0 340.64 115.57 34.52 40.94 01-02-2011 157005000853 Medtronic Sextant screw.21 299.64 96.69 224.64 115.64 134.57 34.42 299.78 35.78 35.69 224.52 40.90 224. 75601xx) / 7669xxxx + 76602x0 340.57 34.57 34.90 224.52 40.57 34.78 35.64 115.69 224.64 115.98 224.69 224.64 115.02 01-02-2011 157005000844 Medtronic SCREW LEGACY 5.21 299.64 115.78 35.52 40.42 299.02 01-02-2011 157005000792 Medtronic Legacy Ti MAS screw + Legacy set screw breakoff ti 7444xxxx + 7440030 340.94 01-02-2011 157005000652 MEDIANN TWINFLEX I Vis pédiculaire polyaxiale + vis de serrage + TWINFLEX I connecteur standard 1010-Xxxx + 1000.78 35.52 40.64 96.64 115. Multi Axial Screw + Legacy Ti.57 34.78 35.42 299. set screw break off G7544xxxx + G7540020 340.64 115.M8 MAS+set screw 8674x5xx + 8670855 359.02 01-02-2011 157005000826 Medtronic Longitude screw MAS+set screw 757xxxx + 7570955 359.15 01-02-2011 157005000625 Johnson & Johnson MedicalDepuy Mountaineer Medial Lateral screws + innie 1883 19 xxx + 1883 42 200 321.64 134.57 34.02 01-02-2011 157005000713 Medtronic Legacy Iliac MAS inox + Legacy set screw breakoff inox 7026xxxx + 7024855 340.94 01-02-2011 157005000661 MEDIANN TWINFLEX II Vis pédiculaire polyaxiale + vis de serrage + TWINFLEX II connecteur standard 6T10-Kxxx + 6T00-BC08 + 1T20-CMxx 359.52 40.64 115.94 01-02-2011 157005000704 Medtronic Legacy HA Coated Screw D-X.57 34.Bijwerking 01-08-2013 Page 4 (700092-700103) .57 34.52 40.42 299.52 40.69 224.02 01-02-2011 157005000774 Medtronic Legacy Ss.21 299.64 115.78 35.64 115.64 134.57 34.69 224.52 59.90 224.42 299.69 224.64 134.86 32.90 224.90 224.50 299.94 01-02-2011 Mise à jour 01-08-2013 .98 224.69 224. L-X + Legacy Ti.21 299.21 299.86 32.21 299.157005000616 Johnson & Johnson MedicalDepuy Mountaineer Long Shank screws + innie 1883 20 xxx + 1883 42 200 321.52 59.02 01-02-2011 157005000817 Medtronic Legacy Ti.69 224.64 115.69 224.69 224.52 40.78 35.94 01-02-2011 157005000835 Medtronic SCREW CDH LEGACY MAS SS + SET SCREW BREAK OFF SS 766xxxxx + 7660020 340.57 34.52 59.42 299.52 40.52 40.02 01-02-2011 157005000747 Medtronic Legacy Reduction Ti + Legacy Ti set screw break off 7549xxxx + 7540220 / 7649xxxx + 7640220 340.98 224.90 224.21 299.69 224.02 01-02-2011 157005000801 Medtronic Legacy Ti.52 59.52 40.42 299.57 34.02 01-02-2011 157005000722 Medtronic Legacy Iliac MAS Ti + Legacy set screw breakoff Ti 7046xxxx + 7049855 340.52 21.50 299.64 115.94 01-02-2011 157005000862 Medtronic SOLERA SCREW MAS xxXxx CC + SET SCREW BREAK OFF 5484000xxxx + 5440020 / 5440030 359.64 115. set screw break off 719xxxx + 7540000 / 7540020 340.52 40.64 115.69 224.52 59.02 01-02-2011 157005000783 Medtronic Legacy Ti MAS Osteogrip screw + set screw 7564xxxx + 7560000 / 7560020 / 75601xx / 76502x0 / 7464xxxx + 7460020 7540xxxx + 7540020 340.5 CANN MAS+ SET SCREW BREAK OFF TI 757x5xx + 7540020 359.90 224.02 01-02-2011 157005000686 Medtronic Legacy Bone Screw Multiaxial + set screw breakoff ti 7442xxx/7443xxx + 7440020 / 340.02 01-02-2011 157005000756 Medtronic Legacy Reduction inox + Legacy Set Screw breakoff inox 7569xxxx + (75602x0 .21 299.52 21.57 34.52 40.

90 224.64 134.52 59.52 0.52 59.90 01-02-2011 157005001027 STRYKER OASYS PA SCREW CANCEL / NON BIAISED.94 01-02-2011 157005001081 STRYKER POLY SCREW SET X.58 299.02 01-02-2011 157005000896 Medtronic Vertex Select + set screw 6958xxx/6958xxxXX + 69503xx 359.52 59.64 95.78 35.52 59.xxXxx + ATR480U.94 01-02-2011 157005001002 SHARK MEDICAL Vis Adaptable 3K + vis de blocage std 3KVX(X)A xxx-A + 3KVBB1005 359.64 134. screws 6900xxx + 6903070 340.36 35.00 299.78 35.36 35.52 59.52 20.64 134.64 134.03 01-02-2011 157005001072 STRYKER PA SCREW REDUCTION x. Bone Screw Ti + Vertex MAX Set Screw 6955xxx + 6950315 340.90 224.64 134.Mxxx + U1L100 359.42 299.69 224. Nut PSSH0xxx 299.52 59.24 299.64 115.42 299.90 224.90 224.90 224.90 224. + BLOCKER (48557xxx / 48558xxx) + 48551000 359.90 224.00000 359.5 XIA III + BLOCKER 03821xxx + 03756230 359.64 134.00 299.52 59.90 224.42 299.S.78 35.78 35.64 115.94 01-02-2011 157005001115 STRYKER POLY SCREW X.02 01-02-2011 157005000887 Medtronic Vertex MAX M.52 59.Bijwerking 01-08-2013 Page 5 (700092-700103) .42 299.78 35.A.42 299.42 299.52 59.78 35.52 59.94 01-02-2011 157005001045 STRYKER OASYS PA SCREW SMOOTH + BLOCKER 48556xxx + 48551000 359.5 XIA III + BLOCKER 03801xxx + 03756230 359.21 299.5 XIA SS + BLOCKER 48221xxx + 03756230 322.157005000871 Medtronic Vertex M.52 40.90 01-02-2011 157005001011 SHARK MEDICAL Vis Pédiculaire de Rappel 3K + vis de blocage std 3KVR650-A + 3KVBB1005 359.36 299.64 134.64 97.42 299.52 59.78 35.48 224.52 22.48 224.42 299.22 01-02-2011 157005001124 STRYKER POLY SCREW X.57 34.42 299.42 299.64 134.78 35.57 34.64 134.90 224.52 59.94 01-02-2011 157005000914 NEW2DM Vis Adaptable 3K + vis de blocage std 3KVX(X)A xxx-A + 3KVBB1005 359.00 224.88 29.64 134.90 01-02-2011 157005000932 Ortho Team WSI . + CLIP PLUS™ titane + vis de blocage M6 U1 .64 134.90 224.94 01-02-2011 157005000905 Medtronic Vertex Select cannulated + set screw 6959xxx/6959xxxXX + 69503xx 359.94 01-02-2011 157005000993 SDI Belgium Vis Multi-axiale PLUS™ Tit.94 01-02-2011 157005001036 STRYKER OASYS PA SCREW MED + BLOCKER 48555xxx + 48551000 359.90 224.52 59.64 134.78 35.5 + BLOCKER 48140xxxxx + 48130000 359.64 134.90 224.5 XIA III + BLOCKER 038019xx + 03756230 359.64 134.PX Polyaxial Pedicle Screw + WSI .60 32.94 32.42 299.64 74.25 01-02-2011 157005001133 STRYKER RADIUS SCR PA + BLOCKER 48661xxxx + 486610000 359.52 40.64 134.xx + 12VUE01 359.64 134.52 59.00 299.64 134.52 299.72 32.52 59.78 35.42 299.69 224.84 224.64 134.72 224.MxxxT + U1L100T 359.78 35.21 299.52 59. Bone Screw Ti + Vertex Set Screw for laminar hook and M.52 59.94 01-02-2011 157005001054 STRYKER P.00 299.42 299.52 23.90 01-02-2011 157005000923 NEW2DM Vis Pédiculaire de Rappel 3K + vis de blocage std 3KVR650-A + 3KVBB1005 359.36 35.A.94 01-02-2011 157005000957 Orthogèse Vis en U polyaxiale + Ecrou de serrage 12VUP(H)xx.94 01-02-2011 157005001106 STRYKER POLY SCREW SET X.S.52 59.90 224.52 59.94 01-02-2011 157005001097 STRYKER POLY SCREW SET X.06 224.42 299.94 01-02-2011 157005000966 OSTEON PEDICULAR SCREW SWIVEL (POLYAXIAL) HEAD incl.48 224.64 134.42 299.A.A.42 299.MxxxT + MS1-L100T 359.42 299.78 35.78 35.78 35.52 59.90 224.90 224.78 35.52 59.94 01-02-2011 157005000941 Orthogèse BJR Vis en U poly-axiale + BJR Boulon vis en U ATR430U.64 134.94 01-02-2011 157005000984 SDI Belgium Vis Multi-axiale PLUS™ + CLIP PLUS™ + vis de blocage M6 U1 .64 134.78 35.94 01-02-2011 157005001063 STRYKER PA SCREW + BLOCKER 4814xxxx + 48130000 320. SCREW + BLOCKER 48552xxx + 48551000 359.36 35.94 01-02-2011 Mise à jour 01-08-2013 .S.48 224.90 224.Grub Screw 2260x-xx + 22650-30-02 359.95 01-02-2011 157005000975 SDI Belgium Vis Multi-axiale LUMIS™ + écrou de blocage MS1.78 35.5 + BLOCKER 48221xxx + 48220000 322.90 224.64 97.

90 224.42 299.78 35.92 01-02-2011 157005001282 Synthes Click'x TAV + Click'x kapje + Click'x afsluitkapje 498.64 134.64 134.94 01-02-2011 157005001325 Synthes Geperforeerd CLICK’X diam 7 + 3D Head + nut 04.42 299.20 299.42 299.5xx + 498.200.000 359.2xx(S) + 04.78 35.52 59.92 01-02-2011 157005001291 Synthes Click'x TAV + Click'x kapje + Click'x afsluitkapje 498.64 125.94 01-02-2011 157005001361 Synthes Pangea + Afsluitkapje 04.94 01-02-2011 157005001194 STRYKER XIA III TIT PA SCREW MED BIAISED + BLOCKER 482371xxxx + (4823000 / 03756230) 359.89 224.90 224.52 59.571(V) + 04.570 + 04.522(S) 359.42 299.614.78 35.78 35.620.78 35.52 59.000 359.94 01-02-2011 157005001404 Synthes Synapse screw diam 4.52 59.606.90 224.000 359.94 01-02-2011 157005001343 Synthes Geperforeerd Pangea diam 6 + nut 04.52 59.64 134.614. X.78 35.42 299.78 35.52 59.64 134.52 59.52 59.64 134.64 134.xxx + 498.56 35.90 224.648.000 359.571(V) 359.68 224.000 359.52 59.64 134.77 35.xxx + 498.606.000 359.64 134.90 224.570(V) + 04.64 134.64 134.64 134.64 134.1xx(S) + 04.94 01-02-2011 157005001334 Synthes Geperforeerd Pangea diam 5 + nut 04.52 59.522(S) 359.94 01-02-2011 157005001176 STRYKER XIA III TIT PA SCREW BIAISED 48238xxx + (4823000 / 03756230) 359.614.94 01-02-2011 157005001395 Synthes Synapse screw diam 4.xxx(V) + 498.94 01-02-2011 157005001255 Synthes Click'x dual core + Click'x kapje + Click'x afsluitkapje 487.42 299.64 134.606.94 01-02-2011 157005001212 STRYKER XIA III TIT PA UNIPLAN SCREW REDUCT + BLOCKER 48236xxxx + (4823000 / 03756230) 359.68 224.42 299.56 35.0xx(S) + 04.5 + nut 04.2 + 3D Head + nut 04.508(S) / 04.64 134.620.98 01-02-2011 157005001377 Synthes Pangea cannulated + Afsluitkapje 04.000 359.7xxS + 04.52 59.522(S) 359.606.90 224.52 50.614.Bijwerking 01-08-2013 Page 6 (700092-700103) .xxx + 04.90 224.28 224.5 + nut 04.23xS + 498.52 59.52 59.80 299.570 + 498.92 01-02-2011 157005001273 Synthes Click'x TAN + Click'x kapje + Click'x afsluitkapje 498.94 01-02-2011 157005001352 Synthes Geperforeerd Pangea diam 7 + nut 04.52 59.20 299.5xx / 04.606.90 224.42 299.64 134.24xS + 498.52 59.620.570 + 498.89 224.92 01-02-2011 157005001307 Synthes Geperforeerd CLICK’X diam 5.000 359.614.56 35.000 359.78 35.570(V) + 498.42 299.6xx + 406.77 35.52 59.92 01-02-2011 157005001264 Synthes Click'x TAN + Click'x kapje + Click'x afsluitkapje 498.94 01-02-2011 157005001316 Synthes Geperforeerd CLICK’X diam 6.52 59.64 134.xxx(V) + 498.606.624.68 224.571 359.52 59.78 35.52 59.64 134.78 35.78 35.571 359.42 299.571(V) + 04.78 35.56 35.90 224.20 299.42 299.508(S) / 04.78 35.620.64 134.64 134.64 134.648.20 299.42 299.614.6xxS + 04.157005001142 STRYKER XIA CANN PA SCREW X.42 299.5xx + 498.52 59.5 + BLOCKER 03829xxx + (48230000 / 03756230) 359.64 134.0xx / 498.52 59.614.0xx / 498.94 01-02-2011 157005001185 STRYKER XIA III TIT PA SCREW CLOSED HEAD 482376xxx / 482377xxx / 482378xxx / 482379xxx 359.90 224.90 224.000 359.42 299.606.16 34.42 299.104 359.20 299.90 224.78 35.648.94 01-02-2011 157005001246 Synthes Click'x dual core + Click'x kapje + Click'x afsluitkapje 487.52 59.56 35.90 224.620.94 01-02-2011 157005001221 STRYKER XIA SCR.620.52 59.64 134.94 01-02-2011 157005001151 STRYKER XIA III PED SCR PA X.68 224.CANN.2 + 3D Head + nut 04.5 + BLOCKER 48231xxx + 03756230 359.56 35.20 299.64 134.90 224.68 224.22xS + 498.94 01-02-2011 157005001203 STRYKER XIA III TIT PA UNIPLAN SCREW + BLOCKER 48233xxx(x) + (4823000 / 03756230) 359.78 35.508(S) / 04.64 134.90 224.5 + BLOCKER 48231xxxx + 48230000 359.94 01-02-2011 Mise à jour 01-08-2013 .90 224.94 01-02-2011 157005001237 Synthes AXON polyaxiale schroef + Afsluitkapje 405.570 + 04.41 299.606.614.92 01-02-2011 157005001386 Synthes Synapse screw diam 3.90 224.5xxS + 04.42 299.94 01-02-2011 157005001167 STRYKER XIA III REDUCT PA SCREW X.68 224.xxx + 04.41 299.90 224.64 134.52 59.571(V) + 04.78 35.0 + nut 04.000 349.64 134.52 59.5 + BLOCKER 48285xxx(S) + 03756230(S) 359.78 35.78 35.42 299.42 299.52 59.606.614.

0 mm Screw + Open Connector Closure Top 2113-40xx + 707-01 350.94 01-02-2011 157005001447 MSH tangoRS screw polyaxial + tangoRS locking screw 04.78 35.48 224.52 59.90 224.94 01-02-2011 Mise à jour 01-08-2013 .64 125.94 01-02-2011 157005001596 Hospithera Osseoscrew F TI + set screw 53xx5-xx + 22015 359. cannulated + Locking cap 04.42 299.52 59.64 134.52 50.94 01-02-2011 157005001571 Cormed Serengeti polyaxial screw + set screw M101.632.90 224.00 01-02-2011 157005001492 Zimmer Nexlink Primary Smooth Shank 3.000(S) / 04.000(S) / 04.607.52 59.94 01-02-2011 157005001632 Synthes Pedicle Screw Matrix 5.5 + Locking cap 04.0 mm Screw + Open Connector Closure Top 2118-40xx + 707-01 350.0xx + 07.5mm Cannulated Polyaxial Screw + closure top 5.52 59.632.36 35.5 + Screwhead + Locking Cap 359.94 01-02-2011 157005001562 Zimmer ST360 Polyaxial screw + ST360 locking nut 07.607.00 299.637.78 35.52 59.294 CS 3060-x-xx + CS 3001 350.64 125.64 125.64 124.Bijwerking 01-08-2013 Page 7 31-08-2012 (700092-700103) .94 01-02-2011 157005001535 Zimmer Optima ZS reduction screw + nut SPAx1xx + SP30x0 359.42 299.64 125.42 299.632.5 mm Screw + Open Connector Closure Top 2120-55xx + 707-01 350.xxxS + 04.099(S) 359.5 mm Screw + Open Connector Closure Top 2113-35xx + 707-01 350.632.614.636.099(S) /09.606.52 58.94 01-02-2011 157005001587 Cormed Fixspine polyaxial screw + set screw OSM21xx / OSM22xx + OSM4153 359.637.00 01-02-2011 157005001517 Zimmer Nexlink XLarge Open Polyaxial 5.90 224.52 59.92 01-02-2011 157005001431 Synthes USS II poly-axiaal schroef + 3D kapje + Moer + huls 349.42 299.00 01-02-2011 157005001501 Zimmer Nexlink Primary Smooth Shank 4.64 125.634.78 34.157005001413 Synthes Synapse shaft screw diam 3.001 359.5 + nut 04.52 50.52 59.78 35.050(S) / 04.64 134.001(S) / 04.050(S) / 04.52 59.90 224.42 299.xxx + 04.42 299.36 35.5 ti 1105-x5xx + 2101-2 357.099(S) 04.52 50.42 299.94 01-02-2011 157005001465 Zimmer Nexlink Large Open Polyaxial 4.xxxS / 04.099(S) /09.614.00326.42 299.42 299.90 224.90 224.36 35.5 mm Screw + Open Connector Closure Top 2119-45xx + 707-01 350.64 134.64 134.64 134.002(S) / 04.607.632.42 299.94 01-02-2011 157005001641 Synthes Pedicle Screw Matrix Polyaxial.639.52 59.632.42 299.632.42 299.90 224.10001 359.90 224.52 49.52 59.52 59.64 134.64 134.78 35.00 299.90 224.050(S) / 04.42 299.xxx(S) + 04.050(S) / 04.xxx / 04.52 59.35 35.00 01-02-2011 157005001456 Zimmer Java polyaxial screw + screw NUT SN2023-0-2xxxx + SN2023-000002 359.52 59.64 134.52 50.64 134.52 50.632.64 125.42 299.000(S) / 04.41X + 499.79 01-02-2011 157005001553 Zimmer Seq poly Screw Assy + Closure Top 3306-x5xx + 3301-1 359.94 01-02-2011 157005001544 Zimmer Pathfinder 5.94 01-02-2011 157005001623 Synthes Reduction Screw Matrix 5.78 35.64 133.64 134.632.00319.52 59.3xx(S) + 04.632.90 224.90 224.64 134.632.94 01-02-2011 157005001605 Zimmer Instinct Java Polyaxial Pedicle screw + blocker 046W0AN2xxxx + 046W0AN00002 359.48 224.64 134.00 299.099(S) 359.99 299.64 134.64 125.47 224.00 299.78 35.64 134.94 01-02-2011 157005001614 Synthes Pedicle Screw Matrix 5.065xx /M101.634.78 35.52 50.90 224.40x + 04.632.xxx(S) + 04.632.42 299.68 224.78 35.78 35.56 35.90 224.00 01-02-2011 157005001526 Zimmer Optima ZS Poly-axial screw + nut SPAxxxx + SP30x0 359.001 359.00 01-02-2011 157005001483 Zimmer Nexlink Primary Polyaxial Rescue 4.636.614.36 35.099(S) 04.52 50.36 35.xxx(S) + 04.00 299.5 mm Screw + Open Connector Closure Top 2112-35xx + 707-01 350.52 59.00 299.78 35.00 01-02-2011 157005001474 Zimmer Nexlink Primary Polyaxial 3.36 35.xxx(S) + 04.003(S) + 04.48 224.00 299.48 224.608.78 35.78 35.075xx + 101.64 134.055xx /M101.36 35.48 224.632.522(S) 359.20 299.48 224.78 35. preassembled.90 224.632.94 01-02-2011 157005001422 Synthes Universal reduction screw + nut 04.000(S) / 04.632.632.90 224.78 35.508(S) / 04.48 224.099(S) / 09.5 Polyaxial preassembled + Locking Cap 359.

64 134.94 01-11-2011 157005001806 Johnson & Johnson MedicalDepuy Viper cortical fix fenestrated screw 186727xxx + 179702000 / 186715000 / 186782000 359.78 35.64 134.632.42 299.78 35.78 35. preassembled + Locking cap 04.78 35.51xS / 152.5 Fene + Set screw 7547x5xx + 7570955 / 7540020 359.90 224.64 134.000(S) / 04.632.52 18.46 01-07-2011 157005001772 Zimmer Cannulated Polyaxial Screw + Open implant Closure Top 3505-x5xx + 3301-1 357.64 134.608.94 01-02-2011 157005001675 Synthes Screw Matrix + polyAxial screw body + lock Cap 359.632.xxx(S) + 178.94 01-02-2011 157005001684 Synthes Screw Perforated + polyAxial screw body + Lock Cap 359.52 59.02 31.xxx(S) + 04.94 01-05-2012 157005001842 Hospithera Zodiac Uniplanar screw + set screw 356.52 59.14 224.90 224.5 preassembled + Locking Cap 359.78 35.42 299.64 134.66 299.61 224.0xx + 03.503(S) /09.61 01-05-2012 157005001851 Globus Medical Belgium Revlok screw + locking cap 22040-xx / 22045-xx / 22055-xx / 22065-xx / 22075-xx / 22145xx / 22155-xx / 22165-xx / 22175-xx + 22015 / 63020 178.94 01-02-2011 157005001727 SHARK MEDICAL Vis de réduction polyaxiale Spine Tune ST2xxxT-S 359.20 30.52 59.52 59.78 35.94 01-02-2011 157005001745 LDR MEDICAL Vis polyaxiale Spine Tune ST1xxxT-S 359.78 35.294 359.64 134.81 01-09-2012 Mise à jour 01-08-2013 .050(S) / 04.94 01-06-2012 157005001867 Globus Medical Belgium TRANSITION HA Dual Outer Diameter screw 152.48 299.52 59.13 299.52 56.00 299.50.64 134.90 01-07-2012 157005001876 Medtronic CD Horizon SOLERA 5.42 299.78 35.64 131.Bijwerking 01-08-2013 Page 8 (700092-700103) .502(S) / 04.42 299.78 35.84 35.78 35.41x + 499.94 01-02-2011 157005001693 Synthes USS II PolyAxiale geperforeerde schroef + 3D-kapje + Moer + huls 04.94 01-09-2011 157005001797 Medtronic Srew L5.94 01-02-2011 157005001666 Synthes Sagittal Screw Matrix 5.607.52 59.050(S) / 04.64 134.53xS 359.500(S) + 04.50xS / 152.64 134.42 299.000(S) 359.631.xxxS + 04.635.64 134.42 299.64 134.90 224.64 134.78 35.90 224.64 134.52 59.52 10.52 59.632.90 224.631.52 59.94 01-02-2011 157005001754 LDR MEDICAL Vis de réduction polyaxiale Spine Tune ST2xxxT-S 359.632.64 134.52 59.42 299.502(S) / 04.52 57.90 224.631.78 35.632.94 01-02-2011 157005001702 SHARK MEDICAL Vis pédiculaire Easyspine ES 1xx T 359.5/6.78 35.xxx(S) + 04.98 01-03-2012 157005001833 InSpine Belgium Quantum Pedicular Polyaxial Cannulated Screw 51-x75-PA-xx 359.42 299.631.52 35.78 35.42 299.78 35.32 224.52 59.90 224.64 224.74 01-09-2011 157005001781 Medtronic CDH Legacy Peek MAS xxmm + set screw 722xxxx + 722xxxx 359.50.90 224.52 59.503(S) /09.42 299.64 93.42 299.64 90.90 224.78 35.42 299.52 59.099(S) 04.xxx(S) + 04.64 134.631.42 299.616.500(S) + 04.94 01-02-2011 157005001763 B Braun Medical S4 Spinal system polyaxial screw canulated + S4 Spinal system set screw SW32xT -> SW37xT + SW790T 314.52 59.49 31.64 132.632.90 224.157005001657 Synthes Matrix Pedicle Screw.90 224.52 59.90 224.16 299.632.52 59.64 134.75 TI NS SXT BRK OFF 359.78 35.0 Multi-Axial Screw 5584000xxxx / 5589000xxxx + 5540030 / 5540230 359.90 224.94 01-02-2011 157005001711 SHARK MEDICAL Vis polyaxiale Spine Tune ST1xxxT-S 359.000(S) / 04.42 299.94 01-11-2011 157005001815 Medtronic Solera screw + Solera set screw 4.632. augmentable.099(S) /09.099(S) (04.656.48 224.xxx(S) + 04.099(S) /09.90 224.52 59.90 224.42 299.099(S) 04.637.36 35.64 134.42 299.42 299.90 224.607.099(S) 359.90 224.94 01-02-2011 157005001736 LDR MEDICAL Vis pédiculaire Easyspine ES 1xx T 359.200 318.52 59.631.64 85.42 299.64 134.84 299.78 35.94 01-01-2012 157005001824 SDI Belgium Vis Ulis multi-axiale + setscrew 548400155xx / 548400165xx / 548400175xx + 5440430 + 5440030 IS1-M5xxT / IS1-M6xxT / IS1M7xxT + MS1-L100T 309.52xS / 152.52 15.40x/ 04.64 134.96 224.94 01-09-2012 157005001885 Medacta Must pedicle screw single sterile + set screw 03.90 224.632.52 59.

51.200 318. par 2 vis) + écrous de blocage (réf.36 35.90 224.52 59.78 35.52 18.64 134.64 134.49 31.90 224.52 18.64 93.90 224.50.78 35.53.94 01-05-2013 157005001982 Biomet Lineum Screw + Lineum HF PLUG 14-524xxx + 14-524038 359.200 318.42 299.50.00 299.52 50. par 2 écrous) KITMxxx + KITMCxxx 359.52 18.64 134.52 18.94 01-06-2013 157005001991 Spinaxis E.50.52 59.0xx + 03.64 134.0xx + 03.61 224.00 01-09-2012 157005001955 Spinaxis Vis multi-axiale Sterispine PS + écrou de blocage PSMxxx + PSMCxxx 359.Bijwerking 01-08-2013 Page 9 (700092-700103) .75 + set screw TI RED BRK Off 5489000xxxx + 5440230 359.94 01-03-2013 157005001964 Spinaxis Kit de vis multi-axiales Sterispine PS (réf.78 35.42 299.0xx + 03.157005001894 Medacta Must pedicle screw sterile + set screw (referentie per 2 schroeven) 03.81 01-09-2012 157005001937 Medacta Must unsterile cannulated pedicle screw single + unsterile set screw 03.64 93.50.52 18.64 93.13 299.64 93.49 31.48 224.50.49 31.42 299.90 224.42 299.13 299.49 31.81 01-09-2012 157005001903 Medacta Must cannulated pedicle screw sterile + set screw 03.210 318.81 01-09-2012 157005001921 Medacta Must unsterile pedicle screw single + unsterile set screw 03.64 125.52 59.48 224.54.61 224.52 59.0xx + 03.52.42 299.81 01-09-2012 157005001912 Medacta Must cannulated pedicle screw sterile + set screw (referentie per 2 schroeven) 03.13 299.94 01-06-2013 157005002007 SpineConcept Vis Adaptable 3K + vis de blocage std 3KVX(X)(A) xxx-A + 3KVBB1005 359.13 299.49 31.55.00 299.210 318.13 299.61 224.200 318.64 134.52 59.0xx + 03.64 134.94 01-03-2013 157005001973 Medtronic CD Horizon – Solera screw RMAS assembly for 4.81 01-09-2012 157005001946 Hospithera tangoRS screw polyaxial + tangoRS locking screw CS 3060-x-xx + CS 3001 350.61 224.90 224.78 35.Spine – Vis pédiculaire multi-axiale + vis de verrouillage A2511xxxx / A2512xxxx + A2511001 359.78 35.36 35.61 224.52 59.90 01-08-2013 Mise à jour 01-08-2013 .64 93.

52 0. / Verstr.Remboursement V.10 500.58 500.34 500.74 € is van toepassing op het geheel van de wervelkolomimplantaten.92 29.00 375.87 412. Prix plafond . met of zonder overeenkomst C = Supplément patient Bén./Prestataire conventionné .00 375.95 42.18 41. / Verstr.Terugbetaling : Marge de sécurité .00 375.Bijwerking 01-08-2013 Page 1 (700114-700125) .Plafondprijs : 601.41 60. ordin.89 59.Supplément patient V.Veiligheidsgrens : 500.35 01-02-2011 157006000067 B Braun Medical Socon screw + Socon connector clamp FG95xT / FG96xT / FG97xT + FG60xT 422.64 0. / Prestataire conventionné .10 € Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157006000015 B Braun Medical Macs bone screw + bone graft clamp SX832T + SX825T 412. / Prestataire avec ou sans convention Terugbetaling Gew.92 95.10 500.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.69 225.87 0. ordin. connecteur inclus Verankeringsschroef waarbij de staaf door middel van een afzonderlijke connector wordt gefixeerd. recht.U waarde : U 485 Remboursement .Prijs (incl.11 01-02-2011 157006000042 B Braun Medical S4C Smooth shank screw + set screw + Lateral offset connector +set screw 601. / Verstr.O. / Prestataire avec ou sans convention Supplement patiënt Gew.69 154. met of zonder overeenkomst D = Remboursement Bén.26 01-02-2011 157006000076 Biomet Altius Polyaxiale schroef + Offset Lateral Connector 1200-2xxx + 1200-260x 530.65 53. / Prestataire non conventionné Supplement patiënt / Verstr. BTW) B = Remboursement Bén.41 60.18 375.P. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700114-700125 Vis d'ancrage pour fixation de la tige fixée au moyen d'un connecteur séparé. / Prestataire non conventionné Terugbetaling Gew.P.69 225.I.69 37.18 375.92 100. ordin.11 01-02-2011 157006000033 B Braun Medical S4C Polyaxial screw + set screw + Lateral offset connector + set screw 601. zonder overeenkomst E = Supplément patient Bén.65 01-02-2011 Mise à jour 01-08-2013 . / Verstr.W. ordin.66 375. met overeenkomst .Terugbetaling W.92 100.69 225.O. / Verstr.A = Prix (TVAc) .I.I.92 100.52 463.69 87.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale . connector inbegrepen Valeur de U .18 375.10 500. inclusief alle toebehoren voor fixatie en blokkering. y compris toutes les pièces de fixation et d'attache.G.G.83 46.W.69 220.I.28 01-02-2011 157006000024 B Braun Medical S4C Favored angle screw + set screw +Lateral offset connector +set screw 601.Supplement patiënt W.42 375.41 60. met overeenkomst .11 01-02-2011 157006000051 B Braun Medical Socon CS screw + Socon connector clamp SW141T -> SW160T / SW121T ->SW124T + SW002T/SW003T + SW005T/SW007T/SW009T/S W011T/SW013T/SW019T/SW0 21T + SW002T/SW003T SW161T -> SW182T + SW002T/SW003T + SW0xxT + SW002T/SW003T SW061T -> SW088T + SW002T/SW003T+ SW0xxT + SW002T/SW003T FG989TS -> FG993TS +FG60xT 463. recht.64 422.92 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.03 01-02-2011 157006000085 Biomet Array schroef + lateral connector 94xxx + 500566x 596.69 46. recht.

975 / 182.08 375.69 157.41 60.69 225.08 375.08 375.69 225.00 500.30 01-02-2011 157006000234 Hospithera Alphatec OFF CONNECTOR ASSEMBLY 10mm +Alphatec Monoaxial screw + ZODIAC TI HEXALOBE SET SCREW 6200x-xx + 62xxx-xx + 22015 / 63020 533.19 375.69 125.69 225.00 500.92 32.00 500.5xx + 182.92 500.3xx / 155.51 49.69 225.xxx.92 64.00 375.00 375.3MM LATERAL CONNECTOR.99x + 182.51 49.92 500.xx + TSC 10.31 60.013 601.23 50.08 375.92 100.00 375.4xx / 155.20 498.92 100. CLOSED + Alphatec 6301x + 63xxx-xx + 22015 / Polyaxial screw + ZODIAC TI HEXALOBE SET SCREW 63020 573.1xx + 155.41 60.11 01-02-2011 157006000146 Cormed Evos screw + connector + breakaway nut 32.92 73.69 189.18 375.10x 500.30 01-02-2011 157006000243 InSpine Belgium Long LP Multiaxial Pedicle Screw + lateral connector ES8xxT 498.0xx + 155.6310 601.69 225.20 0.69 225.92 100.69 225.51 01-02-2011 157006000121 Biomet Polaris schroef + lateral connector 601.10 01-02-2011 157006000304 ISKRA Plaque Ilio-Sacrée 3K + vis de blocage std métrique +vis 3KANR111-A + 3KDCV602 + 3KVX (X)(X) xxx.41 60.11 01-02-2011 157006000137 Cormed Ascent polyaxial screw + Ascent locking screw + ascent connector 2000-2xxx / 2000-7xxx + 2000102x / 14-500132506xxxMP/53-6xxxMP + 645x 65.5mm Clamp 155.69 122.69 122.18 375.69 225.10x 500.69 225.82 01-02-2011 157006000286 ISKRA (Anneau de Rattrapage 3K + vis de blocage moyenne )+ vis 3K + vis de blocage standard 601.10 500.51 49.69 122.18 375.10 01-02-2011 157006000313 ISKRA Point d'ancrage sacré illiaque + vis de blocage longue + vis de blocage métrique courte + vis 601.11 01-02-2011 157006000155 Cormed PASS LP Spinal system + nut + connecteur B0221xxxx / B0218xxxx + B02130005 + B0223xxxx 601.00 375.31 60.69 189.5xx + 068.51 01-02-2011 157006000103 Biomet Omega schroef +Omega Multidirectional Coupling 565.00 375.2xx / 182.20 498.18 375.92 100.00 375.42 56.39 01-02-2011 157006000225 Hospithera Alphatec OFF CONNECTOR ASSEMBLY 10mm + Alphatec Polyaxial screw + ZODIAC TI HEXALOBE SET SCREW 6200x-xx + 62xxx-xx + 22015 / 63020 563.34xx + 65.08 375.08 375.31 60.640 601.11 500.18 375.69 225.xxx(NC) + 036.10 500.92 100.10 01-02-2011 Mise à jour 01-08-2013 .06 375.11 01-02-2011 157006000216 Hospithera Ellipse Lateral Connector + 'Ellipse Polyaxial Screw + Ellipse Locking Cap 182.69 225.4xx / 182.20 498.00 500.82 01-02-2011 157006000252 InSpine Belgium Pedicular Screw Alpha + lateral connector ES1xxT 498.11 01-02-2011 157006000182 Globus Medical Belgium BEACON™ Posted Screw + BEACON™ 5.3xx / 182.00 500.10 01-02-2011 157006000331 Johnson & Johnson MedicalDepuy Expedium Offset Fixed Bolt screw + Closed lateral Connector + nut Titanium 1754 22 xxx + 1797 93 xxx + 1754 91 040 601.92 100.92 100.31 60.00x + TIN 010.5mm Clamp 155.92 100.69 122.92 100.09 01-02-2011 157006000191 Globus Medical Belgium BEACON™ Reduction Screw + BEACON™ 5.69 187.10 500.69 189.31 60.23 50.31 53.92 100.10 500.69 198.92 64.20 0.11 500.08 375.82 01-02-2011 157006000277 InSpine Belgium Standard LP Multiaxial Pedicle Screw + lateral connector ES8xxT 498.500 Alphatec 3.10 01-02-2011 157006000322 Johnson & Johnson MedicalDepuy Expedium 4.82 01-02-2011 157006000261 InSpine Belgium Pedicular Screw standard + lateral connector ES0xxT 498.08 375.09 01-02-2011 157006000207 Globus Medical Belgium 601.Bijwerking 01-08-2013 Page 2 (700114-700125) .19 375.07 601.42 56.92 62.11 01-02-2011 157006000173 Cormed VBR screw (shaft + tube + connector + nut) 068.20 0.5 Transverse Rodded Connector 60 mm + screw + innie 3KPS105-A + 3KBCV601 + 3KVBP1002 + 3KPSV106/ 3KPSVL114 1861 72 xxx + 1861 xx xxx + 186100007 601.69 125.00 500.69 225.00 500.157006000094 Biomet Omega LP schroef + Omega LP Multidirectional Coupling 129x-xx / 139x-xx / 125x-xx / SC120x-xx / SFC130x-xx + 1280-1x 12xx-xx + 1280-0x / 1280-1x 565.20 0.19 375.18 375.31 56.31 60.69 225.20 498.18 375.10 500.92 0.5xx + 036.41 60.00 500.33xx/65.92 100.10 500.98 500.92 64.11 500.92 100.41 60.620 + 036.51 01-02-2011 157006000112 Biomet Omega Vertebroplasty schroef + Omega Multidirectional Coupling 1299-xx / 1300-xx + 1280-0x / 1280-1x 565.A + 3KVBB1005 3KAR101-A + 3KBCV601 + 3KVX (X)(X) xxx .41 60.92 0.29 57.41 60.610 + 068.92 100.10 01-02-2011 157006000295 ISKRA (Attache de Rattrapage 3K + vis de blocage longue) + vis 3K + vis de blocage standard 601.42 56.A + 3KVBB1005 3KPIS120-A + 3KBCV601 + 3KPISVX113xx 601.51 49.10 500.11 01-02-2011 157006000164 Cormed Trinity screw + connector + nut TIS.2002 + 65.

92 100.00 500.00 500.69 225.18 375.92 100.31 60.08 375.08 375.11 01-02-2011 Mise à jour 01-08-2013 .18 375.92 100.31 60.31 60.92 100.08 375.08 375.92 100.10 01-02-2011 157006000505 Johnson & Johnson MedicalDepuy Expedium Offset Polyaxial Bolt screw +Closed lateral Connector + nut Titanium 1754 12 xxx + 1797 93 xxx + 1754 91 040 601.00 500.08 375.10 01-02-2011 157006000453 Johnson & Johnson MedicalDepuy Expedium Offset Polyaxial Bolt screw + Closed lateral Connector + nut SS 1854 12 xxx + 1881 92 xxx + 1854 91 040 601.10 01-02-2011 157006000541 Johnson & Johnson MedicalDepuy Expedium Offset Polyaxial Reduction Bolt screw + Connector + nut Ti 1754 32 xxx + 1754 50 5xx + 1754 91 040 601.11 01-02-2011 157006000584 Johnson & Johnson MedicalDepuy Monarch Bolt screw Osteoporosis+ connector + nut 1725 00 xxx + 1770 50 xxx / 1754 5x 0xx + 1770 91 045 601.10 01-02-2011 157006000523 Johnson & Johnson MedicalDepuy Expedium Offset Polyaxial Reduction Bolt screw + Closed Lateral Connector + nut Ti 1754 32 xxx + 1797 93 xxx + 1754 91 040 601.92 100.10 01-02-2011 157006000557 Johnson & Johnson MedicalDepuy Expedium Offset Polyaxial Reduction Bolt screw + Polyaxial Closed Lateral Connector + nut Ti 1754 32 xxx + 1797 98 xxx + 1754 91 040 601.00 500.69 225.10 01-02-2011 157006000514 Johnson & Johnson MedicalDepuy Expedium Offset Polyaxial Reduction Bolt screw + Closed lateral Connector + nut SS 1854 32 xxx + 1881 92 xxx + 1854 91 040 601.10 01-02-2011 157006000471 Johnson & Johnson MedicalDepuy Expedium Offset Polyaxial Bolt screw + Connector + nut Titanium 1754 12 xxx + 1754 50 5xx + 1754 91 040 601.00 500.08 375.92 100.10 500.69 225.00 500.41 60.92 100.10 01-02-2011 157006000426 Johnson & Johnson MedicalDepuy Expedium Offset Fixed Reduction Bolt screw + Polyaxial Closed lateral Connector + nut SS 1854 62 xxx + 1881 98 xxx + 1854 91 040 601.92 100.11 01-02-2011 157006000602 Johnson & Johnson MedicalDepuy Mountaineer Polyaxial screw + innie + Mountaineer Lateral Offset Connector 1883 19 xxx + 1883 42 200 + 1883 12 001 601.31 60.08 375.00 500.08 375.92 100.08 375.31 60.10 01-02-2011 157006000444 Johnson & Johnson MedicalDepuy Expedium Offset Fixed Reduction Bolt screw +Closed lateral Connector + nut Titanium 1754 62 xxx + 1797 93 xxx + 1754 91 040 601.157006000347 Johnson & Johnson MedicalDepuy Expedium Offset Fixed Bolt screw + Connector + nut Titanium 1754 22 xxx + 1754 5x xxx + 1754 91 040 601.00 500.31 60.92 100.92 100.69 225.69 225.10 500.31 60.08 375.31 60.31 60.31 60.08 375.00 500.08 375.69 225.69 225.69 225.00 500.10 01-02-2011 157006000435 Johnson & Johnson MedicalDepuy Expedium Offset Fixed Reduction Bolt screw + Polyaxial Closed lateral Connector + nut Titanium 1754 62 xxx + 1797 98 xxx + 1754 91 040 601.00 500.92 100.10 01-02-2011 157006000356 Johnson & Johnson MedicalDepuy Expedium Offset Fixed Bolt screw + Polyaxial Closed lateral Connector + nut Titanium 1754 22 xxx + 1797 98 xxx + 1754 91 040 601.41 60.10 01-02-2011 157006000383 Johnson & Johnson MedicalDepuy Expedium Offset Fixed Bolt screw + Polyaxial Closed lateral Connector + nut SS 1854 22 xxx + 1881 98 xxx + 1854 91 040 601.92 100.92 100.Bijwerking 01-08-2013 Page 3 (700114-700125) .69 225.69 225.69 225.10 01-02-2011 157006000532 Johnson & Johnson MedicalDepuy Expedium Offset Polyaxial Reduction Bolt screw + Connector + nut SS 1854 32 xxx + 1854 60 xxx + 1854 91 040 601.00 500.69 225.10 01-02-2011 157006000401 Johnson & Johnson MedicalDepuy Expedium Offset Fixed Reduction Bolt screw + Connector + nut SS 1854 62 xxx + 1854 5x xxx + 1854 91 040 601.69 225.10 500.08 375.41 60.08 375.31 60.00 500.18 375.00 500.00 500.92 100.08 375.69 225.41 60.31 60.69 225.31 60.08 375.69 225.31 60.10 01-02-2011 157006000462 Johnson & Johnson MedicalDepuy Expedium Offset Polyaxial Bolt screw + Connector + nut SS 1854 12 xxx + 1854 60 xxx + 1854 91 040 601.69 225.31 60.31 60.69 225.00 500.92 100.10 01-02-2011 157006000496 Johnson & Johnson MedicalDepuy Expedium Offset Polyaxial Bolt screw + Polyaxial Closed lateral Connector + nut Titanium 1754 12 xxx + 1797 98 xxx + 1754 91 040 601.10 500.92 100.69 225.00 500.10 01-02-2011 157006000487 Johnson & Johnson MedicalDepuy Expedium Offset Polyaxial Bolt screw + Polyaxial Closed lteral Connector + nut SS 1854 12 xxx + 1881 98 xxx + 1854 91 040 601.00 500.92 100.92 100.00 500.10 01-02-2011 157006000575 Johnson & Johnson MedicalDepuy Monarch Bolt screw + connector + nut 1770 xx xxx + 1770 50 xxx / 1754 5x 0xx + 1770 91 045 601.00 500.10 01-02-2011 157006000417 Johnson & Johnson MedicalDepuy Expedium Offset Fixed Reduction Bolt screw + Connector + nut Titanium 1754 62 xxx + 1754 5x xxx + 1754 91 040 601.08 375.08 375.11 01-02-2011 157006000593 Johnson & Johnson MedicalDepuy Mountaineer Polyaxial screw + innie + Mountaineer Lateral Offset Connector 1883 18 xxx + 1883 42 200 + 1883 12 001 601.31 60.31 60.31 60.69 225.92 100.08 375.08 375.08 375.08 375.08 375.10 01-02-2011 157006000566 Johnson & Johnson MedicalDepuy Expedium Offset Polyaxial Reduction Bolt screw +Polyaxial Closed lateral Connector + nut SS 1854 32 xxx + 1881 98 xxx + 1854 91 040 601.69 225.18 375.69 225.69 225.00 500.69 225.92 100.92 100.31 60.69 225.69 225.00 500.31 60.31 60.69 225.92 100.10 01-02-2011 157006000365 Johnson & Johnson MedicalDepuy Expedium Offset Fixed Bolt screw + Closed lateral Connector + nut SS 1854 22 xxx + 1881 92 xxx + 1854 91 040 601.10 01-02-2011 157006000374 Johnson & Johnson MedicalDepuy Expedium Offset Fixed Bolt screw + Connector + nut SS 1854 22 xxx + 1854 5x xxx + 1854 91 040 601.92 100.00 500.10 01-02-2011 157006000392 Johnson & Johnson MedicalDepuy Expedium Offset Fixed Reduction Bolt screw + Closed lateral Connector + nut SS 1854 62 xxx + 1881 92 xxx + 1854 91 040 601.92 100.92 100.31 60.

92 100.69 225.92 100.11 01-02-2011 157006000855 Medtronic Vertex Lateral Connector for standard screws + set screw 6904003 + 69503xx + 690xxxx/695xxxx 601.69 225.87 56.11 01-02-2011 157006000706 MEDIANN TLS Vis pédiculaire polyaxiale + TLS connecteur sacré + clip CT10-BPxxx + 6T50-CSxx + CT60-TLxx 601.92 72.41 60.10 500.69 225.11 01-02-2011 157006000837 Medtronic TSRH-TC Osteogrip screw + set screw + connector 835xxxxx + 828124x+ 83791xx 601.41 60.58 58.18 375.92 100.11 01-02-2011 157006000681 MEDIANN SCS Vis pédiculaire mono-axiale + SCS Connecteur sacré + clip 7T10-AXxxx + 4T00-EB50 + 7T20-XXxx / 6T50-CSxx + 2T00VS53 2T10-AMxxx + 2T50-CAxx + 2T60.69 225.69 225.92 100.157006000611 Johnson & Johnson MedicalDepuy Mountaineer Polyaxial screw + innie + Mountaineer Lateral Offset Connector 1883 20 xxx + 1883 42 200 + 1883 12 001 601.69 225.69 225.18 375.64 375.18 375.92 100.11 01-02-2011 157006000697 MEDIANN SCS Vis sacrée + SCS Connecteur sacré + clip 2T10-Uxxx + 2T50-CAxx + 2T60.69 225.10 500.92 100.41 60.10 500.27 500.41 60.41 60.92 100.11 01-02-2011 157006000715 Medtronic Colorado2 Anterior screw (2x) + Clamp + breakoff nut 601.92 806ECT/G806ECT + 806PXxxX 100.56 500.18 375.69 225.CVxx 601.18 375.41 60.10 500.11 01-02-2011 157006000627 Johnson & Johnson MedicalDepuy Summit Screw MFA + lateral connector + innie 1746 xx xxx + 1746 29 000 + 1746 42 200 601.92 100.35 375.92 100.92 100.10 500. 10mm + set screw + vertex screw 69021xx + 69503xx + 690xxxx/695xxxx 601.10 500.69 197.15 01-02-2011 157006000654 Johnson & Johnson MedicalDepuy VSP Isola Ti Screw + connector (+ nut) '222xxxxx + 5200-xx(X) (+ 22261000 ou 223007R) 561.92 100.18 375.Bijwerking 01-08-2013 Page 4 (700114-700125) .11 01-02-2011 157006000742 Medtronic Colorado2 Pediatric Ti screw + set screw + connector 864xxxx + 8644101 + 8644100 601.92 100.69 225.41 60.46 500.11 01-02-2011 157006000812 Medtronic TSRH-3D Ti screw + set screw + connector 837xxx(x) + 8281246 / 8281248 + 837912x 601.10 500.92 100.18 375.69 185.18 375.69 225.10 500.41 60.56 500.92 100.92 87.92 100.82 01-02-2011 157006000645 Johnson & Johnson MedicalDepuy VSP Isola SS Screw + connector (+ nut) 302xxxxx + 5000xx(X)(X) (+ 203007R ou 20261000) 561.92 100.69 225.10 500.41 60.18 375.41 60.69 225.10 500.64 375.10 500.18 375.92 100.18 375.41 60.92 100.41 60.11 01-02-2011 157006000785 Medtronic Iliac Ti screw + set screw + connector 7046xxxx + 7049855/5440020 + 7041xxx/5443xxx 601.69 225.41 60.11 01-02-2011 157006000751 Medtronic Colorado2 Ti screw + self breaking nut+ Clip 863xxxx + 8634111 + 8634xxx 601.18 375.11 01-02-2011 Mise à jour 01-08-2013 .92 60.10 500.18 375.41 60.41 60.18 375.92 100.11 01-02-2011 157006000794 Medtronic Tenor screw + self breaking nut + connector 806SxxXxxX / 806RxxXxxX + 601.11 01-02-2011 157006000636 Johnson & Johnson MedicalDepuy VSP Isola SS Screw + connector mini offset (+ nut) 302xxxxx + 5000-58(XX) + (203007R / 20261000) 588.92 60.18 375.10 500.11 01-02-2011 157006000767 Medtronic Iliac FAS screw + connector + set screw 704xxxx + 7041xxx + 7045855/7049855 601.18 375.18 375.41 60.54 375.41 60.11 01-02-2011 157006000803 Medtronic TSRH-3D MPA Thrd screw + set screw + connector 837xxx(x) + 8281246 / 8281248 + 837912x 601.69 212.10 500.69 185.10 500.11 01-02-2011 157006000864 Medtronic Vertex Lateral Connector-Closed.11 01-02-2011 157006000846 Medtronic Vertex Lateral Connector + set screw + vertex screw 695xxxx + 69503xx + 695xxxx 601.10 500.92 100.92 100.69 225.10 500.69 225.11 01-02-2011 157006000733 Medtronic Colorado2 inox screw + self breaking nut + connector 861xxxx + 8614111+ X1970455/X347455 601.18 375.CVxx 601.69 225.18 375.69 225.34 01-02-2011 157006000672 MEDIANN ORIA CLARIS Vis pédiculaire + nut vis + ORIA CLARIS Connector lateral + écrou connecteur 601.18 375.87 56.11 01-02-2011 157006000776 Medtronic Iliac ss screw + connector + set screw 7026xxxx + 7021xxx + 7024855/7025855 601.11 01-02-2011 157006000821 Medtronic TSRH-3Dx Ti screw + set screw + connector 835xxxxx + 8281248 + 83791xx 601.18 375.41 60.10 500.41 60.69 225.69 225.77 57.15 01-02-2011 157006000663 MEDIANN ORIA ALIS Vis vertebrale + nut vis + ORIA ALIS Connector GT10-Gxxxx + GT00-ES40 + GT20-CX0x 573.69 225.10 500.18 375.10 500.10 500.10 500.11 01-02-2011 157006000724 Medtronic Colorado2 inox screw + self breaking nut + clip 8632xxx /8612xxx + 8634100/8614100 + 8634111/8614111 861xxxx + 8614111+ 8614xxx 601.41 60.41 60.69 225.41 60.

10 500.41 60.92 500.92 0.92 100.31 60.00 500.xxX0x/ATR4700.18 375.46 59.69 225.18 375.31 60.52 0.08 375.xxXxx 12x.92 100.69 225.10 500.15 500.31 60.69 225.43 500.Bijwerking 01-08-2013 Page 5 31-03-2011 (700114-700125) .31 60.41 60.92 100.92 79.92 100.18 375.08 375.POST X.00 375.31 60.18 375.04 01-02-2011 157006001065 STRYKER OFFSET CONNECTOR + XIA SCREW with blocker + BLOCKER 4822013x + 4822xxxx + 48220000 593.00 500.08 375.A + 3KVBB1005 3KPIS120-A + 3KBCV601 + 3KPISVX113xx 601.31 01-02-2011 157006001074 STRYKER OFFSET CONNECTOR + BLOCKER + XIA SCREW + BLOCKER 4813510x + 481xxxxx(x) + 48130000 601.10 01-02-2011 157006001022 SHARK MEDICAL Point d'ancrage sacré illiaque + vis de blocage longue + vis de blocage métrique courte + vis 601.xxX0 X + MUN43AD.08 375.xxXxx ATR480D.52 0.23 375.41 60.10 01-02-2011 157006001013 SHARK MEDICAL Plaque Ilio-Sacrée 3K + vis de blocage std métrique +vis L2-SH5xxT / L2-S6xxT / L2S7xxT + L2-L9xxT / L2LSPL1xxT / L2-L1xxT 3KANR111-A + 3KDCV602 + 3KVX (X)(X) xxx.00 500.11 01-02-2011 157006000986 SDI Belgium Vis Uni-Thread™ de réduction de spondylolisthesis + Connecteur UNIThread™ 601.00 500.41 60.11 01-02-2011 157006000934 Orthogèse BJR Ecrou + BJR Connecteur universel et long Ø 5.11 01-02-2011 157006001083 STRYKER OFFSET CONNECTOR + Diapason schroef + blocker 695305 + 4848xxxx / 4848xxxxXL + 48482001 / (48482010 + 48482020) 601.69 225.25 01-02-2011 157006001047 STRYKER OFFSET CONNECTOR XIA TIT + Xiaschroef met blocker + blocker 0382013x + 4822xxxx + 48220000 593.A + 3KVBB1005 3KAR101-A + 3KBCV601 + 3KVX (X)(X) xxx .51 375.10 500.10 500.92 100.23 375.41 60.15 500.69 225.5 + BJR Vis à dôme spondylo 601.69 225.10 01-02-2011 157006000916 NEW2DM Point d'ancrage sacré illiaque + vis de blocage longue + vis de blocage métrique courte + vis 601.69 225.92 100.08 375.10 01-02-2011 157006001031 STRYKER L.18 375.69 225.41 60.18 375.00 362.69 225.69 225.92 100.08 375.69 217.92 92.92 100.69 225.00000 + ATR4700.xxX0x/ATR4700.00 36.31 60.92 100.00 500.18 375.10 500.18 375.92 100.31 01-02-2011 157006001056 STRYKER OFFSET CONNECTOR + Xia II schroef + blocker 48220101 + 4822xxxx + 48220000 580.00000 + ATR4700.46 59.31 60.31 60.11 01-02-2011 157006000882 NEW2DM (Anneau de Rattrapage 3K + vis de blocage moyenne )+ vis 3K + vis de blocage standard 601.41 60.10 01-02-2011 157006000925 Orthogèse BJR Ecrou + BJR Connecteur + BJR Vis à dôme 601.10 01-02-2011 157006001004 SHARK MEDICAL (Attache de Rattrapage 3K + vis de blocage longue) + vis 3K + vis de blocage standard 601.69 225.18 375.69 217.69 125.11 01-02-2011 157006000943 Orthogèse Olerud vis + Olerud Bride de connection + Olerud connecteur 3KPS105-A + 3KBCV601 + 3KVBP1002 + 3KPSV106/ 3KPSVL114 ATR480D.xxXxx / ATR43AD.69 204.10 500.08 375.11 01-02-2011 157006000977 SDI Belgium Vis Uni-Thead™ pour abords LIS + Connecteur UNI-Thread™ L2-CH5xxT / L2-C6xxT / L2C7xxT + L2-L9xxT / L2-L1xxT / L2-LSPL1xxT L2-CLISxxxT + L2-L9xxT / L2L1xxT 601.157006000873 Medtronic X'Ngage schroef + nut + connector 9942xxxx / 9941xxxx + 99453105 + X282xxxx 601.xxx 601.92 100.74 58.52 362.10 500.5 SCREW + STAND Connector 3KPS105-A + 3KBCV60x + 3KVBP1002 + 3KPSV106/ 3KPSVL114 48901xxx + 489020xx 362.69 225.41 60.92 100.92 100.69 225.69 225.xxX0 X+ TRO43SD.11 01-02-2011 Mise à jour 01-08-2013 .10 01-02-2011 157006000907 NEW2DM Plaque Ilio-Sacrée 3K + vis de blocage std métrique +vis 3KANR111-A + 3KDCV602 + 3KVX (X)(X) xxx.10 500.11 01-02-2011 157006000995 SHARK MEDICAL (Anneau de Rattrapage 3K + vis de blocage moyenne )+ vis 3K + vis de blocage standard 601.23 50.00 500.A + 3KVBB1005 3KAR101-A + 3KBCV601 + 3KVX (X)(X) xxx .A + 3KVBB1005 3KPIS120-A + 3KBCV601 + 3KPISVX113xx 601.09 01-02-2011 157006000961 SDI Belgium Vis Uni-Thead™ + Connecteur UNI-Thread™ 601.10 500.10 01-02-2011 157006000891 NEW2DM (Attache de Rattrapage 3K + vis de blocage longue) + vis 3K + vis de blocage standard 601.41 60.69 225.08 375.92 92.4xx + 120.00 500.35x + 120.92 100.00 500.92 100.92 100.69 225.92 100.xxXxx / LYS43SD.11 01-02-2011 157006000952 OSTEON PEDICULAR CONNECTOR incl screw 400DTLx5 500.

10 500. cannulated Ø 4 mm + neon easy fit+ neon connector 19 mm + Inlay for neon connector + Neon hex nut + neon locking screw.621.41 60.83x 601.92 100.202 601.69 140.00 375.10 500.627.27x 04.627.607.18 375.7xx + 298.92 500.41 60. for connector with length 19 mm neon screw.93 01-02-2011 31-08-2012 Mise à jour 01-08-2013 .627.99 375.2xx + 498.92 100.00 01-02-2011 31-08-2012 157006001327 MSH 499.92 100. length 45 mm + krypton connector + krypton locking screw CS 2801-6-xxT + CS 2805-xxT + CS 2806T 516.10 500.41 60.41 60.00 362.83x 601.614.41 60.92 100.23 50.294 + 04.34 375.70 52.18 375.7xx / 04.11 01-02-2011 157006001284 Synthes Ventrofix schroef + connector + set screw 498.18 375.18 375.92 100.41 60.92 100. + Xiaschroef + blocker 03820101 + 0382xxxx + 03756230 593.46 59.92 100.621.10 500.69 123.69 217.6xx + 298.39 500.22 58.11 01-02-2011 157006001196 Synthes USS fractuur schanzschroef Ti diam 5 + connector 496.91 500.69 161. self tapping.00x 601.69 84.28 53.10 500.5 x YYMM + NUT + CONNECTOR 4823xxxxx + 48230000 + 482301xx/038201xx 601.627.92 28.41 60. xxx 601.7xx + 298.97 500.25 01-02-2011 157006001126 STRYKER XIA III SCREW X.38 51.18 375.621.69 225.41 60.105 + 405.92 92.92 100.00x 601.xxx(S) + 498.023 + 498.69 225.83x 601.Bijwerking 01-08-2013 Page 6 (700114-700125) . Ø 5 mm + neon easy fit + neon connector 19 mm + Inlay for neon connector + Neon hex nut+ neon locking screw.41 60.18 375.10 500.508(S) 601.15 500.621. cannulated.87 49.621.69 225.41 60.627.15 375.69 177.2xx + 04.17x + 499.00 375.69 225.10 500.xxx + 04.11 01-02-2011 157006001162 Synthes Polyaxial screw + USS II sacro-iliac connector + moer + huls + klem 500.92 52.69 225.18 375.41 60.25x + 498.03 460.11 01-02-2011 157006001266 Synthes USS Ti connector closed + screw USS Ti 499.18 375.60 01-02-2011 31-08-2012 157006001311 MSH neon screw.92 15.41 60.69 225.95 01-02-2011 31-08-2012 157006001336 MSH neon screw.69 225.11 01-02-2011 157006001144 Synthes CLAMPFIX posterieure schroef +klem 04.41 60.92 100.18 375.83x 601.xxx(S) + 498.627.xxx(S) + 498.10 500.69 153.294 + 04.56 499. for connector with length 19 mm CS 1403-xxT + CS 1409-01T + CS 1409-15T / CS 1409-17T + CS 1411-3T + CS 1411-4T CS 1403-xxT + CS 1409-01T + CS 1409-19T + CS 1411-3T + CS 1411-4T + CS 1410T CS 1400-xxT + CS 1409-01T + CS 1409-19T + CS 1411-3T + CS 1411-4T + CS 1410T 529.614.1xx + 04.18 375.23 375.26 500.5 SCREW + STAND Connector 48900xxx + 489020xx 362.0 mm.11 01-02-2011 157006001232 Synthes USS fractuur schanzschroef Ti diam 6 + connector 496.18 375.627.69 225.11 01-02-2011 157006001257 Synthes USS pediatric connector + screw + huls + moer 498.607.07 500.27x 406.xxx + 406.83x 601.69 213.190 + 04.1xx + 499.18 375. self-drilling.69 01-02-2011 31-08-2012 157006001302 MSH krypton sacral screw.10 500.52 362.69 225.11 01-02-2011 157006001241 Synthes USS fractuur schanzschroef Ti diam 7 + connector 496.11 01-02-2011 157006001135 Synthes Axon connector + schroef + afsluitklapje 406.104 601.00 36.92 100.69 225.92 100.022 601.31 01-02-2011 157006001117 STRYKER STAND.69 225.00 375.10 500.92 100.11 01-02-2011 157006001214 Synthes USS fractuur schanzschroef inox diam 6 + connector 296. Ø 5 mm + neon easy fit + neon connector 15/ 17mm + Inlay for neon connector + Neon hex nut 460.11 01-02-2011 157006001187 Synthes SYNAPSE connector + schroef + afsluitkapje 04.190 + 04.89 01-02-2011 157006001101 STRYKER OFFSET CONNECTOR TIT.69 225.56 0.10 500.4xx + 498.69 225.11 01-02-2011 157006001205 Synthes USS fractuur schanzschroef inox diam 5 + connector 296.2xx + 04. cannulated.05 375.92 100.10 500.52 0.11 01-02-2011 157006001223 Synthes USS fractuur schanzschroef inox diam 7 + connector 296.92 87.32 01-02-2011 157006001275 Synthes USS Ti connector open + screw USS Ti 499.10 500.18 375.22x + 498.3xx + 04.11 01-02-2011 157006001153 Synthes CLAMPFIX schanzschroef + klem 04.92 36.10x + 04.92 100.7xx / 04. Ø 6.34 46.83x 601.47 375.57 55.621.157006001092 STRYKER OFFSET CONNECTOR + Xiaschroef met blocker + blocker 4855108x + 4855xxxx + 48551000 588.xxx 553.41 60.09 01-02-2011 157006001171 Synthes Polyaxial screw + USS II sacro-iliac telescopisch + moer + huls + klem 601. self tapping.18 375.69 225.26x + 498.69 125.03 0.41 60.10 500.7xx / 04.92 100. X.10 500.11 01-02-2011 157006001293 MSH krypton pedicle screw+ krypton connector + krypton locking screw CS 2800-x-xxT + CS 2805-xxT + CS 2806T 536.78x + 498.69 225.18 375.52 0.92 0.

44 43.10 500.00 375.5 mm + neon easy fit + neon connector 19 mm + Inlay for neon connector + Neon hex nut+ neon locking screw.634.69 225.00 01-02-2011 157006001467 Zimmer Nexlink XLarge Open Polyaxial 5.69 109.31 52.003 + 04.099(S) + 04.69 144.97 0.Bijwerking 01-08-2013 neon screw.050(S) / 04.050(S) / 04.85 371.5 mm + neon easy fit + neon connector 15/ 17mm + Inlay for neon connector + Neon hex nut 483.099(S) + 04. self-tapping.69 225.31 45.xxx(S) + 04.97 443.69 225.634.31 45.81 48. for connector with length 19 mm neon screw.00 375.632.98 01-02-2011 31-08-2012 157006001354 MSH neon screw.00 01-02-2011 157006001415 Zimmer Nexlink Large Open Polyaxial 4. Ø 3.0mm side loading screw + open offset connector + closed screw Locking set screw + Open connector closure top 2115-40xx + 2116-0x + 704-01 + 707-01 520.39 01-02-2011 31-08-2012 157006001363 MSH 157006001372 MSH neon screw.xxx(S) + 04.11 01-02-2011 157006001537 Synthes 04.11 01-02-2011 Mise à jour 01-08-2013 .637.00319. Ø 3.002 / 04.69 9. Ø 4 mm + neon easy fit + neon connector 19 mm + Inlay for neon connector + Neon hex nut + neon locking screw.18 375.00 375.5 Polyaxial preassembled + Locking Cap + connector 601. for connector with length 19 mm Java Secondary Sacral Fixation Screw 6 L35 + Java Sacral Fixation Page 7 (700114-700125) .97 443.050 / 04.00 375.31 45.00 371.92 19.10 500.632.xxx(S) / 04. cannulated.00 375.0 mm Screw + Open Connector Closure Top (2x) + 4.00319.97 0.28 38.00 450.xxx(S) + 04.50 483.86 0.17 48.00295.157006001345 MSH neon screw.000 / 04.632.001 / 04.00 450.08 375.632.632.099(S) 601.xxx(S) / 04.69 74.00 01-02-2011 157006001442 Zimmer Nexlink Primary Smooth Shank 3.81 48.0 polyaxial offset connector 2120-55xx + 707-01 + 2121-xx 450.35 01-02-2011 31-08-2012 443.633. Ø 4 mm + neon easy fit + neon connector 15/ 17mm + Inlay for neon connector + Neon hex nut 443.00 375.92 100.632.5 mm Screw + Open Connector Closure Top(2x) + 4.00x + 7055-0001-00 + 07.69 63.00 500.13 439.69 107. cannulated + Locking Cap 04.00326.91 01-02-2011 157006001485 Zimmer ST360 schroef + connector + setscrew + locknut 07.632.632.xxx(S) /09.41 60.18 01-02-2011 157006001406 Zimmer Nexlink cannulated 4.69 74.69 74.69 114.632.632.633.00 01-02-2011 157006001424 Zimmer Nexlink Primary Polyaxial 3.15 485.00 0.632.099(S) Pedicle Screw Matrix Polyaxial.51 01-02-2011 157006001503 Synthes Pedicle Screw Matrix 5.28 44.69 74.0 polyaxial offset connector 2112-35xx + 707-01 + 2121-xx 450.632. cannulated.31 45.69 225.632.50 0.632.00 01-02-2011 157006001476 Zimmer Optima ZS Polyaxial screw + nut + lateral connector SPAxxxx + SP30x0 + SH00xx 439.5 mm Screw + Open Connector Closure Top (2x) + 4.92 100.69 68.5 mm Screw + Open Connector Closure Top (2x) + 4.0xx + 07.00 01-02-2011 157006001433 Zimmer Nexlink Primary Polyaxial Rescue 4.69 68.001 384.xxx(S) / 04.85 0.0 polyaxial offset connector 2113-35xx + 707-01 + 2121-xx 450.13 0.000(S) / 04.606.050(S) / 04.00 0.92 100.46 48.632.0 polyaxial offset connector 2119-45xx + 707-01 + 2121-xx 450.5 mm Screw + Open Connector Closure Top(2x) + 4.00326.632. self-tapping.0 polyaxial offset connector 2118-40xx + 707-01 + 2121-xx 450.639.00 450.00 375.00 375.00 0.69 107.0 mm Screw + Open Connector Closure Top(2x) + 4.00 0.28 44.11 01-02-2011 157006001512 Synthes 601. self-drilling.15 0.099(S) + 04.00 375.10 500.xxx(S) /09.11 01-02-2011 157006001521 Synthes 601.00 375.86 489.18 375.00 0.92 100.00 450.49 01-02-2011 157006001494 Zimmer ST360 schroef + offsetconnector + setscrew + locknut 07.00 37.41 60.00 450.xxx(S) /09.31 45.00 375.41 60.000(S) / 04.10 500.633.00x + 7055-0001-00 + 07.632.099(S) Reduction Screw Matrix 5. preassembled.85 0.632.97 0.00 375.633.632.50 483.632.xxx(S) / 04.35 01-02-2011 31-08-2012 157006001397 Zimmer 371.632. self-tapping.97 384.0xx + 07.001 485.100 + 04.00 450.0 polyaxial offset connector 2113-40xx + 707-01 + 2121-xx 450.099(S) Pedicle Screw Matrix 5.00297.69 74.xxx(S) + 04.632.5 + Screwhead + Locking Cap + connector 04.18 375.50 0.31 45.18 375.00 375.xxx(S) /09.69 74.00 0.000(S) / 04.00 01-02-2011 157006001451 Zimmer Nexlink Primary Smooth Shank 4. cannulated Ø 4 mm + neon easy fit+ neon connector 15/ 17mm + Inlay for neon connector + Neon hex nut CS 1400-xxT + CS 1409-01T + CS 1409-15T / CS 1409-17T + CS 1411-3T + CS 1411-4T CS 1401-xxT + CS 1409-01T +CS 1409-15T / CS 1409-17T + CS 1411-3T + CS 1411-4T CS 1401-xxT + CS 1409-01T + CS 1409-19T + CS 1411-3T + CS 1411-4T + CS 1410T CS 1402-xxT + CS 1409-01T + CS 1409-15T / CS 1409-17T + CS 1411-3T + CS 1411-4T CS 1402-xxT + CS 1409-01T + CS 1409-19T + CS 1411-3T + CS 1411-4T + CS 1410T SN2023-0-00200 + SN2023-00020x 489.00 375.5 + Locking Cap + connector 04.39 01-02-2011 31-08-2012 157006001381 MSH 483.41 60. self-tapping.

05 375.41 60.92 15.10 500.11 01-01-2012 157006001643 Aceemed MPM schroef + connector + moer 546.92 85.00 375.633.69 225. + vis à dôme poly-axiale 601.11 01-02-2011 157006001616 Orthogèse BJR écrou + conn.18 375.xxx(S) / 04.11 01-08-2011 157006001625 Orthogèse BJR vis en U monoaxiale + BJR boulon vis en U + connecteur 601.Bijwerking 01-08-2013 Page 8 (700114-700125) .00000 + ATR47U3. augmentable.632.10 500.11 01-02-2011 601.17 375.07 500.92 100.72 375. Ø 5 mm + neon easy fit + neon connector 19 mm + Inlay for neon connector + Neon hex nut+ neon locking screw.92 100.656. self tapping.69 225.18 375.000(S) / 04.92 100.632.56 0.92 45.11 01-02-2011 601.41 60.000(S) / 04.64 01-09-2012 157006001652 Cormed PASS LP screw + nut + connector ATR480D.95 58.xxXxx ATR43MUxxXxx + ATR48OU.10 500.41 60.69 153.92 100.66 01-11-2012 157006001686 Medtronic Colorado2 FX Pedicle screw + Trauma connector + Trauma breakoff nut + set screw 863xxxx + 8634400 + 8630020 + C806T 601.69 225.41 60.41 60.69 225.099(S) + 04.53 01-11-2012 157006001661 Cormed Slick’s screw + nut + connector 586.632.10 500.92 100.099(S) 04.92 100.000(S) / 04.92 100.69 210.35 500. cannulated.34 46.099(S) 04.xxx(S) /09.xxx(S) + 04.10 500.40 500.10 500.xxx(S) / 04. preassembled + Locking Cap + connector 601. length 45 mm + krypton connector + krypton locking screw CS 2801-6-xxT + CS 2805-xxT + CS 2806T 516.10 500.18 375.66 01-11-2012 157006001677 Cormed fixpine screw + nut + connector S11/POxxx + S11/ST3020 + GS019x-06xx / S11/RSxxxx + S11/ST3020 + GS019x-06xx / S11/PRxxxx + S11/ST3030 + GS019x-06xx OSM21xx / 0SM22xx + OSM4153 + GS019x-06xx 586.157006001546 Synthes Matrix Pedicle Screw.099(S) + 04.71 54.632.87 49.95 01-09-2012 157006001731 Hospithera neon screw.632.632.92 100.11 01-02-2011 157006001582 SHARK MEDICAL Vis Easyspine + Connecteur ES 1xxT + ES 022 T 601.11 01-02-2011 157006001591 LDR MEDICAL Vis pédiculaire LP multiaxiale ES 8xx T 601.10 01-11-2012 157006001695 Hospithera krypton pedicle screw+ krypton connector + krypton locking screw CS 2800-x-xxT + CS 2805-xxT + CS 2806T 536. cannulated.69 140.92 85.69 161.92 100. for connector with length 19 mm CS 1403-xxT + CS 1409-01T + CS 1409-15T / CS 1409-17T + CS 1411-3T + CS 1411-4T CS 1403-xxT + CS 1409-01T + CS 1409-19T + CS 1411-3T + CS 1411-4T + CS 1410T CS 1400-xxT + CS 1409-01T + CS 1409-19T + CS 1411-3T + CS 1411-4T + CS 1410T 529.632.64 500.00000 + ATR4700.11 01-02-2011 157006001607 LDR MEDICAL Vis Easyspine + Connecteur ES 1xxT + ES 022 T 601.69 225.69 225.69 84. self tapping.10 500.70 52.632.632.5 preassembled + Locking Cap + connector 157006001564 Synthes Pedicle Screw Matrix 5.41 60.11 01-02-2011 Vis pédiculaire LP multiaxiale 04.66 56.11 01-01-2012 157006001634 Orthogèse BJR vis en U polyaxiale + BJR boulon vis en U + connecteur 601. self-drilling.633.632.0 mm. Ø 6.55X60 ATR43OUxxXxx + ATR48OU.72 375.69 225.39 500.40 60.69 225. cannulated Ø 4 mm + neon easy fit+ neon connector 19 mm + Inlay for neon connector + Neon hex nut + neon locking screw.xxX0x / ATR4700. for connector with length 19 mm neon screw.56 499.xxx(S) /09.099(S) + 04.41 60.03 0.69 225.69 210.18 375.00 375.43 375.60 01-09-2012 157006001713 Hospithera neon screw.64 500.xxx(S) + 04.xxx(S) / 04.xxx(S) + 04.28 53.5 Monoaxial + Locking Cap + connector 157006001573 SHARK MEDICAL 601.633.632.92 100.633.050(S) / 04.93 01-09-2012 Mise à jour 01-08-2013 .09 500.92 36.92 64.xxX0X + ATR43PD.47 375.69 225.92 100.55X60 THVP(X)(X)(x)(X)/ THVS(X)(x)(X)/ THVL(X)x(x)(X)(X)/ THVEGT/THVR2M + THAMER0x + THEAB(1) B0221xxxx + B02130005 + GS019x-06xx 565.97 500.69 225.050(S) / 04.632. Ø 5 mm + neon easy fit + neon connector 15/ 17mm + Inlay for neon connector + Neon hex nut 460.69 01-09-2012 157006001704 Hospithera krypton sacral screw.00 01-09-2012 157006001722 Hospithera 499.632.18 375.632.69 189.00000 + ATR47U3.18 375.18 375.xxx(S) /09.41 60.10 500.69 123.050(S) / 04.18 375.099(S) ES 8xx T 157006001555 Synthes Sagittal Screw Matrix 5.48 375.69 170.41 60.18 375.632.41 60.95 58.15 375.03 460.10 500.635.18 375.92 28.38 51.

69 68.5 mm + neon easy fit + neon connector 19 mm + Inlay for neon connector + Neon hex nut+ neon locking screw. self-tapping.50 483.00 375.69 107. cannulated.50 0.627.103(S) THVP(X)(X)(x)(X)/ THVS(X)(x)(X)/ THVL(X)x(x)(X)(X)/ THVEGT/THVR2M + THAMER0x + THEAB(1) A2516xxxx + A25162001 + A2511001 489.41 60.628.50 0.98 01-09-2012 443.40 500.69 225.92 100.86 0.81 48.69 68.71 54.39 01-09-2012 443. Ø 4 mm + neon easy fit + neon connector 19 mm + Inlay for neon connector + Neon hex nut + neon locking screw. self-drilling.xxx(S) + (0)4.101(S) + (0)4.5 mm + neon easy fit + neon connector 15/ 17mm + Inlay for neon connector + Neon hex nut 157006001765 Hospithera neon screw.00 375.10 500.Spine – Vis TIS + connecteur TIS + vis de verrouillage Mise à jour 01-08-2013 .69 170.Bijwerking 01-08-2013 CS 1400-xxT + CS 1409-01T + CS 1409-15T / CS 1409-17T + CS 1411-3T + CS 1411-4T CS 1402-xxT + CS 1409-01T + CS 1409-15T / CS 1409-17T + CS 1411-3T + CS 1411-4T CS 1401-xxT + CS 1409-01T +CS 1409-15T / CS 1409-17T + CS 1411-3T + CS 1411-4T CS 1402-xxT + CS 1409-01T + CS 1409-19T + CS 1411-3T + CS 1411-4T + CS 1410T CS 1401-xxT + CS 1409-01T + CS 1409-19T + CS 1411-3T + CS 1411-4T + CS 1410T (0)4.97 0. self-tapping. Ø 3.39 01-09-2012 483. self-tapping. cannulated Ø 4 mm + neon easy fit+ neon connector 15/ 17mm + Inlay for neon connector + Neon hex nut 157006001756 Hospithera neon screw. cannulated.00 375.00 375.18 375.92 45.28 44.157006001747 Hospithera neon screw.69 107.50 483.00 375. Ø 3.18 375. for connector with length 19 mm neon screw. Ø 4 mm + neon easy fit + neon connector 15/ 17mm + Inlay for neon connector + Neon hex nut 157006001774 Hospithera 157006001783 Hospithera 157006001792 Synthes neon screw.92 100.69 225.97 443.86 489.48 375.10 500.11 01-02-2013 546.17 48.97 0.81 48.28 44.69 114. for connector with length 19 mm USS fractuur schanzschroef + clamp + locking cap 157006001801 Eurospine MPM vis + cavalier + écrou 157006001817 Spinaxis E.64 01-05-2013 601.11 01-06-2013 Page 9 (700114-700125) .41 60.35 01-09-2012 483.628.35 01-09-2012 601. self-tapping.97 443.

Zelfbrekende schroef 991.A = Prix (TVAc) . en sacro-iliacale plaat 5mm + inox Sacral/Ilio Sacral Locking Screw + BREAK OFF NUT Colorado2 Inox sacro-iliacale plaat X + SACRAL SCREW (x2)+ ILIAC SCREW + Inox conn.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148. ordin. / Prestataire conventionné . Prix plafond .00 826.25 619. met of zonder overeenkomst C = Supplément patient Bén. / Verstr. recht.W.51 826.26 103.81 99.G. ordin. / Prestataire avec ou sans convention Supplement patiënt Gew. ordin.80 826. recht.P.81 99. / Verstr.Terugbetaling W.70 313.00 01-02-2011 157008000046 MEDIANN TWINFLEX I Vis pédiculaire polyaxiale (x2)+ TWINFLEX I connecteur sacral + vis de serrage 1010-Xxxx + 1050-PSxX + 1000-VExx 932. fixées ensemble à la tige.00 01-02-2011 950. sacr.70 330.26 157008000082 Colorado2 Inox sacrale plaat X + Sacral screw (x2) + Inox conn. / Verstr. met overeenkomst . de fixation et d'attache (Ilio-)sacraal verankeringspunt met 2 of meer verankeringsschroeven op ilium en/of sacrum samen gefixeerd aan de staaf.51 826.I. BTW) B = Remboursement Bén./Prestataire conventionné .30 95. Sacrale schroef (x2) + Ti.26 165.26 123.26 106.30 95. Sacral screw (x2) + Ti conn. sacr.I.15 01-02-2011 157008000073 Medtronic 165.26 106.U waarde : U 800 Remboursement . recht.51 € Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot TI ILIAC BONE SCREW x.70 310.70 371.70 330. Zelfbrekende schroef Colorado2 Ti.G.30 93.P.26 165.54 619.15 01-02-2011 Medtronic 991. ordin.74 € is van toepassing op het geheel van de wervelkolomimplantaten.26 165.25 619.00 826. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700151-700162 Point d'ancrage (ilio-)sacral avec 2 vis d'ancrage ou plus sur l'ilium et/ou le sacrum.O. inclusief alle toebehoren voor connectie.70 371. Sacral/Ilio Sacral Locking Screw + Ti.W. sacr. / Verstr.00 01-02-2011 Johnson & Johnson MedicalDepuy Expedium 5.Remboursement V.O.10 93.28 01-02-2011 157008000064 Medtronic 86191xx + 86122xx + 8614110 + 8619300 + 8614111 991.Supplement patiënt W.51 826.Prijs (incl. Sacral/Ilio Sacral Locking Screw + Ti.5 iliac Bar SS + innie 6201x-xx-30 / 6201x-xx-15 + 6200x-xx + 62xxx-xx + 22015 / 63020 1881 90 00x + 1881 02 000 930. sacr.5 iliac Bar Ti + innie 1797 90 00x + 1797 02 000 950.70 313. / Prestataire avec ou sans convention Terugbetaling Gew.15 01-02-2011 157008000091 Medtronic 86192xx + 86122xx + 86120xx + 8614110 + 8619300 + 8614111 86382xx + 8632xxx + 86320xx + 8634110 + 8639300 + 8634111 86381xx + 8632xxx + 8634110 + 8639300 + 8634111 991.I.Bijwerking 01-08-2013 Page 1 (700151-700162) .26 123. met overeenkomst . Ilio-sacrale plaat + Ti. Iliac schroef + Ti conn.15 01-02-2011 Mise à jour 01-08-2013 .70 371.80 826.Plafondprijs : 991.10 93.Veiligheidsgrens : 826. Sacrale plaat X + Ti. / Prestataire non conventionné Supplement patiënt / Verstr.74 619.51 826. / Prestataire non conventionné Terugbetaling Gew.Supplément patient V.I.25 619.25 619.26 € Distributeur Verdeler 157008000012 Hospithera 157008000021 Johnson & Johnson MedicalDepuy 157008000037 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.81 99.74 619.74 619.54 619. en sacro-iliacale plaat 5mm + Ti. en sacro-iliacale plaat 5mm + inox Sacral/Ilio Sacral Locking Screw + BREAK OFF NUT Colorado2 Ti. met of zonder overeenkomst D = Remboursement Bén.70 371. y compris toutes les pièces de connexion. / Verstr.28 01-02-2011 157008000055 MEDIANN TWINFLEX II Vis pédiculaire polyaxiale (x2) + TWINFLEX II connecteur sacral + vis de serrage (x2) 6T10-Xxxx + 1T50-PSxxX + 6T00-BC08 932. fixatie en blokkering Valeur de U .74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .00 826. zonder overeenkomst E = Supplément patient Bén.81 99.Terugbetaling : Code d'identification Identificatiecode Marge de sécurité . en sacro-iliacale plaat 5mm + Ti.xMM X xxMM X xx° + OFF CONNECTOR ASSEMBLY + Polyaxial screw + ZODIAC TI HEXALOBE SET SCREW (x 2) Expedium 5.

25 619.26 165.81 99.5 + BJR Vis Sacrée + BJR Vis à dôme mono-axiale Page 2 (700151-700162) .81 99. Sacrale schroef (x2) + Colorado2 Ti.15 01-02-2011 157008000125 Medtronic 563xxxx + 8632xxx + 563xxxx + 8619300 + 8634111 991.xxXSX / ATR4700.xxXxx / ATR43SA.xxXxx ATR480D.26 165.25 619. Zelfbrekende schroef Praxis sacrale modulaire plaat X + Colorado2 Ti.25 619.51 826.51 826.81 99.70 371.00000 + MUN4700.26 165. Sacrale schroef + Colorado2 Ti.15 01-02-2011 157008000134 Orthogèse ATR480D.81 99.26 165.81 99.81 99.15 01-03-2012 157008000195 SDI Belgium Ti Long Lateral connector PLUS+ screw PLUS (2x) + clip PLUS U1-L403T + U1-MxxxT (2x) / U1-SxxxT (2x) + U1-L100T 991.25 619.15 01-03-2012 157008000186 SDI Belgium Ti Lateral Connector PLUS+ screw PLUS (2x) + clip PLUS U1-L400T + U1-MxxxT (2x) / U1-SxxxT (2x) + U1-L100T 991.00000 + MUN4700.5 + BJR Vis Sacrée + BJR Vis à dôme poly-axiale 991.xxXxx U1P100(LT ou RT) +U1P-6xxT 991.xxXxx / ATR43SA.xxXSX + MUN43SA.81 99.70 371.xxXxx / ATR43AD.15 01-02-2011 157008000161 Cormed PASS LP sacral plate + sacral screw + cap for sacral plate B022500x0 + B0215xxxx + B02150000 991. Zelfbrekende schroef BJR Ecrou + BJR Connecteur sacré Ø 5.15 01-02-2011 157008000116 Medtronic 991.70 371.51 826. Zelfbrekende schroef + Praxis connector Praxis Sacrale plaat X + Colorado2 Ti.15 01-03-2012 Mise à jour 01-08-2013 .0 mm x xx mm long.26 165.157008000107 Medtronic 563xxxx + 8632xxx + 86320xx + 563xxxx + 8619300 + 8634111 563xxxx + 8632xxx + 86320xx + 563xxxx + 8619300 + 8634111 + 563xxxx 991.51 826.70 371.25 619.70 371.26 165.81 99.51 826.70 371. 991.70 371.26 165.51 826. Iliac schroef + Praxis Ti connector + Colorado2 inox Sacral/Ilio Sacral Locking Screw + Colorado2 Ti.15 01-02-2011 157008000177 SDI Belgium ST Lateral Connector PLUS + screw PLUS (2x) + clip PLUS U1-L400 + U1-Mxxx (2x) / U1Sxxx (2x) + U1-L100 991.25 619.15 01-02-2011 157008000143 Orthogèse BJR Ecrou + BJR Connecteur sacré Ø 5.26 165. Iliac schroef + Praxis Iliac extension + Colorado2 inox Sacral/Ilio Sacral Locking Screw + Colorado2 Ti.25 619.26 165.Bijwerking 01-08-2013 Praxis Ilio-sacrale plaat X + Colorado2 Ti.xxXSX + MUN43SA.51 826.xxXxx + MUN43PD.70 371.26 165.xxXxx / ATR43PD.15 01-02-2011 157008000152 SDI Belgium Plaque Ilio Sacré PLUS™ Ti (L/R)+ 2 vis d'ancrage diamètre 6.70 371.81 99.51 826.xxXxx + MUN43AD.25 619.81 99.51 826.xxXSX / ATR4700.51 826.70 371.25 619. Sacrale schroef + Praxis Ti connector + Colorado2 inox Sacral/Ilio Sacral Locking Screw + Colorado2 Ti.25 619.

29 0.Plafondprijs : 340.44 34.I.I.15 232.W.98 01-02-2011 157009000075 Cormed Ascent hook 67.39 73.08 01-02-2011 157009000093 Cormed Solas hook + set screw SSHxxxx-Xx 340.U waarde : U 300 Remboursement .A = Prix (TVAc) .Remboursement V.98 232.62 01-02-2011 157009000066 Biomet Polaris 5./Prestataire conventionné .74 € is van toepassing op het geheel van de wervelkolomimplantaten. inclusief alle toebehoren voor fixatie en blokkering Valeur de U . / Verstr.14 232.00 232. y compris toutes les pièces de fixation et d'attache Verankeringshaak met open kop.98 232. met of zonder overeenkomst D = Remboursement Bén.08 01-02-2011 157009000102 Globus Medical Belgium Ellipse Inline Hook + Ellipse Locking Cap 182.85 30. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700173-700184 Crochet d'ancrage.08 01-02-2011 157009000084 Cormed Fixspine hook + set screw SH.39 95.G.99 309. / Verstr.39 108. ordin. / Prestataire avec ou sans convention Supplement patiënt Gew.83 309.39 77.61 34.85 18.83 309.5 Hook 2000-55xx 309.00 232. met overeenkomst . waarbij de staaf in de kop wordt gefixeerd.60 32. ordin.Bijwerking 01-08-2013 Page 1 (700173-700184) .00 01-02-2011 Mise à jour 01-08-2013 . BTW) B = Remboursement Bén.44 34.85 30.39 108.98 232.I.39 84. / Prestataire avec ou sans convention Terugbetaling Gew.G. ordin. / Verstr.83 309.85 30.W.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale . / Verstr. recht.3011 340.Veiligheidsgrens : 309.85 0.96 309.98 232.Terugbetaling W.XX.P.29 306.P.85 € Prix plafond .83 € Distributeur Verdeler Code d'identification Identificatiecode 10% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.O.3010/60.501 / 182.87 309.Supplement patiënt W.90 30. recht. ordin. Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157009000014 B Braun Medical S4 Hooks + set screw SW827T -> SW837T + SW790T 327. / Prestataire non conventionné Terugbetaling Gew.02 232. / Prestataire non conventionné Supplement patiënt / Verstr.0xxx + SH.08 01-02-2011 157009000041 Biomet Array Laminaire haak 949xx 316.68 01-02-2011 157009000057 Biomet Omega Laminaire haak 127x-xx / 1281-xx 306.O.49x + 182. recht.44 34.85 7. met of zonder overeenkomst C = Supplément patient Bén.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.39 93. avec tête ouverte pour fixation de la tige dans la tête. / Prestataire conventionné .I.SS.79 01-02-2011 157009000023 B Braun Medical S4C Lamina hooks + set screw SW015T/SW017T/SW025T/S W027T + SW002T/SW003T 325.59 01-02-2011 157009000032 Biomet Altius Laminaire haak 1200-276x 340.85 30. zonder overeenkomst E = Supplément patient Bén.Prijs (incl.0001 340.39 108.46 30. met overeenkomst .00 309.Terugbetaling : Marge de sécurité .85 30.57 32.11 232.500 340.39 107.85 309.44 34.85 16.39 108.Supplément patient V. / Verstr.48 31.83 309.

39 107.61 34.31 31.00 01-02-2011 Mise à jour 01-08-2013 .35 SS 1854 43 0xx 340.000 / 224.00 01-02-2011 157009000276 ISKRA Crochet Sous-Lamaire Ouvert 3K + vis de blocage std 3KCSO1080-A + 3KVBB1005 340.00 309.00 309.00 309.15 232.39 107.08 01-02-2011 157009000346 Johnson & Johnson MedicalDepuy Expedium Offset Closed Hooks 5.50x + 115.85 30.98 232.39 107.85 30.83 309.15 232.39 107.00 309.44 34.00 01-02-2011 157009000267 ISKRA Crochet Pédiculaire + vis de blocage std 3KCP(X)(X)xxx(x)-A + 3KVBB1005 340.85 18.08 01-02-2011 157009000321 Johnson & Johnson MedicalDepuy Expedium Hook SS + innie 1881 52 0xx + 1881 02 000 340.92 01-02-2011 157009000172 Hospithera Alphatec CERVICAL HOOK .Left + Ellipse Locking Cap 182.85 29.000 328.39 96.15 232.39 107.39 107.00 309.39 108.75 232. offset.85 30.39 107.20 309.85 30.35 232.00 01-02-2011 157009000355 Johnson & Johnson MedicalDepuy Expedium Offset Closed Hooks 5.61 34.09 27.5 Titanium 1754 42 0xx 340.20 309.89x + 124.08 01-02-2011 157009000145 Globus Medical Belgium REVERE™ Hook + REVERE™ Locking cap 124.15 232.00 309.61 34. small.00 309.000 328.00 309.85 30.61 34.15 232.00 01-02-2011 157009000373 Johnson & Johnson MedicalDepuy Expedium Offset Closed Hooks 6.00 309.86 01-02-2011 157009000163 Hospithera Alphatec 6MM CERVICAL HOOK + ZODIAC TI HEXALOBE SET SCREW 63012 / 63021 + 22015 / 63020 339.5mm Hook + innie 1861 5x xxx + 1861 00 001 340.15 232.44 34.9xx + 224.000 / 124. pedicular.9xx + 124.89x + 224.75 232.15 232.85 29.27 01-02-2011 157009000197 InSpine Belgium Alpha Pedicle Hook ES32xT 273.61 34.15 232.39 107.85 30.83 309.44 34.85 30.00 01-02-2011 157009000233 ISKRA Crochet à Lame Décalée 3K + vis de blocage 3KCXXXxxxx-A + 3KDCV602 / 3KCXXXxxxx-A + 3KVBB1005 340.00 01-02-2011 157009000136 Globus Medical Belgium PROTEX™ CT Hook + PROTEX™ CT Locking Cap 115.39 107.00 309.5MM + ZODIAC TI HEXALOBE SET SCREW 63013 / 63022 + 22015 / 63020 339.61 34.83 309.61 34.85 2.70 309.39 107.85 30.15 232.39 107.500 340.86 01-02-2011 157009000154 Globus Medical Belgium SS REVERE Hook + Stainless Steel REVERE Locking Cap 224.39 108.504 + 182.39 107.00 309.00 01-02-2011 157009000127 Globus Medical Belgium Ellipse Offset Hook.39 106.61 34.85 232.98 232.15 232.81 33.85 30.85 30.85 30.85 30.61 34. left and right + ZODIAC TI HEXALOBE SET SCREW 62xxx + 22015 / 63020 312.44 34.61 34.81 33.00 309.39 108.39 106.00 01-02-2011 157009000242 ISKRA Crochet Lamaire Gorge Moyenne + vis de blocage std 3KCLG5582-A + 3KVBB1005 340.15 232.98 232.00 01-02-2011 157009000224 ISKRA Crochet à Corps Décalé 3K + vis de blocage 3KCXXXxxxx-A + 3KDCV602 / 3KCXXXxxxx-A + 3KVBB1005 340.5 SS 1854 52 0xx 340. Left or Right + Ellipse Locking Cap 182.60 309.85 30.39 107.83 309.503 -> 182.39 80.48 273.00 01-02-2011 157009000215 ISKRA Crochet à Corps Allongé 3K + vis de blocage std 3KCCA5090-A + 3KVBB1005 340.85 30.39 108.61 34.00 01-02-2011 157009000285 ISKRA Crochet Thoracique 3K + vis de blocage std 3KCT4570-A + 3KVBB1005 340.85 18.35 232.85 30. Right .500 340.85 30.00 01-02-2011 157009000312 Johnson & Johnson MedicalDepuy Expedium 4.39 107.98 232.00 232.39 107.15 232.00 309.39 107.61 34.85 30.15 232.00 01-02-2011 157009000251 ISKRA Crochet Lombaire 3K + vis de blocage std 3KCL6595-A + 3KVBB1005 340.34 01-02-2011 157009000206 ISKRA Anneau de Blocage Ouvert 3K + vis de blocage longue 3KAB102-A + 3KBCV601 340.15 232.00 01-02-2011 157009000303 ISKRA Crochet Transversal Barre Monobloc + vis de blocage moyenne 3KCTB13x-A + 3KDCV602 340.15 232.500 340.92 01-02-2011 157009000181 Hospithera Alphatec HOOK large.61 34.85 30.61 34.61 34.157009000111 Globus Medical Belgium Ellipse Inline Hook.21 32.00 309.50x + 182.00 309.21 32.39 107.Bijwerking 01-08-2013 Page 2 (700173-700184) .85 30.15 232.00 309.61 34.00 309.39 41.85 30. laminar.00 01-02-2011 157009000294 ISKRA Crochet Transversaire 3K + vis de blocage moyenne 3KCTX10xx-A + 3KDCV602 340.15 232.85 30.00 01-02-2011 157009000364 Johnson & Johnson MedicalDepuy Expedium Offset Closed Hooks 6.61 34.39 96.08 01-02-2011 157009000337 Johnson & Johnson MedicalDepuy Expedium Hook Ti + innie 1797 52 0xx + 1797 02 000 340.35 Titanium 1754 43 0xx 340.60 309.48 0.

89 30.39 107.98 232.02 01-02-2011 157009000592 Medtronic Legacy Ti Hook + break off screw 74611xx + 7460020 340.36 232.36 232.39 107.30 306.21 309.02 01-02-2011 157009000644 Medtronic Legacy Ti Mini Hook + set screw break off 7341xxxINT + 734xxxxINT 340.35 SS + innie 1854 53 0xx + 1896 02 000 340.85 30.91 30.91 30.98 232.39 73.28 305.85 30.02 01-02-2011 157009000556 Medtronic Legacy ss Hook + break off screw 73611xx + 7360000 340.30 0.21 309.61 34.39 108.85 30.85 18.39 107.39 73.24 232.24 232.39 107.28 0.39 108.86 01-02-2011 157009000504 Medtronic CD Horizon Ti.21 32.82 34.85 30.85 30.39 107.61 34.39 107.82 34.10 01-02-2011 157009000434 Johnson & Johnson MedicalDepuy Monarch Open Hook + nut 1770 7x xxx + 1770 91 060 340.00 232.85 30.63 01-02-2011 157009000486 MEDIANN ORIA ALIS Crochet GT20-CLFx 305.08 01-02-2011 157009000513 Medtronic Colorado2 Inox Laminar thoracic hook + Colorado2 BREAK OFF NUT 8611402 + 8614111 340.85 30.39 96.21 309.82 34.85 21.85 30.85 30.39 107.00 01-02-2011 157009000391 Johnson & Johnson MedicalDepuy Expedium Offset Open Hooks 5.85 30.85 30.21 309.85 30.02 01-02-2011 157009000565 Medtronic Legacy ss Hook + set screw breaf off 7561xxx+ 7560000 / 7560020 / 75601xx/75602x0 340.85 30. Blocage voor Open Implantaten 841xx(X)HT + 89104EHT 340.5 Titanium + innie 1754 52 0xx + 1797 02 000 340.00 309.61 34.85 30.82 34.52 01-02-2011 157009000495 MEDIANN SCS Crochet 2T20-XXxx / 2T20-XXxX 328.83 309.85 30.39 98.82 34.39 107.24 232.83 309.00 01-02-2011 157009000416 Johnson & Johnson MedicalDepuy Expedium Offset Open Hooks 6.02 01-02-2011 157009000635 Medtronic Legacy Ti Hook + set screw breaf off X43501xx + 7440030 340.60 309.10 01-02-2011 157009000452 Johnson & Johnson MedicalDepuy Summit Hook + innie 1746 43 00x + 1746 42 200 331.5 SS + innie 1854 42 0xx + 1881 02 000 340. hook X + CD Horizon Ti.85 30.21 309.02 01-02-2011 157009000626 Medtronic Legacy Ti Hook + set screw breaf off 764xxxx + 7640020 340.15 232.36 232.21 309.09 309.39 107.39 107.70 33.36 232.36 232.70 33.30 0.39 107.82 34.85 21.82 34.21 309.09 309.82 34.98 232.157009000382 Johnson & Johnson MedicalDepuy Expedium Offset Open Hooks 5.39 107.39 108.15 232.83 309.21 309.02 01-02-2011 157009000547 Medtronic Legacy ss Hook + break off screw 73411xx + 7340000 340.98 232.63 01-02-2011 157009000477 Johnson & Johnson MedicalDepuy VSP Isola Hook Ti (+ nut) 5200xx(x) / 5203xx(x) (+ 5200 05 SS) 306.00 01-02-2011 157009000407 Johnson & Johnson MedicalDepuy Expedium Offset Open Hooks 6.21 309.02 01-02-2011 157009000574 Medtronic Legacy ss Hook + set screw breaf off 766xxxx + 7660020 340.39 72.61 34.21 309.36 232.35 Titanium + innie 1754 53 0xx + 1799 02 000 340.00 232.36 232.75 232.36 232.39 107.36 232.08 01-02-2011 157009000522 Medtronic Colorado2 Ti.44 34.10 01-02-2011 157009000461 Johnson & Johnson MedicalDepuy VSP Isola Hook SS (+ nut) 5000xx(x)(X) / 5003xx(x)(X)(X) (+ 5000 05 SS) 306.36 232.82 34.39 107.00 309.08 01-02-2011 157009000443 Johnson & Johnson MedicalDepuy Mountaineer Hook + innie 1883 43 00x + 1883 42 200 331.85 30.15 232.44 34.44 34.21 309.15 232.83 309.39 107.02 01-02-2011 Mise à jour 01-08-2013 .85 21.36 232.00 309.08 01-02-2011 157009000531 Medtronic HOOK CLOSED HOOK xMM + set screw break off X409010x + X4090013 340.44 34.85 30.00 309.Bijwerking 01-08-2013 Page 3 (700173-700184) .02 01-02-2011 157009000601 Medtronic Legacy Ti Hook + break off screw 75411xx + 7540000 / 7540020 340.82 34.85 30.82 34.21 309.00 232.82 34.39 107.70 33.39 98. Laminar hook closed 8631402 340.02 01-02-2011 157009000583 Medtronic Legacy Ti Hook + break off screw 74411xx + 7440020 340.02 01-02-2011 157009000617 Medtronic Legacy Ti Hook + break off screw G75411xx + G7540020 340.85 30.39 98.09 309.39 108.00 01-02-2011 157009000425 Johnson & Johnson MedicalDepuy Monarch Closed Hook 1770 8x xxx 331.30 306.36 232.

00 01-02-2011 157009000897 SHARK MEDICAL Crochet Lamaire Gorge Moyenne + vis de blocage std 3KCLG5582-A + 3KVBB1005 340.39 107.98 232.00 309.00 309.15 232.02 01-02-2011 157009000671 Medtronic Vertex Hook + Vertex Set Screw for laminar hook and M.00 309.00 309.39 107.00 309.00 309.36 232. screws 690xxxx + 6903070 / 6950315 340.39 107.85 30.00 309.85 30.00 01-02-2011 157009000863 SHARK MEDICAL Crochet à Corps Allongé 3K + vis de blocage std 3KCCA5090-A + 3KVBB1005 340.44 34.00 309.00 01-02-2011 157009000766 NEW2DM Crochet Sous-Lamaire Ouvert 3K + vis de blocage std 3KCSO1080-A + 3KVBB1005 340.85 30.85 30.15 232.21 309.00 01-02-2011 157009000732 NEW2DM Crochet Lamaire Gorge Moyenne + vis de blocage std 3KCLG5582-A + 3KVBB1005 340.39 107.85 30.08 01-02-2011 157009000827 Orthogèse BJR Crochet en U + BJR Boulon vis en U ATR44XU.00 309.00 01-02-2011 157009000906 SHARK MEDICAL Crochet Lombaire 3K + vis de blocage std 3KCL6595-A + 3KVBB1005 340.00 01-02-2011 157009000714 NEW2DM Crochet à Corps Décalé 3K + vis de blocage 3KCXXXxxxx-A + 3KDCV602 / 3KCXXXxxxx-A + 3KVBB1005 340.00 01-02-2011 157009000741 NEW2DM Crochet Lombaire 3K + vis de blocage std 3KCL6595-A + 3KVBB1005 340.00 309.61 34.39 107.61 34.02 01-02-2011 157009000696 NEW2DM Anneau de Blocage Ouvert 3K + vis de blocage longue 3KAB102-A + 3KBCV601 340.15 232.83 309.08 01-02-2011 157009000836 SDI Belgium total crochet PLUS™ + clip U1-Hx0x / U1-H30(L/R) / U1340.82 34.85 30.00000 340.39 107.15 232.39 107.00 309.39 107.61 34.08 01-02-2011 157009000845 SDI Belgium total crochet PLUS™ Titane + clip 340.xxxxx + ATR480U.00 01-02-2011 157009000723 NEW2DM Crochet à Lame Décalée 3K + vis de blocage 3KCXXXxxxx-A + 3KDCV602 / 3KCXXXxxxx-A + 3KVBB1005 340.61 34.83 309.S.08 01-02-2011 157009000854 SHARK MEDICAL Anneau de Blocage Ouvert 3K + vis de blocage longue U1-H20R/L(T) / U1-Hx0xT / U1-H30(L/R)T / U1-H31RT/LT + U1L100T 3KAB102-A + 3KBCV601 340.Lamina & Pedicle Hook + WSI.15 232.15 232.39 107.Transverse Process Hook + WSI.00 309.85 30.61 34.15 232.98 232.15 232.00 01-02-2011 157009000775 NEW2DM Crochet Thoracique 3K + vis de blocage std 3KCT4570-A + 3KVBB1005 340.00 309.39 107.15 232.85 30.00 01-02-2011 157009000705 NEW2DM Crochet à Corps Allongé 3K + vis de blocage std 3KCCA5090-A + 3KVBB1005 340.85 H31(R/L) /U1H20(L/R)+ U1L100 30.A.00 01-02-2011 157009000793 NEW2DM Crochet Transversal Barre Monobloc + vis de blocage moyenne 3KCTB13x-A + 3KDCV602 340.00 01-02-2011 157009000802 Ortho Team WSI .44 34.82 34.85 30.85 30.85 30.39 107.61 34.00 309.85 30.00 01-02-2011 157009000757 NEW2DM Crochet Pédiculaire + vis de blocage std 3KCP(X)(X)xxx(x)-A + 3KVBB1005 340.85 30.39 107.39 108.157009000653 Medtronic SOLERA HOOK + SET SCREW BREAK OFF 54411xx + 5440020 / 5440030 340.15 232.83 309.00 309.98 232.Grub screw 22601-xx + 22650-30-02 340.85 30.39 107.61 34.Bijwerking 01-08-2013 Page 4 (700173-700184) .00 309.85 30.61 34.85 30.39 107.15 232.39 107.08 01-02-2011 157009000662 Medtronic Vertex Hook + set screw 695xxxxX+69503xx 340.61 34.85 30.98 232.61 34.44 34.85 30.98 232.85 30.21 309.15 232.44 34.82 34.85 30.39 107.44 34.85 30.00 01-02-2011 157009000881 SHARK MEDICAL Crochet à Lame Décalée 3K + vis de blocage 3KCXXXxxxx-A + 3KDCV602 / 3KCXXXxxxx-A + 3KVBB1005 340.61 34.61 34.15 232.98 232.61 34.83 309.39 107.83 309.00 309.08 01-02-2011 157009000811 Ortho Team WSI .15 232.61 34.44 34.00 01-02-2011 Mise à jour 01-08-2013 .39 107.39 108.02 01-02-2011 157009000687 Medtronic Vertex Hook Foraminal L/R + Vertex Set Screw 690xxxxX + 6903070 / 6950315 340.39 107.15 232.85 30.15 232.21 309.36 232.39 108.39 108.61 34.39 108.00 01-02-2011 157009000784 NEW2DM Crochet Transversaire 3K + vis de blocage moyenne 3KCTX10xx-A + 3KDCV602 340.85 30.39 107.15 232.83 309.00 01-02-2011 157009000872 SHARK MEDICAL Crochet à Corps Décalé 3K + vis de blocage 3KCXXXxxxx-A + 3KDCV602 / 3KCXXXxxxx-A + 3KVBB1005 340.39 108.61 34.85 30.36 232.85 30.Grub screw 2260x-xx + 22650-30-02 340.61 34.

508(S) 340.85 30.44 34.23 232.xxx + 04.85 30.39 107.00 232.8xx + 499.83 309.39 85.61 31.887 318.85 30.23 232.08 01-02-2011 157009001064 Synthes Axon lam haak 499.39 107.80 01-02-2011 157009001177 Synthes USS LP ped haak + USS LP huls + USS LP moer 499.86 309.61 34.48 273.80 01-02-2011 157009001161 Synthes USS LP lam haak + USS LP huls + USS LP moer 499.39 41.85 0.888 + 499.44 34.51 232.38 0.34 01-02-2011 157009001082 Synthes Pangea haak + afsluitkapje 04.15 232.00 01-02-2011 157009000933 SHARK MEDICAL Crochet Thoracique 3K + vis de blocage std 3KCT4570-A + 3KVBB1005 340.39 85.98 01-02-2011 157009001021 STRYKER PEDICULAR HOOK + blocker 65930x00 + 48482001 309.39 77.08 01-02-2011 157009001125 Synthes USS lam haak INOX (uitgez.82 293.83 309.98 01-02-2011 157009001055 STRYKER XIA III HOOK 482302xx + 48230000 340.614.01 30.10 01-02-2011 157009001091 Synthes Pangea haak offset + afsluitkapje 04.01 232.69 33.85 30.23 01-02-2011 157009001134 Synthes USS lam haak Ti 498.61 34.10 01-02-2011 157009001116 Synthes SYNAPSE haak lamina + afsluitkapje 04.85 0.157009000915 SHARK MEDICAL Crochet Pédiculaire + vis de blocage std 3KCP(X)(X)xxx(x)-A + 3KVBB1005 340.98 01-02-2011 157009000994 STRYKER HOOK + BLOCKER 481302xx + 48130000 320.98 232.85 30.83 309.88x + 499.98 232.69 33.620.00 309.43 29.52 0.85 0.39 61.47 30.85 30.85 30.888 + 499.01 232.44 34.00 309.39 85.00 232.98 232.98 232.15 232.13 30.98 232.39 108.39 107.00 309.85 30.82 0.83 309.614.86 309.01 232.94x 273.39 59.97 32./ANGLE BLADE HOOK + blocker 6591xx(x) + (48482001 / (48482010+48482020)) 309.85 30.15 232.31x / 499.00 01-02-2011 157009000924 SHARK MEDICAL Crochet Sous-Lamaire Ouvert 3K + vis de blocage std 3KCSO1080-A + 3KVBB1005 340.15 232.887 318.08 01-02-2011 157009001107 Synthes Pangea transverse haak + afsluitkapje 04.08 01-02-2011 157009001046 STRYKER THOR.34 01-02-2011 157009001073 Synthes Cervifix lam haak 498.39 75.39 108.61 34.85 30.85 8.39 77.39 107.00 309.08 01-02-2011 157009001143 Synthes USS lam haak Ti 498./LUMB.98 232.61 34.15 232.00 01-02-2011 157009000951 SHARK MEDICAL Crochet Transversal Barre Monobloc + vis de blocage moyenne 3KCTB13x-A + 3KDCV602 340.39 108.08 01-02-2011 157009000985 STRYKER HOOK + BLOCKER 038202xx + 03756230 309.61 31.000 340.47 30.620.09 27.39 77.40x 273.47 30.47 30.74 01-02-2011 157009001152 Synthes USS LP frontale haak + USS LP huls + USS LP moer 499.85 0.887 318.85 21.00 309.00 01-02-2011 157009000942 SHARK MEDICAL Crochet Transversaire 3K + vis de blocage moyenne 3KCTX10xx-A + 3KDCV602 340.52 309.30x + 04.48 0.39 41.39 98.36 309.888 + 499.39 108.85 21.08 309.15 232.48 0.61 31.3xx 307.39 77.03 01-02-2011 157009001003 STRYKER HOOK STANDARD / OFFSET + BLOCKER 485510xx + 48551000 309.000 331.85 30.38 01-02-2011 157009000976 STRYKER HOOK + blocker 482202xx + 48220000 340.98 01-02-2011 157009001037 STRYKER REDXIATI HOOK + BLOCKER 038272xx + 03756230 340.620.85 10.38 292.99 29.08 309.00 01-02-2011 157009000967 Spineway MONT BLANC BABY CROCHET + VIS DE VERROUILLAGE BB1PHO / BB1LLH + BB1LS 293.00 232.95 01-02-2011 157009001012 STRYKER LUMBAR SUPRA/INFRA LAM HOOK + blocker 6592xx(x) + (48482001 / (48482010+48482020)) 309.86 309. Frontale haak) 298.00 232.5xx(S) + 04.85 8.000 331.15 232.01 232.00 232.80 01-02-2011 Mise à jour 01-08-2013 .39 108.622.44 34.86 309.83 309.3xx 292.00 232.00 309.61 34.44 34.88x + 499.00 309.00 309.40 307.Bijwerking 01-08-2013 Page 5 (700173-700184) .39 98.312 340.39 107.15 232.09 27.39 77.39 108.40 0.622.39 87.622.xxx + 04.85 8.83 309.44 34.48 273.

00 232.08 01-02-2011 157009001222 Synthes USS ped lam haak 498.00 309.3xx 307.Spine – crochet vertébral + vis de verrouillage A2513xxx + A2511001 340.15 232.39 108.61 34.98 232.099(S) ES 32x T 340.85 309.39 107.00 01-08-2013 157009001405 SpineConcept Crochet Thoracique 3K + vis de blocage std 3KCT4570-A + 3KVBB1005 340.44 34.00 01-08-2013 157009001362 SpineConcept Crochet Pédiculaire + vis de blocage std 3KCP(X)(X)xxx(x)-A +3KVBB1005 340.00 309.15 232.00 01-08-2013 Mise à jour 01-08-2013 .85 30.98 01-02-2011 157009001274 Synthes Lamina of Pedikel haak + locking cap 340.26 33.98 01-11-2012 157009001326 Hospithera Neon hook + Neon locking screw CS 1418-0x + CS 1419 309.85 30.98 232.39 107.39 108.61 34.352 323.00 232.39 107.11 01-06-2013 157009001344 Spinaxis E.44 34.83 309.Bijwerking 01-08-2013 Page 6 31-08-2012 (700173-700184) .38 292.39 77.15 232.350 339.85 0.00 232.98 232.46 01-02-2011 157009001265 MSH Neon hook + Neon locking screw CS 1418-0x + CS 1419 309.85 30.85 0.099(S) /09.01 30.632.39 107.44 34.85 28.85 30.61 34.83 309.85 30.050(S) / 04.99 29.80 232.157009001186 Synthes USS ped haak INOX 298.44 34.74 232.16 309.65 309.00 309.85 29.39 107.85 30.44 34.80 01-02-2011 157009001256 Zimmer Optima ZS hooks + Set screw SH0xxx-Ax + SP30x0 334.85 30.85 13.98 232.39 108.40 0.46 30.39 108.65 309.39 107.40 307.08 01-02-2011 157009001283 SHARK MEDICAL Crochet pédiculaire alpha 04.35x 292.83 309.39 88.39 59.85 24.61 34.23 01-02-2011 157009001204 Synthes USS ped haak Ti 498.000(S) / 04.74 01-02-2011 157009001231 Zimmer Java hook + bloker SN2030-0-500xx + SN2023-000002 334.39 102.00 01-08-2013 157009001371 SpineConcept Crochet à Corps Allongé 3K + vis de blocage std 3KCCA5090-A + 3KVBB1005 340.00 01-08-2013 157009001396 SpineConcept Crochet Sous-Lamaire Ouvert 3K + vis de blocage std 3KCSO1080-A + 3KVBB1005 340.00 232.85 30.85 309.46 30.633.39 108.35x / 499.87 232.5 Closed hook 186154xx0(X) 340.39 77.46 01-02-2011 157009001247 Zimmer Nexlink hook + open connector closure top 2111-xx + 707-01 338.15 232.39 75.46 30.61 33.08 01-02-2011 157009001301 Johnson & Johnson MedicalDepuy Expedium 4.85 24.00 01-08-2013 157009001387 SpineConcept Crochet à Corps Décalé 3K + vis de blocage 3KCXXXxxxx-A + 3KVBB1005 340.59 309.00 309.44 34.39 77.80 232.15 232.632.77 32.08 01-06-2013 157009001353 SpineConcept Crochet Lombaire 3K + vis de blocage std 3KCL6595-A + 3KVBB1005 340.00 309.632.83 309.85 30.83 309.26 33.632.31 232.61 34.85 11.85 30.39 107.98 232.61 34.37 01-02-2011 157009001195 Synthes USS ped haak INOX 298.00 309.98 232.39 91.98 01-09-2012 157009001335 Biomet Lineum Hook + Lineum HF PLUG 14-52403x + 14-524038 321.83 309.15 232.72 309.08 01-02-2011 157009001292 LDR MEDICAL Crochet pédiculaire alpha ES 32x T 340.00 309.00 309.20 33.39 102.85 30.xxx(S) + 04.15 232.33 32.00 01-08-2013 157009001414 SpineConcept Crochet Transversaire 3K + vis de blocage moyenne 3KCTX10xx-A + 3KVBB1005 340.85 30.85 30.08 01-06-2011 157009001317 Cormed GSS Spinal Hook + GSS set screw 161x-0xxx / 162x-0xxx + GS0104-0010 309.15 232.39 107.61 34.85 309.316 340.39 108.38 0.95 01-02-2011 157009001213 Synthes USS ped haak Ti 498.85 0.00 232.39 105.

39 01-02-2011 157010000086 Orthogèse Olerud connecteur + Olerud Crochet ATR480D.82 534.xxxxx / ATR44XD.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.O.I. zonder overeenkomst E = Supplément patient Bén.39 01-02-2011 157010000095 Synthes Axon connector + Hook Axon + Axon innie 406.65 66.5 + BJR Crochet à dôme 71. Clip + nut 86311xx / 86381xx/86312xx + 8634xxx + 8634111 779. / Prestataire avec ou sans convention Terugbetaling Gew.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .622.49 244.47 712.65 66.98 77.49 244. / Prestataire non conventionné Terugbetaling Gew.82 534. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700195-700206 Crochet d'ancrage pour fixation de la tige par moyen d'un connecteur séparé.49 244.xxX0x/ATR4700.98 77.98 77.00 501.00000 + 783. / Prestataire non conventionné Supplement patiënt / Verstr. connecteur inclus Verankeringshaak waarbij de staaf door middel van een afzonderlijke connector wordt gefixeerd.Terugbetaling W.65 71.91 712.94 01-02-2011 157010000034 Medtronic Colorado2 Inox pedicular hook +Colorado2 Inox Clip + nut 86111xx / 86112xx + 8614xxx + 8614111 779. met overeenkomst . / Verstr.xxxxx 120. / Prestataire avec ou sans convention Supplement patiënt Gew.49 31.55 01-02-2011 157010000025 Medtronic Colorado2 Inox Laminar hook X + Break Off Nut + Colorado2 Inox Clip 8611xxx + 8614111 + 8614xxx 779.49 244.65 ATR4700.38 501.94 01-02-2011 157010000061 Medtronic Colorado2 Ti.G.P.47 712. / Verstr. ordin.94 01-02-2011 157010000043 Medtronic Colorado2 Ti hook + Colorado2 Ti. Prix plafond ./Prestataire conventionné .Prijs (incl. recht.Plafondprijs : 783.47 712.65 66.Supplément patient V. / Verstr.620. recht.Bijwerking 01-08-2013 Page 1 31-03-2011 (700195-700206) .65 66.55 565.82 534.13 01-02-2011 157010000104 Synthes USS connector + Pangea haak + Afsluitkapje 499.000 633.xxX0 X + MUN44XD.82 534.xxx + 120.47 712.Remboursement V.55 0. met of zonder overeenkomst D = Remboursement Bén.49 249. Clip 8638xxx + 8634111 + 8634xxx 779.42 78.49 98. y compris toutes les pièces de fixation et d'attache.94 01-02-2011 157010000052 Medtronic Colorado2 Ti Pediatric hook + set screw + connector 864xxxx + 8644100 + 8644101 779.55 63.00 534.O.94 01-02-2011 157010000077 Orthogèse BJR Ecrou + BJR Connecteur universel et long Ø 5. BTW) B = Remboursement Bén.91 € Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157010000016 Johnson & Johnson MedicalDepuy Mountaineer Hook + Innie + Lateral offset connector 1883 43 00x + 1883 42 200 + 1883 12 001 565.49 249.65 66. met overeenkomst . Laminar hook X + Colorado2 Ti. met of zonder overeenkomst C = Supplément patient Bén. connector inbegrepen Valeur de U . ordin.42 78. / Verstr.W.295 + 04. / Verstr.I.105 + 499.I. recht.26 534.98 77.65 € Distributeur Verdeler Code d'identification Identificatiecode 10% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.P.104 501.I. ordin.40x + 406.49 244.98 77.47 712.06 56.38 0. Break Off Nut + Colorado2 Ti.Supplement patiënt W.00 534.A = Prix (TVAc) .W. inclusief alle toebehoren voor fixatie en blokkering.G. / Prestataire conventionné .30 01-02-2011 Mise à jour 01-08-2013 .U waarde : U 690 Remboursement .Terugbetaling : Marge de sécurité .74 € is van toepassing op het geheel van de wervelkolomimplantaten.91 712.Veiligheidsgrens : 712.xxx + 04.04 0.82 534.00 50. ordin.26 534.04 633.38 0.15x 783.

57 0.31 61.68 68.03 62.78 0.81 01-02-2011 157010000201 Synthes USS connector + USS lam haak Ti 499.69 58.69 63. Frontale haak) 499.00 534.35x 589.297 + 499.888 + 499.49 158.000 671.49 124.21 01-02-2011 157010000156 Synthes USS connector + Pangea haak offset + Afsluitkapje 499.00 636.64 643.18 0.888 + 499.622.57 671.60 01-02-2011 157010000314 Synthes USS connector + USS ped haak INOX 499.297 + 04.52 620.60 01-02-2011 157010000287 Synthes USS connector + USS LP ped haak + USS LP huls + USS LP moer 499.00 534.42 01-02-2011 157010000217 Synthes USS connector + USS lam haak Ti 499.352 620.88x + 499.29 59.00 534.00 534.49 54.40 0.000 643.71 60.49 86.40 0.352 631.63 01-02-2011 Mise à jour 01-08-2013 .296 + 298.80 614.297 + 298.296 + 499.15 64.00 534.295 + 298.23 64.91 62.295 + 04.295 + 498.49 69.49 101.12 631.89 61.40 625.00 534.52 0.350 636.622.88x + 499.8xx + 499.3xx 614.31x 638.31x 659.296 + 298.000 692.48 01-02-2011 157010000296 Synthes USS connector + USS LP ped haak + USS LP huls + USS LP moer 499.296 + 498.24 0.3xx 610.295 + 498.295 + 499.297 + 298.80 0.296 + 499.91 62.31 61.8xx + 499.31x 648.05 01-02-2011 157010000323 Synthes USS connector + USS ped haak INOX 499.24 654.54 01-02-2011 157010000253 Synthes USS connector + USS LP lam haak + USS LP huls + USS LP moer 499.77 692.297 + 498.00 534.00 0.157010000113 Synthes USS connector + Pangea haak + Afsluitkapje 499.49 80.63 63.622.18 638.80 614.295 + 498.91 01-02-2011 157010000174 Synthes USS connector + USS lam haak INOX (uitgez.00 636.28 69.51 63.00 534.78 599.88x + 499.17 0.38 0.49 137.888 + 499.42 01-02-2011 157010000131 Synthes USS connector + Pangea haak offset + Afsluitkapje 499.29 64.38 659.72 641.296 + 498.20 604.49 119.08 67.49 147.49 75.49 65.49 90.49 54.89 61.29 59.90 63.40 625.295 + 499.620.887 614.78 648.888 + 499.54 01-02-2011 157010000271 Synthes USS connector + USS LP lam haak + USS LP huls + USS LP moer 499.xxx + 04.80 614.00 534.296 + 04. Frontale haak) 499.3xx 589.17 01-02-2011 157010000366 Synthes USS connector + USS ped haak INOX 499.887 625.75 65.00 534.93 01-02-2011 157010000244 Synthes USS connector + USS lam haak Ti 499.36 01-02-2011 157010000122 Synthes USS connector + Pangea haak + Afsluitkapje 499.00 534.352 641.18 0.49 65.622.295 + 298.12 0.78 0.97 01-02-2011 157010000183 Synthes USS connector + USS lam haak INOX (uitgez.295 + 298.00 534.49 101.622.00 0.39 636.297 + 04.40 625.49 80.49 96.620.27 01-02-2011 157010000165 Synthes USS connector + USS lam haak INOX (uitgez.80 0.31 61.297 + 498.38 610.887 625.38 0.000 654.48 01-02-2011 157010000235 Synthes USS connector + USS lam haak Ti 499.Bijwerking 01-08-2013 Page 2 (700195-700206) .297 + 499.35x 610.64 0.49 101.00 534. Frontale haak) 499.18 0.00 534.49 109.620.620.296 + 298.xxx + 04.00 534.00 534.91 01-02-2011 157010000332 Synthes USS connector + USS ped haak INOX 499.00 534.91 62.49 90.18 589.11 01-02-2011 157010000341 Synthes USS connector + USS ped haak INOX 499.3xx 625.72 0.620.xxx + 04.89 65.51 63.3xx 599.20 0.03 01-02-2011 157010000192 Synthes USS connector + USS lam haak Ti 499.xxx + 04.00 534.17 682.15 01-02-2011 157010000147 Synthes USS connector + Pangea haak offset + Afsluitkapje 499.77 0.00 534.296 + 04.00 534.000 682.887 614.888 + 499.48 01-02-2011 157010000262 Synthes USS connector + USS LP lam haak + USS LP huls + USS LP moer 499.54 01-02-2011 157010000305 Synthes USS connector + USS LP ped haak + USS LP huls + USS LP moer 499.38 610.887 636.38 0.00 534.03 01-02-2011 157010000375 Synthes USS connector + USS ped haak Ti 499.8xx + 499.87 01-02-2011 157010000226 Synthes USS connector + USS lam haak Ti 499.39 0.78 599.xxx + 04.00 534.887 636.18 589.00 534.49 90.00 534.888 + 499.297 + 298.00 534.40 0.35x 599.49 107.3xx 604.00 534.49 103.49 80.00 534.80 0.97 01-02-2011 157010000357 Synthes USS connector + USS ped haak INOX 499.69 58.49 75.49 114.78 0.

49 87.2xx + 498.01 66.295 + 498. Frontale haak) 498.8xx + 499.69 01-02-2011 157010000436 Synthes USS connector + USS ped lam haak 499.00 534.33 588.2xx + 298.75 01-02-2011 157010000411 Synthes USS connector + USS ped haak Ti 499.49 96.03 63.xxx + 04.89 65.2xx + 498.89 697.887 641.296 + 498.3xx 625.54 01-02-2011 157010000463 Synthes USS connector gesloten + Pangea haak + Afsluitkapje 498.52 630.00 534.35x 588.35x 648.18 57.49 53.33 539.Bijwerking 01-08-2013 Page 3 (700195-700206) .88x + 499.38 659.35 0.00 534.157010000384 Synthes USS connector + USS ped haak Ti 499.3xx 630.49 106.67 0.63 64.296 + 498.88x + 499.352 570.888 + 499.69 63.45 01-02-2011 157010000621 Synthes USS connector open + USS lam haak Ti 498.00 534.2xx + 498.297 + 498.888 + 499.00 534.00 534.12 641.18 638.2xx + 04.25x + 498.86 55.95 0.622.49 01-02-2011 157010000524 Synthes USS connector gesloten + USS ped haak INOX 498.20 0.20 604.00 534.25x + 499.31x 664.2xx + 498.33 0.80 0.49 90.83 01-02-2011 157010000497 Synthes USS connector gesloten + USS lam haak Ti 498.89 0.65 01-02-2011 157010000551 Synthes USS connector gesloten + USS ped haak Ti 498.35 554.3xx 539.50 0.59 0.622.31 01-02-2011 157010000472 Synthes USS connector gesloten + USS lam haak INOX (uitgez.295 + 498.95 564.2xx + 499.10 65.49 19.11 01-02-2011 Mise à jour 01-08-2013 .19 583.67 570.00 534.40 625.55 01-02-2011 157010000612 Synthes USS connector open + USS lam haak Ti 498.84 53.95 564.49 163.33 0.54 586.06 01-02-2011 157010000533 Synthes USS connector gesloten + USS ped haak INOX 498.49 69.35x 638.49 112.49 30.49 124.25x + 04.50 615.49 130.887 564.3xx 615.31x 588.63 64.01 61.297 + 498.93 01-02-2011 157010000542 Synthes USS connector gesloten + USS ped haak Ti 498.12 0.93 01-02-2011 157010000594 Synthes USS connector open + Pangea haak offset + Afsluitkapje 498.86 55.95 0.50 0.91 62.xxx + 04.87 65.49 123.000 583.78 0.50 64.78 648.87 01-02-2011 157010000402 Synthes USS connector + USS ped haak Ti 499.49 81.71 60.35x 659.99 0.00 534.18 0.84 58.3xx 554.49 114.12 641.33 0.887 564.888 + 499.35 554.48 01-02-2011 157010000454 Synthes USS connector + USS ped lam haak 499.00 534.80 614.40 0.99 646.25x + 298.33 588.12 0.2xx + 04.3xx 554.00 534.2xx + 298.00 534.49 53.00 534.52 0.36 0.49 124.888 + 499.00 534.35x 539.00 534.00 534.50 664.00 534.2xx + 499.620.000 621.8xx + 499.78 01-02-2011 157010000603 Synthes USS connector open + USS lam haak INOX (uitgez.350 657.40 69.36 659.620.49 52.43 01-02-2011 157010000576 Synthes USS connector gesloten + Pangea haak offset + Afsluitkapje 498.49 103.25x + 498.54 0.83 01-02-2011 157010000567 Synthes USS connector gesloten + USS ped lam haak 498.33 539.84 58.00 534.49 01-02-2011 157010000515 Synthes USS connector gesloten + USS LP ped haak + USS LP huls + USS LP moer 498.350 586.70 58.887 641.49 48.42 01-02-2011 157010000445 Synthes USS connector + USS ped lam haak 499.00 534.3xx 604.25x + 499.46 56.00 534.49 19.31 61.00 534.23 62.17 01-02-2011 157010000585 Synthes USS connector open + Pangea haak + Afsluitkapje 498.05 01-02-2011 157010000637 Synthes USS connector open + USS LP lam haak + USS LP huls + USS LP moer 498.49 4.00 534.622.49 30.49 4.72 0.59 657.000 659.49 106.11 01-02-2011 157010000646 Synthes USS connector open + USS LP ped haak + USS LP huls + USS LP moer 498.xxx + 04. Frontale haak) 498.35 0.93 01-02-2011 157010000427 Synthes USS connector + USS ped haak Ti 499296 + 498.2xx + 498.25x + 04.00 534.29 64.33 0.3xx 614.72 621.622.xxx + 4620000 697.00 534.49 36.49 80.05 58.620.38 0.00 534.00 534.81 01-02-2011 157010000393 Synthes USS connector + USS ped haak Ti 499.00 534.93 01-02-2011 157010000481 Synthes USS connector gesloten + USS lam haak Ti 498.43 01-02-2011 157010000506 Synthes USS connector gesloten + USS LP lam haak + USS LP huls + USS LP moer 498.19 0.350 646.2xx + 298.297 + 498.84 53.46 56.

350 662.05 01-02-2011 157010000707 Synthes USS pediatric connector open + USS pediatric lam haak 498.42 78.49 81.25x + 498.42 78.40 0.00 534.84 646.55 01-02-2011 157010000673 Synthes USS connector open + USS ped haak Ti 498.00 534.Bijwerking 01-08-2013 Page 4 (700195-700206) .91 712.00 534.65 71.91 62.25x + 498.50 664.50 0.00 534.25x + 298.50 615.39 01-02-2011 Mise à jour 01-08-2013 .35x 615.3xx 625.80 614.49 80.39 01-02-2011 157010000743 LDR MEDICAL Crochet sous lamaire Easy spine ES 30x T 783.22 66.48 01-02-2011 157010000716 Synthes USS pediatric connector open + USS pediatric lam haak 498.00 534.49 96.31 61.49 128.01 61.00 534.27 01-02-2011 157010000682 Synthes USS connector open + USS ped haak Ti 498.26 534.91 712.65 71.00 534.229 + 498.45 01-02-2011 157010000691 Synthes USS connector open + USS ped lam haak 498.49 101.25x + 298.26 534.60 01-02-2011 157010000734 SHARK MEDICAL Crochet sous lamaire Easy spine ES 30x T 783.157010000655 Synthes USS connector open + USS ped haak INOX 498.84 0.00 0.25x + 498.71 0.52 0.54 01-02-2011 157010000725 Synthes USS pediatric connector open + USS pediatric lam haak 498.49 90.3xx 630.49 130.01 66.3xx 636.40 625.35x 664.228 + 498.68 01-02-2011 157010000664 Synthes USS connector open + USS ped haak INOX 498.3xx 614.03 63.35 64.00 534.52 630.49 112.71 662.49 249.352 646.227 + 498.80 0.50 0.51 63.49 249.00 636.

Prijs (incl.15 45.87 309.Bijwerking 01-08-2013 Page 1 (700210-700221) .85 144. recht. met of zonder overeenkomst C = Supplément patient Bén. BTW) B = Remboursement Bén.G.44 € Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157011000011 Zimmer Universal Clamp Stainless Steel SN2027-0-300xx 454.85 144.W.15 45. zonder overeenkomst E = Supplément patient Bén. recht. ordin. / Prestataire avec ou sans convention Terugbetaling Gew.13 40.13 € Distributeur Verdeler Code d'identification Identificatiecode 10% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148. / Prestataire conventionné . / Prestataire non conventionné Terugbetaling Gew.85 144.00 413.40 01-02-2011 157011000027 Zimmer Universal Clamp Ti SN2027-0-200xx 454.40 01-11-2012 157011000045 Hospithera JAZZ multi-purpose spinal connector 150150 454.A = Prix (TVAc) .I.U waarde : U 400 Remboursement .O.I.00 413.Supplement patiënt W. y compris toutes les pièces de fixation et d'attache Reduceerbare clamp met brede fixatieband voor gecombineerde lamina en/of transverse fixatie aan de staaf. / Verstr.Veiligheidsgrens : 413.Terugbetaling W.O. inclusief alle toebehoren voor fixatie en blokkering Valeur de U .I.Plafondprijs : 454.15 45.00 413.85 144.Terugbetaling : Marge de sécurité .15 45. / Verstr.G.00 413.I.P.Remboursement V.Supplément patient V. ordin.74 € is van toepassing op het geheel van de wervelkolomimplantaten. / Verstr. / Prestataire avec ou sans convention Supplement patiënt Gew.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700210-700221 Clamp réductible avec bande de fixation large pour fixation combinée laminaire et/ou transverse à la tige. / Verstr. met of zonder overeenkomst D = Remboursement Bén.13 40. ordin. met overeenkomst .74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale . / Verstr.87 309.87 309. met overeenkomst .P.W./Prestataire conventionné .40 01-02-2011 157011000036 CORMED Ligapass Clamp B08106010 454.40 01-02-2013 Mise à jour 01-08-2013 .13 40. Prix plafond . / Prestataire non conventionné Supplement patiënt / Verstr. ordin.13 40. recht.87 309.

xxxxx + MUN44XD.74 € is van toepassing op het geheel van de wervelkolomimplantaten. Clip + Colorado2 Ti. Break Off Nut + Praxis Laminar Clow hook + Praxis set srew Praxis pedicular hook + Praxis conicle break-off plug + Praxis Short Rod plate + Colorado2 Ti.O.I.Plafondprijs : 852. ordin.97 271. / Verstr.U waarde : U 750 Remboursement . connector inbegrepen Valeur de U .I.20 01-02-2011 852.A = Prix (TVAc) .08 774.Supplement patiënt W.Terugbetaling W. met overeenkomst .62 77.W. y compris toutes les pièces de fixation et d'attache. met of zonder overeenkomst C = Supplément patient Bén.Terugbetaling : Marge de sécurité ./Prestataire conventionné .Veiligheidsgrens : 774.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .I. / Prestataire avec ou sans convention Supplement patiënt Gew.P. / Prestataire conventionné . ordin. ordin. inclusief alle toebehoren voor fixatie en blokkering.62 77.62 77.08 774.I.Bijwerking 01-08-2013 10% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.46 580.5 + BJR Contre crochet + BJR Crochet pince à dôme PASS LP hook for claw + counterhook + connector Numéros de référence Referentienummers 5636xxx + 5636205 + 56362xx + 8634xxx + 8634111 + 56364xx + 563xxxx 563620x + 5636205 + 56362xx + 8634xxx + 8634111 + 56364xx + 563xxxx ATR480D. / Prestataire avec ou sans convention Terugbetaling Gew.Supplément patient V.20 01-02-2011 852. zonder overeenkomst E = Supplément patient Bén.O.20 01-02-2011 Page 1 (700232-700243) . recht.xxX0 X + MUN44CX. / Verstr. recht.W.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148. Prix plafond .Prijs (incl.46 580.Remboursement V. Clip + Colorado2 Ti.P.xxxxx / ATR44XD. met overeenkomst .08 774. connecteur inclus Verankeringsklem (haak en tegen-haak) waarbij de staaf door middel van een afzonderlijke connector aan de haak wordt gefixeerd.97 271.08 774.11 85. / Prestataire non conventionné Supplement patiënt / Verstr.20 01-02-2011 852. BTW) B = Remboursement Bén.62 € Distributeur Verdeler Code d'identification Identificatiecode 157012000013 Medtronic 157012000022 Medtronic 157012000031 Orthogèse 157012000047 Cormed Mise à jour 01-08-2013 .46 580. / Verstr.xxxxx B02241xxx + (B02242xxx / B02245xxx) + B022360xx A B A partir de Jusqu'au Vanaf Tot C D E F 852. Break Off Nut + Praxis Laminar Clow hook + Praxis set srew BJR Ecrou + BJR Connecteur universel et long Ø 5.11 85. / Prestataire non conventionné Terugbetaling Gew. ordin. / Verstr. / Verstr.G.08 € Nom du produit Productnaam Praxis laminaire hook + Praxis conicle break-off plug + Praxis Short Rod plate + Colorado2 Ti. met of zonder overeenkomst D = Remboursement Bén.97 271.xxxxx / ATR44CX. recht.46 580. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700232-700243 Pince d'ancrage (crochet et contre-crochet) pour fixation de la tige par moyen d'un connecteur séparé.11 85.97 271.11 85.62 77.00000 + ATR4700.G.xxX0x/ATR4700.

P.94 599.Terugbetaling W.91 50.04 59.66 65.91 50. / Verstr.81 01-02-2011 049E0AN200xx + 049E0AN 20001 + 049E0AN20002 + 049E0AN 20100 + SN2030-0500xx + SN2023 -0-00002 CS 1416-1T + CS 1416-2T + CS 1416-3T 658.90 449. / Prestataire avec ou sans convention Supplement patiënt Gew. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700254-700265 Pince d'ancrage (crochet et contre-crochet) avec crochet à tête ouverte pour fixation de la tige dans la tête. ordin. / Prestataire avec ou sans convention Terugbetaling Gew.00000 + ATR44CC.O. met of zonder overeenkomst D = Remboursement Bén.Bijwerking 01-08-2013 10% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.O.66 65. met overeenkomst . / Verstr.G. inclusief alle toebehoren voor fixatie en blokkering Valeur de U .Veiligheidsgrens : 599.I.19 0.Supplement patiënt W.28 209. ordin.19 0. / Prestataire non conventionné Terugbetaling Gew.A = Prix (TVAc) .94 € Nom du produit Productnaam 157013000015 Orthogèse BJR Crochet pince en U + BJR Contre crochet + BJR Boulon vis en U 157013000024 MSH Atlas hook for neon atlas claw + Counter part for neon atlas claw + Locking screw for neon atlas claw 157013000033 Zimmer Connection Hook Ti + blocker + small blocker + polyaxial Rod + blocker + hook 157013000042 Hospithera Atlas hook for neon atlas claw + Counter part for neon atlas claw + Locking screw for neon atlas claw Mise à jour 01-08-2013 .W.Prijs (incl. ordin.P.W.G. Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot ATR49XU.90 449. met of zonder overeenkomst C = Supplément patient Bén. ordin.0C0000/ ATR44CT./Prestataire conventionné .94 599. recht. / Prestataire conventionné .U waarde : U 580 Remboursement .19 508.28 209.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.Remboursement V.28 58.I. BTW) B = Remboursement Bén.Plafondprijs : 658.00 449.19 508.89 01-02-2011 508.Terugbetaling : Marge de sécurité . recht.Supplément patient V.74 € is van toepassing op het geheel van de wervelkolomimplantaten.I.00000 CS 1416-1T + CS 1416-2T + CS 1416-3T 658. zonder overeenkomst E = Supplément patient Bén.04 59.89 01-02-2011 508.81 01-09-2012 Page 1 31-08-2012 (700254-700265) .04 € Distributeur Verdeler Code d'identification Identificatiecode Prix plafond .00 449. / Verstr. / Verstr.I. y compris toutes les pièces de fixation et d'attache Verankeringsklem (haak en tegen-haak) met haak met open kop.28 58. / Prestataire non conventionné Supplement patiënt / Verstr.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale . met overeenkomst . recht. / Verstr.00001 + ATR480U. waarbij de staaf in de kop wordt gefixeerd.

A = Prix (TVAc) - Prijs (incl. BTW)
B = Remboursement Bén. ordin./Prestataire conventionné - Remboursement V.I.P.O. / Prestataire avec ou sans convention
Terugbetaling Gew. recht. / Verstr. met overeenkomst - Terugbetaling W.I.G.W. / Verstr. met of zonder overeenkomst
C = Supplément patient Bén. ordin. / Prestataire conventionné - Supplément patient V.I.P.O. / Prestataire avec ou sans convention
Supplement patiënt Gew. recht. / Verstr. met overeenkomst - Supplement patiënt W.I.G.W. / Verstr. met of zonder overeenkomst
D = Remboursement Bén. ordin. / Prestataire non conventionné
Terugbetaling Gew. recht. / Verstr. zonder overeenkomst
E = Supplément patient Bén. ordin. / Prestataire non conventionné
Supplement patiënt / Verstr. zonder overeenkomst
F = Marge de délivrance
Afleveringsmarge

700276-700280
Connexion transversale entre tiges, pour l'ensemble des composants, y compris tous les éléments de fixation
Transversale verbinding tussen staven, voor het geheel van de samenstellende elementen, inclusief alle fixatieelementen

Valeur de U - U waarde : U 320
Remboursement - Terugbetaling :

Code d'identification
Identificatiecode

Marge de sécurité - Veiligheidsgrens :
330,50 €

Distributeur
Verdeler

20%

Les montants de la marge de délivrance sont donnés à titre
indicatif : le plafond de 148,74 € est d'application sur l'ensemble
des éléments des implants de la colonne vertébrale - De bedragen
voor de afleveringsmarge worden slechts ter informatie vermeld :
het grensbedrag van 148,74 € is van toepassing op het geheel van
de wervelkolomimplantaten.

Prix plafond - Plafondprijs : 396,60 €

Nom du produit
Productnaam

Numéros de référence
Referentienummers

A

B

C

D

E

F

A partir de Jusqu'au
Vanaf
Tot

157014000017

B Braun Medical

S4 Spinal system adjustable cross connector

SW48xT / SW494T -> SW498T 352,89 330,50

22,39

247,88

105,01

35,28

01-02-2011

157014000026

B Braun Medical

S4 Spinal system adjustable cross connector

SW697T -> SW699T

396,60 330,50

66,10

247,88

148,72

39,66

01-02-2011

157014000035

B Braun Medical

S4 Spinal system straight cross connector

SW690T -> SW696T /
SW490T -> SW493T

271,41 271,41

0,00

247,88

23,53

27,14

01-02-2011

157014000044

B Braun Medical

S4C Cable connector 45° L et R + set screw (x2) + cable 0,8 mm

(SW054T + SW056T) +
SW002T + KY008S

332,73 330,50

2,23

247,88

84,85

33,27

01-02-2011

157014000053

B Braun Medical

S4C Cable connector 45° L et R + set screw (x2) + cable 0,9 mm

(SW054T + SW056T) +
SW002T + KY009S

337,01 330,50

6,51

247,88

89,13

33,70

01-02-2011

157014000062

B Braun Medical

S4C Cable connector 45° L et R + set screw (x2) + cable 1,0 mm

(SW054T + SW056T) +
SW002T + KY010S

338,51 330,50

8,01

247,88

90,63

33,85

01-02-2011

157014000071

B Braun Medical

S4C Cable connector 45° L et R + set screw (x2) + cable 1,2 mm

(SW054T + SW056T) +
SW002T + KY012S

341,27 330,50

10,77

247,88

93,39

34,12

01-02-2011

157014000087

B Braun Medical

S4C Cable connector 90° (x2) + set screw (x2) + cable 0,8 mm

SW049T + SW002T/SW003T+
KY008S

332,73 330,50

2,23

247,88

84,85

33,27

01-02-2011

157014000096

B Braun Medical

S4C Cable connector 90° (x2) + set screw (x2) + cable 1,2 mm

SW049T + SW002T/SW003T
+ KY012S

341,27 330,50

10,77

247,88

93,39

34,12

01-02-2011

157014000105

B Braun Medical

S4C Cable connector 90° (x2) + set screw (x2) + cable 0,9 mm

SW049T + SW002T /
SW003T+ KY009S

337,01 330,50

6,51

247,88

89,13

33,70

01-02-2011

Mise à jour 01-08-2013 - Bijwerking 01-08-2013

Page 1

(700276-700280)

157014000114

B Braun Medical

S4C Cable connector 90° (x2) + set screw (x2) + cable 1,0 mm

SW049T + SW002T/SW003T
+ KY010S

338,51 330,50

8,01

247,88

90,63

33,85

01-02-2011

157014000123

B Braun Medical

S4C Cross connectors fixed

SW112T -> SW114T

271,41 271,41

0,00

247,88

23,53

27,14

01-02-2011

157014000132

B Braun Medical

S4C Cross connectors variable

SW115T -> SW117T

352,89 330,50

22,39

247,88

105,01

35,28

01-02-2011

157014000141

B Braun Medical

Socon Cross Bar + Socon Clamp for Cross Bar (2x)

FG693T -> FG696T + FG606T

396,60 330,50

66,10

247,88

148,72

39,66

01-02-2011

157014000157

Biomet

Altius Adjustable connector Left + Altius Adjustable connector Right +
Altius Rod 3.5mm

1200-0036 + 1200-0035 +
1200-0002

396,60 330,50

66,10

247,88

148,72

39,66

01-02-2011

157014000166

Biomet

Altius Fixed Cross connector

1200-00xx

255,25 255,25

0,00

247,88

7,37

25,52

01-02-2011

157014000175

Biomet

Array Cross Connector

946xx / 6x5x

360,40 330,50

29,90

247,88

112,52

36,04

01-02-2011

157014000184

Biomet

Array Fixed Cross Connector

944xx / 14-50013x

293,69 293,69

0,00

247,88

45,81

29,36

01-02-2011

157014000193

Biomet

Omega Transconnector Hook met nut (x2) + Transverse rod

1287-04 + 1225-x0

323,01 323,01

0,00

247,88

75,13

32,30

01-02-2011

157014000202

Cormed

Ascent transverse cross connector

65.53xx

396,60 330,50

66,10

247,88

148,72

39,66

01-02-2011

157014000211

Cormed

Dyflex transverse Connector

XDxxxx

396,60 330,50

66,10

247,88

148,72

39,66

01-02-2011

157014000227

Cormed

Evos

62.xxx / 47.100

396,60 330,50

66,10

247,88

148,72

39,66

01-02-2011

157014000236

Cormed

GSS transverse Connector

GS0120-00xx

396,60 330,50

66,10

247,88

148,72

39,66

01-02-2011

157014000245

Cormed

Odalys système transverse + vis de blocage

ODLTDxx + ODLS

396,60 330,50

66,10

247,88

148,72

39,66

01-02-2011

157014000254

Cormed

PASS LP Crosslink

B0226xxxx

396,60 330,50

66,10

247,88

148,72

39,66

01-02-2011

157014000263

Cormed

Saxxo transverse link

CRLxx

396,60 330,50

66,10

247,88

148,72

39,66

01-02-2011

157014000272

Cormed

Slick's transverse Connector

S11/TC.xxxx(x)

396,60 330,50

66,10

247,88

148,72

39,66

01-02-2011

157014000281

Cormed

Solas

STCxxxx(x)

396,60 330,50

66,10

247,88

148,72

39,66

01-02-2011

157014000297

Cormed

Solas RS Anatomix Crosslink

SCL3070 / SCL70120

396,60 330,50

66,10

247,88

148,72

39,66

01-02-2011

157014000306

Globus Medical Belgium

Adjustable T-Connector for 3.7mm Rod

115.91x

330,50 330,50

0,00

247,88

82,62

33,05

01-02-2011

157014000315

Globus Medical Belgium

Cross Connector

131.1xx

330,50 330,50

0,00

247,88

82,62

33,05

01-02-2011

157014000324

Globus Medical Belgium

Ellipse Head to Head T-Connector for 3,5mm Rod 21-27mm - 57-63mm

182.91x

396,60 330,50

66,10

247,88

148,72

39,66

01-02-2011

157014000333

Globus Medical Belgium

Ellipse Top-Loading T-Connector for 3,5mm Rod

182.92x

396,60 330,50

66,10

247,88

148,72

39,66

01-02-2011

157014000342

Globus Medical Belgium

REVERE™ Adjustable T Connector

124.91x

330,50 330,50

0,00

247,88

82,62

33,05

01-02-2011

157014000351

Globus Medical Belgium

Stainless Steel REVERE Adjustable T Connector

224.91x

330,50 330,50

0,00

247,88

82,62

33,05

01-02-2011

157014000367

Hospithera

Alphatec SOLANAS - TI 3.3MM ADJUSTABLE BRIDGE

63003-xx

390,00 330,50

59,50

247,88

142,12

39,00

01-02-2011

157014000376

Hospithera

Alphatec TI 5.5MM ADJUSTABLE BRIDGE

11-20xx / 11-25xx

390,00 330,50

59,50

247,88

142,12

39,00

01-02-2011

Mise à jour 01-08-2013 - Bijwerking 01-08-2013

Page 2

(700276-700280)

157014000385

Hospithera

TRANSFER HOOK (2x) + TIGE TRANSFER LG stérile

ELL-TC0000-S + ELL-TR00xxS

392,20 330,50

61,70

247,88

144,32

39,22

01-02-2011

157014000394

Hospithera

TRANSFER HOOK (2x) + TIGE TRANSFER LG non stérile

ELL-TC0000-N + ELL-TR00xxN

360,40 330,50

29,90

247,88

112,52

36,04

01-02-2011

157014000403

InSpine Belgium

closed cross connection

ES006T

335,00 330,50

4,50

247,88

87,12

33,50

01-02-2011

157014000412

InSpine Belgium

cross link

10-x0x0-VXL

335,00 330,50

4,50

247,88

87,12

33,50

01-02-2011

157014000421

InSpine Belgium

open cross connection

ES005T

335,00 330,50

4,50

247,88

87,12

33,50

01-02-2011

157014000437

ISKRA

Barre Transversale Lisse 3K + 2 Crochets pour Barre Transversale 3K +
2 vis de blocage longue

3KBTC(X)25xxx + 3KBC560-A
+ 3KBCV601

396,00 330,50

65,50

247,88

148,12

39,60

01-02-2011

157014000446

ISKRA

Connexion transversale entre tiges + vis (3x)

3KDTP55-A / 3KDTP75-A +
3KBCV601

396,00 330,50

65,50

247,88

148,12

39,60

01-02-2011

157014000455

Johnson & Johnson MedicalDepuy

Cross connector SFX 4.5 + set screw

1894 07 xxx + 1894 07 000

396,60 330,50

66,10

247,88

148,72

39,66

01-02-2011

157014000464

Johnson & Johnson MedicalDepuy

Cross connector SFX 5.5 & 6.35 + set screw TI

1894 xx xxx + 1894 07 000

396,60 330,50

66,10

247,88

148,72

39,66

01-02-2011

157014000473

Johnson & Johnson MedicalDepuy

Crossover

1740xxxxx

383,20 330,50

52,70

247,88

135,32

38,32

01-02-2011

157014000482

Johnson & Johnson MedicalDepuy

Expedium Anterior crossconnector

1877 04 0xx

350,21 330,50

19,71

247,88

102,33

35,02

01-02-2011

157014000491

Johnson & Johnson MedicalDepuy

Expedium offset drop entry connector SS 5.5 + connecteur

1854 30 420 + 1854 30 430

395,00 330,50

64,50

247,88

147,12

39,50

01-02-2011

157014000507

Johnson & Johnson MedicalDepuy

Expedium offset drop entry connector SS 6.35 + connecteur

1854 30 400 + 1854 30 410

395,00 330,50

64,50

247,88

147,12

39,50

01-02-2011

157014000516

Johnson & Johnson MedicalDepuy

Expedium offset drop entry connector Titanium 5.5 + connecteur

1754 30 420 + 1754 30 430

395,00 330,50

64,50

247,88

147,12

39,50

01-02-2011

157014000525

Johnson & Johnson MedicalDepuy

Expedium offset drop entry connector Titanium 6.35 + connecteur

1754 30 400 + 175430 410

395,00 330,50

64,50

247,88

147,12

39,50

01-02-2011

157014000534

Johnson & Johnson MedicalDepuy

Jhook transvers connector SS (1 plaque + 2 crochets + 2 vis + 2 écrous)

20305xx + 2030xxx + 20301000 + 203005SS

396,60 330,50

66,10

247,88

148,72

39,66

01-02-2011

157014000543

Johnson & Johnson MedicalDepuy

J-Hook transverse connector Ti (1 plaque + 2 crochets + 2 vis + 2 écrous) 22305xx + 2230xxx + 22301000 + 223005SS

396,60 330,50

66,10

247,88

148,72

39,66

01-02-2011

157014000552

Johnson & Johnson MedicalDepuy

Modular cross connector Plate connector : conn right + conn left + tige

1754 30 600 + 1754 30 610 +
1754 30 620

395,00 330,50

64,50

247,88

147,12

39,50

01-02-2011

157014000561

Johnson & Johnson MedicalDepuy

Modular cross connector Plate Titanium : 2x J hook + 2x set screw + 2x
hex nut + plaque

1754 30 300 + 1754 30 200 +
1754 30 100 + 1754 30 0xx

395,00 330,50

64,50

247,88

147,12

39,50

01-02-2011

157014000577

Johnson & Johnson MedicalDepuy

Modular cross connector SS 5.5 : 2x J hook + 2x set screw + 2x hex nut
+ plaque

1854 30 255 + 1854 30 200 +
1854 30 100 + 1854 30 0xx

395,00 330,50

64,50

247,88

147,12

39,50

01-02-2011

157014000586

Johnson & Johnson MedicalDepuy

Modular cross connector SS 6.35 : 2x J hook + 2x set screw + 2x hex nut
+ plaque

1854 30 635 + 1854 30 200 +
1854 30 100 + 1854 30 0xx

395,00 330,50

64,50

247,88

147,12

39,50

01-02-2011

157014000595

Johnson & Johnson MedicalDepuy

Modular cross connector Titanium 5.5 : 2x J hook + 2x set screw + 2x hex 1754 30 255 + 1754 30 200 +
nut + plaque
1754 30 100 + 1754 30 0xx

395,00 330,50

64,50

247,88

147,12

39,50

01-02-2011

157014000604

Johnson & Johnson MedicalDepuy

Modular cross connector Titanium 6.35 : 2x J hook + 2x set screw + 2x
hex nut + plaque

1754 30 635 + 1754 30 200 +
1754 30 100 + 1754 30 0xx

395,00 330,50

64,50

247,88

147,12

39,50

01-02-2011

157014000613

Johnson & Johnson MedicalDepuy

Moss Miami Ti Transverse Connector

1755 65 000

255,25 255,25

0,00

247,88

7,37

25,52

01-02-2011

157014000622

Johnson & Johnson MedicalDepuy

1883 41 0xx + 1883 41 200 +
1883 41 100

330,00 330,00

0,00

247,88

82,12

33,00

01-02-2011

157014000631

Johnson & Johnson MedicalDepuy

Mountaineer Head to Head Cross-Connector + Mountaineer Head to
Head Cross-Connector Inner Screw (2x)+ Mountaineer Head to Head
Cross-Connector Outer Nut (2x)
Mountaineer J Hook (2x) + Mountaineer Rod

1883 12 003 + 1883 16 xxx

396,51 330,50

66,01

247,88

148,63

39,65

01-02-2011

Mise à jour 01-08-2013 - Bijwerking 01-08-2013

Page 3

(700276-700280)

35 Rod 8116xxx 396.66 01-02-2011 157014000744 Medtronic Colorado2 Inox verbindingsplaat pour DTT L-X + Colorado2 Inox open clip voor DTT (2x) + self breaking screw for DTT (2x) 5402xx + 520222 + 8614120 396.L.35 01-02-2011 157014000866 Medtronic Vertex MAX Crosslink Adj Crosslink X 700252x 396.88 148.88 148.60 275.88 148.72 39.60 330.T.66 01-02-2011 157014000735 Medtronic CD Horizon Ti.50 66.88 148.10 247.56 0.87 34.60 330.50 66.60 330.72 39.88 27.13 31.66 01-02-2011 157014000726 Medtronic CD Horizon Ti.5 rod SS 8104xxx 396.00 247.50 66.50 283.10 247.50 66. L80-100mm 806LT55L80T/806LT55L100T 344.66 01-02-2011 157014000814 Medtronic SOLERA CROSSLINK 4.60 330.66 01-02-2011 157014000787 Medtronic Equation Verbindingsplaat L-X + Equation Verankeringsschroef voor Verbindingsplaat (x2) + Crosslink Hook (x2) 83141xx + 8315030 + 8314200 396.60 330.72 01-02-2011 157014000832 Medtronic Tenor D.00 186.10 247.10 247.88 148.60 330.66 01-02-2011 157014000656 Johnson & Johnson MedicalDepuy Summit crossconnector (2 crochets + 2 innies + 1 tige) 1746 37 000 (2x) + 1746 36 000 (2x) + 1746 3x xxx 396.50 66.88 148.88 148.56 01-02-2011 157014000692 MEDIANN Tige transverse + connecteurs (x2) 2T40-BTxx + 2T20-DTxx 275.60 330.72 39.66 01-02-2011 157014000753 Medtronic Dual Rod Crosslink Ti.10 247.10 247.88 148.60 0.88 148.72 39.50 14.50 66.88 148.60 330.50 66.65 01-02-2011 157014000683 MEDIANN ORIA CLARIS Tige transverse + connecteurs (x2) 2T40-BTxx + 2T20-DTxx 275.50 66.88 148.88 27.56 01-02-2011 157014000701 Medtronic CD HORIZON FULL SET OF DTT NR6 94147E 396.00 247. Full Set Of DTT NRX 84107XET 396.72 39.10 247.60 330.60 330.10 247.66 01-02-2011 157014000796 Medtronic Legacy Anterior Crosslink 81107xx 396.72 39.5mm rod SS 8103xxx 396.66 01-02-2011 Mise à jour 01-08-2013 .66 01-02-2011 157014000771 Medtronic D-x Low Profile Xlink.50 66.72 27. L40mm 806LT55L40T / G806LT55L40T 287.88 35.72 39.00 18.66 01-02-2011 157014000805 Medtronic Legacy Mini Ti Crosslink 8113xxxINT / 8113xxx 396.66 01-02-2011 157014000674 MEDIANN ORIA ALIS Tige transverse + connecteurs (x2) GT40-BTxx + GT20-DTxx 186.28 0.10 247.L.10 247.88 35.72 39.60 330.75 TI + nut 5442xxx + 8110855 396.60 330.50 0.72 39.50 66.88 96.60 0.88 68.50 66.50 66.88 148.72 39.47 01-02-2011 157014000857 Medtronic Vertex Cross Link Bar + clip 6902530 + 6902525 283.66 01-02-2011 157014000823 Medtronic Tenor D. L-X 811-xxx 396.10 247.72 39.10 247.88 148.L.T.00 247.50 66.88 148.60 330.88 148.60 01-02-2011 157014000841 Medtronic Tenor D.50 66.72 39.62 28.25 247.00 247.56 186.50 66.10 247.50 0. DTT NR4 + 2 Free Hooks 84147ET 396.75 330.56 0.00 247.60 330.88 148.72 27.01 316.62 28.Bijwerking 01-08-2013 Page 4 (700276-700280) .72 39.60 330.157014000647 Johnson & Johnson MedicalDepuy Summit crossconnector (2 connecteurs + 1 tige) 1746 65 000 + 1746 3x xxx 396.72 39.50 66.28 287.72 39.50 66.72 39.66 01-02-2011 157014000893 Medtronic X10 Crosslink for 4. L60mm 806LT55L60T 316.35 01-02-2011 157014000762 Medtronic D-X Low Profile Xlink Offset Ti.66 01-02-2011 157014000884 Medtronic X10 Crosslink for 4. L-X 81106xx 283.66 01-02-2011 157014000717 Medtronic CD HORIZON FULL SET OF DTT NRX 94107XX 396.50 66.10 247.10 247.10 247.5 Rod 8114xxx/8114xxxM 396.10 247.T.00 247.72 39.88 148.88 148.10 247.60 330.50 66.66 01-02-2011 157014000665 Johnson & Johnson MedicalDepuy Summit crossconnector (2 crochets + 2 innies + 1 tige) 9103 37 000 (2x) + 9103 36 000 (2x) + 1746 3x xxx 396.88 39.66 01-02-2011 157014000902 Medtronic X10 Crosslink for 6.60 330. L-X 810-xxx 396.88 148.10 247.72 39.60 275.60 330.66 01-02-2011 157014000875 Medtronic X10 Crosslink for 3.60 330.72 39.01 0.50 283.40 28.

50 65.00 247.72 39. L.50 66.88 148.Connecting Rod 4 mm + WSI .66 01-02-2011 157014000936 Medtronic X10 Ti.62 33.50 65.28 0.88 148.10 247.00 247.00 247.55000 396.82 247.00 330.66 01-02-2011 157014000945 NEW2DM Barre Transversale Lisse 3K + 2 Crochets pour Barre Transversale 3K + 2 vis de blocage longue 3KBTC(X)25xxx + 3KBC560-A + 3KBCV601 396.46 0.10 247.46 0.60 330.88 81.21 01-02-2011 157014001146 STRYKER TRANS CONN RADIUS 4866140xx 348.60 330.50 66.50 247.88 80.Bijwerking 01-08-2013 Page 5 31-03-2011 (700276-700280) .50 330.44 34.88 100.60 330.60 330.62 33.50 66.88 80.66 01-02-2011 157014000981 Orthogèse BJR Crochet de liaison transverse (x2) + BJR Ecrou de liaison transverse (x2) + BJR Tige de liaison 396.00 247.88 148.00 247.84 01-02-2011 157014001112 STRYKER MULTIAXIAL CONNECTOR 481332xx 329.28 328.00002 + ATR4600.50 66.00 330.10 247.88 148.00 330.00001 + ATR4603.60 01-02-2011 157014000954 NEW2DM Connexion transversale entre tiges + vis (3x) 3KDTP55-A / 3KDTP75-A + 3KBCV601 396.46 0.88 148.66 329.88 148. 1232 81055xx + 8100855 396.83 01-02-2011 157014001137 STRYKER TRANS CONN OASYS + set screw 4855107x + 48551005 302.50 66.60 01-02-2011 157014001076 SHARK MEDICAL Connexion transversale entre tiges + vis (3x) 3KDTP55-A / 3KDTP75-A + 3KBCV601 396.40 32.P.88 81.46 328.P.00 247.72 39.62 33.P. Break Off Screw.xxxxx + TNF4603.46 328.72 39.88 82.44 34.32 330.88 82.72 39.60 01-02-2011 157014001085 STRYKER CROSS CONNECTOR / MUTI-AXIAL CONNECTOR 482203xx 328.50 17.12 39. Crosslink 5.50 17.00 247.82 247.88 54.62 33.78 32.00 247.50 65.Set Cross Connector 4 mm 22601-42-02 + 22601-42-00 396.5mm L-X + X10 Inox L.35 rod SS 8106xxx 396.88 148.72 39.10 247. Break Off Screw 12-32 81155xx/G81155xx + 8110855/G8110855 396.66 0.72 39.66 01-02-2011 157014000972 Ortho Team WSI .50 0.50 65.83 01-02-2011 157014001155 STRYKER XIA CROSS CONN 03803xxx / 03804xxx 329.5mm L-X + X10 Ti.50 330.50 66.00 247.00xxx TNF4603.05 01-02-2011 157014001067 SHARK MEDICAL (Connecteur Transverse Multi-Axial Ti (MATC) + vis de blocage M6) + (Connecteur Fixe Transverse Ti (FTC) + vis de blocage M6) + Barre mixte MATC / FTC Ti Barre Transversale Lisse 3K + 2 Crochets pour Barre Transversale 3K + 2 vis de blocage longue 3KBTC(X)25xxx + 3KBC560-A + 3KBCV601 396.88 82.58 32.66 329.10 247.50 330.46 328.50 0.22 30.05 01-02-2011 157014001024 SDI Belgium (Connecteur Transverse Multi-Axial (MATC) + vis de blocage M6) (2x) + Barre transversale pour MATC U1-T610 + U1-T6xx 396.Set Cross Connector 3 mm 22630-40 + 22601-43-00 396.50 247.50 66.96 01-02-2011 157014001164 STRYKER XIA III CROSSLINK 482360xx 328.05 01-02-2011 157014001051 SDI Belgium L2-T610T + L2-T613T + L2T614T 330.72 39.50 0.66 01-02-2011 157014000997 Orthogèse BJR Tige avec machoire + BJR Machoire ATR4603.96 01-02-2011 157014001121 STRYKER RADIUS CC VARIABLE S 4866141xx 348.88 148.50 0.50 66.60 330.10 247.60 330.82 01-02-2011 157014001103 STRYKER MAC CONNECTOR XXmm 41070xx 328.10 302.84 01-02-2011 Mise à jour 01-08-2013 .00 247.88 100.10 247.88 148.88 80.32 330.88 82.157014000911 Medtronic X10 Crosslink for 6.50 247.60 330.50 330.66 01-02-2011 157014000927 Medtronic X10 Inox L.58 32. Crosslink 5.66 01-02-2011 157014001015 OSTEON CROSSLINK PFCLxx(x) 330.12 39.60 330.72 39.12 39.00 330.84 01-02-2011 157014001094 STRYKER CROSSLINK XXmm 038210xx 328.05 01-02-2011 157014001042 SDI Belgium (Connecteur Transverse Multi-Axial (MATC) + vis de blocage M6) + (Barre mixte MATC / FTC + vis de blocage M6 ) + Barre mixte MATC / FTC (Connecteur Transverse Multi-Axial Ti (MATC) + vis de blocage M6) (2x) + Barre transversale pour MATC Ti L2-T610T + L2-T6xxT 330.60 330.88 148.78 32.10 247.72 39.50 247.50 66.88 148.88 148.66 01-02-2011 157014001006 Orthogèse Easys straddler (x2) + Easys bar 12DLT01 + 12BTxx 396.00 247.88 148.12 39.10 247.Connecting Rod 3 mm + WSI .66 0.88 80.66 01-02-2011 157014001033 SDI Belgium U1-T610 + U1-T613 + U1-T614 330.60 01-02-2011 157014000963 Ortho Team WSI .10 0.58 32.

813 + 296.96 01-02-2011 157014001191 Synthes cervifix crosslinkklem (x2) + crosslink staaf 498.50 66.98 01-02-2011 31-08-2012 157014001295 Zimmer Java connecteur transverse CS 2809-1T/CS 2809-2T+ CS 2809-3T + CS 2809-4T + CS 2809-5T CS 2809-1T/CS 2809-2T / CS 3005-2/ CS 3005-3 + CS 28094T + CS 2809-5T + CS 3005-1 CS 1415-1T/ CS 1415-2T+ CS 1415-3T + CS 1415-5T + CS 1411-4T SN2023-0-xx055 291.66 329.87x 396.50 49.88 141.00401.88 148.56 0.50 66.10 247.50 0.60 330.9xx 396.72 39.72 39.56 01-02-2011 31-08-2012 157014001277 MSH 380.61 330.66 01-02-2011 157014001216 Synthes cross-link klem Ti 2stuks + crosslink staaf 498.50 66.66 01-02-2011 157014001401 SHARK MEDICAL Connexion transversale Spine Tune ST101xT-S 396.0 mm 721-xx 392.66 01-02-2011 157014001234 Synthes SYNAPSE dwarsverbinding 04.63 247.66 01-02-2011 157014001225 Synthes dwarsverbinding pangea 497.10 247.60 330.10 247.60 330.88 148.60 330.66 01-02-2011 157014001322 Zimmer Sequoia Transverse Connector 3308-35/3309-40/3310-50 369.001 325.60 330.120(S) 396.00 330.66 329.88 148.0xx 162.88 148.11 247.66 01-02-2011 157014001392 SHARK MEDICAL Connexion transversale Easy spine (rod + 2 hooks) ES005 T / ES 006 T 396.22 01-02-2011 157014001313 Zimmer Optima transverse connector SGA24x0 396.12 0.60 330.88 148.13 330.66 01-02-2011 Mise à jour 01-08-2013 .62 29.10 247.88 148.78 32.66 01-02-2011 157014001383 SHARK MEDICAL Connexion transversale Easy spine ES 014 T / ES 015 T 396.10 247.90 01-02-2011 157014001331 Zimmer ST360 Fixed Transverse Connector 07.01 01-02-2011 31-08-2012 157014001286 MSH TangoRS X-plate for crosslink + TangoRS Nut for crosslink (2x) + TangoRS Locking plate for crosslink (2x) + TangoRShook for crosslink (2x) X-plate for neon crosslink + Locking plate for neon crosslink (2x) + Hook for neon crosslink (2x) + Hex nut for neon easy fit.17 36.87 330.00 247.60 330.00424.66 0.00 247.50 291.00x + 07.72 39.50 66.50 59.25 38.10 247.72 39.99 38.88 142.5 mm Telescoping Bridge 62105-xx 390.66 01-02-2011 157014001261 MSH Krypton X-plate for crosslink + Krypton Hook for crosslink (2x) + Krypton Nut for crosslink (2x) + Krypton Locking plate for crosslink (2x) 385.88 148.5 STR.00 247.60 330.72 39.ILIAC CONNECT 4813510x 329.55 247.10 247.66 01-02-2011 157014001252 Synthes transversale connector langer dan 24mm 497.60 330.88 148.50 66.7xx / 04.56 162.614.50 66.88 148.50 66.50 66.50 38.51x(S) 396.72 39.70 247.72 39.50 66.78 32.50 66.10 247.32 39.10 247.88 43.50 66.73 38.66 01-02-2011 157014001426 LDR MEDICAL Connexion transversale Easy spine (rod + 2 hooks) ES005 T / ES 006 T 396.66 01-02-2011 157014001417 LDR MEDICAL Connexion transversale Easy spine ES 014 T / ES 015 T 396.10 247.88 148.72 39.72 39.95x + 498.60 330.66 0.88 121.9xx 396.88 148.10 247.87x 396.66 01-02-2011 157014001365 Hospithera Zodiac TI 5.72 39.620.50 66.88 148.05 330.50 66.00 16.15 01-02-2011 157014001304 Zimmer Nexlink variable crosslink 4.96 01-02-2011 157014001182 STRYKER XXmm CROSS CONNECTOR 481330xx 329.633.66 01-02-2011 157014001243 Synthes transversale connector korter dan 24 mm 497.50 66.00 162.50 59.50 61.72 39.157014001173 STRYKER XIa4.50 55.00 247.50 66.88 81.37 247.00408.12 39.60 330.72 39.10 247.10 247.88 137.60 330.56 0.88 144.72 39.88 81.72 39.10 247.66 01-02-2011 157014001207 Synthes cross-link klem Inox 2stuks + crosslink staaf inox 298.12 325.20x 396.88 148.88 148.20 330.60 330.60 330. golden (2x) 389.60 330.3xx(S) 396.00 01-02-2011 157014001374 Synthes Snap-On Transverse Connector 04.88 132.50 247.25 01-02-2011 157014001347 Zimmer ST360 transverse connector adjustable rod + ST360 adjustable sleeve 07.88 148.813 + 496.24 32.88 77.51 01-02-2011 157014001356 Cormed Fixspine transverse cross connector OSM620x 396.10 247.Bijwerking 01-08-2013 Page 6 (700276-700280) .72 39.

50 55.61 330.50 330.00 247.87 330.88 148.50 66.63 247.87 330.614.55x(S) + 04.10 247.50 0.10 247.88 108.88 137.Spine – Connexion transversale LTT A25140xx 396.99 35.60 330.10 247.98 01-09-2012 157014001496 Globus Medical Belgium Revere low profile adjustable T-connector CS 2809-1T/CS 2809-2T+ CS 2809-3T + CS 2809-4T + CS 2809-5T CS 2809-1T/CS 2809-2T / CS 3005-2/ CS 3005-3 + CS 28094T + CS 2809-5T + CS 3005-1 CS 1415-1T/ CS 1415-2T+ CS 1415-3T + CS 1415-5T + CS 1411-4T 124.72 39.88 148.11 247.88 148.05 01-03-2013 157014001505 Synthes SYNAPSE dwarsverbinding + écrou – fermeture (2x) 04.68 01-07-2012 157014001453 Aceemed MPM transversale barre THBDLx 396.62 33.60 330.72 39.25 38.10 247.50 66.66 01-02-2011 157014001444 Cormed PASS LP anterior transverse connector B03135510 356.37 247.88 148.01x 330.66 01-05-2013 157014001514 Eurospine MPM barre de liaison THBDLx 396.60 330.60 330.Bijwerking 01-08-2013 Page 7 (700276-700280) .60 330. golden (2x) 389.521(S) 396.50 66.72 39.157014001435 LDR MEDICAL Connexion transversale Spine Tune ST101xT-S 396.614.13 330.72 39.37 247.56 01-09-2012 157014001471 Hospithera 380.50 59.50 66.50 26.99 38.50 66.66 01-05-2013 157014001523 Spinaxis E.66 01-06-2013 Mise à jour 01-08-2013 .72 39.66 01-09-2012 157014001462 Hospithera Krypton X-plate for crosslink + Krypton Hook for crosslink (2x) + Krypton Nut for crosslink (2x) + Krypton Locking plate for crosslink (2x) 385.50 49.73 38.88 132.88 82.10 247.01 01-09-2012 157014001487 Hospithera TangoRS X-plate for crosslink + TangoRS Nut for crosslink (2x) + TangoRS Locking plate for crosslink (2x) + TangoRShook for crosslink (2x) X-plate for neon crosslink + Locking plate for neon crosslink (2x) + Hook for neon crosslink (2x) + Hex nut for neon easy fit.01x / 224.88 148.88 141.

/ Verstr.Terugbetaling W.A = Prix (TVAc) .Remboursement V. / Prestataire conventionné .22 28.03 170.50 01-02-2011 Mise à jour 01-08-2013 . / Prestataire avec ou sans convention Supplement patiënt Gew.03 170. met overeenkomst .22 45.44 170.Veiligheidsgrens : 227.74 € is van toepassing op het geheel van de wervelkolomimplantaten. met overeenkomst .03 170. recht.52 01-02-2011 157015000037 Biomet Omega Coaxial connector 1284-12 255.42 94.22 30.78 25.44 170.Prijs (incl.Plafondprijs : 272.00 227. pour l'ensemble des composants Longitudinale verbinding voor staven. met of zonder overeenkomst C = Supplément patient Bén.Supplement patiënt W.9xx / 254.78 170.52 01-02-2011 157015000055 Cormed Ascent longitudinal connector 65./Prestataire conventionné . / Prestataire avec ou sans convention Terugbetaling Gew.P.00 227.42 84.42 90. BTW) B = Remboursement Bén.5mm to 6. / Verstr.83 25.83 25.22 33.81 170. zonder overeenkomst E = Supplément patient Bén.I.10 01-02-2011 157015000021 Biomet Altius Rod connector 1200-002x / 1200-122x 255.78 170.86x 265.I.58 26.G.66 227.42 87.22 37.G.22 30.42 84.83 25. / Verstr.I.25 227.25 227. met of zonder overeenkomst D = Remboursement Bén. ordin.25 227.I. / Verstr.52 01-02-2011 157015000046 Biomet Omega Parallel Rod connector 1284-14 255. ordin.98 170.20 227.78 25.24 27.U waarde : U 220 Remboursement .66 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.0xxx 258.42 94.50 01-02-2011 157015000107 Globus Medical Belgium Stainless Steel Connector / SS Rod to Rod Clamp / SS Offset Connector / SS In-line Connector 224.22 28.20 227. / Prestataire non conventionné Supplement patiënt / Verstr. ordin.Bijwerking 01-08-2013 Page 1 (700291-700302) .42 87.98 170.22 € Prix plafond .O. recht.9xx 265. recht.82 01-02-2011 157015000082 Globus Medical Belgium Ellipse Parallel Connector 3.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .42 102.22 37. 3. Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157015000012 B Braun Medical S4C Parallel connector SW110T / SW111T 261.82 01-02-2011 157015000073 Cormed Solas Domino connector SSH00xx 258.61 26. 9xx / 115.96x 272.XC. / Verstr.22 45.26 01-02-2011 157015000091 Globus Medical Belgium Parallel Connector/ Rod to Rod Clamp / Offset Connector / In-line Connector 124.22 28.5mm Rod 182. / Prestataire non conventionné Terugbetaling Gew.5mm to 3.P.O. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700291-700302 Connexion longitudinale pour tiges.03 227.42 84.5mm Rod.58 26.Terugbetaling : Marge de sécurité .24 27.66 227. ordin.26 01-02-2011 157015000064 Cormed Fixspine connector FH.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.42 102.W. voor het geheel van de samenstellende elementen Valeur de U .6425 272.W.Supplément patient V.

26 01-02-2011 157015000204 Johnson & Johnson MedicalDepuy Monarch Connector 1770 92 0xx 272.26 01-02-2011 157015000213 Johnson & Johnson MedicalDepuy Mountaineer Axial Connector 1883 11 xxx 272.Ø5.24 27.24 27.26 01-02-2011 157015000362 Medtronic CONNECTOR ROD CONN 3.44 170.24 27.24 27.00 227.58 26.5 86354xx 272.42 102.83 25.38 24.26 01-02-2011 157015000353 Medtronic CONNECTOR RD CNECTR 3.42 102.66 227.44 170.80 227.26 01-02-2011 157015000301 Medtronic CONNECTOR 4.20 01-02-2011 157015000152 Johnson & Johnson MedicalDepuy Expedium 4.25 227.24 27.03 170.66 227.44 170.26 01-02-2011 Mise à jour 01-08-2013 .22 45.66 227.22 45.26 01-02-2011 157015000231 Johnson & Johnson MedicalDepuy VSP Connector SS 5000xx(x)(x) / 2030xx(x) 255.44 170.24 27.22 45.66 227.78 170.44 170.44 170.22 37.42 73.24 27.42 102.26 01-02-2011 157015000335 Medtronic Connector Domino xx X xxmm X39904xx 272.42 102.44 170.42 101.00 227.42 102.5 end to end connector 1861 72 255 265.42 94.24 27.66 227.44 170.44 170.42 102.24 27.66 227.22 44.66 227.58 26.44 170.24 27.52 01-02-2011 157015000247 Johnson & Johnson MedicalDepuy VSP Connector Ti 2230 3x 255.26 01-02-2011 157015000265 Medtronic CD Pediatric Domino xxmm X386040x 272.78 170.25 227.66 227.26 01-02-2011 157015000326 Medtronic CONNECTOR DOMINO DIA xx xx 965xxXX 272.00 227.42 73.22 45.42 102.58 170.42 84.78 170.22 37.42 102.58 27.78 170.50 01-02-2011 157015000161 Johnson & Johnson MedicalDepuy Expedium 4.26 01-02-2011 157015000222 Johnson & Johnson MedicalDepuy Summit Dual Connector 1746 66 0xx / 1746 67 0xx 272.5MM AXIAL ROD CONNECTOR 630xx 243.22 16.42 102.44 170.6-5.00 227.66 227.22 45.22 45.22 45.22 28.22 45.44 170.44 170.26 01-02-2011 157015000344 Medtronic CONNECTOR DOMINO xxMM 811-xxx 272.24 27.42 84.22 16.66 227.44 170.44 170.44 170.5TI X353043655 272.24 27.38 24.5x5.42 94.26 01-02-2011 157015000292 Medtronic Colorado2 Ti.26 01-02-2011 157015000274 Medtronic CD Pediatrisch M7 Inox Domino X 9164x00 272.4MM X110020 272.42 102.78 170.42 94.58 170.24 27.22 45.42 102.66 227.22 45.26 01-02-2011 157015000371 Medtronic CONNECTOR ROD CONN 3.00 227.50 01-02-2011 157015000195 Johnson & Johnson MedicalDepuy Expedium Connector 1774 92 020 / 1774 92 060 / 1797 66 xxx / 1797 77 xxx 272.24 27.80 227.42 102.22 45.58 27.3MM .2 TO 4.78 170.66 227.22 44.03 170.22 45.24 27.24 27.26 01-02-2011 157015000283 Medtronic Colorado2 Inox domino X 86154xx 272.38 01-02-2011 157015000125 Hospithera Alphatec Ø3.50 01-02-2011 157015000177 Johnson & Johnson MedicalDepuy Expedium 4.26 01-02-2011 157015000317 Medtronic CONNECTOR CDH DOMINO 845xxXX 272.42 101.42 102.22 37.66 227.42 102.5 open closed connector + innie 1861 72 3xx + 1861 00 007 265.22 37.Bijwerking 01-08-2013 Page 2 (700291-700302) .24 27.5 extended tandem connector 1861 72 6xx 265.58 26.22 45.5 TI 6902220 272.22 45.58 26.5 side by side connector 1861 73 9xx 265.42 102.20 01-02-2011 157015000143 ISKRA Domino Droit 3K + 4 vis de blocage moyennes 3KDD104-A + 3KDCV602 272.50 01-02-2011 157015000186 Johnson & Johnson MedicalDepuy Expedium 4.66 227.66 227.66 227. clamp 5.22 45.22 45.83 25.2 TO 5.00 227.42 102.44 170.22 28.42 102.66 227.5 TI 6902200 272.22 45.157015000116 Hospithera Alphatec DOMINO 620xx 243.42 94.52 01-02-2011 157015000256 MEDIANN SCS Domino 2T30-XXxx 272.38 01-02-2011 157015000134 ISKRA Domino Carré 3K + 4 vis de blocage moyennes 3KDC103-A + 3KDCV602 272.

26 01-02-2011 157015000581 SHARK MEDICAL Domino Carré 3K + 4 vis de blocage moyennes 3KDC103-A + 3KDCV602 272.00 170.58 27.22 45.Rod Connector 5 / 6 mm 22601-41 272.20 01-02-2011 157015000466 Ortho Team WSI .42 87.22 45.26 01-02-2011 157015000396 Medtronic CONNECTOR xx .19 227.22 227.78 170.26 01-02-2011 157015000633 STRYKER ROD TO ROD CONNECTOR 038201xx 232.5 3.157015000387 Medtronic CONNECTOR VER DOM TI 3.22 0.53 170.24 27.26 01-02-2011 157015000475 Orthogèse BJR Cylindre de connexion tige Ø 5.42 102.42 102.77 25.44 170.24 27.42 102.44 170.24 27.66 227.xx LPC PLATE ASSY X14604xxx 272.22 45.44 170.22 30.24 27.66 227.72 01-02-2011 157015000536 SDI Belgium Connecteur double pour tiges 6 mm Ti U1-L301T 227.26 01-02-2011 157015000441 NEW2DM Domino Carré 3K + 4 vis de blocage moyennes 3KDC103-A + 3KDCV602 272.42 102.58 27.42 102.00 227.22 0.72 01-02-2011 157015000527 SDI Belgium Connecteur double pour tiges 6 mm U1-L301 227.33 23.22 45.24 27.42 101.42 89.Bijwerking 01-08-2013 Page 3 31-03-2011 (700291-700302) .201 272.72 01-02-2011 157015000545 SDI Belgium Petit connecteur double ouvert pour tiges 6 mm X2 (lot) U1-L310 272.22 5.80 22.58 27.44 170.22 0.66 227.27 01-02-2011 157015000642 STRYKER ROD-ROD CONNECTOR 4855108x /48551090 259.81 01-02-2011 157015000624 STRYKER AXIAL/DUAL CONNECTOR 48220102 / 48220103 272.24 27.00 170.72 01-02-2011 157015000511 SDI Belgium Connecteur axial pour tiges 6 mm Ti U1-L302T 227.97 170.44 170.22 44.22 32.24 27.44 170.66 227.42 102.26 01-02-2011 157015000432 Medtronic ROD SINGLE DOMINO 3.00 227.24 27.81 01-02-2011 157015000615 STRYKER ATLRODTORODCLAMPPARALLEL 03805001 258.28 25.42 87.22 45.42 56.22 0.58 27.42 101.78 170.22 45.66 227.42 102.42 102.44 170.26 01-02-2011 157015000554 SDI Belgium Petit connecteur double ouvert pour tiges 6 mm X2 (lot) Ti U1-L310T 272.00 170.00 227.66 227.22 44.78 170.80 22.26 01-02-2011 157015000414 Medtronic IN LINE CONNECTOR L=XX(X) TI Y84403Hxx(x)T / Y84404Hxx(x)T 272.66 227.44 170.000xx 272.48 170.97 01-02-2011 Mise à jour 01-08-2013 .80 22.5 X38103535 272.44 170.42 62.20 01-02-2011 157015000457 NEW2DM Domino Droit 3K + 4 vis de blocage moyennes 3KDD104-A + 3KDCV602 272.22 45.44 170.000xx 272.22 44.22 45.97 170.22 227.26 01-02-2011 157015000563 SDI Belgium Petit connecteur double pour tiges 6 mm x 2 (lot) U1-L303T 272.66 227.2 4PLG X09804232 272.44 170.22 45.24 27.42 102.24 27.22 45.20 01-02-2011 157015000597 SHARK MEDICAL Domino Droit 3K + 4 vis de blocage moyennes 3KDD104-A + 3KDCV602 272.44 170.42 102.22 45.24 27.26 01-02-2011 157015000405 Medtronic IN LINE CONNECTOR L=XX(X) SS Y84403Hxx(x) / Y84404Hxx(x) 272.42 102.26 01-02-2011 157015000484 Orthogèse BJR Domino de connexion tige Ø 5.00 227.44 170.00 170.66 227.70 227.66 227.66 227.44 170.66 227.22 45.5-XX(X)MM X84405Hxx(x)T 272.24 27.5 et Ø 7 ATR4700.42 56.22 45.24 27.22 30.22 45.66 227.26 01-02-2011 157015000493 Orthogèse Domino 120.26 01-02-2011 157015000502 SDI Belgium Connecteur axial pour tiges 6 mm U1-L302 227.66 227.26 01-02-2011 157015000572 SDI Belgium Petit connecteur double pour tiges x 2 (lot) U1-L303 272.75 227.22 227.22 44.5 et Ø 7 ATR4703.20 01-02-2011 157015000606 STRYKER ATLRODTORODCLAMPAXIAL 03805002 258.19 227.78 170.24 27.42 102.22 45.42 102.42 102.44 170.77 25.42 101.22 227.42 56.24 27.42 102.26 01-02-2011 157015000423 Medtronic LEG CONN-INLINE-TI-5.66 227.42 56.80 22.42 101.

00 0.00 0.00 86.66 227.71 01-02-2011 157015000782 Zimmer butterfly connector ST360 7300-0104-00 108.88 227.42 87.44 170.00 8.24 27.77 25.22 37.26 01-02-2011 157015000703 STRYKER XIA III CONNECTOR 48235xxx 272.00 150.44 170.42 102.Bijwerking 01-08-2013 Page 4 31-08-2012 31-08-2012 (700291-700302) .959 / 498.24 27.44 170.42 93.19 86.42 102.960 264.66 227.44 170.00 86.00 108.44 170.42 102.61 01-02-2011 157015000807 Zimmer Java domino 5.00 150.633.19 0.00 0.19 227.77 25.24 27.22 45.1xx 272.42 102.015S 272.632.42 102.42 102.935 / 498.19 86.44 170.44 170.22 45.26 01-02-2011 157015000895 Johnson & Johnson MedicalDepuy Top Notch Connector Ti/SS + set screw 272.19 0.42 102.22 45.66 227.22 39.00 8.24 27.66 227.00 01-02-2011 157015000825 Zimmer Nexlink 4.44 170.19 86.19 0.00 8.24 27.26 01-02-2011 157015000861 Synthes Snap-On parallel connector 04.44 170.22 45.42 102.80 01-02-2011 157015000791 Zimmer Butterfly/domino connector Optima + Set Screw Connector M7X1.44 170.26 01-02-2011 157015000877 SHARK MEDICAL Connecteur ES 025 T 272.66 227.44 170.06 170.66 227.97 170.66 227.28 227.26 01-07-2011 157015000904 Johnson & Johnson MedicalDepuy Variable Offset Connector Ti/SS 179x71555 / 179x71655 + 179x02000.24 27.26 01-07-2011 Mise à jour 01-08-2013 .81 01-02-2011 157015000676 STRYKER XIA 4.00 0.66 227.66 227.24 27.22 45.44 170.12 227.00 15.22 30.00 01-02-2011 157015000834 Zimmer Optima axial connector + set screw connector M7X1.00 108.364 272.19 0.42 102.42 102.19 227.92x(S) 272.5 SN2030-0-5100x 86.22 45.0mm In line rod connector 726-40xx 150.46 26.0mm band rod connector 725-40xx 150.26 01-02-2011 157015000712 STRYKER XIA III CONNECTOR + 2 BLOCKERS 0382013x + 03756230 272.26 01-02-2011 157015000764 Synthes Parallel connector SYNAPSE 498.24 27.66 227.81 01-02-2011 157015000667 STRYKER SM/LG R-R CONNECTOR XIA TIT + BLOCKERS (2x) 0382013x + 03756230 / 48230000 258.66 227.40x(S) / 04.24 27.26 01-02-2011 157015000773 MSH tangoRS clamp for rod-rod connector (2x) CS 3006-01 267.CONNECTOR + BLOCKERS (2x) 48135103 / 48135104 + 48130000 272.42 01-02-2011 157015000755 Synthes Parallel connector 498.44 170.86 26.5 CONN 4813500x 272.24 27.42 92.24 27.00 150.26 01-02-2011 157015000852 MSH Tango RS rod-rod-connector CS 3006 272.26 01-02-2011 157015000746 Synthes Parallel connector 498.00 15.24 27.24 27.26 01-02-2011 157015000886 LDR MEDICAL Connecteur ES 025 T 272.61 01-02-2011 157015000843 Cormed PASS LP domino connector MS025 / MS026 272.66 227.22 45.26 01-02-2011 157015000737 Synthes Extensie connector 498.44 170.42 96.22 45.44 170.66 170.00 0.66 227.157015000651 STRYKER SM/LG R-R CONNECTOR XIA SS + BLOCKERS (2x) 4822013x + 4822000 258.26 01-02-2011 157015000721 STRYKER XIA4.24 27.42 102.66 227.42 102.61 01-02-2011 157015000816 Zimmer Nexlink 4.97 170.19 0.0 SH003x + SH0060 86.90 170.19 0.22 45.42 102.00 150.22 45.70 26.0 SH00x0 + SH0060 86.5: EXT.22 45.22 30.22 45.22 45.66 227.00 0.26 01-02-2011 157015000685 STRYKER XIA CONNECTOR 48135000/48135001 262.42 102.42 102.22 45.00 86.22 35.42 87.24 27.00 10.28 01-02-2011 157015000694 STRYKER XIA CONNECTOR 48230141 272.22 45. 18xx71555 / 18xx71655 + 188102000 / 189602000 18xx74555 / 179x74555 272.

44 170.24 27.22 45.44 170.80 22.44 170.42 102.66 227.26 01-03-2012 157015001026 Medtronic Connector lat conn TI + set screw Ti standard 7042xx0 + 779170005 272.44 170.42 101.42 102.42 56.42 56.24 27.22 45.80 22.22 45.24 27.26 01-07-2011 157015000965 Medtronic Connector TI DOM CL + set screw TI standard (x2) 77812xxx5 / 77912xxx5 + 779170005 272.22 45.66 227.26 01-03-2012 157015001035 Medtronic Connector lat conn SS + set screw SS standard 7022xx0 + 778270001 272.42 15.26 01-09-2012 157015001114 Hospithera tangoRS clamp for rod-rod connector (2x) CS 3006-01 267.24 27.79 01-06-2013 157015001132 Spinaxis E.66 227.42 97.44 170.22 227.44 170.22 0.66 227.26 01-03-2012 157015000992 Medtronic Connector SS SDLD + set screw SS standard (x2) 77824xxx5 + 778270001 272.22 227.44 170.22 45.24 27.95 227.22 5.24 27.66 227.42 102.42 61.90 170.00 170.66 227.Spine – Connecteur droit / Connecteur Domino (vis de blocage inclus) A2515021 / A25150xx 272.157015000913 Johnson & Johnson MedicalDepuy Wedding Band Connector 188165255 272.42 102.66 227.42 102.24 27.66 227.53 26.42 102.44 170.26 01-06-2013 157015001141 SpineConcept Domino 3K+ 4 vis de blocage 3KDx10x-A+ 3KDCV602 272.22 45.11 170.26 01-07-2011 157015000956 Johnson & Johnson MedicalDepuy Expedium Connector Open/Open Side Extended Tab Ti/SS 179x717x5 / 1881717x5 / 1896717x5 272.66 227.22 39.24 27.22 45.22 44.Bijwerking 01-08-2013 Page 5 (700291-700302) .24 27.00 170.23 01-07-2012 157015001053 Biomet Polaris Parallel Ti Wedding Band Domino 14-5008xx 185.42 102.00 170.70 26.42 102.26 01-07-2011 157015000922 Johnson & Johnson MedicalDepuy End-to-end Connector 188165355 272.72 01-11-2012 157015001096 Cormed GSS domino rod connector open + GSS set screw 1370-6060 + GS0104-0010 227.78 170.22 45.24 27.44 170.39 227.22 45.22 45.22 5.42 56.08 18.58 27.71 01-09-2012 157015001123 Biomet Lineum Connector 14-5240xx 267.42 102.50 0.22 45.26 01-03-2012 157015000983 Medtronic Connector TI SDLD + set screw TI standard (x2) 77814xxx5 / 77914xxx5 + 779170005 272.26 01-03-2012 157015001017 Medtronic Connector SS AXL CL + set screw SS standard + set screw break off 77821xxx5 + 778270001 + 7x60020 272.12 227.44 170.17 170.42 102.26 01-03-2012 157015001001 Medtronic Connector TI AXL CL + set screw TI standard + set screw break off 77811xxx5 / 77911xxx5 + 779170005 + 7x40020 272.22 45.22 40.44 170.22 227.66 227.42 102.24 27.42 102.91 23.26 01-07-2011 157015000947 Johnson & Johnson MedicalDepuy Expedium Dual Rod Connector 179x7x555 / 179x7x655 / 18817xx55 / 189670x55 / 189673555 18815xx55 / 18816xx55 272.73 170.24 27.66 227.24 27.44 170.26 01-03-2012 157015000974 Medtronic Connector SS DOM CL + set screw SS standard (x2) 77822xxx5 + 778270001 272.33 227.66 227.23 01-07-2012 157015001071 Cormed GSS axial rod connector 11 mm+ GSS set screw GS0190-6060 + GS0104-0010 227.66 227.24 27.42 102.22 45.44 170.44 170.26 01-07-2011 157015000931 Johnson & Johnson MedicalDepuy Expedium Connector Open/Closed Ti/SS 272.42 102.24 27.22 45.72 01-11-2012 157015001105 Hospithera Tango RS rod-rod-connector CS 3006 272.55 01-07-2012 157015001062 Biomet Polaris Axial Ti Domino 14-5007xx 232.42 102.20 01-08-2013 Mise à jour 01-08-2013 .72 01-11-2012 157015001087 Cormed GSS domino rod connector 21 mm + GSS set screw GS0195-6060 + GS0104-0010 227.22 45.00 170.50 185.66 227.00 227.42 61.80 22.22 0.26 01-03-2012 157015001044 Biomet Polaris Parallel Ti Domino 14-5008xx 232.44 170.42 96.97 23.66 227.22 0.

recht.xxXxx / ATR43PD.032.xxX0x/ATR4700.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .83 1032. met of zonder overeenkomst C = Supplément patient Bén.ISx55 + ATR480D.5 (x2) + BJR Vis à dôme mono-axiale (x2) 1239.ISx55 + ATR480D. / Prestataire non conventionné Terugbetaling Gew. / Prestataire avec ou sans convention Supplement patiënt Gew.00000 + ATR4700.Veiligheidsgrens : 1. / Verstr. / Verstr. recht.61 122.O.P.Remboursement V.Plafondprijs : 1.86 01-02-2011 157016000041 Orthogèse Crochet isthmique (x2) + BJR Ecrou (x2) + BJR Connecteur universel et long Ø 5.xxX0 X + MUN43PD.5 MM interventional spine BONE-LOCK Perpos PLS IMPLANT LSW-45-3040 1223.Supplément patient V.xxXxx / ATR43AD.76 123. / Prestataire non conventionné Supplement patiënt / Verstr. recht. verankerd via 2 haken/schroeven op dezelfde wervel.63 258.00 32.93 01-02-2011 157016000057 Orthogèse Crochet isthmique (x2) + BJR Ecrou (x2) + BJR Connecteur universel et long Ø 5.93 01-02-2011 157016000032 MEDIANN TWINFLEX I Crochet pour lyse isthmique + connecteur + vis 1040-CL40 + 1020-CF25 + 1010-Xxxx 328.W.Terugbetaling W.39 1032.83 206.39 1032. Prix plafond .56 774. BTW) B = Remboursement Bén.390 + 295.xxXxx LYS4403. bedoeld voor de correctie van een spondylolyse Valeur de U .U waarde : U 1000 Remboursement .O.74 € is van toepassing op het geheel van de wervelkolomimplantaten.28 01-02-2011 Mise à jour 01-08-2013 . zonder overeenkomst E = Supplément patient Bén.56 774. / Verstr. met overeenkomst .00 0.W.A = Prix (TVAc) .Terugbetaling : Marge de sécurité .56 774. ordin.60 328.83 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.39 1032.5 (x2) + BJR Vis à dôme spondylo (x2) 1239. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700313-700324 Total des éléments d'un implant. / Verstr. / Verstr.20 103.63 464. met overeenkomst .G.Bijwerking 01-08-2013 0.2x0 + 295.239.P.00000 + ATR4700.60 0.83 190. / Prestataire avec ou sans convention Terugbetaling Gew.63 464.Prijs (incl./Prestataire conventionné . / Prestataire conventionné .De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.60 328.41 774.32 01-02-2011 157016000023 MEDIANN DOS Omega blade transversal + DOS Omega Vis pédiculaire (x2) + DOS Omega Crochet (x2) + locking nut KT40-OMxx + KT10-Xxxx + KT20-CDxX + KT00-EF50 1239.xxXxx / LYS43SD.83 206.G. fixé par 2 crochets/vis sur la même vertèbre. ordin.00000 + ATR4700.00 Page 1 31-10-2012 (700313-700324) .xxXxx 219.93 01-02-2011 157016000066 Orthogèse Crochet isthmique (x2) + BJR Ecrou (x2) + BJR Connecteur universel et long Ø 5. met of zonder overeenkomst D = Remboursement Bén.63 464.4x0 1032.24 1032.xxX0x/ATR4700.ISx55 + ATR480D.76 123. ordin. dans le but de corriger une spondylolyse Totaal van de elementen van een implantaat.63 464. ordin.39 € Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157016000014 Hospithera 4.I.83 206.I.380 + 295.xxX0x/ATR4700.xxX0 X + TRO43SD.39 1032.76 123.63 448.I.Supplement patiënt W.5 (x2) + BJR Vis à dôme poly-axiale (x2) 1239.83 206.I.83 774.93 01-02-2011 157016000075 Synthes Spondylose schroef + compressie veer + moer (2x) + spondylose haak (2x) LYS4403.xxXxx LYS4403.56 774.76 123.xxX0 X + MUN43AD.

93 01-07-2011 1239.Bijwerking 01-08-2013 LYS4403.00000 + ATR430U.56 774.63 464.157016000084 Orthogèse Crochet isthmique (x2) + BJR Ecrou (x2) + BJR Vis en U polyaxiale (x2) 157016000093 Johnson & Johnson MedicalDepuy Cannulated.76 123.ISx55 + ATR480U.39 1032.xxxxx 1757105xx(S) / 1757106xx(S) 1239.63 464.93 01-03-2012 Page 2 (700313-700324) . non-coated facet screw (2x) Mise à jour 01-08-2013 .39 1032.83 206.56 774.83 206.76 123.

ordin.W.0xx + TSC 10.Veiligheidsgrens : 278. BTW) B = Remboursement Bén.I.14 209.W.46 01-02-2011 157017000034 Cormed Evos posterior plate 42. / Verstr.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale . met overeenkomst .Supplement patiënt W. recht.46 01-02-2011 157017000077 Johnson & Johnson MedicalDepuy Expedium Offset Nested Plate SS 1854 65 xxx 334.P.46 01-02-2011 157017000061 Cormed Trinity TI plate TIP 0x.46 01-02-2011 157017000043 Cormed PASS LP Plaat B022700xx 334.O.46 01-02-2011 157017000052 Cormed Trinity Sliding Plate + sliding connector TSP 10.71 30. / Verstr.77 209.77 209. / Prestataire non conventionné Terugbetaling Gew.86 55.Plafondprijs : 334.15 100.48 33.77 209.15 125.77 209.48 33.14 209.Remboursement V.00 278. zonder overeenkomst E = Supplément patient Bén. / Prestataire conventionné .86 55.63 278.86 55.63 278.40 01-02-2011 Mise à jour 01-08-2013 .98 01-02-2011 157017000025 Cormed Evos osta pek plate 43.15 125.86 55.Supplément patient V.U waarde : U 270 Remboursement .48 33.63 278.xxx 334. / Verstr. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700335-700346 Plaque pour fixation postérieure à la colonne vertébrale par vis Plaat voor posterieure fixatie aan de wervelkolom. / Prestataire non conventionné Supplement patiënt / Verstr.85 33.00 209.00x 334.A = Prix (TVAc) .I. ordin. Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157017000016 Biomet Omega Plate 1282-9x 309. met of zonder overeenkomst D = Remboursement Bén.77 209.15 124.15 124. recht./Prestataire conventionné .86 278.xxx 334. ordin.40 01-02-2011 157017000086 Johnson & Johnson MedicalDepuy Expedium Offset Nested Plate Titanium 1754 65 xxx 334.48 33.G. met overeenkomst .Bijwerking 01-08-2013 Page 1 (700335-700346) .Prijs (incl.63 278.86 55.Terugbetaling : Marge de sécurité . met of zonder overeenkomst C = Supplément patient Bén.14 209. te verankeren via schroeven Valeur de U .I.86 55. / Prestataire avec ou sans convention Terugbetaling Gew.P.40 01-02-2011 157017000104 Johnson & Johnson MedicalDepuy Expedium Offset Smooth Plate Titanium 1754 60 xxx 334. / Prestataire avec ou sans convention Supplement patiënt Gew.O.15 125.G.48 33.85 33.xxx 334.15 124.63 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.Terugbetaling W.15 124.86 31.00 278.86 € Prix plafond .85 33.00 278. / Verstr.85 33. / Verstr.86 55.00 278.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.63 278.15 125. recht.86 55.86 55.40 01-02-2011 157017000095 Johnson & Johnson MedicalDepuy Expedium Offset Smooth Plate SS 1854 60 xxx 334.15 125. ordin.14 209.I.74 € is van toepassing op het geheel van de wervelkolomimplantaten.

04 278.04 278.77 209.10 01-02-2011 157017000131 Johnson & Johnson MedicalDepuy Monarch Thin Plate 1725 00 10x 331.15 97.46 01-09-2012 157017000366 Aceemed MPM modulaire dynamische plaat + MPM modulaire rigide plaat THAM 2P(R)M + THPMRx(X)(X) 334.77 209.63 01-02-2011 157017000165 Medtronic Centerpiece Plate 853xxxXX / 853-xxx / 8530000 334.86 30.84 278.86 52.04 209.48 33.77 209.98 209.14 209.77 209.48 33.18 209.63 278.90 278.46 01-09-2012 Mise à jour 01-08-2013 .15 125.39 01-03-2012 157017000314 Johnson & Johnson MedicalDepuy Mountaineer Inline plate 18837040x / 18837041x 333.15 124.04 209.15 100.04 209.48 33.15 125.77 209.89 33.46 01-09-2012 157017000375 Aceemed MPM modulaire dynamische plaat + MPM modulaire dynamische plaat + MPM modulaire rigide plaat THAM 2P(R)M + THAM 2P(R)M + THPMRx(X)(X) 55.86 55.69 30.48 33.46 01-09-2012 157017000341 Aceemed MPM modulaire dynamische plaat + MPM modulaire dynamische plaat THAM 2P(R)M + THAM 2P(R)M 334.75 33.86 30.86 55.15 125.48 33.10 01-02-2011 157017000122 Johnson & Johnson MedicalDepuy Monarch Plate 1770 60 0xx 331.86 55.98 01-02-2011 157017000271 STRYKER TWO LEVEL PLATE 48551020 318.80 01-02-2011 157017000235 STRYKER PLATE LONG 46-58 MM 48204658 309.85 31.157017000113 Johnson & Johnson MedicalDepuy Monarch Nest Plate 1770 65 0xx 331.77 209.45 209.63 278.63 278.39 01-03-2012 157017000323 Aceemed MPM modulaire dynamische plaat THAM 2P(R)M 334.14 209.63 278.46 01-02-2011 157017000183 Medtronic X'NGAGE PLATE PRE BENT XX MM X2820xxx 334.15 124.69 30.86 30.69 30.86 55.69 30.98 209.84 278.63 278.46 01-02-2011 157017000174 Medtronic Holyplate XXmm XA600909-xx 334.86 55.89 33.31 278.77 209.89 33.63 01-02-2011 157017000156 Johnson & Johnson MedicalDepuy VSP Plate Ti 2225 x(x)A 306.39 01-03-2012 157017000305 Johnson & Johnson MedicalDepuy Mountaineer Inline sidebyside plate 18837030x / 18837031x 333.48 33.48 33.10 01-02-2011 157017000147 Johnson & Johnson MedicalDepuy VSP Plate SS 2025xx(x) / 2025xxX / 2025xX(X) 306.98 01-02-2011 157017000296 Johnson & Johnson MedicalDepuy Mountaineer Hinge Plate 188370200 333.98 209.86 55.15 108.48 33.77 209.63 278.80 01-02-2011 157017000287 STRYKER XX MM LORDOTIC PLATE 489120xx 309.46 01-09-2012 157017000332 Aceemed MPM modulaire rigide plaat THPMRx(X)(X) 334.15 108.15 100.15 124.86 27.48 33.00 278.69 30.86 55.xxX00 334.15 125.15 125.15 125.86 39.85 31.86 55.15 121.63 278.14 209.16 30.77 209.63 278.80 01-02-2011 157017000226 STRYKER ONE LEVEL PLATE 48551010 318.77 209.84 278.15 97.63 278.77 209.48 33.63 278.15 125.46 01-02-2011 157017000192 Orthogèse BJR Posterior Lumbar plate ATR4203.15 121.46 01-02-2011 157017000217 STRYKER MULTI LEVEL PLATE 48551030 318.45 209.85 31.86 39.15 100.16 30.86 55.86 52.15 125.15 108.46 01-02-2011 157017000201 Orthogèse Plaque ISOLOCK 12ISOxxX 334.84 278.90 278.98 01-02-2011 157017000244 STRYKER PLATE MEDIUM 22-34 MM 48202234 309.31 278.18 209.15 100.00 278.15 125.63 278.98 209.15 121.86 55.00 278.15 100.04 278.15 125.75 33.98 01-02-2011 157017000253 STRYKER PLATE MEDIUM LONG 28-40 MM 48202840 309.90 278.98 01-02-2011 157017000262 STRYKER PLATE SHORT 22 MM 48200022 309.86 27.48 33.86 39.18 209.86 55.98 209.75 33.84 278.86 55.86 30.86 52.86 55.86 30.86 Page 2 31-03-2011 (700335-700346) .46 01-09-2012 157017000357 Aceemed MPM modulaire rigide plaat + MPM modulaire rigide plaat THPMRx(X)(X) + THPMRx(X)(X) 334.Bijwerking 01-08-2013 334.15 125.

15 125.63 278.48 33.63 278.86 55.63 278.46 01-05-2013 157017000542 Eurospine MPM plaque modulaire dynamique + MPM plaque modulaire dynamique THAM 2P(R)M+ THAM 2P(R)M 334.15 125.15 125.63 278.46 01-05-2013 157017000533 Eurospine MPM plaque modulaire rigide THPMRx(X)(X) 334.15 125.77 209.48 33.46 01-09-2012 157017000454 Aceemed MPM modulaire dynamische plaat (4 elementen) THAM 2P(R)M 334.15 125.15 125.77 209.63 278.77 209.77 209.46 01-09-2012 157017000524 Eurospine MPM plaque modulaire dynamique THAM 2P(R)M 334.86 55.46 01-09-2012 157017000515 Aceemed MPM modulaire dynamische plaat (5 elementen) THAM 2P(R)M 334.48 33.86 55.86 55.48 33.46 01-09-2012 334.86 55.63 278.46 01-09-2012 334.15 125.77 209.15 125.63 278.15 125.77 209.15 125.63 278.46 01-09-2012 157017000497 Aceemed MPM modulaire dynamische plaat + MPM modulaire dynamische plaat + MPM modulaire dynamische plaat + MPM modulaire dynamische plaat + MPM modulaire rigide plaat 334.86 THPMRx(X)(X)+ THPMRx(X)(X) 55.48 33.157017000384 Aceemed MPM modulaire dynamische plaat + MPM modulaire rigide plaat + MPM modulaire rigide plaat THAM 2P(R)M + THPMRx(X)(X) + THPMRx(X)(X) THAM 2P(R)M + THAM 2P(R)M + THAM 2P(R)M 334.15 125.77 209.77 209.86 55.63 278.77 209.77 209.86 55.77 209.77 209.15 125.15 125.63 278.86 55.86 55.46 01-09-2012 157017000506 Aceemed MPM modulaire rigide plaat (5 elementen) THAM 2P(R)M+ THAM 2P(R)M + THAM 2P(R)M + THPMRx(X)(X) + THPMRx(X)(X) THAM 2P(R)M + THPMRx(X)(X) + THPMRx(X)(X) + THPMRx(X)(X) + THPMRx(X)(X) THAM 2P(R)M+ THAM 2P(R)M+ THAM 2P(R)M + THAM 2P(R)M + THPMRx(X)(X) THPMRx(X)(X) 334.48 33.46 01-05-2013 157017000585 Eurospine MPM plaque modulaire dynamique + MPM plaque modulaire rigide + MPM plaque modulaire rigide THAM 2P(R)M + 334.63 278.48 33.Bijwerking 01-08-2013 Page 3 (700335-700346) .63 278.15 125.46 01-05-2013 157017000567 Eurospine MPM plaque modulaire dynamique + MPM plaque modulaire rigide THAM 2P(R)M + THPMRx(X)(X) 334.48 33.77 209.48 33.86 55.48 33.77 209.86 55.46 01-09-2012 157017000472 Aceemed MPM modulaire dynamische plaat + MPM modulaire dynamische plaat + MPM modulaire dynamische plaat + MPM modulaire rigide plaat + MPM modulaire rigide plaat 334.48 33.48 33.86 55.48 33.48 33.63 278.63 278.86 55.15 125.63 278.15 125.46 01-09-2012 157017000393 Aceemed MPM modulaire dynamische plaat + MPM modulaire dynamische plaat + MPM modulaire dynamische plaat 334.46 01-05-2013 157017000576 Eurospine MPM plaque modulaire dynamique + MPM plaque modulaire dynamique + MPM plaque modulaire rigide THAM 2P(R)M + THAM 2P(R)M + THPMRx(X)(X) 334.77 209.86 55.86 55.46 01-09-2012 157017000481 Aceemed MPM modulaire dynamische plaat + MPM modulaire rigide plaat + MPM modulaire rigide plaat + MPM modulaire rigide plaat + MPM modulaire rigide plaat 334.15 125.48 33.86 + THPMRx(X)(X) + THPMRx(X)(X)+ THPMRx(X)(X) 55.86 55.77 209.63 278.46 01-09-2012 334.77 209.63 278.48 33.77 209.15 125.15 125.48 33.63 278.77 209.48 33.86 55.48 33.86 55.63 278.15 125.77 209.63 278.46 01-09-2012 MPM modulaire rigide plaat (4 elementen) THPMRx(X)(X) + THPMRx(X)(X) + THPMRx(X)(X) THAM 2P(R)M + THAM 2P(R)M + THPMRx(X)(X) ) + THPMRx(X)(X) THAM 2P(R)M + THPMRx(X)(X) + THPMRx(X)(X) + THPMRx(X)(X) THAM 2P(R)M+ THAM 2P(R)M+ THAM 2P(R)M + THPMRx(X)(X) THPMRx(X)(X) 157017000411 Aceemed MPM modulaire dynamische plaat + MPM modulaire dynamische plaat + MPM modulaire rigide plaat + MPM modulaire rigide plaat 157017000427 Aceemed MPM modulaire dynamische plaat + MPM modulaire rigide plaat + MPM modulaire rigide plaat+ MPM modulaire rigide plaat 157017000436 Aceemed MPM modulaire dynamische plaat +MPM modulaire dynamische plaat + MPM modulaire dynamische plaat + MPM modulaire rigide plaat 157017000445 Aceemed 334.46 01-05-2013 Mise à jour 01-08-2013 .46 01-09-2012 157017000402 Aceemed MPM modulaire rigide plaat + MPM modulaire rigide plaat + MPM modulaire rigide plaat 334.15 125.86 55.63 278.46 01-09-2012 157017000463 Aceemed MPM modulaire dynamische plaat + MPM modulaire dynamische plaat + MPM modulaire rigide plaat + MPM modulaire rigide plaat + MPM modulaire rigide plaat THAM 2P(R)M+ THAM 2P(R)M 334.77 209.46 01-05-2013 157017000551 Eurospine MPM plaque modulaire rigide + MPM plaque modulaire rigide THPMRx(X)(X) + THPMRx(X)(X) 334.48 33.48 33.

46 01-05-2013 157017000646 Eurospine MPM plaque modulaire rigide (4 éléments) THPMRx(X)(X) + THPMRx(X)(X) + THPMRx(X)(X) THAM 2P(R)M+ THAM 2P(R)M + THPMRx(X)(X) + THPMRx(X)(X) THAM 2P(R)M + THPMRx(X)(X) + THPMRx(X)(X) + THPMRx(X)(X) THAM 2P(R)M + THAM 2P(R)M + THAM 2P(R)M + THPMRx(X)(X) THPMRx(X)(X) 334.15 125.15 125.86 55.77 209.77 209.15 125.48 33.15 125.86 55.15 125.46 01-05-2013 157017000707 Eurospine MPM plaque modulaire rigide (5 éléments) THAM 2P(R)M + THAM 2P(R)M + THAM 2P(R)M + THPMRx(X)(X) + THPMRx(X)(X) THAM 2P(R)M + THPMRx(X)(X) + THPMRx(X)(X) + THPMRx(X)(X) + THPMRx(X)(X) THAM 2P(R)M + THAM 2P(R)M+ THAM 2P(R)M + THAM 2P(R)M + THPMRx(X)(X) THPMRx(X)(X) 334.15 125.63 278.77 209.63 278.15 125.48 33.77 209.48 33.77 209.86 55.63 278.86 55.63 278.77 209.63 278.48 33.63 278.46 01-05-2013 157017000673 Eurospine MPM plaque modulaire dynamique + MPM plaque modulaire dynamique +MPM plaque modulaire dynamique + MPM plaque modulaire rigide + MPM plaque modulaire rigide 334.48 33.77 209.48 33.48 33.77 209.46 01-05-2013 157017000637 Eurospine MPM plaque modulaire dynamique + MPM plaque modulaire dynamique + MPM plaque modulaire dynamique + MPM plaque modulaire rigide 334.86 55.63 278.157017000594 Eurospine MPM plaque modulaire dynamique + MPM plaque modulaire dynamique + MPM plaque modulaire dynamique THAM 2P(R)M + THAM 2P(R)M + THAM 2P(R)M 334.77 209.77 209.Bijwerking 01-08-2013 Page 4 (700335-700346) .63 278.46 01-05-2013 157017000603 Eurospine MPM plaque modulaire rigide + MPM plaque modulaire rigide + MPM plaque modulaire rigide 334.77 209.46 01-05-2013 157017000664 Eurospine MPM plaque modulaire dynamique + MPM plaque modulaire dynamique + MPM plaque modulaire rigide + MPM plaque modulaire rigide + MPM plaque modulaire rigide THAM 2P(R)M + THAM 334.63 278.77 209.48 33.46 01-05-2013 157017000682 Eurospine MPM plaque modulaire dynamique + MPM plaque modulaire rigide + MPM plaque modulaire rigide + MPM plaque modulaire rigide + MPM plaque modulaire rigide 334.86 55.86 55.15 125.15 125.63 278.46 01-05-2013 157017000612 Eurospine MPM plaque modulaire dynamique + MPM plaque modulaire dynamique + MPM plaque modulaire rigide + MPM plaque modulaire rigide 334.48 33.63 278.48 33.15 125.15 125.86 55.63 278.86 55.86 55.86 55.77 209.46 01-05-2013 157017000716 Eurospine MPM plaque modulaire dynamique (5 éléments) THAM 2P(R)M 334.15 125.48 33.86 2P(R)M + THPMRx(X)(X) + THPMRx(X)(X)+ THPMRx(X)(X) 55.48 33.46 01-05-2013 157017000691 Eurospine MPM plaque modulaire dynamique + MPM plaque modulaire dynamique + MPM plaque modulaire dynamique + MPM plaque modulaire dynamique + MPM plaque modulaire rigide 334.15 125.86 55.46 01-05-2013 157017000621 Eurospine MPM plaque modulaire dynamique + MPM plaque modulaire rigide + MPM plaque modulaire rigide + MPM plaque modulaire rigide 334.46 01-05-2013 Mise à jour 01-08-2013 .46 01-05-2013 157017000655 Eurospine MPM plaque modulaire dynamique (4 éléments) THAM 2P(R)M 334.63 278.48 33.

22 01-02-2011 157018000106 Johnson & Johnson MedicalDepuy Expedium Offset Closed Iliac Bolt Bolt SS 1854 26 xxx 322. / Verstr. / Prestataire non conventionné Terugbetaling Gew. Prix plafond .40 108.I.86 268.G.Supplément patient V.Terugbetaling W.W.83 32. ordin.40 120. / Verstr. BTW) B = Remboursement Bén.60 32.86 268.40 108.47 201.I. / Prestataire non conventionné Supplement patiënt / Verstr.53 53.98 01-02-2011 157018000045 Biomet Omega LP Spondylolisthese schroef 139x-xx 309.83 32.I.U waarde : U 260 Remboursement .46 30. / Prestataire conventionné .W. met of zonder overeenkomst D = Remboursement Bén.Prijs (incl.xx + TIN 010. met overeenkomst .Terugbetaling : Marge de sécurité .40 108.70 201.O.33 201. zonder overeenkomst E = Supplément patient Bén. / Verstr.Veiligheidsgrens : 268.53 41. y compris toutes les pièces de fixation et d'attache Schroef voor verankering aan de wervelkolom van een posterieure plaat.46 30.98 01-02-2011 157018000072 Biomet Omega Spondylolisthese schroef 1287-xx 309. / Prestataire avec ou sans convention Terugbetaling Gew.53 41.33 201.A = Prix (TVAc) .40 120.xxx(NC) + 036.33 201. met of zonder overeenkomst C = Supplément patient Bén.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .93 0.86 268.98 01-02-2011 157018000054 Biomet Omega Sacrum schroef 1226-xx 154. ordin.53 53.46 30.Plafondprijs : 322.Supplement patiënt W.53 41.P.23 268.40 108.013 322.98 01-02-2011 157018000081 Cormed Evos screw 32.53 41.46 30.98 01-02-2011 157018000036 Biomet Omega LP pedikelschroef 129x-xx / SC1205-xx / SC1206xx / SC1207-xx / SFC1305-xx / SFC1306-xx / SFC1307-xx 309./Prestataire conventionné . / Verstr. ordin.46 30.07 322.40 108.23 € Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157018000011 Biomet Omega expansive schroef 1288-xx / 1291-35 309.P.98 01-02-2011 157018000027 Biomet Omega LP expansive schroef 125x-xx 309.49 01-02-2011 157018000063 Biomet Omega Selftapping schroef 127x-xx / 128x-xx 309.33 201.I.53 53.00 154.00 15.53 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700350-700361 Vis d'ancrage à la colonne vertébrale d'une plaque postérieure. recht. ordin.46 30.74 € is van toepassing op het geheel van de wervelkolomimplantaten. met overeenkomst . / Prestataire avec ou sans convention Supplement patiënt Gew.O.53 41. / Verstr.33 201. recht. inclusief alle toebehoren voor fixatie en blokkering Valeur de U .40 120.33 201. recht.G.40 108.22 01-02-2011 157018000097 Cormed Trinity screw + nut TIS xxx.20 01-02-2011 Mise à jour 01-08-2013 .De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.86 268.Bijwerking 01-08-2013 Page 1 (700350-700361) .53 41.Remboursement V.86 268.93 154.70 201.86 268.23 268.93 0.00 268.

157018000115

Johnson & Johnson MedicalDepuy

Expedium Offset Closed Iliac Bolt Bolt Titanium

1754 26 xxx

322,00 268,53

53,47

201,40

120,60

32,20

01-02-2011

157018000124

Johnson & Johnson MedicalDepuy

Expedium Offset Reduction Fixed Bolt + nut SS

1754 62 xxx + 1754 91 xxx

322,00 268,53

53,47

201,40

120,60

32,20

01-02-2011

157018000133

Johnson & Johnson MedicalDepuy

Expedium Offset Reduction Fixed Bolt + nut Titanium

1854 62 xxx + 1854 91 xxx

322,00 268,53

53,47

201,40

120,60

32,20

01-02-2011

157018000142

Johnson & Johnson MedicalDepuy

Expedium Offset Reduction Polyaxial Bolt + nut SS

1854 32 xxx + 1854 91 xxx

322,00 268,53

53,47

201,40

120,60

32,20

01-02-2011

157018000151

Johnson & Johnson MedicalDepuy

Expedium Offset Reduction Polyaxial Bolt + nut Titanium

1754 32 xxx + 1754 91 xxx

322,00 268,53

53,47

201,40

120,60

32,20

01-02-2011

157018000167

Johnson & Johnson MedicalDepuy

Expedium Offset Fixed Bolt + nut SS

1854 22 xxx + 1854 91 xxx

322,00 268,53

53,47

201,40

120,60

32,20

01-02-2011

157018000176

Johnson & Johnson MedicalDepuy

Expedium Offset Fixed Bolt + nut Titanium

1754 22 xxx + 1754 91 xxx

322,00 268,53

53,47

201,40

120,60

32,20

01-02-2011

157018000185

Johnson & Johnson MedicalDepuy

Expedium Offset Polyaxial Bolt + nut SS

1854 12 xxx + 1854 91 xxx

322,00 268,53

53,47

201,40

120,60

32,20

01-02-2011

157018000194

Johnson & Johnson MedicalDepuy

Expedium Offset Polyaxial Bolt + nut Titanium

1754 12 xxx + 1754 91 xxx

322,00 268,53

53,47

201,40

120,60

32,20

01-02-2011

157018000203

Johnson & Johnson MedicalDepuy

Monarch Bolt screw + nut

1770 xx xxx + 1770 91 045

322,23 268,53

53,70

201,40

120,83

32,22

01-02-2011

157018000212

Johnson & Johnson MedicalDepuy

Monarch Osteoporosis Bolt Screw + nut

1725 00 xxx +1770 91 045

322,23 268,53

53,70

201,40

120,83

32,22

01-02-2011

157018000221

Johnson & Johnson MedicalDepuy

VSP Isola Screw SS(+ nut)

302xxxxx (+ 20261000 /
203007R)

306,31 268,53

37,78

201,40

104,91

30,63

01-02-2011

157018000237

Johnson & Johnson MedicalDepuy

VSP Isola Screw Ti (+ nut)

222xxxxx (+ 22261000 /
223007R)

306,31 268,53

37,78

201,40

104,91

30,63

01-02-2011

157018000246

Medtronic

Centerpiece Bone Screw

853-4xx / 853-5xx

322,23 268,53

53,70

201,40

120,83

32,22

01-02-2011

157018000255

Medtronic

Holyplate screw + self breaking screw

8630xxx +
XA600909/XA606509

322,23 268,53

53,70

201,40

120,83

32,22

01-02-2011

157018000264

Medtronic

X'ngage Short/Long Post Bolt xxmm + Multi axial nut Ti

9942xxx / 9941xxx + 99453105

322,23 268,53

53,70

201,40

120,83

32,22

01-02-2011

157018000273

Orthogèse

BJR Ecrou + BJR Vis à dôme mono-axiale

322,23 268,53

53,70

201,40

120,83

32,22

01-02-2011

157018000282

Orthogèse

BJR Ecrou + BJR Vis à dôme poly-axiale

322,23 268,53

53,70

201,40

120,83

32,22

01-02-2011

157018000291

STRYKER

LP X.5 REDUC SCR + BLOCKER

ATR480D.00000 +
MUN43AD.xxXxx /
ATR43AD.xxXxx
ATR480D.00000 +
MUN43PD.xxXxx /
ATR43PD.xxXxx
48911xxx + 48912510

309,84 268,53

41,31

201,40

108,44

30,98

01-02-2011

157018000307

STRYKER

PEDICLE SCREW X x YY TECHTONIX + BLOCKER

62625xx / 62606xx + 4820000x

309,84 268,53

41,31

201,40

108,44

30,98

01-02-2011

157018000316

STRYKER

PLATE SCREW

48554xxx

159,00 159,00

0,00

159,00

0,00

15,90

01-02-2011

157018000325

STRYKER

STD X.5 SCREW + BLOCKER

48910xxx + 48912510

309,84 268,53

41,31

201,40

108,44

30,98

01-02-2011

157018000334

Cormed

PASS LP screw for plate

B0221XXXX / B0218XXXX

322,23 268,53

53,70

201,40

120,83

32,22

01-02-2011

157018000343

Johnson & Johnson MedicalDepuy

Mountaineer screw

1883700xx / 1883701xx

322,23 268,53

53,70

201,40

120,83

32,22

01-03-2012

157018000352

Aceemed

MPM schroef + moer

THVP(X)(X)(x)(X)/
301,90 268,53
THVS(X)(x)(X)/
THVL(X)x(x)(X)(X)/
THVEGT/THVR2M + THEAB(1)

33,37

201,40

100,50

30,19

01-09-2012

Mise à jour 01-08-2013 - Bijwerking 01-08-2013

Page 2

(700350-700361)

157018000361

Eurospine

Mise à jour 01-08-2013 - Bijwerking 01-08-2013

MPM vis + écrou

THVP(X)(X)(x)(X)/
301,90 268,53
THVS(X)(x)(X)/
THVL(X)x(x)(X)(X)/
THVEGT/THVR2M + THEAB(1)

33,37

201,40

100,50

30,19

01-05-2013

Page 3

(700350-700361)

A = Prix (TVAc) - Prijs (incl. BTW)
B = Remboursement Bén. ordin./Prestataire conventionné - Remboursement V.I.P.O. / Prestataire avec ou sans convention
Terugbetaling Gew. recht. / Verstr. met overeenkomst - Terugbetaling W.I.G.W. / Verstr. met of zonder overeenkomst
C = Supplément patient Bén. ordin. / Prestataire conventionné - Supplément patient V.I.P.O. / Prestataire avec ou sans convention
Supplement patiënt Gew. recht. / Verstr. met overeenkomst - Supplement patiënt W.I.G.W. / Verstr. met of zonder overeenkomst
D = Remboursement Bén. ordin. / Prestataire non conventionné
Terugbetaling Gew. recht. / Verstr. zonder overeenkomst
E = Supplément patient Bén. ordin. / Prestataire non conventionné
Supplement patiënt / Verstr. zonder overeenkomst
F = Marge de délivrance
Afleveringsmarge

700372-700383
Plaque pour fixation antérieure cervicale à la colonne vertébrale par vis (fixation de 2 ou 3 vertèbres
consécutives), y compris les pièces de fixation et d'attache éventuelles
Plaat voor anterieure cervicale fixatie aan de wervelkolom te verankeren via schroeven (fixatie van 2 of 3
opeenvolgende wervels), inclusief eventuele toebehoren voor fixatie en blokkering

Valeur de U - U waarde : U 330
Remboursement - Terugbetaling :

Marge de sécurité - Veiligheidsgrens :
340,83 €

Distributeur
Verdeler

Code d'identification
Identificatiecode

20%

Les montants de la marge de délivrance sont donnés à titre
indicatif : le plafond de 148,74 € est d'application sur l'ensemble
des éléments des implants de la colonne vertébrale - De bedragen
voor de afleveringsmarge worden slechts ter informatie vermeld :
het grensbedrag van 148,74 € is van toepassing op het geheel van
de wervelkolomimplantaten.

Prix plafond - Plafondprijs : 408,99 €

Nom du produit
Productnaam

Numéros de référence
Referentienummers

A

B

C

D

E

F

A partir de Jusqu'au
Vanaf
Tot

157019000013

B Braun Medical

ABC 2 one or two levels

FJ748T -> FJ765T

362,52 340,83

21,69

255,63

106,89

36,25

01-02-2011

157019000022

B Braun Medical

ABC E-Plate

FJ8xxT

362,52 340,83

21,69

255,63

106,89

36,25

01-02-2011

157019000031

B Braun Medical

Caspar

FG420T -> FG450T

340,83 340,83

0,00

255,63

85,20

34,08

01-02-2011

157019000047

B Braun Medical

Quintex – 1/2 level Dynamic plate

SC6xxT

408,99 340,83

68,16

255,63

153,36

40,89

01-02-2011

157019000056

B Braun Medical

Quintex – 1/2 level Hybrid plate

SC5xxT

408,99 340,83

68,16

255,63

153,36

40,89

01-02-2011

157019000065

Biomet

VueLock Plate 1 Level

831xx

309,86 309,86

0,00

255,63

54,23

30,98

01-02-2011

157019000074

Biomet

VueLock Plate 2 Level

832xx

309,86 309,86

0,00

255,63

54,23

30,98

01-02-2011

157019000083

Cormed

C-tek cervical plate 1 - 2 level

1100.xxxx

408,99 340,83

68,16

255,63

153,36

40,89

01-02-2011

157019000092

Cormed

Liberty cervical plate (1-2 level)

S9/PC0xxx

408,99 340,83

68,16

255,63

153,36

40,89

01-02-2011

157019000101

Cormed

Maxima cervical plate (1-2 level)

SCA10xx.S

408,99 340,83

68,16

255,63

153,36

40,89

01-02-2011

Mise à jour 01-08-2013 - Bijwerking 01-08-2013

Page 1

(700372-700383)

83 68.00 340.16 255.63 82.5) PCM0xx 368.16 255.63 153.37 40.83 68.81 01-02-2011 157019000241 Hospithera TRYPTIK CERVICAL PLATE 2LEVEL 35MM MOSPL06xx-S 338.19mm 171.83 68.17 255.2 level 20.14 0.16 255.157019000117 Cormed OSD Cervical plate (1-2 level) PCEV.30 01-02-2011 157019000232 Hospithera TRYPTIK CERVICAL PLATE 1LEVEL 15MM MOSMP0000-S / MOSPL04xxS 338.89 01-02-2011 157019000205 Globus Medical Belgium VIP Anterior Cervical Plate 1-Level.63 84.89 01-02-2011 157019000162 Globus Medical Belgium ASSURE™ Cervical Plate 1-Level.63 153.00 340.72 340.89 01-02-2011 157019000214 Globus Medical Belgium VIP Cervical Plate 1-Level.09 36.46mm 171.63 152. 10mm-26mm 110.37 34.80 01-02-2011 157019000293 Johnson & Johnson MedicalDepuy Eagle+ micro-plate (1 level) 1836 00 xx5 408.00xx 408.63 153.83 68. 24mm-46mm 110.63 84.16 255.99 340.36 40.36 40. 26mm .63 113.2xx 408.63 153.36 40.00 255.63 54.2xx 408.80 01-02-2011 157019000311 Johnson & Johnson MedicalDepuy Eagle+ plate 2 level 1836 12 0xx 408.83 68.99 340. 10mm .63 82.37 37.26mm 150.99 340.17 255.37 40.63 153.80 01-02-2011 157019000327 Johnson & Johnson MedicalDepuy Skyline Plate 1868 01 0xx 340.89 01-02-2011 157019000187 Globus Medical Belgium Providence Cervical Plate 1-Level.51 33.63 153.83 68.17 255.16 255.99 340.37 40.87 01-02-2011 157019000275 InSpine Belgium Plaat cervicaal Tosca X gaten XX mm DX-0xx 368.98 01-02-2011 157019000354 Johnson & Johnson MedicalDepuy SlimlocPlate 2 level 1796 02 0xx 408.00 255.63 113.1xx 408.36 40.83 27.99 340.00 340.00 340.63 147.83 67.89 01-02-2011 157019000153 Globus Medical Belgium Assure-T Anterior Cervical Plate.89 01-02-2011 157019000363 Johnson & Johnson MedicalDepuy Swift+ plate 1 level 1836 01 0xx 408.00 255.16 255.86 0.1xx 408.89 01-02-2011 157019000196 Globus Medical Belgium Providence Cervical Plate 2-Level.17 255.17 255.1xx 408.16 255.99 340.xxxx 408.36 40.63 152.99 340.80 01-02-2011 157019000372 Johnson & Johnson MedicalDepuy Swift+ plate 2 level 1836 02 0xx 408.83 68.83 67.37 34.99 340.89 255.83 68.00 01-02-2011 157019000345 Johnson & Johnson MedicalDepuy Slimloc Plate 1 level 1796 01 0xx 309.99 340.83 68.99 340.36 40.16 255.89 01-02-2011 157019000223 Hospithera Alphatec Trestle plate 61001-xx / 61002-xx / 710010xx / 71002-0xx 403.Bijwerking 01-08-2013 Page 2 (700372-700383) .17 255.89 01-02-2011 157019000144 Globus Medical Belgium Assure-T Anterior Cervical Plate. 13mm .26mm 117.37 40.83 67.80 01-02-2011 Mise à jour 01-08-2013 .83 68.36 40.00 340.89 01-02-2011 157019000171 Globus Medical Belgium ASSURE™ Cervical Plate 2-Level.63 152.37 40.00 0. 2-Level.00 340.17 255.83 68.23 30.16 255.37 40.51 33.36 40.2xx 408.99 340.00 340.10 01-02-2011 157019000266 InSpine Belgium Plaat cervicaal Morpho XX(.87 01-02-2011 157019000284 ISKRA Plaque Cervicale Morpho PCM0xx 408.00 340.83 67.63 152.83 68. 12mm .81 01-02-2011 157019000257 Hospithera TRYPTIK CERVICAL PLATE 3LEVEL 60MM MOSPL08xx-S 371.89 255.00 255.63 153.86 309. 24mm .36 40.72 340.36 40.16 255.36 40.00 255.83 67.1xx 408.00 01-02-2011 157019000336 Johnson & Johnson MedicalDepuy Skyline Plate 1868 02 0xx 340. 24mm .16 255.00 340.63 152.46mm 117.00 0.83 27.83 62.63 153.14 0.14 338.36 40.63 153.63 153.80 01-02-2011 157019000302 Johnson & Johnson MedicalDepuy Eagle+ plate 1 level 1836 11 0xx 408.89 01-02-2011 157019000126 Cormed SAS 3 cervical plate (1-2 level) S3i/PCxx 408.63 152.2xx 408.99 340.63 115.83 30.63 153.83 67. 1-Level.63 153.37 40.14 338.89 01-02-2011 157019000135 Cormed Sonoma cervical plate 1 .46mm 150.09 36.00 340.17 255.16 255.

36 40.36 40.89 01-02-2011 157019000424 Medtronic Altantis Vision cervical plate xxmm 976-1xx 365.83 68.54 01-02-2011 157019000476 NEW2DM Plaque Cervicale Morpho PCM0xx 408.83 67.83 340.83 68.99 340.89 01-02-2011 157019000397 Johnson & Johnson MedicalDepuy Uniplate Plate 1 level 1897 01 0xx 309.83 24.16 255.63 153.63 153.63 85.63 153.08 01-02-2011 157019000582 STRYKER 2 LEVEL ACP SIZE YYMM 486512xx 340.16 255.63 153.89 01-02-2011 157019000415 MEDIANN ORIA ZENITH Plaque cervicale FT20-xxxx 408.36 40.63 109.63 153.20 34.99 340.11x -> 450.83 340.63 152.63 153.86 36.20 34.83 340.83 0. 189722xxx 408.66 255.37 40.00 255.99 340.63 153.36 40.83 0.83 0.08 01-02-2011 157019000564 SHARK MEDICAL Plaque Cervicale Morpho PCM0xx 408.83 68.83 0.83 67.83 68.89 01-02-2011 157019000546 SDI Belgium Plaque cervicale antérieure C3™ deux niveaux Long.83 340.08 01-02-2011 157019000521 OSTEON CERVICAL PLATE CP 2Lxx A xx/xx 340.63 85.89 01-02-2011 157019000451 Medtronic VENTURE ANT CER PLATE ASS'Y XX MM TRANS 9790019 -> 9790045 / 9791030 408.20 34.16 255.00 340.08 01-02-2011 157019000555 SDI Belgium Plaque cervicale antérieure C3™ un niveau Long.63 85.2xx -> 450.00 255.89 01-02-2011 Mise à jour 01-08-2013 .89 01-02-2011 157019000503 Orthogèse BJR Cervical plate 2 levels BJL42x2.00 255.Bijwerking 01-08-2013 Page 3 (700372-700383) .4xx 408.20 34.20 34.66 255.86 0.63 85.63 85.83 68.89 01-02-2011 157019000467 Medtronic Zephir Cervicale plaat XXX mm 8799xxx 365.00 340.54 01-02-2011 157019000433 Medtronic Atlantis cervicale plaat XXmm 876-1xx / 876-2xx 365.83 68.36 40.83 340.36 40.83 68.99 340.83 24.12x /450.86 309.83 68.00 255.17 255.80 01-02-2011 157019000573 STRYKER 1 LEVEL ACP SIZE YYMM 486511xx 340.16 255.99 340.Plaque cervicale + vis de blocage FPC0xx + VBF430 408.02Xxx 408.16 255.83 68.86 36.63 109.17 255.83 68.54 01-02-2011 157019000442 Medtronic Premier Anterior Cervical plate XXmm 6860123 -> 6860145 408.00 255.36 40.16 255. Locking system CP 1Lxx/ CP 2Lxx(x) / CP 3Lxx(x) 408.00 255.83 68.99 340.xxx 408.83 68.16 255.83 0.66 255.63 153.00 255.98 01-02-2011 157019000406 Johnson & Johnson MedicalDepuy Uniplate Plate 2 level 1897 02 0xx 408.20 34.83 340.80 01-02-2011 157019000485 Ortho Team FENICIA .15x -> 450.63 153.36 40.16 255.01Xxx 408.63 109.99 340.89 01-02-2011 157019000494 Orthogèse BJR Cervical plate 1 level BJL42x2.63 153.16 255.x mm avec SLS + 2 vis de blocage C1P20xxx / C1P20xxxN1 340.83 0.99 340.20 34.36 40.99 340.83 68.86 36.08 01-02-2011 157019000591 STRYKER CERVICAL PLATE SIZE YYMM 48610xxx 340.36 40.63 153.08 01-02-2011 157019000537 OSTEON CERVICAL PLATE incl.89 01-02-2011 157019000512 OSTEON CERVICAL PLATE CP 1Lxx / CP2Lxx / CP 3Lxx 340.63 153.37 40.63 85.49 340.63 85.63 153.36 40.63 54.16 255.16 255.89 01-02-2011 157019000643 Synthes CSLP va 450.49 340.08 01-02-2011 157019000607 STRYKER ONE LEVEL ZP ACP XXMM 48660xxx 408.83 24. xx.x mm avec SLS + 2 vis de blocage C1P10xxx / C1P10xxxN1 340.99 340.83 0.99 340.83 68.157019000381 Johnson & Johnson MedicalDepuy Uniplate 2 Anterior Cervical Plate system 189721xxx.16 255.83 340.63 153.00 255.63 152.36 40.16 255.89 01-02-2011 157019000625 Synthes CSLP 487.99 340.49 340.36 40.89 01-02-2011 157019000616 STRYKER TWO LEVEL ZP ACP XXMM 48660xxx 408.23 30.99 340.17x 408.89 01-02-2011 157019000634 Synthes CSLP narrow 450.36 40.99 340. xx.16 255.

99 340.01616.57 255.89 01-02-2011 157019000792 Zimmer Trinica Select 2 level 07.93 235.63 139. 4-hole.00 23.83 54.36 40.16 255.83 68.36 40.83 68.16 255.83 68.63 94.17 255.0xx 408.63 139.36 40.63 139.63 106.63 153. width 20 mm CS 1307-xxT 235.83 68.63 153. width 20 mm CS 1306-xxT 228.83 68.59 0.16 255.80 340.16 255.36 40.89 01-02-2011 31-08-2012 157019000704 MSH mambo plate L blue.83 54.17 34.16 255.59 01-02-2011 31-08-2012 157019000774 MSH osmium plate.89 01-02-2011 157019000661 Synthes Vectra-T 450.36 40.83 54.89 01-02-2011 157019000853 Biomet MAXAN Fixed Plate – 1 level 14-5221xx 362. titanium.97 255.36 40.16 255.37 39.83 68.63 153. length 26 mm CS 1822-26 395.24 01-06-2012 157019000862 Biomet MAXAN Fixed Plate – 2 level 14-5222xx 362.83 68.37 39.96 228.99 340.99 340.99 340.00341.99 340.36 40. length 29 mm CS 1824-29 395.50 01-02-2011 31-08-2012 157019000713 MSH mambo plate M green.50 01-02-2011 31-08-2012 157019000731 MSH mambo single plate XS yellow.83 68.89 01-02-2011 157019000817 Cormed Sagesse Cervical plate B051101xx / B051102xx 408.0xx 408.63 153.63 153.16 255.99 340.63 153.16 255.40 340.613. 4 holes.xx 349.63 153.36 40.00 22.99 340.36 40.16 255.98 01-02-2011 157019000835 SHARK MEDICAL Plaque cervicale C-Plate CP002xT / CP003xT / CP004xT / CP0050T 408.16 255.17 255.83 68.00 228.xxx 408.89 01-02-2011 157019000844 LDR MEDICAL Plaque cervicale C-Plate CP002xT / CP003xT / CP004xT / CP0050T 408.00 340.99 340.36 40.63 153.00 340.00 235.83 68.99 340.99 340.63 153.17 255.50 01-02-2011 31-08-2012 157019000747 MSH mambo single plate XXS yellow.014 -> 04.83 68. length 22 mm CS 1820-22 395.63 153.17 255.93 0.89 01-09-2012 Mise à jour 01-08-2013 .77 36.50 01-02-2011 31-08-2012 157019000722 MSH mambo plate S yellow.40 340.50 01-02-2011 31-08-2012 157019000756 MSH osmium plate.63 153.89 01-09-2012 157019000905 Hospithera mambo extension plate M green + mambo settling or clamping screw CS 1822-02 + CS 1826-0x 408.16 255.36 40.37 39.63 153.36 40.16 255.83 68.24 01-06-2012 157019000871 Zimmer inViZia 1–Level ACDF Plate 07.99 340. 4-hole.00 340.36 40.63 153.63 106.59 247.00340.17 255.89 01-11-2012 157019000887 Zimmer inViZia 2–Level ACDF Plate 07.89 01-02-2011 31-08-2012 157019000765 MSH osmium plate.63 139.57 255.93 0.83 54. 8 holes. length 20 mm CS 1820-20 395.16 255.36 40.83 68. titanium.83 54.36 40.96 0.89 01-02-2011 157019000677 MSH mambo extension plate L blue + mambo settling or clamping screw CS 1824-02 + CS 1826-0x 408.xxx 408.613.89 01-09-2012 157019000914 Hospithera mambo extension plate S yellow + mambo settling or clamping screw CS 1820-02 + CS 1826-0x 408.83 8.00 340. 6 holes. length 24 mm CS 1820-24 395.83 68.89 01-02-2011 31-08-2012 157019000686 MSH mambo extension plate M green + mambo settling or clamping screw CS 1822-02 + CS 1826-0x 408.89 01-02-2011 31-08-2012 157019000695 MSH mambo extension plate S yellow + mambo settling or clamping screw CS 1820-02 + CS 1826-0x 408.00 24.4.5xx 408.36 40.00 340.89 01-02-2011 157019000801 Cormed Spider cervical plate N60000100 -> N60000113 408.37 39.99 340.89 01-11-2012 157019000896 Hospithera mambo extension plate L blue + mambo settling or clamping screw CS 1824-02 + CS 1826-0x 408.83 21.Bijwerking 01-08-2013 Page 4 (700372-700383) .96 0.89 01-02-2011 157019000826 Ixemel Plaque cervicale antérieure Easy plate 5432.00 247.63 153.99 340.99 340.157019000652 Synthes Vectra 04.01615.63 153.99 340.16 255.269 408.75 01-02-2011 31-08-2012 157019000783 Zimmer Trinica Select 1 level 07.63 153.59 0.83 68. titanium.63 139.37 39. 4-hole.83 21.99 340.16 255. width 20 mm CS 1308-xxT 247.16 255.83 68.77 36.

59 01-09-2012 157019000993 Hospithera osmium plate.93 0.00 340.96 228. Dyn.00 340.89 01-09-2012 157019000984 Hospithera osmium plate.37 39. 4-hole.83 68. Std 21-1xx-S / 21-2xx-S 408. 4-hole.96 0.63 153. width 20 mm CS 1307-xxT 235.00 23.00 235.59 0.83 54.89 01-05-2013 Mise à jour 01-08-2013 . 21-1xx-D / 21-2xx-D 408. titanium. width 20 mm CS 1308-xxT 247.36 40.63 153.83 54.17 255..00 340.00 228.17 255.00 340. length 20 mm CS 1820-20 395.50 01-09-2012 157019000941 Hospithera mambo plate S yellow. length 24 mm CS 1820-24 395.59 0. length 29 mm CS 1824-29 395. titanium.00 24.50 01-09-2012 157019000957 Hospithera mambo single plate XS yellow.17 255.16 255.16 255.36 40. 4 holes.63 139. 8 holes.17 255. length 26 mm CS 1822-26 395.63 139. titanium.37 39.93 235.157019000923 Hospithera mambo plate L blue.50 01-09-2012 157019000966 Hospithera mambo single plate XXS yellow.Bijwerking 01-08-2013 Page 5 (700372-700383) .63 139..50 01-09-2012 157019000975 Hospithera osmium plate. length 22 mm CS 1820-22 395.50 01-09-2012 157019000932 Hospithera mambo plate M green.93 0.99 340.00 247.17 255. width 20 mm CS 1306-xxT 228.89 01-05-2013 157019001011 InSpine Belgium Slimfuse – asm.83 54.83 54.99 340.00 340.63 139. 4-hole.37 39.37 39.75 01-09-2012 157019001002 InSpine Belgium Slimfuse – asm.37 39.83 54.63 139. 6 holes.83 68.59 247.00 22.96 0.

/ Verstr. ordin. met overeenkomst .29 271.P.86 0.Supplement patiënt W.59 345. / Verstr. ordin. inclusief eventuele toebehoren voor fixatie en blokkering (fixatie van 4 of meer opeenvolgende wervels) Valeur de U . y compris les pièces de fixation et d'attache éventuelles (fixation de 4 vertèbres consécutives ou plus) Plaat voor anterieure cervicale fixatie aan de wervelkolom. / Prestataire non conventionné Supplement patiënt / Verstr.49 19.59 0.48 361.74 € is van toepassing op het geheel van de wervelkolomimplantaten.98 01-02-2011 157020000076 Cormed C-tek cervical plate multi level 1100. / Verstr.29 271. / Verstr.74 30.12 38. ordin.12 162.37 01-02-2011 157020000103 Cormed OSD Cervical plate (>2 level) PCEV. recht.S 433. zonder overeenkomst E = Supplément patient Bén.37 01-02-2011 Mise à jour 01-08-2013 .29 271.12 162.66 43.78 361.A = Prix (TVAc) .78 361.29 271.Veiligheidsgrens : 361.49 72.86 309. met of zonder overeenkomst C = Supplément patient Bén.14 01-02-2011 157020000024 B Braun Medical Caspar (3 levels and more) FG450T -> FG490T 345.78 361.86 0.12 110.12 38. Prix plafond .29 271.37 01-02-2011 157020000085 Cormed Liberty cervical plate (>2 level) S9/PC0xxx 433. te verankeren via schroeven.78 € Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157020000015 B Braun Medical ABC 2 (3 levels and more) FJ740T -> FJ744T / FJ768T -> FJ789T 381.W.00 271.49 72.78 361.66 43.O.Terugbetaling W.36 38.37 01-02-2011 157020000051 Biomet VueLock Plate 3 Level 833xx 309.49 72.Bijwerking 01-08-2013 Page 1 (700394-700405) .29 271.I.Plafondprijs : 433.37 01-02-2011 157020000094 Cormed Maxima cervical plate (>2 level) SCA10xx.Remboursement V.78 361.49 72. / Prestataire avec ou sans convention Terugbetaling Gew.49 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.xxxx 433.Terugbetaling : Marge de sécurité .G.12 162.G.Supplément patient V.W.66 43. met overeenkomst .I.I./Prestataire conventionné . recht. / Verstr.12 162. ordin. BTW) B = Remboursement Bén.00 271.I.37 01-02-2011 157020000042 B Braun Medical Quintex – 3/4/5 level Hybrid plate SC5xxT 433.12 162.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .12 162.66 43.12 74.U waarde : U 350 Remboursement .P. / Prestataire non conventionné Terugbetaling Gew.O.86 309.49 72. recht.78 361.55 01-02-2011 157020000033 B Braun Medical Quintex – 3/4/5 level Dynamic plate SC6xxT 433.74 30.47 34.Prijs (incl.66 43.99 271.66 43. met of zonder overeenkomst D = Remboursement Bén. / Prestataire conventionné .00xx 433. / Prestataire avec ou sans convention Supplement patiënt Gew.98 01-02-2011 157020000067 Biomet VueLock Plate 4 Level 834xx 309.49 72. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700394-700405 Plaque pour fixation antérieure cervicale à la colonne vertébrale par vis.00 271.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.

23 271.12 162.80 01-02-2011 157020000252 Johnson & Johnson MedicalDepuy Eagle+ Plate 3-4 level 1836 13 0xx / 1836 14 0xx 432.66 43.00 361.66 43.3xx 433.29 271.12 162.49 4.37 01-02-2011 157020000164 Globus Medical Belgium ASSURE™ Cervical Plate 4-Level.37 01-02-2011 Mise à jour 01-08-2013 .29 271.00 361.88 43.37 36.12 160.12 94.4xx 433.12 162.49 4.66 43.49 70.12 137.29 271.12 160.12 99.78 361.xxxx 433.00 271.78 361.78 361.54 01-02-2011 157020000331 Medtronic Premier Anterior Cervical plate XXmm 6860147 -> 6860210 433.51 271.29 271.29 271. PLATE ASS'Y XX MM '9790047 -> 9790110 / 9791150 433.51 271.00 271.60 36.78 361. 4-Level.66 43.37 01-02-2011 157020000182 Globus Medical Belgium Providence Cervical Plate 4-Level.66 43.00 361.49 72.88 40.Bijwerking 01-08-2013 Page 2 (700394-700405) .51 271.78 361.157020000112 Cormed SAS 3 cervical plate (>2 level) S3i/PCxx 433.78 361.66 43.12 162.12 162.49 9.78 361.49 72. 36mm .88 43.37 01-02-2011 157020000277 Johnson & Johnson MedicalDepuy Slimloc Plate 3-4-5 level 1796 03 0xx / 1796 04 0xx / 1796 05 0xx 433.49 72.29 271.88 37.49 70.66 43.37 01-02-2011 157020000173 Globus Medical Belgium Providence Cervical Plate 3-Level.12 162.10 01-02-2011 157020000225 InSpine Belgium Plaat cervicaal Morpho XX(.66 43.12 162.00 361.78 361.23 271. 60mm-100mm 110.49 72.37 01-02-2011 157020000216 Hospithera TRYPTIK CERVICAL PLATE 4LEVEL MOSPL10x0-S 371.29 271.29 271.12 162.20 01-02-2011 157020000261 Johnson & Johnson MedicalDepuy Skyline Plate 3-4-5 level 1868 03 xxx / 1868 04 xxx / 1868 05 xxx 433.37 01-02-2011 157020000121 Cormed Sonoma cervical plate multi level 20.00 361.339 -> 110. 80mm .49 4.12 160.69mm 117.66 43.37 36.87 01-02-2011 157020000234 InSpine Belgium Plaat cervicaal Tosca X gaten XX mm DX-0xx 368.54 01-02-2011 157020000365 NEW2DM Plaque Cervicale Morpho PCM0xx 408.12 162.49 72.78 361.87 40.49 72.49 72.460 -> 110.88 40.89 01-02-2011 157020000313 Medtronic Altantis Vision cervical plate xxmm 976-1xx 365.104mm 150.37 01-02-2011 157020000191 Globus Medical Belgium Providence Cervical Plate 5-Level.37 01-02-2011 157020000146 Globus Medical Belgium Assure-T Anterior Cervical Plate.49 72.12 162.369 433.6xx 433.49 72.37 01-02-2011 157020000137 Globus Medical Belgium Assure-T Anterior Cervical Plate.12 162.80 01-02-2011 157020000374 Orthogèse BJR Cervical plate 3 levels BJL42x2. 60mm .12 136.78 361.29 271.78 361.66 43.20 01-02-2011 157020000295 Johnson & Johnson MedicalDepuy Swift+ Plate Corpectomy 1836 06 xxx 432.12 136.49 47.12 94.12 162.49 72.500 433.5) PCM0xx 368.49 72.49 72.49 361.49 7.37 01-02-2011 157020000155 Globus Medical Belgium ASSURE™ Cervical Plate 3-Level.49 7.60 36.03Xxx 433.00 271.100mm 117.78 361. 60mm .87 01-02-2011 157020000243 ISKRA Plaque Cervicale Morpho PCM0xx 408.49 72.78 361.29 271.29 271.12 94.51 271.3xx 433.37 01-02-2011 157020000347 Medtronic VENTURE ANT.49 70.12 162.50 271.29 271.66 43.12 162.66 43.72 361.69mm 150.66 43.00 361.51 271.37 01-02-2011 157020000207 Hospithera Alphatec trestle plate 6100x-xxx / 7100x-xxx 433.66 43.29 271.88 43.12 162.49 72.93mm 150.12 97.78 361. 39mm-69mm 110.4xx/117.37 36.66 43.78 361.49 361. CERV.20 01-02-2011 157020000304 MEDIANN ORIA ZENITH Plaque cervicale FT20-xxxx 408.12 97.49 72.51 271.49 46.37 01-02-2011 157020000286 Johnson & Johnson MedicalDepuy Swift+ Plate 3-4-5 level 1836 03 0xx / 1836 04 0xx / 1836 05 xxx 432.72 361.5xx/150.49 46.99 361. 39mm . 3-Level.54 01-02-2011 157020000322 Medtronic Atlantis cervical plate XXmm 876-1xx / 876-2xx 365.29 271.5xx 433.37 01-02-2011 157020000356 Medtronic Zephir Cervical plate XXX mm 8799xxx 365.29 271.49 361.

37 01-02-2011 157020000602 Cormed Spider cervical plate N60000114 -> N60000128 433.29 271.xxx 433.66 43.66 43.14 01-02-2011 157020000462 Synthes CSLP 3-4 niv 450.12 162.66 43.00 271.66 43.49 72.29 271.78 361. 6 holes.12 162.49 361.4xx 433.37 01-02-2011 157020000435 SHARK MEDICAL Plaque Cervicale Morpho PCM0xx 408.59 01-02-2011 31-08-2012 157020000575 MSH osmium plate.37 01-02-2011 157020000593 Zimmer Trinica Std 4 level 07.12 162.66 43.00 361.49 72.12 162.37 36.66 43.66 43.00 271.75 01-02-2011 31-08-2012 157020000584 Zimmer Trinica Select 3 level 07.49 72.29 271.00 361.08 01-02-2011 157020000401 OSTEON CERVICAL PLATE(85-105) CP 4Lxx / CP 5Lxx(x) 433.80 01-02-2011 157020000444 STRYKER 3 LEVEL ACP SIZE YYMM 486513xx 361.00188.59 0.49 0.Bijwerking 01-08-2013 433.49 361.50 01-02-2011 31-08-2012 157020000541 MSH mambo plate M green.71 34.49 47.00 361.37 01-02-2011 157020000487 Synthes Vectra 3-4 niv 04.51 271.66 43.00 271. 4-hole.78 361.12 162.37 01-02-2011 157020000392 OSTEON CERVICAL PLATE(70-80) CP 4Lxx 340.49 Page 3 (700394-700405) .78 361.49 72.88 40.51 271.88 40.xxx 433.12 162.37 01-02-2011 157020000611 Cormed Sagesse cervical plate B051103xx 433.78 361. 4-hole.14 01-02-2011 157020000453 STRYKER 4 LEVEL ACP SIZE YYMM 486514xx 361.88 40.49 72.12 162.88 40.00 361.12 162.78 361.xxx 433. 4-hole.49 72.29 271.49 72. titanium.29 271.90 01-02-2011 31-08-2012 157020000514 MSH mambo extension plate M green + mambo settling or clamping screw CS 1822-02 + CS 1826-0x 409.66 43.xx mm avec 2 SLS + 4 vis de blocage C1-P4 0xx0 433.49 72. width 20 mm CS 1307-xxT 235.49 72.29 271.00 24.66 43.04Xxx 433.00 23. length 24 mm CS 1820-24 395.12 137.12 162.66 43.83 0.12 162.49 46.66 43.00 361.12 123.57x 433.00342.66 43.88 39.37 01-02-2011 157020000417 SDI Belgium Plaque cervicale antérieure C3™ quatre niveaux Long.12 162.78 361.29 271.29 271.49 33.51 271.12 136. length 29 mm CS 1824-29 395.49 72.59 0.37 01-02-2011 157020000426 SDI Belgium Plaque cervicale antérieure C3™ trois niveaux Long.29 271.49 72.12 90.29 271.37 01-06-2012 Mise à jour 01-08-2013 .29 271.66 43.12 90.51 271.50 01-02-2011 31-08-2012 157020000557 MSH mambo plate S yellow.12 137.93 0.29 271.78 361.37 01-02-2011 157020000471 Synthes CSLP var hoek 3-4 niv 450.78 361.49 33.78 361. xx mm avec SLS + 2 vis de blocage C1-P3 0xx0 433.37 01-02-2011 157020000627 SHARK MEDICAL Plaque cervicale C Plate CP005xT / CP006xT / CP0070T 433.12 162.51 271.88 39.49 47.59 247.90 01-02-2011 31-08-2012 157020000523 MSH mambo extension plate S yellow + mambo settling or clamping screw CS 1820-02 + CS 1826-0x 409.00 247.12 69.66 43.12 123. titanium.00 361.29 271.29 271.49 72.90 01-02-2011 31-08-2012 157020000532 MSH mambo plate L blue.00 361.12 137.49 72.00 235.78 361.51 271.18x 433.88 39.93 235.50 01-02-2011 31-08-2012 157020000566 MSH osmium plate.49 0.78 361. length 26 mm CS 1822-26 395.49 47. width 20 mm CS 1308-xxT 247.613.93 0.49 72.12 162.37 01-02-2011 157020000645 Biomet MAXAN Fixed Plate – 3 level 14-5223xx 72.83 340.29 271. 8 holes.37 36.51 271.78 361.37 01-02-2011 157020000636 LDR MEDICAL Plaque cervicale C Plate CP005xT / CP006xT / CP0070T 433.78 361.157020000383 Orthogèse BJR Cervical plate 4 levels BJL42x2.12 162.37 01-02-2011 157020000505 MSH mambo extension plate L blue + mambo settling or clamping screw CS 1824-02 + CS 1826-0x 409.37 01-02-2011 157020000496 Synthes Vectra-T 3-4 niv 450.12 162.78 361.12 123.49 33.78 361.

width 20 mm CS 1307-xxT 235.88 40.00 361.75 01-09-2012 157020000751 InSpine Belgium Slimfuse.12 137.49 47.00 247.12 123.50 01-09-2012 157020000715 Hospithera mambo plate M green.65 43.51 271.01617.157020000654 Zimmer inViZia 3–Level ACDF Plate 07.78 361.37 01-11-2012 157020000672 Hospithera mambo extension plate L blue + mambo settling or clamping screw CS 1824-02 + CS 1826-0x 409. 6 holes.12 123.12 162.00 361.93 0.59 0. Anterior cervical plate 21-3xx-D / 21-4xx-D 433.12 123.00 361.88 40. titanium.00 24.50 01-09-2012 157020000724 Hospithera mambo plate S yellow.93 0. width 20 mm CS 1308-xxT 247.66 43.49 72.29 271.77 361. 8 holes. 4-hole. 4-hole.01618.49 33.28 271.51 271.90 01-09-2012 157020000706 Hospithera mambo plate L blue.88 39. 4-hole.0xx 433.51 271.49 33.0xx 433.59 247.88 40.88 39.49 72.00 361.00 361.77 361.88 39. length 26 mm CS 1822-26 395.49 33. length 29 mm CS 1824-29 395.59 01-09-2012 157020000742 Hospithera osmium plate.12 137.90 01-09-2012 157020000681 Hospithera mambo extension plate M green + mambo settling or clamping screw CS 1822-02 + CS 1826-0x 409.00 235.51 271.00 23.51 271.00 361.12 162.49 72.12 162. dyn.28 271.37 01-05-2013 Mise à jour 01-08-2013 .12 137.50 01-09-2012 157020000733 Hospithera osmium plate.37 01-11-2012 157020000663 Zimmer inViZia 4–Level ACDF Plate 07.Bijwerking 01-08-2013 Page 4 (700394-700405) . length 24 mm CS 1820-24 395.59 0. titanium.93 235.90 01-09-2012 157020000697 Hospithera mambo extension plate S yellow + mambo settling or clamping screw CS 1820-02 + CS 1826-0x 409.49 47.49 47.51 271.65 43.

met of zonder overeenkomst C = Supplément patient Bén.2xxx 173.G. VCR.60 10.16 108.52 144.G.45 46.Plafondprijs : 173.31 15.W.Veiligheidsgrens : 144.07 17.93 144. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700416-700420 Vis simple pour ancrage à la colonne vertébrale d'une plaque antérieure cervicale Enkelvoudige schroef voor verankering aan de wervelkolom van een anterieure cervicale plaat Valeur de U .60 10.60 10.16 108.Terugbetaling W.I.92 108.Supplement patiënt W.07 17. met overeenkomst . / Verstr.W.35 01-02-2011 Mise à jour 01-08-2013 .2mm Fixed Angle Screw 150.31 15.52 144.52 144.45 46. / Verstr.61x / 150. ordin.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.U waarde : U 140 Remboursement . / Prestataire avec ou sans convention Supplement patiënt Gew.74 € is van toepassing op het geheel van de wervelkolomimplantaten. ordin. / Prestataire non conventionné Terugbetaling Gew.35 01-02-2011 157021000087 Cormed SAS 3 cervical screw S3i/Vxx.52 144.35 01-02-2011 157021000062 Cormed Maxima cervical screw SCxxxx-V 173. / Prestataire avec ou sans convention Terugbetaling Gew.07 17. / Verstr. recht.60 28.I.Supplément patient V.07 17.Remboursement V.45 65.45 65.47 01-02-2011 157021000035 B Braun Medical Caspar screw oversized LA0xxT 154.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .60 28. met of zonder overeenkomst D = Remboursement Bén.45 46. VREV-0xx 173.2mm Variable Angle Screw 150.35 01-02-2011 157021000105 Globus Medical Belgium 4.I.40xx 173.P. / Verstr.92 108.07 17.92 108.31 15.47 01-02-2011 157021000044 Biomet VueLock Screw 630xx 154.76 144.0xx 173.35 01-02-2011 157021000071 Cormed OSD cervical screw VPCE-0xx.60 28.47 01-02-2011 157021000026 B Braun Medical Caspar screw monocortical LB55xT 154.45 65. VCS-35xx.35 01-02-2011 157021000096 Globus Medical Belgium 4. recht.52 144. zonder overeenkomst E = Supplément patient Bén.P. / Prestataire non conventionné Supplement patiënt / Verstr.Bijwerking 01-08-2013 Page 1 (700416-700420) .16 108. / Prestataire conventionné . ordin. recht.76 144.45 65.A = Prix (TVAc) .60 28. BTW) B = Remboursement Bén.92 108.92 108.33 108.52 144. ordin.45 65. / Verstr. Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157021000017 B Braun Medical Caspar screw bicortical LB45xT/LB46xT 154.52 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.60 10.Prijs (incl.45 46.60 28.48 15.60 28.I.O.49 01-02-2011 157021000053 Cormed C-tek cervical screw 1100. met overeenkomst .07 17.45 65.O.60 € Prix plafond ./Prestataire conventionné .92 108.76 144.Terugbetaling : Marge de sécurité .8xx 173.

00 144.09 01-02-2011 157021000211 Hospithera TRYPTIK ANTI BACKOUT CERV SCREW ø38 MOSCS38xx-S 140.35 01-02-2011 157021000166 Globus Medical Belgium VIP 4.07 17.45 43. self tapping D-X.60 7.35 01-02-2011 157021000132 Globus Medical Belgium 4.07 17.45 63.27 108.Bijwerking 01-08-2013 Page 2 (700416-700420) . self tapping D-X.0 VPC4xx 168.52 144.00 10.45 65.6mm Fixed Angle Screw 171.92 108.1mm Variable Angle Screw 171.52 144.27 108.60 28.09 01-02-2011 157021000227 InSpine Belgium Schroef fixed D4.X L 1Ymm DX-4x1x 168.60 28.71x / 150.88 01-02-2011 157021000263 ISKRA Vis Cervicale Morpho VPC4xx(x) 173.0mm/4.07 17.98 140.00 108.07 17.45 65.00 144.27 108.52 144.98 0.60 27.81x / 171.55 17. L-X 876-7xx 173.60 22.35 01-02-2011 157021000324 Medtronic Atlantis screw / fixed D-X L-X 876-0xx 173.42 16.60 28.00 144.52 144.52 144.60 27.92 108.92 108.45 60.45 58.52 144.70 01-02-2011 157021000202 Hospithera TRYPTIK ANTI BACKOUT CERV REVISION SCREW ø45 MOSCS45xx-S 140.92 108.98 140.87 144.42 16. L-X 876-3xx 173.35 01-02-2011 157021000367 Medtronic Atlantis screw/ variable.60 28. Self-Tapping 110.88 01-02-2011 157021000245 InSpine Belgium Schroef Morpho LXX diam 4.07 17.40 108.92 108.42 16.88 01-02-2011 157021000236 InSpine Belgium Schroef Morpho LXX diam 4.60 28.60 24. Self-Drilling 110.45 60.35 01-02-2011 157021000184 Globus Medical Belgium VIP 5.42 16.60 28.45 32.45 60.6mm Variable Angle Screw 150.60 28.60 28.45 65.45 65.35 01-02-2011 157021000175 Globus Medical Belgium VIP 5.157021000114 Globus Medical Belgium 4.X L 1Ymm DV-4x1x 168.55 15.45 65.49 01-02-2011 157021000306 Johnson & Johnson MedicalDepuy Uniplate Screw 1897 0x xxx 152.5 mm Standard Screw.35 01-02-2011 157021000123 Globus Medical Belgium 4.95 0.35 01-02-2011 157021000141 Globus Medical Belgium 4.07 17.45 63.60 24.5xx 173.87 144.95 0.60 28.55 17.07 17.92 108.92 108.92 108.07 17.07 17.7xx 173.60 28.60 28.35 01-02-2011 157021000342 Medtronic Atlantis screw/ fixed.52 144.00 144.45 65.9xx 173.9xx 173.87 144.60 24.8xx / 110.52 144.5 mm Standard Screw.60 28.45 64.45 65.52 144.53 14.5 VPC45xx 168.40 108.40 108.92 108.45 65.98 0.35 01-02-2011 157021000157 Globus Medical Belgium VIP 4.35 01-02-2011 157021000351 Medtronic Atlantis screw/ variable D-X.95 104.6mm Variable Angle Screw 171.35 01-02-2011 Mise à jour 01-08-2013 .3xx 173.07 17.92 108.07 17.00 104.55 16.45 65.87 144.41x / 171.45 65.52 144.61x / 171.45 32.5xx 173.07 17.27 108.92 108.6mm Fixed Angle Screw 150.52 144.0mm/ 4.35 01-02-2011 157021000193 Hospithera Alphatec TRESTLE SCREW 61xxx-xxx / 71xxx-xx 167.45 65.92 108.00 144.55 17.20 01-02-2011 157021000281 Johnson & Johnson MedicalDepuy Skyline Screw 172.45 65.60 28.20 01-02-2011 157021000315 MEDIANN ORIA ZENITH Vis FT10-BFxxx 173.01x / 171.6xx / 110.52 144.30 01-02-2011 157021000272 Johnson & Johnson MedicalDepuy Eagle+ / Swift+ screw 1836 5x 0xx 172.1mm Fixed Angle Screw 171.40 108.92 108.52 144.60 28.00 108.9xx 173. L-X 876-8xx 173.88 01-02-2011 157021000254 InSpine Belgium Schroef variabel D4.92 108.35 01-02-2011 157021000333 Medtronic Atlantis screw FIXED SELF TAP xmm X xxmm X47724xx 173.07 17.45 65.53 14.60 24.40 108.45 60.52 144.45 65.7xx 173.20 01-02-2011 157021000297 Johnson & Johnson MedicalDepuy Slimloc Screw 1868 50 xxx / 1868 52 xxx / 1868 54 xxx / 1868 60 0xx / 1868 62 0xx / 1868 64 0xx 1796 06 xxx / 1796 07 xxx 104.60 28.07 17.

55 15.52 144.45 39.60 14.60 28.15 11.52 144.45 65.35 01-02-2011 157021000403 NEW2DM Vis Cervicale Morpho VPC4xx(x) 173.35 01-02-2011 157021000622 Cormed Spider cervical screw N60000135 -> N60000152 173.35 01-02-2011 157021000464 SDI Belgium Vis C3™ à angle variable 4.40 108.93 144.07 17.90 01-02-2011 157021000552 STRYKER REFLEX SCREW 4.00x 173.92 108.45 46.Vis cervicale Ǿ 4 Auto Forante VCFA 40 xx 173.5 mm x xx mm C1-R45xx 173.60 28.60 28.07 17.45 65.90 01-02-2011 157021000534 STRYKER 4x YYMM VAR.35 01-02-2011 157021000394 Medtronic Zephir (screw/ revision screw) D-X L-X 8792xxx 173.45 50.00 144.90 01-02-2011 157021000543 STRYKER REFLEX SCREW 48614xxx 159. titanium.55 17.00x 173.90 01-02-2011 157021000516 STRYKER 4.84 01-02-2011 31-08-2012 157021000595 MSH Osmium / ADD-plus Cancellous bone screw.76 144.48 15.60 0.60 28.45 65.45 46. 48654xxx 159.60 28.614.512 -> 04.45 64.16 108.60 3.52 144.00 144.52 144.613.92 108.60 28.66 01-02-2011 31-08-2012 157021000604 Zimmer Trinica screws 07.Bijwerking 01-08-2013 Page 3 (700416-700420) .40 108.45 65.33 108.60 14.07 17.40 144.92 108.92 108. length 12 mm CS 1301-xxT 116.35 01-02-2011 157021000473 SDI Belgium Vis C3™ à double fonction 4 mm x xx mm C1-D40xx 173.35 01-02-2011 157021000421 Ortho Team FENICIA .Vis Cervicale VCF4xxx 173.92 108.60 14.92 108.92 108.07 17.35 01-02-2011 157021000577 MSH mambo bone screw grey.157021000376 Medtronic Premier screw 686xxxx 173.55 15.92 108.55 17.92 108.31 15.45 50.07 17.00 144.60 28.00 108.07 17.5 mm CS 1830-xx 116.52 144.55 15.45 65.95 14.52 144.07 17.55 15.52 144.45 65.40 108.45 50.613.30 01-02-2011 157021000412 Ortho Team FENICIA .90 01-02-2011 157021000525 STRYKER 4.60 10.35 01-02-2011 Mise à jour 01-08-2013 .80 108.45 65.40 108.45 65.45 65.60 28.07 17.60 28.52 144.ANGLE SCREW 48674xxx 159.52 144.35 01-02-2011 157021000385 Medtronic Venture screw (variable/ fixed/ self tapping/selfdrilling) D-X.ANGLE SCREW 48694xxx 159.ANGLE SELFDR.60 116.45 50.52 144.07 17.07 17.55 15.00 144.00 144.40 108.92 108.60 14. Ø 4 mm.92 108.45 65.X x YYMM 48624xxx 154.35 01-02-2011 157021000631 Cormed Sagesse cervical screw B051114xx 173.52 144.00 108.45 64.60 28. 486440xx 159.60 14.52 144.6xx 173.15 11.30 01-02-2011 157021000507 STRYKER 4 x YYMM FIX.07 17.45 65.49 01-02-2011 157021000561 Synthes Vectra schroef 04.35 01-02-2011 157021000482 SDI Belgium Vis C3™ autotaraudeuses 4 mm x xx mm C1-SD40xx 173.92 108.60 28.60 10.45 8.45 65.ANGLE SELFDR.001xx.60 116.45 65.52 144.07 17.45 50.66 01-02-2011 31-08-2012 157021000586 MSH mambo rescue screw yellow.X x YYMM FIX.07 17.35 01-02-2011 157021000437 OSTEON CERVICAL SCREW CS 30xx / CS 40xx / CS 45xx 154.52 144.60 28.00 144.07 17.92 108.35 01-02-2011 157021000455 SDI Belgium Vis C3™ à angle variable 4 mm x xx mm C1-S40xx 173.45 8.47 01-02-2011 157021000446 SDI Belgium Vis C3™ à angle fixe 4 mm x xx mm C1-C40xx 173.60 28.45 65.92 108.60 28. L-X 979xxxx 173.0081x.45 65.868 / 04.40 108.35 01-02-2011 157021000613 Zimmer Trinica Self-Drilling screw 07.40 108.60 0.52 144.X x YYMM VAR.60 28.92 108.00 144.07 17.60 28.60 28. ø 3.35 01-02-2011 157021000491 SHARK MEDICAL Vis Cervicale Morpho VPC4xx(x) 173. ø 4 mm CS 1832-1x 148.

65 14.10 143.60 116.80 108.31 01-02-2011 157021000656 Ixemel Vis de blocage d'urgence Easy plate 5432.07 17.45 53.92 108.86 16.60 116.66 01-09-2012 157021000771 Hospithera mambo rescue screw yellow.71 108.07 17.23 01-06-2012 157021000735 Biomet MAXAN Variable Self-Drilling screw 14-5216xx 162.40 144.15 11.60 3.00 108.45 53. titanium.92 108.4.09 01-11-2011 157021000701 Biomet MAXAN Fixed Self-Drilling screw 14-5215xx 162.00 108.20T 143.00 108.10 0.4.1x / 5432.86 16.86 16.45 53.31 144.31 01-02-2011 157021000674 SHARK MEDICAL Vis C-plate CP13xxT/ CP14xxT / CP23xxT / CP24xxT 173.45 53.E 143.45 34.31 144.23 01-06-2012 157021000753 Biomet MAXAN Blunt Variable screw 14-5216xxB 162.4.71 108.60 28.45 8.12F -> 5432.45 8.45 53.23 01-06-2012 157021000726 Biomet MAXAN Variable screw 14-5216xx 162.23 01-06-2012 157021000762 Hospithera mambo bone screw grey.60 0.60 17.60 28.66 01-09-2012 Mise à jour 01-08-2013 .10 0.95 14.35 01-02-2011 157021000683 LDR MEDICAL Vis C-plate CP13xxT/ CP14xxT / CP23xxT / CP24xxT 173.4.00 108.4.45 34.45 65.60 17.71 108.98 140.15 11.60 17.86 16.60 17.157021000647 Ixemel Vis de blocage Easy plate 5432.86 16.52 144.45 39. ø 3.98 0.71 108.4.31 144.10 143.52 144.86 16.00 108.53 14.5 mm CS 1830-xx 116.45 65.65 14.20F 143. length 12 mm CS 1301-xxT 116.35 01-02-2011 157021000692 Hospithera TRYPTIK ANTI BACKOUT CERV SCREW ø40 MOSCS40xx-S 140.31 144.71 108.60 17.10 0.84 01-09-2012 157021000787 Hospithera Osmium / ADD-plus Cancellous bone screw.00 108. Ø 4 mm.23 01-06-2012 157021000744 Biomet MAXAN Blunt Fixed screw 14-5215xxB 162.EF / 5432. ø 4 mm CS 1832-1x 148.23 01-06-2012 157021000717 Biomet MAXAN Fixed screw 14-5215xx 162.71 108.31 144.31 01-02-2011 157021000665 Ixemel Vis polyaxiale Easy plate 5432.Bijwerking 01-08-2013 Page 4 (700416-700420) .31 144.60 17.10 143.45 34.45 53.45 32.60 0.65 14.

86 232. / Prestataire avec ou sans convention Supplement patiënt Gew.56 27. inclusief alle toebehoren voor fixatie en blokkering Valeur de U .Prijs (incl. met overeenkomst .47 174.I.39 46. / Verstr. / Prestataire non conventionné Supplement patiënt / Verstr.47 174.86 232.5mm Rigid Screw. / Verstr.O.Bijwerking 01-08-2013 Page 1 (700431-700442) .G.86 232. / Verstr.G.Supplement patiënt W.0mm / 4.51x + 110.88 01-02-2011 157022000064 Cormed Liberty cervical screw S9/VCS.86 232. 10mm-20mm + Set Screw 110. met of zonder overeenkomst D = Remboursement Bén. zonder overeenkomst E = Supplément patient Bén.00 174. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700431-700442 Vis constituée de plusieurs éléments pour l'ancrage d'une plaque antérieure cervicale.Terugbetaling : Marge de sécurité .74 € is van toepassing op het geheel van de wervelkolomimplantaten. recht.56 27.050 232.39 232.Terugbetaling W. recht.P.56 27. ordin.0xx + 110. recht.5xx + 110.56 27.88 01-02-2011 157022000021 B Braun Medical ABC 2 screw oversized FJ94xT 278.39 46.09 23.30 104.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.40xx.88 01-02-2011 157022000055 B Braun Medical Quintex – semiconstrained screw / semiconstrained rescue screw SC5xxT 278.I.56 27. y compris toutes les pièces de fixation et d'attache Schroef bestaande uit meerdere elementen voor verankering van een anterieure cervicale plaat.39 232.39 46. Self-Drilling.47 174.30 58.88 01-02-2011 157022000073 Cormed Sonoma cervical screw 21.47 174. / Verstr.U waarde : U 225 Remboursement .30 104.050 / 110.xxxx 278. Self-Tapping.O.xxxx / 23. 10mm-16mm + Set Screw 110.0mm / 4.050 / 110.P.W.47 174. / Prestataire non conventionné Terugbetaling Gew.88 01-02-2011 157022000082 Globus Medical Belgium 4.39 46.30 104.39 46.39 46.4xXxx 278.00 174.39 0.30 58.86 232.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .23 01-02-2011 157022000107 Orthogèse BJR Vis cervicale (avec insert) BJL4302. met of zonder overeenkomst C = Supplément patient Bén.30 104.30 104.88 01-02-2011 157022000037 B Braun Medical Quintex – constrained screw / constrained rescue screw SC4xxT 278.050 232.I. met overeenkomst .23 01-02-2011 157022000091 Globus Medical Belgium 4. / Prestataire conventionné .I.39 0.A = Prix (TVAc) .30 104.01x + 110.4xXxx / BJL4303.86 232. BTW) B = Remboursement Bén.86 232. / Verstr. ordin. ordin.47 174.88 01-02-2011 Mise à jour 01-08-2013 ./Prestataire conventionné .86 232. ordin.Supplément patient V.56 27.39 46. Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157022000012 B Braun Medical ABC 2 screw monocortical FJ93xT 278.W. S9/VCR.86 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.56 27.39 46. / Prestataire avec ou sans convention Terugbetaling Gew.Plafondprijs : 278.56 27.Remboursement V.45xx 278.88 01-02-2011 157022000046 B Braun Medical Quintex – dynamic screw / dynamic rescue screw SC6xxT 278.5 mm Rigid Screw.30 104.47 174.47 174.09 23.30 104.39 € Prix plafond .Veiligheidsgrens : 232.

30 104.86 232.780 278.00 174.39 46.55 21. bolt.0xx + 497.88 01-02-2011 157022000134 MSH osmium / ADD plus screw incl.53 01-05-2013 157022000177 InSpine Belgium Slimfuse – Self-Tapping rescue screw split tip 21-45R-ST-xxT 235.53 01-05-2013 Mise à jour 01-08-2013 .39 2.157022000116 Synthes CSLP schroef SD + expansie schroef 450.86 232.780 278.32 232. golden.32 232.30 37.18 01-09-2012 157022000152 InSpine Belgium Slimfuse – Self-Tapping rescue screw 21-50R-ST-xxT 235.56 27.93 174.18 01-02-2011 157022000143 Hospithera osmium / ADD plus screw incl.30 37.39 2. bolt.39 2.00 174.56 27.32 232.02 23.93 174.1xx + 497. Ø 5 mm.02 23. titanium CS 1300-1xT 211.Bijwerking 01-08-2013 Page 2 31-08-2012 (700431-700442) .30 104.02 23.30 61.93 174.55 21.53 01-05-2013 157022000161 InSpine Belgium Slimfuse – Self-Tapping (drilling) rescue screw 21-45R-SX-xxT 235. golden.30 61.88 01-02-2011 157022000125 Synthes CSLP schroef ST + expansie schroef 487.85 0.30 61.47 174.39 46.85 211.47 174. Ø 5 mm.85 0.85 211. titanium CS 1300-1xT 211.

38 61. ordin. 20mm-38mm 130.Bijwerking 01-08-2013 Page 1 (700453-700464) ./Prestataire conventionné . ordin. / Verstr.74 01-02-2011 157023000023 Cormed Unity Anterior plate 43.48 0.W.96 01-02-2011 157023000041 Globus Medical Belgium CITADEL Anterior Lumbar Plate 2-Level.28 387.Prijs (incl. met overeenkomst .I.290 619.69 516.38 61.41 103.69 516.163 -> 130.U waarde : U 500 Remboursement .96 01-02-2011 157023000075 Globus Medical Belgium GATEWAY™ Thoracolumbar Plate. met of zonder overeenkomst D = Remboursement Bén.41 103.31 232.69 € Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157023000014 B Braun Medical Macs TL Stabilization plate SX811T -> SX818T 317.69 516. 20mm-34mm 130.96 01-02-2011 157023000057 Globus Medical Belgium CITADEL Anterior Lumbosacral Plate 1-Level.500 619.96 01-02-2011 157023000084 Medtronic Anterior Plate 4 hole xxmm 98740xx 619.31 232.28 387.P. / Verstr.31 232.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .234 619. / Prestataire conventionné .48 0.263 -> 130.I.31 232.Terugbetaling : Marge de sécurité .96 01-02-2011 157023000093 Medtronic Vantaga Thoracic Plate XX cm 9331xxx 619. recht. / Prestataire avec ou sans convention Terugbetaling Gew. pour fixation antérieure ou antéro-laterale à la colonne vertébrale thoraco-lombaire par vis Plaat van vaste lengte voor anterieure of antero-laterale fixatie aan de thoraco-lumbale wervelkolom. ordin.69 516.31 232.41 103.28 387. / Verstr.220 -> 130.Plafondprijs : 619.38 61.Remboursement V. ordin.41 103.28 387. 63mm-99mm 130.28 387.96 01-02-2011 157023000032 Globus Medical Belgium CITADEL Anterior Lumbar Plate 1-Level.69 516.I.G.Supplément patient V.Terugbetaling W.69 516.31 232.69 516.Veiligheidsgrens : 516. / Prestataire non conventionné Terugbetaling Gew. 36mm-42mm 129. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700453-700464 Plaque de longueur fixe. recht.96 01-02-2011 157023000102 Medtronic Vantage ATL Plate XX cm 9330xxx 619.38 61.96 01-02-2011 Mise à jour 01-08-2013 .28 387. te verankeren via schroeven Valeur de U .48 317.38 61.28 387.38 61.69 516.I.41 103. met overeenkomst . Prix plafond .41 103. / Verstr.G.00 31.28 387.00 317.31 232. 63mm-90mm 130.38 61.38 61.41 103.41 103.W.38 61.138 619.74 € is van toepassing op het geheel van de wervelkolomimplantaten.O.Supplement patiënt W. / Verstr.28 387.96 01-02-2011 157023000066 Globus Medical Belgium CITADEL Anterior Lumbosacral Plate 2-Level.31 232. / Prestataire avec ou sans convention Supplement patiënt Gew. BTW) B = Remboursement Bén.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148. met of zonder overeenkomst C = Supplément patient Bén.4xx / 129.31 232. recht.41 103.69 516. / Prestataire non conventionné Supplement patiënt / Verstr.xxxx 619.199 619.P. zonder overeenkomst E = Supplément patient Bén.120 -> 130.A = Prix (TVAc) .O.41 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.

96 01-02-2011 157023000172 Synthes ATB 449.69 516.00 387.0101x.00 387.002 tot 07.96 01-02-2011 157023000285 Globus Medical Belgium TRUSS Plate 163.41 103.69 39.010xx.44 01-02-2011 157023000267 Zimmer Trinica ALP sacral 43mm-47mm 07.31 7.00 0.50 01-09-2012 157023000346 Hospithera Golden Gate C-Plate A/B + Gate CS 3601-xxx-A/ 3601-xxx-B + CS 3603-xxx 619.56 01-02-2011 157023000276 MSH Golden Gate C-Plate A/B + Gate CS 3601-xxx-A/ 3601-xxx-B + CS 3603-xxx 619.41 0.38 61.38 61.006 tot 07.69 39.31 7. length 29 mm CS 1824-29 395.41 103.31 117.23 387.00 387.41 516.28 387. 4-hole.43 0.00 409.31 232.1xx 619.69 516.28 387.010 575. 4-hole.44 01-02-2011 157023000242 Zimmer Trinica ALP lumbar 43mm-51mm 07.50 01-09-2012 157023000337 Hospithera mambo plate M green.69 40.010 575.43 0.31 7.00 387.31 188.31 21.69 516.50 01-02-2011 31-08-2012 157023000224 MSH mambo plate M green.157023000111 Medtronic Xantus Plate XX mm + Xantus Locking Plate XX mm 89671xx + 89672xx 619.69 516.010xx.006 tot 07.38 61.69 39.12 50.31 188.00 0.31 232.31 117.662.43 504.31 232.41 59.31 232.69 516.010xx.31 232.00 387.69 516. 4-hole.00 387.28 387.2xx 619.38 61.96 01-09-2012 Mise à jour 01-08-2013 .00 409.31 232.31 232.41 103.41 59.41 0.38 61.0101x.41 103.00 409.38 61.69 516.31 21.00 387.00 0.00 387.50 01-02-2011 31-08-2012 157023000233 Zimmer Trinica ALP lumbar 35mm-41mm 07.00 0.31 21.90 01-09-2012 157023000312 Hospithera mambo extension plate M green + mambo settling or clamping screw CS 1822-02 + CS 1826-0x 409.10 51. 4-hole.38 61.28 387. length 26 mm CS 1822-26 395.31 21.69 40.00 395.002 tot 07.96 01-02-2011 157023000145 OSTEON THORACALE PLAAT 630DT7V/Lxx(x) 516.96 01-02-2011 157023000181 Synthes TSLP 489.00 387.23 387.xxx 619.90 01-09-2012 157023000321 Hospithera mambo plate L blue.00 395.38 61.00 409.28 387.33 57. length 29 mm CS 1824-29 395.90 01-02-2011 31-08-2012 157023000215 MSH mambo plate L blue.38 61.64 01-02-2011 157023000154 SDI Belgium Plaque antero-latérale d'extension lombaire AARO™ un niveau NG2043x 516.28 387.xxx 619.96 01-02-2011 157023000136 Orthogèse Plaque antélys 12PCLASxx 619.00 387.00 0.31 232.41 103.96 01-02-2011 157023000127 Medtronic XX mm Pyramid Locking Plate & Set Screw + Pyramid Plate XXmm 89692xx + 89691xx 619.64 516.00 0.90 01-02-2011 31-08-2012 157023000206 MSH mambo extension plate M green + mambo settling or clamping screw CS 1822-02 + CS 1826-0x 409.43 504.10 51.41 103.31 232.64 01-02-2011 157023000163 SDI Belgium Plaque antero-latérale lombaire AARO™ proximale + une plaque anterolatérale distale avec vis de blocage NG20431 /NG20481+ NG20425M/NG20455L 619.31 232.31 129.38 61.64 516.00 387.69 516.28 387.0101x.00 387.Bijwerking 01-08-2013 Page 2 31-08-2012 (700453-700464) .33 57.41 516.69 516.12 50.010xx.31 7.41 103.31 129.005 504.69 40.69 39.96 01-02-2011 157023000294 Synthes Oracle plate 04.69 516.56 01-02-2011 157023000251 Zimmer Trinica ALP sacral 35mm-41mm 07.96 01-02-2011 157023000197 MSH mambo extension plate L blue + mambo settling or clamping screw CS 1824-02 + CS 1826-0x 409.005 504. length 26 mm CS 1822-26 395.00 0.00 395.28 387.00 0.00 395.41 103.28 387.41 103.69 40.0101x.41 103.28 387.96 01-02-2011 157023000303 Hospithera mambo extension plate L blue + mambo settling or clamping screw CS 1824-02 + CS 1826-0x 409.

O. ordin.W.Supplément patient V.0xx 848.Terugbetaling : Marge de sécurité . ordin.24 305.G. / Prestataire conventionné . / Verstr.00 722. ordin.Veiligheidsgrens : 722.I.Bijwerking 01-08-2013 Page 1 (700475-700486) . te verankeren via schroeven.75 01-02-2011 Mise à jour 01-08-2013 .I.80 01-02-2011 157024000025 Synthes Telefix 499.G. recht.74 € is van toepassing op het geheel van de wervelkolomimplantaten.98 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.A = Prix (TVAc) .98 125. recht.33 86. recht. / Verstr. ordin.02 542.P. Prix plafond .57 722.00 722. / Prestataire non conventionné Terugbetaling Gew.P.3xx 867./Prestataire conventionné .De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.U waarde : U 700 Remboursement .98 144.W.76 84.Plafondprijs : 867.24 325.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale . met overeenkomst . met of zonder overeenkomst C = Supplément patient Bén. met overeenkomst . / Verstr.O.98 125.0xx 848.I.Prijs (incl.57 € Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157024000016 Synthes Arcofix 04. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700475-700486 Plaque téléscopique (longueur variable) pour fixation antérieure ou antéro-laterale à la colonne vertébrale thoraco-lombaire par vis Telescopische plaat (lengte aanpasbaar) voor anterieure of antero-laterale fixatie . / Verstr.I.661. / Verstr.Supplement patiënt W. / Prestataire avec ou sans convention Terugbetaling Gew.59 542. met of zonder overeenkomst D = Remboursement Bén.02 542.Terugbetaling W. / Prestataire avec ou sans convention Supplement patiënt Gew.80 01-02-2011 157024000034 Globus Medical Belgium TRUSS Compression Plate 163. BTW) B = Remboursement Bén.24 305. zonder overeenkomst E = Supplément patient Bén.Remboursement V. / Prestataire non conventionné Supplement patiënt / Verstr. aan de thoraco-lumbale wervelkolom Valeur de U .76 84.

O.52 144.6xx 159. / Prestataire avec ou sans convention Supplement patiënt Gew. ordin. 22mm-57mm 130.Remboursement V. / Verstr.31 15.45 46.45 61.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .P.Bijwerking 01-08-2013 Page 1 (700490-700501) .60 28.92 108.60 25. met of zonder overeenkomst D = Remboursement Bén.16 108. recht.90 01-02-2011 157025000054 Globus Medical Belgium 6.00 144.55 15.xxxx 173.Supplement patiënt W.W.07 17.5mm Self-tapping Screw.00 144. met of zonder overeenkomst C = Supplément patient Bén.66 17.35 01-02-2011 157025000081 Medtronic Vantage ATL Screw 6.76 144.11 144.60 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.45 50. / Verstr.01 01-02-2011 157025000072 Medtronic Screw VAR xx X xxmm 98716xxx 173.40 108.16 108.I. ordin.Terugbetaling W.45 46.U waarde : U 140 Remboursement .O. / Prestataire avec ou sans convention Terugbetaling Gew. ordin.P.A = Prix (TVAc) . / Verstr.I. / Prestataire conventionné .G.45 61. / Verstr.5mm Self-Tapping Screw.76 144.01 01-02-2011 157025000097 Medtronic Vantage Bolt Ti 9338xxx 170.47 01-02-2011 157025000027 B Braun Medical Macs TL Stabilisation screw thoracic SX826T -> SX829T 154.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148./Prestataire conventionné . zonder overeenkomst E = Supplément patient Bén.45 65.Prijs (incl. Fixed Angle.52 € Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157025000011 B Braun Medical Macs TL Stabilisation screw SX78xT 154.47 01-02-2011 157025000036 Cormed Unity Anterior plate fixation screw 43.66 17.11 144. met overeenkomst .60 25.G. BTW) B = Remboursement Bén.51 108.W.11 144.60 25.11 144. met overeenkomst . recht.45 50.I. / Prestataire non conventionné Terugbetaling Gew.35 01-02-2011 157025000045 Globus Medical Belgium 6.60 14.01 01-02-2011 157025000106 Medtronic Vantage Thoracic Screw 5. / Prestataire non conventionné Supplement patiënt / Verstr.Supplément patient V. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700490-700501 Vis simple pour l'ancrage d'une plaque antérieure ou antéro-laterale à la colonne thoraco-lombaire Enkelvoudige schroef voor verankering aan de thoraco-lumbale wervelkolom van een anterieure of anterolaterale plaat Valeur de U .74 € is van toepassing op het geheel van de wervelkolomimplantaten.5 L-X 93355xx 170.60 14.52 144.45 61.45 65.90 01-02-2011 157025000063 Medtronic Bone Screw D6.55 15.5mm L-X 93365xx 170.92 108.8xx 159.60 10.51 108.60 28.60 10.45 61. 22mm-57mm 130.31 15. recht.5 L-X (Xantus/ Pyramid) 89686xx 170. ordin.Plafondprijs : 173.60 25.40 108. Prix plafond . / Verstr.01 01-02-2011 Mise à jour 01-08-2013 .51 108.07 17.Veiligheidsgrens : 144.Terugbetaling : Marge de sécurité .I.66 17. Variable Angle.51 108.66 17.

45 65.Bijwerking 01-08-2013 Page 2 31-08-2012 (700490-700501) .95 14.35 01-09-2012 Mise à jour 01-08-2013 .35 01-02-2011 157025000151 Synthes ATB / TSLP schroef 489.662.07 17.07 17.01014.60 116.00 108.8xx 173.15 14.07 17.00 108.45 65.45 39.35 01-02-2011 157025000176 MSH mambo bone screw grey.60 28.45 65.60 144.60 28.45 65.95 14.15 11.52 144.35 01-02-2011 157025000246 Synthes Oracle screw 04. ø 4 mm CS 1832-xx 148.45 65.60 28.60 3.60 28. ø 3.60 28.07 17.45 65. ø 3.661.07 17.80 108.07 17.1xx 173.45 65.35 01-02-2011 157025000167 Synthes Telefix ant schroef 499.60 28.52 144.52 144.52 144.52 144.45 65.92 108.92 108.60 116.52 144.35 01-02-2011 157025000237 Globus Medical Belgium Fixed Angle Screw 163.84 01-02-2011 31-08-2012 157025000194 Zimmer Trinica ALP fixed angle screw 07.45 65.35 01-02-2011 157025000212 MSH Golden Gate screw CS 3608-xxx 173.80 108.60 28.40 144.07 17.92 108.45 65.84 01-09-2012 157025000273 Hospithera Golden Gate screw CS 3608-xxx 173.40 144.07 17.00x 173.60 3.07 17.15 11. ø 4 mm CS 1832-xx 148.35 01-02-2011 157025000203 Zimmer Trinica ALP variable angle screw 07.60 28.00 108.92 108.00x 173.01x 173.174 173.52 144.157025000115 Orthogèse Antélys screws 12VCLAS05-xxx 173.52 144.01013.92 108.92 108.35 01-02-2011 157025000142 Synthes Arcofix schroef 04.60 0.45 65.60 28.60 28.07 17.35 01-02-2011 157025000221 Globus Medical Belgium Variable Angle Screw 163.60 28.5 mm CS 1830-xx 116.35 01-02-2011 157025000124 OSTEON ENKELVOUDIGE THORACALE SCHROEF 630Lxx 144.92 108.45 65.66 01-02-2011 31-08-2012 157025000185 MSH mambo rescue screw yellow.60 28.5 mm CS 1830-xx 116.45 8.140 -> 489.45 8.1xx 173.46 01-02-2011 157025000133 SDI Belgium Vis simple d'ancrage pour plaque antérieure AARO Diamètre 6 mm x xx mm / 7 mm x xx mm NG2706xx / NG2707xx 173.07 17.66 01-09-2012 157025000264 Hospithera mambo rescue screw yellow.52 144.92 108.92 108.07 17.45 36.92 108.60 0.52 144.45 39.52 144.35 01-02-2011 157025000255 Hospithera mambo bone screw grey.92 108.92 108.60 0.52 144.6xx 173.

57 01-02-2011 157026000047 B Braun Medical Macs TL Twin screw XL + Macs TL Fixation nut + Macs TL Locking screw SX821T -> SX823T + SX802T + SX803T 495.00x + 499.75 413.57 01-02-2011 157026000031 B Braun Medical Macs TL Polyaxial screw + Macs TL Clamping element + Macs TL Fixation nut + Macs TL Locking screw SX79xT + SX800T / SX801T + SX802T + SX803T 495.O. voor verankering van een anterieure of antero-laterale plaat aan de thoraco-lumbale wervelkolom . ordin.13 82.57 01-02-2011 157026000065 MSH Golden Gate screw polyaxial + Golden gate Inlay + golden gate hex nut CS 3607-xxx + CS 3609-01 + CS3609-02 495.A = Prix (TVAc) .Terugbetaling : Marge de sécurité . / Prestataire non conventionné Supplement patiënt / Verstr.W. met overeenkomst .75 413. ordin.75 413.O.90 49.75 413.57 01-02-2011 157026000056 Synthes Telefix post schroef + blekkeerschroef 499.Terugbetaling W. / Prestataire avec ou sans convention Terugbetaling Gew.P.019 365.90 49.92 413.57 01-02-2011 157026000074 Hospithera Golden Gate screw polyaxial + Golden gate Inlay + golden gate hex nut CS 3607-xxx + CS 3609-01 + CS3609-02 495./Prestataire conventionné .57 01-09-2012 Mise à jour 01-08-2013 .U waarde : U 400 Remboursement .75 € Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157026000013 B Braun Medical Macs HMA Monoaxial screw + Macs TL Fixation nut SW13xT / SW14xT + SX802T 444.I.85 36. inclusief alle toebehoren voor fixatie en blokkering Valeur de U .62 309.Prijs (incl.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.I. y compris toutes les pièces de fixation et d'attache Schroef bestaande uit meerdere elementen.49 01-02-2011 157026000022 B Braun Medical Macs TL HMA Polyaxial screw + Macs TL Fixation nut + Macs TL Locking SX805T -> SX808T + SX802T screw + SX803T 495.70 0.07 44.13 82.90 49. recht. recht.13 82. / Prestataire conventionné .74 € is van toepassing op het geheel van de wervelkolomimplantaten. / Verstr. / Verstr.Plafondprijs : 495.85 185. BTW) B = Remboursement Bén.90 49.79 309.I. ordin.62 309.P. zonder overeenkomst E = Supplément patient Bén.70 365.G.00 309. recht.13 82.W.90 49.Veiligheidsgrens : 413.62 309.85 185.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .I. met overeenkomst .85 185. met of zonder overeenkomst C = Supplément patient Bén.62 309.Supplément patient V.13 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148. / Verstr.85 185.13 82.85 185. / Verstr.85 55.85 135.Remboursement V.13 31.G.75 413. Prix plafond . / Verstr. pour l'ancrage d'une plaque antérieure ou antéro-laterale à la colonne thoraco-lombaire. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700512-700523 Vis constituée de plusieurs éléments. / Prestataire avec ou sans convention Supplement patiënt Gew. met of zonder overeenkomst D = Remboursement Bén.Bijwerking 01-08-2013 Page 1 31-08-2012 (700512-700523) .62 309. ordin. / Prestataire non conventionné Terugbetaling Gew.Supplement patiënt W.

S.47 01-02-2011 157027000076 Hospithera Dens Double-threaded screw. ordin. 4.00 161.00 19.Bijwerking 01-08-2013 Page 1 31-08-2012 (700534-700545) .00 194.74 € is van toepassing op het geheel van de wervelkolomimplantaten. / Prestataire avec ou sans convention Terugbetaling Gew. met of zonder overeenkomst C = Supplément patient Bén.Supplément patient V.P. met overeenkomst . ordin.Plafondprijs : 371.I. titanium CS 1100-xxT 194.00 309.C.00 16. recht. recht. / Verstr.Terugbetaling W. titanium) LB4xxT.12 0.Terugbetaling : Marge de sécurité .74 194.4xx 371. / Prestataire conventionné . ordin.00 194. / Verstr. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700534-700545 Vis isolée pour fixation d'odontoïde Alleenstaande schroef voor densfixatie Valeur de U .O.I.0 mm Cannulated Cortical screw L-X 873-0xx 371.Cort screw (partially and full threaded.Prijs (incl. zonder overeenkomst E = Supplément patient Bén.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148. / Verstr.85 61.85 309. BTW) B = Remboursement Bén. ordin.G.85 61.G.74 194.15 232. met overeenkomst . / Verstr. / Prestataire non conventionné Terugbetaling Gew.W.C.61 37.00 19.U waarde : U 300 Remboursement .74 0. Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157027000015 B Braun Medical Apfelbaum .85 0.00 309.Supplement patiënt W.46 30. met of zonder overeenkomst D = Remboursement Bén.82 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.97 232.82 309.I.39 139.S. recht.74 0.18 01-02-2011 157027000067 MSH Dens Double-threaded screw. titanium CS 1100-xxT 194.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .P.W.A = Prix (TVAc) . / Verstr./Prestataire conventionné .12 161.10 01-02-2011 157027000042 Medtronic U.39 138.43 37.O. / Prestataire non conventionné Supplement patiënt / Verstr. / Prestataire avec ou sans convention Supplement patiënt Gew.0 mm Cannulated Cortical Lag screw L-X 873-1xx 371.74 0.00 232.10 01-02-2011 157027000051 Synthes schroef densfractuur 405. 4.15 232.Remboursement V.85 61.61 37.39 77.74 0.85 € Prix plafond .xxx 161.Veiligheidsgrens : 309.12 0. LB5xxT 309.39 138.I.11 01-02-2011 157027000033 Medtronic U.S.47 01-09-2012 Mise à jour 01-08-2013 .98 01-02-2011 157027000024 Globus Medical Belgium Corridor Bone Screw 148.S.

93 92.04 65. BTW) B = Remboursement Bén./Prestataire conventionné .I.00 154.93 51.57 206.Terugbetaling : Marge de sécurité .G.65 01-02-2011 157028000044 Globus Medical Belgium Single Staple.29 0.685 206.W.04 0. / Prestataire avec ou sans convention Supplement patiënt Gew.00 154.88 206.W.Supplement patiënt W. / Prestataire avec ou sans convention Terugbetaling Gew.65 01-02-2011 157028000053 Johnson & Johnson MedicalDepuy Isola Anterior Single Hole Staple 502016xx 247.01 0. / Verstr.Plafondprijs : 247.0mm-8.31 154.5mm 129.00 122.57 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.64 20. ordin.I.29 0.00 154.00 12.88 206. Prix plafond .29 95. recht.78 01-02-2011 157028000062 Johnson & Johnson MedicalDepuy Staple/ Plate Expedium Anterior 1877 01 0xx 247.O.64 20.04 0.01 0. / Prestataire non conventionné Supplement patiënt / Verstr.20 01-02-2011 157028000105 Medtronic Colorado2 Pediatric Plate 86495xx 247. ordin. ordin.650 ->129.31 154.G.01 122.00 95.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.93 92.29 0. zonder overeenkomst E = Supplément patient Bén.57 206.Terugbetaling W. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700556-700560 Implant placé entre l'implant d'ancrage et l'os pour éviter l'enfoncement d'un implant d'ancrage (STAPLE) Implantaat geplaatst tussen het verankeringsimplantaat en bot ter voorkoming van verzinking van een verankeringsimplantaat (STAPLE) Valeur de U .Prijs (incl. / Prestataire conventionné .Supplément patient V.64 20.01x 206. / Verstr.P.00 9.00 9.U waarde : U 200 Remboursement . met overeenkomst . / Prestataire non conventionné Terugbetaling Gew.31 154. / Verstr.95 24.Remboursement V.57 206.I. met overeenkomst .74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .52 01-02-2011 157028000087 Medtronic CD Eclips staple 12mm ti 848xxxx 95.57 41.93 92.00 65.78 01-02-2011 Mise à jour 01-08-2013 .52 01-02-2011 157028000096 Medtronic Colorado2 Inox Agraffe for pedicular hook 8611300 122.00 95.00 6. met of zonder overeenkomst C = Supplément patient Bén.I.Veiligheidsgrens : 206.50 01-02-2011 157028000026 Globus Medical Belgium Dual Staple 131. ordin.65 01-02-2011 157028000035 Globus Medical Belgium Single Staple 131.A = Prix (TVAc) .74 € is van toepassing op het geheel van de wervelkolomimplantaten.57 0. / Verstr.95 24. 5.29 95.88 206.57 0.O.00x 206.95 24.P.57 0. recht. met of zonder overeenkomst D = Remboursement Bén.88 € Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157028000017 Biomet Omega washer 1270-05 / 1270-06 65. recht.78 01-02-2011 157028000071 Medtronic Antares Staple ti 86985xx 95.93 51. / Verstr.57 41.29 0.57 41.93 51.Bijwerking 01-08-2013 Page 1 (700556-700560) .

02 122.93 92.93 92.78 01-02-2011 157028000254 Synthes Agraffe USS ped 498.95 24.57 31.78 01-02-2011 157028000306 Biomet Fixation washer 686x 247.02 0.57 41.95 23.93 92.93 25.57 9.00 9.93 92.95 24.57 41.31 154.57 31.95 23.57 41.57 31.95 24.31 154.93 92.93 82.93 82. Non-Coated 1757101x0(S) 247.88 206.88 206.78 01-02-2011 157028000272 Synthes staple plate 04.52 01-02-2011 157028000132 Medtronic Colorado2 Staple Pediatric Anterior 8649400 247.88 206.78 01-02-2011 157028000202 Medtronic Vantage Staple 933000x 247.31 154.88 206.88 206.29 0.02 0.93 92.95 24.95 24.95 24.61 21.78 01-02-2011 157028000342 Johnson & Johnson MedicalDepuy Washer.31 154.00 180.78 01-02-2011 157028000281 Cormed C-Jaw Staple B1011151x/B1011201x 247.88 206.07 18.88 206.00 122.93 92.88 206.52 01-02-2011 157028000175 Medtronic Colorado2 Ti.29 0. Anterior Staple 8619400 95.00 9.88 206.93 92.95 24.93 92.31 154.88 206.88 206.57 41.95 23.02 122.31 154.31 154.00 122.29 95.93 92.30x 237.57 41.032 / 498.93 61.93 82.88 206.00 12.93 92.78 01-02-2011 157028000315 Biomet Double rod Fixation washer 685x 247.88 206.31 154.57 41.95 24.57 41.78 01-02-2011 157028000211 STRYKER DUAL STAPLE 03820110 -> 03820115 247.5DUALSTAPLE 48130110 -> 48130113 247.20 01-02-2011 157028000157 Medtronic Colorado2 Ti Anterior Plate 86395xx 247.00 95.95 24.31 154.95 24.78 01-02-2011 157028000193 Medtronic STAPLE xxMM X xxMM 472xxxx 247.02 0.88 206.00 154.93 82.93 92.78 01-02-2011 157028000324 SHARK MEDICAL Rehausseur pour vis pédiculaire ES 03x T 247.97 154.93 92.57 41.0xx 237.57 41.29 0.31 154.20 01-02-2011 157028000184 Medtronic Legacy Anterior staple 6541xxx 247.31 154.88 206.033 237.00 95.57 31.31 154.57 41.31 154.57 41.78 01-02-2011 157028000245 Synthes Agraffe USS 498.78 01-07-2012 157028000367 Cormed PASS LP anterior staple B03100010 216. 498.00 0.78 01-02-2011 157028000141 Medtronic Colorado2 Staple Pedicular 8641300 122.78 01-02-2011 157028000227 STRYKER SINGLE STAPLE 03820104 180.93 92.93 92.88 206.00 01-02-2011 157028000236 STRYKER XIA4.54 206.95 24.31 154.78 01-02-2011 157028000123 Medtronic Colorado2 ss.88 206.78 01-02-2011 157028000166 Medtronic Colorado2 Ti.95 24.31 154.78 01-03-2012 157028000351 Cormed PASS LP anterior plate B031000xx 247.31 154.31 154.31 154.78 01-02-2011 157028000333 LDR MEDICAL Rehausseur pour vis pédiculaire ES 03x T 247.78 01-02-2011 157028000297 Biomet Anterior washer 687x 247.95 23.57 41.88 206.65 01-07-2012 Mise à jour 01-08-2013 .95 24.57 41.57 41.88 206. med.31 154.78 01-02-2011 157028000263 Synthes Agraffe USS.95 24.57 41.031 237.31 154.29 95. Staple for pedicular hook 8631300 122.650. Anterior Staple 8639400 95.157028000114 Medtronic Colorado2 ss Anterior Plate 86195xx 247.29 0.88 206.02 0.93 92.95 24.Bijwerking 01-08-2013 Page 2 (700556-700560) .00 12.95 24.57 41.

35 16.P.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .A = Prix (TVAc) .O.20 8. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700571-700582 Implant séparé. met of zonder overeenkomst D = Remboursement Bén.Plafondprijs : 80. pour correction de la surface de contact entre un implant d'ancrage et la tige/plaque/connecteur (WASHER) Afzonderlijk implantaat ter correctie van het contactoppervlak tussen het verankeringsimplantaat en de staaf/plaat/connector (WASHER) Valeur de U .20 8. zonder overeenkomst E = Supplément patient Bén.00 50.05 01-02-2011 157029000082 Johnson & Johnson MedicalDepuy Expedium Offset Spacer Washer SS 1854 91 020 80. / Prestataire conventionné . met of zonder overeenkomst C = Supplément patient Bén.87 50. / Verstr. met overeenkomst .87 50.65 8.W.13 13.42 50.20 8.35 14.42 50.20 8.35 30.55 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148. recht.50 01-02-2011 157029000021 Cormed Evos concave washer 036.87 50.00 67.00 50.71 01-02-2011 157029000073 Johnson & Johnson MedicalDepuy Expedium Anterior Washer 1877 01 009 80.13 0. Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157029000012 Biomet Plate washer 1284-07 65.13 12.55 67.13 € Prix plafond .U waarde : U 65 Remboursement .35 30.55 67.35 29.00x 80.05 01-02-2011 157029000055 Cormed VBR washer 036.O. met overeenkomst .W. / Verstr.13 13.P.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.I.35 30.Remboursement V.Prijs (incl.00 01-02-2011 157029000107 Johnson & Johnson MedicalDepuy Expedium Polyaxial washer SS 1854 91 010 80.Veiligheidsgrens : 67.Terugbetaling W.13 13.Terugbetaling : Marge de sécurité .35 30. recht.20 8. recht. ordin.65 8.65 8.05 01-02-2011 157029000046 Cormed Trinity washer TXW.55 67.55 67. / Verstr.35 29. / Verstr.Supplément patient V.42 50. / Prestataire avec ou sans convention Terugbetaling Gew.G.20x 67.13 67.Supplement patiënt W. ordin.55 67.G.05 01-02-2011 157029000037 Cormed Evos TI washer 036.Bijwerking 01-08-2013 Page 1 (700571-700582) .04 65.69 6. / Prestataire avec ou sans convention Supplement patiënt Gew.00x / 031./Prestataire conventionné . / Verstr.35 30. / Prestataire non conventionné Terugbetaling Gew. BTW) B = Remboursement Bén.13 12.42 50.00 67.00 01-02-2011 Mise à jour 01-08-2013 .13 13.I. / Prestataire non conventionné Supplement patiënt / Verstr.42 50.74 € is van toepassing op het geheel van de wervelkolomimplantaten.655 80. ordin.00x 80.05 01-02-2011 157029000064 Globus Medical Belgium Staple Washer 131.I.00 67.I.78 6.365 80.13 13.04 0.00 01-02-2011 157029000091 Johnson & Johnson MedicalDepuy Expedium Offset Spacer Washer Titanium 1754 91 020 80. ordin.35 29.13 12.

00 67.13 13.35 29.05 01-02-2011 157029000143 Johnson & Johnson MedicalDepuy Spacer 1770 91 020 80.19 6.55 67.98 0.01x 80. height 4 mm CS 1412-4T 31.20 67.35 30.05 01-02-2011 157029000152 Johnson & Johnson MedicalDepuy VSP Plate Spacer Washer SS 202x xx(xx) 80.05 01-02-2011 157029000161 Johnson & Johnson MedicalDepuy VSP Plate Spacer Washer Ti 222x xx(xx) 80.05 01-02-2011 157029000247 MSH neon spacer.00 32.55 67.55 67.00 3.35 30.80 0.00 3.42 50.18 01-09-2012 157029000292 Hospithera neon spacer.80 0.42 50.13 13.13 13.00 3.35 30. green. green.80 31.20 8.05 01-02-2011 157029000186 Medtronic MULTI-AXIAL WASHER.35 23.13 13.55 67.00 3.35 30.13 13.41 50. height 2 mm CS 1412-2T 31.07 50.65 8.55 67.35 30.42 50.20 8.55 67.80 0.20 8.20 8. red.35 30.35 30.00 31.20 8.13 13.35 30.55 67.035 -> 498.00 31.54 67.18 01-02-2011 31-08-2012 157029000265 Cormed PASS LP anterior washer B02208000 69.13 13.05 01-02-2011 157029000231 Synthes Rondelle USS ped 498.18 01-09-2012 157029000301 Eurospine MPM Cale spondylo THCSPx 80.00 01-02-2011 157029000125 Johnson & Johnson MedicalDepuy Isola Anterior Single Hole Washer 5020 016 32.00 31.80 0.13 13.87 50.35 30. TI 99453110 80.05 01-02-2011 157029000177 Medtronic CD Eclips washer 827xxx(x) 80.20 8. height 2 mm CS 1412-2T 31.05 01-02-2011 157029000213 STRYKER WASHER 48220100 74.20 8.80 0.42 50.05 01-09-2012 157029000283 Hospithera neon spacer.55 67.20 8.42 01-02-2011 157029000222 Synthes Rondelle USS 498.05 01-02-2011 157029000195 STRYKER POLYAXIALITY DOMES 489125xx 34.80 31.20 8.20 8.20 8.55 67.13 7.98 34.42 50.85 7.80 0.00 3.98 0.13 2.18 01-02-2011 31-08-2012 157029000256 MSH neon spacer.80 31.05 01-05-2013 Mise à jour 01-08-2013 .95 01-07-2012 157029000274 Aceemed MPM washer THCSPx 80.037 80. height 4 mm CS 1412-4T 31.13 13.05 32.35 30.20 01-02-2011 157029000134 Johnson & Johnson MedicalDepuy Poly washer 1770 91 010 80.05 0.05 0.00 3.13 13.35 30.49 01-02-2011 157029000204 STRYKER WASHER 03820100 80.80 0.55 67.00 31.42 50.13 12.13 13.157029000116 Johnson & Johnson MedicalDepuy Expedium Polyaxial washer Titanium 1754 91 010 80.42 50.80 0.42 50. red.55 67.Bijwerking 01-08-2013 Page 2 (700571-700582) .80 31.42 50.42 50.35 19.00 34.42 50.

29 01-02-2011 157030000084 Cormed Anatomix .12 88. Prix plafond . zonder overeenkomst E = Supplément patient Bén. / Verstr.W.Terugbetaling : Marge de sécurité . / Prestataire avec ou sans convention Supplement patiënt Gew.Supplement patiënt W.94 444.29 01-02-2011 157030000102 Cormed Osta Pek Acif 238x / 43xx / 053.I.74 € is van toepassing op het geheel van de wervelkolomimplantaten.85 53.G. ordin.12 88.09 199. met of zonder overeenkomst D = Remboursement Bén./Prestataire conventionné .xxx 532. / Prestataire non conventionné Supplement patiënt / Verstr.00 333.09 55. ordin.94 € Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157030000014 B Braun Medical Cespace Peek FJ4xxP 388.82 333. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700593-700604 Implant d'arthrodèse non mobile pour placement dans l'espace intervertébral cervical et conçu pour être utilisé seul par niveau Niet beweegbaar arthrodese-implantaat voor plaatsing in de cervicale tussenwervelruimte en ontworpen om als enige per niveau geplaatst te worden Valeur de U .I.C S9.85 53.12 32.94 444. met of zonder overeenkomst C = Supplément patient Bén.09 199. ordin.82 333. / Verstr.94 444. ordin.71 38.09 191.85 53.94 444.Prijs (incl. met overeenkomst .Supplément patient V.O. / Prestataire conventionné .82 333.85 53.Terugbetaling W.29 01-02-2011 157030000057 Cormed Acif peek cage 1102-1xxx 532.12 80.82 333.94 444.12 88.61 52.82 333.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.80 388.88 333.09 199.00 444. BTW) B = Remboursement Bén.xxx 532. / Prestataire avec ou sans convention Terugbetaling Gew.I.P.12 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148. / Verstr.85 53. / Verstr.P.82 333.58 333.94 444.29 01-02-2011 157030000093 Cormed Clia PxCC 532.Remboursement V.70 01-02-2011 157030000041 BJR Bio-Tecma P822625xxx 532.12 88.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .09 199.09 199.80 0.Bijwerking 01-08-2013 Page 1 (700593-700604) .09 199. / Verstr.29 01-02-2011 Mise à jour 01-08-2013 .91 47.29 01-02-2011 157030000075 Cormed Altus CAx/x*13 532.70 444.29 01-02-2011 157030000066 Cormed Actipore PCA.A = Prix (TVAc) .12 88.47 01-02-2011 157030000032 Biomet NeoCif cage 1263-xx 477.82 333.O.12 88. met overeenkomst .85 53.85 53.G.09 199. recht.Plafondprijs : 532.94 444.12 88. recht.09 143. / Prestataire non conventionné Terugbetaling Gew.W.U waarde : U 430 Remboursement . recht.001.xxxx 532.Veiligheidsgrens : 444.I.88 01-02-2011 157030000023 B Braun Medical Cespace Titanium met plasmapore FJ1xxT 524.

X-Large 365.08 333.88 333.09 182.94 444.0x(x) 532.33 444.3xx/365.12 88.09 198.09 198.08 333.09 106.82 333.24 52.82 333.12 88.09 199.88 333.33 444.82 333.157030000111 EUROSPINE CAGE CERVICALE NON STERILE HRCC HRCC xSd 445.09 196.82 333.20 01-02-2011 157030000276 ISKRA Cage Cervicale CLIA Small Peek PxSC 532.85 53.16 41.09 196.00 444.00 444.00 444.91 44.03 44.21 333.12 87. 5mm-12mm 304.09 111.25 417.09 199.00 444.4xx 532.12 88.0xx/365.11 51.20 01-02-2011 157030000285 Johnson & Johnson MedicalDepuy Cervical Cage 1733 01 xxx 417.93 01-02-2011 157030000373 NEW2DM Cage Cervicale CLIA Peek PxCC 532.24 52.12 0.00 01-02-2011 157030000206 Hospithera TRYPTIK MODULAR CERV CAGE INCL BONE SUBST TRYMC12xx-S / TRYMC14xx-S 530.09 111.21 333.50 01-02-2011 157030000127 EUROSPINE CAGE CERVICALE STERILE HRC HRC xSd 445.12 85.11 51.29 01-02-2011 157030000181 Globus Medical Belgium SUSTAIN™ Radiolucent Medium.88 333.12 85.12 88.00 01-02-2011 157030000215 Hospithera TRYPTIK MODULAR CERV CAGE PEEK MOSMC12xx-S / MOSMC14xxS 439.29 01-02-2011 157030000145 Globus Medical Belgium Colonial ACDF Spacer.91 53.94 444.7xx/365.12 87.94 444.24 52.12 444.09 196.85 53.90 0.88 333.93 01-02-2011 157030000355 Medtronic Prevail cage 4210xxx 532. Small 365.29 01-02-2011 157030000154 Globus Medical Belgium Colonial ACDF Spacer.00 333.09 182.25 0.09 196.82 333.33 444.94 444.50 01-02-2011 157030000136 Globus Medical Belgium Coalition Spacer 384.85 53.29 01-02-2011 157030000364 Medtronic RESTRICTOR SR PEEK CAGE xx X x X105081xx 529.00 333.00 444.82 333.91 53.20 444.91 53.41 01-02-2011 157030000197 Hospithera TRYPTIK CERVICAL CAGE INCL BONE SUBST TRYCA12xx-S / TRYCA14xx-S 530.00 333.8xx 532.09 199.94 444.85 53.90 439.91 44.09 84.11 51.25 0.00 444.12 71.00 333.21 333.12 71.xxx 532.99 01-02-2011 157030000233 InSpine Belgium MC+ Closed MC3xxP 515.29 01-02-2011 157030000321 Medtronic Cornerstone Peek 62714xx 529.33 444.09 198.09 196.99 01-02-2011 157030000224 Hospithera TRYPTIK STAND ALONE CERVICAL CAGE PEEK MOSCA12xx-S / MOSCA14xx-S 439.Bijwerking 01-08-2013 Page 2 (700593-700604) .09 199.29 01-02-2011 157030000172 Globus Medical Belgium Colonial ACDF Spacer.00 333.25 417.91 53.88 333.16 41.12 88.12 71.12 85.20 444.09 199.91 53.88 333.90 439. Large 365.94 444.12 88.72 01-02-2011 157030000294 Johnson & Johnson MedicalDepuy Crystal Cage B2013x1xx 417.1x(x) 532.20 444.93 01-02-2011 157030000346 Medtronic Cornerstone Peek Anatomical XXmm Steriel X3832xxx 529.09 106.93 01-02-2011 157030000337 Medtronic Cornerstone Peek Anatomical XXmm Steriel 6272xxx 529.85 53.12 88.94 444.82 333.12 85.82 333.85 53.09 199.24 52.81 43.52 01-02-2011 157030000242 InSpine Belgium MC+ Open MC1xxP 515.85 53.90 0.29 01-02-2011 157030000312 Medtronic CORNERSTONE HSR XX mm 6290xxxINT 532.09 84.52 01-02-2011 157030000251 InSpine Belgium Shell Closed S-x/xx 515.20 01-02-2011 Mise à jour 01-08-2013 .29 01-02-2011 157030000163 Globus Medical Belgium Colonial ACDF Spacer.09 199.85 53.09 196.12 88.94 444.72 01-02-2011 157030000303 MEDIANN CORBEL cage cervicale LK10-15xx 532.12 85.09 199.00 444.09 182.88 333.12 87. XX-Large 365.21 333.08 333.12 85.12 0.2xx 444.09 111.52 01-02-2011 157030000267 ISKRA Cage Cervicale CLIA Peek PxCC 532.12 0.81 43.

85 53.41 01-02-2011 157030000461 SHARK MEDICAL Cage Cervicale CLIA Peek PxCC 532.xxXxx 532.09 199.82 333.91 53.00 371.29 01-02-2011 157030000574 MSH Cervical Cage Squale SQA-CP-170xS / SQA-CP200xS 371.09 199.29 01-02-2011 157030000425 OSTEON TPA xxxxD12 / xxxxD14 / xxxxD16 498.10 01-02-2011 31-08-2012 157030000601 MSH MDS.09 199.09 199.67 420.94 444.06 01-02-2011 31-08-2012 157030000617 MSH MDS.82 333.06 01-02-2011 31-08-2012 157030000635 Zimmer BAK/C large 6000-1212-00 532.29 01-02-2011 157030000407 Orthogèse BJR Cervical cage CYP4005.12 88.09 87.00 333.58 42.82 333.09 37.20 01-02-2011 157030000477 SHARK MEDICAL Cage Cervicale CLIA Small Peek PxSC 532.617.92x(S) 532.00 333.09 199.09 199.00 0.29 01-02-2011 157030000495 STRYKER KIT CAGE SOLIS RS 1X/Y KITRS1x0x 532.00 444.12 0.33x 532.12 444.85 53.93x(S) 532.09 199.82 333.82 333.00 371.617.Cervical Spacer Peek 2277x-xx 532.88 333.09 199.12 54.20 444.12 88.94 444.09 198.09 111.94 444.09 198.82 01-02-2011 157030000443 SDI Belgium Cage ACIF SpaceVision (Lg-larg-haut en mm) 15-0x-xx AC1-C15-0x-xx 444.12 444.29 01-02-2011 157030000416 Orthogèse CBK 11CBKx(x) 532.94 444.12 88.09 111.12 0.11 49.09 37.94 444.12 88.67 0.12 88.85 53.20 01-02-2011 157030000391 Ortho Team IBS .85 53.00 0.00 444.12 88.08 333.88 333.85 53.09 199.91 53.91 37.12 87.157030000382 NEW2DM Cage Cervicale CLIA Small Peek PxSC 532. height 5 mm CS 2270-16-x(x) / CS 2271-16x(x)-x 420.00 444.00 0.00 371. 0° CS 8200-xx 371.82 333.00 333.20 01-02-2011 157030000486 STRYKER AVS AS SPACER STERILE 6742xxxS / 6744xxxS / 67412xxS 532.00 333.58 42.09 37.82 333.67 0.82 333.09 199.29 01-02-2011 157030000565 Synthes ZeroP 04.03 44.82 01-02-2011 157030000434 OSTEON TPA WP xxxxD12 WP / xxxxD14 WP 498.85 53.29 01-02-2011 157030000547 Synthes Cervios wedge chronos 870.82 333.94 444.93xS 532.88 333.91 37. Ø 12 mm CS 2270-12-x / CS 2271-12-x-x 420.00 333.91 37.58 42.06 01-02-2011 31-08-2012 157030000626 MSH MDS.12 88.10 01-02-2011 157030000583 MSH Cerv-X 12-14mm x 12mm.10 01-02-2011 31-08-2012 157030000592 MSH Cerv-X 14mm x 12mm.85 53.29 01-02-2011 Mise à jour 01-08-2013 .03 44.08 333.2xxS 532.09 199.09 198.91 53.94 444.85 53.Bijwerking 01-08-2013 Page 3 31-03-2011 (700593-700604) .29 01-02-2011 157030000522 Synthes Cervios curved chronos 870.09 199.12 88.82 333.09 87.94 444.09 199.94 444.12 88.12 88.94 444.09 165.85 53.09 199.12 88.11 49.85 53.12 87.94 444.94 444.85 53. 5° CS 8201-xx 371.1xxS / 04.00 333.67 420.94 444.29 01-02-2011 157030000504 STRYKER SOLIS CERVICAL CAGE 1X x Ymm 6741x0x(S) 532.82 333.00 333.20 444.29 01-02-2011 157030000644 Zimmer BAK/C medium 6000-1012-00 532.82 333.12 54.82 333.09 165.82 333.12 88.85 53.00 333.09 87.29 01-02-2011 157030000531 Synthes Cervios wedge 889.67 0.67 420. Ø 16 mm.12 88.92xS 532.41 01-02-2011 157030000452 SDI Belgium Cage ACIF SpaceVision (Lg-larg-haut en mm) 17-0x-xx AC1-C17-0x-xx 444.85 53.12 88.85 53.94 444.29 01-02-2011 157030000556 Synthes Syncage C curved 495.29 01-02-2011 157030000513 Synthes Cervios curved 889.12 87. Ø 14 mm CS 2270-14-x(x) / CS 2271-14x(x)-x 420.

82 333.29 01-02-2011 157030000687 Zimmer Trabecular Metal TM-S angled 06-101-0xxx1 532.94 444.82 333.21xS / 838.94 444.12 88.82 333. w/BaSO4/CaSO4 838.12 88. Convex 838.94 444.09 155.29 01-02-2011 157030000757 SHARK MEDICAL Cage cervicale fermée MC+ MC 3xx P 532.82 333.46 48.12 32.85 53.13xS 532.12 0.12 88.00 333.29 01-02-2011 157030000714 MSH Cerv-X convex CS 8202-0x / CS 8203-0x 371.85 53.03xS.12 88.12 88.85 53.82 333.12 88.09 199.09 199.85 53.82 333.24 52.82 333.12 88.88 333.55 444.88 333.33 444.12 88.21 333.09 198.94 444.82 333.85 53.82 333.82 333.2xx 532.70 01-02-2011 157030000732 Medtronic CORNERSTONE 1 CAGE X121081714x 529.12 88.85 53.88 333.29 01-03-2012 157030000881 Medtronic Cornerstone PEEK Anatomical Cage 6211x0x 529.10 01-02-2011 157030000723 Ixemel Cage cervicale peek CFI 5432.12 88.28. 838.94 444.82 333. 838.29 01-02-2011 157030000802 Globus Medical Belgium MicroFuse LT Slotted Block.12 44.43 333.21 333.33 444.85 53.09 199.12 87.29 01-03-2012 157030000872 Medacta Mecta-C TiPeek Domed L5° 03.85 53.28.94 444.5xx 532.29 01-02-2011 157030000793 LDR MEDICAL Implant ROI-C MC 13xx P 532.12 88.29 01-07-2012 157030000915 Globus Medical Belgium Colonial ACDF Spacer.91 47.43 333.00 444.00 444.09 37.94 444.29 01-01-2012 157030000845 Medacta Mecta-C Flat L7° 03.09 199.82 333.94 444.02xS.00 0.85 01-03-2012 157030000854 Medacta Mecta-C Domed L5° 03.2.20 01-06-2011 157030000811 Aceemed HRC Cervical Locking cage HRC(X)xSD 445.09 199.12 88.CxP 477.24 52.94 444.12 44.94 444.85 53.85 53.91 53.7xx 532.85 01-03-2012 157030000863 Medacta Mecta-C TiPeek Flat L7° 03.91 44.93 01-06-2012 157030000897 Globus Medical Belgium MicroFuse LT Slotted Block w/BaSO4/CaSO4.94 444. 838.09 199.09 143.6xx 532.157030000653 Zimmer BAK/C small 6000-0812-00 532.82 333.12 88.29 01-02-2011 157030000766 SHARK MEDICAL Implant ROI-C MC 13xx P 532.91 37.85 53.00 444.94 444. Convex 365.12 85.28.29 01-02-2011 157030000775 LDR MEDICAL Cage cervicale MC+ MC 1xx P 532.94 444.82 333.20 01-07-2012 157030000906 Globus Medical Belgium Colonial ACDF Spacer. Large.4xx 488.85 53.5xx 488.94 444.647.09 199.91 53.28.09 199.Bijwerking 01-08-2013 Page 4 31-08-2012 (700593-700604) .20 01-02-2011 157030000671 Zimmer Trabecular Metal TM100 06-141-0xxx1 532.93 01-02-2011 157030000741 SHARK MEDICAL Cage cervicale MC+ MC 1xx P 532.29 01-09-2011 157030000836 Hospithera Samarys Peek Cervical Cage 11CC2A15-x(x)S / 11CC2A17x(x)S / 11CC2A20-x(x)S 532.85 53.09 199.12 87.12 88.29 01-02-2011 157030000784 LDR MEDICAL Cage cervicale fermée MC+ MC 3xx P 532.09 199.85 53.82 333.82 333.88 333.09 199.50 01-08-2011 157030000827 Synthes ZeroP Variable Angle 04. Small.85 53.94 444.00 444.09 196.01xS. Convex 365.1xxS 532.94 444.85 53.12 88.09 155.29 01-02-2011 157030000705 Cormed Impix Manta cervical cage B2017xxx3 / B2012xxx3/ B2018xxx3 532.12 88.46 48.09 199.29 01-02-2011 157030000662 Zimmer Fidji Cervical Cage SN3005-0-00xxx 532.12 88.00 371.29 01-02-2011 157030000696 Cormed Impix cervical cage MS111x1x0 / B20140xxx 532.12 85.55 444.09 111.29 01-07-2012 Mise à jour 01-08-2013 .09 196.88 333.82 333.22xS 532.12 87.09 198.09 198.85 53.09 199.09 199.91 53.09 199.09 199.94 444.00 444.09 199.

06 01-09-2012 157030000985 Hospithera MDS.67 0.00 333.58 42.12 88.29 01-08-2013 157030001055 Cormed Recreo Acif cage 03.09 37.88 333.00 333.57 01-08-2013 157030001064 SpineConcept Cage Cervicale CLIA Peek PxCC 532.233 505.12 87.52 01-11-2012 157030000942 Hospithera Cerv-X 12-14mm x 12mm.00 444.12 88.xxS 532. 0° CS 8200-xx 371.67 50. Ø 14 mm CS 2270-14-x(x) / CS 2271-14x(x)-x 420.88 333.09 199.58 42.09 87.91 44.67 0. Ø 16 mm.200 -> 03.58 42.00 371.11 51. height 5 mm CS 2270-16-x(x) / CS 2271-16x(x)-x 420.91 37.67 420.00 0.234 -> 03.843.10 01-09-2012 157030000967 Hospithera MDS.12 71.20 444.12 71.85 53.00 333.20 01-08-2013 Mise à jour 01-08-2013 .09 199.09 182.06 01-09-2012 157030000994 Hospithera Cerv-X convex CS 8202-0x / CS 8203-0x 371.00 333.09 37.00 371.08 333.67 0.11 51. Ø 12 mm CS 2270-12-x / CS 2271-12-x-x 420.157030000924 InSpine Belgium NanOss Cervical Implant 36-NC-1xxx-x(x) 515.82 333.52 01-09-2012 157030000933 InSpine Belgium C-Plus Cervical Implant 30-C(W)-1xxx-x(x) 515.09 172.20 01-08-2013 157030001073 SpineConcept Cage Cervicale CLIA Small Peek PxSC 532.12 88.12 61.00 371.85 53.82 333.91 37.09 87.91 37.Bijwerking 01-08-2013 Page 5 (700593-700604) .12 0.67 420.91 53.00 333.10 01-09-2012 157030001003 Synthes ACIS cage 08.29 01-02-2013 157030001012 Eurospine Cage cervicale UCC UCCx(S) 445.94 444.94 444.52 01-06-2013 157030001037 Cormed Ostecon Acif cage 03.12 87.08 333.267 532.20 444.91 53.10 01-09-2012 157030000951 Hospithera Cerv-X 14mm x 12mm.09 87.00 444.09 182.82 333.64 333.88 333.268 -> 03.00 0.50 01-05-2013 157030001021 Medtronic SHELL Cage Cervical S-x(x)/xx(X) 515.00 444.09 111.12 71.11 51.29 01-08-2013 157030001046 Cormed TSC Acif cage 03.09 37.00 0.09 182.76 444.06 01-09-2012 157030000976 Hospithera MDS.09 199.09 198.94 444.08 333.20 444. 5° CS 8201-xx 371.67 420.00 333.85 53.301 532.09 198.

I.10 720.Plafondprijs : 1. zonder overeenkomst E = Supplément patient Bén.23 115.23 115.40 138.90 01-02-2011 157031000061 Biomet Solitaire cage 1400-06xx / 1400-12xx 1113.W. / Verstr.Remboursement V.26 01-02-2011 157031000095 Cormed Osta Pek Alif 233x / 433x 1152.47 720.47 720.Prijs (incl.08 859.74 € is van toepassing op het geheel van de wervelkolomimplantaten.53 192. / Prestataire conventionné .53 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.90 111.40 138.10 720.63 960.00 720. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700615-700626 Implant d'arthrodèse non mobile pour placement dans l'espace intervertébral de la colonne vertébrale thoracolombaire et conçu pour être utilisé seul par niveau Niet beweegbaar arthrodese-implantaat voor plaatsing in een tussenwervelruimte van de thoraco-lumbale wervelkolom en ontworpen om als enige per niveau geplaatst te worden Valeur de U .86 01-02-2011 157031000052 Biomet Neolif TLIF Cage 1262-1x 859.G.40 397.68 85.40 127. / Prestataire non conventionné Supplement patiënt / Verstr.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.26 01-02-2011 157031000104 EUROSPINE HRCA CAGE LOMBAIRE ANTERIEURE + HRC Alif security screw HRCA ixx(X)(X) + HRCAvis 1100.60 858.53 157.88 01-02-2011 157031000043 Biomet LOOP TLIF Cage M-xx-06 / L-xx-06 858.60 84.152.20 85.00 0.40 338. / Prestataire avec ou sans convention Terugbetaling Gew.63 € Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157031000016 B Braun Medical A-space SJ1xxP 1118. recht.Terugbetaling : Marge de sécurité .00 960.Terugbetaling W.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .30 960.P.xxS 1152.36 720.O.60 0.80 01-02-2011 157031000034 B Braun Medical T-space titanium met plasmapore SJ3xxT 1058. recht.60 110.00 01-02-2011 Mise à jour 01-08-2013 .40 432.Veiligheidsgrens : 960.30 01-02-2011 157031000077 Cormed Actipore Alif ALF001.U waarde : U 930 Remboursement .53 192.A = Prix (TVAc) .40 392.Supplement patiënt W.53 139. ordin. met overeenkomst .00 848.63 960. / Verstr. / Verstr.xxxx 1152.23 115. / Prestataire non conventionné Terugbetaling Gew.08 0.Supplément patient V. ordin.89 960.53 98.00 960.53 152.00 720.W.40 379. recht. met overeenkomst . BTW) B = Remboursement Bén.40 432.00 720.10 720.40 432.I.G.63 960.53 192.26 01-02-2011 157031000086 Cormed Dream Alif cage ALIF.60 111.I. met of zonder overeenkomst C = Supplément patient Bén.83 01-02-2011 157031000025 B Braun Medical T-space peek FJ3xxP / FJ6xxP 848. met of zonder overeenkomst D = Remboursement Bén. ordin. Prix plafond . ordin. / Prestataire avec ou sans convention Supplement patiënt Gew.Bijwerking 01-08-2013 Page 1 (700615-700626) .49 105.O.77 720.I. / Verstr./Prestataire conventionné .P. / Verstr.

34 01-02-2011 157031000217 Hospithera TLIF JULIET PEEK 4 INCL BONE SUBST DYSTL04xx-S 1145.53 189.3xx / 304.63 960.53 192.00 94.40 432.23 115.26 01-02-2011 157031000366 Medtronic CAPSTONE VERTE-STACK PEEK VBS 299xxxxINT 1152.40 432.10 720.00 960.40 943.40 432.51 720.23 115. 7mm-17mm 304.40 432.63 960.53 192.27 01-02-2011 157031000192 Hospithera ALIF JULIET PEEK 5 L26 INCL BONE SUBSTITUTE DYA0526xx-S 1152.00 104.23 115.00 01-02-2011 157031000296 Johnson & Johnson MedicalDepuy Devex Cage 1864 28 xxx / 1725 25 9xx 742.63 960.51 720.40 432.94 01-02-2011 157031000323 MEDIANN OLS Cage lombaire D010-28xx 1152.10 720.00 960.10 720.36 100.40 960.53 42.76 960.87 720.00 742.23 115.60 74.53 4.63 960.04 960.23 115.63 960.40 244.26 01-02-2011 157031000235 InSpine Belgium LOOP TLIF Cage L-xx-06 1152.53 192.23 115.60 115.xxx 1152.20 01-02-2011 157031000201 Hospithera TLIF JULIET PEEK 4 DYNTL04xx-S 943.26 01-02-2011 157031000262 Johnson & Johnson MedicalDepuy Alif Cage 17321xxxx / 6000 3xxx / 173205xxx 969.40 431.53 192.97 01-02-2011 157031000271 Johnson & Johnson MedicalDepuy Concorde Cage 1878 27 xxx / 1878 31 xxx 1149.Bijwerking 01-08-2013 Page 2 (700615-700626) .40 432.23 115.33 720.40 429.63 960.00 0.10 720.xxx 1152.47 720.63 960.63 960.23 720.20 01-02-2011 157031000174 Hospithera ALIF JULIET PEEK 10 L26 DYA1026xx-S 1002.40 432.63 960.58 01-02-2011 157031000226 InSpine Belgium KIMBA TLIF Mini Cage MCxx1232 1152.64 115.23 115.5xx 1152.46 114.23 115.53 192.40 431.53 188.53 191.04 960.10 720.36 100.10 720.86 960.26 01-02-2011 157031000156 Globus Medical Belgium SUSTAIN™ Radiolucent Arch.23 115.53 192.26 01-02-2011 157031000357 Medtronic CAPSTONE PEEK VBS END xx X x X295086xx 1152.23 720.63 960.53 9.53 192.53 192.64 114.20 96.40 432.40 432.40 432.36 96.10 720.63 960.53 192.40 282.40 432.40 425.60 74.53 88.40 432.53 192.6xx 1152.3xx / 368.20 01-02-2011 157031000305 Johnson & Johnson MedicalDepuy Leopard Cage 1864 48 xxx 742.23 720.60 115.26 01-02-2011 157031000147 Globus Medical Belgium SUSTAIN™ Radiolucent 304.26 01-02-2011 157031000332 MEDIANN Tribeca Tlif 12TFCxx-x(x)US / 12TFCLxxx(x)US 964.2xx / 368.10 720.26 01-02-2011 157031000122 Globus Medical Belgium Independence Spacer 376.10 720.53 192.90 01-02-2011 157031000287 Johnson & Johnson MedicalDepuy Cougar Cages 1891 xx xxx 1150.40 432.76 960.40 21.63 960.10 720.63 960.40 282.63 960.10 720.26 01-02-2011 157031000253 InSpine Belgium SEMIAL Alif Cage 5° SK05xxxx 1152.76 960.00 0.40 249.10 720.23 115.23 115.53 191.26 01-02-2011 157031000165 Hospithera ALIF JULIET PEEK 10 L26 INCL BONE SUBSTITUTE DYA1026xx-S 1152.00 742.23 115.47 720.07 720.53 192.00 720.53 192.4xx / 304.23 115.00 720.26 01-02-2011 157031000131 Globus Medical Belgium Signature TLIF Spacer 368. XX mm 917xxxxINT 1152.40 0.10 720.53 192.40 329.26 01-02-2011 157031000375 Medtronic CAPSTONE® PEEK XXxXX – X° 296xxxxINT 1152.40 432.40 21.40 223.26 01-02-2011 157031000244 InSpine Belgium SEMIAL Alif Cage 10° SK101xxx 1152.00 720.53 42.60 960.27 01-02-2011 157031000183 Hospithera ALIF JULIET PEEK 5 L26 DYA0526xx-S 1002.53 185.26 01-02-2011 Mise à jour 01-08-2013 .40 428.46 01-02-2011 157031000341 Medtronic Boomerang Peek.10 720.20 01-02-2011 157031000314 Johnson & Johnson MedicalDepuy Stalif Cage STTxxxxxx(x)LX 1049.157031000113 Globus Medical Belgium Continental ALIF Spacer 364.4xx 1152.

1xxS / 08.87 720.U.13 112.23 115.63 960.53 192.63 960.26 01-02-2011 157031000427 Ortho Team IBS .803.26 01-02-2011 157031000454 Ortho Team IBS .10 720.10 720.10 720.26 01-02-2011 157031000497 OSTEON ALIF xxxxD1825 / xxxxD2130 996.157031000384 Medtronic Crescent XXmm 939xxxxINT 1152.13 96.8xxS 1152.2xxS / 08.23 115. Ø 26 mm CS 2280-xx 333.40 432.809.26 01-02-2011 157031000603 Synthes Syncage LSR 870.40 432.40 432.53 192.26 01-02-2011 157031000646 MSH MDS ALIF.xxXxx 1152.13 96.26 01-02-2011 157031000393 Medtronic PERIMETER X 339xxxx 1152.63 960.26 01-02-2011 157031000481 Orthogèse 'BJR TLIF cage TIL4005.804.26 01-02-2011 157031000585 Synthes Oracle 08.23 115.D.05 01-02-2011 157031000551 STRYKER TLIF SPACER 9 x 30 x 0° 48380xxx(S) / 48385xxx(S) 960.10 720.53 192.40 408.53 192.23 115.00 720.00 49.53 960.40 432.20 0.14 333.40 432.xxXxx 1152.1xxS 1152.00 720.23 115.53 192.00 33.63 960.40 960.804.809.26 01-02-2011 157031000612 Synthes Syncage Ti 495.2xxS 1152.63 960.53 192.40 240.63 960.00 720.0xxS / 08.10 720.40 432.40 432.53 168.53 960.9xxS 1152.3xx / 495.26 01-02-2011 157031000445 Ortho Team IBS .53 0.40 276.00 498.23 115.40 432.63 960.63 960.05 01-02-2011 157031000533 STRYKER AVS AL SPACER 6746xxx(S) / 6748xxx(S) 1152.10 720.10 720.63 960.802.00 99.53 192. 7969xxxINT 1152.23 115.10 720.00 720.40 240.53 192.31 01-02-2011 Mise à jour 01-08-2013 .05 01-02-2011 157031000567 STRYKER Vertebral Spacer 6731xxx(x) / 6733xxx 960.53 192.23 115.64 01-02-2011 157031000506 OSTEON ALIF WP xxxxD1825 WP / xxxxD2130 WP 996.53 192.23 115.26 01-02-2011 157031000436 Ortho Team IBS .40 432.53 0.40 432.23 115.53 960.23 115.40 432.23 115.53 192.40 240.10 720.10 720.40 432.40 432.9xxS/870.508 1128.53 192.53 960.40 276.40 432.63 960.Spacer Dorsolatéral TLIF Peek 22 75x-xx 1152.23 115.26 01-02-2011 157031000637 Synthes Travios 889.Y°) 4880001x + 48801x1x / 48802x1x 960.G.53 192.83x(S) / 08.53 192.40 432.40 432.53 192.53 192.26 01-02-2011 157031000594 Synthes Syncage LR 889.23 115.53 960.6xxS 1152.53 192.63 960.23 115.05 01-02-2011 157031000576 Synthes Opal 08.13 96.Spacer Ventral ALIF titan 22 70x-xx 1152.00 333.10 720.Spacer Dorsolatéral TLIF titan 22 70x-xx 1152.23 115.26 01-02-2011 157031000472 Orthogèse 'BJR ALIF cage ALI4005.26 01-02-2011 157031000463 Orthogèse Antélys 12CLASx(x).Bijwerking 01-08-2013 Page 3 31-08-2012 (700615-700626) .20 0.26 01-02-2011 157031000402 Medtronic Spacer 7967xxxINT.26 01-02-2011 157031000542 STRYKER STABILIS 1X FRONTAL/OBLIQUE (B.40 432.85 01-02-2011 157031000621 Synthes Synfix-LR 08.82 01-02-2011 157031000524 SDI Belgium Cage TLIF SpaceVision (Haut en mn) xx mm TL1Cxx 960.23 115.63 960.87 720. 7968xxxINT.14 0.8xxS/889.53 192.14 0.20 498.10 720.xxxS 1152.803.26 01-02-2011 157031000411 Medtronic Vertestack X 891xxxx / 89150xx 1152.53 0.64 01-02-2011 157031000515 OSTEON TLIF WP xxxxxxW8R30 (WP) / xxxxxxW8R25 (WP) 498.10 720.63 960.10 720.53 0.40 240.63 960. 1Xmm + FRONTAL / OBLIQUE 1X mm .53 35.10 720.63 960.10 720.53 35.x(x) 1152.23 115.10 720.63 960.00 720.Spacer Ventral ALIF Peek 22 75x-xx 1152.40 432.10 720.13 96.00 99.40 960.63 960.63 960.

63 960.53 77.10 720.40 301.40 432.10 720.32 107.23 115.63 960. depth 32 mm.72 960.26 01-02-2011 157031000743 Zimmer TraXis Vue (PEEK-OPTIMA) implanta 2601-xx092x / 2601-xx112x 1060.40 352.23 115.07 720.10 720.48 01-02-2011 157031000725 Zimmer Trabecular Metal TM300 06-173-01xx1 1152.2xxS 1021.00 720.08 0.812.40 339.19 720.00 720.60 960.08 859.63 960.63 960.63 960.23 115.53 61.08 0.26 01-02-2011 157031000883 LDR MEDICAL Implant ROI-T IR 36xx P 1152.40 432.00 960.26 01-02-2011 157031000831 SHARK MEDICAL Implant ROI-A oblique IR 41xx P/ IR 42xx P / IR 43xx P/ IR 44xx P 1152.40 244.40 432.5 mm.42 720.00 371.40 432.20 96.79 01-02-2011 31-08-2012 157031000691 MSH topaz.23 115.26 01-07-2011 Mise à jour 01-08-2013 .40 432.23 115.53 99.23 115.40 317.63 960.60 111. 10° [L5-S1] CS 2370-08-10 1072.10 720.26 01-06-2011 157031000917 Medtronic Cage Clydesdale peek 2920xxx / 2922xxx / 2926xxx / 2968xxx / 2969xxx 1152.26 01-02-2011 157031000777 Synthes T-Pal 08.31 720.23 115.08 859.63 960.90 01-02-2011 157031000813 Biomet Ibex peek 55011xx-00.30 01-02-2011 157031000795 Biomet ESL-Peek long spacer 60478.40 432.95 960.23 115.23 115.55 103.40 432.68 85.63 960.10 720.23 115.40 138.53 192.x0x / 375.00 0. height 8/11.63 960.00 960.18 01-02-2011 157031000786 Biomet Solitaire peek 14-5300xx 1113.26 01-02-2011 31-08-2012 157031000664 MSH Pezo-T .23 115.90 01-02-2011 157031000804 Biomet Ibex 55010xx-00.23 115. Ø 28 mm CS 2365-xx / CS 2366-xx 1037.10 720.23 115.26 01-02-2011 157031000734 Zimmer Trabecular Metal TM400 06-131-x0xx2 1152. 60482.00 0.10 720.10 720.53 152.40 138. 55010xx-06 859.26 01-02-2011 157031000856 SHARK MEDICAL Cage ROI-L/AVENUE L IR 6xxx P 1152.53 4.26 01-02-2011 157031000847 SHARK MEDICAL Implant ROI-T IR 36xx P 1152.00 720.53 192.63 960.26 01-02-2011 31-08-2012 157031000673 MSH Swingo-T Tlif cage SWI-xxS 371.46 01-02-2011 157031000716 Zimmer Fidji Cage SN3001-0-xxxxx 1144.27 01-02-2011 31-08-2012 157031000707 Zimmer Ardis Peek Implant 3201-xxxx3x 964.08 859.47 720.63 960.90 01-02-2011 157031000822 SHARK MEDICAL Implant ROI-A médian IR 24xx P / IR 25xx P / IR 26xx P / IR 27xx P 1152.10 720.27 720.x1x 1152.10 01-02-2011 157031000682 MSH topaz.53 192.10 720.812.53 192.40 424.10 720.53 192.53 192.47 720.40 432. 55011xx-06 859.40 432.40 432.63 960.00 01-02-2011 157031000752 Cormed Impix Alif cage B15111xxx / B15121xxx 1152.40 432.40 392.10 720.80 960.53 184. 60484 859.53 192.53 112.53 192.26 01-02-2011 157031000874 LDR MEDICAL Implant ROI-A oblique IR 41xx P/ IR 42xx P / IR 43xx P/ IR 44xx P 1152.53 192.53 192.23 115.00 371.53 192.53 192.44 102.63 960.10 720.63 960.23 115.53 192.60 106.Bijwerking 01-08-2013 Page 4 (700615-700626) .10 720.68 85.40 138.23 115. 60480.53 192.40 432.63 960.26 01-02-2011 157031000901 Globus Medical Belgium TransContinental LLIF Spacer 375.53 192.0xxS / 08.Alif Cage CS 333x-xx 1152.63 960.26 01-02-2011 157031000892 LDR MEDICAL Cage ROI-L/AVENUE L IR 6xxx P 1152.53 192.40 432.157031000655 MSH Pezo-A . Ø 28 mm.Tlif Cage CS 331x-xx 1152.84 960.10 720.40 432.40 114.26 01-02-2011 157031000761 Cormed Impix Tlif cage B151306xxS 1152.26 01-02-2011 157031000865 LDR MEDICAL Implant ROI-A médian IR 24xx P / IR 25xx P / IR 26xx P / IR 27xx P 1152.08 0.00 37.40 432.10 720.40 432.68 85.

00 01-08-2011 157031000935 Hospithera Solus lumbar spacer 25100-x1x / 25500-x1x 1152.20 01-05-2012 157031001066 Hospithera Interfuse T5 (Interfuse T4 + Interfuse Single T) 9091-x(x)-24-x(x) + 9091-x(x)24-x(x)-B 1152.63 960.00 01-06-2012 157031001111 Biomet Zyston Curve Spacer 27L / 32L 14-5331xx 960.53 191.05 01-09-2012 157031001136 Cormed Aleutian Lordotic Interbody cage 3203-20xxxMX / 3203-21xxxMX 1148.40 379.53 191.26 01-03-2012 157031001014 InSpine Belgium VBR.23 115.40 326.20 01-05-2012 157031001032 Hospithera Interfuse P5 (Interfuse P4 + Interfuse Single P) 9076-x(X)-20-x + 9076-x(x)-20x-B 1152.00 960.4xx + 187.53 960.47 720.53 191.20 01-05-2012 157031001041 Hospithera Interfuse P6 (Interfuse P4 + Interfuse Single P + Interfuse Single P) 9076-x(X)-20-x + 9076-x(x)-20x-B + 9076-x(x)-20-x-B 1152.Alif Cage CS 333x-xx 1152.53 191.00 720.53 30-T-1027-7-6 -> 30-T-1027-156.88 960.53 960.Bijwerking 01-08-2013 Page 5 31-08-2012 (700615-700626) .40 428.40 431.26 01-01-2012 157031000987 Medacta MectaLIF Oblique Interbody Fusion Device PEEK/Ti 03.151 -> 03.05 01-09-2012 157031001127 Biomet Zyston Straight Spacer 30L Convex 14-5341xx 960.40 432.1152.40 410.23.40 432.23 115.00 960.63 960. Ø 26 mm CS 2280-xx 333.26 01-03-2012 157031001023 Hospithera Interfuse P4 (4 éléments) 30-T-1027-7 -> 30-T-1027-15.63 960.23.00 960.14 333.26.40 431.26 01-01-2012 157031000996 Medacta MectaLIF Oblique Interbody Fusion Device PEEK 03.40 431.40 432.01 960.00 960.40 240.10 720.26 01-09-2012 157031001163 Hospithera Pezo-T .23.23 115.14 0.40 379.Tlif Cage CS 331x-xx 1152.60 110.00 960.40 432.06 01-01-2012 157031000971 Medacta MectaLIF Transforaminal Interbody Fusion Device TiPEEK 03.20 01-05-2012 157031001057 Hospithera Interfuse T4 (4 éléments) 9091-x(x)-24-x(x) 1152.48 720.53 86.53 191.48 114.53 192.47 720.53 139.60 115.53 139.00 960.23 115.40 432.31 01-09-2012 157031001154 Hospithera Pezo-A .10 720.61 115.47 720.63 960.23 115.14 720.185 1152.14 0.60 110.53 191.051 -> 03.40 431.60 115. 30-T-1036-7 -> 30-T-103615.10 720.53 / 3203-20xxxSX / 3203-21xxxSX 188.53 960.53 192. 1152.0xx 1152.13 96.157031000926 Aceemed HRCA Locking Cage + HRC Alif Security screw HRCAIxxX(X)S + HRCAvis 1100.00 720.085 1130.00 960.26 01-06-2012 157031001093 Medtronic Spacer Crescent TI 666xxxx / 667xxxx 1152.10 720.40 431.40 431.033 1152.23 115.40 240.53 192.67 960. Implant Assembly 192.60 115.63 960. 30-T-1036-8-6 -> 30-T1036-15-6 9076-x(X)-20-x 1152.60 115.47 720.033 1046.00 960.40 432.47 720.63 960.40 431.13 104.00 01-12-2011 157031000953 Hospithera GLIF Interbody Spacer 20113-xxx / 20115-xxx / 20117.26 01-09-2012 Mise à jour 01-08-2013 .63 960.00 33.47 720.00 960.0xx --> 375.10 720.35 720.53 0.47 720.47 720. T-PLUS.00 720.53 xxx 191.40 432.20 01-05-2012 157031001084 Globus Medical Belgium Transcontinental M Spacer + Intercontinental plate 375.10 720.47 720.63 960.53 191.53 192.20.23.40 432.26 01-06-2012 157031001102 AceeMed A2L – Anterior Lumbar Locking cage A2L x(x) – x(x)(X) / Ax(x)-x(x)(X) 1100.27 113.20.53 170.53 0.26.53 192.47 720.001 -> 03.10 720.40 431.60 115.001 -> 03.10 720.23 115.20 01-05-2012 157031001075 Hospithera Interfuse T6 (Interfuse T4 + Interfuse Single T + Interfuse Single T) 9091-x(x)-24-x(x) + 9091-x(x)24-x(x)-B + 9091-x(x)-24-x(x)-B 1152.53 192.53 139.00 960.20 01-01-2012 157031000962 Medacta MectaLIF Transforaminal Interbody Fusion Device PEEK 03.53 192.23 115.88 01-09-2012 157031001145 Hospithera MDS ALIF.13 96.60 110.65 01-01-2012 157031001005 SDI Belgium SpaceVision TLIF MIS CAGE PL1OCxx26 / PL1OCxx32 1152.40 379.20 01-11-2011 157031000944 EUROSPINE A2L Cage Lombaire A2L (x)x-x(x)(X) / A (x)x-x(x)(X) 1100.60 115.60 115.00 333.

72 960.40 432.23 115.23 115.26 01-02-2013 157031001224 Medtronic WAVE Cage Oblique WO-xx.31.79 01-09-2012 157031001181 Hospithera topaz.69 720.10 720.23 115.40 432.x(x) 1152.10 720.5 mm.26 01-08-2013 157031001285 Medtronic Capstone Control 32 mm 399xx32 / 400xx32 1152.00 720.95 960.63 960.10 720.92 73.10 720.53 77.53 192.63 960.22 960.53 192.05 01-02-2013 157031001215 Zimmer TM Ardis Interbody System Solid 06-702-0xxx1 1152.63 960.26 01-05-2013 157031001242 Hospithera Juliet OL OLIF Lumbar Cage JUL-OL28xx-S / JUL-OL32xx-S 1152.23 115.40 432.53 192.23 115.20 01-06-2013 157031001267 InSpine Belgium Noval Lumbar Interbody Fusion NV00xxxx / NV05xxxx / NV101xxx 1152.40 317.26 01-06-2013 157031001276 Medtronic Capstone Control 27 mm 399xx27 / 400xx27 / 401xx27 / 402xx27 1152.55 103.42 720.26 01-08-2013 157031001294 Medacta MectaLIF Anterior Stand-Alone Peek cage + MectaLIF Anterior Stand-Alone plate 03.x(x) / WO-xx.0xx + 03.19 720.30.53 112.10 720.00 720.63 960.10 720.40 432.40 240.61 115.10 720.40 431.10 720.48 720.82 115. depth 32 mm.22.26 01-05-2013 157031001233 Medtronic Loop TLIF Cage L-xx-06 / M-xx-06 1152.40 432. Ø 28 mm CS 2365-xx / CS 2366-xx 1037.27 01-09-2012 157031001197 Cormed Dualys TLIF cage DUOxxx(x)4S / DUOxxx(x)8S 736.32 0.53 192.32 736. Ø 28 mm.40 432.63 960.26.40 432.30.40 431.2xx 1152.40 432.2xx 1152.63 01-02-2013 157031001206 B Braun Medical T-Space peek (new generation) SJ9xxP 960.23 115.23 115.23 115.63 960.53 960.40 15.53 191.157031001172 Hospithera topaz.22 01-05-2013 157031001251 Hospithera Solus Lumbar spacer 25xxx-xxx-SEU 1152.26 01-08-2013 Mise à jour 01-08-2013 .40 352.53 0.53 192. height 8/11.01 960.63 960.63 960.0xx + 03.53 192.Bijwerking 01-08-2013 Page 6 (700615-700626) .53 192.32 107.53 192.13 96. 10° [L5-S1] CS 2370-08-10 1072.30.26 01-08-2013 157031001303 Medacta MectaLIF Anterior Stand-Alone TiPeek cage + MectaLIF Anterior Stand-Alone plate 03.53 191.

88 48.08 120.08 364.08 364.08 122.08 364. Oblique 304.08 218.51 485.00 364.43 97.25 01-02-2011 157032000106 Globus Medical Belgium SUSTAIN® Radiolucent Spacer. / Verstr. Prix plafond .De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.xxx 582.Veiligheidsgrens : 485.0xx / 304.Supplement patiënt W.43 0.85 55.08 218.8xx / 304.82 48.Bijwerking 01-08-2013 Page 1 (700630-700641) .51 485.43 485.51 € Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157032000011 B Braun Medical Prospace peek SJ2xxP 486.I.U waarde : U 470 Remboursement .47 364.35 48. BTW) B = Remboursement Bén. met of zonder overeenkomst D = Remboursement Bén.08 120. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700630-700641 Implant d'arthrodèse non-mobile pour placement dans l'espace intervertébral de la colonne vertébrale thoracolombaire et conçu pour être utilisé par deux par niveau Niet beweegbaar arthrodese-implantaat voor plaatsing in een tussenwervelruimte van de thoraco-lumbale wervelkolom en ontworpen om per twee per niveau geplaatst te worden Valeur de U .O.08 188.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .08 218. recht. met of zonder overeenkomst C = Supplément patient Bén.25 01-02-2011 157032000072 Cormed Osta Pek Plif 23xx 582.W.O. recht.Plafondprijs : 582.51 485.43 97.G.08 121. / Verstr.49 01-02-2011 157032000045 Biomet Neolif Expansive Cage 1260-xx 484.43 58.43 97. / Prestataire conventionné .43 67. ordin.I. ordin.74 € is van toepassing op het geheel van de wervelkolomimplantaten.43 58.50 364.Terugbetaling : Marge de sécurité . recht.Supplément patient V.51 485.25 01-02-2011 157032000081 Cormed Osta Pek Tlif P29.43 58. / Verstr.90 485./Prestataire conventionné .08 364.G.9xx 485.69 01-02-2011 157032000027 B Braun Medical Prospace titanium met plasmapore FJ2xxT 552.25 01-02-2011 157032000097 Cormed Ulif cage ULIF.I.96 484.A = Prix (TVAc) .43 1.P.43 58.54 01-02-2011 Mise à jour 01-08-2013 .xxx 582. / Verstr. zonder overeenkomst E = Supplément patient Bén.W.25 01-02-2011 157032000063 Cormed Osta Pek Elif 69.43 97. / Prestataire avec ou sans convention Terugbetaling Gew.Prijs (incl.96 0.08 218.08 364. met overeenkomst .00 364.43 58.29 01-02-2011 157032000036 Biomet Neolif Cage 1261-xx 484. ordin. / Prestataire non conventionné Terugbetaling Gew.96 0.93 485.43 97.49 01-02-2011 157032000054 Cormed Anatomix S8.88 48.P.Terugbetaling W.Remboursement V.96 484. / Prestataire non conventionné Supplement patiënt / Verstr.51 485. / Prestataire avec ou sans convention Supplement patiënt Gew. met overeenkomst .xxx 582.08 218.00 364.xxx / 29.43 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.xxxx 582.I. / Verstr. ordin.

08 364.43 97.43 97.08 364.00 364.88 48.51 485. Cage Xmm X° 907-1xx 582.43 58.08 364.08 218.43 97.08 217.51 485.08 218.08 218.08 364.00 0.25 01-02-2011 157032000307 Medtronic Spacer TLMN P3 22mm x 7mm X0205182 582.08 01-02-2011 157032000151 InSpine Belgium TETRIS 0° PLIF Cage TKxx11 582.43 97.Spacer Dorsal PLIF Titan 22 707-xx 582.43 97.43 485.43 97.51 485.08 218.08 218.25 01-02-2011 157032000167 InSpine Belgium TETRIS 4° PLIF Cage TK4xx11 582.08 364.25 01-02-2011 157032000316 Medtronic Telamon Ti.43 58.08 218.08 364.43 58.51 485.51 485.51 485.43 97.43 58.08 217.20 01-02-2011 157032000185 Johnson & Johnson MedicalDepuy Concorde 1878 2x xxx / 1878 5x xxx / 1878 6x xxx 582.92 58.92 47.08 364.25 01-02-2011 157032000352 Ortho Team IBS .36 01-02-2011 157032000133 Hospithera PLIF JULIET PEEK DYNPO22xx-S / DYNP522xx-S 477.08 119. X° .08 218.51 485.08 218.43 97.25 01-02-2011 157032000176 ISKRA Cage Lombaire CLIA Peek Pxxxx(x)L 582.08 218.08 218.51 485.96 484.Spacer Dorsal PLIF Peek 22 757-xx 582.43 97.80 58.43 96.29 58.60 0.43 58.49 01-02-2011 157032000221 MEDIANN ORIA NATURA Cage P010-20xxx / P010-25xxx 582.25 01-02-2011 157032000194 Johnson & Johnson MedicalDepuy Iriom Cage 1876 0x xxx 580.43 97.08 216.43 97.08 120.08 364.25 01-02-2011 157032000361 Orthogèse BJR PLIF cage CER4005.92 58.54 01-02-2011 157032000124 Hospithera Alphatec Cage Novel-SD spacer S-M_L 648xx-xxx 483.08 121. H-X 2900xxxX 582.25 01-02-2011 157032000255 Medtronic CAPSTONE® PEEK XXxXX – X° 296xxxxINT 582.70 01-02-2011 157032000142 Hospithera PLIF JULIET PEEK INCL BONE SUBST DYSPO22xx-S / DYSP522xx-S 580.88 485.08 364.96 0.08 218.08 218.08 364.08 364.51 485.43 58.43 97.08 218.20 01-02-2011 157032000343 Ortho Team IBS .43 58.25 01-02-2011 157032000273 Medtronic Inter Fix Ti.25 01-02-2011 157032000377 Orthogèse CC 12CKNxx(X) 582.43 58.08 364.43 95.157032000115 Globus Medical Belgium SUSTAIN™ Radiolucent Small 304.25 01-02-2011 157032000246 Medtronic CAPSTONE VERTE-STACK PEEK VBS 299xxxxINT 582.25 01-02-2011 157032000334 NEW2DM Cage Lombaire CLIA Peek Pxxxx(x)L 582.43 58.08 364.35 48.43 58.43 97.51 485.25 01-02-2011 157032000212 Johnson & Johnson MedicalDepuy Saber Cage parallel 187x xx xxx 484.08 218.00 364.43 58.43 0.57 364.08 218.00 485.43 97.03 01-02-2011 157032000203 Johnson & Johnson MedicalDepuy Saber Cage lordosed 187x xx xxx 582.51 485.43 58.25 01-02-2011 157032000291 Medtronic R90 Spacer.1xx / 304.37 485. DX L-X 892-1xx 582.94 364.D-X 420xxxxINT 582.51 485.08 364.08 364.08 218.Bijwerking 01-08-2013 Page 2 31-03-2011 (700630-700641) .08 364.07 364.00 485.43 58.08 364.43 58.43 97.50 485.51 485.43 97.00 364.43 58.43 58.25 01-02-2011 157032000325 Medtronic TELAMONP X° .00 477.51 485.25 01-02-2011 157032000237 Medtronic CAPSTONE PEEK VBS END xx X x X295086xx 582.08 218.08 112.08 216.43 97.43 97.08 218.43 94.43 58.00 364.25 01-02-2011 157032000282 Medtronic LT CAGE xx X xx X xx 8941xxx 582.25 01-02-2011 157032000264 Medtronic I-fly cage xxmm 8928xxx 582.xxxxx 582.52 48.45 364.43 97.51 485.51 485.42 58.60 483.57 364.43 96.51 485.43 58.7xx 485.25 01-02-2011 Mise à jour 01-08-2013 . D-X.08 364.08 218.51 485.

80 01-02-2011 157032000553 Zimmer Ardis Peek Implant 3201-xxxx2x 573.25 01-02-2011 157032000474 Synthes Pliviopore 495.08 215.43 97.08 218.43 485.08 364.43 58.84x(S) 582.43 12.08 218.77 364.43 97.08 218.77 364.43 71.21322C / 603.43 58.56 57.25 01-02-2011 31-08-2012 157032000544 MSH Swingo-P Plif cage SAW xx22100S 318.43 58.21 364.64 485.43 97.43 97.32 01-02-2011 31-08-2012 157032000526 MSH heliodor CS 201x-xx 556.08 218.08 218.25 01-02-2011 157032000395 OSTEON IDE xxxxW8D22 / xxxxxxW8D22 / xxxxxxW8D25 498.43 88.43 97.08 364.25 01-02-2011 157032000623 Cormed Impix LR plif cage MS415x2xx 582.43 97.43 94.0xxS 582.43 58.08 218.43 97.08 364.21328C 582.25 01-02-2011 157032000587 Zimmer Trabecular Metal TM500 (straight) 06-165-01xx1 582.57 364.25 01-02-2011 157032000596 Cormed Aleutian Plif Cage 603.08 217.43 0.43 58.43 12.08 99.08 218.12 49.08 364.20722C -> 603.43 97.00 318.157032000386 Orthogèse CO 12COKNxx(X) 582.803.00 364.43 58.22 463.08 364.20 01-02-2011 157032000447 STRYKER PEEK OIC 673xxx(x)(x) / 6760xxx / 6765xxx 485.20 485.51 485.08 218.43 58.43 58.08 218.08 218.08 364.07 364.08 364.00 0.08 364.43 97.92 58.00 01-02-2011 157032000571 Zimmer Trabecular Metal TM500 (angled) 06-165-02xx1 582.42 55.50 485.51 485.08 364.12 49.43 58.08 121.51 485.08 364.08 134.14 46.51 485.25 01-02-2011 157032000431 SHARK MEDICAL Cage Lombaire CLIA Peek Pxxxx(x)L 582.20728C -> 603.08 134.43 97.25 01-02-2011 157032000614 Cormed Impix L plif cage MS412x2xx 582.54 01-02-2011 157032000465 Synthes Contact Fusion Cage 495.Plif Cage CS 330x-xx 582.08 218.25 01-02-2011 157032000605 Cormed Neovix L plif cage MS413x2x0 582.35 48.08 121.Bijwerking 01-08-2013 Page 3 31-03-2011 (700630-700641) .43 0. height 9 mm.08 218.43 97.82 01-02-2011 157032000404 OSTEON IDE WP 498.25 01-02-2011 157032000632 Cormed Isis plif peek cage PC50xx/PC51xx 582.43 485.82 01-02-2011 157032000413 SDI Belgium Cage SpaceVision PLIF (Haut-Lg-Angle) xx-21-0x xxxxW8D22 WP / xxxxxxW8D22 WP / xxxxxxW8D25 WP PL1-Cxx-21-0x 582.20 485.51 485.92 58.25 01-02-2011 157032000483 Synthes Plivios 889.51 485.0xx 582.54 01-02-2011 157032000456 STRYKER TITANIUM OIC 6720xx / 6721xx / 6722xx / 6728xx 485.08 218.51 485.00 485.35 48.00 0.51 485.51 485.08 209.08 218.08 364.25 01-02-2011 157032000492 Synthes Plivios LF 08.43 97.51 485.43 58.43 58.43 58.00 318.08 364.22 0.43 97.43 58.08 364.51 485.51 485.43 97.08 364.08 218.51 485.43 58.25 01-02-2011 157032000501 Synthes Plivios rev 889.0xxS 582.08 218.43 58. 20 mm or 25 mm SN3001-0-3xx0x / SN3001-04xx0x 580.25 01-02-2011 157032000517 MSH beluga PLIF Cage.5xxS 582.00 31.08 192.43 58.43 97.43 96.51 485.65 01-02-2011 31-08-2012 157032000535 MSH Pezo-P . angle 0° CS 3200-xx / CS 3201-xx 463.08 364.00 364.00 364.00 485.43 97.25 01-02-2011 157032000422 SDI Belgium Cage SpaceVision PLIF (Haut-Lg-Angle) xx-25-0x PL1-Cxx-25-0x 582.36 01-02-2011 157032000562 Zimmer Fidji posterieur(e) Cage Long.51 485.25 01-02-2011 Mise à jour 01-08-2013 .57 364.08 364.51 485.

7xx 485.00 364.43 0.08 121.08 364.96 0.25 01-03-2013 157032000894 Medtronic WAVE Lumbar Cage W-xx.08 108.08 218.43 58.43 58.Posterior Lumbar cage Ux / Ux(x)-x(x)L / Ux(x)-x(x)S 582.25 01-03-2013 157032000867 Cormed Recreo composite plif cage 05-08x / 05-09x 582.43 xx.08 218.01 01-02-2013 157032000833 Zimmer TM Ardis Interbody System Solid 06-702-01xx1 582.43 97.08 364.43 97. height 9 mm.00 364.49 01-02-2011 157032000675 Biomet ESL-Peek medium spacer 604xx 484.98 364.43 97.07 364.89 0.41 01-02-2013 157032000824 B Braun Medical Prospace peek implant (new generation) SN0xxP / SN1xxP 550.05 39.25 01-02-2011 157032000702 Medacta MectaLIF Posterior Interbody Fusion Device PEEK/Ti 03.51 485.51 485.08 364.08 218.43 58.96 484.43 96.001 -> 03.08 364.96 0.157032000641 Cormed Swingo plif cage SAW0x22100S 582.08 218.51 485.65 01-09-2012 157032000806 Hospithera Pezo-P .43 58.08 364.21.08 121.25 01-09-2012 157032000754 Globus Medical Belgium Sustain Small cage Titanium 101.43 58.43 58.49 01-02-2011 157032000684 SHARK MEDICAL Implant ROI IR 1xx P 582.08 120.41 485.08 218.96 484.43 0.08 218.001 -> 03.25 01-06-2012 157032000745 InSpine Belgium Tetris II PLIF cage T2Kxxx1124 582.08 218.08 364.25 01-02-2011 157032000657 Biomet ESL Spacer 602xx.96 0.76 364.1xx / 101.51 485.08 218.08 186.24 01-01-2012 157032000711 Medacta MectaLIF Posterior Interbody Fusion Device PEEK 03.00 364.08 30.08 218.x(x)(X) 97.49 01-02-2011 157032000666 Biomet ESL-Peek spacer 602xx 484.28 01-03-2013 157032000851 Cormed OsteoCon Plif cage TA/BA 05-00x / 05-01x / 05-02x / 0503x 582.41 485.43 97.43 97.25 01-02-2011 157032000693 LDR MEDICAL Implant ROI IR 1xx P 582.00 364.88 48.81 47.08 218.35 48.43 58.14 46.51 485.27.00 364.51 485.33 58.51 485.43 97.28.11 55.00 364.08 121.43 64.08 364.08 364.13 394.25 01-03-2013 157032000885 Cormed TSC Plif cage 05-1xx 582.25 01-05-2013 Mise à jour 01-08-2013 .51 485.22 0.35 48.x(C) / WD582.08 364.43 58.43 97.24.43 71.25 01-03-2013 157032000876 Cormed Recreo Plif cage TA/BA 05-04x / 05-05x / 05-06x / 0507x 582.08 120. angle 0° CS 3200-xx / CS 3201-xx 463.00 364.028 582.43 58.43 96.08 364.25 01-09-2012 157032000815 Cormed Dualys Lumbar posterior cage DUPxxx(x)4S / DUPxxx(x)8S 394.27.43 97.51 485.08 218.43 58.54 01-09-2012 157032000781 Hospithera beluga PLIF Cage.24.43 58.Bijwerking 01-08-2013 Page 4 (700630-700641) .08 99.51 485.88 48.51 485.32 01-09-2012 157032000797 Hospithera heliodor CS 201x-xx 556. 60234W 484.54 01-09-2012 157032000772 Biomet Zyston Straight Spacer 20L/25L 14-5341xx / 14-5342xx 485.25 01-02-2013 157032000842 Globus Medical Belgium MicroFuse LT Slotted Block 838.98 364.2xxS 472.00 364.22 463.19 485.33 58.43 58.00 364.08 192.35 48.43 485.24 01-01-2012 157032000727 AceeMed UCH .x(x)(C) / WD-xx.43 485.08 364.43 97.08 364.51 485.50 485.08 218.08 218.43 485.43 97.89 472.54 01-09-2012 157032000763 Biomet Zyston Straight Spacer 20L/25L Convex 14-5340xx 485.08 218.88 48.43 97.Plif Cage CS 330x-xx 582.43 97.13 0.08 364.42 55.21.08 120.028 582.96 484.25 01-06-2012 157032000736 AceeMed HRL – Posterior Lumbar Locking cage HRL Cx(x) / HRL LC x(x) / HRL CSx(x) 582.43 0.43 58.51 485.08 218.

08 218.51 485.157032000903 Medtronic FUSE PLIF Cage FP-xx.08 218.43 58.51 485.51 485.43 58.08 217.08 218.57 364.08 364.43 97.43 97.25 01-05-2013 157032000921 Eurospine cage UCH Ux / Ux(x)-x(x)L / Ux(x)-x(x)S 582.43 97.08 218.43 97.00 485.25 01-08-2013 157032000964 SpineConcept Cage lombaire Clia Pxxxx(x)L 582.43 58.08 364.20 01-08-2013 Mise à jour 01-08-2013 .Bijwerking 01-08-2013 Page 5 (700630-700641) .25 01-05-2013 157032000946 Medtronic Capstone Control 22 mm 399xx22 / 400xx22 / 401xx22 / 402xx22 582.43 96.08 364.43 58.25 01-08-2013 157032000955 Medtronic Capstone Control 27 mm 399xx27 / 400xx27 / 401xx27 / 402xx27 582.08 218.43 97.08 364.08 364.25 01-05-2013 157032000937 Eurospine cage UCL UCLSxx(S) / UCLxx(S) / UCLLxx(S) 582.51 485.25 01-05-2013 157032000912 Eurospine cage HRL HRL Cx(x)(S) / HRL LC x(x)(S) / HRL CSx(x)(S) 582.92 58.51 485.43 58.24.08 218.x 582.51 485.43 58.43 97.08 364.

Supplément patient V.19 52. met of zonder overeenkomst D = Remboursement Bén.Terugbetaling W.05 01-02-2011 Mise à jour 01-08-2013 .38 01-02-2011 157033000065 Johnson & Johnson MedicalDepuy Harms cages 15mm 1760 16 015 397.54 433.79 86.54 433.54 433.54 433. ordin. op maat afknipbaar.79 86.Remboursement V. BTW) B = Remboursement Bén. / Verstr.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .05 01-02-2011 157033000083 Johnson & Johnson MedicalDepuy Harms cages 17mm 1760 14 017 520.71 01-02-2011 157033000074 Johnson & Johnson MedicalDepuy Harms cages 16mm 1760 12 016 520.75 325. / Prestataire avec ou sans convention Terugbetaling Gew. met overeenkomst .75 325.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.00 325. recht.19 52. pour placement cervical Niet beweegbaar corporectomie-implantaat. zonder overeenkomst E = Supplément patient Bén.05 01-02-2011 157033000101 Johnson & Johnson MedicalDepuy Harms cages 30mm 1760 14 030 520.19 52./Prestataire conventionné .00 325. met of zonder overeenkomst C = Supplément patient Bén. / Verstr.05 01-02-2011 157033000092 Johnson & Johnson MedicalDepuy Harms cages 30mm 1760 10 030 / 1760 12 030 520.Bijwerking 01-08-2013 Page 1 (700652-700663) .P. / Prestataire avec ou sans convention Supplement patiënt Gew. recht.75 325.79 86.35 48.75 325.G.Prijs (incl.89 373.77 39.35 71.35 195.54 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.35 195. ordin.05 01-02-2011 157033000022 Johnson & Johnson MedicalDepuy Harms cages 10mm 1760 10 010 373. met overeenkomst .89 0.75 325.54 37.35 48. ordin.35 195.12 397.71 01-02-2011 157033000056 Johnson & Johnson MedicalDepuy Harms cages 15mm 1760 10 015 373. / Prestataire non conventionné Terugbetaling Gew.U waarde : U 420 Remboursement .79 86.00 325.79 86. voor cervicale plaatsing Valeur de U .W.05 01-02-2011 157033000047 Johnson & Johnson MedicalDepuy Harms cages 13mm 1760 14 013 397.54 433.35 195.74 € is van toepassing op het geheel van de wervelkolomimplantaten.12 0.W.38 01-02-2011 157033000031 Johnson & Johnson MedicalDepuy Harms cages 12mm 1760 12 012 520.89 0.I.19 52.Supplement patiënt W.19 52.O.75 325.12 397. / Prestataire non conventionné Supplement patiënt / Verstr.I.12 0.Plafondprijs : 520.I.35 195.O. / Prestataire conventionné .Terugbetaling : Marge de sécurité .89 373.79 € Prix plafond .35 71.P. / Verstr.19 52. Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157033000013 Biomet C-AVR Cage Titanium 700-0050 520.A = Prix (TVAc) . / Verstr.79 86. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700652-700663 Implant de corporectomie non mobile.G.Veiligheidsgrens : 433.54 433. à découper sur mesure. / Verstr.I.54 37.35 195.00 325.77 39. ordin. recht.

35 48.35 108.79 86.4xx 520.75 325.54 37.72 383.35 195.72 0.44 43.3xx / 495.19 52.00 325.366 520.79 433.05 01-02-2011 Mise à jour 01-08-2013 .35 195.19 52.89 0.54 433.37 38.19 52.54 433.05 01-02-2011 157033000162 Synthes synmesh diam 15 mm H 88 mm 495.75 325.157033000117 Johnson & Johnson MedicalDepuy Harms cages 6/10mm 1725 10 80x 383.38 01-02-2011 157033000135 Medtronic Pyramesh TI X CERVICAL 905-xxx/905xxxx 520.79 86.79 0.75 325.00 325.37 01-02-2011 157033000126 Johnson & Johnson MedicalDepuy Harms cages 9mm 1760 14 009 373.00 325.Bijwerking 01-08-2013 Page 2 (700652-700663) .37 01-02-2011 157033000153 Synthes synmesh diam 12 mm H 12/18/32/88 mm 495.35 195.89 373.05 01-02-2011 157033000144 STRYKER CAGE Ø1X x YY 33661x0xx 433.79 86.54 433.35 58.

A = Prix (TVAc) - Prijs (incl. BTW)
B = Remboursement Bén. ordin./Prestataire conventionné - Remboursement V.I.P.O. / Prestataire avec ou sans convention
Terugbetaling Gew. recht. / Verstr. met overeenkomst - Terugbetaling W.I.G.W. / Verstr. met of zonder overeenkomst
C = Supplément patient Bén. ordin. / Prestataire conventionné - Supplément patient V.I.P.O. / Prestataire avec ou sans convention
Supplement patiënt Gew. recht. / Verstr. met overeenkomst - Supplement patiënt W.I.G.W. / Verstr. met of zonder overeenkomst
D = Remboursement Bén. ordin. / Prestataire non conventionné
Terugbetaling Gew. recht. / Verstr. zonder overeenkomst
E = Supplément patient Bén. ordin. / Prestataire non conventionné
Supplement patiënt / Verstr. zonder overeenkomst
F = Marge de délivrance
Afleveringsmarge

700674-700685
Implant de corporectomie non mobile, monobloc, hauteur fixe,disponible en diverses hauteurs, pour placement
cervical
Niet beweegbaar corporectomie-implantaat, monobloc, vaste hoogte, beschikbaar in verschilende hoogtes,
voor cervicale plaatsing

Valeur de U - U waarde : U 670
Remboursement - Terugbetaling :

Marge de sécurité - Veiligheidsgrens :
691,99 €

Distributeur
Verdeler

Code d'identification
Identificatiecode

20%

Les montants de la marge de délivrance sont donnés à titre
indicatif : le plafond de 148,74 € est d'application sur l'ensemble
des éléments des implants de la colonne vertébrale - De bedragen
voor de afleveringsmarge worden slechts ter informatie vermeld :
het grensbedrag van 148,74 € is van toepassing op het geheel van
de wervelkolomimplantaten.

Prix plafond - Plafondprijs : 830,38 €

Nom du produit
Productnaam

Numéros de référence
Referentienummers

A

B

C

D

E

F

A partir de Jusqu'au
Vanaf
Tot

157034000015

Cormed

Biocage

BIOc01xxxx

830,38 691,99

138,39

519,00

311,38

83,03

01-02-2011

157034000024

Cormed

Trabis

015.030.xxx

830,38 691,99

138,39

519,00

311,38

83,03

01-02-2011

157034000033

Globus Medical Belgium

NIKO Corpectomy Spacer

342.7xx / 342.8xx / 342.9xx

830,38 691,99

138,39

519,00

311,38

83,03

01-02-2011

157034000042

OSTEON

CORP REPL

xxxxD12 / xxxxD13 / xxxxD14

775,92 691,99

83,93

519,00

256,92

77,59

01-02-2011

157034000051

OSTEON

CORP REPL WP

xxxxD12 WP/ xxxxD13 WP/
xxxxD14 WP

775,92 691,99

83,93

519,00

256,92

77,59

01-02-2011

157034000067

Zimmer

Trabecular Metal VBRS

06-111-00xxx / 06-115-10xxx

830,38 691,99

138,39

519,00

311,38

83,03

01-02-2011

157034000076

Hospithera

SupStance Small Vertebral Body Replacement Cage

100112xxx / 100114xxx

830,38 691,99

138,39

519,00

311,38

83,03

01-12-2011

Mise à jour 01-08-2013 - Bijwerking 01-08-2013

Page 1

(700674-700685)

A = Prix (TVAc) - Prijs (incl. BTW)
B = Remboursement Bén. ordin./Prestataire conventionné - Remboursement V.I.P.O. / Prestataire avec ou sans convention
Terugbetaling Gew. recht. / Verstr. met overeenkomst - Terugbetaling W.I.G.W. / Verstr. met of zonder overeenkomst
C = Supplément patient Bén. ordin. / Prestataire conventionné - Supplément patient V.I.P.O. / Prestataire avec ou sans convention
Supplement patiënt Gew. recht. / Verstr. met overeenkomst - Supplement patiënt W.I.G.W. / Verstr. met of zonder overeenkomst
D = Remboursement Bén. ordin. / Prestataire non conventionné
Terugbetaling Gew. recht. / Verstr. zonder overeenkomst
E = Supplément patient Bén. ordin. / Prestataire non conventionné
Supplement patiënt / Verstr. zonder overeenkomst
F = Marge de délivrance
Afleveringsmarge

700696-700700
Implant de corporectomie non mobile, à découper sur mesure, pour placement dans la colonne vertébrale
thoraco-lombaire
Niet beweegbaar corporectomie-implantaat, op maat afknipbaar, voor plaatsing in de thoraco-lumbale
wervelkolom

Valeur de U - U waarde : U 650
Remboursement - Terugbetaling :

Marge de sécurité - Veiligheidsgrens :
671,34 €

Prix plafond - Plafondprijs : 805,60 €

Distributeur
Verdeler

Code d'identification
Identificatiecode

20%

Les montants de la marge de délivrance sont donnés à titre
indicatif : le plafond de 148,74 € est d'application sur l'ensemble
des éléments des implants de la colonne vertébrale - De bedragen
voor de afleveringsmarge worden slechts ter informatie vermeld :
het grensbedrag van 148,74 € is van toepassing op het geheel van
de wervelkolomimplantaten.

Nom du produit
Productnaam

Numéros de référence
Referentienummers

A

B

C

D

E

F

A partir de Jusqu'au
Vanaf
Tot

157035000017

Biomet

AVR Cage 30mm à 40 mm

700-0008 -> 700-0015

394,14 394,14

0,00

394,14

0,00

39,41

01-02-2011

157035000026

Johnson & Johnson MedicalDepuy

Harms cages 100mm

1760 12 100

805,60 671,34

134,26

503,51

302,09

80,56

01-02-2011

157035000035

Johnson & Johnson MedicalDepuy

Harms cages 50mm

1741 48 000 / 1741 51 000 /
1741 54 000

805,60 671,34

134,26

503,51

302,09

80,56

01-02-2011

157035000044

Johnson & Johnson MedicalDepuy

Harms cages 50mm

1760 14 050 / 1760 16 050 /
1760 12 050

805,60 671,34

134,26

503,51

302,09

80,56

01-02-2011

157035000053

Johnson & Johnson MedicalDepuy

Harms cages 70mm

1741 49 000 / 1741 52 000 /
1741 55 000

805,60 671,34

134,26

503,51

302,09

80,56

01-02-2011

157035000062

Johnson & Johnson MedicalDepuy

Harms cages 70mm

1760 16 070

805,60 671,34

134,26

503,51

302,09

80,56

01-02-2011

157035000071

Johnson & Johnson MedicalDepuy

Harms cages 90mm

1741 50 000 / 1741 53 000 /
1741 56 000 / 1760 12 090

805,60 671,34

134,26

503,51

302,09

80,56

01-02-2011

157035000087

Medtronic

Pyramesh TI X THORACO-LOMBAIRE

905xxxx / 905-xxx

805,60 671,34

134,26

503,51

302,09

80,56

01-02-2011

157035000096

STRYKER

CAGE ØXX x YYY

3366xxxxx

671,34 671,34

0,00

503,51

167,83

67,13

01-02-2011

157035000105

Synthes

synmesh diam 17 x 22 mm H 26/28/32/52/88 mm

495.3xx / 495.4xx

805,60 671,34

134,26

503,51

302,09

80,56

01-02-2011

Mise à jour 01-08-2013 - Bijwerking 01-08-2013

Page 1

(700696-700700)

157035000114

Synthes

synmesh diam 22 x 28 mm H 34/36/52/64/88 mm

495.3xx / 495.4xx

805,60 671,34

134,26

503,51

302,09

80,56

01-02-2011

157035000123

Synthes

synmesh diam 26 x 33 mm H 88 mm

495.382

805,60 671,34

134,26

503,51

302,09

80,56

01-02-2011

Mise à jour 01-08-2013 - Bijwerking 01-08-2013

Page 2

(700696-700700)

/ Prestataire conventionné . recht.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.W. ordin.U waarde : U 670 Remboursement .Plafondprijs : 830.Supplément patient V.03 01-02-2011 157036000037 Hospithera SupStance Small Vertebral Body Replacement Cage 100112xxx / 100114xxx 830.38 83. met overeenkomst .I.39 519.39 519. vaste hoogte. disponible en diverses hauteurs pour placement dans la colonne vertébrale thoraco-lombaire Niet beweegbaar corporectomie-implantaat. / Prestataire avec ou sans convention Supplement patiënt Gew.38 83.38 691. / Verstr. beschikbaar in verschillende hoogtes. met of zonder overeenkomst C = Supplément patient Bén.P.G. / Prestataire avec ou sans convention Terugbetaling Gew. ordin. ordin. / Verstr.00 311. ordin.03 01-12-2011 Mise à jour 01-08-2013 .Terugbetaling W.I.38 691.Veiligheidsgrens : 691. / Prestataire non conventionné Supplement patiënt / Verstr. recht.38 691.W.00 311.Terugbetaling : Marge de sécurité .I. monobloc. met overeenkomst . / Verstr.39 519.38 83.Remboursement V.00 311.99 138.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale . zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700711-700722 Implant de corporectomie non mobile. recht. met of zonder overeenkomst D = Remboursement Bén. BTW) B = Remboursement Bén.G.74 € is van toepassing op het geheel van de wervelkolomimplantaten./Prestataire conventionné . zonder overeenkomst E = Supplément patient Bén.A = Prix (TVAc) .03 01-02-2011 157036000021 Zimmer Trabecular metal VBRL 06-155-00xxx / 06-131-10xxx 830. Prix plafond . / Prestataire non conventionné Terugbetaling Gew.Prijs (incl. hauteur fixe.03 01-12-2011 157036000046 Hospithera SupStance Corporectomy Cage 100119xxx / 100120xxx / 100122xxx / 100125xxx / 100128xxx 830.P.O.O.99 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.00 311.I. / Verstr.99 138.38 83.99 138.38 691.99 138.Bijwerking 01-08-2013 Page 1 (700711-700722) .39 519. / Verstr.Supplement patiënt W. monobloc. voor plaatsing in de thoraco-lumbale wervelkolom Valeur de U .38 € Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157036000012 OSTEON TLCR xxxxD1825 / xxxxD2130 830.

85 258.64 193.U waarde : U 250 Remboursement .98 01-02-2011 157037000066 Medtronic Pyramesh Round End Cap X 905-xxx 309.66 116.85 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.Terugbetaling W.98 01-02-2011 157037000023 Biomet AVR Endcap 35mm 700-0016 / 700-0036 / 7000037 / 700-0041 309.Supplement patiënt W. met of zonder overeenkomst D = Remboursement Bén. inclusief de elementen voor fixatie aan de cage Valeur de U .21 € Prix plafond .98 01-02-2011 157037000084 Synthes afsluitring + klemschroef synmesh diam 12&15 495. / Verstr. ordin. / Prestataire avec ou sans convention Terugbetaling Gew.19 30. zonder overeenkomst E = Supplément patient Bén. recht. / Verstr.G.64 193.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .491 309.21 51.410 / 495.Bijwerking 01-08-2013 Page 1 (700733-700744) .66 116.21 51.I.3xx / 495.66 116.98 01-02-2011 157037000057 Biomet C-AVR Cage Proximal Endcap 700-0051 / 700-0052 309.66 116.410 309.O.19 30.4xx + 495.19 30.19 30.64 193. Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157037000014 Biomet AVR Endcap 30mm 700-0004 / 700-0040 309.I. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700733-700744 End-cap ou end-ring pour cage de corporectomie monobloc ou découpable.21 51.I.P.21 51.W.64 193. BTW) B = Remboursement Bén.38x + 495.98 01-07-2011 Mise à jour 01-08-2013 . met overeenkomst .66 116. / Prestataire avec ou sans convention Supplement patiënt Gew./Prestataire conventionné .66 116. / Verstr.66 116.98 01-02-2011 157037000032 Biomet AVR Endcap 40mm 700-0055 / 700-0038 / 7000039 / 700-0042 309.64 193.64 193.74 € is van toepassing op het geheel van de wervelkolomimplantaten.66 116. / Prestataire non conventionné Terugbetaling Gew.Prijs (incl.Veiligheidsgrens : 258.64 193.19 30.19 30. recht.Remboursement V.21 51.19 30.85 258.Supplément patient V. ordin.98 01-02-2011 30-06-2011 157037000102 Synthes afsluitring + klemschroef synmesh diam 495. / Prestataire non conventionné Supplement patiënt / Verstr.66 116.Plafondprijs : 309.64 193.491 309.64 193. / Verstr. / Verstr. recht.O. ordin. met of zonder overeenkomst C = Supplément patient Bén. / Prestataire conventionné .98 01-02-2011 157037000041 Biomet C-AVR Cage Distal Endcap Ti 700-0053 / 700-0054 309.85 258.85 258.66 116.19 30.85 258. met overeenkomst .W.85 258.21 51.98 01-02-2011 157037000075 STRYKER ENDPLATE MED / SMALL ØXX x YY 3366xxxxMR / 3366xxxxSR / 3366xxxxMO/ 3366xxxxSO 309.21 51.85 258.64 193.19 30.85 258.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.A = Prix (TVAc) .I.85 258.P.19 30.21 51.21 51.4xx + 495.85 258. ordin.21 51.Terugbetaling : Marge de sécurité .98 01-02-2011 30-06-2011 157037000093 Synthes afsluitring + klemschroef synmesh diam 17-22-26 495.G. y compris les éléments pour fixation à la cage Endcap of endring voor corporectomiecage monobloc of afknipbaar.

recht.Veiligheidsgrens : 1.95 1562. / Verstr.044.00 1278.30xS + 890.74 01-02-2011 157038000061 STRYKER CERVILIFT COMPLEET (cage + 2 endcaps + setscrew) 101xxx + 151xxx + 131000 2044.005S 1704. met overeenkomst . ordin.Prijs (incl.24 1278.87 148.74 01-02-2011 157038000052 OSTEON CEVBR 700DPxxxx / 702DPxxxx 1802.I.16 0.93 129.Supplement patiënt W.04 148. voor cervicale plaatsing Valeur de U .04 148.12 766.28 148.P.83 1278.808. / Verstr.16 340.Terugbetaling W. / Prestataire conventionné .00 1704.87 148.12 284.99 1704.99 1704. / Prestataire non conventionné Terugbetaling Gew.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.00 1278.12 311. / Verstr.74 01-02-2011 157038000043 Medtronic T2 XVBR CENTERPIECE + 2x SKEPTOR ENDCAP 93513xx / 93516xx + 93513xx / 93516xx / 93713xx / 93716xx 2044.84 0. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700755-700766 Cage de corporectomie. pour placement cervical Corporectomiecage.12 766.16 1278. Nom du produit Productnaam Numéros de référence Referentienummers A B C D E A partir de Jusqu'au Vanaf Tot F 157038000016 Biomet TPS-C 1 level + Locking screw (8012 + 8013) + 8001 1562. ordin.00 1278. met overeenkomst .95 0.22 0.16 193.I. zonder overeenkomst E = Supplément patient Bén.93 1290. recht.83 1278.08xS 1897.12 766.16 € Prix plafond .Bijwerking 01-08-2013 97.16 1704.88 148. met of zonder overeenkomst D = Remboursement Bén. 0° + ADD / ADDplus / VBR Set screw CS 2250-1x-xx + CS 2259 1290. / Prestataire non conventionné Supplement patiënt / Verstr.G.Supplément patient V.74 € is van toepassing op het geheel van de wervelkolomimplantaten. recht.99 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.I. ordin.16 340.12 426.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale . BTW) B = Remboursement Bén.O. pour l'ensemble des composants. ordin.16 1278.74 01-02-2011 157038000034 Globus Medical Belgium XPand-R Corpectomy Spacer Small Peek 316.16 340.Terugbetaling : Marge de sécurité .P.09 01-02-2011 Mise à jour 01-08-2013 . voor het geheel van de samenstellende elementen. / Prestataire avec ou sans convention Terugbetaling Gew.Remboursement V. in situ expandeerbaar.12 12.83 1278.W.81 Page 1 31-08-2012 (700755-700766) . / Verstr.G.O.12 426.74 01-02-2011 157038000104 MSH ADD.1xx 1704.W.12 523.I. / Prestataire avec ou sans convention Supplement patiënt Gew.74 01-02-2011 157038000095 Synthes Synex Small 04.87 148.16 1704.10 148.704.83 148.74 01-02-2011 157038000086 Synthes ECD + Locking Clip 891. / Verstr.12 619. met of zonder overeenkomst C = Supplément patient Bén.00 0.Plafondprijs : 2.74 01-02-2011 157038000025 Biomet TPS-C 2 level + Locking screw (8010 + 8011) + 8001 1589.00 1278. extensible in situ.22 1589./Prestataire conventionné .74 01-02-2011 157038000077 STRYKER CERVILIFT COMPLEET (cage + 2 endcaps + setscrew) + EXTENDER 101xxx + 151xxx + 131000 + 121xxx 2044.99 1704.A = Prix (TVAc) .40 1704.U waarde : U 1650 Remboursement .

6° + ADD / ADDplus / VBR Set screw CS 2251-12-25 + CS 2259 1626.42 0.83 1564.04 148.49 0.34 148.74 01-09-2012 Mise à jour 01-08-2013 . 0° + ADD / ADDplus / VBR Set screw CS 2253-12-13 + CS 2259 1533. Ø 12 mm. Ø 12 mm.46 1533.00 1278.12 255.00 1278.30 148. height 13-18 mm.12 145.00 1278. Ø 12 mm.37 148.12 255.83 0. Ø 12 mm.16 0. 6° + ADD / ADDplus / VBR Set screw CS 2253-12-17 + CS 2259 1564.49 1689. 12° + ADD / ADDplus / VBR Set screw CS 2253-12-25 + CS 2259 1626.00 1278.Bijwerking 01-08-2013 Page 2 (700755-700766) . height 13-18 mm.00 1278.64 1423.16 1704.00 1278. 18° + ADD / ADDplus / VBR Set screw CS 2253-12-40 + CS 2259 1689.12 286.83 1564.74 01-02-2011 31-08-2012 157038000183 MSH ADDplus.00 1278.34 148. Ø 12 mm.34 148.74 01-02-2011 31-08-2012 157038000192 MSH ADDplus.30 148.74 01-09-2012 157038000305 Hospithera ADDplus.37 148.12 411.42 1626.74 01-02-2011 31-08-2012 157038000131 MSH ADDplus.00 1278.00 1278.16 340.09 01-09-2012 157038000244 Hospithera ADD.36 01-09-2012 157038000253 Hospithera ADDplus.36 01-02-2011 31-08-2012 157038000122 MSH ADDplus. Ø 12 mm.74 01-09-2012 157038000271 Hospithera ADDplus. Ø 12 mm.12 145. 18° + ADD / ADDplus / VBR Set screw CS 2253-12-40 + CS 2259 1689.46 1533.81 129. Ø 12 mm.30 148.00 1278. Ø 12 mm.30 148.1xx 1704.71 148.12 426.12 426.00 1278.49 1689.00 1278.74 01-09-2012 157038000323 Hospithera ADDplus.12 348. 6° + ADD / ADDplus / VBR Set screw CS 2251-12-17 + CS 2259 1564.00 1278.71 148.16 0. 0° + ADD / ADDplus / VBR Set screw CS 2250-1x-xx + CS 2259 1290.87 148.64 1423.74 01-02-2011 31-08-2012 157038000156 MSH ADDplus.49 0. height 17-26 mm.52 142.00 1278. 6° + ADD / ADDplus / VBR Set screw CS 2251-12-13 + CS 2259 1533.83 0. height 13-18 mm.71 148. height 17-26 mm.71 148.99 1704.42 0. Ø 12 mm.46 0. 6° + ADD / ADDplus / VBR Set screw CS 2253-12-17 + CS 2259 1564.12 348. 6° + ADD / ADDplus / VBR Set screw CS 2251-12-40 + CS 2259 1689. height 25-41 mm.12 411.46 1533. height 25-41 mm.46 0. height 40-65 mm.74 01-01-2012 157038000217 Globus Medical Belgium XPand Corporectomy Spacer Small 116.00 1278.00 1278.12 286.74 01-02-2011 31-08-2012 157038000165 MSH ADDplus.83 1278. 6° + ADD / ADDplus / VBR Set screw CS 2251-12-17 + CS 2259 1564.74 01-02-2011 31-08-2012 157038000147 MSH ADDplus.00 1278.42 0. 12° + ADD / ADDplus / VBR Set screw CS 2253-12-25 + CS 2259 1626. height 40-65 mm.12 12.12 411. 6° + ADD / ADDplus / VBR Set screw CS 2251-12-25 + CS 2259 1626.64 0.04 148.00 1278. height 40-65 mm.83 0.74 01-02-2011 31-08-2012 157038000201 Hospithera Tecorp implant cervical 11ICC13-xx / 11ICC16-xx 2044. height 13-18 mm.157038000113 MSH ADD. height 25-41 mm.46 1533.12 286.74 01-11-2012 157038000235 Hospithera ADD.00 1278.64 0.42 1626.93 1290.12 255.42 1626. Ø 12 mm.83 1564. 6° + ADD / ADDplus / VBR Set screw CS 2250-1x-xx-6 + CS 2259 1423.49 0.49 1689.37 148. Ø 12 mm.00 1278. Ø 12 mm.34 148.93 0.12 255.74 01-09-2012 157038000262 Hospithera ADDplus.00 1278. height 17-26 mm.74 01-02-2011 31-08-2012 157038000174 MSH ADDplus.12 411.12 348.74 01-09-2012 157038000287 Hospithera ADDplus.46 0. height 40-65 mm.74 01-09-2012 157038000296 Hospithera ADDplus. Ø 12 mm. Ø 12 mm. 6° + ADD / ADDplus / VBR Set screw CS 2251-12-40 + CS 2259 1689.49 0. height 25-41 mm.16 1704.12 286.74 01-09-2012 157038000314 Hospithera ADDplus. 6° + ADD / ADDplus / VBR Set screw CS 2250-1x-xx-6 + CS 2259 1423.12 348.12 766.83 0.49 1689.52 142.42 0. Ø 12 mm.74 01-09-2012 157038000226 Cormed GIZA cervical corporectomy GC10100xS / GC20100xS / GC30100xS 1704.42 1626. 0° + ADD / ADDplus / VBR Set screw CS 2253-12-13 + CS 2259 1533. height 17-26 mm.37 148.83 1564.46 0. 6° + ADD / ADDplus / VBR Set screw CS 2251-12-13 + CS 2259 1533.

74 01-02-2011 157039000027 B Braun Medical Hydrolift + Hydrolift endplate (optional) 2416.51 796.I.49 148.51 906.81 € Nom du produit Productnaam Numéros de référence Referentienummers A B C D E A partir de Jusqu'au Vanaf Tot F 157039000011 B Braun Medical Hydrolift SV001T -> SV018T / SV030T > SV032T 2306.G.Terugbetaling : Marge de sécurité .31 148.30 148. met of zonder overeenkomst C = Supplément patient Bén.30 148.51 906.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.W.81 1510. ordin.81 2014.49 148.01 402. voor het geheel van de samenstellende elementen. ordin.P.80 1510. met overeenkomst .Supplement patiënt W.G.01 402.80 1510.81 2014.51 609.416.80 1510.51 906.014.01 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148. pour placement dans la colonne vertébrale thoraco-lombaire Corporectomiecage. / Verstr.74 € is van toepassing op het geheel van de wervelkolomimplantaten. / Verstr. met of zonder overeenkomst D = Remboursement Bén.51 906.60 2014.O.74 01-02-2011 157039000063 Medtronic T2 XVBR CENTERPIECE + 2x SKEPTOR ENDCAP 93519xx / 93522xx / 93525xx + 93519xx / 93522xx / 93525xx/ 93719xx / 93722xx / 93725xx 2416.30 148. / Prestataire avec ou sans convention Terugbetaling Gew. Prix plafond . recht.99 1510.A = Prix (TVAc) . BTW) B = Remboursement Bén.W. / Prestataire conventionné ./Prestataire conventionné .00 2014. in situ expandeerbaar.09 148. ordin.00 2014.Supplément patient V.01 292.U waarde : U 1950 Remboursement .Bijwerking 01-08-2013 Page 1 (700770-700781) .81 2014.2xx 2120.I.P.74 01-02-2011 157039000081 STRYKER VLIFT COMPLEET (2endcaps +cage) 48291xxx(S) + 4829xxxx(S) 2416.01 116.Veiligheidsgrens : 2.30 148. met overeenkomst . voor plaatsing in de thoraco-lumbale wervelkolom Valeur de U . / Prestataire non conventionné Terugbetaling Gew.74 01-02-2011 157039000054 Globus Medical Belgium XPand-R Corpectomy Spacer Medium Peek 316.01 105.51 620.74 01-02-2011 157039000036 Biomet TPS-TL Cage + Locking screw SV001T -> SV018T / SV030T> SV032T + SV019T -> SV021T (1300-xxxx + 1300-xxxx) + 1300-1000 2416.I. / Prestataire avec ou sans convention Supplement patiënt Gew.51 609.O. pour l'ensemble des composants.81 2014.I.74 01-02-2011 157039000072 OSTEON TLEVBR 753DTxxxx / 733DTxxxx 2130.01 402.59 1510.01 402.Remboursement V.Plafondprijs : 2. / Verstr. recht.82 2014.51 906. / Verstr.30 148.74 01-02-2011 157039000097 STRYKER VLIFT COMPLEET (2endcaps +cage) + EXTENDER 48291xxx + 4829xxxx(S) + 48291800(S) / 48292200(S) 2416.81 2014. zonder overeenkomst E = Supplément patient Bén.80 1510.99 1510. extensible in situ.01 402.Terugbetaling W.01 105. recht.80 1510.74 01-02-2011 157039000045 Globus Medical Belgium XPand-R Corpectomy Spacer Large Peek 316. ordin.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .Prijs (incl. / Prestataire non conventionné Supplement patiënt / Verstr. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700770-700781 Cage de corporectomie.74 01-02-2011 Mise à jour 01-08-2013 . / Verstr.0xx 2120.

00 1508. height 28-40 mm + VBR end piece.64 0.08 148. size B. size C.01 2901 25. Ø 20 mm. left + ADD / ADDplus / VBR Set screw (2x) VBR center piece.93 1290.13 0.13 0.74 01-02-2011 31-08-2012 Mise à jour 01-08-2013 .93 0.74 01-02-2011 31-08-2012 157039000212 MSH obelisc center piece (1x) + end piece round (1x) + end piece oval (1x) + locking screw (1x) CS 2920-xx + CS 292x-xx + CS 2039.01 2901 25. left + ADD / ADDplus / VBR Set screw (2x) VBR center piece.74 01-02-2011 31-08-2012 157039000316 MSH 1590.55 148.36 01-02-2011 31-08-2012 157039000151 MSH ADD.3xx 1839.59 0.00 1508. 0° + ADD / ADDplus / VBR Set screw CS 2250-16-12 + CS 2259 1290.08 148.59 0.55 148.15 1708. Ø 20 mm.13 1508.59 1590.59 0.38 0.00 148.05 1510.00 129.51 80.00 1423. 0° + ADD / ADDplus / VBR Set screw CS 2250-16-39 + CS 2259 1290. height 16-25 mm. height 24-40 mm.74 01-02-2011 31-08-2012 157039000203 MSH obelisc center piece (1x) + end piece oval (2x) + locking screw (1x) CS 2920-xx + CS 293x-xx + CS 2039. 0° + ADD / ADDplus / VBR Set screw CS 2250-16-10 + CS 2259 1290.13 0. size B. Ø 24 mm.13 0.00 1508.13 1508.64 1423. left + ADD / ADDplus / VBR Set screw (2x) VBR center piece.00 1290.00 1510.00 1510.00 129.36 01-02-2011 31-08-2012 157039000176 MSH ADD. size K. size G.64 148.09 01-02-2011 31-08-2012 157039000133 MSH ADD. height 24-40 mm.00 129.00 1423.93 1290. size H. size A. height 52-76 mm + VBR end piece.08 148.64 0.13 1508. size K.59 1590.01 293x-xx + CS 2901 25. Ø 16 mm.51 197. right + VBR end piece. height 42-58 mm + VBR end piece. size G. size A. right + VBR end piece. height 12-17 mm. height 38-54 mm + VBR end piece.00 134.00 148. Ø 20 mm.13 0.00 1508. height 10-13 mm.13 0. size H. right + VBR end piece.00 1510.64 1423.13 0.00 1346.20 0. size D.55 148. Ø 24 mm.15 1708.93 0. Ø 16 mm. Ø 20 mm. left + ADD / ADDplus / VBR Set screw (2x) VBR center piece. left + ADD / ADDplus / VBR Set screw (2x) VBR center piece. right + VBR end piece. height 23-29 mm + VBR end piece. size L. height 39-65 mm.00 1290.06 2014. right + VBR end piece.13 1508.15 0. Ø 16 mm.00 129.51 197.51 80.00 1510.74 01-02-2011 31-08-2012 157039000246 MSH 0.05 1510. right + VBR end piece. size K. size M.00 148.93 1290. Ø 24 mm. size D.64 0. size D. height 16-25 mm.51 528.13 1508.13 0.05 1510.93 0. left + ADD / ADDplus / VBR Set screw (2x) VBR center piece.00 1290.09 01-02-2011 31-08-2012 157039000185 MSH obelisc center piece (1x) CS 2920-17 1346.51 328.00 1510.74 01-02-2011 31-08-2012 157039000221 MSH obelisc center piece (1x) + end piece round (1x) + locking screw (1x) CS 2920-20 + CS 292x-xx + CS 2901 1708.00 148. 6° + ADD / ADDplus / VBR Set screw CS 2250-16-24-6 + CS 2259 1423.64 148.00 129. Ø 16 mm. height 74-114 mm + VBR end piece.64 0.93 0.00 1510. left + ADD / ADDplus / VBR Set screw (2x) VBR center piece.51 80.74 01-02-2011 31-08-2012 157039000273 MSH 1508. 0° + ADD / ADDplus / VBR Set screw CS 2250-16-16 + CS 2259 1290. 6° + ADD / ADDplus / VBR Set screw CS 2250-16-16-6 + CS 2259 1423.59 1590.74 01-02-2011 31-08-2012 MSH 1508. Ø 16 mm. size G. Ø 16 mm.59 0.74 01-02-2011 31-08-2012 157039000237 MSH obelisc center piece (1x) + end piece round (2x) + locking screw (1x) CS 2920-xx + CS 292x-xx + CS 2039.93 0. right + VBR end piece. size L. size M.74 01-02-2011 31-08-2012 157039000325 MSH CS 2220-2534-1 + CS 22202534-x + CS 2220-2534-x + CS 2259 CS 2220-3244-1 + CS 22203244 -x + CS 2220-3244 -x + CS 2259 CS 2220-4258-1 + CS 22204258 -x + CS 2220-4258 -x + CS 2259 CS 2220-5684-1 + CS 22205684 -x+ CS 2220-5684 -x + CS 2259 CS 2224-2329-1 + CS 22242329 -x + CS 2224-2329 -x + CS 2259 CS 2224-2840-1 + CS 22242840 -x + CS 2224-2840 -x + CS 2259 CS 2224-3854-1 + CS 22243854 -x + CS 2224-3854 -x + CS 2259 CS 2224-5276-1 + CS 22245276-x + CS 2224-5276-x + CS 2259 CS 2224-74114-1 + CS 222474114-x + CS 2224-74114-x + CS 2259 1508. right + VBR end piece.Bijwerking 01-08-2013 Page 2 (700770-700781) .93 1290. size L. height 25-34 mm + VBR end piece.93 0.00 1290.74 01-02-2011 31-08-2012 157039000264 MSH 1508.00 142.38 1839. height 56-84 mm + VBR end piece.93 0.00 142. Ø 24 mm.51 528.93 0.20 0. height 32-44 mm + VBR end piece. size B.157039000106 Synthes Synex 495.00 1508. left + ADD / ADDplus / VBR Set screw (2x) VBR center piece.59 1590.00 1290. size M. left + ADD / ADDplus / VBR Set screw (2x) 1590.06 2014. Ø 24 mm. size C.00 148.51 528.09 01-02-2011 31-08-2012 157039000142 MSH ADD.93 0. size A. size H.74 01-02-2011 31-08-2012 157039000307 MSH 1590.09 01-02-2011 31-08-2012 157039000167 MSH ADD.74 01-02-2011 157039000115 MSH ADD.15 0.00 1510.74 01-02-2011 31-08-2012 157039000291 MSH 1590.06 2014.93 1290.09 01-02-2011 31-08-2012 157039000124 MSH ADD.13 157039000255 VBR center piece.87 148.74 01-02-2011 31-08-2012 157039000282 MSH 1508. Ø 16 mm.51 80.08 148.93 0.13 0. size C. 0° + ADD / ADDplus / VBR Set screw CS 2250-16-24 + CS 2259 1290. right + VBR end piece.62 01-02-2011 31-08-2012 157039000194 MSH obelisc center piece (1x) + end piece oval (1x) + locking screw (1x) CS 2920-20 + CS 293x-xx + CS 2901 1708.20 1346.

79 1510.00 1508.00 1290. Ø 28 mm. Ø 16 mm.08 148.55 148.00 129. 0° + ADD / ADDplus / VBR Set screw CS 2250-16-10 + CS 2259 1290.74 01-06-2011 157039000377 Medtronic T2 Altitude Centerpiece + T2 Altitude end cap (2x) 2416.59 1590.00 129.93 0.59 1590.01 2901 25.80 2014.64 148.20 1346. size C.09 01-09-2012 157039000447 Hospithera ADD.01 293x-xx + CS 2901 25. 0° + ADD / ADDplus / VBR Set screw CS 2250-16-24 + CS 2259 1290. height 32-44 mm + VBR end piece.05 1510.13 1508.59 0. right + VBR end piece.00 148.74 01-02-2011 31-08-2012 157039000343 MSH 1590. height 56-84 mm + VBR end piece.99 1510.62 01-09-2012 157039000492 Hospithera obelisc center piece (1x) + end piece oval (1x) + locking screw (1x) CS 2920-20 + CS 293x-xx + CS 2901 1708.00 1290.74 01-02-2011 31-08-2012 157039000361 Johnson & Johnson MedicalDepuy 2416.01 402.59 0. size Q.74 01-09-2012 157039000501 Hospithera obelisc center piece (1x) + end piece oval (2x) + locking screw (1x) CS 2920-xx + CS 293x-xx + CS 2039.30 148.64 0.00 1423. size A.00 134.36 01-09-2012 157039000456 Hospithera ADD. left + ADD / ADDplus / VBR Set screw (2x) VBR center piece. 6° + ADD / ADDplus / VBR Set screw CS 2250-16-24-6 + CS 2259 1423.06 2014.64 0.74 01-09-2012 157039000404 Cormed GIZA thoraco-lumbar corporectomy GTx02000S / GLx03000S 2014.00 2014.00 1290.93 0. size B.08 148. size A. height 10-13 mm. size B. Ø 16 mm.13 4258 -x + CS 2220-4258 -x + CS 2259 0.01 0.08 148.74 01-09-2012 Mise à jour 01-08-2013 .00 129.51 197.13 1508. Ø 16 mm.50 148.81 2014. size R. height 16-25 mm.00 142.13 1508.00 1510.157039000334 MSH VBR center piece.00 1290. height 42-58 mm + VBR end piece.59 1590. left + ADD / ADDplus / VBR Set screw (2x) VBR center piece.Bijwerking 01-08-2013 Page 3 (700770-700781) .30 148.51 906. height 30-44 mm + VBR end piece.00 129.74 01-01-2012 157039000395 Globus Medical Belgium XPand Corporectomy Spacer Medium / Large 116.74 01-09-2012 157039000544 Hospithera 1508.74 01-02-2011 31-08-2012 157039000352 MSH 1590.00 148. Ø 16 mm. right + VBR end piece.01 2014.2xx / 116.74 01-09-2012 Hospithera 0. left + ADD / ADDplus / VBR Set screw (2x) X-MESH ALT SM/MED/LG CS 2228-3044-1 + CS 22283044-x + CS 2228-3044-x + CS 2259 CS 2228-4258-1 + CS 22284258-x + CS 2228-4258-x + CS 2259 CS 2228-5684-1 + CS 22285684-x + CS 2228-5684-x + CS 2259 18890xxxx 1590.51 528.01 2901 25.93 1290. height 24-40 mm.51 503.55 148. size R.59 0.93 0.51 906.80 1510.64 1423. Ø 28 mm.64 148.13 0. right + VBR end piece. Ø 16 mm.64 1423. Ø 20 mm.06 2014.09 01-09-2012 157039000431 Hospithera ADD. right + VBR end piece.15 1708.80 1510. size P. height 39-65 mm.93 1290.01 105.55 148. left + ADD / ADDplus / VBR Set screw (2x) VBR center piece. size P.06 2014.0xx 2120.01 402.93 1290.51 528.93 1290.15 0.09 01-09-2012 157039000465 Hospithera ADD.05 1510.00 1423. Ø 20 mm.00 1508. Ø 16 mm. 0° + ADD / ADDplus / VBR Set screw CS 2250-16-16 + CS 2259 1290.13 2534-x + CS 2220-2534-x + CS 2259 CS 2220-3244-1 + CS 22201508.00 1510. right + VBR end piece.74 01-09-2012 157039000535 Hospithera obelisc center piece (1x) + end piece round (2x) + locking screw (1x) CS 2920-xx + CS 292x-xx + CS 2039. Ø 20 mm.74 01-09-2012 157039000526 Hospithera obelisc center piece (1x) + end piece round (1x) + locking screw (1x) CS 2920-20 + CS 292x-xx + CS 2901 1708.15 1708.00 1346. 0° + ADD / ADDplus / VBR Set screw CS 2250-16-12 + CS 2259 1290.93 0. left + ADD / ADDplus / VBR Set screw (2x) VBR center piece. left + ADD / ADDplus / VBR Set screw (2x) 0.93 0.74 01-09-2012 157039000517 Hospithera obelisc center piece (1x) + end piece round (1x) + end piece oval (1x) + locking screw (1x) CS 2920-xx + CS 292x-xx + CS 2039. height 42-58 mm + VBR end piece.09 01-09-2012 157039000422 Hospithera ADD.51 197.09 01-09-2012 157039000483 Hospithera obelisc center piece (1x) CS 2920-17 1346.74 01-09-2012 157039000562 Hospithera CS 2220-2534-1 + CS 22201508.20 0.51 528.51 80.93 0.13 0.00 148. size Q. size A.01 402.64 0.93 0.93 0.00 1290. 0° + ADD / ADDplus / VBR Set screw CS 2250-16-39 + CS 2259 1290.51 609.93 0. height 16-25 mm. height 25-34 mm + VBR end piece.81 2014.93 0.74 01-11-2012 157039000413 Hospithera ADD. size C.64 0.00 1510. right + VBR end piece.36 01-09-2012 157039000474 Hospithera ADD.00 142.93 1290.13 3244 -x + CS 2220-3244 -x + CS 2259 CS 2220-4258-1 + CS 22201508.13 0. Ø 28 mm.20 0. 6° + ADD / ADDplus / VBR Set screw CS 2250-16-16-6 + CS 2259 1423.74 01-11-2011 157039000386 Hospithera Tecorp implant thoraco-lombaire + Endplates (x2) 93916xx / 93913xx / 93925xx / 93922xx / 93919xx + 94016xx / 94013xx / 94025xx / 94022xx / 94019xx 12ICT21-xx / 12ICL27-xx + 12PIC2x-x 2416. height 12-17 mm.15 0. size B.00 1510.49 148.51 906. size P. height 24-40 mm. size C. size R. size Q.51 80.29 148.00 157039000553 VBR center piece.51 80.05 1510.00 1510.00 1510. Ø 16 mm.00 129.

size M.00 1508. right + VBR end piece.08 148. height 56-84 mm + VBR end piece. size Q. size L. size R.00 148. right + VBR end piece.51 80. size R.59 1590. Ø 24 mm. size L.00 1510.74 01-09-2012 1590. right + VBR end piece.74 01-09-2012 1590.00 1510. Ø 28 mm. size G.59 0. left + ADD / ADDplus / VBR Set screw (2x) VBR center piece. size H. size G.59 0.59 1590.08 148.51 80.00 1510.13 0.00 148. height 56-84 mm + VBR end piece. Ø 24 mm. size H.59 0.08 148.08 148.157039000571 Hospithera 157039000587 Hospithera 157039000596 Hospithera 157039000605 Hospithera 157039000614 Hospithera 157039000623 Hospithera 157039000632 Hospithera 157039000641 Hospithera 157039000657 Hospithera Mise à jour 01-08-2013 . height 74-114 mm + VBR end piece. left + ADD / ADDplus / VBR Set screw (2x) VBR center piece. Ø 24 mm. size P. size M. size K. size L. left + ADD / ADDplus / VBR Set screw (2x) VBR center piece.13 0. size G.00 1510.13 0. size D. height 42-58 mm + VBR end piece.00 1510.08 148. Ø 28 mm. size K. size P. height 28-40 mm + VBR end piece. size D. left + ADD / ADDplus / VBR Set screw (2x) CS 2220-5684-1 + CS 22205684 -x+ CS 2220-5684 -x + CS 2259 CS 2224-2329-1 + CS 22242329 -x + CS 2224-2329 -x + CS 2259 CS 2224-2840-1 + CS 22242840 -x + CS 2224-2840 -x + CS 2259 CS 2224-3854-1 + CS 22243854 -x + CS 2224-3854 -x + CS 2259 CS 2224-5276-1 + CS 22245276-x + CS 2224-5276-x + CS 2259 CS 2224-74114-1 + CS 222474114-x + CS 2224-74114-x + CS 2259 CS 2228-3044-1 + CS 22283044-x + CS 2228-3044-x + CS 2259 CS 2228-4258-1 + CS 22284258-x + CS 2228-4258-x + CS 2259 CS 2228-5684-1 + CS 22285684-x + CS 2228-5684-x + CS 2259 1508.59 1590. Ø 28 mm.59 0. size K. left + ADD / ADDplus / VBR Set screw (2x) VBR center piece.74 01-09-2012 1590.13 1508. right + VBR end piece.59 1590. right + VBR end piece.51 80.59 1590. right + VBR end piece.13 1508. right + VBR end piece.74 01-09-2012 1590.59 1590. right + VBR end piece. left + ADD / ADDplus / VBR Set screw (2x) VBR center piece. size H. left + ADD / ADDplus / VBR Set screw (2x) VBR center piece.Bijwerking 01-08-2013 VBR center piece. Ø 24 mm.74 01-09-2012 1590.08 148.74 01-09-2012 Page 4 (700770-700781) . height 30-44 mm + VBR end piece.59 0.00 1508. size M. size Q.74 01-09-2012 1590.51 80. Ø 20 mm.51 80.00 1510. size D. size Q.59 1590.00 1510.08 148. Ø 24 mm.59 0.74 01-09-2012 1590. size R.51 80. left + ADD / ADDplus / VBR Set screw (2x) VBR center piece.74 01-09-2012 1508. size P. left + ADD / ADDplus / VBR Set screw (2x) VBR center piece. height 23-29 mm + VBR end piece. height 38-54 mm + VBR end piece.13 0.51 80. right + VBR end piece. height 52-76 mm + VBR end piece.59 0.

97 116.Supplement patiënt W.40mm 176.19 38.19 69.Remboursement V.5mm.Prijs (incl.92 18.92 30.U waarde : U 150 Remboursement .92 € Prix plafond .2mm Bone Screw 184. recht.98 116.60 116.74 € est d'application sur l'ensemble des éléments des implants de la colonne vertébrale .90 154. ordin.Bijwerking 01-08-2013 Page 1 (700836-700840) .98 116. met overeenkomst .89 154. / Verstr.92 30.1xx / 176.81 15.35 01-02-2011 Mise à jour 01-08-2013 . Fixed Angle 5.92 30.01 116.90 154.90 € Distributeur Verdeler Code d'identification Identificatiecode 20% Les montants de la marge de délivrance sont donnés à titre indicatif : le plafond de 148.1xx 185.W.I. / Prestataire non conventionné Terugbetaling Gew. / Prestataire non conventionné Supplement patiënt / Verstr.08 116.19 42. inclusief alle toebehoren voor fixatie en blokkering Valeur de U .92 0.I.74 € is van toepassing op het geheel van de wervelkolomimplantaten. BTW) B = Remboursement Bén. / Verstr.33 17.59 01-02-2011 157040000074 Johnson & Johnson MedicalDepuy Stalif Screw (par pièce) STTxxxxS 159.19 38. / Verstr.59 01-02-2011 157040000065 Globus Medical Belgium INDEPENDENCE Screw.O.98 116.92 30. / Verstr. recht.19 38. met of zonder overeenkomst D = Remboursement Bén.Veiligheidsgrens : 154. 79760xxINT 185.71 18.I. / Prestataire avec ou sans convention Terugbetaling Gew.19 42.90 154.52 154. zonder overeenkomst F = Marge de délivrance Afleveringsmarge 700836-700840 Vis osseuse pour fixer une cage à la colonne vertébrale.49 01-02-2011 157040000031 Biomet TPS-TL Bone Screw 1300-06xx 154.Terugbetaling : Marge de sécurité .W.71 18.Plafondprijs : 185. / Verstr. zonder overeenkomst E = Supplément patient Bén. ordin.O. met of zonder overeenkomst C = Supplément patient Bén.2xx 185. / Prestataire conventionné .92 0. 79660xxINT / 79755xxINT.49 01-02-2011 157040000047 Globus Medical Belgium 3.G.A = Prix (TVAc) .92 4.74 15.Terugbetaling W.08 116. Nom du produit Productnaam Numéros de référence Referentienummers A B C D E F A partir de Jusqu'au Vanaf Tot 157040000013 Biomet Solitaire Bone Screw 1400-10xx / 14-5301xx 154.58 01-02-2011 157040000101 Medtronic Zephir screw (for Prevail cage) 8792xxx 173.P.92 4.74 15.0xx 185.19 57.71 18. / Prestataire avec ou sans convention Supplement patiënt Gew. y compris toutes les pièces de fixation et d'attache Botschroef voor verankering van een cage aan de wervelkolom.93 154.I.19 69.Supplément patient V.90 01-02-2011 157040000083 Johnson & Johnson MedicalDepuy Stalif Screw (par pièce) STTxxxxx 159.59 01-02-2011 157040000056 Globus Medical Belgium 4.70 18.6mm Bone Screw 184. met overeenkomst .00 154.De bedragen voor de afleveringsmarge worden slechts ter informatie vermeld : het grensbedrag van 148.01 116./Prestataire conventionné .19 69.19 69.49 01-02-2011 157040000022 Biomet TPS-C Bone Screw 80xx 154.81 15.74 15. ordin.01 116. 20mm .G.92 0.93 154.P.93 154. recht.90 01-02-2011 157040000092 Medtronic Screw Sovereign 79655xxINT. ordin.00 154.

647.98 116.59 01-02-2011 157040000205 LDR MEDICAL Plaque agrafe ROI (réf pour 2 agrafes) IR 200xT / IR 600xT 185. bolt.59 01-02-2011 157040000171 SHARK MEDICAL Plaque agrafe ROI (réf pour 2 agrafes) IR 200xT / IR 600xT 185.66 01-02-2011 31-08-2012 157040000153 MSH Topaz Cancellous bone screw. golden.90 154.802.802.41 11.90 154.98 116.98 116.21x 185.60 116.5 mm CS 2375-xx 159.81x.19 69.90 154.71 18.617.92 4.1xxS / 187.19 69.71 18.59 01-02-2011 157040000135 MSH osmium / ADD plus screw incl.19 69.2xxS 185.92 4.81 15.90 154.92 30.8xx 185.90 154.90 154.19 69.71 18.92 30.617.90 154.19 69.08 116.98 116.00 116.98 116.81 15. titanium CS 1300-1xT 185.98 116. Ø 4 mm.71 18.20x / 04.59 01-02-2011 157040000214 LDR MEDICAL Ancre MC 001 T 185.90 154.60 116.59 01-02-2011 31-08-2012 157040000144 MSH Osmium / ADD-plus Cancellous bone screw. Ø 4 mm.98 116. titanium CS 1301-xxT 116.5 mm CS 2375-xx 159.92 30.66 01-09-2012 157040000257 Hospithera Topaz Cancellous bone screw.92 30.Bijwerking 01-08-2013 Page 2 (700836-700840) .71 18.19 0.98 116.92 30.98 116.41 11.59 01-02-2011 157040000196 LDR MEDICAL Plaque agrafe ROI-C (réf pour 2 agrafes) MC 1005T / MC 1006T 185. titanium CS 1300-1xT 185. titanium CS 1301-xxT 116.92 30.19 69.19 69.19 0. golden.71 18.60 0.00 154. Ø 6.8xx / 04. Ø 5 mm. Ø 6.19 69.59 01-02-2011 157040000223 Globus Medical Belgium HA Coated screw 187.02S / 04.00 116.60 0.19 69.71 18.71 18.92 30. Ø 5 mm.98 116.59 01-06-2012 157040000232 Hospithera osmium / ADD plus screw incl.98 116.92 30.71 18.92 30.00 154.19 42.90 154.08 116.71 18.19 69.19 42.71 18.157040000117 Synthes Synfix schroef 04.59 01-09-2012 157040000241 Hospithera Osmium / ADD-plus Cancellous bone screw.90 154.19 69.92 30.90 01-02-2011 31-08-2012 157040000162 SHARK MEDICAL Plaque agrafe ROI-C (réf pour 2 agrafes) MC 1005T / MC 1006T 185.90 01-09-2012 Mise à jour 01-08-2013 .92 30.59 01-02-2011 157040000126 Synthes ZeroP schroef 04.59 01-02-2011 157040000187 SHARK MEDICAL Ancre MC 001 T 185.90 154. bolt.

Mise à jour 01-08-2013 .Bijwerking 01-08-2013 Page 3 (700836-700840) .