v1 - ortho 01-01-2018-web - gbs-vbs. · pdf fileeffectuées par les orthopédistes...

Avenue de Tervueren 211 B-1150 Bruxelles Tél.: 02 739 71 11 Fax: 02 739 72 91 Actuariat WU 1.21.00.00

I.N.A.M.I.

Institut National d'Assurance Maladie-Invalidité

Soins de Santé

Circulaire OA n° 2017/375 du 21 décembre 2017 En vigueur à partir du 1 janvier 2018

3910/1626

Tarifs ; Orthopédistes ; 01-01-2018. Conformément à la décision prise lors de la réunion de la Commission de conventions orthopédistes - Organismes Assureurs du 5 décembre 2017, les tarifs des prestations effectuées par les orthopédistes sont linéairement indexées de 1,68% au 1er janvier 2018.

Orthopédistes

Date d’application : 1er janvier 2018

Le Fonctionnaire Dirigeant, H. De Ridder

Directeur général.

Annexes : V1 - Ortho 01-01-2018-circ OA

01-01-2017 01-01-2018

I. Prestations reprises sous SUR MESURE 3,059240 3,110635

II. SUR MESURE HIGH-TECH 3,346191 3,402407

III. Prestations reprises sous PREFAB

1) Prestations SANS quote-part personnelle à l'exception

1) des numéros de code suivants: 1,703694 1,732316

- 653811-653822, 653833-653844, 653855-653866, 1,777294 1,807153

656611-656622 et 677950-677962

- 654570-654581 1,315745 1,337850

- 647570-647581 1,370013 1,393029

2) Prestations AVEC quote-part personnelle à l'exception

2) des numéros de code suivants: 1,703694 1,732316

- 649434-649445 1,533324 1,559084

- 645175-645186 1,158512 1,177975

- 646973-646984 et 646995-647006 1,737815 1,767010

- 647592-647603 1,336467 1,358920

- 646951-646962 2,044490 2,078837

- 647555-647566 1,086912 1,105172

- 645632-645643 1,201104 1,221283

- 655690-655701 1,343652 1,366225

- 647533-647544 1,216266 1,236699

- 647614-647625 1,456023 1,480484

IV. Prestations reprises sous I.M.F. 2,855536 2,903509

V. LOMBOSTATS en coutil et métal 2,539392 2,582054

VI. Prestations relatives aux CHAUSSURES ORTHOPEDIQUES

1) Chaussures orthopédiques - affections majeures (A) -

1) Prestations AVEC quote-part personnelle 2,480034 2,521699

2) Chaussures orthopédiques - affections avec indication

2) absolue (B) - Prestations AVEC quote-part personnelle 2,480034 2,521699

3) Chaussures orthopédiques - affections avec indication

3) relative (C) - Prestations AVEC quote-part personnelle 2,480034 2,521699

4) Applications orthopédiques - affections

4 secondaires (D) - Prestations AVEC quote-part personnelle 2,480034 2,521699

VII. Prestations relatives à la SEMELLE ORTHOPEDIQUE 1,761357 1,790948

VIII. Prestations relatives aux PROTHESES MYOELECTRIQUES

Sur mesure high-tech 3,346191 3,402407

Sur mesure 3,059240 3,110635

Préfab 1,717835 1,746695

IX Prestations relatives aux VETEMENTS COMPRESSIFS

Sur mesure 1,059834 1,077639

Préfab 1,022315 1,039490

Lettre-clé T dans l'article 29 de la nomenclature

Prestations Valeur lettre-clé

Tarifs en EUR des prestations fournies par les orthopédistes à partir du 1er janvier 2018

01-01-2018

1

Honoraires

Bénéficiaires sans régime préférentiel /Prestataire conventionné

Bénéficiaires sans régime préférentiel /Prestataire non conventionné

AMB HOSBénéficiaires avec régime préférentiel /

Prestataire avec ou sans convention

I. Prestations reprises sous "SUR MESURE"

A. TETE - COU - TRONC

T = 3,110635 645013 645024 = T 224,20 697,40 697,40 523,05T = 3,110635 645072 645083 = T 253,70 789,17 789,17 591,88T = 3,110635 645094 645105 = T 330,40 1.027,75 1.027,75 770,82T = 3,110635 645116 645120 = T 413,00 1.284,69 1.284,69 963,52T = 3,110635 645131 645142 = T 472,00 1.468,22 1.468,22 1.101,17T = 3,110635 645153 645164 = T 531,00 1.651,75 1.651,75 1.238,82T = 3,110635 645330 645341 = T 77,81 242,04 242,04 181,53T = 3,110635 645470 645481 = T 189,25 588,69 588,69 441,52T = 3,110635 645492 645503 = T 123,47 384,07 384,07 288,06T = 3,110635 645514 645525 = T 354,00 1.101,16 1.101,16 825,87T = 3,110635 645536 645540 = T 354,00 1.101,16 1.101,16 825,87T = 3,110635 645551 645562 = T 489,20 1.521,72 1.521,72 1.141,29T = 3,110635 645573 645584 = T 459,47 1.429,24 1.429,24 1.071,93T = 3,110635 645595 645606 = T 63,20 196,59 196,59 147,45T = 3,110635 645676 645680 = T 531,00 1.651,75 1.651,75 1.238,82T = 3,110635 645691 645702 = T 531,00 1.651,75 1.651,75 1.238,82T = 3,110635 645713 645724 = T 619,50 1.927,04 1.927,04 1.445,28T = 3,110635 645735 645746 = T 438,60 1.364,32 1.364,32 1.023,24T = 3,110635 645750 645761 = T 472,00 1.468,22 1.468,22 1.101,17T = 3,110635 645772 645783 = T 556,96 1.732,50 1.732,50 1.299,38T = 3,110635 645794 645805 = T 448,40 1.394,81 1.394,81 1.046,11T = 3,110635 645816 645820 = T 531,00 1.651,75 1.651,75 1.238,82T = 3,110635 645831 645842 = T 531,00 1.651,75 1.651,75 1.238,82T = 3,110635 645853 645864 = T 501,50 1.559,98 1.559,98 1.169,99T = 3,110635 645875 645886 = T 767,00 2.385,86 2.385,86 1.789,40T = 3,110635 645890 645901 = T 560,50 1.743,51 1.743,51 1.307,64T = 3,110635 645912 645923 = T 767,00 2.385,86 2.385,86 1.789,40T = 3,110635 645934 645945 = T 796,56 2.477,81 2.477,81 1.858,36T = 3,110635 645956 645960 = T 263,90 820,90 820,90 615,68T = 3,110635 646015 646026 = T 1.020,70 3.175,03 3.175,03 2.381,28T = 3,110635 646030 646041 = T 1.020,70 3.175,03 3.175,03 2.381,28T = 3,110635 646052 646063 = T 826,00 2.569,38 2.569,38 1.927,04T = 3,110635 646074 646085 = T 317,60 987,94 987,94 740,96T = 3,110635 646111 646122 = T 352,20 1.095,57 1.095,57 821,68T = 3,110635 646133 646144 = T 306,41 953,13 953,13 714,85T = 3,110635 646155 646166 = T 289,74 901,28 901,28 675,96T = 3,110635 646170 646181 = T 252,07 784,10 784,10 588,08T = 3,110635 646192 646203 = T 246,15 765,68 765,68 574,26T = 3,110635 646214 646225 = T 214,15 666,14 666,14 499,61T = 3,110635 646236 646240 = T 35,40 110,12 110,12 82,59T = 3,110635 646251 646262 = T 719,80 2.239,04 2.239,04 1.679,28T = 3,110635 646273 646284 = T 613,60 1.908,69 1.908,69 1.431,52T = 3,110635 646295 646306 = T 532,00 1.654,86 1.654,86 1.241,15T = 3,110635 646310 646321 = T 459,00 1.427,78 1.427,78 1.070,84T = 3,110635 646332 646343 = T 802,40 2.495,97 2.495,97 1.871,98T = 3,110635 646354 646365 = T 696,20 2.165,62 2.165,62 1.624,22T = 3,110635 646376 646380 = T 84,37 262,44 262,44 196,83T = 3,110635 646391 646402 = T 35,40 110,12 110,12 82,59T = 3,110635 646413 646424 = T 47,20 146,82 146,82 110,12T = 3,110635 646435 646446 = T 41,30 128,47 128,47 96,36T = 3,110635 646450 646461 = T 41,30 128,47 128,47 96,36T = 3,110635 646472 646483 = T 41,30 128,47 128,47 96,36T = 3,110635 646494 646505 = T 172,32 536,02 536,02 402,02T = 3,110635 646516 646520 = T 66,38 206,48 206,48 154,86T = 3,110635 646531 646542 = T 4,00 12,44 12,44 9,33T = 3,110635 646553 646564 = T 4,00 12,44 12,44 9,33T = 3,110635 655410 655421 = T 526,40 1.637,44 1.637,44 1.228,08

Numéro de code Remboursements

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Honoraires





B. MEMBRES INFERIEURS

T = 3,110635 646612 646623 = T 147,50 458,82 458,82 344,12T = 3,110635 646634 646645 = T 118,00 367,05 367,05 275,29T = 3,110635 646656 646660 = T 59,00 183,53 183,53 137,65T = 3,110635 646671 646682 = T 59,00 183,53 183,53 137,65T = 3,110635 646693 646704 = T 59,00 183,53 183,53 137,65T = 3,110635 646715 646726 = T 129,80 403,76 403,76 302,82T = 3,110635 646730 646741 = T 129,80 403,76 403,76 302,82T = 3,110635 646752 646763 = T 59,00 183,53 183,53 137,65T = 3,110635 646774 646785 = T 182,90 568,94 568,94 426,71T = 3,110635 646796 646800 = T 70,80 220,23 220,23 165,18T = 3,110635 646811 646822 = T 70,80 220,23 220,23 165,18T = 3,110635 646833 646844 = T 70,80 220,23 220,23 165,18T = 3,110635 646855 646866 = T 141,60 440,47 440,47 330,36T = 3,110635 646870 646881 = T 141,60 440,47 440,47 330,36T = 3,110635 646892 646903 = T 94,40 293,64 293,64 220,23T = 3,110635 647010 647021 = T 188,80 587,29 587,29 440,47T = 3,110635 647032 647043 = T 118,00 367,05 367,05 275,29T = 3,110635 647054 647065 = T 82,60 256,94 256,94 192,71T = 3,110635 647076 647080 = T 59,00 183,53 183,53 137,65T = 3,110635 647091 647102 = T 23,60 73,41 73,41 55,06T = 3,110635 647113 647124 = T 59,00 183,53 183,53 137,65T = 3,110635 647135 647146 = T 118,00 367,05 367,05 275,29T = 3,110635 647150 647161 = T 59,00 183,53 183,53 137,65T = 3,110635 647172 647183 = T 59,00 183,53 183,53 137,65T = 3,110635 647194 647205 = T 59,00 183,53 183,53 137,65T = 3,110635 647216 647220 = T 188,80 587,29 587,29 440,47T = 3,110635 647231 647242 = T 70,80 220,23 220,23 165,18T = 3,110635 647253 647264 = T 77,80 242,01 242,01 181,51T = 3,110635 647275 647286 = T 59,00 183,53 183,53 137,65T = 3,110635 647290 647301 = T 141,60 440,47 440,47 330,36T = 3,110635 647312 647323 = T 94,40 293,64 293,64 220,23T = 3,110635 647356 647360 = T 283,20 880,93 880,93 660,70T = 3,110635 647371 647382 = T 141,60 440,47 440,47 330,36T = 3,110635 647393 647404 = T 70,80 220,23 220,23 165,18T = 3,110635 647415 647426 = T 141,60 440,47 440,47 330,36T = 3,110635 647430 647441 = T 70,80 220,23 220,23 165,18T = 3,110635 647452 647463 = T 94,40 293,64 293,64 220,23T = 3,110635 647474 647485 = T 23,60 73,41 73,41 55,06T = 3,110635 647496 647500 = T 118,00 367,05 367,05 275,29T = 3,110635 647511 647522 = T 141,60 440,47 440,47 330,36T = 3,110635 647636 647640 = T 354,00 1.101,16 1.101,16 825,87T = 3,110635 647651 647662 = T 70,80 220,23 220,23 165,18T = 3,110635 647673 647684 = T 70,80 220,23 220,23 165,18T = 3,110635 647695 647706 = T 141,60 440,47 440,47 330,36T = 3,110635 647710 647721 = T 123,90 385,41 385,41 289,06T = 3,110635 647732 647743 = T 88,50 275,29 275,29 206,47T = 3,110635 647754 647765 = T 141,60 440,47 440,47 330,36T = 3,110635 647776 647780 = T 123,90 385,41 385,41 289,06T = 3,110635 647791 647802 = T 88,50 275,29 275,29 206,47T = 3,110635 647813 647824 = T 82,60 256,94 256,94 192,71T = 3,110635 647835 647846 = T 118,00 367,05 367,05 275,29T = 3,110635 647850 647861 = T 141,60 440,47 440,47 330,36T = 3,110635 647872 647883 = T 141,60 440,47 440,47 330,36T = 3,110635 647894 647905 = T 47,20 146,82 146,82 110,12T = 3,110635 647916 647920 = T 23,60 73,41 73,41 55,06T = 3,110635 647931 647942 = T 283,20 880,93 880,93 660,70T = 3,110635 647953 647964 = T 94,40 293,64 293,64 220,23T = 3,110635 647975 647986 = T 94,40 293,64 293,64 220,23T = 3,110635 647990 648001 = T 94,4 293,64 293,64 220,23T = 3,110635 648012 648023 = T 118,00 367,05 367,05 275,29T = 3,110635 648034 648045 = T 141,60 440,47 440,47 330,36T = 3,110635 648056 648060 = T 70,80 220,23 220,23 165,18T = 3,110635 648071 648082 = T 70,80 220,23 220,23 165,18T = 3,110635 648093 648104 = T 141,60 440,47 440,47 330,36T = 3,110635 648115 648126 = T 141,60 440,47 440,47 330,36T = 3,110635 648130 648141 = T 59,00 183,53 183,53 137,65T = 3,110635 648152 648163 = T 141,60 440,47 440,47 330,36T = 3,110635 648174 648185 = T 141,60 440,47 440,47 330,36T = 3,110635 648196 648200 = T 59,00 183,53 183,53 137,65T = 3,110635 648211 648222 = T 70,80 220,23 220,23 165,18T = 3,110635 648233 648244 = T 59,00 183,53 183,53 137,65T = 3,110635 648255 648266 = T 70,80 220,23 220,23 165,18T = 3,110635 648270 648281 = T 40,69 126,57 126,57 94,93T = 3,110635 648292 648303 = T 123,90 385,41 385,41 289,06


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Honoraires





B. MEMBRES INFERIEURS (suite)

T = 3,110635 648314 648325 = T 59,00 183,53 183,53 137,65T = 3,110635 648336 648340 = T 354,00 1.101,16 1.101,16 825,87T = 3,110635 648351 648362 = T 59,00 183,53 183,53 137,65T = 3,110635 648373 648384 = T 141,60 440,47 440,47 330,36T = 3,110635 648395 648406 = T 88,50 275,29 275,29 206,47T = 3,110635 648410 648421 = T 123,90 385,41 385,41 289,06T = 3,110635 648432 648443 = T 141,60 440,47 440,47 330,36T = 3,110635 648454 648465 = T 88,50 275,29 275,29 206,47T = 3,110635 648476 648480 = T 123,90 385,41 385,41 289,06T = 3,110635 648491 648502 = T 141,60 440,47 440,47 330,36T = 3,110635 648513 648524 = T 141,60 440,47 440,47 330,36T = 3,110635 648535 648546 = T 100,30 312,00 312,00 234,00T = 3,110635 648550 648561 = T 141,60 440,47 440,47 330,36T = 3,110635 648594 648605 = T 150,02 466,66 466,66 350,00T = 3,110635 648616 648620 = T 241,92 752,52 752,52 564,39T = 3,110635 656110 656121 = T 59,00 183,53 183,53 137,65T = 3,110635 656132 656143 = T 88,50 275,29 275,29 206,47T = 3,110635 656316 656320 = T 59,00 183,53 183,53 137,65T = 3,110635 656331 656342 = T 88,50 275,29 275,29 206,47T = 3,110635 656714 656725 = T 88,50 275,29 275,29 206,47T = 3,110635 656736 656740 = T 88,50 275,29 275,29 206,47T = 3,110635 656751 656762 = T 59,00 183,53 183,53 137,65T = 3,110635 656773 656784 = T 88,50 275,29 275,29 206,47T = 3,110635 656795 656806 = T 84,37 262,44 262,44 196,83T = 3,110635 656913 656924 = T 354,00 1.101,16 1.101,16 825,87T = 3,110635 657016 657020 = T 70,80 220,23 220,23 165,18T = 3,110635 657031 657042 = T 88,50 275,29 275,29 206,47T = 3,110635 657053 657064 = T 123,90 385,41 385,41 289,06T = 3,110635 657075 657086 = T 88,50 275,29 275,29 206,47T = 3,110635 657090 657101 = T 123,90 385,41 385,41 289,06T = 3,110635 657112 657123 = T 59,00 183,53 183,53 137,65T = 3,110635 657134 657145 = T 141,60 440,47 440,47 330,36T = 3,110635 657156 657160 = T 88,50 275,29 275,29 206,47T = 3,110635 657171 657182 = T 200,40 623,37 623,37 467,53T = 3,110635 657215 657226 = T 82,60 256,94 256,94 192,71T = 3,110635 657230 657241 = T 118,00 367,05 367,05 275,29T = 3,110635 657252 657263 = T 59,00 183,53 183,53 137,65T = 3,110635 657274 657285 = T 141,60 440,47 440,47 330,36T = 3,110635 657296 657300 = T 59,00 183,53 183,53 137,65T = 3,110635 657311 657322 = T 141,60 440,47 440,47 330,36T = 3,110635 657510 657521 = T 70,80 220,23 220,23 165,18T = 3,110635 657532 657543 = T 123,90 385,41 385,41 289,06T = 3,110635 657554 657565 = T 123,90 385,41 385,41 289,06T = 3,110635 657576 657580 = T 141,60 440,47 440,47 330,36T = 3,110635 657613 657624 = T 118,00 367,05 367,05 275,29T = 3,110635 657635 657646 = T 141,60 440,47 440,47 330,36T = 3,110635 657812 657823 = T 70,80 220,23 220,23 165,18T = 3,110635 657834 657845 = T 123,90 385,41 385,41 289,06T = 3,110635 657856 657860 = T 141,60 440,47 440,47 330,36T = 3,110635 657871 657882 = T 200,40 623,37 623,37 467,53T = 3,110635 657915 657926 = T 118,00 367,05 367,05 275,29T = 3,110635 657930 657941 = T 141,60 440,47 440,47 330,36T = 3,110635 658114 658125 = T 70,80 220,23 220,23 165,18T = 3,110635 658136 658140 = T 123,90 385,41 385,41 289,06T = 3,110635 658151 658162 = T 123,90 385,41 385,41 289,06T = 3,110635 658173 658184 = T 141,60 440,47 440,47 330,36T = 3,110635 658195 658206 = T 200,40 623,37 623,37 467,53T = 3,110635 658210 658221 = T 118,00 367,05 367,05 275,29T = 3,110635 658232 658243 = T 141,60 440,47 440,47 330,36T = 3,110635 658416 658420 = T 70,80 220,23 220,23 165,18T = 3,110635 658431 658442 = T 88,50 275,29 275,29 206,47T = 3,110635 658453 658464 = T 141,60 440,47 440,47 330,36T = 3,110635 658475 658486 = T 200,40 623,37 623,37 467,53T = 3,110635 648933 648944 = T 218,55 679,83 679,83 509,88T = 3,110635 648955 648966 = T 259,83 808,24 808,24 606,18T = 3,110635 648970 648981 = T 330,20 1.027,13 1.027,13 770,35T = 3,110635 648992 649003 = T 796,50 2.477,62 2.477,62 1.858,22T = 3,110635 649014 649025 = T 23,60 73,41 73,41 55,06T = 3,110635 649036 649040 = T 141,60 440,47 440,47 330,36T = 3,110635 649051 649062 = T 23,60 73,41 73,41 55,06T = 3,110635 649073 649084 = T 58,70 182,59 182,59 136,95T = 3,110635 649095 649106 = T 9,12 28,37 28,37 21,28T = 3,110635 653435 653446 = T 4,00 12,44 12,44 9,33T = 3,110635 697093 697104 = T 324,36 1.008,97 1.008,97 756,73


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Honoraires





C. MEMBRES SUPERIEURS

T = 3,110635 649176 649180 = T 29,50 91,76 91,76 68,82T = 3,110635 649250 649261 = T 70,80 220,23 220,23 165,18T = 3,110635 649272 649283 = T 29,50 91,76 91,76 68,82T = 3,110635 649331 649342 = T 141,60 440,47 440,47 330,36T = 3,110635 649574 649585 = T 141,60 440,47 440,47 330,36T = 3,110635 653494 653505 = T 109,40 340,30 340,30 255,23T = 3,110635 649736 649740 = T 141,60 440,47 440,47 330,36T = 3,110635 649854 649865 = T 160,00 497,70 497,70 373,28T = 3,110635 649876 649880 = T 141,60 440,47 440,47 330,36T = 3,110635 649891 649902 = T 295,00 917,64 917,64 688,23T = 3,110635 649913 649924 = T 236,00 734,11 734,11 550,59T = 3,110635 649935 649946 = T 17,70 55,06 55,06 41,30T = 3,110635 649950 649961 = T 29,50 91,76 91,76 68,82T = 3,110635 649972 649983 = T 59,00 183,53 183,53 137,65T = 3,110635 649994 650005 = T 118,00 367,05 367,05 275,29T = 3,110635 650016 650020 = T 94,40 293,64 293,64 220,23T = 3,110635 650031 650042 = T 94,40 293,64 293,64 220,23T = 3,110635 650053 650064 = T 94,40 293,64 293,64 220,23T = 3,110635 650156 650160 = T 56,22 174,88 174,88 131,16T = 3,110635 653575 653586 = T 4,00 12,44 12,44 9,33

D. ORTHESES SPECIFIQUES

T = 3,110635 650252 650263 = T 59,00 183,53 183,53 137,65T = 3,110635 650274 650285 = T 23,60 73,41 73,41 55,06T = 3,110635 650296 650300 = T 23,60 73,41 73,41 55,06T = 3,110635 650311 650322 = T 35,40 110,12 110,12 82,59T = 3,110635 650333 650344 = T 29,50 91,76 91,76 68,82T = 3,110635 650355 650366 = T 19,85 61,75 61,75 46,32T = 3,110635 650436 650440 = T 35,40 110,12 110,12 82,59T = 3,110635 650532 650543 = T 88,50 275,29 275,29 206,47T = 3,110635 650554 650565 = T 47,20 146,82 146,82 110,12T = 3,110635 650576 650580 = T 47,20 146,82 146,82 110,12T = 3,110635 650591 650602 = T 35,40 110,12 110,12 82,59T = 3,110635 650613 650624 = T 35,40 110,12 110,12 82,59T = 3,110635 650635 650646 = T 59,00 183,53 183,53 137,65T = 3,110635 650650 650661 = T 47,20 146,82 146,82 110,12T = 3,110635 650672 650683 = T 47,20 146,82 146,82 110,12T = 3,110635 650694 650705 = T 29,50 91,76 91,76 68,82T = 3,110635 650716 650720 = T 29,50 91,76 91,76 68,82T = 3,110635 650731 650742 = T 70,80 220,23 220,23 165,18T = 3,110635 650753 650764 = T 29,50 91,76 91,76 68,82T = 3,110635 650775 650786 = T 29,50 91,76 91,76 68,82T = 3,110635 650790 650801 = T 29,50 91,76 91,76 68,82T = 3,110635 650812 650823 = T 70,80 220,23 220,23 165,18T = 3,110635 650834 650845 = T 29,50 91,76 91,76 68,82T = 3,110635 650856 650860 = T 29,50 91,76 91,76 68,82T = 3,110635 650871 650882 = T 29,50 91,76 91,76 68,82T = 3,110635 650893 650904 = T 29,50 91,76 91,76 68,82T = 3,110635 650915 650926 = T 40,00 124,43 124,43 93,33T = 3,110635 650930 650941 = T 88,50 275,29 275,29 206,47T = 3,110635 650952 650963 = T 35,40 110,12 110,12 82,59T = 3,110635 650974 650985 = T 35,40 110,12 110,12 82,59T = 3,110635 651033 651044 = T 41,30 128,47 128,47 96,36T = 3,110635 651055 651066 = T 94,40 293,64 293,64 220,23T = 3,110635 651070 651081 = T 59,00 183,53 183,53 137,65T = 3,110635 651092 651103 = T 41,30 128,47 128,47 96,36T = 3,110635 651114 651125 = T 41,30 128,47 128,47 96,36T = 3,110635 651136 651140 = T 41,30 128,47 128,47 96,36T = 3,110635 653730 653741 = T 4,00 12,44 12,44 9,33


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E. PROTHESES DES MEMBRES INFERIEURS

1. Prothèse cosmétique (Groupe 1), prothèse de transfert (Groupe 2) et prothèse d'évaluation (Groupes 3, 4 et 5)

T = 3,110635 676056 676060 = T 143,62 446,75 446,75 335,07T = 3,110635 676071 676082 = T 239,37 744,59 744,59 558,45T = 3,110635 676093 676104 = T 321,22 999,20 999,20 749,40T = 3,110635 676115 676126 = T 575,86 1.791,29 1.791,29 1.343,47T = 3,110635 676130 676141 = T 974,28 3.030,63 3.030,63 2.272,98T = 3,110635 676152 676163 = T 558,11 1.736,08 1.736,08 1.302,06T = 3,110635 676174 676185 = T 651,13 2.025,43 2.025,43 1.519,08T = 3,110635 676196 676200 = T 930,18 2.893,45 2.893,45 2.170,09T = 3,110635 676211 676222 = T 1.180,45 3.671,95 3.671,95 2.753,97T = 3,110635 676233 676244 = T 1.251,96 3.894,39 3.894,39 2.920,80T = 3,110635 676255 676266 = T 910,07 2.830,90 2.830,90 2.123,18T = 3,110635 676270 676281 = T 1.061,75 3.302,72 3.302,72 2.477,04T = 3,110635 676292 676303 = T 1.516,80 4.718,21 4.718,21 3.538,66T = 3,110635 676314 676325 = T 961,72 2.991,56 2.991,56 2.243,67T = 3,110635 676336 676340 = T 1.122,00 3.490,13 3.490,13 2.617,60T = 3,110635 676351 676362 = T 1.602,86 4.985,91 4.985,91 3.739,44T = 3,110635 676373 676384 = T 1.459,91 4.541,25 4.541,25 3.405,94T = 3,110635 676395 676406 = T 1.703,25 5.298,19 5.298,19 3.973,65T = 3,110635 676410 676421 = T 2.433,20 7.568,80 7.568,80 5.676,60T = 3,110635 676432 676443 = T 1.512,79 4.705,74 4.705,74 3.529,31T = 3,110635 676454 676465 = T 1.718,07 5.344,29 5.344,29 4.008,22T = 3,110635 676476 676480 = T 2.521,32 7.842,91 7.842,91 5.882,19T = 3,110635 676491 676502 = T 237,23 737,94 737,94 553,46T = 3,110635 676513 676524 = T 227,19 706,71 706,71 530,04T = 3,110635 676550 676561 = T 52,58 163,56 163,56 122,67T = 3,110635 676572 676583 = T 52,58 163,56 163,56 122,67T = 3,110635 676594 676605 = T 52,58 163,56 163,56 122,67

2. Nouveau fût pour: prothèse cosmétique, de transfert et d'évaluation pour les groupes 1, 2, 3, 4 et 5

T = 3,110635 676616 676620 = T 182,73 568,41 568,41 426,31T = 3,110635 676631 676642 = T 264,58 823,01 823,01 617,26T = 3,110635 676653 676664 = T 519,23 1.615,14 1.615,14 1.211,36T = 3,110635 676675 676686 = T 879,78 2.736,67 2.736,67 2.052,51T = 3,110635 676690 676701 = T 618,91 1.925,20 1.925,20 1.443,90T = 3,110635 676712 676723 = T 756,88 2.354,38 2.354,38 1.765,79T = 3,110635 676734 676745 = T 828,40 2.576,85 2.576,85 1.932,64T = 3,110635 676756 676760 = T 875,49 2.723,33 2.723,33 2.042,50T = 3,110635 676771 676782 = T 781,27 2.430,25 2.430,25 1.822,69T = 3,110635 676793 676804 = T 1.306,75 4.064,82 4.064,82 3.048,62T = 3,110635 676815 676826 = T 1.394,85 4.338,87 4.338,87 3.254,16

3. Prothèse définitive

T = 3,110635 676830 676841 = T 269,21 837,41 837,41 628,06T = 3,110635 676852 676863 = T 301,02 936,36 936,36 702,27T = 3,110635 676874 676885 = T 643,02 2.000,20 2.000,20 1.500,15T = 3,110635 676896 676900 = T 332,58 1.034,53 1.034,53 775,90T = 3,110635 676911 676922 = T 377,08 1.172,96 1.172,96 879,72T = 3,110635 676933 676944 = T 678,99 2.112,09 2.112,09 1.584,07T = 3,110635 676955 676966 = T 618,62 1.924,30 1.924,30 1.443,23T = 3,110635 676970 676981 = T 636,71 1.980,57 1.980,57 1.485,43T = 3,110635 676992 677003 = T 799,30 2.486,33 2.486,33 1.864,75T = 3,110635 677095 677106 = T 1.036,19 3.223,21 3.223,21 2.417,41T = 3,110635 677110 677121 = T 1.057,77 3.290,34 3.290,34 2.467,76T = 3,110635 677132 677143 = T 1.222,60 3.803,06 3.803,06 2.852,30T = 3,110635 677154 677165 = T 1.020,01 3.172,88 3.172,88 2.379,66T = 3,110635 677176 677180 = T 1.020,01 3.172,88 3.172,88 2.379,66T = 3,110635 677191 677202 = T 1.070,72 3.330,62 3.330,62 2.497,97T = 3,110635 677294 677305 = T 1.301,99 4.050,02 4.050,02 3.037,52T = 3,110635 677316 677320 = T 1.301,99 4.050,02 4.050,02 3.037,52T = 3,110635 677331 677342 = T 1.326,43 4.126,04 4.126,04 3.094,53T = 3,110635 677353 677364 = T 1.355,49 4.216,43 4.216,43 3.162,33T = 3,110635 677375 677386 = T 1.355,49 4.216,43 4.216,43 3.162,33T = 3,110635 677390 677401 = T 1.431,54 4.453,00 4.453,00 3.339,75T = 3,110635 677412 677423 = T 1.672,72 5.203,22 5.203,22 3.902,42T = 3,110635 677434 677445 = T 1.900,62 5.912,14 5.912,14 4.434,11T = 3,110635 677456 677460 = T 2.002,02 6.227,55 6.227,55 4.670,67T = 3,110635 677471 677482 = T 1.728,77 5.377,57 5.377,57 4.033,18T = 3,110635 677493 677504 = T 1.951,93 6.071,74 6.071,74 4.553,81T = 3,110635 677515 677526 = T 2.053,33 6.387,16 6.387,16 4.790,37T = 3,110635 677530 677541 = T 2.706,22 8.418,06 8.418,06 6.313,55


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3. Prothèse définitive(suite)

T = 3,110635 677552 677563 = T 2.731,57 8.496,92 8.496,92 6.372,69T = 3,110635 677574 677585 = T 2.794,34 8.692,17 8.692,17 6.519,13T = 3,110635 677596 677600 = T 2.819,70 8.771,06 8.771,06 6.578,30T = 3,110635 677611 677622 = T 663,43 2.063,69 2.063,69 1.547,77T = 3,110635 677633 677644 = T 1.132,95 3.524,19 3.524,19 2.643,15T = 3,110635 677655 677666 = T 1.683,86 5.237,87 5.237,87 3.928,41T = 3,110635 677670 677681 = T 2.152,67 6.696,17 6.696,17 5.022,13T = 3,110635 677692 677703 = T 223,85 696,32 696,32 522,24T = 3,110635 677714 677725 = T 447,70 1.392,63 1.392,63 1.044,48T = 3,110635 677736 677740 = T 404,65 1.258,72 1.258,72 944,04T = 3,110635 677751 677762 = T 809,27 2.517,34 2.517,34 1.888,01T = 3,110635 677773 677784 = T 129,46 402,70 402,70 302,03T = 3,110635 677795 677806 = T 192,76 599,61 599,61 449,71T = 3,110635 677810 677821 = T 224,61 698,68 698,68 524,01T = 3,110635 677832 677843 = T 227,19 706,71 706,71 530,04T = 3,110635 677854 677865 = T 700,91 2.180,28 2.180,28 1.635,21T = 3,110635 677876 677880 = T 128,60 400,03 400,03 300,03T = 3,110635 677891 677902 = T 100,85 313,71 313,71 235,29T = 3,110635 677913 677924 = T 693,68 2.157,79 2.157,79 1.618,35T = 3,110635 677935 677946 = T 101,31 315,14 315,14 236,36T = 3,110635 677972 677983 = T 237,50 738,78 738,78 554,09T = 3,110635 677994 678005 = T 194,40 604,71 604,71 453,54T = 3,110635 696010 696021 = T 101,11 314,52 314,52 235,89T = 3,110635 696032 696043 = T 163,93 509,93 509,93 382,45T = 3,110635 696054 696065 = T 51,65 160,66 160,66 120,50T = 3,110635 696076 696080 = T 51,65 160,66 160,66 120,50T = 3,110635 696091 696102 = T 51,65 160,66 160,66 120,50

4. Nouveau fût pour prothèse définitive

T = 3,110635 696113 696124 = T 212,59 661,29 661,29 495,97T = 3,110635 696135 696146 = T 244,39 760,21 760,21 570,16T = 3,110635 696150 696161 = T 586,39 1.824,05 1.824,05 1.368,04T = 3,110635 696172 696183 = T 275,96 858,41 858,41 643,81T = 3,110635 696194 696205 = T 320,44 996,77 996,77 747,58T = 3,110635 696216 696220 = T 622,36 1.935,93 1.935,93 1.451,95T = 3,110635 696231 696242 = T 561,99 1.748,15 1.748,15 1.311,12T = 3,110635 696253 696264 = T 580,08 1.804,42 1.804,42 1.353,32T = 3,110635 696275 696286 = T 742,66 2.310,14 2.310,14 1.732,61T = 3,110635 696290 696301 = T 941,67 2.929,19 2.929,19 2.196,90T = 3,110635 696312 696323 = T 963,26 2.996,35 2.996,35 2.247,27T = 3,110635 696334 696345 = T 1.128,08 3.509,05 3.509,05 2.631,79T = 3,110635 696356 696360 = T 711,16 2.212,16 2.212,16 1.659,12T = 3,110635 696371 696382 = T 711,16 2.212,16 2.212,16 1.659,12T = 3,110635 696393 696404 = T 761,86 2.369,87 2.369,87 1.777,41T = 3,110635 696415 696426 = T 879,94 2.737,17 2.737,17 2.052,88T = 3,110635 696430 696441 = T 879,94 2.737,17 2.737,17 2.052,88T = 3,110635 696452 696463 = T 905,29 2.816,03 2.816,03 2.112,03T = 3,110635 696474 696485 = T 934,35 2.906,42 2.906,42 2.179,82T = 3,110635 696496 696500 = T 934,35 2.906,42 2.906,42 2.179,82T = 3,110635 696511 696522 = T 1.010,40 3.142,99 3.142,99 2.357,25T = 3,110635 696533 696544 = T 875,49 2.723,33 2.723,33 2.042,50T = 3,110635 696555 696566 = T 976,90 3.038,78 3.038,78 2.279,09T = 3,110635 696570 696581 = T 1.078,29 3.354,17 3.354,17 2.515,63T = 3,110635 696592 696603 = T 874,98 2.721,74 2.721,74 2.041,31T = 3,110635 696614 696625 = T 1.077,78 3.352,58 3.352,58 2.514,44T = 3,110635 696636 696640 = T 1.179,18 3.668,00 3.668,00 2.751,00T = 3,110635 696651 696662 = T 1.433,49 4.459,06 4.459,06 3.344,30T = 3,110635 696673 696684 = T 1.458,84 4.537,92 4.537,92 3.403,44T = 3,110635 696695 696706 = T 1.521,60 4.733,14 4.733,14 3.549,86T = 3,110635 696710 696721 = T 1.546,95 4.812,00 4.812,00 3.609,00T = 3,110635 696732 696743 = T 525,25 1.633,86 1.633,86 1.225,40T = 3,110635 696754 696765 = T 837,12 2.603,97 2.603,97 1.952,98T = 3,110635 696776 696780 = T 1.121,78 3.489,45 3.489,45 2.617,09T = 3,110635 696791 696802 = T 1.336,94 4.158,73 4.158,73 3.119,05T = 3,110635 696813 696824 = T 51,65 160,66 160,66 120,50T = 3,110635 696835 696846 = T 51,65 160,66 160,66 120,50T = 3,110635 696850 696861 = T 51,65 160,66 160,66 120,50


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5. Entretien et réparations

T = 3,110635 697115 697126 = T 1,87 5,82 5,82 4,37T = 3,110635 696872 696883 T = 3,75 11,66 11,66 8,75T = 3,110635 696894 696905 T = 3,75 11,66 11,66 8,75

6. Cosmétique (annuel ou en cas de nouveau fût, groupes 1, 2, 3, 4 et 5)

T = 3,110635 696916 696920 = T 60,03 186,73 186,73 140,05T = 3,110635 696931 696942 = T 98,84 307,46 307,46 230,60T = 3,110635 696953 696964 = T 136,00 423,05 423,05 317,29T = 3,110635 696975 696986 = T 172,79 537,49 537,49 403,12T = 3,110635 696990 697001 = T 247,58 770,13 770,13 577,60T = 3,110635 697012 697023 = T 107,40 334,08 334,08 250,56

7. Liner (annuel)

T = 3,110635 697034 697045 = T 227,19 706,71 706,71 530,04T = 3,110635 697056 697060 = T 700,91 2.180,28 2.180,28 1.635,21

Dispositions transitoires

T = 3,110635 653774 653785 = T 3,75 11,66 11,66 8,75T = 3,110635 652256 652260 = T 112,21 349,04 349,04 261,78

F. PROTHESES DES MEMBRES SUPERIEURS

T = 3,110635 652536 652540 = T 258,30 803,48 803,48 602,61T = 3,110635 652551 652562 = T 344,40 1.071,30 1.071,30 803,48T = 3,110635 652573 652584 = T 393,60 1.224,35 1.224,35 918,27T = 3,110635 652595 652606 = T 522,75 1.626,08 1.626,08 1.219,56T = 3,110635 652610 652621 = T 584,25 1.817,39 1.817,39 1.363,05T = 3,110635 652632 652643 = T 615,00 1.913,04 1.913,04 1.434,78T = 3,110635 652654 652665 = T 615,00 1.913,04 1.913,04 1.434,78T = 3,110635 652676 652680 = T 369,00 1.147,82 1.147,82 860,87T = 3,110635 652691 652702 = T 418,20 1.300,87 1.300,87 975,66T = 3,110635 652713 652724 = T 492,00 1.530,43 1.530,43 1.147,83T = 3,110635 652735 652746 = T 676,50 2.104,34 2.104,34 1.578,26T = 3,110635 652750 652761 = T 676,50 2.104,34 2.104,34 1.578,26T = 3,110635 652772 652783 = T 738,00 2.295,65 2.295,65 1.721,74T = 3,110635 652794 652805 = T 738,00 2.295,65 2.295,65 1.721,74T = 3,110635 652816 652820 = T 984,00 3.060,86 3.060,86 2.295,65T = 3,110635 652831 652842 = T 1.230,00 3.826,08 3.826,08 2.869,56T = 3,110635 652853 652864 = T 73,80 229,56 229,56 172,17T = 3,110635 652875 652886 = T 159,90 497,39 497,39 373,05T = 3,110635 652890 652901 = T 246,00 765,22 765,22 573,92T = 3,110635 652912 652923 = T 86,10 267,83 267,83 200,88T = 3,110635 652934 652945 = T 110,70 344,35 344,35 258,27T = 3,110635 652956 652960 = T 135,30 420,87 420,87 315,66T = 3,110635 652971 652982 = T 135,30 420,87 420,87 315,66T = 3,110635 652993 653004 = T 221,40 688,69 688,69 516,52T = 3,110635 653015 653026 = T 301,75 938,63 938,63 703,98T = 3,110635 653030 653041 = T 73,00 227,08 227,08 170,31T = 3,110635 653052 653063 = T 60,00 186,64 186,64 139,98T = 3,110635 653074 653085 = T 61,50 191,30 191,30 143,48T = 3,110635 653096 653100 = T 246,00 765,22 765,22 573,92T = 3,110635 653111 653122 = T 59,00 183,53 183,53 137,65T = 3,110635 653133 653144 = T 118,00 367,05 367,05 275,29T = 3,110635 653155 653166 = T 246,00 765,22 765,22 573,92T = 3,110635 653796 653800 = T 4,00 12,44 12,44 9,33T = 3,110635 653192 653203 = T 169,55 527,41 527,41 395,56T = 3,110635 653214 653225 = T 200,40 623,37 623,37 467,53T = 3,110635 653236 653240 = T 250,94 780,58 780,58 585,44T = 3,110635 653251 653262 = T 22,60 70,30 70,30 52,73T = 3,110635 653273 653284 = T 27,44 85,36 85,36 64,02


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II. SUR MESURE HIGH-TECH

T = 3,402407 656014 656025 = T 583,85 1.986,50 1.986,50 1.489,88T = 3,402407 656036 656040 = T 684,72 2.329,70 2.329,70 1.747,28T = 3,402407 656051 656062 = T 175,09 595,73 595,73 446,80T = 3,402407 656213 656224 = T 827,90 2.816,85 2.816,85 2.112,64T = 3,402407 656412 656423 = T 420,57 1.430,95 1.430,95 1.073,22T = 3,402407 656434 656445 = T 494,74 1.683,31 1.683,31 1.262,49T = 3,402407 656515 656526 = T 530,75 1.805,83 1.805,83 1.354,38T = 3,402407 657414 657425 = T 455,74 1.550,61 1.550,61 1.162,96T = 3,402407 657436 657440 = T 716,32 2.437,21 2.437,21 1.827,91T = 3,402407 657716 657720 = T 1.555,74 5.293,26 5.293,26 3.969,95T = 3,402407 657731 657742 = T 1.679,13 5.713,08 5.713,08 4.284,81T = 3,402407 658011 658022 = T 323,76 1.101,56 1.101,56 826,17T = 3,402407 658313 658324 = T 1.797,75 6.116,68 6.116,68 4.587,51T = 3,402407 658335 658346 = T 2.084,08 7.090,89 7.090,89 5.318,17

III. Prestations reprises sous PREFAB

1) Prestations SANS quote-part personnelle

T = 1,732316 645035 645046 = T 250,59 434,10 434,10 325,58T = 1,732316 645212 645223 = T 160,16 277,45 277,45 208,09T = 1,732316 645256 645260 = T 343,20 594,53 594,53 445,90T = 1,732316 645271 645282 = T 228,80 396,35 396,35 297,27T = 1,732316 645293 645304 = T 2.231,53 3.865,72 3.865,72 2.899,29T = 1,732316 645610 645621 = T 334,44 579,36 579,36 434,52T = 1,732316 645993 646004 = T 363,38 629,49 629,49 472,12T = 1,393029 647570 647581 = T 197,65 275,33 275,33 206,50T = 1,732316 648572 648583 = T 518,62 898,41 898,41 673,81T = 1,732316 649456 649460 = T 65,37 113,24 113,24 84,93T = 1,732316 649471 649482 = T 74,09 128,35 128,35 96,27T = 1,732316 649493 649504 = T 224,88 389,56 389,56 292,17T = 1,732316 649515 649526 = T 54,48 94,38 94,38 70,79T = 1,732316 649530 649541 = T 37,04 64,16 64,16 48,12T = 1,732316 649552 649563 = T 41,40 71,72 71,72 53,79T = 1,732316 649596 649600 = T 56,66 98,15 98,15 73,62T = 1,732316 649611 649622 = T 39,22 67,94 67,94 50,96T = 1,732316 649655 649666 = T 187,40 324,64 324,64 243,48T = 1,732316 649795 649806 = T 84,11 145,71 145,71 109,29T = 1,732316 649810 649821 = T 350,83 607,75 607,75 455,82T = 1,732316 650171 650182 = T 84,98 147,21 147,21 110,41T = 1,732316 650193 650204 = T 61,01 105,69 105,69 79,27T = 1,732316 650370 650381 = T 69,73 120,79 120,79 90,60T = 1,732316 650392 650403 = T 65,37 113,24 113,24 84,93T = 1,732316 650414 650425 = T 14,16 24,53 24,53 18,40T = 1,732316 650495 650506 = T 117,67 203,84 203,84 152,88T = 1,732316 650996 651000 = T 32,69 56,63 56,63 42,48T = 1,732316 651011 651022 = T 82,80 143,44 143,44 107,58T = 1,732316 653376 653380 = T 2,60 4,50 4,50 3,38T = 1,732316 653391 653402 = T 125,30 217,06 217,06 162,80T = 1,732316 653413 653424 = T 75,18 130,24 130,24 97,68T = 1,732316 653450 653461 = T 2,60 4,50 4,50 3,38T = 1,732316 653531 653542 = T 588,35 1.019,21 1.019,21 764,41T = 1,732316 653553 653564 = T 325,21 563,37 563,37 422,53T = 1,732316 653590 653601 = T 2,60 4,50 4,50 3,38T = 1,732316 653656 653660 = T 83,17 144,08 144,08 108,06T = 1,732316 653671 653682 = T 83,17 144,08 144,08 108,06T = 1,732316 653693 653704 = T 82,00 142,05 142,05 106,54T = 1,732316 653715 653726 = T 83,17 144,08 144,08 108,06T = 1,732316 653752 653763 = T 2,60 4,50 4,50 3,38T = 1,807153 653811 653822 = T 109,74 198,32 198,32 148,74T = 1,807153 653833 653844 = T 8,56 15,47 15,47 11,61T = 1,807153 653855 653866 = T 8,56 15,47 15,47 11,61T = 1,33785 654570 654581 = T 298,30 399,08 399,08 299,31T = 1,807153 656611 656622 = T 339,45 613,44 613,44 460,08T = 1,732316 676535 676546 = T 63,74 110,42 110,42 82,82T = 1,807153 677950 677961 = T 196,88 355,79 355,79 266,85


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2) Prestations AVEC quote-part personnelle

T = 1,732316 645190 645201 = T 43,58 75,49 65,44 46,57T = 1,732316 645234 645245 = T 87,16 150,99 130,90 93,16T = 1,732316 645315 645326 = T 70,25 121,70 105,52 75,10T = 1,732316 645654 645665 = T 325,77 564,34 539,34 398,26T = 1,732316 645971 645982 = T 451,07 781,40 746,77 551,42T = 1,732316 646096 646100 = T 67,55 117,02 111,86 82,61T = 1,732316 646590 646601 = T 77,75 134,69 116,78 83,11T = 1,732316 697071 697082 = T 432,99 750,08 714,90 527,38T = 1,732316 649213 649224 = T 8,72 15,11 14,47 10,70T = 1,732316 649353 649364 = T 43,58 75,49 72,15 53,28T = 1,732316 649375 649386 = T 41,40 71,72 68,55 50,62T = 1,732316 649670 649681 = T 21,79 37,75 32,73 23,30T = 1,732316 649714 649725 = T 56,66 98,15 93,80 69,27T = 1,732316 649751 649762 = T 161,25 279,34 266,95 197,12T = 1,732316 650510 650521 = T 31,99 55,42 48,07 34,22T = 1,732316 653472 653483 = T 30,51 52,85 50,53 37,32T = 1,732316 653612 653623 = T 82,00 142,05 123,17 87,66T = 1,732316 653634 653645 = T 82,00 142,05 123,17 87,66T = 1,559084 649434 649445 = T 34,86 54,35 47,12 33,54T = 1,767010 646973 646984 = T 54,91 97,03 83,60 59,35T = 1,767010 646995 647006 = T 105,45 186,33 177,74 131,16T = 1,358920 647592 647603 = T 575,17 781,61 673,30 477,90T = 1,105172 647555 647566 = T 54,91 60,68 52,28 37,11T = 1,221283 645632 645643 = T 551,30 673,29 643,44 475,12T = 1,366225 655690 655701 = T 409,32 559,22 480,98 341,18T = 1,236699 647533 647544 = T 115,04 142,27 135,72 100,16T = 1,480484 647614 647625 = T 230,07 340,61 324,90 239,75

IV. Prestations reprises sous I.M.F.

T = 2,903509 645050 645061 = T 36,37 105,60 100,32 73,92T = 2,903509 649235 649246 = T 19,83 57,58 54,71 40,32T = 2,903509 649294 649305 = T 23,55 68,38 64,95 47,86T = 2,903509 649316 649320 = T 22,14 64,28 61,06 44,99T = 2,903509 649390 649401 = T 36,37 105,60 100,32 73,92T = 2,903509 649633 649644 = T 45,23 131,33 124,77 91,94T = 2,903509 649773 649784 = T 45,23 131,33 124,77 91,94T = 2,903509 650075 650086 = T 17,01 49,39 46,92 34,58T = 2,903509 650090 650101 = T 28,34 82,29 78,17 57,60T = 2,903509 650112 650123 = T 90,70 263,35 250,20 184,37T = 2,903509 650134 650145 = T 90,70 263,35 250,20 184,37T = 2,903509 653516 653520 = T 33,10 96,11 91,32 67,30


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V. LOMBOSTATS en coutil et métal

T = 2,582054 645352 645363 = T 130,80 337,73 337,73 253,30T = 2,582054 645374 645385 = T 141,70 365,88 365,88 274,41T = 2,582054 645396 645400 = T 152,60 394,02 394,02 295,52T = 2,582054 645411 645422 = T 175,00 451,86 451,86 338,90T = 2,582054 645433 645444 = T 250,00 645,51 645,51 484,14T = 2,582054 645455 645466 = T 13,00 33,57 33,57 25,18

VI. Prestations relatives aux CHAUSSURES ORTHOPEDIQUES

1) Chaussures orthopédiques - affections majeures (A) - Prestations AVEC quote-part personnelle (X = T 6,71)

T = 2,521699 643016 643020 = T 333 839,73 822,81 612,88T = 2,521699 643031 643042 = T 510 1.286,07 1.269,15 947,64T = 2,521699 643053 643064 = T 510 1.286,07 1.269,15 947,64T = 2,521699 643075 643086 = T 660 1.664,32 1.647,40 1.231,32T = 2,521699 643090 643101 = T 537 1.354,15 1.337,23 998,70T = 2,521699 643112 643123 = T 512 1.291,11 1.274,19 951,42T = 2,521699 643134 643145 = T 590 1.487,80 1.470,88 1.098,93T = 2,521699 643156 643160 = T 391 985,98 969,06 722,57T = 2,521699 643171 643182 = T 537 1.354,15 1.337,23 998,70T = 2,521699 643193 643204 = T 381 960,77 943,85 703,66T = 2,521699 643215 643226 = T 650 1.639,10 1.622,18 1.212,41T = 2,521699 643230 643241 = T 750 1.891,27 1.874,35 1.401,54T = 2,521699 643252 643263 = T 471 1.187,72 1.170,80 873,87T = 2,521699 643274 643285 = T 506 1.275,98 1.259,06 940,07T = 2,521699 643296 643300 = T 567 1.429,80 1.412,88 1.055,43T = 2,521699 643311 643322 = T 175 441,30 424,38 314,06T = 2,521699 643333 643344 = T 471 1.187,72 1.170,80 873,87T = 2,521699 643392 643403 = T 392 988,51 971,59 724,47T = 2,521699 643414 643425 = T 462 1.165,02 1.148,10 856,85T = 2,521699 643436 643440 = T 416 1.049,03 1.032,11 769,86T = 2,521699 643451 643462 = T 286 721,21 704,29 523,99T = 2,521699 643473 643484 = T 430 1.084,33 1.067,41 796,33T = 2,521699 643495 643506 = T 512 1.291,11 1.274,19 951,42T = 2,521699 643510 643521 = T 198 499,30 482,38 357,56T = 2,521699 653870 653881 = T 192 484,17 467,25 346,21T = 2,521699 653892 653903 = T 286 721,21 704,29 523,99T = 2,521699 653914 653925 = T 388 978,42 961,50 716,90T = 2,521699 653936 653940 = T 286 721,21 704,29 523,99T = 2,521699 653951 653962 = T 376 948,16 931,24 694,20


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2) Chaussures orthopédiques - affections avec indication absolue (B) - Prestations AVEC quote-part personnelle (Y = T 26,82)

T = 2,521699 643716 643720 = T 217 547,21 479,58 342,78T = 2,521699 643731 643742 = T 177 446,34 378,71 267,13T = 2,521699 643753 643764 = T 272 685,90 618,27 446,80T = 2,521699 643775 643786 = T 227 572,43 504,80 361,70T = 2,521699 643790 643801 = T 304 766,60 698,97 507,32T = 2,521699 643812 643823 = T 227 572,43 504,80 361,70T = 2,521699 643834 643845 = T 367 925,46 857,83 626,47T = 2,521699 643856 643860 = T 376 948,16 880,53 643,49T = 2,521699 643871 643882 = T 288 726,25 658,62 477,06T = 2,521699 643893 643904 = T 227 572,43 504,80 361,70T = 2,521699 643915 643926 = T 394 993,55 925,92 677,54T = 2,521699 643930 643941 = T 310 781,73 714,10 518,67T = 2,521699 643952 643963 = T 227 572,43 504,80 361,70T = 2,521699 643974 643985 = T 288 726,25 658,62 477,06T = 2,521699 643996 644000 = T 339 854,86 787,23 573,52T = 2,521699 644011 644022 = T 370 933,03 865,40 632,15T = 2,521699 644033 644044 = T 430 1.084,33 1.016,70 745,62T = 2,521699 644055 644066 = T 370 933,03 865,40 632,15T = 2,521699 644070 644081 = T 370 933,03 865,40 632,15T = 2,521699 644092 644103 = T 370 933,03 865,40 632,15T = 2,521699 644114 644125 = T 362 912,86 845,23 617,02T = 2,521699 644136 644140 = T 376 948,16 880,53 643,49T = 2,521699 644151 644162 = T 430 1.084,33 1.016,70 745,62T = 2,521699 644173 644184 = T 430 1.084,33 1.016,70 745,62T = 2,521699 644195 644206 = T 348 877,55 809,92 590,54T = 2,521699 644210 644221 = T 170 428,69 361,06 253,89

3) Chaussures orthopédiques - affections avec indication relative (C) -Prestations AVEC quote-part personnelle (Z = T 33,52)

T = 2,521699 644512 644523 = T 217 547,21 462,68 325,88T = 2,521699 644534 644545 = T 177 446,34 361,81 250,23T = 2,521699 644593 644604 = T 217 547,21 462,68 325,88T = 2,521699 644615 644626 = T 142 358,08 273,55 184,03

4) Applications orthopédiques - affections secondaires (D) - Prestations AVEC quote-part personnelle (W = T 13,41)

T = 2,521699 644814 644825 = T 100 252,17 218,35 155,31T = 2,521699 644836 644840 = T 86 216,87 183,05 128,84T = 2,521699 644851 644862 = T 98 247,13 213,31 151,53


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VII. Prestations relatives à la SEMELLE ORTHOPEDIQUE

T = 1,790948 653973 653984 = T 18,35 32,86 25,02 16,81

VIII. Prestations relatives aux PROTHESES MYOELECTRIQUES

Sur mesure high-tech

T = 3,402407 744015 744026 = T 3.951,14 13.443,39 13.443,39 10.082,55T = 3,402407 744030 744041 = T 3.897,01 13.259,21 13.259,21 9.944,41T = 3,402407 744052 744063 = T 4.213,00 14.334,34 14.334,34 10.750,76T = 3,402407 744074 744085 = T 4.158,88 14.150,20 14.150,20 10.612,65T = 3,402407 744096 744100 = T 4.323,89 14.711,63 14.711,63 11.033,73T = 3,402407 744111 744122 = T 4.269,76 14.527,46 14.527,46 10.895,60T = 3,402407 744133 744144 = T 5.531,43 18.820,18 18.820,18 14.115,14T = 3,402407 744155 744166 = T 5.477,30 18.636,00 18.636,00 13.977,00T = 3,402407 744170 744181 = T 6.145,17 20.908,37 20.908,37 15.681,28T = 3,402407 744192 744203 = T 6.091,05 20.724,23 20.724,23 15.543,18T = 3,402407 744214 744225 = T 937,69 3.190,40 3.190,40 2.392,80T = 3,402407 744236 744240 = T 841,05 2.861,59 2.861,59 2.146,20T = 3,402407 744251 744262 = T 858,83 2.922,09 2.922,09 2.191,57T = 3,402407 744273 744284 = T 1.154,02 3.926,45 3.926,45 2.944,84T = 3,402407 744295 744306 = T 1.790,16 6.090,85 6.090,85 4.568,14T = 3,402407 744310 744321 = T 4.012,01 13.650,49 13.650,49 10.237,87T = 3,402407 744332 744343 = T 1.994,56 6.786,30 6.786,30 5.089,73T = 3,402407 744354 744365 = T 772,89 2.629,69 2.629,69 1.972,27T = 3,402407 744376 744380 = T 1.277,14 4.345,35 4.345,35 3.259,02T = 3,402407 744391 744402 = T 786,55 2.676,16 2.676,16 2.007,12T = 3,402407 744413 744424 = T 8.613,11 29.305,31 29.305,31 21.978,99T = 3,402407 744435 744446 = T 1.900,28 6.465,53 6.465,53 4.849,15T = 3,402407 744553 744564 = T 255,13 868,06 868,06 651,05T = 3,402407 744575 744586 = T 204,09 694,40 694,40 520,80T = 3,402407 744693 744704 = T 4,00 13,61 13,61 10,21T = 3,402407 744730 744741 = T 543,36 1.848,73 1.848,73 1.386,55T = 3,402407 744833 744844 = T 543,36 1.848,73 1.848,73 1.386,55

Sur mesure

T = 3,110635 744450 744461 = T 92,62 288,11 288,11 216,09T = 3,110635 744472 744483 = T 132,84 413,22 413,22 309,92T = 3,110635 744494 744505 = T 254,07 790,32 790,32 592,74T = 3,110635 744531 744542 = T 488,45 1.519,39 1.519,39 1.139,55T = 3,110635 744612 744623 = T 58,77 182,81 182,81 137,11T = 3,110635 744656 744660 = T 112,61 350,29 350,29 262,72T = 3,110635 744671 744682 = T 137,24 426,90 426,90 320,18T = 3,110635 744752 744763 = T 92,62 288,11 288,11 216,09T = 3,110635 744774 744785 = T 132,84 413,22 413,22 309,92T = 3,110635 744855 744866 = T 488,45 1.519,39 1.519,39 1.139,55

Préfab

T = 1,746695 744516 744520 = T 464,16 810,75 810,75 608,07T = 1,746695 744590 744601 = T 33,62 58,72 58,72 44,04T = 1,746695 744634 744645 = T 292,86 511,54 511,54 383,66T = 1,746695 744715 744726 = T 464,16 810,75 810,75 608,07T = 1,746695 744796 744800 = T 292,86 511,54 511,54 383,66T = 1,746695 744811 744822 = T 33,62 58,72 58,72 44,04


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IX. Prestations relatives aux VETEMENTS COMPRESSIFS

Sur mesure

T = 1,077639 641174 641185 = T 127,29 137,17 137,17 102,88T = 1,077639 641211 641222 = T 175,31 188,92 188,92 141,69T = 1,077639 641233 641244 = T 888,80 957,81 957,81 718,36T = 1,077639 641255 641266 = T 1.033,33 1.113,56 1.113,56 835,17T = 1,077639 641314 641325 = T 1.421,24 1.531,58 1.531,58 1.148,69T = 1,077639 641336 641340 = T 1.495,05 1.611,12 1.611,12 1.208,34T = 1,077639 641373 641384 = T 799,92 862,02 862,02 646,52T = 1,077639 641395 641406 = T 929,99 1.002,19 1.002,19 751,65T = 1,077639 641410 641421 = T 1.279,11 1.378,42 1.378,42 1.033,82T = 1,077639 641432 641443 = T 1.342,85 1.447,11 1.447,11 1.085,34T = 1,077639 644954 644965 = T 71,49 77,04 77,04 57,78T = 1,077639 641616 641620 = T 744,29 802,08 802,08 601,56T = 1,077639 641631 641642 = T 875,11 943,05 943,05 707,29T = 1,077639 641653 641664 = T 1.263,83 1.361,95 1.361,95 1.021,47T = 1,077639 641675 641686 = T 1.348,48 1.453,17 1.453,17 1.089,88T = 1,077639 641690 641701 = T 291,92 314,58 314,58 235,94T = 1,077639 641712 641723 = T 479,48 516,71 516,71 387,54T = 1,077639 641734 641745 = T 507,58 546,99 546,99 410,25T = 1,077639 641756 641760 = T 813,52 876,68 876,68 657,51T = 1,077639 641771 641782 = T 748,83 806,97 806,97 605,23T = 1,077639 641793 641804 = T 1.179,18 1.270,73 1.270,73 953,05T = 1,077639 641815 641826 = T 59,15 63,74 63,74 47,81T = 1,077639 641830 641841 = T 78,83 84,95 84,95 63,72T = 1,077639 641852 641863 = T 379,81 409,30 409,30 306,98T = 1,077639 641874 641885 = T 636,46 685,87 685,87 514,41T = 1,077639 641896 641900 = T 521,00 561,45 561,45 421,09T = 1,077639 641911 641922 = T 884,68 953,37 953,37 715,03T = 1,077639 641970 641981 = T 234,87 253,11 253,11 189,84T = 1,077639 641992 642003 = T 14,55 15,68 15,68 11,76T = 1,077639 642154 642165 = T 678,14 730,79 730,79 548,10T = 1,077639 642176 642180 = T 264,39 284,92 284,92 213,69T = 1,077639 642191 642202 = T 346,83 373,76 373,76 280,32T = 1,077639 642633 642644 = T 183,22 197,45 197,45 148,09T = 1,077639 642655 642666 = T 252,72 272,34 272,34 204,26T = 1,077639 642670 642681 = T 183,22 197,45 197,45 148,09T = 1,077639 642692 642703 = T 228,61 246,36 246,36 184,77T = 1,077639 642714 642725 = T 135,85 146,40 146,40 109,80T = 1,077639 642736 642740 = T 187,56 202,12 202,12 151,59T = 1,077639 642795 642806 = T 234,87 253,11 253,11 189,84T = 1,077639 642810 642821 = T 14,55 15,68 15,68 11,76T = 1,077639 642832 642843 = T 678,14 730,79 730,79 548,10T = 1,077639 642854 642865 = T 124,21 133,85 133,85 100,39T = 1,077639 642876 642880 = T 208,16 224,32 224,32 168,24T = 1,077639 642891 642902 = T 398,83 429,79 429,79 322,35T = 1,077639 642913 642924 = T 428,15 461,39 461,39 346,05T = 1,077639 642935 642946 = T 636,00 685,38 685,38 514,04T = 1,077639 642950 642961 = T 109,28 117,76 117,76 88,32T = 1,077639 642972 642983 = T 705,96 760,77 760,77 570,58T = 1,077639 643554 643565 = T 234,87 253,11 253,11 189,84T = 1,077639 643576 643580 = T 14,55 15,68 15,68 11,76T = 1,077639 643591 643602 = T 544,34 586,60 586,60 439,95T = 1,077639 643613 643624 = T 360,93 388,95 388,95 291,72T = 1,077639 643635 643646 = T 441,60 475,89 475,89 356,92T = 1,077639 643650 643661 = T 246,13 265,24 265,24 198,93T = 1,077639 643672 643683 = T 520,66 561,08 561,08 420,81T = 1,077639 643694 643705 = T 617,58 665,53 665,53 499,15T = 1,077639 644232 644243 = T 997,97 1.075,45 1.075,45 806,59T = 1,077639 644254 644265 = T 153,80 165,74 165,74 124,31T = 1,077639 644276 644280 = T 224,84 242,30 242,30 181,73T = 1,077639 644291 644302 = T 516,90 557,03 557,03 417,78T = 1,077639 644313 644324 = T 781,23 841,88 841,88 631,41T = 1,077639 644335 644346 = T 668,72 720,64 720,64 540,48T = 1,077639 644350 644361 = T 1.305,90 1.407,29 1.407,29 1.055,47T = 1,077639 644372 644383 = T 562,27 605,92 605,92 454,44T = 1,077639 644394 644405 = T 1.050,79 1.132,37 1.132,37 849,28T = 1,077639 644453 644464 = T 234,87 253,11 253,11 189,84T = 1,077639 644475 644486 = T 14,55 15,68 15,68 11,76T = 1,077639 644490 644501 = T 544,34 586,60 586,60 439,95T = 1,077639 644630 644641 = T 154,07 166,03 166,03 124,53T = 1,077639 644652 644663 = T 217,95 234,87 234,87 176,16T = 1,077639 644711 644722 = T 234,87 253,11 253,11 189,84T = 1,077639 644733 644744 = T 14,55 15,68 15,68 11,76T = 1,077639 644755 644766 = T 544,34 586,60 586,60 439,95T = 1,077639 644770 644781 = T 397,44 428,30 428,30 321,23T = 1,077639 644932 644943 = T 159,75 172,15 172,15 129,12


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Honoraires





Préfab

T = 1,039490 641933 641944 = T 49,40 51,35 51,35 38,52T = 1,039490 641955 641966 = T 3,98 4,14 4,14 3,11T = 1,039490 642751 642762 = T 49,40 51,35 51,35 38,52T = 1,039490 642773 642784 = T 3,98 4,14 4,14 3,11T = 1,039490 642994 643005 = T 49,40 51,35 51,35 38,52T = 1,039490 643532 643543 = T 3,98 4,14 4,14 3,11T = 1,039490 644416 644420 = T 49,40 51,35 51,35 38,52T = 1,039490 644431 644442 = T 3,98 4,14 4,14 3,11T = 1,039490 644674 644685 = T 44,46 46,22 46,22 34,67T = 1,039490 644696 644700 = T 3,98 4,14 4,14 3,11T = 1,039490 644792 644803 = T 36,31 37,74 37,74 28,31T = 1,039490 644910 644921 = T 36,31 37,74 37,74 28,31

A.R. du 4 mai 2004, M.B. du 14 mai 2004

« Lorsque le bénéficiaire est appareillé avec des prestations appartenant à des catégories différentes, l'intervention personnelle de la catégorie avec l'intervention personnelle la plus faible est d'application à ces prestations. »


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