11 JUILLET 2023. - Arrêté royal modifiant l'arrêté royal du 23 mars 2019 portant exécution de l'article 37, § 16bis, alinéa 1er, 3°, et alinéa 4, de la loi relative à l'assurance obligatoire soins de santé et indemnités, coordonnée le 14 juillet 1994, en ce qui concerne les pansements actifs
Art. 1-4
Article 1er. L'annexe 1rejointe à l'arrêté royal du 23 mars 2019 portant exécution de l'article 37, § 16bis, alinéa 1er, 3°, et alinéa 4, de la loi relative à l'assurance obligatoire soins de santé et indemnités, coordonnée le 14 juillet 1994, en ce qui concerne les pansements actifs, est complétée par ce qui suit:
Code | Dénomination /Benaming | Conditionne- ment: | Conditionne- ment: | Type | Observa- tions/ Opmer-kingen | Prijs | Basis van | TM Interventionmajorée | TM Ordi-naires | Code * | Prijs * |
nombre / | dimensions / | Prix | tegemoetk. | I | II | Prix * | |||||
Verpakking: | Verpakking: | Base de | |||||||||
aantal | afmetingen | rembours. | |||||||||
41551205 | AQUACEL Ag + Extrahydrofibre | 10 | (5 x 5 cm) | Hydrofibre /Hydrofiber+ AG | M | 20,26 | 20,26 | 16,21 | 16,21 | 7115983 | 1,1950 |
4151221 | AQUACEL Ag + Extrahydrofibre | 5 | (15 x 15 cm) | Hydrofibre /Hydrofiber+ AG | M | 56,37 | 56,37 | 45,10 | 45,10 | 7115991 | 8,4820 |
4313755 | KerraCelT Ref. CWL116610x (10x10cm) | 10 | 10x10 cm | Hydrofibre /Hydrofiber | M | 40,09 | 40,09 | 32,07 | 32,07 | 7115942 | 3,6390 |
4313722 | KerraCelT Ref. CWL103210 x (5x5cm) | 10 | 5x5 cm | Hydrofibre /Hydrofiber | M | 13,84 | 13,84 | 11,07 | 11,07 | 7115959 | 1,1370 |
4313789 | KerraCelT Ref. CWL1034 5x(15x15cm) | 5 | 15x15 cm | Hydrofibre /Hydrofiber | M | 43,83 | 43,83 | 35,06 | 35,06 | 7115967 | 8,1480 |
4313797 | KerraCelT Ref. CWL1035 5x(2x45cm) | 5 | 2x45 cm | Hydrofibre /Hydrofiber | M | 24,91 | 24,91 | 19,93 | 19,93 | 7115975 | 4,0940 |
3553484 | HYDROTAC transparent 10 x (10x10cm) | 10 | 10x10cm | Hydrogel en plaque/Hydrogel in plaatvorm | M | 35,11 | 35,11 | 28,09 | 28,09 | 7116494 | 3,0330 |
3960648 | PERMAFOAM classic 10 x (15x15cm) | 10 | (15x15cm) | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 55,93 | 55,93 | 44,74 | 44,74 | 7116189 | 5,1950 |
3960655 | PERMAFOAM classic 10 x (10x20cm) | 10 | (10 x 20 cm) | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 61,06 | 61,06 | 48,85 | 48,85 | 7116197 | 5,6930 |
3960663 | PERMAFOAM classic 10 x (20x20cm) | 10 | (20 x 20 cm) | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 91,85 | 91,85 | 73,48 | 73,48 | 7116205 | 8,6820 |
3960689 | PERMAFOAM classic border 10 x (10x10cm) | 10 | (10x10cm) | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 35,11 | 35,11 | 28,09 | 28,09 | 7116213 | 3,0330 |
3960705 | PERMAFOAM classic border 10 x (15x15cm) | 10 | (15x15cm) | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 55,93 | 55,93 | 44,74 | 44,74 | 7116221 | 5,1950 |
2643526 | HYDROTAC Concave 10 x (18x18,5cm) | 10 | 18x18,5cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 78,1 | 78,1 | 62,48 | 62,48 | 7116239 | 7,3470 |
3323730 | HYDROTAC Sacral 10 x (22x22cm) | 10 | 22x22cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 109,09 | 109,09 | 87,272 | 87,272 | 7116247 | 10,3560 |
2643500 | HYDROTAC Sacral 3 x (22x22cm) | 3 | 22x22cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 47 | 47 | 37,6 | 37,6 | 7116254 | 14,4267 |
4111662 | HYDROTAC Comfort 10 x (20x20cm) | 10 | 20x20cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 91,85 | 91,85 | 73,48 | 73,48 | 7116262 | 8,6820 |
2643468 | HYDROTAC Comfort 3 x (20x20cm) | 3 | 20x20cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 40,09 | 40,09 | 32,072 | 32,072 | 7116270 | 12,1300 |
2643450 | HYDROTAC Comfort 10 x (15x20cm) | 10 | 15x20cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 71,32 | 71,32 | 57,056 | 57,056 | 7116288 | 6,6890 |
2643443 | HYDROTAC Comfort 3 x (15x20cm) | 3 | 15x20cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 32,62 | 32,62 | 26,096 | 26,096 | 7116296 | 9,0967 |
3323714 | HYDROTAC Comfort 10 x (15x15cm) | 10 | 15x15cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 55,93 | 55,93 | 44,744 | 44,744 | 7116304 | 5,1950 |
2643435 | HYDROTAC Comfort 3 x (15x15cm) | 3 | 15x15cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 27,02 | 27,02 | 21,616 | 21,616 | 7116312 | 6,8233 |
3349958 | HYDROTAC Comfort 10 x (8x15cm) | 10 | 8x15cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 40,09 | 40,09 | 32,072 | 32,072 | 7116320 | 3,6390 |
2643427 | HYDROTAC Comfort 10 x (12,5x12,5cm) | 10 | 12,5x12,5cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 49,83 | 49,83 | 39,864 | 39,864 | 7116338 | 4,6030 |
2643419 | HYDROTAC Comfort 3 x (12,5x12,5cm) | 3 | 12,5x12,5cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 24,37 | 24,37 | 19,496 | 19,496 | 7116346 | 5,9267 |
2805794 | HYDROTAC Comfort 10 x (10x20cm) | 10 | 10x20cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 61,06 | 61,06 | 48,848 | 48,848 | 7116353 | 5,6930 |
2805802 | HYDROTAC Comfort 10 x (6,5x10cm) | 10 | 6,5x10cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 26,39 | 26,39 | 21,112 | 21,112 | 7116361 | 1,9720 |
2643401 | HYDROTAC Comfort 10 x (8x8cm) | 10 | 8x8cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 26,14 | 26,14 | 20,912 | 20,912 | 7116379 | 1,9410 |
2643286 | HYDROTAC 10 x (diam 6cm) | 10 | diam 6cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 14,7 | 14,7 | 11,76 | 11,76 | 7116387 | 0,7150 |
4111993 | HYDROTAC 10 x (20x20cm) | 10 | 20x20cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 91,85 | 91,85 | 73,48 | 73,48 | 7116395 | 8,6820 |
2643393 | HYDROTAC 3 x (20x20cm) | 3 | 20x20cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 40,09 | 40,09 | 32,072 | 32,072 | 7116403 | 12,1300 |
2643377 | HYDROTAC 10 x (15x20cm) | 10 | 15x20cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 71,32 | 71,32 | 57,056 | 57,056 | 7116411 | 6,6890 |
3323748 | HYDROTAC 10 x (15x15cm) | 10 | 15x15cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 55,93 | 55,93 | 44,744 | 44,744 | 7116429 | 5,1950 |
2643369 | HYDROTAC 3 x (15x15cm) | 3 | 15x15cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 27,02 | 27,02 | 21,616 | 21,616 | 7116437 | 6,8233 |
2643344 | HYDROTAC 10 x (12,5x12,5cm) | 10 | 12,5x12,5cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 49,83 | 49,83 | 39,864 | 39,864 | 7116445 | 4,6030 |
4111712 | HYDROTAC 10 x (10x20cm) | 10 | 10x20cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 61,06 | 61,06 | 48,848 | 48,848 | 7116452 | 5.6930 |
2643351 | HYDROTAC 3 x (10x20cm) | 3 | 10x20cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 24,93 | 24,93 | 19,944 | 19,944 | 7116460 | 6,0667 |
2643302 | HYDROTAC 10 x (10x10cm) | 10 | 10x10cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 35,11 | 35,11 | 28,088 | 28,088 | 7116478 | 3,0330 |
2643294 | HYDROTAC 3 x (10x10cm) | 3 | 10x10cm | (Pseudo)Schuimver-band/Pansement (pseudo)mousse | M | 15,6 | 15,6 | 12,48 | 12,48 | 7116486 | 3,7933 |
Code | Dénomination /Benaming | Conditionne- ment: | Conditionne- ment: | Type | Observa- tions/ Opmer-kingen | Prijs | Basis van | TM Interventionmajorée | TM Ordi-naires | Code * | Prijs * |
nombre / | dimensions / | Prix | tegemoetk. | I | II | Prix * | |||||
Verpakking: | Verpakking: | Base de | |||||||||
aantal | afmetingen | rembours. | |||||||||
1544691 | SUPRASORB "G" | 5 | (10 x 10 cm) | Hydrogel en plaque/ Hydrogel in plaatvorm | M | 20,77 | 20,77 | 16,62 | 16,62 | 7102882 | 3,0320 |
1544709 | SUPRASORB "G" | 3 | (20 x 20 cm) | Hydrogel en plaque/ Hydrogel in plaatvorm | M | 40,09 | 40,09 | 32,07 | 32,07 | 7102890 | 12,1300 |
1544683 | SUPRASORB "G" | 5 | (5 x 7,5 cm) | Hydrogel en plaque/ Hydrogel in plaatvorm | M | 9,74 | 9,74 | 7,79 | 7,79 | 7103518 | 1,4220 |
2324317 | SUPRASORB "H" | 10 | (10 x 10 cm) | Hydrocolloïde | M | 40,71 | 40,71 | 32,57 | 32,57 | 7102932 | 3,7150 |
1544576 | SUPRASORB "H" | 5 | (14 x 14 cm) | Hydrocolloïde | M | 38,03 | 38,03 | 30,42 | 30,42 | 7102908 | 6,7780 |
1544568 | SUPRASORB "H" | 5 | (14 x 16 cm) | Hydrocolloïde | M | 42,02 | 42,02 | 33,62 | 33,62 | 7102924 | 7,7480 |
1544493 | SUPRASORB "H" | 5 | (15 x 15 cm) | Hydrocolloïde | M | 42,16 | 42,16 | 33,73 | 33,73 | 7102957 | 7,7820 |
1544501 | SUPRASORB "H" | 5 | (20 x 20 cm) | Hydrocolloïde | M | 55,65 | 55,65 | 44,52 | 44,52 | 7102916 | 10,5120 |
1544535 | SUPRASORB "H" dun | 10 | (10 x 10 cm) | Hydrocolloïde | M | 38,61 | 38,61 | 30,89 | 30,89 | 7102932 | 3,4590 |
1544519 | SUPRASORB "H" dun | 10 | (5 x 10 cm) | Hydrocolloïde | M | 27,95 | 27,95 | 22,36 | 22,36 | 7102965 | 2,1610 |
1544527 | SUPRASORB "H" dun | 10 | (5 x 20 cm) | Hydrocolloïde | M | 38,61 | 38,61 | 30,89 | 30,89 | 7102940 | 3,4590 |
1544543 | SUPRASORB "H" dun | 5 | (15 x 15 cm) | Hydrocolloïde | M | 42,16 | 42,16 | 33,73 | 33,73 | 7102999 | 7,7820 |
1544550 | SUPRASORB "H" dun | 5 | (20 x 20 cm) | Hydrocolloïde | M | 55,65 | 55,65 | 44,52 | 44,52 | 7102981 | 10,5120 |
2324309 | SUPRASORB "H" fijn | 10 | (5 x 5 cm) | Hydrocolloïde | M | 14,81 | 14,81 | 11,85 | 11,85 | 7103898 | 1,0810 |
Code | Dénomination /Benaming | Conditionne- ment: | Conditionne- ment: | Type | Observa- tions/ Opmer-kingen | Prijs | Basis van | TM Interventionmajorée | TM Ordi-naires | Code * | Prijs * |
nombre / | dimensions / | Prix | tegemoetk. | I | II | Prix * | |||||
Verpakking: | Verpakking: | Base de | |||||||||
aantal | afmetingen | rembours. | |||||||||
3356011 | SUPRASORB "G" | 5 | (10 x 10 cm) | Hydrogel en plaque/ Hydrogel in plaatvorm | M | 20,77 | 20,77 | 16,62 | 16,62 | 7102882 | 3,0320 |
3356003 | SUPRASORB "G" | 3 | (20 x 20 cm) | Hydrogel en plaque/ Hydrogel in plaatvorm | M | 40,09 | 40,09 | 32,07 | 32,07 | 7102890 | 12,1300 |
3356029 | SUPRASORB "G" | 5 | (5 x 7,5 cm) | Hydrogel en plaque/ Hydrogel in plaatvorm | M | 9,74 | 9,74 | 7,79 | 7,79 | 7103518 | 1,4220 |
3945557 | SUPRASORB "H" | 10 | (10 x 10 cm) | Hydrocolloïde | M | 40,71 | 40,71 | 32,57 | 32,57 | 7102932 | 3,7150 |
3945649 | SUPRASORB "H" | 5 | (14 x 14 cm) | Hydrocolloïde | M | 38,03 | 38,03 | 30,42 | 30,42 | 7102908 | 6,7780 |
3945656 | SUPRASORB "H" | 5 | (14 x 16 cm) | Hydrocolloïde | M | 42,02 | 42,02 | 33,62 | 33,62 | 7102924 | 7,7480 |
3945565 | SUPRASORB "H" | 5 | (15 x 15 cm) | Hydrocolloïde | M | 42,16 | 42,16 | 33,73 | 33,73 | 7102957 | 7,7820 |
3945573 | SUPRASORB "H" | 5 | (20 x 20 cm) | Hydrocolloïde | M | 55,65 | 55,65 | 44,52 | 44,52 | 7102916 | 10,5120 |
3945615 | SUPRASORB "H" dun | 10 | (10 x 10 cm) | Hydrocolloïde | M | 38,61 | 38,61 | 30,89 | 30,89 | 7102932 | 3,4590 |
3945599 | SUPRASORB "H" dun | 10 | (5 x 10 cm) | Hydrocolloïde | M | 27,95 | 27,95 | 22,36 | 22,36 | 7102965 | 2,1610 |
3945607 | SUPRASORB "H" dun | 10 | (5 x 20 cm) | Hydrocolloïde | M | 38,61 | 38,61 | 30,89 | 30,89 | 7102940 | 3,4590 |
3945623 | SUPRASORB "H" dun | 5 | (15 x 15 cm) | Hydrocolloïde | M | 42,16 | 42,16 | 33,73 | 33,73 | 7102999 | 7,7820 |
3945631 | SUPRASORB "H" dun | 5 | (20 x 20 cm) | Hydrocolloïde | M | 55,65 | 55,65 | 44,52 | 44,52 | 7102981 | 10,5120 |
3945581 | SUPRASORB "H" fijn | 10 | (5 x 5 cm) | Hydrocolloïde | M | 14,81 | 14,81 | 11,85 | 11,85 | 7103898 | 1,0810 |