﻿<?xml version="1.0" encoding="utf-8"?>
<NominativeListDetail xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://www.riziv.fgov.be/xsd/cti/201411">
  <Header>
    <SequenceNumber>154</SequenceNumber>
    <ModificationsFrom>2024-03-28</ModificationsFrom>
    <ModificationsTo>2024-04-17</ModificationsTo>
  </Header>
  <Data>
    <NominativeListGroupCode>327</NominativeListGroupCode>
    <NominativeListCode>32707</NominativeListCode>
    <IdentificationCode>327070003195</IdentificationCode>
    <OldCode />
    <Version>1</Version>
    <Distributor>Artivion</Distributor>
    <ProductName>Artivex custom-made</ProductName>
    <ProductReference>Geen referentie</ProductReference>
    <ValidFrom>2024-05-01</ValidFrom>
    <ModificationTypes>
      <ModificationType>A</ModificationType>
    </ModificationTypes>
    <LastModified>2024-04-16</LastModified>
    <Published>2024-04-16</Published>
  </Data>
  <Data>
    <NominativeListGroupCode>327</NominativeListGroupCode>
    <NominativeListCode>32708</NominativeListCode>
    <IdentificationCode>327080003501</IdentificationCode>
    <OldCode />
    <Version>1</Version>
    <Distributor>Artivion</Distributor>
    <ProductName>Artivex custom-made</ProductName>
    <ProductReference>Geen referentie</ProductReference>
    <ValidFrom>2024-05-01</ValidFrom>
    <ModificationTypes>
      <ModificationType>A</ModificationType>
    </ModificationTypes>
    <LastModified>2024-04-16</LastModified>
    <Published>2024-04-16</Published>
  </Data>
  <Data>
    <NominativeListGroupCode>340</NominativeListGroupCode>
    <NominativeListCode>34003</NominativeListCode>
    <IdentificationCode>340030013542</IdentificationCode>
    <OldCode />
    <Version>1</Version>
    <Distributor>FH Ortho</Distributor>
    <ProductName>FHK COMPOSANT FEMORAL / A CIMENTER</ProductName>
    <ProductReference>257708 -&gt; 257719 / 266691 / 266692</ProductReference>
    <ProductPrice>1269.13</ProductPrice>
    <Reimbursement>1269.13</Reimbursement>
    <PatientSupplement>0.00</PatientSupplement>
    <DeliveryMargin>126.91</DeliveryMargin>
    <ValidFrom>2024-05-01</ValidFrom>
    <ModificationTypes>
      <ModificationType>A</ModificationType>
    </ModificationTypes>
    <LastModified>2024-04-16</LastModified>
    <Published>2024-04-16</Published>
  </Data>
  <Data>
    <NominativeListGroupCode>340</NominativeListGroupCode>
    <NominativeListCode>34003</NominativeListCode>
    <IdentificationCode>340030013641</IdentificationCode>
    <OldCode />
    <Version>1</Version>
    <Distributor>FH Ortho</Distributor>
    <ProductName>FHK COMPOSANT FEMORAL / POSTERO STABILISE / A CIMENTER</ProductName>
    <ProductReference>257684 -&gt; 257695 / 266695 / 266696</ProductReference>
    <ProductPrice>1269.13</ProductPrice>
    <Reimbursement>1269.13</Reimbursement>
    <PatientSupplement>0.00</PatientSupplement>
    <DeliveryMargin>126.91</DeliveryMargin>
    <ValidFrom>2024-05-01</ValidFrom>
    <ModificationTypes>
      <ModificationType>A</ModificationType>
    </ModificationTypes>
    <LastModified>2024-04-16</LastModified>
    <Published>2024-04-16</Published>
  </Data>
  <Data>
    <NominativeListGroupCode>340</NominativeListGroupCode>
    <NominativeListCode>34005</NominativeListCode>
    <IdentificationCode>340050008707</IdentificationCode>
    <OldCode />
    <Version>1</Version>
    <Distributor>FH Ortho</Distributor>
    <ProductName>FHK COMPOSANT FEMORAL / SANS CIMENT</ProductName>
    <ProductReference>257720 -&gt; 257731 / 266693 / 266694</ProductReference>
    <ProductPrice>1388.11</ProductPrice>
    <Reimbursement>1388.11</Reimbursement>
    <PatientSupplement>0.00</PatientSupplement>
    <DeliveryMargin>138.81</DeliveryMargin>
    <ValidFrom>2024-05-01</ValidFrom>
    <ModificationTypes>
      <ModificationType>A</ModificationType>
    </ModificationTypes>
    <LastModified>2024-04-16</LastModified>
    <Published>2024-04-16</Published>
  </Data>
  <Data>
    <NominativeListGroupCode>340</NominativeListGroupCode>
    <NominativeListCode>34005</NominativeListCode>
    <IdentificationCode>340050008806</IdentificationCode>
    <OldCode />
    <Version>1</Version>
    <Distributor>FH Ortho</Distributor>
    <ProductName>FHK COMPOSANT FEMORAL / POSTERO STABILISE / SANS CIMENT</ProductName>
    <ProductReference>257696 -&gt; 257707 / 266697 / 266698</ProductReference>
    <ProductPrice>1388.11</ProductPrice>
    <Reimbursement>1388.11</Reimbursement>
    <PatientSupplement>0.00</PatientSupplement>
    <DeliveryMargin>138.81</DeliveryMargin>
    <ValidFrom>2024-05-01</ValidFrom>
    <ModificationTypes>
      <ModificationType>A</ModificationType>
    </ModificationTypes>
    <LastModified>2024-04-16</LastModified>
    <Published>2024-04-16</Published>
  </Data>
  <Data>
    <NominativeListGroupCode>340</NominativeListGroupCode>
    <NominativeListCode>34026</NominativeListCode>
    <IdentificationCode>340260011826</IdentificationCode>
    <OldCode />
    <Version>1</Version>
    <Distributor>FH Ortho</Distributor>
    <ProductName>FHK EMBASE TIBIALE / FIXE / A CIMENTER</ProductName>
    <ProductReference>257659 -&gt; 257664 / 266703</ProductReference>
    <ProductPrice>793.20</ProductPrice>
    <Reimbursement>793.20</Reimbursement>
    <PatientSupplement>0.00</PatientSupplement>
    <DeliveryMargin>79.32</DeliveryMargin>
    <ValidFrom>2024-05-01</ValidFrom>
    <ModificationTypes>
      <ModificationType>A</ModificationType>
    </ModificationTypes>
    <LastModified>2024-04-16</LastModified>
    <Published>2024-04-16</Published>
  </Data>
  <Data>
    <NominativeListGroupCode>340</NominativeListGroupCode>
    <NominativeListCode>34026</NominativeListCode>
    <IdentificationCode>340260011925</IdentificationCode>
    <OldCode />
    <Version>1</Version>
    <Distributor>FH Ortho</Distributor>
    <ProductName>FHK EMBASE TIBIALE / ROTATOIRE A CIMENTER</ProductName>
    <ProductReference>257671 -&gt; 257676 / 266705</ProductReference>
    <ProductPrice>793.20</ProductPrice>
    <Reimbursement>793.20</Reimbursement>
    <PatientSupplement>0.00</PatientSupplement>
    <DeliveryMargin>79.32</DeliveryMargin>
    <ValidFrom>2024-05-01</ValidFrom>
    <ModificationTypes>
      <ModificationType>A</ModificationType>
    </ModificationTypes>
    <LastModified>2024-04-16</LastModified>
    <Published>2024-04-16</Published>
  </Data>
  <Data>
    <NominativeListGroupCode>340</NominativeListGroupCode>
    <NominativeListCode>34026</NominativeListCode>
    <IdentificationCode>340260012024</IdentificationCode>
    <OldCode />
    <Version>1</Version>
    <Distributor>FH Ortho</Distributor>
    <ProductName>EMBASE TIBIALE / ASYMETRIQUE A CIMENTER</ProductName>
    <ProductReference>264988 -&gt; 264999</ProductReference>
    <ProductPrice>793.20</ProductPrice>
    <Reimbursement>793.20</Reimbursement>
    <PatientSupplement>0.00</PatientSupplement>
    <DeliveryMargin>79.32</DeliveryMargin>
    <ValidFrom>2024-05-01</ValidFrom>
    <ModificationTypes>
      <ModificationType>A</ModificationType>
    </ModificationTypes>
    <LastModified>2024-04-16</LastModified>
    <Published>2024-04-16</Published>
  </Data>
  <Data>
    <NominativeListGroupCode>340</NominativeListGroupCode>
    <NominativeListCode>34028</NominativeListCode>
    <IdentificationCode>340280006593</IdentificationCode>
    <OldCode />
    <Version>1</Version>
    <Distributor>Medacta</Distributor>
    <ProductName>3D Metal Tibia Cementless</ProductName>
    <ProductReference>02.12.3DxxR / L</ProductReference>
    <ProductPrice>1130.31</ProductPrice>
    <Reimbursement>941.93</Reimbursement>
    <PatientSupplement>188.38</PatientSupplement>
    <DeliveryMargin>113.03</DeliveryMargin>
    <ValidFrom>2024-05-01</ValidFrom>
    <ModificationTypes>
      <ModificationType>A</ModificationType>
    </ModificationTypes>
    <LastModified>2024-04-16</LastModified>
    <Published>2024-04-16</Published>
  </Data>
  <Data>
    <NominativeListGroupCode>340</NominativeListGroupCode>
    <NominativeListCode>34028</NominativeListCode>
    <IdentificationCode>340280006692</IdentificationCode>
    <OldCode />
    <Version>1</Version>
    <Distributor>FH Ortho</Distributor>
    <ProductName>FHK EMBASE TIBIALE / FIXE / SANS CIMENT</ProductName>
    <ProductReference>257665 -&gt; 257670 / 266704</ProductReference>
    <ProductPrice>941.93</ProductPrice>
    <Reimbursement>941.93</Reimbursement>
    <PatientSupplement>0.00</PatientSupplement>
    <DeliveryMargin>94.19</DeliveryMargin>
    <ValidFrom>2024-05-01</ValidFrom>
    <ModificationTypes>
      <ModificationType>A</ModificationType>
    </ModificationTypes>
    <LastModified>2024-04-16</LastModified>
    <Published>2024-04-16</Published>
  </Data>
  <Data>
    <NominativeListGroupCode>340</NominativeListGroupCode>
    <NominativeListCode>34028</NominativeListCode>
    <IdentificationCode>340280006791</IdentificationCode>
    <OldCode />
    <Version>1</Version>
    <Distributor>FH Ortho</Distributor>
    <ProductName>FHK EMBASE TIBIALE / ROTATOIRE / SANS CIMENT</ProductName>
    <ProductReference>257677 / 257679 -&gt; 257683 / 266854</ProductReference>
    <ProductPrice>941.93</ProductPrice>
    <Reimbursement>941.93</Reimbursement>
    <PatientSupplement>0.00</PatientSupplement>
    <DeliveryMargin>94.19</DeliveryMargin>
    <ValidFrom>2024-05-01</ValidFrom>
    <ModificationTypes>
      <ModificationType>A</ModificationType>
    </ModificationTypes>
    <LastModified>2024-04-16</LastModified>
    <Published>2024-04-16</Published>
  </Data>
  <Data>
    <NominativeListGroupCode>340</NominativeListGroupCode>
    <NominativeListCode>34028</NominativeListCode>
    <IdentificationCode>340280006890</IdentificationCode>
    <OldCode />
    <Version>1</Version>
    <Distributor>FH Ortho</Distributor>
    <ProductName>FHK fastrack EMBASE TIBIALE / FIXE / SANS CIMENT</ProductName>
    <ProductReference>268779 -&gt; 268785</ProductReference>
    <ProductPrice>941.93</ProductPrice>
    <Reimbursement>941.93</Reimbursement>
    <PatientSupplement>0.00</PatientSupplement>
    <DeliveryMargin>94.19</DeliveryMargin>
    <ValidFrom>2024-05-01</ValidFrom>
    <ModificationTypes>
      <ModificationType>A</ModificationType>
    </ModificationTypes>
    <LastModified>2024-04-16</LastModified>
    <Published>2024-04-16</Published>
  </Data>
  <Data>
    <NominativeListGroupCode>340</NominativeListGroupCode>
    <NominativeListCode>34028</NominativeListCode>
    <IdentificationCode>340280006989</IdentificationCode>
    <OldCode />
    <Version>1</Version>
    <Distributor>FH Ortho</Distributor>
    <ProductName>FHK fastrack EMBASE TIBIALE / ROTATOIRE / SANS CIMENT</ProductName>
    <ProductReference>268786 -&gt; 268792</ProductReference>
    <ProductPrice>941.93</ProductPrice>
    <Reimbursement>941.93</Reimbursement>
    <PatientSupplement>0.00</PatientSupplement>
    <DeliveryMargin>94.19</DeliveryMargin>
    <ValidFrom>2024-05-01</ValidFrom>
    <ModificationTypes>
      <ModificationType>A</ModificationType>
    </ModificationTypes>
    <LastModified>2024-04-16</LastModified>
    <Published>2024-04-16</Published>
  </Data>
  <Data>
    <NominativeListGroupCode>340</NominativeListGroupCode>
    <NominativeListCode>34053</NominativeListCode>
    <IdentificationCode>340530010930</IdentificationCode>
    <OldCode />
    <Version>1</Version>
    <Distributor>FH Ortho</Distributor>
    <ProductName>FHK COMPOSANT ROTULIEN</ProductName>
    <ProductReference>257733 -&gt; 257737 / 265951</ProductReference>
    <ProductPrice>188.38</ProductPrice>
    <Reimbursement>188.38</Reimbursement>
    <PatientSupplement>0.00</PatientSupplement>
    <DeliveryMargin>18.83</DeliveryMargin>
    <ValidFrom>2024-05-01</ValidFrom>
    <ModificationTypes>
      <ModificationType>A</ModificationType>
    </ModificationTypes>
    <LastModified>2024-04-16</LastModified>
    <Published>2024-04-16</Published>
  </Data>
  <Data>
    <NominativeListGroupCode>340</NominativeListGroupCode>
    <NominativeListCode>34060</NominativeListCode>
    <IdentificationCode>340600003061</IdentificationCode>
    <OldCode />
    <Version>1</Version>
    <Distributor>FH Ortho</Distributor>
    <ProductName>FHK RALLONGE DIAPHYSAIRE</ProductName>
    <ProductReference>263381 -&gt; 263384</ProductReference>
    <ProductPrice>297.45</ProductPrice>
    <Reimbursement>297.45</Reimbursement>
    <PatientSupplement>0.00</PatientSupplement>
    <DeliveryMargin>29.74</DeliveryMargin>
    <ValidFrom>2024-05-01</ValidFrom>
    <ModificationTypes>
      <ModificationType>A</ModificationType>
    </ModificationTypes>
    <LastModified>2024-04-16</LastModified>
    <Published>2024-04-16</Published>
  </Data>
  <Data>
    <NominativeListGroupCode>340</NominativeListGroupCode>
    <NominativeListCode>34071</NominativeListCode>
    <IdentificationCode>340710018877</IdentificationCode>
    <OldCode />
    <Version>1</Version>
    <Distributor>FH Ortho</Distributor>
    <ProductName>FHK INSERT FIXE / POSTERO-CONSERVE</ProductName>
    <ProductReference>257740-&gt; 257775 / 266708 -&gt; 266713</ProductReference>
    <ProductPrice>401.23</ProductPrice>
    <Reimbursement>401.23</Reimbursement>
    <PatientSupplement>0.00</PatientSupplement>
    <DeliveryMargin>40.12</DeliveryMargin>
    <ValidFrom>2024-05-01</ValidFrom>
    <ModificationTypes>
      <ModificationType>A</ModificationType>
    </ModificationTypes>
    <LastModified>2024-04-16</LastModified>
    <Published>2024-04-16</Published>
  </Data>
  <Data>
    <NominativeListGroupCode>340</NominativeListGroupCode>
    <NominativeListCode>34071</NominativeListCode>
    <IdentificationCode>340710018976</IdentificationCode>
    <OldCode />
    <Version>1</Version>
    <Distributor>FH Ortho</Distributor>
    <ProductName>FHK INSERT FIXE / POSTERO-STABILISE</ProductName>
    <ProductReference>257776 -&gt; 257811 / 266714 -&gt; 266719</ProductReference>
    <ProductPrice>401.23</ProductPrice>
    <Reimbursement>401.23</Reimbursement>
    <PatientSupplement>0.00</PatientSupplement>
    <DeliveryMargin>40.12</DeliveryMargin>
    <ValidFrom>2024-05-01</ValidFrom>
    <ModificationTypes>
      <ModificationType>A</ModificationType>
    </ModificationTypes>
    <LastModified>2024-04-16</LastModified>
    <Published>2024-04-16</Published>
  </Data>
  <Data>
    <NominativeListGroupCode>340</NominativeListGroupCode>
    <NominativeListCode>34071</NominativeListCode>
    <IdentificationCode>340710019075</IdentificationCode>
    <OldCode />
    <Version>1</Version>
    <Distributor>FH Ortho</Distributor>
    <ProductName>FHK INSERT ROTATOIRE</ProductName>
    <ProductReference>257812 -&gt; 257847 / 266720 -&gt; 266725</ProductReference>
    <ProductPrice>401.23</ProductPrice>
    <Reimbursement>401.23</Reimbursement>
    <PatientSupplement>0.00</PatientSupplement>
    <DeliveryMargin>40.12</DeliveryMargin>
    <ValidFrom>2024-05-01</ValidFrom>
    <ModificationTypes>
      <ModificationType>A</ModificationType>
    </ModificationTypes>
    <LastModified>2024-04-16</LastModified>
    <Published>2024-04-16</Published>
  </Data>
  <Data>
    <NominativeListGroupCode>340</NominativeListGroupCode>
    <NominativeListCode>34071</NominativeListCode>
    <IdentificationCode>340710019174</IdentificationCode>
    <OldCode />
    <Version>1</Version>
    <Distributor>FH Ortho</Distributor>
    <ProductName>FHK INSERT ROTATOIRE ULTRA CONGRUENT UC</ProductName>
    <ProductReference>265915 -&gt; 265950 / 266726 -&gt; 266731</ProductReference>
    <ProductPrice>401.23</ProductPrice>
    <Reimbursement>401.23</Reimbursement>
    <PatientSupplement>0.00</PatientSupplement>
    <DeliveryMargin>40.12</DeliveryMargin>
    <ValidFrom>2024-05-01</ValidFrom>
    <ModificationTypes>
      <ModificationType>A</ModificationType>
    </ModificationTypes>
    <LastModified>2024-04-16</LastModified>
    <Published>2024-04-16</Published>
  </Data>
  <Data>
    <NominativeListGroupCode>340</NominativeListGroupCode>
    <NominativeListCode>34071</NominativeListCode>
    <IdentificationCode>340710019273</IdentificationCode>
    <OldCode />
    <Version>1</Version>
    <Distributor>FH Ortho</Distributor>
    <ProductName>INSERT ASYMETRIQUE</ProductName>
    <ProductReference>265012 -&gt; 265071</ProductReference>
    <ProductPrice>401.23</ProductPrice>
    <Reimbursement>401.23</Reimbursement>
    <PatientSupplement>0.00</PatientSupplement>
    <DeliveryMargin>40.12</DeliveryMargin>
    <ValidFrom>2024-05-01</ValidFrom>
    <ModificationTypes>
      <ModificationType>A</ModificationType>
    </ModificationTypes>
    <LastModified>2024-04-16</LastModified>
    <Published>2024-04-16</Published>
  </Data>
  <Data>
    <NominativeListGroupCode>390</NominativeListGroupCode>
    <NominativeListCode>39001</NominativeListCode>
    <IdentificationCode>390010000346</IdentificationCode>
    <OldCode />
    <Version>1</Version>
    <Distributor>Medtronic</Distributor>
    <ProductName>Prestige Cervical Disc (per niveau, voor een implantatie op 1 of 2 niveau’s)</ProductName>
    <ProductReference>6971xx0</ProductReference>
    <ProductPrice>1700.60</ProductPrice>
    <Reimbursement>1546.00</Reimbursement>
    <PatientSupplement>154.60</PatientSupplement>
    <DeliveryMargin>148.74</DeliveryMargin>
    <ValidFrom>2024-05-01</ValidFrom>
    <ModificationTypes>
      <ModificationType>A</ModificationType>
    </ModificationTypes>
    <LastModified>2024-04-16</LastModified>
    <Published>2024-04-16</Published>
  </Data>
</NominativeListDetail>