| Code | Description | Chapitre | Art. | Type | Clé | Tarif | Max. |
|---|---|---|---|---|---|---|---|
| 769613 | Mono AT-kous rechterbeen, klasse II |
CH06 | 27/1 | Ambulant | O 133.84 | 138,31 € | - |
| 769635 | Mono AT-kous rechterbeen, klasse III of IV |
CH06 | 27/1 | Ambulant | O 133.84 | 138,31 € | - |
| 769650 | Mono AT-kous rechterbeen, vlakbrei, klasse II |
CH06 | 27/1 | Ambulant | O 418.26 | 432,23 € | - |
| 769672 | Mono AT-kous rechterbeen, vlakbrei, klasse III |
CH06 | 27/1 | Ambulant | O 469.86 | 485,55 € | - |
| 769694 | Mono AT-kous rechterbeen, vlakbrei, klasse IV |
CH06 | 27/1 | Ambulant | O 501.92 | 518,68 € | - |
| 769716 | Compressiebroek, vlakbrei, klasse II, III of IV |
CH06 | 27/1 | Ambulant | O 447.55 | 462,50 € | - |
| 769731 | Eenmalige forfaitaire tegemoetkoming voor een kousaantrekhulp |
CH06 | 27/1 | Ambulant | O 69.71 | 72,04 € | - |
| 769753 | AD-kous linkerbeen, klasse III of IV |
CH06 | 27/1 | Ambulant | O 35.26 | 36,44 € | - |
| 769775 | AD-kous linkerbeen, klasse III of IV |
CH06 | 27/1 | Ambulant | O 35.26 | 36,44 € | - |
| 769790 | AD-kous, rechterbeen, klasse III of IV |
CH06 | 27/1 | Ambulant | O 35.26 | 36,44 € | - |
| 769812 | AD-kous, rechterbeen, klasse III of IV |
CH06 | 27/1 | Ambulant | O 35.26 | 36,44 € | - |
| 769834 | AD-kous linkerbeen, klasse II |
CH06 | 27/1 | Ambulant | O 35.26 | 36,44 € | - |
| 769856 | AD-kous linkerbeen, klasse III of IV |
CH06 | 27/1 | Ambulant | O 35.26 | 36,44 € | - |
| 769871 | AD-kous linkerbeen, klasse II |
CH06 | 27/1 | Ambulant | O 35.26 | 36,44 € | - |
| 769893 | AD-kous linkerbeen, klasse III |
CH06 | 27/1 | Ambulant | O 35.26 | 36,44 € | - |
| 769915 | AD-kous linkerbeen, klasse IV |
CH06 | 27/1 | Ambulant | O 35.26 | 36,44 € | - |
| 769930 | AD-kous rechterbeen, klasse II |
CH06 | 27/1 | Ambulant | O 35.26 | 36,44 € | - |
| 769952 | AD-kous rechterbeen, klasse III of IV |
CH06 | 27/1 | Ambulant | O 35.26 | 36,44 € | - |
| 769974 | AD-kous rechterbeen, klasse II |
CH06 | 27/1 | Ambulant | O 35.26 | 36,44 € | - |
| 769996 | AD-kous rechterbeen, klasse III |
CH06 | 27/1 | Ambulant | O 35.26 | 36,44 € | - |
| 770571 | AD-kous rechterbeen, klasse IV |
CH06 | 27/1 | Ambulant | O 35.26 | 36,44 € | - |
| 770593 | AG-kous linkerbeen, klasse III of IV |
CH06 | 27/1 | Ambulant | O 59.95 | 61,95 € | - |
| 770615 | AG-kous linkerbeen, vlakbrei, klasse III |
CH06 | 27/1 | Ambulant | O 182.65 | 188,75 € | - |
| 770630 | AG-kous linkerbeen, vlakbrei, klasse IV |
CH06 | 27/1 | Ambulant | O 182.65 | 188,75 € | - |
| 770652 | AGT-kous linkerbeen, klasse III of IV |
CH06 | 27/1 | Ambulant | O 73.89 | 76,36 € | - |