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payment arrangement 100 euro (€ 100,00) payment arrangement 50 euro (€ 50,00) retention check-up fixed appliance in 2 jaws (F533A) (€ 50,18) retention check-up fixed appliance in 1 jaw (F532A) (€ 40,14) (overview) x-ray assessment (F156A) (€ 21,18) (overview) x-ray manufacture (F155A) (€ 36,13) braces consultation from the 25th month of treatment (F521A) (€ 35,12) braces consultation fixes appliance in 2 jaws (category 6: F516A) (€ 50,18) braces consultation fixed appliance in 1 jaw (category 5: F515A) (€ 40,14) removable braces consultation (category 1 t/m 4: F511A t/m F514A) (€ 35,12) removing braces category 5/6/7, per jaw - F492A (€ 115,56) place braces category 2 (HG) (€ 183,19) place braces category 2 (TPA) (€ 171,39) place braces category 2 (HG+TPA) (€ 184,83) place braces category 3 (Twin-block) (€ 310,48) place braces category 3 (Twin-block+HG) (€ 349,58) place braces category 3 (New T-appliance) (€ 366,22) place braces category 2 (Hyrax) (€ 316,42) place braces category 5 (lock-braces in 1 jaw) (€ 451,47) place braces category 6 (lock-braces in 2 jaws) (€ 745,46) place extra retention brace IOR (€ 100,08) place extra retention brace Hawley (€ 120,47)

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iDEAL
I hereby give authorization to collect the recurring amount from my account periodically.

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