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ANS-n® 41449-2
EMPRESARIAL
SAUDE
Pelo presente instrumento particular, de uma lado, como operadora de plano de saúde qualificada LIFE EMPRESARIAL SAÚDE LTDA.,
inscrita no CNPJ sob o n° 04.558.034/0001-57, com registro na ANS sob n° 41.449-2, com sede na Cidade de São Paulo, Estado de São
Paulo na Alameda dos Guaramomis, n° 1176; Complemento: Térreo Partes Andar 1, 2 e 3; Bairro Planalto Paulista, CEP 04.076-012, neste
ato representada nos termos do seu Contrato Social, doravante denominada CONTRATANTE, e, de outro lado, NÚCLEO DE ONCOLÓGIA
DA BAHIA S/A., inscrito(a) no CNPJ sob o n° 41.980.319/0001-08 e no CNES sob o n° 0005118, com sede na Cidade Salvador, Estado
Bahia, na Rua Adhemar de Barros, n° 123, Bairro Ondina, CEP 40.170-110, por seu representante legal abaixo assinado, que neste ato
declara, sob as penas da lei, possuir poderes para assinatura do presente instrumento, doravante denominada CONTRATADA, resolvem,
de comum acordo, firmar o presente termo aditivo ao Contrato de Prestação de Serviços, pactuado em 01 de agosto de 2018 de acordo
com as cláusulas e condições a seguir expostas, que passará a viger em 01/08/2023:
CONTRATANTE e CONTRATADA optam por reajustar no objeto originário do presente contrato, os serviços abaixo relacionados:
Ia Subsequente: AMB96
Tabelas Subsequentes 2a Subsequente: AMB99
3a Subsequente: CBHPM 3a Edição - 2004, UCO R$ 11,50
Filme R$ 28,87m2
PROCEDIMENTOS VALORADOS
Cód. Descrição
1D
DocuSign Envelope ID: 7EC1F816-5B66-441A-AB97-C6EC332E9442
ANS-ne 41449-2
1
EMPRESARIAL
SAÚDE
20104251 Terapia oncológica com altas doses - por dia subsequente de tratamento (até o início do próximo ciclo)
20104260 Terapia oncológica com aplicação de medicamentos por via intracavitária ou intratecal - por procedimento
Terapia oncológica com aplicação intra-arterial ou intravenosa de medicamentos em infusão de duração mínima de 6
20104278
horas - planejamento e Io dia de tratamento
20204086 Terapia oncológica com aplicação intra-arterial de medicamentos, em regime de aplicação peroperatória, por meio de
cronoinfusor ou perfusor extra-corpórea
30913012 Implante de cateter venoso central por punção, para NPP, QT, Hemodepuração ou para infusão de soros/drogas
TAXAS
60015292 Taxa de aplicação de injeção ev, fora da uti/semi-uti e do centro cirúrgico, por uso/sessão R$ 24,96
60015322 Taxa de aplicação de injeção im, fora da uti/semi-uti e do centro cirúrgico, por uso/sessão R$ 24,96
PLANOS CONTRATADOS
PRODUTOS ACOMODAÇÃO
BÁSICO ENFERMARIA
CUSSICO APARTAMENTO
EXCLUSIVO + APARTAMENTO
EXECUTIVO APARTAMENTO
2D
ijfAt
Ml
DocuSign Envelope ID: 7EC1F816-5B66-441A-AB97-C6EC332E9442
ANS-ne 41449-2
f
EMfRESARlAL
SAÚDE
PLENO APARTAMENTO
PREMIUM + APARTAMENTO
SUPERIOR APARTAMENTO
Ficam inalteradas e ratificadas todas as demais cláusulas e respectivos parágrafos do contrato ora aditado, que não tenham sido alteradas
por este instrumento.
E, por assim estarem, justas e contratadas, as partes assinam o presente termo de aditamento contratual, celebrado em 02 (duas) vias de
igual teor e forma, juntamente com 02 (duas) testemunhas.
Testemunhas:
/
JacÍMO* fUtUfa. At Jl44+i
Nome: Nome: Jackson Batista de Jesus
RG n«> Cássia Menezes Silva Rodrigues RG n°
CPF n° cpfn° 778.696.805-91
Gerente de Credenciamento
Life Empresarial Saúde LTDA
3D
1
DocuSign
Certificado de Conclusão
Identificação de envelope: 7EC1F8165B66441AAB97C6EC332E9442 Status: Concluído
Assunto: Complete com a DocuSign: 02072- Núcleo de Oncologia da Bahia - Reajuste 01.08.2023.pdf
Envelope fonte:
Documentar páginas: 3 Assinaturas: 2 Remetente do envelope:
Certificar páginas: 5 Rubrica: 2 Carla Garofalo
Assinatura guiada: Ativado Selos: 3 Av. Brigadeiro Faria Lima 4300
Selo com Envelopeld (ID do envelope): Ativado SAO PAULO, SP 04538-132
Fuso horário: (UTC-03:00) Brasília carla.garofalo@oncoclinicas.com
Endereço IP: 200.143.112.198
Rastreamento de registros
Status: Original Portador: Carla Garofalo Local: DocuSign
20/09/2023 20:05:13 carla.garofalo@oncoclinicas.com
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