DRAFT NEW AGREEMENT (1) -3- Transportation for the patient and escort as defined in PL No. 7-116, by field trip ships and subsistence while on such Ships, both in accordance with prevailing Marshall Islands rates. (2) Transportation by air to and between Majuro and Ebeye when required. (3) Payments of $2.00 per day per patient for incidental expenses while an inpatient. (4) Payments of $10.00 per day for escorts and for patients while on outpatient status. NOTE: At its discretion the TTPI May deduct subsistence charges from payments made to outpatients or escorts who use hospital room and board facilities. 4, Bilting for reimbursement under Provision 3 of this Agreement shall be submitted to DOE/PASO quarterly and must include: a. Name of Claimant b. Status (patient or escort) c. Hospital to which referred (Majuro, Ebeye) d. Reason for escort (per criteria PL NO. 7-116) e. Referred by (health aide, medex, BNL physician) T. Diagnosis upon arrival Majuro or Ebeye ¥ g. Wis Treatment 5000348