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| | |
 | Issue Date FY: 2022 ( Subtotal = -$160,263 ) |
| | 2022 | 2021 | American Samoa Medicaid Agency | 998383 Tafuna Road #306 | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | Children's Health Insurance Program | 3 | 1 | 2/3/2022 | SUPPLEMENT FOR EXPANSION | -$160,263 |
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| Issue Date FY: 2021 ( Subtotal = $6,485,339 ) |
| | 2021 | 2021 | American Samoa Medicaid Agency | 998383 Tafuna Road #306 | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | Children's Health Insurance Program | 2 | 1 | 9/21/2021 | SUPPLEMENT FOR EXPANSION | $400,000 |
| | 2021 | 2021 | American Samoa Medicaid Agency | 998383 Tafuna Road #306 | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | Children's Health Insurance Program | 0 | 1 | 10/1/2020 | NEW | $4,669,782 |
| | 2021 | 2021 | American Samoa Medicaid Agency | 998383 Tafuna Road #306 | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | Children's Health Insurance Program | 1 | 1 | 1/1/2021 | NEW | $1,415,557 |
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